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Kunisada K.,Kishiwada Eishinkai Hospital | Ishikawa H.,Kishiwada Eishinkai Hospital | Takafuji J.,Kishiwada Eishinkai Hospital | Komuta K.,Osaka Police Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2013

In 2009, a 91-year-old man with renal dysfunction was detected with a small nodule in the left pulmonary field. The nodule was found to have gradually increased in size by April, 2010. A trans-bronchial lung biopsy (TBLB) and computed tomography (CT) revealed squamous cell lung cancer and stage IV (a tumor was found on the right side as well), respectively. Systemic chemotherapy was not administered because of the advanced age of the patient and mild renal dysfunction. We obtained informed consent from the patient and his family before trans-arterial chemo-embolization (TACE) was performed. No side effects were observed either during or after treatment. Although his visits to our hospital stopped, he sought treatment for a cold 8 months after TACE. CT showed 87% shrinkage of the tumor shadow. This method could be a new therapeutic option for non-small cell lung cancer with little side effects, particularly in older patients or those with pulmonary complications.

Imagita H.,Kio University | Ogaki M.,Heisei Memorial Hospital | Fukuoka H.,Kishiwada Eishinkai Hospital | Yamada T.,Kishima Hon in Hospital | And 5 more authors.
Biomedical Research (Japan) | Year: 2013

The purpose of this study was to determine the physiological and biochemical properties of hindlimb muscles after hypoventilation (HPO) induced by bilateral phrenic nerve denervation. Male Wistar rats (10 weeks-old) underwent HPO by the phrenic nerve denervation at the cervical level or sham surgery. Analyses were performed 4, 8, and 12 weeks after the surgery. The myosin heavy chain (MHC) isoform profile and in vitro isometric contractile properties of the soleus (SOL) and extensor digitrum longus muscles (EDL) were analyzed. From the postoperative period, HPO induced characteristic changes in SpO2 such as hypoventilation disorder. After 12 weeks, significant increases in MHC1 and significant decreases in MHC2a were observed in the MHC isoform composition in SOL. Moreover, significant increases in MHC2a and significant decreases in MHC2b were also observed in the MHC isoform composition in EDL muscles in the HPO compared with sham (SHM) group. In our study, the tidal volume after unilateral phrenic nerve denervation decreased by approximately 12%, and that after bilateral phrenic nerve denervation decreased by approximately 35%. We concluded that the reduction in behavioral activity levels in the HPO group may have resulted in changes of the peripheral skeletal muscles as a result of disuse atrophy.

Umeda M.,Kansai Medical University | Sasai K.,Kishiwada Eishinkai Hospital | Kushida T.,Kansai Medical University | Wakabayashi E.,Kishiwada Eishinkai Hospital | And 3 more authors.
Journal of Neurosurgery: Spine | Year: 2013

Object. Modified cervical laminoplasty techniques have been developed to reduce postoperative axial neck pain and preserve function in patients with cervical spondylotic myelopathy (CSM). However, the previous studies demonstrating satisfactory surgical outcomes had a retrospective design. Here, the authors aimed to prospectively evaluate the 2-year outcomes of a modified cervical laminoplasty technique for CSM that preserves the paravertebral muscles. Methods. Outcomes were analyzed for 40 patients (22 men and 18 women; mean age, 66.6 years; age range 44-92 years) with CSM who underwent C4-6 laminoplasty with C-3 and C-7 partial laminectomies or C-3 total and C-7 partial laminectomies and received hydroxyapatite spacers. Neurological, pain severity, and spinal radiographic evaluations were performed preoperatively and at 3, 6, 12, 18, and 24 months postoperatively. Plain radiography and MRI of the cervical spine were performed to evaluate the range of motion (ROM), sagittal alignment, and crosssectional areas of the deep extensor muscles. The extent of bone-spacer bonding and bony union at the gutter was assessed by CT. Results. The mean preoperative Japanese Orthopaedic Association CSM score was 10.2, but it increased to 14.4 by 24 months after surgery. Eleven patients had axial neck pain preoperatively, but only 3 reported mild pain at 24 months, and in all 3 cases the pain was mild. The mean angle of lordosis was 11.7° preoperatively and 12.0° 2 years postoperatively. Although the ROM at the C2-7 levels was significantly reduced 3 months postoperatively, an increasing trend was observed up to 12 months, and 86% of the preoperative ROM was achieved by 2 years postoperatively. The mean paravertebral muscle cross-sectional areas were 833 ±? 215 mm2 preoperatively and 763 ±? 197 mm2 24 months postoperatively, but the difference was not statistically significant. The rates of bone-spacer bonding and bony union at the gutter were low during the early stages but increased to 90% and 93%, respectively, by 2 years after surgery. Conclusions. The modified laminoplasty technique used in this study ensured very good neurological status and ROM after 2 years and was associated with low incidences of axial neck pain and serious complications. This simple and easy operative method could benefit future laminoplasty protocols. © 2013 AANS.

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