Comparative study of subjective fatigue between automatic transmission bus drivers and manual transmission bus drivers.

The difference in the physiological condition of drivers of manual transmission buses (MTB) and automatic transmission buses (ATB) was examined from the viewpoint of occupational health. This study was based on a self-administered questionnaire which involved items concerning subjective fatigue complaints. No differences in the mental fatigue and stress between MTB drivers and ATB drivers were observed. Although ATB drivers tended to feel less physical fatigue than MTB drivers, the difference was not statistically significant. From these results, it was suggested that there was little difference in the subjective fatigue between ATB drivers and MTB drivers.</p

Local Thrombolysis for Acute Massive Pulmonary Embolism using a Pulse-Infusion-Thrombolysis Catheter

Acute massive pulmonary embolism (PE) is a common life-threatening condition requiring emergent and suitable treatment. The aim of this study is to assess the efficacy and safety of local thrombolysis with a pulse-infusion-thrombolysis (PIT) catheter in the management of acute massive PE. Thirty-nine patients with PE were treated with catheter directed intervention (CDI). CDI involves suction embolectomy and local thrombolysis with a PIT catheter. Procedural success was achieved in all patients (100%). After the CDI, a significant increase of mean systemic blood pressure was observed (93.8 ± 22.0 mmHg versus 100.8 ± 22.9 mmHg, P = 0.02), and pulmonary perfusion on the basis of Miller score was improved (19.6 ± 7.6 versus 16.3 ± 7.1, P = 0.04). Clinical success was achieved in 36 of 39 patients (92.3%). Two patients died of PE after CDI despite a successful recanalization, and 1 patient died of disseminated intravascular coagulation after the CDI. No major complication occurred in the remaining 36 patients and minor complications developed in 3 patients (7.7%). Local thrombolysis using a PIT catheter for massive PE is safe and effective treatment with minimal complication

Endolymphatic Sac Tumor, A Patient Report

Endolymphatic sac tumors are rare low malignant neoplasms of the petrous temporal bone, with symptoms referable to auditory, vestibular or facial nerves, which should be strictly discriminated from benign tumors of the temporal bone. Differential diagnosis between both at the early stages of checkup controls the treatment and prognosis. Complete surgical resection is the treatment of choice, which commonly provides long-term control. We have experienced a 48-year-old man with progressive hearing loss, unsteadiness and constant tinnitus. Computed tomography and magnetic resonance imaging (MRI) demonstrated a tumor invading the posterior petrous bone, extending to the posterior fossa. In the course of image diagnosis of his disease, we observed diagnostic efficacy of 3-tesla MRI, which showed excellent lesion visualization even in a small-size endolymphatic sac tumor. The intraoperative pathologic diagnosis was not available

Vanishing Parotid Tumors on MR Imaging

【Background】 Of all parotid gland tumors, only oncocytoma has been reported to appear isointense to the parotid gland, namely vanishing, on fat-saturated T2 and T1 postcontrast gadolinium-enhanced magnetic resonance imaging (MRI). The purpose of this study was to evaluate vanishing of parotid tumors on conventional MRI with and/or without postcontrast gadolinium-enhancement and on diffusion weighted imaging (DWI). 【Methods】 In 8 of 51 patients, ten parotid gland tumors had homogeneously enhanced lesions and were retrospectively analysed. Comparisons of signal intensity between those parotid tumors and parotid glands and evaluations of vanishing were performed on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fat-suppressed T2WI (FS-T2WI), postcontrast gadolinium-enhanced T1WI (CE-T1WI) and fat-suppressed CET1WI (FS-CE-T1WI), DWI as well as apparent diffusion coefficient (ADC). 【Results】 Ten parotid gland tumors consisted of five Warthin tumors, two pleomorphic adenomas, two parotid carcinomas (small cell carcinoma and adenoid cystic carcinoma) and one oncocytoma. All tumors showed hypointensity on T1WI and hyperintensity on DWI. Nine of ten tumors showed vanishing on the other MR sequences. All Warthin tumors showed vanishing on FST2WI, FS-CE-T1WI and the ADC map. One oncocytoma showed vanishing on FS-T2WI and the ADC map and hyperintensity on FS-CE-T1WI. All pleomorphic adenomas showed vanishing on T2WI and CE-T1WI. One adenoid cystic carcinoma showed vanishing only on CE-T1WI. 【Conclusion】 Vanishing of parotid tumors can be observed not only on FS-T2WI and FS-CE-T1WI but also on T2WI, CE-T1WI and ADC mapping

Bilateral Ovarian Tumors on MRI : How Should We Differentiate the Lesions?

