Nagoya Journal of Medical Science最新文献_第7页

Delivery management of pregnant blue rubber bleb nevus syndrome patients: a case report and literature review. 蓝色橡皮样痣综合征孕妇的分娩管理：病例报告和文献综述。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.507

Mie Nagahama, Yoshitsugu Chigusa, Atsuko Shiraki, Yui Takei, Ayaka Yamaguchi, Toshiyuki Mizota, Maya Komatsu, Takashi Nomura, Moritoki Egi, Masaki Mandai, Haruta Mogami

{"title":"Delivery management of pregnant blue rubber bleb nevus syndrome patients: a case report and literature review.","authors":"Mie Nagahama, Yoshitsugu Chigusa, Atsuko Shiraki, Yui Takei, Ayaka Yamaguchi, Toshiyuki Mizota, Maya Komatsu, Takashi Nomura, Moritoki Egi, Masaki Mandai, Haruta Mogami","doi":"10.18999/nagjms.86.3.507","DOIUrl":"10.18999/nagjms.86.3.507","url":null,"abstract":"Blue rubber bleb nevus syndrome (BRBNS) is a rare systemic vascular disorder characterized by multifocal venous malformations (VMs). Little is known about the perinatal management of pregnant women with BRBNS owing to the limited number of reported cases. We present the case of a 36-year-old primigravida with BRBNS who underwent an uneventful cesarean section under spinal anesthesia for breech presentation. A thorough systemic examination revealed VMs in various organs, including the skin, conjunctiva, larynx, gastrointestinal tract, lungs, and vulva. Prior to spinal anesthesia, careful examination using imaging modalities was conducted to assess the spinal and epidural involvement of the VMs to avoid complications, including accidental puncture of the VMs, associated bleeding, and epidural hematoma. In pregnant women with BBNS, it is imperative to scrutinize the localization and distribution of VMs throughout the body to anticipate potential complications and select the appropriate delivery mode and anesthetic management.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"507-513"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362364","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

Adenosine triphosphate release inhibitors targeting pannexin1 improve recovery after spinal cord injury. 以 pannexin1 为靶点的三磷酸腺苷释放抑制剂可改善脊髓损伤后的恢复。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.392

Kazuaki Morishita, Hiroaki Nakashima, Masaaki Machino, Sadayuki Ito, Naoki Segi, Yuichi Miyairi, Yoshinori Morita, Shiro Imagama

{"title":"Adenosine triphosphate release inhibitors targeting pannexin1 improve recovery after spinal cord injury.","authors":"Kazuaki Morishita, Hiroaki Nakashima, Masaaki Machino, Sadayuki Ito, Naoki Segi, Yuichi Miyairi, Yoshinori Morita, Shiro Imagama","doi":"10.18999/nagjms.86.3.392","DOIUrl":"10.18999/nagjms.86.3.392","url":null,"abstract":"Traumatic spinal cord injury is characterized by immediate and irreversible tissue loss at the lesion site and secondary tissue damage. Secondary injuries should, in principle, be preventable, although no effective treatment options currently exist for patients with acute spinal cord injury. Traumatized tissues release excessive amounts of adenosine triphosphate and activate the P2X purinoceptor 7/pannexin1 complex, which is associated with secondary injury. We investigated the neuroprotective effects of the blue dye Brilliant Blue FCF, a selective inhibitor of P2X purinoceptor 7/pannexin1 that is approved for use as a food coloring, by comparing it with Brilliant Blue G, a P2X7 purinoceptor antagonist, and carbenoxolone, which attenuates P2X purinoceptor 7/pannexin1 function, in a rat spinal cord injury model. Brilliant Blue FCF administered early after spinal cord injury reduced spinal cord anatomical damage and improved motor recovery without apparent toxicity. Brilliant Blue G had the highest effect on this neurological recovery, with Brilliant Blue FCF and carbenoxolone having comparable improvement. Furthermore, Brilliant Blue FCF administration reduced local astrocytic and microglial activation and neutrophil infiltration, and no differences in these histological effects were observed between compounds. Thus, Brilliant Blue FCF protects spinal cord neurons after spinal cord injury and suppresses local inflammatory responses as well as Brilliant Blue G and carbenoxolone.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"392-406"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362292","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

