A Retained Epidural Catheter Fragment Treated by Surgery

Kiyoshi Tarukado,Takaaki Oda,Osamu Tono,Hiroyuki Suetsugu,Toshio Doi 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.3

The breakage of an epidural catheter is an extremely rare complication. We describe a unique case where a retained epidural catheter fragment after epidural anesthesia was treated by surgery. The epidural catheter broke during its removal, requiring surgery to remove the retained catheter. Intraoperatively, the removal of the catheter was attempted by simple traction, but was impossible because of the adhesion. The adhesion of the dura mater surface was carefully exfoliated and the successful removal of the catheter was accomplished. Conventionally, it was said that this follow-up was enough for the retained catheter. However, if a catheter is retained within the spinal canal, surgical removal should thus be considered before the adhesion advances.

Ordinary Disc Herniation Changing into Posterior Epidural Migration of Lumbar Disc Fragments Confirmed by Magnetic Resonance Imaging: A Case Report of a Successful Endoscopic Treatment

Kiyoshi Tarukado,Osamu Tono,Toshio Doi 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.1

The posterior epidural migration of lumbar disc fragments is an extremely rare event with an unknown pathogenesis. To the best of our knowledge, there are no previously reported cases of a change of ordinary disc herniation into the posterior epidural migration of lumbar disc fragments as confirmed by magnetic resonance imaging (MRI). A 26-year-old male presented to our department complaining of left buttock and lateral leg pain. An ordinary herniation was shown in the first MRI. The patient’s unilateral symptoms changed into bilateral symptoms while awaiting admission to the hospital. Posterior migrated lumbar disc fragments were shown in the second MRI taken at the time of admission. Microendoscopic surgery providing a detailed observation of the region was performed. Our case indicates that an ordinary lumbar disc herniation may lead to the posterior migration of lumbar disc fragments, and that microendoscopic surgery may provide a treatment.

Simultaneous Use of Both Bilateral Intralaminar and Pedicle Screws for C2 Stabilization

Kiyoshi Tarukado,Osamu Tono,Toshio Doi 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.5

Four patients underwent stabilization surgery using both bilateral C2 pedicle screw (PS) and intralaminar screw (LS). Neural and vascular injury resulting from incorrect screw placement was assessed using computed tomography (CT). The evaluation of bone union was assessed by lateral flexion-extension X-ray films and CT. The symptoms were improved in all patients. There were no intraoperative complications. Furthermore, there were no cases of neurological worsening or vascular injury from incorrect screw placement. Failure of instrumentation or screw loosening during the follow-up period did not occur in any of the patients. All cases had accomplished bone union at the final follow-up. Theoretically, the stabilization technique using both bilateral C2 PS and LS at the same time can provide more stability than any other single technique. Simultaneous use of both bilateral C2 PS and LS is potentially a good choice for surgical repair.

Radiographic and Clinical Results of C1 Laminoplasty for the Treatment of Compressive Myelopathy

Tarukado Kiyoshi,Ikuta Ko,Iida Keiichiro,Tono Osamu,Doi Toshio,Harimaya Katsumi 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.4

Study Design: Case series.Purpose: To evaluate the radiographic and clinical results of C1 laminoplasty without fusion.Overview of Literature: C1 laminectomy has been the standard procedure for decompression at the C1 level. However, there have been some reports of trouble cases after C1 laminectomy. C1 laminoplasty might be superior to C1 laminectomy with regard to maintaining the original C1 anatomical shape, preventing compression from the posterior soft tissue, and ensuring an adequate bonegrafting site around the C1 posterior part if additional salvage fusion surgery is necessary afterward.Methods: Seven patients with spinal cord compression without obvious segmental instability at the C1/2 level treated by C1 laminoplasty were included. The indication of C1 laminoplasty was same as that of C1 laminectomy. C1 laminoplasty was performed in the same way as subaxial double-door laminoplasty. The imaging findings were evaluated using X-ray, computed tomography, and magnetic resonance imaging. The clinical results were evaluated using the Japanese Orthopaedic Association (JOA) Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and JOA score. Peri- and postoperative complications were also investigated.Results: No patient showed increased C1/2 segmental instability after the surgery. The mean pre- and postoperative JOA scores were 8.6 and 11.7, respectively. The mean recovery rate was 40.2%. The effective rate in the JOACMEQ was 50% for the cervical spine function, 33% for the upper extremity function, 50% for the lower extremity function, 17% for the bladder function, and 17% for the quality of life. No major complication that seemed to be unique to C1 laminoplasty was observed over a period of about 4 years follow-up.Conclusions: C1 laminoplasty for patients without obvious segmental instability might be a viable alternative procedure to C1 laminectomy.

