Atsushi Mori

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Advantage of a higher position of the tracheostoma with glottic closure for preventing complications related to tracheostomy tube: a retrospective cohort study

BMC Surgery (2022)

Yuji Kanazawa Yasuhisa Kurata Miki Nagai Kenji Inoue Fumihito Nozaki

Abstract Background Surgery to prevent aspiration has complications related to tracheostomy tube, such as the trachea-brachiocephalic artery fistula. Glottic closure procedure makes tracheostoma at a position higher than the first ring of the trachea and theoretically has a potential to prevent such complications owing to a longer distance between the tip of tracheostomy tube and the tracheal membrane adjacent to the brachiocephalic artery. Our aim is to evaluate the safety of glottic closure in neurologically impaired patients by comparing outcomes with laryngotracheal separation. Methods This study is a single-center retrospective study from 2004 to 2019, using data of 15 and 12 patients who underwent glottic closure (GC) and laryngotracheal separation (LTS). The primary outcome was the incidence of postoperative complications induced by tracheostomy tube placement and adjustment of the tracheostomy tube position to prevent these complications, such as by converting to a length-adjustable tube and/or placing gauze between the skin and tube flange. Additionally, we analyzed the anatomical relationship between the tracheostomy tube tip and brachiocephalic artery and measured the distance between them using postoperative CT images. Results No patients in either group had trachea-brachiocephalic artery fistula. Erosion or granuloma formation occurred in 1 patient (7%) and 4 patients (33%) in the GC and LTS groups, respectively. Adjustment of the tracheostomy tube was needed in 2 patients (13%) and 6 patients (50%) in the GC and LTS groups. CT revealed a higher proportion of patients with the tracheostomy tube tip superior to the brachiocephalic artery in GC than LTS group. The mean tracheostoma-brachiocephalic artery distance was 40.8 and 32.4 mm in the GC and LTS groups. Conclusions Glottic closure reduces the risk of postoperative complications related to a tracheostomy tube. This may be due to the higher position of the tracheostoma at the level of the cricoid cartilage, increasing the distance between the tracheostoma and brachiocephalic artery.

Brachiocephalic artery

Tracheal tube

10.1186/s12893-022-01505-2

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Citations (3)

Pelvic abscess secondary to nonperforated seromuscular rectal injury during laparoscopic adnexectomy: A case report

JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY (2020)

Atsushi Mori Yuki Ibuki Yukiko Fujii Hiroko Sakon Chizue Nishizawa

Rectal injury is a serious complication of laparoscopic surgery and is associated with poor prognosis. We describe a patient who developed a pelvic abscess secondary to bacterial infection after a seromuscular rectal injury during laparoscopic surgery, who was successfully treated with drainage alone. Laparoscopic bilateral adnexectomy was performed for bilateral chocolate cysts; however, she developed fever and abdominal pain, 5 days postoperatively. Computed tomography revealed an intrapelvic abscess, and the intraoperative video recording led to a suspicion of rectal injury. Based on bacterial cultures of pus from the abscess, she was diagnosed with infection transmitted from the site of rectal injury. However, colonoscopy did not reveal any rectal mucosal injury. Therefore, we concluded that the injury was confined to the seromuscular layer. The abscess was successfully treated with drainage and antibiotics. Pelvic abscesses may occur secondary to seromuscular injuries without complete perforation of the rectal mucosa. Notably, drainage and antibacterial drugs are effective and emergency surgery is not required in patients without perforation. Colonoscopy may be useful to determine the treatment course.

Perforation

10.5180/jsgoe.36.2_258

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Mast Cells in Smooth Muscle Tumors of the Uterus

International Journal of Gynecological Pathology (1998)

Ayaka Orii Atsushi Mori Ya-Li Zhai Toshihiko Toki Toshio Nikaido

Summary Mast cells (MCs) have been reported in the myometrium and uterine smooth muscle tumors. We examined the number of MCs in various uterine smooth muscle tumors (including leiomyosarcomas) and assessed whether this feature might be of value in their pathologic diagnosis. The number of MCs in 95 uterine smooth muscle tumors, including 55 ordinary leiomyomas, 17 cellular leiomyomas, 8 bizarre leiomyomas, and 15 leiomyosarcomas, was counted using toluidine blue and immunohistochemical staining. The number of MCs that stained for tryptase was lowest in leiomyosarcoma and next lowest in ordinary leiomyoma; the number in each of these two groups was significantly lower than in the myometrium (p < 0.001). In cellular and bizarre leiomyomas, the number of MCs was significantly higher than in ordinary leiomyoma (p < 0.001 and p < 0.001, respectively) and leiomyosarcoma (p < 0.001 and p < 0.005, respectively). Statistical analysis revealed that counting the number of MCs and using a cut-off value of 16 MCs per high-power-field is useful for the differential diagnosis of leiomyosarcomas from cellular leiomyoma and bizarre leiomyoma, yielding 100% sensitivity and 96% specificity. The number of MCs was significantly lower in leiomyosarcomas at TNM stages III and IV than in those at stages I and II (p < 0.05), but there was no significant correlation between the number of MCs and patient survival. These results suggest that the number of MCs might be useful as part of a multivariate approach to the differential diagnosis of leiomyosarcoma from bizarre or cellular leiomyoma.

