Nagoya Journal of Medical Science最新文献_第6页

Potency of real-time virtual sonography for the preoperative evaluation of invasion in nephroblastoma. 实时虚拟超声在肾母细胞瘤侵袭术前评估中的价值。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-11-01 DOI: 10.18999/nagjms.87.4.801

Akiyoshi Nomura, Masaya Yamoto, Hideto Iwafuchi, Masashi Koyama, Kenichiro Watanabe, Koji Fukumoto

{"title":"Potency of real-time virtual sonography for the preoperative evaluation of invasion in nephroblastoma.","authors":"Akiyoshi Nomura, Masaya Yamoto, Hideto Iwafuchi, Masashi Koyama, Kenichiro Watanabe, Koji Fukumoto","doi":"10.18999/nagjms.87.4.801","DOIUrl":"10.18999/nagjms.87.4.801","url":null,"abstract":"Fusion with a real-time virtual sonography system is an ultrasonography fusion technology with magnetic position navigation. We present a case of a left nephroblastoma successfully resected using real-time virtual sonography for tumor margin assessment and excision boundary determination. A 2-year-old girl presented with fever and abdominal distension. Contrast-enhanced computed tomography revealed a large heterogeneous mass (90 × 75 × 125 mm3) in the left kidney. Needle biopsy confirmed nephroblastoma. Chemotherapy with vincristine and actinomycin was initiated according to the International Society of Pediatric Oncology Wilms Tumor 2001 guidelines. Subsequent computed tomography revealed that the tumor size decreased to 45 × 25 × 63 mm3; however, margins with adjacent muscles remained unclear, indicating potential invasion beyond Gerota's fascia. Real-time virtual sonography evaluation revealed a single fat layer separating the tumor from the muscle groups, showing tumor regression to the medial side of Gerota's fascia, with visible respiratory movements on ultrasonography. Left nephrectomy, including Gerota's fascia, was performed, preserving the abdominal wall muscles. Pathology confirmed that the tumor had penetrated the renal capsule but was completely resected with clear margins. The postoperative diagnosis was high-risk stage II blastemal type nephroblastoma, prompting chemotherapy on postoperative day 12. During the 5-year follow-up, no recurrence was observed. Real-time virtual sonography is a valuable adjunct for detailed preoperative evaluation when computed tomography alone is inadequate, facilitating precise tumor margin assessment and successful surgical outcomes.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 4","pages":"801-807"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12805129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reconsidering psychological safety from the perspective of personality organization levels. 从人格组织层面重新审视心理安全。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-11-01 DOI: 10.18999/nagjms.87.4.814

Rieko Fujie, Nobutaro Ban

{"title":"Reconsidering psychological safety from the perspective of personality organization levels.","authors":"Rieko Fujie, Nobutaro Ban","doi":"10.18999/nagjms.87.4.814","DOIUrl":"10.18999/nagjms.87.4.814","url":null,"abstract":"In medical education, psychological safety in teams and organizations facilitates problem solving in healthcare teams and learning opportunities for learners. Based on four types of organizational climate, this study examines the interventions needed for each type of team and organization to increase psychological safety and create an environment in which learners can learn independently and effectively. In considering interventions, the concept of three levels of personality organization, a framework for psychological assessment, seems to be valuable. Based on the overlap between the four types of organizational climate and the three levels of personality organization, the \"Apathy Zone\" requires educators and learners to reestablish autonomy rooted in reality. In the \"Anxiety Zone,\" the challenge is for educators to recognize their own limitations and be willing to understand learners. In the \"Comfort Zone,\" educators must respect learners' autonomy while observing norms. Both educators and learners must distinguish between the realms of self and others, focusing on essential goals. The \"Learning Zone\" requires educators and learners to move without overthinking to achieve essential goals. The psychological perspective provides guidance for understanding the formation of organizational climate and considering specific interventions.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 4","pages":"814-824"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12805134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of specific health guidance in small municipality using 7 years data of National Health Insurance database. 利用国家医保数据库7年数据评价小城市专项健康指导。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.407

