Journal of Nippon Medical School最新文献_第9页

Use of a Rigid Curved Laryngoscope for Observation and Debridement of Degenerated Cricoid Cartilage in Nasogastric Tube Syndrome: A Case Report. 使用硬质弯曲喉镜观察和清创鼻胃管综合征的环状软骨变性：病例报告。

IF 1.4 4区医学

Journal of Nippon Medical School Pub Date : 2025-09-02 Epub Date: 2024-08-21 DOI: 10.1272/jnms.JNMS.2025_92-402

Kotoko Arai, Koji Sakamoto, Masashi Nakaishi, Atsuko Sakanushi, Ayaho Yoshino, Kimihiro Okubo

{"title":"Use of a Rigid Curved Laryngoscope for Observation and Debridement of Degenerated Cricoid Cartilage in Nasogastric Tube Syndrome: A Case Report.","authors":"Kotoko Arai, Koji Sakamoto, Masashi Nakaishi, Atsuko Sakanushi, Ayaho Yoshino, Kimihiro Okubo","doi":"10.1272/jnms.JNMS.2025_92-402","DOIUrl":"10.1272/jnms.JNMS.2025_92-402","url":null,"abstract":"Nasogastric tube syndrome (NGTS) is a complication of NGT placement that can cause sore throat, bilateral vocal cord paralysis, and airway constriction. Although rare, this condition should be known by all physicians because it is sometimes fatal. We report a case of NGTS that was successfully diagnosed and debrided with a rigid curved laryngoscope. A 79-year-old man was referred to our department for evaluation of persistent pharyngeal pain and dysphagia after thoracic aortic aneurysm surgery. He had restricted bilateral vocal fold abduction, and the NGT had been placed for nearly 120 days. After induction of general anesthesia, the patient underwent laryngeal examination using a rigid curved laryngoscope, which revealed ossified cricoid cartilage in the postcricoid area, leading to confirmation of NGTS. The NGT was removed, and the protruding bony lesion was debrided. Subsequently, the patient underwent gastrostomy to improve his nutritional status. One month later, the postcricoid lesion improved, and the patient was able to tolerate an oral diet. The pathophysiology of NGTS is thought to involve ulceration of the postcricoid mucosa and injury of the posterior cricoarytenoid muscle by contact with the NGT. Although the treatment has not been established, early removal of the NGT is important. In the present case, the rigid curved laryngoscope was useful for resection of the bony lesion, which contributed to early epithelialization and symptom improvement.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"374-378"},"PeriodicalIF":1.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Collaborative Management Between Dermatologists and Pediatricians of a 3-Year-Old Boy with Atopic Dermatitis-Related Sleep Disturbance and Reduced Quality of Life Using Dupilumab: A Case Report. 皮肤科医生和儿科医生合作管理一名患有特应性皮炎相关睡眠障碍和使用杜匹单抗降低生活质量的3岁男孩：一例报告。

IF 1.4 4区医学

Journal of Nippon Medical School Pub Date : 2025-08-26 DOI: 10.1272/jnms.JNMS.2026_93-601

Toru Sugimoto, Yuri Kinoshita, Toru Igarashi, Mami Kurihara, Yuka Ota, Keigo Ito, Hidehisa Saeki, Azusa Ogita

{"title":"Collaborative Management Between Dermatologists and Pediatricians of a 3-Year-Old Boy with Atopic Dermatitis-Related Sleep Disturbance and Reduced Quality of Life Using Dupilumab: A Case Report.","authors":"Toru Sugimoto, Yuri Kinoshita, Toru Igarashi, Mami Kurihara, Yuka Ota, Keigo Ito, Hidehisa Saeki, Azusa Ogita","doi":"10.1272/jnms.JNMS.2026_93-601","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-601","url":null,"abstract":"A 3-year-old boy presented with recurrent eczema that began at 2 months of age. The patient was treated by multiple dermatologists using topical steroids, topical immunosuppressants, and oral antihistamines. The patient was subsequently referred to our clinic for improved symptom control. During the initial visit, he exhibited serous erythema, scaling, and scratch marks on the scalp, face, and limbs. Laboratory findings revealed elevated levels of immunoglobulin E at 5400 IU/mL, thymus and activation-regulated chemokine at 3029 pg/mL, and an Eczema Area and Severity Index score of 16. Due to sleep disturbances caused by nocturnal itching and substantially reduced quality of life, we initiated treatment with dupilumab. A pediatrician conducted pre-treatment assessments, including blood tests and chest radiography. Following the initiation of dupilumab therapy, the pediatrician monitored the patient for potential reactions and side effects, and the dermatologist managed the skin symptoms. This case underscores the importance of interdisciplinary collaboration between pediatrics and dermatology in managing severe eczema in young children treated with dupilumab.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laparoscopic Resection of a Large Mucinous Cystic Neoplasm of the Liver: A Case Report. 腹腔镜下肝大粘液囊性肿瘤切除术1例报告。

