研究者詳細 - 齋藤　太一

論文 - 齋藤　太一

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Risk Factors for Infection Following Operative Treatment of Traumatic Upper Extremity Amputation Injury. 国際誌

Taichi Saito, Takenori Uehara, Ryuichi Nakahara, Yasunori Shimamura, Atsunori Nakao, Toshifumi Ozaki

The journal of hand surgery Asian-Pacific volume 27 ( 4 ) 691 - 697 2022年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: Identification of the risk factors for surgical site infection (SSI) can be a straightforward and cost-effective measure to reduce or prevent the occurrence of SSI. However, there are no studies that revealed risk factors for SSI for traumatic upper extremity amputation. The aim of this study is to investigate the risk factors that promote SSI after surgery for traumatic upper extremity amputation using a large nationwide database. Methods: We used data from the Japan Trauma Data Bank. Diagnoses were defined using the Abbreviated Injury Scale code. We applied multivariate logistic regression to evaluate the infection risk factor. We chose age, sex, vital signs, cause and type of trauma, concomitant injury, diabetes, amputation level, Glasgow coma scale, Injury Severity Score (ISS) and blood transfusion within 24 hours following hospital arrival as confounders. Receiver operating characteristic (ROC) curve analysis was adopted to identify thresholds for change in infection risk. We also applied propensity score (PS) matching to adjust for confounding factors that may affect the outcome. Results: A total of 1,150 patients (967 males, 183 females) had traumatic upper extremity amputation. The mean patient age was 46.5 years. A total of 21 patients (1.8%) suffered from SSI. ISS, blood transfusion, systolic blood pressure (BP) and the upper extremity amputation except for finger were identified as the independent significant risk factors for SSI occurrence by the multivariate analysis (p < 0.05, p < 0.005, p < 0.05 and p < 0.005, respectively). ROC modelling revealed that patients with ISS of over 9 or systolic BP of over 160 had a risk for SSI. After PS matching, the patients with blood transfusion or systolic BP of over 160 had a significantly higher risk of infection (OR 9.0; p = 0.01 and OR 7.0; p = 0.03, respectively). Conclusions: In treating patients with these risk factors, we must be especially careful in performing thorough debridement and wound care. Level of Evidence: Level II (Therapeutic).

DOI： 10.1142/S2424835522500709

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Surgical treatment of humeral medial column stress fracture in a baseball pitcher: a case report

Satoshi Nezu, Yasunori Shimamura, Tadashi Yamawaki, Taichi Saito, Toshifumi Ozaki

JSES Reviews, Reports, and Techniques 2022年5月

The effect of mechanical stress on enthesis homeostasis in a rat Achilles enthesis organ culture model

Taichi Saito, Ryo Nakamichi, Aki Yoshida, Takaaki Hiranaka, Yuki Okazaki, Satoshi Nezu, Minami Matsuhashi, Yasunori Shimamura, Takayuki Furumatsu, Keiichiro Nishida, Toshifumi Ozaki

Journal of Orthopaedic Research 40 ( 8 ) 1872 - 1882 2021年11月

掲載種別：研究論文（学術雑誌）出版者・発行元：Wiley

Tendons and ligaments are jointed to bones via an enthesis that is essential to the proper function of the muscular and skeletal structures. The aim of the study is to investigate the effect of mechanical stress on the enthesis. We used ex vivo models in organ cultures of rat Achilles tendons with calcaneus including the enthesis. The organ was attached to a mechanical stretching apparatus that can conduct cyclic tensile strain. We made the models of 1-mm elongation (0.5 Hz, 3% elongation), 2-mm elongation (0.5 Hz, 5% elongation), and no stress. Histological evaluation by Safranin O staining and Toluidin Blue and Picro Sirius red staining was conducted. Expression of sex-determining region Y-box 9 (Sox9), scleraxis (Scx), Runt-related transcription factor 2 (Runx2), and matrix metalloproteinase 13 (Mmp13) were examined by real-time polymerase chain reaction and immunocytochemistry. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick end-labeling and live/dead staining and was conducted for evaluation of the apoptosis and cell viability. The structure of the enthesis was most maintained in the model of 1-mm elongation. The electronic microscope showed that the enthesis of the no stress model had ill-defined borders between fibrocartilage and mineralized fibrocartilage, and that calcification of mineralized fibrocartilage occurred in the model of 2-mm elongation. Sox9 and Scx was upregulated by 1-mm elongation, whereas Runx2 and Mmp13 were upregulated by 2-mm elongation. Apoptosis was inhibited by low stress. The results of this study suggested that 1-mm elongation can maintain the structure of the enthesis, while 2-mm elongation promotes degenerative changes.

