50 results on '"Arizono T"'
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2. Effect of additional element and heat treating temperature on micro-structure and mechanical behavior of Ag alloy thin film
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JU, Dong-ying, ISHIGURO, S, ARIZONO, T, and HASEGAWAK, K
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- 2006
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3. Evaluation of Residual Stress in Nano-TiO2 Film on ITO Glass by Synchrotron X-Ray Diffraction
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Ju, Dong Ying, primary, Ueda, T., additional, Hatakeyama, Tetsuo, additional, Arizono, T., additional, Kusaka, Kazuya, additional, and Hanabusa, Takao, additional
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- 2005
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4. Differentiation of vertebral osteomyelitis and tuberculous spondylitis by magnetic resonance imaging
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Arizono, T., Oga, M., Shiota, E., Honda, K., and Sugioka, Y.
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- 1995
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5. Effect of Additional Element and Heat Treating Temperature on the Microstructure and Mechanical Behaviour of Ag Thin Film
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Ju, Dong Ying, primary, Ishiguro, S., additional, Hasegawa, K., additional, and Arizono, T., additional
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- 2009
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6. Standing radiographs cannot determine the correction in high tibial osteotomy
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Ogata, K, primary, Yoshii, I, additional, Kawamura, H, additional, Miura, H, additional, Arizono, T, additional, and Sugioka, Y, additional
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- 1991
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7. Distribution of capsular materials on the cell wall surface of strain Smith diffuse of Staphylococcus aureus
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Arizono, T, primary, Umeda, A, additional, and Amako, K, additional
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- 1991
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8. Evaluation of Residual Stress in Nano-TiO2 Film on ITO Glass by Synchrotron X-Ray Diffraction
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Ju, Dong Ying, Ueda, T., Hatakeyama, Tetsuo, Arizono, T., Kusaka, Kazuya, and Hanabusa, Takao
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In this study, evaluation of residual stress in nano-TiO2 film on ITO glass is carried out. The films with thickness less than 30 nm are prepared by the dual-arcs magnetron sputtering with gas pressure 10 and 20 Pa. The surface microstructure and grain morphology of the nano-TiO2 films are observed by the atomic force microscopy (AFM). In order to accurately evaluate the residual stress in the film, the Young’s modulus of the film is determined by the nanoindentation with three point bending method at first, then the internal residual stress in the film is measured by high energy X-ray diffraction with the synchrotron radiation facility Spring-8. The measured residual stresses of nano-TiO2 films prepared with gas pressure 10 and 20 Pa are -11.6 and -9.1 GPa, respectively. It is shown that the residual stress of TiO2 films decrease with the increasing of gas pressure.
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- 2005
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9. Erratum: Linear Optical Quantum Computation with Frequency-Comb Qubits and Passive Devices [Phys. Rev. Lett. 130, 200602 (2023)].
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Yamazaki T, Arizono T, Kobayashi T, Ikuta R, and Yamamoto T
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This corrects the article DOI: 10.1103/PhysRevLett.130.200602.
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- 2024
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10. Linear Optical Quantum Computation with Frequency-Comb Qubits and Passive Devices.
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Yamazaki T, Arizono T, Kobayashi T, Ikuta R, and Yamamoto T
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We propose a linear optical quantum computation scheme using time-frequency degrees of freedom. In this scheme, a qubit is encoded in single-photon frequency combs, and manipulation of the qubits is performed using time-resolving detectors, beam splitters, and optical interleavers. This scheme does not require active devices such as high-speed switches and electro-optic modulators and is robust against temporal and spectral errors, which are mainly caused by the detectors' finite resolution. We show that current technologies almost meet the requirements for fault-tolerant quantum computation.
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- 2023
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11. Gluteal Compartment Syndrome After Femoral Nail Extraction: A Case Report.
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Kuroki Y, Imamura R, Inoue H, Inoue T, Ebihara T, Nakamura K, Izumi T, Hamada T, Inokuchi A, and Arizono T
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Gluteal compartment syndrome is a rare disorder and no definitive treatment has yet been established. Fasciotomy is often the treatment of choice for gluteal compartment syndrome, but there have been only a few cases that have improved with conservative therapy. A 26-year-old male with a body mass index of 40.5 who underwent femoral nail extraction surgery had severe pain in the right buttock and numbness in the right lower extremity. Initially, we suspected transient pain due to prolonged exposure to the same posture, but muscle weakness in the lower extremities and worsening of renal function appeared over time. Orthopedic evaluation revealed physical examination findings and MRI imaging findings consistent with gluteal compartment syndrome. Conservative treatment with temporary dialysis was chosen instead of fasciotomy because of the time required for diagnosis. Dialysis was started on postoperative day 3, renal function and muscle weakness recovered over time, and the patient was discharged home on postoperative day 37. At six months post-op, the patient was walking without pain and he had no changes in his peripheral neurologic examination compared to his preoperative baseline. Orthopedic surgeons should always be aware of the possibility of gluteal compartment syndrome when especially obese patients with prolonged operation times appeal to acute buttock pain. Diagnosis should be made as early as possible to get a good prognosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kuroki et al.)
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- 2023
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12. Co-existence of Lumbar Disc Herniation and Posterior Ring Apophyseal Fracture: It Is Not Rare and Computed Tomography Is Useful.
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Inoue T, Inokuchi A, Izumi T, Imamura R, Hamada T, Nakamura K, Ebihara T, Inoue H, Kuroki Y, and Arizono T
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Introduction Posterior ring apophyseal fracture (PRAF) is characterized by the separation of bone fragments and sometimes coexists with lumbar disc herniation (LDH). However, how often these conditions coexist and the details of the clinical course remain unclear. Methods We analyzed 200 patients who underwent surgical treatment for LDH at our hospital from January 2016 to December 2020. Among these, we reviewed 21 patients who underwent microendoscopic surgery to treat PRAF. They consisted of 11 male and 10 female patients, ranging in age from 15 to 63 years. The average age was 32.8 months, and the average follow-up period was 39.8 years. We performed simple roentgenography and magnetic resonance imaging for all patients and computed tomography for about 80% of the patients. We evaluated the type of PRAF fragment (Takata classification), disease level, Japanese Orthopedic Association (JOA) score, Roland-Morris Disability Questionnaire (RDQ) score, operating time, intraoperative blood loss, and perioperative complications. Results A total of 10.5% of patients with LDH also had PRAF. The mean JOA score significantly improved from 10.6 ± 5.7 points before surgery to 21.4 ± 5.1 points at the final observation (p < 0.05). The mean RDQ score significantly improved from 17.1 ± 4.5 preoperatively to 5.5 ± 0.5 at the final observation (p < 0.05). The average operation time was 88.6 minutes. There were no complications requiring early surgery that were due to postoperative infection or epidural hematoma, but one patient required reoperation. Conclusion This study showed that PRAF coexisted with LDH in about 10% of cases, and the outcomes of surgical treatment were generally good. Computed tomography is recommended to improve the diagnostic rate and assist with surgical planning and intraoperative decision-making., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Inoue et al.)
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- 2023
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13. Bisphosphonates Prescription for Patients With Hip Fractures Based on Evaluation by a Dentist.
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Inoue H, Oyama R, Nakamura K, Inokuchi A, Hamada T, Izumi T, Imamura R, Ebihara T, Inoue T, and Arizono T
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Background The purpose of this study is to clarify the current status of the prescription of postoperative bisphosphonates for patients with hip fractures and to explore the factors that prevent the postoperative prescription of bisphosphonates. Methods Of 180 patients with hip fractures treated surgically at our hospital between August 2019 and April 2020, 149 patients (46 men and 103 women; mean age: 83.9 ± 9.0 years), excluding 31 patients already prescribed bisphosphonates or denosumab, were included in the study. All patients were treated based on our clinical pathway, and their risk of jaw osteonecrosis was evaluated prior to the initiation of bisphosphonates by a dentist in our hospital. We collected data from the medical records on osteoporosis treatment interventions at admission and discharge, the reasons why postoperative bisphosphonates could not be prescribed at discharge, the proportion of patients who had follow-ups at our hospital, and patients' osteoporosis treatment status. Results Eighteen (12.8%) and 95 (63.8%) patients were prescribed anti-osteoporosis drugs at admission and discharge, respectively. One hundred and twenty-one patients (86.8%) could not be prescribed postoperative bisphosphonates at discharge - 71 (58.7%) because of oral hygiene problems, 34 (28.1%) because they did not have regular dental consultations, seven (5.8%) because of renal dysfunction, eight (6.6%) because of poor cognitive and swallowing function, and one (0.8%) because of medication side effects. Forty-nine patients (32.9%) went to our hospital for follow-up and 11 were introduced to bisphosphonates or denosumab at follow-up. Conclusions The number of patients with hip fractures who were prescribed postoperative bisphosphonates was low in our study. The oral hygiene problems identified by dentists accounted for responsible for the low prescription rate of postoperative bisphosphonates. Therefore, coordination with dentists may be important to increase the postoperative bisphosphonate prescription., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Inoue et al.)
