Faculty Profiles - NISHIDA Keiichiro

Papers - NISHIDA Keiichiro

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Experience of High Tibial Osteotomy for Patients with Rheumatoid Arthritis Treated with Recent Medication: A Case Series

Yasuhiro Takahara, Hirotaka Nakashima, Keiichiro Nishida, Yoichiro Uchida, Hisayoshi Kato, Satoru Itani, Yuichi Iwasaki

Journal of Clinical Medicine 2025.5

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

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

Modern Rheumatology 2025.2

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

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 2025.1

Publishing type：Research paper (scientific journal) Publisher：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

Distribution and Incorporation of Extracellular Vesicles into Chondrocytes and Synoviocytes Reviewed

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 2024.11

関節リウマチの前足部変形の痛みと保存的・外科的治療 Reviewed

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 2024.11

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

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

Modern Rheumatology 35 ( 2 ) 265 - 272 2024.9

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

Other Link： 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 2024.9

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 2024.9

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 2024.8

Publishing type：Research paper (scientific journal) Publisher：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

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

Comparison of early clinical outcome in carpal tunnel release - mini-open technique with palmar incision vs. endoscopic technique with wrist crease incision. Reviewed International journal

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

BMC musculoskeletal disorders 25 ( 1 ) 251 - 251 2024.4

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

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

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 2024.3

Publishing type：Research paper (scientific journal) Publisher：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

Other Link： https://academic.oup.com/mr/article-pdf/34/6/1103/60153600/roae019.pdf

リウマチ性疾患の手術(休薬・合併症・その他) 関節リウマチの整形外科手術において,周術期の休薬は非休薬に比べて術後合併症を増やすか

伊藤宣, 石川肇, 辻成佳, 中山政憲, 西田圭一郎, 望月猛, 蛯名耕介, 小嶋俊久, 松本卓巳, 窪田綾子, 中島新, 金子敦史, 松下功, 原良太, 櫻庭康司, 赤崎幸穂, 松原司, 持田勇一, 神戸克明, 桃原茂樹

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 645 - 645 2024.3

非転位型の橈骨遠位端骨折において骨折部位,Lister結節形状は長母指伸筋腱断裂に影響する

斎藤太一, 近藤秀則, 古谷友希, 中道亮, 島村安則, 西田圭一郎, 今谷潤也, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S781 - S781 2024.3

人工膝関節置換術後の関節リウマチ患者における生物学的製剤・JAK阻害剤使用とD-dimer値の関係

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

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 846 - 846 2024.3

自動統計のための日本語大規模言語モデルを用いたカルテサマリーからの情報抽出

中原龍一, 西田圭一郎, 那須義久, 原田遼三, 浪花崇一, 志水紀之, 市川千夏, 高橋康, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 714 - 714 2024.3

リウマチ性疾患の手術(上肢) 関節リウマチに対するMCP人工関節置換術と手関節・手指伸筋腱同時手術症例の検討

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

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 532 - 532 2024.3

リウマチ性疾患の手術(上肢) AVANTAとINTEGRAを用いたMCP人工指関節置換術の術後短期成績の比較

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

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 532 - 532 2024.3

Consensus statement on the management of late-onset rheumatoid arthritis

Masayo Kojima, Takahiko Sugihara, Yutaka Kawahito, Toshihisa Kojima, Yuko Kaneko, Hajime Ishikawa, Asami Abe, Kazuo Matsui, Shintaro Hirata, Mitsumasa Kishimoto, Eiichi Tanaka, Akio Morinobu, Motomu Hashimoto, Isao Matsushita, Toshihiko Hidaka, Toshihiro Matsui, Keiichiro Nishida, Shuji Asai, Hiromu Ito, Ryozo Harada, Masayoshi Harigai

Modern Rheumatology 34 ( 6 ) 1095 - 1102 2024.2

Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objectives

Late-onset rheumatoid arthritis (LORA), which has been increasing in recent years, lacks evidence for initial treatment. Japanese rheumatology experts recognized this gap and addressed it by developing consensus statements on the first clinical application of LORA.

Methods

These statements were created following an introductory discussion about treatment fundamentals, which included a review of existing literature and cohort data. The steering committee created a draft, which was refined using a modified Delphi method that involved panel members reaching a consensus. The panel made decisions based on input from geriatric experts, clinical epidemiologists, guideline developers, patient groups, and the LORA Research Subcommittee of the Japan College of Rheumatology.

Results

The consensus identified four established facts, three basic approaches, and six expert opinions for managing LORA. Methotrexate was recommended as the primary treatment, with molecular-targeted agents being considered if treatment goals cannot be achieved. An emphasis was placed on assessing the lives of older patients due to challenges in risk management and methotrexate accessibility caused by comorbidities or cognitive decline.

Conclusions

The experts substantiated and refined 13 statements for the initial treatment of LORA. To validate these claims, the next is to conduct a registry study focusing on new LORA cases.

DOI： 10.1093/mr/roae011

Other Link： https://academic.oup.com/mr/article-pdf/34/6/1095/60153479/roae011.pdf

High Fracture Rate of AVANTA Silicone Implant Following Arthroplasty of the Thumb MCP Joint of Rheumatoid Arthritis Patients with Boutonniere Deformities. Reviewed

Daisuke Kaneda, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Ryozo Harada, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki

Acta medica Okayama 78 ( 1 ) 71 - 78 2024.2

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

We retrospectively investigated the mid-term outcomes of arthroplasty using the AVANTA silicone implant for thumb metacarpophalangeal (MCP) joints with boutonniere deformity in patients with rheumatoid arthritis (RA). This study involved 36 thumbs of 33 RA patients with a mean follow-up period of 5.1 years (range, 2.0-13.3). Postoperatively, the mean extension was significantly increased and the mean flexion was significantly decreased (p<0.001, p<0.001, respectively), resulting in the mean arc of range of motion (ROM) shifting in the direction of extension after surgery. Implant fracture was observed in 10 thumbs (28%), and 4 of these (11%) underwent revision surgery. The survivorship with implant fracture and revision surgery as endpoints were 73.4% and 91.8% at 5 years, respectively. The preoperative arc of ROM and the postoperative flexion range of the implant-fracture group were significantly greater than those in the no-implant-fracture group (p=0.039, 0.034, respectively). These results suggest the importance of patient education and careful rehabilitation to prevent excessive flexion. Overall, the AVANTA silicone implant showed a relatively high rate of implant fracture at our institute.

DOI： 10.18926/AMO/66673

Inhibitory Effect of a Tankyrase Inhibitor on Mechanical Stress-Induced Protease Expression in Human Articular Chondrocytes Reviewed

Yoshifumi Hotta, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Shuichi Naniwa, Noriyuki Shimizu, Chinatsu Ichikawa, Deting Lin, Tomohiro Fujiwara, Toshifumi Ozaki

International Journal of Molecular Sciences 2024.1

Intra-Articular Corrective Osteotomy for Distal Radial Intra-Articular Malunion Using Patient-Matched Instruments: A Prospective, Multicenter, Open-Label, Single-Arm Trial. Reviewed International journal

Kunihiro Oka, Satoshi Miyamura, Ryoya Shiode, Hiroyuki Tanaka, Norimasa Iwasaki, Daisuke Kawamura, Kazuki Sato, Takuji Iwamoto, Michiro Yamamoto, Keiichiro Nishida, Yasunori Shimamura, Tomomi Yamada, Seiji Okada, Tsuyoshi Murase

JB & JS open access 9 ( 3 ) e24 2024

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

BACKGROUND: Corrective osteotomy for intra-articular malunion is a challenging procedure. However, recent advancements, including patient-matched instruments created on the basis of preoperative computer simulation, enable accurate intra-articular correction. We hypothesized that intra-articular corrective osteotomy using patient-matched instruments for the treatment of distal radial intra-articular malunion would reduce intra-articular deformity and restore wrist function at 12 months of follow-up. METHODS: This prospective study included 12 patients with distal radial intra-articular malunion who underwent intra-articular corrective osteotomy external to the joint using patient-matched instruments. The primary end point was the maximum step-off on the articular surface of the distal radius, measured with use of computed tomography (CT), with an expected postoperative value of ≤1.5 mm. The secondary end points included the gap of the articular surface; range of motion; grip strength; pain evaluated using a visual analog scale (VAS); patient satisfaction; Disabilities of the Arm, Shoulder and Hand (DASH) score; and Patient-Rated Wrist Evaluation (PRWE) score. A mean postoperative step-off of ≤1.5 mm for the primary end point was assessed with use of the 1-sample t test. The secondary end points were assessed with use of the Dunnett multiple comparison test. RESULTS: The average step-off significantly improved from 3.75 ± 1.04 mm preoperatively to 0.51 ± 0.40 mm at the 52-week postoperative follow-up and was maintained within 1.5 mm. The average wrist and forearm range of motion, VAS score, grip strength, DASH score, and PRWE score significantly improved. Eleven patients were either very satisfied or satisfied with their outcomes. CONCLUSIONS: The use of patient-matched instruments could contribute to improving postoperative outcomes of intra-articular corrective osteotomy procedures involving the distal radius. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

DOI： 10.2106/JBJS.OA.24.00026

A preliminary survey of rheumatologists on the management of late-onset rheumatoid arthritis in Japan

Satoshi Takanashi, Yuko Kaneko, Yutaka Kawahito, Takashi Kida, Takahiko Sugihara, Toshihisa Kojima, Ryozo Harada, Michinori Ishitoku, Shintaro Hirata, Motomu Hashimoto, Toshihiko Hidaka, Asami Abe, Hajime Ishikawa, Hiromu Ito, Mitsumasa Kishimoto, Kazuo Matsui, Toshihiro Matsui, Isao Matsushita, Akira Onishi, Akio Morinobu, Keiichiro Nishida, Shuji Asai, Eiichi Tanaka, Masayoshi Harigai, Masayo Kojima

