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21.
K. Fukuda Shinichiro Ushigome Takashi Nikaidou Kazuo Asanuma Fumiaki Masui 《Skeletal radiology》1999,28(5):294-297
A case of osteosarcoma arising from a metatarsal bone is reported, focusing on the radiological findings and differential
diagnosis.
Received: 16 November 1998 Revision requested: 17 December 1998 Revision received: 11 January 1999 Accepted: 14 January 1999 相似文献
22.
Yoshiba F 《Masui. The Japanese journal of anesthesiology》2008,57(9):1103-1108
Variant conformity blood is often used in transfusion at massive unpredictable hemorrhage under an operation or at hemorrhagic shock in a lifesaving emergency arena. This is because of difficulty in performing blood grouping, because of difficulty in deciding blood types in the laboratory, or because of lack in store of the same blood type transfusion as a pharmaceutical preparation needed for the patients. In performing variant conformity transfusion in the hospital, it is vitally important that in-house system be well-organized and staff be thoroughly informed about variant conformity transfusion. This chapter explains system arrangements of organization for variant conformity transfusion in hospital settings based on our experience in the urgent use of O type RCC-LR (Red Cells Concentrates-Leukocytes Reduce, "Nisseki") pharmaceutical preparation. 相似文献
23.
Takamitsu Haku MD Shin''ya Okuda MD Fumiaki Kanematsu MD Takenori Oda MD Akira Miyauchi MD Tomio Yamamoto MD Motoki Iwasaki MD 《The spine journal》2008,8(5):831-835
BACKGROUND CONTEXT: Perforation of the esophagus after anterior cervical spine surgery is a rare, but well-recognized complication. The management of esophageal perforation is controversial, and either nonoperative or operative treatment can be selected. PURPOSE: Several reports have described the use of a sternocleidomastoid muscle flap for esophageal repair. In this case report, we describe a longus colli muscle flap as a substitute for a sternocleidomastoid flap in a patient with an esophageal perforation. STUDY DESIGN: Case report. PATIENT SAMPLE: A 20-year-old man sustained cervical spinal cord injury, on diving and hitting his head against the bottom of a pool. A C6 burst fracture was observed with posterior displacement of a bone fragment into the spinal canal. The patient exhibited complete paralysis below the C8 spinal segment level. METHODS: The patient underwent subtotal corpectomy of the sixth cervical vertebra with the iliac bone graft and augmented posterior spinal fixation (C5-7) with pedicle screws. After the primary operation, the patient showed signs of infection such as throat pain, a high fever, and osteolytic change of the grafted bone by cervical radiograph. A second operation was performed to replace the graft bone using fibula. On the day after the operation, food residue was confirmed in the suction drainage tube, suggesting esophagus perforation. A third operation was immediately performed to confirm and treat esophagus perforation, although apparent esophageal perforation could not be detected at the second operation. Because the erosion around the perforation of the esophageal posterior wall was extensive, a longus colli muscle flap transposition was accordingly performed into the interspace between the esophageal posterior wall and the grafted bone in addition to simple suturing of the perforation. RESULTS: Neither high fever nor pharyngeal pain has recurred at latest follow-up, 5 years after surgery. CONCLUSIONS: To the best of our knowledge, this is the first report concerning the use of a longus colli muscle flap for esophageal perforation after anterior cervical spine surgery. 相似文献
24.
Fumiaki Inori Hirotsugu Ohashi Yukihide Minoda Toshiaki Masada Yoshiki Yamano 《Journal of orthopaedic science》2001,6(6):585-590
We investigated the possibility of articular cartil-age distraction for use in reconstructing joint structure and for increasing
the donor site of osteochondral grafts. Intraarticular osteotomy was performed at the femoral condyle in 12 Japanese white
rabbits. The bone segment was fixed with a specially designed external fixator. After a 3-week waiting period, distraction
was performed intermittently for 3 weeks (0.7 mm × 3 times per week) in the distraction group (n = 7) and, in the remaining animals (gap group; n = 5), a gap of 6.3 mm in length was made at surgery. All rabbits received etidronate injections (20 mg/kg ×2 times per week)
for 5 weeks, to slow mineralization. The femoral condyle was harvested 9 weeks postoperatively and decalcified sagittal sections
were stained and evaluated, using a histological grading scale. In the distraction group, distraction of 4.2 ± 1.4 mm was
achieved, and the distracted cartilage area was filled with regenerated cartilage, without any gap between the regenerated
and the adjacent articular cartilage. This regenerated cartilage showed metachromasia with toluidine blue. In the gap group,
newly formed cartilage tissue was folded from the edge of the osteotomy site and fibrous tissue was interposed in the gap.
