Faculty Profiles - NISHIDA Keiichiro

Papers - NISHIDA Keiichiro

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Results of Total Elbow Arthroplasty with Cementless Implantation of an Alumina Ceramic Elbow Prosthesis for Patients with Rheumatoid Arthritis Reviewed

Keiichiro Nishida, Kenzo Hashizume, Masatsugu Ozawa, Ayumu Takeshita, Daisuke Kaneda, Ryuichi Nakahara, Yoshihisa Nasu, Yasunori Shimamura, Hajime Inoue, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 71 ( 1 ) 41 - 47 2017.2

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

We investigated the long-term clinical results of total elbow arthroplasty (TEA) by cementless fixation of alumina ceramic unlinked elbow prostheses (J-alumina ceramic elbows: JACE) for the reconstruction of elbow joints with rheumatoid arthritis (RA). Seventeen elbows in 17 patients (aged 44-72 years, average 54.8) replaced by JACE TEA without bone cement were investigated. The average follow-up period was 10.7 (range, 1.0-19.3) years. Clinical conditions of each elbow before and after surgery were assessed according to the Mayo Elbow Performance Index (MEPI). Radiographic loosening was defined as a progressive radiolucent line of more than 1 mm that was completely circumferential around the intramedullary stem. The average MEPI significantly improved from 46.8 points preoperatively to 66.8 points at final follow-up (p= 0.0226). However, aseptic loosening was noted in 10 of 17 elbows (58.8%) and revision surgery was required in 7 (41.2%). Most loosening was observed on the humeral side. With radiographic loosening and revision surgery defined as the end points, the likelihoods of prosthesis survival were 41.2% and 51.8%, respectively, up to 15 years by Kaplan-Meier analysis. The clinical results of JACE implantation without bone cement were disappointing, with high revision and loosening rates of the humeral component.

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Finger Joint Replacement Surgery and Post-operative Rehabilitation

Nasu Yoshihisa, Sakaguchi Kazuki, Nishida Keiichiro

The Japanese Journal of Rehabilitation Medicine 54 ( 3 ) 191 - 194 2017

Safety and effectiveness of certolizumab pegol in patients with rheumatoid arthritis: Interim analysis of post-marketing surveillance Reviewed

Hideto Kameda, Keiichiro Nishida, Toshihiro Nannki, Akira Watanabe, Yukiya Oshima, Shigaki Momohara

Japanese Journal of Clinical Immunology 40 ( 3 ) 196 - 205 2017

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Society for Clinical Immunology

Objective: To evaluate the safety and effectiveness of certolizumab pegol (CZP) in a real-world setting among Japanese patients with rheumatoid arthritis. Methods: Post-marketing surveillance data from 2,579 patients treated with CZP were analyzed. Adverse events (AEs) observed during the 24-week CZP treatment period were recorded. Disease activity was evaluated using DAS28-ESR and DAS28-CRP at baseline, Week 12, Week 24, or at withdrawal. Results: The total period of exposure to CZP was 1313.8 patient-years (PY). AEs were reported in 658 (25.5%) patients, at an event rate (ER) of 73.68/100 PY. The most frequent serious AEs were pneumonia, herpes zoster, and interstitial lung disease, at ER per 100 PY of 2.06, 1.29, and 1.22, respectively. Mean disease activity scores at baseline, as measured by DAS28-ESR and DAS28-CRP, were 4.77 ± 1.34 and 4.21 ± 1.27, respectively. Mean changes from baseline at the last observation were –1.29 ± 1.46 and –1.30 ± 1.42, respectively. EULAR good or moderate responses were achieved in 65% of patients. Longer disease duration, prior biologics use, and treatment without MTX co-therapy were associated with EULAR no response. Conclusion: In this interim analysis, no new safety signals were observed. Clinical response to CZP was observed in approximately two thirds of patients.

