While atrial septal defect is a common associated feature of partial anomalous pulmonary venous return, atrial septum reportedly remains intact in the incidences ranging from 2.2 to 26.0%. We have experienced four cases of isolated partial anomalous pulmonary venous return without other cardiac anomalies including atrial septal defect. Entire right pulmonary veins returned to right atria in two of the cases. Remaining two cases were extremely rare in type. In one of those, right and left upper pulmonary veins returned to superior vena cava and left innominate vein, respectively, and entire left pulmonary veins returned to left innominate vein in the other. Three of the cases underwent complete correction with excellent results.

STUDY DESIGN: Cross sectional study. PURPOSE: To clarify the difference in position of the psoas muscle between adult spinal deformity (ASD) and lumbar spinal stenosis (LSS). OVERVIEW OF LITERATURE: Although it is known that the psoas major muscle deviates in ASD patients, no report is available regarding the difference in comparison with LSS patients. METHODS: This study investigates 39 patients. For evaluating spinal alignment, pelvic tilt (PT), pelvic incidence (PI), sacral slope, lumbar lordosis (LL), PI–LL, Cobb angle, and the convex side, the lumbar curves were measured. For measuring the position of the psoas major at the L4/5 disk level, magnetic resonance imaging was used. The displacements of psoas major muscle were measured separately in the anterior–posterior and lateral directions. We examined the relationship between the radiographic parameters and anterior displacement (AD) and lateral displacement (LD) of the psoas major muscle. RESULTS: AD was demonstrated in 15 cases with ASD and nine cases with LSS (p>0.05). LD was observed in 13 cases with ASD and no cases with LSS (p < 0.01). The Cobb angle was significantly greater in cases with AD than in those without AD (p=0.04). PT, LL, PI–LL, and Cobb angle were significantly greater in cases with LD (p < 0.05). All cases with LD had AD, but no case without AD had LD (p < 0.001). The side of greater displacement at L4/5 and the convex side of the lumbar curve were consistent in all cases. CONCLUSIONS: Despite AD being observed in LSS as well, LD was observed only in the ASD group. Radiographic parameters were worse when LD was seen, rather than AD.
Adult ; Animals ; Congenital Abnormalities ; Humans ; Incidence ; Lordosis ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Posture ; Psoas Muscles ; Rheumatic Diseases ; Scoliosis ; Spinal Stenosis

We added Kampo medicine (Japanese traditional herbal medicine) to disease-­modifying anti-­rheumatic drugs (DMARDs) to treat rheumatoid arthritis (RA) in 41 patients. After 1 year, disease activity assessments showed improvement in the number of tender joints and DAS 28-­CRP, and Boolean remission increased from 3 cases to 6 cases. However, 16 of 41 patients had an insufficient therapeutic effect with Kampo medicine ; therefore, their DMARD treatment was strengthened. Disease activity in the 16 patients with strengthened DMARD therapy (Western group) was compared with that in the 25 patients who did not require strengthened DMARD therapy (Kampo group). The Western group had high disease activity at the beginning of Kampo medicine, and a year later CRP and DAS 28­-CRP improved. In the Kampo group, disease activity was relatively good at the beginning of Kampo medicine, and patient global assessment (PGA) improved. We believe that combination therapy, with DMARDs controlling synovitis and Kampo medicine improving PGA, is an effective way to achieve Boolean remission.