Dural Laceration Resulting in the Formation of Syringomyelia Caused by a Loosened Hydroxyapatite Intraspinous Spacer after Spinous Process-splitting Laminoplasty.

A 63-year-old man was admitted in our hospital with the chief complaint of upper limb numbness 3 years after undergoing spinous process-splitting laminoplasty (C3-C7) in another hospital. The hydroxyapatite spacers used for the laminoplasty had dislocated, resulting sensory disorders of the upper extremities. Additionally, loosened hydroxyapatite intraspinous spacers and syringomyelia were confirmed.

Comparison of clinical outcomes following percutaneous coronary intervention versus optimal medical therapy based on gray-zone fractional flow reserve in stable angina patients with intermediate coronary artery stenosis (COMFORTABLE prospective study): Study protocol for a multicenter randomized controlled trial.

Background: Even in the current drug-eluting stent era, revascularization for coronary stenosis with fractional flow reserve (FFR) between 0.75 and 0.80, the so-called "gray zone," is a matter of debate.

Long-Term Results of Crossover Bypass for Iliac Atherosclerotic Lesions in the Era of Endovascular Treatment: The Re-ACTION Study (trospective ssessment of rossover Bypass as a reatment for liac Lesis).

The aim of this study was to elucidate the long-term results of crossover bypass (CB) for iliac atherosclerotic lesions in the era of endovascular treatment (EVT). A retrospective multicenter cohort study was performed. CB was performed in 242 patients between 2003 and 2014 by vascular surgeons at multiple medical centers in Japan.

Risk estimation model for nonalcoholic fatty liver disease in the Japanese using multiple genetic markers.

Unlabelled: The genetic factors affecting the natural history of nonalcoholic fatty liver disease (NAFLD), including the development of nonalcoholic steatohepatitis (NASH) and NASH-derived hepatocellular carcinoma (NASH-HCC), are still unknown. In the current study, we sought to identify genetic factors related to the development of NAFLD, NASH, and NASH-HCC, and to establish risk-estimation models for them. For these purposes, 936 histologically proven NAFLD patients were recruited, and genome-wide association (GWA) studies were conducted for 902, including 476 NASH and 58 NASH-HCC patients, against 7,672 general-population controls.

Prediction of a null response to pegylated interferon α-2b plus ribavirin in patients with high viral load genotype 1b hepatitis C.

Background/aims: The present study aimed to clarify whether virological response within 2 weeks after therapy initiation can predict a null response to pegylated interferon α-2b plus ribavirin therapy in patients with high viral load genotype 1b hepatitis C.

Methods: The participants consisted of 72 patients with high viral load genotype 1b. The dynamics of viral load within 2 weeks were measured.

A Case-Control Study of Esomeprazole Plus Rebamipide vs. Omeprazole Plus Rebamipide on Post-ESD Gastric Ulcers.

Objectives: Endoscopic submucosal dissection (ESD) is useful for treating gastric tumors. Several trials have shown the efficacy of 4 or 8 weeks of proton pump inhibitor (PPI) administration for post-ESD ulcers. However, if the size of the post-ESD ulcer is larger than predicted, PPI administration alone might not be sufficient for the ulcer to heal within 4 weeks.

Deep venous external valvuloplasty using a rigid angioscope.

Purpose: The aim of this study was to evaluate the long-term results of deep venous valvuloplasty using a rigid metal angioscope.

Methods: Forty patients who underwent deep venous external valvuloplasty using a rigid metal angioscope for primary deep venous insufficiency were enrolled. The preoperative CEAP (Clinical/Etiology/Anatomy/Pathophysiology) classifications were class 2 in 13 patients, class 3 in 8 patients, class 4 in 12 patients, class 5 in 1 patient, and class 6 in 6 patients.

Plasma adiponectin as a predictive factor of survival after a bypass operation for peripheral arterial disease.

Objective: We investigated an association between adiponectin and long-term survival in patients requiring an arterial bypass operation for peripheral arterial disease.

Methods: An enzyme-linked immunosorbent assay kit was used to measure plasma adiponectin levels in 49 patients (38 men, 11 women) before they underwent an arterial bypass operation. Median patient age was 70 years (range, 49-90 years).

Impact of reduced endogenous anti-coagulation protein activity on vascular events of peripheral arterial disease.

Aim: Aim of the study is to elucidate the prevalence and the prognosis of patients with peripheral arterial disease (PAD) who have reduced endogenous anti-coagulation protein activity.

Methods: Ninety six patients with PAD were studied, including 45 patients with intermittent claudication and 51 with critical limb ischemia. Among them 65 patients underwent peripheral artery bypass grafting.

Removal of a foreign body (artificial tooth) from the bronchial tree: a new method.

A 70-year-old man who had aspirated an artificial tooth during treatment at a dental clinic visited our hospital. His symptoms and physical condition were not remarkable. CT of chest revealed a foreign body in the right middle bronchus; bronchoscopy revealed it was wedged there.