DOI： 10.2177/jsci.40.196

Scopus

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Discrimination between Malignant and Benign Vertebral Fractures Using Magnetic Resonance Imaging. International journal

Tomoyuki Takigawa, Masato Tanaka, Yoshihisa Sugimoto, Tomoko Tetsunaga, Keiichiro Nishida, Toshifumi Ozaki

Asian spine journal 11 ( 3 ) 478 - 483 2017

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

STUDY DESIGN: Retrospective analysis using magnetic resonance imaging (MRI). PURPOSE: To identify MRI features that could discriminate benign from malignant vertebral fractures. OVERVIEW OF LITERATURE: Discrimination between benign and malignant vertebral fractures remains challenging, particularly in patients with osteoporosis and cancer. Presently, the most sensitive means of detecting and assessing fracture etiology is MRI. However, published reports have focused on only one or a few discriminators. METHODS: Totally, 106 patients were assessed by MRI within six weeks of sustaining 114 thoracic and/or lumbar vertebral fractures (benign, n=65; malignant, n=49). The fractures were pathologically confirmed if malignant or clinically diagnosed if benign and were followed up for a minimum of six months. Seventeen features were analyzed in all fractures' magnetic resonance images. Single parameters were analyzed using the chi-square test; a logit model was established using multivariate logistic regression analysis. RESULTS: The chi-square test revealed 11 malignant and 4 benign parameters. Multivariate logistic regression analysis selected (i) posterior wall diffuse protrusion (odds ratio [OR], 48; 95% confidence interval [CI], 4.2-548; p=0.002), (ii) pedicle involvement (OR, 21; 95% CI, 2.0-229; p=0.01), (iii) posterior involvement (OR, 21; 95% CI, 1.5-21; p=0.02), and (iv) band pattern (OR, 0.047; 95% CI, 0.0005-4.7; p=0.19). The logit model was expressed as P=1/[1+exp (x)], x=-3.88×(i)-3.05×(ii)-3.02×(iii)+3.05×(iv)+5.00, where P is the probability of malignancy. The total predictive value was 97.3%. The only exception was multiple myeloma with features of a benign fracture. CONCLUSIONS: Although each MRI feature had a different meaning with a variable differentiation power, combining them led to an accurate diagnosis. This study identified the most relevant MRI features that would be helpful in discriminating benign from malignant vertebral fractures.

DOI： 10.4184/asj.2017.11.3.478

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小児上腕骨顆上骨折後にVolkmann拘縮を来した1例

柏原尚子, 島村安則, 原田遼三, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

日本小児整形外科学会雑誌 25 ( 2 ) 183 - 187 2016.12

Language：Japanese Publisher：(一社)日本小児整形外科学会

小児上腕骨顆上骨折は、小児肘関節周囲骨折の中で最も高頻度に発生し、合併症が多い疾患である。上腕骨顆上骨折後にVolkmann拘縮を来した1例を経験したので報告する。7歳男児、ジャングルジムより墜落して受傷。前医で上腕骨顆上骨折と診断され、当日創外固定術を施行された。術後徐々に手指の屈曲傾向が進行し、当科紹介となった。Volkmann拘縮と診断し、装具加療や徹底したリハビリの後、屈筋腱解離術を施行した。手術所見としては、屈筋群深層筋線維に変性像を認め、正中・尺骨神経剥離術、屈筋群剥離・前進術を施行した。術後6ヵ月時、DIP関節の屈曲拘縮が残存するも全指伸展位保持可能となり、術後7年時生活に支障のない状態まで回復した。小児上腕骨顆上骨折の合併症であるVolkmann拘縮は、重篤な後遺症を残す。本骨折に対していかなる治療方法を選択しても、阻血性障害への注意が重要である。(著者抄録)

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【初期研修医・後期研修医のための必修整形外科】各種検査法超音波検査

中原龍一, 西田圭一郎

関節外科 35 ( 10月増刊 ) 71 - 77 2016.10

痛みリエゾン外来における慢性疼痛患者の痛みと動作能力の関係

太田晴之, 岩井賢司, 野澤康明, 築山尚司, 堅山佳美, 千田益生, 西田圭一郎, 鉄永倫子, 佐々木賢太郎, 西江宏行

理学療法学 43 ( Suppl.2 ) P - 3 2016.10

変形性関節症における骨棘形成に対するADAM12の関与

堀田昌宏, 西田圭一郎, 古松毅之, 宮澤慎一, 那須義久, 中原龍一, 藤原智洋, 町田崇博, 竹下歩, 兼田大輔, 前原亜美, 櫻井美和, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1590 - S1590 2016.8

RA手指変形の治療関節リウマチのボタン穴変形・スワンネック変形に対する再建術

西田圭一郎, 中原龍一, 那須義久, 島村安則, 尾崎敏文

日本手外科学会雑誌 33 ( 1 ) S19 - S19 2016.4

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 2016.3

Consensus-based identification of factors related to false-positives in ultrasound scanning of synovitis and tenosynovitis Reviewed

