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Pulmonary malignant lymphoma presents diverse imaging findings, thus making an imaging-based diagnosis difficult. Furthermore, because of the low histological diagnostic rate of approximately 30% based on transbronchial lung biopsy, there are difficulties in the early diagnosis of pulmonary malignant lymphoma. We report a case of pulmonary malignant lymphoma that was difficult to diagnose until a surgical biopsy was performed. A 72-year-old female was referred to our hospital with an abnormal chest shadow on a medical examination. Chest computed tomography(CT) scan demonstrated groundglass opacity and consolidation in both lung fields. Bronchoscopy was performed but a histological definitive diagnosis could not be obtained. We suspected organized pneumonia and initiated steroid therapy that resulted in improvement in the chest shadow. However, new multiple lung nodules and mediastinal lymphadenopathy were noticed on CT scan performed 9 months after the initiation of steroid therapy, and a lung biopsy and mediastinal lymph node biopsy were performed. learn more Finally, the diagnosis was malignant lymphoma with pulmonary infiltrates.Propofol infusion syndrome (PRIS) is one of the severe complications which occur during continuous venous infusion of propofol, and has a high mortality rate. It is featured by high fever, oliguria, myogloblin urine, acute renal failure, hepatomegaly, fatty liver, and so on. We have experienced a case of PRIS who was saved by prompt changing of sedatives from propofol to midazolam and dexmedetomidine. The patient was an 82-year-old man, who underwent off-pump coronary bypass grafting due to effort angina pectoris. After the operation, he suffered from continuous high fever over 38 ℃, acute renal impairment, and high level of creatine kinase (CK) without CK-MB increment, suggesting PRIS. We promptly changed sedatives from propofol to midazolam and dexmedetomidine, then the patient recuperated from these abnormalities. It is strongly suggested that meticulous observation is necessary during propofol infusion.While minimally invasive cardiac surgery (MICS) has become increasingly popular recently even in the field of cardiovascular surgery, the conventional full median sternotomy is still the main approach to the mediastinum, especially for cases which cannot be applied for MICS or in the facilities where MICS is not performed. It has been known that sternal instability is one of the leading causes of sternal infection after median sternotomy. Therefore, we have sought for an additional product to secure strong sternal stability. Since August in 2018, we used a new type of corrugated plate( Super Fixsorb Wave) which is placed inside the sternum in addition to regular sternal wires for 140 patients who had full median sternotomy. Up to now, we have no complications regarding sternotomy including mediastinitis. We believe that additional use of Super Fixsorb Wave enables firm sternal stability and prevents mediastinitis following full median sternotomy.Metabolomics offers systematic identification and quantification of all metabolic products from the human body. This field could provide clinicians with new sets of diagnostic biomarkers for disease states in addition to quantifying treatment response to medications at an individualised level. This literature review aims to highlight the technology underpinning metabolic profiling, identify potential applications of metabolomics in clinical practice and discuss the translational challenges that the field faces. We searched PubMed, Medline and Embase for primary and secondary research articles regarding clinical applications of metabolomics. Metabolic profiling can be performed using mass spectrometry and NMR based techniques using a variety of biological samples. This is carried out in vivo or in vitro following careful sample collection, preparation and analysis. The potential clinical applications constitute disruptive innovations in their respective specialities, particularly oncology and metabolic medicine. Outstanding issues currently preventing widespread clinical use centre around scalability of data interpretation, standardisation of sample handling practice and e-infrastructure. Routine utilisation of metabolomics at a patient and population level will constitute an integral part of future healthcare provision.

The embryogenesis of limited dorsal myeloschisis (LDM) likely involves impaired disjunction between the cutaneous and neural ectoderms during primary neurulation. Because LDM and congenital dermal sinus (CDS) have a shared origin in this regard, CDS elements can be found in the LDM stalk. Retained medullary cord (RMC) is a closed spinal dysraphism involving a robust, elongated, cord-like structure extending from the conus medullaris to the dural cul-de-sac. Because the RMC is assumed to be caused by impaired secondary neurulation, concurrent RMC and CDS cannot be explained embryologically. In the present article, we report a case in which CDS elements were noted in each tethering stalk of a coexisting LDM and RMC.

A 2.5-month-old boy with left clubfoot and frequent urinary and fecal leakage had 2 tethering tracts. The upper tract, which ran from the thoracic tail-like cutaneous appendage, had CDS elements in the extradural stalk and a tiny dermoid cyst in the intradural stalk immediately after the dural entry. In the lower tract, which ran from the lumbosacral dimple, the CDS as an extradural stalk continued to the RMC at the dural cul-de-sac. Both stalks were entirely resected through skip laminotomy/laminectomy at 1 stage to untether the cord and resect the CDS elements.

Surgeons should be aware that CDS elements, in addition to LDM, may coexist with RMC that extends out to the extradural space.

Surgeons should be aware that CDS elements, in addition to LDM, may coexist with RMC that extends out to the extradural space.

Recent endoscopic studies have revealed that small colorectal tumors are often overlooked during colonoscopy, indicating that more sensitive detection methods are needed.

Molecular imaging has received considerable attention as a new endoscopic technique with high sensitivity. It generally employs a fluorescence-labeled compound that specifically binds to a molecule on the tumor. Fluorescent probes for molecular imaging are largely classified as 2 types a fluorescence-labeled antibody targeting a molecule specifically expressed on the tumor cell surface such as epidermal growth factor receptor or vascular endothelial growth factor (VEGF); and a fluorescence-labeled small molecule compound targeting a molecule specifically expressed in tumor cells including c-Met, glutathione S-transferase, γ-glutamyltranspeptidase, cathepsin, or endothelin A receptor. These probes successfully detected colorectal tumors in several animal studies. Moreover, 3 recent human clinical trials evaluating endoscopic molecular imaging for colorectal tumors have been reported.