Thoracic spondylotic myelopathy presumably caused by diffuse idiopathic skeletal hyperostosis in a patient who underwent decompression and percutaneous pedicle screw fixation.

A 74-year-old man developed bilateral lower limb spastic paresis. He was diagnosed with thoracic spondylotic myelopathy presumably caused by mechanical stress that was generated in the intervertebral space (T1-T2) between a vertebral bone bridge (C5-T1) due to diffuse idiopathic skeletal hyperostosis after anterior fixation of the lower cervical spine and a vertebral bone bridge (T2-T7) due to diffuse idiopathic skeletal hyperostosis in the upper thoracic spine. Treatment included posterior decompression (T1-T2 laminectomy) and percutaneous pedicle screw fixation at the C7-T4 level. Six months after surgery, the patient could walk with a cane, and the vertebral bodies T1-T2 were bridged without bone grafting. For thoracic spondylotic myelopathy associated with diffuse idiopathic skeletal hyperostosis, decompression and percutaneous pedicle screw fixation are effective therapies.

Effects of partial body-weight support and functional electrical stimulation on gait characteristics during treadmill locomotion: Pros and cons of saddle-seat-type body-weight support.

Robotic therapy for rehabilitation of the lower extremity is currently in its early stage of development. Aiming at exploring an efficacious intervention for gait rehabilitation, we investigate the characteristics of an end-effector gait-training device that combines saddle-seat-type body-weight-supported treadmill training with functional electrical stimulation (FES). This is a task-oriented approach to restoring voluntary control of locomotion in patients with neuromuscular diseases. We evaluate the differences between walking with saddle-seat-type support and with harness-type support, in terms of personal preference, the preferred walking speed, profiles of kinematics and ground reaction force, and the effectiveness of FES. The results indicate that the proposed gait-training device maintains subjects in a natural posture and supports important gait functions such as hip extension and ankle push-off effectively, in particular, at slow walking speed.

Development of tumor-specific caffeine-potentiated chemotherapy using a novel drug delivery system with Span 80 nano-vesicles.

In recent years, chemotherapy with caffeine has manifested potently high efficacy against osteosarcoma, although adverse effects have been observed. Recently, we developed a novel drug delivery system (DDS) with nonionic vesicles prepared from Span 80 which have promising physicochemical properties as an attractive possible alternative to commonly used liposomes. Herein, we demonstrated that tumor-specific caffeine-potentiated chemotherapy for murine osteosarcoma administered by a novel DDS with Span 80 nano-vesicles showed significant antitumor effects as well as limited adverse effects. The osteosarcoma cell line, LM8, was transplanted into C3H/HeJ mice which then were administered therapeutic agents. Ifosfamide (IFO) was employed as well as caffeine as an enhancer. Span 80 vesicles containing IFO and/or caffeine were freshly prepared. On days 0, 2 and 4, different combinations of the agents were administered to mice: IFO alone (direct i.v.), IFO vesicles (IV), IV+caffeine, IV+caffeine vesicles (CV), PBS alone vesicles (PV), and PBS alone as negative control (PBS i.v.). Then, the mice were sacrificed on day 7. Antitumor effects of the reagents were also analyzed in vitro. Moreover, fertility examination was performed. In vitro, a combination of IV+CV showed significant induction of apoptosis in the early phase. Tumor volumes in the IV+CV group were significantly reduced compared with the other groups. Histological analyses showed that the IV and IV+CV groups had significantly lower viable tumor areas. The IFO direct i.v. group showed a certain grade of renal injury as well as marked suppression of spermatogenesis, while the IV or IV+CV group showed no marked changes. The fertility test revealed that the male mice with IV+CV administration had normal fertility, and no malformations were detected in their progeny. This DDS model is of potential importance for clinical application in the therapy of metastatic osteosarcoma.

[Prediction of lateral lymph node metastasis by magnetic resonance imaging].

