[A case of eosinophilic gastroenteritis caused after the use of Seprafilm®]

Eosinophilic gastroenteritis is a fairly uncommon condition. It has been suggested that allergic reactions may have played a role in the development of this illness. The case of a 66-year-old woman who had a total hysterectomy due to a right ovarian tumor is described here. At this operation, a sodium hyaluronate carboxymethylcellulose bioresorbable membrane (Seprafilm^®) was used. She was admitted to our hospital 47 days after the operation with abdominal pain. Laboratory data indicated elevated WBC (29450/μl) and eosinophilia (69.2%), and CT scan showed thickening of intestinal wall and ascites around there. Ascites cytology showed a significant increase of eosinophils (94.0%). She began taking oral steroids after being diagnosed with eosinophilic gastroenteritis, and her symptoms improved quickly. Despite the fact that Seprafilm^® was thought to be a reliable and safe tool, it was suggested that a foreign body reaction to Seprafilm^® could lead to eosinophilic gastroenteritis.

Collaborative work to evaluate toxicity on male reproductive organs by repeated dose studies in rats 3). Effects of repeated doses of ethinylestradiol for 2 and 4 weeks on the male reproductive organs

Male Sprague-Dawley rats were subcutaneously administered 0.3 and 3.0 mg/kg/day of ethinylestradiol for 2 and 4 weeks. Two weeks treatment decreased body weight gain, food consumption, absolute weights of testis, epididymis, prostate and seminal vesicle, and relative weights of epididymis, prostate and seminal vesicle. On the other hand, it increased absolute and relative weights of pituitary and adrenal glands, and induced atrophy of Leydig cells, degeneration/necrosis of pachytene spermatocytes, vacuolar degeneration of Sertoli cells, and retention of spermatids. In addition to the changes found after 2 weeks treatment, 4 weeks treatment induced exfoliation of germinal cells, decreases in spermatid and multinucleated giant cell formation and relative weights of testis. These results suggest that examination of prostate and seminal vesicle weights and histopathological changes in the testis are important for evaluation of male reproductive toxicity of ethinylestradiol and 2 weeks treatment is sufficient to detect toxicity on male reproductive organs.

Giant meningioma fed by the anterior choroidal artery: successful removal following embolization--case report

A 53-year-old female was admitted with apathy, left sensory and motor disturbance, left homonymous hemianopsia, and dressing apraxia. Computed tomography and magnetic resonance imaging showed a huge mass markedly enhanced in and around the right trigone. Cerebral angiography revealed rich vascularity of the tumor mainly fed by the right anterior choroidal artery. The feeding vessel was embolized with microfibrillar collagen after superselective catheterization. Seven days later, the tumor was totally removed with low blood loss. The histological diagnosis was fibroblastic meningioma. She was discharged without neurological deficit, except for left homonymous hemianopsia.

Arteriovenous malformation associated with moyamoya disease--case report

The authors report a case of moyamoya disease accompanied by arteriovenous malformation (AVM). Angiography demonstrated typical moyamoya vessels on the right and early changes of moyamoya disease on the left. A small AVM in the left frontal lobe supplied by a distal branch of the middle cerebral artery (MCA) was also revealed. The AVM was surgically resected simultaneously with contralateral encephaloaponeurotic synangiosis for the moyamoya vessels. One month after surgery, left MCA occlusion at the origin occurred probably due to hemodynamic changes after the resection of the AVM.

[Brain abscess following cerebral infarction: a case report]

The authors report a case of brain abscess following cerebral infarction. A 73-year-old man was admitted to our clinic with symptoms of right hemiparesis and total aphasia. CT scan revealed abnormal low density area in the left fronto-temporo-parietal region. Cerebral angiography demonstrated occlusion of the left middle cerebral artery at the M1 portion. On the 16th hospital day, an episode of generalized seizure with high fever appeared, and intermittent high fever persisted thereafter. Two months after admission, CT scan revealed several cystic lesions with marked ring enhancement at the site of cerebral infarction, suggesting multiple abscesses. Aspirations of left frontal and parietal abscesses were accomplished and the cultures of the pus disclosed Proteus vulgaris. Due to progressive hydrocephalus, a ventriculoperitoneal shunt was constructed one month later. Repeated CT scans showed a gradual diminution of the abscesses. It is considered that the blood-brain barrier is broken and the local immunological system against bacteria may be weakened when the brain is damaged by ischemia. Brain abscess seems to be developed in such circumstances even under the influence of transient bacteremia which originates in other parts of the body. Therefore the possibility of cerebral abscess should be suspected if patients with cerebral infarction suffer from the symptoms such as fever, neck stiffness or disturbance of consciousness.