Publications by authors named "Masayuki Ishihara"
Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.
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- This study analyzed 389 patients aged 65 and older with cervical spinal cord injury (CSCI) but no bone injury to assess the effects of diabetes on neurological recovery.
- The research found that there were no significant differences in neurological outcomes between diabetic patients and those without diabetes at 6 months post-injury.
- Additionally, moderate-severe diabetes did not adversely impact recovery, suggesting that diabetic patients had similar improvements in neurological function as their nondiabetic counterparts.
Study Design: Prospective multicenter study.
Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.
Article Synopsis
- Dysphagia, a serious swallowing disorder, affects older adults post-spinal cord injury, particularly those with cervical injuries, though its risk factors are not well understood.
- A study involving 707 patients aged 65 and older identified male sex, low nutritional status (GNRI <92), dementia, fractures, complete paralysis, anterior surgery, and tracheostomy as significant risk factors for dysphagia.
- The findings suggest that a low geriatric nutritional risk index (GNRI) is a key indicator of dysphagia risk, implying that nutritional health is critical for recovery in elderly patients with cervical spinal injuries.
Novel germline STAT3 gain-of-function mutation causes autoimmune diseases and severe growth failure.
J Allergy Clin Immunol Glob
November 2024
Article Synopsis
- The study investigates a young boy with severe autoimmune conditions who was found to have a germline gain-of-function mutation in the STAT3 gene through whole-exome sequencing.* -
- Treatment with the targeted therapy tocilizumab led to a reduction in hospital stays and slowed the progression of pulmonary fibrosis, showing promise for managing his condition without increasing steroid use.* -
- The findings suggest that genetic testing and functional analysis of STAT3 mutations are important for diagnosing early-onset autoimmune diseases and for considering targeted treatment options.*
Article Synopsis
- The study investigated the postoperative outcomes for patients with spinal metastases from prostate cancer, focusing on improvements in their quality of life and other patient-oriented assessments.
- Conducted across 35 centers, the research assessed 413 patients, with 41 specifically having prostate cancer, and followed them for at least a year following surgery using various evaluation methods.
- Results showed significant improvements in neurological function, quality of life, and patient motivation post-surgery, indicating that surgical intervention is beneficial for these patients.
: Proximal junctional kyphosis (PJK) and failure (PJF), the most prevalent complications following long-segment thoracolumbar fusions for adult spinal deformity (ASD), remain lacking in defined preventive measures. We studied whether one of the previously reported strategies with successful results-a prophylactic augmentation of the uppermost instrumented vertebra (UIV) and supra-adjacent vertebra to the UIV (UIV + 1) with polymethylmethacrylate (PMMA)-could also serve as a preventive measure of PJK/PJF in minimally invasive surgery (MIS). : The study included 29 ASD patients who underwent a combination of minimally invasive lateral lumbar interbody fusion (MIS-LLIF) at L1-2 through L4-5, all-pedicle-screw instrumentation from the lower thoracic spine to the sacrum, S2-alar-iliac fixation, and two-level balloon-assisted PMMA vertebroplasty at the UIV and UIV + 1.
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- The study aimed to determine minimal clinically important differences (MCIDs) for patients undergoing surgery for spinal metastases to improve patient care by linking quality of life assessments with clinical outcomes.
- A total of 171 patients were evaluated pre- and post-surgery using various scales, leading to the identification of specific MCID values for different quality of life aspects based on their treatment outcomes.
- The study successfully established both anchor-based and distribution-based MCIDs for surgical interventions, which can help in assessing patient progress and overall treatment effectiveness.
Objectives: Macroprolactinemia is one of the major causes of hyperprolactinemia. The aim of this study was to clarify the origin of macroprolactin (macro-PRL).
Methods: We examined macro-PRL in the sera of 826 pregnant women and in those of their babies' umbilical cords at delivery.
This retrospective cohort study established malnutrition's impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk.
View Article and Find Full Text PDFStudy Design: Retrospective cohort study.
Objectives: To define the prognosis and predictive factors for neurological improvement in older patients with incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale grade C (AIS-C).
Settings: Multi-institutions in Japan.
Study Design: Retrospective multicenter study.
Objectives: The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear.
Objective: The efficacy of anterior column realignment (ACR) remains relatively unclear, possibly because some safety concerns have limited its adoption and extensive evaluation. The authors aimed to study whether a minimally invasive surgery (MIS) triad consisting of ACR, lateral lumbar interbody fusion, and percutaneous pedicle screw fixation in a select group of adult spinal deformity (ASD) patients helps shorten fusion length without compromising clinical and radiographic outcomes over a minimum 2-year follow-up period.
Methods: A series of 61 ASD patients (mean age 72.
