Brain and nerve = Shinkei kenkyū no shinpo
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Spondylosis deformans of the spine occurs due to degenerative changes of the intervertebral disc, vertebral body and hypertrophy of the interarticular joint. Such changes, including narrowing of the disc space, degeneration of the endplate, spur formation, hypertrophy of the facet joint, spondylolisthesis, abnormal curvature of the spine, are generally observed in the elderly people. Neurological abnormalities may develop because of spinal cord compression or circulation disturbances. ⋯ Various techniques of decompressive laminoplasty have been developed exclusively in Japan. Clinical evidence regarding the applicability of these methods is inconclusive; however, some significant improvements have been observed after the reconstruction of posterior elements of the spine in some cases. Here, the chronological developments in the surgical procedures used for treating-cervical and lumbar lesions have been briefly described.
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The radiographic appearance of gas collection in the intervertebral disc represents the so-called "vacuum phenomenon." Incidence of the vacuum phenomenon on plain radiographs is reported to be 1-20%, whereas gas-containing disc herniations are rarely observed. We present a case report involving a patient with L4/5 gas-containing disc herniation, which was demonstrated by CT and MRI scans and was also surgically documented. A 48-year-old man with no previous back trauma presented with a 14-day history of left leg pain. ⋯ Manipulation of the mass resulted in rupture and the release of gas. The displaced nerve root immediately relaxed to its normal position. Seven months after the operation, the patient remains free of pain.
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We report a case of enlargement of a intradiploic epidermoid cyst following head trauma in a 19-year-old man. The patient had a swelling on the right side of his forehead from the time of his birth. He sustained a bruise in this region when he was 15 years old, following which the swelling gradually enlarged. ⋯ Needle-like cholesterol crystals and hemosiderosis were seen shown in the granulation-like tissue. On the basis of these findings, we diagnosed the mass to bean intradiploic epidermoid cyst and thought that it might have grown following head trauma associated with chronic hemorrhage. This paper reviews the differential diagnosis and pathologic findings of the intradiploic epidermoid cyst along with some previously published cases.
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Review Case Reports
[Transient bilateral complete blindness and severe abdominal pain in a patient with alcoholic ketoacidosis].
A 66-year-old man presented with bilateral complete blindness and severe abdominal pain. He was diagnosed with ethanol-induced severe ketoacidosis and septic shock and dopamine and sodium bicarbonate was administered to him. This treatment rapidly ameliorated his symptoms of blindness and abdominal pain. It should be noted that alcoholic ketoacidosis (AKA) may induce severe acidosis and hypotension, leading to transient blindness,which is a condition that can be cured by appropriate treatment.