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Otani H, Notsu M, Yamauchi M, Nawata K, Kanasaki K. Association Between Papillary Thyroid Carcinoma and Vertebral Fracture. Horm Metab Res 2023; 55:592-598. [PMID: 37068493 DOI: 10.1055/a-2059-8830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Suppression of TSH levels associated with levothyroxine treatment is a known risk factor for fracture. However, it is unclear whether patients with papillary thyroid carcinoma (PTC) have a higher risk of vertebral fracture (VF) before TSH suppression. The aim of the study was to examine whether the risk of VF is higher in PTC than in healthy subjects. A hospital-based, matched case-control study was conducted comparing PTC and healthy individuals. We enrolled 43 postoperative patients with PTC scheduled for radioiodine therapy and 43 age- and sex-matched healthy controls. Serum and urinary biological parameters, bone mineral density (BMD), and presence of VFs were evaluated in both groups. We compared these indices using χ2 and Mann-Whitney U-test and analyzed the association between PTC and VF by logistic regression analysis. The PTC group had higher BMI, HbA1c and phosphorus, and lower intact PTH than the control group. Lumbar and femoral neck BMD did not differ between the two groups. Prevalence of VFs was significantly higher in the PTC group (44.1%) than in the control group (16.3%). Multivariate logistic regression analyses adjusted for age, sex, and BMI identified PTC as being associated with the presence of VFs (odds ratio, 5.63; 95% confidence interval: 1.82 to 17.5). This relationship remained significant after additional adjustment for HbA1c and BMD. There is an association between PTC and a risk of VF independent of sex, BMI, glucose metabolism, and BMD, suggesting the importance of fracture risk assessment before TSH suppression.
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Affiliation(s)
- Hazuki Otani
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
| | - Masakazu Notsu
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
| | - Mika Yamauchi
- Research Institute for Metabolic Bone Diseases, Eikokai Ono Hospital, Ono, Japan
| | - Kiyoko Nawata
- Health and Nutrition, The University of Shimane, Izumo, Japan
| | - Keizo Kanasaki
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
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Takedani K, Notsu M, Yamauchi M, Nawata K, Sugimoto T, Kanasaki K. Graves' disease and vertebral fracture: Possible pathogenic link in postmenopausal women. Clin Endocrinol (Oxf) 2020; 93:204-211. [PMID: 32324288 DOI: 10.1111/cen.14208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Thyrotoxicosis is associated with accelerated bone turnover and increases the risk of fractures and osteoporosis. Graves' disease is the most common cause of hyperthyroidism. However, studies that examined risk factors associated with fragility fractures only in patients with Graves' disease are limited. Here, we investigated whether the risk of vertebral fracture (VF) of postmenopausal Graves' disease patients is high and tried to identify the risk factors for VF in that population. DESIGN AND METHODS Forty-three postmenopausal women with Graves' disease were enrolled. Physical and biochemical indices, thyroid indices and bone mineral density (BMD) were measured, and lateral X-rays were obtained to evaluate VFs. Age- and sex-matched healthy individuals were enrolled as the control group (n = 86). RESULTS The prevalence of VFs (35% vs 17%, P < .05), osteoporosis (63% vs 33%, P < .01) and severe osteoporosis (40% vs 17%, P < .01) was significantly higher in the Graves' disease group. Although there was no significant difference in either thyroid hormone levels or the positive ratio of thyroid antibodies, the prevalence of thyroid-stimulating antibody (TSAb) was significantly higher in Graves' disease patients with VF compared to without (100% vs 68%, P < .05). Multivariate logistic regression analyses adjusted for age identified Graves' disease as being associated with the presence of VFs (OR 2.72, 95% CI: 1.13-6.54, P < .05) in postmenopausal women. CONCLUSIONS Postmenopausal Graves' disease patients had high risks of VF and severe osteoporosis. TSAb could be involved as a risk factor for VF in postmenopausal Graves' disease.
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Affiliation(s)
- Kai Takedani
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
| | - Masakazu Notsu
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
| | - Mika Yamauchi
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
| | - Kiyoko Nawata
- Department of Health and Nutrition, Faculty of Nursing and Nutrition, The University of Shimane, Izumo, Japan
| | - Toshitsugu Sugimoto
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
- Research Institute for Metabolic Bone Diseases, Eikokai Ono Hospital, Ono, Japan
| | - Keizo Kanasaki
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
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Notsu M, Yamauchi M, Morita M, Nawata K, Sugimoto T. Papillary thyroid carcinoma is a risk factor for severe osteoporosis. J Bone Miner Metab 2020; 38:264-270. [PMID: 31664535 DOI: 10.1007/s00774-019-01053-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/06/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Thyroid-stimulating hormone (TSH)-suppressive therapy is recommended after surgical treatment in high-risk papillary thyroid carcinoma (PTC) patients. TSH-suppressive therapy is a known risk factor for osteoporosis and fractures. However, whether patients with PTC themselves are at a higher risk of osteoporosis than healthy individuals remains unclear. This study aimed to clarify whether PTC is a risk factor for osteoporosis. MATERIALS AND METHODS Serum and urinary biochemical parameters, bone mineral density (BMD), and presence of vertebral fractures (VFs) and non-VFs were evaluated in 35 PTC patients and 35 age- and sex-matched healthy individuals. We compared the parameters between PTC and control subjects and performed multiple logistic regression analyses after adjustments for variables. RESULTS Patients with PTC had higher body mass index (BMI) and hemoglobin (Hb)A1c, as well as lower eGFR and intact PTH than controls (p < 0.05, each). There were no significant differences in the prevalence of osteoporosis and VFs and non-VFs between patients with PTC and controls. However, the prevalence of severe osteoporosis diagnosed according to WHO criteria was significantly higher in PTC subjects (34.3%) than in controls (11.4%, p < 0.05). Multivariate logistic regression analyses adjusted for age, BMI, eGFR and HbA1c identified PTC as being associated with the presence of severe osteoporosis (odds ratio, 4.20; 95% confidence interval, 1.05-16.8; p < 0.05). CONCLUSIONS We identified PTC as a risk factor for severe osteoporosis, independent of BMI, renal function and glucose profile.
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Affiliation(s)
- Masakazu Notsu
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Mika Yamauchi
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Miwa Morita
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kiyoko Nawata
- Health and Nutrition, The University of Shimane, Matsue, Shimane, Japan
| | - Toshitsugu Sugimoto
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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Itoda Y, Kimura M, Kinoshita O, Yamauchi H, Nawata K, Ono M. Total Replacement of Implantable Left Ventricular Assist Device for Pump Pocket/Device Infection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Sayama S, Takeda N, Iriyama T, Inuzuka R, Maemura S, Fujita D, Yamauchi H, Nawata K, Bougaki M, Hyodo H, Shitara R, Nakayama T, Komatsu A, Nagamatsu T, Osuga Y, Fujii T. Peripartum type B aortic dissection in patients with Marfan syndrome who underwent aortic root replacement: a case series study. BJOG 2017; 125:487-493. [PMID: 28294527 DOI: 10.1111/1471-0528.14635] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). DESIGN Retrospective case series study. SETTING Tertiary perinatal care centre at a university hospital. POPULATION Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS who were managed at our institute. METHODS The pregnancy outcomes of all patients with MFS managed at our institute between 1982 and September 2016 were reviewed retrospectively based on medical records. MAIN OUTCOME MEASURES Obstetrical management and complication including the incidence of AD throughout the peripartum period. RESULTS Among 22 patients (28 pregnancies) who had been managed as potential MFS or related disorders, 14 (17 pregnancies) fulfilled the revised Ghent nosology (2010) criteria for MFS and were enrolled in this study. Five patients (five pregnancies) had received ARR before conception: three (60%) developed type B aortic dissection [AD(B)] during the peripartum period, compared with only one of 10 patients (12 pregnancies) without ARR (P < 0.05, Chi-square test). CONCLUSIONS Our study results suggest that MFS patients after prophylactic ARR are still at high risk of AD(B) during the peripartum period. Careful pre-pregnancy counselling and multidisciplinary care throughout the peripartum period are essential for the management of MFS, even after surgical repair of an ascending aortic aneurysm. TWEETABLE ABSTRACT MFS patients after prophylactic ARR are still at high risk of type B aortic dissection during the peripartum period.