The histological grading score was significantly lower in the distraction group (P < 0.02). Our preliminary results demonstrated the possibility of cartilage distraction; however, long-term observation will
be necessary to confirm the characteristics of the distracted cartilage. We may call the process "distraction arthrogenesis",
because the entire articular entity, which consists of cartilage, subchondral bone, and bone, could be distracted at once.
Received: April 5, 2001 / Accepted: July 15, 2001 相似文献
25.
Sayaka Otake Norio Suzuki Atsushi Takahashi Fumiaki Toki Akira Nishi Hideki Yamamoto Minoru Kuroiwa Hiroyuki Kuwano 《Surgery today》2014,44(8):1400-1405
Background/purpose
To clarify the role of interval appendectomy (IA) in pediatric patients with acute appendicitis with an appendiceal inflammatory mass or abscess, we histologically analyzed the appendices removed during IA.Patients and methods
We treated 355 consecutive pediatric patients with acute appendicitis and reviewed the admission charts of patients who started conservative management (CM). The histology of the appendix removed during IA was also examined. The relationships among the clinical features, appendicolith formation at the time of IA and histological findings were analyzed by stepwise regression analyses.Results
(1) CM was started in 48 patients (13.5 %). Recurrence or a remaining abscess was observed in nine patients (18.8 %). (2) Histopathological changes, particularly foreign body reaction with fibrosis and infiltration of inflammatory cells, were observed in about half of the specimens. (3) In a stepwise regression analysis, the presence of an appendicolith at IA was correlated with an appendicolith at diagnosis, foreign body reaction in the appendix and a decrease in the inflammatory reaction at diagnosis.Conclusion
More than half the patients had strong histopathological changes in the appendix, suggesting a high possibility of recurrence. The presence of appendicolith formation at IA, which is a risk factor for recurrence, was influenced by the presence of an appendicolith at diagnosis, foreign body reaction in the appendix and the inflammatory status of patients at diagnosis. These clinical findings are indications for IA. 相似文献26.
Kuroiwa M Hatakeyama SI Suzuki N Murai H Toki F Tsuchida Y 《Asian journal of surgery / Asian Surgical Association》2004,27(1):43-48
OBJECTIVE: Ultrasound (US) has been used as a tool to determine the indication for surgery for neonatal ovarian cysts. The purpose of this study was to investigate whether magnetic resonance imaging (MRI) contributes to optimal management. METHODS: Between 1993 and 2001, US and MRI studies were simultaneously performed on 13 consecutive infants younger than 2 months of age with ovarian cysts. The US Patterns were classified as complex or simple. Signal intensity (SI) of the cysts on MRI was compared with that of the liver on T1-weighted images (T1WI) and with urine on T2-weighted images (T2WI). We assumed that high SI on T1WI and iso or low SI on T2WI indicated complications. RESULTS: There were 10 complex and three simple cysts on US. Of the 10 complex cysts, two had no complications at surgery or resolved spontaneously. These two cysts showed low SI on T1WI. Eight complex cysts showed high SI on T1WI and all were haemorrhagic. The US diagnosis corresponded to the MRI findings in three simple cysts. The sensitivity of US for haemorrhage was 80%, and that of MRI was 100%. CONCLUSIONS: We found that MRI was a more reliable diagnostic modality than US for diagnosing neonatal ovarian cysts. 相似文献
27.