Appendiceal adenocarcinoma associated with Amyand's hernia: a case report. 阑尾腺癌伴发阿米氏疝：病例报告。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.514

Kotaro Momota, Koji Shibata, Hideo Miyake, Hidemasa Nagai, Yuichiro Yoshioka, Norihiro Yuasa, Hideki Murakami

{"title":"Appendiceal adenocarcinoma associated with Amyand's hernia: a case report.","authors":"Kotaro Momota, Koji Shibata, Hideo Miyake, Hidemasa Nagai, Yuichiro Yoshioka, Norihiro Yuasa, Hideki Murakami","doi":"10.18999/nagjms.86.3.514","DOIUrl":"10.18999/nagjms.86.3.514","url":null,"abstract":"We encountered a rare case of appendiceal carcinoma associated with Amyand's hernia, which was difficult to diagnose preoperatively. A 74-year-old man presented to our hospital with right lower abdominal pain. A hard mass was palpable in the right lower abdomen, and blood tests showed a slightly elevated inflammatory response. Computed tomography revealed a 7 × 5 cm mass with indistinct borders and heterogeneous internal density extending from the cecum to the right lower abdominal wall. We diagnosed appendiceal abscess, however, percutaneous biopsy which was performed for differential diagnosis with appendiceal carcinoma showed no malignancy. Thereafter, the patient was followed up. Two months later, a blood test showed insignificant changes in the inflammatory response and a high serum carcinoembryonic antigen level (48.6 ng/mL). An ultrasound showed a mass contiguous to the appendix, extending to the abdominal wall, with abundant blood flow signals. Fluorodeoxyglucose-positron emission tomography showed a high accumulation of fluorodeoxyglucose in the mass. Four months after the initial visit, the patient had an open ileocecal resection combined with an abdominal wall resection based on the preoperative diagnosis of appendiceal carcinoma invading the abdominal wall. During laparotomy, an enlarged appendix tip extended from the internal inguinal ring outside the inferior epigastric artery to the abdominal wall. Histopathological examination of the appendiceal tumor revealed well-differentiated adenocarcinoma, T4b (abdominal wall), N0, Ly0, and V0. When a right lower abdominal mass extends from the cecum to the abdominal wall, appendiceal tumors associated with Amyand's hernia should be considered.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"514-523"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362361","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

Mild hyperthermia upregulates PD-L1 in the tumor microenvironment and enhances antitumor efficacy of PD-L1 blockade in murine squamous cell carcinoma. 轻度热疗可上调肿瘤微环境中的 PD-L1 并增强 PD-L1 阻断剂在小鼠鳞状细胞癌中的抗肿瘤疗效。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.497

Yuya Ohta, Norihisa Ichimura, Satoshi Yamaguchi, Go Ohara, Noriyuki Yamamoto, Yoshiyuki Itoh, Keiichiro Yamada, Seiji Nakamura, Hideharu Hibi