Kazunari Kobayashi

{"title":"Evaluation of specific health guidance in small municipality using 7 years data of National Health Insurance database.","authors":"Kazunari Kobayashi","doi":"10.18999/nagjms.87.3.407","DOIUrl":"10.18999/nagjms.87.3.407","url":null,"abstract":"Small municipalities have few users with specific health guidance, which makes accurate evaluation difficult. This study verified the effectiveness of specific health guidance using data from specific health checkups and specific health guidance from a municipality in Gifu Prefecture over 7 years. The data were provided by Kokuho Database (KDB; National Health Insurance database) system and included 3,786 individuals who underwent a specific health checkup for the first time between 2008 and 2014, followed by another check the subsequent year. I calculated the differences in weight, body mass index (BMI), and waist circumference from the year of the health check to the weight, BMI, and waist circumference between the initial and the following year's checks based on health guidance usage status. I also evaluated whether there was a difference in the median and metabolic syndrome status in the following year. Weight, BMI, and waist circumference improvements were observed in the group that received health guidance at both incentive and active support groups. In the incentive support group, less than 40% of those who went from the preliminary group became the non-applicable group and more than 40% of those who went from applicable group also became the non-applicable group. In the active support group, less than 80% of those who moved from the preliminary group became the non-applicable group, while less than 30% of those who went from the applicable group also became the non-applicable group.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"407-420"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The relationship between gratitude and presenteeism among workers: a cross-sectional study. 员工感恩与出勤的关系：一项横断面研究。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.473

Hotaka Tsukada, Daisuke Hori, Yu Komase, Shotaro Doki, Tsukasa Takahashi, Kei Muroi, Mami Ishitsuka, Asako Matsuura, Norishige Kanai, Wakako Migaki, Satoshi Uchida, Toshiya Hayashida, Reem Al Assaad, Soma Nishimura, Akari Fujii, Maral Soronzonbold, Ichiyo Matsuzaki, Shin-Ichiro Sasahara

{"title":"The relationship between gratitude and presenteeism among workers: a cross-sectional study.","authors":"Hotaka Tsukada, Daisuke Hori, Yu Komase, Shotaro Doki, Tsukasa Takahashi, Kei Muroi, Mami Ishitsuka, Asako Matsuura, Norishige Kanai, Wakako Migaki, Satoshi Uchida, Toshiya Hayashida, Reem Al Assaad, Soma Nishimura, Akari Fujii, Maral Soronzonbold, Ichiyo Matsuzaki, Shin-Ichiro Sasahara","doi":"10.18999/nagjms.87.3.473","DOIUrl":"10.18999/nagjms.87.3.473","url":null,"abstract":"This study investigates the relationship between gratitude and presenteeism (working while unwell) among workers. Productivity loss due to health issues among workers is a critical problem. The largest portion of health-related costs comes from presenteeism, with mental disorders being the main contributors. Gratitude, as one of the positive psychological factors, might have a protective effect against presenteeism. This is because gratitude can reduce stress, increase support from others, improve the workplace atmosphere, and enhance self-efficacy. Therefore, we hypothesized that higher trait gratitude (individual differences in the tendency to feel gratitude) and higher frequency of gratitude expression would be associated with lower levels of presenteeism. In 2022, a cross-sectional study was conducted with workers in Tsukuba City. The outcome variable was the Single-item Presenteeism Question, which is an indicator of presenteeism. The explanatory variables included the Gratitude at Work Scale, a measure of trait gratitude in workplace, along with frequency of expressing gratitude. Multiple regression analysis was performed. The results showed that higher trait gratitude was associated with lower levels of presenteeism (standardized coefficient, -0.203; p < 0.001). Higher frequency of gratitude expression was associated with lower levels of presenteeism (standardized coefficient, -0.048; p = 0.016). The study confirmed that trait gratitude and frequency of gratitude expression were associated with presenteeism. However, it remains unclear whether gratitude directly reduces presenteeism, and further longitudinal studies are needed to explore this possibility.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"473-482"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preliminary observations on neuromuscular pathways of the lower extremities: findings from intraoperative nerve root stimulation. 下肢神经肌肉通路的初步观察：术中神经根刺激的结果。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.538

Hiroaki Nakashima, Go Yoshida, Tokumi Kanemura, Sadayuki Ito, Naoki Segi, Jun Ouchida, Mikito Tsushima, Hiroyuki Tomita, Kazuaki Morishita, Shiro Imagama