Kei Ikeda, Akihiro Narita, Michihiro Ogasawara, Shigeru Ohno, Yutaka Kawahito, Atsushi Kawakami, Hiromu Ito, Isao Matsushita, Takeshi Suzuki, Kenta Misaki, Takehisa Ogura, Tamotsu Kamishima, Yohei Seto, Ryuichi Nakahara, Atsushi Kaneko, Takayuki Nakamura, Mihoko Henmi, Jun Fukae, Keiichiro Nishida, Takayuki Sumida, Takao Koike

MODERN RHEUMATOLOGY 26 ( 1 ) 9 - 14 2016.1

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

Introduction: We aimed to identify causes of false-positives in ultrasound scanning of synovial/tenosynovial/bursal inflammation and provide corresponding imaging examples.Methods: We first performed systematic literature review to identify previously reported causes of false-positives. We next determined causes of false-positives and corresponding example images for educational material through Delphi exercises and discussion by 15 experts who were an instructor and/or a lecturer in the 2013 advanced course for musculoskeletal ultrasound organized by Japan College of Rheumatology Committee for the Standardization of Musculoskeletal Ultrasonography.Results: Systematic literature review identified 11 articles relevant to sonographic false-positives of synovial/tenosynovial inflammation. Based on these studies, 21 candidate causes of false-positives were identified in the consensus meeting. Of these items, 11 achieved a predefined consensus (80%) in Delphi exercise and were classified as follows: (I) Gray-scale assessment [(A) non-specific synovial findings and (B) normal anatomical structures which can mimic synovial lesions due to either their low echogenicity or anisotropy]; (II) Doppler assessment [(A) Intra-articular normal vessels and (B) reverberation)]. Twenty-four corresponding examples with 49 still and 23 video images also achieved consensus.Conclusions: Our study provides a set of representative images that can help sonographers to understand false-positives in ultrasound scanning of synovitis and tenosynovitis.

DOI： 10.3109/14397595.2015.1091123

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Clinical and radiographic study of partial arthrodesis for rheumatoid wrists. International journal

Taichi Saito, Keiichiro Nishida, Kenzo Hashizume, Ryuichi Nakahara, Ryozo Harada, Takahiro Machida, Masahiro Horita, Toshifumi Ozaki

Modern rheumatology 26 ( 1 ) 57 - 61 2016

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

OBJECTIVES: To retrospectively investigate the clinical and radiographic results of partial arthrodesis for the wrists with rheumatoid arthritis (RA). METHODS: Forty-one wrists with RA were treated by radiolunate (RL) or radiolunotriquetral (RLT) arthrodesis with ulnar head resection. The average follow-up period after surgery was 7.1 years. Preoperative radiographs of all wrists were classified according to Schulthess classification. We performed RL arthrodesis for all Type II (n = 26) and Type III wrists (n = 7), and RLT arthrodesis for Type III wrists (n = 8). Pre- and postoperative pain score (visual analog scale), grip strength, range of motion, and radiographic parameters were statistically compared. RESULTS: Pain scores in all groups were significantly improved at final follow-up (P < 0.05). Grip strength increased from 5.9 to 12.4 (kg) significantly in Type II wrists (P < 0.01), from 7.2 to 9.1 in Type III wrists after RLT arthrodesis, but decreased from 6.9 to 6.0 in Type III wrists after RL arthrodesis. In all groups, the arc of pronation and supination improved significantly (P < 0.05), and all radiographic parameters improved. CONCLUSIONS: RL arthrodesis for Type II wrists showed satisfactory clinical results. RLT arthrodesis would be a reliable method in case of unstable wrist joint.

DOI： 10.3109/14397595.2015.1072293

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Shortening Oblique Osteotomy with Screw Fixation for Correction of the Lesser Metatarsophalangeal Joints of Rheumatoid Forefoot.

Keiichiro Nishida, Takahiro Machida, Masahiro Horita, Kenzo Hashizume, Ryuichi Nakahara, Yoshihisa Nasu, Hideki Ohashi, Kenta Saiga, Toshifumi Ozaki

Acta medica Okayama 70 ( 6 ) 477 - 483 2016

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

The metatarsophalangeal (MTP) joints are often and predominantly affected in rheumatoid arthritis. The aim of the current study was to describe surgical techniques of shortening oblique osteotomy for lesser metatarsal bone with screw fixation at the osteotomy site, and to investigate the short-term clinical outcomes of our procedure. Twenty-seven feet (78 toes) of 24 RA patients underwent the shortening oblique osteotomy for the correction of deformity at the lesser MTP joints. The average Japanese Society of Surgery of the Foot (JSSF) standard rating system for the RA foot and ankle scale improved significantly from 59.6 points preoperatively to 88.3 points postoperatively (p＜0.001). Twenty-four feet (89% ) were free from metatarsalgia and symptomatic callosities at the lesser MTP joint after surgery. Our present findings showed satisfactory early clinical outcomes of the shortening oblique osteotomy of the metatarsal bone with screw fixation for RA forefoot.

