Association between diffuse idiopathic skeletal hyperostosis and thoracic kyphosis in patients with cervical myelopathy: a retrospective observational study.

BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is a structural abnormality of the thoracic spine that is known to impair posture. However, the relationship between DISH and sagittal balance in the whole spine is unclear. The aims of this study were to investigate the prevalence of DISH in patients with cervical myelopathy caused by cervical ossification of the posterior longitudinal ligament (OPLL) or cervical spondylosis and to compare sagittal alignment of the spine between patients with and without DISH. METHODS: A total of 103 consecutive patients with a diagnosis of cervical myelopathy due to cervical OPLL or spondylosis were retrospectively enrolled in this single-center study. DISH was defined as an ossified lesion that was seen to be completely bridging at least four contiguous adjacent vertebral bodies in the thoracic spine on computed tomography scans. Cervical and spinopelvic sagittal parameters were measured in whole spine radiographs. RESULTS: The study population included 28 cases with DISH [DISH (+) group] and 75 without DISH [DISH (-) group]. OPLL was more prevalent in the DISH (+) group than in the DISH (-) group; however, there were no significant differences in other clinical findings. Propensity score matching produced 26 pairs. C7 slope, C2-7 sagittal vertical axis (C-SVA), whole thoracic kyphotic angles, upper thoracic kyphosis, and T5-T12 thoracic kyphosis values were significant higher in the DISH (+) group than in the DISH (-) group. There was no significant between-group difference in the other sagittal spinopelvic parameters. CONCLUSIONS: This study is the first to compare sagittal alignment in patients with cervical myelopathy according to whether or not they have DISH. Patients with DISH are more likely to have excessive kyphosis in the thoracic spine, a high C7 slope, and a high C2-7 SVA.

A Case Report of Successful Surgical Treatment of Removing an Inferior Vena Cava Filter / 日本心臓血管外科学会雑誌

Acute pulmonary embolism (PE), usually secondary to deep venous thrombosis (DVT), is a serious disease which may cause sudden death. An inferior vena cava filter (IVCF) is placed in certain circumstances to prevent recurrence of PE. However, some complications of IVCF have been reported and the indications of IVCF should be reviewed. We encounted a case of IVCF migration which required surgical removal through right intercostal thoracotomy. The patient was a 53-year-old woman. She had undergone the placement of IVCF for DVT followed by anticoagulant therapy. Eight days after, CT revealed IVCF migrated above renal veins. As percutaneous extraction was attempted unsuccessfully, the direct approach to remove IVCF between the hepatic vein and renal vein was indicated. Through the right side thoracotomy at the seventh intercostal space with the division of costal arch, the inferior vena cava (IVC) was exposed near the right atrium. The diaphragm was longitudinally divided straight to IVC and the liver was retraced anteriorly after the careful dissection of the venous plexus on the back of the liver. IVCF could be palpated and just below the branch of the caudate rami and above the right renal vein. After systemic heparinization, IVC and branches were clamped simply and IVC was incised longitudinally. The proximal tip of the IVCF dug into the intima and the distal hook penetrated the vein. IVCF was carefully removed and incision and penetration of IVC were repaired. Her postoperative course was unremarkable, and the patient was discharged without any complications.

Six Cases with ‘Honton’ Disease Successfully Treated with Combination of Goshuyuto Extract and Ryokeijutsukanto Extract / 日本東洋医学雑誌

We report six cases with honton disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (Zhouhou fang) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.

Six Cases with \lqHonton\rq Disease Successfully Treated with Combination of Goshuyuto Extract and Ryokeijutsukanto Extract / 日本東洋医学雑誌

We report six cases with honton disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (Zhouhou fang) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.

Six Cases with 'Honton' Disease Successfully Treated with Combination of Goshuyuto Extract and Ryokeijutsukanto Extract / 日本東洋医学雑誌

We report six cases with <I>honton</I> disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (<I>Zhouhou fang</I>) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.

Six Cases with 'Honton' Disease Successfully Treated with Combination of Goshuyuto Extract and Ryokeijutsukanto Extract / 日本東洋医学雑誌

We report six cases with <I>honton</I> disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (<I>Zhouhou fang</I>) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.

Two Cases of Chronic Hepatitis B Successfully Treated with Hochuekkito-go-Keishibukuryogan / 日本東洋医学雑誌

We successfully treated two chronic hepatitis B patients with Hochuekkito-go-Keishibukuryogan. Case 1 was a 27-year-old male diagnosed with chronic hepatitis B in 1998, who had received interferon (IFN) therapy. Liver function tests did not improve with this therapy. He visited the department of Japanese Oriental Medicine at Yukiguni-Yamato Hospital, complaining of fatigue, on **********. We initiated treatment with Hochuekkito-go-Keishibukuryogan. At two months of treatment, marked improvement in liver function tests was noted, with normalization of ALT, seroconversion (SC) and negative HBV-DNA. Case 2 was a 26-year-old male diagnosed with chronic hepatitis B in 2001 who had received IFN therapy. Seven months after termination of this therapy, on **********, he visited our department for a flare-up of hepatitis. Treatment with Hochuekkito-go-Keishibukuryogan was begun. Almost immediately, marked improvements were observed in the form of ALT and SC normalizations, and only slightly positive HBV-DNA.

