The diagnostic value of single-photon emission computed tomography/computed tomography for severe sacroiliac joint dysfunction.

Purpose: We aimed to evaluate the value of single-photon emission computed tomography (SPECT)/computed tomography (CT) for the diagnosis of sacroiliac joint (SIJ) dysfunction.

Methods: SPECT/CT was performed in 32 patients with severe SIJ dysfunction, who did not respond to 1-year conservative treatment and had a score of >4 points on a 10-cm visual analog scale. We investigated the relationship between the presence of severe SIJ dysfunction and tracer accumulation, as confirmed by SPECT/CT.

Short lingual osteotomy without fixation: a new strategy for mandibular osteotomy known as "physiological positioning".

We describe the strategy of physiological positioning, which we regard as a new alternative treatment to conventional orthognathic operations, and treated 18 patients with skeletal mandibular prognathism using it. The positions of SNB, FMA, and Me were measured postoperatively to assess skeletal stability, changes in the angle and perpendicular length of the upper and lower central incisors were measured to assess dental stability, and we confirmed that both skeletal and dental stability were excellent. The width to which the jaw could be opened recovered early, and we saw only one case of disorder of the temporomandibular joint.

Concomitant use of radiotherapy and two topoisomerase inhibitors to treat adult T-cell leukemia with a radiotherapy-resistant bulky disease: a case series.

Concomitant chemoradiotherapy is established as the standard treatment to improve the prognosis of several types of solid tumor, but has not been the general practice for hematological malignancies. Here, I report two cases of adult T-cell leukemia (ATL) with a radiotherapy-resistant bulky disease treated with concomitant radiotherapy and two topoisomerase inhibitors: etoposide (VP-16) and irinotecan (CPT-11). Patient 1 was a 78-year-old man with chemotherapy-resistant inguinal bulky mass.

[A case of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) with treatment-resistant status epilepticus that was effectively treated with lamotrigine].

A 16-year-old woman with MELAS developed fever and myoclonic epilepsy which improved with conventional anti-epileptic drugs. Since seizures recurred one month after successful treatment, the doses of phenobarbital, clonazepan, and valproate were increased. However, there was no improvement and status epilepticus continued.

Risk factors for development of myelopathy in patients with cervical spondylotic cord compression.

Purpose: To clarify risk factors for the development of myelopathy in patients with cervical spondylotic cord compression.

Method: The authors reviewed articles in which risk factors for the development of myelopathy in patients with cervical spondylotic cord compression were discussed. Ossification of the posterior longitudinal ligament (OPLL) was also reviewed as a disease which causes cervical cord compression to clarify pathomechanism of the development of myelopathy.

Distractive flexion injuries of the subaxial cervical spine treated with a posterior procedure using cervical pedicle screws or a combined anterior and posterior procedure.

The purpose of this study was to compare the clinical and radiographic outcomes of patients with distractive flexion (DF) injuries of the subaxial cervical spine who had undergone a posterior procedure using cervical pedicle screw (CPS) fixation with those who had undergone a combined anterior and posterior procedure. Recommendations for the surgical treatment of DF injuries of the subaxial cervical spine remain controversial. There are few clinical reports of posterior CPS fixation for DF injuries.

The use of antibiotic-impregnated fibrin sealant for the prevention of surgical site infection associated with spinal instrumentation.

Purpose: The purpose of this study was to determine if the use of antibiotic-impregnated fibrin sealant (AFS) was effective in preventing surgical site infections (SSI) associated with spinal instrumentation.

Methods: In a preliminary study, five pieces of vancomycin-impregnated fibrin sealant, five nuts that were not treated with the sealant, and five nuts that were treated with the sealant were subjected to agar diffusion testing. In a clinical study, the rates of deep SSI were compared between 188 patients who underwent procedures involving spinal instrumentation without AFS (group 1) and 196 patients who underwent procedures involving spinal instrumentation with AFS (group 2).