DOI： 10.18926/AMO/54811

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Risk factors for surgical site infection and delayed wound healing after orthopedic surgery in rheumatoid arthritis patients. International journal

Yasutaka Kadota, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Ryuichi Nakahara, Tomoko Kanazawa, Masatsugu Ozawa, Ryozo Harada, Takahiro Machida, Toshifumi Ozaki

Modern rheumatology 26 ( 1 ) 68 - 74 2016

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

OBJECTIVE: To investigate the prevalence and the risk factors of surgical-site infection (SSI) and delayed wound healing (DWH) in patients with rheumatoid arthritis (RA) underwent orthopedic surgery. METHODS: We reviewed the records of 1036 elective orthopedic procedures undertaken in RA patients. Risk factors for SSI and DWH were assessed by logistic regression analysis using age, body mass index, disease duration, pre-operative laboratory data, surgical procedure, corticosteroid use, co-morbidity, and use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and biological DMARDs (bDMARDs) as variables. RESULTS: SSI and DWH were identified in 19 cases and 15 cases, respectively. One case of SSI and three cases of DWH were recorded among 196 procedures in patients using bDMARDs. Foot and ankle surgery was associated with an increased risk of SSI (odds ratio (OR), 3.167; 95% confidence interval (CI), 1.256-7.986; p = 0.015). Total knee arthroplasty (TKA; OR, 4.044; 95% CI, 1.436-11.389; p = 0.008) and disease duration (OR, 1.004; 95% CI, 1.000-1.007; p = 0.029) were associated with an increased risk of DWH. CONCLUSIONS: Our results indicated foot and ankle surgery, and TKA and disease duration as risk factors for SSI and DWH, respectively. bDMARDs was not associated with an increased risk of SSI and DWH.

DOI： 10.3109/14397595.2015.1073133

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Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain. International journal

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

Pain research & management 2016 7458534 - 7458534 2016

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

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

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The process of collecting and evaluating evidences for the development of Guidelines for the management of rheumatoid arthritis, Japan College of Rheumatology 2014: Utilization of GRADE approach. Reviewed International journal

Masayo Kojima, Takeo Nakayama, Yutaka Kawahito, Yuko Kaneko, Mitsumasa Kishimoto, Shintaro Hirata, Yohei Seto, Hirahito Endo, Hiromu Ito, Toshihisa Kojima, Keiichiro Nishida, Isao Matsushita, Kiichiro Tsutani, Ataru Igarashi, Naoyuki Kamatani, Mieko Hasegawa, Nobuyuki Miyasaka, Hisashi Yamanaka

Modern rheumatology 26 ( 2 ) 175 - 9 2016

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

OBJECTIVES: To describe the process of collecting and evaluating evidence for treating rheumatoid arthritis (RA) for developing clinical practice guidelines (CPGs) for rheumatologists in Japan. METHODS: The task force comprised rheumatologists, epidemiologists, health economists, and patients. First, the critical outcomes were determined according to a three-round Delphi method, and eight topics with 88 clinical questions (CQs) were formulated. A systematic review of CQs was conducted using the Cochran Database of Systematic Reviews, MEDLINE, and Japana Centra Revvo Medicina (2003-2012). A questionnaire survey and focus group interview were performed to capture the patients' values and preferences. Data from the National Health Insurance drug price list and product information provided by pharmaceutical companies were collected to evaluate drug cost and safety. The GRADE approach was used to describe the evidence quality and determine the strength of recommendations. Recommendations were developed using a modified Delphi method by a multidisciplinary panel including patients. RESULTS: Eight meetings and frequent e-mail communications were conducted to draft a quality assessment of evidence and recommendations. For 88 CQs, recommendation statements were determined. CONCLUSIONS: Using the GRADE approach, new CPGs successfully addressed important clinical issues for treating RA patients. Timely updating of recommendations should be routinely considered.

