研究者詳細 - 鉄永　智紀

論文 - 鉄永　智紀

分割表示 317 件中 181 - 200 件目／全件表示 >>

3大小児整形外科疾患と言われた先天股脱、先天性内反足、筋性斜頸その過去と現在先天性筋性斜頸

赤澤啓史, 青木清, 鉄永智紀, 寺本亜留美, 釜付祐輔

日本整形外科学会雑誌 90 ( 7 ) 497 - 500 2016年7月

50歳未満でCharnley THAを施行後25年以上経過した症例の検討

藤井洋佑, 遠藤裕介, 藤原一夫, 鉄永智紀, 三宅孝昌, 尾崎敏文

中部日本整形外科災害外科学会雑誌 59 ( 4 ) 729 - 730 2016年7月

記述言語：日本語出版者・発行元：(一社)中部日本整形外科災害外科学会

過去14年5ヵ月間のCharnley THA術症例122股のうち術後25年以上経過した20例23股(追跡調査率18.8%)について検討した。全例女性で手術時年齢27〜49歳(平均43歳)、術後経過観察期間は25〜39年6ヵ月(平均32年8ヵ月)であった。X線学的評価はソケット側はHodgkinson分類、ステム側はHarris分類を用い、累積生存率は非感染性のゆるみ、再置換術をend pointとしたKaplan-Meier法で算出した。その結果、術後30年の累積生存率はゆるみをend pointとするとソケット側61.7%、ステム側75.3%、再置換をend pointとするとソケットで70.0%、ステムで81.0%であった。再置換術は9例11股(47.8%)、手術時年齢57〜79歳(平均70歳)、術後19〜36年(平均27年)であった。

researchmap

岡山大学病院における難治性慢性痛に対する集学的治療の検討

鉄永倫子, 西田圭一郎, 鉄永智紀, 尾崎敏文, 西江宏行, 太田晴之, 井上真一郎, 小田幸治, 龍野耕一, 宮脇卓也, 神崎浩孝

日本整形外科学会雑誌 90 ( 2 ) S39 - S39 2016年3月

【運動器疼痛性疾患に対する薬物療法update】運動器疾患に対する非ステロイド性抗炎症薬(NSAIDs)の使い方

鉄永倫子, 鉄永智紀

整形・災害外科 59 ( 2 ) 155 - 162 2016年2月

Clinical Assessment of Postoperative Anemia Associated with Edoxaban in Patients Undergoing Total Knee Arthroplasty Compared to Fondaparinux.

Yasuhisa Izushi, Yoichiro Takami, Naofumi Shiota, Tomonori Tetsunaga, Yusuke Ookura, Kenichi Shimada, Takashi Egawa, Tsukasa Kiuchi, Toru Sato, Ritsugi Takuma

Biological & pharmaceutical bulletin 39 ( 4 ) 516 - 23 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）

Edoxaban, an oral direct factor Xa inhibitor, was developed and approved for anticoagulant thromboprophylaxis after total knee arthroplasty (TKA). We retrospectively investigated the postoperative anemia by oral administration of edoxaban 30 mg compared with fondaparinux 2.5 mg in TKA patients. Two hundred twenty nine patients who underwent TKA in National Hospital Organization Okayama Medical Center from July 2010 to June 2012 were divided into two groups; pre and post approval of edoxaban: fondaparinux-group (F-group) and edoxaban-group (E-group). As the primary endpoint, the frequency of postoperative anemia was evaluated. Blood coagulation values and relations between these parameters and postoperative anemia were also investigated. The frequency of postoperative anemia was significantly higher in E-group than F-group patients (52.7% vs. 37.8%; p<0.05). Hemoglobin (Hgb) levels were decreased with the peak at postoperative day (POD) 3 in both groups, and the change of Hgb values from POD1 (ΔHgb) was significantly increased in the E-group (p=0.04). At each POD, prothrombin time (PT) and international normalized ratio of PT (PT-INR) prolonged from the preoperative day in E-group were significantly higher than F-group. Additionally, PT and PT-INR in the E-group at POD3 were significantly prolonged in patients with postoperative anemia and the sensitivity of cut-off values to predict postoperative anemia was superior to the activated partial thromboplastin time (APTT). Thus, as the frequency of postoperative anemia tended to be higher in E-group, edoxaban 30 mg might require vigilance, and prolonged PT and PT-INR could potentially predict edoxaban-associated postoperative anemia after TKA.

