Aggressive fibromatosis is characterized by locally aggressive proliferation of fibroblasts and occasionally occurs in the head and neck. Although the etiology of this disease is still controversial, recent studies have shown that high levels of growth factors are found in these lesions. This article reports a case of 51-year-old woman with aggressive fibromatosis in the neck and inguinal region bilaterally. Gastric fiberscopic examination revealed a complication of advanced gastric scirrhous carcinoma. There were remarkably high levels of basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) in the serum. Postmortem autopsy examination was performed and scattered gastric carcinoma cells were observed in the fibromatosis lesions. Immunohistological staining showed positive expression of bFGF in the fibromatoses and stomach. We concluded that this was a rare case in which bFGF and PDGF released from gastric carcinoma cells caused aggressive fibromatosis by promoting unregulated proliferation of fibroblasts and collagen production locally.

Adenocarcinoma, Scirrhous↗

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Association of diabetes mellitus and hypertension with Bell's palsy and Ramsay Hunt syndrome.

This study included 625 patients with Bell's palsy and 124 patients with Ramsay Hunt syndrome. Seven percent of the cases of Bell's palsy and 1.6% of the cases of Ramsay Hunt syndrome were associated with diabetes mellitus, while 14.1% of the cases of Bell's palsy and 10.4% of the cases of Ramsay Hunt syndrome were associated with hypertension. In the patients over 40 years of age, rates of association with diabetes and hypertension were 11.2% and 23.0% in Bell's palsy and 1.3% and 10.4% in Ramsay Hunt syndrome, respectively. The rates of diabetes and hypertension in association with Bell's palsy were significantly high compared with those of the general population.

Adult↗

PubMedDate not supplied

Effect of sinus surgery on visual disturbance caused by spheno-ethmoid mucoceles.

Fifteen patients suffering from visual disturbance of varying degrees caused by a mucocele of the posterior ethmoid and/or sphenoid sinuses underwent marsupialization of a mucocele into the nasal cavity. Five of the eight patients with severe visual loss worse than 20/200 showed recovery of measurable vision. Two of these five were operated on within 24 hours after the onset of visual loss and showed marked recovery to 20/25 and 20/15. The other seven patients who had relatively mild visual disturbance experienced improvement of visual acuity or remission of subjective complaints such as blurred vision post-operatively. During operation partial bony defect was found in the optic canal in 12 patients and in the skull base in 12 patients. A good understanding of this disease by ophthalmologists and otolaryngologists is essential for early diagnosis and prompt surgical treatment to avoid permanent visual dysfunction and operative sequelae.

Adult↗

PubMedDate not supplied

A clinical study on SSP (silver spike point) electro-therapy combined with splint therapy for temporo-mandibular joint dysfunction.

When the functional limits of the muscles related to the temporo-mandibular joint and adjacent tissue exceed their anatomical capability, pain, crepitation, and functional abnormality appear as the main complaints. Although the precise nature of the condition is unknown, pain at the temporo-mandibular joint sometimes in combination with muscular tension is assumed to be due to compression of the myoneural mechanism. It is reported that occlusal lifting using a splint enables the alleviation of this muscular tension. On the other hand, there are only a few reports on the usefulness of SSP therapy for Temporo-Mandibular Joint Dysfunction. We studied the efficacy of SSP therapy combined with splint therapy in 33 patients diagnosed as having Temporo-Mandibular Joint Dysfunction who consulted our department primarily due to pain, and report our findings below. Evaluation of the results was conducted 2 weeks later. Very beneficial results were seen in 6 cases. Beneficial results were seen in 7 cases. Slightly beneficial results were seen in 18 cases, while there were no changes found in 2 cases. When combined SSP and splint therapies were conducted for Temporo-Mandibular Joint Dysfunction, favorable results were seen in about 90% of the cases.

Acupuncture Analgesia↗

PubMedDate not supplied

Pancreas-sparing duodenectomy: classification, indication and procedures.

