Surgical Treatment of dialysis-associated spondylosis

【Objective】The purposes of this study were to classify the lesions of dialysis-associated spondylosis and evaluate the results of surgical treatment. 【Subjects and methods】The subjects were 87 patients (43 men and 44 women) who underwent surgery. These patients were studied in terms of lesion classification, surgical method, duration of dialysis, duration of surgery, intraoperative blood loss, and postoperative complications. 【Results】Among patients with cervical spine involvement, 13 had destructive spondyloarthropathy (DSA), 29 had amyloid deposition, and 8 had a dens axis lesion. Among patients with lumbar spine involvement, 20 had DSA, and 17 had amyloid deposition. With regard to 6 patients with a dens axis lesion involving atlantoaxial subluxation, each had posterior fusion (PF) of the occiput to the upper cervical spine. With regard to the patients with lumbar DSA, 10 patients had posterolateral fusion (PLF), 8 patients had posterior lumbar interbody fusion (PLIF) and 2 patients had laminectomy. The duration of dialysis in cases of a dens axis lesion varied between 25 and 35 years, with the mean duration being 28.9 years. 【Conclusions】All patients who underwent surgery for dens axis lesions were long-term dialysis patients who had been on dialysis for 25 years. Lumbar spine DSA was treated with PLIF in patients with lateral slipping and marked instability, with laminectomy in patients with a narrowed intervertebral disk space and no instability

Clinical relevance of heparin-PF4 complex antibody in DVT after total joint replacement

<p>Abstract</p> <p>Background</p> <p>Antibodies to the heparin-platelet factor-4 (HPF-4) complex (HIT antibodies) have been observed in patients with heparin-induced thrombocytopenia (HIT). These antibodies are thought to be involved in thrombosis through activation of platelet/endothelial cells. This prospective study was conducted to determine the incidence of post-operative HIT antibodies to assess the associated risk of deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).</p> <p>Methods</p> <p>We studied 104 patients who underwent unilateral primary TKA (n = 44) and primary THA (n = 60) with short-duration prophylaxis (1–2 days of a fixed dose of unfractionated heparin). HIT antibodies were assayed using a sandwich-type ELISA before the operation and after heparin treatment (post-operative day 7).</p> <p>Results</p> <p>In the clinical outcome, the incidence of symptomatic DVT was 15.4% (16/104, TKA; 10, THA 6) and pulmonary embolism (PE) was not observed. The total seroconversion rate of HIT antibodies at post-operative day 7 was 34.6% (36/104). Among 36 seroconverted patients, 11 (30.6%) developed symptomatic DVT and 5 out of 68 of the non-seroconverted patients (7.4%) developed symptomatic DVT. The incidence for DVT was significantly higher in the seroconverted patients compared with that of the non-seroconverted patients (odds ratio 5.5, 95%CI: 1.7–17.6 <it>p </it>= 0.0028). Furthermore, in the patients with symptomatic DVT, the titer of HIT antibodies at post-operative day 7 was significantly higher compared with those without symptomatic DVT.</p> <p>Conclusion</p> <p>Our data therefore suggest that seroconversion for HIT antibodies generated by heparin is associated with a risk of DVT in patients undergoing total joint replacement.</p

Surgical Treatment of dialysis-associated spondylosis

【Objective】The purposes of this study were to classify the lesions of dialysis-associated spondylosis and evaluate the results of surgical treatment. 【Subjects and methods】The subjects were 87 patients (43 men and 44 women) who underwent surgery. These patients were studied in terms of lesion classification, surgical method, duration of dialysis, duration of surgery, intraoperative blood loss, and postoperative complications. 【Results】Among patients with cervical spine involvement, 13 had destructive spondyloarthropathy (DSA), 29 had amyloid deposition, and 8 had a dens axis lesion. Among patients with lumbar spine involvement, 20 had DSA, and 17 had amyloid deposition. With regard to 6 patients with a dens axis lesion involving atlantoaxial subluxation, each had posterior fusion (PF) of the occiput to the upper cervical spine. With regard to the patients with lumbar DSA, 10 patients had posterolateral fusion (PLF), 8 patients had posterior lumbar interbody fusion (PLIF) and 2 patients had laminectomy. The duration of dialysis in cases of a dens axis lesion varied between 25 and 35 years, with the mean duration being 28.9 years. 【Conclusions】All patients who underwent surgery for dens axis lesions were long-term dialysis patients who had been on dialysis for 25 years. Lumbar spine DSA was treated with PLIF in patients with lateral slipping and marked instability, with laminectomy in patients with a narrowed intervertebral disk space and no instability