DOI： 10.1248/bpb.b15-00713

PubMed

researchmap

Combination Therapy with Continuous Three-in-One Femoral Nerve Block and Periarticular Multimodal Drug Infiltration after Total Hip Arthroplasty. 国際誌

Tomonori Tetsunaga, Tomoko Tetsunaga, Kazuo Fujiwara, Hirosuke Endo, Toshifumi Ozaki

Pain research & management 2016 1425201 - 1425201 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）

Background. Various postoperative pain relief modalities, including continuous femoral nerve block (CFNB), local infiltration analgesia (LIA), and combination therapy, have been reported for total knee arthroplasty. However, no studies have compared CFNB with LIA for total hip arthroplasty (THA). The aim of this study was to compare the efficacy of CFNB versus LIA after THA. Methods. We retrospectively reviewed the postoperative outcomes of 93 THA patients (20 men, 73 women; mean age 69.2 years). Patients were divided into three groups according to postoperative analgesic technique: CFNB, LIA, or combined CFNB+LIA. We measured the following postoperative outcome parameters: visual analog scale (VAS) for pain at rest, supplemental analgesia, side effects, mobilization, length of hospital stay, and Harris Hip Score (HHS). Results. The CFNB+LIA group had significantly lower VAS pain scores than the CFNB and LIA groups on postoperative day 1. There were no significant differences among the three groups in use of supplemental analgesia, side effects, mobilization, length of hospital stay, or HHS at 3 months after THA. Conclusions. Although there were no clinically significant differences in outcomes among the three groups, combination therapy with CFNB and LIA provided better pain relief after THA than CFNB or LIA alone, with few side effects.

DOI： 10.1155/2016/1425201

PubMed

researchmap

Microgeodic Disease Affecting the Fingers and Toes in Childhood: A Case Report. 国際誌

Tomonori Tetsunaga, Hirosuke Endo, Kazuo Fujiwara, Tomoko Tetsunaga, Toshifumi Ozaki

The open orthopaedics journal 10 500 - 504 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）

Microgeodic disease is a disease of unknown etiology that affects the fingers and toes of children, with ≥ 90% of cases involving the fingers alone. We present a rare case of microgeodic disease affecting an index finger and two toes simultaneously in a 7-year-old girl. X-ray and magnetic resonance imaging (MRI) showed multiple small areas of osteolysis in the middle phalanges of the left index finger, hallux, and second toe. Microgeodic disease was diagnosed from X-ray and MRI findings, and conservative therapy involving rest and avoidance of cold stimuli was provided. Although pathological fractures occurred in the course of conservative treatment, the affected finger healed under splinting without any deformity of the finger.

PubMed

researchmap

Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain. 国際誌

Tomoko Tetsunaga, Tomonori Tetsunaga, Masato Tanaka, Keiichiro Nishida, Yoshitaka Takei, Toshifumi Ozaki

Pain research & management 2016 7458534 - 7458534 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）

Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment. Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief. Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP.

DOI： 10.1155/2016/7458534

PubMed

researchmap

85歳以上の超高齢者に対する人工股関節全置換術

鉄永智紀, 佐藤徹, 塩田直史, 金澤智子, 内野崇彦, 山田晋也, 井上洋一

日本人工関節学会誌 45 129 - 130 2015年12月

記述言語：日本語出版者・発行元：(一社)日本人工関節学会

人工股関節全置換術を施行した64例70股(男性9名、女性55名、37〜96歳)を、85歳未満の35例35膝(若年者群)と85歳以上の29例35股(超高齢者群)に分け、術後成績について検討した。手術に至った原因は、若年者群は変形性股関節症、特発性大腿骨頭壊死であったのに対し、超高齢者群は変形性股関節症に加え、人工股関節再置換術、大腿骨近位部骨折術後、感染が含まれた。術後せん妄を認めたのは超高齢者群で有意に多かった。術後合併症は若年者群で2例、超高齢者群では脱臼、感染、ステム周囲骨折、一過性脳虚血発作、脳梗塞、深部静脈血栓症をそれぞれ1例認めた。独歩もしくはT字杖歩行の割合は、若年者群で術前80%から最終調査時97.1%に、超高齢者群では22.9%から54.3%に増加した。平均JOAスコアは、若年者群で術前44点から最終調査時86点に、超高齢者群では34点から74点に有意に改善を認めた。

researchmap

Four-Year Results of Summit Stems for Total Hip Arthroplasty in Japanese Patients 査読

Tomonori Tetsunaga, Toru Sato, Naofumi Shiota, Tomoko Tetsunaga, Yoshiki Okazaki, Kazuki Yamada

HIP International 25 ( 6 ) 553 - 556 2015年11月

担当区分：筆頭著者掲載種別：研究論文（学術雑誌）出版者・発行元：SAGE Publications

<sec><title>Purpose</title> A retrospective study to evaluate the clinical and radiographic outcome of the Summit primary total hip arthroplasty (THA) at a minimum follow-up of 4 years.

