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1.
Acta Neurochir (Wien) ; 160(12): 2479-2484, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30377830

RESUMO

Superficial radial intraneural ganglion cysts are rare. Only nine previous cases have been described. We provide two examples with a wrist joint connection and review the literature to provide further support for the unifying articular (synovial) theory for the pathogenesis and treatment of intraneural ganglia.


Assuntos
Cistos Glanglionares/cirurgia , Punho/cirurgia , Adulto , Feminino , Cistos Glanglionares/diagnóstico por imagem , Cistos Glanglionares/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Punho/diagnóstico por imagem , Punho/patologia
2.
Acta Med Okayama ; 70(4): 261-8, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27549670

RESUMO

Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome) is a rare systemic vasculitis and is difficult to diagnose. EGPA has a number of symptoms including peripheral dysesthesia caused by mononeuropathy multiplex, which is similar to radiculopathy due to lumbar disc hernia or lumbar spinal stenosis. Therefore, EGPA patients with mononeuropathy multiplex often visit orthopedic clinics, but orthopedic doctors and spine neurosurgeons have limited experience in diagnosing EGPA because of its rarity. We report a consecutive series of patients who were initially diagnosed as having lumbar disc hernia or lumbar spinal stenosis by at least 2 medical institutions from March 2006 to April 2013 but whose final diagnosis was EGPA. All patients had past histories of asthma or eosinophilic pneumonia, and four out of five had peripheral edema. Laboratory data showed abnormally increased eosinophil counts, and nerve conduction studies of all patients revealed axonal damage patterns. All patients recovered from paralysis to a functional level after high-dose steroid treatment. We shortened the duration of diagnosis from 49 days to one day by adopting a diagnostic algorithm after experiencing the first case.


Assuntos
Algoritmos , Granulomatose com Poliangiite/diagnóstico , Degeneração do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/diagnóstico , Estenose Espinal/diagnóstico , Idoso de 80 Anos ou mais , Feminino , Granulomatose com Poliangiite/patologia , Humanos , Degeneração do Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/patologia , Masculino , Pessoa de Meia-Idade , Estenose Espinal/patologia
3.
J Neurosurg ; 124(1): 264-8, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26207601

RESUMO

The aim of this study was to report the feasibility of robotic intercostal nerve harvest in a pig model. A surgical robot, the da Vinci Model S system, was installed after the creation of 3 ports in the pig's left chest. The posterior edges of the fourth, fifth, and sixth intercostal nerves were isolated at the level of the anterior axillary line. The anterior edges of the nerves were transected at the rib cartilage zone. Three intercostal nerve harvesting procedures, requiring an average of 33 minutes, were successfully performed in 3 pigs without major complications. The advantages of robotic microsurgery for intercostal nerve harvest include elimination of physiological tremor, free movement of joint-equipped robotic arms, and amplification of the surgeon's hand motion by as much as 5 times. Robot-assisted neurolysis may be clinically useful for intercostal nerve harvest for brachial plexus reconstruction.


Assuntos
Nervos Intercostais/cirurgia , Transferência de Nervo/métodos , Procedimentos Neurocirúrgicos/instrumentação , Procedimentos Neurocirúrgicos/métodos , Procedimentos Cirúrgicos Robóticos , Suínos/fisiologia , Animais , Plexo Braquial/cirurgia , Estudos de Viabilidade , Microcirurgia/instrumentação , Microcirurgia/métodos , Procedimentos Cirúrgicos Reconstrutivos , Sus scrofa , Tórax
4.
Biomed Res Int ; 2015: 713952, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26583128

RESUMO

Incidences of cervical laminoplasty in the elderly are increasing; the influence of other age-related complications and neurological status must be considered for justifying surgery. This study identified the aforementioned influence on long-term outcomes of cervical laminoplasty in patients aged ≥75 years. Thirty-seven of 38 consecutive patients aged ≥75 years who underwent cervical laminoplasty were retrospectively evaluated. Minimum 5-year follow-up was acceptable if patients were complication-free. Follow-up was terminated when neurological evaluation was not possible, owing to death or other serious complications affecting activities of daily living (ADL). Postoperative neurological changes and newly developed severe complications were investigated. Postoperatively, one patient died of acute pneumonia, one remained nonambulatory owing to cerebral infarction, and 35 were ambulatory and were discharged. At a mean follow-up of 78 months, three patients died and nine developed serious complications severely affecting ADL. Of the 25 remaining patients, 23 remained ambulatory at mean follow-up of 105 months. Cox proportional hazard analysis revealed that postoperative motor upper and lower extremities JOA scores of ≤2 and ≤1, respectively, were risk factors for mortality or other severe complications. Postoperative neurological status can be maintained in the elderly if they remain complication-free. Poorer neurological status significantly affected their ADL and mortality.


