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放射線治療を行った転移性脊椎腫瘍のADL予後に関する検討

魚谷弘二, 杉原進介, 中田英二

Journal of Spine Research 9 ( 3 ) 698 - 698 2018.3

当院での下肢リンパ浮腫に対する集中排液治療

冨永律子, 明崎禎輝, 中田英二, 杉原伸介, 河村進

理学療法えひめ 31 39 - 40 2018.1

Language：Japanese Publisher：(公社)愛媛県理学療法士会

2015年8月〜2016年10月の下肢リンパ浮腫患者13例(男2例、女11例、平均年齢72歳)19肢を対象に、リンパ浮腫チームによる複合的治療を2週間毎日実施し、成績を報告した。リンパ浮腫チームは形成外科医師・乳腺外科医師・理学療法士・病棟看護師で構成し、複合的治療はスキンケア・用手的リンパドレナージ・バンテージによる圧迫療法・圧迫下での運動療法・日常生活指導にて構成した。患肢周径は全ての部位で経時的に改善し、入院後1、2週目における平均下肢周径は入院時と比べ有意に改善した。入院時と入院後1・2週目、入院後1週目と2週目の平均体重および平均細胞内水分量に有意な減少を認めた。体水分量は入院時と入院後1・2週目に有意な減少を認めた。細胞外水分比は全身・体幹・患肢でそれぞれ、入院後1・2週目の値が入院時と比べ有意に減少した。

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肺がん骨転移に対するニボルマブの治療効果

中田英二, 杉原進介, 上月稔幸, 原田大二郎, 武智宣佳, 尾崎敏文

中部日本整形外科災害外科学会雑誌 61 ( 1 ) 39 - 40 2018.1

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

抗PD-1抗体であるニボルマブの肺がん転移に対する治療効果について検討した。平成28年1月〜平成29年3月に当院でニボルマブの治療を行った非小細胞肺がん骨転移16例(男性11例、女性5例、平均年齢65歳)を対象とした。治療効果はPR 3例、SD 3例、PD 10例で、奏効率19%、病勢コントロール率38%であった。PRの全例、SDの1例で骨転移巣の骨形成や骨外腫瘤の縮小を認めたが、他の症例では不変あるいは骨破壊の進行を認めた。4例で骨転移巣に骨形成を認め、骨転移に対する治療効果はCR1例、PR3例、SD10例、PD2例であった。Second lineとしてニボルマブ投与が行われた5例の治療効果はPR2例、SD2例、PD1例で、骨転移に対する治療効果はCR1例、PR2例、SD2例であった。CRの1例は有害事象により投与開始後2ヵ月でニボルマブの投与を休止し、その後抗がん剤投与を行わなかったが、経時的に原発巣と肺転移巣の縮小と骨転移巣の骨形成を認め、最終観察時(投与中止後6ヵ月)には再増大を認めなかった。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00831&link_issn=&doc_id=20180409210014&doc_link_id=10.11359%2Fchubu.2018.39&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2018.39&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

大腿骨近位部病的骨折の治療成績

中田英二, 杉原進介, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 6 ) 1033 - 1034 2017.11

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

大腿骨近位部病的骨折にて手術を行った24例24肢(男性6例、女性18例、平均年齢63歳)の治療成績を検討した。原発巣は乳癌12例、肺癌6例、その他6例、部位は頸部14例、転子部5例、転子下5例であった。頸部骨折に対しては人工骨頭置換術14例、転子部骨折に対しては髄内釘3例、腫瘍用人工骨頭置換術2例、転子下骨折に対しては髄内釘1例、プレート1例、DHS 1例、腫瘍用人工骨頭置換術2例が施行された。術後PSは術前PSと比較し22例(83%)で改善を認めた。術後合併症は1例に認め、深部感染1例(腫瘍用人工骨頭置換術例)であった。人工骨頭群と髄内釘・プレート群の1年累積生存率は各々58%、17%で有意差を認めた。

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緊急疾患に対する腹腔鏡下大腸手術

近藤圭策, 天上俊之, 河合功, 徳原孝哉, 富岡淳, 駕田修史, 上田博文, 中田英二

日本臨床外科学会雑誌 78 ( 増刊 ) 921 - 921 2017.10

The incidence of atypical femoral fractures in breast cancer patients with bone metastases who received bisphosphonate treatment.

