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Toyama S.,Shakaihoken Kobe Central Hospital | Tamai K.,Matsushita Memorial Hospital | Sakamoto A.,Matsushita Memorial Hospital | Hirashima T.,Matsushita Memorial Hospital
Modern Rheumatology | Year: 2011

The Sauvé-Kapandji (S-K) procedure is a common treatment for rheumatoid wrists, but in some cases severe bone destruction makes this operative modality difficult to perform, while also resulting in a poor outcome. A modified S-K procedure for these wrists has been reported, but the clinical outcomes of the modified procedure are unclear. This study evaluated 24 wrists in 20 patients who underwent the modified S-K procedure. The mean follow-up period was 34.5 months. The clinical assessments were range of motion, carpal bone translation and bony shelf size. The range of motion and carpal bone translation were similar to those produced by the S-K procedure. In regard to bony shelf size, wrists with an excessively large bony shelf tended to have a progression of carpal bone translation toward the palmar direction due to the residual malposition of the ECU tendon. The modified S-K procedure appears to be a safe and effective surgical alternative for the treatment of severely destroyed rheumatoid wrists. Although the modified procedure allows for the adjustment of the bony shelf size, it should not be used with wrists that have an excessively large bony shelf. © 2010 Japan College of Rheumatology.

Wani I.,S.M.H.S Hospital | Kitagawa M.,Shakaihoken Kobe Central Hospital | Rather M.,S.M.H.S Hospital | Singh J.,S.M.H.S Hospital | And 2 more authors.
Cases Journal | Year: 2014

Introduction: Torsion of the vermiform appendix is a rare disorder, which causes abdominal symptoms indistinguishable from acute appendicitis and is found by chance during the laparotomy. Case presentation: We report a case (a 76-year-old male) suffering of torsion of the vermiform appendix with fecalith. It was twisted 540 degrees in an anti-clockwise direction. Appendectomy was done. Conclusion: Appendiceal torsion may be assocated with the presence of fecalith. This case is the oldest one among the patients with appendiceal torsion reported to literature. © 2008 Wani et al; licensee BioMed Central Ltd.

Hisanaga T.,Tsukuba Medical Center Hospital | Shinjo T.,Shakaihoken Kobe Central Hospital | Morita T.,Seirei Mikatahara General Hospital | Nakajima N.,Tenshi Hospital | And 6 more authors.
Japanese Journal of Clinical Oncology | Year: 2010

Objective: The aim of this study was to evaluate the efficacy and safety of octreotide for malignant bowel obstruction in a multicenter study. Methods: Terminally ill patients diagnosed with inoperable malignant bowel obstruction were treated with octreotide 300 μg/day. The primary endpoint was the overall improvement rate of subjective abdominal symptoms. The degrees of nausea, vomiting, abdominal pain, distension, anorexia, fatigue, thirst and overall quality of life were evaluated by the self-rating scores selected from the MD Anderson Symptoms Inventory and Kurihara's Face Scale. Results: Forty-nine patients were enrolled in the study, and 46 patients received study treatment, including 17 gastric, 13 colorectal, 7 ovarian and other cancers. The median survival time was 25 days. The number of vomiting episodes significantly correlated with the MD Anderson Symptoms Inventory nausea and vomiting scores (P , 0.001) before octreotide treatment. Of 43 patients evaluable for efficacy, the scores of all the MD Anderson Symptoms Inventory items except abdominal pain and the number of vomiting episodes improved during the first 4 days of octreotide treatment (P< 0.0062). The MD Anderson Symptoms Inventory scores were decreased in 59-72% of patients, and overall quality-of-life scores improved in 56% of patients. No serious adverse events were observed. Conclusions: The high improvement rate in abdominal symptoms suggested the efficacy of octreotide in terminally ill patients with malignant bowel obstruction. © The Author (2010). Published by Oxford University Press. All rights reserved.

Wani I.,S.M.H.S Hospital | Maqbool M.,S.M.H.S Hospital | Amin A.,GB Pant Hospital | Shah F.,S.M.H.S Hospital | And 4 more authors.
Annals of Saudi Medicine | Year: 2010

Background : The propensity of Ascaris lumbricoides to wander leads to varied surgical complications in the abdomen. Wandering A lumbricoides may sometimes reach the vermiform appendix and its presence there may remain silent or incite pathology. Our aim was to study ascariadial appendicitis. Methods : Over a period of 3 years, we identified children who were found to have appendiceal ascariasis during surgery for different intestinal complications due to ascariasis. We studied the relationship between ascariasis and its lodgement inside the vermiform appendix in these patients. No preoperative diagnosis was made in this series. Results : We found 11 patients with appendiceal ascariasis. It was incidentally found that 8/11 (72.7%) patients had worms inside their vermiform appendix but not appendicitis, whereas the remaining three patients (27.2%) were found to have Ascaris-associated appendicitis. The characteristic finding in Ascaris-infested vermiform appendix was that the worm is positioned with its head at the base and its tail at the tip of the appendix. Conclusion : Migration of A lumbrocoides inside the vermiform appendix is an incidental finding and tends to pursue a silent course in most patients. Only rarely does the presence of Ascaris inside the vermiform appendix cause appendicitis.

Shimoyama N.,Jikei University School of Medicine | Gomyo I.,Saito Yukoukai Hospital | Gomyo I.,Red Cross | Katakami N.,Institute of Biomedical Research and Innovation Hospital | And 4 more authors.
International Journal of Clinical Oncology | Year: 2015

Background: Breakthrough cancer pain typically has a rapid onset and relatively short duration. Due to this temporal profile, it may not be adequately relieved by oral opioid analgesics. The sublingual fentanyl orally disintegrating tablet is a formulation by which fentanyl can be rapidly absorbed across the oral mucosa producing rapid-onset analgesia, and which may be effective for breakthrough pain treatment. Methods: A multicenter, randomized, placebo-controlled, double-blind comparative study was conducted to evaluate the efficacy and safety of the sublingual fentanyl tablet at optimized doses for breakthrough pain treatment in cancer patients treated with strong opioid analgesics at fixed intervals. The optimal dose was determined by open-label dose titration. The efficacy and safety of a 12-week extended treatment were also evaluated. Results: Eleven of 42 subjects who received the sublingual fentanyl tablet experienced adverse drug reactions. Common reactions were somnolence, constipation, nausea, and vomiting. No serious adverse reactions occurred. Sublingual fentanyl tablets at optimal doses and placebo were administered to 37 subjects in a double-blinded manner. A significant analgesic effect of the sublingual fentanyl tablet was present compared to placebo at 30 min after administration. The sublingual fentanyl tablet was also effective and safe during extended treatment, in which changes in basal opioid doses as well as sublingual fentanyl tablet doses were made as needed. Conclusion: Sublingual fentanyl tablets at doses determined by titration were effective and safe for breakthrough pain treatment in cancer patients treated with strong opioid analgesics at fixed intervals. Extended treatment up to 12 weeks was also effective and safe. © 2014, Japan Society of Clinical Oncology.

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