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Kunio Yokoyama,Naokado Ikeda,Hidekazu Tanaka,Yutaka Ito,Akira Sugie,Makoto Yamada,Masahiko Wanibuchi,Masahiro Kawanishi 대한척추신경외과학회 2023 Neurospine Vol.20 No.4
Objective: Whether the use of a balloon or stent in vertebroplasty for vertebral fractures, such as balloon kyphoplasty (BKP) or vertebral body stenting (VBS), actually contributes to the restoration of postoperative vertebral height is unclear. The aim of the current study was to compare the effectiveness of percutaneous vertebroplasty (PVP), BKP, and VBS in the correction of collapsed vertebrae in patients with painful vertebral fractures. Methods: The cases studied involved 34 vertebrae in 28 patients treated with PVP, 43 vertebrae in 38 patients treated with BKP, and 20 vertebrae in 20 patients treated with VBS at Izinkai Takeda General Hospital. Changes in the vertebral height and local kyphosis angle were measured based on standing lumbar radiographs before and after surgery and were compared among the treatment groups. Results: There were no differences in changes in the height of the anterior wall, middle body, or posterior wall of the treated vertebrae among the 3 treatment groups. The same was true for changes in the local kyphosis angle. The effectiveness of vertebral height restoration depended heavily upon preoperative vertebral instability in all the treatment groups. Correction loss due to balloon deflation effect or balloon sinking was noted with VBS or BKP. Conclusion: BKP and VBS have the advantage of reducing the risk of extravertebral leakage of injected bone cement, but they have a disadvantage in that they are no more effective than PVP in restoring collapsed vertebrae despite the use of a balloon or metal stent.
Masahiro Kawanishi,Hidekazu Tanaka,Yutaka Ito,Makoto Yamada,Kunio Yokoyama,Akira Sugie,Naokado Ikeda 대한척추신경외과학회 2023 Neurospine Vol.20 No.4
The management of osteoporotic vertebral fractures (OVFs) in the elderly includes nonoperative treatment and vertebroplasty, but has not been established due to the diversity of patient backgrounds. The purpose of this study was to compare the impact of 3 treatment modalities for the management of OVF: orthotic treatment, percutaneous vertebroplasty (PVP), and balloon kyphoplasty (BKP). The method was based on an analysis of the latest RCTs, meta-analyses, and systematic reviews on these topics. No study showed a benefit of bracing with high level of evidence. Trials were found that showed comparable outcomes without orthotic treatment. Only 1 randomized controlled trial (RCT) showed an improvement in pain relief up to 6 months compared with no orthosis. Rigid and nonrigid orthoses were equally effective. Four of 5 RCTs comparing vertebroplasty and sham surgery were equally effective, and one RCT showed superior pain relief with vertebroplasty within 3 weeks of onset. In open trials comparing vertebroplasty with nonoperative management, vertebroplasty was superior. PVP and BKP were comparable in terms of pain relief, improvement in quality of life, and adjacent vertebral fractures. BKP does not affect global sagittal alignment, although BKP may restore vertebral body height. An RCT was published showing that PVP was effective in chronic cases without pain relief. Vertebroplasty improved life expectancy by 22% at 10 years. The superiority of orthotic therapy for OVF was seen only in short-term pain relief. Soft orthoses proved to be a viable alternative to rigid orthoses. Vertebroplasty within 3 weeks may be useful. There is no significant difference in clinical efficacy between PVP and BKP. Vertebroplasty improves life expectancy.
Adachi, Mayuko,Itoh, Kunio,Masubuchi, Akiko,Watanabe, Nobuaki,Tanaka, Yorihisa Korean Society for Biochemistry and Molecular Biol 2007 Journal of biochemistry and molecular biology Vol.40 No.6
We demonstrated the genetic polymorphism of aldehyde oxidase (AO) in Donryu strain rats: the ultrarapid metabolizer (UM) with nucleotide mutation of (377G, 2604C) coding for amino acid substitution of (110Gly, 852Val), extensive metabolizer (EM) with (377G/A, 2604C/T) coding for (110Gly/Ser, 852Val/Ala), and poor metabolizer (PM) with (377A, 2604T) coding for (110Ser, 852Ala), respectively. The results suggested that 377G > A and/or 2604C > T should be responsible for the genetic polymorphism. In this study, we constructed an E. coli expression system of four types of AO cDNA including Mut-1 with (377G, 2604T) and Mut-2 with (377A, 2604C) as well as naturally existing nucleotide sequences of UM and PM in order to clarify which one is responsible for the polymorphism. Mut-1 and Mut-2 showed almost the same high and low activity as that of the UM and PM groups, respectively. Thus, the expression study of mutant AO cDNA directly revealed that the nucleotide substitution of 377G > A, but not that of 2604C > T, will play a critical role in the genetic polymorphism of AO in Donryu strain rats. The reason amino acid substitution will cause genetic polymorphism in AO activity was discussed.
Iori Kisu,Kouji Banno,Asahi Tokuoka,Keigo Yamaguchi,Kunio Tanaka,Tetsuro Shiraishi,Kanako Nakamura,Hiroshi Senba,Kiyoko Matsuda,Nobumaru Hirao 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.3
ObjectiveTransvaginal removal of large specimens during laparoscopic hysterectomy can be a complex surgical procedure thatposes a risk of organ injury and tissue spillage into the abdominal cavity and is associated with extraction of thespecimen and manual morcellation. Our objective was to demonstrate a technique for transvaginal removal of largespecimens using the Alexis Contained Extraction System (CES) in laparoscopic hysterectomy. MethodsThe technique used for transvaginal removal of large specimens using the Alexis CES was presented in this video. Surgery was performed at a tertiary hospital. ResultsFollowing resection of the specimen during laparoscopic hysterectomy, the Alexis CES was inserted into the abdominalcavity through the umbilical trocar wound. The specimen was placed in a bag to prevent tissue spillage. The ringretractor was guided to the vagina and pulled out transvaginally. By repeatedly turning the ring retractor, tensionwas applied to the specimen bag, and the vaginal wall was unfolded all around to enable a secure surgical field. During manual morcellation of the specimen in the bag, the retractor was pulled and additionally turned to roll andre-tension the specimen bag when the bag was loosened. The specimen was pushed out of the vagina and safely andeffectively extracted without concerns about tissue spillage in the abdominal cavity or related organ injuries. ConclusionThe technique for transvaginal removal of large specimens using the Alexis CES enables simple, effective, and safetissue extraction with contained manual morcellation during laparoscopic hysterectomy. 영어