JaLCDOI 10.18926/AMO/53556
フルテキストURL 69_4_205.pdf
著者 Okada, Yoshiki| Endo, Hirosuke| Mitani, Shigeru| Fujiwara, Kazuo| Tetsunaga, Tomonori| Kagawa, Yohei| Fujii, Yosuke| Kunisada, Toshiyuki| Ozaki, Toshifumi|
抄録 Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15オ, 9.0オ, 6.0オ, and 6.4オ, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0オ), minor bleeding in 2 cases (2.0オ), persistent wound drainage in 3 cases (3.0オ), and eruption in 1 case (1.0オ). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0オ) and progression of anemia in 1 case (1.0オ). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.
キーワード total hip arthroplasty venous thromboembolism anticoagulant prophylaxis complications
Amo Type Original Article
発行日 2015-08
出版物タイトル Acta Medica Okayama
69巻
4号
出版者 Okayama University Medical School
開始ページ 205
終了ページ 212
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26289911
Web of Sience KeyUT 000365519100003
関連URL http://doi.org/10.18926/AMO/53680
JaLCDOI 10.18926/AMO/55308
フルテキストURL 71_4_315.pdf
著者 Fujii, Yosuke| Endo, Hirosuke| Mitani, Shigeru| Akazawa, Hirofumi| Tetsunaga, Tomonori| Miyake, Takamasa| Yamada, Kazuki| Aoki, Kiyoshi| Ozaki, Toshifumi|
抄録 We retrospectively reviewed 29 hips in which intertrochanteric osteotomies were performed for severe slipped capital femoral epiphyses. Mean age at surgery: 12.6 years. Mean follow-up period: 6 years. At the final follow-up evaluation, one patient had coxalgia, and six hips showed a limited range of motion. A pistol-grip deformity was observed in 13 hips, osteoarthritis in two hips, and a bump existed in 19 hips on the latest radiographs. Gradual remodeling of the bumps was observed post-operatively in 22 hips. The mean α and β angles and offset α and β improved over time. The remodeling proceeded rapidly for 1 year post-surgery. We compared hips classified as β angles of ≥ 63° to < 63° at the final follow-up evaluation, the mean β angle 1 year post-surgery, and the mean ratio of improvement of the β angle per year from 1 year post-surgery to the final follow up, which differed significantly. Nearly all of the patients who underwent intertrochanteric osteotomies had residual morphologic abnormalities, but few had clinical symptoms. The β angle 1 year post-surgery and the ratio of remodeling of the bump from 1 year post-surgery to the final follow-up can be regarded as a potential predictor of morphologic results after intertrochanteric osteotomy.
キーワード slipped capital femoral epiphyses intertrochanteric osteotomy residual femoral deformity femoroacetabular impingement bone remodeling
Amo Type Original Article
発行日 2017-08
出版物タイトル Acta Medica Okayama
71巻
4号
出版者 Okayama University Medical School
開始ページ 315
終了ページ 323
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28824187
JaLCDOI 10.18926/AMO/54987
フルテキストURL 71_2_179.pdf
著者 Nosaka, Nobuyuki| Tsukahara, Kohei| Knaup, Emily| Yabuuchi, Toshihiko| Kikkawa, Tomonobu| Fujii, Yosuke| Yashiro, Masato| Yasuhara, Takao| Okada, Ayumi| Ugawa, Toyomu| Nakao, Atsunori| Tsukahara, Hirokazu| Date, Isao|
抄録 Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management.
