研究者詳細 - 西田　圭一郎

論文 - 西田　圭一郎

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Telemedicine as an alternative to in-person care in the field of rheumatic diseases: A systematic scoping review 国際誌

Ken-ei Sada, Shigeru Iwata, Yuzaburo Inoue, Eiichi Tanaka, Keiichiro Nishida, Yutaka Kawahito, Asami Abe, Atsushi Kawakami, Takako Miyamae

Modern Rheumatology 2025年2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：Oxford University Press (OUP)

ABSTRACT

Objective

The COVID-19 pandemic prompted the widespread adoption of telemedicine as an alternative to in-person care. This systematic scoping review evaluated the effectiveness, cost-efficiency, and challenges of telemedicine for patients with rheumatic diseases.

Methods

A comprehensive search of the MEDLINE database was conducted using specific terms related to rheumatoid or juvenile arthritis, and telemedicine. The literature search included studies published up to March, 2024. In this review, we only considered studies assessing telemedicine as an alternative to in-person care.

Results

The search, conducted on 15 March 2024, generated 258 references. Eight reports from three randomized controlled trials and three observational studies were included. Randomized controlled trials have shown that the outcomes of telemedicine intervention are comparable to those of in-person care in terms of disease activity, functional status, and quality of life, while enabling fewer outpatient visits and cost-effectiveness. However, the high dropout rates highlight the importance of patient preferences and comprehensive education. Observational studies revealed similar findings but were limited by a high confounding bias.

Conclusion

Telemedicine offers economic advantages and maintains clinical outcomes comparable to those of in-person care. Its success depends on structured patient education and alignment with patient preferences. Further research is required, particularly in the context of healthcare in Japan.

DOI： 10.1093/mr/roaf012

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LRP4 and Agrin Are Modulated by Cartilage Degeneration and Involved in β-Catenin Signaling in Human Articular Chondrocytes

Shuichi Naniwa, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Takashi Ohtsuki, Yoshifumi Hotta, Noriyuki Shimizu, Chinatsu Ichikawa, Deting Lin, Noriaki Otsuka, Toshifumi Ozaki

International Journal of Molecular Sciences 26 ( 3 ) 1007 - 1007 2025年1月

掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI AG

We investigated the roles of low-density lipoprotein receptor-related protein (LRP) 4 and its ligand Agrin in the pathophysiology of cartilage degeneration. Immunohistochemical analysis of human normal articular cartilage and cartilage tissues from patients with osteoarthritis (OA) obtained during surgery of the knee joint showed marked LRP4 expression in the early stages of OA, which then decreased with cartilage degeneration, whereas Agrin was consistently increased with cartilage degeneration. In normal human articular chondrocytes (NHACs), mild cyclic tensile strain (CTS) (0.5 Hz, 5% elongation, 2 h) increased the expression of LRP4 and aggrecan (ACAN), while intense CTS (0.5 Hz, 10% elongation, 6 h) increased the expression of Agrin without affecting LRP4 expression. Treatment with recombinant human (rh) Agrin downregulated the mRNA expression of LRP4 and ACAN, but upregulated the expression of LRP5/6, SRY-box transcription factor 9 (SOX9), Runt-related transcription factor 2 (RUNX2), and a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4). Immunocytochemistry and Western blot analysis showed that rhAgrin treatment upregulated the expression of β-catenin and SOX9. Agrin knockdown by siAGRN transfection partially reduced the nuclear protein expression of β-catenin, which was increased with intense CTS. LRP4 knockdown by siLRP4 transfection increased the expression of LRP5/6, SOX9, RUNX2, ADAMTS-4, and Agrin. These results suggested that intense CTS increases the expression of Agrin, which might interfere with the role of LRP4 in the inhibition of LRP5/6 and their downstream β-catenin signaling, leading to cartilage degeneration.