Internal Medicine 2024

Unlinked TEAを第一選択とする治療戦略

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

関節の外科 51 ( 2 ) 51 - 51 2024

関節リウマチ患者における人工関節置換術のリスクファクターの検討

志水紀之, 大塚憲昭, 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

関節の外科 51 ( 2 ) 70 - 70 2024

最適な治療を目指した周術期管理 JAK阻害剤

西田圭一郎, 市川千夏, 那須義久, 中原龍一, 原田遼三, 浪花崇一, 志水紀之, 林徳てい, 大塚憲昭

関節の外科 51 ( 2 ) 40 - 40 2024

前方及び後方アプローチを併用した尺骨鉤状突起および肘頭骨折を伴う肘関節脱臼開放骨折の1例

古谷友希, 齋藤太一, 中道亮, 島村安則, 西田圭一郎, 尾崎敏文

日本肘関節学会雑誌 31 ( 1 ) S84 - S84 2024

The Effectiveness of Rehabilitation after Open Surgical Release for Trigger Finger: A Prospective, Randomized, Controlled Study Reviewed

Taichi Saito, Ryo Nakamichi, Ryuichi Nakahara, Keiichiro Nishida, Toshifumi Ozaki

Journal of Clinical Medicine 12 ( 22 ) 7187 - 7187 2023.11

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

Background: It is not clear whether rehabilitation after surgery for trigger finger is effective. The aim of this study was to reveal its effectiveness for trigger finger. Methods: This study was a randomized, controlled trial that included patients who underwent operations for trigger fingers. The patients in the rehabilitation group had postoperative occupational therapy (OT) for 3 months, while the patients in the control group were not referred for rehabilitation but received advice for a range of motion exercises. We evaluated the severity of trigger finger, Disability of Arm-Shoulder-Hand (DASH) score, pain-visual analogue scale (VAS), grip strength, whether they gained a full range of motion (ROM), and complications before and after surgery. Results: Finally, 29 and 28 patients were included in the control and rehabilitation groups, respectively. At final follow-up, the DASH score, grip strength, and ROM were significantly improved in the rehabilitation group compared to that preoperatively. At final follow-up, pain was significantly improved in both groups from that preoperatively. There were no significant differences in the results, including the DASH score, grip strength, ROM and pain-VAS between the control and rehabilitation groups at the final follow-up. Subgroup analysis showed that there is a significant difference in the DASH score of patients doing housework or light work and those with a duration of symptoms >12 months between the control and rehabilitation groups at the final follow-up.

DOI： 10.3390/jcm12227187

ChatGTP と paper mills

西田圭一郎

整形外科 74 ( 11 ) 1168 - 1168 2023.11

変形性関節症の画像診断，バイオマーカーのトピックス

西田圭一郎

関節外科 42 ( 10 ) 16 - 22 2023.10

関節リウマチ患者の整形外科手術における手術部位感染，創傷治癒遅延の治療と生物学的製剤使用の関係

浪花崇一, 那須義久, 西田圭一郎

別冊整形外科 1 ( 84 ) 149-153 2023.10

慢性疼痛患者の破局的思考が身体的機能と活動能力に与える影響 1年間の継時的推移の特徴

太田晴之, 齋藤圭介, 横山暁大, 堅山佳美, 濱田全紀, 鉄永倫子, 西田圭一郎, 尾崎敏文

日本運動器理学療法学会学術大会抄録集 11回 348 - 348 2023.10

完全 Web 化された医工連携の試み：関節可動域自動計測システムの開発 Reviewed

速川湧気, 吉岡健太郎, 鈴木諒, 中原龍一, 那須義久, 西田圭一郎, 尾﨑敏文

中・四整会誌 35 ( 2 ) 225 - 230 2023.9

深層学習と民生用 3D センサを用いた低コスト高精度肘関節可動域自動計測システムの試み Reviewed

鈴木諒, 吉岡健太郎, 速川湧気, 中原龍一, 那須義久, 西田圭一郎, 尾﨑敏文

中・四整会誌 35 ( 2 ) 219 - 224 2023.9

Wrist arthrodesis combined with a bulk bone allograft for implant loosening after total wrist arthroplasty: a case report. Reviewed International journal

Yoshihisa Nasu, Keiichiro Nishida, Masamitsu Natsumeda, Ryuichi Nakahara, Ryozo Harada, Toshifumi Ozaki

Modern rheumatology case reports 2023.8

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

Total wrist arthroplasty is a challenging procedure for wrist joints severely destroyed by rheumatoid arthritis. The most common postoperative complication of total wrist arthroplasty is the loosening of the carpal component. Revision surgeries for failed total wrist arthroplasties can be complicated owing to severe bone loss and concomitant soft-tissue problems. Here we report a case (68-year-old woman with a history of rheumatoid arthritis for 24 years) of severe aseptic loosening of semi-constrained total wrist arthroplasty and its salvage surgery. During the primary arthroplasty procedure, severe instability at the second through fifth carpometacarpal joints was observed, and arthrodesis of these joints was required. The radiographs obtained nine months after surgery showed loosening of the carpal component. Subsequently, she suffered a stroke, resulting in a loss of follow-up, and higher stress was loaded on her upper extremities during standing and walking. In the radiograph taken at her revisit 25 months after the primary surgery, the subsidence of the carpal component progressed, and loosening of the radial component was observed. Total wrist arthrodesis was performed using a bulk bone allograft of the femoral head, combined with a penetrating Wrist Fusion Rod®. Rapid bone union was achieved without soft tissue irritation. We conclude that wrist arthrodesis with a bulk bone allograft combined with an intramedullary nail is a reasonable option for failed total wrist arthroplasty.

DOI： 10.1093/mrcr/rxad048

大規模言語モデル(AI)の医師国家試験解答解析 ChatGPTとGPT-4の比較

中原龍一, 西田圭一郎, 那須義久, 堀田佳史, 浪花崇一, 志水紀之, 高橋康, 長谷川嬢

日本整形外科学会雑誌 97 ( 8 ) S1609 - S1609 2023.8

新しい関節リウマチ診療ガイドラインとアバタセプトの位置付け

西田圭一郎

大阪臨床整形外科医会会報 ( 49 ) 2023 - 2023 2023.7

Influence of Janus kinase inhibitors on early postoperative complications in patients with rheumatoid arthritis undergoing orthopaedic surgeries Reviewed

Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Shuichi Naniwa, Ryuichi Nakahara, Yoshifumi Hotta, Noriyuki Shimizu, Deting Lin, Toshifumi Ozaki

Modern Rheumatology 34 ( 3 ) 466 - 473 2023.6

Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objective

We retrospectively reviewed the records of rheumatoid arthritis (RA) patients who underwent orthopaedic surgery to examine the influence of the perioperative use of Janus kinase (JAK) inhibitors on early postoperative complications.

Patients and Methods

Thirty-two patients with RA under disease control with JAK inhibitors who underwent 49 orthopaedic procedures were included in the study. Patient records after surgery were investigated for surgical site infection (SSI), delayed wound healing (DWH), a flare-up of the disease, preoperative and postoperative absolute lymphocyte counts (ALCs), venous thromboembolism, and other postoperative complications.

Results

JAK inhibitors were continued during the perioperative period in 31 procedures. In the remaining 18 procedures, JAK inhibitors were discontinued perioperatively with a mean discontinuation period of 2.4 days. No instances of SSI were identified in any patient during at least 90 days’ follow-up, while DWH was seen in one patient. Disease flare-up was noted in two patients after 3 and 9 days of discontinuation of JAK inhibitors, respectively. The ALCs significantly decreased on postoperative Day 1 (P &lt; .0001), and there was a significant correlation between pre- and post-one-day ALCs (r = 0.75, P &lt; .0001).

Conclusion

JAK inhibitors seem to be safe during the perioperative period of orthopaedic surgery.

DOI： 10.1093/mr/road047

Other Link： https://academic.oup.com/mr/article-pdf/34/3/466/57109151/road047.pdf

J-SC人工肘関節の連結部に破損を生じた1例

那須義久, 西田圭一郎, 志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 270 - 270 2023.6

関節リウマチ患者に対する前足部切除関節形成術後の骨棘切除術

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 249 - 249 2023.6

両手関節炎様の所見を呈した腱黄色腫の1例

浪花崇一, 志水紀之, 林徳てい, 堀田佳史, 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 42 ( 3 ) 214 - 214 2023.6

骨吸収抑制薬長期使用下で高度変形肘を伴う関節リウマチ患者に生じた尺骨非定形骨折の一例

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 42 ( 3 ) 208 - 208 2023.6

大規模言語モデル(ChatGPT)による医師国家試験解答解析

中原龍一, 西田圭一郎, 高橋康, 那須義久, 堀田佳史, 浪花崇一, 志水紀之, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 191 - 191 2023.6

【知っておきたい関節痛のみかた・考えかた】実際の診察室で困ること関節痛をきたす患者をいつ外科医へコンサルトすべきか

那須義久, 西田圭一郎

診断と治療 111 ( 6 ) 823 - 828 2023.6

Language：Japanese Publisher：(株)診断と治療社

＜文献概要＞Headline 1 関節リウマチでは,薬物療法が適切に行われたうえで,残存する関節症状に対する非薬物療法が検討される.関節注射やリハビリテーション,装具療法などの保存療法が無効な場合は手術治療が検討される.2 関節破壊・変形が軽度な段階から高度に進行した段階まで,様々な手術方法の適応があるが,関節構造を温存し,より高度な機能再建を求めるならば早期に手術治療を行ったほうがよい.3 合併する腱断裂,絞扼性神経障害や脊椎脊髄障害などの進行にも注意する必要があり,発症・進行が疑われる場合は整形外科へのコンサルトが必要である.4 手術治療のタイミングを逸さないためには,手術適応の判断だけではなく保存的治療や経過観察も含めた内科・整形外科の連携体制がとられていることが望ましい.