BACKGROUND/AIMS: Recent advances in the surgical anatomy of the pancreatoduodenal region have permitted duodenum-preserving pancreatic head resection. However, pancreas-sparing duodenectomy (PSD) has not been systematically studied and various types of such procedures have been reported under the designation of PSD. METHODOLOGY: PSD was performed in 6 patients with extensive duodenal lesions including trauma, mucosa-associated lymphoid tissue (MALT) lymphoma, corrosive necrosis, bleeding, leiomyosarcoma and congenital stenosis. Three patients had the whole papilla Vateri and half of the duodenum preserved and anastomosed to the jejunum. One patient had the duodenal button including the papilla of Vater transplanted to the jejunum. Another patient had the intraduodenal portion of the major papilla excised and the terminal portion of the bile and pancreatic ducts anastomosed to the jejunum. RESULTS: Two patients with moribund conditions died of the underlying disorders 2 weeks and 3 months after surgery, respectively, but without leakage or other surgery-associated complications. The other 4 patients survived the surgery without anastomotic insufficiency. Three survivors, who had complete preservation of the major and minor papillae along with the half portion of the duodenum, had normal morphology and function of the biliopancreatic system post-operatively. The fourth survivor, that with excision of the intrapancreatic portion of the major papilla, had regurgitation of contrast material into the bile and pancreatic ducts 2 months after surgery on active insufflation of the intestinal lumen, but remained asymptomatic. No abnormality in liver and pancreatic function was detected as of 7 months post-operatively. CONCLUSIONS: PSD appears to be applicable in the clinical setting, although classification of the procedure seems mandatory in consideration of indications, techniques, and long-term consequences of biliopancreatic function.

Adult↗

PubMedDate not supplied

Pancreatogastrostomy (PG) after pancreatoduodenectomy with or without duct-to-mucosa anastomosis for the small pancreatic duct: short- and long-term results.

BACKGROUND/AIMS: Pancreatogastrostomy, generally considered to pose less postoperative complications for a small-duct pancreas after pancreatoduodenectomy than pancreatojejunostomy, has usually been conducted with an invagination method, which can cause obstruction of the duct during the follow-up. The purpose of this study was to investigate the short- and long-term results with special reference to the patency of the main pancreatic duct after pancreatogastrostomy performed on a small-duct pancreas, combining an invagination technique with a duct-to-mucosa approximation. METHODOLOGY: Out of 73 patients with a nondilated pancreatic duct, 24 in an earlier series underwent pancreatogastrostomy only with an invagination. The other 49 in a later period had an additional duct-to-mucosa anastomosis. RESULTS: Four patients (5.5%) developed a minor anastomotic leak of the pancreas which healed uneventfully within 16-41 days without mortality. Long-term results revealed that the pancreatic duct tended to dilate after pancreatogastrostomy without mucosal adaptation, while the new method of pancreatogastrostomy with duct-to-mucosa anastomosis left the diameter of the pancreatic duct unchanged. Body weight and peripheral blood glycohemoglobin A1c retained preoperative levels, irrespective of the mucosal anastomosis. CONCLUSIONS: Pancreatogastrostomy with mucosa-to-mucosa anastomosis appears to be a useful method of pancreatic reconstruction in both the short- and long-term.

Adult↗

PubMedDate not supplied

Peptic diseases and Helicobacter pylori infection after pancreatogastrostomy.

BACKGROUND/AIMS: To investigate the correlation between peptic diseases and Helicobacter pylori after pancreatogastrostomy. Pylorus-preserving pancreatodudenectomy is associated with an increased risk of postoperative peptic diseases. They are thought to be associated with Helicobacter pylori. Little is known about the long-term effects of instillation of alkaline pancreatic juice on the gastric mucosa and Helicobacter pylori infection. METHODOLOGY: We periodically checked the histology and Helicobacter pylori infection of gastric mucosae in 16 patients who had undergone pancreatogastrostomy and pylorus-preserving pancreatodudenectomy. Helicobacter pylori infection and gastritis were assessed according to the culture grade and the updated Sydney System. RESULTS: A stomal ulcer occurred in one patient without Helicobacter pylori. Another 2 patients with Helicobacter pylori infection contracted gastric ulcers. They were cured with anti-ulcer drugs in a short period of time. Gastroesophageal reflux disease occurred in one patient without Helicobacter pylori. None of the patients' Helicobacter pylori infectious states changed postoperatively. Culture grade of Helicobacter pylori significantly decreased after pancreatogastrostomy. The severity of gastritis tended to ameliorate after pancreatogastrostomy. CONCLUSIONS: Pancreatogastrostomy appears to decrease the grade of Helicobacter pylori infection. Peptic diseases are rather frequent minor grade complications. However, they are unlikely to be associated with Helicobacter pylori.

Aged↗