研究者詳細 - 鉄永　智紀

論文 - 鉄永　智紀

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小児下肢疾患の診断・治療運動器検診も含めて

鉄永智紀, 赤澤啓史, 山田和希, 小浦卓, 井上智博, 奥田龍一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 333 - 333 2023年11月

当院におけるOrthoMasterのカップアライメント精度

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 430 - 430 2023年11月

小児期股関節MRIで将来の関節適合性を予測する新たな指標

小浦卓, 鉄永智紀, 山田和希, 井上智博, 奥田龍一郎, 赤澤啓史, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S68 - S68 2023年11月

10代の若年者に対するTHAの検討

奥田龍一郎, 鉄永智紀, 山田和希, 小浦卓, 井上智博, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S76 - S76 2023年11月

腫瘍切除後に遠位脛腓間固定を行った多発性外骨腫症の1例

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S160 - S160 2023年11月

観血的整復術を施行した発育性股関節形成不全患者の寛骨臼と大腿骨頭の解剖学的位置関係の検討

小浦卓, 鉄永智紀, 山田和希, 井上智博, 奥田龍一郎, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 秋季学会 ) 280 - 280 2023年10月

大腿骨延長後骨折の変形癒合に対して一期的矯正骨切り術(3次元骨切り術)を施行した片側肥大の1例

奥田龍一郎, 山田和希, 鉄永智紀, 井上智博, 小浦卓, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 秋季学会 ) 367 - 367 2023年10月

Floating Hip術後に対してTHAを行い感染した1例

福岡史朗, 依光正則, 上原健敬, 鉄永智紀, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 46回 186 - 186 2023年6月

Expression of Acetabular Labral Vascular Endothelial Growth Factor and Nerve Growth Factor Is Directly Associated with Hip Osteoarthritis Pain: Investigation by Immunohistochemical Staining. 国際誌

Yoshihiro Sato, Tomonori Tetsunaga, Kazuki Yamada, Yoshi Kawamura, Aki Yoshida, Toshifumi Ozaki

International journal of molecular sciences 24 ( 3 ) 2023年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

The acetabular labrum enhances hip joint stability and plays a key role in osteoarthritis (OA) progression. Labral nerve endings contribute to hip OA pain. Moreover, vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) are associated with pain. Consequently, we analysed VEGF and NGF expression levels in the labrum and their roles in OA. Labra obtained from OA patients were stained immunohistochemically, and labral cells were cultured and subjected to a reverse transcription (RT)-polymerase chain reaction (PCR) to analyse VEGF and NGF mRNA expression. VEGF and NGF expression were compared in each region of the labrum. Correlations between VEGF and NGF expression and age, body mass index, Kellgren-Lawrence grade, Harris Hip Score, the visual analogue scale (VAS), and Krenn score were analysed, and the RT-PCR confirmed the findings. VEGF and NGF expression were high on the labral articular side, negatively correlated with the Krenn score, and positively correlated with the VAS in early OA. VEGF and NGF mRNA expression increased significantly in patients with severe pain and decreased significantly in severely degenerated labra. In early OA, VEGF and NGF expression in the acetabular labrum was associated with the occurrence of hip pain; therefore, these factors could be effective targets for pain management.

DOI： 10.3390/ijms24032926

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Elevated Expression of CCN3 in Articular Cartilage Induces Osteoarthritis in Hip Joints Irrespective of Age and Weight Bearing. 国際誌

Kazuki Hirose, Miho Kuwahara, Eiji Nakata, Tomonori Tetsunaga, Kazuki Yamada, Kenta Saiga, Masaharu Takigawa, Toshifumi Ozaki, Satoshi Kubota, Takako Hattori

International journal of molecular sciences 23 ( 23 ) 2022年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