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Affiliation(s)
- S Sayama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - N Takeda
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Iriyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - R Inuzuka
- Department of Pediatrics, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - S Maemura
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - D Fujita
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - H Yamauchi
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - K Nawata
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - M Bougaki
- Department of Anesthesiology and Pain Relief Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - H Hyodo
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - R Shitara
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Nakayama
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - A Komatsu
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Nagamatsu
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Y Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - T Fujii
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Nitta D, Kinugawa K, Imamura T, Iino J, Endo M, Amiya E, Hatano M, Kinoshita O, Nawata K, Ono M, Komuro I. Association of the Number of HLA-DR Mismatches With Early Post-transplant Acute Cellular Rejection Among Heart Transplantation Recipients: A Cohort Study in Japanese Population. Transplant Proc 2017; 49:125-129. [PMID: 28104119 DOI: 10.1016/j.transproceed.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although many risk factors are reported about graft rejection after heart transplantation (HTx), the effect of HLA mismatch (MM) still remains unknown, especially in the Japanese population. The aim of the present study was to investigate the influence of HLA MM on graft rejection among HTx recipients in Japan. METHODS We retrospectively investigated the association of the number of HLA MM including class I (A, B) and class II (DR) (for each locus MM: 0 to 2, total MM: 0 to 6) and the incidence of moderate to severe acute cellular rejection (ACR) confirmed by endomyocardial biopsy (International Society for Heart and Lung Transplantation grade ≥ 3A/2R) within 1 year after HTx. RESULTS Between 2007 and 2014, we had 49 HTx cases in our institute. After excluding those with insufficient data and positive donor-specific antigen, finally 35 patients were enrolled. Moderate to severe ACR was observed in 16 (45.7%) patients. The number of HLA-DR MM was significantly associated with the development of ACR (ACR+: 1.50 ± 0.63, ACR-: 1.11 ± 0.46, P = .029). From univariate analysis, DR MM = 2 was the only independent risk factor for ACR episodes (P = .017). The frequency of ACR within 1 year was significantly higher in those with DR MM = 2 (DR MM = 0 to 1: 0.3 ± 0.47, DR MM = 2: 1.17 ± 1.34 times, P = .007). CONCLUSIONS The number of HLA-DR MMs was associated with the development and recurrence of ACR episodes among HTx recipients within 1 year after transplantation in Japanese population.
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Affiliation(s)
- D Nitta
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - K Kinugawa
- Department of Internal Medicine 2, The University of Toyama, Toyama, Japan.
| | - T Imamura
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - J Iino
- Department of Blood Transfusion, The University of Tokyo, Tokyo, Japan
| | - M Endo
- Department of Organ Transplantation, The University of Tokyo, Tokyo, Japan
| | - E Amiya
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - M Hatano
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Tokyo, Japan
| | - O Kinoshita
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - K Nawata
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - M Ono
- Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - I Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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Notsu M, Yamauchi M, Yamamoto M, Nawata K, Sugimoto T. Primary Aldosteronism as a Risk Factor for Vertebral Fracture. J Clin Endocrinol Metab 2017; 102:1237-1243. [PMID: 28182819 DOI: 10.1210/jc.2016-3206] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 02/02/2017] [Indexed: 01/22/2023]
Abstract
CONTEXT Some observational studies have revealed an association between excessive aldosterone levels and reduced bone mineral density (BMD). However, whether patients with primary aldosteronism (PA) are at higher risk of fracture than healthy individuals remains unclear. OBJECTIVE This study aimed to clarify whether PA represents a risk factor for vertebral fracture (VF). DESIGN AND PATIENTS We enrolled 56 patients with PA and 56 age- and sex-matched healthy individuals. Serum and urinary biological parameters, BMD, and presence of VFs were evaluated in both groups. We compared parameters between PA and control participants and performed multiple logistic regression analyses after adjustments for variables. RESULTS Patients with PA showed higher systolic and diastolic blood pressure, higher hemoglobin A1c (HbA1c) and triglycerides, higher urinary calcium-to-creatinine ratio, and lower high-density lipoprotein cholesterol than controls (P < 0.05, each). Prevalence of VFs was significantly higher in patients with PA (44.6%) than in controls (23.2%, P < 0.05). Patients with PA showed severe fracture more frequently than controls. Multivariate logistic regression analyses adjusted for age, sex, and body mass index identified PA as being associated with the presence of VFs (odds ratio, 3.13; 95% confidence interval, 1.30 to 7.51; P < 0.05). This association remained statistically significant after further adjustment for systolic and diastolic blood pressure, HbA1c, triglycerides, and high-density lipoprotein cholesterol but not after adjustment for calcium-to-creatinine ratio and BMD. CONCLUSIONS We identified PA as a risk factor for VF, independent of blood pressure, HbA1c, and lipid profile. Fracture severity was significantly higher in patients with PA than in age- and sex-matched controls.
