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Kagawa, Japan

Ikuma H.,Kagawa Rosai Hospital
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society | Year: 2012

To describe a technique for C2 lamina reconstruction using locking miniplates for the extirpation of spinal tumors in the craniocervical junction. Many spinal surgery cases in which lamina reconstructions have been performed using non-locking miniplates have been reported. However, there is only one report of the use of locking miniplates for lamina reconstruction in spinal tumor cases. We performed C2 lamina reconstructions using locking miniplates in a patient with a spinal tumor and another with a cystic lesion. The clinical and radiologic features of both cases are reported, and the surgical technique is described. A 62-year-old female and a 30-year-old male were diagnosed with meningioma and a neurenteric cyst, respectively, in the craniocervical junction. Extirpation of these lesions was performed in combination with C2 lamina reconstruction and reattachment of the paraspinous muscle to the C2 spinous process. A follow-up examination at 1 year postoperatively demonstrated no significant change in the sagittal alignment of the cervical spine and a good postoperative course in both cases. Bony fusion was detected in both cases, and no implant failure occurred in either case. This procedure results in rigid fixation of the reimplanted C2 lamina and helps to restore the paraspinous muscles. For these reasons, it appears to be a useful surgical procedure for spinal tumors requiring C2 laminectomy and does not cause postoperative kyphosis of the cervical spine. Source


Maehara T.,Kagawa Rosai Hospital | Moritani S.,Okayama Saiseikai General Hospital | Ikuma H.,Kagawa Rosai Hospital | Shinohara K.,Kagawa Rosai Hospital | Yokoyama Y.,Kagawa Rosai Hospital
Injury | Year: 2013

Objective: This study was designed to evaluate the frequency of intraoperative complications associated with titanium locking compression plate (LCP) removal. Design: Retrospective study. Methods: Medical records were reviewed for surgical technique, plate types used, position and number of screws, time from internal fixation to plate removal, and intraoperative complications. Radiographs were reviewed to evaluate the position of the plates and screws and the accuracy of the screw direction. Mann-Whitney and Yates Chi-square tests were calculated with the level of significance at P < 0.05. Results: All LCPs could be removed. Of the 342 locking head screws (LHSs), a total of 21 (6.1%) screws, 3 (2.0%) 5.0 mm screws (3/153) and 18 (10.7%) 3.5 mm screws (18/169), were difficult to remove. The frequency of difficulty associated with the 3.5 mm LHSs was significantly higher than that of the 5.0 mm LHSs (P < 0.01). The frequency of difficulty associated with the removal of LHSs at the diaphysis was higher than that of LHSs at the epiphysis (P < 0.01), especially with 3.5 mm LHSs. The mean age was significantly lower in the patients in whom removal was difficult (P < 0.05). Our analysis revealed that the frequency of removal difficulty was high when a 3.5 mm LHS was inserted into the diaphysis of young patients. Conclusions: We should recognize that the removal of LCPs can involve numerous problems and great care should be exercised, especially in cases involving 3.5 mm LHSs. © 2013 Elsevier Ltd. Source


Okano M.,Okayama University of Science | Fujiwara T.,Okayama University of Science | Kariya S.,Okayama University of Science | Haruna T.,Okayama University of Science | And 5 more authors.
Journal of Allergy and Clinical Immunology | Year: 2015

Background Recent studies have revealed that Staphylococcus aureus and its components participate in the pathogenesis of eosinophilic airway diseases, such as chronic rhinosinusitis with nasal polyps. Objective We sought to determine whether staphylococcal protein A (SpA) from S aureus regulated cellular responses in nasal polyps, especially when coupled to immunoglobulins in immune complexes (ICs). Methods Dispersed nasal polyp cells (DNPCs) or peripheral blood monocytes were cultured in vitro with SpA in the presence or absence of IgG, and IL-5, IL-13, IFN-γ, IL-17A, and IL-10 levels were measured in the supernatants. The effect of SpA exposure on staphylococcal enterotoxin B-induced cytokine production by DNPCs in the presence and absence of IgG, IgA, and autologous serum was also examined. Results Exposure to SpA induced DNPCs to produce significantly higher IL-10, IL-13, and IL-17A levels than DNPCs without SpA, although the magnitude of the IL-17A increase was less than that of IL-10 and IL-13. SpA induced IL-10 production mainly from adherent DNPCs, and this was significantly enhanced in the presence of IgG; similar results were observed in peripheral blood monocytes. IC formation between SpA and IgG (SpA-IgG ICs) was confirmed by using native polyacrylamide gel electrophoresis. SpA-IgG ICs, but not SpA alone, almost completely suppressed staphylococcal enterotoxin B-induced IL-5, IL-13, IFN-γ, and IL-17A production by DNPCs; similar inhibition was observed in DNPCs treated with SpA in the presence of either IgA or autologous serum. Conclusions Our results suggest that SpA can regulate the pathogenesis of enterotoxin-induced inflammation in patients with chronic rhinosinusitis with nasal polyps through coupling to immunoglobulins. © 2015 American Academy of Allergy, Asthma & Immunology. Source


