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Successful Treatment of PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) Syndrome with Shinbuto

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International Journal of Clinical Medicine 2014年第20期5卷 1261-1264页

作者： yuichirou tsuji Chitose Karasawa Department of Pediatrics Tokyo Takanawa Hospital Tokyo Japan

Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is an autoimmune disorder and the most common disorder characterized by periodic fever in children. A male patient has been followed up from 11 months to 10 years of age because of repeated high fever. We prescribed antifebriles and antibiotics for each febrile episode without a beneficial effect to him each time. He required several days of rest at home to recover from each episode. During his most recent febrile episode at 10 years of age, we prescribed 5.0 g of shinbuto (TJ-30;Tsumura Co., Tokyo, Japan). His fever resolved the next day and he was able to attend school. His growth and development are normal. Shinbuto had a therapeutic effect in this patient with PFAPA syndrome and may be useful in this condition.

关键词： Periodic Fever Aphthous PFAPA Syndrome Shinbuto

Difference of the Pain during the DPT (Diphtheria-Pertussis-Tetanus) Vaccination

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World Journal of Vaccines 2012年第2期2卷 91-95页

作者： yuichirou tsuji Izumi Ichihashi Kouji Morita Kazuo Itabashi Department of Pediatrics Showa University School of Medicine Tokyo Japan Sempos Tokyo Takanawa Hospital Pediatrics Tokyo Japan

Background: The objective of this study is to determine whether analyze of the infant’s pain associated with diphtheria-pertussis-tetanus (DPT) immunization is useful for vaccination in children. It is not known whether the immunization pain can be prevented with the adequate choice of DPT vaccines among several manufacturers in Japan. Further, it is not clear whether the difference of the reaction during vaccination between gender and age. Design: Three manufacturer’s Japanese DPT vaccines were used in this study. The parents assessed their infant’s pain on a modified visual analogue scale (MVAS), the start of the crying and total crying time during the immunization. Results: The A manufacturer’s DPT vaccine was significantly lower on the proportion of crying, the duration of crying and MVAS score than the other two manufacturer’s DPT vaccines. The proportion of crying, the duration of crying and MVAS score was lower in the boy than in the girl. On the other hand, it had not found the difference of their reactions with age. Conclusions: Our studies have found that the adequate choice of DPT vaccine decreased vaccination pain. The studies also indicate that some tendencies with vaccinations were shown in children. To consider these tendencies was useful in performing less painful vaccination.

关键词： Diphtheria-Pertussis-Tetanus Vaccine Immunization Pain Thimerosal Phenoxyethanol Questionnaire

Factors associated with surgical-site infection after total laparoscopic hysterectomy

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第4期5卷 131-135页

作者： Kosuke Shigematsu Koki Samejima yuichirou Kizaki Shigetaka Matsunaga Tomonori Nagai Yasushi Takai Department of Obstetrics and Gynecology Saitama Medical CenterSaitama Medical UniversitySaitama 350-8550Japan

Objective:In recent years,minimally invasive surgery has been emphasized in gynecological surgery,and total laparoscopic hysterectomy has been increasingly *** this retrospective single-center study,the main objective was to identify risk factors for the development of surgical-site infection(SSI)after total laparoscopic *** secondary objective was to investigate the efficacy of transvaginal drainage as a treatment for ***:This retrospective study investigated 377 patients who underwent total laparoscopic hysterectomy in the Department of Obstetrics and Gynecology at the Saitama Medical Center,Saitama Medical University,Japan between January 1,2015 and December 31,*** were divided into the SSI group and non-SSI group based on whether they suffered from *** data of preoperative,intraoperative,and postoperative risk factors for SSI were collected and ***:Of the 377 patients who underwent total laparoscopic hysterectomy,21 patients were in the SSI group and 356 patients were in the non-SSI *** the comparison between the two groups and the multivariate analysis,only the C-reactive protein level on postoperative day 3(OR¼1.556,95%CI:1.233 e1.964,p7.6 mg/dL on postoperative day 3 could detect the SSI onset *** the SSI group,the hospital stay was longer for patients with transvaginal drainage than for patients without(17.40±3.21 d vs.10.90±2.39 d,p¼0.0027).However,none required ***:Patients with a high postoperative C-reactive protein level may be experiencing SSI,and ultrasonography and other imaging procedures should be performed *** a vaginal abscess is confirmed on imaging,transvaginal drainage should be performed early,which may prevent reoperation.

