Reconstruction of the esophagojejunostomy by double stapling method using EEA™ OrVil™ in laparoscopic total gastrectomy and proximal gastrectomy

Here we report the method of anastomosis based on double stapling technique (hereinafter, DST) using a trans-oral anvil delivery system (EEATM OrVilTM) for reconstructing the esophagus and lifted jejunum following laparoscopic total gastrectomy or proximal gastric resection

Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

<p>Abstract</p> <p>Background</p> <p>Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly.</p> <p>Methods</p> <p>We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake.</p> <p>Results</p> <p>Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture.</p> <p>Conclusions</p> <p>The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.</p

ROLE OF TRAUMATIC SUBDURAL FLUID COLLECTION IN DEVELOPING PROCESS OF CHRONIC SUBDURAL HEMATOMA

We investigated the role of traumatic subdural fluid collection in the genesis of chronic subdural hematoma (CSDH) in 43 consecutive patients with traumatic subdural fluid collection. Traumatic subdural fluid collection was found in 43 (6%) of 715 patients who underwent CT scans because of head injury. Twenty-four of the 43 patients were more than 65 years of age and this problem occurred in 30% of the 79 head-injured patients over 65 years of age. In 20 (Group 1) of the 43 patients CSDH subsequently developed. During the same period, 30 other patients were treated for CSDH. Twenty-four (Group 2) of these 30 patients had a history of head injury more than two weeks prior to the developing sings and symptoms and had hyper- or iso-dense hematomas on their first CT scan. It may have been that they too first had a traumatic subdural collection. Forty to sixty percent of the patients with asymptomatic traumatic subdural fluid collection may develop CSDH, and this may occur especially in the older patients. Careful observations after the head injury are particularly important in the aged because of the frequent occurrence of traumatic subdural fluid collection and the subsequent development of CSDH