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Watanabe S, Morimoto H, Futagami D, Mukai S. Removal of a left ventricular thrombus complicated by cardiac sarcoidosis using a 3D microscope system. BMJ Case Rep 2023; 16:e253905. [PMID: 38087486 PMCID: PMC10729194 DOI: 10.1136/bcr-2022-253905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 12/18/2023] Open
Abstract
A woman in her 60s was brought to the previous hospital with respiratory distress. She was referred for the treatment of severe cardiac dysfunction and a mobile mass in the left ventricle. Echocardiography revealed the mass to be of 20×11 mm in size, mobile and slightly attached to the left ventricle by a stalk. As MRI had already revealed a small cerebral infarction, we have decided to perform emergency thrombectomy of the left ventricle. As the left ventricular contractility was diffusely impaired, we were able to remove the mass without any residuals using a transseptal approach without a left ventricular incision using a three-dimensional microscope system. The pathological diagnosis of the mass was thrombus, and subsequent close examination led to the diagnosis of cardiac sarcoidosis. We report the surgical technique and removal of a left ventricular thrombus complicated by cardiac sarcoidosis.
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Affiliation(s)
- Saeki Watanabe
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
| | - Hironobu Morimoto
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
| | - Daisuke Futagami
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
| | - Shogo Mukai
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Hiroshima, Japan
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Todoriki K, Kai Y, Mukai S, Murata S. Validating Knee Varus Alignment Measurements Using Markerless Motion Capture. Geriatrics (Basel) 2023; 8:109. [PMID: 37987469 PMCID: PMC10660526 DOI: 10.3390/geriatrics8060109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/09/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
This study aimed to determine the validity of specific knee varus alignment measurement methods. We measured the femorotibial angle (FTA) using radiography and optical motion capture and validated the FTA measurement using markerless motion capture. The subjects included 34 legs of 19 patients with knee osteoarthritis (OA). One-way analysis of variance and multiple comparison tests were used to compare the FTA values between the Kellgren-Lawrence classification (KL) and Pearson's correlation coefficient for validity. The analysis showed that the FTA measured by markerless motion capture had a significant correlation to the FTA measured by radiography (r = 0.869, p < 0.01) and significantly increased with increasing KL (p < 0.05). These results indicate that markerless motion capture is a valid outcome measure for varus alignment in patients with knee OA.
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Affiliation(s)
- Kensuke Todoriki
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Yoshihiro Kai
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (Y.K.); (S.M.)
| | - Shogo Mukai
- Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto 612-0861, Japan;
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (Y.K.); (S.M.)
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Nakagawa Y, Mukai S, Miyata M, Minami K, Hattori Y, Yamagishi H. Radiological Findings of the Lumbar Spine in High School and Collegiate Sumo Wrestlers. Orthop J Sports Med 2023; 11:23259671231206712. [PMID: 37941889 PMCID: PMC10629334 DOI: 10.1177/23259671231206712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/19/2023] [Indexed: 11/10/2023] Open
Abstract
Background Sumo wrestling is a traditional sport in Japan and becoming popular worldwide. Risk factors for lower back injuries in sumo wrestlers are heavier weight and larger body mass index (BMI). The mawashi (loincloth belt) worn by sumo wrestlers has been shown to restrict motion of the lumbar spine. Purpose To study the effects of sumo wrestling on the lumbar spine of high school and freshmen collegiate wrestlers, investigating the relationship between radiological findings, wearing of the mawashi during training, and lower back symptoms. Study Design Case series; Level of evidence, 4. Methods From 2001 to 2017, a total of 197 members of the Japanese Sumo Federation (55 high school and 142 college freshman students) underwent routine radiographic examination of their lumbar spines and answered a questionnaire regarding lumbar symptoms. Wrestlers were classified as symptomatic and asymptomatic based on responses to a custom questionnaire. We used the unpaired t test to evaluate patient demographics and the chi square test to analyze radiographic lumbar spine abnormalities between symptomatic and asymptomatic wrestlers. Results The wrestlers' mean height, weight, BMI, and duration in the sport were 174.0 ± 6.7 cm, 107.1 ± 22.4 kg, 35.2 ± 6.4, and 8.0 ± 3.2 years, respectively. There were 91 participants in the symptomatic group (46.2%) and 106 (53.8%) in the asymptomatic group. Ten wrestlers (5.1%) had osteophyte formations in the lumbar body; 8 of the 11 osteophytes (72.7%) appeared in the upper lumbar spine. Of the total, 48 wrestlers (24.4%) had deformities (Schmorl nodules) in the lumbar body, and 23 of 50 (46.0%) and 10 of 16 (62.5%) deformities were found in the upper lumbar spine of collegiate and high school wrestlers, respectively. Five wrestlers of the total 197 athletes (2.5%) had disc space narrowing in the lumbar body, with 3 of the 5 cases of disc space narrowing (60.0%) found in the upper lumbar spine. Spondylolysis in the lumbar body was found in 25 wrestlers (12.7%); 19 of the 91 symptomatic wrestlers (20.9%) had spondylolysis, compared with 6 of the 106 (5.7%) asymptomatic wrestlers (P = .0028). Conclusion Almost one-third of sumo wrestlers had ≥1 abnormal radiological finding in the lumbar spine. There was a significant relationship between symptomatic wrestlers and spondylolysis.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Masahiko Miyata
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kazufumi Minami
- Department of Orthopedic Surgery, International University of Health and Welfare, Tokyo, Japan
| | | | - Hiroya Yamagishi
- Department of Chest Surgery, Japanese Red Cross Fukui Hospital Fukui, Japan
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Nakagawa Y, Mukai S, Satomi K, Shinya Y, Nakamura R, Takahashi M. Autologous Osteochondral Grafts for Knee Osteochondral Diseases Result in Good Patient-Reported Outcomes in Patients Older Than 60 Years. Arthrosc Sports Med Rehabil 2023; 5:100774. [PMID: 37564902 PMCID: PMC10410132 DOI: 10.1016/j.asmr.2023.100774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/15/2023] [Indexed: 08/12/2023] Open
Abstract
Purpose This study aims to examine the clinical autologous osteochondral grafts (AOG) outcomes for knee osteochondral diseases at operative ages >60 years, and to determine whether patients are able to sit straight in Japanese style after AOG. Methods All patients who underwent AOG for knee osteochondral diseases between November 2001 and April 2018 were retrospectively identified. The inclusion criteria were AOG only without osteotomy, operative ages between 60 and 79 years, >2 years of follow-up, and involved femorotibial angle between 169° and 179° (normal alignment). Patients who underwent osteotomy to improve knee alignment and patients with inflammatory diseases such as rheumatoid arthritis were excluded. The patients' knee symptoms and their clinical outcome were evaluated according to the criteria of the knee scoring system of the Japanese Orthopedic Association (JOA), International Knee Documentation Committee (IKDC) subjective score, and the ability of straight sitting in Japanese style. Results This study enrolled 57 cases and 60 knee joints during the study period. The follow-up ratio was 85.1%. Moreover, 14 men and 43 women and 29 right and 31 left knee joints were included in this study. The mean operative age and mean follow-up period were 67.8 years (range 60-76 years) and 81.1 months (range 24-167 months), respectively. In addition, the study involved 30 cases and 32 knee joints (60s group), and 27 cases and 28 knee joints (70s group). Moreover, 34 cases and 36 knee joints had osteonecrosis (ON group), and 23 cases and 24 knee joints had cartilage injury (CI group). The IKDC subjective and JOA scores in both the 60s and 70s groups showed significant differences: 2 years after AOG >at the follow-up period, >at the preoperative period. The scores in both the CI and ON groups showed similar significant differences. Furthermore, 8.3% and 53.5% of the patients could sit straight in Japanese style at the preoperative period and 2 years after AOG, respectively. Conclusion Even if the patient's operative age was >60 years, the AOG only for their knee osteochondral diseases had good clinical outcomes, including the ability to sit straight in Japanese style. Level of Evidence IV, Therapeutic case series Key words: autologous osteochondral grafts, aged patients, clinical outcome, knee joint, straight sitting in Japanese style.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Kentaro Satomi
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Yuki Shinya
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Ryota Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Motoi Takahashi
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
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Nakagawa Y, Mori K, Mukai S, Shinya Y, Nakamura R, Takahashi M. Intraoperative Acoustic Evaluation of Living Human Knee Cartilage-Comparison with Respect to Cartilage Degeneration and Aging. Cartilage 2023; 14:261-268. [PMID: 36788438 PMCID: PMC10601570 DOI: 10.1177/19476035231154509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE The objective of the study was to evaluate the mechanical properties of living human knee cartilage using our ultrasonic device, and to compare the measurements with respect to cartilage degeneration and aging. DESIGN A total of 95 knees which had undergone arthroscopic knee surgery, from 88 patients, were included in the study, with informed consent. All procedures were reviewed and approved by the ethical committee of our hospital. In the study group, there were 41 men, 47 women, 39 right knees, and 56 left knees. The conditions primarily included knee osteoarthritis and anterior cruciate ligament rupture. The mean operative age was 44.1 years old (range = 10-83). We compared mechanical properties of the knee cartilage with respect to aging and gender, in comparison with normal cartilage. A P value of <0.05 represented statistical significance. RESULTS In the context of the International Cartilage Repair Society (ICRS) classification of cartilage degeneration (grade 0-3), the signal intensity in grade 0 was significantly larger than that in grade 1, 2, or 3. The thickness in grade 0 was significantly higher than that in grade 1, 2, or 3. Normal cartilage in older women had the lowest signal intensity and the least cartilage thickness among all the groups. CONCLUSION The ultrasonic system we developed was able to detect early degenerative changes in living cartilage in knees. The lowest signal intensity and least cartilage thickness in normal cartilage among older women were correlated to a large prevalence of knee osteoarthritis in women. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Kyoto, Japan
| | - Koji Mori
- Department of Applied Medical Engineering Science, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yuki Shinya
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Ryota Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Motoi Takahashi
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Nimura Y, Madeda Y, Tamura E, Kouyama Y, Matsudaira S, Nakamura H, Misawa M, Miyachi H, Baba T, Mukai S, Sawada N, Ishida F, Nemoto T, Kudo SE. Gastrointestinal: Real-time observation of rectal malignant lymphoma using endocytoscopy for differentiation from adenocarcinoma. J Gastroenterol Hepatol 2023; 38:1456. [PMID: 36863707 DOI: 10.1111/jgh.16155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Y Nimura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Y Madeda
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - E Tamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Y Kouyama
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S Matsudaira
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - H Nakamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - M Misawa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - H Miyachi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - T Baba
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S Mukai
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - N Sawada
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - F Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - T Nemoto
- Department of Diagnostic Pathology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S-E Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
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Watanabe S, Morimoto H, Harada T, Kitaura J, Futagami D, Mukai S. [Ruptured Thoracic Aortic Aneurysm Treated with Total Arch Replacement and Direct Transaortic Thoracic Endovascular Aortic Repair]. Kyobu Geka 2023; 76:604-607. [PMID: 37500547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Open stent grafting is an effective technique in surgery for treating-ruptured aortic aneurysms in the distal aortic arch, but it is not always applied as it depends on the shape of the aneurysm. In this case, the aneurysm was long in the distal aortic arch and sharply angulated into the descending aorta;thus, it was anticipated that an off-the-shelf open stent graft would not cover the ruptured area. Therefore, we used a stent graft device for thoracic endovascular aortic repair as an open stent and succeeded in saving the patient's life.
