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Hayashi S, Ohi T. [A case of idiopathic propriospinal myoclonus accompanied by giant somatosensory evoked potential]. Rinsho Shinkeigaku 2022; 62:865-868. [PMID: 36288962 DOI: 10.5692/clinicalneurol.cn-001737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 41-year-old man visited our clinic because of headache with fever, suggestive of aseptic meningitis. His headache improved in a few days. His neurological examination showed positive jolt accentuation and myoclonus of the thoracoabdominal muscles extending to extremities upon patellar tapping. His myoclonus had been occurring spontaneously from early adolescence, especially in relaxed states such as drowsiness. The myoclonus was not triggered by tactile, auditory, or visual stimulation. Polymyography revealed that the myoclonus originated around the T4 spinal level and slowly propagated both upward and downward. These findings were indicative of spontaneous and reflex propriospinal myoclonus (PSM). No abnormalities were seen on brain and spinal MRI. Furthermore, the amplitude of the cortical component of the somatosensory evoked potential (SEP) after electrical stimulation of the tibial nerve was enlarged bilaterally. It was speculated that the ascending signals from the myoclonus generator at T4 to S1 may have modulated the excitability and inhibitory function of S1 in this patient. This report may be the first case of idiopathic PSM accompanied by giant SEP.
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Topolnitskiy E, Chekalkin T, Marchenko E, Yasenchuk Y, Kang SB, Kang JH, Obrosov A. Evaluation of Clinical Performance of TiNi-Based Implants Used in Chest Wall Repair after Resection for Malignant Tumors. J Funct Biomater 2021; 12:jfb12040060. [PMID: 34842727 PMCID: PMC8628886 DOI: 10.3390/jfb12040060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 12/14/2022] Open
Abstract
In this study, we assessed the outcomes after surgical treatment of thoracic post-excision defects in 15 patients, using TiNi knitted surgical meshes and customized artificial TiNi-based ribs. Methods: Eight patients were diagnosed with advanced non-small cell lung cancer (NSCLC) invading the chest wall, of which five patients were T3N0M0, two were T3N1M0, and one was T3N2M0. Squamous cell carcinoma was identified in three of these patients and adenocarcinoma in five. In two cases, chest wall resection and repair were performed for metastases of kidney cancer after radical nephrectomy. Three-dimensional CT reconstruction and X-ray scans were used to plan the surgery and customize the reinforcing TiNi-based implants. All patients received TiNi-based devices and were prospectively followed for a few years. Results: So far, there have been no lethal outcomes, and all implanted devices were consistent in follow-up examinations. Immediate complications were noted in three cases (ejection of air through the pleural drains, paroxysm of atrial fibrillation, and pleuritis), which were conservatively managed. In the long term, no complications, aftereffects, or instability of the thoracic cage were observed. Conclusion: TiNi-based devices used for extensive thoracic lesion repair in this context are promising and reliable biomaterials that demonstrate good functional, clinical, and cosmetic outcomes.
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Affiliation(s)
- Evgeniy Topolnitskiy
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
- Department of Surgery, Siberian State Medical University, 634050 Tomsk, Russia
| | - Timofey Chekalkin
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
- R&D Center, TiNiKo Co., Ochang 28119, Korea;
- Correspondence:
| | - Ekaterina Marchenko
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
| | - Yuri Yasenchuk
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
| | - Seung-Baik Kang
- Boramae Medical Center, Seoul National University Hospital, Seoul 07061, Korea;
| | | | - Aleksei Obrosov
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
- Department of Physical Metallurgy and Materials Technology, Brandenburg University of Technology, 03-046 Cottbus, Germany
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Imagama S, Ito Z, Ando K, Kobayashi K, Hida T, Ito K, Tsushima M, Ishikawa Y, Matsumoto A, Morozumi M, Tanaka S, Machino M, Ota K, Nakashima H, Wakao N, Sakai Y, Matsuyama Y, Ishiguro N. Optimal Timing of Surgery for Intramedullary Cavernous Hemangioma of the Spinal Cord in Relation to Preoperative Motor Paresis, Disease Duration, and Tumor Volume and Location. Global Spine J 2017; 7:246-253. [PMID: 28660107 PMCID: PMC5476360 DOI: 10.1177/2192568217707938] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY DESIGN Prospective study. OBJECTIVE Investigate factors associated with preoperative motor paresis, recovery, ambulatory status, and intraoperative neurophysiological monitoring (IONM) among patients with no preoperative paresis (N group), complete preoperative motor recovery (CR group), and no complete recovery (NCR group) in patients with intramedullary spinal cavernous hemangioma