Eiji Nakata, Shinsuke Sugihara, Natsumi Yamashita, Shozo Osumi

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 22 ( 5 ) 946 - 950 2017.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Atypical femoral fractures (AFFs) have been reported to occur in patients with bone metastases who received long-term bisphosphonate treatment. However, the incidence of AFFs in breast cancer patients with bone metastases who received intravenous bisphosphonate is unclear. The purpose of this study is to examine the incidence of AFFs in breast cancer patients with bone metastases who received intravenous bisphosphonate. In addition, we estimated the number of dose and duration of intravenous bisphosphonate at the time of occurrence of AFFs. METHODS: We identified 356 female breast cancer patients with bone metastases who received intravenous bisphosphonate between November 2004 and October 2013 in our institution. The median number of doses of intravenous bisphosphonate was 18 (range, 1-103). The median duration of intravenous bisphosphonate treatment was 16 months (range, 1-102 months). We estimated the incidence of AFFs in patients who received intravenous bisphosphonate and used Poisson regression model to obtain the incidence rates of AFFs. RESULTS: Three AFFs in two patients were identified and the estimated incidence of AFFs was 2.99 per 1000 person-years. At the time of occurrence of AFFs, the patients had received 41 and 83 doses of intravenous bisphosphonate, for 37 and 79 months, respectively. The patients underwent open reduction and internal fixation with intramedullary nail. The frequency and incidence of AFFs in patients who received intravenous bisphosphonate for at least 41 or 83 doses or for more than 37 or 79 months were 2/60 (3.3%), 1/7 (14.3%), 2/70 (2.9%), and 1/9 (11.1%), respectively. CONCLUSIONS: The incidence of AFFs is low in breast cancer patients with bone metastases who received intravenous bisphosphonate. Careful observation is warranted and radiography should be performed to investigate AFFs when clinical signs such as thigh pain appear. STUDY DESIGN: Clinical study.

DOI： 10.1016/j.jos.2017.04.011

PubMed

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麻痺の無い脊椎の骨関連事象(SRE)に対するRTの治療成績

中田英二, 杉原進介, 尾崎敏文

整形外科と災害外科 66 ( 4 ) 921 - 925 2017.9

Language：Japanese Publisher：西日本整形・災害外科学会

【目的】当院では、脊椎SREに保存的治療を行う場合、アルゴリズムを作成して安静度を決定し、廃用症候群予防のため早期離床させる取り組みを行っている。今回、麻痺の無い脊椎SREに対するRTの治療成績について報告する。【対象と方法】H24年7月よりH27年12月迄に当院で治療を行った麻痺を認めない脊椎SRE 201例を対象とした。全例保存的治療(RT 188例)が行われた。このうち、再発を除く175例の脊椎不安定性(SINS)、脊椎SRE部の体動時の疼痛(Numerical Rating Scale(NRS))、ADL(Barthel Index(BI))、QOL(EORTC-QLQ C30のglobal health status)の治療開始時と開始後1、2、3、4、6ヵ月の比較をWilcoxonの符号付順位和検定を用いて検討した。【結果】経時的にSINS、NRS、BI、C30の改善が認められた。再発例を除く症例では、経過中に固定術を要する不安定性や疼痛の増悪は認めなかった。【考察】麻痺を認めない症例は保存的治療で良好な成績が得られた。したがって、根治的治療(TES)の適応がない場合、不安定性が著明でなければ、保存的治療が第一選択と考えられた。(著者抄録)

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未来人が拓く整形外科医療骨盤骨腫瘍に対する切除後再建法

長谷井嬢, 国定俊之, 藤原智洋, 中田英二, 尾崎敏文

中国・四国整形外科学会雑誌 29 ( 3 ) 329 - 329 2017.9

悪性骨腫瘍切除後の機能再建手術

尾崎敏文, 中田英二, 藤原智洋, 長谷井嬢, 国定俊之

The Japanese Journal of Rehabilitation Medicine 54 ( 秋季特別号 ) S138 - S138 2017.9

Risk stratification for predicting symptomatic skeletal events (SSEs) in breast cancer patients with bone metastases.

