Poster Session:PS 0205 ; Endocrinology : 31yrs. Old Young Female Presented with Weight Loss, Polyuria, Polydipsia and Hypertensive Urgency: Diagnosed to Have Malignant Phaechromocytoma

( Toshihiko Hata ),( Hiroyuki Sato ),( Ako Machino ),( Mai Wakabayashi ),( Morito Kise ),( Hiroki Ohashi ),( Daisuke Yamashita ),( Kaoru Sakural ),( Toru Matsubayashi ),( Masahiko Hatao ),( Ken Ueda ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

31yrs. old female known to have hypertension and dyslipidemia for 1 yr.presented with h/o weight loss around 10 kg for 1 yr,palpiations,diaphoresis and hypertensive urgencyBp 210/110 mmhg)and also found to have diabetes (newly diagnosed)further investigations shows large adrenal mass (left side)suspicion of phaechromocytoma and urine catecholamoines was high, urology was consulted and she underwent left adrenalectomy and biopsy confi rm the diagnosis of malignant phaechromcytoma. Repeat Urine catecholamines which was quite high on presentation later normalized after surgey. Now she is under active follow up with endocrinologist and on antihypertensive medications very minimal doses and for her diabetes she is not on any medications as well after surgery.

Ulnar nerve strain during throwing motion and ulnar nerve transfer which is suitable for throwing motion

Mitsuhiro Aoki,Eiichi Uchiyama,Gen Murakami,Toshihiko Yamashita 대한견주관절의학회 2006 대한견주관절학회 학술대회논문집 Vol.2006 No.5

Standalone Percutaneous Vertebroplasty for Hyperextension Injuries of the Ankylosed Thoracolumbar Spinal Kyphosis

Fukushi Ryunosuke,Kawaguchi Satoshi,Horigome Keiko,Yajima Hideki,Yamashita Toshihiko 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.6

Hyperextension injuries of the ankylosed thoracolumbar spine, particularly those with preexisting kyphotic deformity, present significant therapeutic challenges. The authors viewed that such injuries without displacement or fractures of the posterior elements are reasonable candidates for standalone percutaneous vertebroplasty (PVP). In such cases, the posterior tension band is spared; thus, fractures are unstable not in the lateral direction, which would lead to the translation of the fracture, but in the vertical direction. Such vertical instability of the fracture can be stabilized if the open mouth-type vertebral cleft is adequately filled with a sufficiently large amount of polymethylmethacrylate (PMMA) cement. Our three patients receiving standalone PVP received injections of 12 mL, 16.5 mL, and 18 mL of PMMA cement. This minimally invasive surgical procedure achieved both short-term (immediate pain relief and mobilization) and long-term (fracture healing) goals.

Cubital Tunnel Syndrome in Adolescent Baseball Players

Mitsuhiro Aoki,Kohei Kanaya,Hikono Aiki,Takuro Wada,Toshihiko Yamashita,Naoshi Ogiwara 대한견주관절의학회 2006 대한견주관절학회 학술대회논문집 Vol.2006 No.5

Effect of Cryotherapy after Spine Surgery

Kenji Murata,Mitsunori Yoshimoto,Tsuneo Takebayashi,Kazunori Ida,Kazuhiko Nakano,Toshihiko Yamashita 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.6

Study Design: Historical controlled trial. Purpose: To clarify the usefulness of cryotherapy after spine surgery. Overview of Literature: Cryotherapy has generally been performed subsequent to surgery on joints and in this application its clinical effects are well understood. However, cryotherapy has yet to be used following spine surgery. Its clinical efficacy in this context is unknown. Methods: Thirty six patients had undergone one level microendoscopic surgery. Sixteen were enrolled into the cooling group, with the remaining 20 making up the no postoperative cryotherapy control group. Cryotherapy was performed at 5℃ using an icing system. A silicone balloon catheter with a thermo sensor on the tip was placed in the surgical wound. The temperature in the wound was recorded every 30 minutes until the next morning. The relationship between the depth of the sensor and the temperature in the wound were investigated using simple linear regression analysis. Laboratory data, visual analogue scale (VAS) for wound pain and postoperative bleeding were investigated. Results: The mean temperature in the surgical wound was 37.0 in the control group and 35.0℃ in the cooling group (p <0.001). There was a positive correlation between the depth of the thermo sensor and the temperature in the wound in the cooling group (y=0.91x+30.2, r =0.67, p =0.004). There were no significant differences between the groups in terms of laboratory data, VAS or postoperative bleeding. Conclusions: The temperature in the wound was decreased significantly by spinal surgery cryotherapy.

