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Keisuke Sugahara,Yu Koyama,Masahide Koyachi,Akira Watanabe,Kiyohiro Kasahara,Masayuki Takano,Akira Katakura 대한악안면성형재건외과학회 2022 Maxillofacial Plastic Reconstructive Surgery Vol.44 No.-
Background: Excessive bleeding is a major intraoperative risk associated with orthognathic surgery. This studyaimed to investigate the factors involved in massive bleeding during orthognathic surgeries so that safe surgeriescan be performed. Patients (n=213) diagnosed with jaw deformities and treated with bimaxillary orthognathicsurgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) in the Department of Oral andMaxillofacial Surgery at the Suidobashi Hospital, Tokyo Dental College between January 2014 and December 2016were included. Using the patients’ medical and operative records, the number of cases according to sex, age at thetime of surgery, body mass index (BMI), circulating blood volume, diagnosis of maxillary deformity, direction ofmaxillary movement, operative duration, incidence of bad split, injury of nasal mucosa, and blood type were analyzed. Results: The results revealed that BMI, circulating blood volume, nasal mucosal injury, and operative time wereassociated with the risk of intraoperative massive bleeding in orthognathic surgeries. Chi-square tests and binomiallogistic regression analyses showed significant differences in BMI, circulating blood volume, direction of maxillarymovement, operative duration, and injury to the nasal mucosa. Operative duration emerged as the most important riskfactor. Furthermore, a >4-mm upward migration of the posterior nasal spine predicted the risk of massive bleeding inorthognathic surgery. Conclusions: The upward movement of the maxilla should be recognized during the preoperative planning stage as arisk factor for intraoperative bleeding, and avoiding damage to the nasal mucosa should be considered a requirementfor surgeons to prevent massive bleeding during surgery
Watanabe Shinichi,Iida Yuki,Hirasawa Jun,Naito Yuji,Mizutani Motoki,Uemura Akihiro,Nishimura Shogo,Suzuki Keisuke,Morita Yasunari 대한재활의학회 2023 Annals of Rehabilitation Medicine Vol.47 No.3
Objective: To investigate the effect on early mobilization in patients undergoing extra-corporeal membrane oxygenation (ECMO) and acute blood purification therapy in the intensive care unit (ICU).Methods: We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU, aged ≥18 years, and received mechanical ventilation for >48 hours were eligible. The analyzed were divided into two groups: ECMO/blood purification or control group. Clinical outcomes; time to first mobilization, number of total ICU rehabilitations, mean and highest ICU mobility scale (IMS); and daily barrier changes were also investigated.Results: A total of 204 patients were included in the analysis, 43 in the ECMO/blood purification group and 161 in the control group. In comparison of clinical outcome, the ECMO/blood purification group had a significantly longer time to first mobilization: ECMO/blood purification group 6 vs. control group 4 (p=0.003), higher number of total ICU rehabilitations: 6 vs. 5 (p=0.042), lower mean: 0 vs. 1 (p=0.043) and highest IMS: 2 vs. 3 (p=0.039) during ICU stay. Circulatory factor were most frequently described as barriers to early mobilization on days 1 (51%), 2 (47%), and 3 (26%). On days 4 to 7, the most frequently described barrier was consciousness factors (21%, 16%, 19%, and 21%, respectively)Conclusion: The results of this study comparing the ECMO/blood purification group and the untreated group in the ICU showed that the ECMO/blood purification group had significantly longer days to mobilization and significantly lower mean and highest IMS.
Watanabe Shinichi,Liu Keibun,Kozu Ryo,Yasumura Daisetsu,Yamauchi Kota,Katsukawa Hajime,Suzuki Keisuke,Koike Takayasu,Morita Yasunari 대한재활의학회 2023 Annals of Rehabilitation Medicine Vol.47 No.6
Objective: To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70. Methods: This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL. Results: Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07–1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69). Conclusion: These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.