{"title":"Mild hyperthermia upregulates PD-L1 in the tumor microenvironment and enhances antitumor efficacy of PD-L1 blockade in murine squamous cell carcinoma.","authors":"Yuya Ohta, Norihisa Ichimura, Satoshi Yamaguchi, Go Ohara, Noriyuki Yamamoto, Yoshiyuki Itoh, Keiichiro Yamada, Seiji Nakamura, Hideharu Hibi","doi":"10.18999/nagjms.86.3.497","DOIUrl":"10.18999/nagjms.86.3.497","url":null,"abstract":"Head and neck squamous cell carcinoma (HNSCC) has a low five-year survival rate because of its high rate of recurrence and metastasis. After surgical resection or radiation, the main treatments for HNSCC, patients sometimes experience functional or aesthetic disorders. Therefore, there is a great demand for the development of non-surgical treatment strategies to improve clinical outcomes and patients' quality of life. One such non-surgical treatment is mild hyperthermia (mHT). Many studies have investigated combination treatments with mHT and immune checkpoint inhibitors in preclinical settings. However, there have been no detailed reports on the effects of mHT on immune checkpoint molecules. Here, we investigated the effects of mHT on the tumor microenvironment (TME), particularly on programmed cell death receptor-1 (PD-1)/programmed cell death ligand-1 (PD-L1), in SCCVII cells and a squamous cell carcinoma mouse model. First, we found that PD-L1 mRNA levels and surface PD-L1 expression significantly increased after mHT. Second, a single tumor model was used to determine the effect of HT on the TME. mHT enhanced the accumulation of CD4+ and CD8+ T cells, elevated PD-L1 expression in the TME, and decreased the PD-1 positive rate of CD4+ T cells. Finally, using a bilateral tumor model, we found that anti-PD-L1 monotherapy and combination therapy resulted in longer survival than the isotype control or mHT monotherapy. Moreover, the combination therapy resulted in a significantly higher survival rate than anti-PD-L1 monotherapy. In conclusion, our findings elucidate changes in PD-L1 expression in the TME and strengthen the rationale for mHT and PD-L1 blockade combination therapy.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"497-506"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362369","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

Decubitus ulcer infection and bacteremia due to tazobactam/piperacillin-resistant Veillonella parvula. 耐他唑巴坦/哌拉西林维龙菌引起的褥疮感染和菌血症。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.524

Shoko Sahara, Teruhisa Kinoshita, Tomomi Amano, Misa Ishida, Takashi Yamakita, Norio Takimoto, Keisuke Oka

{"title":"Decubitus ulcer infection and bacteremia due to tazobactam/piperacillin-resistant Veillonella parvula.","authors":"Shoko Sahara, Teruhisa Kinoshita, Tomomi Amano, Misa Ishida, Takashi Yamakita, Norio Takimoto, Keisuke Oka","doi":"10.18999/nagjms.86.3.524","DOIUrl":"10.18999/nagjms.86.3.524","url":null,"abstract":"This is the first case report of decubitus infection and bacteremia due to Veillonella parvula (V. parvula). A patient in his 70s with pre-existing diabetes mellitus was admitted with decubitus infection, and tazobactam/piperacillin treatment was initiated. Tazobactam/piperacillin-resistant V. parvula was detected in the blood and decubitus site cultures. The antimicrobial treatment was changed to clindamycin and cefmetazole. Antimicrobial therapy was administered for 28 days. The patient was transferred to a convalescent hospital. V. parvula occasionally causes infection in immunocompromised patients with underlying diseases, such as diabetes. An appropriate evaluation by culture test is important for diagnosis, treatment, and recurrence prevention. Tazobactam/piperacillin is often used in the treatment of multi-bacterial infections such as decubitus infections. V. parvula may be resistant to tazobactam/piperacillin, and this possibility should be taken into account when administering treatment.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"524-530"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362363","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

Intraoperative transverse carpal muscle during endoscopic carpal tunnel release: a case report. 内窥镜腕管松解术中的术中腕横肌：病例报告。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.531

Shunpei Hama, Koji Moriya, Naoto Tsubokawa, Yutaka Maki, Hiroaki Nakamura

引用次数: 0

Our experience in repairs using the native esophagus such as the Foker and Gazi methods in the management of patients with long-gap esophageal atresia. 在治疗长间隙食道闭锁患者时，我们利用原生食道进行修复的经验，如 Foker 和 Gazi 方法。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.479

Cem Kaya, Alparslan Kapisiz, Sibel Eryilmaz, Zafer Turkyilmaz, Ramazan Karabulut, Leyla Turker, Ibrahim Murat Hirfanoglu, Ebru Ergenekon, Canan Turkyilmaz, Kaan Sonmez