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- 2023
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14. Efficacy of Corticosteroid Addition to a Periarticular Cocktail Injection to Counteract Nausea and Vomiting After Total Knee Arthroplasty.
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Ebihara T, Hamada T, Nakamura K, Inokuchi A, Izumi T, Imamura R, Inoue T, Inoue H, Kuroki Y, and Arizono T
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Background: Intraoperative periarticular injection of a "cocktail" of drugs is undertaken commonly in total knee arthroplasty (TKA). The addition of a corticosteroid to the periarticular injection is believed to offer greater pain relief because of its local anti-inflammatory effects, but the prevalence of postoperative nausea and vomiting (PONV) is not known. This retrospective observational study aimed to elucidate the relationship between corticosteroid addition to a periarticular cocktail injection (PCI) and PONV., Materials and Methods: Fifty-nine patients who underwent unilateral TKA for primary osteoarthritis were divided into two groups: corticosteroid and non-corticosteroid. The former had triamcinolone acetonide (40 mg) added to the same PCI. The primary outcome was the prevalence of nausea and vomiting within 48 hours following TKA., Results: There was no significant difference between the two groups in terms of patient demographics. The overall prevalence of PONV was 16.9%. Fewer patients in the corticosteroid group complained of PONV than in the non-corticosteroid group (6.4% vs . 58.3%; p = 0.012)., Conclusions: The addition of a corticosteroid to a PCI suppressed PONV. Our results suggested that cocktail injections may have local and systemic effects., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ebihara et al.)
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- 2023
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15. Prophylactic Intrawound Vancomycin Powder in Minimally Invasive Spine Stabilization May Cause an Acute Inflammatory Response.
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Hyodo Y, Arizono T, Inokuchi A, Hamada T, and Imamura R
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Introduction Surgical site infections (SSIs) with methicillin-resistant Staphylococcus aureus are serious complications of spinal instrumentation surgery. Many spine surgeons are concerned that using prophylactic vancomycin powder will lead to certain risks: the development of multidrug-resistant pathogens, anaphylactic reactions, and organ toxicity. Minimally invasive spine stabilization (MISt) is associated with shorter operation times and less blood loss and may therefore require the use of less vancomycin powder, which may reduce these risks. This retrospective comparative study of patients who underwent MISt at a single institution aimed to evaluate the complications (such as allergy, SSIs, and organ toxicity) and the local and serum levels associated with using prophylactic intrawound vancomycin powder compared with IV cefazolin alone. Methods Thirty-four patients received intrawound vancomycin powder (1 g) applied during wound closure in minimally invasive posterior lumbar interbody fusion (MIS-PLIF). This group was compared with 133 control patients who did not receive vancomycin. White blood cell counts and C-reactive protein (CRP) levels were measured for both groups on postoperative days (PODs) 1, 3, and 7 and were statistically analyzed. In the vancomycin group, serum vancomycin levels were measured on PODs 1, 3, 7, and 14; drain vancomycin levels and postoperative blood loss were determined on PODs 1 and 2. Results The CRP levels on PODs 1 and 3 were significantly higher in the vancomycin group than in the control group (P<0.001, P=0.024). In the vancomycin group, mean drain levels trended downward from 313 μg/mL (POD 1) to 155 μg/mL (POD 2). These levels correlated negatively with drain drainage volume on both days (POD 1: r=-0.48, P=0.015; POD 2: r=-0.47, P=0.019). Mean serum vancomycin levels also trended downward from 2.3 μg/mL (POD 1) to 1.7 μg/mL (POD 14). Conclusions Our results unexpectedly demonstrated that the local application of vancomycin powder causes an acute inflammatory response and the long-term detection of low serum vancomycin levels. Less than 1 g of intrawound vancomycin powder may be useful only at high risk of SSI., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Hyodo et al.)
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- 2022
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16. Minimally Invasive Spinal Treatment (MIST)-A New Concept in the Treatment of Spinal Diseases: A Narrative Review.
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Ishii K, Watanabe G, Tomita T, Nikaido T, Hikata T, Shinohara A, Nakano M, Saito T, Nakanishi K, Morimoto T, Isogai N, Funao H, Tanaka M, Kotani Y, Arizono T, Hoshino M, and Sato K
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- Humans, Lumbar Vertebrae surgery, Minimally Invasive Surgical Procedures methods, Neurosurgical Procedures methods, Treatment Outcome, Spinal Diseases, Spinal Fusion methods
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In the past two decades, minimally invasive spine surgery (MISS) techniques have been developed for spinal surgery. Historically, minimizing invasiveness in decompression surgery was initially reported as a MISS technique. In recent years, MISS techniques have also been applied for spinal stabilization techniques, which were defined as minimally invasive spine stabilization (MISt), including percutaneous pedicle screws (PPS) fixation, lateral lumbar interbody fusion, balloon kyphoplasty, percutaneous vertebroplasty, cortical bone trajectory, and cervical total disc replacement. These MISS techniques typically provide many advantages such as preservation of paraspinal musculature, less blood loss, a shorter operative time, less postoperative pain, and a lower infection rate as well as being more cost-effective compared to traditional open techniques. However, even MISS techniques are associated with several limitations including technical difficulty, training opportunities, surgical cost, equipment cost, and radiation exposure. These downsides of surgical treatments make conservative treatments more feasible option. In the future, medicine must become "minimally invasive" in the broadest sense-for all patients, conventional surgeries, medical personnel, hospital management, nursing care, and the medical economy. As a new framework for the treatment of spinal diseases, the concept of minimally invasive spinal treatment (MIST) has been proposed.
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- 2022
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17. The History and Development of the Percutaneous Pedicle Screw (PPS) System.
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Ishii K, Funao H, Isogai N, Saito T, Arizono T, Hoshino M, and Sato K
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- Humans, Lumbar Vertebrae surgery, Minimally Invasive Surgical Procedures methods, Pedicle Screws, Spinal Fusion methods
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Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using the SEXTANT
® system (Medtronic) featured the first generation of commercially available percutaneous pedicle screw (PPS) system in 2001. The innovative system has since become standard instrumentation used worldwide, and PPS is now used for long-segment minimally invasive surgery (MIS) spinal fixation from the thoracic spine to the pelvis for pathological conditions. PPS systems have been developed for approximately 20 years for the purpose of improving minimally invasive techniques, safety of instrumentation, and ease of use. The third-generation PPS systems established the insertion technique, and the development of the fourth-generation PPS systems have made great strides in minimizing the number of steps in the operative procedure. In the future, PPS systems are expected to continue making use of the latest technological advancements and to develop further with the aim of ensuring greater safety, reducing operator stress, and preventing complications such as insertion errors and infection. In this review article, we describe the historical evolution from the first-generation PPS system to the current PPS systems used today.- Published
- 2022
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18. A Case of Delayed Airway Stenosis Due to Retropharyngeal Hematoma Caused by Low Energy Trauma.
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Tanaka I, Arizono T, Inokuchi A, Imamura R, and Izumi T
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Airway narrowing due to trauma-induced retropharyngeal hematoma is rare. However, it is dangerous to overlook this lesion because it can lead to airway obstruction and even death. In this article, we report a case of a patient who developed pharyngeal pain and dysphagia two days after bruising on the forehead due to a fall and required intubation management. A 52-year-old man fell while walking and bruised his forehead two days before visiting our hospital. He had a sore throat and dysphagia two days after the injury and came to our hospital three days after the injury. The swelling was observed in the anterior neck, and stenotic sounds were heard in the upper airway. Cervical CT and MRI of the cervical spine showed extensive hyperabsorption areas in the ventral side of the cervical spine that appeared to be hematomas. No fracture of the cervical spine was observed. The patient has been placed on emergency tracheal intubation due to concerns about airway stenosis caused by the hematoma. Although pneumonia was observed during treatment, it resolved with antimicrobial therapy, and the hematoma tended to shrink, so the patient was extubated on the 15th day of admission. However, the patient was intubated again on the 17th day of hospitalization due to poor oxygenation. A tracheostomy was performed on the 26th day of hospitalization due to suspected narrowing of the upper airway caused by hematoma or sputum. On day 59 of hospitalization, the cannula was removed, and the patient was discharged home on the 68th day after hospitalization. Low-energy trauma tends to be underrecognized as producing anterior cervical hematomas that can lead to fatal airway narrowing. Care should be taken because fatal anterior cervical hematomas are not often part of the differential diagnosis due to their often delayed onset. More caution is needed if an underlying disease may cause coagulation abnormalities., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Tanaka et al.)
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- 2022
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19. Factors Affecting Postoperative Spinal Epidural Hematoma and the Optimal Order of Vertebral Body Decompression in Multivertebral Microendoscopic Laminectomy.
