1.Creating Flowcharts of Eating and Swallowing
Hirotaka SHOJI ; Taizo YAMAMOTO ; Tomoko INOUE ; Chizuru OIKAWA ; Natsumi ADACHI ; Shuzo SHINTANI ; Taro HINO
Journal of the Japanese Association of Rural Medicine 2010;58(5):526-532
Purpose: To create flow charts of eating and swallowing that make it easy to identify the cases requiring professional treatment including dysphagia rehabilitation during oral intake.Subjects: 28 patients (mean age: 78.7±11.3 years) with dysphagia who underwent videofluorography (hereinafter “VF”).Methods: We conducted various tests such as Repetitive Salvia Swallowing Test (RSST), Modified Water Swallowing Test (MWST) and Food Test (FT), and studied relationships between VF findings and Fujishima's grade of eating and swallowing capability.Results: After the examination of th results of RSST (sensitivity: 0.83, specificity: 0.22), MWST (sensitivity: 0.56, specificity: 0.72), FT (sensitivity: 0.33, specificity: 0.75), VF and grade of eating and swallowing capability of Fujishima, the use of MWST and FT was appropriate. However, four cases in which the results of MWST and FT were over the cut-off value had misswallowed water and food. We created the flowcharts considering that all of those 4 cases are also the cases that suffered from the consequences of cerebral strokes.
2.Multi-focal Myxopapillary Ependymoma in the Lumbar and Sacral Regions Requiring Cranio-spinal Radiation Therapy: A Case Report.
Hirotaka ANDOH ; Yoshiharu KAWAGUCHI ; Shoji SEKI ; Yumiko ASANUMA ; Jun FUKUOKA ; Shin ISHIZAWA ; Tomoatsu KIMURA
Asian Spine Journal 2011;5(1):68-72
Ependymomas are uncommon tumors that arise in the brain, spinal cord or cauda equina. Myxopapillary ependymomas is located exclusively in the conus medullaris or cauda equina, or film terminale region. In most myxopapillary ependymomas, the histological examination reveals low mitotic activity that is associated with a low MIB-1 labeling index (LI). The prognosis is generally favorable, when the appropriate treatment, including a total resection, is performed. The authors encountered a 39-year-old man with multifocal type of myxopapillary ependymomas compressing the cauda equina from the L2 to L3 level and L5-S1 level. A subtotal resection of the tumor was carried out. The histological examination revealed extremely high mitotic activity with a MIB-1 LI of 9.1%. Therefore, cranio-spinal radiation was added after surgery. The postoperative course was uneventful over the 3.5 year follow-up period.
Adult
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Brain
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Cauda Equina
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Conus Snail
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Ependymoma
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Follow-Up Studies
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Humans
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Prognosis
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Sacrococcygeal Region
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Spinal Cord