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Nagoya Journal of Medical Science

Tomotaka Ohshima, Taiki Yamamoto, Shunsaku Goto, Kojiro Ishikawa, Toshihisa Nishizawa, Shinji Shimato
Carotid artery stenting (CAS) is increasingly utilized in patients with carotid artery stenosis. Various intraprocedural and postprocedural complications have been reported in the literature. We present a case of symptomatic major thromboembolism after CAS. The intraprocedural angiogram showed extraordinary slow filling of the contrast medium into the plaque, which we named as "crevice sign." An 83-year-old man presented repeat right amaurosis fugax for 6 months. The radiological examinations revealed 85% stenosis of the origin of the right internal carotid artery...
November 2017: Nagoya Journal of Medical Science
Takaaki Shinohara, Hitoshi Hirata
We describe a 59-year-old man who had nonunion of a right distal radius fracture after volar locking plate fixation. He underwent open reduction and internal fixation with a volar locking plate system for a dorsally displaced, unstable distal radius fracture at a previous hospital 5 months ago. Radiographs of the injured wrist showed nonunion of the distal radius with 1.5-mm ulnar minus variance. Radiographs of the unaffected wrist showed 3.5-mm ulnar plus variance. Intraoperative findings of surgical revision showed an unstable nonunion; thus, debridement of the nonunion, autogenous inlay bone grafting, and internal fixation using another type of volar locking plate system were performed...
November 2017: Nagoya Journal of Medical Science
Tetsuro Hida, Kei Ando, Kazuyoshi Kobayashi, Kenyu Ito, Mikito Tsushima, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Shunsuke Kanbara, Sadayuki Ito, Yoshihiro Nishida, Naoki Ishiguro, Shiro Imagama
Surgical site infections (SSIs) are one of the most serious complications in spine surgery. We investigated the efficacy of locally administered vancomycin (VCM) powder for prophylaxis on SSI after invasive spine surgery. We retrospectively studied 174 consecutive patients who underwent spine surgery. In patients of the VCM group (n = 81), VCM powder was administered in the wound before closing wound. Patients who did not receive VCM treatment were set as a control group (n = 93). We compared the patients' background, operation time, intraoperative blood loss, usage of implants, presence of deep SSI, and side effects between the two groups...
November 2017: Nagoya Journal of Medical Science
Kazuhiro Kitajima, Masatoyo Nakajo, Hayato Kaida, Ryogo Minamimoto, Kenji Hirata, Masakatsu Tsurusaki, Hiroshi Doi, Yoshiko Ueno, Keitaro Sofue, Yukihisa Tamaki, Koichiro Yamakado
Positron emission tomography/computed tomography (PET/CT) integrated with 2-[18F]fluoro-2-deoxy-D-glucose (FDG) is a useful tool for acquisition of both glucose metabolism and anatomic imaging data, as only a single device and one diagnostic session is required, thus opening a new field in clinical oncologic imaging. FDG-PET/CT has been successfully used for initial staging, restaging, assessment of early treatment response, evaluation of metastatic disease response, and prognostication of intestinal cancer as well as various malignant tumors...
November 2017: Nagoya Journal of Medical Science
Nobuyuki Hamajima, Takuya Sugimoto, Ryo Hasebe, Su Myat Cho, Moe Khaing, Tetsuyoshi Kariya, Yu Mon Saw, Eiko Yamamoto
Medical facility statistics provide essential information to policymakers, administrators, academics, and practitioners in the field of health services. In Japan, the Health Statistics Office of the Director-General for Statistics and Information Policy at the Ministry of Health, Labour and Welfare is generating these statistics. Although the statistics are widely available in both Japanese and English, the methodology described in the technical reports are primarily in Japanese, and are not fully described in English...
November 2017: Nagoya Journal of Medical Science
Tomotaka Ohshima, Shunsaku Goto, Taiki Yamamoto, Kojiro Ishikawa
Despite major developments in treating intracranial aneurysms by endovascular coil embolization, complete occlusion of the entire aneurysmal neck remains a problem. We present a novel endovascular strategy for middle- and large sized aneurysms called the "hemispheric divided coiling technique" and compare the short-term follow-up results of this technique with those of conventional coil embolization. Ten patients (mean age, 69.7 ± 9.7 years) with middle- or large-sized ruptured or unruptured intracranial aneurysms (mean maximum aneurysmal diameter, 12...
November 2017: Nagoya Journal of Medical Science
Kazuyoshi Kobayashi, Kei Ando, Yuko Inagaki, Yusuke Suzuki, Yoshimasa Nagao, Naoki Ishiguro, Shiro Imagama
Fall in hospitalized patients can cause trauma and fractures, which can reduce ADL and QOL, whereas prevention of fall decreases medical expenses. The purpose of this study is to examine prevention of fall due to intervention from a fall working group established in our hospital. The working group focused on three main points. First, colored wrist bands for patients classified as grade 3 risk for fall are used to alert medical staff. Second, information on fall prevention was distributed to patients. Third, standardization of two bed fences and reduced use of slippers for inpatients have been introduced...