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Affiliation(s)
- Saeki Watanabe
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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8
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Kitaura J, Mukai S, Morimoto H, Futagami D, Furuta A. [Distal Anastomosis with Pleural Flap Wrap for Ruptured Acute Aortic Dissection]. Kyobu Geka 2023; 76:443-446. [PMID: 37258022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 69-year-old woman developed back pain was brought to our hospital. She was diagnosed with acute Stanford type B aortic dissection, and had a history of ascending aortic replacement for acute Stanford type A aortic dissection at another hospital 10 years before. In three days after admission, enhanced computer tomography (CT) revealed ruptured aortic dissection at the distal arch. Total aortic arch replacement was performed using the frozen elephant trunk technique. The Dacron polyester fabric prosthesis and aorta were anastomosed using the modified turn-up method at the distal anastomosis. Due to the fragility of the oesophageal side, the pleural flap was detached with the surrounding fatty tissue and transection was performed from the elephant trunk to the intima, adventitia, pleural flap, and felt strip. The use of an autologous pleural flap is a simple and effective method for controlling bleeding in a ruptured aortic dissection and for the distal anastomosis of fragile adventitia.
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Affiliation(s)
- Junya Kitaura
- Department Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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Nakagawa Y, Mukai S, Sakai S, Nakamura R, Takahashi M, Nakagawa S. Preoperative diagnosis of knee cartilage, meniscal, and ligament injuries by magnetic resonance imaging. J Exp Orthop 2023; 10:47. [PMID: 37079120 PMCID: PMC10119346 DOI: 10.1186/s40634-023-00595-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/07/2023] [Indexed: 04/21/2023] Open
Abstract
PURPOSE The purpose of the study was to report on the current accuracy measures specific to 1.5-Tesla MRI of the knee in the patient population prone to injuries of the anterior cruciate ligament (ACL), the menisci, and the articular cartilage. METHODS We accrued patients between January 2018 through August 2021 who underwent a preoperative MRI and were diagnosed with an articular cartilage injury either due to unevenness of articular cartilage in T2-weighted sequences or due to the irregularity of subchondral bone in T1-weighted sequences. All patients were treated arthroscopically. Sensitivity, specificity, and accuracy were calculated for the detection of ACL, meniscus, and cartilage injuries. A P-value of < 0.05 represented statistical significance. RESULTS One-hundred and forty-seven cases which included 150 knee joints were enrolled in this study. The mean age at the time of surgery was 42.9 years-old. The sensitivity in the diagnosis of ACL injuries was significantly greater than that in the diagnosis of cartilage injuries (P = 0.0083). The ratios of the equality of operative indication in 6 recipient sites were found to be between 90.0% and 96.0%. The diagnostic critical point was within a 1 cm in diameter. CONCLUSION The diagnostic sensitivity in cartilage injuries was significantly lower than ones of ACL and meniscal injuries. The ratios of the equality of operative indication was determined to be between 90.0% and 96.0%, if we consider the unevenness of articular cartilage or the irregularity of subchondral bone. LEVEL OF EVIDENCE Level III, Prospective diagnostic cohort study.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-Cho, Fushimi-Ku, Kyoto, 612-8555, Japan.
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Kyoto, Japan.
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Sayako Sakai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Ryota Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Motoi Takahashi
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Mukai S, Nakagawa Y, Nishitani K, Sakai S, Nakamura R, Takahashi M. Mosaicplasty With High Tibial Osteotomy for Knee Subchondral Insufficiency Fracture Had Better Magnetic Resonance Observation of Cartilage Repair Tissue Scores With Less Bone Marrow Edema and Better Plug Union and Less Plug Necrosis Compared With Mosaicplasty Alone. Arthroscopy 2023; 39:337-346. [PMID: 36064155 DOI: 10.1016/j.arthro.2022.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/20/2022] [Accepted: 07/28/2022] [Indexed: 02/09/2023]
Abstract
PURPOSE To determine the magnetic resonance imaging (MRI) findings after mosaicplasty (MOS) for knee subchondral insufficiency fracture (SIFK), and to analyze the relationship between MRI findings and clinical outcomes. METHODS We retrospectively reviewed the cases of consecutive patients who underwent MOS for SIFK with/without high tibial osteotomy (HTO) between January 1998 and December 2015. The MRI findings at 12 months after the surgery were assessed by the modified magnetic resonance observation of cartilage repair tissue (MOCART) score to determine the degree of bone marrow edema (BME), plug union, and plug necrosis. The clinical outcomes were assessed by Lysholm score to clarify the minimal clinically important difference (MCID) and patient acceptable symptom state analysis. RESULTS In total, 58 patients (17 men and 41 women) were enrolled in this study. Among them, 30 knees were treated by MOS alone and 28 knees were treated by MOS with HTO. The MOCART scores of patients who received MOS alone were significantly lower in BME score (P = .0060), plug union score (P = .0216), and in plug necrosis score (P = .0326) than patients who received MOS with HTO. BME lesion was less likely to persist among elderly (odds ratio 1.20, P = .0248) and female (OR 41.8, P = .0118) patients. The MCID of Lysholm score was 6.6 in MOS alone and 8.4 in MOS with HTO cases, but there were no significant association between MRI findings and the postoperative Lysholm score. CONCLUSIONS The MOS with HTO cases had better MOCART scores with less BME, better plug union, and less plug necrosis compared with MOS alone cases. Female and older patients had better resolution of BME, but there was no significant correlation between MRI findings and the postoperative Lysholm score. All cases in both groups showed improvement of Lysholm score exceeding MCID; thus, MOS may be effective as a joint preserving surgery for SIFK. LEVEL OF EVIDENCE Level IV, clinical case series.
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Affiliation(s)
- Shogo Mukai
- Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
| | - Yasuaki Nakagawa
- Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan; Department of Orthopedic Surgery, Kyoto University, Kyoto, Japan
| | - Sayako Sakai
- Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Ryouta Nakamura
- Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Motoi Takahashi
- Department of Orthopedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Tokutome M, Matsukawa R, Noma A, Kisanuki H, Nakashima H, Watanabe T, Sakemi T, Okabe K, Okahara A, Kawai S, Matsuura H, Masuda S, Mukai S. Aggressive combined pharmacotherapy for heart failure reduces new onset atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Backgrounds
Heart failure (HF) is a risk factor for new onset atrial fibrillation (AF), and the new onset AF is associated with a worse prognosis in HF patients. It has been reported that renin-angiotensin system inhibitor (RASi), β-blocker and mineral-corticoid receptor antagonist (MRA) prevent the new onset AF in HF patients. However, the effect of combined pharmacotherapy including angiotensin receptor neprilysin inhibitor (ARNI) and sodium glucose co-transporter 2 inhibitor (SGLT2i) on AF is unknown. We investigated the impact of contemporary regimen of combined pharmacotherapy for HF (RASi/ARNI+β-blocker+MRA+SGLT2i) on new onset AF.
Methods and results
We retrospectively studied rEF and mrEF patients without AF admitted to our hospital due to decompensated HF between 2015 and 2021 (n=366). Long-term (The mean follow-up was 635±421 days) incidence of new onset AF was investigated with regard to medical therapies. Patients were divided into 2 groups; patients with ≤2 HF drugs (n=181) and patients with ≥3 HF drugs (n=185). Patients with ≤2 HF drugs group were older (77.3 vs 67.0 years old, P<0.001), had a poorer renal function (Cre: 1.66 vs 1.09 mg/dl, P<0.001), and had a higher rate of ischemic heart disease (52 vs 38%, P=0.009), whereas left ventricular systolic function was better (EF: 31.9 vs 27.3%, P<0.001). There were 19 (10.5%) new onsets AF in the ≤2 HF drugs group, whereas only 7 (3.8%) had new onsets AF in the ≥3 HF drugs group (HR 0.36, 95% CI 0.15–0.85, P=0.01). All-cause death and hospitalization for HF were fewer in the ≥3 HF drugs group. A multivariate analysis revealed that ≥3 HF drugs use was an independent negative predictor of new onset AF (HR 0.37, 95% CI 0.15–0.93, P=0.03). Even after a propensity score matching of the clinical variables, the incidence of new onset AF was consistently fewer in the ≥3 HF drugs group (HR 0.36, 95% CI 0.13–0.99, P=0.04). Finally, patients with new onset AF had a higher rate of hospitalization for HF in the studied population (HR 9.68, 95% CI 5.67–16.5, P<0.01).
