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Yamatotakada, Japan

Koizumi M.,Nara Medical University | Iida J.,Nara Medical University | Shigematsu H.,Yamatotakada Municipal Hospital | Satoh N.,Higashi Osaka Municipal Hospital | And 5 more authors.
Asian Spine Journal | Year: 2012

An 80-year-old woman presented with neck pain and paraparesis of Frankel C in her upper and lower extremities after falling. Imaging revealed an ankylosing cervical spine and a fracture line running obliquely from the anterior C3-4 to the posterior C4-5 level. Posterior fixation from the occi pit to T3 was performed using the RRS Loop Spine System and concomitant polyethylene tape fixation. This system is characterized by the uniqueness of how it screws to the occi pit and its use of a fixation rod with a larger diameter than in other instrumentation devices for use in the cervical region. Sublaminar banding using polyethylene tape was used to secure fixation. Her postoperative course was unremarkable, and her neck pain was relieved, although neurological improvement was minor. To our knowledge, this is the first report of an application of the RRS Loop Spine System to an ankylosing spondylitis patient with a cervical fracture. © 2012 by Korean Society of Spine Surgery.

Yamashiro H.,Kure Medical Center Chugoku Cancer Center | Takada M.,Kyoto University | Nakatani E.,Translational Research Informatics Center | Imai S.,Kurashiki Central Hospital | And 21 more authors.
International Journal of Clinical Oncology | Year: 2014

Background: Bone metastasis (BM) is important for studying systemic spread of breast cancer. It often causes skeletal-related events (SREs) that worsen quality of life. We investigated the prevalence and risk factors for BM and SRE using a dataset from the Breast Oncology Research Network (BORN) in Japan.Patients and methods: We collected data on primary breast cancer patients with node-positive or node-negative disease at intermediate to high risk of recurrence. The risk factors affecting the BM-free rate, SRE-free rate and overall survival were analyzed by using the Cox proportional hazard model.Results: Data of 1,779 patients who were diagnosed with breast cancer during 2003–2005 were collected from the BORN and 1,708 cases were used for analysis. The median follow-up duration was 5.71 years. BM developed in 193 cases (11.3 %) and the BM-free rate at 5 years was 89.2 %. The annual hazard ratio of BM development differs remarkably according to the tumor subtype. SREs occurred in 133 (68.9 %) out of 193 patients and the SRE-free rate at 5 years was 92.6 %. In the multivariate analysis, clinical stage (P < 0.0001), number of lymph node (LN) metastases (P = 0.0029), tumor subtype (P = 0.034) and progesterone receptor status (P = 0.038) were independently significant risk factors for BM-free rate, but only clinical stage (P < 0.0001) and number of LN metastases (P = 0.0004) significantly correlated with SRE-free rate.Conclusions: This retrospective study clarifies the prevalence and risk factors for BM and SRE in Japanese breast cancer patients. Our results show the importance of considering subtype in the care of BM and SRE. © 2013, Japan Society of Clinical Oncology.

Shigematsu H.,Yamatotakada Municipal Hospital | Yoneda M.,Yamatotakada Municipal Hospital | Tanaka Y.,Nara Medical University
Asian Spine Journal | Year: 2014

We report a very rare case of negative pressure pulmonary edema (NPPE) that occurred immediately after anterior cervical discectomy and fusion (ACDF). The patient was a 25-year-old man who sustained a facet fracture-dislocation of C5 during a traffic accident. After ACDF, he developed NPPE and needed mechanical ventilation. Fortunately, he recovered fully within 24 hours. NPPE is a rare postoperative complication that may occur after cervical spine surgery. The aims of this report are to present information regarding the diagnosis and emergent treatment of NPPE, and to review the previous literature regarding this serious complication. © 2014 by Korean Society of Spine Surgery.

Yoh T.,Yamatotakada Municipal Hospital | Yoh T.,Kyoto University | Okamura R.,Yamatotakada Municipal Hospital | Nakayama H.,Yamatotakada Municipal Hospital | And 3 more authors.
Clinical Journal of Gastroenterology | Year: 2014

Multicystic biliary hamartoma (MCBH) is a rare cystic disease of the liver. A 69-year-old man was referred to our hospital with radiographic abnormality. Physical examination of the patient was unremarkable, and he denied any previous medical, travel, or surgical history. An abdominal computed tomography (CT) scan demonstrated a 3-cm low-density lesion in segment 3 of the liver, with dilation of the intrahepatic bile duct. The peripheral site of this lesion was slightly enhanced in the arterial phase. In the portal phase, the peripheral site was enhanced more clearly and showed a honeycomb-like dilated bile duct. Ultrasonography also revealed that the lesion was an irregularly shaped mass. On magnetic resonance imaging (MRI), T1-weighted images revealed a low-density mass and T2-weighted images revealed a dappled-density mass with honeycomb-like dilated bile duct and dilation of major intrahepatic bile duct. The patient was diagnosed with intrahepatic cholangiocarcinoma (ICC) and underwent left hepatectomy. However, pathological findings revealed that the lesion was MCBH. Our case highlights the potential difficulties in differentiating between MCBH and ICC under such circumstances. © 2014, Springer Japan.

Yoh T.,Kyoto University | Kato T.,Yamatotakada Municipal Hospital | Hirohata Y.,Yamatotakada Municipal Hospital | Nakamura Y.,Yamatotakada Municipal Hospital | And 2 more authors.
Clinical Journal of Gastroenterology | Year: 2016

Cholangiolocellular carcinoma (CoCC) is a rare malignant liver tumor derived from hepatic progenitor cells, which exist in the canals of Hering. We encountered a case of CoCC with an extremely poor clinical course, initially showing abnormally elevated serum alfa-fetoprotein (AFP). A 72-year-old male presented with a liver tumor and abnormally elevated serum AFP levels (16,399 ng/ml). We preoperatively diagnosed hepatocellular carcinoma and performed extended right hepatectomy, after which the serum AFP levels remarkably decreased to 97 ng/ml. Postoperatively, the disease was pathologically diagnosed as CoCC. Furthermore, immunohistochemical pathological findings were alcian blue negative, cytokeratin (CK) 7 partially positive, CK19 positive, hepatocyte paraffin-1 negative, membranous negative for epithelial membrane antigen, and AFP negative. Fifty-five days later, intra- and extrahepatic recurrence developed, and the patient died 65 days after surgery. Although CoCCs show favorable outcomes, these characteristics of our case were not previously reported. It is necessary to accumulate more information on CoCC. © 2016, Japanese Society of Gastroenterology.

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