IF 1.4 4区医学

Journal of Nippon Medical School Pub Date : 2025-08-26 DOI: 10.1272/jnms.JNMS.2026_93-503

Yuto Aoki, Yukio Oshiro, Ryo Ga, Mampei Kawashima, Chikako Hasegawa, Youichi Kawano, Junji Ueda, Yoshiharu Nakamura, Hiroshi Yoshida

{"title":"Laparoscopic Resection of a Large Mucinous Cystic Neoplasm of the Liver: A Case Report.","authors":"Yuto Aoki, Yukio Oshiro, Ryo Ga, Mampei Kawashima, Chikako Hasegawa, Youichi Kawano, Junji Ueda, Yoshiharu Nakamura, Hiroshi Yoshida","doi":"10.1272/jnms.JNMS.2026_93-503","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-503","url":null,"abstract":"Mucinous cystic neoplasms of the liver (MCNs-L) are rare cystic tumors characterized by multilocular cysts lined with a mucin-producing epithelium and supported by ovarian-like stroma. These tumors account for <5% of all cystic liver lesions and carry a potential risk of malignant transformation, necessitating early diagnosis and surgical resection. This report describes the successful laparoscopic partial liver resection of segments 4 and 5 for a large MCN-L in a woman in her 40s who presented with upper abdominal discomfort. Imaging studies revealed a multilocular cystic lesion measuring 11.9 × 8.5 × 13.0 cm in segments 4 and 5 of the liver. The primary challenges were the size of the lesion and the need to prevent cystic content spillage during surgery. Using meticulous techniques, including the use of a retrieval bag and controlled aspiration, we successfully excised the tumor laparoscopically and without contamination. Pathological analysis confirmed a diagnosis of mucinous cystic adenoma with no evidence of malignancy. The patient recovered uneventfully and was discharged on postoperative day 7. This case highlights the feasibility and safety of a laparoscopic approach for large MCNs-L. Furthermore, it underscores the importance of preoperative planning, precise surgical techniques, and measures to prevent cystic content dissemination. Minimally invasive surgery offers significant benefits, including reduced recovery time and improved cosmetic outcomes, and can be effectively applied to large hepatic cystic lesions by experienced surgical teams.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combination therapy with laparoscopic Hassab's procedure and three subsequent endoscopic variceal ligation sessions for pipeline esophageal varices: A report of two cases. 联合腹腔镜Hassab手术和随后的三次内镜下静脉曲张结扎治疗食道静脉曲张：两例报告。

IF 1.4 4区医学

Journal of Nippon Medical School Pub Date : 2025-08-26 DOI: 10.1272/jnms.JNMS.2026_93-602

Tetsuya Shimizu, Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Masato Yoshioka, Akira Matsushita, Yoichi Kawano, Junji Ueda, Takahiro Murokawa, Takashi Ono, Takahiro Haruna, Akira Hamaguchi, Ryo Ga

