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We report the case of a 45-year-old man who was diagnosed with clinically amyopathic dermamyositis (CADM) and interstitial lung disease (ILD) after presenting with skin lesions typical of CADM and testing positive for anti-Melanoma Diferentiation-Associated gene 5 (anti-MDA5) anti-bodies. He was treated with a regimen including steroid pulse therapy, intravenous cyclophosphamide (IVCY), and calcineurin Inhibitor drug, which initially improved his ILD. However, three months post-treatment, the first deterioration of his conditions occurred, necessitating further administration of steroid pulse therapy and IVCY. After eight cycles of IVCY therapy, the serum levels of KL-6 and anti-MDA5 antibodies decreased, and reaching their lowest values. Nevertheless, two years and six months after the first observed deterioration, the second deterioration of his conditions occurred, leading to acute respiratory failure, treated again with steroid pulse therapy and IVCY. This treatment did not result in improvement of respiratory failure, therefore plasma exchange was attempted, which demonstrated a beneficial effect on the ILD for a short time. This case suggests that IVCY and plasma exchange might be effective therapeutic options for CADM with ILD.

A 65-year-old female presented with an elevated lesion that was identified in the gallbladder fundus via abdominal ultrasound during a medical checkup. The tumor was a pedunculated lesion, measuring 30mm in diameter, that exhibited a blood flow pattern with gradual dense staining throughout the equilibrium phase on the abdominal contrast computed tomography and a high signal intensity on T2-weighted magnetic resonance imaging. Histopathological findings revealed the proliferation of poorly differentiated adenocarcinoma, including signet ring cells, throughout the tumor along with the formation of a mucous lake. The patient was consequently diagnosed with poorly differentiated mucinous carcinoma of the gallbladder.

A 52-year-old male visited a local clinic with a subjective complaint of pain in the left side of his abdomen. Abdominal CT revealed the presence of a pancreatic body tumor. On EUS, the tumor presented hypoechoic signals with an obscure boundary, which continued from the pancreatic parenchyma to the inside of the main pancreatic duct. Abdominal contrast CT revealed a hypervascular tumor with densely stained pancreatic parenchyma. ERP findings revealed that main pancreatic duct invasion was suspected based on partial radiolucency in the duct. Distal pancreatectomy was performed, and a definitive diagnosis of pancreatic neuroendocrine tumor (WHO class G1) was made histopathologically.

A 58-year-old man visited a local clinic after experiencing epigastric and dorsal pain. A computed tomography scan revealed a hypovascular mass in the pancreatic tail. T1-weighted magnetic resonance imaging (MRI) of the tumor showed a heterogeneous isointense signal and T2-weighted MRI showed a hyperintense signal. Contrast studies revealed contrast enhancement, showing a cystic wall and parts of a septal structure and lumen. Endoscopic ultrasonography revealed a multilocular hypoechoic tumor containing large quantity of debris. We experienced difficulty arriving at a diagnosis and are reporting this case of a pancreatic dermoid cyst, which was diagnosed based on pathological findings.

In the carotid artery plaque diagnosis, it is said that properties evaluation is important. For this inspection, it is general to use electrocardiogram (ECG)-trigger-dark blood (DB)-fat suppression (fs)-turbo spin echo (TSE)-T1 weighted image (T1WI), T2WI, and magnetization prepared rapid gradient echo (MPRAGE) methods though many problems still remain. This time, a comparative study of the carotid artery plaque diagnosis that used the sampling perfection with application optimized contrasts was made. This used different flip angle evolutions method sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) method that was 3 dimension (3D) imaging procedure that used variable flip angle with the law so far. The subjects were normal volunteers, handmade phantoms changed by T1 and T2 value, and the five patients on five cases who had taken carotid endoarterectomy (CEA) (male, mean 70.6 yr). Findings by the pathologist were obtained for the CEA enforcement patient. There is an excellent result in the contrast ratio by phantom, the signal intensity ratio of a clinical patient, and the comparison with pathological findings. The SPACE method can solve various problems, be evaluated by a properties evaluation of the plaque, a grasp of the range, and an arbitrary section, and be devised as a useful imaging procedure.

