Yasuaki Tamaki, Kazuta Yamashita, Daiki Nakajima, Yasuyuki Ohmichi, Yoshinori Takahashi, Michihiro Takai, Shunsuke Tamaki, Tomohiro Goto, Hiroaki Hayashi, Kousaku Higashino, Yoshihiro Tsuruo and Koichi Sairyo : Radiation exposure doses to the surgical team during hip surgery is significantly higher during lateral imaging than posteroanterior imaging: a cadaveric simulation study., Journal of Occupational Medicine and Toxicology, Vol.18, No.1, 27, 2023.
(要約)
Radiation exposure doses to the surgeon were significantly higher during 3 min of lateral imaging than during 3 min of posteroanterior imaging at the optic lens (8.1 times higher), thyroid gland (10.3 times), chest (10.8 times), and hand (19.8 times) (p = 0.018, p = 0.018, p = 0.018, and p = 0.018, respectively). During lateral imaging, the radiation doses to the nurse were 0.16, 0.12, 0.09, 0.72, and 0.38 times those to the surgeon at the optic lens, thyroid, chest, gonads, and foot, respectively. The radiation dose to the anesthesiologist was zero at all anatomic sites during posteroanterior imaging and very small during lateral imaging.
Yasuaki Tamaki, Daisuke Hamada, Keizo Wada, Tomoya Takasago, Akihiro Nitta, Yasuyuki Ohmichi, Tomohiro Goto, Yoshihiro Tsuruo and Koichi Sairyo : Kinematic comparison between the knee after bicruciate stabilized total knee arthroplasty and the native knee: A cadaveric study., The Knee, Vol.42, 289-296, 2023.
(要約)
Kinematics of BCS-TKA is close to that of the native knee. However, there is a statistically significant difference in AP position of the femur during mid flexion and initial rotational position of the tibia between the BCS-TKA knee and the native knee.
Katsuhito Hori, Yutaro Sasaki, Keito Shiozaki, Fumiya Kadoriku, Kei Daizumoto, Ryotaro Tomida, Yoshiteru Ueno, Megumi Tsuda, Yoshito Kusuhara, Tomoya Fukawa, Kunihisa Yamaguchi, Yasuyo Yamamoto, Masayuki Takahashi, Yoshihiro Tsuruo and Hiroomi Kanayama : Efficacy of fresh-frozen cadaveric surgical training for arteriovenous fistula in vascular access., The Journal of Vascular Access, 2023.
(要約)
Twelve CST sessions were performed on nine FFCs. All training sessions allowed completion of AVF creation with a median operative time of 78.5 min. Although veins and arteries were more difficult to identify than in a living body, other surgical operations could be performed in the same way as in a living body. All the respondents stated that it was good for them to experience CST. In addition, 86% of surgeons responded that CST improved their surgical techniques, and 71% of surgeons responded that they were less anxious about AVF creation.
Yasuaki Tamaki, Tomohiro Goto, Jyoji Iwase, Keizo Wada, Yasuyuki Ohmichi, Daisuke Hamada, Yoshihiro Tsuruo and Koichi Sairyo : Relationship between iliopsoas muscle surface pressure and implant alignment after total hip arthroplasty: a cadaveric study., Scientific Reports, Vol.13, No.1, 2023.
(要約)
Iliopsoas impingement after total hip arthroplasty is caused by the implant irritating the iliopsoas muscle, but changes in the iliopsoas muscle have not been quantitatively evaluated. This study assessed changes in the surface pressure of the iliopsoas muscle when the implant alignment was varied. Total hip arthroplasty was performed in 10 fresh-frozen cadaveric hips. We evaluated the maximum and mean surface pressure of the iliopsoas muscle with the hip in 20° and 10° extension, the neutral position, and 10° flexion when the anterior cup protrusion length (ACPL), stem version, and stem offset were varied. When the ACPL was changed to 0, 3, and 6 mm in 20° extension, the maximum surface pressure was significantly increased for ACPL of 6 mm compared with 0 mm. Decreased stem anteversion resulted in a significant reduction in both the maximum and mean surface pressure compared with native anteversion from 20° extension to the neutral position. Increased stem offset resulted in significant increases in the maximum and mean surface pressure of the iliopsoas muscle compared with decreased stem offset in 20° extension. Not only large ACPL but also changes in stem version and offset affected the maximum surface pressure of the iliopsoas muscle.
(キーワード)
Humans / Arthroplasty, Replacement, Hip / Prostheses and Implants / Plastic Surgery Procedures / Cadaver / Muscles
Kazuta Yamashita, Yasuaki Tamaki, Daiki Nakajima, Yasuyuki Omichi, Yoshinori Takahashi, Michihiro Takai, Tomohiro Goto, Hiroaki Hayashi, Kousaku Higashino, Yoshihiro Tsuruo and Koichi Sairyo : A Cadaveric Simulation Study of Radiation Exposure to the Surgical Team during Fluoroscopic Spinal Surgery: How Much Are We Exposed?, Spine Surgery and Related Research, Vol.7, No.4, 341-349, 2023.
