Novel Landmark for Cervical Pedicle Screw Insertion Point from Computed Tomography-Based Study

Kazuya Nishizawa,Kanji Mori,Akira Nakamura,Shinji Imai 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.1

Study Design: Cross-sectional study. Purpose: The purpose of this study was to evaluate a novel landmark for the cervical pedicle screw insertion point. Overview of Literature: To improve the accuracy of pedicle screw placement, several studies have employed the lateral mass, lateral vertical notch, and/or inferior articular process as landmarks; however, we often encounter patients in whom we cannot identify accurate insertion points for pedicle screws using these landmarks because of degenerative changes in the facet joints. The superomedial edge of the lamina is less affected by degenerative changes, and we hypothesized that it could be a new landmark for identifying an accurate cervical pedicle screw insertion point. Methods: A total of 327 consecutive patients, who had undergone neck computed tomographic scanning for determination of neck disease in our institute, were included in the study. At first, the line was drawn parallel to the superior border of the pedicle in the sagittal plane and parallel to the vertical body in the coronal plane. The line was moved downward in 1-mm increments to the inferior border of the pedicle. We determined whether the line passing through the superomedial edge of the lamina (termed the “N-line”) was located between the superior and inferior borders of the pedicle in the sagittal plane. Results: The percentages of N-lines located between the superior and inferior borders of the pedicle were 100% at C3, 100% at C4, 99% at C5, 96% at C6, and 97% at C7. The lower cervical spine has the higher N-line location. Conclusions: The N-line was frequently located at the level of the pedicle of each cervical spine in the sagittal plane. The superomedial edge of the lamina could be a new landmark for the insertion point of the cervical pedicle screw.

Short-Term Clinical Result of Cortical Bone Trajectory Technique for the Treatment of Degenerative Lumbar Spondylolisthesis with More than 1-Year Follow-Up

Kanji Mori,Kazuya Nishizawa,Akira Nakamura,Shinji Imai 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.2

Study Design: Retrospective follow-up study on the result of surgical treatment for patients with degenerative lumbar spondylolisthesis (DLS) using cortical bone trajectory (CBT) technique. Purpose: To evaluate the capability of CBT to manage patients with DLS. Overview of Literature: CBT is a recently advocated, novel, less-invasive technique of lumbar pedicle screw, which provides enhanced screw purchase by maximizing the thread contact with higher density bone surface. Despite the frequent use of CBT technique in the lumbar spine surgery, little is known of the capability of this technique to manage patients with DLS. Methods: Thirty two consecutive patients (5 males, 27 females) surgically treated with single-level DLS in our institute using CBT were included. All patients were followed up at least 12 months (mean 24 months). Their clinical and radiological features were measured. Results: Good leg pain relief was achieved in all patients. The mean postoperative percentage slip demonstrated significant reduction with significant neurological recovery when compared with preoperative percentage slip, and it was maintained until the latest follow-up. Loss of correction of more than 3 mm during the follow-up period was observed in 3 cases. Surgical site infection was observed in one case; however, pull-out of PSs or neurological deterioration was not found. No patient needed additional surgery during the follow-up period. Conclusions: These preliminary results confirmed that CBT is useful for the treatment for patients with DLS. This technique allows good reduction of spondylolisthesis and neurological improvement.

Induction of a T-Helper 1 (Th1) Immune Response in Mice by an Extract from the Pleurotus eryngii (Eringi) Mushroom

Kazunori Ike,Natsuko Kameyama,Akira Ito,Soichi Imai 한국식품영양과학회 2012 Journal of medicinal food Vol.15 No.12

To assess the effect of edible mushroom extracts on the induction of T-helper 1 (Th1) immunity, we examined differences in interferon-gamma (IFN-γ) and interleukin (IL)-4 production in mice induced by hot-water extracts of 15 species of edible mushroom. Extracts from Agaricus bisporus, Flammulina velutipes, Hypsizigus marmoreus, Lentinula edodes, and Lyophyllum decastes induced both IFN-γ and IL-4 production in mice, whereas extracts from Pleurotus ostreatus only induced IL-4. In contrast, extracts from Agaricus blazei, Grifola frondosa, Morchella esculenta, Pholiota nameko, Pleurotus citrinopileatus, and Pleurotus eryngii induced only IFN-γ production. In particular, the extract from P. eryngii induced high levels of IFN-γ and reduced levels of IL-4. We further investigated the use of a trial immunogen using the P. eryngii extract as a Th1 immunostimulator. An oil-in-water emulsion of the hot-water extract from P. eryngii (immunostimulator) and ovalbumin (OVA; antigen) was used as a trial immunogen. This immunogen induced strong OVA-specific IgG2a antibody production in mice compared with the negative controls. In addition, OVA-specific IgG1 antibody levels were lower than those for the negative controls. Marked increases in serum IFN-γ levels and high-level production of IFN-γ in the culture supernatant from the CD4+ spleen cells in the trial immunogen group mice were observed. Our results suggested that the hot-water extract from P. eryngii induced Th1 immunity by acting as an immunostimulator.