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00697&link_issn=&doc_id=20230615020023&doc_link_id=%2Fae4digta%2F2023%2F011106%2F018%2F0823-0828%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae4digta%2F2023%2F011106%2F018%2F0823-0828%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

大規模言語モデル(ChatGPT)による医師国家試験解答解析

中原龍一, 西田圭一郎, 高橋康, 那須義久, 堀田佳史, 浪花崇一, 志水紀之, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 191 - 191 2023.6

両手関節炎様の所見を呈した腱黄色腫の1例

浪花崇一, 志水紀之, 林徳てい, 堀田佳史, 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 42 ( 3 ) 214 - 214 2023.6

関節リウマチ患者に対する前足部切除関節形成術後の骨棘切除術

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 249 - 249 2023.6

J-SC人工肘関節の連結部に破損を生じた1例

那須義久, 西田圭一郎, 志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 270 - 270 2023.6

弾発指に対する術後リハビリテーションの有効性

斎藤太一, 中道亮, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 40 ( 1 ) O32 - 2 2023.4

野球選手における有鉤骨骨折に対する皮皺に沿った掌側進入法における手術治療成績

島村安則, 根津智史, 斎藤太一, 中道亮, 山脇正, 久禮美穂, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 40 ( 1 ) O38 - 5 2023.4

リウマチ手外科の原点と挑戦手関節に対する関節温存手術の適応と課題

那須義久, 西田圭一郎

日本手外科学会雑誌 40 ( 1 ) SY1 - 1 2023.4

骨粗鬆症と骨代謝-3 ロモソズマブ治療の骨質に与える影響について

原田遼三, 西田圭一郎, 那須義久, 中原龍一, 高杉幸司, 江澤和彦, 藤田慎一朗, 井上貴絵, 井上るみ, 山本渉, 新名早希子

日本リウマチ学会総会・学術集会プログラム・抄録集 67回 648 - 648 2023.3

関節リウマチ患者の骨粗鬆症に対するロモソズマブ治療の解析

高杉幸司, 原田遼三, 井上るみ, 井上貴絵, 藤田慎一朗, 山本渉, 新名早希子, 宮脇義亜, 松本佳則, 中原龍一, 西田圭一郎, 江澤和彦

日本リウマチ学会総会・学術集会プログラム・抄録集 67回 882 - 882 2023.3

生物学的製剤の使用は手術部位感染と創傷治癒遅延のリスク因子となるか

木曽洋平, 西田圭一郎, 原田遼三, 那須義久, 中原龍一, 渡辺雅仁, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S1022 - S1022 2023.3

リウマチ性疾患における画像検査教師なしAIを用いたトポロジー学習・関節リウマチ超音波画像同一断面自動検出

中原龍一, 西田圭一郎, 那須義久, 浪花崇一, 堀田佳史, 志水紀之, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 67回 718 - 718 2023.3

リウマチ性疾患の手術:周術期管理・手術関連諸問題関節リウマチに対する整形外科手術後の手術部位感染・創傷治癒遅延の発生頻度と治癒過程はb/tsDMARD使用に影響されるか?

浪花崇一, 志水紀之, 堀田佳史, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

日本リウマチ学会総会・学術集会プログラム・抄録集 67回 691 - 691 2023.3

生物学的製剤の使用は手術部位感染と創傷治癒遅延のリスク因子となるか

木曽洋平, 西田圭一郎, 原田遼三, 那須義久, 中原龍一, 渡辺雅仁, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S1022 - S1022 2023.3

人工肘関節置換術-合併症に対する創意と工夫- 人工肘関節周囲骨折の治療戦略

那須義久, 志水紀之, 浪花崇一, 堀田佳史, 原田遼三, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S565 - S565 2023.3

関節リウマチ関節手術のフレイル脱却に対する効果

小嶋俊久, 浅井秀司, 石川肇, 田中栄, 橋本淳, 西田圭一郎, 寺部健哉, 鈴木望人, 服部陽介, 小嶋雅代, 今釜史郎

日本整形外科学会雑誌 97 ( 2 ) S57 - S57 2023.3

在宅医療への治療移行における専門医,非専門医との連携課題と医療ソーシャルワーカー(MSW)の役割

新名早希子, 原田遼三, 高杉幸司, 山本渉, 藤田慎一朗, 井上貴絵, 井上るみ, 那須義久, 中原龍一, 西田圭一郎, 江澤和彦

日本リウマチ学会総会・学術集会プログラム・抄録集 67回 805 - 805 2023.3

人工肘関節置換術-合併症に対する創意と工夫- 人工肘関節周囲骨折の治療戦略

那須義久, 志水紀之, 浪花崇一, 堀田佳史, 原田遼三, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S565 - S565 2023.3

Association of phase angle with sarcopenia in chronic musculoskeletal pain patients: a retrospective study. Reviewed International journal

Hironori Tsuji, Tomoko Tetsunaga, Haruo Misawa, Keiichiro Nishida, Toshifumi Ozaki

Journal of orthopaedic surgery and research 18 ( 1 ) 87 - 87 2023.2

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

BACKGROUND: In chronic musculoskeletal pain patients, detection of sarcopenia is of significant clinical interest. Phase angle, which can be measured through bioelectrical impedance analysis (BIA), can detect sarcopenia; however, the evidence in chronic musculoskeletal pain patients is limited. This study aimed to assess the relationship between phase angle and sarcopenia in patients with chronic musculoskeletal pain. Our hypothesis was that phase angle would be a useful indicator to identify sarcopenia in patients with chronic musculoskeletal pain. METHODS: A total of 190 patients (51 men and 139 women) with chronic musculoskeletal pain were included in this retrospective cross-sectional study. Patient data of backgrounds, numeric rating scale score for pain, skeletal muscle index, and phase angle assessed using BIA were retrospectively reviewed. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. RESULTS: A total of 51 patients (26.7%), including 10 men (19.6%) and 41 women (29.5%), were diagnosed with sarcopenia. Phase angle, sarcopenia-related factors, age, and body mass index (BMI) differed significantly in patients with and without sarcopenia. On multiple logistic regression analysis, the prevalence of sarcopenia was significantly correlated with phase angle and BMI. The areas under the curve exhibited high accuracy in discriminating sarcopenia in men and moderate accuracy in both sexes and in women. CONCLUSIONS: Phase angle may be a valid discriminator of sarcopenia in patients with chronic musculoskeletal pain.

DOI： 10.1186/s13018-023-03567-1

Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old Reviewed

Keiichiro Nishida, Yoshihisa Nasu, Kenzo Hashizume, Shunji Okita, Ryuichi Nakahara, Taichi Saito, Toshifumi Ozaki, Hajime Inoue

Bone & Joint Open 4 ( 1 ) 19 - 26 2023.1

関節リウマチにおける手指関節・手関節の超音波パワードプラスコアと関節破壊の関連 Reviewed

沖田駿治, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 4 ) 524 - 527 2023.1

Language：Japanese Publisher：(一社)日本手外科学会

関節リウマチ患者において,関節超音波検査(以下US)で滑膜炎を認めた関節と関節破壊が進行する関節は必ずしも一致しないことが報告されている.USで評価を行った手指・手関節の関節破壊に対する予後を検討した.調査開始時にUSによるパワードプラ(以下PD)スコアの計測が行われ,調査開始時および調査開始後1年以上経過時に両手単純X線写真による関節破壊の進行が評価可能であった関節リウマチ患者70例を対象とした.多変量解析ではPDスコアの合計値のみが関節破壊の有意な危険因子として同定された(オッズ比1.19,P=0.010).両手のPDスコアの合計値は手関節の関節破壊(P=0.001)およびMCP関節の関節破壊(P<0.001)と相関を認めた.各関節のPDスコアは同関節の関節破壊と相関を認めた(P<0.001).諸家の報告と異なりUSで滑膜炎を認めた関節は関節破壊が進行しやすい結果であった.(著者抄録)

関節リウマチによる高度手関節変形に対して手関節全固定術あるいは人工手関節置換術を行った8例の術後経過

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

関節の外科 50 ( 2 ) 122 - 122 2023

関節リウマチ患者に対するSauve-Kapandji法の臨床成績の検討

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

関節の外科 50 ( 2 ) 121 - 121 2023

関節リウマチ患者に対するSauve-Kapandji法の臨床成績の検討

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

関節の外科 50 ( 2 ) 121 - 121 2023

関節リウマチによる高度手関節変形に対して手関節全固定術あるいは人工手関節置換術を行った8例の術後経過

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

関節の外科 50 ( 2 ) 122 - 122 2023

Late-onset rheumatoid arthritis registry study, LORIS study: study protocol and design. International journal

Masayo Kojima, Yutaka Kawahito, Takahiko Sugihara, Toshihisa Kojima, Ryozo Harada, Shintaro Hirata, Motomu Hashimoto, Toshihiko Hidaka, Hajime Ishikawa, Hiromu Ito, Mitsumasa Kishimoto, Yuko Kaneko, Kazuo Matsui, Toshihiro Matsui, Isao Matsushita, Akio Morinobu, Keiichiro Nishida, Eiichi Tanaka, Asami Abe, Michinori Ishitoku, Shuji Asai, Takashi Kida, Akira Onishi, Satoshi Takanashi, Masayoshi Harigai

BMC rheumatology 6 ( 1 ) 90 - 90 2022.12

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

BACKGROUND: Although drug treatment strategies for rheumatoid arthritis (RA) are relatively well established, there is a paucity of evidence on the treatment in older patients. The purpose of this study is to build a registry for late-onset RA (LORA), which is expected to increase rapidly worldwide. In addition, we aim to propose optimal treatment strategies according to the patient background including frailty, thereby contributing to improving the quality of treatment and daily living in patients with RA. METHODS/DESIGN: The LORIS (Late-onset Rheumatoid Arthritis Registry) Study is a prospective nation-wide multicenter observational study of patients with LORA. The inclusion criteria were patients aged ≥ 65 years at onset, meeting 2010 ACR/EULAR classification criteria for RA, and starting either any disease-modifying antirheumatic drugs (DMARDs) in a DMARD-naïve patient or the first biologic/targeted synthetic DMARDs during the study period. Enrollment was started on 11 January, 2022 and will be closed on 31 December, 2023. Patients will undergo a comprehensive baseline assessment including clinical data, medication, cognitive and physical function, psychosocial factors, and frailty. Data will be collected at baseline, Month 3, 6, 12, 18, 24, 36, and summarized descriptively. The factors associated with adverse events and achieving remission will be determined. DISCUSSION: A multi-disciplinary panel including patients, rheumatologists, and geriatric specialists will discuss the results and build a consensus regarding the treatment goals of LORA. We expect to provide a broad range of information for evidence-based shared decision making in the treatment of LORA. STUDY REGISTRATION: Registered at the UMIN registry (UMIN000046086) on 1 January 2022.