to determine the optimal timing of surgery. METHODS The study evaluated 41 surgical cases in our institute. Disease duration, tumor lesion, manual muscle testing (MMT), and gait at onset, just before surgery, and final follow-up (FU), tumor and lesion volume, IONM, extent of tumor resection, and tumor recurrence were evaluated among N, CR, and NCR groups. RESULTS Motor paresis at onset was found in 26 patients (63%), with 42% of those in CR group. Disease duration from onset negatively affected stable gait just before surgery and FU as well as lower preoperative MMT (P < .05). Thoracic tumors were associated with patients with unstable gait before surgery (P < .05). Tumor volume was larger in NCR group (P < .05). IONM significantly decreased in NCR and CR groups than in N group (P < .05). The NCR group had residual mild motor paresis at FU (P < .05). Stable gait at FU was similar in N group and CR group, though lower in NCR group (P < .05). CONCLUSIONS Early surgery is generally recommended for thoracic tumors and large tumors during stable gait without motor paresis before long disease duration. Surgery may be postponed until patients recover from preoperative motor paresis to allow optimal surgical outcome. IONM should be carefully monitored in patients with a history of preoperative paresis even with preoperative complete motor recovery.
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Affiliation(s)
- Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan,Shiro Imagama, Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.
| | - Zenya Ito
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | | | - Tetsuro Hida
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Kenyu Ito
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Mikito Tsushima
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Yoshimoto Ishikawa
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Akiyuki Matsumoto
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Masayoshi Morozumi
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Satoshi Tanaka
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Masaaki Machino
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Kyotaro Ota
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Hiroaki Nakashima
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
| | - Norimitsu Wakao
- Department of Orthopaedic Surgery, Aichi Medical University, Aichigun, Aichi-ken, Japan
| | - Yoshihito Sakai
- Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yukihiro Matsuyama
- Department of Orthopaedic Surgery, Hamamatsu University, Hamamatsu, Shizuoka, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University, Nagoya, Aichi, Japan
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Yang H, Zhao H, Garfield DH, Teng J, Han B, Sun J. Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of non-lymph node thoracic lesions. Ann Thorac Med 2013; 8:14-21. [PMID: 23439919 PMCID: PMC3573552 DOI: 10.4103/1817-1737.105714] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 10/26/2012] [Indexed: 12/25/2022] Open
Abstract
AIMS: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has shown excellent diagnostic capabilities for mediastinal and hilar lymphadenopathy. However, its value in thoracic non-lymph node lesions is less clear. This study was designed to assess the value of EBUS-TBNA in distinguishing malignant from benign thoracic non-lymph node lesions. METHODS: From October 2009 to August 2011, 552 patients underwent EBUS-TBNA under local anesthesia and with conscious sedation. We retrospectively reviewed 81 of these patients who had tracheobronchial wall-adjacent intrapulmonary or isolated mediastinal non-lymph node lesions. On-site cytological evaluation was not used. Immunohistochemistry (IHC) was performed to distinguish the origin or type of malignancy when necessary. RESULTS: EBUS-TBNA was performed in 68 tracheobronchial wall-adjacent intrapulmonary and 13 isolated mediastinal non-lymph node lesions. Of the 81 patients, 77 (95.1%, 60 malignancies and 17 benignancies) were diagnosed through EBUS-TBNA, including 57 primary lung cancers, 2 mediastinal tumors, 1 pulmonary metastatic adenocarcinoma, 7 inflammation, 5 tuberculosis, 3 mediastinal cysts, 1 esophageal schwannoma, and 1 focal fibrosis. There were four false-negative cases (4.9%). Of the 60 malignancies, there were 9 (15.0%) which originally had no definite histologic origin or type. Thus, IHC was performed, with 7 (77.8%) being subsequently confirmed. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA in distinguishing malignant from benign lesions were 93.4% (60/64), 100% (17/17), 100% (60/60), 81.0% (17/21), and 95.1% (77/81), respectively. CONCLUSION: EBUS-TBNA is a safe procedure with a high sensitivity for distinguishing malignant from benign thoracic non-lymph node lesions within the reach of EBUS-TBNA, with IHC usually providing a more definitive diagnosis.
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Affiliation(s)
- Huizhen Yang
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, PR China
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