(要約)
The occupational radiation exposure dose to surgical team members during C-arm fluoroscopy-guided lumbar spinal procedures varies according to the X-ray source position. Our findings would help surgical team members to know the risk of radiation exposure during various fluoroscopic procedures. Surgeons in particular need to reduce their radiation exposure by using appropriate shielding and technique.
Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Relationship Between the Lateral Plantar Artery and the Retrograde Intramedullary Nail During Tibiotalar and Subtalar Arthrodesis: A Fresh Cadaveric Study., Foot & Ankle Specialist, Vol.15, No.6, 551-555, 2022.
Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Examination of Safe Zone to Avoid Injury of the Lateral Plantar Artery During Calcaneal Osteotomy: A Fresh Cadaveric Study., Foot & Ankle Specialist, Vol.15, No.5, 432-437, 2022.
Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Implications of dorsalis pedis artery anatomical variants for dorsal midfoot surgery, Foot & Ankle International, Vol.43, No.7, 942-947, 2022.
(要約)
The dorsalis pedis artery (DPA) usually branches into the arcuate artery (AA) from its lateral side which in turn crosses the bases of the lateral four metatarsals. The DPA then passes into the first interosseous space, where it divides into the first metatarsal artery and the deep plantar artery. In this study, we aimed to determine the extent of variation in the DPA and the distance between the AA and the tarsometatarsal (TMT) joint with the aim of reducing the risk of vascular complications arising from dorsal midfoot surgery. In 29 fresh cadaveric feet, we examined the course of the DPA and the distance between the AA and the TMT joint on computed tomography images with barium sulfate contrast. The DPA was observed to have a standard course in 11 of the 29 cases (37.9%) but did not give rise to the AA and lateral tarsal artery or branches of the plantar arterial arch supplying to the second to fourth metatarsal spaces in 10 of 29 cases (34.5%). The mean closest distance from the TMT joint to the AA at the second, third, and fourth metatarsal level in the sagittal plane was 11.4, 14.6, and 17.1 mm, respectively. We found substantial variation in the arterial anatomy of the DPA system across the dorsal midfoot. The risk of pseudoaneurysm and frank arterial disruption may be mitigated if the surgeon is aware of the variations of the course of the DPA when performing dorsal midfoot surgery.
Yasuaki Tamaki, Tomohiro Goto, Jyoji Iwase, Keizo Wada, Daisuke Hamada, Yoshihiro Tsuruo and Koichi Sairyo : Contributions of the ischiofemoral ligament, iliofemoral ligament, and conjoined tendon to hip stability after total hip arthroplasty : a cadaveric study, Journal of Orthopaedic Research, Vol.40, No.12, 2885-2893, 2022.
(要約)
An adequate soft tissue balance is important in total hip arthroplasty (THA). This study assessed the contribution of the iliofemoral ligament, ischiofemoral ligament, and conjoined tendon to the range of hip rotation after THA and hip stability in response to axial traction. THA was performed in eight fresh-frozen cadaveric specimens via an anterolateral approach using a navigation system. The ischiofemoral ligament, the medial arm of the iliofemoral ligament, and the conjoined tendon were resected in that order. The ranges of external and internal rotation and the amount of movement of the femoral head in response to axial traction were measured with the hip in 10° of extension, the neutral position, and in 10°, 30°, and 60° of flexion. Resection of the medial arm of the iliofemoral ligament significantly increased the range of external rotation in 10° of extension, the neutral position, and in 10°, 30°, and 60° of flexion. The conjoined tendon was the most important inhibitor of internal rotation from 10° of extension to 30° of flexion. Although each single element had a minor role in stabilizing the hip when axial traction was applied, resection of two or more elements significantly affected joint stability. The iliofemoral ligament and conjoined tendon are the main inhibitors of external rotation and internal rotation, respectively, when THA is performed using an anterior or anterolateral approach. Resection of two or more elements could greatly affect hip stability when axial traction is applied.
(キーワード)
Humans / Arthroplasty, Replacement, Hip / Biomechanical Phenomena / Cadaver / Ligaments, Articular / Range of Motion, Articular / Tendons
Katsutoshi Miyatake, Shoji Fukuta, Ichiro Tonogai, Keizo Wada, Kousaku Higashino, Hiroshi Mikami, Hiroshi Yonezu, Koichi Sairyo and Yoshihiro Tsuruo : Influence of the glenoid baseplate position on the direction and length of the superior and inferior locking screws., The Journal of Medical Investigation : JMI, Vol.69, No.3.4, 185-190, 2022.
