Intradural extramedullary spinal ependymomas are extremely rare. Herein, we describe a lesion-type spinal ependymoma that followed a malignant course, and discuss its clinical presentation, etiopathogenesis, and treatment. We present a patient who was diagnosed with an intradural extramedullary spinal tumor at T4-T6. The patient underwent gross total resection of the tumor without damage to the spinal cord. Histological examination, classified the lesion as a World Health Organization (WHO)-grade 2 ependymoma. One and a half years later, magnetic resonance imaging detected a recurring tumor at T4-T5. The tumor was removed and classified as a WHO-grade 3 anaplastic ependymoma. The patient was started on a course of regional spinal cord radiotherapy. The patient achieved tumoral control and clinical stabilization after the recurrence. We must consider the differential diagnosis of intradural extramedullary spinal tumors. The best treatment for this lesion is gross total resection and adjunctive radiotherapy is necessary in cases of malignant-change.
Diagnosis, Differential ; Ependymoma ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Spinal Cord ; Spinal Cord Neoplasms ; World Health Organization

Investigation on the working time, energy expenditure and fatigue were carried out for members of three families engaged principally in raising silk worms.
Group examinations of physical conditions and blood constituents and survey of nutritional intake were performed on the residents, including the above families, in a community in Fukueisland, Nagasaki-prefecture.
The results were as follows;
1) The average values of energy expenditure on a most busy day in a raising period of silk worm calculated to be 3150 kcal (max. 3500 kcal) for males, 2340 kcal (max. 2890 kcal) for females of the above three families. Their working times on this day were about 14 hours.
2) The physical fatigue of the subjects was estimated by means of Fliker frequency, near point and threshold of patellar reflex. Remarkable changes of these values were found, suggesting the heavy physical load of the raising works, and the changes were more remarkable in olders and females than in youngers and males.
3) Donaggio's reaction and Na/K in the first urine of morning were investigated at an interval of five days during one period of silk worm raising.
The Donaggio's reaction values were increased about two times higher in the latter term, on the other hand Na/K dropped in the former term of the period.
4) The group examinations of the inhabitants in the community showed that the body fat of silk raising farmers were fewer than that of the farmers engaged in other kinds of farming reported by the present authors.
Blood values (Ht, Hb and TP) of them in 1975 were lower than in 1974, because one more raising period was added and so the physical load of them might be greater in '75 than in '74.
5) The nutritional intakes of silk raising farmers were almost as same as these of the farmers in other districts.

BACKGROUND: Placenta previa and placenta accreta associate with high morbidity and mortality for both mothers and fetus. Metal exposure may have relationships with placenta previa and placenta accreta. This study analyzed the associations between maternal metal (cadmium [Cd], lead [Pb], mercury [Hg], selenium [Se], and manganese [Mn]) concentrations and placenta previa and placenta accreta. METHODS: We recruited 17,414 women with singleton pregnancies. Data from a self-administered questionnaire regarding the first trimester and medical records after delivery were analyzed. Maternal blood samples were collected to measure metal concentrations. The subjects were classified into four quartiles (Q1, Q2, Q3, and Q4) according to metal concentrations. RESULTS: The odds ratio for placenta previa was significantly higher among subjects with Q4 Cd than those with Q1 Cd. The odds ratio for placenta previa was significantly higher for subjects with Q2 Pb than those with Q1 Pb. CONCLUSION Participants with placenta previa had higher Cd concentrations. However, this study was cross-sectional and lacked important information related to Cd concentration, such as detailed smoking habits and sources of Cd intake. In addition, the subjects in this study comprised ordinary pregnant Japanese women, and it was impossible to observe the relationship between a wide range of Cd exposure and placenta previa. Therefore, epidemiological and experimental studies are warranted to verify the relationship between Cd exposure and pregnancy abnormalities.
Adult ; Cross-Sectional Studies ; Female ; Humans ; Japan ; Metals, Heavy ; blood ; metabolism ; Placenta Accreta ; metabolism ; Placenta Previa ; metabolism ; Pregnancy ; Selenium ; blood ; metabolism