Echocardiographic and surgical findings of spontaneous avulsion of the aortic valve commissure.

Spontaneous detachment of the aortic valve commissure (ie, avulsion of a commissure) is a rare cause of acute massive aortic regurgitation that follows a rapidly deteriorating clinical course. The aortic valve commissure between the non-coronary and right coronary cusps detached from the aortic wall in a 79-year old man with ascending aortic aneurysm. Emergency aortic valve replacement and aneurysmoplasty were successfully performed; histopathology of the aorta and aortic valve showed cystic medial necrosis and myxomatous degeneration, respectively. Preoperative transthoracic echocardiography showed an eccentric massive regurgitant jet at the site of the prolapsing cusps with a vegetation-like echodense mass, and transesophageal echocardiography showed the prolapsing non-coronary and right coronary cusps conjoined by the commissural tissue. It was the precise echocardiographic evaluation of the avulsion that enabled sucessful emergency aortic valve surgery.

A Case of Rheumatoid Arthritis with Malaise after Taking Methotrexate Treated with Toki-shakuyaku-san-ka-bushi / 日本東洋医学雑誌

We treated one rheumatoid arthritis (RA) patient with Toki-shakuyaku-san-ka-bushi. A 51-year-old woman was diagnosed as RA in another hospital and was treated with salazosulfapyridine (SASP) and methotrexate (MTX). She was living a restricted daily life while taking MTX. She had to lie down for almost 48 hours after taking MTX once a week because of general fatigue. She was also suffering from depression. After the administration of Toki-shakuyaku-san-ka-bushi, her malaise after taking MTX and her depressive-mood disappeared. Her quality of life improved measurably.

Five Cases of Chronic Headache Treated with Bukuryo-shigyaku-to (Fu-Ling-Si-Ni-Tang) / 日本東洋医学雑誌

The administration of Bukuryo-shigyaku-to has been effective in five cases of chronic headache. All five patients visited our department because of unsatisfactory results using Western medicine. They suffered from severe migraines with restlessness, and they were treated effectively with Bukuryo-shigyaku-to. In four of all cases (cases 1-4), symptoms and signs related to coldness were obvious, and especially cases 1 and 3 complained about undesirable coldness on their backs. It is suggested that Bukuryo-shigyaku-to can be useful against severe migraine with restlessness caused by exposure to strong coldness. Case 5 was initially thought to have a status of heat and excess, but the effect of Bukuryo-shigyaku-to revealed the existence of cold and deficiency. Case 5 emphasizes the importance of being aware of the possibility of hidden coldness and deficiency, and that Bukuryo-shigyaku-to can be useful in such a case.

A Case Report of the Use of Bukuryo-takusha-to(Fu-Ling-Ze-Xie-Tang) / 日本東洋医学雑誌

Repeated relapses of vomiting were treated with Bukuryo-takusha-to in a patient with resistant gastric ulcer. A 77-year-old woman, who had been admitted to our hospital due to manic disorder, presented tarry stool in February 1997. Gastrointestinal endscopy revealed an active gastric ulcer. The ulcer remained at the healing stage even after three years of treatment with H₂ receptor antagonist or proton pump inhibitor. She developed vomiting attacks in February 1998; thereafter, these vomiting episodes recurred repeatedly. During one three-day episode, she vomited the contents of breakfast every evening. Therefore, we regarded this attack as “ihon” from the view of Kampo diagnosis. After the administration of Bukuryo-takusha-to, the vomiting attacks disappeared within a day. The gastric ulcer then reached the scarring stage. In this patient, Bukuryo-takusha-to might have been effective in treating the resistant gastric ulcer as well as the recurring vomiting attacks.

Case Report of Seinetsu-hoketsu-to / 日本東洋医学雑誌

It is reported that the administration of Seinetsu-hoketsu-to has been effective in four cases of recurrent aphthous stomatitis. The literature states that Seinetsu-hoketsu-to is indicated for “blood deficiency and the combination of pathogenic dryness and heat in blood which causes ulceration or erosion with scaling pain in the tongue and oral mucosa, and its healing is often prolonged.” All four cases the patients are female. Their aphthous stomatitis is often exacerbated during pregnancy, childbirth, and/or each menstruation. In one case aphthous stomatitis reoccurred after the remission of general symptoms due to high fever and inflammation in the acute phase of Beçhet disease. The conclusion is that Seinetsu-hoketsu-to would be useful to patients with recurrent aphthous stomatitis in conditions where blood deficiency is worsening.