Nishida N Yamashita S Mimori K Sudo T Tanaka F Shibata K Yamamoto H Ishii H Doki Y Mori M 《Annals of surgical oncology》2012,19(9):3065-3071
Purpose
Recent evidence has shown that altered patterns of microRNA (miRNA) expression correlate with various human cancers. We investigated the clinical significance of miR-10b and its involvement in chemotherapeutic resistance to 5-fluorouracil (5-FU), which is a key component of common chemotherapy regimens in colorectal cancer.Methods
Quantitative RT-PCR was used to evaluate the clinicopathologic significance of miR-10b expression in 88 colorectal cancer cases. We also investigated the chemotherapeutic sensitivity to 5-FU in miR-10b-overexpressing colorectal cancer cells. To explore the mechanism of chemoresistance in miR-10b transfected cells, we examined whether miR-10b inhibits the pro-apoptotic BH3-only Bcl-2 family member BIM(BCL2L11), a key mediator of chemotherapy-induced cell death.Results
High level miR-10b expression was found to be significantly associated with high incidence of lymphatic invasion (P?=?0.0257) and poor prognosis (P?=?0.0057). Multivariate analysis indicated that high miR-10b expression is an independent prognostic factor for survival. In vitro studies revealed that miR-10b directly inhibits pro-apoptotic BIM, and the overexpression of miR-10b confers chemoresistance in colorectal cancer cells to 5-FU.Conclusions
MiR-10b is a novel prognostic marker in colorectal cancer. Moreover, the expression of miR-10b is a potential indicator of chemosensitivity to the common 5-FU-based chemotherapy regimen. 相似文献28.
Morimae H Maekawa T Tamai H Takahashi N Ihara T Hori A Narita H Banno H Kobayashi M Yamamoto K Komori K 《Surgery today》2012,42(2):121-126
Purpose
We conducted this study to compare the cost of open surgical repair (OR) with that of endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm (AAA).Methods
Between January 2007 and November 2008, 70 patients underwent open repair and 57 patients underwent EVAR. We evaluated the total cost, including that of the Diagnosis Procedure Combination (DPC), that of the surgical procedure, that of materials such as grafts and guide wires, and that of the anesthesia.Results
The mean costs for OR versus EVAR were as follows: DPC, ??632370 versus ??490050, respectively, which was significant; anesthesia, ??123540 versus ??86220, respectively (P?0.05); and materials, ??257770 versus ??2113280, respectively (P?0.05). Thus, the mean total cost was ??1825830 versus ??3159270 for open repair and EVAR, respectively (P?0.05).Conclusions
New technologies should not only be clinically effective, but also cost effective. EVAR is less invasive clinically, but the cost of endovascular prostheses and other materials remains high. 相似文献29.
Tsuchida Y Takahashi A Suzuki N Kuroiwa M Murai H Toki F Kawarasaki H Hashizume K Honna T 《Journal of pediatric surgery》2002,37(2):165-167
Background: The incidence of intrahepatic cholelithiasis and cholangitis has not yet been well studied postoperatively in patients with choledochal cysts. Methods: One hundred three patients with choledochal cysts had operative cholangiography, underwent standard excision of a choledochal cyst with Roux-en-Y hepatico-jejunal anastomosis, and were at a mean follow-up of 12[frac12] years. The incidence of intrahepatic bile duct stones was analyzed according to the 3 morphologic types of intrahepatic bile duct observed at initial operative cholangiography: type 1, no dilatation of the intrahepatic bile ducts; type 2, dilatation of the intrahepatic bile ducts but without any downstream stenosis; and type 3, dilatation of the intrahepatic bile ducts associated with downstream stenosis. Initially, there was no evidence of intrahepatic bile duct stones in any of the 103 patients. Results: Among 50 type 1 patients, intrahepatic cholelithiasis developed in only 1 patient (2%). Among 43 type 2 patients, 1 patient (2%) had intrahepatic cholelithiasis, and 2 (5%) had postoperative cholangitis. Among 10 type 3 patients, 4 (40%) had intrahepatic cholelithiasis (P [lt ] .01), and 3 (30%) had postoperative cholangitis. Time intervals between the initial surgery and the first identification of intrahepatic stones ranged from 3 to 22 years. Conclusions: One of the major causes of formation of intrahepatic cholelithiasis has been clarified; patients with intrahepatic biliary dilatation with downstream stenosis can get intrahepatic bile duct stones long after excision of a choledochal cyst. 相似文献
30.