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Affiliation(s)
- Masakazu Notsu
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan, and
| | - Mika Yamauchi
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan, and
| | - Masahiro Yamamoto
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan, and
| | - Kiyoko Nawata
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan, and
- Health and Nutrition, The University of Shimane, Matsue, Shimane 690-0044, Japan
| | - Toshitsugu Sugimoto
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan, and
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Okamura K, Nawata K, Kimura M, Kinoshita O, Masuzawa A, Yamauchi H, Hirata Y, Owada Y, Oshiro Y, Okamoto H, Ohkohchi N, Ono M. The Prevalence of Hepatitis E Virus Serum Antibodies and RNA in Heart Transplant Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Kimura M, Nawata K, Kinoshita O, Yamauchi H, Itoda Y, Imamura T, Hatano M, Kinugawa K, Ono M. Cerebrovascular Accident Rate Is Different Between Centrifugal and Axial-Flow Pumps, but Survival and Driveline Infection Rates Are Similar. Transplant Proc 2017; 49:121-124. [DOI: 10.1016/j.transproceed.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nakatani T, Sase K, Oshiyama H, Akiyama M, Horie M, Nawata K, Nishinaka T, Tanoue Y, Toda K, Tozawa M, Yanase M, Yamazaki S, Ishida M, Hiramatsu A, Kitamura S. Report of Japanese Registry for Mechanically Assisted Circulatory Support (J-MACS) - Non-Pulsatile Implantable LVAS vs. Extracorporeal LVAD as Bridge to Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nawata K, Kinoshita O, Kimura M, Yamauchi H, Itoda Y, Yoshitake S, Hoshino Y, Ono M. Outcomes of Heart Transplantation after Long-Term Circulatory Support by Ventricular Assist Devices with Driveline/Pump Infection. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Imamura T, Kinugawa K, Nitta D, Hatano M, Itoda Y, Kimura M, Kinoshita O, Yamauchi H, Nawata K, Ono M. Novel Effect of Everolimus in Heart Transplant Recipients - Attenuation of Myocardial Hypertrophy and Improvement of Diastolic Function. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Imamura T, Kinugawa K, Nitta D, Inaba T, Maki H, Hatano M, Kinoshita O, Nawata K, Ono M. Recipients With Shorter Cardiopulmonary Bypass Time Achieve Improvement of Parasympathetic Reinnervation Within 6 Months After Heart Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Imamura T, Kinugawa K, Inaba T, Maki H, Hatano M, Kinoshita O, Nawata K, Ono M. New Scoring System Using Cardiopulmonary Exercise Parameters Can Predict Prognosis in Heart Failure Patients Receiving Guideline-Directed Optimal Medical Therapy Including Beta-Blocker, Angiotensin Converting Enzyme Inhibitor, and Aldosterone Antagosnit. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Yamauchi M, Yamaguchi T, Nawata K, Tanaka KI, Takaoka S, Sugimoto T. Increased low-density lipoprotein cholesterol level is associated with non-vertebral fractures in postmenopausal women. Endocrine 2015; 48:279-86. [PMID: 24853884 DOI: 10.1007/s12020-014-0292-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 05/07/2014] [Indexed: 12/20/2022]
Abstract
Although a high serum low-density lipoprotein cholesterol (LDL-C) level is an established risk factor for atherosclerosis, it is unclear whether it is associated with osteoporosis. In this study, the associations between the serum LDL-C level and bone mineral density (BMD), bone metabolic markers, and the presence of prevalent vertebral or non-vertebral fractures were examined. A total of 211 healthy postmenopausal women (age range, 46-80 years) who visited a community health center were recruited consecutively. Their radiographic and biochemical characteristics were collected. Prevalent vertebral and non-vertebral fractures were found in 49 (23.2%) and 36 (17.1%) subjects, respectively. Simple regression analyses showed that the serum LDL-C level was not significantly correlated with lumbar or femoral BMD or serum levels of total amino-terminal propeptide of type I collagen (PINP) or carboxy-terminal telopeptide of type I collagen (CTX). Logistic regression analyses adjusted for age and BMI showed that the increased serum LDL-C level was selected as an index affecting the presence of prevalent non-vertebral fractures, but not vertebral fractures. This result was still significant after additional adjustments for years since menopause, physical activity, previous cardiovascular events, bone markers, BMD, serum Ca, P, Cr, 25(OH)D, grip strength, tandem gait test, and use of drugs for hyperlipidemia [odds ratio 1.76 (1.13-2.73), p=0.012]. These findings suggest that a high serum LDL-C level may be a risk factor for prevalent non-vertebral fragility fractures independent of bone turnover, bone mass, vitamin D insufficiency, or frail status in postmenopausal women, and that it may be detrimental to bone, as well as blood vessels.
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Affiliation(s)
- Mika Yamauchi
- Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan,
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Imamura T, Kinugawa K, Hatano M, Muraoka H, Fujino T, Inaba T, Maki H, Kinoshita O, Nawata K, Kyo S, Ono M. Low Cardiac Output Stimulates Vasopressin Release in Patients with Stage D Heart Failure - Its Relevance to Poor Prognosis and Reversal by Surgical Treatment. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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17
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Nawata K, Yamauchi M, Takaoka S, Yamaguchi T, Sugimoto T. Association of n-3 polyunsaturated fatty acid intake with bone mineral density in postmenopausal women. Calcif Tissue Int 2013; 93:147-54. [PMID: 23708886 DOI: 10.1007/s00223-013-9743-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
Abstract
n-3 Polyunsaturated fatty acids (n-3 fatty acids) have been shown to have a beneficial effect on bone in animal studies, although little is known about their role in bone metabolism in humans. We investigated the association between bone mineral density (BMD) and daily n-3 fatty acid intake. This cross-sectional, community-based, epidemiologic study was conducted among 205 healthy postmenopausal women (mean age 63.5 years, range 46-79). We examined BMD, serum N-terminal propeptide of type I collagen (PINP), urinary type-I collagen cross-linked-N-telopeptide (uNTX), total cholesterol, triglycerides, and high-density lipoprotein cholesterol. Nutrient intake was calculated using a food-frequency questionnaire. BMD was measured at the lumbar spine and femoral neck by dual-energy X-ray absorptiometry. Simple regression analysis showed that intake of neither n-3 fatty acid nor n-6 fatty acid was associated with age or lipid metabolism indices. However, simple regression analysis showed that n-3 fatty acid intake was positively associated with both lumbar spine BMD and femoral neck BMD. n-6 fatty acid intake was positively associated with femoral neck BMD but not lumbar spine BMD. Multiple regression analysis showed that n-3 fatty acid intake was positively associated with lumbar spine BMD after adjustment for age, BMI, duration of menopausal state, grip strength, PINP, uNTX, and intakes of calcium, vitamin D, vitamin K, and n-6 fatty acid. In conclusion, n-3 fatty acid intake was positively associated with lumbar spine BMD independent of bone resorption and serum levels of cholesterol and triglycerides in postmenopausal women.
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Affiliation(s)
- Kiyoko Nawata
- Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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Yamamoto M, Yamaguchi T, Nawata K, Yamauchi M, Sugimoto T. Decreased PTH levels accompanied by low bone formation are associated with vertebral fractures in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 2012; 97:1277-84. [PMID: 22337915 DOI: 10.1210/jc.2011-2537] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Patients with type 2 diabetes (T2DM) have an increased risk of vertebral fractures (VF) compared with non-T2DM controls due to poor bone quality. The aim of this study was to investigate the association between VF and bone turnover. RESEARCH DESIGN AND METHODS We compared clinical parameters, such as serum PTH and osteocalcin (OC), between hospital-based Japanese T2DM patients (123 postmenopausal women and 132 men over 50 yr old) and medical checkup-based non-T2DM controls (189 women and 51 men). The association between PTH and OC levels was investigated, and the VF risks were compared for four subgroups classified by PTH and OC values. RESULTS T2DM patients had lower PTH and OC levels than the controls for both sexes (P < 0.01). Multivariate regression analysis showed that PTH levels of T2DM patients were significantly and positively correlated with OC levels (women, r = 0.324, P < 0.01; men, r = 0.343, P < 0.01). When participants were divided into two subgroups based on mean PTH and OC levels, the group of T2DM women with lower PTH and lower OC levels had a significantly higher risk of VF than those with higher PTH and higher OC levels after adjusting for age, body mass index, hemoglobin A(1c), creatinine, 25-hydroxyvitamin D, and lumbar bone mineral density (odds ratio, 4.73; 95% confidence interval, 1.20-18.6; P = 0.026). CONCLUSIONS Patients with T2DM had decreased PTH levels. In T2DM postmenopausal women, lower PTH levels accompanied by low bone formation may elevate VF risk independently of bone mineral density compared with higher bone formation, possibly as a result of reduced bone quality.
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Affiliation(s)
- Masahiro Yamamoto
- Internal Medicine 1, Shimane University Faculty of Medicine, 89-1, Enya-cho, Izumo, Shimane 693-8501, Japan.
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Chaudhuri K, Guddati R, Nawata K, Bhuyan R, Sawada T, Crouch G, Worthington M, Stuklis R, Edwards J. Technical Aspects of CO2 Gas Insufflation in Minimally Invasive Mitral Valve Surgery. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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20
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Wang YY, Notake T, Tang M, Nawata K, Ito H, Minamide H. Terahertz-wave water concentration and distribution measurement in thin biotissue based on a novel sample preparation. Phys Med Biol 2011; 56:4517-27. [PMID: 21719948 DOI: 10.1088/0031-9155/56/14/018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The measurement of water concentration and distribution in thin biotissues with terahertz (THz)-wave has been proposed. In this paper, a novel sample preparation approach was introduced to effectively preserve tissue freshness at room temperature. Excellent stability of this method was demonstrated by measuring the transmittance spectroscopy and imaging many times within a certain time. Moreover, the reliability of water volume concentration measurement with THz-wave was evaluated. Measurement results using THz-wave were in good agreement with volume concentration measurement results based on other quantitative methods. The results suggest that water concentration and distribution measurement in thin biotissues using THz-wave will be a potential modality for medical and biological diagnosis.
