Kagawa Rosai Hospital

Kagawa, Japan

Kagawa Rosai Hospital

Kagawa, Japan
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Maehara T.,Kagawa Rosai Hospital | Moritani S.,Okayama Saiseikai General Hospital | Ikuma H.,Kagawa Rosai Hospital | Shinohara K.,Kagawa Rosai Hospital | Yokoyama Y.,Kagawa Rosai Hospital
Injury | Year: 2013

Objective: This study was designed to evaluate the frequency of intraoperative complications associated with titanium locking compression plate (LCP) removal. Design: Retrospective study. Methods: Medical records were reviewed for surgical technique, plate types used, position and number of screws, time from internal fixation to plate removal, and intraoperative complications. Radiographs were reviewed to evaluate the position of the plates and screws and the accuracy of the screw direction. Mann-Whitney and Yates Chi-square tests were calculated with the level of significance at P < 0.05. Results: All LCPs could be removed. Of the 342 locking head screws (LHSs), a total of 21 (6.1%) screws, 3 (2.0%) 5.0 mm screws (3/153) and 18 (10.7%) 3.5 mm screws (18/169), were difficult to remove. The frequency of difficulty associated with the 3.5 mm LHSs was significantly higher than that of the 5.0 mm LHSs (P < 0.01). The frequency of difficulty associated with the removal of LHSs at the diaphysis was higher than that of LHSs at the epiphysis (P < 0.01), especially with 3.5 mm LHSs. The mean age was significantly lower in the patients in whom removal was difficult (P < 0.05). Our analysis revealed that the frequency of removal difficulty was high when a 3.5 mm LHS was inserted into the diaphysis of young patients. Conclusions: We should recognize that the removal of LCPs can involve numerous problems and great care should be exercised, especially in cases involving 3.5 mm LHSs. © 2013 Elsevier Ltd.

Sakai A.,University of Occupational and Environmental Health Japan | Oshige T.,University of Occupational and Environmental Health Japan | Zenke Y.,Kagawa Rosai Hospital | Yamanaka Y.,University of Occupational and Environmental Health Japan | And 2 more authors.
Osteoporosis International | Year: 2010

Unipedal standing time was shorter and bone mineral density was lower in Japanese women aged 50 years and over with low-energy distal radius fractures resulting from falls than those in age-matched community-dwelling Japanese women without distal radius fractures. Introduction: The aim of this study was to compare unipedal standing time and bone mineral density (BMD) of women ≥50 years of age with distal radius fractures with those of age-matched women without fractures. Methods: Fracture group was 54 Japanese women with low-energy distal radius fractures resulting from fall. Non-fracture group was 52 community-dwelling Japanese women without fractures. Unipedal standing time and BMD were measured. Results: There were no significant differences in age and body mass index between the two groups. The percentage of women with unipedal standing time <15 s was 44.4% in the fracture group and 13.5% in the non-fracture group, while the respective frequencies for >120 s were 20.4% and 50.0%. The T-score of BMD was significantly lower in the fracture than non-fracture group. Logistic regression analysis identified unipedal standing time <15 s and T-score <70% as significant factors associated with distal radius fractures. Notably, T-score <70% was significant in subjects <65 years, and unipedal standing time <15 s was significant in those ≥65 years. Conclusion: Unipedal standing time was shorter and BMD was lower in women ≥50 years of age with distal radius fractures than those in age-matched women without fractures. © 2009 International Osteoporosis Foundation and National Osteoporosis Foundation.

Zenke Y.,University of Occupational and Environmental Health Japan | Zenke Y.,Kagawa Rosai Hospital
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2013

Currently, volar locking plates are commonly used to treat distal radius fractures (DRF) because of their stable biomechanical construct and because they cause less soft tissue disturbance and allow early mobilisation of the wrist. Complications such as rupture of tendons have been reported to occur with use of volar locking plates. We describe six cases of rupture of extensor pollicis longus (EPL) tendons after the use of volar locking plates. EPL tendon injuries occurred in 2.1% (6/286) of cases after DRF surgery. The causes of EPL rupture after DRF surgery were protrusion of the head tip and insufficient reduction of the dorsal roof fragment of the distal radius. These were considered iatrogenic problems. The cause of EPL rupture was unknown in three cases. We should be extremely careful when determining optimum screw length and reducing displaced dorsal roof fragments to prevent damaging the EPL tendons.

