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Hirofumi Bekki,Katsumi Harimaya,Yoshihiro Matsumoto,Kenichi Kawaguchi,Mitsumasa Hayashida,Seiji Okada,Toshio Doi,Yasuharu Nakashima 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4
Study Design: Prospective cohort study. Purpose: The present study aimed to evaluate the difference in the preoperative curve fl exibility between the supine and prone positions in patients with adolescent idiopathic scoliosis (AIS). Overview of Literature: In AIS, a side-bending view is necessary to differentiate a structural curve from a nonstructural curve using the Lenke classifi cation system. However, there are no published studies about which position, supine or prone, is more effective when evaluating preoperative curve fl exibility using side-bending X-ray images in AIS patients. Methods: Radiographs were analyzed for 32 AIS patients (26 females, six males) who underwent posterior correction and fusion of their main thoracic (MT) curves. Cobb angles of MT, proximal thoracic (PT), and thoracolumbar/lumbar (TL/L) curves were measured preoperatively using upright, supine (anteroposterior and side-bending), and prone (posteroanterior and side-bending) X-rays. Results: The average Cobb angles of PT, MT, and TL/L curves on preoperative upright/supine/prone X-rays were 29.1°/26.7°/26.6°, 60.7°/48.5°/48.2°, and 41.0°/32.6°/33.1°, respectively. The average Cobb angles of PT, MT, and TL/L curves on supine/prone sidebending X-rays were 19.2°/20.3°, 36.3°/36.4°, and 13.9°/15.7°, respectively. The fl exibility rates of PT, MT, and TL/L curves in supine/ prone positions were 35.3%/32.5%, 40.6%/40.2%, and 71.7%/68.2%, respectively. Comparing fl exibility rates in the prone position with those in the supine position in each case, the average ratios of PT, MT, and TL/L curves were found to be 1.0, 1.0, and 0.9, respectively. There were no statistically signifi cant differences between supine and prone side-bending X-ray measurements. However, the Lenke classifi cation in six of 32 patients (18.8%) differed between supine and prone positions because the TL/L curve in the supine position was slightly more fl exible than in the prone position. Conclusions: Supine side-bending fi lms may be suitable for the evaluation of preoperative curve fl exibility in AIS, especially for lumbar modifi er C.
Matsumoto Kazuyuki,Kato Hironari,Morimoto Kosaku,Miyamoto Kazuya,Saragai Yosuke,Kawamoto Hirofumi,Okada Hiroyuki 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.1
Background/Aims: Bilateral endoscopic drainage with self-expanding metallic stent (SEMS) can be used to effectively manage hilar malignant biliary obstruction. However, the benefits of using a trisegment drainage method remain unknown. Methods: This study retrospectively reviewed the data of 125 patients with Bismuth type IIIa or IV unresectable malignant strictures who underwent bilateral endoscopic drainage using SEMSs at four tertiary centers. The patients were divided into the bilateral and trisegment drainage groups for comparison. The primary endpoint was stent patency and the secondary endpoints were technical success, technical and clinical success of reintervention, and overall survival. Results: The technical success rates of the bilateral and trisegment drainage groups were 95% (34/36) and 90% (80/89) (p=0.41), respectively, with median stent patency durations of 226 and 170 days (p=0.26), respectively. Although the technical success of reintervention was not significantly different between the two groups (p=0.51), the clinical success rate of reintrvention was significantly higher in the trisegment drainage group (73% [11/15] vs 96% [47/49], p=0.009). The median survival times were 324 and 323 days in the bilateral and trisegment drainage groups, respectively (p=0.72). Multivariate Cox hazards model revealed no stent patency-associated factor; however, chemotherapy was associated with longer survival. Conclusions: Although no significant difference was noted with respect to stent patency, significantly higher clinical success rates were achieved with reintervention using the trisegment drainage method than using the bilateral drainage method alone.
