Efficacy of TachoSil, a Fibrin-Based Hemostat, for Anterior Lumbar Spine Surgery

Jo Watanabe,Seiji Ohtori,Sumihisa Orita,Kazuyo Yamauchi,Yawara Eguchi,Yasuchika Aoki,Junichi Nakamura,Miyako Suzuki,Kazuhide Inage,Jun Sato,Yasuhiro Shiga,Koki Abe,Kazuki Fujimoto,Hirohito Kanamoto,Ei 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.5

Study Design: Retrospective case series. Purpose: To examine the efficacy of TachoSil for vessel injury in 6 patients who underwent anterior lumbar fusion surgery (ALF). Overview of Literature: ALF for the lumbar spine has a high rate of success, although intraoperative concerns and iatrogenic complications are known, and injury of a major vessel is sometimes a complication. The efficacy of TachoSil, a fibrin-based hemostat, has been reported for several types of surgery; however, use of TachoSil for ALF surgery has not been described. Here, we report on the efficacy of TachoSil in 6 patients, who underwent ALF after vascular surgeons having difficulty in repairing vessels. Methods: Two man and 4 women with average age of 50.8±10.9 (mean±standard deviation) were diagnosed with a vertebral tumor (2 patients), L4 degenerative spondylolisthesis (2 patients), and L5 spondylolytic spondylolisthesis (2 patients) and underwent ALF. The blood vessels injured included the common iliac vein in 2 patients and a branch of a segmental artery from the aorta in 4 patients. We consulted a vascular surgeon to suture or repair the vessels during surgery, and although the vascular surgeon attempted to address the injuries, suturing or repair was not possible in these cases. For this reason, we used TachoSil to repair the injury in the vessels walls or to stop the bleeding. Results: Time to pressure hemostasis using TachoSil was 34±12 minutes, and total blood loss was 1,488±1,711 mL. Nevertheless, all vessel injuries were controlled by the use of TachoSil. Conclusions: We recommend the use of TachoSil for vessel injuries that vascular surgeons cannot suture or repair during ALF surgery.

Experimental and numerical flow analysis in hydraulic vane pump

Junichi SUEMATSU,Tetsuhiro TSUKIJI,Mariko WATANABE,Shinji YAKABE,Hirohito WATANABE,Yoshinari NAKAMURA,Kazunari SUZUKI 유공압건설기계학회 2015 유공압건설기계학회 학술대회논문집 Vol.2015 No.10

The purpose of this study is to conduct a three dimensional flow analysis of a hydraulic vane pump by using computational fluid dynamics (CFD), to evaluate an accuracy of volumetric flow rate in CFD compared to experimental value and to examine a influence of the evaporation coefficient and condensation coefficient in Zwart–Gerber–Belamri cavitation model to pressure in a vane chamber. In this study, standard k-ε turbulent model with the Zwart–Gerber–Belamri cavitation model is used to estimate the cavitating flow in vane pump. In CFD, two notch models are used. From results of experiments and CFD analysis of volumetric flow rate, there is little difference between the experiments and CFD results in the low speed range. However, for high speed range, in a case with no cavitation model, the CFD results of volumetric flow rate are different from the experimental ones. On the other hand, in the case with cavitation model, those agree with the experimental values. In this case, the error of volumetric flow rate is less than 1% in the low speed range and less than 2.5% in the high speed range. From CFD results of pressure fluctuation in a vane chamber when the evaporation coefficient and condensation coefficient in the cavitation model are varied, the surge pressure can be seen in a vane chamber. In conclusion, it could be considered that the CFD calculation with cavitation model is sufficiently accurate in volumetric flow rate. In addition, as the evaporation coefficient becomes large, amplitude of the pressure fluctuation in a vane chamber after a surge pressure becomes large, as the condensation coefficient becomes large, the surge pressure in a vane chamber becomes low.

STM study of the size-selected Pt clusters on CeO₂(111)/Ru(0001)

Syed Mohammad Fakruddin SHAHED,Atsushi BENIYA,Hirohito HIRATA,Tadahiro KOMEDA,Yoshihide WATANABE 한국진공학회 2016 한국진공학회 학술발표회초록집 Vol.2016 No.8

Usefulness of fecal calprotectin by monoclonal antibody testing in adult Japanese with inflammatory bowel diseases: a prospective multicenter study

( Shiro Nakamura ),( Hirotsugu Imaeda ),( Hiroki Nishikawa ),( Masaki Iimuro ),( Minoru Matsuura ),( Hideo Oka ),( Junsuke Oku ),( Takako Miyazaki ),( Hirohito Honda ),( Kenji Watanabe ),( Hiroshi Nak 대한장연구학회 2018 Intestinal Research Vol.16 No.4

