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Matsumoto S.,Saiseikai Yokohamashi Tobu Hospital | Sekine K.,Saiseikai Yokohamashi Tobu Hospital | Yamazaki M.,Saiseikai Yokohamashi Tobu Hospital | Sasao K.,Saiseikai Yokohamashi Tobu Hospital | And 5 more authors.
Journal of Trauma - Injury, Infection and Critical Care | Year: 2010

Background: We aimed to investigate the value of the diameter of the inferior vena cava (IVC) on initial computed tomography (CT) to predict hemodynamic deterioration in patients with blunt torso trauma. Methods: We reviewed the initial CT scans, taken after admission to emergency room (ER), of 114 patients with blunt torso trauma who were consecutively admitted during a 24-month period. We measured the maximal anteroposterior and transverse diameters of the IVC at the level of the renal vein. Flat vena cava (FVC) was defined as a maximal transverse to anteroposterior ratio of less than 4:1. According to the hemodynamic status, the patients were categorized into three groups. Patients with hemodynamic deterioration after the CT scans were defined as group D (n = 37). The other patients who remained hemodynamically stable after the CT scans were divided into two groups: patients who were hemodynamically stable on ER arrival were defined as group S (n = 60) and those who were in shock on ER arrival and responded to the fluid resuscitation were defined as group R (n = 17). Results: The anteroposterior diameter of the IVC in group D was significantly smaller than those in groups R and S (7.6 mm ± 4.4 mm, 15.8 mm ± 5.5 mm, and 15.3 mm ± 4.2 mm, respectively; p < 0.05). Of the 93 patients without FVC, 16 (17%) were in group D, 14 (15%) required blood transfusion, and 8 (9%) required intervention. However, of the 21 patients with FVC, all patients were in group D, 20 (95%) required blood transfusion, and 17 (80%) required intervention. The patients with FVC had higher mortality (52%) than the other patients (2%). Conclusion: In cases of blunt torso trauma, patients with FVC on initial CT may exhibit hemodynamic deterioration, necessitating early blood transfusion and therapeutic intervention. Copyright © 2010 by Lippincott Williams & Wilkins. Source

Suzuki N.,Scoliosis Center | Kono K.,Saiseikai Kanagawa ken Hospital
Studies in Health Technology and Informatics | Year: 2010

We applied a new surgical technique utilizing conventional hybrid instrumentation to achieve better correction of trunk deformity in adolescent idiopathic scoliosis. The purpose of this study is to introduce our "Super Hybrid Method" and to analyze the results at minimum 2-year follow-up. The technique consists of rib mobilization (2006), a rod rotation maneuver (1997) and a hook rotation maneuver (2007). Forty-four idiopathic cases (female: 43) with minimum 2-year follow-up were reviewed (24-39months, average 32). The average age at surgery was 20.4 years (12-57). The average pre-operative Cobb angle was 56.7 degrees (40-93). The average pre-operative rib hump was 23.2mm in height and 14.3 degrees by scoliometer. The average post-op Cobb angle was 13.3 degrees at 3 weeks and 18.1 degrees at follow-up. The average initial overall correction at 3 weeks post-op was 78% (83% for age<18, 73% for age ≤18) and 70% at later follow up (75% for age<18, 67% for age ≤18). The average rib hump 2 years post-operatively was 12.4mm in height and 7.3 degrees. Sixty nine percent of patients (18/26) with a pre-operative rib hump ≤20mm (20-49) had a decrease in hump height by more than 10mm (10-34). In Moiré analysis, the hump-sum measure (Suzuki) showed a statistically significant decrease from 13.4 preoperatively to 9.2 at 1 year post-op (p<0.001). Correction of deformity was excellent with our new technique. It is a less expensive procedure and carries little inherent risks. © 2010 The authors and IOS Press. All rights reserved. Source

Iida T.,Dokkyo Medical University | Suzuki N.,Scoliosis Center | Kono K.,Saiseikai Kanagawa ken Hospital | Ohyama Y.,Dokkyo Medical University | And 4 more authors.
Spine | Year: 2015