Conclusion
Aggressive combined pharmacotherapy for HF may be associated with fewer new onset AF in patients with HF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Tokutome
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - R Matsukawa
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - A Noma
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Kisanuki
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Nakashima
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Watanabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - T Sakemi
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - K Okabe
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - A Okahara
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - S Kawai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - H Matsuura
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - S Masuda
- Fukuoka Red Cross Hospital , Fukuoka , Japan
| | - S Mukai
- Fukuoka Red Cross Hospital , Fukuoka , Japan
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Nakagawa Y, Mukai S, Minami K, Hattori Y, Yamagishi H, Nakamura R. Radiological osteoarthritic knee joint changes in high school and collegiate sumo wrestlers: The observational study. Medicine (Baltimore) 2022; 101:e30642. [PMID: 36123914 PMCID: PMC9478220 DOI: 10.1097/md.0000000000030642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We examined the effects of sumo on their knee joints, and investigated the relationship between radiological changes and knee joints symptoms, and the relationship between knee radiological changes and the physical characteristics of the wrestlers. Fifty-six high-school and 128 college freshman sumo wrestlers who belonged to the Japanese Sumo Federation. To evaluate radiological changes in the knee joints of high-school and college freshmen sumo wrestlers. They underwent routine radiographic examination of their knee joints and were instructed to answer a questionnaire regarding their knee symptoms as a medical check. The mean height, weight, body mass index (BMI), and sumo career/experience of the participants were 174.1 cm, 106.9 kg, 35.1 kg/m2, and 7.9 years, respectively. Twenty-five high-school (44.6%) and 54 collegiate (42.2%) sumo wrestlers had some knee symptoms, which was significantly associated with sumo career as a risk factor. Five high-school (8.9 %) and 18 collegiate (14.1 %) sumo wrestlers had joint space narrowing. Considering the relationship between knee symptoms and radiological changes, significant correlations between osteophyte formation and bony sclerosis and knee symptoms were observed. According to the Kellgren-Laurence (KL) classification, 7 high-school (12.5%) and 26 collegiate (20.3%) sumo wrestlers were grade 2, 3, or 4. The risk factors of degenerative radiographic changes in the knee joints of the participants were heavyweight, large BMI, and older age. The knee osteoarthritic changes had already appeared in 12.5% high-school sumo wrestlers at the admission.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Japan
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Japan
- *Correspondence: Yasuaki Nakagawa, Clinical Research Center, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan (e-mail: )
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Japan
| | - Kazufumi Minami
- Department of Orthopaedic Surgery, International University of Health and Welfare, Japan
| | | | - Hiroya Yamagishi
- Department of Chest Surgery, Japanese Red Cross Fukui Hospital, Japan
| | - Ryota Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Japan
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Furuta A, Futagami D, Morimoto H, Kitaura J, Mukai S. Arteriovenous malformation with pseudoaneurysm on the left upper limb. Clin Case Rep 2022; 10:e6026. [PMID: 35846916 PMCID: PMC9272232 DOI: 10.1002/ccr3.6026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/02/2022] [Accepted: 06/25/2022] [Indexed: 11/12/2022] Open
Abstract
A 61‐year‐old woman developed a pulsatile mass on the left upper limb and was diagnosed with arteriovenous malformation with pseudoaneurysm. A two‐stage operation including ligation and resection of the aberrant branches and subsequent resection of the mass with revascularization was performed. Histological analysis suggested arteriovenous malformation and pseudoaneurysm.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery Fukuyama Cardiovascular Hospital Hiroshima Japan
| | - Daisuke Futagami
- Department of Cardiovascular Surgery Fukuyama Cardiovascular Hospital Hiroshima Japan
| | - Hironobu Morimoto
- Department of Cardiovascular Surgery Fukuyama Cardiovascular Hospital Hiroshima Japan
| | - Junya Kitaura
- Department of Cardiovascular Surgery Fukuyama Cardiovascular Hospital Hiroshima Japan
| | - Shogo Mukai
- Department of Cardiovascular Surgery Fukuyama Cardiovascular Hospital Hiroshima Japan
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Nakagawa Y, Mori K, Yamada S, Mukai S, Hirose A, Nakamura R. The Oral Administration of Highly-Bioavailable Curcumin for One Year Has Clinical and Chondro-Protective Effects: A Randomized, Double-Blinded, Placebo-Controlled Prospective Study. Arthrosc Sports Med Rehabil 2022; 4:e393-e402. [PMID: 35494290 PMCID: PMC9042777 DOI: 10.1016/j.asmr.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 10/23/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose The purpose of this study was to determine the clinical and chondroprotective efficacy and safety of orally administered Theracurmin in patients who underwent mosaicplasty for knee chondral or osteochondral diseases over 12 months of treatment. Methods We enrolled 50 patients, older than 20 years of age, who underwent mosaicplasty for their knee joint diseases. Theracurmin at 180 mg of curcumin per day or placebo was administered orally every day for 12 months. Because 7 patients dropped out of the study, 43 patients were examined; they included 14 men and 29 women and 24 right and 19 left knees. The mean operative age was 59.5 years (range, 24-84 years). We evaluated the Japanese Orthopaedic Association knee osteoarthritis score (JOA), visual analog scale (VAS), and Japanese Knee Osteoarthritis Measure (JKOM) as clinical symptoms; T2 mapping values using magnetic resonance imaging as an indication of the chondroprotective effect; and blood concentration of curcumin at 0, 3, 6, and 12 months after the operations. We performed intraoperative acoustic evaluation of articular cartilage as a measure of chondroprotective effect during the operations and second-look arthroscopy. Results The JOA, VAS and JKOM at 3, 6, and 12 months were significantly better than those during the preoperative period. However, the values of JOA, VAS and JKOM and T2 mapping were not significantly different between the Theracurmin and placebo groups. The blood concentration of curcumin in the Theracurmin group was significantly higher than that in the placebo group at 3, 6, and 12 months after the operations. Cartilage stiffness and surface roughness were significantly better in the Theracurmin group than in the placebo group at second-look arthroscopy. Conclusions The oral administration of Theracurmin for 1 year demonstrated significantly better chondroprotective effects and no worse clinical effects and adverse events than the placebo. Level of Evidence Level I, double-blinded, placebo-controlled, prospective study.
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Nakagawa Y, Mukai S, Nishitani K, Murata S, Satomi K, Shinya Y, Nakamura R. Autologous Osteochondral Grafts Result in Improved Clinical Outcomes in Patients With Early Knee Osteoarthritis. Arthrosc Sports Med Rehabil 2022; 4:e713-e719. [PMID: 35494285 PMCID: PMC9042906 DOI: 10.1016/j.asmr.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 12/16/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To determine whether autologous osteochondral grafts improve clinical outcomes in early knee osteoarthritis (EKOA) and whether the grafts prevent progression of radiographic joint degeneration. Methods In this study, we identified patients older than 40 years with EKOA having no traumatic events, with grade 0, 1, or 2 on the Kellgren-Lawrence (KL) classification and more than grade 3 of cartilage degeneration according to the International Cartilage Repair Society scale. Recipient sites were as follows: 14 patellofemoral (PF3) joint, 18 medial femoral condyle (M1), and 6 lateral femoral condyle (L2). Japanese Orthopedic Association (JOA) score and International Knee Documentation (IKDC) subjective score (SUB) were examined as clinical outcomes. Results The study included 31 knees in 31 patients who underwent autologous osteochondral grafts for EKOA and more than two years follow-up. The sample included 15 men and 16 women. The mean operative age was 56.0 years, and the mean follow-up period was 76 months (range, 24-170 months). In the preoperative period, JOA and SUB were 73.9 and 49.5, respectively. At follow-up, the JOA and SUB scores were 93.7 and 84.5, respectively. The differences were statistically significant. Progression of KL classification occurred in 0% of the PF3 group, 17% of the L2 group, and 33% of the M1 group. The outcomes of the M1 group significantly became worse (P = .0381) than those of the L2 and the PF3 groups, and the PF3 group significantly maintained good clinical outcomes (P = .0334). Conclusion Autologous osteochondral grafts for degenerated cartilage improved clinical outcomes of EKOA even if the recipient had cartilage degeneration, and not trauma. The PF3 group maintained significantly good clinical outcomes, and the M1 group became significantly worse.
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Affiliation(s)
- Yasuaki Nakagawa
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
- Address correspondence to Yasuaki Nakagawa, M.D., Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho Fushimi-ku, Kyoto 612-8555, Japan.
| | - Shogo Mukai
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Kentaro Satomi
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Yuki Shinya
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Ryota Nakamura
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
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Furuta A, Morimoto H, Mukai S, Futagami D, Kitaura J. Successful one-stage operation for type B acute intramural hematoma with descending aortic rupture. Clin Case Rep 2022; 10:e05267. [PMID: 35028151 PMCID: PMC8743423 DOI: 10.1002/ccr3.5267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/13/2021] [Accepted: 12/22/2021] [Indexed: 11/11/2022] Open
Abstract
A 76-year-old man who complained of back pain was referred to our hospital. Computed tomography revealed an intramural hematoma with a descending aortic rupture. Total arch replacement with the frozen elephant trunk technique and thoracic endovascular aortic repair was performed emergently in one stage. The patient was discharged without symptoms.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Hironobu Morimoto
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Shogo Mukai
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Daisuke Futagami
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Junya Kitaura
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
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Nakahata A, Ito A, Nakahara R, Kishimoto A, Imaizumi A, Hashimoto T, Mukai S, Nakagawa Y, Kuroki H. Intra-Articular Injections of Curcumin Monoglucuronide TBP1901 Suppresses Articular Cartilage Damage and Regulates Subchondral Bone Alteration in an Osteoarthritis Rat Model. Cartilage 2021; 13:153S-167S. [PMID: 34474599 PMCID: PMC8804728 DOI: 10.1177/19476035211043202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Curcumin monoglucuronide (TBP1901) is highly water soluble and can convert to free form curcumin, which has pharmacological effects, on intravenous administration. This study aimed to investigate the effectiveness of TBP1901 intra-articular injections in an osteoarthritis (OA) rat model. METHODS Sixty-four male Wistar rats (12 weeks old) who underwent destabilized medial meniscus (DMM) surgery were randomly separated into the TBP1901 injection or saline solution (control) injection group. They were sacrificed at 1, 2, 6, or 10 weeks postoperatively (weeks 1, 2, 6, and 10; n = 8 for each group). TBP1901 (30 mg/mL) or saline solution of 50 μL was injected into the knee joints twice a week during weeks 1 and 2 to investigate the effects in the acute phase of posttraumatic (PT) OA or once a week during weeks 6 and 10 to investigate it in the chronic phase of PTOA. Histology, immunohistochemistry, and micro-computed tomography were performed to evaluate the changes in OA. RESULTS TBP1901 injections significantly reduced synovial inflammation at weeks 1 and 2, and tumor necrosis factor-α expression in the articular cartilage at week 6. The TBP1901 injections also significantly suppressed articular cartilage damage, subchondral bone (SB) plate thickening, SB plate perforation, and osteophyte formation at week 10. CONCLUSIONS TBP1901 intra-articular injections suppressed synovial inflammation in the acute phase of PTOA in DMM rats. In the chronic phase, TBP1901 suppresses articular cartilage damage and regulates SB plate changes.