{"title":"Combination therapy with laparoscopic Hassab's procedure and three subsequent endoscopic variceal ligation sessions for pipeline esophageal varices: A report of two cases.","authors":"Tetsuya Shimizu, Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Masato Yoshioka, Akira Matsushita, Yoichi Kawano, Junji Ueda, Takahiro Murokawa, Takashi Ono, Takahiro Haruna, Akira Hamaguchi, Ryo Ga","doi":"10.1272/jnms.JNMS.2026_93-602","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-602","url":null,"abstract":"High blood flow and intravariceal pressure in pipeline esophageal varices (EVs) can cause refractory variceal bleeding that is difficult to control with endoscopic procedures and interventional radiology. We used combination therapy with Hassab's procedure (HP) and subsequent endoscopic variceal ligation (EVL) to successfully treat two patients with pipeline EVs.Case 1A woman in her 30s with recurrent hemorrhagic pipeline EVs caused by idiopathic portal hypertension was referred for surgery. Magnetic resonance imaging revealed a dilated left gastric vein (LGV) connected to EVs with no palisade zone. Esophagogastroduodenoscopy (EGD) identified high-risk EVs (Ls, F3, Cw, RC1) and gastric varices (GVs) (Lg-c, F2, Cw, RC0). Eradication of the esophagogastric varices was maintained 5 years after laparoscopic HP followed by EVL at 1, 6 and 16 months postoperatively.Case 2A woman in her 50s with cirrhosis (type B) and enlarged pipeline EVs was referred for prophylactic surgery. Computed tomography (CT) imaging revealed that the EVs were supplied by a dilated LGV without a palisade zone. EGD identified high-risk EVs (Lm, F3, Cb, RC2) and GVs (Lg-c, F3, Cw, RC1). Combination therapy with laparoscopic HP and EVL at 2, 4, and 6 months showed the eradication of esophagogastric varices 8 months after surgery. CT scanning performed 10 days postoperatively in case 2 revealed residual EVs supplied by gastric intramural blood flow, strongly supporting the need for additional EVL after HP. HP involves gastroesophageal devascularization and splenectomy, which reduce blood supply to EVs, facilitating subsequent EVL to eradicate pipeline EVs. This combination therapy appears to enhance outcomes and should be considered a viable option for treating refractory pipeline EVs.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Delayed Diagnosis of Painless Thyroiditis in an Adolescent Presenting with Aggression and Disruptive Behavior Initially Attributed to Worsening of a Psychiatric Disorder. 最初因精神障碍恶化而出现攻击和破坏行为的青少年被延迟诊断为无痛性甲状腺炎》（Delayed Diagnosis of Painless Thyroiditis in an Adolescent Presenting with Aggression and Disruptive Behavior Initially Attributed to Worseening of a Psychiatric Disorder）。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-07-02 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-302

Yutaka Furuta, Takahiro Masuoka, Ryuichiro Narishige, Amane Tateno

{"title":"Delayed Diagnosis of Painless Thyroiditis in an Adolescent Presenting with Aggression and Disruptive Behavior Initially Attributed to Worsening of a Psychiatric Disorder.","authors":"Yutaka Furuta, Takahiro Masuoka, Ryuichiro Narishige, Amane Tateno","doi":"10.1272/jnms.JNMS.2025_92-302","DOIUrl":"10.1272/jnms.JNMS.2025_92-302","url":null,"abstract":"Painless thyroiditis, which is rare in children, exhibits the characteristic sequence of hyperthyroidism, including aggressive and disruptive behaviors. Unlike subacute thyroiditis or Graves' disease, painless thyroiditis is challenging to diagnose because of its mild symptoms and minimal or absent physical findings. Moreover, aggressive and disruptive behaviors in children with psychiatric disorders may be misconstrued as exacerbation of underlying symptoms. The present patient was a 16-year-old male with adjustment disorder who presented to a pediatric psychiatric clinic for assessment of irritability. After 4 months, he developed aggressive and disruptive behaviors that prompted initiation of risperidone but without improvement. After 1 month, he reported palpitations and dyspnea. His neck was supple and non-tender without thyroid enlargement. Thyroid studies revealed elevated free T4 and T3 levels and suppressed thyroid-stimulating hormone level, suggesting hyperthyroidism. A radioactive iodine uptake test revealed a barely visible thyroid gland, consistent with thyroiditis. Painless thyroiditis, without thyroid tenderness, was diagnosed. We describe a case of painless thyroiditis in an adolescent patient with aggressive and disruptive behaviors that were initially attributed to worsening of an underlying adjustment disorder. Even when minimal or no signs of hyperthyroidism are present, painless thyroiditis should be considered in the differential diagnosis of children with aggressive and disruptive behaviors. Awareness of potential anchoring bias is also recommended to prevent its delayed diagnosis of such behaviors.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"296-299"},"PeriodicalIF":1.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New-Onset Schizophrenia in an Adolescent after COVID-19. 一名青少年在服用 COVID-19 后新发精神分裂症。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-07-02 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-301

