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Pancreatoduodenectomy combined with intestinal de-rotation as a complete artery-first approach for inexperienced surgeons
Get PDFBackground : Recent technical advances have reduced the incidence of intraoperative complications associated with pancreatoduodenectomy (PD). We aimed to determine whether inexperienced surgeons (ISs) would be as successful as experienced surgeons (ESs) when performing the complete artery-first approach using the intestinal de-rotation method of PD. Methods : Seventy patients who underwent PD using the intestinal de-rotation method in Tokushima University Hospital were enrolled in the present study. Intra- and post-operative parameters were compared between patients operated on by ESs (n = 20) or ISs (n = 50). Results : The surgical procedure lasted longer in the IS group (ES : 402 ± 68 min vs. IS : 483 ± 51 min, p III did not differ between the groups. Grade B postoperative pancreatic fistulae developed in 20.0% of patients in the ES group and 22.0% in the IS group (p = 0.9569). Finally, the postoperative hospital stay of the IS group (32 ± 33 days) was equivarent to that of the ES group (33 ± 16 days) (p = 0.9256). Conclusion : ISs were able to perform similarly successful PDs using the intestinal de-rotation method to ESs.journal articl
Long-term effect of posterior nasal neurectomy for perennial allergic rhinitis
Get PDFBackground : Surgical treatment is recommended for patients with severe allergic rhinitis (AR) refractory to medical treatment. Endoscopic posterior nasal neurectomy (PNN) is primarily performed to improve rhinorrhea in severe perennial AR, however studies on its long-term prognosis are lacking. Aims / Objectives : This study aimed to investigate the long-term prognosis of PNN. Materials and Methods : A questionnaire survey was administered to 17 patients (12 men and 5 women) at least 1 year after PNN. Nasal symptoms and medications, as well as patient satisfaction with surgery at the time of survey, were scored. Furthermore, scores were compared between patients with postoperative periods of > 5 years and 5 years and 5 years.journal articl
種々の配合のセメント系材料を媒質とした無線タグの通信状態に着目した限界かぶり厚さに関する実験的検討
No full text無線タグの通信は，空気を媒質することが前提である。しかしながら，著者らは，静電容量型加速度センサを搭載した無線タグが，フレッシュコンクリートが媒質であっても加速度を計測することが可能であることを見出した。ただし，コンクリートのかぶり厚さによって通信遮断が生じるという欠点がある。本研究では，セメント系材料として，コンクリート，モルタル，グラウトを媒質とした場合の無線タグの通信状態に着目し，限界かぶり厚さに関する試験方法を新たに開発した。種々の配合のセメント系材料で実験を実施した結果，コンクリートを媒質にした場合の限界かぶり厚さは250mm前後であることが明らかになった。journal articl
Full-Endoscopic Foraminal Decompression for Foraminal Stenosis Following Osteoporotic Vertebral Fracture in an Elderly Woman Under Local Anesthesia : A Case Report
Get PDFOsteoporotic vertebral fracture (OVF) is common in the elderly population. In this report, we describe a case with radiculopathy due to foraminal stenosis caused by OVF in a very elderly patient that was treated successfully by full-endoscopic foraminotomy under local anesthesia. The patient was an 89-year-old woman who presented with a chief complaint of left leg pain for 5 years. She visited a couple of hospitals and finally consulted us to determine the exact cause of the pain. Computed tomography scans were obtained and selective nerve root block at L3 was performed. The diagnosis was radiculopathy at L3 due to foraminal stenosis following OVF. The patient had severe heart disease, so we decided to avoid surgery under general anesthesia and planned full-endoscopic spine surgery under local anesthesia. We performed transforaminal full-endoscopic lumbar foraminotomy at L3-L4 to decompress the L3 nerve root. The leg pain disappeared completely immediately after surgery. Postoperative computed tomography confirmed appropriate bone resection. The leg pain did not recur during a year of postoperative follow-up. OVF may cause lumbar radiculopathy as a result of foraminal stenosis, and transforaminal full-endoscopic lumbar foraminotomy under local anesthesia would be the best option in an elderly patient with poor general condition.journal articl
Usefulness of hand-assisted retroperitoneal laparoscopic radical nephrectomy for extreme obese patients : a case report
Get PDFWe report a case of retroperitoneal laparoscopic radical nephrectomy (LRN) in which the addition of a hand port was necessary and effective. A 52-year-old man with obesity (BMI 40.6 kg/m2) was diagnosed with a 52-mm left renal cell carcinoma (cT1bN0M0). To avoid thick subcutaneous and visceral fat in the abdomen, we selected LRN using a retroperitoneal approach with four ports in the kidney position. During surgery, a large amount of flank pad and perirenal fat prevented us from securing a sufficient surgical field through traction of the kidney with a retractor. A pure laparoscopic procedure was not feasible ; therefore, we added a hand port. Subsequently, we removed the flank pad from the hand port and secured the surgical field by tracing the kidney manually. Finally, hand-assisted LRN was completed without an open conversion. In retroperitoneal LRN, we rarely encounter patients for whom a pure laparoscopic procedure is not feasible because of the large amount of flank pad or perirenal fat. It is important to preoperatively confirm not only the BMI but also the amount of flank pad and perirenal fat on imaging. Hand-assisted LRN via the retroperitoneal approach can be safely performed even in extremely obese patients.journal articl
外科治療を受ける肺がん患者に対する高齢者機能評価の有用性の検討
Get PDFObjective : We compared between the evaluation by the use of 6 Geriatric Assessment（GA） and surgeonʼs preoperative decision of vulnerable cases in lung cancer patients undergoing surgical treatment.
