1.Effects of Serial Bathing in a Cold Spring on Immunological Parameters of Patients with Rheumatoid Arthritis. Supplements of the study on Kan no Jigoku Spa.
Masashi NOBUNAGA ; Keiji TATSUKAWA ; Hironobu ISHII ; Fumio YOSHIDA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1994;57(2):113-122
Previously one of our colleagues reported that the serial bathing (twice a day for 3 weeks) in a cold spring, Kan-no-Jigoku (simple hydrogen sulfide spring of 14°C) resulted in clinical improvements for patients with rheumatoid arthritis (RA). In that study, the effect on immune functions was also investigated, since RA is characterized by immune abnormalities. The following results were obtained.
1. No change was observed in serum gamma globulin levels and hemolytic complement activities.
2. Rheumatoid factor titers after the latex fixation test were improved in 2 out of 8 cases, by 1-2 steps after 2 weeks of bathing.
3. Circulating immune complex levels, which were significantly higher initially, fell gradually during 3 weeks of bathing, but insignificantly.
4. OKT4T cells decreased significantly after 3 weeks of bathing, while OKT3 and OKT8T cells decreased insignificantly. The OKT4/OKT8 ratio was elevated slightly after serial bathing of 3 weeks.
5. Plasma prostaglandin E levels were elevated significantly after 2 weeks, but returned to the initial levels after 3 weeks of bathing, although all the levels were within normal range. No such changes of them were observed by a hot spring bathing.
6. Plasma cyclic AMP levels, which were a little higher than the normal range in 3 out of 9 cases initially, were also elevated significantly after 1 week of bathing and returned to the initial levels thereafter gradually, while no significant changes of them were observed by a hot spring bathing.
7. Urinary hydroxyproline excretion was not changed by the serial bathing.
From the above results it was suggested that a cold spring bathing may give an immunosuppressive effect to a living body, resulting in benefit for RA patients.
2.Postoperative Loss of Lumbar Lordosis Affects Clinical Outcomes in Patients with Pseudoarthrosis after Posterior Lumbar Interbody Fusion Using Cortical Bone Trajectory Screw Fixation
Akira YAMAGISHI ; Hironobu SAKAURA ; Masayoshi ISHII ; Atsunori OHNISHI ; Tetsuo OHWADA
Asian Spine Journal 2021;15(3):294-300
Retrospective cohort study. This study aimed to investigate relationships between clinical outcomes and radiographic parameters in patients with pseudoarthrosis after posterior lumbar interbody fusion (PLIF). In some patients with pseudoarthrosis after PLIF, clinical symptoms improve following surgery, although pseudoarthrosis can often be one of the complications. However, there are no previous reports describing differences between patients with pseudoarthrosis after PLIF who have obtained better clinical outcomes and those who have not. Twenty-seven patients who were diagnosed with pseudoarthrosis after single-level PLIF with cortical bone trajectory screw fixation (CBT-PLIF) were enrolled in this study. They were divided into two groups based on mean improvement of 22 points on the Oswestry Disability Index (ODI) at the 2-year follow-up. Group G consisted of 15 patients who showed improvement on the ODI of ≥22 points, and group P consisted of the residual 12 patients. Radiographic parameters, percentage of slip, lumbar lordosis (LL), segmental lordosis, segmental range of motion, screw loosening, and subsidence were compared between the two groups. There were no significant differences between the two groups on radiographic parameters except for postoperative changes in LL. Although surgery-induced changes in LL showed no significant difference between the two groups, changes in LL from before surgery to 2-year follow-up and during postoperative 2-year follow-up were significantly better in group G (mean change of LL: +3.5° and +5.1°, respectively) compared to group P (mean change of LL: −4.6° and −0.5°, respectively) ( Patients with greater improvement in ODI gained LL over the 2-year follow-up, whereas patients with less improvement in ODI lost LL during the 2-year follow-up. These results indicate that there is a significant correlation between clinical outcomes and LL even in patients with pseudoarthrosis after single-level CBT-PLIF.
3.Postoperative Loss of Lumbar Lordosis Affects Clinical Outcomes in Patients with Pseudoarthrosis after Posterior Lumbar Interbody Fusion Using Cortical Bone Trajectory Screw Fixation
Akira YAMAGISHI ; Hironobu SAKAURA ; Masayoshi ISHII ; Atsunori OHNISHI ; Tetsuo OHWADA
Asian Spine Journal 2021;15(3):294-300
Retrospective cohort study. This study aimed to investigate relationships between clinical outcomes and radiographic parameters in patients with pseudoarthrosis after posterior lumbar interbody fusion (PLIF). In some patients with pseudoarthrosis after PLIF, clinical symptoms improve following surgery, although pseudoarthrosis can often be one of the complications. However, there are no previous reports describing differences between patients with pseudoarthrosis after PLIF who have obtained better clinical outcomes and those who have not. Twenty-seven patients who were diagnosed with pseudoarthrosis after single-level PLIF with cortical bone trajectory screw fixation (CBT-PLIF) were enrolled in this study. They were divided into two groups based on mean improvement of 22 points on the Oswestry Disability Index (ODI) at the 2-year follow-up. Group G consisted of 15 patients who showed improvement on the ODI of ≥22 points, and group P consisted of the residual 12 patients. Radiographic parameters, percentage of slip, lumbar lordosis (LL), segmental lordosis, segmental range of motion, screw loosening, and subsidence were compared between the two groups. There were no significant differences between the two groups on radiographic parameters except for postoperative changes in LL. Although surgery-induced changes in LL showed no significant difference between the two groups, changes in LL from before surgery to 2-year follow-up and during postoperative 2-year follow-up were significantly better in group G (mean change of LL: +3.5° and +5.1°, respectively) compared to group P (mean change of LL: −4.6° and −0.5°, respectively) ( Patients with greater improvement in ODI gained LL over the 2-year follow-up, whereas patients with less improvement in ODI lost LL during the 2-year follow-up. These results indicate that there is a significant correlation between clinical outcomes and LL even in patients with pseudoarthrosis after single-level CBT-PLIF.
4.A Case of Abdominal Abscess Possibly Due to Digestive Tract Perforation by an Ingested Fish Bone
Masatsugu ISHII ; Junichi SANO ; Yuki HIRANO ; Hironobu KASHIWAGI ; Michihito NISHIOKA ; Hiroshi IIO ; Yasuo KABESHIMA
Journal of the Japanese Association of Rural Medicine 2018;67(1):87-91
A 74-year-old woman visited our hospital complaining of pain in the left lower quadrant of the abdomen. Physical examination revealed tenderness to palpation without peritoneal signs. Blood test results showed elevated inflammatory response. Both ultrasonography and computed tomography revealed an intra-abdominal abscess containing a foreign body (fish bone) immediately below the left inferior abdominal wall. Lower gastrointestinal endoscopy conducted under fluoroscopic guidance revealed no intraluminal lesion in the colon adjacent to the abscess, and contrast examination also revealed no communication between the colon and the abscess. Fasting and administration of antibiotics did not improve the symptoms. We planned surgical procedure. Partial resection of the sigmoid colon was performed because of the presence of strong adhesions between the colonic wall and abscess. The postoperative course was uneventful, and the patient was discharged on hospital day 12. Histological examination of the resected specimen showed chronic abscess formation, but no communication between the intestinal tract and abscess. Onset was thought to be chronic in this case, because of uncertainty about the history of ingestion of fish bone and failure to verify any communication with the intestinal tract.