Does Degree of the Pelvic Deformity Affect the Accuracy of Computed Tomography-Based Hip Navigation?

Although some navigation systems have been used for improvement of component positioning, there have been few reports regarding cases of severe pelvic deformity. We performed a retrospective review of 25 cases of total hip arthroplasty with a computed tomography-based navigation system in patients with severe pelvic deformities and estimated acetabular component position and angle between severe deformity group and mild dysplastic group as a control. There were no significant differences in accuracy of navigation system between 2 groups in terms of 3-dimensional component position or angle. Accuracy of computed tomography-based hip navigation does not depend on the degree of pelvic deformity, and this system is also useful to identify acetabular orientation and for precise component implantation in cases of pelvic deformity. © 2012 Elsevier Inc

Determination of topological structure of ARL6ip1 in cells: Identification of the essential binding region of ARL6ip1 for conophylline

AbstractConophylline (CNP) has various biological activities, such as insulin production. A recent study identified ADP-ribosylation factor-like 6-interacting protein 1 (ARL6ip1) as a direct target protein of CNP. In this study, we revealed that ARL6ip1 is a three-spanning transmembrane protein and determined the CNP-binding domain of ARL6ip1 by deletion mutation analysis of ARL6ip1 with biotinyl-amino-CNP. These results suggest that CNP is expected to be useful for future investigation of ARL6ip1 function in cells. Because of the anti-apoptotic function of ARL6ip1, CNP may be an effective therapeutic drug and/or a novel chemosensitizer for human cancers and other diseases

Hyperostosis around the bilateral acetabulum associated with hypoparathyroidism

We report the case of a 57-year-old woman with hyperostosis around the bilateral acetabulum associated with untreated secondary hypoparathyroidism. She presented with gait disturbance and inability to walk. Radiographs showed abnormal ossification around her hips. We resected the ossifications to improve joint function. One year after surgery, radiographs showed no recurrence of ossification. When radiographs show excessive hyperostosis, it is important to exclude presence of metabolic bone disease. © Japan College of Rheumatology 2012.This is the pre-peer reviewed version of the following article: [Full cite], which has been published in final form at [link to final article]

Quantitative analysis of the Trendelenburg test and invention of a modified method

Background While the Trendelenburg test has been used for 120 years to detect hip abductor muscle weakness, the methodology has not been standardised. Purposes This study undertook to quantitatively analyze the relation between abductor muscle activity and pelvic tilt angle in the Trendelenburg one-leg stance, examine the pitfalls associated with performing the T-test, and develop a modified method that will produce reliable results. Methods A convenience sample of 15 healthy males was asked to assume a one-leg stance in ten different postures, five with mild flexion on the unsupported side, and five with severe flexion. Trunk sway angle, pelvic tilt angle, and the pelvic on femur (POF) angle were measured for each posture. Statistical analysis was used to assess differences in hip abductor activity and public tilt angle between the control posture and the test postures. Results With minimum trunk sway, hip abductor muscle activity increases when the pelvis is elevated and decreases when it is dropped. With trunk sway toward the test side, abductor muscle activity decreased when the pelvis was elevated; with trunk sway toward the non-test side, muscle activity stayed approximately constant when the pelvis was dropped. Conclusions Based on the results we developed a modified T-test methodology that would improve reliability. This test should be performed with minimum trunk sway and severe flexion on the non-test side. The assessment of muscle weakness is based on whether the patient can keep the single-leg standing posture when forced to elevate the pelvis, not simply on the pelvic drop. In future research, we will perform the modified T-test on patients with a suspected hip abductor deficiency, and assess the usefulness of the modified test. © 2016 The Japanese Orthopaedic Associatio