Watanabe, Genya,Motoyama, Michiyo,Nakajima, Ikuyo,Sasaki, Keisuke Asian Australasian Association of Animal Productio 2018 Animal Bioscience Vol.31 No.6
Objective: The relationship between water-holding capacity (WHC) and intermuscular fat (IMF) was studied in Japanese commercial pork. Methods: Longissimus muscles of pigs (n = 62), obtained from two meat packing plants, were analyzed for IMF content, moisture content, drip loss, cooking loss, and pH. Pairwise relationships among these traits were determined using correlation analyses. Results: IMF content was significantly correlated with moisture content (r = -0.88; p<0.01) and pH (r = 0.32; p<0.05), but not with drip loss (r = -0.23; p = 0.07) or cooking loss (r = -0.10; p = 0.42). In contrast, drip loss was significantly (and negatively) correlated with pH (r = -0.57; p<0.01). Conclusion: IMF content was not significantly correlated with WHC in pork, and so ultimately, we consider pH to be one of the most important factors influencing WHC in pork meat.
Mitsuru Okuno,Keisuke Iwata,Tsuyoshi Mukai,Yusuke Kito,Takuji Tanaka,Naoki Watanabe,Senji Kasahara,Yuhei Iwasa,Akihiko Sugiyama,Youichi Nishigaki,Yuhei Shibata,Junichi Kitagawa,Takuji Iwashita,Eiichi 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.3
Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) using a 19-gauge needle is an efficient sampling method for the diagnosis of lymphadenopathy. This study compared 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma (ML). Methods: Patient characteristics, number of needle passes, puncture route, sensitivity, specificity, and accuracy of cytology/histology for lymphadenopathy were analyzed in patients diagnosed with lymphadenopathy by EUS-FNA using conventional or Franseen needles. Results: Between 2012 and 2022, 146 patients met the inclusion criteria (conventional [n=70] and Franseen [n=76]). The median number of needle passes was significantly lower in the conventional group than in the Franseen group (3 [1–6] vs. 4 [1–6], p=0.023). There were no significant differences in cytological/ histological diagnoses between the two groups. For ML, the immunohistochemical evaluation rate, sensitivity of flow cytometry, and cytogenetic assessment were not significantly different in either group. Bleeding as adverse events (AEs) were observed in three patients in the Franseen group. Conclusions: Both the 19-gauge conventional and Franseen needles showed high accuracy in lymphadenopathy and ML classification. Considering sufficient tissue collection and the avoidance of AEs, the use of 19-gauge conventional needles seems to be a good option for the diagnosis of lymphadenopathy.
Masahide Ikeguchi,Keisuke Goto,June Watanabe,Shoichi Urushibara,Tomohiro Osaki,Kanenori Endo,Shigeru Tatebe,Seiichi Nakamura 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.4
Backgrounds/Aims: The prognostic nutritional index (PNI) is based on the albumin concentration and absolute lymphocyte count and is designed to assess the nutritional and immunological status of patients. In this study, we evaluated the prognostic importance of the preoperative and postoperative PNI in patients who underwent curative resection of pancreatic ductal adenocarcinoma (PDAC). Methods: From 2006 to 2017, 50 patients with PDAC underwent curative resection at our hospital. We performed distal pancreatectomy (DP) with splenectomy in 15 patients, pancreaticoduodenectomy (PD) in 27 patients, PD combined with portal vein partial resection in 6 patients, and total pancreatectomy with splenectomy in 2 patients. We compared the preoperative PNI and postoperative PNI (1 and 2 months postoperatively) and analyzed the prognostic importance for these patients. Results: The mean PNI significantly decreased from 45.5 preoperatively to 39.8 at 1 month postoperatively (p<0.001), but recovered to 42.7 at 2 months postoperatively. In 23 patients, the PNI at 2 months postoperatively recovered to the preoperative level (recovered group), but in the remaining 27 patients, the PNI at 2 months postoperatively did not reach the preoperative level (non-recovered group). The overall median survival time in the recovered group (29 months) was significantly longer than that in the non-recovered group (12 months, p=0.003). The multivariate overall analysis demonstrated that good recovery of the postoperative PNI was strongly correlated with a better prognosis. Conclusions: Effective postoperative nutrition may have a prognostic benefit for patients with operable PDAC.