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Yamauchi M, Kaji H, Nawata K, Takaoka S, Yamaguchi T, Sugimoto T. Role of parathyroid hormone in bone fragility of postmenopausal women with vitamin D insufficiency. Calcif Tissue Int 2011; 88:362-9. [PMID: 21287159 DOI: 10.1007/s00223-011-9464-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 01/06/2011] [Indexed: 11/30/2022]
Abstract
Vitamin D insufficiency is related to an increase in PTH, which might be critical for an increase in bone fragility. However, the role of endogenous PTH in vitamin D insufficiency-induced fracture risk remains unclear. The present study was performed to examine the relationships among vitamin D insufficiency, bone fragility, and PTH in 202 Japanese postmenopausal women. Serum 25-hydroxyvitamin D (25[OH]D) levels were measured. The percentages of subjects with 25(OH)D levels below 10, 15, and 20 ng/ml were 5.0, 41.0, and 80.7%, respectively. Serum 25(OH)D levels were negatively related to age and serum levels of Cr and PTH; they were positively related to bone mineral density (BMD). In multiple regression analysis, BMD was significantly related to 25(OH)D levels when adjusted for age, body mass index (BMI), and serum levels of Cr and PTH. Multiple logistic regression analysis showed that lower 25(OH)D levels were significantly related to prevalent fracture risk when adjusted for age, BMI, serum levels of Cr and PTH, as well as femoral neck BMD. The proportion of subjects with prevalent fractures was significantly higher in the group with lower PTH and lower 25(OH)D than in the group with lower PTH and higher 25(OH)D or higher PTH and higher 25(OH)D. In conclusion, vitamin D insufficiency was found to be related to prevalent fracture risk independently of PTH. Functional hypoparathyroidism, rather than functional hyperparathyroidism, might be a risk factor for bone fragility in vitamin D insufficiency.
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Affiliation(s)
- Mika Yamauchi
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
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22
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Abstract
ABSTRACTThe crystallographic structures of seven refractory metal (Ti, V, Cr, Nb, Mo, Ta and W) disilicides with the C11b, C40 and C54 structures have been refined through analysis of single-crystal X-ray diffraction data. Crystallographic parameters refined are lattice constants, atomic parameters and the space group of the C40 disilicides. In most of previous studies, silicon atoms have been considered to locate at the ideal positions so that the refractory metal atoms are perfectly six-fold coordinated in RSi2 layers prevailing in all the three structures. The present analysis shows that the silicon atoms are displaced from the ideal positions. The magnitude of such displacement is found to be closely related to the interatomic distance in these pseudo-hexagonally arranged RSi2 layers. The space group of three of the four C40 disilicides, VSi2, CrSi2 and TaSi2, is determined to be P6422, which is of chirality with respect to that (P6222) assigned in the previous studies.
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23
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Nawata K, Okida M, Furuki K, Miyamoto K, Omatsu T. Sub-100 W picosecond output from a phase-conjugate Nd:YVO4 bounce amplifier. Opt Express 2009; 17:20816-20823. [PMID: 19997315 DOI: 10.1364/oe.17.020816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We demonstrated >80 W picosecond output at a pulse repetition frequency of 100 MHz from a dual Nd:YVO(4) amplifier laser system consisting of a phase-conjugate Nd:YVO(4) bounce amplifier combined with a second diode-side-pumped Nd:YVO(4) bounce amplifier. The output exhibited high quality spatial form with M(2) < 1.8 and a pulse duration (FWHM) of 9.2 ps. A peak power of >7.4 MW with an average power of 78.5 W was also achieved at a pulse repetition frequency of 1.0 MHz.
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Affiliation(s)
- K Nawata
- Department of Information and Image Sciences, Chiba University, 1-33, Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan
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24
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Nawata K, Ojima Y, Okida M, Ogawa T, Omatsu T. Power scaling of a pico-second Nd:YVO(4) master-oscillator power amplifier with a phase-conjugate mirror. Opt Express 2006; 14:10657-10662. [PMID: 19529471 DOI: 10.1364/oe.14.010657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We investigated design issues for the power scaling of a pico-second Nd:YVO(4) master-oscillator power amplifier system with a photorefractive phase-conjugate mirror by using standard beam propagation analysis. We also demonstrated a 25 W diffraction-limited pico-second output. A corresponding extraction efficiency of 31 % was achieved.
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25
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Nawata K, Sohmiya M, Kawaguchi M, Nishiki M, Kato Y. Increased resting metabolic rate in patients with type 2 diabetes mellitus accompanied by advanced diabetic nephropathy. Metabolism 2004; 53:1395-8. [PMID: 15536591 DOI: 10.1016/j.metabol.2004.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thirty-three patients with type 2 diabetes mellitus (16 men, 17 women) were divided into 3 groups based on urinary excretion of albumin (U-Alb)--group A: U-Alb < 30 mg/d; group B: 30 mg/d < or = U-Alb < or = 300 mg/d; and group C: 300 mg/d < U-Alb. Serum creatinine levels were lower than 2.0 mg/dL in all the subjects. There was no difference in age, sex, therapy, body weight, body mass index (BMI), lean body mass (LBM), or hemoglobin A(1c) (HbA(1c)) levels among the 3 groups. Resting metabolic rate (RMR) (kJ/h/m(2)) and adjusted RMR for lean body mass (kJ/h/m(2)) were significantly increased in group C compared with groups A and B. Hb concentrations, serum albumin levels, and creatinine clearance were much lower in group C than in groups A and B (P < .001). There were no difference in serum urea nitrogen, total cholesterol, cholinesterase and free thyroxine, or plasma insulin-like growth factor I (IGF-I) levels among the 3 groups. Linear regression analysis revealed an inverse correlation between RMR and serum albumin levels, correlation between RMR and U-Alb, and inverse correlation between RMR and Hb concentrations, respectively, in these patients. In conclusion, RMR in diabetic patients correlated directly with U-Alb and inversely with serum albumin and Hb concentration. These findings suggest that RMR is related with urinary albumin loss and anemia in patients with type 2 diabetes mellitus accompanied by diabetic nephropathy.