Study Design. A retrospective minimum 20-year follow-up study using 4 standard self-administered questionnaires, one of which, the SRS-22 was also administered to control groups. Objective. To evaluate long-term postoperative pain and other clinical outcomes of scoliosis correction and fusion surgery with Harrington instrumentation using Moe square-ended rods for better preservation of sagittal alignment. Summary of Background Data. Only a few long-term outcome studies have used standardized and validated self-administered tools, and no studies have established SRS-22 control data within their own population. There is no previous minimum 20-year followup evaluation after correction surgery preserving thoracic kyphosis and lumbar lordosis. Methods. Of 86 consecutive patients who underwent instrumentation surgery for scoliosis by a single surgeon, 61 patients participated using Japanese Orthopaedic Association, Roland- Morris Disability Questionnaire, Oswestry Disability Index, and Scoliosis Research Society (SRS-22) questionnaires and 51 patients were included in this study. Results were analyzed for pain and other clinical outcomes. A total of 771 hospital employees were sent SRS-22 questionnaires. A total of 763 responded, resulting in 2 control groups composed of nonscoliosis and untreated mild scoliosis controls of the same culture and language as the long-term follow-up group. Results. The prevalence of continuous low back pain was about 15%. Average Japanese Orthopaedic Association, Oswestry Disability Index, and Roland-Morris Disability Questionnaire scores at follow-up were 25 points, 7.3%, and 1.6, respectively. The average SRS-22 scores were 4.2 (function), 4.3 (pain), 3.7 (self-image), and 3.9 (mental health) for the postoperative follow-up group compared with 4.5 (function), 4.3 (pain), 3.5 (self-image), and 3.5 (mental health) for the nonscoliosis controls. Conclusion. Improved preservation of normal sagittal alignment resulted in a prevalence of low back pain comparable with the age-matched general population. Moreover, SRS-22 results for selfimage and mental health were positive compared with the controls, possibly refl ecting the surgeon's emphases on mental health and management of patient expectations. © 2015 Wolters Kluwer Health, Inc. Source

Hasegawa M.,Saiseikai Kanagawa ken Hospital | Ohara R.,Saiseikai Yokohamashi Tobu Hospital | Kanao K.,Saiseikai Yokohamashi Tobu Hospital | Nakajima Y.,Saiseikai Yokohamashi Tobu Hospital
Urological Research | Year: 2011

Prostatic calculi are classified into two types, endogenous and exogenous calculi, based on their origin. Endogenous calculi are commonly observed in elderly men; however, exogenous prostatic calculi are extremely rare. We report here the case of a 51-year-old man who suffered incontinence and pollakiuria with a giant exogenous prostatic calculus almost completely replacing the prostatic tissue. X-rays and computed tomography demonstrated a large calculus of 65 × 58 mm in the small pelvic cavity. The patient underwent a transurethral lithotripsy with a holmium-YAG laser and a total of 85 g of disintegrated stones was retrieved and chemical stone analysis revealed the presence of magnesium ammonium phosphate. The incontinence improved and the voiding volume increased dramatically, and no stone recurrence in the prostatic fossa occurred at the 2 years follow-up. The etiology of this stone formation seemed to be based on some exogenous pathways combined with urinary stasis and chronic urinary infection due to compression fracture of the lumbar vertebra. © 2010 Springer-Verlag. Source

Yamanaka K.,Saiseikai Kanagawa ken Hospital | Sasaki T.,Saiseikai Kanagawa ken 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: 2014

We treat radial neck fractures by a minimally invasive technique using bone paste. The indication of this technique is radial neck fractures in which the continuity with the radius shaft is retained. We have treated 13 patients using this technique. As a result, the average range of motion of the elbow was 90° for supination and 92° for pronation, +5° for extension, and 141° for flexion. The reduced position at surgery was kept unchanged until bone union. None of the patients complained of pain. The surgical scar was unnoticeable. This technique is recommended surgery for the radial neck fractures when the indication is appropriate. Source

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