Novel Hybrid Hydroxyapatite Spacers Ensure Sufficient Bone Bonding in Cervical Laminoplasty

Nobuhiro Tanaka,Kazuyoshi Nakanishi,Naosuke Kamei,Toshio Nakamae,Shinji Kotaka,Yoshinori Fujimoto,Mitsuo Ochi,Nobuo Adachi 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.6

Study Design: Prospective observational study. Purpose: This prospective analysis aimed to evaluate the efficacy and bone-bonding rate of hybrid hydroxyapatite (HA) spacers in expansive laminoplasty. Overview of Literature: Various types of spacers or plates have been developed for expansive laminoplasty. Methods: Expansive open-door laminoplasty was performed in 146 patients with cervical myelopathy; 450 hybrid HA spacers and 41 autogenous bone spacers harvested from the spinous processes were grafted into the opened side of each lamina. The patients were followed up using computed tomography (CT), and their bone-bonding rates for hybrid HA and autogenous spacers, bone-fusion rates of the hinges of the laminae, and complications associated with the implants were then examined. Results: Clinical symptoms significantly improved in all patients, and no major complications related to the procedure were noted. The hybrid HA spacers exhibited sufficient bone bonding on postoperative CT. The hinges completely fused in over 95% patients within 1 year of the procedure. Only 4 spacers (0.9%) developed lamina sinking, and most expanded laminae maintained their positions without sinking or floating throughout the follow-up period. Conclusions: Hybrid HA spacers contributed to high bone-fusion rates of the spacers and hinges of the laminae, and no complications were associated with their use. Cervical laminoplasty with these spacers is safe and simple, and it yields sufficient fixation strength while ensuring sufficient bone bonding during the immediate postoperative period.

A study on design review of the control performance of the air conditioning to prevent room pressure change troubles

Daiki Tanaka,Takamitsu Koike,Nobuhiro Tanaka,Takayuki Miyake,Shigeyuki Tateno,Hisayoshi Matsuyama 제어로봇시스템학회 2006 제어로봇시스템학회 국제학술대회 논문집 Vol.2006 No.10

Finite Element Analysis of Stress Distribution in Flat and Elevated-Rim Polyethylene Acetabular Liners

Nobuhiro Kaku,Ai Tanaka,Hiroaki Tagomori,Hiroshi Tsumura 대한정형외과학회 2020 Clinics in Orthopedic Surgery Vol.12 No.3

Background: No study has compared flat and elevated-rim polyethylene liners in terms of stress distribution on the bearing surface. The purpose of this study was to investigate the difference in stress distribution between flat and elevated-rim polyethylene liners. Methods: A stress analysis was performed by using the 3-dimensional finite element method. The cup was placed at an open angle of 20°, the flat liner and the liner with a 10° elevation was placed at inclination angles of 80°, 70°, and 60°. Results: Compared with the 60° flat liner, the 80° and 70° flat liners showed higher stress at the liner edge. In the elevated-rim liner, the stress was high at the liner edge along the cup edge. When the von Mises equivalent stress was applied to each element of the liner, the high stress area (volume) was the largest for the 80° flat liner, second largest for the 80° elevated-rim liner, and third largest for the 70° flat liner. The average contact pressure also followed the same order. Conclusions: Elevated-rim liners affect the stress distribution by increasing the area of contact. However, since elevated-rim liners exhibit high stress at the cup edge, they are likely to result in new problems including liner failure. These findings could aid surgeons in the selection of liners and determination of revision methods such as isolated liner exchange vs. acetabular cup revision for a well-fixed metal cup with a higher inclination angle in revision total hip arthroplasty.

Relationship between cortical bone thickness and implant stability at the time of surgery and secondary stability after osseointegration measured using resonance frequency analysis

Tanaka, Kenko,Sailer, Irena,Iwama, Ryosuke,Yamauchi, Kensuke,Nogami, Shinnosuke,Yoda, Nobuhiro,Takahashi, Tetsu Korean Academy of Periodontology 2018 Journal of Periodontal & Implant Science Vol.48 No.6