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Affiliation(s)
- Kiyoko Nawata
- Department of Endocrinology, Shimane University School of Medicine, Izumo 693-8501, Japan
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26
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Morio Y, Teshima R, Nagashima H, Nawata K, Yamasaki D, Nanjo Y. Correlation between operative outcomes of cervical compression myelopathy and mri of the spinal cord. Spine (Phila Pa 1976) 2001; 26:1238-45. [PMID: 11389390 DOI: 10.1097/00007632-200106010-00012] [Citation(s) in RCA: 205] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Magnetic resonance images of cervical compression myelopathy were retrospectively analyzed in comparison with surgical outcomes. OBJECTIVES To investigate which magnetic resonance findings in patients with cervical compression myelopathy reflect the clinical symptoms and prognosis, and to determine the radiographic and clinical factors that correlate with the prognosis. SUMMARY OF BACKGROUND DATA Signal intensity changes of the spinal cord on magnetic resonance imaging in chronic cervical myelopathy are thought to be indicative of the prognosis. However, the prognostic significance of signal intensity change remains controversial. METHODS The participants in this study were 73 patients who underwent cervical expansive laminoplasty for cervical compression myelopathy. Their mean age was 64 years, and the mean postoperative follow-up period was 3.4 years. The pathologic conditions were cervical spondylotic myelopathy in 42 patients and ossification of the posterior longitudinal ligament in 31 patients. Magnetic resonance imaging (spin-echo sequence) was performed in all the patients. The transverse area of the spinal cord at the site of maximal compression was computed, and spinal cord signal intensity changes were evaluated before and after surgery. Three patterns of spinal cord signal intensity changes on T1-weighted sequences/T2-weighted sequences were detected as follows: normal/normal, normal/high-signal intensity changes, and low-signal/high-signal intensity changes. Surgical outcomes were compared among these three groups. The most useful combination of parameters for predicting prognosis was determined using a stepwise regression analysis. RESULTS The findings showed 2 patients with normal/normal, 67 patients with normal/high-signal, and 4 patients with low-signal/high-signal change patterns before surgery. Regarding postoperative recovery, the preoperative low-signal/high-signal group was significantly inferior to the preoperative normal/high-signal group. There was no significant difference between the transverse area of the spinal cord at the site of maximal compression in the normal/high-signal group and the low-signal/high-signal group. A stepwise regression analysis showed that the best combination of surgical outcome predictors included age (correlation coefficient R = -0.348), preoperative signal pattern, and duration of symptoms (correlation coefficient R = -0.231). CONCLUSIONS The low-signal intensity changes on T1-weighted sequences indicated a poor prognosis. The authors speculate that high-signal intensity changes on T2 weighted images include a broad spectrum of compressive myelomalacic pathologies and reflect a broad spectrum of spinal cord recuperative potentials. Predictors of surgical outcomes are preoperative signal intensity change pattern of the spinal cord on radiologic evaluations, age at the time of surgery, and chronicity of the disease.
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Affiliation(s)
- Y Morio
- Department of Orthopaedic Surgery, Tottori University, Faculty of Medicine, Yonago, Japan.
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27
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Nawata K, Enokida M, Yamasaki D, Minamizaki T, Hagino H, Morio Y, Teshima R. Tensile properties of rat anterior cruciate ligament in collagen induced arthritis. Ann Rheum Dis 2001; 60:395-8. [PMID: 11247872 PMCID: PMC1753621 DOI: 10.1136/ard.60.4.395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate the effects of collagen induced arthritis (CIA) on the tensile properties of rat anterior cruciate ligament (ACL). METHODS The tensile strength, bone mineral density (BMD), and histology of ACL units from rats with CIA were investigated. RESULTS The tensile strength of the ACL unit was significantly lower in the rats with CIA at 10 weeks after immunisation (ultimate failure load, 74.9% of the control; stiffness, 62.0% of the control). The major mode of failure was femoral avulsion, and the BMD was significantly lower in the rats with CIA. A histological examination of the ligament insertion in rats with CIA showed resorption of the cortical bone beneath the ACL insertion and an enlarged mineralised fibrocartilage zone. CONCLUSIONS These findings indicate that the decrease in tensile strength of ACL units correlated with histological changes in the ligament-bone attachment, such as bone resorption beneath the ligament insertion site and an enlargement of the mineralised fibrocartilage zone.
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Affiliation(s)
- K Nawata
- Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, 683-8504 Japan.
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28
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Morio Y, Nagashima H, Teshima R, Nawata K. Radiological pathogenesis of cervical myelopathy in 60 consecutive patients with cervical ossification of the posterior longitudinal ligament. Spinal Cord 1999; 37:853-7. [PMID: 10602528 DOI: 10.1038/sj.sc.3100940] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
STUDY DESIGN The radiological pathogenetic factors for cervical myelopathy in 60 consecutive patients with cervical ossification of the posterior longitudinal ligament (OPLL) were investigated retrospectively. OBJECTIVE To clarify which patients with OPLL will develop cervical myelopathy. METHODS Sixty consecutive patients with OPLL were radiologically assessed comparing the myelopathic patient group (M group, n=41) and the mild or non-myelopathic patient group (non-M group, n=19). RESULTS The narrowing ratio of the spinal canal in the M group (47.1%) was significantly greater (P=0.026) than that in the non-M group (38.3%). The two groups showed a significant difference (P=0.0016) with regard to the Pavlov ratio (M group, 0.73; non-M group, 0.84). The total range of motion of the cervical spine did not differ between the two groups but the per cent range of motion was significantly greater (P=0.037) in the M group than in the non-M group. CONCLUSION This study suggests that factors important in the onset or aggravation of myelopathy are factors related to pathological compression by OPLL, cervical soft disc herniation, developmentally narrow spinal canal, and local or non-proportional hypermobility.
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Affiliation(s)
- Y Morio
- Department of Orthopaedic Surgery, Tottori University, Faculty of Medicine, Yonago, Japan
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29
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Abstract
Twenty-three knees of 21 patients over 40 years of age with discoid lateral menisci were examined by radiography. The mean age of the patients was 59.7 years (range: 40-78 years). No patient had symptoms before the age of 40 and only 12 knees gave symptoms from the lateral compartment, although tears of a discoid lateral meniscus were diagnosed by arthrography in 21 of the 23 knees. Varus inclination occurred more frequently than valgus inclination. Subchondral bone sclerosis was more common in the medial compartment. However, high incidences of marginal osteophytes in the lateral compartment and morphological anomalies (cupping or flattening) of the lateral tibial plateau were revealed by radiography.
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Affiliation(s)
- K. Nawata
- />Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan e-mail: Tel: +81 859 34 8115 Fax: +81 859 34 8093, , , , JP
| | - R. Teshima
- />Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan e-mail: Tel: +81 859 34 8115 Fax: +81 859 34 8093, , , , JP
| | - M. Ohno
- />Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan e-mail: Tel: +81 859 34 8115 Fax: +81 859 34 8093, , , , JP
| | - T. Takita
- />Department of Orthopaedic Surgery, Misasa-onsen Hospital, Misasa, Japan, , , , JP
| | - K. Otuki
- />Department of Orthopaedic Surgery, Misasa-onsen Hospital, Misasa, Japan, , , , JP
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Nawata K, Teshima R, Enokida M, Suzuki T, Yamagata T. Magnetic resonance imaging of meniscal degeneration in torn menisci: a comparison between anterior cruciate ligament deficient knees and stable knees. Knee Surg Sports Traumatol Arthrosc 1999; 7:274-7. [PMID: 10525695 DOI: 10.1007/s001670050163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Signal anomalies observed in magnetic resonance imaging of the intrameniscal tissue adjacent to the tear were compared between stable knees (group 1, 54 menisci) and anterior cruciate ligament (ACL) deficient knees (group 2, 98 menisci). The histological significance of these signal anomalies was also studied (n = 25). The frequency of intrameniscal signal anomalies adjacent to the tear was significantly lower in ACL-deficient knees than in ACL-stable knees (P = 0.0022). There was a close correlation between the imaging anomalies and the presence of histological lesions (fissures, degeneration) within meniscal tissues adjacent to the tear (sensitivity: 0.95, specificity: 0.60). Our results suggest that the severity of intrameniscal degenerative changes adjacent to the tear are lower in ACL-deficient knees than in ACL-stable knees.
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Affiliation(s)
- K Nawata
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan.
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31
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Abstract
BACKGROUND Anomalies of ossification in the lower femoral epiphysis are often radiographically indistinguishable from juvenile osteochondritis dissecans. OBJECTIVE To clarify the MRI characteristics of the anomalies of ossification in the posterolateral femoral condyle that distinguish it from juvenile osteochondritis dissecans. MATERIALS AND METHODS We retrospectively examined the medical records, plain radiographs (n = 4), MRI (n = 4) and follow-up MRI (n = 2) of four boys (age 8-11 years) with anomalies of ossification in the posterolateral femoral condyle. RESULTS Plain radiography showed symmetrical marginal irregularity of the posterolateral femoral condyles of both knees. These lesions were asymptomatic, and the areas of irregular radiographic appearances reduced in size or disappeared without treatment within a mean observation period of 3.5 months. MRI showed a clearly demarcated low-intensity islet with the same signal intensity as subchondral bone (which was considered to be an accessory ossification nucleus) in a high-signal area in which the signal intensity was equal to that of normal articular cartilage. The areas observed as radiolucent zones on plain radiography were visualised at the same signal intensity as articular cartilage, and were continuous with articular cartilage on MRI; thus they were regarded as uncalcified cartilage. These MR findings are different from MR images of osteochondritis dissecans. CONCLUSIONS MRI is considered to be the most effective non-invasive diagnostic method for these two conditions.