Myometrium

Smooth Muscle Tumor

Uterine Leiomyoma

Tryptase

10.1097/00004347-199810000-00007

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Citations (36)

Remodeling of patellar tendon grafts augmented with woven polyester after anterior cruciate ligament reconstruction in humans

Journal of Orthopaedic Science (1999)

Yoshihito Nakayama Yasumasa Shirai Tetsuya Narita Atsushi Mori

10.1007/s007760050088

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Citations (7)

A case of salivary duct carcinoma in the maxilla.

Japanese Journal of Oral & Maxillofacial Surgery (2001)

Tetsuhito Kawase Yoshiaki Kazaoka Atsushi Shinohara Hajime Kuno Atsushi Mori

We describe a 55-year-old man in whom salivary duct carcinoma developed in the maxilla. He was admitted for evaluation of dysesthesia in the left buccal region. Magnetic resonance imaging revealed a 2×2cm mass in the left side of the maxilla. Biopsy of the lesion was performed under local anesthesia, and histological examination showed a malignant adenocarcinoma. The tumor originated in the minor salivary glands of the maxilla. The patient underwent maxillectomy and reconstruction with a vascularized fibula flap under general anesthesia. The postoperative histopathological diagnosis was invasion of the maxillary nerve, so the base of the skull was operated on. The patient was postoperatively given irradiation (60Gy) and chemotherapy (5 FU, CDDP). Two years later, he died of intracranial recurrence. Histopathological examination revealed comedonecrosis of the tumor nests, and the lesion was diagnosed as a salivary duct carcinoma.

Salivary duct carcinoma

10.5794/jjoms.47.236

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Citations (1)

A case of a mandibular gunshot wound.

Japanese Journal of Oral & Maxillofacial Surgery (1993)

Yutaka Seki Madoka Inui Taku Murata Atsushi Mori Joji Yoneda

A 21-year-old male was shot with a handgun in the mandible, chest, inguinal region, and upper limbs. Upon admission to the emergency room, vital signs were relatively stable.X-ray examination of the head and neck region apparently revealed that the right side of the mandible was fractured and that the bullet-shaped radiopaque object was lodged in the tongue. However, because the radiopaque object in the tongue was found intraoperatively to be a full cast crown on the mandibular firstmolar, the initial clinical impression of the route that the bullet passed through the body proved to be mistaken. The comminuted mandibular fracture was reduced and stabilized with a miniplate under general anesthesia.Five months later, after an abscess appeared in the right submandibular region, the remaining bullet fragments were surgically removed. The postoperative course was uneventful.The unique characteristics of gunshot wounds shoud be carefully considered at initial assessment.

Gunshot wound

Mandible (arthropod mouthpart)

Mandibular fracture

GUNSHOT INJURY

10.5794/jjoms.39.67

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Significance of expeditious diagnosis and treatment following menarche in obstructed hemivagina and ipsilateral renal agenesis syndrome: A case report

Radiology Case Reports (2023)

Atsushi Mori Shotaro Fujino Riku Honda Kyosuke Kamijo Megumi Sano

Obstructed hemivagina and ipsilateral renal agenesis syndrome is a rare complex of structural abnormalities of female urogenital tract. Moreover, delayed treatment of this condition can reportedly lead to pelvic infection, endometriosis, and infertility. We present a rare case of obstructed hemivagina and ipsilateral renal agenesis syndrome wherein appropriate treatment was initiated early due to the identification of left renal agenesis. A 14-year-old girl visited the gynecology department due to worsening left lower abdominal pain after menarche. She was diagnosed with renal dysplasia in the pediatric department at the ages of 3 and 9 years, and it was recommended that she visits the gynecology department right after menarche. She experienced her first menarche at the age of 14 years. Imaging studies revealed uterine didelphys with occlusion of the left vagina and formation of hematocolpos. Additionally, hematomas were observed in the left uterine cavity and the left fallopian tube; left renal agenesis was confirmed. Based on these findings, we diagnosed this patient with obstructed hemivagina and ipsilateral renal agenesis syndrome and performed a surgical incision and excision of the closed left vaginal wall, resulting in the disappearance of the hematocolpos. Approximately 2 years postoperatively, the patient has remained recurrence-free. Early diagnosis and treatment are crucial for preserving fertility in patients with obstructed hemivagina and ipsilateral renal agenesis syndrome, and early referral to the obstetrics and gynecology department is recommended if renal dysplasia is detected during childhood.

