Optimal Timing of Preoperative Skin Preparation with Povidone-Iodine for Spine Surgery: A Prospective, Randomized Controlled Study

Tatsuya Yasuda,Tomohiko Hasegawa,Yu Yamato,Sho Kobayashi,Daisuke Togawa,Hideyuki Arima,Yukihiro Matsuyama 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.3

Study Design: A prospective, randomized, controlled study. Purpose: The objective of this study was to evaluate the effectiveness of two techniques of skin preparation with povidone-iodine. Overview of Literature: Preoperative skin preparation is important for preventing surgical site infection by reducing the bacteria in the surgical area. Povidone-iodine is a commonly used agent for preoperative skin preparation, and further decrease in surgical site infections can be expected by understanding how to apply it more effectively. Methods: Eighty-nine spine surgery patients were randomly allocated to two groups. In group A, povidone-iodine was applied to the surgical site just before starting the operation; in group B, povidone-iodine was applied several minutes prior to starting the operation and was allowed to dry. We collected samples from the wound edge before suturing, and we compared the rates of positive culture between the two groups. Results: The rate of positive culture was 30.2% (13 out of 43 patients) in group A, and 6.5% (3 out of 46 patients) in group B. This indicates that there was a significant difference in postoperative infection rates between group A and group B. Conclusions: Because bacteria on the skin appeared significantly reduced by allowing povidone-iodine to dry for several minutes prior to surgery, we recommend this approach to reduce the incidence of postoperative infections.

Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy

Tatsuya Kato,Hidemichi Watari,Mahito Takeda,Masayoshi Hosaka,Takashi Mitamura,Noriko Kobayashi,Satoko Sudo,Masanori Kaneuchi,Masataka Kudo,Noriaki Sakuragi 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.3

Objective: The aim of this study was to investigate the prognostic factors and treatment outcome of patients with adenocarcinoma of the uterine cervix who underwent radical hysterectomy with systematic lymphadenectomy. Methods: A total of 130 patients with stage IB to IIB cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy from 1982 to 2005 were retrospectively analyzed. Clinicopathological data including age, stage, tumor size, the number of positive node sites, lymphovascular space invasion, parametrial invasion, deep stromal invasion (>2/3 thickness), corpus invasion, vaginal infiltration, and ovarian metastasis, adjuvant therapy, and survival were collected and Cox regression analysis was used to determine independent prognostic factors. Results: An estimated five-year survival rate of stage IB1 was 96.6%, 75.0% in stage IB2, 100% in stage IIA, and 52.8% in stage IIB. Prognosis of patients with one positive-node site is similar to that of those with negative-node. Prognosis of patients with multiple positive-node sites was significantly poorer than that of negative and one positive-node site. Multivariate analysis revealed that lymph node metastasis, lymphovascular space invasion, and parametrial invasion were independent prognostic factors for cervical adenocarcinoma. Survival of patients with cervical adenocarcinoma was stratified into three groups by the combination of three independent prognostic factors. Conclusion: Lymph node metastasis, lymphovascular space invasion, and parametrial invasion were shown to be independent prognostic factors for cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy.

Noninvasive Assessment of Advanced Fibrosis Based on Hepatic Volume in Patients with Nonalcoholic Fatty Liver Disease

( Tatsuya Hayashi ),( Satoshi Saitoh ),( Kei Fukuzawa ),( Yoshinori Tsuji ),( Junji Takahashi ),( Yusuke Kawamura ),( Norio Akuta ),( Masahiro Kobayashi ),( Kenji Ikeda ),( Takeshi Fujii ),( Tosiaki M 대한간학회 2017 Gut and Liver Vol.11 No.5

Background/Aims: Noninvasive liver fibrosis evaluation was performed in patients with nonalcoholic fatty liver disease (NAFLD). We used a quantitative method based on the he-patic volume acquired from gadoxetate disodium-enhanced (Gd-EOB-DTPA-enhanced) magnetic resonance imaging (MRI) for diagnosing advanced fibrosis in patients with NAFLD. Methods: A total of 130 patients who were diagnosed with NAFLD and underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. Histological data were available for 118 patients. Hepatic volumetric parameters, including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio), were measured. The usefulness of the L/R ratio for diag-nosing fibrosis ≥F3-4 and F4 was assessed using the area under the receiver operating characteristic (AUROC) curve. Multiple regression analysis was performed to identify vari-ables (age, body mass index, serum fibrosis markers, and histological features) that were associated with the L/R ratio. Results: The L/R ratio demonstrated good performance in differentiating advanced fibrosis (AUROC, 0.80; 95% confi-dence interval, 0.72 to 0.88) from cirrhosis (AUROC, 0.87; 95% confidence interval, 0.75 to 0.99). Multiple regression analysis showed that only fibrosis was significantly associat-ed with the L/R ratio (coefficient, 0.121; p<0.0001). Conclu-sions: The L/R ratio, which is not influenced by pathologi-cal parameters other than fibrosis, is useful for diagnosing cirrhosis in patients with NAFLD. (Gut Liver 2017;11:674- 683)