(要約)
Introduction : Superior screw insertion in reverse shoulder arthroplasty (RSA) carries the potential risk of suprascapular injury. The purpose of this study was to evaluate how the baseplate position affects the superior screw position and length in RSA. Methods : Three-dimensional (3D) computer simulation models of RSA were established using computed tomography data of baseplates with superior and inferior screws and 3D scapular models from 10 fresh cadavers. Superior screw position, the distance from the superior screw hole to the suprascapular notch, and the screw lengths were measured and compared among various baseplate positions with two inferior tilts (0 and 10 degrees) and three rotational patterns (11-5, 12-6, and 1-7 o'clock in the right shoulder). Results : For the 1-7 o'clock / inferior tilt 0 degrees baseplate, the superior screw located anterior to the SS notch in all shoulders, the distance to the SS notch was the longest (12.8 mm), and the inferior screw length was the shortest (23.1 mm). Conclusion : Although there is a concern of a short inferior screw length, initial fixation using a baseplate with 1-7 o'clock rotation and an inferior tilt of 0 degrees appears preferable for SS nerve injury prevention during superior screw insertion. J. Med. Invest. 69 : 185-190, August, 2022.
Takeshi Nishino, Hiroaki Toba, Takahiro Yoshida, Seiya Inoue, Masakazu Goto, Naoya Kawakita, Hiromitsu Takizawa, Yoshihiro Tsuruo and Akira Tangoku : Endobronchial Ultrasound Improves the Diagnosis of the Tracheobronchial Invasion of Advanced Esophageal Cancer, Annals of Surgical Oncology, Vol.28, No.11, 6398-6406, 2021.
(要約)
Accurate diagnosis of the tracheobronchial invasion of advanced esophageal cancer is essential to select appropriate treatment and improve prognosis; however, it is difficult using the conventional modalities. This study aimed to clarify the diagnostic usefulness of convex probe endobronchial ultrasound (CP-EBUS) for the diagnosis of the tracheobronchial invasion of advanced esophageal cancer. We conducted a cadaveric study to clarify the changes in ultrasonic and histopathologic findings in the esophageal tumor and tracheal invasion models. Additionally, we examined CP-EBUS for patients with advanced thoracic esophageal cancer in whom tracheobronchial invasion was suspected on contrast-enhanced computed tomography (CE-CT) scan. We retrospectivity evaluated the diagnosis of CP-EBUS, comparing the pathological findings and treatment outcomes. Cadaveric esophageal tumor and tracheal invasion models showed the disappearance of the third layer observed with CP-EBUS and histologically proven interruption of the adventitia. This indicated that the third layer corresponded with the tracheal adventitia. We examined 40 patients with advanced thoracic esophageal cancer in whom tracheobronchial invasion was suspected. The precise diagnosis was pathologically confirmed in 9 of 14 patients diagnosed with cT3 who underwent radical surgery. 20 of 26 cases diagnosed with cT4b received definitive chemoradiotherapy, and 4 cases received salvage surgery and pathologically confirmed precise diagnosis. CP-EBUS is extremely useful for diagnosing the tracheobronchial invasion of advanced esophageal cancer. It could be an effective modality for determining treatment strategies in cases with a marginal surgical indication.
Kazuta Yamashita, Kousaku Higashino, Hiroaki Hayashi, Kazuki Takegami, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Direct measurement of radiation exposure dose to individual organs during diagnostic computed tomography examination., Scientific Reports, Vol.11, No.1, 2021.
(要約)
Ionizing radiation from Computed tomography (CT) examinations and the associated health risks are growing concerns. The purpose of this study was to directly measure individual organ doses during routine clinical CT scanning protocols and to evaluate how these measurements vary with scanning conditions. Optically stimulated luminescence (OSL) dosimeters were surgically implanted into individual organs of fresh non-embalmed whole-body cadavers. Whole-body, head, chest, and abdomen CT scans were taken of 6 cadavers by simulating common clinical methods. The dosimeters were extracted and the radiation exposure doses for each organ were calculated. Average values were used for analysis. Measured individual organ doses for whole-body routine CT protocol were less than 20 mGy for all organs. The measured doses of surface/shallow organs were higher than those of deep organs under the same irradiation conditions. At the same tube voltage and tube current, all internal organ doses were significantly higher for whole-body scans compared with abdominal scans. This study could provide valuable information on individual organ doses and their trends under various scanning conditions. These data could be referenced and used when considering CT examination in daily clinical situations.
Shoji Fukuta, Keizo Wada, Kousaku Higashino, Koichi Sairyo and Yoshihiro Tsuruo : Optimal baseplate position in reverse shoulder arthroplasty in small-stature Japanese women : a cadaveric study., The Journal of Medical Investigation : JMI, Vol.68, No.1.2, 175-180, 2021.