{"title":"Preliminary observations on neuromuscular pathways of the lower extremities: findings from intraoperative nerve root stimulation.","authors":"Hiroaki Nakashima, Go Yoshida, Tokumi Kanemura, Sadayuki Ito, Naoki Segi, Jun Ouchida, Mikito Tsushima, Hiroyuki Tomita, Kazuaki Morishita, Shiro Imagama","doi":"10.18999/nagjms.87.3.538","DOIUrl":"10.18999/nagjms.87.3.538","url":null,"abstract":"The segmental innervation patterns of lower extremity muscles remain poorly defined, despite their critical importance in both clinical diagnosis and surgical planning for lumbar spinal conditions. Variability in these patterns, particularly under chronic nerve root compression, complicates the development of accurate diagnostic and therapeutic strategies. This study aimed to elucidate the segmental innervation patterns of lower extremity muscles through intraoperative nerve root stimulation during lumbar spinal surgery combined with motor evoked potential (MEP) during lumbar spinal surgery. A total of 30 patients diagnosed with unilateral nerve root impairment due to degenerative lumbar canal stenosis were enrolled in this study. All patients provided informed consent, demonstrated lower extremity muscle strength graded 4 or higher on the manual muscle test, and were scheduled for surgeries that enabled direct visualization of bilateral nerve roots. During the surgical procedures, 128 lumbosacral nerve roots (L2-S1) were stimulated using a monopolar stimulator, and MEPs were recorded from key lower extremity muscles, including the vastus lateralis, tibialis anterior, and medial gastrocnemius. The vastus lateralis muscle was consistently innervated by the L2 root in 100% of cases, confirming a stable and reproducible pattern. In contrast, stimulation of the L5 root revealed notable anomalies in 8% of cases, where compensatory mechanisms or anatomical anomalies appeared to alter the expected innervation patterns. Furthermore, differences in muscle innervation between the left and right sides were observed in 39% of tested nerve roots, with variability being particularly pronounced in lower lumbar levels, such as L4, L5, and S1.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"538-545"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dietary intake and its association with sarcopenia in older adults: a cross-sectional analysis. 老年人饮食摄入及其与肌肉减少症的关系：一项横断面分析。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.451

Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Yasuhiko Takegami, Shinya Ishizuka, Kenji Wakai, Yukiharu Hasegawa, Shiro Imagama

{"title":"Dietary intake and its association with sarcopenia in older adults: a cross-sectional analysis.","authors":"Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Yasuhiko Takegami, Shinya Ishizuka, Kenji Wakai, Yukiharu Hasegawa, Shiro Imagama","doi":"10.18999/nagjms.87.3.451","DOIUrl":"10.18999/nagjms.87.3.451","url":null,"abstract":"Sarcopenia, a condition characterized by the loss of muscle mass and function, poses a major health challenge among older adults. Identifying nutritional factors and dietary patterns associated with sarcopenia is critical for developing targeted interventions. This study analyzed data from 584 community-dwelling older adults (245 male, 339 female) enrolled in the Yakumo Study to investigate the relationship between dietary factors and sarcopenia. Nutritional intake was assessed using a validated Food Frequency Questionnaire (FFQ), while dietary diversity was evaluated using dietary variety score (DVS). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) criteria, based on skeletal muscle mass, hand grip strength, and walking speed. The prevalence of sarcopenia in the study population was 7.4%. Nutritional intake of individual nutrients, such as protein and vitamin D, did not significantly differ between sarcopenic and non-sarcopenic participants. However, the intake rates for total calories, dietary fiber, vitamin B1, vitamin B2, and vitamin C were significantly higher in the sarcopenia group. No significant differences were found in DVS, and no correlations were found between DVS scores and skeletal muscle mass index, grip strength, or walking speed. These results may indicate that factors beyond nutrient intake-such as nutrient absorption, utilization, and metabolic efficiency-play a pivotal role in sarcopenia development.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"451-461"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Calcium chloride within carbon dioxide absorbents prevents Compound A production from sevoflurane. 二氧化碳吸收剂中的氯化钙阻止七氟烷产生化合物A。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.392