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Affiliation(s)
- K Nawata
- Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan
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Teshima R, Nawata K, Hagino H, Morio Y, Inoue M, Irizawa Y. Effects of weight bearing on the tidemark and osteochondral junction of articular cartilage: histomorphometric analyses of 7 normal femoral heads. Acta Orthop Scand 1999; 70:381-6. [PMID: 10569269 DOI: 10.3109/17453679908997828] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To study the effect of weight bearing on the tidemark and osteochondral junction, we compared the morphology of these two boundaries in weight-bearing and less weight-bearing regions of normal human femoral heads. We measured the irregularities of the boundaries in the two regions using an X-Y digitizer connected to a computer in histological whole sections of femoral heads in 7 subjects without joint diseases. The irregularity of the tidemark was small, showing no difference between the two regions. However, the irregularity of the osteochondral junction in the weight-bearing region was greater than in the less weight-bearing region, which was confirmed by three-dimensional reconstructed images. Our findings suggest that mechanical stresses greatly influence the morphology of the osteochondral junction compared to the influence of such stresses on the tidemark, and that the marked irregularity of the osteochondral junction in the weight-bearing region is a reactive phenomenon against mechanical fragility due to simple contact between calcified cartilage and subchondral bone without fibrous connections.
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Affiliation(s)
- R Teshima
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
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Nawata K, Teshima R, Morio Y, Hagino H, Enokida M, Yamamoto K. Anterior-posterior knee laxity increased by exercise. Quantitative evaluation of physiologic changes. Acta Orthop Scand 1999; 70:261-4. [PMID: 10429601 DOI: 10.3109/17453679908997803] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To quantify physiologic changes in anterior-posterior laxity of the normal knee caused acutely by exercise, we evaluated the exercise level and the duration of exercise needed to cause changes in laxity, the magnitude of changes in laxity, and the time needed for laxity to return to the level before exercise, by continuously applying a fixed exercise load. After a 20-minute run at 7 km/hr, anterior laxity with a displacement force of 133 N increased by about one third, and the compliance increased by one half with anterior drawer between 0 and 67 N. These changes were maintained at a similar level during exercise. The levels before exercise were restored gradually over 1 hour after exercise. As the muscle strength showed no changes during exercise, we consider these changes in laxity are not associated with a decrease in muscle strength. Furthermore, since the changes in knee laxity after triathlon (in which the knee is subjected to prolonged excessive exercise) are similar to those after running at 7 km/hr, we believe that the magnitude of changes in laxity after exercise is fixed, regardless of the level of the exercise load. Moreover, the threshold of exercise that causes the maximum change is low.
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Affiliation(s)
- K Nawata
- Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
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Otsuki T, Nawata K, Okuno M. Quantitative evaluation of gait pattern in patients with osteoarthrosis of the knee before and after total knee arthroplasty. Gait analysis using a pressure measuring system. J Orthop Sci 1999; 4:99-105. [PMID: 10199987 DOI: 10.1007/s007760050081] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Using a pressure measuring system, we quantitatively evaluated gait pattern in patients with osteoarthrosis (OA) of the knee before and after total knee arthroplasty (TKA). In the OA group, the stance time was longer, and the average vertical component of the floor reaction force (AVF) was lower than the values in normal age-matched subjects. These gait parameters correlated with the clinical score. These results suggest that changes in the gait parameters reflect gait patterns that reduce load on the knee. The center of pressure (COP) under the foot was correlated with the axial alignment of the lower limb in the mid-stance phase. In the TKA group, the clinical scores and gait parameters were improved 12 months after surgery compared with the preoperative values. The COP in the mid-stance phase moved inward after the TKA. However, in patients examined more than 2 years after a TKA, stance time and AVF did not reach normal levels, despite the patients' good clinical scores. These findings indicate that the gait pattern before surgery continues although pain on walking is reduced early after a TKA. Gait evaluation with a simple pressure measuring system revealed the changes in gait that are difficult to define by subjective clinical assessment.
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Affiliation(s)
- T Otsuki
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan
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Li TS, Sugi K, Ueda K, Nawata K, Nawata S, Esato K. Isolated lung perfusion with cisplatin in a rat lung solitary tumor nodule model. Anticancer Res 1998; 18:4171-6. [PMID: 9891463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND The present study was conducted to evaluate the toxicity, pharmacokinetics and anti-tumor potency of isolated lung perfusion (ILP) with cisplatin in a visible lung tumor nodule model in rats. MATERIALS AND METHODS A solitary tumor nodule was established by the injection of Methylcholanthrene-induced sarcoma cells into the left lung. Thirty rats were randomized to undergo ILP with either 0.1, 0.25, or 0.5 mg/mL cisplatin and buffered hespan (BHE), or with an intravenous injection of 1.0 or 2.5 mg cisplatin. RESULTS The highest dose of cisplatin tolerated by the rats was 0.1 mg/mL for perfusion. A much higher platinum concentration in the tumor, of 6.67 +/- 1.64 vs. 2.51 +/- 0.60 micrograms/g tissue, but a significantly lower concentration in the serum and kidneys, was achieved by perfusion compared to that achieved by intravenous injection. A significantly lower tumor weight and 20% complete treatment response was achieved in rats given cisplatin than in those given BHE perfusion at 43.9 +/- 11.6 vs. 226.3 +/- 44.6 mg. CONCLUSION ILP with cisplatin achieved superior results to intravenous injection according to the levels of toxicity and pharmacokinetic analysis, and it was effective against a visible tumor nodule model in rats.
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Affiliation(s)
- T S Li
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Kurata S, Nawata K, Nawata S, Hongo H, Suto R, Nagashima H, Kuroda Y, Nakayasu K, Shirasawa B, Esato K. Surgery for abdominal aortic aneurysms associated with malignancy. Surg Today 1998; 28:895-9. [PMID: 9744397 DOI: 10.1007/s005950050249] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Of 148 patients treated for abdominal aortic aneurysms (AAA), 33 (22%) also had cancer. According to the classification of Szilagyi, there were 13 patients in group I, 19 in group II, and 1 in group IV. In group I, the mean interval between the cancer and AAA operations was 7 years (range 1-14 years). Aneurysmectomy was performed in 9 patients, wrapping in 2, and no operation in 2. In group II, a two-stage operation was performed in 8 patients, a single-stage operation in 4, only surgery for cancer in 4, and no operation in 3. Of 4 patients undergoing single-stage operations, 3 had colorectal cancer, and there were no postoperative complications such as graft infection or anastomotic breakdown. In group I, 6 of 13 patients died, but there were no cancer deaths. In group II, 9 of 19 patients died, 6 from progressive cancer. The group IV patient also died of cancer. These results suggest that if a patient can tolerate surgery for both diseases, a single-stage operation is preferable.
