A 34-year-old man with cretinism complained of motor and sensory distrubance of the extremities. The neurological examination revealed spastic paralysis. Roentgenograms of the cervical spine showed an atlanto-axial dislocation with os odontoideum. The transoral anterior atlanto-axial fusion described by Thuyama was recommended. Reduction and fusion is satisfactly at 10 months after surgery. We did not find any other case of atlanto-axial dislocation with cretinism, in the literature.
We reported the case of a 40-year-old man who had cervical myelopathy due to ossification of the ligamentum flavum accompanied with cervical spondylosis. The ossification of the ligamentum flavum was obscure in the plain radiograph and tomogram. But, the computerized tomogram showed the accurate diagnosis of the level of the spinal canal stenosis. The ossification of the ligamentum flavum seemed to be the major cause of spinal cord compression.The expansive laminoplasty was carried out with resection of the ossified ligamentum flavum. And the good result was obtained.Microscopic examination of the removed ligamentum showed not only a bony structure consisting of haversian systems but also calcified tissues in the ligamentum flavum.
For recent six years, from September in 1969 to August in 1975, sixty-three patients with sixty-four fractures of the femoral neck and trochanter were operated in Yamaguchi-Rosai Hospital. As one patient had bilateral operations and seven were revised, so operations were seventy-two in all.As concerns the method of the operation, fifty-six operations of seventy-two (77.5%) were ostesyntheses and eleven were replacement operations to prostheses. In point of the site of the fracture, operations for fracture of the femoral neck were twenty-five (34.7%) and the rest was for the trochanteric fractures.In the femoral cervical fracture, the ratio of osteosyntheses to prostheses was thirteen to ten, and in another group, forty-three to one.These patients are usually old and having any complications, therefor have to be prevented various secondary diseases of bedsore, inflammation of urinary tract, stiffness or contracture of joint, dementia and so, which are caused by prolonged bedridden lying. If patients are able to be permited exercises on the bed or in Hubbard tank in a few days after operation, the operative therapy is reasonable.
Four cases of pyogenic spondylitis were reported. It is important to discriminate this disease from tuberculous spondylitis. In early period, the collective judgment by past history, family history, clinical sign, erythrocyte-sedimentation-rate, Mantoux reaction and X-ray films are necessary.
Abstract Multidrug resistance 1 (MDR1) gene encodes for P-glycoprotein (P-gp), a Mr 170,000 transmembrane calcium-dependent efflux pump that is inactivated in prostate cancer. We hypothesize that inactivation of the MDR1 gene through CpG methylation contributes to the pathogenesis and progression of prostate cancer. To test this hypothesis, CpG methylation status of the MDR1 promoter and its correlation with clinicopathological findings were evaluated in 177 prostate cancer samples and 69 benign prostate hypertrophy (BPH) samples. Cellular proliferation index and apoptotic index were determined by proliferating cell nuclear antigen (PCNA) and single-strand DNA immunostaining, respectively. After 5-aza-2′-deoxycytidine treatment, increased expression of MDR1 mRNA transcript was found in prostate cancer cell lines (DU145, DuPro, and ND1). MDR1 methylation frequency was significantly higher in prostate cancer samples compared with BPH samples (54.8 versus 11.6%, respectively, P < 0.001). Logistic regression analysis revealed that PC patients are 11.5 times more likely to have MDR1 methylation than BPH patients (95% confidence interval 4.87–27.0) and that MDR1 methylation is independent of the age. Significant correlation of MDR1 methylation was observed with high pT category (P < 0.001), high Gleason sum (P = 0.008), high preoperative prostate-specific antigen (P = 0.01), and advancing pathological features. In addition, PCNA-labeling index were significantly higher in methylation-specific PCR (MSP)-positive than in MSP-negative prostate cancer samples (P = 0.048). In contrast, no significant difference in apoptotic index was found between MSP-positive and -negative prostate cancer samples. These findings suggest that CpG hypermethylation of MDR1 promoter is a frequent event in prostate cancer and is related to disease progression via increased cell proliferation in prostate cancer cells.
