1.Baseball elbow and elbow joint instability.
KAZUSHI TEZUKA ; YUKINORI TOMODA ; TOKUHIDE DOI ; AKIRA HIRAOKA ; HIROKO NAKAGAWA ; HARUHI KIKUCHI ; TORU FUKUBAYASHI ; YUTAKA KAMIMAKI ; HITOSHI SHIMOJO ; ATSUSHI MASUJIMA
Japanese Journal of Physical Fitness and Sports Medicine 1988;37(1):37-45
97 baseball players from high school, universities and companies were subjected to this study in order to attempt to clarify the relationship between derangement of the elbow joint and lateral instabilitly by measuring various conventional parameters and the degree of lateral instability.
From the survey by questionnaire, 29 out of 97 players complained of elbow pain, paticularily on the medial side of the joint. The painful phases of the throwing motions were the acceleration phase (23 players, 61%) and release phase (7 players, 46%) . The hyperexten sion of the elbow on the dominant side was significantly smaller than that observed on the undominant side. X-ray examination revealed osteophyte formation at the tip of olecranon and medial joint space.
On the application of 63 kg⋅cm torque force, the varus deflection angle for the dominant side was 8.3° and that for the undominant side was 8.8°. The valgus angle for the dominant side was 12.2° and that for the undominant side was 10.8°. The varus stiffness (kg⋅cm/angle) was 9.5 for the dominant side and 8.4 for the undominant side. Valgus stiffness were 6.3 for the dominant side and 9.2 for the undominant side.
Thses results indicate that the lateral side become stiffer and medial side become looser in the dominant elbow than in the undominant one.
The unphysiological valgus stress at the acceleration phase would induce the osteophyte formation as well as the elongation of the medial collateral ligament on the medial side of the elbow. At the same time the impigement of the olecranon at follow through phase, would induce the osteophyte formation around the olecranon. Thses two factors would considerably influence the range of motion and the instability of the elbow joint.
2.Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study
Kazuya KARIYAMA ; Kazuhiro NOUSO ; Atsushi HIRAOKA ; Hidenori TOYODA ; Toshifumi TADA ; Kunihiko TSUJI ; Toru ISHIKAWA ; Takeshi HATANAKA ; Ei ITOBAYASHI ; Koichi TAKAGUCHI ; Akemi TSUTSUI ; Atsushi NAGANUMA ; Satoshi YASUDA ; Satoru KAKIZAKI ; Akiko WAKUTA ; Shohei SHIOTA ; Masatoshi KUDO ; Takashi KUMADA
Journal of Liver Cancer 2024;24(1):71-80
Background:
/Aim: The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods:
The study included consecutive 2,067 patients with solitary HCC who were treated with either ablation (n=1,248) or surgery (n=819). Th e patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
Results:
No significant difference in recurrence-free survival (RFS) or overall survival (OS) was found between surgery and ablation groups for tumors measuring ≤2 cm or >2 cm but ≤3 cm. For tumors measuring >3 cm but ≤5 cm, RFS was significantly better with surgery than with ablation (3.6 and 2.0 years, respectively, P=0.0297). However, no significant difference in OS was found between surgery and ablation in this group (6.7 and 6.0 years, respectively, P=0.668).
Conclusion
The study suggests that surgery and ablation can be equally used as a treatment for solitary HCC no more than 3 cm in diameter. For HCCs measuring 3-5 cm, the OS was not different between therapies; thus, ablation and less invasive therapy can be considered a treatment option; however, special caution should be taken to prevent recurrence.
3.Malignant biliary obstruction treated with preoperative endoscopic ultrasound-guided hepaticogastrostomy: A case report
Taira KURODA ; Hideki MIYATA ; Yuka KIMURA ; Ayaka NAKAMURA ; Takuya MATSUDA ; Kana MATSUOKA ; Mai FUKUMOTO ; Kazuya MURAKAWA ; Taisei MURAKAMI ; Hirofumi IZUMOTO ; Kei ONISHI ; Shogo KITAHATA ; Kozue KANEMITSU-OKADA ; Tomoe KAWAMURA ; Fujimasa TADA ; Eiji TSUBOUCHI ; Jun HANAOKA ; Atsushi HIRAOKA ; Tomoyuki NINOMIYA
International Journal of Gastrointestinal Intervention 2025;14(1):20-23
We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.
4.Malignant biliary obstruction treated with preoperative endoscopic ultrasound-guided hepaticogastrostomy: A case report
Taira KURODA ; Hideki MIYATA ; Yuka KIMURA ; Ayaka NAKAMURA ; Takuya MATSUDA ; Kana MATSUOKA ; Mai FUKUMOTO ; Kazuya MURAKAWA ; Taisei MURAKAMI ; Hirofumi IZUMOTO ; Kei ONISHI ; Shogo KITAHATA ; Kozue KANEMITSU-OKADA ; Tomoe KAWAMURA ; Fujimasa TADA ; Eiji TSUBOUCHI ; Jun HANAOKA ; Atsushi HIRAOKA ; Tomoyuki NINOMIYA
International Journal of Gastrointestinal Intervention 2025;14(1):20-23
We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.
5.Malignant biliary obstruction treated with preoperative endoscopic ultrasound-guided hepaticogastrostomy: A case report
Taira KURODA ; Hideki MIYATA ; Yuka KIMURA ; Ayaka NAKAMURA ; Takuya MATSUDA ; Kana MATSUOKA ; Mai FUKUMOTO ; Kazuya MURAKAWA ; Taisei MURAKAMI ; Hirofumi IZUMOTO ; Kei ONISHI ; Shogo KITAHATA ; Kozue KANEMITSU-OKADA ; Tomoe KAWAMURA ; Fujimasa TADA ; Eiji TSUBOUCHI ; Jun HANAOKA ; Atsushi HIRAOKA ; Tomoyuki NINOMIYA
International Journal of Gastrointestinal Intervention 2025;14(1):20-23
We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.