</sec><sec><title>Methods</title> 87 hips in 84 Japanese patients underwent THA using Summit stems. 3 patients were lost to follow-up, and 4 patients were excluded because a Summit stem was judged to be inappropriate for their narrow femoral canals. The remaining 80 hips in 77 patients were evaluated. Mean age was 66 years (range, 33-86 y). Mean postoperative follow-up period was 52 months (range, 48-66 m).

</sec><sec><title>Results</title> There was no early stem subsidence after surgery. Of the 80 hips, 60 (75%) showed radiographic signs of stem osseointegration including zones 3 and 5 at final follow-up. Stress shielding occurred in 50 hips (62.5%), and third-degree stress shielding was observed in 12 hips (15%). 3 patients experienced postoperative thigh pain due to distal fixation.

</sec><sec><title>Conclusions</title> These short-term results indicate that the Summit stem achieved good initial fixation, although there were some cases of distal fixation. Careful long-term follow-up and observation will be necessary for hips in which stress shielding occurs.

</sec>

DOI： 10.5301/hipint.5000287

researchmap

その他リンク： http://journals.sagepub.com/doi/full-xml/10.5301/hipint.5000287

【決定版!もう苦手とは言わせないまるごと股関節これ1冊】(第5章)術前・術後看護術前・術後によく使う薬剤とナースが知っておくべきポイント

鉄永智紀, 藤原一夫

整形外科看護 ( 2015秋季増刊 ) 186 - 189 2015年11月

岡山大学病院における難治性慢性痛に対する薬剤師の介入意義について

神崎浩孝, 北村佳久, 千堂年昭, 鉄永倫子, 鉄永智紀, 尾崎敏文, 西江宏行, 太田晴之, 井上真一郎, 小田幸治, 流王雄太, 宮脇卓也, 西田圭一郎

Journal of Musculoskeletal Pain Research 7 ( 3 ) S71 - S71 2015年11月

仙骨形態CT評価に基づいたtranssacral screw刺入安全域の検討

吉田昌弘, 佐藤徹, 塩田直史, 鉄永智紀

骨折 37 ( 4 ) 966 - 969 2015年10月

記述言語：日本語出版者・発行元：(一社)日本骨折治療学会

当院にて骨盤寛骨臼骨折に対する加療を行った患者のCT画像評価を行い、仙骨S1、S2におけるtranssacral screwの刺入安全域を評価した。対象は当院にて2008〜14年まで骨盤、寛骨臼骨折の加療を行った56名であり、CT axial像にてS1、S2における刺入安全域(safe zone)を計測した。S1のsafe zoneは平均10.6mmであったが、S1においてはsafe zoneが全く存在しない症例を7例で認めた。対してS2のsafe zoneは平均11.6mmであったが、S2においては全症例でsafe zoneが存在した。Transsacral screwの刺入においてはS1よりもS2の方が安全に刺入できる可能性が高いことが示唆された。(著者抄録)

researchmap

Establishment of a liaison clinic for patients with intractable chronic pain.

Tomoko Tetsunaga, Tomonori Tetsunaga, Hiroyuki Nishie, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 20 ( 5 ) 907 - 13 2015年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: A multidisciplinary approach has been shown to be effective for the treatment of intractable pain. However, few hospitals in Japan have established liaison clinics for such patients. In this study, we investigated the short-term results of a liaison clinic for patients with intractable chronic pain. METHODS: Study participants comprised 53 outpatients (20 men, 33 women) with intractable chronic pain who visited our hospital between April 2012 and March 2013. At baseline, patients completed a self-reported questionnaire and provided demographic and clinical information. Experts in various fields (anesthesia, orthopedic surgery, psychiatry, physical therapy, and nursing) conducted examinations of patients and attended a weekly conference during which patients' physical, psychological, and social problems were discussed and courses of treatment were determined. All patients were assessed using the Numerical Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Pain Disability Assessment Scale (PDAS). Eligibility for the pain liaison outpatient clinic was evaluated using multiple logistic regression analysis. RESULTS: After a 6-month follow-up period, no significant changes were seen in scores for the NRS, PDAS, or HADS for depression. In contrast, scores for both the PCS and HADS for anxiety were significantly reduced after 6 months of treatment (p < 0.05). HADS for anxiety was identified as a factor related to patient resistance to attending the pain liaison outpatient clinic (p < 0.05). CONCLUSIONS: This liaison clinic for patients with intractable chronic pain was able to improve patient anxiety. Severe anxiety at the initial visit represented a risk factor for dropout from the clinic.