Masatsugu Ishii, Kakusho C Nakajima-Ohyama, Hayato Saito, Tomoyuki Ohya, Shotaro Uchiyama, Mizuho Takahashi, Masanori Sakamaki, Akihiro Watanabe, Jun-Ichi Inoue, Tetsuro Sekine, Amane Tateno, Yasuhiro Kishi

{"title":"New-Onset Schizophrenia in an Adolescent after COVID-19.","authors":"Masatsugu Ishii, Kakusho C Nakajima-Ohyama, Hayato Saito, Tomoyuki Ohya, Shotaro Uchiyama, Mizuho Takahashi, Masanori Sakamaki, Akihiro Watanabe, Jun-Ichi Inoue, Tetsuro Sekine, Amane Tateno, Yasuhiro Kishi","doi":"10.1272/jnms.JNMS.2025_92-301","DOIUrl":"10.1272/jnms.JNMS.2025_92-301","url":null,"abstract":"Schizophrenia develops during adolescence. Maternal infections during the fetal period increase the incidence of schizophrenia in children, which suggests that the pathogenesis involves neuroinflammation. Here, we report a case of new-onset schizophrenia in a 16-year-old boy after COVID-19. After developing COVID-19, he entered a catatonic state 4 days later and was hospitalized. Benzodiazepines alleviated his catatonia, but hallucinations and delusions persisted. Encephalitis and epilepsy were excluded by magnetic resonance imaging (MRI), encephalography, and cerebrospinal fluid examination. Psychosis persisted after the virus titer declined and the inflammatory response subsided. Moreover, the patient exhibited delusions of control-a Schneider's first-rank symptom. Schizophrenia was diagnosed, and olanzapine improved his symptoms. He had a brief history of insomnia before COVID-19 but his symptoms did not satisfy the ultra-high-risk criteria. However, COVID-19 may have facilitated development of schizophrenia through neuroinflammation and volume reduction in the gray matter of the right medial temporal lobe. This case demonstrates that infectious diseases in adolescents should be carefully managed, to prevent schizophrenia.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"287-295"},"PeriodicalIF":1.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Tocilizumab to Treat Arthritis Associated with Mixed Connective Tissue Disease Complicated by Ovarian Teratoma: A Case Report. 使用托西珠单抗治疗卵巢畸胎瘤并发混合结缔组织病相关关节炎：病例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-07-02 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-303

Haruka Ota, Toru Igarashi, Ryosuke Matsui, Hikaru Takeshita, Koji Hashimoto, Masaki Miyao, Norio Motoda, Tsubasa Takahashi, Jun Hayakawa, Makoto Migita, Yasuhiko Itoh

{"title":"Use of Tocilizumab to Treat Arthritis Associated with Mixed Connective Tissue Disease Complicated by Ovarian Teratoma: A Case Report.","authors":"Haruka Ota, Toru Igarashi, Ryosuke Matsui, Hikaru Takeshita, Koji Hashimoto, Masaki Miyao, Norio Motoda, Tsubasa Takahashi, Jun Hayakawa, Makoto Migita, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2025_92-303","DOIUrl":"10.1272/jnms.JNMS.2025_92-303","url":null,"abstract":"Mixed connective tissue disease (MCTD) is characterized by mixed features of systemic lupus erythematosus, systemic sclerosis, and polymyositis/dermatomyositis and is rare in children. Here, we report a case of MCTD in a 10-year-old girl who presented at our hospital with arthralgia, Raynaud's phenomenon, and fatigue. Blood tests were positive for anti-U1-ribonucleoprotein (RNP) antibodies and for rheumatoid factors (RFs) IgG-RF and anti-galactose-deficient IgG. Levels of myogenic enzymes and hypergammaglobulinemia were elevated. Macrophages were prominent in bone marrow, with scattered phagocytic macrophages. MCTD was diagnosed based on the patient's symptoms and laboratory findings. Methylprednisolone pulse therapy combined with oral tacrolimus was administered, which led to resolution of symptoms. Three months after pulse therapy, arthralgia worsened and methotrexate was administered. Arthralgia improved but did not resolve. Magnetic resonance imaging performed to investigate the hip pain revealed a mature ovarian teratoma, which was surgically removed. Because the pain persisted and interfered with her daily life, she was treated with tocilizumab for joint pain relief, which decreased the pain level. Tocilizumab is a candidate for additional treatment of juvenile idiopathic arthritis-like arthritis associated with childhood-onset MCTD.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"300-304"},"PeriodicalIF":1.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Isolated Prosopagnosia Caused by Damage to the Right Inferior Longitudinal Fasciculus: A Case Report. 右下纵筋膜受损导致的孤立性嗜眠症：病例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-05-21 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-202

