Niigata Medical Center

Niigata-shi, Japan

Niigata Medical Center

Niigata-shi, Japan
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PubMed | Niigata University, Niigata Medical Center and Hirosaki University
Type: Journal Article | Journal: Oncology reports | Year: 2016

Both the invasive growth types of colorectal cancer (CRC) and the number of myofibroblasts have been associated with histopathological factors such as lymph node and liver metastasis, and local recurrence. However, there are few studies, that have assessed the association between invasive growth type and myofibroblast distribution in CRC. We aimed to evaluate the relationship between the clinicopathological factors of CRC and two invasive growth types, the expanding and infiltrating types. We categorized 150cases of pT3 CRC into the expanding and infiltrating types and measured the myofibroblast density of three histological layers: the submucosa (SM), the muscularis propria (MP) and the subserosa(SS). We compared these two invasive growth types and analyzed the relationship between clinicopathological factors and myofibroblast density. Myofibroblast density was significantly higher in the infiltrating type than that in the expanding type (P<0.05). In the lymph node metastasis-positive group of the infiltrating type, myofibroblast density in MP was significantly higher than that in the lymph node metastasis-negative group (P<0.001). In the infiltrating type, the group with the higher level of lymphatic invasion had a significantly higher density of myofibroblasts in the MP than the group with the lower level of lymphatic invasion (P<0.01). These results suggest that myofibroblasts participate more in the infiltrating type compared with the expanding type of CRC. It would appear that myofibroblasts present in the MP play an important role in the malignant potential of the infiltrating type compared to the expanding type.

Saitoh A.,Niigata University | Aizawa Y.,Niigata University | Sato I.,Yoiko no Syounika Sato Clinic | Hirano H.,Saiseikai Niigata Daini Hospital | And 2 more authors.
Vaccine | Year: 2015

As compared with standard intramuscular and subcutaneous vaccines, intradermal (ID) vaccines elicit a more potent immune response in both adults and children, with equivalent dosage or antigen dose sparing.Recently, various devices for ID injection have been developed; the length of needles ranges in 0.6-1.5. mm. However, skin thickness must be measured to determine optimal needle length for ID vaccines. Use of ID vaccines in infants and children is appealing because children require more vaccines than do adults; however, information on skin thickness in infants and children is limited. We used ultrasound echography to measure skin thickness in Japanese infants aged 2 months (. n=. 78) and adolescents aged 13-15 years (. n=. 82). Mean (range) deltoid and suprascapular skin thickness was 1.67. mm (1.16-2.39. mm) and 1.83. mm (1.24-2.60. mm), respectively, in infants and 1.81. mm (1.25-3.00. mm) and 2.43. mm (1.51-3.95. mm), respectively, in adolescents. Among infants who underwent re-measurement of skin thickness at age 6 months (. n=. 11), mean deltoid skin thickness (1.84. mm) was significantly greater than at age 2 months (1.60. mm) (. P<. 0.001). In contrast, no significant difference was observed in suprascapular skin thickness (1.79. mm vs. 1.67. mm, respectively; P=. 0.17). Gender was not associated with skin thickness in either age group. Skin thickness was positively correlated with body weight in adolescents (. r=. 0.43, P<. 0.001 in deltoid region; r=. 0.30, P=. 0.01 in suprascapular region). In conclusion, this is the first study to evaluate skin thickness in different age groups of children, including at age 2 months. Skin thickness gradually increased from age 2 months to age 13-15 years, but no consistent trend was noted in analysis stratified by measurement site, gender, or age. These findings suggest that an appropriate length of ID device needle for infants and children is likely to be less than 1.2. mm and a special device with shorter length of needle is warranted for infants and children. © 2015 Elsevier Ltd.

