[Three cases of psittacosis].

Case 1 was a 55 year old female whose primary complaint was pyrexia. Anamnesis consisted of a fever at a 39 degrees C level beginning on September 15, 1987 with headache and muscle pain. The patient was examined by a nearby physician. Despite taking medication, there was no break in the fever. The patient was examined and admitted to this institution on September 18. Case 2 was a 32 year old female whose primary complaint was pyrexia and an abnormal sensation in the pharynx. Anamnesis consisted of a fever at a 39 degrees C level beginning on February 13, 1989 and the manifestation of a cough beginning on February 17. Although the fever broke on February 20, as the abnormal sensation in the pharynx persisted, the patient was examined and admitted to this institution on February 21. Case 3 was a 42 year old male whose primary complaint was pyrexia. Anamnesis consisted of a fever of 38 degrees C, cough and a sensation of pressure in the right precordia beginning on November 18, 1989. The patient was examined and admitted to this institution on November 21. Chest X-rays revealed the presence of atypical pneumonia in all three cases. As a significant rise in antibodies to the Chlamydia of parrot fever was observed in the cases at the time of admittance as well as after admittance, treatment was begun by administration of Minocycline.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of traumatic intramural hematoma of the duodenum effectively treated with ultrasonically guided aspiration drainage and endoscopic balloon catheter dilation.

A 52-year-old man was admitted on February 15, 1990, with hiccups and vomiting. He had been well until 13 days before admission when he stumbled and fell when intoxicated, striking his abdomen. A diagnosis of intramural hematoma was made with computerized tomography and sonography of the abdomen after admission, revealing a mass that was intimately related to the duodenum. Treatment of the intramural duodenal hematoma is controversial. However, this case illustrates the ideal situation where conservative management could be applied with total parenteral nutrition, percutaneous aspiration drainage, and endoscopic balloon catheter dilatation of the narrowed lumen of the duodenum. The patient's subsequent course supports the concept of planned conservative management.

[A case of Akiyami C disease, infected in the area of Yoshino].

A 47-year-old male was admitted because of persistent jaundice. Akiyami C disease was diagnosed by serological tests using the microscopic agglutination tests. The source was considered to be a water contaminated with leptospiras which he had drunk while working at a civil engineering job. The reported cases of Akiyami C disease have recently decreased and this is the 6th case reported in the last 15 years.

[The role of antineoplastic solution in transcatheter hepatic arterial embolization--in terms of survival rates affecting anticancer agents together with gelatin sponge].

In a multicentered randomized prospective study, hepatic arterial embolization using gelatin sponge (GS) alone or together with anticancer agents was performed in a total of 112 patients with hepatocellular carcinoma to ascertain the clinical availability of the anticancer agents combined with gelatin sponge. Envelopes, each of which contained a note mentioning one of the following three kinds of regimens, were allocated at random to the participating institutes: 1) GS + mitomycin C (MMC) 10 mg + adriamycin (ADR) 20 mg (group A, n = 45), 2) GS + MMC 10 mg + ADR 20 mg + 200 mg/day of oral 5-fluorouracil (5-FU) (group B, n = 36), and 3) GS + 200 mg/day of 5-FU (group C, n = 31). The envelopes so allocated were opened just prior to embolization, and the treatment was carried out as instructed. Survival rates were estimated according to the method of Kaplan-Meier for comparative analysis. The survival rate was significantly higher in group A than in group C on days 465 (p less than 0.05). It was also significantly higher in group B than in group C on days 279, 558 and 651 (p less than 0.05) as well as on days 372 and 465 (p less than 0.01). These observations suggest that this embolization using anticancer agents such as MMC and ADR, compared with the embolization using gelatin sponge alone, may exert a life-prolonging effect in patients with hepatocellular carcinoma.

Immunoblastic lymphadenopathy-like T-cell lymphoma with multiple cutaneous and visceral involvements.

Morphologic and immunological findings found in a patient with immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma (IBL-T) are presented. Though the initial clinical features were suggestive of IBL, multiple cutaneous and visceral tumors appeared later in his course. The cutaneous lesion is considered to be unique, because the neoplastic T cells with suppressor/cytotoxic (S/C) phenotype showed focal epidermotropism, resulting in necrosis and ulceration of the overlying epidermis. An interesting feature in IBL-T is the frequent association of polyclonal hypergammaglobulinemia, yet the neoplastic T cells show S/C phenotype. Since Ia-like antigen was expressed on the neoplastic T cells, it is stressed that antigen-presenting and contrasuppressor cells should also be included in the cell populations which have a possibility to be a normal counterpart of IBL-T.