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Effect of central sensitization inventory on the number of painful sites and pain severity in a Japanese regional population cohort
Get PDFBackground: To investigate the association between the central sensitization inventory (CSI), a screening tool for central sensitization, and the number of painful sites and the severity of pain in locomotive organs in an epidemiological study in the elderly.
Methods: A total of 379 individuals who underwent musculoskeletal disease screening were enrolled in this study. The CSI was used to assess symptoms of central sensitization. The number and location of painful sites and the severity of pain were evaluated using pain mapping and a numerical rating scale (NRS) at 37 sites. We investigated the association between the number of painful sites and CSI score, and the association between the severity of low back pain or knee pain and CSI score.
Results: There was a positive correlation between CSI score and the number of painful sites. The CSI score was significantly higher in those with significant low back pain than in those without pain, and the high-CSI group tended to have a greater number of painful sites. Comparison of CSI scores between participants with low back pain alone and those with low back pain and posterior lower leg pain showed that the latter group had a significantly higher CSI score than the former group. The CSI score in participants with radiographic evidence of knee osteoarthritis was significantly higher in those with knee pain than in those without pain.
Conclusions: The results of this study suggest that participants with significant low back pain and a higher number of painful sites are more susceptible to the influence of central sensitization. In addition, CSI score was higher in participants with low back pain and posterior lower leg pain than in those with low back pain alone, suggesting that the spread of pain may be due to central sensitization.journal articl
Clinical outcomes of corrective fusion surgery from the thoracic spine to the pelvis for adult spinal deformity at 1, 2, and 5 years post-operatively
Get PDF雑誌掲載タイトル：Clinical Outcomes of Corrective Fusion Surgery From the Thoracic Spine to the Pelvis for Adult Spinal Deformity at 1, 2, and 5 years PostoperativelyStudy Design: Retrospective cohort study.
Objective: To investigate whether patient-reported outcomes (PROs) were consistent at 2 and 5 years after corrective fusion surgery from the thoracic spine to the pelvis in patients with adult spinal deformity (ASD) and to analyze whether revision surgery affected long-term outcomes.
Summary of Background Data: PROs up to 2 years after corrective surgeries for ASD have been well-studied, but there are few reports of mid- to long-term results.
Methods: We retrospectively analyzed patients with ASD who underwent corrective fusion surgery from the thoracic spine to the pelvis between 2010 and 2015. We investigated radiographic parameters and PROs (Scoliosis Research Society 22r [SRS-22r], Oswestry Disability Index [ODI]) pre-operatively and at 1, 2, and 5 years post-operatively, and the correlations between PROs at these time points. We also compared changes in PROs at 5 years in patients who underwent revision surgery and those who did not.
Results: A total of 131 patients who underwent corrective fusion surgery from the thoracic spine to the pelvis were analyzed. The PROs at 1 and 5 years after surgery showed significant correlations in all SRS-22r domains [function (r=0.620), pain (r=0.577), self-image (r=0.563), mental health (r=0.589), subtotal (r=0.663), and ODI (r=0.654)]. The PROs at 2 and 5 years after surgery showed significantly strong correlations in all domains [function (r=0.715), pain (r=0.678), self-image (r=0.653), mental health (r=0.675), subtotal (r=0.741), and ODI (r=0.746)]. There were no significant differences in the change in PROs at 5 years in any domain in patients who underwent revision surgery (all P>0.05).