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Affiliation(s)
- Akihiro Nakahata
- Department of Motor Function Analysis,
Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku,
Kyoto, Japan
| | - Akira Ito
- Department of Motor Function Analysis,
Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku,
Kyoto, Japan
| | - Ryo Nakahara
- Department of Motor Function Analysis,
Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku,
Kyoto, Japan
| | | | | | | | - Shogo Mukai
- Department of Orthopedic Surgery,
National Hospital Organization, Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Yasuaki Nakagawa
- Department of Orthopedic Surgery,
National Hospital Organization, Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis,
Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku,
Kyoto, Japan,Hiroshi Kuroki, Department of Motor
Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto
University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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Nishitani K, Nakagawa Y, Kobayashi M, Nakamura S, Mukai S, Kuriyama S, Matsuda S. Long-Term Survivorship and Clinical Outcomes of Osteochondral Autologous Transplantation for Steroid-Induced Osteonecrosis of the Knee. Cartilage 2021; 13:1156S-1164S. [PMID: 32911970 PMCID: PMC8808826 DOI: 10.1177/1947603520954489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Treatments for steroid-induced osteonecrosis of the knee remains challenging, and there has not been sufficient evidence to support joint preservation surgery. This study evaluated long-term outcomes of osteochondral autologous transplantation (OAT) for steroid-induced osteonecrosis of the knee. DESIGN This retrospective case series included patients who underwent OAT for steroid-induced osteonecrosis of the knee from 1998 to 2008. The survivorship and need for secondary surgery were evaluated, and the clinical outcome was evaluated with the International Knee Documentation Committee (IKDC) subjective score. Preoperative and final Kellgren-Lawrence (KL) grade of the femorotibial and patellofemoral joints were individually evaluated. RESULTS Fourteen knees of 10 patients whose mean age was 32.5 (95%CI 26.4-38.6) years were included and followed for 14.0 (12.4-15.7) years. The mean lesion size of 6.9 (5.3-8.5) cm2 was repaired using 4 median (minimum 2, maximum 5) osteochondral plugs. No revision surgeries were performed for transplanted osteochondral plugs. The IKDC subjective score improved from 32.9 (24.5-41.3) to 74.2 (61.9-88.5) (P < 0.001). Knee flexion was improved at the final follow-up, and Seiza sitting was finally possible in 9 knees in 7 patients. Although the osteoarthritic change did not progress in femorotibial joint, patellofemoral joint showed early osteoarthritic changes at the final follow-up (mean KL grade: 0.8 [0.5-1.1]). CONCLUSIONS Prosthetic joint replacement was successfully avoided for at least the first decade by OAT in young patients with steroid-induced osteonecrosis of the knee. The progression of KL grade of the patellofemoral joint is of concern.
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Affiliation(s)
- Kohei Nishitani
- Department of Orthopaedic Surgery,
Graduate School of Medicine, Kyoto University, Kyoto, Japan,Kohei Nishitani, Department of Orthopaedic
Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho,
Sakyo, Kyoto, 606-8507, Japan.
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Masahiko Kobayashi
- Department of Orthopaedic Surgery, Kyoto
Shimogamo Hospital, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery,
Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery,
Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery,
Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Kitaura J, Mukai S, Morimoto H, Futagami D, Furuta A. [Florida Sleeve Technique Concomitant with Total Aortic Arch Replacement]. Kyobu Geka 2021; 74:1063-1066. [PMID: 34876534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 73-year-old man with chest pain was brought to our hospital. He was diagnosed with acute myocardial infraction (AMI) by coronary arteriogram and underwent emergent intervention. Enhanced computer tomography( CT) revealed thoracic aortic aneurysm extending from sinus of Valsalva to proximal aortic arch. Fifty days after the onset of AMI, we performed valve-sparing aortic root replacement with the Florida sleeve technique, total aortic arch replacement and coronary artery bypass grafting. Post operatively, the patient's recovery went well without any complications. In subsequent CT, sinus of Valsalva was shrunk from 47 mm to 38 mm. The Florida sleeve technique is simple, effective and could reduce surgical risks.
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Affiliation(s)
- Junya Kitaura
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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Nakagawa Y, Mukai S, Maeda T, Akamatsu S, Satomi K, Nakamura R. Midterm Outcomes of Autologous Osteochondral Graft Transplantation Only in the Femoral Condyle without Treating the Tibial Plateau with Subchondral Bone Exposed. Cartilage 2021; 13:1178S-1186S. [PMID: 33095027 PMCID: PMC8808809 DOI: 10.1177/1947603520967066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study aimed to examine the midterm clinical outcomes of autologous osteochondral grafts (AOG) that were performed in the femoral condyle without treating the tibial plateau with subchondral bone exposed, and to compare these outcomes with those of AOG used in patients with osteoarthritis (lateral type or medial type) or osteonecrosis. DESIGN The study included 6 men and 16 women and 11 right knees and 11 left knees. The mean operative age was 56.0 years (range, 21-76 years), and the mean follow-up period was 98.4 months (range, 60-164 months). Six patients had lateral type osteoarthritis (OAL), 7 had medial type osteoarthritis (OAM), and 9 had osteonecrosis (ON). The patients' knee symptoms as their clinical outcome were evaluated using the knee scoring system of the Japanese Orthopedic Association (JOA), and the International Knee Documentation Committee (IKDC) subjective score. RESULTS The postoperative clinical outcomes of the OAL and ON group were significantly better than their preoperative clinical scores and remained the same until the final follow-up. However, the clinical outcomes of OAM improved 2 years after AOG, but eventually decreased thereafter. The number of worse cases in the OAM group was significantly larger than those in the OAL and ON groups. CONCLUSION In these procedures, the postoperative clinical outcomes of the OAL and ON groups were significantly better than their preoperative clinical scores and were maintained for about 8 years. However, the clinical outcomes of OAM improved until 2 years after AOG, but eventually decreased thereafter.
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Affiliation(s)
- Yasuaki Nakagawa
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan,Yasuaki Nakagawa, Department of Orthopaedic
Surgery, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa
Mukaihata-cho Fushimi-ku, Kyoto, 612-8555, Japan.
| | - Shogo Mukai
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takahiro Maeda
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shota Akamatsu
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kentaro Satomi
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Ryota Nakamura
- Department of Orthopaedic Surgery,
National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Furuta A, Mukai S, Morimoto H, Kitaura J, Futagami D. Concomitant decalcification of the anterior mitral leaflet via the aortic annulus during aortic valve replacement for significant aortic and mitral stenoses. Clin Case Rep 2021; 9:e05119. [PMID: 34853686 PMCID: PMC8614090 DOI: 10.1002/ccr3.5119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 11/09/2022] Open
Abstract
An 82-year-old man undergoing regular hemodialysis with substantial aortic and mitral valve stenoses underwent aortic valve replacement with concomitant mitral decalcification via the aortic annulus. Postoperative transthoracic echocardiography showed reduced mitral stenosis. The patient was discharged on the 14th postoperative day uneventfully.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalFukuyamaJapan
| | - Shogo Mukai
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalFukuyamaJapan
| | - Hironobu Morimoto
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalFukuyamaJapan
| | - Junya Kitaura
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalFukuyamaJapan
| | - Daisuke Futagami
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalFukuyamaJapan
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Furuta A, Mukai S, Sato K, Morimoto H, Goto K, Futagami D, Kitaura J. [The Mid-term Results of Transapical Transcatheter Aortic Valve Implantation for Aortic Stenosis]. Kyobu Geka 2021; 74:174-180. [PMID: 33831868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We aimed to evaluate the results of transapical transcatheter aortic valve implantation (TAVI) for aortic stenosis. Thirty patients who had aortic stenosis and underwent transapical TAVI between 2016 and 2020 were enrolled. Medical records were reviewed, and the following data were retrieved and analyzed:basic demographic data, and intraoperative data and postoperative outcomes. Mean age was 85.8 years. There were 3 intraoperative complications (1 apex bleeding, 1 coronary stenosis and 1 mitral regurgitation). Extracorporeal membrane oxygenation was initiated due to unstable hemodynamics in two patients. One patient was converted to mitral valve replacement due to severe mitral regurgitation. There were 2 in-hospital complications (1 with sick sinus syndrome and 1 with cerebral infarction). One patient died of cerebral infarction and eventually, the 30-day mortality was 3%. Median observational period was 1.3 years. Three-year survival was 87.3%. Left ventricular ejection fraction increased by six months after the procedure and then, reached plateau. Left ventricular mass index decreased constantly throughout the observational period. Both parameters at one year after the procedure were significantly higher than preoperative ones. In conclusion, survival after transapical TAVI was favorable because of the low critical complication rate. Both left ventricular functional improvement and reverse remodeling were obtained.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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Tanaka Y, Nakamura S, Mukai S, Nishitani K, Yamada S, Matsuda S, Nakagawa Y. Domino osteochondral autograft transplantation for osteonecrosis of the knee and femoral head: A case based review. J Orthop Sci 2021; 26:196-199. [PMID: 30055878 DOI: 10.1016/j.jos.2018.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 04/12/2018] [Accepted: 06/07/2018] [Indexed: 02/09/2023]
Affiliation(s)
- Yoshihisa Tanaka
- Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Shigeru Yamada
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Kiyan W, Nakagawa Y, Mukai S, Ito A, Arai T, Kuroki H. Quantitative Parameters for the Degeneration in Cartilage and Subchondral Bone of Human Knee by 3-D Ultrasound Scanning System. Ultrasound Med Biol 2020; 46:3239-3248. [PMID: 32980159 DOI: 10.1016/j.ultrasmedbio.2020.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/27/2020] [Accepted: 08/24/2020] [Indexed: 06/11/2023]
Abstract
This study was aimed at investigating the use of ultrasound parameters obtained non-invasively through soft tissue (ST) to evaluate degeneration in cartilage and subchondral bone (SB) in the human knee. We developed a 3-D ultrasound system and introduced the ratio parameters Rcb and RcbT to suppress the attenuation effect in the ST or in both the ST and cartilage. As reference measurements, the grade for cartilage by visual judgment (Gsum) and ultrasound parameters for the cartilage and the SB were directly evaluated under arthroscopy. Rcb correlated significantly with Gsum (rs = -0.63) and with the corresponding parameter obtained directly under arthroscopy (r = 0.55). RcbT also correlated significantly with Gsum (rs = -0.46) but was not superior to Rcb. Rcb is considered to be an efficient parameter that reflects the total degeneration in both the cartilage and SB, including the information on cartilage thickness.
