Psychologic stress and disease activity in patients with inflammatory bowel disease: A multicenter cross-sectional study.

Background And Aims: Psychologic stress can affect the pathogenesis of inflammatory bowel disease (IBD), but the precise contribution of psychologic stress to IBD remains unclear. We investigated the association of psychologic stress with disease activity in patients with IBD, especially in terms of mental state and sleep condition.

Methods: This was a multi-center observational study comprising 20 institutions.

Efficacy of chemotherapy for older patients with gastric cancer: a multicenter retrospective cohort study.

Background: Gastric cancer is one of the leading causes of malignant disease-related mortality, worldwide. With the use of recently developed anti-tumor agents, the prognoses of patients with unresectable gastric cancer are improving. However, the development of an aggressive treatment strategy for older patients (OPs) remains under debate due to concerns regarding treatment feasibility or patient frailty.

A prospective multicenter observational study evaluating the risk of periendoscopic events in patients using anticoagulants: the Osaka GIANT Study.

 An increasing number of patients have been using anticoagulants including anti-vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs); however, in patients using anticoagulants, limited data are available with regard to the risks of gastrointestinal bleeding and thromboembolic events during the peri-endoscopic period. We aimed to evaluate the peri-endoscopic bleeding and thrombotic risks in patients administered VKAs or DOACs.  Consecutive patients using anticoagulants who underwent endoscopic biopsy, mucosal resection, or submucosal dissection were prospectively enrolled across 11 hospitals.

Differences in activities of daily living after hip arthroplasty among hip resurfacing, anterolateral THA, and posterolateral THA: a propensity score matched analysis.

The aim was to elucidate the differences in activities of daily living (ADL) after hip arthroplasty among hip resurfacing (HRA), anterolateral total hip arthroplasty (AL-THA), and posterolateral THA (PL-THA) patients after age, sex, body mass index, bilateral/unilateral hip arthroplasty, and postoperative duration were matched using propensity scores. A total of 673 hips from 540 consecutive patients who underwent hip arthroplasty were included. A self-completed questionnaire on preoperative and postoperative ADLs was administered during postsurgical visits at least ≥ 4 years postoperatively.

Polyethylene Wear Associated With 26- and 32-mm Heads in Total Hip Arthroplasty: A Multicenter, Prospective Study.

Background: Although there were many clinical studies of highly cross-linked polyethylene (XLPE) wear among different femoral head diameters, few referred to thickness of XLPE in case larger femoral heads were used because smaller sockets were frequently used for Asian population.

Methods: This prospective study included 240 hips that underwent primary total hip arthroplasty using XLPE combined with 26-mm (group S) or 32-mm (group L) cobalt-chromium head with maximum follow-up of 10 years. We measured 3-dimensional (3-D) linear penetration rate of XLPE among same implant design groups except head diameter and estimated the validity of thinner XLPE.

Laparoscopic gastropexy for chronic gastric volvulus.

Gastric volvulus is an infrequently encountered clinical entity characterized by abnormal rotation of the stomach. Surgical treatment by anterior gastropexy is indicated for acute and chronic gastric volvulus. Recently, laparoscopic surgery has been used in abdominal surgery.

Biomechanical testing of the fractured distal radius treated with a new bone cement--is it strong enough?

This study evaluates the in vitro ability of CAP, a bone graft substitute with osteointegration and osteoconductive properties, to restore the anatomy and strength of fractured distal radii. Ten pairs of cadaveric radii were imaged and tested to failure, simulating a fracture. The radii were reconstructed using CAP and were re-fractured and sequentially imaged.

Persistent intracranial hypertension caused by superior sagittal sinus stenosis following depressed skull fracture. Case report and review of the literature.