Conclusions: One-year post-operative PROs improved significantly. Two-year PROs correlated strongly with 5-year post-operative PROs, indicating that 2-year PROs can predict longer term outcomes. The need for revision surgery did not influence the mid- to long-term clinical outcomes of corrective fusion surgery for ASD.journal articl
An 11-month-old boy with cellulitis from diaper dermatitis in which MRI was useful for diagnosis and investigation of the cause
Get PDFおむつ皮膚炎は殆どの乳幼児が経験する日常的な疾患である．今回我々は，おむつ皮膚炎から蜂窩織炎を発症したと考えられる症例を経験した．蜂窩織炎は表面上おむつで覆われていない部位に認めたが，MRIでは蜂窩織炎の部位からおむつ庇護部に連続する皮下脂肪織の炎症所見を認めた．外傷がないこと，先行しておむつ皮膚炎を認めていたこと，及びMRI上炎症の最も強い部位がおむつ内の鼠径部にあったことを踏まえて，おむつ皮膚炎によって引き起こされた蜂窩織炎と判断した．蜂窩織炎の診断においては十分な問診と診察が当然重要であるが，皮膚病変を診療するにあたり，原因不明の発熱や自発運動の低下のような皮膚症状のみでは説明が付かない他覚所見を伴う際は，MRIを含めた画像検査が診断及び原因究明に有用と考えられた．journal articl
A case of transient abnormal myelopoiesis associated with mosaic Down syndrome without any morphological features
Get PDF新生児期に一過性骨髄異常造血（transient abnormal myelopoiesis：TAM）を発症した一例を報告する．症例は在胎37週5日，出生体重3052gの男児．形態学的な特徴は有さず，日齢1に点状出血の精査目的に実施した血液検査で白血球の異常高値を認めた．染色体G分染法により，腫瘍細胞の核型が21トリソミーと判明し，GATA1遺伝子の変異を伴っていたことからTAMと診断した．末梢血細胞は正常核型であったが，頬粘膜細胞の一部に21トリソミーが確認され，モザイク型Down症候群と診断した．診断に至っていない類似の症例が潜在している可能性があり，形態学的特徴を有さないモザイク型Down症候群の疫学や病態解明のため，今後さらなる研究が望まれる．journal articl
Recurrent follicular lymphoma diagnosed using ovarian tissue obtained during laparoscopic surgery: A case report
Get PDF濾胞性リンパ腫は低悪性度B細胞リンパ腫のひとつであり、化学療法が奏効するものの、再発を繰り返し治癒困難な疾患である。我々は濾胞性リンパ腫初回化学療法から3年後に腹腔鏡下に摘出した卵巣腫瘍を用いて再発と診断した症例を経験した。症例は64歳、0妊、59歳時に人間ドックで後縦隔腫瘍を指摘され、精査後濾胞性リンパ腫Stage IVAと診断された。化学療法を行い寛解したが、3年後に4cm大の両側付属器腫瘤を指摘され当科を受診した。リンパ腫再発を疑い、血液内科医、病理医と協議し、腹腔鏡下に右付属器を摘出した。病理組織学的・細胞遺伝学的検査により濾胞性リンパ腫の再発と診断された。初回と異なるレジメンの化学療法を行った後、再発所見を認めていない。濾胞性リンパ腫の再発時には組織学的悪性度が高くなることがあり、病理組織評価は特に重要である。その際、腹腔鏡下の組織生検は低侵襲で術後回復が早くスムーズな化学療法の導入に有用である。Follicular lymphoma, a type of indolent Bcell lymphoma, is difficult to treat due to iterative recurrence despite its response to chemotherapy. We report a case of recurrent follicular lymphoma that developed 3 years after initial chemotherapy, which was diagnosed based on laparoscopically obtained ovarian tissue. A 64-year-old woman (gravida 0, para 0) was initially diagnosed with stage IVA follicular lymphoma after thorough examination of a posterior mediastinal tumor found during health screening at the age of 59. She underwent 8 courses of chemotherapy and achieved remission. Three years later, 4-cm bilateral adnexal masses were found. As we suspected lymphoma recurrence, we removed the right adnexa under laparoscopy after consultation with the hematologist and pathologist. Histopathological and cytogenetic examinations revealed recurrent follicular lymphoma. After chemotherapy following a different regimen, no physical findings of lymphoma recurrence were observed. Histopathological evaluation is important in the case of follicular lymphoma recurrence because its histological transformation can exacerbate malignancy. Therefore, tissue biopsy under minimally invasive laparoscopic surgery may be effective for the introduction of chemotherapy based on the definite histological diagnosis.journal articl