Isolated Splenic Metastasis from Renal Cell Carcinoma: Case Report and Review

This report presents the case of a 70-year-old woman with a previous history of a left nephrectomy for renal cell carcinoma (RCC), who developed general malaise and fatigue. Abdominal computed tomography demonstrated an enhancing 6 × 7 cm necrotic lesion in the lower pole of the spleen suggestive of a metastasis. Given the highly suspicious nature of the lesion we proceeded to splenectomy. The tumour did not breach the splenic capsule, and there was no local diaphragmatic involvement. The mass was concluded to be a true metastasis of the original RCC rather than local recurrence of the disease. The causes of isolated solid splenic lesions are wide and varied, however a past or present history of malignancy should lead to a high index of suspicion for a splenic metastasis. We report an extremely unusual case of spread from a RCC

Eosinophilic gastroenteritis with ascites and diffuse intestinal wall thickening

A 60-year-old woman was admitted to our hospital with abdominal pain and diarrhea. Examination revealed eosinophilia (white blood count, 24,900/ml; eosinophils, 79.9%) and an elevated immunoglobulin E level. Abdominal computed tomography showed fluid collection and diffuse intestinal wall thickening, and biopsy specimens from the stomach, duodenum and colon showed eosinophil infiltration. We diagnosed the patient with eosinophilic gastroenteritis, and started treatment with steroid hormones (predonisolone, 40 mg/day perorally). The patient's symptoms and eosinophilia improved dramatically and she was discharged. Eosinophilic gastroenteritis is an inflammatory disease characterized by eosinophil infiltration into the gastrointestinal tract. It usually involves the stomach and small intestine, but may also involve the entire whole gastrointestinal tract. Although ascites sometimes complicates this disease, massive ascites, as in our patient, is rare. Here we report a case of eosinophilic gastroenteritis with massive ascites and diffuse intestinal wall thickening. Steroid hormones are an effective treatment for this disease, and early diagnosis and the administration of steroid hormones are essential

Optimal foraging and community structure: implications for a guild of generalist grassland herbivores

A particular linear programming model is constructed to predict the diets of each of 14 species of generalist herbivores at the National Bison Range, Montana. The herbivores have body masses ranging over seven orders of magnitude and belonging to two major taxa: insects and mammals. The linear programming model has three feeding constraints: digestive capacity, feeding time and energy requirements. A foraging strategy that maximizes daily energy intake agrees very well with the observed diets. Body size appears to be an underlying determinant of the foraging parameters leading to diet selection. Species that possess digestive capacity and feeding time constraints which approach each other in magnitude have the most generalized diets. The degree that the linear programming models change their diet predictions with a given percent change in parameter values (sensitivity) may reflect the observed ability of the species to vary their diets. In particular, the species which show the most diet variability are those whose diets tend to be balanced between monocots and dicots. The community-ecological parameters of herbivore body-size ranges and species number can possibly be related to foraging behavior.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47765/1/442_2004_Article_BF00377109.pd

Pancreas: Alcoholic pancreatitis—it\u27s the alcohol, stupid

The management of alcoholic pancreatitis is mostly reactive; little is done to prevent disease progression. It is time for physicians to pay attention to the root cause of the condition—that is, alcohol—rather than just responding to its effects. This article discusses an important paper that describes the first prospective, randomized, controlled, clinical trial to investigate the effect of brief interventions for alcohol abuse on the progression of alcoholic pancreatitis