DOI： 10.1186/s41927-022-00322-7

尺骨突き上げ症候群に対する尺骨骨幹部短縮骨切り術と遠位部短縮骨切り術の治療成績の比較

齋藤太一, 中道亮, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 3 ) 315 - 318 2022.12

Language：Japanese Publisher：(一社)日本手外科学会

当院では以前より尺骨突き上げ症候群に対しては尺骨骨幹部での短縮骨切りを施行してきたが,近年皮膚切開量が短く,骨癒合が有利な尺骨遠位部での骨切りをおこなっている.今回骨切り部位別に治療成績を比較検討したので報告する.尺骨突き上げ症候群に対して骨切り術を行い,術後評価可能であった37例を対象とした.骨幹部骨切り症例は15例,遠位部骨切り症例は,22例含まれていた.これらの群に対して平均の骨癒合期間,握力,手関節可動域,DASH,Pain-VAS,および術後合併症をそれぞれ比較した.平均骨癒合期間は骨幹部骨切り群では3.3ヵ月,遠位部骨切り群では2.6ヵ月,術後1年経過時の握力については骨幹部,遠位部骨切り群それぞれ平均31.7kg,30.2kgであった.術後1年経過時の掌背屈可動域は骨幹部,遠位部骨切り群それぞれ150.0度,152.7度,回内外可動域は骨幹部,遠位部骨切り群それぞれ155.0度,170.1度であり,平均術後成績に有意差は認められなかった.DASHに関しては骨幹部骨切りでは23.9から20.1,遠位部骨切りでは33.3から9.9へと遠位部骨切りに関してのみ術後有意差をもって改善していた.またVASを用いた痛み評価では骨幹部骨切りでは7.2から1.0,遠位部骨切りでは5.8から1.2へとどちらの群も有意差をもって改善していた.(著者抄録)

Five cases of atypical ulnar fractures associated with long-term bisphosphonate use: An anatomical and mechanical analysis using a finite element model

Shunji Okita, Taichi Saito, Norio Yamamoto, Yusuke Mochizuki, Ryuichi Nakahara, Yasunori Shimamura, Toshiyuki Kunisada, Keiichiro Nishida, Toshifumi Ozaki

Journal of Orthopaedic Science 2022.11

Japanese version of Patient-Rated Elbow Evaluation is a useful outcome measure that potentially reflects hand function in patients with rheumatoid arthritis who underwent total elbow arthroplasty Reviewed International journal

Ryozo Harada, Keiichiro Nishida, Yoshiyuki Matsuyama, Kenzo Hashizume, Takuro Wada, Yoshihisa Nasu, Ryuichi Nakahara, Masahiro Horita, Masuo Senda, Toshifumi Ozaki

Modern Rheumatology 32 ( 6 ) 1041 - 1046 2022.10

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objectives

We examined the relationship between the Japanese version of Patient-Rated Elbow Evaluation (PREE-J) and other established subjective and objective outcome measures in Japanese patients with rheumatoid arthritis (RA) who underwent total elbow arthroplasty (TEA).

Materials and Methods

This study involved 46 elbows of 40 RA patients. We collected clinical data 1 year after surgery, including the PREE-J, the Mayo Elbow Performance Score (MEPS), Disability of the Arm, Shoulder, and Hand (DASH), and Hand20. The correlation and responsiveness to PREE-J were evaluated compared with other outcome measures preoperatively and postoperatively.

Results

Almost all outcome measures were improved significantly after surgery. Preoperative PREE-J was significantly correlated with preoperative DASH, Hand20, and MEPS. Interestingly, postoperative PREE-J did not correlate with postoperative MEPS. Multiple regression analyses revealed that preoperative grip strength [B = −0.09; 95% confidence interval (95% CI) −0.17 to −0.01, p = 0.03] and preoperative Hand20 (B = 0.31, 95% CI 0.03–0.58, p = 0.03) were significant factors that might influence the postoperative PREE-J.

Conclusions

The PREE-J was shown to correlate well with other preoperative outcome measures among the RA patients included in the current study. The postoperative PREE-J after TEA was influenced by the preoperative grip strength and function of the hand.

DOI： 10.1093/mr/roab100

Other Link： https://academic.oup.com/mr/article-pdf/32/6/1041/46543404/roab100.pdf

慢性疼痛患者を対象とした集学的治療における活動能力の継時的推移の類型化に関する検討

太田晴之, 齋藤圭介, 原田和宏, 京極真, 鉄永倫子, 西田圭一郎, 千田益生

運動器理学療法学 2 ( Suppl. ) O - 28 2022.10

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 2022.10

超音波検査におけるリスター結節の解剖学的形状の観察

松山宜之, 中原龍一, 那須義久, 堅山佳美, 濱田全紀, 西田圭一郎, 千田益生

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S563 - S563 2022.10

両側の人工肘関節置換術術後に異所性骨化を生じた1例

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 406 - 406 2022.10

AIを用いた超音波画像同一断面自動保存機能の開発

中原龍一, 西田圭一郎, 那須義久, 堀田佳史, 浪花崇一, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 375 - 375 2022.10

水銀式握力計で使用する新たな握力カフの開発(第二報)

藤岡晃, 高木涼, 松岡玲衣, 鍋倉由佳, 小川加苗, 松山宜之, 岡佳純, 西田圭一郎, 岡久雄, 堅山佳美, 濱田全紀, 千田益生

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S468 - S468 2022.10

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 2022.10

Factors influencing caregiver burden in chronic pain patients: A retrospective study International journal

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

Medicine 101 ( 39 ) e30802 - e30802 2022.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Ovid Technologies (Wolters Kluwer Health)

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

DevOpsを用いた機械学習・医療アプリケーションの開発効率の改善

中原龍一, 西田圭一郎, 高橋康, 那須義久, 原田遼三, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1796 - S1796 2022.9

慢性疼痛患者を対象とした集学的治療における活動能力の継時的推移の類型化に関する検討

太田晴之, 齋藤圭介, 原田和宏, 京極真, 鉄永倫子, 西田圭一郎, 千田益生

Journal of Musculoskeletal Pain Research 14 ( 3 ) 171 - 181 2022.9

Language：Japanese Publisher：(一社)日本運動器疼痛学会

慢性疼痛患者における集学的治療が6ヵ月間可能であった集団の治療経過における継時的推移について,活動能力を指標に潜在プロフィール分析(Latent Profile Analysis:LPA)を用い集団を類型化すること,類型化された各集団の特徴について検討することである。結果,慢性疼痛患者において,活動能力の継時的推移は4つの集団に類型化できること,その治療経過は開始時の身体的パフォーマンスの状態で異なる治療経過を辿る可能性を明らかにした。(著者抄録)

両側の人工肘関節置換術術後に異所性骨化を生じた1例

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本関節病学会誌 41 ( 3 ) 165 - 165 2022.9

DevOpsを用いた機械学習・医療アプリケーションの開発効率の改善

中原龍一, 西田圭一郎, 高橋康, 那須義久, 原田遼三, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1796 - S1796 2022.9

関節リウマチにおけるMCP人工指関節再置換術の短期成績

浪花崇一, 堀田佳史, 志水紀之, 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 41 ( 3 ) 167 - 167 2022.9

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

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 2022.8

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

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jor.25210

Evaluation of SARC-F and SARC-CalF for sarcopenia screening in patients with chronic musculoskeletal pain: A prospective cross-sectional study. International journal

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

Medicine 101 ( 29 ) e29568 2022.7

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

OBJECTIVES: Early sarcopenia detection using screening tools, such as SARC-F and SARC-CalF, has been proven reliable. However, the relationship between chronic musculoskeletal pain with sarcopenia is unknown. This study assessed sarcopenia morbidity as well as the reliability of sarcopenia screening with SARC-F and SARC-CalF in patients with chronic musculoskeletal pain. METHODS: Overall, 172 patients with chronic musculoskeletal pain were included in this cross-sectional study. All participants completed the SARC-F, SARC-CalF, numeric rating scale (NRS), and pain disability assessment scale (PDAS) assessments. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. Correlations between SARC-F and SARC-CalF scores and each measured variable were evaluated using univariate and multiple linear regression analyses. A receiver operating characteristic curve analysis was conducted, and reliabilities of SARC-F and SARC-CalF scores for diagnosing sarcopenia were compared. RESULTS: Thirty-nine patients were diagnosed with sarcopenia. Among these, 10 patients were <65 years old, and 29 were >65 years old. Both SARC-F and SARC-CalF scores significantly correlated with grip power, gait speed, skeletal mass index, numeric rating scale score, and PDAS score. In multiple linear regression analysis, SALC-F and SALC-CalF scores significantly correlated with PDAS score, skeletal mass index, and gait speed. The area under the curve were 0.70 for SARC-F and 0.88 for SARC-CalF; SARC-CalF had a significantly higher area under the curve than SARC-F. DISCUSSION: Sarcopenia was diagnosed in patients aged <65 years with chronic musculoskeletal pain. SALC-F and SARC-CalF scores showed a significant correlation with disability due to pain and were reliable sarcopenia screening tools for chronic musculoskeletal pain. SARC-CalF was more reliable than SARC-F.