A 56-year-old man had an endoscopic examination for dysphagia in March 2007 which revealed tumors in the esophagus and stomach. Pathological examination of the esophagus biopsy specimens showed an unspecified peripheral T cell lymphoma. The esophagus tumor was tolerant to CHOP and EPOCH therapy. After an autologous peripheral blood stem cell transplantation, a complete response was observed in the patient. However, a lymphoma relapse was diagnosed in the lung in September 2008. The relapsed lung lymphoma was tolerant to EPOCH therapy. The refractory pulmonary peripheral T cell lymphoma was remarkably reduced by PEGS therapy. PEGS therapy is useful for relapsed peripheral T cell lymphoma cases that tolerated standard chemotherapy. An allogenic hematopoietic stem cell transplantation or new molecular target therapy might be finally selected for refractory peripheral T cell lymphoma. However, an allogenic transplantation has some severe complications. Furthermore we could not easily try phase I or II new molecular target drug treatment. We think that PEGS therapy is a useful treatment for refractory peripheral T cell lymphoma before allogenic transplantation or new molecular target drug treatment.

The patient was a woman, aged 69, diagnosed with acute pancreatitis by a local physician; simultaneously, with US, a low-echo tumor was indicated in the pancreas' uncinate process. Diagnosis was made of acute pancreatitis resulting from a pancreatic IPMN, and the patient was referred. Ultrasound showed hypoechoic tumor images accompanied by posterior echo enhancement. With radiography-CT, from the pancreas parenchymal phase, the peripheral portion was densely stained, while internally, images showed densely stained dendriforms towards the equilibrium phase. With MRI T1-weighted images, there was appearance at low intensity, and with T2-weighted images, there was appearance at high intensity; with MRCP, there was depiction at relatively high intensity. In the final pathological diagnosis, there was prominent formation of mucinous nodules, and mucinous carcinoma including large quantity of mucous.

A 53-year-old man was referred to our hospital for dry cough and a mass in the hilum of the right lung on chest CT which was diagnosed as small cell lung cancer by bronchofiberscopy (T3N2M0, stage IIIB). Also, he was aware of progressive muscle weakness in the lower extremities on the first consultation. An electromyogram showed neuropathic changes and did not show waxing phenomenon in response to high frequency repetitive stimulation. Sensory nerve conduction velocity was low, so we diagnosed small cell cancer associated with paraneoplastic sensory neuropathy. Serum antineuronal antibodies were negative. His neurological symptoms improved dramatically after chemoradiotherapy for small cell lung cancer. A complete response was obtained by concurrent chemoradiotherapy and prophylactic cranial irradiation was administrated. He is alive without recurrence at 11 months after the treatment.

To clarify the clinical features of acute acalculous cholecystitis (AAC), we reviewed 113 cases of AAC experienced from January, 2000 to December, 2007 in regard to patient background, etiology, imaging diagnosis, treatment, and outcomes. Functional bile stasis caused AAC in 34 of 113 cases (30.1%), and 28 of those developed in a nosocomial manner (82.4%). On the contrary, mechanical bile stasis caused 37 cases (32.7%), and all but one case developed in a community-acquired manner. mechanical bile stasis included 9 cases of biliary tract neoplasm (5, cystic duct cancer; 3, gallbladder cancer; 1, papillary adenoma). Since considerable cases of AAC were caused by biliary tract neoplasm, we have to pay attention to their existences.

As the primary prevention of disease has been emphasized, there may be a growing need for well-conditioned development and spread of OTC test equipment, OTC test reagent and remote healthcare. Some typical examples of "simple and rapid examination items, which can be done at home by established technology" are explained in this paper and may be required in the near future by the whole Japanese population with a view to the current status of OTC test and the coming relaxation of governmental regulation. The reasons why these examination items should be commercialized as Switch OTC and the epidemiological background are further discussed. In relation to metabolic syndrome derived from super spreader-like visceral mature adipocyte: SSVMAC, visceral fat rate measurement by bioelectrical impedance technology, postprandial blood glucose determination/urinary glucose determination, and urinary microalbumin detection, are explained with an example, together with the importance of early morning blood pressure recording. In the field of cancer and infectious diseases, immunological fecal occult blood determination as a marker of distal colorectal cancer, in which both higher survival rate and recovery rate by early detection have been established, Helicobacter pylori IgG antibodies or antigen examination including an examination of gastroduodenal disorder, prostate-specific antigen (PSA) and genital chlamydia are emphasized.

Upgrading and expanding of preventive measures for lifestyle-related diseases is an urgent national priority because they are recognized as the most important health risks by both the general population and government. With such a social background, the spread of self-medication by self-test is eagerly awaited by health-oriented individuals. In this paper, legal position of OTC test reagent, OTC test equipment and remote healthcare as current status of OTC test are explained, reference is made to the current status of their diffusion here in Japan, and some typical examples of "self-collection sample and corresponding OTC test item" are clearly described. In consideration of the large number of potential patients with folk disease such as metabolic syndrome, drug stores should be an accessible and convenient spot for Japanese people to enjoy the benefit of OTC test by obtaining test kits for such diseases.