DOI： 10.1002/jor.25210

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jor.25210

Effect of difference in fixation methods of tendon graft and the microfracture procedure on tendon-bone junction healing

Satoshi Nezu, Taichi Saito, Aki Yoshida, Shinji Narazaki, Yasunori Shimamura, Takayuki Furumatsu, Toshifumi Ozaki

JSES International 6 ( 1 ) 155 - 166 2021年11月

掲載種別：研究論文（学術雑誌）出版者・発行元：Elsevier {BV}

Background: There are generally two methods of fixation for tendon grafts used in ligament reconstruction: bone tunnel fixation and anchor fixation. The microfracture (Mf) procedure is a technique to induce bleeding from the bone marrow, and the bleeding may contain cells with differentiation potential. However, few studies have compared the effects of the Mf procedure with those of the fixation methods. This study aimed to evaluate the effectiveness of the Mf procedure on two tendon graft fixation methods: histological, gene expression, tendon graft thickness, and mechanical. We especially focused our investigation on junction healing of tendon grafts and bone in the two fixation methods. Methods: We used 20 rabbits to evaluate tendon and bone healing in a peroneal tendon graft model. The rabbit models were divided into five groups according to the combination of peroneal tendon graft fixation method and Mf technique as follows: control group (C, n = 4), bone tunnel fixation without Mf procedure group (BT − Mf, n = 4), bone tunnel fixation with Mf procedure group (BT + Mf, n = 4), anchor fixation without Mf procedure group (A − Mf, n = 4), and anchor fixation with Mf procedure group (A + Mf, n = 4). All animals were sacrificed at 4 weeks postoperatively. The specimens underwent histological evaluation, mRNA analysis, tendon graft thickness at the tendon-bone junction, and biomechanical testing. Results: Histological evaluation of the BT + Mf and A + Mf groups showed healing with fibrocartilage formation at the tendon graft-bone junction. The mRNA expression showed significant increase in type 2 collagen, Scleraxis, and SRY-box9 in the BT + Mf and A + Mf groups. In biomechanical tests, the BT + Mf and A + Mf groups showed significantly increased tensile strength compared with the BT − Mf and A − Mf groups (BT + Mf group, 21.6 ± 1.7 N; A + Mf group, 22.5 ± 2.3 N vs. BT − Mf group, 12.3 ± 2.4 N; A − Mf group, 11 ± 2.3 N). Conclusion: The Mf procedure resulted in fibrocartilage formation at the tendon-bone junction in the BT and anchor fixation and improved the fixation strength at 4 weeks.

DOI： 10.1016/j.jseint.2021.10.001

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尺骨非定型骨折の2例

望月雄介, 齋藤太一, 尾崎敏文

中国・四国整形外科学会雑誌 33 ( 2 ) 216 - 216 2021年9月

ISB座標系と後顆平面座標系を用いた3D-CT計測と従来法による大腿骨骨幹部骨折術後の回旋変形の比較

佐藤浩平, 上原健敬, 福岡史朗, 近藤宏也, 畑利彰, 齋藤太一, 島村安則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1688 - S1688 2021年8月

移植腱固定法の違いとmicrofracture手技が腱骨接合部癒合に与える影響

根津智史, 齋藤太一, 吉田晶, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1828 - S1828 2021年8月

ISB座標系と後顆平面座標系を用いた3D-CT計測と従来法による大腿骨骨幹部骨折術後の回旋変形の比較

佐藤浩平, 上原健敬, 福岡史朗, 近藤宏也, 畑利彰, 齋藤太一, 島村安則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1688 - S1688 2021年8月

Treatment for postoperative infection of pathological femoral fracture after radiotherapy: two case reports and review of the literature 国際誌

Minami Matsuhashi, Taichi Saito, Tomoyuki Noda, Takenori Uehara, Yasunori Shimamura, Toshifumi Ozaki

Archives of Orthopaedic and Trauma Surgery 141 ( 7 ) 1139 - 1148 2021年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media {LLC}

INTRODUCTION: Radiation-induced pathological fractures show high nonunion and infection rates. Successful treatment of postoperative infections of these fractures without limb amputation is extremely rare. METHODS: We report two cases of postoperative infection of pathological femoral fracture after radiation therapy for soft tissue tumors. Considering the poor condition of the irradiated site, a two-staged operation was selected to create the optimal situation for bone union. The treatment involved the Masquelet technique, latissimus dorsi (LD) flap, and a free vascularized fibula graft (FVFG). In the first stage, we drastically resected the necrotic bone and the surrounding infected tissue and placed antibiotic polymethylmethacrylate space on the bone gap according to the Masquelet technique. Next, we used an Ilizarov external fixator as a temporizing stabilizer and performed the LD flap. Six weeks later, in the second stage, we changed the external fixation to plate fixation; packed the artificial bone (β-TCP) and autograft bone to the induced membrane; and performed FVFG on the other side of the plate. As postoperative therapy, toe touch was allowed immediately, and partial weight bearing was started 2 months after second surgery. RESULTS: Both patients achieved bone union and were able to walk without postoperative complications. At the 2-year follow-up, there was no recurrence of infection. CONCLUSION: Our treatment is effective for controlling postoperative infection of radiation-induced pathological fracture.

DOI： 10.1007/s00402-020-03493-5

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寛骨臼骨折に対する術後臨床成績評価方法の比較 Matta scoreとJHEQの比較検討

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S283 - S283 2021年7月