Okano M.,Okayama University of Science | Fujiwara T.,Okayama University of Science | Kariya S.,Okayama University of Science | Haruna T.,Okayama University of Science | And 5 more authors.
Journal of Allergy and Clinical Immunology | Year: 2015

Background Recent studies have revealed that Staphylococcus aureus and its components participate in the pathogenesis of eosinophilic airway diseases, such as chronic rhinosinusitis with nasal polyps. Objective We sought to determine whether staphylococcal protein A (SpA) from S aureus regulated cellular responses in nasal polyps, especially when coupled to immunoglobulins in immune complexes (ICs). Methods Dispersed nasal polyp cells (DNPCs) or peripheral blood monocytes were cultured in vitro with SpA in the presence or absence of IgG, and IL-5, IL-13, IFN-γ, IL-17A, and IL-10 levels were measured in the supernatants. The effect of SpA exposure on staphylococcal enterotoxin B-induced cytokine production by DNPCs in the presence and absence of IgG, IgA, and autologous serum was also examined. Results Exposure to SpA induced DNPCs to produce significantly higher IL-10, IL-13, and IL-17A levels than DNPCs without SpA, although the magnitude of the IL-17A increase was less than that of IL-10 and IL-13. SpA induced IL-10 production mainly from adherent DNPCs, and this was significantly enhanced in the presence of IgG; similar results were observed in peripheral blood monocytes. IC formation between SpA and IgG (SpA-IgG ICs) was confirmed by using native polyacrylamide gel electrophoresis. SpA-IgG ICs, but not SpA alone, almost completely suppressed staphylococcal enterotoxin B-induced IL-5, IL-13, IFN-γ, and IL-17A production by DNPCs; similar inhibition was observed in DNPCs treated with SpA in the presence of either IgA or autologous serum. Conclusions Our results suggest that SpA can regulate the pathogenesis of enterotoxin-induced inflammation in patients with chronic rhinosinusitis with nasal polyps through coupling to immunoglobulins. © 2015 American Academy of Allergy, Asthma & Immunology.

Zenke Y.,Kagawa Rosai Hospital | Zenke Y.,University of Occupational and Environmental Health Japan | Sakai A.,University of Occupational and Environmental Health Japan | Oshige T.,University of Occupational and Environmental Health Japan | And 4 more authors.
Journal of Orthopaedic Trauma | Year: 2011

Objectives: The purpose of this study was to compare the postoperative radiologic and clinical outcomes of conventional plate osteosynthesis (C) with minimally invasive plate osteosynthesis (M) using a transverse skin incision without cutting the pronator quadratus muscle for distal radius fractures. Design: Retrospective consecutive cohort with prospective data collection. Setting: One community teaching hospital. Surgical treatment was performed by a single surgeon. Patients: Sixty-six patients (C group, 36; M group, 30) underwent open reduction and internal fixation of dorsally displaced distal radius fractures with the volar locking plating system from June 2006 to August 2008. Their mean age was 63.5 years and the mean follow-up period was 22.7 months. Main Outcome Measures: Radiologic parameters (volar tilt, radial inclination, ulnar variance), range of motion, grip strength, and Disability of the Arm, Shoulder, and Hand score were evaluated at each examination. The visual analog scale of wrist pain and evaluations of cosmetic problems were assessed at the final follow-up. Results: The groups did not differ significantly in all main outcomes. In the M group, the mean values of the Disability of the Arm, Shoulder, and Hand score at 2 weeks postoperatively (P = 0.06) and visual analog scale (P = 0.07) were lower and the mean value of the patient's satisfaction score of cosmetic problems (P = 0.08) was higher than those in the C group, but no statistically significant differences were apparent in these values. Conclusion: No significant differences were found between the minimally invasive plate osteosynthesis and conventional plating for distal radius fractures based on the data from postoperative radiologic and clinical outcomes. Copyright © 2011 by Lippincott Williams & Wilkins.

Ikuma H.,Kagawa Rosai Hospital
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society | Year: 2012

To describe a technique for C2 lamina reconstruction using locking miniplates for the extirpation of spinal tumors in the craniocervical junction. Many spinal surgery cases in which lamina reconstructions have been performed using non-locking miniplates have been reported. However, there is only one report of the use of locking miniplates for lamina reconstruction in spinal tumor cases. We performed C2 lamina reconstructions using locking miniplates in a patient with a spinal tumor and another with a cystic lesion. The clinical and radiologic features of both cases are reported, and the surgical technique is described. A 62-year-old female and a 30-year-old male were diagnosed with meningioma and a neurenteric cyst, respectively, in the craniocervical junction. Extirpation of these lesions was performed in combination with C2 lamina reconstruction and reattachment of the paraspinous muscle to the C2 spinous process. A follow-up examination at 1 year postoperatively demonstrated no significant change in the sagittal alignment of the cervical spine and a good postoperative course in both cases. Bony fusion was detected in both cases, and no implant failure occurred in either case. This procedure results in rigid fixation of the reimplanted C2 lamina and helps to restore the paraspinous muscles. For these reasons, it appears to be a useful surgical procedure for spinal tumors requiring C2 laminectomy and does not cause postoperative kyphosis of the cervical spine.

