[A case of aortic thrombus during chemotherapy for esophageal cancer].

A 59-year-old man presented to our hospital with a chief complaint of epigastric pain. Pertinent history included a distal gastrectomy for gastric cancer and alcohol dependence. He underwent contrast-enhanced computed tomography (CT) and esophagogastroduodenoscopy, which led to a diagnosis of esophageal cancer (cT2N2M1, stage IVb). Subsequently, he underwent chemotherapy using 5-fluorouracil and cis-diamminedichloroplatinum and radiotherapy. A total of 44 days after treatment initiation, the patient experienced nausea and hepatobiliary enzyme elevation. CT and abdominal ultrasonography were performed, and he was diagnosed with an abdominal aortic thrombus. Intravenous heparin was administered as an anticoagulant therapy. Twenty-two days after treatment initiation, the thrombus was no longer visible on abdominal ultrasonography. The patient was then treated with warfarin. It cannot be ruled out that the patient's hepatobiliary enzyme elevation was induced by the anticancer drugs. However, enzyme elevation improved with the disappearance of the abdominal aortic thrombus, suggesting that the aortic thrombus may have contributed to the hepatobiliary enzyme elevation. No thrombus recurrence was observed until the patient's death after an initial treatment with antithrombotic agents. This case indicates that malignant tumors and chemotherapy can cause aortic thrombi, and thus, care should be exercised in monitoring this potential complication.

Spatiotemporal inflection points in human running: Effects of training level and athletic modality.

The effect of the different training regimes and histories on the spatiotemporal characteristics of human running was evaluated in four groups of subjects who had different histories of engagement in running-specific training; sprinters, distance runners, active athletes, and sedentary individuals. Subjects ran at a variety of velocities, ranging from slowest to fastest, over 30 trials in a random order. Group averages of maximal running velocities, ranked from fastest to slowest, were: sprinters, distance runners, active athletes, and sedentary individuals. The velocity-cadence-step length (V-C-S) relationship, made by plotting step length against cadence at each velocity tested, was analyzed with the segmented regression method, utilizing two regression lines. In all subject groups, there was a critical velocity, defined as the inflection point, in the relationship. In the velocity ranges below and above the inflection point (slower and faster velocity ranges), velocity was modulated primarily by altering step length and by altering cadence, respectively. This pattern was commonly observed in all four groups, not only in sprinters and distance runners, as has already been reported, but also in active athletes and sedentary individuals. This pattern may reflect an energy saving strategy. When the data from all groups were combined, there were significant correlations between maximal running velocity and both running velocity and step length at the inflection point. In spite of the wide variety of athletic experience of the subjects, as well as their maximum running velocities, the inflection point appeared at a similar cadence (3.0 ± 0.2 steps/s) and at a similar relative velocity (65-70%Vmax). These results imply that the influence of running-specific training on the inflection point is minimal.

[A case of primary leiomyosarcoma of the small bowel with hepatic portal venous gas].

A 92-year-old woman was admitted with speech disturbance. She had severe anemia (hemoglobin, 6.3g/dl), and abdominal ultrasonography revealed hepatic portal venous gas and an intra-abdominal tumor. Abdominal computed tomography also revealed an irregularly enhanced intra-abdominal tumor, 32x35mm in diameter, which was surgically resected. The tumor was located in the small intestine. Histopathological examination revealed spindle-shaped atypical cells. Immunological evaluation showed the tumor to be SMA (+), c-kit (-), CD34 (-), S100 (-). The Ki-67/MIB1 labeling index was 2.3%. The tumor was diagnosed as leiomyosarcoma of the small bowel. The patient recovered after surgery and was discharged.

[Successful treatment of Crow-Fukase syndrome with radiation therapy].

A 73-year-old woman was referred to our hospital because of gait disturbance. She had peripheral polyneuropathy which was mainly of the demyelinating type, splenomegaly, a skin change and M protein (IgA-lambda). A bone scinti and a CT scan showed a mass lesion in the thoracic vertebra, and a biopsy revealed plasmacytoma. She was diagnosed as Crow-Fukase syndrome, and treated with local radiation therapy. After the treatment, M protein became undetectable, and gait disturbance was improved.