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Affiliation(s)
- Wataru Kiyan
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Researching Department, Furuno Electric Company, Ltd., Nishinomiya, Japan
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Fushimi-ku, Kyoto, Japan
| | - Akira Ito
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuo Arai
- Researching Department, Furuno Electric Company, Ltd., Nishinomiya, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Furuta A, Morimoto H, Mukai S, Futagami D, Kitaura J. [Giant Left Atrial Myxoma Complicated with Hemorrhagic Cerebral Infarction]. Kyobu Geka 2020; 73:905-909. [PMID: 33130711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 48-year-old woman developed paralysis of the left upper limb and dysarthria. Two days later, she was admitted to a local hospital due to no improvement of symptoms. Brain magnetic resonance imaging showed acute hemorrhagic cerebral infarction in the left nucleus basalis. Echocardiography demonstrated a large left atrial mass in the left atrium, shuttling between the left atrium and the left ventricle and moderate mitral regurgitation. Then, she was transferred to our hospital for surgery. Five days after the initial symptoms, resection of the left atrial mass was performed under total cardiopulmonary bypass. First, heparin sodium, and then nafamostat mesilate were used as intraoperative anticoagulation treatment. The left mitral mass was removed via an atrial septal incision and the defect was repaired using a bovine pericardium. The mitral valve was intact and there was no regurgitation. The mass was immunohistologically diagnosed as myxoma. Postoperative brain computed tomography scans demonstrated no exacerbation of the cerebral infarction. She was discharged 13 days after surgery without neurological symptoms.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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26
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Kegai S, Sato K, Goto K, Ozawa T, Kimura T, Kobayashi K, Kikuta Y, Taniguchi M, Hiramatsu S, Takebayashi H, Haruta S, Mukai S. TCT CONNECT-148 Impact of Foreshortening in SAPIEN 3 Balloon-Expandable Transcatheter Heart Valve Implantation. J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Furuta A, Morimoto H, Mukai S, Futagami D, Kitaura J. [Missing Floating Mass in the Ascending Aorta;Report of a Case]. Kyobu Geka 2020; 73:690-693. [PMID: 32879274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 65-year-old man, with a history of hypertension, presented with dizziness and emesis and was admitted to a local hospital. He was a moderate smoker, but he did not take any hormone-based medication. Magnetic resonance imaging showed scattered cerebral infarction in the bilateral cerebral hemisphere and right cerebellar hemisphere. There were no abnormal findings in Holter monitor and echography of heart, carotid artery, and leg vein and then, antiplatelet therapy was initiated. After that, both computed tomography and magnetic resonance imaging demonstrated a floating pedunculated mass in the ascending aorta measuring 10×8×14 mm. He was admitted to our hospital 15 days after the symptom onset. Laboratory tests including immunological and coagulation studies were within normal. Computed tomography showed on the second day of the admission that the mass spontaneously disappeared, thus canceling the schedule of surgery. He received an oral anticoagulant and discharged uneventfully. During a follow-up period of 6 months, there is no recurrence of the thrombus in the aorta and thromboembolic events.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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Nakagawa Y, Mukai S, Yamada S, Murata S, Yabumoto H, Maeda T, Akamatsu S. The Efficacy and Safety of Highly-Bioavailable Curcumin for Treating Knee Osteoarthritis: A 6-Month Open-Labeled Prospective Study. Clin Med Insights Arthritis Musculoskelet Disord 2020; 13:1179544120948471. [PMID: 32848491 PMCID: PMC7425263 DOI: 10.1177/1179544120948471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022]
Abstract
Background We previously developed a surface-controlled water-dispersible form of curcumin that we called Theracurmin®. The area under the blood concentration-time curve (AUC) of Theracurmin in humans was 27-fold higher than that of curcumin powder. Previously, we reported on the anti-inflammatory effects of Theracurmin for knee osteoarthritis. Hypothesis/Purpose We determined the clinical effects of orally administered Theracurmin in patients with knee osteoarthritis over a 6-month period. Study Design Open prospective study. Methods Fifty patients Kellgren-Lawrence grade II, III, or IV knee osteoarthritis who were above 40 years old were enrolled in this clinical study. Theracurmin containing 180 mg/day of curcumin was administered orally every day for 6 months. To monitor for adverse events, blood biochemistry analyses were performed before and after 6 months of each intervention. The patients' knee symptoms were evaluated at 0, 1, 2, 3, 4, 5, and 6 months based on the Japanese Knee Osteoarthritis Measure, the knee pain visual analog scale, and the knee scoring system of the Japanese Orthopedic Association. Results Five cases dropped out during the study, but no cases dropped out because of major problems. No major side effects were observed with Theracurmin treatment, including the blood biochemistry analysis results. The effective group included 34 cases (75.6%), while the not-effective group included 11 cases. Conclusion This study demonstrates the safety and good efficacy of Theracurmin for various types of knee osteoarthritis. Theracurmin shows great potential for the treatment of human knee osteoarthritis.
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Affiliation(s)
- Yasuaki Nakagawa
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Shigeru Yamada
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Satoru Murata
- Department of Orthopedic Surgery, Goshohigashi Clinic, Kyoto, Japan
| | - Hiromitsu Yabumoto
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Takahiro Maeda
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Shota Akamatsu
- Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
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Kitaura J, Mukai S, Morimoto H, Futagami D, Furuta A. [Rapid Expansion of Distal Aortic Arch Aneurysm with the Short Elephant Trunk;Report of a Case]. Kyobu Geka 2020; 73:453-456. [PMID: 32475972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 78-year-old female patient was introduced to our hospital with chief complaint of massive hemoptysis. She had a history of total arch replacement using a short elephant trunk for acute Stanford type A aortic dissection 3 years before. A contrast-enhanced computed tomography (CT) revealed kinking of the short elephant trunk and distal aortic arch aneurysm which caused aortobronchial fistula. She was treated by emergency thoracic endovascular aortic repair and long-term administration of antibiotics. Three years later, distal aortic arch aneurysm disappeared by CT and there was no recurrence of hemoptysis. This is the aortic aneurysm was considered to be caused by the short elephant trunk.
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Affiliation(s)
- Junya Kitaura
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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Furuta A, Morimoto H, Mukai S, Futagami D, Kitaura J. [Surgical Results for Left Ventricular Thrombus Formation after Myocardial Infarction]. Kyobu Geka 2020; 73:331-338. [PMID: 32398388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We aimed to review the surgical results of left ventricular restoration for left ventricular thrombus after myocardial infarction. A retrospective study was conducted on 5 patients who underwent thrombus removal and left ventricular restoration for left ventricular thrombus after myocardial infarction. Two patients were in an acute phase of myocardial infarction, and 3 in a chronic phase. Cerebral infarction occurred in 3 patients preoperatively. Median observational period was 1.0 year. Left ventricular thrombus removal with septal anterior ventricular exclusion technique was performed. Concomitant procedure included 3 coronary artery bypass graftings and 1 left ventricular apex ablation. There was no perioperative bleeding event. The 30-day mortality occurred in 1 patient. There has been no systemic embolic complication, left ventricular dysfunction, nor recurrence of left ventricular thrombus during the observational period. The postoperative left ventricular volume reduced in 3 of the 4 survivors. The left ventricular ejection fraction increased postoperatively in 3 of the 4 survivors. In conclusion, the septal anterior ventricular exclusion technique is an effective method for controlling perioperative bleeding, removing left ventricular thrombus completely, and preventing a recurrence of left ventricular thrombus and systemic embolism. This procedure also contributed to reducing the left ventricular volume, resulting in the improvement of the left ventricular function.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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31
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Yabumoto H, Nakagawa Y, Mukai S. Surgical Technique and Clinical Outcomes of Osteochondral Autograft Transplantation for Large Osteonecrotic Lesions of the Femoral Condyle With Residual Normal Cartilage: The Eyeglass Technique. Orthop J Sports Med 2019; 7:2325967119872446. [PMID: 31637267 PMCID: PMC6783664 DOI: 10.1177/2325967119872446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Osteochondral autograft transplantation (OAT) is usually performed for a
defect that is <400 mm2 because of the limitations of
autografts. Purpose: To present the surgical technique and clinical outcomes of OAT using the
eyeglass technique for large osteonecrotic lesions of the femoral condyle
(LOFs) (>400 mm2) with residual normal cartilage. Study Design: Cohort study; Level of evidence, 3. Methods: Cases (group 1) included 15 patients (18 knees) who underwent OAT using the
eyeglass technique for LOFs with residual normal cartilage, while controls
(group 2) included 11 patients (11 knees) who underwent OAT using the
standard technique for small osteonecrotic lesions of the femoral condyle
(≤400 mm2). Clinical outcomes were evaluated preoperatively and
at the final follow-up (group 1, 56 months; group 2, 48 months) according to
the International Knee Documentation Committee (IKDC) objective grade, the
IKDC subjective score, and the Japanese Orthopaedic Association (JOA)
score. Results: The mean lesion size was 685 mm2 in group 1 and 230 mm2
in group 2. Patients in group 1 had postoperative scores equivalent to those
in group 2. The postoperative IKDC subjective scores in group 1 (mean, 86.9)
and group 2 (mean, 87.0) showed no significant difference at the final
follow-up (P = .653). For postoperative IKDC objective
grades, 83.3% of group 1 and 81.8% of group 2 were graded as “nearly normal”
or better, and no significant intergroup difference was found for the IKDC
objective grade (P = .989). Also, no significant intergroup
difference was found for the postoperative JOA score (group 1, 93.9; group
2, 81.4; P = .480). Nine second-look arthroscopic
procedures were performed in group 1 compared with 4 in group 2, and all
patients had plugs that were graded as “nearly normal” or better by the
International Cartilage Repair Society classification system. Conclusion: The postoperative results of patients who underwent OAT using the eyeglass
technique for large osteonecrotic lesions (>400 mm2) were
equivalent to the results of patients who underwent OAT using the standard
technique for small osteonecrotic lesions (≤400 mm2).
