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Arai Yuji,Hara Kunio,Inoue Hiroaki,Kanamura Hitoshi,Nakagawa Shuji,Atsumi Satoru,Mikami Yasuo 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-
We use magnetic resonance angiography to evaluate the difference of vascular ingrowth to the bone tunnel on the anterior and posterior walls quantitatively after anterior cruciate ligament reconstruction.One hundred patients underwent anterior cruciate ligament reconstruction with multi-stranded semitendinosus tendons. They were retrospectively divided into those who underwent magnetic resonance angiography 2, 3, 4 to 6, and ≥ 7 months after surgery. The mean signal-to-noise ratios of the bone tunnel walls in the femur and tibia from the digital data were measured and compared for the anterior and posterior walls.The signal-to-noise ratio of the posterior wall of the femoral bone tunnel was significantly higher than that of the anterior wall in each group. On the tibial side, the signal-to-noise ratio of the anterior wall was significantly higher than that of the posterior wall at ≥4 months after surgery.This study showed that the blood flow after anterior cruciate ligament reconstruction to the femoral bone tunnel is maintained from the posterior wall, and is maintained to the tibial side from the anterior wall 4 months postoperatively. Revascularization to the bone tunnel wall after anterior cruciate ligament reconstruction may relate to the distance from the vessels.
Kohei Maruya,Hiroaki Fujita,Tomoyuki Arai,Ryoma Asahi,Yasuhiro Morita,Hideaki Ishibashi 대한골다공증학회 2019 Osteoporosis and Sarcopenia Vol.5 No.1
Objectives: To clarify the prevalence and characteristics of pain associated with sarcopenia and to verify the usefulness of evaluation of pain for sarcopenia. Methods: In total, 759 community-dwelling people (aged 65e79 years) with or without sarcopenia and lower limb pain were classified into 4 groups (NSp, nonsarcopenia; NSpP, nonsarcopenia with pain; Sp, sarcopenia; and SpP, sarcopenia with pain). Body composition, motor function, history of fractures since age 50 years, and number of falls in the past 1 year were compared between the groups. Results: Participant proportions by group were: NSp, 53.9%; NSpP, 42.8%; Sp, 1.3%; and SpP, 2.0%. Participants with lower limb pain showed low single leg standing, walking speed, and 2-step value scores and high 25-question Geriatric Locomotive Functional Scale (GLFS-25) score after adjusting for age, sex, body mass index, and presence of sarcopenia. The SpP group showed lower functional reach test and higher GLFS-25 scores than the Sp group. Regarding the history of fractures since 50 years of age and falls in past 1 year, a high retention rate of fracture was noted in the NSpP group. They also experienced significantly more falls in the past 1 year than those in the NSp group. The SpP group noted more falls and fractures although it was insignificant. Conclusions: The results indicate that participants with lower limb pain showed declining motor function and a high risk for falls and fractures. Sarcopenia could escalate this risk. Therefore, evaluating patients for both pain and sarcopenia may be useful for risk assessment and treatment.
Seiji Ishiguro,Hiroaki Onaya,Minoru Esaki,Tomoo Kosuge,Nobuyoshi Hiraoka,Yasunori Mizuguchi,Yasuaki Arai 대한영상의학회 2012 Korean Journal of Radiology Vol.13 No.5
We report three cases of mucin-producing carcinoma of the gallbladder, along with the magnetic resonance (MR) findings, especially the findings on a MR cholangiopancreatography. In our cases, linear or curvilinear streaks were detected running along the long axis of an enlarged gallbladder (mucus thread sign). When such findings were seen, a mucin-producing carcinoma of the gallbladder should be included as a differential diagnosis. Thus, gadolinium-enhanced MR imaging is mandatory for the precise diagnosis of the mucin-producing carcinoma of the gallbladder.
( Hiroyuki Kan ),( Yuji Arai ),( Masashi Kobayashi ),( Shuji Nakagawa ),( Hiroaki Inoue ),( Manabu Hino ),( Shintaro Komaki ),( Kazuya Ikoma ),( Keiichiro Ueshima ),( Hiroyoshi Fujiwara ),( Toshikazu 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.1
Purpose: The fixed flexion view (FFV) of the knee is considered useful for evaluating the joint space when assessing the severity of osteoarthritis (OA) of the knee. To clarify the usefulness of FFV for evaluation of the joint space and severity of knee OA, this study evaluated changes in the joint space on the FFV and standing extended view (SEV) in patients with knee OA. Materials and Methods: The SEV and FFV images were acquired in 567 patients (1,102 knees) who visited the hospital with a chief complaint of knee joint pain. Medial joint space width (MJSW) and Kellgren-Lawrence (K-L) classification assessed using the SEV and FFV images were compared. Results: Mean MJSW was significantly smaller when assessed on the FFV than on the SEV (3.02±1.55 mm vs. 4.31±1.30 mm; p<0.001). The K-L grade was the same or higher on the FFV than on the SEV. Conclusions: The FFV is more useful than the SEV for evaluating the joint space in OA knees. Treatment strategies in patients with knee OA should be determined based on routinely acquired FFV images.