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Soejima Y, Arizono T, Bekki H, Inokuchi A, Izumi T, Imamura R, Hamada T, Nakamura K, Sakai M, Yoshimoto M, and Yamamoto M
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Purpose Symptomatic postoperative spinal epidural hematoma (POSEH) is a complication of spine surgery that occurs infrequently but may cause ongoing serious neurological damage. Due to the narrow entry portal, the risk of hematoma is increased after microendoscopic laminectomy (MEL) compared with conventional open surgery, and the risk might be even higher for multivertebral MEL (m-MEL). The purpose of this study was to clarify the factors affecting the development of POSEH after m-MEL and identify the optimal order for the decompression of vertebral bodies. Methods A total of 313 patients who underwent m-MEL from 2016 to 2020 were retrospectively assessed. The cohort comprised 238 patients who underwent two-level MEL, 67 who underwent three-level MEL, and eight who underwent four-level MEL. Symptomatic POSEH was defined as the presence of an epidural hematoma at the surgical site on MRI with symptoms such as lower extremity pain or muscle weakness. We elucidated the incidence of POSEH at each vertebral level and investigated the relationship between POSEH and possible risk factors such as clinical and operative variables. Results There were 41 patients in the POSEH group and 272 patients in the non-POSEH group. Seven patients in the POSEH group underwent reoperation. The occurrence of POSEH was related to the number of decompressed vertebral bodies. Patients who underwent L2/3 and L3/4 decompression at the end of the procedure also showed a higher incidence of POSEH at the surgical level. Conclusion In patients undergoing m-MEL, treatment of the upper lumbar vertebrae at the end of decompression surgery might be a risk factor for symptomatic POSEH. The incidence of POSEH was particularly increased at L2/3, suggesting that L2/3 decompression should not be performed at last and that careful hemostasis should be applied., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Soejima et al.)
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- 2022
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20. Efficacy of Nerve Root Block for the Treatment of Lumbar Spinal Canal Stenosis in Adults Older Than 80 Years of Age.
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Sakai M, Inokuchi A, Imamura R, Izumi T, Yamamoto M, Yoshimoto M, Soejima Y, Nakamura K, Hamada T, and Arizono T
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Background: Patients with advanced lumbar spinal canal stenosis (LCS) often prefer non-operative treatment owing to decreased physiological function and comorbidities. Although the therapeutic value of selective nerve root block (SNRB) for LCS is confirmed, there are few reports of its effectiveness in the elderly. We investigated the efficacy of SNRB for LCS in patients over 80 years of age., Methods: The subjects were 112 patients aged over 80 years (mean age: 84 years; 45 men and 67 women ) with medication-resistant LCS without cauda equina syndrome who underwent SNRB. Cases with acute-onset lumbar disc herniation were excluded. We retrospectively investigated and compared the presence or absence of surgery, effect of SNRB, number of procedures, duration of disease, and magnetic resonance imaging findings. Patients who could avoid the surgery by SNRB were defined as the effective group. Patients whose symptoms were not relieved by SNRB and who underwent surgery and those whose symptoms were not relieved but who continued conservative treatment were defined as the ineffective group. A total of one to seven SNRBs were performed in both groups, and the same spine surgeon performed the entire procedure from SNRB to surgery., Results: There were 86 nonoperative patients (69 effective cases) and 26 operative patients; the overall rate of effectiveness was 61% (69/112 patients). The area of the spinal canal at the responsible level was 108.63 mm
2 in the effective group compared with 77.06 mm2 in the ineffective group. This was significantly narrower in the ineffective group (p=0.0094). There was no significant difference in the duration of illness, number of blocks, or hernia complication rate between the groups. No patient experienced severe neuralgia that may have been caused by neuropathy during SNRB., Discussion: Our outcome showed that more than 60% of older patients with LCS showed symptomatic improvement with SNRB. SNRB can be performed relatively safely in the elderly and appears to be a favorable treatment option for older patients with various risks, such as poor general condition., Conclusions: Multiple sessions of SNRB may provide older patients with symptomatic improvement and may be an option for treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Sakai et al.)- Published
- 2022
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21. Comparison of Microendoscopic Laminotomy (MEL) Versus Spinous Process-Splitting Laminotomy (SPSL) for Multi Segmental Lumbar Spinal Stenosis.
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Oyama R, Arizono T, Inokuchi A, Imamura R, Hamada T, and Bekki H
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Aims This study was aimed to compare the perioperative and postoperative outcomes of patients who underwent posterior decompression for multi-segmental lumbar spinal stenosis by microendoscopic laminotomy (MEL) versus spinous process-splitting laminotomy (SPSL) retrospectively. Methods We retrospectively reviewed 73 consecutive patients who underwent two or three levels MEL (n=51) or SPSL (n=22) for lumbar spinal stenosis between 2012 and 2018. The perioperative outcomes were operative time, intraoperative blood loss, length of postoperative hospital stay, complications, and reoperation rate. The postoperative outcomes were evaluated using a visual analog scale (VAS) and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores at one year postoperatively. Results The mean follow-up time was 26.6 months in MEL and 35.6 months in SPSL. The mean operative time was significantly longer in MEL than SPSL (two levels, 183.6 ± 43.2 versus 134.8 ± 26.7 min, respectively; three levels: 241.6 ± 47.8 versus 179.9 ± 28.8 min, respectively). MEL's mean postoperative hospital stay was significantly shorter than SPSL (12.3 ± 5.9 versus 15.5 ± 7.2 days, respectively). There was no significant difference in the mean intraoperative blood loss, complication rate, reoperation rate, and postoperative outcomes between the two groups. Conclusions This study suggests that both techniques are effective in treating multi-segmental lumbar spinal stenosis. There was no significant difference between the two procedures in intraoperative blood loss (IBL), complications rate, reoperation rate, or improvement in VAS and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores. MEL had an advantage in the postoperative hospital stay., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Oyama et al.)
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- 2022
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22. Association of Postoperative Neutrophil Lymphocyte Ratio (NLR) and Monocyte Lymphocyte Ratio (MLR) with the Presence of Osteoporosis in Japanese Patients after Hip Fracture Surgery: A Retrospective Cohort Study.
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Bekki H, Arizono T, Hama D, Inokuchi A, Hamada T, and Imamura R
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Background: The diagnosis of osteoporosis is based on bone mineral density measurements expressed as a percentage of the young adult mean (YAM) in Japan. Osteoporosis is defined as YAM <70%, and intervention is recommended at this cutoff. Because osteoporosis has a strong association with systemic metabolic disorders, we postulated that patients with YAM <70% had higher inflammatory biomarker concentrations owing to the higher systemic stress compared with YAM >70%., Method: We retrospectively reviewed 94 patients with low-trauma hip fractures. Blood examinations were performed on postoperative day (POD) 1 and POD 7. We used neutrophil lymphocyte ratio (NLR) and monocyte lymphocyte ratio (MLR) to evaluate postoperative recovery. After dividing the 94 patients into two groups according to a YAM cutoff of 70%, we compared the differences in NLR and MLR., Results: On POD 1, patients with YAM >70% had a median NLR of 5.7 and a median MLR of 0.66, which were significantly lower than for patients with YAM <70% (8.8 and 0.9, respectively). Similarly, on POD 7, patients with YAM >70% had a median NLR of 2.0 and a median MLR of 0.31, which were significantly lower than for patients with YAM <70% (3.5 and 0.43, respectively)., Conclusion: A YAM cutoff of 70% is an appropriate intervention threshold regarding postoperative recovery after hip fracture surgery. Mini-Abstract . Patients with YAM >70% showed lower NLR and MLR on POD 1 and POD 7. A YAM cuffoff of 70% is an appropriate intervention threshold regarding postoperative recovery after hip fracture surgery., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Hirofumi Bekki et al.)
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- 2021
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23. Massive Lumbar Disc Herniation Causing Cauda Equina Syndrome That Presents As Bladder and Bowel Dysfunction in the Absence of Lower Extremity Weakness.
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Nakamura K, Arizono T, Inokuchi A, Hamada T, and Imamura R
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The purpose of this report is to examine the features of cauda equina syndrome (CES) presenting as bladder and bowel dysfunction in the absence of lower extremity weakness. Between July 2015 and July 2016, we experienced four cases of massive LDH causing CES that presented as bladder and bowel dysfunction in the absence of lower extremity weakness. Herein, we describe the clinical features of these four patients (two males and two females) who were followed for a minimum of two years postoperatively. The mean age at the time of surgery was 46.8 years (range, 37-71 years). The disc herniation lesion was at the L4/5 level in one patient, and the L5/S1 level in three. The mean interval between the onset of CES and complete surgical decompression was 10.5 days (range, 1-18 days). Postoperative outcomes were better than poor in three of four cases, while one case had residual sphincter dysfunction. LDH causing CES is considered an indication for immediate surgical decompression; however, diagnosis of CES is likely to be delayed in atypical cases of CES that present as bladder and bowel dysfunction in the absence of lower extremity weakness. Diagnosis of CES tended to be delayed in cases without lower extremity weakness. Clinicians should recognize even sensory impairment alone of the dominant area supplied by S2-4 is an important diagnostic sign of CES in the early stage., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Nakamura et al.)