Effects of treatment interruption due to patient convenience on treatment of once a week teriparatide

Genichiro Katahira,Kotaro Akiba,Junichi Takada,Kousuke Iba,Toshihiko Yamashita 대한골다공증학회 2020 Osteoporosis and Sarcopenia Vol.6 No.1

Objectives: Once-weekly teriparatide (W-TPTD) is an effective drug for patients with osteoporosis; however, some patients discontinue W-TPTD owing to its adverse drug reactions (ADRs). Sequential treatment with W-TPTD and antiresorptive therapy may be effective in treating such patients. In this study, we evaluate the efficacy of this sequential treatment regimen. Methods: This retrospective study was conducted at a single institution in Japan. The target subjects were patients with osteoporosis who started W-TPTD treatment. The subjects who received W-TPTD for 6 months or morewere divided into3 groups: TTT (W-TPTD for 18 months); TBT (sequentialtreatmentof W-TPTD/bisphosphonates/W-TPTD; each for 6 months); and TET (sequential treatment of W-TPTD/ elcatonin/W-TPTD,each for 6months) groups. The efficacyendpoints were bonemineral densities (BMD) in the lumbar spine and femur. Results: Lumbar spine BMD in groupTBT increased significantlyby1.6% (P¼0.023), 2.9% (P¼0.001), and 4.4% (P < 0.001) after 6,12, and 18 months, respectively, compared with baseline values. In group TET, it increased by 2.1%, (P ¼ 0.001), 1.3% (P ¼ 0.066), and 3.0% (P ¼ 0.015) after 6, 12, and 18 months, respectively. A significant increase was observed only after 6 and 18 months. In group TTT, it increased significantly by 3.3% (P ¼ 0.023), 5.1% (P ¼ 0.019), and 7.1% (P ¼ 0.010) after 6, 12, and 18 months, respectively. However, no significant difference in total hip BMD was observed among all three groups. No serious ADRs were reported. Conclusion: Inpatients who discontinue treatment with W-TPTD due to ADRs, sequential treatment with W-TPTD and antiresorptive therapy would be beneficial.

Acetabular Morphology in Patients with Developmental Dysplasia of the Hip with High Dislocation

( Kenji Tateda ),( Satoshi Nagoya ),( Daisuke Suzuki ),( Ima Kosukegawa ),( Toshihiko Yamashita ) 대한고관절학회 2021 Hip and Pelvis Vol.33 No.1

Purpose: The current study aimed to investigate the morphology of the true acetabulum in developmental dysplasia of the hip (DDH) with high dislocation. A secondary was to evaluate the acetabular cup placement in patients with high dislocation who were treated with total hip arthroplasty (THA). Materials and Methods: Using a retrospective design, 23 hips with DDH with high dislocation in patients who were treated with THA were included in this study. We measured the depth, width and thickness of the anterior and posterior walls of the original acetabulum using preoperative computed tomography images and investigated the cup size applied in these cases. Results: The mean depth and width of the acetabulum was 18.4 and 16.2 mm proximal end, 18.4 and 24.3 mm in the middle, and 15.8 and 27.6 mm at the distal part. Mean thickness of the anterior and posterior walls was 10.9 and 23.9 mm at the proximal end, 10.3 and 22.2 mm in the middle, and 10.9 and 22.7 mm at the distal part. A 42-mm cup was using in one hip, a 46-mm cup in three hips, a 48-mm cup in 13 hips, and a 50-mm cup in six hips. Conclusion: In patients with Crowe IV DDH, the morphology of the acetabulum comprises a triangle that broadens from proximal to distal points, with a relatively thick posterior wall. Reaming the acetabulum posteriorly and inferiorly may enable the placement of a relatively larger cup to achieve stable fixation.

Clinical Presentation of Cervical Myelopathy at C1–2 Level

Yasutaka Murahashi,Tsuneo Takebayashi,Yoshinori Terashima,Hajime Tsuda,Mitsunori Yoshimoto,Toshihiko Yamashita 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.4

Study Design: Single-center retrospective study. Purpose: To clarify the clinical features of cervical myelopathy at the C1–2 level. Overview of Literature: Methods for distinguishing the affected level based on myelomere symptoms or dysfunction of the conducting pathway were established. However, no symptoms have been identified as being specific to the C1–2 level segment. Methods: We evaluated 24 patients with cervical myelopathy due to spinal cord compression at the C1–2 level. Preoperative neurological assessment were investigated and compared with the rate and site of compression of the spinal cord using computed tomography-myelography. Results: Impaired temperature and pain sensation were confirmed in 18 of the 24 patients with that localized to the upper arms (n=3), forearm (n=9), both (n=2), and whole body (n=4). Muscle weakness was observed in 18 patients, muscle weakness extended from the biceps brachii to the abductor digiti minimi in 10 patients, and in the whole body in 8 patients. Deep tendon reflexes were normal in 10 patients, whereas hyperactive deep tendon reflexes were noted in 14 patients. The rate of spinal cord compression was significantly higher in patients with perceptual dysfunction and muscle weakness compared with those with no dysfunction. However, no significant difference in the rate and site of compression was identified in those with dysfunction. Conclusions: Perceptual dysfunction and muscle weakness localized to the upper limbs was observed in 58% and 42% of patients, respectively. Neurological abnormalities, such as perceptual dysfunction and muscle weakness, were visualized in patients with marked compression.