DOI： 10.1097/MD.0000000000029568

Safety and effectiveness of certolizumab pegol in Japanese patients with rheumatoid arthritis: Results from a 24-week post-marketing surveillance study Reviewed

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

Modern Rheumatology 33 ( 3 ) 460 - 471 2022.7

Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objectives

To report 24-week safety and effectiveness of certolizumab pegol (CZP) in Japanese patients with rheumatoid arthritis from a post-marketing surveillance study.

Methods

Enrolled patients were newly receiving CZP. All adverse events (AEs) and adverse drug reactions (ADRs) were recorded for patients who received ≥1 CZP dose. Effectiveness outcomes included: 28-joint Disease Activity Score with erythrocyte sedimentation rate (DAS28-ESR) and European Alliance of Associations for Rheumatology (EULAR) response. Missing data were imputed using the last observation carried forward.

Results

3727 patients were enrolled; safety and effectiveness were evaluated in 3586 and 1794 patients, respectively. 24.9% of patients reported AEs (893/3586), 14.7% reported ADRs (528/3586), 8.3% (298/3586) reported serious AEs and 5.3% (190/3586) reported serious ADRs. Selected serious ADRs of interest: infections (110; 3.1%), tuberculosis (6; 0.2%), interstitial pneumonia (15; 0.4%), malignancy (8; 0.2%), and hepatic function disorder (7; 0.2%). No allergic reactions, autoimmune disease, cardiac failure, demyelinating diseases, or pancytopenia were reported. Mean DAS28-ESR reduced from 4.8 (baseline) to 3.4 (final evaluation). At final evaluation, 34.7% of patients achieved EULAR good response.

Conclusions

These real-world safety and effectiveness results were consistent with previously reported data, with no new safety signals identified. Long-term, real-world CZP safety and effectiveness data are needed.

DOI： 10.1093/mr/roac073

Other Link： https://academic.oup.com/mr/article-pdf/33/3/460/49879660/roac073.pdf

関節リウマチにおける手指関節・手関節の超音波パワードプラスコアと関節破壊の関連

沖田駿治, 中原龍一, 那須義久, 西田圭一郎

日本手外科学会雑誌 39 ( 1 ) O31 - 3 2022.4

尺骨突き上げ症候群に対する尺骨骨幹部短縮骨切り術と遠位部短縮骨切り術の治療成績の比較

齋藤太一, 根津智史, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 1 ) O66 - 5 2022.4

Non-drug and surgical treatment algorithm and recommendations for the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis—secondary publication

Hiromu Ito, Keiichiro Nishida, Toshihisa Kojima, Isao Matsushita, Masayo Kojima, Shintaro Hirata, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Masaaki Mori, Akio Morinobu, Atsuko Murashima, Yohei Seto, Takahiko Sugihara, Eiichi Tanaka, Takeo Nakayama, Hisashi Yamanaka, Yutaka Kawahito, Masayoshi Harigai

Modern Rheumatology 33 ( 1 ) 36 - 45 2022.3

Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objectives

The aim of this study was to update the Japan College of Rheumatology (JCR) clinical practice guidelines (CPGs) for the management of rheumatoid arthritis (RA) and prepare an algorithm for non-drug and surgical treatments. This article is a digest version of the guidelines.

Methods

The Japanese Ministry of Health, Labour and Welfare’s research group, in collaboration with the JCR, used the Grading of Recommendations, Assessment, Development, and Evaluation method to update the 2014 JCR CPG for RA. The consensus was formed by CPG panel members.

Results

We raised 19 clinical questions regarding non-drug and surgical treatments for RA and developed recommendations. The treatments included exercise therapy; occupational therapy; joint injection of corticosteroids; and orthopaedic surgeries including cervical spine surgery, wrist and foot arthroplasty, ankle arthrodesis, and replacement arthroplasty of the shoulder, elbow, finger, hip, knee, and ankle. Recommendations regarding the risks of surgery and perioperative discontinuation of medications have also been developed. Based on these recommendations, we created an original algorithm for the non-drug and surgical treatment of RA.

Conclusions

These recommendations are expected to serve rheumatologists, health care professionals, and patients with RA as tools for shared decision-making to treat residual limb joint symptoms and functional impairment.

DOI： 10.1093/mr/roac019

Other Link： https://academic.oup.com/mr/article-pdf/33/1/36/48626507/roac019.pdf

Drug treatment algorithm and recommendations from the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis—secondary publication Reviewed

Yutaka Kawahito, Akio Morinobu, Yuko Kaneko, Masataka Kohno, Shintaro Hirata, Mitsumasa Kishimoto, Yohei Seto, Takahiko Sugihara, Eiichi Tanaka, Hiromu Ito, Toshihisa Kojima, Isao Matsushita, Keiichiro Nishida, Masaaki Mori, Atsuko Murashima, Hisashi Yamanaka, Takeo Nakayama, Masayo Kojima, Masayoshi Harigai

Modern Rheumatology 33 ( 1 ) 21 - 35 2022.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objective

The aim of this study was to update the Japan College of Rheumatology (JCR) clinical practice guidelines (CPG) for the management of rheumatoid arthritis (RA; JCR CPG for RA) according to recent changes in the medical environment in Japan. This article is a digest version of the guidance.

Methods

We used the Grading of Recommendations, Assessment, Development, and Evaluation method to update the 2014 JCR CPG for RA. A consensus was formed by CPG panel members.

Results

We identified 36 important clinical questions regarding drug treatment and developed corresponding recommendations for RA. The recommendations included the following RA medications: non-steroidal anti-inflammatory drugs, corticosteroids, conventional synthetic disease-modifying antirheumatic drugs, biological disease-modifying antirheumatic drugs, anti-receptor activator for nuclear factor-κB ligand antibodies, and Janus kinase inhibitors, as well as the tapering and discontinuation of these medications. Recommendations regarding the efficacy and safety of treatments in the elderly and patients with comorbidities were also developed. Finally, we used these recommendations to create an original algorithm for drug treatment for RA based on the Treat-to-Target approach.

Conclusion

The 2020 JCR CPG for RA provides a useful tool for rheumatologists, health care professionals, and patients with RA, enabling shared decision-making in a variety of clinical situations.

DOI： 10.1093/mr/roac017

Other Link： https://academic.oup.com/mr/article-pdf/33/1/21/49137216/roac017.pdf

リハビリテーション T2Tを実践した場合の1年間のSMIの推移

藤田慎一朗, 原田遼三, 高杉幸司, 江澤和彦, 井上貴絵, 井上るみ, 新名早希子, 山本渉, 中原龍一, 那須義久, 西田圭一郎

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 405 - 405 2022.3

リウマチ性疾患の上肢手術リウマチ母指に対する母指MCP人工関節置換術の長期成績

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 原田遼三, 渡辺雅仁, 堀田佳史, 浪花崇一

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 352 - 352 2022.3

リウマチ肘に対するPROSNAP人工肘関節置換術の短期成績

堀田佳史, 西田圭一郎, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S247 - S247 2022.3

関節リウマチ患者に対する連結型人工肘関節全置換術(PROSNAP)の臨床成績の検討

堀田佳史, 西田圭一郎, 浪花崇一, 原田遼三, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 618 - 618 2022.3

人工手関節置換術後のゆるみに対して他家骨移植を併用した全人工手関節固定術を施行した1例

那須義久, 西田圭一郎, 中原龍一, 浪花崇一, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 616 - 616 2022.3

関節リウマチの増悪との鑑別に苦慮した両側踵脆弱性骨折の1例

氏家正皓, 片山祐, 松本和也, 廣瀬啓, 志田原健太, 縄稚翔一, 中土井崇人, 浅野洋介, 大橋敬司, 宮脇義亜, 勝山恵理, 勝山隆行, 楢崎真理子, 佐田憲映, 松本佳則, 中原龍一, 那須義久, 西田圭一郎, 和田淳

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 753 - 753 2022.3

人工肘関節全置換術を施行した関節リウマチ患者の上肢機能に影響を与える因子の検討

松山宜之, 那須義久, 原田遼三, 中原龍一, 西田圭一郎, 尾崎敏文, 千田益生

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 636 - 636 2022.3

リウマチ性疾患の上肢手術関節リウマチに対するAVANTAとINTEGRAを用いたMCP人工指関節置換術の術後可動域の比較

浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 353 - 353 2022.3

関節リウマチにおける外科的治療の意義-機能障害の回復を目指して- RA患者に対する人工肘関節全置換術による機能回復

西田圭一郎, 松山宜之, 原田遼三, 那須義久, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 251 - 251 2022.3

AIを用いた骨端線の年齢変化の学習と単純X線画像自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S427 - S427 2022.3

関節リウマチ治療のパラダイムシフトに伴う上肢手術とリハビリテーション-変遷と展望- 人工肘関節全置換術後のリハビリテーションの変遷と展望

西田圭一郎, 松山宜之, 那須義久, 原田遼三, 中原龍一, 千田益生, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S413 - S413 2022.3

その他の(多彩な)膠原病機械学習を用いたサマリー自動可視化システムによるサマリー記載の標準化

中原龍一, 西田圭一郎, 高橋康, 浪花崇一, 堀田佳史, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 477 - 477 2022.3

腱骨接合部の恒常性におけるメカニカルストレスの影響

齋藤太一, 根津智史, 吉田晶, 島村安則, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S315 - S315 2022.3

AIを用いた骨端線の年齢変化の学習と単純X線画像自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S427 - S427 2022.3

関節リウマチの増悪との鑑別に苦慮した両側踵脆弱性骨折の1例

氏家正皓, 片山祐, 松本和也, 廣瀬啓, 志田原健太, 縄稚翔一, 中土井崇人, 浅野洋介, 大橋敬司, 宮脇義亜, 勝山恵理, 勝山隆行, 楢崎真理子, 佐田憲映, 松本佳則, 中原龍一, 那須義久, 西田圭一郎, 和田淳