PURPOSE: Considering the advantages and disadvantages of lateral lymph node dissection in patients with advanced lower rectal cancer, it would be ideal to select candidates for lateral lymph node dissection by preoperative imaging study including magnetic resonance imaging(MRI). We have reported that the cut-off value of minimal diameter of lateral lymph node could be set at 6 mm for indication of lateral lymph node dissection. In the present study, we evaluated whether it would be appropriate to apply the cut-off value of minimal diameter of lateral lymph node in MRI. PATIENTS AND METHODS: Forty-four patients with advanced lower rectal cancer underwent a curative surgery with lateral lymph node dissection or sampling from 1997 to 2009 in our institute. Among them, 25 patients received MRI preoperatively and analyzed. The images were obtained by a sagittal method that was diagonal along sacro-iliac joint with 5 mm thick sections. RESULTS: Lateral lymph node metastasis was detected in 5 cases, one side in 4 cases and both sides in 1 case. The sensitivity, specificity, positive predict value, and accuracy for predicting metastasis was 50%, 90%, 42.9% and 84.8% respectively, when the cut-off value of the minimal diameter was set at 6 mm in MRI. CONCLUSIONS: Our results indicated that a 6 mm set as the cut-off value of minimal diameter of lateral lymph node was suitable for the prediction of lateral lymph node metastasis since the accuracy was relatively high (84.8%), though it was hardly to detect metastatic lymph node less than 6 mm.

High-resolution computed tomography findings of P. westermani.

Paragonimiasis westermani, or Oriental lung fluke, is a common parasitic zoonosis, which is acquired from eating the flesh of wild boar or freshwater crabs. After being ingested by humans, the larvae of P. westermani migrate across small intestinal mucosa into the intra-abdominal space, and then finally into to the pleural space and lung parenchyma. High-resolution CT findings of P. westermani consist of worm cysts, migration track, peripheral density, bronchial wall thickening, and centrilobular nodules, which prompt serological tests and detection of eggs in sputum or BAL fluid for definitive diagnosis.

[Relationship between effectiveness of hepatic artery injection chemotherapy and serum VEGF].

Elevated plasma VEGF levels were reported in patients with colorectal cancer. This report presents regarding VEGF in patients who underwent hepatic artery injection chemotherapy (TAI) for liver metastasis of colorectal cancers. Thirty patients who underwent TAI for liver metastases of colorectal cancer during January 2002 to March 2003 were studied. Their serum CEA, CA19-9, and plasma VEGF were measured, and the relationships between these, their doubling times (DT) and therapeutic efficacy were examined. While the detected values and DTs were not considered significant, the tendency for DT to be the same was observed. One case with negative CEA and CA19-9 had high VEGF but negative VEGF-DT, which is compatible with therapeutic effects (PR). It appears that VEGF is a parameter that changes without direct correlation to CEA or CA19-9, and that VEGF may possibly be used as a therapeutic marker for cases with negative CEA or CA19-9.

[Short-term intraperitoneal infusion of cisplatin and OK-432 for a case of malignant mesothelioma of the peritoneum].

A case of malignant mesothelioma of the peritoneum successfully treated with short-term intraperitoneal chemotherapy is reported. A 67-year-old woman underwent laparotomy for ascending colon cancer. During, laparotomy, numerous mucoid nodules were found on the peritoneal surface, even though the colonic tumor did not invade the serosa. Ileocecal resection (D1) with partial omentectomy was performed. Intraperitoneal infusion with cisplatin (200 mg) was started immediately after surgery and additional cisplatin (150 mg) was administered with OK-432 (30KE). The serum level of CA125 rapidly decreased after the chemotherapy, and was normalized 3 months postoperatively. The histological diagnosis of the peritoneal lesions was malignant mesothelioma of the peritoneum (diffuse type). The patient is living without any evidence of recurrence 10 months postoperatively. These results suggest that this short-term chemotherapy is worth trying in cases of malignant mesothelioma of the peritoneum.

Minute pulmonary meningothelial-like nodules: high-resolution computed tomography and pathologic correlations.

Minute pulmonary meningothelial-like nodules (MPMNs), previously known as minute pulmonary chemodectomas, are relatively rare lesions. They are small (1-3 mm) and often multiple. Pathologically, they represent an interstitial nodular proliferation of small oval or spindle-shape cells arranged in a "zellenballen" nesting pattern. The function and origin of the cells are unknown. These nodules are associated with specific conditions, including thromboembolism, cardiac disease, and malignancy. We describe a patient with MPMNs and adenocarcinoma of the lung in whom HRCT showed tiny (1-3 mm in diameter) nodules of ground-glass attenuation.