Osteoarthritis (OA) occurs not only in the knee but also in peripheral joints throughout the whole body. Previously, we have shown that the expression of cellular communication network factor 3 (CCN3), a matricellular protein, increases with age in knee articular cartilage, and the misexpression of CCN3 in cartilage induces senescence-associated secretory phenotype (SASP) factors, indicating that CCN3 promotes cartilage senescence. Here, we investigated the correlation between CCN3 expression and OA degenerative changes, principally in human femoral head cartilage. Human femoral heads obtained from patients who received total hip arthroplasty were categorized into OA and femoral neck fracture (normal) groups without significant age differences. Gene expression analysis of RNA obtained from femoral head cartilage revealed that CCN3 and MMP-13 expression in the non-weight-bearing part was significantly higher in the OA group than in the normal group, whereas the weight-bearing OA parts and normal cartilage showed no significant differences in the expression of these genes. The expression of COL10A1, however, was significantly higher in weight-bearing OA parts compared with normal weight-bearing parts, and was also higher in weight-bearing parts compared with non-weight-bearing parts in the OA group. In contrast, OA primary chondrocytes from weight-bearing parts showed higher expression of CCN3, p16, ADAMTS4, and IL-1β than chondrocytes from the corresponding normal group, and higher ADAMTS4 and IL-1β in the non-weight-bearing part compared with the corresponding normal group. Acan expression was significantly lower in the non-weight-bearing group in OA primary chondrocytes than in the corresponding normal chondrocytes. The expression level of CCN3 did not show significant differences between the weight-bearing part and non-weight-bearing part in both OA and normal primary chondrocytes. Immunohistochemical analysis showed accumulated CCN3 and aggrecan neoepitope staining in both the weight-bearing part and non-weight-bearing part in the OA group compared with the normal group. The CCN3 expression level in cartilage had a positive correlation with the Mankin score. X-ray analysis of cartilage-specific CCN3 overexpression mice (Tg) revealed deformation of the femoral and humeral head in the early stage, and immunohistochemical analysis showed accumulated aggrecan neoepitope staining as well as CCN3 staining and the roughening of the joint surface in Tg femoral and humeral heads. Primary chondrocytes from the Tg femoral head showed enhanced expression of Ccn3, Adamts5, p16, Il-6, and Tnfα, and decreased expression of Col2a1 and -an. These findings indicate a correlation between OA degenerative changes and the expression of CCN3, irrespective of age and mechanical loading. Furthermore, the Mankin score indicates that the expression level of Ccn3 correlates with the progression of OA.

DOI： 10.3390/ijms232315311

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The importance of renal function in anemic patients treated with edoxaban after orthopedic surgery in a real-world clinical setting: A retrospective study. 国際誌

Yasuhisa Izushi, Yoichiro Takami, Soichiro Ushio, Tomonori Tetsunaga, Naofumi Shiota, Hiroshi Yamamoto, Toru Sato, Yoshihisa Kitamura

Medicine 101 ( 47 ) e31298 2022年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Edoxaban (Edx) has been approved to prevent venous thromboembolism after total knee and/or hip arthroplasty in Japan. However, the risk of anemia with Edx treatment remains elusive. No risk factors for Edx-associated anemia after orthopedic surgery have been reported. This study aimed to clarify the risk of anemia associated with Edx treatment and determine the risk factors for Edx-associated anemia after orthopedic surgery with a high risk for bleeding. First, the association between Edx treatment and the incidence of anemia-related events was retrospectively investigated by pharmacovigilance analyses using data from 5769,866 reports between the first quarters of 2016 and 2020 in the Food and Drug Administration Adverse Event Reporting System and 2752,050 reports between the fourth quarters of 2011 and 2019 in the Japanese Adverse Drug Event Report. Second, 221 patients who underwent Edx treatment after total knee and/or hip arthroplasty between July 2011 and June 2012 at a single center were included in a case-control study to clarify the risk factors for anemia. Edx treatment was associated with an increased risk of anemia-related events in orthopedic patients. Reduced renal function was identified as a critical risk factor for Edx-associated anemia after orthopedic surgery. The present study indicates that renal function should be considered in the risk management of increased Edx-associated anemia after orthopedic surgery.