(要約)
The purpose of this study was to determine the optimal position of the baseplate on the small glenoid of female Japanese. Two sets of 3D scapular models were made according to the CT data of 7 female cadavers. We set two scenarios of the baseplate placement : A and B. In scenario A, the baseplate was placed on the glenoid face centrally in the anteroposterior direction. In scenario B, the baseplate was implanted at the point where the baseplate post was contained within the glenoid vault. Whether or not the baseplate post perforated the scapular neck was recorded. In scenario A, the central post penetrated the scapular neck posteriorly in 5 scapulae. In scenario B, the average distances from the guide pin position to the anterior glenoid rim was 9.7 ± 1.7 mm and the optimal position of the guide pin was 1.9 ± 1.7 mm anterior from the glenoid center. The central post was contained within the scapula without breakage of the cortex. This study demonstrated that shifting the center of the baseplate slightly anterior to the anatomic center is necessary to avoid perforation of the scapular neck in small female Japanese. J. Med. Invest. 68 : 175-180, February, 2021.
Tomoya Takasago, Daisuke Hamada, Keizo Wada, Akihiro Nitta, Yasuaki Tamaki, Tomohiro Goto, Yoshihiro Tsuruo and Koichi Sairyo : Insufficient lateral joint laxity after bicruciate-retaining total knee arthroplasty potentially influences kinematics during flexion: A biomechanical cadaveric study., The Knee, Vol.28, 311-318, 2021.
(要約)
Knee joint laxity after BCR TKA under varus-valgus movement, anterior translation, and internal-external rotation loadings was similar to that of the native knee. However, lateral joint laxity was decreased during flexion in some cases. BCR TKA-treated knees with decreased lateral joint laxity at 90° of flexion demonstrated more limited tibial internal rotation in deep flexion than the native knee (p < 0.05). The loss of internal rotation in deep flexion was partly recovered by using a lateral insert with a posterior slope of +3°.
Recently, endoscopic surgery is the most common procedurein the field of thoracic surgery. The newestthoracic surgeryapproaches are the video-assisted thoracic surgery(VATS), the one-port video-assisted thoracic surgery, and the robotic surgery. The individual advantages and disadvantages of these procedures have been discussed. VATS covers a field of view of the surgical field from the leg to the head. The basic method in performing VATS is that the surgeon operates on the abdominal area of the patient and the assistant expands the surgical field from the patient's back. It is currently the standard surgical procedure. The advantage of one-port VATS is the one port itself and its cosmetic advantages and pain reduction. The advantage of robotic surgery is that it has a clear three-dimensional enlarged field of view and can be performed using the delicate moving robotic arm. However, a good surgical training system should be established for the familiarization of these procedures. The clinical anatomy laboratory is the most efficient surgical training in addition to dry and wet lab training. Our institution has fresh-frozen cadavers, which are rare in Japan. The participating thoracic surgeons underwent training for VATS lobectomy, subxiphoid extended thymectomy, and pleurectomy decortication. This training is beneficial for educational and clinical purposes. In the future, we must obtain consistent surgical education before and after graduation using fresh-frozen cadavers. At the same time, a good organ model for training is also necessary. The surgeon has to cooperate with anatomy doctors for the development of a good surgical organ model. For the development of future surgical medicine, surgical training programs should be implemented.
(キーワード)
thoracic surgery / fresh frozen cadaver / surgical training
Yasuaki Tamaki, Tomohiro Goto, Keizo Wada, Daisuke Hamada, Yoshihiro Tsuruo and Koichi Sairyo : Anatomic evaluation of the insertional footprints of the iliofemoral and ischiofemoral ligaments: a cadaveric study., BMC Musculoskeletal Disorders, Vol.21, No.1, 828, 2020.
(要約)
The mean length of the distal medial arm of the ILFL footprint was 17.9 mm and the mean width was 9.0 mm. The mean length of the distal lateral arm of the ILFL footprint was 23.0 mm and the mean width was 9.7 mm. For the footprint of the medial arm, the insertion was in the distal third of the intertrochanteric line and that of the lateral arm was in the proximal 42% of this line. The mean distance from the lesser trochanter to the footprint of the medial arm was 24.6 mm. The mean length of the distal ISFL footprint was 11.3 mm and the mean width was 6.9 mm. The footprint of the distal ISFL was located forward of the femoral neck axis in all specimens.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Akihiro Nitta, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Joint distraction force changes the three-dimensional articulation of the femur and tibia in total knee arthroplasty: a cadaveric study., Knee Surgery, Sports Traumatology, Arthroscopy, Vol.28, No.5, 1488-1496, 2020.
(要約)
Regardless of PCL resection, the joint center gap became larger (p = 0.002, p = 0.020) and varus ligament balance became more varus (p = 0.002, p = 0.002) with increasing joint distraction force, whereas the tibia was more internally rotated (p = 0.015, p = 0.009) and more anteriorly located (p = 0.004, p = 0.009). The tibia was more internally rotated (p = 0.015) and more posteriorly located (p = 0.026) after PCL resection than before resection.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : The Origin of the Anterior Lateral Malleolar Artery From the Anterior Tibial Artery: A Fresh Cadaveric Study., Foot & Ankle Specialist, Vol.13, No.1, 69-73, 2020.