DOI： 10.3390/ijms26031007

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Distribution and Incorporation of Extracellular Vesicles into Chondrocytes and Synoviocytes 査読

Takashi Ohtsuki, Ikumi Sato, Ren Takashita, Shintaro Kodama, Kentaro Ikemura, Gabriel Opoku, Shogo Watanabe, Takayuki Furumatsu, Hiroshi Yamada, Mitsuru Ando, Kazunari Akiyoshi, Keiichiro Nishida, Satoshi Hirohata

International Journal of Molecular Sciences 25 ( 22 ) 11942 2024年11月

関節リウマチの前足部変形の痛みと保存的・外科的治療査読

西田圭一郎, 那須義久, 中原龍一, 植田昌敬, 鷹取亮, 鉄永倫子

日本運動器疼痛学会誌 16 91 - 95 2024年11月

The use of biologic disease-modifying antirheumatic drugs does not increase surgical site infection or delayed wound healing after orthopaedic surgeries for rheumatoid arthritis 国際誌

Yohei Kiso, Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Ryuichi Nakahara, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki

Modern Rheumatology 35 ( 2 ) 265 - 272 2024年9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：Oxford University Press (OUP)

ABSTRACT

Objective

To investigate the effect of the use of biologic disease-modifying antirheumatic drugs (bDMARDs) on surgical site infection (SSI) and delayed wound healing (DWH) in rheumatoid arthritis (RA) patients undergoing orthopaedic surgery.

Methods

We retrospectively reviewed the records of 965 elective orthopaedic procedures undertaken in RA patients. The incidences of SSI and DWH were compared between the bDMARDs user and nonuser groups. Subsequently, univariate and multivariate logistic regression analyses were performed to evaluate risk factors for SSI and DWH after propensity score matching. The incidence of postoperative flare-up was also examined.

Results

In 965 procedures, SSI and DWH were identified in 12 and 28 cases, respectively. SSI and DWH were identified in 3 and 17 of 414 procedures treated with bDMARDs, respectively. Flare-up occurred in 21 cases. Propensity score matching identified 315 cases in both groups, with no significant difference in incidence between the two groups. No risk factors for SSI were identified, whereas age, diabetes mellitus, foot and ankle surgery, and a history of musculoskeletal-related infection were identified as risk factors for DWH.

Conclusion

The use of bDMARDs was not associated with an increased incidence of SSI or DWH, with the incidence of flare-up being relatively low.

DOI： 10.1093/mr/roae089

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その他リンク： https://academic.oup.com/mr/article-pdf/35/2/265/60523967/roae089.pdf

テリボンオートインジェクターの投与時反応について

是友行美, 原田遼三, 高杉幸司, 江澤和彦, 藤田慎一郎, 後藤京子, 山本渉, 中原龍一, 那須義久, 西田圭一郎

日本骨粗鬆症学会雑誌 10 ( Suppl.1 ) 588 - 588 2024年9月

関節軟骨におけるLRP4とAGRINの発現調節因子とβ-catenin signalへの影響

浪花崇一, 市川千夏, 林徳てい, 志水紀之, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

日本整形外科学会雑誌 98 ( 8 ) S1934 - S1934 2024年9月

Insomnia among patients with chronic pain: A retrospective study

Masataka Ueda, Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Ryo Takatori, Hisakazu Shitozawa, Koji Uotani, Kennsuke Shinohara, Yoshiaki Oda, Toshifumi Ozaki

Medicine 103 ( 32 ) e39113 - e39113 2024年8月

掲載種別：研究論文（学術雑誌）出版者・発行元：Ovid Technologies (Wolters Kluwer Health)