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Affiliation(s)
- S Kurata
- Department of Surgery, Yamaguchi Central Hospital, Hofu, Japan
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Sugi K, Matsuoka T, Tanaka T, Sakano H, Nawata K, Ueda K, Fujita N, Kaneda Y, Esato K. Lung volume reduction surgery for pulmonary emphysema using dynamic Xenon-133 and Tc-99m-MAA SPECT images. Ann Thorac Cardiovasc Surg 1998; 4:149-53. [PMID: 9660913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The usefulness of Xe-133 and Tc-99m-MAA single photon emission computed tomography (SPECT) in identifying areas to be resected during video-assisted thoracoscopic lung reduction surgery for emphysema was examined. Twenty-nine patients with advanced emphysema were examined using Xe-133 and Tc-99m-MAA SPECT prior to and following surgery. For the Xe-133 dynamic SPECT, patients inhaled Xe-133 gas for 6 minutes. Equilibrium and subsequent washout SPECT images were acquired every 30 seconds for 6 to 7 minutes during spontaneous breathing. Ventilation was quantified by Xe-133 clearance time (T1/2) in addition to visual assessment. The patients underwent unilateral thoracoscopic volume reduction in the regions with abnormal Xe-133 retention and Tc-99m-MAA defect. All patients demonstrated marked, heterogeneous Xe-133 retention and Tc-99m-MAA defects preoperatively. The worst functioning areas were identified as nonventilated and noflow areas, or areas with air trapping and low perfusion. These changes were found even in patients with diffuse and symmetrical impairments on chest CT. After surgery, most of these "target areas" disappeared and pulmonary function tests demonstrated significant improvement. T1/2 correlated closely with the percent predicted FEV1 (%FEV) and 6-minute walk distance before and after surgery (p<0.0001). Xe-133 and Tc-99m-MAA SPECT imaging was useful in identifying "target areas" in the emphysematous lung. Directed unilateral thoracoscopic volume reduction based on these SPECT images is an effective treatment for emphysema.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, 1144 Kogushi, Ube, Yamaguchi 755-8505, Japan
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Abstract
We reviewed our experience with video-assisted thoracic surgery (VATS) in our most recent 80 patients for the purpose of cost analysis. The costs incurred in the patients undergoing a VATS wedge resection for nodules (n = 30) and a VATS lobectomy for lung cancer (n = 10) were compared with the costs in similar patients undergoing a wedge resection (n = 20) and lobectomy (n = 20) using open techniques. The disposable instrument costs were US $1071 higher for a VATS wedge resection; however, the operative time was shorter (0.99 h for VATS versus 1.75 h for the open procedure). The length of hospital stay was also shorter after a VATS wedge resection (10.4 days for VATS versus 16.8 days for the open procedure), thus resulting in lower total hospital charge in the VATS group. The disposable instrument costs were $3190 higher for a VATS lobectomy, and the operative time was longer (5.56 h for VATS versus 4.25 h for the open procedure). The length of hospital stay was similar in both groups (25.2 days for VATS versus 27.7 days for the open procedure), thus resulting in a higher total hospital charge in the VATS lobectomy group. The cost of a VATS wedge resection for removing peripheral nodules is competitive with that of open techniques, but the cost of a VATS lobectomy is higher than that for an open lobectomy.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Sugi K, Nawata K, Fujita N, Ueda K, Tanaka T, Matsuoka T, Kaneda Y, Esato K. Systematic lymph node dissection for clinically diagnosed peripheral non-small-cell lung cancer less than 2 cm in diameter. World J Surg 1998; 22:290-4; discussion 294-5. [PMID: 9494422 DOI: 10.1007/s002689900384] [Citation(s) in RCA: 169] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The value of radical systematic lymphadenectomy for treatment of early-stage bronchial carcinoma is controversial. We performed a prospective randomized study to address this question. Altogether 115 patients with peripheral non-small-cell lung cancers smaller than 2 cm in diameter were enrolled in this study. They were randomly assigned into a lobectomy with lymph node sampling group (sampling group, n = 56) or a lobectomy with radical systematic lymph node dissection group (dissection group, n = 59). Inclusion criteria were based only on preoperative clinical studies. Four tumors were larger than 2 cm postoperatively. One patient had disseminated disease, and two had intrapulmonary metastases discovered at surgery. Two patients had small-cell carcinoma. There were four with pathologic N1 disease and seven with N2 disease in the dissection group and three with N1 and eight with N2 disease in the sampling group. The numbers of local and distant recurrences were two and six, respectively, in the dissection group and two and five in the sampling group. The overall 5-year survival was 81% in the dissection group and 84% in the sampling group. No significant differences in the recurrence rate or survival was seen between the groups. Our results demonstrate that clinically evaluated peripheral non-small-cell carcinomas smaller than 2 cm in diameter do not require radical systematic mediastinal and hilar lymph node dissection.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Sugi K, Yoshimura K, Fujita N, Ueda K, Nawata K, Esato K. Obstruction of the right ventricle outflow tract during right cardiac prolapse. Jpn J Thorac Cardiovasc Surg 1998; 46:131-3. [PMID: 9558854 DOI: 10.1007/bf03250606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We observed cardiac prolapse following right pneumonectomy in which the patient experienced a 90 degree rotation of the heart and compression of right ventricular outflow tract from behind by the aorta, which led to an increase in right atrial pressure and a decrease of pulmonary artery pressure and cardiac output. Compression of the right ventricular outflow tract by the base of the aorta was observed as an additional shock inducing factor in right cardiac prolapse.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Sugi K, Nawata K, Ueda K, Kaneda Y, Nawata S, Oga A, Esato K. Chest wall implantation of lung cancer at the drainage tube site: report of a case. Surg Today 1997; 27:666-8. [PMID: 9306574 DOI: 10.1007/bf02388228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report herein the case of a 70-year-old man in whom a chest wall implantation of adenocarcinoma of the lung at the drainage tube site was found 4 months after a right lower lobectomy with mediastinal lymph node dissection had been performed for adenocarcinoma of the right lower lobe. The lesion was successfully treated by tumor extirpation. We believe that tumor seeding to the chest wall occurred at the time of thoracotomy. To prevent such tumor seeding, the pleural cavity should be washed out routinely with a massive volume of physiological saline solution prior to closure of the chest wall.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Sugi K, Fujita N, Ued K, Nawata K, Tanaka T, Matsuoka T, Kaneda Y, Esato K. [Lymph node dissection during a video-assisted lobectomy is inferior to that in a standard lobectomy]. Nihon Kyobu Geka Gakkai Zasshi 1997; 45:1701-5. [PMID: 9394580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The indications for a video-assisted lobectomy are currently ill-defined. Clinicians recommend based on the extent of lymph node involvement. Fifty-nine patients with clinical stage I non-small cell lung cancer underwent lobectomies with systemic lymph node dissections through a standard thoracotomy (Group C), and 26 patients underwent lobectomies with lymph node dissections using the video-assisted procedure (Group V). The number of dissected lymph nodes at all node levels were compared between the two groups. There was no significant difference between groups in the total number of dissected lymph nodes in patients with right lung cancer. The number of dissected hilar and interlobar lymph nodes, however, was less in Group V than that in Group C (hilar: 1.2 +/- 0.4 vs. 2.8 +/- 0.6, interlobar: 1.1 +/- 0.4 vs. 2.1 +/- 0.4). The total number of dissected lymph nodes in patients with left lung cancer was significantly less in Group V than that in Group C (18.5 +/- 0.3 vs. 28.7 +/- 2.4). In addition, the number of dissected lymph nodes in pratracheal, pretracheal, tracheobronchial, subcarinal, hilar, and interlobar lymph nodes were significantly less in the group V than those in Group C. Although there was no significant difference in the actual survival rates between the groups in this preliminary study, a sufficiently small number of dissected lymph nodes in the video-assisted lobectomy may have resulted in inaccurate staging and poor prognosis in these patients.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Sugi K, Nawata K, Fujita N, Kaneda Y, Ueda K, Nawata S, Esato K. Combined thoracoscopic lung resection and laser ablation for lung cancer with pulmonary emphysema: report of a case. Surg Today 1997; 27:68-70. [PMID: 9035304 DOI: 10.1007/bf01366943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We report herein the case of the 71-year-old man with lung cancer and pulmonary emphysema requiring supplementary oxygen at 21/min by nasal cannula for whom thoracoscopic wedge resection of an adenocarcinoma in his left lower lobe was successfully performed. During the same procedure, thoracoscopic laser ablation of pulmonary bullae was also carried out. There were no postoperative complications, and the patient is currently well 12 months following surgery without any evidence of local or regional recurrence, or distant metastasis. His severe dyspnea on exertion improved, and he no longer requires supplementary oxygen.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Abstract
At our institute patients with lung cancer had traditionally undergone lobectomy with mediastinal lymph node dissection using a standard posterolateral approach. The considerable morbidity associated with the standard posterolateral thoracotomy led us to investigate an alternative muscle-sparing approach. A prospective, randomized study of 30 patients with primary lung cancer (stage I or II) was performed to compare the following: operative field size, number of dissected lymph nodes, surgery time, postoperative pain, shoulder range of motion, and pulmonary function test results between patients who underwent either standard thoracotomy (SP group, n = 15) or the muscle-sparing thoracotomy (MS group, n = 15). The procedure should provide enough operative field size to access to mediastinum. Compared with the standard posterior thoracotomy, the muscle-sparing thoracotomy supplied a smaller operative field (218 +/- 31 versus 165 +/- 41 cm2) and required more surgery time (87 +/- 13 minutes) than the standard posterior thoracotomy (66 +/- 12 minutes). There were no significant differences in the number of dissected mediastinal lymph nodes. During the early postoperative days, pain and restriction of shoulder flexion were significantly less in the MS group than in the SP group. There were no significant differences in pulmonary function between the two groups. In terms of the operative field there is a marked disadvantage with the muscle-sparing incision compared with standard thoracotomy. The operative field is significantly smaller than with a standard thoracotomy, requiring more time to dissect the mediastinum; however, the pain is less and shoulder range of motion is superior to what is seen after standard thoracotomy during the early postoperative period. We conclude that there is no overall advantage to using the muscle-sparing incision in patients with lung cancer.