Hiromi Matsumoto,Hiroshi Hagino,Hirofumi Sageshima,Mari Osaki,Shinji Tanishima,Chika Tanimura 대한골다공증학회 2015 Osteoporosis and Sarcopenia Vol.1 No.1
Objectives: To examine the relationship between history of falling, and musculoskeletal disease, bone mass, muscle strength, muscle mass, kyphosis, and gait speed and variability in osteoporotic older adults. Methods: The GAINA study, which began in 2014, is a population-based prospective study of subject cohorts from the town of Hino, Tottori Prefecture, Japan. Participants were recruited from among individuals who had an annual town-sponsored medical check-up in 2014, between May and June. A total 223 of residents were screened for our study. Inclusion criteria were osteoporotic older adults who had: (1) a ?70% young adult mean (YAM) bone mass as assessed using quantitative ultrasound (QUS) methods, (2) a prior hip fracture or vertebral fracture, (3) fragility fractures other than hip and vertebral fractures and <80% YAM of bone mass. From the total screened, 91 residents (mean age, 76.0 ± 8.0 years; 22 men and 69 women) met the eligibility criteria. History of falling, diagnosis of musculoskeletal disease, bone mass, grip strength, muscle mass, kyphosis, and gait speed were assessed. Gait variability analysis was based on acceleration in three directions: mediolateral (ML), vertical (VT), and anteroposterior (AP) using a wireless triaxial accelerometer. Subjects were classified as belonging to a nonfall group or fall group based on their history of falling. Results: During the previous 12 months, 26 falls were reported by 16 subjects (5 men and 11 women). Sixteen of the 91 included patients (17.6%) fell (22% men and 15% women), and 8 of the 16 subjects reported multiple falls. In a multivariable analysis, diagnosis of knee osteoarthritis and higher gait variability had a significant independent relationship with falling in these osteoporotic adults. Conclusions: Diagnosis of knee osteoarthritis and gait variability are associated with previous falls in osteoporotic older adults. Accelerometrybased gait analysis may be a useful tool with which to assess the risk of falling in this population.
Kei Matsumoto,Shinwa Tanaka,Takashi Toyonaga,Nobuaki Ikezawa,Mari Nishio,Masanao Uraoka,Tomoatsu Yoshihara,Hiroya Sakaguchi,Hirofumi Abe,Tetsuya Yoshizaki,Madoka Takao,Toshitatsu Takao,Yoshinori Morit 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1
Background/Aims: The anastomotic site after distal gastrectomy is the area most affected by duodenogastric reflux. Differentreconstruction methods may affect the lesion characteristics and treatment outcomes of remnant gastric cancers at the anastomoticsite. We retrospectively investigated the clinicopathologic and endoscopic submucosal dissection outcomes of remnant gastriccancers at the anastomotic site. Methods: We recruited 34 consecutive patients who underwent endoscopic submucosal dissection for remnant gastric cancer at theanastomotic site after distal gastrectomy. Clinicopathology and treatment outcomes were compared between the Billroth II and non-Billroth II groups. Results: The tumor size in the Billroth II group was significantly larger than that in the non-Billroth II group (22 vs. 19 mm;p=0.048). More severe gastritis was detected endoscopically in the Billroth II group (2 vs. 1.33; p=0.0075). Moreover, operation timewas longer (238 vs. 121 min; p=0.004) and the frequency of bleeding episodes was higher (7.5 vs. 3.1; p=0.014) in the Billroth IIgroup. Conclusions: Compared to remnant gastric cancers in non-Billroth II patients, those in the Billroth II group had larger lesions with abackground of severe remnant gastritis. Endoscopic submucosal dissection for remnant gastric cancers in Billroth II patients involvedlonger operative times and more frequent bleeding episodes than that in patients without Billroth II.
Ryo Harada,Hironari Kato,Soichiro Fushimi,Hirofumi Inoue,Daisuke Uchida,Yutaka Akimoto,Takeshi Tomoda,Kazuyuki Matsumoto,Yasuhiro Noma,Naoki Yamamoto,Shigeru Horiguchi,Koichiro Tsutsumi,Hiroyuki Okada 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.4
Background/Aims: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy ofspecimen sampling using endosonography. We conducted this study to evaluate the effcacy of the BLS in sampling of specimens byendoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses. Methods: This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on grossvisual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence inthe first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium wasevaluated by a cytopathologist who was blinded to any clinical information. Results: A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) withthe BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement wasobserved both with and without BLS (kappa score 0.40 and 0.29, respectively). Conclusions: The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacyusing gross visual inspection.