Hypoglossal Nerve Palsy as a Complication of an Anterior Approach for Cervical Spine Surgery

Tatsuya Yasuda,Daisuke Togawa,Tomohiko Hasegawa,Yu Yamato,Sho Kobayashi,Hideyuki Arima,Yukihiro Matsuyama 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.2

A recurrent laryngeal nerve injury is known as a complication referring to an anterior cervical spine surgery. However, hypoglossal nerve injury is not well known yet. Herein we report a rare case of a 39-years-old male with a hypoglossal nerve injury after C3/4 osteophyte resection with Smith-Robinson approach. In this case there appeared difficulties of articulation and tongue movement with deviation of the tongue to the left side after the surgery and we diagnosed a hypoglossal nerve injury due to retraction against the nerve during the operation. During the operative approach to the upper cervical spine we had to retract the internal carotid artery and the soft tissue to reach the vertebrae. This retract was the cause of the hypoglossal nerve injury. A gently traction and intermittent release is important to avoid a hypoglossal nerve damage.

Preoperative and Postoperative Pulmonary Function in Elderly Patients with Thoracolumbar Kyphoscoliosis

Tatsuya Yasuda,Tomohiko Hasegawa,Yu Yamato,Sho Kobayashi,Daisuke Togawa,Yukihiro Matsuyama 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.6

Study Design: Case series. Purpose: The objective of this study was to investigate the change in pulmonary function in adult patients with a spinal deformity who underwent spinal corrective surgery. Overview of Literature: Degenerative lumbar and/or thoraco-lumbar deformities are is often prominent in adult spinal deformity cases, whereas a thoracic deformity involving the chest wall is inconspicuous. A lumbar spine deformity could affect the pulmonary function; however, few reports have investigated pulmonary function in adult patients with a spinal deformity. Methods: This study included 14 adult patients with a spinal deformity who underwent posterior corrective fusion (3 males, 11 females; mean age, 67.4 years). We measured percent vital capacity (%VC) and percent forced expiratory volume in 1 second (%FEV1) before surgery and six months after surgery. We investigated the change in pulmonary function after corrective surgery and the correlation between radiographic parameters and pulmonary function. Results: Mean preoperative %VC and %FEV1 values were 99.9% and 79.3%, respectively. Two cases were diagnosed with restrictive impairment, and two cases were diagnosed with obstructive impairment before surgery. %VC improved in the restrictive impairment cases six months after surgery. However, %FEV1 did not improve significantly after surgery in the obstructive impairment cases. Conclusions: Restrictive impairment was improved in adult patients with a spinal deformity by corrective spinal surgery. However, spinal surgery did not improve obstructive impairment.

Relationship between Spinal Hemangioblastoma Location and Age

Tatsuya Yasuda,Tomohiko Hasegawa,Yu Yamato,Sho Kobayashi,Daisuke Togawa,Tomohiro Banno,Hideyuki Arima,Shin Oe,Yukihiro Matsuyama 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.2

Study Design: Retrospective case series. Purpose: To investigate the relationship between tumor location and clinical characteristics. Overview of Literature: Hemangioblastoma is a rare disease that develops in the central nervous system. Magnetic resonance imaging (MRI) is useful to evaluate hemangioblastomas. Hemangioblastoma’s location is designated as intramedullary, intramedullary+extramedullary, or extramedullary by MRI. Methods: We analyzed 11 patients who underwent surgery for spinal hemangioblastoma. Using T1 contrast axial MRI data, the cases were divided into three groups (intramedullary, intramedullary+extramedullary, and extramedullary). Patient demographics, MRI findings, and preoperative neurological status were analyzed and compared for each group. Results: The average age of patients with intramedullary, intramedullary+extramedullary, and extramedullary hemangioblastoma was 34.0, 64.4, and 67.5 years, respectively. Patients in the intramedullary hemangioblastoma group were younger than the other groups. Extramedullary cases had a smaller syrinx compared to the other groups. Conclusions: Age may play an important role in the hemangioblastoma tumor location and the subsequent diagnosis by an MRI.