(要約)
The anterior lateral malleolar artery (ALMA), which usually originates from the anterior tibial artery (ATA), courses transversely and laterally, passing under the extensor digitorum longus and peroneus tertius tendons. Variations in the origin of the ALMA from the ATA can occur. Branches of the ATA, such as the ALMA, are prone to pseudoaneurysm. This study reviewed the origin of the ALMA from the ATA and aimed to identify problems in anterior ankle arthroscopy that might cause injury to the ALMA. Enhanced computed tomography scans of 24 feet of 24 fresh cadavers (13 males, 11 females; average age 78.1 years) were assessed. The limb was injected with barium sulfate suspension through the external iliac artery; the origin of the ALMA from the ATA on the sagittal plane was recorded. The origin was at the ankle joint level in 4 specimens and below the ankle joint in 17 specimens. The distance from the ankle joint to the branching point of the ALMA on the sagittal plane was 5.2 mm distal to the joint. The level of origin of the ALMA from the ATA was established. Instruments should not be inserted from the distal direction when placing anterolateral portals. Levels of Evidence: Level IV, cadaveric study.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Rotational and varus-valgus laxity affects kinematics of the normal knee: A cadaveric study., Journal of Orthopaedic Surgery (Hong Kong), Vol.27, No.3, 2309499019873726, 2019.
(要約)
The present study revealed that the rotation angle of the tibia was correlated to the intermediate angle of IE laxity at 0°, 30°, 60°, and 90° of knee flexion and the coronal alignment of the lower limb also correlated to the intermediate angle of VV laxity. These findings provide important reference data on soft tissue laxity and kinematics of the normal knee.
The rotation angles of the tibia in BCR-XP were significantly different from those of the native knees both in the early flexion phase (p = 0.002 at minimum knee flexion, p = 0.002 at 0°, p = 0.041 at 10°, p = 0.009 at 20°, p = 0.026 at 30°) and in the late flexion phase (p = 0.015 at 130°, p = 0.015 at maximum knee flexion), whereas the rotational angles of the tibia in BCR-AS were similar to those of the native knee.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Examination of the Origin and Branching Direction of the Anterior Medial Malleolar Artery From the Anterior Tibial Artery: A Cadaveric Study., Foot & Ankle Specialist, Vol.12, No.2, 167-171, 2019.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Direction and location of the nutrient artery to the fifth metatarsal at risk in osteotomy for bunionette., Foot and Ankle Surgery, Vol.25, No.2, 193-197, 2019.
(要約)
The nutrient artery entered the medial aspect of the fifth metatarsal around the junction of the middle and proximal thirds obliquely from a distal direction (mean angle 36°) in the coronal plane in all cases; in the axial plane, the point of entry and direction of the artery was medial-plantar (mean angle 49°).
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Mitsuhiro Kamada, Tomohiro Goto, Yoshihiro Tsuruo and Koichi Sairyo : Intraoperative analysis of the kinematics of the native knee including two-dimensional translation of the femur using a navigation system : a cadaveric study., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 367-371, 2019.
(要約)
The aim of this cadaveric study was to evaluate the intraoperative kinematics of the native knee including two-dimensional translation of the femur using a navigation system. Eight native knees of 4 fresh-frozen whole-body cadavers were used for the study. The kinematics of each knee were analyzed intraoperatively using the navigation system. Although anterior-posterior translation could not be assessed directly, it could be calculated using a formula derived from the parameters in the navigation system. The native knee showed external rotation of the femur in early knee flexion, transient internal rotation in mid flexion, and gradual external rotation in late flexion. There was no marked change in the coronal rotation angle of the mechanical axis during knee flexion. The femoral center moved anteriorly in early knee flexion and posteriorly in late flexion. The distance moved in the medial-lateral direction was relatively smaller than that in the anterior-posterior direction. Two-dimensional translation of the surgical epicondylar axis showed a medial pivot-like motion. In this cadaveric study, the kinematics of the native knee, including two-dimensional translation of the femur, could be satisfactorily assessed intraoperatively using a navigation system. The intraoperative kinematics of the knee can be analyzed in more detail using this methodology. J. Med. Invest. 66 : 367-371, August, 2019.
Mariko Aoyama, Hiromitsu Takizawa, Mitsuhiro Tsuboi, Shinichi Yamasaki, Yoshihiro Tsuruo and Akira Tangoku : Surgical training in video-assisted neck surgery-based thyroidectomy using fresh frozen human cadavers., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 293-296, 2019.
