[Case of the month: Acute focal bacterial nephritis].
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Biomedical subjects
Publications and source records attributed to S Tada.
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Fifty-six patients with laryngeal cancer were examined. The rate of correct diagnosis of clinical staging was 64.3%. Whereas the rate of correct diagnosis of staging by CT was markedly improved, 89.3%. In particular, CT facilitated correct diagnosis of T4. Supraglottic T3 cancer is diagnosed on the basis of deep infiltration or fixation of the hemi-larynx. Disappearance of the pre-epiglottic space or ulcer formation was recognized as a CT finding of deep infiltration. Disappearance of the paraglottic space and dislocation of the arytenoid cartilage were used as the standard for CT findings of laryngeal T3 cancer. CT allowed diagnosis to be made in 84.4% of cases which were pathologically determined to be T4. It can be said that CT is a very effective method for staging diagnosis in patients with laryngeal cancer. Fifty-seven patients with hypopharyngeal cancer and cancer of the cervical esophagus were also examined. When 40 post-surgical patients were compared according to pathological classification of T, the rate of correct diagnosis of clinical staging was 77.5% while that of staging diagnosis by CT was 82.5%. The rate of correct diagnosis by postoperative CT was 80.0% compared with the pathological determination of depth of invasion. The diagnosis of depth of invasion by CT on initial examination is thus an effective means for the determination of prognosis.
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A case of nodular cutaneous amyloidosis and Sjögren's syndrome occurred in a 63-year-old woman. Nodules had been seen for the past ten years and Sjögren's syndrome had accompanied amyloidosis for the last three years. The concomitant occurrence of nodular cutaneous amyloidosis and Sjögren's syndrome may not be by chance, since four of 12 cases of nodular cutaneous amyloidosis that have been reported to date in Japan were in patients with both amyloidosis and Sjögren's syndrome. The amyloid deposits in the tissue were stained with anti-lambda light-chain amyloid antibody. Amyloid fibrils were purified from the skin lesions in this patient and were characterized biochemically, immunologically, and ultrastructurally. The results indicated that the amyloid fibrils consisted of 29,000-, 20,000-, and 17,000- dalton peptides, the 29,000-dalton peptide of which was shown to react with the lambda light chain of immunoglobulin by immunoblot study.
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A case of 46, Xp+, Y with gonadal dysgenesis is described. The patient was a 14-year-old boy with short status (129 cm) complaint of underdeveloped testicle. IVP and cystourethrogram showed no abnormality. Chromosomal analysis of peripheral lymphocytes revealed 46, Xp+, Y. Histological examination of the specimen obtained by testicular biopsy revealed an immature tubule-like structure without spermatogenesis. Chromosomal study on his mother who was also short status revealed a karyotype of 46, X, Xp+ in peripheral lymphocytes.
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