{"title":"Our experience in repairs using the native esophagus such as the Foker and Gazi methods in the management of patients with long-gap esophageal atresia.","authors":"Cem Kaya, Alparslan Kapisiz, Sibel Eryilmaz, Zafer Turkyilmaz, Ramazan Karabulut, Leyla Turker, Ibrahim Murat Hirfanoglu, Ebru Ergenekon, Canan Turkyilmaz, Kaan Sonmez","doi":"10.18999/nagjms.86.3.479","DOIUrl":"10.18999/nagjms.86.3.479","url":null,"abstract":"This study aimed to share our experience with infants with repaired long-gap esophageal atresia (LGEA) using the native esophagus and Foker and Gazi methods. We retrospectively analyzed the medical records of 10 patients with LGEA (six with pure esophageal atresia [EA], and four with distal trachea-esophageal fistula [TEF] + EA). The mean length between the esophageal pouches was 5.9 cm (4-9 cm). Five Foker methods, three Gazi methods, and two delayed primary repairs after a daily bougie were performed an average of 19.3 days after the first surgery and 26.4 days after the final esophageal anastomosis. For the Foker technique, it was 36.1 days. Their first oral intake was 10.2 days, and their transition to full enteral food was 26.2 days. An esophageal leak was detected in six patients. Fundoplication and dilatations were performed for three and four patients, respectively. For good results, LGEA patients should be operated on at least under the supervision of an experienced surgeon in specialized centers, and the team should be familiar with the techniques for using the native esophagus.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"479-486"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362371","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 study of the effect of the web application on caregiver burden in dementia and behavioural and psychological symptoms of dementia. 关于网络应用对痴呆症护理负担以及痴呆症行为和心理症状影响的初步研究。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.383

Yasuyuki Goto, Mina Suematsu, Takahiro Imaizumi, Yusuke Suzuki

{"title":"Preliminary study of the effect of the web application on caregiver burden in dementia and behavioural and psychological symptoms of dementia.","authors":"Yasuyuki Goto, Mina Suematsu, Takahiro Imaizumi, Yusuke Suzuki","doi":"10.18999/nagjms.86.3.383","DOIUrl":"10.18999/nagjms.86.3.383","url":null,"abstract":"This study aimed to investigate if our web application could be a viable intervention for providing caregivers with information on resilient coping strategies for the reduction of their burden, thereby leading to the alleviation of behavioural and psychological symptoms of dementia (BPSD). We recruited outpatients with dementia and informal caregiver dyads at Nagoya University Hospital from April 2022 to October 2022. The caregivers were asked to have the web application installed on their smartphones during the study period and answer the following two self-administered questionnaires once a month for 3 months: (a) Abe's BPSD Score (ABS), which assesses BPSD, and (b) the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI) score, which measures caregiver burden. Thirteen patients and informal caregiver dyads were enrolled in this study. The caregivers exchanged information on the care of patients with dementia in the virtual community using the web application during the study period. Upon entry, J-ZBI scores were correlated with ABSs (r = 0.65). Linear mixed-effects model revealed the average J-ZBI scores decreased over time with significance (p = 0.013), however, the average ABSs did not change during the study period. This is the first study to show that our web application reduces caregiver burden. However, to confirm the efficacy of our web application, further investigations are required.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"383-391"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362373","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 of air leaks in patients undergoing robotic thoracic surgery and video-assisted thoracic surgery. 机器人胸腔手术和视频辅助胸腔手术患者的漏气发生率。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.464

Harushi Ueno, Yuri Takada, Yoshito Imamura, Shoji Okado, Yuji Nomata, Hiroki Watanabe, Keita Nakanishi, Yuka Kadomatsu, Taketo Kato, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa

{"title":"Incidence of air leaks in patients undergoing robotic thoracic surgery and video-assisted thoracic surgery.","authors":"Harushi Ueno, Yuri Takada, Yoshito Imamura, Shoji Okado, Yuji Nomata, Hiroki Watanabe, Keita Nakanishi, Yuka Kadomatsu, Taketo Kato, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa","doi":"10.18999/nagjms.86.3.464","DOIUrl":"10.18999/nagjms.86.3.464","url":null,"abstract":"Postoperative air leakage is the most common complication in surgery for malignant lung tumors, leading to extended hospital stays and substantial medical expenses. This study aimed to identify the incidence and characteristics of intraoperative and postoperative air leaks in both robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS), as well as the causes of persistent air leakage following RATS. We conducted a retrospective analysis of patients who underwent lung resection for malignant lung tumors at our institution from October 2018 to August 2022. We compared the incidence rates of intraoperative air leak, postoperative air leak, and persistent air leak between patients who underwent RATS and those who underwent VATS. Background factors were adjusted using propensity score matching. A subanalysis was performed to compare unexpected air leaks, defined as air leaks not observed intraoperatively but confirmed postoperatively. The study included 295 cases of RATS and 227 cases of VATS. In both the overall population and the matched group (187 cases each for RATS and VATS), RATS demonstrated a significantly higher incidence of persistent air leaks compared to VATS (11% vs 3%, p < 0.01; 9% vs 3%, p = 0.02, respectively). RATS also had a significantly higher incidence of unexpected air leaks compared with VATS (29% vs 18%, p = 0.05). Although there was no statistically significant difference in hospital stays, RATS showed a higher incidence of postoperative persistent air leaks and unexpected postoperative air leaks than VATS.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"464-471"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362366","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

A novel technique for C1-C2 posterior screw insertion using patient-specific guides created by CT-based 3D printing. 利用基于 CT 的 3D 打印技术创建的患者特异性导板，采用新技术插入 C1-C2 后螺钉。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2024-08-01 DOI: 10.18999/nagjms.86.3.487

Yujiro Kagami, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Jun Ouchida, Ryuichi Shinjo, Shiro Imagama

{"title":"A novel technique for C1-C2 posterior screw insertion using patient-specific guides created by CT-based 3D printing.","authors":"Yujiro Kagami, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Jun Ouchida, Ryuichi Shinjo, Shiro Imagama","doi":"10.18999/nagjms.86.3.487","DOIUrl":"10.18999/nagjms.86.3.487","url":null,"abstract":"C1-C2 fixation has been developed for the rigid fusion of atlantoaxial instability. C1 lateral mass screw (C1 LMS)-C2 pedicle screw fixation is used more frequently due to its rigid fixation and high bone fusion rate. However, C1 screw placement is relatively unsafe even with recently developed image-based navigation systems. Patient-specific screw guide templates (PSGT) were developed to improve the accuracy and safety of C1 screw placement. Herein, we investigated the outcomes of the C1-C2 posterior fixation technique using PSGT. This was a retrospective study of six patients who underwent posterior cervical spinal fusion using the PSGT between January 2022 and April 2023. Operative time, estimated blood loss, intraoperative radiation dose, surgical cost, and screw placement accuracy were evaluated and compared with those achieved with preoperative CT-based navigation (navigation group, n = 15). Screw accuracy was assessed using Neo's classification. PSGT showed good results, although the differences were not statistically significant (operation time: 104.3 ± 9.7 min vs 116.4 ± 20.8 min; estimated blood loss: 56.7 ± 72.4 mL vs 123.2 ± 162.3 mL; and radiation dose: 1.8 ± 1.2 mSv vs 2.6 ± 0.8 mSv, respectively). PSGT was particularly better in terms of the accuracy of C1 LMS (PSGT: 100%, navigation: 83.3%). The deviation at the entry point was minimal, and the difference between the sagittal and transversal angles from the preoperative plan was small. We investigated the clinical efficacy of using the PSGT for C1-C2 posterior fixation. PSGT improved the accuracy of C1 LMS insertion.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"86 3","pages":"487-496"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362291","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