Prototype single-balloon enteroscopy with passive bending and high force transmission improves depth of insertion in the small intestine

( Yasuhiro Morita ),( Shigeki Bamba ),( Osamu Inatomi ),( Kenichiro Takahashi ),( Takayuki Imai ),( Masaki Murata ),( Masashi Ohno ),( Masaya Sasaki ),( Tomoyuki Tsujikawa ),( Akira Andoh ) 대한장연구학회 2020 Intestinal Research Vol.18 No.2

Background/Aims: We retrospectively analyzed Crohn’s disease (CD) patients with small intestinal strictures who underwent single-balloon enteroscopy (SBE) to ascertain whether prototype SBEs with a passive bending mechanism and high force transmission insertion tube had better insertability in the small intestine than a conventional SBE. Methods: Among 253 CD patients who underwent SBE, we identified 94 CD patients who had undergone attempted endoscopic balloon dilatation (EBD) for small intestinal stenosis for inclusion in this study. We analyzed whether the type of scope used for their initial procedure affected the cumulative surgery-free rate. For the insertability analysis, patients who underwent SBE at least twice were divided into 3 groups according to the type of scope used: conventional SBE only, prototype SBE only, and both conventional and prototype SBEs. For each group, depth of insertion, procedure time, and number of EBDs were compared in the same patient at different time points. Results: The success rate of EBD was 88.3%. The 5- and 10-year cumulative surgery-free rate was 75.7% and 72.8%, respectively. Cox regression analysis indicated that the factors contributing to surgery were long stricture (≥2 cm), EBD failure, and elevated Crohn’s Disease Activity Index, but not the type of scope used for EBD. The prototype SBEs significantly improved the depth of insertion (P=0.03, Wilcoxon’s signed-rank test). Conclusions: In CD patients with small intestinal stenosis, the prototype SBEs with a passive bending mechanism and high force transmission insertion tube did not improve long-term EBD outcome but did improve deep insertability. (Clinical Trial Registration No. UMIN000037102) (Intest Res 2020;18:229-237)

Relationship between the gut microbiota and bile acid composition in the ileal mucosa of Crohn’s disease

Shigeki Bamba,Osamu Inatomi,Atsushi Nishida,Masashi Ohno,Takayuki Imai,Kenichiro Takahashi,Yuji Naito,Junichi Iwamoto,Akira Honda,Naohiro Inohara,Akira Andoh 대한장연구학회 2022 Intestinal Research Vol.20 No.3

Background/Aims: Crosstalk between the gut microbiota and bile acid plays an important role in the pathogenesis of gastrointestinal disorders. We investigated the relationship between microbial structure and bile acid metabolism in the ileal mucosa of Crohn’s disease (CD).Methods: Twelve non-CD controls and 38 CD patients in clinical remission were enrolled. Samples were collected from the distal ileum under balloon-assisted enteroscopy. Bile acid composition was analyzed by liquid chromatography-mass spectrometry. The gut microbiota was analyzed by 16S rRNA gene sequencing.Results: The Shannon evenness index was significantly lower in endoscopically active lesions than in non-CD controls. β-Diversity, evaluated by the UniFrac metric, revealed a significant difference between the active lesions and non-CD controls (<i>P</i>=0.039). The relative abundance of <i>Escherichia</i> was significantly higher and that of <i>Faecalibacterium</i> and <i>Roseburia</i> was significantly lower in CD samples than in non-CD controls. The increased abundance of <i>Escherichia</i> was more prominent in active lesions than in inactive lesions. The proportion of conjugated bile acids was significantly higher in CD patients than in non-CD controls, but there was no difference in the proportion of primary or secondary bile acids. The genera <i>Escherichia</i> and <i>Lactobacillus</i> were positively correlated with the proportion of conjugated bile acids. On the other hand, <i>Roseburia</i>, <i>Intestinibacter</i>, and <i>Faecalibacterium</i> were negatively correlated with the proportion of conjugated bile acids.Conclusions: Mucosa-associated dysbiosis and the alteration of bile acid composition were identified in the ileum of CD patients. These may play a role in the pathophysiology of ileal lesions in CD patients.

Proposal of the Coma Aberration Dependent Overlay Error Compensation Technology

Nakao Asai,Norio Hasegawa,Yasuko Gotoh,Hidetoshi Satoh,Katsuya Hayano,Akira Imai,Shinji. Okazaki 대한전자공학회 1998 International Conference on Electronics, Informati Vol.- No.-