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Nagoya-shi, Japan

Lee S.-H.,Kyung Hee University | Lee J.C.,Soonchunhyang University | Tauchi R.,Meijo Hospital | Daniel Riew K.,Columbia University
Spine | Year: 2016

Study Design. A retrospective study. Objective. To analyze the influence of the number of cervical fusion levels on total cervical motion and health-related quality of life (HRQoL) in patients with solid anterior cervical fusions (ACFs). Summary of Background Data. Few studies have analyzed the degree to which cervical range of motion (ROM) and HRQoL are affected by the number of cervical fusion segments. Methods. We analyzed a cohort of patients who underwent ACF for degenerative disc disease. To assess the clinical outcomes and HRQoL, preoperative, 1-and 2-year postoperative neck and arm pain, visual-analogue scale, neck disability index, and short form-36 were analyzed. Radiographically, C2-7 and C0-2 ROM, C2-7 sagittal vertical axis (SVA), and Kellgren grade of radiographic adjacent segment pathology (RASP) were evaluated. Results. A total of 105 patients (M:F=46:59, mean age of 51.4 yr) were enrolled. There were 36 patients who underwent single-level ACF (group 1), 41 patients who had a double level ACF (group 2), and 28 patients who underwent ACF involving 3 or more levels (group 3). There was no decrease in C2-7 motion in group 1, a mean 7-degree decrease in group 2, a mean 18-degree decrease in those who underwent a 3-level ACF, and a mean 22-degree decrease after 4-level ACF. The grade of RASP was not influenced by the number of fusion levels. All HRQoL parameters showed no significant correlation between number of fusion levels, cervical ROM, and SVA. Conclusion. Single-level ACF showed no decrease in total cervical motion; multilevel ACF decreased cervical motion by a mean of 7.8 degrees per segment of fusion. Progression of RASP showed no correlation with the number of fusion levels. HRQoLs were not influenced by the number of fusion levels, cervical ROM, or SVA after solid ACF. Level of Evidence: 3 © 2016 Wolters Kluwer Health, Inc. Source

Ichikawa S.,Meijo Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013

A 60-year-old male was referred to our hospital due to suspected chronic heart failure. He also had a symptom of ischemic heart disease. The multi-detector row computed tomography (MDCT) demonstrated the coronary-pulmonary artery fistula with a giant coronary aneurysm, which was partly thrombosed. Two abnormal arteries to the aneurysm and the outflow to the pulmonary artery were clearly detected. Intraoperative epicardial echocardiography revealed the complete interruption of blood flow and the thrombus formation in the coronary aneurysm, that was achieved just by ligation of 2 arteries under off-pump surgery. Generally, congenital coronary-pulmonary artery fistula has complex morphological variations. In this case, MDCT and epicardial echocardiography were useful for the surgical decision-making to avoid the residual and/or the recurrent fistula. Source

Jin C.X.,Jilin University | Hayakawa T.,Meijo Hospital | Ko S.B.H.,Nagoya University | Ishiguro H.,Nagoya University | Kitagawa M.,Nagoya University of Arts and Sciences
Internal Medicine | Year: 2011

Pancreatic stone protein (PSP; reported in 1979), pancreatitis-associated protein (PAP; 1984) and regenerating protein (Reg I; 1988) were discovered independently in the fields of the exocrine (pancreatitis) and endocrine (diabetes) pancreas. Subsequent analysis revealed that PSP and Reg I are identical and PAP belongs to the same protein family. PSP/Reg I and PAP share a selective and specific trypsin cleavage site and result in insoluble fibrils (PTP, PATP). Search for a functional role of PSP had led to the idea that it might serve as an inhibitor in pancreatic stone formation and PSP was renamed lithostathine. Inhibitory effects of lithostathine in stone formation have been questioned. Evidence so far obtained can support a lithogenic role rather than a lithostatic role of PSP. PAP and its isoforms have been investigated mainly regarding responses to inflammation and stress. Reg I and its isoforms have been examined on regeneration, growth and mitogenesis in gastrointestinal neoplastic diseases as well as diabetes. Evidence obtained can be applied in the prediction of prognosis and therapy for inflammatory and neoplastic diseases. © 2011 The Japanese Society of Internal Medicine. Source

Morse L.J.,University of California at San Francisco | Kawakami N.,Meijo Hospital | Lenke L.G.,Washington University in St. Louis | Sucato D.J.,Texas Scottish Rite Hospital for Children | And 2 more authors.
Spine | Year: 2012

Study Design. Retrospective comparative study. Objective. To report preoperative differences in the Scoliosis Research Society Outcomes Instrument (SRS-30) between multiple US ethnicities and native Japanese and Korean children with adolescent idiopathic scoliosis (AIS). Summary of Background Data. The SRS-24 was developed in a US cohort with AIS. Comparative studies using the SRS-24 between US and Japanese patients showed differences, suggesting that culture might affect functional outcome. Methods. Preoperative SRS-30 outcomes were collected from 1853 children with AIS from 6 different ethnic groups: US white (1234), black (213), Hispanic (78), and Asian (29), as well as native Japanese (192) and Koreans (107). Analysis of covariance of 4 SRS-30 domains (pain, appearance, activity, and mental) was compared between groups adjusting for differences in age, sex, major curve magnitude, and body mass index. Pairwise comparisons of the 4 SRS-30 domains were adjusted for multiple comparisons, using Bonferroni correction. A P value of less than 0.05 was considered significant. Results. Significant differences between ethnicities were found in all domains (P < 0.001). Whites reported more pain than Japanese or Koreans (Japanese = 4.52, Korean = 4.47, white = 4.04). Korean and Japanese patients had the lowest appearance scores (Japanese = 2.89, Korean = 2.73, US Asian = 3.55, Hispanic = 3.11, black = 3.47, white = 3.29). Koreans also had the lowest activity (Korean = 3.64, Japanese = 4.24, US Asian = 4.07, Hispanic = 4.02, black = 4.06, white = 4.16), mental (Korean = 3.70, Japanese = 4.23, US Asian = 4.05, Hispanic = 3.75, black = 4.03, white = 3.94), and total scores (Korean = 3.63, Japanese = 3.92, US Asian = 4.02, Hispanic = 3.75, black = 3.92, and white = 3.84). Conclusion. Culture and ethnicity influence SRS-30 outcomes in AIS. Whites reported more pain than Japanese and Koreans. Japanese and Koreans had the lowest appearance scores. Koreans additionally were distinguished by the lowest activity, mental, and total scores. These cultural and ethnic differences must be taken into account when counseling patients with AIS and studying functional outcomes. © 2012 Lippincott Williams & Wilkins. Source

Ichikawa S.,Meijo Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

A 69-year-old male with a history of total esophagectomy and substernal placement of the gastric tube for esophageal carcinoma was admitted due to an unstable angina. Cardiac catheterization revealed a severe stenosis just proximal to the left anterior descending coronary artery and a 75% stenosis of the right coronary artery. Intraaortic balloon pumping was started in the catheter laboratory. Off-pump coronary artery bypass grafting was performed through left thoracotomy. The left internal mammary artery could not be utilized as a bypass graft to the left anterior descending artery due to severe substernal adhesion. Percutaneous coronary intervention was selected for the revascularization of the right coronary artery lesion. Source

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