Multifidus Muscles Lipid Content Is Associated with Intervertebral Disc Degeneration: A Quantitative Magnetic Resonance Imaging Study

Izaya Ogon,Tsuneo Takebayashi,Hiroyuki Takashima,Tomonori Morita,Tsutomu Oshigiri,Yoshinori Terashima,Mitsunori Yoshimoto,Toshihiko Yamashita 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.4

Study Design: Cross-sectional study. Purpose: To determine the association between fatty degeneration of the multifidus muscle (Mm) and intervertebral disc degeneration (IVDD) using quantitative magnetic resonance imaging (MRI). Overview of Literature: Few studies have reported on quantitative MRI analysis of the relation between the Mm and IVDD. Methods: The subjects with chronic low back pain comprised 45 patients (19 males, 26 females; mean age, 63.8±2.0 years; range, 41–79 years). We analyzed the intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) of the Mm using magnetic resonance spectroscopy. The T2 values of the anterior annulus fibrosus (AF), nucleus pulposus (NP), and posterior AF were evaluated using MRI T2 mapping. We compared the possible correlations of IMCL and EMCL of the Mm with the T2 values of anterior AF, NP, and posterior AF. Results: There was a significant negative correlation between IMCL and T2 values of the anterior AF (r=−0.65, p<0.01). There were no significant correlations between the IMCL and T2 values of NP (r=−0.16, p=0.30) and posterior AF (r=0.07, p=0.62). There were no significant correlations between the EMCL and T2 values of the anterior AF (r=−0.11, p=0.46), NP (r=0.15, p=0.32), and posterior AF (r=0.07, p=0.66). After adjustment for age and sex using multiple linear regression analysis, there was a significant negative correlation between the IMCL and T2 values of anterior AF (standardized partial regression coefficient=−0.65, p<0.01). Conclusions: The results indicated that IMCL of the Mm might be accompanied with anterior AF degeneration. Therapeutic exercises using IMCL of the Mm as evaluation index might have the potential to identify novel targets for the treatment and prevention of IVDD.

Is the Lipid Content of the Psoas Major Correlated with Chronic Low Back Pain and Spinopelvic Alignment? A Magnetic Resonance Spectroscopic Study

Ogon Izaya,Hiroyuki Takashima,Tomonori Morita,Tsutomu Oshigiri,Yoshinori Terashima,Mitsunori Yoshimoto,Makoto Emori,Atsushi Teramoto,Tsuneo Takebayashi,Toshihiko Yamashita 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.4

Study Design: Cross-sectional observational study.Purpose: This study aimed to analyze any potential associations of extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) contents with (1) the intensity of low back pain (LBP); (2) age, cross-sectional area (CSA), and fatty infiltration (FI) of the psoas major; and (3) spinopelvic parameters.Overview of Literature: The psoas major has clinically relevant function; however, the association of this muscle with chronic LBP is controversial. Magnetic resonance spectroscopy enables a detailed analysis of the composition of muscular fat tissues such as its EMCL and IMCL contents.Methods: The study population comprised 40 patients (19 males, 21 females; mean age, 61.7±2.4 years). Possible correlations of LBP Visual Analog Scale (VAS) scores, age, CSA, FI, and spinopelvic parameters with EMCL and IMCL contents of the psoas major were assessed.Results: No association was identified between the EMCL and IMCL contents and LBP VAS scores (<i>r</i>=0.05, <i>p</i>=0.79 and <i>r</i>=0.06, <i>p</i>=0.75, respectively). The EMCL content correlated with age (<i>r</i>=0.47, <i>p</i><0.01), body mass index (BMI) (<i>r</i>=0.44, <i>p</i><0.01), CSA (<i>r</i>=−0.59, <i>p</i>< 0.01), and FI (<i>r</i>=0.49, <i>p</i><0.01). EMCL content showed a significant negative correlation with sacral slope (SS) (<i>r</i>=−0.43, <i>p</i><0.05) and positive correlation with pelvic tilt (PT) (<i>r</i>=0.56, <i>p</i><0.01).Conclusions: EMCL content correlated with age, BMI, CSA, and FI of the psoas major, while IMCL content had no correlation. This study found correlations between SS and PT and EMCL content of the psoas major, but no correlations were found between spinopelvic parameters and IMCL content of the psoas major.