Subdural spread of injected local anesthetic in a selective transforaminal cervical nerve root block: a case report.

Introduction: Although uncommon, selective cervical nerve root blocks can have serious complications. The most serious complications that have been reported include cerebral infarction, spinal cord infarction, transient quadriplegia and death.

Case Presentation: A 40-year-old Japanese woman with a history of severe right-sided cervical radicular pain was scheduled to undergo a right-sided C6 selective cervical nerve root block using a transforaminal approach under fluoroscopic guidance.

Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history.

Study Design: Review article.

Objective: To review the etiology, natural history, measurement tools, and image diagnosis of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine.

Summary Of Background Data: OPLL is a well-known disease that causes myelopathy.

Cervical pedicle screw insertion using a gutter entry point at the transitional area between the lateral mass and lamina.

Purpose: The purpose of this study was to describe a free-hand pedicle screw insertion technique and to evaluate the accuracy of pedicle screw placement and validity of pedicle screw fixation in patients with subaxial cervical spine injuries.

Methods: We retrospectively reviewed 32 consecutive patients with subaxial cervical spine injuries who underwent posterior cervical fixation using our cervical pedicle screw (CPS) insertion technique. We also assessed the clinical and radiological outcomes and the accuracy of pedicle screw placement.

[Anti-aquaporin-4 antibody autoimmune syndrome with disturbance of consciousness, respiratory failure, and ophthalmoplegia associated with extensive brain stem involvement with intractable hiccup and nausea as an initial manifestation. A case report].

A 45-year-old female was positive for anti-aquaporin-4 antibody with disturbance of consciousness, respiratory failure, and ophthalmoplegia associated with extensive brain stem involvement with intractable hiccup and nausea as an initial manifestation. Her level of consciousness and state of respiration worsened approximately one month later. There was no abnormality in the cerebrospinal fluid examination.

Combined posterior and delayed staged mini-open anterior short-segment fusion for thoracolumbar burst fractures.

Study Design: A prospective study.

Objectives: To assess the outcome of patients with a single thoracolumbar burst fracture treated with circumferential short-segment fusion consisting of posterior reduction, short-segment fusion, and delayed staged mini-open anterior short-segment fusion.

Summary Of Background Data: The surgical treatment of thoracolumbar burst fractures remains controversial.

Conservative treatment with hyperbaric oxygen therapy for cervical spondylotic amyotrophy.

Study Design: Small case series of patients with cervical spondylotic amyotrophy (CSA) managed by conservative treatment with hyperbaric oxygen (HBO) therapy.

Objective: To study the effects of conservative treatment with HBO therapy of CSA patients.

Setting: Department of Orthopaedic Surgery, Imakiire General Hospital, Kagoshima, Japan.

Relationship between enlargement of the lateral ventricle and periventricular leukomalacia in infants.

Aim: To examine if we could predict periventricular leukomalacia (PVL) from the area of the lateral ventricle (LV).

Methods: Six neonates in whom cystic PVL could be detected by magnetic resonance imaging (MRI) but not by ultrasound (US) were termed the 'invisible group'. Six neonates in whom cystic PVL could be detected by MRI and US were termed the 'visible group'.

Investigation of actual conditions of mammography in Kagoshima Prefecture.

We surveyed the actual conditions of mammography with regard to image quality and radiation dose at 44 facilities in Kagoshima prefecture in 1999. In April 2004, guidelines for mammography newly included the standard of digital mammography. From September to October 2005, the survey was conducted at 48 facilities, and the results of the survey were compared with that in 1999.

[Updates on ossification of posterior longitudinal ligament. Epidemiology and pathogenesis of OPLL].

The study aimed for epidemiology and pathogenesis of ossification of the posterior longitudinal ligament of the cervical spine (OPLL) has been continued by The Investigation Committee of Japanese Ministry of Health, Labour and Welfare till now. As a result, the number of patients and frequency in Japan were clarified, and the epidemiology in foreign countries came to be reported, too. The association of various factors to development of OPLL was reported, but a hereditary factor is most important as the pathogenesis of OPLL.