November 2017: Nagoya Journal of Medical Science
Susumu Ota, Kazutoshi Kurokouchi, Shigeo Takahashi, Masaki Yoda, Ryuichiro Yamamoto, Tadahiro Sakai
Patellofemoral cartilage degeneration is a potential complication of anterior cruciate ligament reconstruction (ACLR) surgery. Hypomobility of the patella in the coronal plane is often observed after ACLR. Few studies, however, have examined the relationship between cartilage degeneration in the patellofemoral joint and mobility after ACLR. The present study investigated 1) the coronal mobility of the patella after ACLR, 2) the relationship between patellar mobility and cartilage degeneration of the patellofemoral joint, and 3) the relationship between patellar mobility and knee joint function after ACLR...
November 2017: Nagoya Journal of Medical Science
Maimaiti Yisireyili, Kyosuke Takeshita, Shinichi Saito, Toyoaki Murohara, Toshimitsu Niwa
Indoxyl sulfate (IS) induces fibrosis and inflammation in kidneys via oxidative stress through the induction of transforming growth factor-β1 (TGF-β1) and monocyte chemotactic protein-1 (MCP-1). Furthermore, IS is a potent endogenous agonist for aryl hydrocarbon receptor (AHR), which regulates the transcription of genes such as cytochrome P450 (CYP) 1A1. Indole-3-propionic acid (IPA) is an antioxidant and has been reported to be neuroprotective. We determined whether IPA suppresses IS-induced expression of AHR, CYP1A1, TGF-β1, and MCP-1 in proximal tubular cells...
November 2017: Nagoya Journal of Medical Science
Naruhiro Jingushi, Mitsunaga Iwata, Teruhiko Terasawa
Infective endocarditis (IE) is an uncommon clinical problem with diverse, nonspecific presentations. Therefore, information on the clinical features of IE patients presenting to emergency departments (EDs) is scarce. To descriptively analyze the pertinent data, we performed a retrospective chart review. We reviewed 15 consecutive IE patients admitted directly from ED in a university hospital in Japan between 2013 and 2015. We compared their clinical features with those of 14 IE patients admitted during the same period without ED presentations...
November 2017: Nagoya Journal of Medical Science
Kazuyoshi Kobayashi, Kei Ando, Hideki Yagi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Yukihiro Matsuyama, Naoki Ishiguro, Shiro Imagama
A retrospective study was performed to examine the efficacy of intraoperative monitoring of the external anal sphincter (EAS) muscle-evoked potential after a transcranial muscle-action potential (Tc-MsEP) in spinal cord surgery, and to evaluate alarm points for EAS waveform deterioration related to postoperative bowel bladder disorder (BBD). BBD is caused by damage to the hypogastric, pelvic, and pudendal nerves and leads to a significant reduction in quality of life. Intraoperative Tc-MsEP monitoring using the EAS is common to prevent neurological deficit, but the relationship of BBD with intraoperative monitoring of the EAS has not been examined...
November 2017: Nagoya Journal of Medical Science
Patommatat Bhanthumkomol, Kazuo Hara, Nobumasa Mizuno, Susumu Hijioka, Nozomi Okuno, Tsukasa Yoshida, Junya Tokuhisa, Sith Siramolpiwat, Ratha-Korn Vilaichone, Bubpha Pornthisarn, Yasumasa Niwa, Masahiro Tajika, Tsutomu Tanaka, Makoto Ishihara, Yutaka Hirayama, Kenji Yamao
Endoscopic placement of the plastic stent has been adopted as an initial treatment for chronic pancreatitis with pancreatic duct stricture. Stent fracture while attempting removal is one of the complications of stent exchange. The use of the unilateral-flange stent in these patients has never been reported. We investigated the outcomes associated with the use of this stent with regard to stent exchange and stent-related adverse events. From 2011 to 2015, 9 patients with chronic pancreatitis and main pancreatic duct (MPD) stricture treated with the unilateral-flange stent were included...
November 2017: Nagoya Journal of Medical Science
Tomonobu Abe, Sachie Terazawa, Hideki Ito, Yoshiyuki Tokuda, Kazuro Fujimoto, Masato Mutsuga, Yuji Narita, Hideki Oshima, Akihiko Usui
Wrapping and graft replacement are two optional procedures for the treatment of dilated ascending aorta at the time of aortic valve replacement (AVR). Wrapping is considered less invasive. The aim of this study was to compare the short- and long-term clinical outcomes as well as the long-term quality of life in patients undergoing these two procedures.This study enrolled 40 consecutive patients with dilated ascending aorta who had undergone either wrapping (WAA group, n=20) or replacement (RAA group, n=20) of the ascending aorta at the time of AVR...
