Salvage Surgery for Symptomatic Recurrence of Retro-Odontoid Pseudotumor after a C1 Laminectomy

We provide the first report of successful salvage surgery for a post-C1 laminectomy symptomatic recurrence of a retro-odontoid pseudotumor (ROP) that caused myelopathy. The 72-year-old Japanese woman presented with an ROP causing symptomatic cervical myelopathy. With ultrasonography support, we performed the enucleation of the ROP via a transdural approach and fusion surgery for the recurrence of the mass. At the final observation 2-year post-surgery, MRI demonstrated the mass’s regression and spinal cord decompression, and the patient’s symptoms had improved. Our strategy is an effective option for a symptomatic recurrence of ROP

Territory and District in Historical Townscape Preservation

学位の種別: 課程博士審査委員会委員 : （主査）東京大学教授 出口 敦, 東京大学教授 岡部 明子, 東京大学教授 辻 誠一郎, 東京大学准教授 清家 剛, 東京大学教授 西村 幸夫University of Tokyo(東京大学

A Strategic Protocol to Improve the Process and Outcomes of Two-stage Revision Total Hip Arthroplasty

Two-stage revision total hip arthroplasty (THA) is the most commonly used treatment approach for deep prosthetic infection. However, in this approach the interval between the first and second stage tends to be prolonged. We devised a strategic protocol for improving the infection eradication rate and shortening the interval between the stages in two-stage revision THA. This study analyzed a series of 14 patients (14 hips) from 2008 to 2012, who were treated using an antibiotic-loaded acrylic cement (ALAC) spacer at the first stage and re-implantation at the second stage. The ALAC included vancomycin and amikacin for most of the cases. Patients with MRSA infection were additionally administered intravenous vancomycin in combination with either oral rifampicin or trimethoprim-sulfamethoxazole. The average interval between the stages was 54.2 days overall, and 58.7 days for cases with MRSA infection. Our infection eradication rate was 100%, with no reported recurrence of infection. The presence of MRSA tended to be associated with a longer interval between the two stages. Our protocol for two-stage revision THA was associated with a high eradication rate of infection and a shortened interval between the stages

Locomotive syndrome is associated with body composition and cardiometabolic disorders in elderly Japanese women

The 25-question Geriatric Locomotive Function Scale [7]. (DOCX 154 kb

Impaired Healing of a Cutaneous Wound in an Inducible Nitric Oxide Synthase-Knockout Mouse

Background. We investigated the effects of loss of inducible nitric oxide synthase (iNOS) on the healing process of cutaneous excisional injury by using iNOS-null (KO) mice. Population of granulation tissue-related cell types, that is, myofibroblasts and macrophages, growth factor expression, and reepithelialization were evaluated. Methods. KO and wild type (WT) mice of C57BL/6 background were used. Under general anesthesia two round full-thickness excision wounds of 5.0 mm in diameter were produced in dorsal skin. After specific intervals of healing, macroscopic observation, histology, immunohistochemistry, and real-time reverse transcription-polymerase chain reaction (RT-PCR) were employed to evaluate the healing process. Results. The loss of iNOS retards granulation tissue formation and reepithelialization in excision wound model in mice. Detailed analyses showed that myofibroblast appearance, macrophage infiltration, and mRNA expression of transforming growth factor b and of collagen 1α2 were all suppressed by lacking iNOS. Conclusions. iNOS is required in the process of cutaneous wound healing. Lacking iNOS retards macrophage invasion and its expression of fibrogenic components that might further impair fibrogenic behaviors of fibroblasts

A New Electrophysiological Method for the Diagnosis of Extraforaminal Stenosis at L5-S1

Study DesignA retrospective study.PurposeTo examine the effectiveness of using an electrodiagnostic technique as a new approach in the clinical diagnosis of extraforaminal stenosis at L5-S1.Overview of LiteratureWe introduced a new effective approach to the diagnosis of extraforaminal stenosis at the lumbosacral junction using the existing electrophysiological evaluation technique.MethodsA consecutive series of 124 patients with fifth lumbar radiculopathy were enrolled, comprising a group of 74 patients with spinal canal stenosis and a second group of 50 patients with extraforaminal stenosis at L5-S1. The technique involved inserting a pair of needle electrodes into the foraminal exit zone of the fifth lumbar spinal nerves, which were used to provide electrical stimulation. The compound muscle action potentials from each of the tibialis anterior muscles were recorded.ResultsThe distal motor latency (DML) of the potentials ranged from 11.2 to 24.6 milliseconds in patients with extraforaminal stenosis. In contrast, the DML in patients with spinal canal stenosis ranged from 10.0 to 17.2 milliseconds. After comparing the DML of each of the 2 groups and at the same time comparing the differences in DML between the affected and unaffected side of each patient, we concluded there were statistically significant differences (p<0.01) between the 2 groups. Using receiver operating characteristic curve analysis, the cutoff values were calculated to be 15.2 milliseconds and 1.1 milliseconds, respectively.ConclusionsThis approach using a means of DML measurement enables us to identify and localize lesions, which offers an advantage in diagnosing extraforaminal stenosis at L5-S1