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61.
Chieko Nakamura Yoshiharu Kawaguchi Hirokazu Ishihara Hiroshi Sainoh Tomoatsu Kimura 《Journal of orthopaedic science》2004,9(6):629-634
We report two cases of rheumatoid arthritis (RA) with upper thoracic myelopathy and a review of the literature. Clinical data of a 47-year-old woman (case 1) and a 54-year-old woman (case 2) are described. Case 1 showed a transverse-type myelopathy at the T2 segment level of the spinal cord and case 2 had the same type of myelopathy at the T4 segment level. Case 1 had anterior vertebral subluxation of C7 due to marked vertebral collapse and Case 2 had subluxation of T2 with vertebral destruction. These two patients had the mutilating type of RA with multilevel spontaneous fusion in the cervical spine. The lesions in the thoracic spine might be caused by the severe destructive inflammation that is characteristic in mutilating disease. The vertebral collapse might lead to subluxation of the upper thoracic vertebra, resulting in spinal cord compression. Upper thoracic subluxation might be caused by vertebral collapse due to RA and the increased motion as a compensation for decreased mobility caused by spontaneous fusion in the cervical spine. 相似文献
62.
63.
When stimulating the mixed nerve to record evoked potential, both sensory and motor fibers are activated before entering the spinal cord. The N10 potential has been described as an antidromic motor evoked potential based on results obtained by recording at the anterior midneck. In the present study, we examined the changes in latencies of Erb's potential, N10, and N13 by stimulating the median nerve distally at the wrist and proximally at the elbow. The conduction velocity of N10 calculated by the difference between N10 latencies at the two stimulation points was consistent with motor conduction velocity, although N13 conduction velocity estimated by the same method reflected a sensory conduction velocity. A positive relation was also observed between the indirect latency from the stimulation point to the anterior root as calculated using the equation (F - M - 1) / 2 (ms) and the direct latency to the negative peak of the N10 potential. Our data support the notion that N10 represents antidromic motor potential originating in the spinal entry zone of the anterior root. 相似文献
64.
Y Matsuki K Suzuki M Hara A Kitani T Hirose M Harigai M Kawakami N Tanaka M Kawagoe H Nakamura 《Ryūmachi》1992,32(2):154-9; discussion 159-62
Arterial thrombosis is one of the major symptoms of antiphospholipid syndrome (APS). However, thrombosis in a primary branch of the aorta has rarely been reported in APS. We report here a case of APS complicated by thromboses in both the left subclavian artery and the left external iliac vein. A 32-year-old woman was admitted in May, 1990 complaining of no pulse in the left superficial arteries (e.g., left radial artery) for the past 5 years and acute swelling of the left lower extremity. A left ascending phlebography showed an occlusion of the external iliac vein and arteriography revealed obstruction in the left subclavian artery. Collateral circulations were developed at the site of each thrombus. Clotting and immunological studies revealed a prolonged APTT, a high titer of anticardiolipin antibody and lupus anticoagulant positive. We ruled out various diseases and clinical risk factors predisposing to both arterial and venous thromboses. Accordingly, we concluded that both thromboses were based on APS. Following treatment with anticoagulants, aspirin and corticosteroid, the swelling of her left thigh was diminished and the antibody titer was decreased within 3 months. 相似文献
65.
S. M. Manzurul Haque Kai Chen Noriaki Usui Yasuhiko Iiboshi Hiroomi Okuyama Akira Masunari Riichiro Nezu Yoji Takagi Akira Okada 《Surgery today》1997,27(6):500-505
The purpose of this study was to investigate the intestinal hemodynamics and gut glutamine metabolism during endotoxemia,
and their correlation with altered intestinal absorptive capacity and permeability. Seventeen Sprague-Dawley rats were used
in the study. The endotoxin group (ENDO) recieved endotoxin (10 mg/kg intraperitoneally,n=9), while the control group (CONT,n=8) received saline injection. Twelve hours later, D-xylose (0.5 g/kg) and fluorescein isothiocyanate-dextran (FITC-dextran,
750 mg/kg) were given by oral gavage. One hour later abdominal aortic (AA) blood flow, superior mesenteric venous (SMV) flow,
mean arterial pressure (MAP), central venous pressure (CVP), and SMV pressure (SMVP) were also measured. The MAP, AA, and
SMV blood flow decreased (P<0.05), while the CVP and SMVP increased (P<0.05) in the ENDO group as compared with the CONT group. The ENDO group showed significant decreases for both intestinal
glutaminase activity and net intestinal glutamine uptake (P<0.05). The D-xylose concentration in SMV decreased significantly (P<0.05) in the ENDO group as compared with the CONT group. However, the plasma FITC-dextran concentration showed no significant
difference between the groups. Endotoxin produced a hypodynamic effect in rats 12h after intraperitoneal administration in
association with both a decreased intestinal glutamine metabolism and an absorptive capacity. 相似文献
66.