This study aimed to devise measures and investigate their effect on coronal imbalance (CI) after circumferential minimally invasive correction surgery (CMIS) with lateral lumbar interbody fusion and percutaneous pedicle screw for adult spinal deformity (ASD). A total of 115 patients with ASD who underwent CMIS from the lower thoracic spine to the ilium were included. Patients were stratified based on the distance between the spinous process of the upper instrumented vertebra and central sacrum vertical line (UIV-CSVL) after the first intraoperative rod application into groups P (UIV-CSVL > 10 mm, = 50) and G (UIV-CSVL < 10 mm, = 65).
View Article and Find Full Text PDFObjective: We present the surgical approaches and short-term (2 years postoperative) results pertaining to circumferential minimally invasive spine surgery (CMIS) with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw application for adult idiopathic scoliosis (AS).
Methods: We enrolled eight patients with AS who underwent CMIS (2018-2020) and examined the number of fused levels, upper instrumented vertebra, lower instrumented vertebra, number of LLIF-treated segments, number of preoperative intervertebral fusions, intraoperative blood loss, operative time, various spinopelvic parameters, Oswestry Disability Index, low back pain, visual analog scale (VAS), leg VAS, bone fusion rate, and perioperative complications.
Results: The upper instrumented vertebra was T4, T7, T8, and T9 in two cases, whereas lower instrumented vertebra was the pelvis in all the cases.
Article Synopsis
- The study is a retrospective multicenter analysis comparing elderly patients with cervical diffuse idiopathic skeletal hyperostosis (cDISH) injuries to matched controls, focusing on those with and without fractures.
- It involved 140 patients aged 65 and older, revealing that those with fractures had similar complication rates and ambulation outcomes as controls, while nonambulatory patients without fractures had significantly poorer ambulation.
- Logistic regression highlighted complete paralysis and age as major risk factors for early mortality, with 14 patients passing away within three months of the injury.*
Purpose: To investigate the impact of early post-injury respiratory dysfunction for neurological and ambulatory ability recovery in patients with cervical spinal cord injury (SCI) and/or fractures.
Methods: We included 1,353 elderly patients with SCI and/or fractures from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were included in the respiratory dysfunction group, which was further classified into mild and severe respiratory groups based on respiratory weaning management.
Objective: Reconstruct compound median nerve action currents using magnetoneurography to clarify the physiological characteristics of axonal and volume currents and their relationship to potentials.
Methods: The median nerves of both upper arms of five healthy individuals were investigated. The propagating magnetic field of the action potential was recorded using magnetoneurography, reconstructed into a current, and analyzed.
Objective: The mechanism underlying the generation of P9 far-field somatosensory evoked potentials (SEPs) is unresolved. Accordingly, we used magnetoneurography to visualize the current distribution in the body at the P9 peak latency and elucidate the origin of P9 generation.
Methods: We studied five healthy male volunteers without neurological abnormalities.
Article Synopsis
- - The study focuses on the increasing elderly population at high risk for delirium due to cervical trauma, aiming to create a risk score to predict delirium in patients with cervical spinal cord injury or fracture regardless of their treatment type.
- - A total of 1,512 elderly patients (aged 65+) were analyzed, and significant risk factors for delirium were identified through multivariate logistic regression, leading to a delirium risk score based on six important variables.
- - The newly developed risk score can help healthcare providers make informed decisions regarding treatment strategies, despite needing further validation with additional data, having shown a prediction accuracy area under the curve of 0.66.
Article Synopsis
- - The study analyzed 1512 patients aged 65 and older with cervical spine injuries, revealing that 6.3% of them had dementia, which was more common in older, mainly female patients with lower body mass index and higher frailty.
- - Patients with dementia showed worse short-term outcomes, including lower functional ability in activities of daily living (ADLs) and a higher rate of dysphagia compared to those without dementia.
- - Mortality rates were significantly higher in patients with dementia following their injuries, highlighting the adverse effects of dementia on recovery and survival in this demographic.
Objective: Shock heart syndrome (SHS) is associated with lethal arrhythmias (ventricular tachycardia/ventricular fibrillation, VT/VF). We investigated whether liposome-encapsulated human hemoglobin vesicles (HbVs) has comparable persistent efficacy to washed red blood cells (wRBCs) for improving arrhythmogenesis in the subacute to chronic phase of SHS.
Methods: Optical mapping analysis (OMP), electrophysiological study (EPS), and pathological examinations were performed on blood samples from Sprague-Dawley rats following induction of hemorrhagic shock.
Although the incidence of cervical spinal cord injury (CSCI) with ossification of the posterior longitudinal ligament (OPLL) has increased in older adults, its etiology and neurological outcomes remain unknown. We identified OPLL characteristics and determined whether they influence neurological severity and improvement of CSCI in older patients. This multicenter retrospective cohort study identified 1512 patients aged ≥ 65 years diagnosed with CSCI on admission during 2010-2020.
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- * Findings show that while patients who had early surgery had worse baseline neurological conditions, they experienced a greater improvement in motor scores within six months of surgery.
- * Factors like delirium, pneumonia, and diabetes negatively affected recovery, suggesting that early surgery may be beneficial but requires more research for confirmation.