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Affiliation(s)
- K Sugi
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Nawata S, Sugi K, Ueda K, Nawata K, Kaneda Y, Esato K. Prostacyclin analog OP2507 prevents pulmonary arterial and airway constriction during lung preservation and reperfusion. J Heart Lung Transplant 1996; 15:470-4. [PMID: 8771502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The effects of OP2507 on lung preservation with cold Euro-Collins solution and during the reperfusion period were evaluated. METHODS For this study, canine lungs were flushed with a 10 micrograms/ml OP2507 solution (n = 7) or saline solution (control group, n = 7) (0.1 ml/kg body weight) and stored in the same solution. Pulmonary arterial pressure, pulmonary vascular resistance, airway pressure, respiratory capacity, and wet to dry weight ratio of the lungs were measured before and after 24 hours of cold preservation and after a 60-minute reperfusion period. RESULTS Treatment with OP2507 significantly attenuated increases in pulmonary arterial pressure, pulmonary vascular resistance, and airway pressure after preservation and during the reperfusion period. Oxygen tension in outflow blood also was maintained with OP2507 treatment throughout the experimental period, whereas it was depressed during the reperfusion period in the control group. By electron microscopy, there was little evidence of vascular endothelial damage, such as cell swelling, detachment of endothelial cells from the lamina, and attenuation of the cytoplasm, in both groups. However, the tight junctions between cells were observed more clearly in the control group than in the OP2507 group, suggesting more cell membrane damage in the control group. CONCLUSIONS Pretreatment with OP2507 prevented pulmonary artery and airway constriction after 12 hours of cold lung preservation and a decrease of oxygen tension in outflow blood during a 60-minute reperfusion period.
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Affiliation(s)
- S Nawata
- First Department of Surgery, Yamaguchi University School of Medicine, Japan
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Nawata K, Teshima R, Minamizaki T, Yamamoto K. Knee deformities in multiple hereditary exostoses. A longitudinal radiographic study. Clin Orthop Relat Res 1995:194-9. [PMID: 7641480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
For a mean period of 7.8 years, the morphology of knee deformity and its annual changes in 8 patients (16 knees; mean age at the initial examination, 8.4 years) with multiple hereditary exostoses were evaluated radiographically. Knee deformity developed during the growth spurt period. Genu valgum with a femorotibial angle that decreased more than 2 standard deviations from the mean of age-matched normal children was observed in 6 of the 16 knees. In 3 of these 6 knees, recurrent dislocation of the patella was observed. Angulation of the femur varied among the knees, but the tibia showed valgus angulation in the proximal metaphysis in all knees. Thus, knee deformity in patients with multiple hereditary exostoses was primarily genu valgum caused by valgus angulation of the tibia.
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Affiliation(s)
- K Nawata
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
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Nawata K, Teshima R, Suzuki T. Osseous lesions associated with anterior cruciate ligament injuries. Assessment by magnetic resonance imaging at various periods after injuries. Arch Orthop Trauma Surg 1993; 113:1-4. [PMID: 8117503 DOI: 10.1007/bf00440586] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In 56 patients with anterior cruciate ligament (ACL) rupture, we retrospectively examined osseous lesions secondary to the rupture using magnetic resonance imaging (MRI). Depending on the time from their ligamentous injury to the performance of MRI, the patients were divided into three groups: the acute group (less than 1 month, n = 20), the subacute group (between 1 and 12 months, n = 16), and the chronic group (12 months or more, n = 20). Occult osseous lesions which were not detected by roentgenography were revealed by MRI in 14 patients in the acute group (70.0%), 5 in the subacute group (31.3%), and 1 in the chronic group (5%). The detection rate of osseous lesions by MRI was significantly higher in the acute group than in the other groups (P < 0.001). Osseous lesions were always detected in the same locations of the lateral compartment of the knee joint. When examined by arthroscopy, these lesions were often found to be accompanied by articular cartilage injuries. In the acute group, osseous lesions were visible in the high signal intensity area of T2-weighted images and in the low signal intensity area of proton density images. They were interpreted as representing hemorrhage and edema within the bone marrow. In the subacute and chronic groups, the osseous lesions were smaller, and their signal intensity on T2-weighted images was lower than that in the acute group, probably reflecting the ongoing resorption of the hemorrhage and healing of the lesions. These results suggest that osseous lesions develop following injury to the ACL.
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Affiliation(s)
- K Nawata
- Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
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Koga M, Tokura N, Nawata K. Gain-controlled all-optical inverter switch in a semiconductor laser amplifier. Appl Opt 1988; 27:3964-3965. [PMID: 20539501 DOI: 10.1364/ao.27.003964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Fujiwara J, Kasai T, Tada C, Nishimura K, Nawata K. [The effects of the methods of total hysterectomy in the ensuing years]. Kango Gijutsu 1985; 31:1032-40. [PMID: 3848535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
Promising results of various coupling experiments between laser diodes and single-mode fibers to determine the optimum coupling method are reported. The cylindrical lens method is shown to be most efficient, with a coupling loss of 1.8 dB under optimum alignment conditions. More than -2 dB coupling efficiency is attained with a cylindrical lens whose radius is less than 8 microm. The laser to fiber coupling characteristics are estimated by Gaussian beam approximation. The optimum radius of a cylindrical lens, which gives maximum coupling efficiency, is derived by theoretical calculation, using the ray matrix method. The cylindrical lens alignment tolerance is also shown theoretically and experimentally.
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