Purpose: It has been suggested that resonance frequency analysis (RFA) can measure changes in the stability of dental implants during osseointegration. This retrospective study aimed to evaluate dental implant stability at the time of surgery (primary stability; PS) and secondary stability (SS) after ossseointegration using RFA, and to investigate the relationship between implant stability and cortical bone thickness. Methods: In total, 113 patients who attended the Tohoku University Hospital Dental Implant Center were included in this study. A total of 229 implants were placed in either the mandibular region (n=118) or the maxilla region (n=111), with bone augmentation procedures used in some cases. RFA was performed in 3 directions, and the lowest value was recorded. The preoperative thickness of cortical bone at the site of implant insertion was measured digitally using computed tomography, excluding cases of bone grafts and immediate implant placements. Results: The mean implant stability quotient (ISQ) was $69.34{\pm}9.43$ for PS and $75.99{\pm}6.23$ for SS. The mandibular group had significantly higher mean ISQ values than the maxillary group for both PS and SS (P<0.01). A significant difference was found in the mean ISQ values for PS between 1-stage and 2-stage surgery (P<0.5). The mean ISQ values in the non-augmentation group were higher than in the augmentation group for both PS and SS (P<0.01). A weak positive correlation was observed between cortical bone thickness and implant stability for both PS and SS in all cases (P<0.01). Conclusions: Based on the present study, the ISQ may be affected by implant position site, the use of a bone graft, and cortical bone thickness before implant therapy.

Predictors of Poor Outcome in Patients with Acute Cerebral Infarction

Nobuhiro Dougu,Shutaro Takashima,Etsuko Sasahara,Yoshiharu Taguchi,Shigeo Toyoda,Tadakazu Hirai,Takashi Nozawa,Kortaro Tanaka,Hiroshi Inoue 대한신경과학회 2011 Journal of Clinical Neurology Vol.7 No.4

Background and Purpose Plasma D-dimer levels are elevated during the acute phase of cerebral infarction (CI). We investigated whether the D-dimer level on admission and other clinical characteristics could be used to predict the poor outcome of patients with acute CI. Methods The clinical characteristics and plasma D-dimer levels measured within 3 days of onset were compared according to outcome among patients with acute CI. Results In total, 359 consecutive patients (mean age, 71.8 years) were examined, of which 174 had a poor outcome [score on the modified Rankin scale (mRS) ≥3] at 30 days after hospitalization. The mean mRS score was higher and a poor outcome was observed more frequently among women than among men (p<0.001 for each). The proportions of women, cardioembolism, atrial fibrillation, advanced age (≥75 years), prior history of CI or transient ischemic attack, and elevated D-dimer level (≥1.0 μg/mL) were significantly higher among patients with a poor outcome than among those with a good outcome. A multivariate analysis showed that elevated D-dimer level [≥1.0 μg/mL; odds ratio (OR), 2.45; 95% confidence interval (95% CI),1.52-3.89; p<0.01], advanced age (OR, 1.93; 95% CI, 1.21-3.07; p<0.01), and female gender (OR, 1.75; 95% CI, 1.08-2.83; p=0.02) were independent predictors of a poor outcome. Conclusions Certain clinical characteristics (gender and advanced age) and an elevated Ddimer level upon admission can be used to predict the outcome of patients with acute CI at 30 days after hospitalization.

Relationship between cortical bone thickness and implant stability at the time of surgery and secondary stability after osseointegration measured using resonance frequency analysis

Kenko Tanaka,Irena Sailer,Ryosuke Iwama,Kensuke Yamauchi,Shinnosuke Nogami,Nobuhiro Yoda,Tetsu Takahashi 대한치주과학회 2018 Journal of Periodontal & Implant Science Vol.48 No.6

Purpose: It has been suggested that resonance frequency analysis (RFA) can measure changes in the stability of dental implants during osseointegration. This retrospective study aimed to evaluate dental implant stability at the time of surgery (primary stability; PS) and secondary stability (SS) after ossseointegration using RFA, and to investigate the relationship between implant stability and cortical bone thickness. Methods: In total, 113 patients who attended the Tohoku University Hospital Dental Implant Center were included in this study. A total of 229 implants were placed in either the mandibular region (n=118) or the maxilla region (n=111), with bone augmentation procedures used in some cases. RFA was performed in 3 directions, and the lowest value was recorded. The preoperative thickness of cortical bone at the site of implant insertion was measured digitally using computed tomography, excluding cases of bone grafts and immediate implant placements. Results: The mean implant stability quotient (ISQ) was 69.34±9.43 for PS and 75.99±6.23 for SS. The mandibular group had significantly higher mean ISQ values than the maxillary group for both PS and SS (P<0.01). A significant difference was found in the mean ISQ values for PS between 1-stage and 2-stage surgery (P<0.5). The mean ISQ values in the non-augmentation group were higher than in the augmentation group for both PS and SS (P<0.01). A weak positive correlation was observed between cortical bone thickness and implant stability for both PS and SS in all cases (P<0.01). Conclusions: Based on the present study, the ISQ may be affected by implant position site, the use of a bone graft, and cortical bone thickness before implant therapy

