The authors report a case of intradural myxopapillary ependymoma of the cauda equina that was clinically similary to herniated lumbar disc disease. The tumor was totally removed under microsurgical condition and the diagnosis was confirmed pathologically.
Cauda Equina* ; Diagnosis ; Ependymoma*

The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.
Aged ; Humans ; Spine ; Vertebral Artery

Recently, cardiovascular morbidity and mortality have been continuously reduced in people with diabetes through the intensive management of multiple risk factors. However, contrary to this trend, the prevalence and clinical significance of neurodegenerative disorders are steadily increasing. In previous studies, diabetes mellitus has been found to play an important role in increasing the risk of dementia and cognitive dysfunction through various mechanisms. In particular, hypoglycemia is a frequent clinical situation in the strict management of diabetes and is well known as an important factor that directly affects the risk of dementia and cognitive impairment. This article describes the occurrence of hypoglycemia in patients with diabetes, and summarizes the resultant risks of dementia and cognitive dysfunction.
Cognition Disorders ; Dementia* ; Diabetes Mellitus ; Humans ; Hypoglycemia* ; Mortality ; Neurodegenerative Diseases ; Prevalence ; Risk Factors

The immune system contributes to body defence mechanism, but sometimes show unfavorable immune disease. Cerebral vasospasm is a major problem in aneurysmal subarachnoid hemorrhage(SAH), but the pathogenesis is poorly understood. Some authors suggest cerebral vasospasm is one type of autoimmune vasculitis. In 35 patients(male 20, female 15) with aneurysmal SAH. the levels of serum immunoglobulin(Ig) G, A, M, E and complement C3(C3) were determined to analyze the relation among Igs, C3, cerebral vasospasm and clinical grade. The results were as follows : 1) Highly significant correlation presented between C3 level and cerebral vasospasm(p<0.001). 2) Highly significant correlation presented between IgA level and cerebral vasospasm(p<0.001). 3) Significant correlation showed IgA with admission grade(p<0.001) and outcome(p<0.01). 4) Significant correlation showed C3 with admission grade(p<0.05) and outcome(p<0.01). 5) Among the 4 groups(SAH without vasospasm, SAH within vasospasm, hypertensive intracranial hematoma(HICH), herniated intervertebral disc(HIVD)), significant statistical difference at the level of IgA and C3 with others is observed in the group 2. 6) In serial determination of C3 levels performed in 8 patients(group 1 and group 2), correlative alteration between C3 level and cerebral vasospasm was observed. From the above results, these findings suggest that IgA and C3 levels not only might be reflected the severity of the neurological insult but also provide the usefulness as a predictable marker of cerebral vasospasm in aneurysmal SAH.
Aneurysm* ; Complement C3* ; Complement System Proteins* ; Female ; Humans ; Immune System ; Immune System Diseases ; Immunoglobulin A ; Immunoglobulins* ; Subarachnoid Hemorrhage* ; Vasculitis ; Vasospasm, Intracranial*

The report of basilar bifurcation aneurysm accompanying carotid-ophthalmic aneurysm is extremely rare and some technical dexterity must be needed on surgical treatment for each of two aneurysms. Authors report a case of basilar top aneurysm accompanied with a carotid- ophthalmic aneurysm clipped successfully in one stage operation with review of literatures concerning basilar bifurcation aneurysm, carotid-ophthalmic aneurysm and multiple aneurysms.
Aneurysm*

Studies have reported that people with chronic diseases such as diabetes and obesity have a higher risk of coronavirus disease 2019 (COVID-19) infection than does the general population and are associated with poor prognosis. As a number of research results have been published, our understanding of COVID-19 infection is deepening. In this article, I would like to summarize and introduce clinical considerations for COVID-19 infection in people with diabetes and/or obesity based on the results of major studies published to date.

One of the important physical changes associated with aging is a decline in muscle mass and strength. Such change is known to occur starting in the early thirties, and multiple factors such as ethnicity, gender, genetic factors, lifestyle, and underlying medical conditions intricately affect this phenomenon. Especially in elderly people, sarcopenia is crucial for declining physical function and quality of life associated with such physiologic changes, and it is also considered to be a risk factor for chronic diseases such as type 2 diabetes mellitus. In this article, I briefly describe the definition, clinical implications, and influence on diabetes mellitus of sarcopenia, and discuss current clinical recommendations for preventing sarcopenia in diabetic patients.
Aged ; Aging ; Chronic Disease ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Humans ; Life Style ; Muscles ; Quality of Life ; Risk Factors ; Sarcopenia*

It is well known that the kidney is important for maintaining glucose homeostasis in vivo. However, the physiological role of the kidney in glucose metabolism is typically underestimated. Recently, a new class of anti-diabetic medications that affect the renal glucose regulatory mechanism was introduced into the market, sparking the interest of many researchers to better understand this mechanism. In this article, I briefly describe the role of the kidney in glucose metabolism and the changes of its function in patients with diabetes mellitus.
Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Gluconeogenesis ; Glucose* ; Homeostasis ; Humans ; Kidney* ; Metabolism*