Cluster analysis of trajectory data on hospital laboratory examinations.

Large-scale cross-patient analysis of time series laboratory tests is a challenging task because of the temporal irregularity of data, coexistence of various events, and multidimensionalty of examinations. In this paper, we present a novel cluster analysis method for multidimensional, inhomogeneous time series based on the trajectory comparison technique. Application to the chronic hepatitis dataset delivered some interesting findings, for example, there existed some patterns in ALB-PLT trajectories that took similar temporal courses, and the clusters well corresponded to the fibrotic stages.

[Testicular abscess: report of 2 cases].

We report two cases of testicular abscess. The first case is in a 53-year-old man who had been suffering from diabetes mellitus. Because of cerebral infarction, he had been bedridden and a Foley catheter had been indwelt for a long period of time. The second case is in a 78-year-old man who had suffered from acute prostatitis six months earlier. In both cases, the chief complaints were high fever and painful scrotal swelling. At initial evaluation, ultrasonography revealed that the affected testes were swollen without abscess formation and an ipsilateral epididymal swelling was demonstrated in the second case but not in the first case. The urine bacterial culture (UBC) result was positive for Escherichia coli in first case and Pseudomonas aeruginosa in the second case. In both cases, fever and scrotal pain subsided after antibiotic chemotherapy, and inflammatory reactions on routine blood studies were normalized within 2 weeks. Nevertheless, the swollen testes did not sigunificantly reduce in size, and testicular abscess was suspected by magnetic resonance imaging (MRI). Orchiectomy was performed, and intratesticular abscess formations were confirmed macroscopically and microscopically. In each case, bacterial culture from the abscess was positive for the same bacterium as detected from the UBC. It is difficult to distinguish testicular abscess from acute epididymitis at the early stage because of similarities on symptoms or signs between the two. If testicular swelling lasts after appropriate chemotherapy, we believe that attention should be directed to testicular abscess, which needs orchiectomy to obtain a complete cure and MRI is useful in its diagnosis.

Transurethral fulguration for empyema of ectopic ureteral stump.

A 55-year-old woman who had undergone left nephrectomy 7 years prior because of pyonephrosis, suffered from refractory cystitis and was diagnosed with empyema of the left ureteral stump associated with ectopic ureter. Although removal of the stump is a popular treatment for this disease, transurethral fulguration of the stump lumen was performed in the patient described here. The procedure was technically easy and safe, resulting in the disappearance of the dilated stump and cessation of recurring cystitis.

Multiscale analysis of long time-series medical databases.

Data mining in time-series medical databases has been receiving considerable attention since it provides a way of revealing useful information hidden in the database; for example relationships between the temporal course of examination results and onset time of diseases. This paper presents a new method for finding similar patterns in temporal sequences based on multiscale matching. Multiscale matching enables us the cross-scale comparison of sequences, namely, it enable us to compare temporal patterns by partially changing observation scales. We examined the usefulness of the method on the chronic hepatitis dataset and found some interesting patterns. On GPT sequences, we found patterns that may represent the effectiveness of interferon (IFN) treatment. On platelet count sequences, we found that, if IFN treatment was ineffective, platelet count kept decreasing following the progress of liver fibrosis, while it started increasing if the treatment was effective.

[Prostatic cancer with multiple pulmonary metastases treated successfully with hormonal therapy: a case report].

A 66-year-old, man was referred to our hospital for further examination of multiple pulmonary nodules on chest X-ray performed on medical examination. He was referred to our clinic because his chief complaint was poor urinary stream. Prostatic cancer was suspected on digital rectal examination and magnetic resonance imaging. Serum prostatic specific antigen (PSA) level was 134.9 ng/ml. Histological examination of transrectal prostatic sextant biopsy revealed well differentiated adenocarcinoma of prostate. Abdominal computed tomography-scan, gastro-intestinal tract examination and bone scintigraphy demonstrated no other primary lesions or distant metastases. Under the diagnosis of prostatic cancer with multiple pulmonary metastasis, we performed total androgen blockade (TAB) consisting of luteinizing hormone releasing hormone agonist and flutamide following dietylstilbestrol (DES) intravenous injection therapy. After three months, pulmonary nodules disappeared on chest X-ray and PSA level decreased to below 0.1 ng/ml. Pulmonary nodules also disappeared on CT-scan after six months after TAB. He is alive and free from the recurrence for 42 months.