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- 2021
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24. Predictive factors of non-treatment and non-persistence to osteoporosis medication after fragility hip fractures at 3 years after discharge: a multicentre, prospective cohort study in the northern Kyushu district of Japan.
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Kanahori M, Matsumoto Y, Fujiwara T, Kimura A, Tsutsui T, Arisumi S, Oyamada A, Ohishi M, Ikuta K, Tsuchiya K, Tayama N, Tomari S, Miyahara H, Mae T, Hara T, Saito T, Arizono T, Kaji K, Mawatari T, Fujiwara M, Takasaki M, Shin K, Ninomiya K, Nakaie K, Antoku Y, Iwamoto Y, and Nakashima Y
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- Aged, Humans, Japan epidemiology, Male, Patient Discharge, Prospective Studies, Quality of Life, Bone Density Conservation Agents therapeutic use, Hip Fractures epidemiology, Osteoporosis drug therapy, Osteoporosis epidemiology, Osteoporotic Fractures epidemiology, Osteoporotic Fractures prevention & control
- Abstract
We examined osteoporosis medication use and factors affecting persistence in 497 patients with fragility hip fractures. Only 25.5% of patients received continuous medication for 3 years, and 44.1% of patients received no treatment. Low Barthel index at discharge was a risk factor for both non-treatment and non-persistence to osteoporosis medication., Purpose: Fragility hip fractures (FHF) caused by osteoporosis decrease the quality of life and worsen life expectancy. Use of osteoporosis medication may be an efficient method in the prevention of secondary FHF. However, previous studies have reported low rates of osteoporosis medication and persistence after FHF. This study aimed to evaluate osteoporosis medication use and factors affecting persistence in patients with FHF in the northern Kyushu area of Japan., Methods: A total of 497 FHF patients aged ≥ 60 years with a 3-year follow-up were included. We prospectively collected data from questionnaires sent every 6 months regarding compliance with osteoporosis medication. We compared baseline characteristics among three groups: no treatment (NT), no persistence (NP), and persistence (P), and conducted multivariable regression models to determine covariates associated with non-treatment (NT vs. NP/P) and non-persistence (NP vs. P)., Results: There were 219 (44.1%), 151 (30.4%), and 127 (25.5%) patients in the NT, NP, and P groups, respectively. Factors associated with non-treatment were male sex, chronic kidney disease, no previous osteoporosis treatment, and low Barthel index (BI) at discharge. The only factor associated with non-persistence was a low BI at discharge. Factors associated with a low BI at discharge were male sex, older age, trochanteric fracture, and surgical delay., Conclusion: Low BI at discharge is a risk factor for both non-treatment and non-persistence to osteoporosis medication. Therefore, appropriate interventions to improve BI may result in persistence to osteoporosis medication., (© 2021. International Osteoporosis Foundation and National Osteoporosis Foundation.)
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- 2021
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25. Risk Factors for Incidence of Postoperative Spinal Epidural Hematoma Following Multilevel Microendoscopic Laminectomy.
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Bekki H, Arizono T, Inokuchi A, Imamura R, Hamada T, Oyama R, Hyodo Y, Kinoshita E, and Kido M
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Introduction: Due to the narrow portal of entry, microendoscopic laminectomy (MEL) is associated with a risk of postoperative spinal epidural hematoma (POSEH). This risk might be higher when performing multiple-level (m-) MEL. The purpose of this study is to clarify the incidence rate of POSEH following single-level (s-) and m-MEL by each interlaminar level and identify the risk factors for POSEH following m-MEL., Methods: A total of 379 patients underwent MEL of the lumbar spine (s-MEL, n=141; m-MEL, n=238). We determined the incidence of POSEH following s-MEL and m-MEL by each interlaminar level. For m-MEL, we clarified the correlation between POSEH and possible risk factors, such as operative findings, the sequence of operated interlaminar levels, and the preoperative cross-sectional dural area (CSA) on magnetic resonance imaging., Results: The incidence rate at L2/3 was significantly higher than that at L3/4 and L4/5. Patients who underwent L2/3 decompression at the end of the procedure showed a higher incidence of POSEH at the L2/3 level. Preoperative spinal stenosis was associated with POSEH at the L2/3 level, and CSA of 56 mm
2 was a predictive factor for POSEH. Logistic regression analysis revealed that both were significant risk factors., Conclusions: In patients undergoing m-MEL, the incidence of POSEH is highest at the L2/3 level, and treatment of the L2/3 level at the end of the procedure and the presence of spinal stenosis are risk factors for POSEH., Competing Interests: Conflicts of Interest: The authors declare that there are no relevant conflicts of interest., (Copyright © 2022 by The Japanese Society for Spine Surgery and Related Research.)- Published
- 2021
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26. Ascending Aortic Calcification as a Potential Predictor for Low Bone Mineral Density: A Pilot Study.
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Bekki H, Arizono T, Suzuki Y, Inokuchi A, Hamada T, Imamura R, Oyama R, Hyodo Y, Kinoshita E, and Kita T
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Background: Identifying the factors related to low bone mineral density (BMD) can have significant implications for preventing hip fractures. The correlation between ascending aortic calcification and BMD has never been reported. Therefore, the purpose of the current study is to confirm the hypothesis that ascending aortic calcification can be used as a predictive factor for low BMD and to find a radiographic sign to show it., Method: Plain film and computed tomography (CT) images of the thorax were obtained from 91 patients with hip fractures. Using the images, the calcification line of the ascending aorta adjacent to the aortic arch was evaluated. A prominent calcification line confirmed by both plain film and CT was classified as +2. A line which was ambiguous on plain film but confirmed by CT was classified as +1. Cases with no calcification were categorized as 0 (control). We compared the classified score with the BMD and calculated the kappa coefficient to measure intraobserver reliabilities for this radiographic finding., Results: Twenty-eight patients showed a +2 line, twenty-four patients showed a +1 line, and thirty-nine patients showed 0 lines. The median BMD of each group was 0.37 for the +2 line, 0.45 for the +1 line, and 0.51 for the 0 line. The BMD for the +2 group was significantly lower than the others. The kappa coefficient was approximately 0.6 ( p < 0.01)., Conclusion: The imaging finding of calcification of the ascending aorta might be considered as a potential surrogate marker of low BMD. In such subjects, BMD might be ordered for the confirmation of diagnosis of osteoporosis. Mini-Abstract . The Aortic Arch Tail Sign, a calcification line on the ascending aorta, was relevant to low BMD in the current study. BMD can be ordered for the confirmation of diagnosis of osteoporosis in a subject incidentally found to have ascending aorta calcification on X-ray or CT., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Hirofumi Bekki et al.)
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- 2021
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27. Changes in a Single Institution's Orthopedic Hospitalization Service in Japan Owing to COVID-19 in 2020.
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Bekki H, Arizono T, Tagata R, Inokuchi A, Hamada T, and Imamura R
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Introduction The coronavirus disease 2019 (COVID-19) pandemic has had immense impact on people and institutions, including the number of admissions to hospitals for surgery. Our aim in this study was to determine the impact of the pandemic on surgeries in a single institution located in Fukuoka, Japan, between 2019 and 2020. Methods We quantified the numbers of surgeries in both years according to three sites of injury (indoor, outdoor, and unknown), 14 disease categories, and 9 primary diseases using patients' medical records. We also compared the hospital cost per day in each month from March to November in both 2019 and 2020 and compared the change in these costs between the two years. Results The number of admissions in 2020 was 1,187 cases vs 1,282 cases in 2019. The average patients' age was higher in 2020 vs 2019 (69.7 ± 0.5 vs 67.5 ± 0.5 years, respectively; p = 0.004), with no gender differences (2020: 705 women and 482 men; 2019: 716 women and 566 men). We found no significant differences in the number of admissions by month between 2019 and 2020. The percentages of outdoor injuries were significantly lower in 2020 vs 2019 (29.8% vs 37.9%, respectively; p = 0.004), and we found significantly different rates when comparing 2020 and 2019 for degenerative disease (42.6% vs 37.4%; p = 0.007), trauma related to falls (34.4% vs 30.2%; p = 0.02), chronic disease (1.9% vs 3.7%; p = 0.005), and sports injuries (0.8% vs 3.7%; p < 0.0001). The rate of sports-related injury was significantly lower in 2020 (1.6%) than in 2019 (7.7%) (p < 0.0001). The daily hospital charge was $10,517.09 (US dollars) in 2020 vs $11,225.32 in 2019, and the charges in the months of April and June were significantly higher in 2020 vs 2019 (p = 0.003 and p = 0.001, for April and June, respectively). Both the number and rate of upper limb fractures were higher in 2020. Conclusions The COVID-19 pandemic is affecting some hospitals' revenue. Although the charges per day were sufficient in our institution in 2020, compared with 2019, some hospital beds were unused during this phase of the pandemic. Hospitals may increase the revenue by mixing both short-term and long-term patients' hospital stays effectively., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bekki et al.)
