[A case report of suspected Stauffer syndrome presenting with fever, extensive inflammation, and abnormal liver function tests].

A man was referred to our hospital because of malaise and abnormal liver function tests. He had had a kidney removed for early renal cell carcinoma. We performed ultrasonography, CT scan, and liver biopsy, all of which were normal. However, FDG-PET revealed abnormal, diffuse uptake in the bone. A bone biopsy showed abnormal clear cells resembling renal cell carcinoma. Because there was no other primary origin, this histopathological finding led to the diagnosis of bone metastasis of renal cell carcinoma, and the abnormal liver function test was thus inferred to be due to Stauffer syndrome.

[CT enterography with polyethylene glycol electrolyte solution for diagnosis of Crohn's disease].

This study aimed to assess the diagnostic usefulness of CT enterography (CTE) in Crohn's disease in Japanese patients. A total of 32 cases with bowel symptoms underwent CT enterography with polyethylene glycol electrolyte solution as oral contrast medium, among which 18 were clinically diagnosed as Crohn's disease and 14 were not: ulcerative colitis 1, Beçhet disease 1, simple ulcer 1, inflammatory bowel disease without definite diagnosis 5 and bowel symptoms of unknown origin 6. The incidence of bowel wall thickening, mural hyperenhancement, "the comb sign", mesenteric lymph nodes swelling, and stenosis were significantly higher in Crohn's disease than in other disease. Moreover, uneven bowel wall thickening and unilateral mural hyperenhancement on CTE were characteristic features of Crohn's disease, which our original quantitative evaluation with imaging analysis could support. Consequently, CTE is useful in Japanese patients with Crohn's disease.

[A case of jejunal adenocarcinoma with serum DUPAN-2 elevation].

A 50-year-old woman was admitted to our hospital because of abdominal pain and vomiting. Ileus with ulcerated jejunal tumor was diagnosed and biopsy revealed adenocarcinoma. Because her serum level of DUPAN-2 was high, she was examined by PET scan, which revealed that she had a left ovarian mass in addition to the jejunal tumor. Surgical resection was performed: both tumors were adenocarcinoma, but the ovarian tumor was considered to be metastatic clinically and histologically. Immunostaining for DUPAN-2 was positive in the both tumors. The serum level of DUPAN-2 returned to normal after the surgery, and has been within normal limits for about 3 years without any additional therapy. This case shows a possible relation between small bowel adenocarcinoma and DUPAN-2.

Low serum alpha-tocopherol concentrations in subjects with various coronary risk factors.

BACKGROUND: Oxidative stress may play an important role in the genesis and development of atherosclerosis. METHODS AND RESULTS: To examine whether oxidative stress is increased in the presence of various coronary risk factors, serum alpha-tocopherol concentrations were determined in 168 apparently healthy subjects recruited from Daioh town (73 men and 95 women, mean age: 42+/-11 years). The alpha-tocopherol concentration (mg/g lipids) was significantly lower in men, older subjects (>or=50 years of age), smokers, those with hyper-low density lipoprotein (LDL)-cholesterolemia (C) (>or=160 mg/dl), hypertriglyceridemia (TG) (>or=150 mg/dl), hypo-high density lipoprotein (HDL)-C (<40 mg/dl), fasting hyperglycemia (>110 mg/dl) and obesity (body mass index >or=25 kg/m (2)) than in women, younger subjects, nonsmokers, those with normoLDL-C, normoTG, normoHDL-C, fasting normoglycemia and the non-obese. The concentration was not significantly different between hypertensives and nonhypertensives. Multivariate logistic regression analysis showed that the adjusted odds ratios (95% confidence interval) for hyperTG and hypoHDL-C as a factor for the lowest tertile of alpha-tocopherol concentration were 6.2 (1.6-24.4, p<0.01) and 6.0 (1.5-22.6, p<0.01), and those of the other risk factors were not significant. The alpha-tocopherol concentrations were significantly positively correlated with HDL-C concentrations (R=0.53) and negatively with TG concentrations (R=-0.53), BMI (R=-0.35), LDL-C concentrations (R=-0.25) and age (R=-0.22). CONCLUSION: Increased oxidative stress, as shown by decreased alpha-tocopherol concentrations, was linked to the presence of various coronary risk factors, among which hyperTG and hypoHDL-C appeared to be most heavily associated with oxidative stress.