Takahiro Ando, Atsushi Mori, Masahiro Nakatochi, Kimitoshi Nishiwaki

{"title":"Calcium chloride within carbon dioxide absorbents prevents Compound A production from sevoflurane.","authors":"Takahiro Ando, Atsushi Mori, Masahiro Nakatochi, Kimitoshi Nishiwaki","doi":"10.18999/nagjms.87.3.392","DOIUrl":"10.18999/nagjms.87.3.392","url":null,"abstract":"Calcium chloride (CaCl2)-containing carbon dioxide (CO2) absorbers are characterized by their ability to produce almost no pentafluoroisopropenyl fluoromethyl ether (Compound A), a potentially nephrotoxic byproduct of sevoflurane, in vitro. However, the precise role of CaCl2 in this process remains unclear. We aimed to clarify the role of CaCl2 in vitro and determine whether CaCl2-containing CO2 absorbents produce Compound A during prolonged surgery under low- and minimal-flow sevoflurane anesthesia using Japanese brand Yabashi Lime-f (YL-f). In vitro, a reaction between 1 L of sevoflurane gas (8%) with 5% CO2 and an absorbent specimen (20 g) with or without water was performed in an artificial closed-circuit system for 15 or 60 min at 45 °C. In vivo, patients scheduled for colorectal resection received 2.0 vol% sevoflurane at fresh gas flows of 2.0, 1.0, or 0.5 L/min (N = 6) with YL-f. Gas samples from the anesthetic circuit were collected 6 h after induction and at the conclusion of surgeries lasting over 7 h. Compound A concentrations were measured using gas chromatography-flame ionization detection. Compound A production was observed in CaCl2-free absorbents but not in those containing CaCl2 in vitro. During 60-min reactions, CaCl2-free YL-f derivatives produced a median 3.5 ppm of Compound A, with higher concentrations (7.1 ppm) observed upon the addition of 3 mL of water. YL-f did not produce Compound A, regardless of the presence of water. Compound A was not detected in in vivo samples. In conclusion, CaCl2 suppresses Compound A production from sevoflurane, likely by trapping water within the anesthetic circuit.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"392-406"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence and risk factors of cerebrospinal fluid leakage related complications after spinal intradural tumor resection. 脊髓硬膜内肿瘤切除术后脑脊液漏相关并发症的发生率及危险因素。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.521

Hiroaki Nakashima, Kyotaro Ota, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Yukihito Ode, Shiro Imagama

{"title":"Incidence and risk factors of cerebrospinal fluid leakage related complications after spinal intradural tumor resection.","authors":"Hiroaki Nakashima, Kyotaro Ota, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Yukihito Ode, Shiro Imagama","doi":"10.18999/nagjms.87.3.521","DOIUrl":"10.18999/nagjms.87.3.521","url":null,"abstract":"Cerebrospinal fluid (CSF) leakage is a common and serious complication of spinal surgery, particularly after intradural tumor resection. CSF leakage can lead to debilitating headaches, neurological deficits, and other symptoms, with an incidence rate of 0.3%-16%. This study aimed to investigate the incidence, risk factors, and outcomes of CSF-related complications in patients who underwent spinal intradural tumor surgery. This was a retrospective cohort study including 102 patients who underwent resection of intradural tumors, including ependymomas, astrocytomas, and meningiomas. Data were collected, including patient demographics, surgical details, and postoperative outcomes. The extent of CSF accumulation was evaluated using magnetic resonance imaging (MRI) findings. Statistical analyses were performed to identify risk factors for symptomatic CSF leakage. Postoperative CSF accumulation was observed in 94.1% of patients. Among them, 28.1% experienced symptomatic complications, such as severe headache (20.8%), unexplained fever (6.3%), and CSF leakage (3.1%). Patients with larger CSF accumulation, particularly subcutaneous accumulation, had a significantly higher incidence of symptomatic complications, with the highest rate observed in subfascial accumulation cases (P = 0.0002). Symptomatic patients did not show significant differences in age, sex, surgical level, drainage duration, or blood loss compared to asymptomatic patients. Additionally, the use of artificial dura mater did not significantly affect symptomatic outcomes. Predicting the occurrence of symptoms based on preoperative and surgical factors remains challenging. However, patients with subfascial CSF accumulation were more likely to develop symptoms, highlighting the necessity of confirming CSF accumulation using MRI for appropriate postoperative management.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"521-527"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current status of indirect decompression with lateral lumbar interbody fusion. 腰椎侧位椎间融合术间接减压的现状。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.381

Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Yoshinori Morita, Tokumi Kanemura, Shiro Imagama