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 753 - 753 2022.3

関節リウマチ治療のパラダイムシフトに伴う上肢手術とリハビリテーション-変遷と展望- 人工肘関節全置換術後のリハビリテーションの変遷と展望

西田圭一郎, 松山宜之, 那須義久, 原田遼三, 中原龍一, 千田益生, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S413 - S413 2022.3

リウマチ肘に対するPROSNAP人工肘関節置換術の短期成績

堀田佳史, 西田圭一郎, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S247 - S247 2022.3

リウマチ性疾患の上肢手術関節リウマチに対するAVANTAとINTEGRAを用いたMCP人工指関節置換術の術後可動域の比較

浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 353 - 353 2022.3

関節リウマチにおける外科的治療の意義-機能障害の回復を目指して- RA患者に対する人工肘関節全置換術による機能回復

西田圭一郎, 松山宜之, 原田遼三, 那須義久, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 251 - 251 2022.3

人工手関節置換術後のゆるみに対して他家骨移植を併用した全人工手関節固定術を施行した1例

那須義久, 西田圭一郎, 中原龍一, 浪花崇一, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 616 - 616 2022.3

その他の(多彩な)膠原病機械学習を用いたサマリー自動可視化システムによるサマリー記載の標準化

中原龍一, 西田圭一郎, 高橋康, 浪花崇一, 堀田佳史, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 477 - 477 2022.3

人工肘関節全置換術を施行した関節リウマチ患者の上肢機能に影響を与える因子の検討

松山宜之, 那須義久, 原田遼三, 中原龍一, 西田圭一郎, 尾崎敏文, 千田益生

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 636 - 636 2022.3

関節リウマチ患者に対する連結型人工肘関節全置換術(PROSNAP)の臨床成績の検討

堀田佳史, 西田圭一郎, 浪花崇一, 原田遼三, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 618 - 618 2022.3

フットケア外来を通じ手術治療機会を得た高齢RA患者の一例

井上るみ, 原田遼三, 高杉幸司, 江澤和彦, 井上貴絵, 藤田慎一朗, 新名早希子, 山本渉, 中原龍一, 那須義久, 西田圭一郎

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 731 - 731 2022.3

JAK阻害薬継続下にCOVID-19ワクチン接種を行った症例の経過について症例報告

原田遼三, 高杉幸司, 江澤和彦, 井上貴絵, 藤田慎一朗, 井上るみ, 新名早希子, 山本渉, 中原龍一, 那須義久, 西田圭一郎

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 701 - 701 2022.3

リウマチ患者に対する母指MCP人工関節置換術の長期成績

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 渡辺雅仁, 堀田佳史, 浪花崇一

日本整形外科学会雑誌 96 ( 2 ) S139 - S139 2022.3

リウマチ性疾患の上肢手術リウマチ母指に対する母指MCP人工関節置換術の長期成績

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 原田遼三, 渡辺雅仁, 堀田佳史, 浪花崇一

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 352 - 352 2022.3

Comprehensive risk analysis of postoperative complications in patients with rheumatoid arthritis for the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis International journal

Hiromu Ito, Koichi Murata, Yasumori Sobue, Toshihisa Kojima, Keiichiro Nishida, Isao Matsushita, Yutaka Kawahito, Masayo Kojima, Shintaro Hirata, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Masaaki Mori, Akio Morinobu, Atsuko Murashima, Yohei Seto, Takahiko Sugihara, Eiichi Tanaka, Takeo Nakayama, Masayoshi Harigai

Modern Rheumatology 32 ( 2 ) 296 - 306 2022.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Objectives

To examine the risk factors of surgical site infection (SSI), delayed wound healing, and death after orthopedic surgery in patients with rheumatoid arthritis (RA).

Methods

We identified articles indexed in the Cochrane Library, PubMed, and Japan Centra Revuo Medicina Web published from 2013 to 2019 and other articles. Articles fulfilling the predefined inclusion criteria were reviewed systematically and their quality was appraised according to the Grading of Recommendations Assessment, Development, and Evaluation system with some modifications.

Results

After inclusion and exclusion by full-text review, 29 articles were analyzed. Use of biological disease modifying antirheumatic drugs was a risk factor of SSI (risk ratio 1.66, 95% confidence interval 1.25–2.19), but not of delayed wound healing. RA itself was a risk factor of SSI, and oral glucocorticoid use was a risk factor of SSI in three of the four studies analyzed and of postoperative death. Age, male sex, comorbidities such as diabetes mellitus and chronic obstructive pulmonary disease, surgical factors such as foot/ankle and spine surgery and longer operative time were risk factors of those postoperative complications.

Conclusion

Patients with those factors should be dealt with appropriate cautions to strike a risk–benefit balance of orthopedic surgeries.

DOI： 10.1080/14397595.2021.1913824

Other Link： https://academic.oup.com/mr/article-pdf/32/2/296/42644947/1913824.pdf

Systematic review for the treatment of older rheumatoid arthritis patients informing the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis International journal

Takahiko Sugihara, Yutaka Kawahito, Akio Morinobu, Yuko Kaneko, Yohei Seto, Toshihisa Kojima, Hiromu Ito, Masataka Kohno, Takeo Nakayama, Yasumori Sobue, Keiichiro Nishida, Isao Matsushita, Atsuko Murashima, Masaaki Mori, Eiichi Tanaka, Shintaro Hirata, Mitsumasa Kishimoto, Hisashi Yamanaka, Masayo Kojima, Masayoshi Harigai

Modern Rheumatology 32 ( 2 ) 313 - 322 2022.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Objectives

To provide an evidence base for clinical practice guidelines (CPG) for the management of rheumatoid arthritis (RA) in older adults.

Methods

PubMed, Cochrane library, and Japan Centra Revuo Medicina databases were searched for articles published between 1990 and 2019. Quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation system, with some modifications.

Results

Among 702 identified articles, there were 5 post-hoc analyses of randomized controlled trials and 10 observational studies. Meta-analysis of the former yielded a mean difference of the van der Heijde-modified total Sharp score of −2.79 (95% confidence interval [CI] − 3.74 to −1.84) for treatment with tumor necrosis factor inhibitors. The risk ratio (RR) for the American College of Rheumatology 50% response rate, and for serious adverse events was 2.83 (95%CI 1.90–4.21) and 1.32 (95%CI 0.53–3.31), respectively, for Janus kinase inhibitors. Meta-analysis of the observational studies yielded an RR for disease activity score-28 remission and serious infections of 0.76 (95%CI 0.64–0.91) and 1.92 (95%CI 1.31–2.81) for older-versus-younger patients receiving biological disease-modifying antirheumatic drugs, respectively.

Conclusion

This systematic review provides the necessary evidence for developing CPG for the management of RA in older adults.

DOI： 10.1080/14397595.2021.1912922

Other Link： https://academic.oup.com/mr/article-pdf/32/2/313/42644941/1912922.pdf

Patients’ perspectives of rheumatoid arthritis treatment: a questionnaire survey for the 2020 update of the Japan college of rheumatology clinical practice guidelines International journal

Masayo Kojima, Mieko Hasegawa, Shintaro Hirata, Hiromu Ito, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Toshihisa Kojima, Isao Matsushita, Masaaki Mori, Akio Morinobu, Atsuko Murashima, Keiichiro Nishida, Yohei Seto, Yasumori Sobue, Takahiko Sugihara, Eiichi Tanaka, Takeo Nakayama, Yutaka Kawahito, Masayoshi Harigai

Modern Rheumatology 32 ( 2 ) 307 - 312 2022.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Objectives

This study aimed to evaluate patients’ opinions regarding their rheumatoid arthritis (RA) therapy and to reflect the patients’ perspectives in the 2020 update of the Japan College of Rheumatology clinical practice guidelines.

Methods

A self-administered questionnaire was mailed to 1600 members of the Japan Rheumatology Friendship Association, who were randomly selected by age and prefecture.

Results

A total of 1156 patients returned the questionnaire (response rate, 72.3%; mean age, 63.0 ± 11.9 years). Those who reported having discussed their treatment goals with their doctors (450 respondents, 38.9%) were more likely to be satisfied with their current medical care (odds ratio, 7.13; 95% CI 4.72–10.8) compared with those who had not discussed their goals nor had them explained (287 respondents, 24.8%). The benefits exceeded the adverse effects for all pharmacotherapy (methotrexate, corticosteroids, conventional synthetic antirheumatic drugs, biological agents, Janus kinase inhibitor, and anti-RANKL antibodies). However, while 74.2% of the respondents using biological agents perceived that ‘the favorable aspects outweighed the unfavorable aspects,’ most of those taking anti-RANKL antibodies (69.2%) felt uncertain.

Conclusions

The questionnaire successfully collected information regarding patients’ perceptions regarding their therapy. Further implementation of treat-to-target is necessary in Japan to improve patient satisfaction.

DOI： 10.1080/14397595.2021.1913276

Other Link： https://academic.oup.com/mr/article-pdf/32/2/307/42644853/1913276.pdf

CD30-targeted therapy induces apoptosis of inflammatory cytokine-stimulated synovial fibroblasts and ameliorates collagen antibody-induced arthritis in mice Reviewed International journal

Minami Matsuhashi, Keiichiro Nishida, Misa Sakamoto, Yuka Gion, Aki Yoshida, Takayuki Katsuyama, Ryuichi Nakahara, Yoshihisa Nasu, Yoshinori Matsumoto, Yasuharu Sato, Toshifumi Ozaki

Inflammation Research 71 ( 2 ) 215 - 226 2022.2

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

OBJECTIVE: It has been reported that levels of soluble CD30 in serum and joint fluid are significantly elevated in patients with rheumatoid arthritis (RA). This study aimed to investigate whether CD30 could be a therapeutic target for RA. METHODS: The expression and localization of CD30 were examined by immunohistochemical and double immunofluorescence staining on synovial tissue samples obtained from patients with RA or osteoarthritis (OA) during surgery. Changes in CD30 expression of fibroblast-like synoviocytes (FLS) from RA patients with or without TNFα and IL-1β stimulation were examined by the polymerase chain reaction (PCR) and flow cytometry. Collagen antibody-induced arthritis (CAIA) was created in DBA/1 mice, and the therapeutic effect of brentuximab vedotin (BV) was examined by clinical score, histological findings and measurement of serum levels of SAA, IL-6, and TNFα. RESULTS: CD30 expression was significantly higher in samples from patients with RA than from those with OA. Double immunofluorescence showed a low rate of co-localization of CD30 with CD20 or CD90, but a high rate of co-localization of CD30 and CD138. CD30 mRNA expression was upregulated 11.7-fold in FLS following stimulation by inflammatory cytokines. The clinical scores of CAIA mice were significantly lower following both BV treatments, however, the histological scores of CAIA mice were significantly lower only following treatment with high dose BV (70 mg/kg). CONCLUSIONS: CD30 was expressed on immunocompetent cells in synovial tissue from RA patients and in cytokine-stimulated FLS in vitro. High dose BV (70 mg/kg) showed significant therapeutic effects in ameliorating inflammation and joint destruction in CAIA mice, but low dose BV (30 mg/kg) was insufficient.