Assuntos
Medula Cervical/cirurgia , Vértebras Cervicais/fisiopatologia , Laminoplastia , Doenças da Medula Espinal/cirurgia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Medula Cervical/fisiopatologia , Vértebras Cervicais/cirurgia , Feminino , Humanos , Laminectomia , Masculino , Modelos de Riscos Proporcionais , Doenças da Medula Espinal/fisiopatologia , Resultado do Tratamento
5.
Asian Spine J ; 9(4): 595-9, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26240720

RESUMO

Although several cases of a dumbbell tumor of thoracic nerve roots have been reported, reports on the surgical procedures for a dumbbell tumor of the first thoracic (T1) nerve root are rare. Surgeons should be cautious, especially when performing a surgical procedure for a dumbbell tumor of the T1 nerve root because the tumor is anatomically located adjacent to important organs and because the T1 nerve root composes the lower trunk of the brachial plexus with the eighth cervical nerve root. We present cases with dumbbell tumors of the T1 nerve root that were treated with combined surgical treatment to remove the tumor. We first performed video-assisted thoracic surgery (VATS) to release the organs anteriorly and then performed posterior spinal surgery in the prone position. The combined VATS and posterior spinal surgery may become a standard surgical procedure for the treatment of dumbbell tumors of the T1 nerve root.

6.
Nihon Rinsho ; 72(2): 240-3, 2014 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-24605521

RESUMO

The number of labor accident casualties between 2003 and 2012 has ranged from 110,000 to 130,000 per year in Japan. Japan Advanced Trauma Evaluation and Care (JATEC) program was established for major trauma and has been developed in emergency rooms. Surgical intervention to fractures in extremities includes various methods such as internal fixation with plates and screws including locking compression plate system, interlocking nailing system and external fixation. Definitive treatment for spinal cord injury is still unsolved. Cell transplantation therapy using iPS cells is anticipated to be applied clinically. Some problems still remain in the certification criteria for residual disabilities caused by labor accidents. The criteria should be revised at some early date.


Assuntos
Sistema Musculoesquelético/lesões , Traumatismos Ocupacionais , Humanos , Traumatismos Ocupacionais/cirurgia
7.
J Proteome Res ; 8(10): 4766-78, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19658438

RESUMO

The inducible genes and proteins were analyzed using transcriptome and proteome techniques to explore the mechanisms underlying soybean response to flooding stress. Soybean seedlings were germinated for 2 days and subjected to flooding for 12 h, and the total RNAs and proteins were extracted from the root and hypocotyl. High-coverage gene expression profiling analysis as transcriptome technique was performed. Ninety-seven out of the 29,388 peaks observed demonstrated a greater than 25-fold change following 12 h of flood-induced stress. Furthermore, 34 proteins out of 799 proteins were changed by 12 h stress. Genes associated with alcohol fermentation, ethylene biosynthesis, pathogen defense, and cell wall loosening were significantly up-regulated. Hemoglobin, acid phosphatase, and Kunitz trypsin protease inhibitor were altered at both transcriptional and translational levels. Reactive oxygen species scavengers and chaperons were changed only at the translational level. It is suggested that the early response of soybean under flooding might be important stress adaptation to ensure survival against not only hypoxia but also the direct damage of cell by water.


Assuntos
Perfilação da Expressão Gênica/métodos , Proteínas de Plantas/metabolismo , Proteômica/métodos , Soja , Estresse Fisiológico , Álcoois/metabolismo , Inibidores de Cisteína Proteinase , Eletroforese em Gel Bidimensional , Etilenos/metabolismo , Inundações , Regulação da Expressão Gênica de Plantas , Redes Reguladoras de Genes , Genes de Plantas , Glucosiltransferases/metabolismo , Proteínas de Choque Térmico/metabolismo , Hipocótilo/metabolismo , Chaperonas Moleculares/metabolismo , Proteínas de Plantas/classificação , Proteínas de Plantas/genética , Raízes de Plantas/metabolismo , Proteoma/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Soja/genética , Soja/metabolismo , Fatores de Tempo
8.
J Proteome Res ; 8(7): 3539-48, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19489578

RESUMO

The Soybean Proteome Database aims to be a data repository for functional analyses of soybean responses to flooding injury, recognized as a major constraint for establishment and production of this plant. The current release contains 21 reference maps of soybean (Glycine max cv. Enrei) proteins electrophoresed on two-dimensional polyacrylamide gels of which the samples were collected from several organs, tissues and organelles. These reference maps include 7311 detected proteins and 532 identified proteins, or proteins for which a sequence or peptide peak has been determined. The database is searchable by protein properties such as accession number, description and isoelectric point and molecular weight range. The Soybean Proteome Database also integrates multiple "omes". An omics table reveals relationships among 106 mRNAs, 51 proteins and 89 metabolites that vary over time under flooding stress. The tabulated metabolites are anchored to a metabolome network. A unified temporal-profile tag attached to the mRNAs, proteins and metabolites facilitates retrieval of the data based on the temporal expression profiles. A graphical user interface based on dynamic HTML facilitates viewing the metabolome network as well as the profiles of multiple omes in a uniform manner. The entire database is available at http://proteome.dc.affrc.go.jp/Soybean/.


