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Kohei Nishitani,Shinichi Kuriyama,Shinichiro Nakamura,Hiromu Ito,Shuicih Matsuda 대한슬관절학회 2019 대한슬관절학회지 Vol.31 No.1
Purpose: Despite the long history of drain use in total knee arthroplasty (TKA), no drain has been gaining popularity. The purpose of this study was to investigate whether drainage is related to the length of hospital stay.Materials and Methods: A total of 166 consecutive unilateral TKAs performed on 135 patients with osteoarthritis were retrospectively reviewed. Closed suction drainage was used in 111 cases (67%). Length of hospital stay after surgery was recorded, and a multivariate linear regression analysis was performed to evaluate various variables (patient factors, surgical factors, and postsurgical factors) and to investigate whether drainage was an independent variable.Results: Hospital stay was shorter in no drain cases (21.7±4.8 days) than in drain cases (24.2±3.7 days, p<0.001). The multivariate analysis showed that older age (β=0.12, p=0.02), drain use (β=2.81, p=0.03), and occurrence of comorbidity (β=1.46, p=0.04) were the independent variables associated with the extended hospital stay. There was no difference in comorbidity between drain cases (39.6%) and no drain cases (27.2%, p=0.13). Conclusions: The drain use, age, and occurrence of comorbidity were related to the length of hospital stay. TKA without drain is an effective procedure both medically and economically.
Current Status of the Diagnosis and Management of Pancreatic Neuroendocrine Tumors in Japan
Tetsuhide Ito,Masami Miki,Keijiro Ueda,Lingaku Lee,Ken Kawabe,Hisato Igarashi,Nao Fujimori,Kazuhiko Nakamura,Kohei Yasunaga,Robert T. Jensen,Takao Ohtsuka,Yoshihiro Ogawa Korean Society of Gastrointestinal Cancer 2016 Journal of digestive cancer reports Vol.4 No.2
The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.
Design of Low Power All-Optical Networks with Dynamic Lightpath Establishment
Kouji Hirata,Kohei Ito,Yutaka Fukuchi,Masahiro Muraguchi 한국통신학회 2016 Journal of communications and networks Vol.18 No.4
In multifiber all-optical networks, optical amplifiers areused for amplifying multiple optical signals with different wavelengthsin fibers. An optical amplifier operates when any of lightpathspasses through it. Therefore, it should simultaneously amplifyas many lightpaths as possible for efficiently utilizing itspower. This paper proposes a dynamic lightpath establishmentscheme considering the use efficiency of the optical amplifiers andthe depletion of the wavelength resources in multifiber all-opticalnetworks. The proposed scheme provides a routing and wavelengthassignment strategy that reduces both the power consumption ofthe optical amplifiers and the blocking probability of the lightpathestablishment. Through simulation experiments, we demonstratethe effectiveness of the proposed scheme.
Design of Low Power All-Optical Networks with Dynamic Lightpath Establishment
Hirata, Kouji,Ito, Kohei,Fukuchi, Yutaka,Muraguchi, Masahiro The Korea Institute of Information and Commucation 2016 Journal of communications and networks Vol.18 No.4
In multifiber all-optical networks, optical amplifiers are used for amplifying multiple optical signals with different wavelengths in fibers. An optical amplifier operates when any of lightpaths passes through it. Therefore, it should simultaneously amplify as many lightpaths as possible for efficiently utilizing its power. This paper proposes a dynamic lightpath establishment scheme considering the use efficiency of the optical amplifiers and the depletion of the wavelength resources in multifiber all-optical networks. The proposed scheme provides a routing and wavelength assignment strategy that reduces both the power consumption of the optical amplifiers and the blocking probability of the lightpath establishment. Through simulation experiments, we demonstrate the effectiveness of the proposed scheme.
Kazuyoshi Kobayashi,Shiro Imagama,Zenya Ito,Kei Ando,Kohei Yokoi,Naoki Ishiguro 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.2
We describe successful vertebrectomy from a posterior approach using a computed tomography (CT)-based navigation system (O-arm) in a 53-year-old man with adenocarcinoma of the posterior apex of the right lung with invasion of the adjacent rib, thoracic wall, and T2 and T3 vertebral bodies. En bloc partial vertebrectomy for lung cancer adjacent to the thoracic spine was planned using O-arm. First, laminectomy was performed from right T2 to T3, and pedicles and transverse processes of T2 to T3 were resected. O-arm was used to confirm the location of the cutting edge in the T2 to 3 right vertebral internal body, and osteotomy to the anterior cortex was performed with a chisel. Next, the patient was placed in a left decubitus position. The surgical specimen was extracted en bloc . This case shows that O-arm can be used reliably and easily in vertebrectomy from a posterior approach and can facilitate en bloc resection.
Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors
Naomi Kakushima,Masao Yoshida,Yohei Yabuuchi,Noboru Kawata,Kohei Takizawa,Yoshihiro Kishida,Sayo Ito,Kenichiro Imai,Kinichi Hotta,Hirotoshi Ishiwatari,Hiroyuki Matsubayashi,Hiroyuki Ono 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.6
Prediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-band imaging is useful to differentiate between Vienna category 3 (C3) and C4/5 lesions. Less invasive endoscopic resection procedures, such as cold snare polypectomy, are quick to perform and convenient for small (<10 mm) C3 lesions. Neoplasms with higher grade histology, such as C4/5 lesions, should be treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or surgery. Although EMR often requires piecemeal resection, the complication rate is acceptable. Excellent complete resection rates could be achieved by ESD; however, it remains a challenging method considering the high risk of complications. Shielding or closure of the ulcer after ESD is effective at decreasing the risk of delayed bleeding and perforation. Laparoscopic endoscopic cooperative surgery is an ideal treatment with a high rate of en bloc resection and a low rate of complications, although it is limited to high-volume centers. Patients with NADETs could benefit from a multidisciplinary approach to stratify the optimal treatment based on endoscopic diagnoses.
Natural History of Early Gastric Cancer: a Case Report and Literature Review
Tomohiro Iwai,Masao Yoshida,Hiroyuki Ono,Naomi Kakushima,Kohei Takizawa,Masaki Tanaka,Noboru Kawata,Sayo Ito,Kenichiro Imai,Kinichi Hotta,Hirotoshi Ishiwatari,Hiroyuki Matsubayashi 대한위암학회 2017 Journal of gastric cancer Vol.17 No.1
Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma.
Natural History of Early Gastric Cancer: a Case Report and Literature Review
Iwai, Tomohiro,Yoshida, Masao,Ono, Hiroyuki,Kakushima, Naomi,Takizawa, Kohei,Tanaka, Masaki,Kawata, Noboru,Ito, Sayo,Imai, Kenichiro,Hotta, Kinichi,Ishiwatari, Hirotoshi,Matsubayashi, Hiroyuki The Korean Gastric Cancer Association 2017 Journal of gastric cancer Vol.17 No.1
Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma. The depth of the lesion was estimated to be intramucosal. Although the lesion met the indications for endoscopic resection, periodic endoscopic follow-up was performed due to the patient's advanced age and comorbidities. The mucosal GC invaded into the submucosa 3 years later, and finally progressed to advanced cancer 5 years after the initial examination. The patient died of tumor hemorrhage 6.4 years after the initial examination. In this case, mucosal GC progressed to advanced GC, eventually leading to the patient's death from GC. Early and appropriate treatment is required to prevent GC-related death.