PubMed | Kagawa Prefectural Central Hospital, Okayama Prefectural University, Okayama University of Science and Kagawa Rosai Hospital
Type: Journal Article | Journal: Allergology international : official journal of the Japanese Society of Allergology | Year: 2016

Vascular endothelial growth factor (VEGF) is known to be associated with the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). VEGF is produced by a variety of cells including fibroblasts. It was recently reported that prostaglandin (PG) ENasal polyp fibroblasts were established from nasal polyps. These fibroblasts were stimulated with serial dilutions of PGD5M of PGDPGD

PubMed | Kagawa Prefectural Central Hospital, Okayama University of Science and Kagawa Rosai Hospital
Type: Clinical Trial | Journal: Allergology international : official journal of the Japanese Society of Allergology | Year: 2016

Minimal persistent inflammation (MPI) contributes to hyperreactivity in allergic rhinitis. However, little is known regarding whether pre-onset activation of eosinophils and mast cells is present or not in Japanese cedar pollinosis (JCP). Furthermore, a prophylactic effect of intranasal corticosteroids on such MPI in JCP has not been investigated.We designed a double-blinded, randomized, placebo-controlled, crossover trial. Twenty patients with JCP were examined outside the pollen season (UMIN000008410). Nasal provocation with paper discs containing extracts of Japanese cedar pollen was performed once a day for 3 consecutive days. Onset of nasal symptoms was monitored over 15min after each provocation. The levels of eosinophil cationic protein (ECP) and tryptase in nasal secretions were examined. Fluticasone furoate nasal spray or placebo treatment was started one day before the first provocation.In the placebo group, 25% of the patients showed onset of nasal symptoms following provocation on the first day. In addition, 75% and 68% of the patients showed symptom onset on the second and third day of provocation, respectively. After the first provocation, the levels of ECP and tryptase in nasal secretions were significantly increased. These increases were seen not only in symptomatic but also in asymptomatic subjects in response to provocation, and the levels were similar between these subjects. Prophylactic treatment with fluticasone significantly suppressed the increase in nasal ECP and tryptase associated with repeated provocations.These results suggest that pre-onset activation of eosinophils and mast cells is present in experimental JCP, and that prophylactic treatment with intranasal corticosteroids has the potential to control such activation.

PubMed | Kagawa Rosai Hospital
Type: Journal Article | Journal: Neurologia medico-chirurgica | Year: 2016

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification and ossification of the soft tissues, mainly ligaments and entheses. The spines of patients with DISH generally become increasingly rigid and osteoporotic, and fractures may occur after even a relatively minor traumatic event such as a ground-level fall. Moreover, the prevalence of DISH may be rapidly increasing in affluent societies. Thus, awareness of this condition is becoming more important for neurosurgeons when assessing trauma patients. For the present article, a literature review was conducted to summarize the current clinical, pathogenetic, and therapeutic knowledge of this disease. Furthermore, current treatment strategies for DISH-related spine injuries are also reviewed. Although the recommended treatment for spinal injuries in DISH patients is surgical, mainly through long-segment posterior fusion, rather than conservative options, stable fractures without any associated neurologic deficits have often been successfully managed with immobilization alone. Percutaneous instrumentation and the use of teriparatide may be useful depending on the surgical risks and patient neurological status.

PubMed | Ishitoya ENT Clinic, Kansai Medical University, Kagawa Rosai Hospital, National Hospital Organization Sagamihara National Hospital and 2 more.
Type: Journal Article | Journal: Allergology international : official journal of the Japanese Society of Allergology | Year: 2016

IL-22 is an IL-10-family cytokine that regulates chronic inflammation. We investigated the role of IL-22 and its receptor, IL-22R1, in the pathophysiology of chronic rhinosinusitis with nasal polyps (CRSwNP).IL-22 and IL-22R1 protein and mRNA expression in NP and in uncinate tissues (UT) from CRS and non-CRS patients was examined using immunohistochemistry and real-time PCR, respectively. Dispersed NP and UT cells were cultured with the Staphylococcus aureus exotoxins, staphylococcal enterotoxin B and alpha-toxin, following which exotoxin-induced IL-22 levels and their association with clinicopathological factors were analyzed. Effects of IL-22 on MUC1 expression and cytokine release in NP cells were also determined.IL-22 and IL-22R1 in NP were mainly expressed in infiltrating inflammatory cells and in epithelial cells, respectively. IL-22 mRNA levels in NP were significantly higher than those in UTs from non-CRS patients whereas IL-22R1 levels were conversely lower in NPs. NP cells produced substantial amounts of IL-22 in response to exotoxins. Exotoxin-induced IL-22 production by NP cells significantly and negatively correlated with the degree of local eosinophilia and postoperative computed tomography (CT) score, whereas conversely it positively correlated with the forced expiratory volume in 1s (FEVThese data suggest that imbalance of IL-22/IL-22R1 signaling regulates the pathogenesis of CRSwNP, including local eosinophilia, via alteration of MUC1 expression.

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