关键词： Hysterectomy Laparoscopic surgery Surgical-site infection

Outcomes of Single-Incision Laparoscopic Appendectomy at a Single Center

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Surgical Science 2013年第10期4卷 426-428页

作者： Takahiro Watanabe Hidetosi Wada Masanori Sato yuichirou Miyaki Junpei Tochikubo Norihiko Shiiya Division of General Surgery and Endoscopic Surgery Surgery I Hamamatsu University School of Medicine Hamamatsu Japan

Background and Objectives: Recently, single-incision laparoscopic surgery has been popular for minimally invasive surgery and cosmetic improvement. We studied outcomes of single-incision laparoscopic appendectomy (SILA) in accordance with our strategy for acute appendicitis. Methods: Clinical outcomes were revealed in each of nine emergency SILA (e-SILA) cases and eight interval SILA (i-SILA) cases performed for the treatment of acute appendicitis between September 2010 and August 2012 at our hospital. Results: The male to female ratio was 6:3 for e-SILA and 5:3 for i-SILA cases. Mean ages were 33.1 ± 17.8 years and 41 ± 21.6 years for e-SILA and i-SILA, respectively. The pretreatment white blood cell (WBC) count and C-reactive protein (CRP) levels were 14960 ± 4080/μL and 1.4 ± 2.3 mg/d, respectively, for e-SILA and 12657 ± 4290/μL and 6.7 ± 8.3 mg/d, respectively, for i-SILA. The maximum transverse diameter of appendix was 12.6 ± 3.5 mm for e-SILA and 11.6 ± 3.5 mm for i-SILA. Appendiceal abscesses were encountered in one (11%) e-SILA and three (38%) i-SILA cases. Perforation of the appendix at operation occurred in two (22%) e-SILA cases and no i-SILA cases. Generalized peritonitis occurred in 4 (44%) e-SILA cases but in none of the i-SILA cases. The postoperative hospital stay was 5.3 days for e-SILA, 2.7 days for i-SILA. Conversion to laparotomy was not required in either group. One additional trocar was needed for an e-SILA case, and paralytic ileus occurred as a postoperative complication in one e-SILA case. Conclusion: The outcomes of SILA performed under our strategy were acceptable and useful without major postoperative complications.

关键词： Laparoscopic Appendectomy Single Access Laparoscopic Surgery Minimally Invasive Surgery

Femoral Nerve Pulsy due to Iliopsoas Muscle Hematoma: A Mini Literature Review

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Open Journal of Orthopedics 2017年第11期7卷 375-381页

作者： Taisei Sako yuichirou Yokoyama Keiji Hasegawa Shintaro Tsuge Kazumasa Nakamura Akihito Wada Hiroshi Takahashi Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan

We encountered a patient who developed femoral nerve paralysis due to iliopsoas muscle hematoma. Surgical removal of the hematoma is recommended for such cases, but conservative treatment may also be sufficient and there are no clear judgment criteria. An investigation of past reports showed that recovery was faster after surgery than after conservative treatment, regardless of the severity of paralysis, and that hematoma removal was especially effective for cases with severe paralysis. In our case, pain of the femoral nerve-innervated region was rapidly relieved by removal of the hematoma.

关键词： Femoral Nerve Pulsy Iliopsoas Hematoma Therapy

Spinal Epidural Cavernous Hemangioma of the Thoracic Spine: A Case Report

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Open Journal of Orthopedics 2015年第10期5卷 311-318页

作者： Ryoichi Fukano Yasuaki Iida Keiji Hasegawa yuichirou Yokoyama Akihito Wada Shigeta Takeuchi Kazutoshi Shibuya Hiroshi Takahashi Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan Department of Pathology Toho University School of Medicine Tokyo Japan

Cavernous hemangiomas can arise in any region of the body, including the central nervous system. Spinal cavernous hemangiomas account for 5% - 12% of all cases of vertebral vascular malformation. Most of these are of vertebral origin, and cases that are non-vertebral in origin are rare. We encountered a patient with a relatively rare spinal epidural cavernous hemangioma of the thoracic spine that was non-vertebral in origin. The patient was a 63-year-old man. He had become aware of bilateral leg pain and numbness about 2 months earlier, and gait disturbance appeared gradually thereafter. On MRI, a lesion showing iso-intensity on T1-weighted imaging and high intensity on T2-weighted imaging was detected at the 7th thoracic vertebra. On gadolinium contrast-imaging, the lesion was found to be a homogenously-enhanced dumbbell-shaped extradural spinal neoplasm protruding from the left 7th/8th thoracic intervertebral foramen. A neurogenic tumor was suspected based on myelography and MRI findings, and complete tumorectomy was performed, which improved the lower limb symptoms and gait disturbance. The histopathological diagnosis was cavernous hemangioma. Epidural hemangiomas arise from the vertebra in many cases, and pure spinal epidural cavernous hemangiomas are rare. It is difficult to make a preoperative diagnosis because there are no specific imaging findings that can differentiate these tumors. It may be important to consider this disease before surgery in the differential diagnosis of epidural tumors.