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Affiliation(s)
- Hiromitsu Yabumoto
- Department of Orthopaedic Surgery, Kansai Denryoku Hospital, Osaka, Japan
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Furuta A, Sato K, Morimoto H, Mukai S, Goto K. The interference with transapical transcatheter aortic valve implantation by the anterior chordae tendineae preserved at previous mitral valve replacement. Clin Case Rep 2019; 7:1948-1950. [PMID: 31624615 PMCID: PMC6787798 DOI: 10.1002/ccr3.2406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/05/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022] Open
Abstract
Preserved anterior chordae tendineae is a possible risk factor for disturbing delivery of a transcatheter heart valve. Inserting a sheath just below the aortic valve for delivery of the transcatheter heart valve might be proposed as an alternative to avoid the chordae tendineae.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Katsumasa Sato
- Department of CardiologyFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Hironobu Morimoto
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Shogo Mukai
- Department of Cardiovascular SurgeryFukuyama Cardiovascular HospitalHiroshimaJapan
| | - Kenji Goto
- Department of CardiologyFukuyama Cardiovascular HospitalHiroshimaJapan
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Kitaura J, Mukai S, Morimoto H, Futagami D, Furuta A. [Mediastinal Hematoma after Intravenous Thrombolytic Therapy for Cerebral Infarction in a Patient with a History of Total Aortic Arch Replacement]. Kyobu Geka 2019; 72:673-676. [PMID: 31506408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
An 80-year-old male patient with a history of total arch replacement for thoracic aortic aneurysm 5 years before was introduced to our hospital with a chief complaint of chest pain. Tissue plasminogen activator (t-PA) had been administrated because of acute brain infarction. A contrast-enhanced computed tomography (CT) scan demonstrated a large hematoma in the posterior mediastinum extending from the level of distal aortic arch to the descending aorta together with left pleural effusion. On the next day after admission, CT scan revealed that the hematoma became smaller. This is a rare case of a posterior mediastinal hematoma caused by t-PA with a history of total aortic arch replacement.
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Affiliation(s)
- Junya Kitaura
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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34
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Furuta A, Morimoto H, Mukai S, Futagami D, Okubo S. Valve-sparing partial root repair for aortic dissection limited to the right coronary sinus of Valsalva. J Card Surg 2019; 34:1133-1136. [PMID: 31374594 DOI: 10.1111/jocs.14203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY To reveal a technical feasibility and safety of valve-sparing partial aortic root repair for spontaneous aortic dissection limited to the right coronary sinus of Valsalva. METHODS A 68-year-old woman presented with chest pain. Twelve-lead electrocardiogram revealed atrioventricular dissociation and ST-segment elevation on II, III, and aVF. Enhanced computed tomography images showed aortic dissection limited to the right-coronary sinus and the other non-dilated sinuses of Valsalva. Localized aortic dissection was repaired by valve-sparing partial aortic root repair using a trimmed U-shaped Dacron graft and a felt strip, and the right coronary artery was revascularized by coronary artery bypass grafting using saphenous vein graft. RESULTS The patient was discharged on postoperative day 12 with no complications. CONCLUSION Valve-sparing partial aortic root repair with the patch and coronary artery bypass grafting for aortic dissection limited to the right coronary sinus of Valsalva were technically feasible and safe.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Hironobu Morimoto
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Shogo Mukai
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Daisuke Futagami
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Shuhei Okubo
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
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Tarumi E, Nakagawa Y, Mukai S, Yabumoto H, Nakamura T. The clinical outcomes and the ability to sit straight in the Japanese style following high tibial osteotomy combined with osteochondral autologous transfer for osteonecrosis of the medial femoral condyle. J Orthop Sci 2019; 24:136-141. [PMID: 30245092 DOI: 10.1016/j.jos.2018.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/13/2018] [Accepted: 08/12/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND There have been some reports of high tibial osteotomy combined with osteochondral autograft transfer for osteonecrosis of the medial femoral condyle of the knee. However, few of them have focused on the deep knee flexion needed to sit straight in the Japanese style. PURPOSE To evaluate the clinical outcomes and the knee flexion of HTO combined with OAT for osteonecrosis of the medial femoral condyle of the knee, especially the ability to sit straight in the Japanese style. METHODS Between 1998 and 2012, valgus HTO combined with OAT was performed in 23 patients for stage IV osteonecrosis according to Koshino's radiological classification of the medial femoral condyle. The follow-up period was more than 2 years in all cases. The mean age at the time of the surgery was 65.8 years, and the mean follow-up period was 72.2 months. The function of the knee and the ability to sitting straight in the Japanese style were examined. Twenty-one knees were examined with second-look arthroscopy to assess the recipient and donor sites. RESULTS The JOA scale and IKDC subjective scores were significantly improved. Twelve patients were able to sit straight in the Japanese style after the surgery, compared to 3 patients who were able to do so before surgery. On second-look arthroscopy of 21 knees, the average ICRS score was 10.5 points. No patient needed additional surgery except for removal of the implants. CONCLUSION Valgus HTO combined with OAT is one treatment option for osteonecrosis of the medial femoral condyle with osteoarthritis. In the present study, many of the patients regained good knee function, and 50% of the patients were able to sit straight in the Japanese style after surgery, which is a higher rate than after total knee arthroplasty and unilateral knee arthroplasty.
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Affiliation(s)
- Eri Tarumi
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Japan.
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Japan
| | - Hiromitsu Yabumoto
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Japan
| | - Takashi Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan
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36
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Kiyan W, Nakagawa Y, Ito A, Iijima H, Nishitani K, Tanima-Nagai M, Mukai S, Tajino J, Yamaguchi S, Nakahata A, Zhang J, Aoyama T, Kuroki H. Ultrasound Parameters for Human Osteoarthritic Subchondral Bone ex Vivo: Comparison with Micro-Computed Tomography Parameters. Ultrasound Med Biol 2018; 44:2115-2130. [PMID: 30064850 DOI: 10.1016/j.ultrasmedbio.2018.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 06/01/2018] [Accepted: 06/04/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study was to identify ultrasound parameters reflecting subchondral porosity (Po), subchondral plate thickness (Tpl) and bone volume fraction at the trabecular bone region (BV/TVTb). Sixteen osteoarthritic human lateral femoral condyles were evaluated ex vivo using a 15-MHz pulsed-echo ultrasound 3-D scanning system. The cartilage-subchondral bone (C-B) surface region (layer 1) and inner subchondral bone region (layer 2) were analyzed; we newly introduced entropy (ENT) and correlation (COR) of ultrasound texture parameters of the parallel (x) or perpendicular (z) direction to the C-B interface for this analysis. Po, Tpl and BV/TVTb were evaluated as reference measurements using micro-computed tomography. ENTL1x (ENT of layer 1, x-direction) and ENTL1z were significantly correlated with Po (both r values = 0.58), CORL2x with Tpl (r = -0.73) and CORL2z with BV/TVTb (r = -0.66). These are efficient indicators of the characteristics of osteoarthritis-related subchondral bone; the other texture parameters were not significant.
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Affiliation(s)
- Wataru Kiyan
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Researching Department, Furuno Electric Company, Ltd., Nishinomiya, Japan
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Akira Ito
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hirotaka Iijima
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of System Design Engineering, Keio University, Yokohama, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoko Tanima-Nagai
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Junichi Tajino
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shoki Yamaguchi
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Chiba, Japan
| | - Akihiro Nakahata
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jue Zhang
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Furuta A, Morimoto H, Mukai S, Futagami D, Okubo S. Giant Thrombus Formation Originating From the Aortic Annulus. Ann Thorac Surg 2018; 107:e59. [PMID: 30248325 DOI: 10.1016/j.athoracsur.2018.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/15/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan.
| | - Hironobu Morimoto
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Shogo Mukai
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Daisuke Futagami
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Shuhei Okubo
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
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Furuta A, Morimoto H, Mukai S, Futagami D, Okubo S, Goto K. [Acute Aortic Insufficiency due to the Avulsion of Aortic Valve Commissure;Report of a Case]. Kyobu Geka 2018; 71:626-629. [PMID: 30185762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 61-year-old man with a history of hypertension and cerebral infarction, presented to a clinic with sudden dyspnea at rest. He was diagnosed with heart failure and referred to our hospital. Echocardiography and three-dimensional computed tomography showed acute heart failure and aortic insufficiency due to avulsion of the aortic valve commissure between the right coronary cusp and the non-coronary cusp. He had no symptoms such as fever or infection and no history of rheumatic disease. He underwent intima fixation of the avulsed commissure and aortic valve replacement using a tissue valve because acute left heart failure was refractory to medical treatment. Postoperative echocardiography demonstrated good left ventricular contraction without any aortic regurgitation. He was discharged on the 35th postoperative day.
