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Cystic echinococcosis is an uncommon zoonosis in Japan. Typical location of the cyst is the liver and the lung. Mediastinal hydatidosis is found in less than 0.1% of all hydatid disease patients. We report a rare case of 68 years old male with mediastinal and liver hydatid cysts. Serological test confirmed the diagnosis of hydatidosis. The patient underwent complete resection of mediastinal and liver cysts successfully. Postoperative follow-up for two years has not shown any signs of recurrence. Simultaneous resection of the cysts in different sites including mediastinum is rare and has not been reported in Japan. Hydatid disease is an important differential diagnosis for patient who has cryptogenic liver cyst and history of contact to wildlife or unsterile water.

Purpose: To evaluate clinical characteristics of rhegmatogenous retinal detachment in high myopic and phakic eyes., Subjects and Method: The subjects were 1174 eyes of phakic rhegmatogenous retinal detachment detected in 1199 eyes that underwent initial vitreoretinal surgery between April 2006 and March 2011. Eyes with macular hole retinal detachment or secondary retinal detachment were excluded. The 486 eyes with high myopia (spherical equivalent ≤ -6.0 D or axial length ≥ 26.5 mm) and the 688 eyes with non-high myopia were compared., Results: The mean age was significantly younger in the high myopia group (42.7 ± 14.2 years old, p < 0.001) with a single peak of higher incidence in 40 years old. The retinal detachment caused by retinal hole was significantly frequent in the high myopia group (p < 0.001) and that caused by retinal tear was less frequent (p = 0.021). The initial retinal attachment rate and the final attachment rate were not significant. In the fellow eye of the high myopia group, the incidence of retinal detachment and lattice degeneration were more frequent (16.7%, 20.4%, respectively)., Conclusions: The incidences of the retinal detachment in younger age and those caused by retinal holes were higher in the high myopia group. Higher incidence of retinal detachment and lattice degeneration in the fellow eyes of the high myopia group indicated that careful observation also in the fellow eyes was recommended.

Purpose: Retinal detachment associated with atopic dermatitis has been reported to have several similarities to retinal detachment with blunt trauma both in location and types of retinal breaks. To clarify the difference between these two types of retinal detachment, the clinical features of retinal detachment associated with atopic dermatitis to those with blunt trauma were compared., Method: Among phakic eyes of rhegmatogenous retinal detachment which underwent surgery in our clinic between 2006 and 2011, 51 eyes of 41 cases of retinal detachment associated with atopic dermatitis (Atopy group) and 53 eyes of 51 cases of retinal detachment with blunt trauma (Trauma group) were compared., Results: In the Atopy group, the patients were younger, and the incidence of cataracts and bilateral detachment were more frequent. In the Trauma group, the occurence was more frequent in men and associated vitreous hemorrhage and iritis were more frequent. Shallow retinal detachments and ciliary breaks located at the superotemporal quadrant were more frequent in the Atopy group and bullous detachments and retinal breaks located at the superonasal quadrant were more frequent in the trauma group. Oral dialysis and ciliary breaks were frequent in both groups. The initial retinal reattachment rates were similar between both groups but the final reattachment rate was worse in the trauma group., Conclusions: Retinal detachment associated with atopic dermatitis had many similarities to the detachment with blunt trauma in types of retinal breaks. However, it was distinct in featuring higher incidence of bilateral retinal detachment, cataracts, and ciliary breaks at the superotemporal quadrant.

This is a case of a 72-year-old male whose chest computed tomography (CT) revealed a 2.0 x 1.6 cm anterior mediastinal solid tumor during follow-up of an abnormal shadow of the lung. The tumor increased its size during preoperative follow-up, and multilocular cyst was also observed. Radical thymectomy was performed, and histopathologically the tumor was diagnosed as thymic basaloid carcinoma. Thymic basaloid carcinoma is a rare tumor and is often associated with multilocular thymic cyst. There are only 32 cases reported both locally and internationally. Surgical resection is the general treatment for this disease. Adjuvant radiotherapy can be considered in cases of incomplete resection and invasive tumor. In our case, no recurrence of the tumor was noted 12 months post-operative. Generally, the malignancy of thymic basaloid carcinomas are regarded as low-grade compared with other thymic carcinomas, however, since mortality and recurrence have been reported, careful follow-up is required.

Background: There have been few case reports of 3rd-line chemotherapy for gastric cancer. So we reported the results of CPT-11 therapy as the 3rd-line chemotherapy for gastric cancer., Patients and Methods: 549 cases underwent gastrectomy from Jan. 2004 to Aug. 2007 in our hospital. In 76 of these cases, which underwent non-curative resection or evidenced a recurrence until July 2009, were analyzed in this study. CPT -11 3rd-line chemotherapy was administered to 11 cases., Results: The mean survival time of non-curative or recurrent cases was 16.9 months. Mean survival times of the non-chemotherapy group, the group administered only 1st-line chemotherapy, the group administered until 3rd-line chemotherapy, the group administered 3rd-line chemotherapy were 7.9 , 11.3 , 21.4 and 28.9 months, respectively(p=0.000 ). Adverse effects occurred in 90.9% of 3rd-line CPT-11, however, all cases were categorized in GradeI., Conclusion: The group administered 3rd-line chemotherapy survived the longest. It is probably correct to administer 3rd-line chemotherapy, if the patient maintains a good performance status.

An autopsy case of polycythemia vera with der(15) and der(20) associated with remarkable neutrophilia was reported. A 87-year-old man was diagnosed as polycythemia vera in August 1987. The red blood cell count was 621 x 10(4)/microliters, Ht 58.5% and the white blood cell count 45,400/microliters with 92% neutrophils. The splenomegaly, increased red blood cell volume and the low erythropoietin level were present. The arterial SaO2 value was above 92%. The chromosome analysis of bone marrow cells revealed 46, XY, -15, -20, +der(15)t(15;?)(q13-15;?), +der(20)t(20;?)(q11;?). The breakpoint in No. 20 was in q11. The remarkable leukocytosis with relative and absolute neutrophilia were observed. Particularly late in the clinical course the white blood cell count was 92,900/microliters with 99% neutrophils. The Ph1 chromosome was negative and the bcr rearrangement was not detected. He died of bronchopneumonia in January 1989. At the autopsy findings neither the marrow fibrosis nor the extramedullary leukemic cell infiltration was noticed.