{"title":"Current status of indirect decompression with lateral lumbar interbody fusion.","authors":"Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Yoshinori Morita, Tokumi Kanemura, Shiro Imagama","doi":"10.18999/nagjms.87.3.381","DOIUrl":"10.18999/nagjms.87.3.381","url":null,"abstract":"The adoption of lumbar fusion techniques, particularly lateral lumbar interbody fusion (LLIF), has significantly evolved the management of degenerative lumbar spinal conditions. LLIF, introduced as a minimally invasive surgical procedure, offers the advantage of indirect neural decompression and robust bone fusion using large interbody cages, reducing complications such as cage subsidence and nerve injuries. Systematic reviews have indicated that LLIF was effective for foraminal decompression, although evidence regarding its effectiveness for spinal canal and lateral recess decompression remains limited. Comparisons between indirect decompression techniques like LLIF and direct methods (posterior lumbar interbody fusion and transforaminal lumbar interbody fusion) have revealed that while indirect approaches generally promoted lower surgical times and blood loss, outcomes related to pain, disability, and complications were comparable. Indirect decompression with LLIF should be approached cautiously or avoided in patients with severe stenosis or preoperative neurological impairments due to the increased risk for postoperative complications. Furthermore, meticulous surgical planning and advanced imaging techniques are essential for mitigating risks such as vascular, bowel, and ureteral injuries. Continued advancements in surgical instrumentation and navigation technologies are expected to further refine the utility of LLIF in treating complex spinal pathologies, offering a promising minimally invasive option for achieving effective spinal stabilization and decompression.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"381-391"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Influence of renal function on the clinical efficacy of carboplatin plus pemetrexed in patients with non-small cell lung cancer. 肾功能对卡铂联合培美曲塞治疗非小细胞肺癌临床疗效的影响。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2025-08-01 DOI: 10.18999/nagjms.87.3.483

Kazuki Komeda, Tetsunari Hase, Toru Hara, Tomoki Kimura, Eiji Kojima, Takashi Abe, Yoshitsugu Horio, Yasuhiro Goto, Futoshi Ushijima, Shohei Watanabe, Yuki Yamada, Tomoya Shimokata, Tetsuya Oguri, Masashi Yamamoto, Kiyoshi Yanagisawa, Masahiko Ando, Masashi Kondo, Yoshinori Hasegawa, Makoto Ishii

{"title":"Influence of renal function on the clinical efficacy of carboplatin plus pemetrexed in patients with non-small cell lung cancer.","authors":"Kazuki Komeda, Tetsunari Hase, Toru Hara, Tomoki Kimura, Eiji Kojima, Takashi Abe, Yoshitsugu Horio, Yasuhiro Goto, Futoshi Ushijima, Shohei Watanabe, Yuki Yamada, Tomoya Shimokata, Tetsuya Oguri, Masashi Yamamoto, Kiyoshi Yanagisawa, Masahiko Ando, Masashi Kondo, Yoshinori Hasegawa, Makoto Ishii","doi":"10.18999/nagjms.87.3.483","DOIUrl":"10.18999/nagjms.87.3.483","url":null,"abstract":"Pemetrexed, a structural antifolate agent that is eliminated via renal excretion, is commonly used to treat non-squamous non-small-cell lung cancer (NS-NSCLC). Although poor renal function is associated with a high incidence of toxicities, the association of high renal function with chemotherapy efficacy and toxicity remains unknown. We aimed to investigate the effect of renal function on the efficacy and toxicity of carboplatin-pemetrexed chemotherapy in patients with NS-NSCLC. We performed a post-hoc analysis of a prospective observational study of carboplatin-pemetrexed treatment in NS-NSCLC patients. Baseline renal function was calculated using the Japanese estimated glomerular filtration rate (eGFR) formula, and the patients were then divided into two groups based on the eGFR: high-eGFR (eGFR ≥ 80 mL/min/1.73 m2, N = 162) and low-eGFR (eGFR < 80 mL/min/1.73 m2, N = 176) groups. Although the response rates in the high- and low-eGFR groups were similar (22.2% vs 23.9%, P = 0.7205), the disease control rate was significantly lower in the high-eGFR group than in the low-eGFR group (75.9% vs 84.7%, P = 0.043). Progression-free survival (PFS) and overall survival (OS) in the high-eGFR group were significantly shorter than those in the low-eGFR group (adjusted hazard ratio for PFS and OS, 1.32 [95% CI, 1.04-1.69; P = 0.0245] and 1.49 [95% CI, 1.15-1.93, P = 0.0023], respectively). The incidence of hematological and non-hematological toxicities was lower in the high-eGFR group. In conclusion, a high-eGFR is associated with poor efficacy and mild toxicity of carboplatin-pemetrexed in patients with NSCLC.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"87 3","pages":"483-497"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0