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- 2021
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28. Long-term outcomes of spinal meningioma resection with outer layer of dura preservation technique.
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Saiwai H, Okada S, Hayashida M, Harimaya K, Matsumoto Y, Kawaguchi KI, Iida KI, Kobayakawa K, Yokota K, Maeda T, Tsuchiya K, Arizono T, Saito T, Nakaie K, Iwamoto Y, and Nakashima Y
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local epidemiology, Retrospective Studies, Spinal Cord Neoplasms surgery, Time, Dura Mater surgery, Meningeal Neoplasms surgery, Meningioma surgery, Neurosurgical Procedures methods
- Abstract
Spinal meningioma is a common benign intradural spinal tumor. It has been reported that the local recurrence rate after surgical resection increases with longer follow-up duration. Simpson grade 1 resection could reduce the risk of recurrence, but this procedure needs dural reconstruction, which would cause cerebrospinal fluid (CSF) leakage or iatrogenic spinal cord injury. Saito et al. reported dura preservation technique to reduce the risk of CSF leakage, in which the meningioma together with the inner layer of the dura is removed and the outer layer is preserved for simple dural closure. The long-term outcomes with this technique have never been investigated. In this study, we retrospectively analyzed the data of 38 surgically treated patients (dura preservation technique, 12 patients; Simpson grade 2 resection, 26 patients) to assess the long-term recurrence rate (mean, 121.5 months; range, 60-228 months). The local recurrence rate in the dura preservation group was 8.3% (1 of 12 cases), which was similar to that in Simpson grade 2 resection group (2 of 26 cases [7.7%]). Although this case series did not indicate the significant difference in the recurrence rates between the dura preservation group and Simpson grade 2 group, we consider that this technique still has advantages for surgically less invasiveness in terms of dural reconstruction which is necessary for Simpson grade 1 and higher possibility of complete resection of tumors compared with Simpson grade 2 resection., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
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- 2021
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29. Surgery-related predictable risk factors influencing postoperative clinical outcomes for thoracic myelopathy caused by ossification of the posterior longitudinal ligament: a multicenter retrospective study.
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Saiwai H, Okada S, Hayashida M, Harimaya K, Matsumoto Y, Kawaguchi KI, Kobayakawa K, Maeda T, Ohta H, Shirasawa K, Tsuchiya K, Terada K, Kaji K, Arizono T, Saito T, Fujiwara M, Iwamoto Y, and Nakashima Y
- Abstract
Objective: Compression of the spinal cord by thoracic ossification of the posterior longitudinal ligament (T-OPLL) often causes severe thoracic myelopathy. Although surgery is the most effective treatment for T-OPLL, problems associated with surgical intervention require resolution because surgical outcomes are not always favorable, and a small number of patients experience deterioration of their neurological status after surgery. The aim of the present study was to examine the surgery-related risk factors contributing to poor clinical outcomes for myelopathy caused by T-OPLL., Methods: Data were extracted from the records of 55 patients with thoracic myelopathy due to T-OPLL at institutions in the Fukuoka Spine Group. The mean follow-up period was 5.3 years. Surgical outcomes were assessed using the Japanese Orthopaedic Association (JOA) scale. To investigate the definitive factors associated with surgical outcomes, univariate and multivariate regression analyses were performed with several patient-related and surgery-related factors, including preoperative comorbidities, radiological findings, JOA score, surgical methods, surgical outcomes, and complications., Results: Neurological status improved in 33 patients (60.0%) and deteriorated in 10 patients (18.2%) after surgery. The use of instrumentation was significantly associated with an improved outcome. In the comparison of surgical approaches, posterior decompression and fusion resulted in a significantly higher neurological recovery rate than did anterior decompression via a posterior approach and fusion or decompression alone. It was also found that postoperative neurological status was significantly poorer when there were fewer instrumented spinal levels than decompression levels. CSF leakage was a predictable risk factor for deterioration following surgery., Conclusions: It is important to identify preventable risk factors for poor surgical outcomes for T-OPLL. The findings of the present study suggest that intraoperative CSF leakage and a lower number of instrumented spinal fusion levels than decompression levels were exacerbating factors for the neurological improvement in T-OPLL surgery.
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- 2019
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30. DAY-LENGTH-DEPENDENT DELAYED-GREENING1, the Arabidopsis Homolog of the Cyanobacterial H+-Extrusion Protein, Is Essential for Chloroplast pH Regulation and Optimization of Non-Photochemical Quenching.
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Harada K, Arizono T, Sato R, Trinh MDL, Hashimoto A, Kono M, Tsujii M, Uozumi N, Takaichi S, and Masuda S
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- Arabidopsis Proteins metabolism, Cell Membrane metabolism, Cyanobacteria metabolism, Escherichia coli Proteins metabolism, Photosynthesis physiology, Protons, Arabidopsis metabolism
- Abstract
Plants convert solar energy into chemical energy through photosynthesis, which supports almost all life activities on earth. Because the intensity and quality of sunlight can change dramatically throughout the day, various regulatory mechanisms help plants adjust their photosynthetic output accordingly, including the regulation of light energy accumulation to prevent the generation of damaging reactive oxygen species. Non-photochemical quenching (NPQ) is a regulatory mechanism that dissipates excess light energy, but how it is regulated is not fully elucidated. In this study, we report a new NPQ-regulatory protein named Day-Length-dependent Delayed-Greening1 (DLDG1). The Arabidopsis DLDG1 associates with the chloroplast envelope membrane, and the dldg1 mutant had a large NPQ value compared with wild type. The mutant also had a pale-green phenotype in developing leaves but only under continuous light; this phenotype was not observed when dldg1 was cultured in the dark for ≥8 h/d. DLDG1 is a homolog of the plasma membrane-localizing cyanobacterial proton-extrusion-protein A that is required for light-induced H+ extrusion and also shows similarity in its amino-acid sequence to that of Ycf10 encoded in the plastid genome. Arabidopsis DLDG1 enhances the growth-retardation phenotype of the Escherichia coli K+/H+ antiporter mutant, and the everted membrane vesicles of the E. coli expressing DLDG1 show the K+/H+ antiport activity. Our findings suggest that DLDG1 functionally interacts with Ycf10 to control H+ homeostasis in chloroplasts, which is important for the light-acclimation response, by optimizing the extent of NPQ., (� The Author(s) 2019. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
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31. Anatomical Evaluation of Lumbar Arteries for Lateral Lumbar Interbody Fusion with Magnetic Resonance Imaging.
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Kiyohara M, Arizono T, Inokuchi A, Hamada T, Nishida K, and Imamura R
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Introduction: Lateral lumbar interbody fusion (LLIF) is becoming a more common surgical treatment option for adult degenerative lumbar conditions. LLIF is a mini-open access technique with wound retractors, and postoperative hematoma due to segmental vessels injury is reported. Thus, it is considered that there is a need to conduct detailed preoperative examinations to identify where the lumbar vessels are. As far as we know, there are only a few studies investigating the location of the lumbar arteries. This study evaluates the anatomical position of lumbar arteries using magnetic resonance imaging (MRI)., Methods: We studied 101 MRIs of patients with lumbar disease. The length from the upper and lower end plates of the vertebra to the lumbar arteries was measured. The measurement was conducted with coronal MRI images of every quarter slice of L1 to L4 vertebrae. We also investigated sagittal MRI images to determine whether the lumbar vessels are located on intervertebral disc in each level from L1/2 to L5/S1., Results: The lumbar vessels are not always located at the center of the vertebrae. Some lumbar vessels are located within 8 mm from the end plates. Especially in L4, the lumbar vessels tended to go down from the anterior cranial side to the posterior caudal side (P < 0.01). 8, 24, and 54 lumbar vessels are located at the anterior quarter, the center, and the posterior quarter slice of the vertebrae, respectively, in L4. There were seven lumbar vessels in total located on the vertebral disc level., Conclusions: It is necessary to investigate where the lumbar arteries are located to prevent its injury in LLIF, because the lumbar artery is not always located at the center of a vertebra. MRIs may provide a valuable information to avoid vascular injury during LLIF., Competing Interests: Conflicts of Interest: The authors declare that there are no relevant conflicts of interest., (Copyright © 2020 by The Japanese Society for Spine Surgery and Related Research.)
- Published
- 2019
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32. Predictive factors of mortality of patients with fragility hip fractures at 1 year after discharge: A multicenter, retrospective study in the northern Kyushu district of Japan.