(要約)
Endoscopic surgery has been introduced in various surgical fields. Endoscopic surgery requires different skills from open surgery due to the restricted surgical field and difficulty in identifying anatomical structures from certain viewpoints. Therefore, surgeons need to undergo sufficient surgical training before performing such surgery in the clinical setting. We examined the utility of fresh frozen human cadavers for surgical training aimed at introducing video-assisted neck surgery (VANS) at our department. First, we performed surgical training using fresh human cadavers four times. Next, we performed hemi-thyroidectomy with VANS in 5 clinical patients. After the cadaver training and the actual surgery, the surgeons evaluated each step of the surgical procedure using a 3-point scale. In the cadaver training, the scores for steps : creation of a subcutaneous tunnel and lifting up the skin flap and pre-thyroid muscles were higher than other steps. And a tracheal injury occurred as a complication. However, we were able to recognize anatomical structures under the endoscopic view. And it was also useful for confirming the role of surgical staff and simulating the placement of surgical equipment. Surgical training using fresh frozen human cadavers was effective at introducing a new surgical method. J. Med. Invest. 66 : 293-296, August, 2019.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Distances from the deep plantar arch to the lesser metatarsals at risk during osteotomy: a fresh cadaveric study., Journal of Foot and Ankle Research, Vol.11, 57, 2018.
(要約)
Overpenetration into the medial and plantar aspect of the second metatarsal or the proximal and plantar aspect of the fourth metatarsal during shaft or proximal osteotomy could easily damage the deep plantar arch. Shaft or proximal osteotomy approximately 45-47 mm proximal to the distal epiphysis or 18-23 mm distal to the tarsometatarsal joint on the plantar aspect could interrupt blood flow in the deep plantar arch.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Akihiro Nitta, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Native rotational knee kinematics is restored after lateral UKA but not after medial UKA., Knee Surgery, Sports Traumatology, Arthroscopy, Vol.26, No.11, 3438-3443, 2018.
(要約)
The rotation angles of the tibia in the early flexion phase of medial UKA were significantly larger than those of native knees (p = 0.008 at minimum knee flexion, p = 0.008 at 0° knee flexion). The rotational kinematics of lateral UKA was similar to those of the native knees throughout knee flexion. There were no significant differences in varus/valgus kinematics between native and UKA knees.
Toru Maeda, Kousaku Higashino, Hiroaki Manabe, Kazuta Yamashita, Fumio Hayashi, Yuichiro Goda, Yoshihiro Tsuruo and Koichi Sairyo : Pullout Strength of Pedicle Screws Following Redirection After Lateral or Medial Wall Breach., Spine, Vol.43, No.17, E983-E989, 2018.
(要約)
Forty-seven vertebrae (T9-L5) were harvested from 8 fresh cadaveric spines. The 18 pedicle screws that breached the lateral wall were then removed and redirected using a pedicle screw of 1 mm larger in diameter. The 16 pedicle screws that had breached the medial wall were then removed and redirected using a pedicle screw of the same diameter. The other 13 pedicle screws that had breached the medial wall were then removed and redirected using a pedicle screw of 1 mm larger in diameter. The pullout strength was measured.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Entry points of nutrient arteries at risk during osteotomy of the lesser metatarsals: a fresh cadaveric study., Journal of Foot and Ankle Research, Vol.11, 46, 2018.
(要約)
Each nutrient artery entered the lateral or medial plantar aspect of the lesser metatarsal in the middle third (just proximal to the middle point of the metatarsal) or proximal third obliquely from a distal direction. The mean ± standard deviation (SD) distances from the dorsal plane of the second, third, and fourth metatarsals to the point of entry of the nutrient artery in the axial plane were 8.2 ± 1.5, 7.6 ± 1.2, and 7.6 ± 1.5 mm, respectively. The mean ± SD distances from the distal epiphysis to the point of entry of the nutrient artery into the second, third, and fourth metatarsals in the coronal plane were 3.3 ± 1.1, 3.1 ± 1.0, and 2.8 ± 1.2 mm, respectively. The mean ± SD distances from the distal epiphysis to the point of entry of the nutrient artery into the second, third, and fourth metatarsals in the coronal plane were 46.0 ± 5.2, 40.9 ± 2.6, and 39.1 ± 3.7 mm, respectively. The mean ± SD distances from the proximal epiphysis to the entry point of the nutrient artery into the second, third, and fourth metatarsals in the coronal plane were 23.8 ± 4.7, 25.8 ± 4.3, and 25.0 ± 3.2 mm, respectively.
(キーワード)
Aged / Aged, 80 and over / Arteries / Cadaver / Computed Tomography Angiography / Female / Humans / Image Enhancement / Male / Metatarsal Bones / Middle Aged / Organs at Risk / Osteotomy
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Anatomic Study of Anterior and Posterior Ankle Portal Sites for Ankle Arthroscopy in Plantarflexion and Dorsiflexion: A Cadaveric Study in the Japanese Population., The Journal of Foot and Ankle Surgery, Vol.57, No.3, 537-542, 2018.