Intracranial hypertension caused by a compound depressed skull fracture on the posterior part of the superior sagittal sinus is a rare condition, and nonspecific symptoms and signs can delay appropriate diagnosis and treatment. The authors report on a case of intracranial hypertension that persisted despite conservative treatment, including anticoagulation therapy, which did not improve severe flow disturbance related to the venous sinus compression. Management of this rare condition is discussed and the literature is reviewed.

Left atrial diameter is a simple indicator of a deficiency in atrial natriuretic peptide secretion in patients with mitral stenosis: efficacy of postoperative supplementation with synthetic human alpha-atrial natriuretic peptide.

Objective: With regard to a deficiency in atrial natriuretic peptide (ANP) secretion, the relationship between plasma ANP and left atrial diameter measured by echocardiography was examined and the efficacy of postoperative supplementation was evaluated.

Methods: (1) Ninety-six patients with mitral valve disease from 1997 to 2002 (M:F = 65:31, mean-age 65.3 +/- 8.

Retrieved total hip prostheses. Part I: the effects of cup thickness, head sizes and fusion defects on wear.

The effects of polyethylene cup thickness, femoral head sizes (22, 28 and 32 mm) and fusion defects on wear were investigated on retrieved total hip prostheses. When the cup thickness was less than 9 mm, the larger the femoral head, the higher the linear wear rate; however, when the cup thickness was more than 9 mm, the larger the femoral head, the linear wear rate was lower. When the cup thickness was less than 11 mm, the volumetric wear rate increased with increasing size of the femoral head, and when it was more than 11 mm, the volumetric wear rate of the three kinds of the prosthetic cups approached the same values.

The effects of polyethylene cup thickness on wear of total hip prostheses.

The wear rate of the ultrahigh molecular weight polyethylene cups in combination with a 28 mm alumina femoral head was measured on the radiographs of patients without any complications, and on cups retrieved due to slight loosening of the prosthesis or due to late infection between bone and components. The wear rate on the radiographs did not include the initial wear, but the wear rate on the retrieved cups did include the initial wear. The wear rate on the retrieved cups was higher, by 50%, than that measured on the radiographs.

Retrieved total hip prostheses: part II. Wear behaviour and structural changes.

Polyethylene cups and femoral heads of retrieved total hip prostheses (Charnley 22 mm stainless steel ball, Bioceram 28 mm alumina ball and Müller 32 mm Co-Cr-Mo alloy ball) were observed by the naked-eye and scanning electron microscopy. Cross-linked cups irradiated with gamma radiation in heavy high doses of 100 Mrad were included. On the weight-bearing surface of the cups non-gamma irradiated, carpet-like conspicuous fine fibres, scratches and fine crevices for the 22 mm ball, scale-like with rough and fine crevices for the 28 mm ball, and scale-like structures and many scratches for the 32 mm ball, were observed, mainly.

Fibroblast growth factor-2 promotes the repair of partial thickness defects of articular cartilage in immature rabbits but not in mature rabbits.

Objective: To investigate cartilage response to fibroblast growth factor-2 (FGF-2) with increasing age in vivo, we examined the effect of FGF-2 on partial thickness defects of immature and mature rabbits.

Design: Sixty-nine Japanese white rabbits (34 immature rabbits, 35 mature rabbits) were examined. We made experimental partial thickness defects in articular cartilage of the knees.

Reduced collateral circulation to the infarct-related artery in elderly patients with acute myocardial infarction.

Objectives: The purpose of this study was to investigate the hypothesis that circulation via collateral vessels to an infarct-related artery (IRA) is impaired with aging in patients with acute myocardial infarction (AMI).

Background: Animal experiments have shown that advanced age blunts the development of new vessels in response to angiogenic cytokines.

Methods: Of 3,573 consecutive patients with AMI, 1,934 patients who fulfilled the following criteria were enrolled in this study: 1) coronary angiograms were obtained within 72 h after the onset of AMI; and 2) IRA showed complete occlusion (Thrombolysis In Myocardial Infarction [TIMI] flow grade 0 or 1).