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Kimura A, Matsumoto Y, Wakata Y, Oyamada A, Ohishi M, Fujiwara T, Ikuta K, Tsuchiya K, Tayama N, Tomari S, Miyahara H, Mae T, Hara T, Saito T, Arizono T, Kaji K, Mawatari T, Fujiwara M, Sakimura R, Shin K, Ninomiya K, Nakaie K, Antoku Y, Tokunaga S, Nakashima N, Iwamoto Y, and Nakashima Y
- Subjects
- Aged, 80 and over, Comorbidity, Female, Follow-Up Studies, Hip Fractures physiopathology, Humans, Japan epidemiology, Length of Stay trends, Male, Prognosis, Retrospective Studies, Risk Factors, Survival Rate trends, Time Factors, Activities of Daily Living, Frailty mortality, Hip Fractures mortality, Patient Discharge statistics & numerical data
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Purpose: Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan., Methods: A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models., Results: The 1-year mortality rate was 9.1% (95% confidence interval: 6.8-12.0%, n = 45). Log-rank test revealed that previous fractures ( p = 0.003), Barthel index (BI) at discharge ( p = 0.011), and place-to-discharge ( p = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p = 0.023), total Charlson comorbidity index (TCCI; p = 0.005), smoking ( p = 0.007), length of hospital stay (LOS; p = 0.009), and BI ( p = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p = 0.044), and BI <30 (HR 5.42, p = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m
2 (HR 2.70, p = 0.023), TCCI ≥5 (HR 2.61, p = 0.032), smoking history (HR 3.59, p = 0.018), LOS <14 days (HR 13.9; p = 0.007), and BI <30 (HR 2.76; p = 0.049) were the counterparts for females., Conclusions: Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m2 , TCCI ≥5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.- Published
- 2019
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33. Primary extradural malignant melanoma of the spine: A case report.
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Yoshizaki S, Inokuchi A, Hamada T, Nishida K, Imamura R, Nakahara H, Komatsu T, and Arizono T
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- Biopsy, Combined Modality Therapy, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Melanoma therapy, Middle Aged, Myelography, Tomography, X-Ray Computed, Melanoma diagnosis, Spinal Neoplasms diagnosis, Thoracic Vertebrae
- Published
- 2019
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34. Characteristics of patients with fragility hip fractures in the northern Kyushu district in Japan: a multicenter prospective registry based on an electronic data capture system.
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Oyamada A, Matsumoto Y, Wakata Y, Kimura A, Ikuta K, Tsuchiya K, Tayama N, Tomari S, Miyahara H, Mae T, Shiraishi H, Saito T, Arizono T, Kaji K, Mawatari T, Fujiwara M, Sakimura R, Shin K, Ninomiya K, Nakaie K, Antoku Y, Tokunaga S, Nakashima N, Iwamoto Y, and Nakashima Y
- Subjects
- Aged, 80 and over, Bone Density, Female, Hip Fractures physiopathology, Hospitalization, Humans, Japan epidemiology, Male, Osteoporosis drug therapy, Osteoporosis physiopathology, Prospective Studies, Electronic Health Records, Hip Fractures epidemiology, Osteoporosis epidemiology, Registries
- Abstract
Osteoporosis has become a worldwide public health problem, in part due to the fact that it increases the risk of fragility hip fractures (FHFs). The epidemiological assessment of FHFs is critical for their prevention; however, datasets for FHFs in Japan remain scarce. This was a multicenter, prospective, observational study in the northern district of Kyushu Island. Inclusion criteria were age > 60 years with a diagnosis of FHF and acquisition of clinical data by an electronic data capture system. Of 1294 registered patients, 1146 enrolled in the study. Nearly one third of patients (31.8%) had a history of previous fragility fractures. The percentage of patients receiving osteoporosis treatment on admission was 21.5%. Almost all patients underwent surgical treatment (99.1%), though fewer than 30% had surgery within 48 h after hospitalization. Bone mineral density (BMD) was evaluated during hospitalization in only 50.4% of patients. The rate of osteoporosis treatment increased from 21.5% on admission to 39.3% during hospitalization. The main reasons that prescribers did not administer osteoporosis treatment during hospitalization were forgetfulness (28.4%) and clinical judgment (13.6%). Age and female ratio were significantly higher in patients with previous FHFs than in those without. There was a significant difference in the rate of osteoporosis treatment or L-spine BMD values in patients with or without previous FHFs on admission. In conclusion, this study confirmed that the evaluation and treatment of osteoporosis and FHFs is still suboptimal in Japan, even in urban districts.
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- 2018
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35. A Case of Spontaneous Regression of Recurrent Desmoid Tumor Originating From the Internal Obturator Muscle After Delivery.
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Sueishi T, Arizono T, Nishida K, Hamada T, and Inokuchi A
- Abstract
Desmoid-type fibromatoses are pathologically benign but locally aggressive tumors. We report the case of a desmoid tumor that disappeared spontaneously after recurrence. A 21-year-old woman was referred to our hospital because of left lower limb weakness during menstruation. The following day this weakness had disappeared but menstrual colic remained; consequently, the patient underwent an internal examination that revealed an intrapelvic tumor. Magnetic resonance imaging demonstrated an enhanced mass (diameter, 8 cm) arising from the internal obturator muscle and attached to the urinary bladder. The tumor was diagnosed as a desmoid-type fibromatosis after histologic evaluation of a transvaginal biopsy; marginal resection was carried out at < 1 month after the first hospital admission. The patient experienced recurrence at 2 years after surgery, which was confirmed as two enhanced masses (diameter, 1 cm) using magnetic resonance imaging. Eleven months later, the diameters of these masses had increased to 1.8 cm; however, there was no further increase in size beyond this point. The patient delivered successfully at 5 and 7 years after surgery; at 8 years, the recurrent tumors had disappeared completely as confirmed by magnetic resonance imaging. This case involving recurrence is rare for two reasons. The first was that no change in the size of the tumors occurred during pregnancy and after delivery, and the second was that the patient experienced complete remission of the recurrent tumors after only simple observation. Thus, it is important to recognize that even a recurrent desmoid tumor can sometimes exhibit spontaneous regression., Competing Interests: The authors declare that they have no conflicts of interest.
- Published
- 2016
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36. Subchondral insufficiency fracture of the femoral head in a patient with alkaptonuria.
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Hamada T, Yamamoto T, Shida J, Inokuchi A, and Arizono T
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- Aged, Diagnosis, Differential, Female, Femur Head diagnostic imaging, Femur Head pathology, Humans, Radiography, Alkaptonuria complications, Alkaptonuria diagnosis, Femur Head injuries, Fractures, Stress diagnosis, Fractures, Stress etiology, Hip Fractures diagnosis, Hip Fractures etiology
- Abstract
We report a patient with alkaptonuria accompanied by bilateral rapidly destructive arthrosis of the hip. The destruction of the left hip joint with its severe functional impairment necessitated total hip arthroplasty (THA). The outcome was satisfactory. Both magnetic resonance imaging (MRI) and pathologic findings were compatible with a subchondral insufficiency fracture. A year and half later, during a follow-up visit, the patient complained of right coxalgia. Radiography showed that the right femoral head had already disappeared, requiring THA of the right hip. Although there have been a few reports of rapid destructive hip osteoarthritis associated with ochronotic arthropathy, the pathogenesis of the destructive change is not clear. Subchondral insufficiency fracture was diagnosed on MR imaging and pathologically confirmed in our patient with alkaptonuria, suggesting that subchondral insufficiency fracture is one of the causes of ochronotic hip destruction.
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- 2014
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37. Case of critical complication after surgery for ankylosing spinal hyperostosis.
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Miake G, Arizono T, Yamaguchi T, and Akune H
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- Anesthesia, General, Fatal Outcome, Humans, Intubation, Intratracheal, Male, Middle Aged, Orthopedic Procedures, Asphyxia etiology, Asphyxia prevention & control, Cervical Vertebrae surgery, Heart Arrest etiology, Heart Arrest prevention & control, Hematoma prevention & control, Hyperostosis, Diffuse Idiopathic Skeletal surgery, Hypoxia, Brain etiology, Hypoxia, Brain prevention & control, Postoperative Complications prevention & control
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We experienced a case who received a bone resection for ankylosing spinal hyperostosis through the anterior approach. He subsequently became asphyxic and suffered a cardiopulmonary arrest owing to a postoperative hematoma. His complaint before the surgery was sticking of his throat and dyspnea that continued for 3 years. X-ray films revealed an osteophyte on the anterior side of the C3-C6 vertebral bodies, and we made an anterior approach under general anesthesia. There were no problems during the surgery. After being returned to the ward without intubation, he complained that he had a catch in his throat that progressed little by little, and subsequently suffered a cardiopulmonary arrest at 5 hours after surgery. Upon revival, he had brain hypoxia. He passed away owing to malnutrition and pneumonia at 4 years after the surgery. To prevent this complication, it is important to have an understanding of this condition. We should have alerted the nurses that such a complication may occur after anterior spinal surgery. It is also important to be aware that intubation of such a case becomes difficult once the trachea has become compressed and curved because of a hematoma.
- Published
- 2009
38. Degenerative change in the adjacent segments to the fusion site after posterolateral lumbar fusion with pedicle screw instrumentation--a minimum 4-year follow-up.
