Perfusion abnormality on three-dimensional arterial spin labeling with a 3T MR system in pediatric and adolescent patients with migraine.

PURPOSE: Few studies have assessed the prevalence of perfusion abnormality with migraine. This study aimed to determine the prevalence and topography of perfusion abnormality on three-dimensional (3D) arterial spin labeling (ASL) and assess the correlation between perfusion abnormality and clinical data in pediatric and adolescent patients with migraine. METHODS: Forty-nine consecutive pediatric and adolescent patients with migraine were enrolled, and they underwent 3 T MRI, including 3D ASL. Perfusion abnormality on 3D ASL was qualitatively evaluated using a five-point grading system and was compared with non-ASL MR findings. In patients with perfusion abnormality, relative cerebral perfusion signal intensity (rCPS) was measured. Moreover, we compared clinical data and 3D ASL findings between patients with and those without perfusion abnormality. RESULTS: Of the 49 patients, 11 (22%) exhibited perfusion abnormality, and the occipital lobe was the most frequently involved (73%). One patient showed mild hyperperfusion (rCPS =2.474), and 10 showed hypoperfusion (mean rCPS = 0.405 ±â€¯0.134). There was no abnormality on non-ASL MRI, except in one case. We found statistically significant differences in the presence of aura (P < .001), motor disabilities (P = .019), confusion (P = .004), hospitalization (P = .004), between patients with and those without perfusion abnormality. CONCLUSION: In pediatric and adolescent patients with migraine, 3D ASL shows a high prevalence of perfusion abnormality, especially in the occipital lobe. Patients with perfusion abnormality tend to show the specific clinical symptoms at disease onset and need hospitalization.

Percutaneous aspiration embolectomy of superior mesenteric artery using a 5MAX ACE reperfusion catheter.

Acute mesenteric ischaemia is a rare abdominal emergency that commonly results in bowel infarction and has a very high mortality rate. Therefore, prompt recognition and treatment are crucial for a successful outcome. A thrombectomy for embolism in the mid portion of the main trunk of the superior mesenteric artery (SMA) is proposed. A near-complete thrombi removal from the main trunk of the SMA was achieved by using a 5MAX ACE reperfusion catheter, which was designed for treating cerebral embolism. This is the first report describing the treatment of acute mesenteric ischaemia using this catheter. Percutaneous aspiration embolectomy with this catheter is a useful modality for recanalization of embolic occlusion of not only the cerebral artery but also the SMA.

Comparative study for pharmaceutical quality among bland-name drug and generic drugs of compound glycyrrhizin injections in China.

The physicochemical properties (pH and osmolarity), ingredients, and impurities containing in compound glycyrrhizin injections (eight items) marketed in China were compared with those in bland-name drug (Stronger Neo-Minophagen C injection). Glycyrrhizin (GZ), glycine (Gly), and l-cysteine (CysH) as the ingredients, moreover, glycyrrhetinic acid (GA), 3-monoglucuronyl-glycyrrhetinic acid (MGGA), and l-cystine (CysS) as the impurity were determined by HPLC. The pH and osmolarity were different every each pharmaceutical product, but the variation between batch was very small. On the other hand, although the contents of GZ, Gly, and CysH in bland-name drug were approximately 100% of the label claim, the contents of GZ in generic drugs were the range of 91.8-100.9%, indicating the GZ contents in four products were clearly less than value indicated in label (<97%). The remarkable difference was not accepted by impurities content such as GA and MGGA. The contents of CysH in generic drugs were the range of 79.9-100.4%, and CysS was determined in all generic drugs, suggesting that CysH may decompose to be CysS depending on the pH of injections in generic drug only. Because the variation of the ingredient content was big and products with a little quantity for the ingredients were recognized, establishment of the preparation that can maintain the prescribed ingredient content and the severity of the assay will be required.

[A case of advanced gastric cancer responding to S-1/paclitaxel/lentinan as neoadjuvant chemoimmunotherapy].

A 71-year-old man suffering from epigastric discomfort and dizziness was admitted to our hospital and diagnosed with advanced gastric cancer with bulky lymph node metastases and liver metastasis. We thought a complete resection would be difficult, so he was treated with neo-adjuvant immunochemotherapy in combination with S-1 80 mg/m2 (2 weeks administration and 2-week rest), paclitaxel (PTX) 50 mg/m2 (day 1, 8, 15) and Lentinan (LNT) 2 mg/body (day 1, 8, 15). After 5 courses of this treatment, swollen lymph nodes decreased in size and the metastatic liver tumor disappeared. Total gastrectomy with lymph node dissection was performed. The histological diagnosis was pT2 pN0, Stage I B. Histological effects of primary tumor and lymphnodes were judged to be grade 2 and grade 3, respectively. We considered that the combination of S-1, PTX and LNT can be effective and safe for advanced gastric cancer.