Insomnia can coexist with chronic pain and is a major cause of rapidly increasing medical expenses. However, insomnia has not been fully evaluated in patients with chronic pain. This retrospective study aimed to identify the risk factors for insomnia in patients with chronic non-cancer pain. A total of 301 patients with chronic non-cancer pain were enrolled. Patients with the Athens insomnia scale scores ≥ 6 and < 6 were classified into insomnia (+) and insomnia (−) groups, respectively. All patients completed self-report questionnaires as part of their chronic pain treatment approach. Univariate and multivariate analyses were performed to predict insomnia. We found that 219 of 301 (72.8%) patients met the AIS criteria for insomnia. Significant differences were depicted between patients with and without insomnia in terms of body mass index, numeric rating scale, pain catastrophizing scale, hospital anxiety, and depression scale (HADS), pain disability assessment scale, EuroQol 5 dimension (EQ5D), and pain self-efficacy questionnaire. Multiple regression analysis identified the numeric rating scale, HADS, and EQ5D scores as factors related to insomnia in patients with chronic non-cancer pain. Anxiety, depression, and disability were associated with a greater tendency toward insomnia. HADS and EQ5D scores are useful screening tools for preventing insomnia in patients with chronic non-cancer pain.

DOI： 10.1097/md.0000000000039113

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マルチモーダル大規模言語を用いた自動病理画像解析

中原龍一, 竹内孔一, 那須義久, 長谷井嬢, 高橋康, 西田圭一郎, 尾崎敏文

日本関節病学会誌 43 ( 2 ) 252 - 252 2024年6月

大規模言語モデルの外部文書読み込み(RAG)を用いた医療文書の自動Q&A開発

那須義久, 竹内孔一, 中原龍一, 長谷井嬢, 西田圭一郎, 尾崎敏文

日本関節病学会誌 43 ( 2 ) 251 - 251 2024年6月

当院における関節リウマチに対する手部手術の変遷(2004-2022)

志水紀之, 市川千夏, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

日本関節病学会誌 43 ( 2 ) 156 - 156 2024年6月

関節リウマチ手外科手術における手術部位感染/創傷治癒遅延の発生率とb/ts DAMRDs使用の影響

市川千夏, 志水紀之, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

日本関節病学会誌 43 ( 2 ) 156 - 156 2024年6月

関節リウマチ手外科手術における手術部位感染/創傷治癒遅延の発生率とb/ts DAMRDs使用の影響

市川千夏, 志水紀之, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

日本関節病学会誌 43 ( 2 ) 156 - 156 2024年6月

当院における関節リウマチに対する手部手術の変遷(2004-2022)

志水紀之, 市川千夏, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

日本関節病学会誌 43 ( 2 ) 156 - 156 2024年6月

大規模言語モデルの外部文書読み込み(RAG)を用いた医療文書の自動Q&A開発

那須義久, 竹内孔一, 中原龍一, 長谷井嬢, 西田圭一郎, 尾崎敏文

日本関節病学会誌 43 ( 2 ) 251 - 251 2024年6月

マルチモーダル大規模言語を用いた自動病理画像解析

中原龍一, 竹内孔一, 那須義久, 長谷井嬢, 高橋康, 西田圭一郎, 尾崎敏文

日本関節病学会誌 43 ( 2 ) 252 - 252 2024年6月

変形性膝関節症に対するCoolief疼痛管理用高周波システムを用いた治療経験

原田遼三, 西田圭一郎, 那須義久, 中原龍一

日本関節病学会誌 43 ( 2 ) 266 - 266 2024年6月

若年者に対する人工関節手術:克服すべき困難と成功の秘訣若年例に対する人工肘関節置換術

那須義久, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 43 ( 2 ) 213 - 213 2024年6月

Comparison of early clinical outcome in carpal tunnel release - mini-open technique with palmar incision vs. endoscopic technique with wrist crease incision. 査読国際誌

Ryo Nakamichi, Taichi Saito, Yasunori Shimamura, Masanori Hamada, Keiichiro Nishida, Toshifumi Ozaki