DOI： 10.1007/s00776-015-0748-y

PubMed

researchmap

後十字靱帯付着部裂離骨折に対する術中3D-imageを用いた低侵襲内固定法

山田和希, 佐藤徹, 塩田直史, 鉄永智紀, 吉田昌弘, 寺本亜留美, 岡崎良紀, 井上洋一, 山田晋也

中国・四国整形外科学会雑誌 27 ( 2 ) 373 - 373 2015年9月

処方エキスパートへの道(第2回) プレガバリン

鉄永智紀, 鉄永倫子

Loco Cure 1 ( 2 ) 150 - 154 2015年8月

Apathy scaleを用いた変形性股関節症患者と慢性腰痛患者の意欲低下の比較検討

鉄永智紀, 佐藤徹, 塩田直史, 鉄永倫子

Hip Joint 41 65 - 68 2015年8月

記述言語：日本語出版者・発行元：日本股関節学会

当院整形外科を受診した慢性腰痛患者63例(以下A群)と末期変股症患者25例(B群)および健常対照群30例(C群)についてApathy scaleの測定を行い、群間比較した。また、疼痛の程度をNumerical rating scale(NRS)で測定するとともに、神経障害性疼痛スクリーニング質問票による調査、疼痛生活障害評価(Pain disability assessment scale:PDAS)、不安抑うつ評価(Hospital anxiety and depression scale:HADS)、破局的思考評価(Pain catastrophizing scale:PCS)を行い、群間比較した。結果、Apathy scaleの点数はA群とB群がC群に比べて有意に高く、A群とB群の間に有意差はなかった。NRSはA群>B群>C群の順に高く各群間に有意差を認め、神経障害性疼痛も同様であった。PDAS、HADS、PCSはA群とB群がC群に比べて有意に高値で、A群とB群の間に有意差はなかった。

researchmap

【ぜんぶ説明できるようになろう! 大腿骨頸部/転子部骨折病気のこと手術のこと患者さんにそのまま渡せる患者説明シートつき】人工股関節全置換術患者パンフレット編

佐藤徹, 鉄永智紀

整形外科看護 20 ( 6 ) 542 - 543 2015年6月

Comparison of Continuous Epidural Analgesia, Patient-Controlled Analgesia with Morphine, and Continuous Three-in-One Femoral Nerve Block on Postoperative Outcomes after Total Hip Arthroplasty. 国際誌

Tomonori Tetsunaga, Toru Sato, Naofumi Shiota, Tomoko Tetsunaga, Masahiro Yoshida, Yoshiki Okazaki, Kazuki Yamada

Clinics in orthopedic surgery 7 ( 2 ) 164 - 70 2015年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Postoperative pain relief can be achieved with various modalities. However, there are only few reports that have analyzed postoperative analgesic techniques in total hip arthroplasty patients. The aim of this retrospective study was to compare the postoperative outcomes of three different analgesic techniques after total hip arthroplasty. METHODS: We retrospectively reviewed the influence of three analgesic techniques on postoperative rehabilitation after total hip arthroplasty in 90 patients divided into three groups (n = 30 patients per group). Postoperative analgesia consisted of continuous epidural analgesia (Epi group), patient-controlled analgesia with morphine (PCA group), or a continuous femoral nerve block (CFNB group). We measured the following parameters relating to postoperative outcome: visual analog scale scores, the use of supplemental analgesia, side effects, length of the hospital stay, plasma D-dimer levels, and the Harris hip score. RESULTS: Each group had low pain scores with no significant differences between the groups. The PCA group had a lower frequency of supplemental analgesia use compared to the Epi and CFNB groups. Side effects (nausea/vomiting, inappetence) and day 7 D-dimer levels were significantly lower in the CFNB group (p < 0.05). There were no significant differences between the groups in terms of the length of the hospital stay or the Harris hip score. CONCLUSIONS: Although there were no clinically significant differences in outcomes between the three groups, the CFNB provided good pain relief which was equal to that of the other analgesics with fewer side effects and lower D-dimer levels in hospitalized patients following total hip arthroplasty.

DOI： 10.4055/cios.2015.7.2.164

PubMed

researchmap

【ぜんぶ説明できるようになろう! 大腿骨頸部/転子部骨折病気のこと手術のこと患者さんにそのまま渡せる患者説明シートつき】人工股関節全置換術ナース資料編

鉄永智紀, 佐藤徹, 西川梨沙, 秋平詩織

整形外科看護 20 ( 6 ) 544 - 549 2015年6月

　前のページ - 次のページ　

<鉄永 智紀>

論文 - 鉄永 智紀

<鉄永　智紀>

論文 - 鉄永　智紀