Harumi Morioka, Masaru Yanagihashi, Mikito Toda, Takanori Ikeda, Masafumi Mizuno, Masaaki Hori, Kouhei Kamiya, Osamu Kano

引用次数: 0

Diagnostic Performance of Advanced Tomosynthesis in Patients with Metal Devices in the Affected Knee: A Case Report. 先进断层扫描对患膝关节金属装置患者的诊断效果：病例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-03-07 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-101

Yasushi Oshima, Tokifumi Majima

{"title":"Diagnostic Performance of Advanced Tomosynthesis in Patients with Metal Devices in the Affected Knee: A Case Report.","authors":"Yasushi Oshima, Tokifumi Majima","doi":"10.1272/jnms.JNMS.2025_92-101","DOIUrl":"10.1272/jnms.JNMS.2025_92-101","url":null,"abstract":"Simple radiography is the most frequently and widely available technology to examine bone pathologies. Computed tomography (CT) can evaluate pathologies more accurately in multiple planes and three dimensions; however, radiation exposure is much higher than with simple radiography. In addition, diagnostic ability is decreased for both technologies when metal devices are present. Tomosynthesis is a radiographic technology used to evaluate tissues quasi-three-dimensionally with less radiation exposure. Tomosynthesis technology was recently upgraded to reduce the effects of metal artifacts. This case report compares examination time, medical expense, image resolution, and radiation exposure for upgraded tomosynthesis, simple radiography, CT, and standard tomosynthesis in three patients with metal devices in the affected knees. Examination times were similar for the imaging technologies. Diagnostic performance was better for upgraded tomosynthesis than for simple radiography and standard tomosynthesis, and similar to that for CT. Moreover, radiation exposure and expense were higher for tomosynthesis than for simple radiography but lower than for CT. These findings suggest that upgraded tomosynthesis is the best method for evaluating bone pathology when metal devices are present and radiation exposure must be limited.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"104-110"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cerebrospinal Fluid Leakage Due to Dural Thinning after Endoscopic Pituitary Tumor Resection. 内窥镜垂体瘤切除术后硬脑膜变薄导致脑脊液漏。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-03-07 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-102

Shinichiro Teramoto

{"title":"Cerebrospinal Fluid Leakage Due to Dural Thinning after Endoscopic Pituitary Tumor Resection.","authors":"Shinichiro Teramoto","doi":"10.1272/jnms.JNMS.2025_92-102","DOIUrl":"10.1272/jnms.JNMS.2025_92-102","url":null,"abstract":"Sellar reconstruction is important for preventing cerebrospinal fluid (CSF) leakage after transsphenoidal pituitary surgery. This report describes how, despite standard sellar reconstruction, CSF exudation resulted from dural thinning at the anterior skull base, outside the intrasellar area manipulated during pituitary tumor resection. A 76-year-old man underwent endoscopic transsphenoidal surgery for a pituitary tumor extending toward the anterior skull base. After opening the sellar floor, intractable bleeding from the anterior intercavernous sinus occurred during bone removal at the anterior skull base. Pseudocapsule-based extracapsular resection was completed after stopping the bleeding. On the 10th postoperative day, the patient developed CSF rhinorrhea complicated by marked pneumocephalus, and emergency endoscopic repair of the CSF leak was performed. CSF leakage originated from the thinned dura at the anterior skull base located outside the intrasellar area manipulated during tumor resection. The thinned dural area at the anterior skull base coincided with the site of intractable bleeding of the anterior intercavernous sinus during bone removal in tumor resection. The thinned anterior skull base dura was covered with fascia, overlaid with fat, and closed with the nasoseptal flap. Endoscopic CSF leak repair was successful. Severe damage to the anterior intercavernous sinus can cause extensive exposure of the single-layered inner meningeal dura, where thinning might result in CSF exudation. Therefore, use of autologous tissues to cover and reinforce the severely damaged area of the anterior intercavernous sinus might help prevent postoperative CSF exudation.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"111-115"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0