Assuntos
Proteínas de Plantas/química , Proteômica/métodos , Soja/química , Arabidopsis/metabolismo , Bases de Dados de Proteínas , Eletroforese em Gel Bidimensional , Internet , Espectrometria de Massas/métodos , Metaboloma , Modelos Biológicos , Mapeamento de Peptídeos/métodos , Estrutura Terciária de Proteína , Proteoma , RNA Mensageiro/metabolismo , Fatores de Tempo
9.
J Spinal Disord Tech ; 18(2): 200-2, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15800443

RESUMO

A case of pelvic ring reconstruction with a vascularized pedicle iliac bone graft for removal of a huge sacral schwannoma is reported. It is necessary to reconstruct a pelvic ring when its integrity is impaired. Spinal instrumentation is essential for a temporary stability of the pelvic ring in the course of complete healing, which at times results in instrumentation failure. Several cases of pelvic ring reconstruction using vascularized fibular bone grafts have also indicated positive results attributable to their good blood circulation, but techniques with them are relatively complicated. We applied a vascularized pedicle iliac bone graft to the pelvic ring reconstruction after resection of a huge sacral schwannoma. When a stable pelvic ring was regained by using a lumbosacral instrumentation technique, a tricortical iliac bone graft with its vascular pedicle was harvested, transported into the dead space, and tied to the right residual sacrum and the left ilium. The vascularized graft healed rapidly, and continuity of the pelvic ring was regained. This method is effective for pelvic ring reconstruction in that it does not require microvascular techniques and rapid bone healing can be obtained.


Assuntos
Transplante Ósseo/métodos , Ílio/transplante , Neurilemoma/cirurgia , Neoplasias Pélvicas/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Sacro/cirurgia , Feminino , Humanos , Artéria Ilíaca/anatomia & histologia , Artéria Ilíaca/cirurgia , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/patologia , Ossos Pélvicos/cirurgia , Neoplasias Pélvicas/diagnóstico por imagem , Neoplasias Pélvicas/patologia , Radiografia , Sacro/diagnóstico por imagem , Sacro/patologia , Ciática/etiologia , Ciática/patologia , Ciática/fisiopatologia , Raízes Nervosas Espinhais/diagnóstico por imagem , Raízes Nervosas Espinhais/patologia , Resultado do Tratamento
10.
Spine (Phila Pa 1976) ; 29(21): E488-91, 2004 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-15507788

RESUMO

STUDY DESIGN: A retrospective review of 21 patients with spondyloepiphyseal dysplasia congenita (SEDC), including 7 operated patients for atlantoaxial subluxation. OBJECTIVES: To clarify the morphological findings of atlantoaxial subluxation in SEDC patients and to evaluate the operative procedures based on these image findings. SUMMARY AND BACKGROUND DATA: The presence of atlanto axial sublucation with hypoplasia of the odontoid and/or lax ligaments leads to myelopathy in patients with spondyloepiphyseal dysplasia congenita. METHODS: We retropectively reviewed the physical and morphological findings on atlantoaxial images and the clinical findings of myelopathy in 21 patients with SEDC. RESULTS: Myelopathy was found in 9 individuals with severe SEDC who presented with marked short stature and severe coxa vara; of these, 6 had gait disturbances. On the images of the 9 patients with myelopathy, the average sagittal canal diameter (SCD) at the level of the atlas was only 9.2 mm (range, 7-12 mm) with progressive atlantoaxial subluxation. The average atlantodental interval (ADI) was 3.5 mm (range, 2-6 mm) in the presence of a sagittal atlas diameter (SAD) of less than 27.1 mm (range, 22-36 mm). Surgery was performed for 6 of the patients with myelopathy. Since their SADs were small, and the average SCD, at 9.9 mm (8-14 mm), was narrow even at the position of extension (the position of reduction for atlantoaxial subluxation), C1 laminectomy was needed for all these patients, and occipital-cervical posterior fusion was performed. Stability was satisfactory in all cases and the operative outcome for myelopathy was excellent for 1 case, fine for 4, and fair for 2. CONCLUSION: A small SAD may limit the effectiveness of reducing atlantoaxial subluxation. Persistent narrowing of the SCD may require concomitant C1 laminectomy and occipital-cervical fusion.


Assuntos
Articulação Atlantoccipital/cirurgia , Luxações Articulares/cirurgia , Laminectomia , Osteocondrodisplasias/congênito , Compressão da Medula Espinal/etiologia , Fusão Vertebral , Adolescente , Adulto , Fatores Etários , Articulação Atlantoccipital/diagnóstico por imagem , Transplante Ósseo , Braquetes , Criança , Pré-Escolar , Descompressão Cirúrgica , Feminino , Seguimentos , Forame Magno/cirurgia , Humanos , Luxações Articulares/complicações , Luxações Articulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Processo Odontoide/patologia , Osteocondrodisplasias/complicações , Cuidados Pré-Operatórios , Radiografia , Estudos Retrospectivos , Índice de Gravidade de Doença , Técnicas de Sutura , Tração , Resultado do Tratamento
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