Ventral Schwannoma of the Thoracolumbar Spine

We report two patients with ventral schwannoma in the thoracolumbar region manifesting as low back pain with or without paraparesis. In both patients magnetic resonance imaging (MRI) revealed a heterogeneously-enhanced intradural extramedullary mass in the thoracolumbar region. The tumors were successfully removed via the posterior approach. Their histology was consistent with schwannoma. Postoperative MRI showed no evidence of a tumor in either patient. Spinal schwannomas are common benign intradural extramedullary spinal neoplasms; most arise from the dorsal- and very few from the anterior roots. A literature review revealed that ventral schwannomas, including giant tumors as in the one from case 2 in our study, affect mainly the cervical region, and most are surgically addressed via the posterior approach. Careful handling of the spinal cord is mandatory for satisfactory surgical results.

Multilineage Cells from Apical Pulp of Human Tooth with Immature Apex / Oral Science International

The human tooth with immature apex is a developing organ available for investigation. In this tooth, especially in the apical pulp, the proliferation and differentiation of various cells are activated to make a complete tooth. We investigated the notion that unique cells are included in the apical pulp of human tooth with immature apex. Human impacted third molars with immature apex freshly extracted for orthodontic reasons or treatment were obtained. Histological analyses revealed that BrdU-incorporating cells and cells positive for the mesenchymal stem cell markers SH2 and SH3 were located in the same region. The cells from the apical pulp of a human tooth with immature apex, designated here as apical pulp-derived cells (APDCs), can be cultured easily <i>in vitro</i> under ordinary serum-supplemented culture condition. The expression of surface markers of expanded APDCs is similar to that of bone marrow mesenchymal stem cells, except for CD49d (α4-integrin). APDCs differentiated into mineralized cells, adipocytes, chondroblasts and neural cells <i>in vitro</i>. APDCs have a high capacity for proliferation and multilineage potential <i>in vitro</i>. Our results indicate that human tooth with immature apex is a precious tissue source for the research of human adult stem cells and for the advancement of dental and regenerative medicine.

Obturator hernia in an ageing society

<p><b>INTRODUCTION</b>Obturator hernia is an important cause of small bowel obstruction and is associated with difficult diagnosis and high mortality.</p><p><b>MATERIALS AND METHODS</b>We reviewed 22 cases of intestinal obstruction due to obturator hernia that necessitated surgical intervention over the last 17 years and evaluated the changes in the number of patients based on the census data.</p><p><b>RESULTS</b>All cases were elderly females. The Howship-Romberg sign was present in 15 patients (68%). Computed tomography (CT) correctly diagnosed 13/15 (87%) of cases in which it was performed prospectively. The median time to surgery was 7.5+/-5.2 days for those patients with bowel resection, compared to 0.8+/-1.3 days for those without (P <0.05). The number of patients with obturator hernia has increased with an ageing society.</p><p><b>CONCLUSIONS</b>The rising incidence of obturator hernia is probably linked to an ageing society. CT of the pelvis was helpful in obtaining the correct diagnosis. The shorter the delay between admission and surgery, the lower the bowel resection rate. Laparotomy at an early stage is recommended in such patients as it leads to reduced morbidity and mortality.</p>

Observation on The Plethysmogramm of The Allen Test and its Clinical Significance in Cervical Syndrome / 全日本鍼灸学会雑誌

Among several manual examinations in cervical syndrome, there is a typical test called ‘Allen Test’ connected with hypertonus in the scalene muscles. We evaluated the clinical effectiveness of this test in cervical syndrome.<br>Both the positive group in the Allen test and the healthy group were examined with the plethysmogramm at the finger tips. As a result, in comparison with the healthy group, the positive group showed a low pulse wave. As their syndrome was improved clinically, their pulse wave heights were also improved.<br>It was thought that the Allen test was valuable to both the clinical test in cervical syndrome and the decisive test in a recovery from this syndrome.