DOI： 10.1007/s00011-021-01537-z

Other Link： https://link.springer.com/article/10.1007/s00011-021-01537-z/fulltext.html

Patient satisfaction with total joint replacement surgery for rheumatoid arthritis: a questionnaire survey for the 2020 update of the Japan college of rheumatology clinical practice guidelines International journal

Yasumori Sobue, Masayo Kojima, Toshihisa Kojima, Hiromu Ito, Keiichiro Nishida, Isao Matsushita, Shintaro Hirata, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Atsuko Murashima, Akio Morinobu, Masaaki Mori, Takeo Nakayama, Takahiko Sugihara, Yohei Seto, Eiichi Tanaka, Mieko Hasegawa, Yutaka Kawahito, Masayoshi Harigai

Modern Rheumatology 32 ( 1 ) 121 - 126 2022.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Objective

This study aimed to evaluate satisfaction with total joint replacement (TJR) surgery among patients with rheumatoid arthritis (RA).

Methods

We mailed questionnaires to randomly selected members of the Japan Rheumatism Friendship Association, stratified by age and prefecture, throughout Japan. The questionnaire collected demographic and clinical characteristics as well as patients’ satisfaction with TJR and their current therapy.

Results

Of the 1156 patients who returned the questionnaire, 339 (29.3%) responded that they had had TJR of any type. The mean age was 66.6 years, and 94.4% were women. The mean time period from the hip and knee TJR was 14–15 years. Over half of the patients who had had TJR were satisfied with the results, especially those who had had hip (89.6%) and knee TJR (87.3%), who reported a high level of satisfaction. Multivariable linear regression analysis revealed that, in patients with knee TJR, satisfaction with current therapy was significantly related to whether they were satisfied with the results of the surgery.

Conclusion

Most patients with RA who had undergone TJR were satisfied with the results even after a long period of time, and their level of satisfaction was associated with their satisfaction with current therapy.

DOI： 10.1080/14397595.2021.1892258

Other Link： https://academic.oup.com/mr/article-pdf/32/1/121/42083431/1892258.pdf

Systematic review and meta-analysis of biosimilar for the treatment of rheumatoid arthritis informing the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis International journal

Eiichi Tanaka, Yutaka Kawahito, Masataka Kohno, Shintaro Hirata, Mitsumasa Kishimoto, Yuko Kaneko, Hiroya Tamai, Yohei Seto, Akio Morinobu, Takahiko Sugihara, Atsuko Murashima, Masayo Kojima, Masaaki Mori, Hiromu Ito, Toshihisa Kojima, Yasumori Sobue, Keiichiro Nishida, Isao Matsushita, Takeo Nakayama, Hisashi Yamanaka, Masayoshi Harigai

Modern Rheumatology 32 ( 1 ) 74 - 86 2022.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Objectives

To evaluate the efficacy and safety of biosimilars compared with reference biological disease modifying antirheumatic drugs (bDMARDs) in patients with rheumatoid arthritis (RA) as a part of the process of developing the 2020 update of the Japan College of Rheumatology guidelines for the management of RA.

Methods

PubMed, Cochrane Library, and Japan Centra Revuo Medicina were searched for articles to conduct a systematic review (SR). The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system.

Results

Twenty randomized controlled trials were included (biosimilars of infliximab, etanercept, and adalimumab). A meta-analysis revealed that the risk ratios (RRs) and 95% confidence intervals (CIs) of achieving the American College of Rheumatology 50% response (ACR50) at week 24 and serious adverse events (SAEs) for biosimilars compared with the reference bDMARDs were 1.04 (0.98–1.10) and 0.84 (0.61–1.18), respectively. The RRs of achieving ACR50 and SAEs at week 24 were respectively 0.93 (0.69–1.26) and 2.15 (0.55–8.35) in the patients who switched to biosimilars from the reference bDMARDs and 0.92 (0.76–1.12) and 1.41 (0.32–6.15) in those who continued the reference bDMARDs.

Conclusion

Biosimilars and reference bDMARDs were equally useful for the management of RA.

DOI： 10.1080/14397595.2021.1899591

Other Link： https://academic.oup.com/mr/article-pdf/32/1/74/42083415/1899591.pdf

Does exercise therapy improve patient-reported outcomes in rheumatoid arthritis? A systematic review and meta-analysis for the update of the 2020 JCR guidelines for the management of rheumatoid arthritis International journal

Yasumori Sobue, Toshihisa Kojima, Hiromu Ito, Keiichiro Nishida, Isao Matsushita, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Takahiko Sugihara, Yohei Seto, Eiichi Tanaka, Takeo Nakayama, Shintaro Hirata, Atsuko Murashima, Akio Morinobu, Masaaki Mori, Masayo Kojima, Yutaka Kawahito, Masayoshi Harigai

Modern Rheumatology 32 ( 1 ) 96 - 104 2022.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Objectives

This study aimed to evaluate the impact of exercise therapy on patient-reported outcomes (PROs) in rheumatoid arthritis (RA) as part of the process of updating the 2020 Japanese guidelines for the management of RA according to the Grading of Recommendations, Assessment, Development, and Evaluation system.

Methods

We searched PubMed, Japana Centra Revuo Medicina Web, and the Cochrane Library (from 2009 to 2018) to identify articles that evaluated PROs of exercise therapy and RA disease activity.

Results

A total of 662 articles were identified, including nine RCTs, and meta-analyses were performed on six RCTs on systemic exercise therapy and three RCTs on upper extremity exercise therapy. Analyzed exercise therapies were diverse, differing in target population, intervention method, and duration. Significant improvements were observed in the Health Assessment Questionnaire Disability Index (mean difference −0.35, 95% confidence interval (CI): −0.60 to −0.10), pain (standardized mean difference −2.04, 95% CI: −3.77 to −0.32), and SF-36. For upper extremity exercise therapy, significant improvements in PROs (Disabilities of the Arm, Shoulder, and Hand Questionnaire, Michigan Hand Outcome Questionnaire) were observed.

Conclusion

Exercise therapy in RA treatment improves patient subjective assessment of pain, physical function, and quality of life.

DOI： 10.1080/14397595.2021.1886653

Other Link： https://academic.oup.com/mr/article-pdf/32/1/96/42083491/1886653.pdf

Subjective and Objective Outcomes of Surgery for Rheumatoid Forefoot Deformities Under the Current Treatment Paradigm International journal

Masahiro Horita, Keiichiro Nishida, Daisuke Kaneda, Kenzo Hashizume, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Hideki Ohashi, Masahito Watanabe, Toshifumi Ozaki

The Journal of Foot and Ankle Surgery 61 ( 1 ) 53 - 59 2022.1

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

We investigated the clinical outcomes of surgical procedures for the treatment of forefoot deformities in patients with rheumatoid arthritis. Twenty feet in 16 women (mean age 62.1 years) underwent corrective osteotomy of the first metatarsal bone with shortening oblique osteotomy of the lesser metatarsophalangeal joints (joint-preservation group), while 13 feet in 12 women (mean age 67.4 years) underwent arthrodesis of the first metatarsophalangeal joint with resection arthroplasty of the lesser metatarsophalangeal joints (joint-sacrifice group); mean follow-up for each group was 25.8 and 23.8 months, respectively. The mean total Japanese Society for Surgery of the Foot (JSSF) scale improved significantly from 64.2 to 89.2 in the joint-preservation group (p < .001), and from 54.2 to 74.2 in the joint-sacrifice group (p = .003). In the joint-preservation group, the postoperative range of motion (ROM) of the joint, walking ability, and activities of daily living scores of the JSSF scale were significantly higher than those in the joint-sacrifice group (p = .001, p = .001, and p = .019, respectively). There were no differences in the subscale scores of the self-administered foot evaluation questionnaire between 2 groups either pre- or postoperatively. No differences in the postoperative complications were found between 2 groups. Although the joint-sacrificing procedure resulted in lower objective outcomes than the joint-preserving procedure regarding the ROM of the joint, the walking ability, and the level of activities of daily living, both procedures resulted in similar treatment outcomes when evaluated by the subjective measures.

DOI： 10.1053/j.jfas.2021.06.008

Outcome after resection arthroplasty or shortening oblique osteotomy of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal joint for severe rheumatoid forefoot deformities Reviewed International journal

Masahiro Horita, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Masanori Hamada, Toshifumi Ozaki

Journal of Orthopaedic Surgery 30 ( 2 ) 102255362211179 - 102255362211179 2022.1

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Purpose

We investigated objective and patient-reported outcomes after resection arthroplasty or shortening oblique osteotomy (SOO) of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal (MTP) joint for severe rheumatoid forefoot deformities.

Methods

17 feet from 14 women (mean age, 67.8 years) underwent resection arthroplasty of the lesser metatarsal heads (MTH resection group), while 13 feet from nine women and two men (mean age, 68.7 years) underwent SOO of the lesser metatarsals (MTH preservation group). Arthrodesis of the first MTP joint was performed in all cases. Mean follow-up in the MTH resection and preservation groups was 25.0 and 21.3 months, respectively. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) scale and self-administered foot evaluation questionnaire (SAFE-Q) scores.