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Hayashi T, Arizono T, Fujimoto T, Moro-oka T, Shida J, Fukumoto S, and Masuda S
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- Adult, Aged, Female, Follow-Up Studies, Humans, Intervertebral Disc diagnostic imaging, Intervertebral Disc pathology, Intervertebral Disc Displacement diagnostic imaging, Intervertebral Disc Displacement pathology, Lumbar Vertebrae diagnostic imaging, Male, Middle Aged, Radiography, Retrospective Studies, Spinal Stenosis diagnostic imaging, Spinal Stenosis pathology, Spinal Stenosis surgery, Spondylolisthesis diagnostic imaging, Spondylolisthesis pathology, Spondylolisthesis surgery, Spondylolysis diagnostic imaging, Spondylolysis pathology, Spondylolysis surgery, Time Factors, Bone Screws, Lumbar Vertebrae pathology, Lumbar Vertebrae surgery, Spinal Fusion methods
- Abstract
Background: Controversy remains regarding the subsequent degeneration of adjacent segments, and little reliable information could be found in the literature regarding long-term clinical results and adjacent segment degeneration. The objective of this study is to investigate the degenerative change of adjacent segments to the fusion site and clinical outcome after posterolateral lumbar fusion with pedicle screw instrumentation and identify the risk factors in degenerative change at adjacent segments., Methods: Thirty-two patients who underwent posterolateral lumbar fusion and were able to be followed over four years were evaluated in this study. The intervertebral disc height, percent of slip, lumbosacral joint angle, lumbar lordosis and disc angle were all examined. The postoperative progression of degeneration at adjacent segments were defined as more than a 50 % narrowing in the adjacent disc height or more than a 5 % slip in adjacent segments in comparison to the preoperative neutral lateral radiographs. The clinical results were assessed using an evaluation scores for lumbar lesions proposed by the Japanese Orthopedic Association., Results: Fifteen (46.8%) of the 32 patients had adjacent segment degeneration including slip or narrowing. No significant correlation was found between the adjacent segment degeneration and the recovery rate at the final follow-up. In addition, no significant correlation was observed between the adjacent segment degeneration at the lastest follow-up and postoperative radiographic measurements., Conclusions: The rate of radiographic degeneration at the adjacent segments was 46.8%. No significant correlation was found between degenerative change in the adjacent segments and the clinical results. We could not identify any preoperative radiographic factors which might have influenced the segments adjacent to the fusion.
- Published
- 2008
39. Pyomyositis in adults without any predisposing factors in a non-tropical region.
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Arizono T, Saito T, Matsuda S, Arita Y, and Iwamoto Y
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- Abscess pathology, Abscess therapy, Adult, Anti-Bacterial Agents therapeutic use, Buttocks diagnostic imaging, Cefazolin therapeutic use, Drug Therapy, Combination, Fever etiology, Humans, Male, Middle Aged, Myositis pathology, Myositis therapy, Pain etiology, Staphylococcal Infections microbiology, Staphylococcal Infections therapy, Staphylococcus aureus isolation & purification, Suction, Tomography, X-Ray Computed, Treatment Outcome, Abscess etiology, Myositis etiology, Staphylococcal Infections complications
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- 2005
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40. Cervical alignment, range of motion, and instability after cervical laminoplasty.
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Maeda T, Arizono T, Saito T, and Iwamoto Y
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- Aged, Cervical Vertebrae physiopathology, Female, Humans, Male, Middle Aged, Movement, Ossification of Posterior Longitudinal Ligament complications, Spinal Cord Compression etiology, Spinal Cord Compression surgery, Cervical Vertebrae surgery, Decompression, Surgical, Postoperative Complications
- Abstract
It has been reported that flexibility of the neck decreases after cervical laminoplasty. It also is known that kyphosis can be an unfavorable result after posterior decompression surgery of the cervical spine. To examine whether a decrease in cervical mobility resulting from contracture of the cervical spine helps prevent postoperative kyphotic alignment, changes in radiographic findings after cervical expansive laminoplasty were evaluated. There was a strong correlation postoperatively between range of motion of the cervical spine and cervical lordotic alignment, namely, the more that cervical mobility was maintained, the more that cervical lordosis was preserved. This relationship was not found preoperatively. A postoperative increase in the number of unstable vertebrae was found only in a few patients and was not associated with any deterioration in clinical outcome. The current results suggest that postoperative cervical lordosis is preserved not through intervertebral soft tissue contracture or bony fusion, but through more dynamic factors such as muscles or ligaments, therefore implicating the importance of early removal of cervical orthosis and early postoperative rehabilitation.
- Published
- 2002
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41. A novel technique for surgical resection of spinal meningioma.
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Saito T, Arizono T, Maeda T, Terada K, and Iwamoto Y
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- Aged, Dura Mater surgery, Female, Humans, Meningeal Neoplasms pathology, Meningioma pathology, Middle Aged, Treatment Outcome, Meningeal Neoplasms surgery, Meningioma surgery, Surgical Procedures, Operative
- Abstract
Study Design: A technical note., Objectives: To describe and discuss a novel technique for surgical resection of spinal meningioma., Summary of Background Data: With conventional methods for surgical resection of isolated intradural spinal meningioma, there are two ways of dealing with the dural attachment of the tumor. One is complete resection of the involved dura together with the tumor, and the other is coagulation only of the tumor base of the dura. In the case of the novel technique herein described, the dura mater is preserved in a new manner., Methods: In the surgical procedure a small incision is made in the surface of the dura mater after the conventional laminectomy. The spinal dura can be easily divided into two layers, comprising inner and outer layers. The outer layer is stripped away from the inner layer surrounding the tumor base. The tumor is then resected together with the inner layer alone outside the arachnoid membrane, and finally the outer layer is simply closed., Results: This method has been applied to three cases. The preserved outer layer of the dura mater did not demonstrate the existence of tumor cells histologically. Neither complications nor tumor recurrence have been experienced., Conclusion: The authors introduced a novel technique for surgical resection of isolated intradural spinal meningioma. Using this simple procedure the outer part of the dura mater, which is not involved by the tumor, can be preserved and complicated dural reconstruction is not necessary. Furthermore, there is less risk of postoperative cerebrospinal fluid fistulas than when the dura is completely resected together with the tumor. However, long-term observation as a result of the possibility of local recurrence is strongly recommended.
- Published
- 2001
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42. Surgical treatment of a desmoid tumor from the serratus anterior in the subscapular region with use of a scapula-splitting posterior approach.
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Arizono T, Chuman H, and Shiota E
- Subjects
- Female, Fibroma pathology, Humans, Middle Aged, Muscle Neoplasms pathology, Orthopedic Procedures methods, Shoulder Joint pathology, Fibroma surgery, Muscle Neoplasms surgery, Scapula surgery, Shoulder Joint surgery
- Published
- 2001
- Full Text
- View/download PDF
43. Ethylene oxide sterilization of bone grafts. Residual gas concentration and fibroblast toxicity.
- Author
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Arizono T, Iwamoto Y, Okuyama K, and Sugioka Y
- Subjects
- Bone Transplantation, Cells, Cultured, Cryopreservation methods, Gases, Humans, Transplantation, Homologous, Ethylene Oxide adverse effects, Ethylene Oxide analysis, Femur chemistry, Femur transplantation, Fibroblasts drug effects, Sterilization methods
- Abstract
We examined the concentration of ethylene oxide in bone allografts after gas sterilization. Chips of the human femoral head were investigated. Residual gas concentration was determined by gas chromatography after the bone chips had been subjected to defatting and freeze-drying, followed by ethylene oxide gas sterilization. Bones were prepared in various ways in an attempt to reduce the concentration of residual ethylene oxide. The concentration was higher when gas sterilization was performed before freeze-drying than when it was done afterwards. An experiment performed with fibroblasts showed the high toxicity of residual ethylene oxide in bone chips, even when the concentration was very low. The growth of fibroblast was reduced more in medium which had been shaken with bones sterilized with ethylene oxide before freeze-drying than in medium which had been shaken with bones sterilized after freeze-drying. The higher residual ethylene oxide concentrations resulted in a decrease in fibroblastic culture activity. Our experiment showed the importance of reducing the residual ethylene oxide gas concentration. Defatting and freeze-drying result in lower residual ethylene oxide concentrations.