BMC musculoskeletal disorders 25 ( 1 ) 251 - 251 2024年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The purpose of this study was to examine two techniques for Carpal Tunnel Syndrome, mini-Open Carpal Tunnel Release (mini-OCTR) and Endoscopic Carpal Tunnel Release (ECTR), to compare their therapeutic efficacy. METHODS: Sixteen patients who underwent mini-OCTR in palmar incision and 17 patients who underwent ECTR in the wrist crease incision were included in the study. All patients presented preoperatively and at 1, 3, and 6 months postoperatively and were assessed with the Visual Analogue Scale (VAS) and the Disabilities of Arm, Shoulder and Hand Score (DASH). We also assessed the pain and cosmetic VAS of the entire affected hand or surgical wound, and the patient's satisfaction with the surgery. RESULTS: In the objective evaluation, both surgical techniques showed improvement at 6 months postoperatively. The DASH score was significantly lower in the ECTR group (average = 3 months: 13.6, 6 months: 11.9) than in the mini-OCTR group (average = 3 months: 27.3, 6 months: 20.6) at 3 and 6 months postoperatively. Also, the pain VAS score was significantly lower in the ECTR group (average = 17.1) than in the mini-OCTR group (average = 36.6) at 3 months postoperatively. The cosmetic VAS was significantly lower in the ECTR group (average = 1 month: 15.3, 3 months: 12.2, 6 months: 5.41) than in the mini-OCTR group (average = 1 month: 33.3, 3 months: 31.2, 6 months: 24.8) at all time points postoperatively. Patient satisfaction scores tended to be higher in the ECTR group (average = 3.3) compared to the mini-OCTR group (average = 2.7). CONCLUSIONS: ECTR in wrist increase incision resulted in better pain and cosmetic recovery in an early postoperative phase compared with mini-OCTR in palmar incision. Our findings suggest that ECTR is an effective technique for patient satisfaction.

DOI： 10.1186/s12891-023-07151-w

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Safety and effectiveness of certolizumab pegol in Japanese patients with rheumatoid arthritis: Up to 3-year results from a postmarketing surveillance study

Hideto Kameda, Keiichiro Nishida, Toshihiro Nanki, Akira Watanabe, Yukiya Oshima, Shigeki Momohara

Modern Rheumatology 34 ( 6 ) 1103 - 1114 2024年3月

掲載種別：研究論文（学術雑誌）出版者・発行元：Oxford University Press (OUP)

ABSTRACT

Objectives

To report up to 3-year safety and effectiveness of certolizumab pegol (CZP) in Japanese patients with rheumatoid arthritis from a postmarketing surveillance study.

Methods

Patients enrolled previously completed 24 weeks of CZP in the 24-week postmarketing surveillance study. Adverse drug reactions (ADRs) were recorded for patients who received ≥1 CZP dose. Effectiveness outcomes were 28-joint Disease Activity Score with erythrocyte sedimentation rate and European Alliance of Associations for Rheumatology response. Week 24–156 safety and Week 0–52 effectiveness data are reported here.

Results

A total of 781 patients were enrolled, with 735 and 376 patients evaluated for safety and effectiveness, respectively. Within the safety set, 17.8% (131/735) of patients reported ADRs; 9.4% (69/735) reported serious ADRs. Among patients with history of respiratory, thoracic, and mediastinal disorders, 38.4% (28/73) reported ADRs. The most frequent ADRs were infections and infestations (11.8%; 87/735); skin and subcutaneous tissue disorders (1.9%; 14/735); respiratory, thoracic, and mediastinal disorders (1.6%; 12/735). Mean 28-joint Disease Activity Score with erythrocyte sedimentation rate reduced from 4.6 (Week 0) to 2.8 (Week 52). At Week 52, 51.8% (161/311) of patients achieved European Alliance of Associations for Rheumatology Good response.

Conclusions

The long-term safety and effectiveness of CZP in the real-world setting in Japan were consistent with previously reported data; no new safety signals were identified.

DOI： 10.1093/mr/roae019

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その他リンク： https://academic.oup.com/mr/article-pdf/34/6/1103/60153600/roae019.pdf

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