Background: We investigated the distinguishing pathological features of bilateral ovarian tumors using magnetic resonance (MR) imaging. Methods: Eighty-six patients with bilateral ovarian tumors on MR imaging were evaluated. The pathological diagnosis was investigated, and the results were subjected to statistical analysis using Mann-Whitney U test, Fisher’s exact test, Chi-squared test and receiver operating characteristic (ROC) curve to determine the features useful for the differentiation of distinct types of lesions. Results: The diagnosis of bilateral ovarian tumors was confirmed in eighty-one patients and the majority of the lesions were further classified into serous carcinoma (n = 36), mature teratoma (n = 20) and metastasis (n = 12). We assessed the existence of factors useful for the MR imaging differentiation between metastasis and serous carcinoma or primary malignant ovarian tumors. Cancer antigen (CA) 125 serum level and maximum tumor diameter were significantly different between metastasis and serous carcinoma and similarly, between metastasis and primary malignant ovarian tumors. MR imaging morphology, ascites and peritoneal implants did not show any significant difference between the different types of lesions. Conclusion: Within our patient cohort, most bilateral ovarian tumor lesions were determined to be serous carcinoma, mature teratoma or metastasis. CA 125 serum level and maximum tumor diameter are useful markers for the differentiation between metastasis and serous carcinoma or primary malignant ovarian tumors

Light and Electron Microscopic Observation in a Case of Congenital Renal Proximal Tubular Dysfunction

We report a case of congenital renal proximal tubular dysfunction (CRPTD) accompanied by IgA nephropathy. The mesangial matrix was slightly increased with depositions of IgA and C3. Podocytes contained many clear vacuoles. Cuboidal cells, as well as squamous cells, lined the parietal epithelium of Bowman's capsule, although the functional or pathological significance of the cuboidal cells is unknown. The proximal tubular cells appeared to have a less-developed apical endocytic complex, basal infoldings and fewer lysosomes. These morphological changes may reflect proximal tubular dysfunction

Role of Neuroimaging on Differentiation of Parkinson’s Disease and Its Related Diseases

An accurate diagnosis of Parkinson’s disease (PD) is a prerequisite for therapeutic management. In spite of recent advances in the diagnosis of parkinsonian disorders, PD is misdiagnosed in between 6 and 25% of patients, even in specialized movement disorder centers. Although the gold standard for the diagnosis of PD is a neuropathological assessment, neuroimaging has been playing an important role in the differential diagnosis of PD and is used for clinical diagnostic criteria. In clinical practice, differential diagnoses of PD include atypical parkinsonian syndromes such as dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, caused by a striatal dopamine deficiency following nigrostrial degeneration. PD may also be mimicked by syndromes not associated with a striatal dopamine deficiency such as essential tremor, drug-induced parkinsonism, and vascular parkinsonism. Moreover, difficulties are associated with the clinical differentiation of patients with parkinsonism from those with Alzheimer’s disease. In this review, we summarize the typical imaging findings of PD and its related diseases described above using morphological imaging modalities (conventional MR imaging and neuromelanin MR imaging) and functional imaging modalities (99mTc-ethyl cysteinate dimer perfusion single photon emission computed tomography, 123I-metaiodobenzylguanidine myocardial scintigraphy, and 123I-FP-CIT dopamine transporter single photon emission computed tomography) that are clinically available in most hospitals. We also attempt to provide a diagnostic approach for the differential diagnosis of PD and its related diseases in clinical practice