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Arteriovenous fistula (AVF) of splenic vessels is rare. It is most commonly caused by spontaneous rupture of an extant splenic artery aneurysm into an adjacent vein, or by traumatic or iatrogenic pseudoaneurysm. Blunt abdominal trauma can sometimes lead to vascular damage to spleen, resulting in AVF formation. Presently described is case of an elderly patient with high-grade splenic injury. Early post-traumatic AVF was detected by volume-rendered 3D reconstruction using fused arterial and venous phase computed tomography (CT) images. [ABSTRACT FROM AUTHOR]

A 36-year-old woman presented to our hospital with a complaint of melena. Examinations revealed type 3 gastric cancer with left supraclavicular lymph node(Virchow's node)and para-aortic lymph node(PAN)metastases. The patient was treated with S-1 and CDDP combination chemotherapy. After 2 courses of chemotherapy, the lymph node metastases were significantly reduced. Subsequently, a total gastrectomy with D2 plus PAN dissection was performed. Histopathological examination revealed the complete absence of cancer cells in both the primary lesion of the stomach and all dissected lymph nodes. No additional surgery or radiation therapy was performed for Virchow's node metastasis. Postoperatively, she received S-1 chemotherapy for 2.5 years. She remains well 9.5 years after the surgery, without any evidence of recurrent disease.

Arteriovenous fistula (AVF) of splenic vessels is rare. It is most commonly caused by spontaneous rupture of an extant splenic artery aneurysm into an adjacent vein, or by traumatic or iatrogenic pseudoaneurysm. Blunt abdominal trauma can sometimes lead to vascular damage to spleen, resulting in AVF formation. Presently described is case of an elderly patient with high-grade splenic injury. Early post-traumatic AVF was detected by volume-rendered 3D reconstruction using fused arterial and venous phase computed tomography (CT) images.

Human tumor necrosis factor alpha (TNFalpha) is a pro-inflammatory cytokine expressed in many cell types. Although the TNFalpha gene expression in human hepatocytes has been detected previously, its regulation is not well understood yet. In this study, we demonstrated that TNFalpha gene expression in human hepatoma cell line, huH2-2, was activated as a function of cell density. TNFalpha mRNA expression was low in the low-density culture, while significantly high expression was detected in the high-density culture. Moreover, stability of TNFalpha mRNA was not changed by cell density, eliminating a possibility of post-transcriptional regulation. Antibody neutralization against human TNFalpha had no significant effect on the TNFalpha mRNA expression. A cellular factor for the TNFalpha gene expression is suggested to be accumulated in the high-density cells. Data indicate that the level of TNFalpha gene transcription is elevated by a cellular factor in a cell density-dependent manner without influencing the TNFalpha secretion under the present cell-culture conditions used.

A 43-year-old male with respiratory arrest due to neck hanging was resuscitated at the scene. The head CT on arrival showed diffuse brain swelling predominantly in the right cerebral hemisphere. The swelling improved but right transverse sinus thrombosis was recognized on the 4th hospital day. His conscious state gradually recovered and recanalization of the sinus was confirmed on a subsequent MR venography. He was discharged without neurological deficit. A sinus thrombosis should be considered as a differential diagnosis of brain swelling after hanging.

Purpose: We investigated blunt traumatic out-of-hospital cardiopulmonary arrest patients whether any clinical differences between with and without head injury existed or not., Methods: A retrospective chart review of 332 blunt traumatic out-of-hospital cardiopulmonary arrest cases that had been transported to our hospital between January 1980 and April 2003. They were divided into two groups, head injury (HI, n = 175) and non-head injury (NHI, n = 157)., Results: There were no significant differences between the groups with respect to sex, age, mechanism of injury, witnessed arrest, bystander cardiopulmonary arrest, value of hemoglobin, value of base excess, and electrocardiogram on arrival. Averaged total abbreviated injury scale in the HI was greater than in the NHI, however return of spontaneous circulation in the HI was more frequent than in the NHI. Survival discharge rate was under 2% and good recovery case was none in the two groups., Conclusions: Among lethal blunt traumatic injuries, there were no different backgrounds between with and without head injury. The return of spontaneous circulation in the blunt traumatic patients with head injury became higher than without head injury, however the outcomes were similarly extremely poor.