An atypical extrahepatic metastasis of the distal phalanx from hepatocellular carcinoma.

A 49-year-old woman presented with severe swelling and pain of the left little finger, which had exacerbated rapidly, in October 2006. The patient had a history of hepatocellular carcinoma and metastatic lung cancer. She had undergone partial hepatectomy for the hepatocellular carcinoma in September 2001 and pulmonary resection for metastatic lung cancer in November 2005.

Uncommon cases of immature-type CD56+ natural killer (NK)-cell neoplasms, characterized by expression of myeloid antigen of blastic NK-cell lymphoma.

Immature-type CD56(+) natural killer (NK)-cell neoplasms are classified as either myeloid/NK-cell precursor acute leukemia or blastic NK-cell lymphoma. We identified two cases of immature-type CD56(+) NK-cell neoplasms that were not categorizable as either of these entities. The first case involved a 74-year-old woman presenting with skin eruptions and pancytopenia due to bone marrow necrosis.

Radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligament: a multicenter cohort study.

Study Design: A multicenter cohort study was performed retrospectively.

Objective: To identify radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligaments (OPLL).

Summary Of Background Data: The pathomechanism of myelopathy in the OPLL remains unknown.

Alpha-fetoprotein (AFP)-producing adrenocortical carcinoma--long survival with various therapeutic strategies including a lung resection: report of a case.

We experienced a very rare case of late pulmonary metastasis from ACC. The patient was a 40-year-old woman who had undergone a left adrenectomy 12 years earlier. Instead of a large metastatic lung tumor with hemothorax and the existence of metastases in other organs, combined therapy of repeated resections for metastases and adjuvant therapy allowed for almost a 36-month survival following the first recurrence and a good quality of life.

Ossification of the posterior longitudinal ligament in dizygotic twins with schizophrenia: a case report.

The pathogenesis of ossification of the posterior longitudinal ligaments (OPLL) has not been clarified. We here report dizygotic twin sisters with OPLL of the cervical spine and propose a new pathogenesis of OPLL. This is the first report of dizygotic twins with OPLL.

Occult spinal canal stenosis due to C-1 hypoplasia in children with Down syndrome.

Object: Little has been published about subclinical spinal canal stenosis due to C-1 hypoplasia in patients with Down syndrome. In this paper the authors performed a matched comparison study with cross-sectional survey to investigate occult spinal canal stenosis due to C-1 hypoplasia in children with Down syndrome.

Methods: A total of 102 children with Down syndrome ranging in age from 10 to 15 years were matched according to age and physique with 176 normal children.

A case of mixed connective tissue disease complicated with thymic carcinoma and Hashimoto's thyroiditis.

We report the case of a 63-year-old woman who suffered from mixed connective tissue disease (MCTD) complicated with thymic carcinoma and Hashimoto's thyroiditis. Although many systemic syndromes associated with thymoma and thymic carcinoma, i.e.

Epstein-Barr virus-associated enteritis with multiple ulcers after stem cell transplantation: first histologically confirmed case.

The present case involves unique enteritis forming multiple ulcers associated with Epstein-Barr virus (EBV). A 57-year-old man had undergone a reduced intensity allogeneic stem cell transplantation for a relapse of multiple myeloma following sequential autologous peripheral blood stem cell transplantation. The ileum, resected for massive melena, showed multiple irregular ulcers with occasional cobblestone-like appearance.

Treatment of recurrent chordomas by percutaneous ethanol injection therapy and radiation therapy.

We report a case of recurrent sacral chordomas that have been successfully controlled by the combination therapy of percutaneous ethanol injection therapy (PEIT) and radiation therapy in a 71-year-old man. PEIT may be one of the adjuvant therapies for recurrent chordomas.