A 48-year-old male was diagnosed to be unclassified chronic myeloproliferative disorder (UCMPD)/Ph negative bcr rearrangement negative (Ph-/bcr-) CML by hematological, cytogenetical and DNA analyses (Jpn. J. Clin. Hematol. 33(4): 525-531, 1992). Three years and a half after the diagnosis of UCMPD/Ph-bcr- CML, Ph chromosome was observed in 17 of 20 examined cells. Hematological findings showed a transformation into blast crisis. The late appearing of Ph in a case of UCMPD/Ph1-bcr- CML described here is rare. Southern blot analysis using 3' and 5' bcr probe showed no bcr rearrangement. Analyses of BCR/ABL chimeric RNA by RT-PCR method were negative in both of Major- and Minor BCR/ABL chimeric RNA. In the present case it is speculated that Ph is developed as the result of multistep progression and also speculated that the breakpoint at BCR gene differs from Major- and Minor-bcr in usual Ph+CML and de nove Ph+ ALL. Therefore, it may be reasonable that the present case is understood to be a case with late appearing Ph-like chromosome.

Fluorescence in situ hybridization was done with specimens obtained by bronchial brushing from 25 patients with abnormal lung shadows. A satellite DNA probe, specific for chromosome 11, was used to detect numerical chromosome aberrations in tumor cell nuclei. Normal diploid human lymphocyte nuclei, which served as control, had two signal spots in 99.6% of the nuclei in response to the chromosome 11 probe. The most frequent signal spots in class V cells (Case 1-7) ranged from 3 to 5, followed by 6 to 8, regardless of histopathological findings of lung cancer. In class I cells (cases 8-11) the signal appearance was similar to that in class V cells. The disease in patients from whom class I cells were obtained was found to be malignant by other diagnostic procedures performed afterward. The abnormalities in cases 13-25 were diagnosed as non-malignant by brush cytology, and clinical course showed a little more than 3 spots. These data indicate that fluorescence in situ hybridization with specimens obtained by bronchial brushing can be useful for detecting numerical chromosome abnormalities and can aid in the rapid diagnosis of lung cancer.

Six-week-old male Wistar rats were given a low fat diet containing 15% cod liver oil (FO; n = 30) or 15% safflower oil (SO; n = 30) for 6 weeks. In the polymorphonuclear leukocytes, arachidonic acid (AA) was significantly lower in the FO group than in the SO group (p < 0.001), and eicosapentaenoic acid (EPA) in the FO group was present in large amounts showing the EPA/AA ratio of 1.76. When lipopolysaccharide (LPS; 10mg/kg) was intraperitoneally injected, white blood cell counts in the blood significantly decreased in both groups (p < 0.001) compared to the controls 2 hours later, and at 4 hours, the counts in the SO group (2,033 +/- 151/mm3) were lower than in the FO group (3,189 +/- 624/mm3), (p < 0.01). In both groups, leukotriene B4 (LTB4) in the whole blood increased at 4 hours following LPS-administration compared to the controls (1,219 +/- 167.3pg/ml in the SO group and 600.0 +/- 109.0pg/ml in the FO group, p < 0.001). It should be noted that the level of LTB4 in the SO group was significantly higher than in the FO group (p < 0.001). Changes of the metabolites including decreased LTB4 production in the arachidonic cascade related to the increase of EPA may play a role in the inhibition of the decrease in white blood cell counts.

Glycated albumin (G-Alb) measured as one of the glycated proteins is recognized to be the clinical significant index of blood glucose control at earlier stage rather than HbA1c. The borate affinity column (BAC) method is regarded as a reference assay method, but the assay of fructosamine (FRA) is widely used at present as the easier method of G-Alb. In this paper, the characteristics, problems and usefulness of BAC method and FRA assay were described.

Measurement of serum myoglobin, CK-MM isoforms and CK-MB isoenzyme protein are useful for diagnosis and therapy of acute myocardial infarction (AMI). As latex agglutination turbidimetry of serum myoglobin is an easy and rapid assay method, it can be applied for early diagnosis of AMI and its observation of progress after break out of AMI. CK-MM isoforms also can be applicable for early diagnosis of AMI. The assay method of CK-MB isoenzyme protein by immunochemiluminescence is useful for anticipating the infarct size of AMI since this format is not influenced by CK-BB, myokinase, or mitochondria CK.