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Affiliation(s)
- Akihisa Furuta
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan
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39
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Koshiyama H, Okubo S, Futagami D, Morimoto H, Mukai S. Adventitial Wrap Technique for Acute Type A Aortic Dissection. Ann Thorac Surg 2018; 106:e329-e331. [PMID: 29966593 DOI: 10.1016/j.athoracsur.2018.05.076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 05/10/2018] [Accepted: 05/22/2018] [Indexed: 11/16/2022]
Abstract
We describe a simple and reproducible technique to achieve complete and immediate hemostasis of the distal anastomosis in total arch replacement with the frozen elephant trunk technique. The adventitia was left seamlessly 1.0 cm longer than the level of the suture line. The adventitial remnant covered most of the distal anastomosis line tightly while the distal anastomosis was completed with continuous sutures. The adventitia was thin and tough, making it suitable to cover the suture line. This technique can contribute to eliminating bleeding from the distal anastomosis independent of unreliable blood coagulability during aortic surgery for acute aortic dissection.
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Affiliation(s)
- Hiroshi Koshiyama
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan.
| | - Shuhei Okubo
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Daisuke Futagami
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Hironobu Morimoto
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Shogo Mukai
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
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Nishitani K, Nakagawa Y, Nakamura S, Mukai S, Kuriyama S, Matsuda S. Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results. Am J Sports Med 2018; 46:617-622. [PMID: 29161095 DOI: 10.1177/0363546517739614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Plug protuberance occasionally occurs in osteochondral autologous transplantation (OAT). The incongruity of plugs results in poor clinical outcomes, especially in cases of protuberance. However, a surgical procedure to deal with this problem has not been reported. Purpose/Hypothesis: The purpose was to evaluate the efficacy and safety of cartilage resection of elevated plugs, with the hypothesis that patients whose elevated plugs were resected and leveled would achieve clinical outcomes equivalent to those of patients with flush plugs. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Cases (group P) included 22 patients who underwent OAT of the knee and whose plugs showed protuberance greater than 1 mm that was resected with a scalpel to obtain smooth congruity, while controls (group C) included 22 background-matched patients who did not require plug resection. The International Knee Documentation Committee (IKDC) subjective score, IKDC objective grade, and Japanese Orthopaedic Association score for knee osteoarthritis (JOA knee score) were used preoperatively and at the final follow-up (mean ± SD, 49.3 ± 18.1 months). International Cartilage Repair Society (ICRS) Cartilage Repair Assessment was used to evaluate lesion healing during the second-look arthroscopy. RESULTS IKDC subjective scores of group C (82.5 ± 11.8) and group P (82.1± 15.1) showed no difference at the final follow-up. On postoperative IKDC objective grading, 86% of group C and 82% of group P patients were graded as "nearly normal" or better ( P = .639). The mean JOA knee scores of group C (90.9 ± 8.9) and group P (90.1 ± 9.5) did not differ significantly ( P = .647). Nine second-look arthroscopies were performed in group C versus 8 in group P, and all patients had plugs that were graded as "nearly normal" or better by the ICRS Cartilage Repair Assessment. Larger plugs tended to be used in those patients who required resection. CONCLUSION Resection of the elevated plug surface did not negatively affect patient outcomes in the midterm follow-up period.
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Affiliation(s)
- Kohei Nishitani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Yabumoto H, Nakagawa Y, Mukai S, Saji T. Osteochondral autograft transplantation for isolated patellofemoral osteoarthritis. Knee 2017; 24:1498-1503. [PMID: 28970117 DOI: 10.1016/j.knee.2017.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 06/13/2017] [Accepted: 07/29/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The purpose of this retrospective study was to evaluate clinical outcomes of osteochondral autograft transplantation (OAT) for isolated patellofemoral (PF) osteoarthritis (OA). METHODS OAT was performed in seven patients (six men, one woman; mean age, 61.1years) with isolated PF OA. The mean duration of follow up was 46.9months (range, 24-84months). Clinical outcomes were evaluated preoperatively and postoperatively according to the International Knee Documentation Committee (IKDC) objective score and the knee scoring system of the Japanese Orthopaedic Association (JOA) score. The International Cartilage Repair Society (ICRS) score was recorded in three cases that underwent second-look arthroscopies postoperatively. For morphological evaluation, the Kellgren and Lawrence (KL) classification and the modified magnetic resonance observation of cartilage repair tissue (MOCART) score were used. RESULTS The mean IKDC and JOA scores were both significantly improved. The percentage of normal and nearly normal on the IKDC score was increased from 28.6% (2/7) to 85.7% (6/7) (P=0.05). The mean JOA score was improved from 80.0 (range, 65.0-85.0) to 95.0 (range, 90.0-100) (P=0.0008). The mean ICRS scores were 10.3 (nearly normal) in the three cases that underwent second-look arthroscopies postoperatively. Regarding KL classification, the grade was unchanged in five cases (two cases in grade 1, three cases in grade 2) and improved in two cases (from grade 3 to 2, from grade 4 to 3). The mean modified MOCART score was 67.9 (range, 60.0-75) at 12-month follow up. There were no complications, and satisfaction was obtained in all cases. The study design was case series: level IV. CONCLUSIONS All clinical scores improved significantly postoperatively. Osteochondral plugs were transplanted perpendicular to the articular surface to obtain good congruity of the repaired articular surface. In this way, OAT is an effective procedure to prevent progression of isolated PF OA.
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Affiliation(s)
- Hiromitsu Yabumoto
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takahiko Saji
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Abstract
BACKGROUND Sumo has long been a traditional sport in Japan and is rapidly attracting enthusiasts abroad. Sumo wrestling entails a risk of impact to the cervical spine during an initial charge. Few reports are available in the English-language literature regarding radiological changes in the cervical spine in sumo wrestlers. PURPOSE To examine radiological changes in the cervical spine in freshmen collegiate sumo wrestlers. STUDY DESIGN Case series; Level of evidence, 4. METHODS A total of 53 freshmen sumo wrestlers (age, 18-19 years) who belonged to the Japan Sumo Federation underwent routine radiographic examination of the cervical spine and completed questionnaires on cervical symptoms. RESULTS Of the 53 wrestlers, 81% showed loss of lordosis, 45% showed osteophyte formation (mainly at C3-C4), 11% showed disc space narrowing (mainly at C5-C6), and 51% showed narrowing of the cervical nerve root foramina (mainly at C3-C4). Fifty-one percent had some cervical symptoms. A correlation was found between deformity of the cervical bodies (such as intervertebral disc ballooning) and cervical symptoms, but no correlation was found between cervical degenerative changes and cervical symptoms. CONCLUSION Our data suggest that loss of lordosis, osteophyte formation, and narrowing of the cervical nerve root foramina at C3-C4 were frequently present in freshmen wrestlers and may be due to the axial load incurred prior to their collegiate careers.
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Affiliation(s)
- Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Kazufumi Minami
- Department of Orthopaedic Surgery, International University of Health and Welfare, Otawara, Tochigi, Japan
| | | | - Takashi Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
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Abstract
Background: The use of autologous osteochondral grafts has become popular in the treatment of small, isolated, well-contained articular cartilage defects. However, donor site morbidity is a problem, and few reports are available of donor site morbidity after mosaicplasty. Purpose: To examine the clinical outcomes of donor sites after osteochondral grafts from healthy knees. Study Design: Case series; Level of evidence, 4. Methods: Between September 1997 and September 2011, there were 40 patients (40 knees; 32 men, 8 women; 31 right knees, 9 left knees) with asymptomatic osteochondral graft donor sites used for autologous transfer; all had a follow-up period of >2 years. The mean patient age at surgery was 21.0 years (range, 12-58 years). The recipient sites included the elbow (n = 28), contralateral knee (n = 5), and ankle (n = 7). The mean diameter of the grafted plugs was 7.5 mm (range, 4.5-9 mm), and the mean number of grafted plugs was 2.2 (range, 1-3). At a mean follow-up of 43.1 months (range, 24-177 months), knee symptoms, return to sport, ability to sit straight in Japanese style, and radiological changes of the patellofemoral joint were evaluated. Whether operative age, follow-up period, and diameter or number of the grafted plugs were risk factors was analyzed statistically. Significance was defined as P < .05. Results: Thirty-four patients had no knee symptoms, and 4 patients had occasional mild knee pain. Two patients underwent reoperation for arthrofibrosis and not for cartilage defect. Twenty-seven patients had complete return to sports, and 32 patients could sit straight; donor site morbidity was not the cause of failure to return to sports or inability to sit straight. The radiological changes became worse in 3 patients, and the risk factor for degenerative change was older operative age. Conclusion: When osteochondral plugs were obtained from healthy knees, 34 patients (85%) were asymptomatic at follow-up. No donor site defects required surgical intervention due to persistent symptoms.