Background/Aims: Noninvasive objective monitoring is advantageous for optimizing treatment strategies in patients inflammatory bowel disease (IBD). Fecal calprotectin (FCP) is superior to traditional biomarkers in terms of assessing the activity in patients with IBD. However, there are the differences among several FCP assays in the dynamics of FCP. In this prospective multicenter trial, we investigated the usefulness of FCP measurements in adult Japanese patients with IBD by reliable enzyme immunoassay using a monoclonal antibody. Methods: We assessed the relationship between FCP levels and disease or endoscopic activity in patients with ulcerative colitis (UC, n=64) or Crohn’s disease (CD, n=46) compared with healthy controls (HCs, n=64). Results: FCP levels in UC patients strongly correlated with the Disease Activity Index (r_s=0.676, P<0.0001) and Mayo endoscopic subscore (MES; r_s=0.677, P<0.0001). FCP levels were significantly higher even in patients with inactive UC or CD compared with HCs (P=0.0068, P<0.0001). The optimal cutoff value between MES 1 and 2 exhibited higher sensitivity (94.1%). FCP levels were significantly higher in active UC patients than in inactive patients (P<0.001), except those with proctitis. The Crohn’s Disease Activity Index tended to correlate with the FCP level (rs=0.283, P=0.0565). Conclusions: Our testing method using a monoclonal antibody for FCP was well-validated and differentiated IBD patients from HCs. FCP may be a useful biomarker for objective assessment of disease activity in adult Japanese IBD patients, especially those with UC. (Intest Res 2018;16:554-562)

Diagnosis of Lumbar Foraminal Stenosis using Diffusion Tensor Imaging

Yawara Eguchi,Seiji Ohtori,Munetaka Suzuki,Yasuhiro Oikawa,Hajime Yamanaka,Hiroshi Tamai,Tatsuya Kobayashi,Sumihisa Orita,Kazuyo Yamauchi,Miyako Suzuki,Yasuchika Aoki,Atsuya Watanabe,Hirohito Kanamoto 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.1

Diagnosis of lumbar foraminal stenosis remains difficult. Here, we report on a case in which bilateral lumbar foraminal stenosis was difficult to diagnose, and in which diffusion tensor imaging (DTI) was useful. The patient was a 52-year-old woman with low back pain and pain in both legs that was dominant on the right. Right lumbosacral nerve compression due to a massive uterine myoma was apparent, but the leg pain continued after a myomectomy was performed. No abnormalities were observed during nerve conduction studies. Computed tomography and magnetic resonance imaging indicated bilateral L5 lumbar foraminal stenosis. DTI imaging was done. The extraforaminal values were decreased and tractography was interrupted in the foraminal region. Bilateral L5 vertebral foraminal stenosis was treated by transforaminal lumbar interbody fusion and the pain in both legs disappeared. The case indicates the value of DTI for diagnosing vertebral foraminal stenosis.

Discrimination between Lumbar Intraspinal Stenosis and Foraminal Stenosis using Diffusion Tensor Imaging Parameters: Preliminary Results

Yawara Eguchi,Seiji Ohtori,Munetaka Suzuki,Yasuhiro Oikawa,Hajime Yamanaka,Hiroshi Tamai,Tatsuya Kobayashi,Sumihisa Orita,Kazuyo Yamauchi,Miyako Suzuki,Yasuchika Aoki,Atsuya Watanabe,Hirohito Kanamoto 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.2

Study Design: Retrospective observational study. Purpose: To examine fractional anisotropy (FA) values and apparent diffusion coefficient (ADC) values of damaged nerves to discriminate between lumbar intraspinal stenosis (IS) and foraminal stenosis (FS) using diffusion tensor imaging (DTI) Overview of Literature: It is important in the selection of surgical procedure to discriminate between lumbar IS and FS, but such discrimination is difficult. Methods: There were 9 cases of IS, 7 cases of FS, and 5 healthy controls. The regions of interest were established in the lumbar intraspinal zone (Iz), nerve root (N), and extraforaminal zone (Ez). The FA and ADC values were measured on the affected and unaffected sides of the nerves. The FA ratio and the ADC ratio were calculated as the affected side/unaffected side ×100 (%). Results: In the Ez, the FA value was significantly lower in FS than in IS (p <0.01). FA ratio was significantly lower in FS than in IS for the Ez (p <0.01). In the Iz, the ADC value was significantly higher in IS than FS (p <0.01). ADC ratio was significantly higher in FS than in IS for the N and Ez (p <0.05). For the Ez, receiver operating characteristic analysis of parameters revealed that the FA values showed a higher accuracy for the diagnosis of FS than the ADC values, and the FA value cut-off value was 0.42 (sensitivity: 85.7%, false positive: 11.1%) and the FA ratio cut-off value was 83.9% (sensitivity: 85.7%, false positive: 22.2%). Conclusions: The low FA value in the extraforaminal zone suggests the presence of foraminal stenosis. When the FA value and FA ratio cut-off value were established as 0.42 and 83.9%, respectively, the accuracy was high for the diagnosis of foraminal stenosis. It may be possible to use DTI parameters to help in the discrimination between IS and FS.