- Published
- 1994
- Full Text
- View/download PDF
44. Spontaneous hemarthrosis of the knee in the elderly: etiology and treatment.
- Author
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Kawamura H, Ogata K, Miura H, Arizono T, and Sugioka Y
- Subjects
- Aged, Arteries, Arthroscopy, Female, Humans, Male, Menisci, Tibial pathology, Menisci, Tibial surgery, Middle Aged, Hemarthrosis etiology, Hemarthrosis surgery, Knee Joint surgery, Menisci, Tibial blood supply, Osteoarthritis complications
- Abstract
The etiology of spontaneous hemarthrosis of the knee in elderly patients with osteoarthritis is still unknown. This report discusses six cases, one that was managed with conservative measures and five in which arthroscopic evaluation and treatment were performed. These patients were elderly individuals whose chief complaint was knee pain and swelling about the joint, without an obvious history of trauma. Each of the five operative patients underwent arthroscopic surgery after repeated hemorrhage into the joint that did not respond to serial aspirations of large amounts of blood and immobilization, using a knee immobilizer. The roentgenograms of each involved knee demonstrated lateral compartment osteoarthritis. Arthroscopic examination revealed a degenerative flap tear of the posterior horn of the lateral meniscus in the five operative cases. These patients underwent arthroscopic resection of the injured lateral meniscus and did not experience a recurrence of the hemarthrosis. The origin of the bleeding was most likely from the peripheral arteries of the posterior horn of the lateral meniscus.
- Published
- 1994
- Full Text
- View/download PDF
45. Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis. Clinical and biologic study.
- Author
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Oga M, Arizono T, Takasita M, and Sugioka Y
- Subjects
- Adult, Antitubercular Agents therapeutic use, Bacterial Adhesion, Debridement, Female, Humans, Male, Mycobacterium tuberculosis physiology, Risk Factors, Stainless Steel, Staphylococcus epidermidis physiology, Tuberculosis, Spinal drug therapy, Tuberculosis, Spinal epidemiology, Foreign Bodies, Internal Fixators adverse effects, Lumbar Vertebrae surgery, Spinal Fusion, Thoracic Vertebrae surgery, Tuberculosis, Spinal surgery
- Abstract
The risk of persistence and recurrence of infection in posterior spinal instrumentation surgery for spinal tuberculosis was studied clinically and microbiologically. Eleven patients with thoracic, thoracolumbar, and lumbar spinal tuberculosis treated by debridement, anterior fusion, and combined posterior instrumentation surgery were analyzed. Seven patients had tuberculosis in both anterior and posterior spinal elements. There were no cases of persistence or recurrence of infection after surgery, and instrumentation provided immediate stability and protected against development of kyphotic deformity. The adherence properties of Mycobacterium tuberculosis to stainless steel (SUS 316) was evaluated experimentally. The results showed that posterior instrumentation surgery was not a hazard to spinal tuberculosis infection when combined with radical debridement and intensive anti-tuberculosis chemotherapy.
- Published
- 1993
- Full Text
- View/download PDF
46. Bacterial adherence to bioinert and bioactive materials studied in vitro.
- Author
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Oga M, Arizono T, and Sugioka Y
- Subjects
- Durapatite, Microscopy, Electron, Scanning, Titanium, Alloys, Bacterial Adhesion, Biocompatible Materials, Hydroxyapatites, Materials Testing, Stainless Steel, Staphylococcus epidermidis ultrastructure
- Abstract
In vitro, bioinert stainless steel and titanium alloy, and bioactive sintered hydroxyapatite and hydroxyapatite-coated titanium materials were exposed to Staphylococcus epidermidis to study bacterial adhesion. Scanning electron microscopy showed that fibrous strands interconnected the adherent bacteria, and that background matrix enclosed bacterial colonies. This adherent mode of growth may reduce the susceptibility of the bacteria to host clearance mechanisms and antibiotic therapy. Adherence assays revealed that bacterial adherence to sintered hydroxyapatite was higher than to the other 3 materials.
- Published
- 1993
- Full Text
- View/download PDF
47. Increased resistance of bacteria after adherence to polymethyl methacrylate. An in vitro study.
- Author
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Arizono T, Oga M, and Sugioka Y
- Subjects
- Drug Resistance, Microbial, Microscopy, Electron, Scanning, Staphylococcus epidermidis physiology, Staphylococcus epidermidis ultrastructure, Surface Properties, Bacterial Adhesion physiology, Biocompatible Materials, Cephaloridine pharmacology, Joint Prosthesis, Methylmethacrylates, Staphylococcus epidermidis drug effects
- Abstract
The pathobiology of total joint prosthesis infection was investigated in vitro. Discs of polymethylmethacrylate (PMMA) were exposed to a suspension containing cells of 10(8) per mL Staphylococcus epidermidis E-46. After 12 hours, exposed discs were rinsed with phosphate-buffered saline and placed in brain heart infusion broth containing antibiotics (2.5 mg per mL of Cephaloridine). After gentle shaking for 24 hours at 37 degrees C, the bacteria on the PMMA surface were detached and washed with phosphate-buffered saline to remove the antibiotics. Compared with the free bacteria which were detached from the PMMA by sonication immediately after exposure to the antibiotic solution, those allowed to remain adhered to the PMMA surface were more resistant to antibiotics. Scanning electron microscopy showed accumulation of bacteria surrounded by slime on PMMA discs exposed for 12 hours. Our results indicate that resistance of bacteria to antibiotics is increased after adherence to the biomaterial and formation of a slime layer.
- Published
- 1992
- Full Text
- View/download PDF
48. Inhibition of bacterial adhesion by tobramycin-impregnated PMMA bone cement.
- Author
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Oga M, Arizono T, and Sugioka Y
- Subjects
- Bacteriological Techniques, Microscopy, Electron, Scanning, Staphylococcus epidermidis growth & development, Staphylococcus epidermidis ultrastructure, Bacterial Adhesion drug effects, Methylmethacrylates, Staphylococcus epidermidis drug effects, Tobramycin pharmacology
- Abstract
We investigated the effect of tobramycin-impregnated polymethylmethacrylate (PMMA) bone cement on the adhesion and colonization of Staphylococcus epidermidis. The pattern of colonization was quantitated using plate count techniques and electron microscopy. Colonization of the tobramycin-impregnated disc surface by adhesive bacteria was demonstrated but it was less than in the control disc. This finding suggests that tobramycin may reduce bacterial adherence and proliferation on the PMMA surface.
- Published
- 1992
- Full Text
- View/download PDF
49. Location of peptidoglycan and teichoic acid on the cell wall surface of Staphylococcus aureus as determined by immunoelectron microscopy.
- Author
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Umeda A, Yokoyama S, Arizono T, and Amako K
- Subjects
- Antibodies, Bacterial immunology, Cell Wall ultrastructure, Freeze Fracturing, Microscopy, Immunoelectron, Staphylococcus aureus ultrastructure, Cell Wall chemistry, Peptidoglycan analysis, Staphylococcus aureus chemistry, Teichoic Acids analysis
- Abstract
Anti-peptidoglycan (PG) and anti-teichoic acid (TA) antibodies were prepared from sera of rabbits immunized with the cell wall fraction of Staphylococcus aureus Cowan I by the specific adsorption technique with purified teichoic acid or peptidoglycan. The anti-PG antibody recognized the trichloroacetic acid-treated walls (TCA wall) prepared from S. aureus, Bacillus subtilis, and Micrococcus luteus but did not react with teichoic acid or proteins extracted from the cell wall of Staphylococcus. The anti-TA antibody specifically reacted with cell wall teichoic acid of beta-type sugar configuration. The reaction sites of these antibodies on the cell wall of S. aureus Wood 46 were determined by immunoelectron microscopy using colloidal gold as a probe. The anti-TA antibody reacted mostly with the fibrous electron-dense mass on the cell surface. The reaction was also seen on the inner surface of the cell wall. The anti-PG antibody reacted with the fibrous structures and also directly on the cell wall surface. The distribution of the probes on the cell wall surface examined with the scanning electron microscope showed that there was no localized distribution in respect to the cell division. We knew from these observations that the external surface of the cell wall of Staphylococcus is covered with the fibrous mass which consists mostly of teichoic acid but partially of peptidoglycan.
- Published
- 1992
50. The inhibition of bacterial adhesion to a tobramycin-impregnated polymethylmethacrylate substratum.
- Author
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Oga M, Arizono T, Sugioka Y, Naylor PT, Myrvik QN, and Gristina AG
- Subjects
- Colony Count, Microbial, Humans, Prostheses and Implants, Staphylococcal Infections prevention & control, Staphylococcus epidermidis, Bacterial Adhesion drug effects, Bone Cements, Methylmethacrylates, Tobramycin pharmacology
- Abstract
Tobramycin sulfate powder (1.2 g) was mixed with Palacos polymethylmethacrylate (PMMA) bone cement (40 g) to produce 100 discs containing 5.9 mg tobramycin per disc. These discs were used to evaluate the inhibition of bacterial adhesion to an antibiotic-laden biomaterial. Tobramycin-impregnated PMMA discs and control discs containing no tobramycin were exposed in vitro to Staphylococcus epidermidis. Colonization was quantitated using plate count techniques and electron microscopy. Tobramycin-impregnated surfaces reduced adhesive bacteria colonization by 1 log relative to control discs. These observations suggest that tobramycin-impregnated PMMA may not be significantly effective in preventing colonization of the biomaterial substratum and PMMA may be a poor choice as a drug delivery vehicle in biomaterial and compromised tissue-centered infections.
- Published
- 1992
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