Eiji Nakata, Shinsuke Sugihara, Shozo Osumi, Natsumi Yamashita

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 22 ( 4 ) 743 - 748 2017.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Symptomatic skeletal events (SSEs) affect many patients with bone metastases from breast cancer. However, predictive models of SSEs in patients with bone metastases from breast cancer have not been established for clinical use. The purpose of this study is to examine risk factors for SSEs in those patients and by combining these risk factors patients are classified into several groups. With this risk-stratification model, we can identify patients at higher risk of SSEs and require close follow-up to maintain ADL. METHODS: Participants included 189 female patients with bone metastases from breast cancer and treated in our institute between 2009 and 2012. To assess risk factors for the first SSEs, clinical data at the time of registration were assessed. To estimate the effects of covariates, we used cause-specific hazard modeling. RESULTS: Multivariate analysis revealed that a high number of metastasized vertebral bodies (≥20) (p < 0.001) and elevated carcinoembryonic antigen (CEA) level (>5 ng/mL) (p = 0.003) were risk factors for SSEs. Patients were classified into four subgroups according to the combination of the number of vertebral metastases and CEA level: patients with CEA level > 5 ng/mL and ≥20 vertebral metastases; patients with CEA level ≤ 5 ng/mL and ≥20 vertebral metastases; patients with CEA level > 5 ng/mL and <20 vertebral metastases; and patients with CEA level ≤ 5 ng/mL and <20 vertebral metastases. Cumulative incidences of SSEs in these four subgroups at 6 months were 35.6%, 15.6%, 9.3%, and 3.7%, respectively. CONCLUSIONS: Patients with elevated CEA level (>5 ng/mL) and extensive vertebral metastases (≥20) should be closely monitored in routine clinical care, to allow prevention of pathological fracture or paraplegia with the intervention of orthopedists or radiologists.

DOI： 10.1016/j.jos.2017.03.014

PubMed

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MRIによる膝窩嚢腫の検討

中田英二, 大森貴夫, 黒住健人, 時岡孝光, 福田昇司, 土井英之, 西山武, 阿部光伸

中国・四国整形外科学会雑誌 21 ( 2 ) 413 - 414 2009.9

高齢者上腕骨骨幹部骨折後骨髄炎の治療経験

大森貴夫, 黒住健人, 阿部光伸, 菊地剛, 西山武, 中田英二, 福田昇司, 時岡孝光

中国・四国整形外科学会雑誌 21 ( 2 ) 422 - 423 2009.9

当院における鏡視下腱板修復術の術後成績

西山武, 福田昇司, 時岡孝光, 黒住健人, 大森貴夫, 土井英之, 中田英二, 阿部光伸

中国・四国整形外科学会雑誌 20 ( 2 ) 312 - 313 2008.9

大腿骨顆部・顆上骨折の検討―骨癒合不全例について―

大森貴夫, 黒住健人, 阿部光伸, 中田英二, 土井英之, 三代卓哉, 福田昇司, 時岡孝光

中国・四国整形外科学会雑誌 20 ( 2 ) 306 - 307 2008.9

外側型変形性関節症に発症した特発性膝関節血腫の一例

島津裕和, 福田昇司, 土井英之, 中田英二, 大森貴夫, 三代卓哉, 黒住健人, 時岡孝光

中国・四国整形外科学会雑誌 19 ( 2 ) 341 - 342 2007.9

患肢温存を行った高齢者のMFHの1例

中田英二, 時岡孝光, 福田昇司, 黒住健人, 三代卓哉, 大森貴夫, 土井英之, 島津裕和

中国・四国整形外科学会雑誌 19 ( 2 ) 337 - 338 2007.9

Magnetic resonance angiography without contrast enhancement medium in bone and soft tissue tumors. International journal

