Effects of preemptive analgesia using continuous subcutaneous morphine for postoperative pain in scoliosis surgery: a randomized study.

The authors evaluated prospectively the efficacy and safety of continuous subcutaneous morphine administration for postoperative analgesia after posterior spinal fusion and instrumentation for idiopathic scoliosis. Thirty patients were given the subcutaneous morphine infusion (20 mg/day), and 20 patients were not given morphine (control group). Postoperative pain control was assessed using a verbal response score (VRS) and a visual analog pain scale (VAS).

Cervical laminoplasty for subaxial lesion in rheumatoid arthritis.

Expansive laminoplasty of the cervical spine was performed for 15 patients with subaxial lesion (SAL) in rheumatoid arthritis (RA) with or without symptomatic occipitocervical pathology. Clinical results were satisfactory, and radiographic evaluation revealed that the range of movement of the cervical spine decreased to 56.3%, spinal alignment was well preserved, and intervertebral slipping advanced only slightly.

[Characteristics of hemiplegic outpatients with stroke who try to remove their clothes unnecessarily].

We have observed that patients who suffer from hemiplegia after a cerebral stroke, tend to remove their clothes although it is not necessary to change them while they are in hospital. Not only does this activity make it difficult to manage the ward and carry out rehabilitation, but it also often becomes problematic for home care once the patient has been discharged from hospital. However, there have been no previous reports on this activity.

[Treatment of pressure sores accompanied by infection in outpatients with spinal cord injury].

The occurrence of infection at pressure sore sites due to multiple drug resistant microbes not only delays healing at the time of infection, but it can become a major factor preventing an acceptable level of ADL (activities of daily living) in the home. We studied a method for treating infection in pressure sores in spinal cord injury patients living at home who were commuting to our hospital for treatment. After establishing drug sensitivity in all patients, we instructed patients and their families how to apply dressings using 2% chloramphenicol (CP) ointment, and then studied the status regarding infection and the course of the pressure sores.

[A case of amyopathic dermatomyositis with rapidly progressive interstitial pneumonia].

We report here a case of interstitional pneumonia (IP) associated with amyopathic dermatomyositis (DM). In August, 1998, a 53-year-old Japanese man was admitted to our hospital because of fever, polyarthritis and erythematous heliotrope eruption and Gottron's sign without any symptom of myositis. Serum CK level and EMG were normal.

Follicular contact dermatitis due to polyoxyethylene laurylether.

Polyoxyethylene laurylether, an addition polymer of lauryl alcohol and ethylene oxide, is used as an emulsifier in cosmetics. We report a case of follicular contact dermatitis after the use of polyoxyethylene laurylether that was contained in a cosmetic. A patch test with polyoxyethylene laurylether 1% petrolatum showed a follicular papular reaction.

Anterior instrumentation in idiopathic scoliosis: a minimum follow-up of 10 years.

One hundred and thirty-four patients with idiopathic scoliosis were treated between 1973 and 1993 in our hospital, and 53 were followed for a minimum of 10 years in a retrospective study. Forty-five were female and 8 male with an average age of 32 years at follow up. Dwyer instrumentation was used in 17 and Zielke in 36.

Development of anti-Sm and anti-DNA antibodies followed by clinical manifestation of systemic lupus erythematosus in an elderly woman with long-standing Sjögren's syndrome.

A 69-year-old Japanese women who had been followed up for 10 years as a primary Sjögren's syndrome, is reported. She suddenly developed serological and clinical characteristics of systemic lupus erythematosus (SLE): anti-Sm and anti-dsDNA antibodies followed by nephrotic syndrome and pancytopenia. This case suggests that the diagnosis of primary Sjögren's syndrome should be considered as tentative in certain cases and that the development of serological characteristics precede and are associated with the development of clinical symptoms of SLE.

Recurrent annular erythema with anti-SSA/Ro and anti-SSB/La antibodies localized on palms and fingers in an elderly man.

A 69-year-old Japanese man with recurrent annular erythema localized on palms and flexor surface of fingers with anti-SSA/Ro and anti-SSB/La antibodies, is reported. The present case indicates that even in an elderly man with atypical localization, annular erythema with autoimmunity may be considered and serological analysis should be performed. Systematic studies will be required to understand the relationship between 'recurrent annular erythema associated with anti-SSB/La antibodies' in Japanese, subacute cutaneous lupus erythematosus (SCLE) and 'annular erythema associated with Sjogren's syndrome'.

Marked thrombocytosis with chromosomal abnormalities in a patient with rheumatoid arthritis.

An 80 year-old Japanese woman with rheumatoid arthritis (RA), complicated with thrombocytosis is described. Mild to moderate thrombocytosis is commonly observed in patients with RA, but she had marked thrombocytosis of over 1000 x 10(3)/mm3 and monosomy 22 with marker chromosome. This case suggests that thrombocytosis unusual with disease activity of RA might occur, and that careful evaluation of the thrombocytosis is required.

Chronic destructive monoarthritis of the wrist in patients with anti-SSA/Ro antibodies: report of two cases.

Among 340 patients with rheumatic diseases, two cases of chronic destructive monoarthritis of the wrist with anti-SSA/Ro antibodies and rheumatoid factor, were observed for over three years. It is not clear whether these cases represent a specific subset of rheumatoid arthritis (RA) or whether they may progress to diffuse symmetrical destructive polyarthritis typical of RA. Long-term follow-up studies including analysis of autoantibodies will be needed to clarify the characteristics and course of chronic monoarthritis.

A case of Sjögren's syndrome complicating immune-mediated aplastic anaemia.

A 78-year-old Japanese woman with Sjögren's syndrome complicating immune-mediated aplastic anaemia is described. A diagnosis of aplastic anaemia was made from severe pancytopenia with hypoplastic marrow. Laboratory studies suggested an association of bone marrow suppressive T-lymphocytes with the pathogenesis of aplastic anaemia.