DOI： 10.3109/14397595.2015.1069474

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痛みリエゾン外来における慢性疼痛患者の痛みと動作能力の関係

太田晴之, 岩井賢司, 野澤康明, 築山尚司, 堅山佳美, 千田益生, 西田圭一郎, 鉄永倫子, 佐々木賢太郎, 西江宏行

理学療法学Supplement 2015 309 - 309 2016

Language：Japanese Publisher：公益社団法人日本理学療法士協会

【はじめに】2012年4月より慢性疼痛患者に対し，痛みリエゾン外来（開始時は麻酔科リエゾン外来）を開始した。チームは麻酔科医，整形外科医，精神科医，理学療法士，看護師，臨床心理士，薬剤師で構成されている。条件として問診票の記入ができるもの，各医療者側の検査測定が可能なものとした。6ヵ月を治療期間とし，初診時，1ヵ月目，3ヵ月目，終了時の6ヵ月目で定期的な検査測定から評価を実施している。【目的】理学療法を施行した前後の変化，痛みと動作能力の関係を比較検討する。【対象と方法】対象は他院にて身体的・精神的に治療困難とされた慢性疼痛患者136名のうち，理学療法にて6ヵ月間経過が追えた，50例（55.7±15.3歳，男性20名・女性30名）とした。主な疾患の内訳は脊柱管狭窄症12例，頸椎症9例，変形性脊椎症6例，腰椎椎間板ヘルニア4例，筋筋膜性腰痛2例，繊維筋痛症2例，その他15例であった。症候は腰痛15例，全身痛11例，下肢痛7例，頭頸部痛3例，坐骨神経痛4名，その他10名であった。理学療法前後の測定項目はTimed up ＆ go test（以下，TUG），Finger Floor Distance（以下，FFD），片脚立位時間とし，痛みの測定はNumeric Rating Scale（以下，NRS）にて施行し，最も痛みの強い時期のNRSを使用した。検討項目はTUG，FFD，片脚立位時間に対し①初診時のPT施行前後の比較，②6ヵ月時のPT施行前後を比較，③初診時PT施行前と6ヵ月時のPT施行後の比較はWilcoxon符号付順位和検定ならびに，④初診時PT開始前TUG，FFD，片脚立位時間とNRSの関係性，⑤6ヵ月時PT施行後TUG，FFD，片脚立位時間とNRSの関係性についてはピアソンの積率相関係数を用い，5％水準にて統計学的検討を行った。【結果】初回時の理学療法施行した前後では，FFDのみ16.7±17.1cmと12.1±15.5cmであり施行前後で有意差（p＜0.05）が認められた。6ヵ月時の理学療法施行した前後ではTUG10.0±5.7秒と9.4±5.1秒，FFDは11.6±13.4cmと7.1±9.6cm，左片脚立位時間では27.9±19.6秒と30.2±19.7秒施行前後で有意差（p＜0.05）があった。初回時の理学療法施行前と6ヵ月時のPT施行後の比較ではTUG，FFD，左片脚立位時間で有意差（p＜0.01）が認められ，右片脚立位時間では有意差は無かった。初診時TUG，FFD，片脚立位時間とNRSの関係性では，TUGとNRS間に弱いながら相関関係（r=0.33，p＜0.05）を認めた。また6ヵ月時TUG，FFD，片脚立位時間とNRSの相関関係は，初診時と同様にTUGとNRS間に弱いながらも相関関係（r=0.42，p＜0.05）を認めた。【結論】痛みリエゾン外来が6ヶ月間継続可能な症例では理学療法に対し，施行直後より良好な反応を示す患者が多く，初回時と6ヶ月時では明らかな改善がみられた。またNRSとTUGに弱いながらも相関関係を認め，PT開始時よりも6ヵ月時に相関関係が強くなる傾向がみられた。慢性疼痛患者の痛みの改善度と動作能力をみる指標として，TUGが利用できることが示唆された。

DOI： 10.14900/cjpt.2015.0309

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Recent advances in upper extremity surgery for rheumatoid arthritis

Nishida, K.

Nihon rinsho. Japanese journal of clinical medicine 74 ( 6 ) 2016

滑膜細胞におけるA to I microRNA editingによる機能調節の解明

田中陽子, 高田修治, 飯笹久, Artemis Hatzigeorgiou, 宮澤慎一, 古松毅之, 西田圭一郎, 浅原弘嗣

日本生化学会大会・日本分子生物学会年会合同大会講演要旨集 88回・38回 [3T特 - 03(3P1127)] 2015.12

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 2015.11

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