This study analyzed the genomic DNA extracted from 170 patients with Kawasaki disease as well as their clinical and laboratory parameters to determine whether uteroglobin gene polymorphism, which may be associated with the morbidity rate and severity of IgA nephropathy, is involved in the pathogenesis of Kawasaki disease, which is another type of vasculitic syndrome in childhood. The uteroglobin genotype at position 38 was determined by Sau96I digestion of PCR products. The uteroglobin genotype and allele frequency in Kawasaki disease patients were compared with those of published control data reported by three independent studies on Japanese individuals. The clinical parameters investigated were age at onset, gender, duration of fever, white blood cell count, C-reactive protein, aspartate aminotransferase, alanine aminotransferase and total protein. No significant difference associated with the uteroglobin genotype was observed in the clinical parameters. The genotypic and allele frequencies at position 38 of the uteroglobin gene did not differ significantly in the three studies of Japanese healthy controls and the present study. The logistic regression analysis demonstrated that no clinical parameter was associated with the progression to coronary artery lesions except for the duration of fever (odds ratio = 1.7; 95% confidential interval = 1.42-2.05). In conclusion, the present study failed to prove an association of uteroglobin gene polymorphism with the morbidity rate or the severity of Kawasaki disease, but suggested the existence of a factor contributing to the onset of Kawasaki disease and progression to coronary artery lesions in Kawasaki disease patients.

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Objective: Numerous studies have shown a relationship between the duration of untreated psychosis (DUP) in schizophrenia and short-term outcome. However, few studies have investigated the relationships between DUP and the medium-term and long-term outcomes. Furthermore, we are unaware of any reports regarding the relationship between DUP and the ultralong-term outcome. This study aimed to investigate the relationship between DUP and ultralong-term outcome at 28 years in patients with schizophrenia. Method: Patients with schizophrenia completed an interview survey 28 years after their initial psychiatric examination during the period 1979-1980. It was possible to conduct the survey using suitable assessment scales in 31 patients in whom DUP was confirmed. These patients were divided into a short DUP group and a long DUP group on the basis of the median DUP, and the outcomes of these two groups were compared. Results: Longer DUP correlated significantly with poorer symptomatic outcome; degree of social adjustment; and, global functioning. Multiple linear regression analysis found no changes in these results even after controlling for various factors, including gender, age at onset, mode of onset, diagnostic subtype, and premorbid adjustment. Conclusion: DUP adversely affected ultralong-term outcome of schizophrenia after 28 years. This finding supports the need to establish a system to enable early detection and appropriate intervention for patients with schizophrenia to reduce the risk of a deleterious outcome after more than 25 years.

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Objective: Sporadic Parkinson's disease (PD) is thought to be a complex multifactorial, age-related neurodegenerative disease caused by the interaction between genetic and environmental factors. Whether PARK2, a major responsible gene causing familial PD, affects to the disease susceptibility or the phenotypic variability in sporadic PD remains controversial. In this study, we perform the sequence analysis of PARK2 and assess the correlation between clinical features of sporadic PD patients and the detected variants. Materials and Methods: A total of 92 sporadic PD patients were sequenced and underwent the clinical examinations. MIBG scintigraphy was performed in 61 patients and the cardiac uptake was measured as the heart/mediastinum (H/M) ratio. Results: We only detected two novel variants (R51R, L272I) in 3 patients and three common polymorphisms, S167N, V380L, and R366W, which had the allele frequencies of 38.6%, 7% and 0.5%, respectively. There were no significant difference of the allele frequencies between patients and controls. On the evaluation of clinical features, the patients with S167N had the younger onsets of age and the tendency of preserved cardiac uptake of MIBG in the early Hoehn and Yahr (HY) stage compared to the patients without S167N. Conclusions: These results suggest the common polymorphisms of PARK2 might affect the phenotype of sporadic PD without altered susceptibility to PD.

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Incidentally detected small pancreatic cyst is a therapeutic challenge. As these lesions include a spectrum of pathologies ranging from benign lesions to malignant mucinous tumors, it is important to differentiate potential malignant mucinous cystic neoplasms (MCN) from others. However, a definitive diagnosis might be difficult, since computed tomography (CT) and magnetic resonance imaging (MRI) cannot depict the morphologic features characteristic of small MCN. This report presents a case of a small pancreatic cyst incidentally detected during medical check-up for inguinal hernia. Although the preoperative diagnosis was uncertain with CT and MRI, the diagnosis of MCN was strongly suspected because the majority of MCN tend to often occur in elderly women and the most common locations are in the pancreatic tail. Laparoscopic ultrasonography (LUS) was employed to obtain a correct diagnosis, and it showed a 16 mm cyst with characteristic features indicating a diagnosis of MCN. The patient underwent a laparoscopic distal pancreatectomy and the diagnosis of MCN was confirmed histopathologically. In conclusion, LUS allowed a timely curative resection of a small MCN in this case.

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Omental torsion is a rare cause of acute abdomen. The clinical symptoms can mimic other acute abdominal disorders, and therefore many patients are often diagnosed during a laparotomy performed under a presumptive diagnosis of appendicitis, cholecystitis and so on. Recent advances in diagnostic modalities has made it possible to determine the correct preoperative diagnosis of omental torsion, and the chances of treating this rare condition are therefore expected to increase. Laparoscopic surgery has been used extensively for various emergent disorders; however, the laparoscopic management of omental torsion might be troublesome for most surgeons. A case of omental torsion secondary to inguinal hernia is herein reported, where a huge torted omentum was successfully managed laparoscopically. It was useful to hang up the pedicle of the congested and fragile omentum with polyester tape to manage it atraumatically. Moreover this device made it easy to remove of the specimen through a 4-cm minilaparotomy.

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