STUDY DESIGN: Retrospective study. PURPOSE: The aims of the current study are to evaluate the minimum 10-year follow-up clinical results of anterior lumbar interbody fusion (ALIF) for degenerative spondylolisthesis. OVERVIEW OF LITERATURE: ALIF has been widely used as a treatment regimen in the management of lumbar spondylolisthesis. Still much controversy exists regarding the factors that affect the postoperative clinical outcomes. METHODS: The author performed a retrospective review of 20 patients with degenerative spondylolisthesis treated with ALIF (follow-up, 16.4 years). The clinical results were assessed by the Japanese Orthopaedic Association (JOA) score for low back pain, vertebral slip and disc height index on the radiographs. RESULTS: The mean preoperative JOA score was 7.1 +/- 1.8 points (15-point-method). At 1 year, 5 years, and 10 years or more after surgery, the JOA scores were assessed as 12.4 +/- 2.2 points, 12.7 +/- 2.6 points, 12.0 +/- 2.5 points, respectively (excluding the data of reoperated cases). The adjacent disc degeneration developed in all cases during the long-term follow-up. The progressive pattern of disc degeneration was divided into three types. Initially, disc degeneration occurred due to disc space narrowing. After that, the intervertebral discs showed segmental instability with translation at the upper level. But the lower discs showed osteophyte formation, and occasionally lead to the collapse or spontaneous union. CONCLUSIONS: The clinical results of the long-term follow-up data after ALIF became worse due to the adjacent disc degeneration. The progressive pattern of disc degeneration was different according to the adjacent levels.
Asian Continental Ancestry Group ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Low Back Pain ; Lumbosacral Region ; Osteophyte ; Retrospective Studies ; Spondylolisthesis

Here, we report on a rare case of a giant invasive sacral schwannoma. The patient was a 58-year-old woman who had a 6-year history of non-specific buttock pain. Histological investigation confirmed the diagnosis of cellular schwannoma. The following numerical aberration was detected using the GTG-banding method for karyotypes: 47,XX,-14,+18,+22. Cytogenetic studies of schwannomas have indicated a complete or partial loss of chromosome 22 as the most common abnormality, but this case is cytogenetically rare because of the recurrence of trisomy 22.
Buttocks ; Chromosomes, Human, Pair 22 ; Cytogenetics ; Female ; Humans ; Middle Aged ; Neurilemmoma ; Recurrence ; Sacrum ; Trisomy

PURPOSE: This research was conducted to reveal Japanese mothers' changing perceptions towards their technology-dependent children in the home care setting. METHODS: Fourteen Japanese mothers participated in semi-structured interviews, which were analyzed using a grounded theory approach. RESULTS: "Degree of preoccupation with the child" emerged as the category representing the mothers' perceptions towards their child. Three categories emerged that represented the progression of maternal perceptions over time: "accepting the child's conditions", "mastering the management of care in various conditions", and "considering social participation for the child". CONCLUSIONS: First, mothers gradually accepted the conditions of their child after his/her disease and disability were known. Second, others managed technology-required care and concurrently considered the social participation of their child through daily care at home. Third, the level of preoccupation with the child was affected by the mothers' management of care and their attitude towards the social participation of their child in home care. In this study, as is widely alleged in historical recognition of Japan, mothers provided daily care almost without help from other family members. Additionally, they thought it natural and good for their children. Above all, especially in Japan, professional support for mothers are necessary so that they can take breaks from care.
Adaptation, Psychological ; Adolescent ; Adult ; *Attitude to Health ; Biomedical Technology ; Caregivers ; Child ; Child Advocacy ; Disabled Children/*psychology ; Female ; Home Care Services ; Humans ; Japan ; Male ; Middle Aged ; Mother-Child Relations ; Mothers/*psychology ; Perception ; Personal Autonomy ; Self-Help Devices ; Young Adult

Lung cancer has a high mortality rate and is often diagnosed at the metastatic stage. Recently, gefitinib, a molecule target therapeutic drug, has offered a new approach for patients with non-small-cell lung cancer (NSCLC). This report describes the effects of gefitinib on bone metastases in two patients with NSCLC. The pain induced by a bone metastasis was relieved after the administration of gefitinib. Furthermore, the radiographs and CT findings showed sclerotic changes that matched those of the metastatic bone tumor after gefitinib administration in both patients. It is believed that gefitinib inhibited tumor cell proliferation and induced normal bone formation. In patients with NSCLC, gefitinib may be effective in the treatment of bone metastases.
Cell Proliferation ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Osteogenesis ; Quinazolines