Renal agenesis

Agenesis

Menarche

10.1016/j.radcr.2023.09.070

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Omission of mediastinal lymph node dissection in lung cancer: its techniques and diagnostic procedures.

PubMed (2006)

Hiroaki Nomori Kazunori Iwatani Hironori Kobayashi Atsushi Mori S Yoshioka

To reduce or omit a mediastinal lymph node dissection in the patients with clinical stage I non-small cell lung cancer (NSCLC), several authors examined the prevalence of metastatic sites of lymph nodes. Because lymphatic drainage usually heads for the upper mediastinum in upper lobe cancer and for the lower mediastinum in lower lobe cancer, upper and lower mediastinal lymph node dissection could be reduced in lung cancers of lower lobe and upper lobe. By using sentinel node (SN) navigation surgery, it is possible to omit mediastinal lymph node dissection. Radiological findings are also useful to determine reduction of mediastinal lymph node dissection. In clinical stage Ia adenocarcinomas that show ground glass opacity (GGO) findings on computed tomography (CT) or negative for fluorodeoxyglucose accumulation on positron emission tomography (PET), mediastinal lymph node dissection can be omitted, because these types of adenocarcinomas rarely metastasize to the lymph nodes. By using these procedures, mediastinal lymph node dissection can be reduced or omitted with little risk of local recurrence.

Mediastinal lymph node

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Citations (23)

The case of invasive lobular carcinoma of the breast which appeared in ascites, which was indistinguishable from reactive mesothelial cell.

The Journal of the Japanese Society of Clinical Cytology (2002)

Akiko KAMIGAITO Hirofumi Sakurai Atsushi Mori Noriko Hosaka

A 74-year-old wolnan was admitted becase of a large amount of ascites. The patient also pointed out the presence of a breast tumor. Aspiration cytology of the breast tumor and a cytology exalnination of the ascites were pcrformed.Cytologicaly, the tumor cells in the ascites were small. sized and uniform-In celis with a low N/C ratio, the chromatin pat. tern was fine and uniform. ICL was observed in the cytoplasm. The tulnor cells were individually dispersed.The cytological findings strongly suggested that these cells were reactive mesothelial cells.Histologlcally, the breast tumor was diagnosed as an invasive lobular carcinoma that was positive for CA19-9. The peritoneum biopsy was diagnosed as a metastasis of the invasive lobular carcinoma of the breast. Thus, the cells which had been regarded as reactivc mesothelial cells were in fact adenocarcinoma cells.

Invasive lobular carcinoma

Lobular carcinoma

CA 15-3

Breast carcinoma

Cytopathology

10.5795/jjscc.41.457

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Citations (2)

Five Years of Clinical Evaluation of Nonresorbable Membranes in the Treatment of Intrabony Defects Following Guided Tissue Regeneration.

Nihon Shishubyo Gakkai Kaishi (Journal of the Japanese Society of Periodontology) (1996)

Nobuo Yoshinari Tosyo Tohya Koji Inagaki Atsushi Mori Saeko Nishiyama

GTR法の5年間の臨床的評価を行うために, 成人性歯周炎を有する患者28名に対して14名14部位 (年齢21から57歳, 平均40.9歳の男性3名, 女性11名の14名) に組織再生誘導法 (GTR群), 14名14部位 (年齢23から54歳, 平均39.6歳の男性5名, 女性9名の14名) に歯肉剥離掻爬術 (FOP群) を行った。GTR群の被験部位の骨欠損形態は, 1壁性骨欠損1部位, 2壁性骨欠損11部位, 3壁性骨欠損2部位であった。FOP群の被験部位の骨欠損形態は, 1壁性骨欠損2部位, 2壁性骨欠損9部位, 3壁性骨欠損3部位であった。術前, 術後5年の臨床所見から, 歯周ボクット (PD) の減少量はGTR群3.9±1.6mm, FOP群2.9±1.5 mmであり, 臨床的アタッチメントレベル (CAL) の獲得量はGTR群3.2±1.8mm, FOP群1.1±1.4mmであり, 歯肉退縮量 (MR) は, GTR群0.7±1.3mm, FOP群1.8±1.5mmであった。GTR群の術前, 術後5年のCALに有意な改善を認めた。また, CALの獲得量は, GTR群がFOP群と比べて有意な増加を示した。さらに術後1年と5年の間の両群のPD, CALは安定していた。以上より, 5年間にわたってGTR群のPD, CALは安定しており, 有用であることが示唆された。

10.2329/perio.38.211

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Citations (3)