November 2017: Nagoya Journal of Medical Science
Tomotaka Ohshima, Chinmaya Dash, Andrey Belayev, Taiki Yamamoto, Shunsaku Goto, Yoko Kato
The use of 8-F balloon guide catheter (BGC) for proximal flow control was previously shown to prevent distal embolic complications during mechanical clot retrieval in patients with acute ischemic stroke. In this retrospective study, the utility of 8-F BGCs for proximal flow control during endovascular coiling of anterior circulation aneurysms was investigated. Patients who underwent endovascular coiling for anterior circulation aneurysms between August 2013 and December 2016 were retrospectively analyzed. Among a total of 152 patients included in this series, 64 patients presented with aneurysmal rupture, whereas the aneurysms were detected incidentally or due to mass effects in the remaining patients...
November 2017: Nagoya Journal of Medical Science
Hizuru Amano, Yujiro Tanaka, Hiroshi Kawashima, Kyoichi Deie, Keisuke Suzuki, Michimasa Fujiogi, Kaori Morita, Tadashi Iwanaka, Hiroo Uchida
Fundoplication is a standard treatment for gastroesophageal reflux disease (GERD) in neurologically impaired children. However, it has a high recurrence rate due to wrap herniation and disruption resulting from the failure or enlargement of the esophageal hiatus suture site. In adult patients with GERD, reinforcement of the sutured esophageal hiatus with a mesh significantly reduces the recurrence rate after surgery for esophageal hiatus hernia. In children, there are no big series of fundoplication with mesh reinforcement...
November 2017: Nagoya Journal of Medical Science
Takaaki Shinohara, Sayako Takahashi, Hitoshi Hirata
We describe the case of a patient with distal radius fracture who became unable to flex the distal interphalangeal joint of the index finger after internal fixation using a volar locking plate. There was palpable crepitus with active thumb motion, and wrist radiographs showed prominence of the volar plate at the watershed line. Therefore, our initial diagnosis was plate-induced closed rupture of the flexor digitorum profundus tendon of the index finger. However, upon surgical removal of the plate, no tendon rupture was found...
August 2017: Nagoya Journal of Medical Science
Wataru Sumida, Hiroo Uchida, Yujiro Tanaka, Takahisa Tainaka, Chiyoe Shirota, Naruhiko Murase, Kazuo Oshima, Ryo Shirotsuki, Kousuke Chiba
Portoenterostomy (PE) is the standard therapy for biliary atresia (BA). PE offers the chance of survival to children with BA. PE was the ultimate therapeutic modality for BA before liver transplantation (LT) was available. Failure of biliary drainage with PE was almost invariably fatal in children with BA. In such cases, redo-PE was performed to salvage patients following PE failure. PE remains the standard first treatment for BA despite the availability of LT. Further, redo-PE is also performed in a limited number of cases despite the development of LT as an alternative means of PE...
August 2017: Nagoya Journal of Medical Science
Hirokazu Nagai, Reiji Fukano, Masahiro Sekimizu, Akiko Kada, Akiko M Saito, Ryuta Asada, Tetsuya Mori
Currently, a standard therapy has not been established for recurrent or refractory anaplastic lymphoma kinase-positive anaplastic large cell lymphoma. While there are many treatment options, such as hematopoietic stem cell transplantation, patients with resistant disease to conventional chemotherapies have particularly poor prognosis. There is urgent need to develop new drugs because of the lack of a standard therapy and poor prognoses. This phase II trial is designed for evaluating the efficacy and safety of alectinib hydrochloride for patients with recurrent or refractory anaplastic lymphoma kinase -positive anaplastic large cell lymphoma...
August 2017: Nagoya Journal of Medical Science
Tomotaka Ohshima, Shunsaku Goto, Taiki Yamamoto, Kojiro Ishikawa
The introduction of stent retrievers has changed the methods used for acute intracranial thrombectomy, but the training approach has not been discussed enough. We, therefore, aimed to establish a simple skill up method which can be used to train anytime and anywhere with low costs. Also, we introduce our experimental confront clot scrambling method (CCSM) which makes a profitable visualization in how the stent retriever works. The CCSM involved a sham clot set in the middle of a polyvinyl chloride tube, after which two stent retrievers were navigated from each side before being simultaneously withdrawn with the same force...
August 2017: Nagoya Journal of Medical Science
Kazuhiro Kitajima, Kazuhito Fukushima, Shingo Yamamoto, Takashi Kato, Soichi Odawara, Haruyuki Takaki, Masayuki Fujiwara, Koichiro Yamakado, Yukako Nakanishi, Akihiro Kanematsu, Michio Nojima, Shozo Hirota
The aim of this study was to compare 11C-choline PET/CT and bone scintigraphy (BS) for detection of bone metastases in patients with prostate cancer. Twenty-one patients with histologically proven prostate cancer underwent 11C-choline PET/CT and BS before (n = 4) or after (n = 17) treatment. Patient-, region-, and lesion-based diagnostic performances of bone metastasis of both 11C-choline PET/CT and BS were evaluated using a five-point scale by two experienced readers. Bone metastases were present in 11 (52...
August 2017: Nagoya Journal of Medical Science
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