国立姫路病院にて原発巣に外科的治療を施行した腎細胞癌の予後因子に関する統計学的解析

1992年1月から1998年10月までに, 国立姫路病院にて原発巣に対し外科的治療を施行した62症例を対象に, その臨床的, 病理学的予後因子の統計学的解析を行った.平均観察期間は32カ月であった.全体の1, 3, 5年疾患特異的生存率はそれぞれ86.7, 81.3, 81.3%であった。観察期間中, 癌死した症例は11例(17.7%)で, 2例(3.2%)は他因死した.単変量解析の結果, 症状の有無, CRP, ESR, ALP, 腫瘍径, 組織学的細胞異型度, 組織学的浸潤増殖様式, 病理学的病期, N分類, M分類が有意な予後因子であったが, 多変量解析では, ALP, N分類, M分類のみで有意に予後に関与しており, M分類が最も危険な因子であった。A clinico-pathological study was performed retrospectively on 62 patients who underwent surgery for renal cell carcinoma between January 1992 and October 1998 at Himeji National Hospital to clarify the prognostic determinants for survival. The median follow-up period was 32 months and the cause-specific survival rates at 1, 3 and 5 years were 86.7, 81.3, 81.3%, respectively. Of the 62 patients, 11 (17.7%) patients died of renal cell carcinoma and 2 (3.2%) patients died of unrelated causes. Of the variables related to survival, presenting symptoms, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alkaline phosphatase (ALP), tumor size, pathological tumor grade, infiltration pattern, pathological tumor stage, N classification and M classification were significant risk factors for survival by univariate analysis. However, ALP, N classification and M classification were significant for survival as determined by the step-wise procedure and M classification was the most significant factor according to Cox's proportional hazard model analysis

Solid-Phase Synthesis of <i>P</i>‑Boronated Oligonucleotides by the <i>H</i>‑Boranophosphonate Method

Recently, <i>P</i>-boronated oligonucleotides have been attracting much attention as potential therapeutic oligonucleotides. In this study, we developed <i>H</i>-boranophosphonate oligonucleotide bearing a borano group and hydrogen atom on the internucleotidic phosphorus and demonstrated that this novel <i>P</i>-boronated oligonucleotide is a versatile precursor to various <i>P</i>-boronated oligonucleotides such as boranophosphate, boranophosphorothioate, and boranophosphoramidate. The method was also applicable to the synthesis of a locked nucleic acid-modified boranophosphate oligonucleotide, which exhibited a dramatically enhanced affinity to complementary oligonucleotides

Photocatalytic TiO2 particles confer superior antibacterial effects in a nutrition-rich environment: an in vitro study

Titanium dioxide (TiO2) is known to confer photocatalytic bactericidal effects under ultraviolet (UV) irradiation. Few reports are available, however, on the clinical applications of TiO2 particle mixtures. Our objective in the present research was to evaluate the in vitro bactericidal effects of a TiO2 particle mixture in a nutrition-rich biological environment. A bacterial suspension of Staph-ylococcus aureus and epidermidis 3 × 103CFU/mL was added to a TiO2 particle mixture (0.038 mg/mL) containing mainly sodium percarbonate and citric acid. To simulate a biological environment, 40 μL of 10% bovine serum albumin was added and the culture temperature was maintained at 37°C. The resulting product was irradiated by UV light and the bacterial survival rate was calculated for each time of UV irradiation. In the control sample treated with distilled water + UV, the bacteria survived at a high rate even after 180 min. In the TiO2 mixture+ UV sample, meanwhile, the bacterial survival rate dropped to 43.8% and 6.0% of the baseline values in S. aureus and S. epidermidis, respectively, after 60 min of UV irradiation. The photocatalytic antibacterial action of the TiO2 particle mixture was high even in a protein-rich biological environment