T. Terada H. Matsumoto Y. Nakamura Y. Kinoshita E. Nakai K. Nakai T. Itakura 《Neuroradiology》1996,38(7):615-617
A transjugular snare technique was used to retrieve a stretched, residual mechanical detachable coil which extended from
the cavernous sinus to the femoral vein, obliterating the transpetrosal route for further embolisation. The coil was snared
by a microguidewire. Our new technique is described in this paper.
Received: 19 April 1995 Accepted: 31 July 1995 相似文献
67.
Fumitaka Nakamura Jan Kvasnicka Micheline Levame Franoise Lange Hassan Bousbaa Herbert J. Geschwind 《Lasers in surgery and medicine》1993,13(4):412-420
This study was designed to examine the acute response of normal arterial wall to pulsed laser irradiation. Irradiation with an Excimer or a Holmium YAG laser was performed in 15 normal iliac sites of 8 male New Zealand white rabbits. The excimer laser was operated at 308 nm, 25 Hz, 50 mj/mm2/pulse, and 135 nsec/pulse and the Ho:YAG laser was operated at 2.1 μm, 3.5 Hz, 400 mj/ pulse, 250 μsec/pulse. The excimer and Ho:YAG laser were coupled into a multifiber wire-guided catheter of 1.4 and 1.5 mm diameter, respectively. The mean luminal diameter increased similarly from 2.01 ± 0.29 to 2.46 ± 0.27 mm (P < 0.0005) and from 2.09 ± 0.53 to 2.45 ± 0.30 mm (P < 0.005) after excimer and Ho:YAG laser irradiation, respectively. Perforation occurred in 3 of 15 Ho:YAG irradiated sites and 0 of 15 excimer laser irradiated sites. The sites irradiated with excimer or Ho:YAG laser had similar histologic features, consisting of shedding of the endothelium, disorganization of internal elastic lamina, localized necrosis of vascular smooth muscle cells, and fissures in the medial layer. However, the sites irradiated with excimer laser had lower grading scores than those irradiated with the Ho:YAG laser (P<0.05). Irradiation with excimer or Ho:YAG laser of normal arteries results in: (1) vasodilation of the irradiated artery; (2) localized mechanical vascular injury, and (3) Ho:YAG laser induces more severe damage to the arterial wall than excimer. © 1993 Wiley-Liss, Inc. 相似文献
68.
K Matsuda Y Kiyota N Tamura M Takahashi H Miki H Suzuki Y Nakagawa Y Satou M Noda T Nakamura 《Kyobu geka. The Japanese journal of thoracic surgery》1990,43(5):389-391
A 64-year-old man, who had an aneurysm of aortic arch associated with the aberrant right subclavian artery, was treated successfully. He was pointed out to have an aneurysm of aortic arch three years ago. Three years later angiograms and computed tomography revealed that it became larger compared with the initial finding. He underwent a replacement of the aortic arch using a woven Dacron graft under open distal method. Aberrant subclavian artery was not involved in the aneurysm. But because the left subclavian artery was involved in it, a woven Dacron graft was interposed between the ascending aorta and left subclavian artery. Postoperative course was uneventful and there were no complications. 相似文献
69.
T Yamaga H Nakamura N Sugiyama Y Yoshino S Morio 《Kyobu geka. The Japanese journal of thoracic surgery》1990,43(6):462-466
We reported three cases of spontaneous rupture which were surgically treated with direct suture method. One patient was operated on within eight hours after rupture with good results. In two patients diagnoses were made more than two days after rupture. One had esophageal fistula, but completely recovered after cervical oesophageal fistula, and another died of multiple organ failure. In this syndrome, early diagnosis and surgical treatment are essential for acceptable results. For early diagnosis, we emphasized on the presence of roentgenologic mediastinal and cervical emphysema. In patients for whom diagnosis was delayed and post-operative leakage at the oesophageal suture line occurred, temporarily fistulation of the cervical oesophagus proved to be effective in exclusion and diversion of the ruptured segment. 相似文献
70.
Hiroyuki Ishizu Masatoshi Takahashi Yukifumi Kondo Akihiko Kataoka Takashi Nakamura Kuniaki Okada Hiroyuki Masuko Yasunori Nishida Hideaki Ogawa Ryoji Yokoyama Yutaka Kimura 《Surgery today》1997,27(3):285-287
Magnetic resonance cholangiopancreatography (MRCP) was performed in 35 patients to evaluate the feasibility of its use as a postsurgical imaging technique after resection of the pancreas. The surgical procedures performed were: pancreatoduodenectomy in 22 patients, segmental pancreatectomy in 1, distal pancreatectomy in 7, and pyroluspreserving pancreatoduodenectomy in 5. The pancreatic duct was shown in its entirety in 24 of the 35 patients (68.6%) and was partially visualized in 8 patients (22.9%), but the intrahepatic and extrahepatic bile ducts were visualized completely in all patients. Furthermore, MRCP was able to demonstrate lesions in 3 of 6 patients who had shown clinical evidence of recurrence. The visualization of the pancreatic and bile duct system was satisfactory despite anatomical changes brought about by resection of the pancreas. Thus, we conclude that MRCP is an appropriate follow-up screening test for patients with suspected abnormalities of the biliary and pancreatic duct system. 相似文献