DOI： 10.1097/MD.0000000000031298

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THA後の腸腰筋障害に対する股関節鏡下腸腰筋腱部分切離術の治療経験

安藤輝彦, 山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 392 - 392 2022年10月

THA後の腸腰筋障害とその対策

廣瀬一樹, 山田和希, 鉄永智紀, 小浦卓, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 392 - 392 2022年10月

当院におけるAR Hip Navigation Systemのカップアライメント精度

井上智博, 鉄永智紀, 山田和希, 廣瀬一樹, 小浦卓, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 388 - 388 2022年10月

人工股関節全置換術における軟部組織保護に対する取り組み

小浦卓, 鉄永智紀, 山田和希, 廣瀬一樹, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 389 - 389 2022年10月

運動器慢性疼痛患者において生理的インピーダンス法における位相角はサルコペニア検出に有用である

辻寛謙, 鉄永倫子, 鉄永智紀, 高尾真一郎, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 14 ( 4 ) S49 - S49 2022年10月

THA後の腸腰筋障害に対する股関節鏡下腸腰筋腱部分切離術の治療経験

安藤輝彦, 山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 392 - 392 2022年10月

生理的インピーダンス法におけるPhase angleは運動器慢性疼痛患者においてサルコペニア検出に有用である

辻寛謙, 三澤治夫, 鉄永智紀, 濱田全紀, 堅山佳美, 小田孔明, 西田圭一朗, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S343 - S343 2022年10月

Factors influencing caregiver burden in chronic pain patients: A retrospective study. 国際誌

Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Yoshiaki Oda, Shinichiro Takao, Keiichiro Nishida, Toshifumi Ozaki

Medicine 101 ( 39 ) e30802 2022年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

Chronic pain coexists with disability, anxiety, depression, and sleep disturbances, which are factors of pain chronicity in the fear-avoidance model. Self-efficacy for managing pain plays a protective role against pain chronicity. For chronic pain sufferers, social support from caregivers is important. However, such caregivers face enormous physical and mental burdens. This study aimed to assess how self-efficacy and factors related to the fear-avoidance model affect caregiver burden. Participants were 135 chronic pain patients and their caregivers who visited our outpatient pain special clinic. In clinical assessments, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), Athens insomnia scale (AIS), pain disability assessment scale (PDAS), pain self-efficacy questionnaire (PSEQ) for the patients and Zarit Burden Interview (ZBI) for their caregivers were evaluated. Participants were divided into 2 groups (L group ZBI < 24 points and H group ZBI ≥ 24 points) and compared. Regression analyses were conducted to identify factors correlated with the ZBI scores. Compared to L group, H group showed significantly higher NRS and HADs depression scores, and lower PSEQ scores. In univariate regression analysis, ZBI scores were significantly correlated with NRS, PCS, HADS anxiety, HADS depression, PDAS and PSEQ. Multiple linear regression analysis revealed that ZBI scores were significantly correlated with PSEQ. The caregivers who perceived high caregiver burden had significantly higher patients' pain intensity, depression, and lower self-efficacy than those who perceived low caregiver burden. Caregiver burden correlated with the pain intensity, pain catastrophizing, anxiety, depression, disability, and self-efficacy of chronic pain patients. Among these factors, self-efficacy was the most negatively correlated with caregiver burden. Treatments focused on increasing self-efficacy for managing pain have the potential to reduce caregiver burden.

DOI： 10.1097/MD.0000000000030802

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大腿骨延長後骨折の変形治癒に対して3次元骨切り術を施行した片側肥大の1例

山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 井上智博, 尾崎敏文, 赤澤啓史, 青木清, 寺本亜留美, 田中千晴

中国・四国整形外科学会雑誌 34 ( 2 ) 325 - 325 2022年9月

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