关键词： Epidural Cavernous Hemangioma Thoracic Spine Myelopathy

A Case of Thoracic Disc Herniation Extruded to the Dorsal Epidural Space

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Open Journal of Orthopedics 2015年第8期5卷 229-234页

作者： Shigeta Takeuchi yuichirou Yokoyama Yasuaki Iida Keiji Hasegawa Akihito Wada Ryoichi Fukano Kazutoshi Shibiuya Hiroshi Takahashi Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan Department of Pathology Toho University School of Medicine Tokyo Japan

We encountered a patient with thoracic disc herniation that extruded to the dorsal epidural space. The patient was a 78-year-old man in whom listlessness of the lower limbs developed without an inducer and walking became difficult. The patient was diagnosed as having a thoracic spinal cord tumor on MRI by a physician, and was referred to our hospital. Since ring enhancement was observed on contrast MRI performed at our hospital, the patient was diagnosed with disc herniation and surgery was performed. A hernia continuous with the intervertebral space that extruded to the dorsal epidural space was excised. At the final follow up, 1 year and 4 months after surgery, the patient could walk with a cane. Among thoracic disc herniation cases, hernia extruded to the dorsal epidural space is rare and difficult to diagnose by imaging before surgery, but evaluation using contrast MRI is useful in the diagnosis. When a space-occupying lesion is observed in the spinal canal in the lower thoracic spinal region, it is necessary to evaluate it by contrast MRI in consideration of thoracic disc herniation.

关键词： Disc Hernia Dorsal Epidural Space Thoracic Spine

A Case of Acute Cauda Equina Syndrome for Combined Lumbar Ossification of the Posterior Longitudinal and Yellow Ligament

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Open Journal of Orthopedics 2014年第6期4卷 145-149页

作者： Kazumasa Nakamura yuichirou Yokoyama Akihito Wada Yasuhiro Inoue Keiji Hasegawa Shintaro Tsuge Hiroshi Takahashi Yasuaki Iida Department of Orthopaedic Surgery School of Medicine Toho University Tokyo Japan

Acute cauda equina syndrome is known as a symptom of lumbar disc herniation, but to date, there have been no reports of cases caused by lumbar vertebral ligament ossification. We encountered a 61-year-old female patient with acute cauda equina syndrome associated with lumbar vertebral OPLL and OLF. The symptoms were improved by emergency laminectomy. One year after the surgery, the disturbances of gait and urination have been resolved.

关键词： Lumbar Spine Ossification of the Yellow Ligament Ossification of the Posterior Longitudinal Ligament Cauda Equina Syndrome

Intraspecific Relationships and Variation of Two <i>Lefua</i>Species (Balitoridae, Cypriniformes) in the Tokai Region, Honshu, Japan

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Journal of Water Resource and Protection 2017年第2期9卷 238-253页

作者： Jun-Ichi Miyazaki Seiya Hida Takurou Ozaki yuichirou Tabata Misaki Iwata Masashi Nakazawa Youki Fukasawa Tomonari Asaka Faculty of Education and Human Sciences University of Yamanashi Kofu Japan Department of Education Graduate School of Medical and Engineering University of Yamanashi Kofu Japan Mikawa Freshwater Life Network Toyokawa Japan

Two species Lefua echigonia and Lefua sp. 2 of the eight-barbel loach inhabit the Tokai region of Honshu, Japan. We determined sequences of the mitochondrial D-loop region to elucidate intraspecific phylogenetic relationships and variation in these two species. Lefua sp. 2 represented high intraspecific genetic similarity and complicated haplotype network, but three assemblages were recognized, including specimens mainly from Yahagi, Toyo, and Tenryu River systems, respectively, and named Groups 1 to 3. Divergence of Group 1 from the others was marginally supported, but Group 2 was paraphyletic to Group 3, suggesting the existence of two populations, i.e. Yahagi River population and Toyo-Tenryu River population. Lefua echigonia also represented high intraspecific genetic similarity, and two assemblages with slight genetic differentiation were discernible, including specimens from Shizuoka and southeastern Aichi prefectures and those from northwestern Aichi, Gifu, and Mie prefectures, respectively, and named Groups A and B. Star-like relationships of haplotypes suggested the dispersal origin located in eastern Aichi prefecture. The two species are threatened to extinction and thus we proposed evolutionary significant units for conservation.

关键词： Population Phylogeography Mitochondrial D-Loop Region Conservation River Capturing