Omori G.,Niigata University | Koga Y.,Niigata Medical Center | Tanaka M.,Niigata Institute for Health and Sports Medicine | Nawata A.,Alcare Co. | And 3 more authors.
Journal of Orthopaedic Science | Year: 2013

Background: Knee osteoarthritis (OA) is a multifactorial disease and strongly affected by mechanical factors. The aims of the present study were to assess validity and reliability of a new muscle strength measuring device, the Quadriceps Training Machine (QTM) and evaluate the relationship between quadriceps strength measured by QTM and radiographic knee OA by epidemiological survey. Methods: The isometric knee extension muscle strength of QTM was compared with BIODEX in 24 healthy adults. Then, the relationship between radiographic knee OA and quadriceps strength using QTM was investigated with 2,032 knees in 1,016 subjects by an epidemiological survey (Matsudai Knee Osteoarthritis Survey). Results: Significant correlation was observed between QTM and BIODEX (r = 0.69, 0.82). In the Matsudai Knee Osteoarthritis Survey, the prevalence of radiographic OA (grade II or higher upon Kellgren-Lawrence classification) was: 13, 36.9, 67.8, and 86.5 %, regarding women in their fifties, sixties, seventies, and eighties, respectively, and was 1.7, 13.4, 33.5, and 66.2 % regarding men, respectively. Quadriceps muscle strength declined following 50 years of age, and significant decline was observed in the their sixties and seventies. Quadriceps muscle strength of the OA group (grades II, III and IV) was significantly declined compared with that of the Non-OA group (grade-0 and I). Furthermore, the tendency of the muscle strength level to decline with the progression of knee OA grade was particularly observed between grade 0 and grade I in both men and women and between grade I and grade II in men. Conclusion: The relationship between radiographic knee OA and quadriceps strength was quantitatively evaluated by an epidemiological survey, and we found a correlation between knee OA and the decline in quadriceps strength. Furthermore, it was suggested that the decline in quadriceps muscle strength may be more strongly related to the incidence of knee OA than to its progression. © 2013 The Japanese Orthopaedic Association.

PubMed | Niigata University of Health and Welfare, Hokuetsu Hospital, Niigata University and Niigata Medical Center
Type: Journal Article | Journal: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association | Year: 2016

Anterior cruciate ligament (ACL) injury often leads to symptoms of instability, which may cause meniscus injury, osteochondral lesions, and degenerative changes. For thorough evaluation of the effects of abnormal motion of ACL-deficient (ACLD) knees on the meniscus and articular cartilage, it is necessary to assess tibiofemoral motion in the medial and lateral compartments separately. Our aim was to determine if invivo three-dimensional (3D) dynamic motion of ACLD knees differs from that of contralateral uninjured knees by assessing knee motion in the medial and lateral compartments respectively.A total of 22 patients with an isolated ACL-injured knee were examined. 3D to two-dimensional registration was used to determine 3D knee motion during squatting from full knee extension to full flexion for both ACLD and contralateral uninjured knees. The knee motion was evaluated by the movement of the geometric center axis of the femur projected onto the tibial axial plane.In ACLD knees the lateral femoral condyle was located significantly more posteriorly during nearly full extension than in contralateral uninjured knees. The range of anteroposterior translation of the medial femoral condyle was significantly greater than those of contralateral uninjured knees. Almost all of the contralateral uninjured knees demonstrated medial pivot motion, while the ACLD knees showed higher variance.The ACLD knees exhibited a motion pattern different from those of contralateral uninjured knees with higher variance. During nearly full extension of the ACLD knees, the lateral femoral condyle translated posteriorly and the screw-home movement seemed to be impaired. The ACL might have an important role in maintaining normal knee function, especially during the early flexion phase. The larger range of anteroposterior translation of the medial femoral condyle in ACLD knees may be associated with a risk of secondary meniscal injury and degenerative change in the articular cartilage.Level IV.