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Affiliation(s)
- Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | | | - Tadashi Goto
- Department of Orthopaedic Surgery, Biwako Ohashi Hospital, Otsu, Japan
| | - Taizo Furukawa
- Department of Orthopaedic Surgery, Furukawa Clinic, Uji, Japan
| | - Takashi Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.,Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Kiyan W, Ito A, Nakagawa Y, Mukai S, Mori K, Arai T, Uchino E, Okuno Y, Kuroki H. Relationships Between Quantitative Pulse-Echo Ultrasound Parameters from the Superficial Zone of the Human Articular Cartilage and Changes in Surface Roughness, Collagen Content or Collagen Orientation Caused by Early Degeneration. Ultrasound Med Biol 2017; 43:1703-1715. [PMID: 28499496 DOI: 10.1016/j.ultrasmedbio.2017.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 06/07/2023]
Abstract
We aimed to quantitatively investigate the relationship between amplitude-based pulse-echo ultrasound parameters and early degeneration of the knee articular cartilage. Twenty samples from six human femoral condyles judged as grade 0 or 1 according to International Cartilage Repair Society grading were assessed using a 15-MHz pulsed-ultrasound 3-D scanning system ex vivo. Surface roughness (Rq), average collagen content (A1) and collagen orientation (A12) in the superficial zone of the cartilage were measured via laser microscopy and Fourier transform infrared imaging spectroscopy. Multiple regression analysis with a linear mixed-effects model (LMM) revealed that a time-domain reflection coefficient at the cartilage surface (Rc) had a significant coefficient of determination with Rq and A12 (RLMMm2=0.79); however, Rc did not correlate with A1. Concerning the collagen characteristic in the superficial zone, Rc was found to be a sensitive indicator reflecting collagen disorganization, not collagen content, for the early degeneration samples.
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Affiliation(s)
- Wataru Kiyan
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Research Department, Furuno Electric Company, Ltd., Nishinomiya, Japan
| | - Akira Ito
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Koji Mori
- Applied Medical Engineering Science, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Tatsuo Arai
- Research Department, Furuno Electric Company, Ltd., Nishinomiya, Japan
| | - Eiichiro Uchino
- Department of Biomedical Data Intelligence, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasushi Okuno
- Department of Biomedical Data Intelligence, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Yabumoto H, Nakagawa Y, Mukai S, Saji T, Nakamura T. Surgical Technique and Clinical Outcomes of Retrograde Osteochondral Autograft Transfer for Osteochondral Lesions of the Tibial Plateau. Arthroscopy 2017; 33:1241-1247. [PMID: 28325693 DOI: 10.1016/j.arthro.2017.01.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 12/27/2016] [Accepted: 01/05/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To present the surgical technique, clinical outcomes, and poor prognostic factors of arthroscopic retrograde osteochondral autograft transfer of the tibial plateau. METHODS Twelve patients (6 men, 6 women; mean age, 38.7 years) with tibial plateau osteochondral lesions underwent surgery. The primary diseases were osteonecrosis in 4 cases, cartilage injuries in 6, and postfractures of the tibial plateau in 2. Clinical outcomes were evaluated preoperatively and postoperatively according to the International Knee Documentation Committee score and the Japanese Orthopaedic Association score. The International Cartilage Repair Society score was recorded in 7 cases who underwent second-look arthroscopies postoperatively. Statistical analyses were performed to identify prognostic factors associated with the clinical outcomes. RESULTS The mean International Knee Documentation Committee and Japanese Orthopaedic Association scores were both significantly improved from 39.0 (range, 13.0-57.1) to 72.4 (range, 33.3-100) (P = .0022) and from 65.8 (range, 30.0-85.0) to 85.8 (range, 50.0-100) (P = .0022 < .05), respectively. In 2 cases, secondary operations were performed because of knee pain (1 varus osteotomy of the femur and 1 total knee replacement). The mean International Cartilage Repair Society scores were significantly worse in the 2 cases who required a secondary operation (3.5; abnormal) than in the 5 cases who did not (10.6; nearly normal). The secondary operation rate was significantly higher in cases with lesion size ≥400 mm2 than in those <400 mm2 (Fisher's exact test; P = .046). CONCLUSIONS Most clinical scores improved significantly postoperatively. The results indicate that arthroscopic retrograde osteochondral autograft transfer is an effective procedure to achieve sufficient cartilage congruity for osteochondral lesions of the tibial plateau <400 mm2 in size. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Hiromitsu Yabumoto
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Fukakusa, Fushimi-ku, Kyoto, Japan.
| | - Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Fukakusa, Fushimi-ku, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Fukakusa, Fushimi-ku, Kyoto, Japan
| | - Takahiko Saji
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Fukakusa, Fushimi-ku, Kyoto, Japan
| | - Takashi Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Fukakusa, Fushimi-ku, Kyoto, Japan
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Mukai S, Nakagawa Y, Saji T, Yabumoto H. Osteochondral autograft transfer (OAT) combined with OWHTO for spontaneous osteonecrosis of the knee (SONK). Asia Pac J Sports Med Arthrosc Rehabil Technol 2016. [DOI: 10.1016/j.asmart.2016.07.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yamane Y, Uchida N, Okubo S, Morimoto H, Mukai S. Impact of the size mismatch between saphenous vein graft and coronary artery on graft patency. Gen Thorac Cardiovasc Surg 2016; 65:25-31. [DOI: 10.1007/s11748-016-0694-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 07/21/2016] [Indexed: 12/01/2022]
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48
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Sato Y, Nakahara K, Shimada M, Hara Y, Takayanagi D, Sawada N, Mukai S, Shimada S, Yamaguchi N, Hidaka E, Takehara Y, Ishida F, Kudo SE. Donor Left-Sided Heptectomy by Use of the Real-Time Moving Windows Method With 8-Centimeter Transverse Skin Incision. Transplant Proc 2016; 48:1083-6. [PMID: 27320563 DOI: 10.1016/j.transproceed.2015.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 11/11/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND In this study, we demonstrated our new device for open donor liver surgery with left-sided heptectomy by use of the real-time moving windows (RTMW) method with 8-cm transverse skin incision for living donors from the viewpoints of cosmetic, economic, and safety procedures. METHODS After the upper abdominal 8-cm transverse skin incision was made, the subcutaneous area was exfoliated and the reverse T-shaped-abdominal incision was made, as in open surgery. After that, the 2 Kent hooks for the upper region and the 2 surgical arms for the lower region were placed. The operative fields of hepatic vein, hepatic hilus, and common hepatic artery were explored, respectively, by use of the RTMW method with the use of the 4 surgical hooks. Hepatic parenchymal dissection was carried out with the use of CUSA and laparosonic coagulating shears. Manipulations of 3 hepatic vessels and the hepatic duct were done by the usual procedure of open surgery. RESULTS This operative procedure could be performed without laparoscopic techniques. The operative time was 7 hours, without blood transfusion. The operative course was uneventful, and the patient was discharged on postoperative day 11. CONCLUSIONS Our RTMW method for donor left-sided hepatectomy is considered to be a useful operative procedure from the viewpoints of donor safety, cosmetic advantage, and cost performance.
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Affiliation(s)
- Y Sato
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan.
| | - K Nakahara
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - M Shimada
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - Y Hara
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - D Takayanagi
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - N Sawada
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - S Mukai
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - S Shimada
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - N Yamaguchi
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - E Hidaka
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - Y Takehara
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - F Ishida
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
| | - S E Kudo
- Digestive Disease Center, Showa University Yokohama Northern Hospital, Yokohama City, Kanagawa Prefecture, Japan
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Nakagawa Y, Mukai S, Yabumoto H, Tarumi E, Nakamura T. Serial Changes of the Cartilage in Recipient Sites and Their Mirror Sites on Second-Look Imaging After Mosaicplasty. Am J Sports Med 2016; 44:1243-8. [PMID: 27022060 DOI: 10.1177/0363546516634299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND It has been reported that the short-term results of mosaicplasty are good, but there have been no reports of the serial cartilage changes in the recipient sites and their mirror sites for mosaicplasty. PURPOSE To examine the serial changes in cartilage in the recipient sites and their mirror sites using second-look imaging. STUDY DESIGN Case series; Level of evidence, 4. METHODS A total of 33 patients (37 knees, 40 sites) underwent mosaicplasty and second-look arthroscopy at a single institution over a 7-year period. There were 14 men and 19 women (12 right knees and 25 left knees). The recipient sites were the patella (n = 3), trochlea (n = 7), medial femoral condyle (n = 21), and lateral femoral condyle (n = 9). The mean patient age at surgery was 38.3 years; the mean period from mosaicplasty to second-look arthroscopy was 15.4 months; and the mean follow-up period was 34.9 months (range, 24-65 months). The results of second-look arthroscopy at the recipient site were categorized as cartilage with a smooth surface (group S) and fibrillation or an irregular surface (group I), and results of second-look arthroscopy at the mirror site were categorized as worse (group W), improved (group E), and unchanged (group U). RESULTS There were 30 sites in group S, 10 sites in group I, 3 sites in group W, 4 sites in group E, and 33 sites in group U. The age at operation was significantly greater in group S than in group I. There was a significant correlation between group S and groups E and U. The clinical outcome was significantly worse in group W when compared with groups E and U. CONCLUSION If a smooth surface was seen in the recipient site during second-look arthroscopy, the cartilage degeneration in its mirror site did not become worse after mosaicplasty.
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Affiliation(s)
- Yasuaki Nakagawa
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Hiromitsu Yabumoto
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Eri Tarumi
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Takashi Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan
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Yamane Y, Mukai S, Morimoto H, Koshiyama H, Okubo S. Patch Repair for a Subepicardial Aneurysm With an Approach From Inside the Heart. Ann Thorac Surg 2016; 100:1905-7. [PMID: 26522541 DOI: 10.1016/j.athoracsur.2014.12.095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 11/25/2014] [Accepted: 12/16/2014] [Indexed: 11/28/2022]
Abstract
We present a case of subepicardial aneurysm that developed as a complication of acute myocardial infarction. Although the patient had stable hemodynamics, the diameter of the aneurysm tended to increase over time; thus, an operation was performed. We thought that approaching the aneurysm from outside the heart would injure the papillary muscle or distort the left ventricle and exacerbate mitral regurgitation. Therefore, we performed patch repair using bovine pericardium and approached the aneurysm from inside the heart. This is the first case report of a subepicardial aneurysm that was approached and repaired from inside the heart.
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Affiliation(s)
- Yoshitaka Yamane
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan.
| | - Shogo Mukai
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Hironobu Morimoto
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Hiroshi Koshiyama
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
| | - Shuhei Okubo
- Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Hiroshima, Japan
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