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Seike T.,Tokushima University | Hashimoto I.,Tokushima University | Matsumoto K.,Taoka Hospital | Tanaka E.,Tokushima University | Nakanishi H.,Tokushima University
Journal of Medical Investigation | Year: 2012

Background: Alveolar bone grafting is a standard procedure used to achieve good occlusion for both functional and aesthetic purposes in patients with cleft lip and palate. At the past, main methods used to evaluate bone bridge formation after bone grafting are radiographs, such as dental, occlusal, and panoramic. Purpose: To evaluate bone bridge both qualitatively and quantitatively, we used CT scans (conventional and QCT). Quantitative computed tomography (QCT) has previously been used for measuring bone mineral density of the lumbar vertebrae. Patients and methods: The study comprised 26 male and 15 female patients who underwent alveolar bone grafting. We analyzed bone bridge with regard to four factors: marginal bone level, vertical height, anteroposterior bone width and bone mineral density using dental radiographs, and CT scans such as conventional and QCT. The clinical results of orthodontic treatment were evaluated more than 2 years postoperatively. Results: Orthodontic treatment was considered to be successfulwhen the bone bridge satisfied the following criteria: marginal bone level≧3, vertical height 6.5 mm, anteroposterior bone width≧ 5 mm, and bone mineral density <350 mg Ca 5 (PO 4) OH/mL. Conclusion: we could predict the prognosis of patients' orthodontic treatment in early stage after bone grafting.


Katayama K.,Anan Medical Associatiori Ceriter Hospital | Nishino T.,Anan Medical Associatiori Ceriter Hospital | Takahashi Y.,Anan Medical Associatiori Ceriter Hospital | Tanaka T.,Anan Medical Associatiori Ceriter Hospital | And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2013

Carcinomatous peritonitis may develop after operation for gastric cancer. As ascites are difficult to control, especially for gastric cancer postoperative carcinomatous peritonitis, many cases are difficult to treat. The present case was a female patient with carcinomatous peritonitis that occurred 2 years post-surgery. Administration of docetaxel (DOC) and S-1 combination therapy achieved a complete response. However, she had a relapse of carcinomatous peritonitis 3 years post-surgery. She underwent bypass operation, followed by DOC and S-1 combination therapy again. She achieved a good quality of life for more than two years. As side effects in patients worsen with the repeated exposure to chemotherapy, continuing the same treatment is difficult. Therefore, we changed the therapy method to irinotecan (CPT-11)/cisplatin (CDDP) therapy, weekly paclitaxel (PTX) and methotrexate (MTX)/5-fluorouracil (5-FU) therapy, and bypass operation when necessary. Rapid progression of her condition was sequentially suppressed, allowing her to continue her everyday life. Overall, this treatment method provided survival benefits of approximately four years following the recurrence of carcinomatous peritonitis.


Tashiro S.,Taoka Hospital | Miyake H.,Tokushima Municipal Hospital | Yoshioka K.,Taoka Hospital
European journal of Clinical and Medical Oncology | Year: 2011

Hepatic resection is a potential curative therapy for selected hepatic malignancies. However, reserving an appropriate volume of future liver emnant (FLR) hampers adequate surgical resection in many cases. In order to keep a sufficient volume of FLR and to conduct effective urgery at the same time, portal vein embolization (PVE) has been conducted to induce hypertrophy in the nonembolized FLR. Thus, we eviewed the related literatures to find the current status of PVE practice and to determine tumor growth in the embolized atrophic lobe and he nonembolized hypertrophic lobe. Although data from randomized controlled trials was lacking, currently reported cases indicate safety nd effectiveness of PVE. However, a consensus on the standard technique and appropriate patient selection has not yet been established. urthermore, the potential effects of PVE on tumor growth and proliferation should be fully elucidated. Nevertheless, PVE appears to be a afe technique that effectively decreases the risk of fulminant hepatic failure in patients requiring major hepatic resection. Future studies are ecessary to address appropriate patient selection for this technique and its optimal role in the multidisciplinary management of hepatic alignancies.


Ohnishi J.,Taoka Hospital
Sports Orthopaedics and Traumatology | Year: 2015

MRI findings were analyzed to determine their value in the differential diagnosis of tibial stress fractures and shin splints.The study subjects were the long-distance runners who complained of pain on the posteromedial side of the tibia. They had undergone plain radiographs and MRI.The diagnosis of stress fracture was possible if a patch-shaped high-intensity area distributed entirely or partially in the bone marrow was accompanied by thick periosteal edema in the posterior region. Shin splints presented no specific feature on MRI.MRI seems to be useful in the differential diagnosis of these conditions. © 2015.


Sumise Y.,Taoka Hospital | Yoshioka K.,Taoka Hospital | Yoshioka K.,Tokushima University | Okitsu N.,Taoka Hospital | And 8 more authors.
Journal of Medical Investigation | Year: 2013

Purposes: The purpose of this study was to verify the outcome of the emergency one stage resection and anastomosis procedure for patients with obstructed colorectal cancer. Methods: An emergency one stage resection and anastomosis procedure was performed for 40 patients with obstructive colorectal cancer. The outcome was verified and compared dividing into two groups. 17 patients under the age of 70 in (Group A), 23 patients 70 years and over in (Group B). Results: The operative mortality rate in both groups was 0%. As a result, postoperative complications were not significantly different between the two groups. The overall survival rate after a 5-year period in both groups was 41.8%, regarding all patients and the survival curves for the two groups, was not significantly different. The 5 year survival rate in stage II or III showed no differences between the two groups. Conclusion: The one-stage resection and anastomosis of the large bowel could be applied safely to emergency patients, which in turn allows for excellent shortterm operative results in both groups mentioned. This particular procedure should be positively enforced, even in elderly patients in their 70's.