Impaired flow-mediated endothelium-dependent and endothelium-independent vasodilation of the brachial artery in patients with atherosclerotic peripheral vascular disease.

A flow-mediated endothelium-dependent vasodilation and endothelium-independent nitroglycerin-induced vasodilation were carried out in 70 patients and 15 age-matched adults without any atherosclerotic risk factors to clarify vascular responsiveness in patients with atherosclerotic peripheral vascular disease. The percent change in flow-mediated vasodilation was significantly lower in patients than in controls (5.4 +/- 0.

[Arteriosclerosis and vascular calcification in chronic kidney disease (CKD) patients].

Chronic kidney disease (CKD) patients are belonging to high risk patients to atherosclerosis with vascular calcification. These patients are well recognized advanced arteriosclerosis with vascular medial calcification, with high risk of cardiovascular death. With basic investigated results, the mechanism of vascular calcification is making clear.

Massive spouting bleeding from chronic stasis ulceration caused by arteriovenous communication of the lower extremity.

We report a case of massive bleeding from a varicose vein in a calf. A 56-year-old man was brought into the emergency unit of our hospital with massive bleeding from an ulcer on his left calf. A duplex scan and arteriography revealed arteriovenous communication at the site of stasis ulceration.

Balloon or Stent-assisted Coil Embolization for Acutely Ruptured Wide-necked Aneurysms.

In this paper, we report five cases with acutely ruptured wide-necked aneurysms, which were treated with coil embolization using a balloon or stent-assisted technique. Balloon-assisted coil embolization using Equinox balloon, Commodore balloon, and Hyperform balloon were performed for four patients and stent-assisted coil embolization using BX velocity for one patient. We discuss problems of coil embolization for acutely ruptured wide-necked aneurysms with a balloon or stent-assisted technique.

Enhanced efficacy of nilvadipine in hypertensives whose raised ambulatory blood pressure is sustained during sleep.

This study was designed to clarify the relationship between the antihypertensive effects of the calcium antagonist nilvadipine, and circadian changes in blood pressure. Based on measurements using an ambulatory blood pressure monitoring system (ABPM), 17 outpatients with untreated essential hypertension were divided into two groups: a sustained hypertensive group (with a fall in blood pressure during sleep < 10%, n = 7) and a waking time hypertensive group (with a fall in blood pressure during sleep > or = 10%, n = 10). During treatment with nilvadipine (8 mg/day, > or = 2 weeks), patients were reexamined by ABPM.

Treatment of malignant tracheobronchial stenosis by Dacron mesh-covered Z-stents.

Z-stents partially covered with an expandable Dacron mesh into which epinephrine and thrombin were infiltrated, were used to reopen both mainstem bronchi, stenosed by bronchogenic carcinoma and to deliver hemostatic agents to the lesion. On follow-up 4 and 6 weeks later, airway patency was retained, the tumor surface was compressed, and the glossy surface of the stent suggested that it was covered with mucosa. For treatment of airway stenosis due to cancer invasion, a stent covered with a Dacron mesh sheet is thought to be effective in compressing the tumor and preventing tumor ingrowth into the stent.

Self-expandable metallic stent therapy for superior vena cava syndrome: clinical observations.

Purpose: To study clinical and physiologic aspects of Z-stent therapy for superior vena cava (SVC) syndrome secondary to malignant disease.

Materials And Methods: Signs and symptoms of SVC syndrome were classified, graded, and scored in 11 cases. Six patients with caval pressure higher than 22 mm Hg peripheral to the stenosis underwent stent therapy.

Dacron-covered stent therapy for portal vein tumor thrombus in hepatocellular carcinoma.

A tumor thrombus of the portal vein is refractory to therapy and constitutes a serious prognostic factor in hepatocellular carcinoma. For the purpose of treating portal vein tumor thrombus by restoring the blood flow and preventing recurrent ingrowth of tumor, we devised a metallic stent partially covered with a Dacron mesh sheet, and a coaxial percutaneous delivery system. One half of the wall of a Gianturco Z-stent was covered with a sheet of 0.

Time courses of PIVKA-II and AFP levels after hepatic artery embolization and hepatic artery infusion against hepatocellular carcinoma: relation between the time course and tumor necrosis.

We examined 35 untreated patients with unresectable hepatocellular carcinoma who exhibited positivity for both plasma PIVKA-II and serum AFP, and studied the weekly course of these markers from the pre-TAE or -HAI period to the third week of treatment. We correlated changes in these markers with the tumor necrosis rate and the time course on X-ray CT images. One week after TAE, the tumor necrosis rate and the time course of PIVKA-II showed a significant correlation (r = 0.

[A stent therapy for portal tumor thrombi. Use of Dacron sheet covered self expandable metallic stent].

We developed a method of intraportal placement of a covered stent against portal tumor thrombi. Half around a z-stent was covered with a Dacron mesh sheet. In one case with portal tumor thrombi protruding into the main portal branch, the stent was placed percutaneously-transhepatically, through a coaxial introducer.