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      • KCI등재

        Impact of hydroxyethyl starch 70/0.5 on acute kidney injury after gastroenterological surgery

        Takeshi Umegaki,Takeo Uba,Chisato Sumi,Sachiyo Sakamoto,Sachiko Jomura,Kiichi Hirota,Koh Shingu 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.5

        Background: Previous studies reported a higher mortality risk and a greater need for renal replacement therapy in patients administered hydroxyethyl starch (HES) rather than other fluid resuscitation preparations. In this study, we investigated the association between 6% HES 70/0.5 use and postoperative acute kidney injury (AKI) in gastroenterological surgery patients. Methods: We conducted retrospective full-cohort and propensity-score-based analyses of patients who underwent gastroenterological surgery between June 2011 and August 2013 in a Japanese university hospital. The study sample comprised 66 AKI and 2,152 non-AKI patients in the full-cohort analysis and 35 AKI and 1,269 non-AKI patients in the propensity-score-based analysis. Propensity scores were calculated using an ordered logistic regression model in which the dependent variable comprised three groups based on HES infusion volumes (0, 1–999, and ≥ 1,000 ml). The association between HES groups and postoperative AKI incidence was analyzed using multiple logistic regression models. Other candidate independent variables included patient characteristics and intraoperative measures. Results: In the full-cohort analysis, 40 (60.6%) AKI patients were diagnosed as “risk,” 15 (22.7%) as “injury,” and 11 (16.7%) as “failure.” In the propensity-score-based analysis, the corresponding values were 22 (62.9%), 8 (22.9%), and 5 (14.3%). There was no significant association between total infused HES and postoperative AKI incidence in either the full-cohort or the propensity-score-based analysis (P = 0.168 and P = 0.42, respectively). Conclusions: AKI incidence was not associated with clinical 6% HES 70/0.5 administration in gastroenterological surgery patients treated at a single center.

      • KCI등재

        Vertebral Endplate Cyst Formation in Relation to Properties of Interbody Cages

        Manabu Sasaki,Masao Umegaki,Takanori Fukunaga,Yasukazu Hijikata,Yohei Banba,Katsumi Matsumoto,Yasuyoshi Miyao 대한척추신경외과학회 2021 Neurospine Vol.18 No.1

        Objective: This retrospective study aimed to compare vertebral endplate cyst formation (VECF), an early predictor for pseudoarthrosis, in different types of interbody cages. Methods: We reviewed 84 cases treated with single-level posterior/transforaminal lumbar interbody fusion. We utilized a polyetheretherketone cage in 20 cases (group P), a titanium cage in 16 cases (group Ti), a titanium-coating polyetheretherketone cage in 13 cases (group TiP) and a porous tantalum cage in 35 cases (group Tn). VECF was evaluated comparing the computed tomography scans taken at day 0 and 6-month postoperation. We defined VECF (+) as enlargement of a pre-existing cyst or de novo formation of a cyst with the diameter over 2 mm. We calculated the adjusted odds ratio (OR) and 95% confidence intervals (CIs) as an indicator of association between different types of cages and VECF using a logistic regression model. Results: VECF was observed in 13 (65%), 7 (44%), 9 (69%), and 8 (23%) cases in groups P, Ti, TiP and Tn, respectively. VECF correlated with the type of cage (p=0.04). In comparison with group P, the proportion of VECF (+) cases was lower in group Tn (OR, 0.16; 95% CI, 0.04–0.60) but not different in group Ti (OR, 0.47; 95% CI, 0.10–2.20) and group TiP (OR, 1.06; 95% CI, 0.21–5.28). No patient underwent additional surgery for the fused spinal level during the follow-up periods (average, 37.9 months; range, 6–76 months). Conclusion: VECF was the least in the porous Tn cage, suggesting its potential superiority for initial stability.

      • Target-Composition Effect on Hydroxyapatite Thin Films Coated on Titanium by r.f. Sputtering

        Hamagami, Jun-ichi,Kokubu, Daisuke,Umegaki, Takao,Yamashita, Kimihiro The Korean Ceramic Society 1998 The Korean journal of ceramics Vol.4 No.4

        Using calcium-phosphate-powder targets with the Ca/P ratios of 1.0-1.67, hydroxyapatite ($Ca_{10}(PO_4)_6(OH)_2$, HAp) thin films with 4-7㎛ thickness were prepared on titanium metal plates by r.f. magnetron sputtering, followed an annealing at $200^{\circ}C$ for 24 hr under a high water vapor pressure using an autoclave. All the specimens were systematically characterized by XRD, FT-IR, SEM and EDS analyses. The post-annealed films were confirmed to be a nonstoichiometric oxyhydroxyapatite by XRD and FT-IR measurements.

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        Reasons for Diagnostic Failure in Forty-Five Consecutive Mucosal Cutting Biopsy Examinations of Gastric Subepithelial Tumors

        Yoshiko Nakano,Toshitatsu Takao,Yoshinori Morita,Shinwa Tanaka,Takashi Toyonaga,Eiji Umegaki,Yuzo Kodama 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.5

        Background/Aims: Mucosal cutting biopsy (MCB) is useful for the histopathological diagnosis of gastric subepithelial tumors (SETs). However, there is little information on cases in which MCB did not establish a diagnosis. In the current study, we aimed to investigatethe characteristics of cases in which MCB was unsuccessful. Methods: Cases in which MCB was used to histopathologically diagnose gastric SETs at Kobe University Hospital between August 2012and October 2018 were retrospectively reviewed. Results: Forty-five cases in which MCB was used to diagnose 43 gastric SETs in 43 patients were analyzed. The median tumor sizewas 20 mm (range, 8–50 mm). Pathological examinations resulted in definitive and suspected diagnoses and no diagnosis in 29(gastrointestinal stromal tumor: n=17, leiomyoma: n=7, aberrant pancreas: n=3, others: n=2), 6, and 10 cases, respectively. Failure toexpose the tumor according to retrospective examinations of endoscopic images was significantly associated with no diagnosis. Otherpossible explanations included a less elevated tumor, biopsy of the surrounding field instead of the tumor due to the mobility, and poorendoscope maneuverability due to the tumor being close to the cardia. Conclusions: Clear exposure of gastric SETs during MCB may improve the diagnostic rate of such examinations.

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