Hideyuki Doi, Atsushi Ono, Akira Kawai, Yuki Morimoto, Toshiyuki Kunisada, Eiji Nakata, Toshifumi Ozaki

Oncology reports 15 ( 3 ) 681 - 5 2006.3

Language：English Publishing type：Research paper (scientific journal)

The aim of this study was to assess the ability of a new magnetic resonance (MR) angiography technique that does not use contrast enhancement medium to depict the vascularity of musculoskeletal neoplasms, and evaluate its clinical utility. We performed 3D fresh blood imaging (FBI) MR angiography in 57 patients with bone or soft tissue tumors, and the detection of vessels in and around the tumor was evaluated. Moreover, differences in vascularity between benign and malignant tumors were analyzed. In the lower leg, large arteries such as femoral or popliteal arteries were visible. In the trunk or arm, large vessels such as subclavian or iliac arteries were visible. Discrimination between benign and malignant tumors was impossible in bone tumors; however, the mean value of vascularity differed between benign and malignant tumors in the soft tissue tumors. This is the first trial of the FBI method for bone and soft tissue tumors. The still developing method of MRA without contrast materials could clearly depict major arteries in the trunk and the extremities, this method may replace conventional MRA of bone and soft tissue tumors because it produces vivid images while being non-invasive.

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Expression of connective tissue growth factor/hypertrophic chondrocyte-specific gene product 24 (CTGF/Hcs24/CCN2) during distraction osteogenesis.

Hiroaki Kadota, Tohru Nakanishi, Koji Asaumi, Tomoichiro Yamaai, Eiji Nakata, Shigeru Mitani, Kiyoshi Aoki, Ayako Aiga, Hajime Inoue, Masaharu Takigawa

Journal of bone and mineral metabolism 22 ( 4 ) 293 - 302 2004

Language：English Publishing type：Research paper (scientific journal)

To investigate the localization and expression of connective tissue growth factor/hypertrophic chondrocyte-specific gene product 24/CCN family member 2 (CTGF/Hcs24/CCN2) during distraction osteogenesis in the rat femur, we studied a total of 54 male rats (11 weeks old). We performed osteotomy in the midshaft of the right femur. After 7 days (lag phase), distraction was started, at the rate of 0.25 mm/12 h for 21 days (distraction phase) by using a small external fixator, and this was followed by a 7-day consolidation phase. Localization and expression of CTGF/Hcs24 during distraction osteogenesis in the femur were examined by immunostaining, in situ hybridization, and reverse transcriptase polymerase chain reaction (RT-PCR). Immunostaining showed the localization of CTGF/Hcs24 in various cells located in the bone-forming area around the osteotomy site. During the distraction phase, in situ hybridization showed that CTGF/Hcs24 mRNA was expressed not only in hypertrophic chondrocytes and osteoblasts but also in fibroblast-like cells and mesenchymal cells at sites of end-ochondral ossification, and not only in osteoblasts but also in pre-osteoblasts and fibroblast-like cells at sites of intramembranous ossification. RT-PCR showed higher level expression of CTGF/Hcs24 mRNA in the distracted group than in the nondistracted group. These results revealed an elevated pattern of CTGF/Hcs24 mRNA expression during distraction osteogenesis, and suggest that CTGF/Hcs24 may play some roles in the endochondral and intramembranous ossification processes that occur during distraction osteogenesis.

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CTGF/Hcs24軟骨強制発現トランスジェニックマウスの解析

縄稚久美子, 中西徹, 吉道玄, 中田英二, 服部高子, 小守壽文, 滝川正春

日本骨代謝学会雑誌 19 ( 2 ) 30 - 30 2001.7

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