Methods : One hundred-ten lung cancer patients who underwent lung resection at Tokushima University Hospital between 2021 and 2023 were included in the study. GA tools defined by JCOG for use in studies of the elderly : 1） G8（Geriatric 8） Health status screening tool 2） Instrumental activities of daily living（IADL） scale,（3） Charlson Comorbidity Index（CCI） scale,（4） residential status,（5） Mini-Cog, and（6） Mini Nutritional Assessment（MNA） were completed.
Results : Of the 110 patients, 64.5％ were below baseline on at least one of five scales, including MNA, G8, IADL, Mini-Cog, and CCI（n=71）, and 12.7%（n=14） were below baseline on three or more scales. The G8 and CCI scale items significantly influenced the surgeonʼs preoperative decision to be frail and vulnerable.
Conclusions : The medical staffs should examine the status of the surgical patients with lung cancer using comprehensively GA.journal articl
Prevalence of Malocclusion and Orthodontic Treatment Need in 9- to 12-Year-Old Schoolchildren in Ulaanbaatar, Mongolia
Get PDFBackground
The prevalence of malocclusion in Mongolia is increasing every year. Estimating the need for orthodontic treatment in the population is crucial for planning orthodontic care services and monitoring oral health programs. Therefore, the present study aimed to assess the need for orthodontic treatment among schoolchildren in Ulaanbaatar, Mongolia, using the Index of Orthodontic Treatment Need (IOTN).
Methods
A total of 656 schoolchildren aged 9-12 years were enrolled from 8 schools located in urban and suburban areas of 6 districts of Ulaanbaatar city. All the children were assessed according to the two components of the IOTN, the Dental Health Component (DHC) and the aesthetic component (AC). Statistical analyses were carried out using IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York, United States).
Results
The prevalence of malocclusion was 561 (84.5%), consisting of 452 (68%) Angle Class I, 178 (26.8%) Angle Class II, and 34 (5.2%) Angle Class III malocclusion. For the DHC, the moderate need for treatment was 194 (29.3%) and the definite need was 53 (8.1%). For the AC, the moderate need was 148 (22.3%) and the definite need was 45 (6.9%). The association between the DHC and the AC was found to be statistically significant (p<0.001). The most common malocclusions were an increased overjet (maxillary protrusion), a contact point displacement (crowding), and an increased overbite (deep bite). The AC, Angle’s molar relationship, an increased overjet, a contact point displacement, and an increased overbite were factors associated with the need for orthodontic treatment.
Conclusion
Approximately one-third of schoolchildren in Ulaanbaatar, Mongolia, require orthodontic treatment. This finding helps dental practitioners to better understand oral health problems, leading to an improvement in the overall quality of life of children.journal articl
New treatment strategies for uterine sarcoma using secreted frizzled‑related proteins
Get PDFSecreted frizzled‑related proteins (SFRPs) are involved in the development of various types of cancer and function by suppressing the Wnt signaling pathway. To elucidate the clinical implications of SFRPs in uterine sarcoma, SFRP expression levels and their effects on uterine leiomyosarcoma cells were examined. Immunostaining for SFRP4 was performed on uterine smooth muscle, uterine fibroid and uterine leiomyosarcoma tissues. Additionally, the effects of SFRP4 administration on cell viability, migration and adhesion were evaluated in uterine leiomyosarcoma SKN cells using the WST‑1 assay (Roche Diagnostics) and the CytoSelect™ 24‑well Cell Migration Assay Kit and the CytoSelect™ 48‑well Cell Adhesion Assay Kit. The expression levels of SFRP4 in uterine leiomyosarcoma tissues were lower than those in normal smooth muscle and uterine fibroid tissues. In addition, SFRP4 suppressed the viability and migration, and increased the adhesion ability of uterine leiomyosarcoma cells compared with in the control group. In conclusion, SFRP4 may suppress the viability and migration, and enhance the adhesion of sarcoma cells. These results suggested that SFRP4 could be considered as a novel therapeutic target for uterine sarcoma.doctoral thesi