Shuji Nakagawa,Yuji Arai,Kunio Hara,Hiroaki Inoue,Manabu Hino,Toshikazu Kubo 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.4
We describe a patient who underwent arthroscopic pullout fixation for a posterior cruciate ligament (PCL) avulsion fracture. A 46-year-old female, injured in a fall while riding a motorcycle, was diagnosed with a right knee PCL tibial attachment avulsion fracture and underwent arthroscopic osteosynthesis. A Kirschner wire was drilled to a point just medial to the medial border of the anterior tibial bony bed. A suture wire was folded into a loop and introduced into the posteromedial compartment via the bone tunnel. A fixation thread was inserted from the posteromedial portal, through the medial and lateral loop wires, and into the posteromedial compartment. The lateral and medial loop wires attached to the thread were pulled to the outside, and the thread was fixed onto the tibia. Three months post-surgery, she returned to her job. This procedure represents a minimally invasive method of treating avulsion fractures of the tibial attachment of the PCL.
Medial and Lateral Discoid Menisci of Both Knees
( Hiroyuki Kan ),( Yuji Arai ),( Shuji Nakagawa ),( Hiroaki Inoue ),( Ginjiro Minami ),( Kazuya Ikoma ),( Hiroyoshi Fujiwara ),( Toshikazu Kubo ) 대한슬관절학회 2016 대한슬관절학회지 Vol.28 No.4
Discoid menisci on both the medial and lateral sides are rare, and there are very few reports on cases involving both sides. We report a case of a 52-year-old female with medial and lateral discoid menisci in both knees. Arthroscopy revealed the lateral menisci of both knees were complete discoid menisci, and partial meniscectomy was performed. The medial menisci were incomplete discoid menisci, but there were no findings of abnormal mobility or injury; therefore, the medial menisci were observed without treatment. At six months postoperatively, her pain and range of motion restrictions disappeared.
( Shuji Nakagawa ),( Yuji Arai ),( Hiroaki Inoue ),( Hiroyuki Kan ),( Manabu Hino ),( Shohei Ichimaru ),( Kazuya Ikoma ),( Hiroyoshi Fujiwara ),( Fumimasa Amaya ),( Teiji Sawa ),( Toshikazu Kubo ) 대한슬관절학회 2016 대한슬관절학회지 Vol.28 No.3
Purpose: This study compared the analgesic effects of local infiltration analgesia (LIA) and femoral nerve block (FNB) after total knee arthroplasty (TKA) and assessed factors associated with analgesia obtained by these two methods. Materials and Methods: Study subjects included 66 patients (72 knees) who underwent TKA for osteoarthritis of the knee. Pain visual analogue scale (VAS), the amount of analgesics used, number of days to achieve 90o of flexion of the knee joint, date of initiating parallel-bar walking, range of motion of the knee joint at discharge, and adverse events were investigated. Results: The VAS scores did not differ significantly between two groups, whereas the amount of analgesics used was significantly lower in the LIA group. Preoperative flexion contracture was significantly more severe in the LIA group with high VAS compared with low VAS. No serious adverse event occurred in the LIA or FNB group. Conclusions: The lower analgesic usage in the LIA group than the FNB group indicates that the analgesic effect of LIA was greater than that of singleshot FNB after TKA. There were no serious complications in either group. The postoperative analgesic effect of LIA was smaller in patients with severe than less severe preoperative flexion contracture.
( Motoyasu Kato ),( Yuta Arai ),( Hiroaki Motomura ),( Issei Sumiyoshi ),( Yusuke Ochi ),( Junko Watanabe ),( Hiroaki Ihara ),( Shinsaku Togo ),( Shinichi Sasaki ),( Kazuhisa Takahashi ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Background: Acute exacerbation of chronic fibrotic idiopathic interstitial pneumonia (AE-IIP) is associated with a high mortality rate. In 2016, the International Working Group classified the etiology of AE-IIP into idiopathic and triggered. Several factors can trigger AE-IIP; however, the triggers associated with the worst prognosis have not been identified. The aim of this study was to investigate the prognosis of patients with various types of AE-IIP, particularly infection-triggered, non-infection-triggered, and idiopathic AE-IIPs. Methods: We retrospectively collected data for 128 patients with chronic fibrotic IIP (CF-IIP) who were hospitalized because of respiratory failure during the period between April 2009 and March 2019 at Juntendo University Hospital. There were 79 patients who developed AE-IIP, and 21 patients who developed bacterial pneumonia combined with CF-IIP. AE-IIP was classified into idiopathic, infection-triggered, and non-infection-triggered. We analyzed differences in patient characteristics, examination findings, and prognosis among the types. Finally, we evaluated risk factors for early death due to AE-IIPs. Results: Idiopathic, infection-triggered, and non-infection-triggered AE-IIPs were diagnosed in 34, 25, and 20 patients, respectively. The survival time was significantly longer for bacterial pneumonia combined with IIP than for AE-IIP. Moreover, the survival time was significantly longer for infection-triggered AE-IIP than for idiopathic or non-infection-triggered AE-IIP. The mortality rate was significantly lower with infection-triggered AEIIP than with other types of AE-IIP. Finally, a multivariate analysis revealed that radiological findings at the time of onset of AE-IIPs and AE-IIP patterns were independent risk factors for early death. Conclusion: Our results suggest that patients with infection-triggered AE-IIP may have a better prognosis than those with other types of AE-IIP.