(要約)
Arthroscopy is an important and minimally invasive diagnostic and therapeutic tool. However, the risk of injury to the neurovascular structures around the portals exists during arthroscopy of the ankle. In the present study, we measured the distance between each portal and the adjacent neurovascular structures with the foot in plantarflexion and dorsiflexion in the Japanese population. Standard anterolateral (AL), anteromedial, posterolateral (PL), and posteromedial portal positions were identified in 6 fresh adult cadaveric feet. The skin was dissected from the underlying tissue to visualize the adjacent neurovascular structures as noninvasively as possible. The superficial peroneal nerve was the structure closest to an anterior (i.e., AL) portal (3.2 ± 4.2 and 8.3 ± 3.9 mm in plantarflexion and 5.2 ± 4.3 and 10.8 ± 4.1 mm in dorsiflexion), followed by the saphenous nerve and great saphenous vein (SpV). The distance from the superficial peroneal nerve to the AL portal and from the saphenous nerve and great SpV to the anteromedial portal increased significantly with dorsiflexion and decreased significantly with plantarflexion. The sural nerve was the structure closest to the posterior (i.e., PL) portal (10.4 ± 4.8 mm in plantarflexion and 8.5 ± 3.9 mm in dorsiflexion), followed by the lesser SpV. The distance from the sural nerve, saphenous nerve, and lesser SpV to the PL portal and from flexor hallucis longus, posterior tibial artery, and tibial nerve to the posteromedial portal increased significantly in plantarflexion and decreased significantly in dorsiflexion. These findings could help to prevent damage to the neurovascular structures during ankle arthroscopy.
T Nishi, Y Yamamoto, N Yamagishi, M Iguchi, H Tamai, T Ito, Yoshihiro Tsuruo, M Ichinose, M Kitano and T Ueyama : Lansoprazole prevents the progression of liver fibrosis in non-alcoholic steatohepatitis model rats., The Journal of Pharmacy and Pharmacology, Vol.70, No.3, 383-392, 2018.
(要約)
We previously demonstrated that lansoprazole provided hepatoprotection in a drug-induced hepatitis animal model partially through the Nrf2/HO-1 pathway. Here, we examined whether lansoprazole could also provide hepatoprotection in a rat model of non-alcoholic steatohepatitis (NASH). Six-week-old rats were fed a normal chow or a choline-deficient amino acid-defined (CDAA) diet to establish a rat model of NASH. The groups fed a CDAA diet for 5 weeks were subcutaneously administered either a vehicle or a lansoprazole suspension for 4 weeks beginning the second week of the experiment. Bridging fibrosis was observed in the livers of almost all the NASH model rats (six of seven), but it was not always observed in NASH model rats (one of seven) continuously administered lansoprazole. The serum aspartate aminotransferase level elevated by the CDAA diet was significantly decreased following lansoprazole administration. Lansoprazole also increased the expression of Nrf2, but not HO-1, in the liver of NASH model rats. Lansoprazole decreased the level of activated TGF-β protein. Furthermore, interleukin-6 gene and protein expression were decreased. Lansoprazole inhibits hepatic fibrogenesis, at least during the early stages, in CDAA diet-induced NASH model rats. The mechanisms might be associated with cytokine suppression but not the inhibition of reactive oxygen species.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Distance Between the Anterior Distal Tibial Edge and the Anterior Tibial Artery in Distraction and Nondistraction During Anterior Ankle Arthroscopy: A Cadaveric Study., Foot & Ankle International, Vol.39, No.1, 113-118, 2017.
(要約)
The anatomic relationship of the ATA to its surrounding structures may be at more risk without saline injection or with distraction during anterior ankle arthroscopy.
Michihiro Nakamura, Koichiro Hayashi, Hitoshi Kubo, Masafumi Harada, Keisuke Izumi, Yoshihiro Tsuruo and Toshinobu Yogo : Mesoscopic multimodal imaging provides new insight to tumor tissue evaluation: an example of macrophage imaging of hepatic tumor using organosilica nanoparticles., Scientific Reports, Vol.7, No.1, 3953, 2017.
(要約)
Multimodal imaging using novel multifunctional nanoparticles provides new approach to biomedical field. Thiol-organosilica nanoparticles containing iron oxide magnetic nanoparticles (MNPs) and rhodamine B (thiol OS-MNP/Rho) were applied to multimodal imaging of hepatic tumor of Long-Evans Cinnamon (LEC) rat. The magnetic resonance imaging (MRI) of LEC rats revealed tumors in the liver clearly and semi-quantitatively due to a labeling of macrophages in liver. The fluorescent imaging (FI) showed abnormal fluorescent patterns of the liver at the mesoscopic level that was between macroscopic and microscopic level. We performed correlation analysis between optical imaging including FI and MRI. We found that the labeled macrophages located specific area in the tumor tissue and influenced the tumor size on MRI. In addition histological observation showed the labeled macrophages related specific tissue in the pathological region. We demonstrated a new approach to evaluate tumor tissue at the macroscopic and microscopic level as well as mesoscopic level using multimodal imaging.
Y Yamamoto, T Ueyama, T Ito and Yoshihiro Tsuruo : Gene expression profiling in rats with depressive-like behavior, Genomics Data, Vol.5, 279-280, 2015.