Bolus intertransverse process block and continuous erector spinae plane block for perioperative analgesic management of video-assisted thoracoscopic surgery - Three cases report -

Yamamoto Yuki,Tanaka Nobuhiro,Kadoya Yuma,Umehara Miki,Suzuka Takanori,Kawaguchi Masahiko 대한마취통증의학회 2023 Anesthesia and pain medicine Vol.18 No.2

Background: Common regional anesthesia approaches for video-assisted thoracoscopic surgery (VATS) include paravertebral block (PVB) and erector spinae plane block (ESPB). PVB is considered a deep nerve block which is contraindicated in antithrombotic therapy. ESPB is effective when administered as a bolus, as well as continuously. However, the recently proposed intertransverse process block (ITPB) ensures more effective diffusion of the local anesthetic into the paravertebral space.Case: We report cases of three patients who received bolus ITPB (costotransverse foramen block and mid-point transverse process-to-pleura block in one and two cases, respectively) combined with continuous ESPB when a deep nerve block could not be administered. Opioids were not required postoperatively, and all postoperative numerical rating scale scores (0–10) at rest were maintained below 4.Conclusions: The combination of bolus ITPB and continuous ESPB may be an alternative analgesic method when deep nerve blocks are contraindicated in VATS.

Expansion of simulator of pressure control system for air-conditioning system

Yu Fukuhara,Nobuhiro Tanaka,Takayuki Miyake,Shigeyuki Tateno,Hisayoshi Matsuyama 제어로봇시스템학회 2008 제어로봇시스템학회 국제학술대회 논문집 Vol.2008 No.10

It is necessary to manage room pressure strictly in order to prevent air flowing from outside for maintenance of products quality in clean rooms. A local exhaust system is installed in a special environment in which poisonous substances are handled to prevent the contamination. The reversal of pressure is not allowed under any situation as for such the special environment while usual air-conditioning operation is done. However, it is difficult to express room pressure changes of the air-conditioning system because present simulators do not have functions for expression of presser propagation. In this research, a dynamic simulator of pressure control with MATLAB is expanded in order to adapt to the more large-scale actual air-conditioning system. In addition, actual problems of the room pressure changes can be simulated successfully.

Effects of acute kidney injury after liver resection on long-term outcomes

Seiji Ishikawa,Manami Tanaka,Fumi Maruyama,Arisa Fukagawa,Nobuhiro Shiota,Satoshi Matsumura,Koshi Makita 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.5

Background: To investigate the effects of acute kidney injury (AKI) after liver resection on the long-term outcome, including mortality and renal dysfunction after hospital discharge. Methods: We conducted a historical cohort study of patients who underwent liver resection for hepatocellular carcinoma with sevoflurane anesthesia between January 2004 and October 2011, survived the hospital stay, and were followed for at least 3 years or died within 3 years after hospital discharge. AKI was diagnosed based on the Acute Kidney Injury Network classification within 72 hours postoperatively. In addition to the data obtained during hospitalization, serum creatinine concentration data were collected and the glomerular filtration rate (GFR) was estimated after hospital discharge. Results: AKI patients (63%, P = 0.002) were more likely to reach the threshold of an estimated GFR (eGFR) of 45 ml/ min/1.73 m2 within 3 years than non-AKI patients (31%) although there was no significant difference in mortality (33% vs. 29%). Cox proportional hazard regression analysis showed that postoperative AKI was significantly associated with the composite outcome of mortality or an eGFR of 45 ml/min/1.73 m2 (95% CI of hazard ratio, 1.05–2.96, P = 0.033), but not with mortality (P = 0.699), the composite outcome of mortality or an eGFR of 60 ml/min/1.73 m2 (P = 0.347). Conclusions: After liver resection, AKI patients may be at higher risk of mortality or moderate renal dysfunction within 3 years. These findings suggest that even after discharge from the hospital, patients who suffered AKI after liver resection may need to be followed-up regarding renal function in the long term.

SEQUENTIAL NUCLEAR ANGIOCARDIOLOGY OF MILD ACUTE MYOCARDIAL INFARCTION WITHIN 48 HOURS AFTER ATTACK

Ueda, Hideo,Takao, Nobuhiro,Tanaka, Toshihide,Abe, Mitsuki 대한핵의학회 1984 핵의학 분자영상 Vol.18 No.1