絶滅危惧種トウテイラン（オオバコ科）の 分布・生育立地と現存個体数

Veronica ornata is a perennial plant endemic to Japan. Although V. ornata has been designated as a threat-ened species by the government of Japan and by some prefectural governments, few studies have examined its habitats and population sizes. Therefore, we investigated the distribution areas, habitat conditions, and num-ber of individuals of this plant in different localities: Kyotango City （Tango-sakyu and Kotohiki-hama）, Kyoto Prefecture; Yurihama Town, Tottori Prefecture; and Oki Islands, Shimane Prefecture. Over 15,000 individuals of V. ornata were counted in the Tango-sakyu coast. In contrast, fewer than 70 individuals were observed in Yurihama town. Veronica ornata habitats were categorized into the following five types based on topographical conditions, location, and influence of human activities: 1） coastal dune, 2） coastal cliff, 3） inland cliff, 4） arti-ficial slope, and 5） pastureland. Across all study sites, the main habitats of V. ornata were found to be coastal dune and coastal cliff. In the Oki Islands, it is important to conserve not only the coastal cliff habitats of V. ornata, but also the inland cliff habitats

Hybrid Surgery for Portosystemic Encephalopathy in a Patient with Liver Cirrhosis: a case report

Regarding the treatment for a portosystemic shunt, surgical or interventional radiological closure of the shunt was established. Interventional radiology including balloon-occluded retrograde transvenous obliteration can worsen portal hypertension and create a large thrombus close to the major venous system in the case of a huge portosystemic shunt. In contrast, it is also difficult to treat some cases through surgery alone when huge complicated shunts exist very deep in the body. Herein, we report a successful case of surgical shunt ligation for portosystemic encephalopathy in a hybrid operation room that enabled intraoperative angiography and computed tomography. A 62-year-old woman with chronic hepatitis C was referred to our hospital due to high levels of serum ammonia and hepatic encephalopathy. She had a massive, complicated portosystemic shunt from the inferior mesenteric vein to the left renal vein but did not have esophageal or gastric varices. It was difficult to occlude the portosystemic shunt by interventional radiologic techniques because the shunt had an extremely large amount of blood flow and many collateral routes. We performed the shunt ligation in the hybrid operation room. Intraoperative angiography provided detailed information about the portosystemic shunt, such as direction or volume of blood flow and collateral routes in real time. Her encephalopathy disappeared completely and she remains healthy with improved liver functional reserve to date. In conclusion, this is a successful case of a hybrid operation for an extremely large and complicated portosystemic shunt, providing for intraoperative angiography as a safe and reliable surgical treatment for portosystemic encephalopathy in patients with liver cirrhosis

Successful Resection of Solitary Abdominal Wall Metastasis of Sarcomatous Intrahepatic Cholangiocarcinoma

Sarcomatous intrahepatic cholangiocarcinoma (ICC) is a rare histological variant of ICC that is composed of both adenocarcinoma (ICC component) and sarcomatous components. Surgery is believed to be the primary treatment, and some reports describe primary resection. However, due to the aggressive malignancy of sarcomatous ICC, there is no report regarding resection of a metastatic lesion. In this report, we present the case of a 75-year-old woman admitted to our hospital with the chief complaint of weight loss. Various imaging techniques demonstrated a single mass in the liver and cecum. A cecal gastrointestinal stromal tumor accompanied by liver metastasis was suspected, and ileocecal resection was performed for diagnostic purposes. However, the tumor was present in the abdominal wall rather than in the cecum. The tumor was resected and diagnosed as undifferentiated sarcoma. We suspected the liver tumor was a series of lesions, so we performed hepatectomy. As the tumor was composed of both adenocarcinoma and sarcomatous components, it was diagnosed as sarcomatous ICC. The histological findings of the abdominal wall tumor were similar to those of sarcomatous ICC, so we diagnosed the abdominal wall tumor as a solitary metastasis of sarcomatous ICC. In this case, solitary metastasis was observed, and we were able to resect both the primary and metastatic lesions. This case illustrates that when solitary metastasis can be seen in sarcomatous ICC, radical resection is possible