PubMed | Niigata University of Health and Welfare, Niigata Institute for Health and Sports Medicine, Hokuetsu Hospital, Niigata University and Niigata Medical Center
Type: | Journal: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association | Year: 2017

The relative torsional angle of the distal tibia is dependent on a deformity of the proximal tibia, and it is a commonly used torsional parameter to describe deformities of the tibia; however, this parameter cannot show the location and direction of the torsional deformity in the entire tibia. This study aimed to identify the detailed deformity in the entire tibia via a coordinate system based on the diaphysis of the tibia by comparing varus osteoarthritic knees to healthy knees.In total, 61 limbs in 58 healthy subjects (age: 5418 years) and 55 limbs in 50 varus osteoarthritis (OA) subjects (age: 727 years) were evaluated. The original coordinate system based on anatomic points only from the tibial diaphysis was established. The evaluation parameters were 1) the relative torsion in the distal tibia to the proximal tibia, 2) the proximal tibial torsion relative to the tibial diaphysis, and 3) the distal tibial torsion relative to the tibial diaphysis.The relative torsion in the distal tibia to the proximal tibia showed external torsion in both groups, while the external torsion was lower in the OA group than in the healthy group (p<0.0001). The proximal tibial torsion relative to the tibial diaphysis had a higher external torsion in the OA group (p=0.012), and the distal tibial torsion relative to the tibial diaphysis had a higher internal torsion in the OA group (p=0.004) in comparison to the healthy group.The reverse torsional deformity, showing a higher external torsion in the proximal tibia and a higher internal torsion in the distal tibia, occurred independently in the OA group in comparison to the healthy group. Clinically, this finding may prove to be a pathogenic factor in varus osteoarthritic knees.Level .

Watanabe S.,Niigata University | Sato T.,Niigata Medical Center | Omori G.,Niigata University | Koga Y.,Niigata Medical Center | Endo N.,Niigata University
Journal of Orthopaedic Science | Year: 2014

Background: Rotational mismatch between femoral and tibial components has been recognized as a risk factor of unsuccessful total knee arthroplasty (TKA), but a main cause of rotational mismatch is uncertain. This study aims to evaluate rotational alignment of the knee by measuring both component rotation and version of the knee in TKA. Method: Fifty-one TKAs (mean age 73.7 years) were included in this study. The three dimensional, weight-bearing knee alignment was measured before and after TKA. A transepicondylar axis was referenced to femoral component rotation, and an anteroposterior axis of the tibia (middle of posterior cruciate ligament attachment to medial border of patella tendon attachment) was referenced to tibial component rotation. Knee rotational angle was defined as the angle between these two axes. Result: The mean preoperative knee rotation angle of 9.7° (±8.5°) internal rotation was significantly reduced to 1.8° (±7.3°) external rotation after TKA. Twenty-one of 51 knees (41 %) exhibited rotational mismatch (>10°) preoperatively, and this number was reduced to eight knees (16 %) post-TKA. The femoral component was rotationally aligned within 5° of neutral in all knees, while rotational alignment of the tibial component showed a high degree of variability (range 20.7° internal rotation to 17.2° external rotation). Conclusion: Rotational malposition of the tibial component was considered to be a main factor of rotational mismatch of the knee after TKA. © 2014 The Japanese Orthopaedic Association.

Tanifuji O.,Niigata University | Tanifuji O.,Niigata Medical Center | Sato T.,Niigata Medical Center | Kobayashi K.,Niigata University | And 5 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013