Design and Characterization of Hydrophilic Smart Polymer Coatings

Motoyasu Kobayashi,Yuki Terayama,Tatsuya Ishikawa,Moriya, Kikuchi,Kohji Mitamura,Atsushi Takahara 한국고분자학회 2011 한국고분자학회 학술대회 연구논문 초록집 Vol.2011 No.1

Tumor microenvironment and radioresistance

Suwa Tatsuya,Kobayashi Minoru,Nam Jin-Min,Harada Hiroshi 생화학분자생물학회 2021 Experimental and molecular medicine Vol.53 No.-

Metastasis is not the result of a random event, as cancer cells can sustain and proliferate actively only in a suitable tissue microenvironment and then form metastases. Since Dr. Stephen Paget in the United Kingdom proposed the seed and soil hypothesis of cancer metastasis based on the analogy that plant seeds germinate and grow only in appropriate soil, considerable attention has focused on both extracellular environmental factors that affect the growth of cancer cells and the tissue structure that influences the microenvironment. Malignant tumor tissues consist of not only cancer cells but also a wide variety of other cells responsible for the inflammatory response, formation of blood vessels, immune response, and support of the tumor tissue architecture, forming a complex cellular society. It is also known that the amounts of oxygen and nutrients supplied to each cell differ depending on the distance from tumor blood vessels in tumor tissue. Here, we provide an overview of the tumor microenvironment and characteristics of tumor tissues, both of which affect the malignant phenotypes and radioresistance of cancer cells, focusing on the following keywords: diversity of oxygen and nutrient microenvironment in tumor tissue, inflammation, immunity, and tumor vasculature.

Relationship between Knee Osteoarthritis and Spinopelvic Sagittal Alignment in Volunteers over 50 Years of Age

Yasuda Tatsuya,Togawa Daisuke,Hasegawa Tomohiko,Yamato Yu,Kobayashi Sho,Yoshida Go,Banno Tomohiro,Arima Hideyuki,Oe Shin,Hoshino Hironobu,Koyama Hiroshi,Hanada Mitsuru,Imada Takayuki,Matsuyama Yukihir 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.4

Study Design: Large cohort study of volunteers.Purpose: The purpose of this study was to investigate the relationship between the severity of knee osteoarthritis, assessed using the Kellgren-Lawrence (KL) grading scale, and spinopelvic sagittal alignment in older adult volunteers.Overview of Literature: The relationship between spinopelvic alignment in the sagittal plane and knee osteoarthritis in the coronal plane is unclear.Methods: Volunteers over 50 years of age underwent radiographic analysis. Radiographic parameters including pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), thoracic kyphosis, and sagittal vertical axis (SVA) were measured. The the three Scoliosis Research Society-Schwab sagittal modifiers (PT, SVA, I–LL) were categorized and the KL grade was assessed. Differences in spinopelvic parameters and Oswestry Disability Index (ODI) scores among KL grades were evaluated.Results: A total of 396 volunteers (160 men, 236 women; mean age, 74.4 years) were analyzed. PI–LL and PT in KL4 were significantly higher compared to that in the other KL grades. However, there were no significant group differences in SVA. In women, but not in men, higher frequencies of the worst modifier grade (++) were observed for PI–LL and PT in the KL3 and KL4 groups compared to those for the other KL grades. In women, the ODI score in KL4 was worse compared to that in the other KL grades.Conclusions: Individuals over 50 years of age with severe knee osteoarthritis had poor lumbo-pelvic sagittal alignment. Moreover, the progression severity of knee osteoarthritis had more impact onstronger relationship with lumbo-pelvic malalignment and disability-related low back pain in women than in men.

Clathrin Required for Phosphorylation and Internalization of β2-Adrenergic Receptor by G Protein-coupled Receptor Kinase 2 (GRK2)

( Supachoke Mangmool ),( Tatsuya Haga ),( Hiroyuki Kobayashi ),( Kyeong Man Kim ),( Hiroyasu Nakata ),( Motohiro Nishida ),( Hitoshi Kurose ) 전남대학교 약품개발연구소 2006 약품개발연구지 Vol.15 No.-