(要約)
Individual differences indicate stronger phenotypes than model animals especially in behavioral studies, and some animals show unexpected behaviors in control and animal model groups. High-throughput analysis including cDNA microarray analysis are more affected by individual differences, because more samples are needed to reduce the difference in multiple factor analysis than single factor analysis such as real-time PCR. We measured the depressive-like behavior of over 100 normal rats in the forced swimming test and selected the rats for control and depression group from them to minimize the individual difference using data of force swimming test. Here, we provided the detail of methods and quality control parameters for the cDNA microarray data. This dataset can reflect the increase of depressive-like behavior. The dataset is deposited in the gene expression omnibus (GEO), series GSE63377.
Y Yamamoto, T Ueyama, T Ito and Yoshihiro Tsuruo : Downregulation of growth hormone 1 gene in the cerebellum and prefrontal cortex of rats with depressive-like behavior, Physiological Genomics, Vol.47, No.5, 170-176, 2015.
(要約)
Depressive-like behaviors in animals are usually assessed by standardized behavioral tests such as the forced swimming test (FST). However, individual variation in test performance may obscure group differences and thereby hinder the discovery of genes responsible for depression. Few reports have shown the influence of individual variability in identifying the genes associated with depressive-like behaviors. In this study, we conducted microarray analysis to identify genes differentially expressed in the prefrontal cortex (PFC) and cerebellum of rats stratified by FST immobility ratio (% immobility in 5 min) into a control group [immobility ratio: -1 to +1 standard deviation (SD) from the mean] and a depressive group (immobility ratio: +1 to +2 SDs above the mean). Genes differentially expressed in both the cerebellum and PFC of the depressive group were Alas2, Gh1, Hba-a2, Hbb, Hbb-b1, Hbe2, LOC689064, Mrps10, Mybpc, Olf6415, and Pfkb1. Ingenuity Pathway Analysis identified Gh1 as a hub gene in the networks of differentially expressed genes in both brain regions. This study indicates that the depressive-like behavior may be related to the decrease of Gh1 expression in the cerebellum and PFC.
Yasuyo Yamamoto, Yoshito Kusuhara, Tomoya Fukawa, Kunihisa Yamaguchi, Tomoharu Fukumori, Masayuki Takahashi, Hiro-omi Kanayama, Yoshihiro Tsuruo, Kei Daizumoto and Hidehisa Mori : Usefulness of Fresh Frozen Cadaver and Animal Models for Surgical Training in Laparoscopic Sacrocolpopexy, The 36th World Congress of Endourology, Paris, Sep. 2018.
2.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Fresh cadaveric study of the origin and branching direction of the anterior medial malleolar artery from the anterior tibial artery., 44th Annual meeting of the Japanese Orthopaedic Society for Sports Medicine(September 7-September 9,2018), Tokushima, Sep. 2018.
3.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Cadaveric anatomical study of anterior and posterior ankle arthroscopic portals in ankle plantarflexion and dorsiflexion positions., 2018 American Orthopaedic Foot & Ankle Society Annual meeting(July 11-14,2018), Boston, Jul. 2018.
4.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Joint Distraction Force Changes the Three-Dimensional Position of the Femur and the Tibia in Total Knee Arthroplasty: a Cadaveric Study, The 19th European Federation of National Associations of Orthopaedics and Traumatology(May 30-June 1,2018), Barcelona, May 2018.
5.
Tomoya Takasago, Daisuke Hamada, Keizo Wada, Tomohiro Goto, Akihiro Nitta, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Retention of the anterior cruciate ligament increase the joint stability in anterior, external rotation and varus directions in TKA, A biomechanical cadaveric study, 18th ESSKA congress(May 9-12,2018), Glasgow, May 2018.
6.
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Knee kinematics after lateral UKA are closer to native knee kinematics compared to those after medial UKA, a cadaveric study, 18th ESSKA congress(May 9-12,2018), Glasgow, May 2018.
7.
Daisuke Hamada, Keizo Wada, Tomoya Takasago, Akihiro Nitta, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo and Koichi Sairyo : Native rotational kinematics are lost in bicruciate-retaining total knee arthroplasty when the tibial component is replaced: an in vitro study, 18th ESSKA congress(May 9-12,2018), Glasgow, May 2018.
8.
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo and Koichi Sairyo : Direction and location of the nutrient artery to the fifth metatarsal at risk in osteotomy for bunionette: enhanced computed tomographic study in fresh cadavers., 2018 Orthopaedic Research Society Annual Meeting (March 10-13,2018), New Orleans, Mar. 2018.
Eisuke Shimokita, Hitomi Suzuki, Yoshihiro Tsuruo and Tatsuya Takemoto : Mesodermal cell migration does NOT depend on mesoderm-inducible transcriptional factor cTbx6L, 第52回日本発生生物学会, May 2019.
Yoshihiro Tsuruo : Morphological appearance of GABAergic neuroactive steroid-synthesizing enzymes, Journal of Physiological Society of Japan, Vol.65, No.Suppl 1, S83-1, Mar. 2015.