Kamo H.,Taoka Hospital | Tashiro S.,Taoka Hospital | Tashiro S.,Tokushima University | Yoshioka K.,Taoka Hospital | And 7 more authors.
Journal of Medical Investigation | Year: 2015

Purposes : Pancreatoduodenectomy (PD) was performed for 6 periampullary cancer patients by using methods verified by quality randomized controlled trials (RCT) in a low-volume center (LVC). The purpose of this study was to verify the clinical results. Methods : No-touch pylorus-resecting pancreatoduodenectomy (PrPD), antecolic gastrojejunostomy, pancreatico-jejunostomy with a lost stent tube to the main pancreatic duct, and early removal of a prophylactic drain were performed. Results : The drain could be removed 4 days after operation, and no pancreatic fistula was observed in all cases. Solid food could be started on POD4 after removing the drain. Furthermore, postoperative systemic chemotherapy could be started earlier. Conclusion : Although we have only a few PD cases a year in our institution, PD can be conducted safely without complications by using the methods verified by quality RCTs. © 2015, University of Tokushima. All rights reserved.


PubMed | Taoka Hospital
Type: Journal Article | Journal: The journal of medical investigation : JMI | Year: 2013

The purpose of this study was to verify the outcome of the emergency one stage resection and anastomosis procedure for patients with obstructed colorectal cancer.An emergency one stage resection and anastomosis procedure was performed for 40 patients with obstructive colorectal cancer. The outcome was verified and compared dividing into two groups. 17 patients under the age of 70 in (Group A), 23 patients 70 years and over in (Group B).The operative mortality rate in both groups was 0%. As a result, postoperative complications were not significantly different between the two groups. The overall survival rate after a 5-year period in both groups was 41.8%, regarding all patients and the survival curves for the two groups, was not significantly different. The 5 year survival rate in stage II or III showed no differences between the two groups.The one-stage resection and anastomosis of the large bowel could be applied safely to emergency patients, which in turn allows for excellent short-term operative results in both groups mentioned. This particular procedure should be positively enforced, even in elderly patients in their 70s.


PubMed | Taoka Hospital
Type: Journal Article | Journal: The journal of medical investigation : JMI | Year: 2015

Pancreatoduodenectomy (PD) was performed for 6 periampullary cancer patients by using methods verified by quality randomized controlled trials (RCT) in a low-volume center (LVC). The purpose of this study was to verify the clinical results.No-touch pylorus-resecting pancreatoduodenectomy (PrPD), antecolic gastrojejunostomy, pancreatico-jejunostomy with a lost stent tube to the main pancreatic duct, and early removal of a prophylactic drain were performed.The drain could be removed 4 days after operation, and no pancreatic fistula was observed in all cases. Solid food could be started on POD4 after removing the drain. Furthermore, postoperative systemic chemotherapy could be started earlier.Although we have only a few PD cases a year in our institution, PD can be conducted safely without complications by using the methods verified by quality RCTs.


PubMed | Taoka Hospital
Type: Case Reports | Journal: Clinical journal of gastroenterology | Year: 2015

We describe a case of chylous ascites with strangulated ileus, and review all 22 cases (including our case) of chylous ascites with strangulated ileus reported in the English and Japanese literature. The patient we describe was a 51-year-old woman with medical history of radiotherapy for cervical cancer of the uterus 15months prior to being admitted to our hospital with abdominal pain after consuming a meal. A computed tomography (CT) scan revealed ascites, expansion of the small intestine, and whirl sign. Laparotomy revealed chylous ascites with an incarcerated internal hernia of the small intestine, which was released without intestinal resection. In our case the postoperative phase was uneventful, and as in the other 21 literature cases reviewed, treatment by either detorsion, release of the incarcerated internal hernia, or incision of the adhesion band without intestinal resection resulted in rapid improvement in the color of the intestine. It is considered that minimally invasive laparoscopic laparotomy should be selected as the treatment of first choice, because the degree of strangulation is slight in cases where chylous ascites is associated with strangulated ileus.


PubMed | Taoka Hospital
Type: Case Reports | Journal: The journal of medical investigation : JMI | Year: 2013

A 74-year-old male with abdominal pain was admitted to the emergency room in our hospital. The high value of serum amylase was shown in his blood test. The postcontrast computed tomography (CT) showed the huge retroperitoneal tumor with a thin-walled mass occupying most of the part of the right retroperitoneal space. The tumor spread into the soft tissues around the pancreas; as a result, the duodenum was compressed and the pancreas was displaced to the right side. The irregular pancreatic outline, obliterated peripancreatic fatty tissue and fluid in the left anterior pararenal space were revealed, so acute pancreatitis was diagnosed. The diagnostic biopsy of retroperitoneal tumor was done, and the pathological findings of retroperitoneal mass revealed dedifferentiated liposarcoma. The medical treatment against acute pancreatitis was performed firstly. After the patient recovered from that, the surgical resection of the tumor with the right kidney and right adrenal gland was completed successfully. The patient remained well, without any evidence of recurrence three months after surgery. However, the histology showed dedifferentiated liposarcoma; therefore, postoperative regular examination is necessary.

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