キーワード cerebral perfusion encephalopathy child intracranial pressure neurological intensive care
Amo Type Short Communication
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 179
終了ページ 180
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420900
JaLCDOI 10.18926/AMO/53674
フルテキストURL 69_5_279.pdf
著者 Saito, Yukie| Fujii, Yousuke| Yashiro, Masato| Tsuge, Mitsuru| Nosaka, Nobuyuki| Yamashita, Nobuko| Yamada, Mutsuko| Tsukahara, Hirokazu| Morishima, Tsuneo|
抄録 Lung hyperpermeability affects the development of acute respiratory distress syndrome (ARDS), but therapeutic strategies for the control of microvascular permeability have not been established. We examined the effects of edaravone, dexamethasone, and N-monomethyl-L-arginine (L-NMMA) on permeability changes in human pulmonary microvascular endothelial cells (PMVEC) under a hypercytokinemic state. Human PMVEC were seeded in a Boyden chamber. After monolayer confluence was achieved, the culture media were replaced respectively by culture media containing edaravone, dexamethasone, and L-NMMA. After 24-h incubation, the monolayer was stimulated with tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). Fluorescein-labeled dextran was added. Then the trans-human PMVEC leak was measured. Expressions of vascular endothelial-cadherin (VE-cadherin) and zonula occludens-1 protein (ZO-1) were evaluated using real-time quantitative polymerase chain reaction and immunofluorescence microscopy. The results showed that TNF-α+IL-1β markedly increased pulmonary microvascular permeability. Pretreatment with edaravone, dexamethasone, or L-NMMA attenuated the hyperpermeability and inhibited the cytokine-induced reduction of VE-cadherin expression on immunofluorescence staining. Edaravone and dexamethasone increased the expression of ZO-1 at both the mRNA and protein levels. Edaravone and dexamethasone inhibited the permeability changes of human PMVEC, at least partly through an enhancement of VE-cadherin. Collectively, these results suggest a potential therapeutic approach for intervention in patients with ARDS.
キーワード pulmonary microvascular endothelial cells permeability edaravone vascular endothelial-cadherin zonula occludens-1 protein
Amo Type Original Article
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 279
終了ページ 290
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490025
Web of Sience KeyUT 000365519600004
JaLCDOI 10.18926/AMO/53680
フルテキストURL 69_5_325.pdf
著者 Okada, Yoshiki| Endo, Hirosuke| Mitani, Shigeru| Fujiwara, Kazuo| Tetsunaga, Tomonori| Kagawa, Yohei| Fujii, Yosuke| Kunisada, Toshiyuki| Ozaki, Toshifumi|
抄録 Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15%, 9.0%, 6.0%, and 6.4%, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0%), minor bleeding in 2 cases (2.0%), persistent wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0%) and progression of anemia in 1 case (1.0%). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.
キーワード total hip arthroplasty venous thromboembolism anticoagulant prophylaxis complications
Amo Type Erratum
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 325
終了ページ 325
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490031
関連URL http://doi.org/10.18926/AMO/53556
JaLCDOI 10.18926/AMO/55304
フルテキストURL 71_4_279.pdf
著者 Fujii, Yosuke| Fujiwara, Kazuo| Tetsunaga, Tomonori| Miyake, Takamasa| Yamada, Kazuki| Endo, Hirosuke| Abe, Nobuhiro| Sugita, Naohiko| Mitsuishi, Mamoru| Inoue, Takayuki| Nakashima, Yoshio| Ozaki, Toshifumi|
抄録 We developed a surface matching-type computed tomography (CT)-based navigation system for total hip arthroplasty (the N-navi; TEIJIN NAKASHIMA MEDICAL, Okayama, Japan). In the registration step, surface matching was performed with digitizing points on the pelvic bone surface after coarse paired matching. In the present study, we made model bones from the CT data of patients whose acetabular shapes had various deformities. We measured the distances and angles after surface matching from the fiducial points and evaluated the ability to correct surface-matching registration on each pelvic form, using several areas and numbers of points. When the surface-matching points were taken on the superior area of the acetabulum, the correction was easy for the external direction, but it was difficult to correct for the anterior and proximal directions. The correction was difficult for external and proximal directions on the posterior area. Each area of surface-matching points has particular directions that are easily corrected and other directions that are difficult to correct. The shape of the pelvis also affected the correction ability. Our present findings suggest that checking the position after coarse paired matching and choosing the surface-matching area and points that are optimal to correct will improve the accuracy of total hip arthroplasty and reduce surgical times.
キーワード total hip arthroplasty CT-based navigation system surface matching
Amo Type Original Article
発行日 2017-08
出版物タイトル Acta Medica Okayama
71巻
4号
出版者 Okayama University Medical School
開始ページ 279
終了ページ 289
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28824183