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Ogawa K.-I.,Fukuyama City Hospital Emergency Medical Center | Doi T.,Fukuyama City Hospital Emergency Medical Center | Miyasho K.,Fukuyama City Hospital Emergency Medical Center | Munetomo K.,Fukuyama City Hospital Emergency Medical Center | And 3 more authors.
Skeletal Radiology | Year: 2010

Objective The purpose of this study was to evaluate retrospectively the safety and effectiveness of the computed tomography (CT) fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures. Materials and methods Six patients (four women and two men; mean age 55.8 years; range 35-77 years) with unstable posterior pelvic fractures underwent iliosacral screw placement under CT fluoroscopy guidance between November 2007 and August 2008. Unstable pelvic rin injury (AO types B and C) was the indication for this procedure. Results In all the six patients except one, CT fluoroscopyguided placement had been technically successful. In one patient, a second screw had been inserted, with a tilt to the caudal site, and slightly advanced into the extrasacral body; afterward, it could be exchanged safely for a shorter screw. Five patients and one patient underwent placement of two screws and one screw, respectively. The mean duration of the procedure was 15.0 min (range 9-30 min) per screw; the duration was 12.3 min and 18.2 min for the first and second screws, respectively. No complications requiring treatment occurred during or after the procedure. The mean clinical and radiologic follow-up period was 14 months (range 6-21 months). All pelvic injuries had healed satisfactorily, without complication, and all patients are now doing well clinically and can walk. Conclusion CT fluoroscopy-guided placement of iliosacral screws is a safe and effective treatment in patients with unstable posterior pelvic fractures. © ISS 2009.


Ishibashi N.,Fukuyama City Hospital Emergency Medical Center | Miyasho K.,Fukuyama City Hospital Emergency Medical Center | Kitamura T.,Osaka University | Ookuma T.,Fukuyama City Hospital Emergency Medical Center | And 4 more authors.
Acta Medica Okayama | Year: 2015

We evaluated the hemodynamics and outcomes of septic shock (SS) patients who did not respond to fluid resuscitation, after treatment with or without intravenous calcium. We retrospectively collected information on 154 eligible SS patients who were admitted to Fukuyama City Hospital Emergency Medical Center and did not respond to fluid resuscitation. To compare their degree of hemodynamic impairment, we compared the changes in the vasoactive-inotropic score (VIS) in the calcium-treated group (n = 112) and the noncalcium-treated group (n = 42). We compared the length of stay in the inten sive care unit (ICU) and hospital, in-hospital deaths, 28-day deaths, and changes in the Sequential Organ Failure Assessment score within 72h of ICU admission between the 2 groups. Changes in the VIS at 1 h after the baseline time were significantly greater in the calcium-treated group than in the noncalcium-treated group (1.41 vs. -1.25, respectively; p < 0.001). However, the changes in the VIS at 3, 6, 24, 48, and 72h did not differ between the 2 groups. The secondary outcomes also did not differ between the groups. Our findings indicate that calcium administered to SS patients might reduce their hemodynamic stabilization, but only for a short time after its administration. © 2015 by Okayama University Medical School.

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