藥用植物 Virus의 調査

李準琸,土居養二,與良 淸 韓國自然史博物學會 1981 生物과 自然 Vol.11 No.2

斑紋과 mosaic 등의 病徵을 나타내는 樂用植物을 1979年과 1980年에 日本의 各地에서 採集하여 汁液 接種과 電子顯微鏡觀察에 依해서 調査한 結果 34科 58種이 植物에서 各種의 virus를 檢出하였다. 長形 virus로서 carlavirus가 7種, potyvirus는 20種의 植物에서 檢出되었고 球形 virus에 있어서는 CMV가 21種, comovirus인 BBWV가 8種, nepovirus가 2種의 植物에서 檢出되었으며 gemini-virus가 2種의 植物에서 檢出되었다. 그리고 未同定의 長形 virus 粒子가 2種, 球形 virus 粒子가 7種의 植物에서 檢出되었으며 이들중 23種의 植物 virus 病은 未記錄인 新病害라 생각된다. The medicinal plants of 73 species in 43 families showing mosaic and mottling symptoms were collected from 1979 to 1980 at 13 areas in Japan. Various viruses were detected from 58 species in 34 families among them by sap inoculation tests and electron microscopy. It was observed that seven species of medicinal plants were infected by carla-viruses, 20 by potyviruses, 21 by cucumoviruses, eight by comoviruses, two by nepoviruses, and two by geminiviruses. New virus diseases that have not been reported in Japan were found from 23 species of medicinal plants.

Utility of Noncontrast Magnetic Resonance Angiography for Aneurysm Follow-Up and Detection of Endoleaks after Endovascular Aortic Repair

Kawada Hiroshi,Goshima Satoshi,Sakurai Kota,Noda Yoshifumi,Kajita Kimihiro,Tanahashi Yukichi,Kawai Nobuyuki,Ishida Narihiro,Shimabukuro Katsuya,Doi Kiyoshi,Matsuo Masayuki 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.4

Objective: To assess the noncontrast two-dimensional single-shot balanced turbo-field-echo magnetic resonance angiography (b-TFE MRA) features of the abdominal aortic aneurysm (AAA) status following endovascular aneurysm repair (EVAR) and evaluate to detect endoleaks (ELs). Materials and Methods: We examined four aortic stent-grafts in a phantom study to assess the degree of metallic artifacts. We enrolled 46 EVAR-treated patients with AAA and/or common iliac artery aneurysm who underwent both computed tomography angiography (CTA) and b-TFE MRA after EVAR. Vascular measurements on CTA and b-TFE MRA were compared, and signal intensity ratios (SIRs) of the aneurysmal sac were correlated with the size changes in the AAA after EVAR (AAA prognoses). Furthermore, we examined six feasible b-TFE MRA features for the assessment of ELs. Results: There were robust intermodality (r = 0.92–0.99) correlations and interobserver (intraclass correlation coefficient = 0.97–0.99) agreement. No significant differences were noted between SIRs and aneurysm prognoses. Moreover, “mottled high-intensity” and “creeping high-intensity with the low-band rim” were recognized as significant imaging findings suspicious for the presence of ELs (p < 0.001), whereas “no signal black spot” and “layered high-intensity area” were determined as significant for the absence of ELs (p < 0.03). Based on the two positive features, sensitivity, specificity, and accuracy for the detection of ELs were 77.3%, 91.7%, and 84.8%, respectively. Furthermore, the k values (0.40–0.88) displayed moderate-toalmost perfect agreement. Conclusion: Noncontrast MRA could be a promising imaging modality for ascertaining patient follow-up after EVAR.