Minimally-diluted blood cardioplegia supplemented with potassium and magnesium for combination of 'initial, continuous and intermittent bolus' administration.

Background: The present study was designed to examine the hypothesis that minimally-diluted blood cardioplegia (BCP) supplemented with potassium and magnesium provides superior myocardial protection in comparison with the standard-diluted BCP for a combination of 'initial, continuous, and intermittent bolus' BCP administration.

Methods And Results: Seventy patients undergoing elective coronary revascularization between 1997 and 2001 (M : F =55:15, mean age 67.6+/-7.

[The advanced technology of three-dimensional medical imaging in spine, bone and joints].

The advanced technology of three-dimensional (3-D) medical imaging allows us to understand the patient specific anatomy in detail. Especially, in orthopedic surgery, treated spinal diseases or the disorders of bone and joints, the 3-D computed tomography(CT), such as multi-slice CT and helical CT is a useful tool for clinical diagnosis and surgical treatment. Since 1995, by the use of these 3-D CT image data, computer navigation system and surgical robot were developed and applied to a spinal instrumentation surgery and an artificial joint replacement.

[Support of TS-1, 5-FU preparation containing potent DPD inhibitor by determination of urinary uracil/serum 5-FU clearance].

Though FU-derived anticancer agents are metabolized and detoxicated by dihydropyrimidine dehydrogenase (DPD), its wide distribution of activity is concerned primarily in the antitumor effects or side effects of 5-FU. In recent years, it has become possible to predict the metabolism of FU-derived anticancer agents by DPD activity through the determination of urinary uracil levels. In the present study, therefore, we examined whether or not urinary uracil levels could be used as a predictor for as certaining the efficacy and/or side effects of TS-1, which contains a potent DPD inhibitor.

Synthetic human alpha-atrial natriuretic peptide improves the management of postoperative hypertension and renal dysfunction after the repair of abdominal aortic aneurysm.

Objective: Delayed hypertension (HT) and renal dysfunction (RD) are observed after aortic operations accompanied by infra-renal aortic cross-clamping (AXC). Atrial natriuretic peptide (ANP) has effects on vasodilation and renal protection, and we examined the hypothesis that synthetic human alpha-ANP (hANP) improves the postoperative management for abdominal aortic aneurysm (AAA).

Methods: Fifty patients undergoing elective aneurysmectomy for infrarenal-AAA between 1998 and 2001 (M:F = 43:7, mean age 70.

Posterior approach to the degenerative cervical spine.

Laminoplasty has been gradually accepted as a treatment for choice for cervical compression myelopathy. The historical perspective of laminoplasty is described. The aims of laminoplasty are to expand the spinal canal, to secure spinal stability, to preserve the protective function of the spine, and to preserve spinal mobility.

Synthetic human alpha-atrial natriuretic peptide infusion in management after open heart operations.

Cardiopulmonary bypass (CPB) induces water retention in the third space, and the mechanism is partially associated with the activation of the renin-angiotensin-aldosterone system (RAAS). Atrial natriuretic peptide (ANP) has a gradual but strong diuretic effect and suppresses the RAAS activation. We examined the efficacy of synthetic human alpha-ANP (hANP) infusion in the management of the postoperative water balance control.

Aortic valve replacement for a patient with warm-reactive autoimmune hemolytic anemia.

We treated a 68-year-old woman with warm-reactive type of autoimmune hemolytic anemia (AIHA) who underwent aortic valve replacement. In consideration of the different hemolytic mechanisms between cardiopulmonary bypass and warm-reactive AIHA, conventional surgical procedures could be performed after the discontinuation of steroid therapy.

Imaging of distal internal carotid artery by ultrasonography with a 3.5-MHz convex probe.

Background And Purpose: Conventionally, carotid ultrasonography has been performed with a 7.5-MHz linear probe to evaluate the extracranial internal carotid artery (ICA). However, usually only the carotid bulb or proximal portion of the ICA can be evaluated.