Sakai A.,University of Occupational and Environmental Health Japan | Oshige T.,University of Occupational and Environmental Health Japan | Zenke Y.,Kagawa Rosai Hospital | Yamanaka Y.,University of Occupational and Environmental Health Japan | And 2 more authors.
Osteoporosis International | Year: 2010

Unipedal standing time was shorter and bone mineral density was lower in Japanese women aged 50 years and over with low-energy distal radius fractures resulting from falls than those in age-matched community-dwelling Japanese women without distal radius fractures. Introduction: The aim of this study was to compare unipedal standing time and bone mineral density (BMD) of women ≥50 years of age with distal radius fractures with those of age-matched women without fractures. Methods: Fracture group was 54 Japanese women with low-energy distal radius fractures resulting from fall. Non-fracture group was 52 community-dwelling Japanese women without fractures. Unipedal standing time and BMD were measured. Results: There were no significant differences in age and body mass index between the two groups. The percentage of women with unipedal standing time <15 s was 44.4% in the fracture group and 13.5% in the non-fracture group, while the respective frequencies for >120 s were 20.4% and 50.0%. The T-score of BMD was significantly lower in the fracture than non-fracture group. Logistic regression analysis identified unipedal standing time <15 s and T-score <70% as significant factors associated with distal radius fractures. Notably, T-score <70% was significant in subjects <65 years, and unipedal standing time <15 s was significant in those ≥65 years. Conclusion: Unipedal standing time was shorter and BMD was lower in women ≥50 years of age with distal radius fractures than those in age-matched women without fractures. © 2009 International Osteoporosis Foundation and National Osteoporosis Foundation. Source


Sato Y.,Okayama University of Science | Inoue D.,Kanazawa University | Asano N.,Nagoya University | Takata K.,Okayama University of Science | And 12 more authors.
Modern Pathology | Year: 2012

Progressively transformed germinal centers is a benign condition of unknown pathogenesis characterized by a distinctive variant form of reactive follicular hyperplasia in lymph nodes. We recently reported Ig G4-related disease in progressively transformed germinal centers. However, no large case series has been reported and clinicopathologic findings remain unclear. Here, we report 40 Japanese patients (28 men, 12 women; median age, 56 years) with progressively transformed germinal centers of the lymph nodes who fulfilled the histological diagnostic criteria for IgG4-related disease (IgG4 progressively transformed germinal centers), with asymptomatic localized lymphadenopathy involving the submandibular nodes in 24, submandibular and cervical nodes in 14, cervical nodes only in 1, and cervical and supraclavicular nodes in 1. In all, 16 (52%) of 31 examined patients had allergic disease. Histologically, the lymph nodes demonstrated uniform histological findings, namely marked follicular hyperplasia with progressively transformed germinal centers, and localization of the majority of IgG4 plasma cells in the germinal centers. Serum IgG4, serum IgE and peripheral blood eosinophils were elevated in 87%, 92% and 53% of examined patients, respectively. Eighteen patients subsequently developed extranodal lesions (including five who developed systemic disease), which on histological examination were consistent with IgG4-related disease. IgG4 progressively transformed germinal centers presents with uniform clinicopathological features of asymptomatic localized submandibular lymphadenopathy, which persists and/or relapses, and sometimes progresses to extranodal lesions or systemic disease. Nine patients were administered steroid therapy when the lesions progressed, to which all responded well. We suggest that IgG4 progressively transformed germinal centers should be included in the IgG4-related disease spectrum. © 2012 USCAP, Inc. All rights reserved. Source

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