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Kōbe-shi, Japan

Matsui H.,Kobe medical center
Otolaryngology - Head and Neck Surgery (Tokyo)

A case of consciousness disturbance due to voriconazole (VRCZ) for invasive sphenoidal aspergillosis was reported. A 61-year-old woman presented with a complaint of headache, diplopia, right-sided blepharoptosis and exophthalmos. Clinical findings and imaging studies showed that she had invasive sphenoidal fungal sinusitis. Immediately she was treated with 400 mg/day of VRCZ and underwent endoscopic sphenoidotomy. On the postoperative day (POD) 2, her symptoms significantly improved. However, on POD 3, she suffered from visual and auditory hallucination. Afterwards, her consciousness deteriorated into Japan Coma Scale 200. On POD 9, administration of VRCZ was discontinued. Subsequently, her symptoms were resolved. Source

Oh-oka H.,Kobe medical center
Current Bladder Dysfunction Reports

The application of various forms of neuromodulation has become more common and has been reported to be effective for stress and urgency urinary incontinence. In clinical practice, external (vaginal, anal, and surface electrodes) and internal stimulation (sacral nerve stimulation) are popular treatment modalities. However, appropriate treatment strategies using various neuromodulation techniques with or without pelvic floor muscle training or anticholinergics are still unclear. Further studies are needed not only to elucidate modes of action and to choose the optimal modality to improve results, but also to understand the appropriate indication and reduce morbidity and invasiveness. © 2010 Springer Science+Business Media, LLC. Source

Teshima M.,Kobe medical center
Otolaryngology - Head and Neck Surgery (Tokyo)

Relapsing polychondritis is a rare multi systemic rheumatic disease characterized by recurrent inflammation of cartilaginous structures. Various symptoms in the ear, nose, ocular structures, joints, and airway are manifested, and these inflammations spread to the whole body. Therefore, this disease is important in terms of diagnosis and treatment in otorhinolaryngology clinic. We presented three cases of relapsing polychondritis which showed different symptoms. There was one fatal case among three cases. Source

Takeuchi K.,Kobe medical center | Tsujino T.,Kobe medical center | Yabuta M.,Hyogo Prefectural Tsukaguchi Hospital | Kitazawa S.,Ehime University
European Journal of Gynaecological Oncology

Background: Ichthyosis uteri is an uncommon entity in which the entire endometrium is replaced by stratified squamous epithelium. Though the condition often is considered as benign, dysplastic changes have been reported. Case: We describe herein an exceedingly rare case of primary squamous cell carcinoma of the endometrium (PSCCE) associated with extensive ichthyosis uteri with chronic pyometra, who presented with blood-stained vaginal discharge of six-seven months duration. Although repeated endometrial biopsies revealed only strips of stratified squamous epithelium showing moderate to severe dysplastic changes, the tumor markers and magnetic resonance imaging strongly suggested advanced uterine body malignancy. Exploratory laparotomy was performed, and histologic findings of the superficial layer were consistent with ichthyosis uteri; in contrast the lesion of invasive squamous cell carcinoma was located in the deeper layer and lymph nodes. No dysplastic changes of the cervix were noted. Conclusions: It is suggested that PSCCE could be associated with pre-existing ichthyosis uteri and deeper biopsies should be performed for the accurate preoperative diagnosis of cases with chronic pyometra. Source

Miyamoto H.,Kinki University | Maeno K.,Kobe University | Uno K.,Kobe medical center | Kakutani K.,Kobe University | And 2 more authors.
European Spine Journal

Purpose: The surgical strategy for cervical spondylotic myelopathy (CSM) accompanying local kyphosis is controversial. The purpose of the present study was to compare and evaluate the outcomes of two types of surgery for CSM accompanying local kyphosis: (1) laminoplasty alone (LP) and (2) posterior reconstruction surgery (PR) in which we corrected the local kyphosis using a pedicle screw or lateral mass screw. Methods: Sixty patients who presented with local kyphosis exceeding 5 were enrolled. LP and PR were each performed on a group of 30 of these patients; 30 CSM patients without local kyphosis, who had undergone LP, were used as controls. The follow-up period was 2 years or longer. Preoperative local kyphosis angles in LP and PR were 8.3 ± 4.4 and 8.8 ± 5.7, respectively. Preoperative C2-7 angles in LP, PR and controls were -1.7 ± 9.6, -0.4 ± 7.2 and -12.0 ± 5.6, respectively. The recovery rate of the JOA score, local kyphosis angle and C2-7 angle at post-op and follow-up were compared between the groups. Results: The recovery rate of the JOA score in the LP group (32.6 %) was significantly worse than that in the PR group (44.5 %) and that of controls (53.8 %). Local kyphosis angles in the PR and LP groups at follow-up were 4.0 ± 8.6 and 8.0 ± 6.0, respectively. However, although the C2-7 angle at follow-up was improved to -11.1 ± 12.7 in PR, and maintained at -11.6 ± 6.2 in controls, it deteriorated to 0.5 ± 12.7 in LP. Conclusions: The present study is the first to compare the outcomes between LP alone and PR for CSM accompanying local kyphosis. It revealed that PR resulted in a better clinical outcome than did LP alone. This result may be due to reduction of local kyphosis, stabilization of the unstable segment, and/or the maintenance of C2-7 angle until follow-up in the PR group. © 2013 Springer-Verlag Berlin Heidelberg. Source

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