Purpose: The transepicondylar axis (TEA) has been used as a flexion axis of the knee and a reference of the rotational alignment of the femoral component. However, no study has showed dynamic normal knee kinematics employing TEA as the evaluation parameter throughout the full range of motion in vivo. The purpose of this study was to analyze dynamic kinematics of the normal knee through the full range of motion via the 3-dimensional to 2-dimensional registration technique employing TEA as the evaluation parameter. Methods: Dynamic motion of the right knee was analyzed in 20 healthy volunteers (10 female, 10 male; mean age 37.2 years). Knee motion was observed as subjects squatted from standing with knee fully extended to maximum flexion. The following parameters were determined: (1) Anteroposterior translations of the medial and lateral ends of the TEA; and (2) changes in the angle of the TEA on the tibial axial plane (rotation angle). Results: The medial end of the TEA demonstrated anterior translation (3.6 ± 3.0 mm) from full extension to 30° flexion and demonstrated posterior translation (18.1 ± 3.7 mm) after 30°, while the lateral end of the TEA demonstrated consistent posterior translation (31.1 ± 7.3 mm) throughout knee flexion. All subjects exhibited femoral external rotation (16.9 ± 6.2°) relative to the tibia throughout knee flexion. Conclusion: Compared to previously used parameters, the TEA showed bicondylar posterior translation from early flexion phase. These results provide control data for dynamic kinematic analyses of pathologic knees in the future and will be useful in the design of total knee prostheses. © 2012 Springer-Verlag.

Kai S.,Niigata University | Sato T.,Niigata Medical Center | Koga Y.,Niigata Medical Center | Omori G.,Niigata University | And 3 more authors.
Journal of Biomechanics | Year: 2014

Automated methods for constructing patient-specific anatomical coordinate systems (ACSs) for the pelvis, femur and tibia were developed based on the bony geometry of each, derived from computed tomography (CT). The methods used principal axes of inertia, principal component analysis (PCA), cross-sectional area, and spherical and ellipsoidal surface fitting to eliminate the influence of rater's bias on reference landmark selection. Automatic ACSs for the pelvis, femur, and tibia were successfully constructed on each 3D bone model using the developed algorithm. All constructions were performed within 30. s; furthermore, between- and within- rater errors were zero for a given CT-based 3D bone model, owing to the automated nature of the algorithm. ACSs recommended by the International Society of Biomechanics (ISB) were compared with the automatically constructed ACS, to evaluate the potential differences caused by the selection of the coordinate system. The pelvis ACSs constructed using the ISB-recommended system were tilted significantly more anteriorly than those constructed automatically (range, 9.6-18.8°). There were no significant differences between the two methods for the femur. For the tibia, significant differences were found in the direction of the anteroposterior axis; the anteroposterior axes identified by ISB were more external than those in the automatic ACS (range, 17.5-25.0°). © 2013 Elsevier Ltd.

The patient was a 78 year-old female with chronic hepatitis C and diagnosed with HCC. TAE was performed five times via the hepatic artery and PEIT three times. But no treatment effect was obtained and the hepatic artery was obstructed due to repeated TAE. Via the 11th intercostal artery which was an extrahepatic collateral feeding artery of HCC, doxorubicin 30 mg, mitomycin C 8 mg and lipiodol 1 ml were injected. After some time, redness and pain appeared in the right abdomen and back. Four weeks later, skin ulcer and necrosis developed. We suspected that the density of the anticancer drug in the vessel increased more than usual by the embolic material after the TAE via the 11th intercostal artery in the part where the microcirculation problem existed due to radiation, and a severe skin injury developed. We should keep in mind that anti-cancer drugs and embolic materials may cause skin injury after TAE via the intercostal artery especially in the part radiated repeatedly.

Kudo H.,Niigata Medical Center
Japanese Journal of Plastic Surgery | Year: 2011

A 60-year-old man presented with adenoid cystic carcinoma of the skin of his lower leg. Adenoid cystic carcinoma (ACC) is uncommon but usually occurs from the salivary gland, mammary gland, bronchus, lacrimal gland, uterine cervix, prostate or ear canal. ACC of the skin is rare and is usually seen in the head and neck area, but only 1 case that occurred from the lower leg has been reported on examination of domestic and foreign literatures. He underwent a wide resection and the tissue defect was reconstructed with a distally based sural flap. As more than half of patients will develop local recurrence and some patients with distant metastasis are reported even after a long-term interval, we must be careful to prevent overlooking such cases for long periods of time.

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