Results

Mean total JSSF scale significantly improved from 53.4 to 76.4 in the MTH resection group ( p < .001) and from 50.1 to 74.2 in the MTH preservation group ( p = .002). Pain and pain-related and shoe-related SAFE-Q subscale scores significantly improved after surgery in both groups. In the MTH resection group, recurrence of painful callosities and claw toe deformity was observed in four and three feet, respectively. In the MTH preservation group, one patient experienced recurrence of painful callosities and one underwent revision surgery for IP joint dislocation.

Conclusion

Resection arthroplasty or SOO of the lesser metatarsals combined with arthrodesis of the first MTP joint achieved significant improvement with respect to pain relief, deformity correction, and footwear comfort.

DOI： 10.1177/10225536221117903

Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/10225536221117903

上腕筋三頭筋温存アプローチ用いてPROSNAP人工肘関節置換術を施行した症例

堀田佳史, 西田圭一郎, 志水紀之, 中原龍一, 那須義久, 尾崎敏文

関節の外科 49 ( 2 ) 106 - 106 2022

生物学的製剤の使用は手術部位感染と創傷治癒遅延のリスク因子となるか

木曽洋平, 西田圭一郎, 原田遼三, 那須義久, 中原龍一, 堀田佳史, 浪花崇一, 尾崎敏文

関節の外科 49 ( 2 ) 59 - 59 2022

バリシチニブ内服中の関節リウマチ患者が骨折術後に白血球減少を生じた一例

志水紀之, 西田圭一郎, 浪花崇一, 堀田佳史, 中原龍一, 那須義久

関節の外科 49 ( 2 ) 93 - 93 2022

関節リウマチとして加療後、掌蹠膿疱症性骨関節炎と診断した1例の関節鏡視所見

那須義久, 志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 西田圭一郎

関節の外科 49 ( 2 ) 94 - 94 2022

Both microRNA-455-5p and -3p repress hypoxia-inducible factor-2α expression and coordinately regulate cartilage homeostasis Reviewed International coauthorship International journal

Yoshiaki Ito, Tokio Matsuzaki, Fumiaki Ayabe, Sho Mokuda, Ryota Kurimoto, Takahide Matsushima, Yusuke Tabata, Maiko Inotsume, Hiroki Tsutsumi, Lin Liu, Masahiro Shinohara, Yoko Tanaka, Ryo Nakamichi, Keiichiro Nishida, Martin K. Lotz, Hiroshi Asahara

Nature Communications 12 ( 1 ) 4148 - 4148 2021.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

<title>Abstract</title>Osteoarthritis (OA), the most common aging-related joint disease, is caused by an imbalance between extracellular matrix synthesis and degradation. Here, we discover that both strands of microRNA-455 (miR-455), -5p and -3p, are up-regulated by Sox9, an essential transcription factor for cartilage differentiation and function. Both miR-455-5p and -3p are highly expressed in human chondrocytes from normal articular cartilage and in mouse primary chondrocytes. We generate miR-455 knockout mice, and find that cartilage degeneration mimicking OA and elevated expression of cartilage degeneration-related genes are observed at 6-months-old. Using a cell-based miRNA target screening system, we identify hypoxia-inducible factor-2α (HIF-2α), a catabolic factor for cartilage homeostasis, as a direct target of both miR-455-5p and -3p. In addition, overexpression of both miR-455-5p and -3p protect cartilage degeneration in a mouse OA model, demonstrating their potential therapeutic value. Furthermore, knockdown of HIF-2α in 6-month-old miR-455 knockout cartilage rescues the elevated expression of cartilage degeneration-related genes. These data demonstrate that both strands of a miRNA target the same gene to regulate articular cartilage homeostasis.

DOI： 10.1038/s41467-021-24460-7

Other Link： http://www.nature.com/articles/s41467-021-24460-7

骨粗鬆症性椎体骨折に対する骨折リエゾンサービスー骨粗鬆症マネージャーが果たす役割―

鉄永倫子, 鉄永智紀, 高尾真一郎, 小橋靖子, 西田圭一郎

整形外科最小侵襲手術ジャーナル 101 2021.12

股関節痛を契機に診断された強直性脊椎炎の1例

山田和希, 那須義久, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 中原龍一, 西田圭一郎, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 2 ) 166 - 170 2021.12

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

股関節痛を契機に診断に至った、強直性脊椎炎:ankylosing spondylitis(以下、AS)の1例を経験したので報告する。症例は16歳男子で、右股関節痛のため近医を受診した。大腿骨寛骨臼インピンジメントの診断で当科に紹介された。当科初診時、右股関節痛は安静時と夜間に強く、運動時には感じなかった。右股関節の可動域制限を認め疼痛誘発テストは陽性であった。詳細に問診したところ、過去に腰臀部痛と両股関節痛を繰り返していた。単純X線では左仙腸関節に硬化像を認め、MRIでは右股関節水腫と両仙腸関節周囲の骨髄浮腫像を認めた。血液検査では炎症反応が上昇し、HLA-B27は陽性であった。ASと診断し、疾患活動性が高かったため、Infliximabの適応とした。治療は奏効し、現在も継続している。詳細な病歴聴取により早期の診断と治療が行えたため、短期の成績ではあるが経過良好であった。(著者抄録)

Difficult-to-treat RA の定義，臨床的特徴とマネジメント

西田圭一郎, 堀田佳史, 浪花崇一, 那須義久

臨床リウマチ 33 ( 4 ) 271 - 277 2021.12

Authorship：Lead author Language：Japanese Publisher：(一社)日本臨床リウマチ学会

治療が困難なRA(Difficult t-to-treat rheumatoid arthritis;D2T RA)とは、数種類の治療を行っても症状が改善せず、患者および経済的負担が大きいRA患者を指す新しい概念である。欧州リウマチ学会議(EULAR)では(1)治療不成功の病歴があり、(2)活動性/症候性の特性を有し、(3)臨床的に認識されていること、の3つの基準がすべて揃うものをD2T RAとした。D2T RAはRA患者の5～10%程度に発生するという報告が多く、患者は社会生活、労働能力、QOLに直接影響する症状に悩まされ続ける他、年間にかかる医療コストが非D2T RA患者より高額である。臨床的背景として、呼吸器障害、心血管系障害などの合併症、薬剤に対する有害事象、治療に対するアドヒアランスの低さの他、線維筋痛症や変形性関節症なとの疼痛症候群の合併、喫煙、肥満、抑うつなどが報告されている。治療にあたっては、患者教育、運動療法、心理学的介入、患者ケアの強化や医療従事者とのコミュニケーションの強化を基本として、個々の患者において過去の薬剤歴やmode of actionを考慮した薬剤選択や、整形外科的介入などによるカスタマイズを行って治療の最適化を図る必要がある。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J02269&link_issn=&doc_id=20220204090002&doc_link_id=10.14961%2Fcra.33.271&url=https%3A%2F%2Fdoi.org%2F10.14961%2Fcra.33.271&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

周術期の投薬コントロールと合併症対策特集:関節リウマチ診療ガイドライン2020 ―整形外科医から見るガイドラインアップデート ― Reviewed

西田圭一郎, 中原龍一, 那須義久, 原田遼三

Loco Cure 7 ( 4 ) 314 - 318 2021.11

Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(株)先端医学社

人工関節感染の有意なリスク因子として、BMI、DM、ステロイド、低アルブミン、関節リウマチ(RA)、輸血、悪性腫瘍、免疫低下、手術時間の延長、過去の手術歴などが指摘されており、疾患活動性のコントロールを含めて術前に可能な限り改善しせめて手術に臨むべきである。抗リウマチ薬には免疫抑制効果の懸念があり、長期の休薬はRAの再燃を惹起する可能性があるため、周術期の薬剤マネジメントが重要である。メトトレキサート(MTX)については、わが国のガイドラインでは12.5mg/週以下の使用量であれば再燃のリスクを抑制し、術後感染症、創傷治癒遅延に影響しないとされているため、休薬の必要はない。生物学的製剤、JAK阻害薬は免疫抑制作用によってSSIのリスクを増大させる可能性があるが、現時点では休薬期間を設けることによって安全に整形外科手術が可能である。(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J06622&link_issn=&doc_id=20211203480007&doc_link_id=%2Fae6locoe%2F2021%2F000704%2F008%2F0314-0318%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae6locoe%2F2021%2F000704%2F008%2F0314-0318%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

関節リウマチに対するAVANTAとINTEGRAを用いたMP人工指関節置換術の術後可動域の比較

浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎

日本関節病学会誌 40 ( 3 ) 304 - 304 2021.11

AIを用いた単純X線画像における骨端線変化の自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本関節病学会誌 40 ( 3 ) 308 - 308 2021.11

AIを用いた単純X線画像における骨端線変化の自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本関節病学会誌 40 ( 3 ) 308 - 308 2021.11

関節リウマチに対するAVANTAとINTEGRAを用いたMP人工指関節置換術の術後可動域の比較

浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎

日本関節病学会誌 40 ( 3 ) 304 - 304 2021.11

Adipose-Derived Extract Suppresses IL-1β-Induced Inflammatory Signaling Pathways in Human Chondrocytes and Ameliorates the Cartilage Destruction of Experimental Osteoarthritis in Rats Reviewed International journal

Hideki Ohashi, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Yoshinori Matsumoto, Ayumu Takeshita, Daisuke Kaneda, Masanori Saeki, Toshifumi Ozaki

International Journal of Molecular Sciences 22 ( 18 ) 9781 - 9781 2021.9

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

We investigated the effects of adipose-derived extract (AE) on cultured chondrocytes and in vivo cartilage destruction. AE was prepared from human adipose tissues using a nonenzymatic approach. Cultured human chondrocytes were stimulated with interleukin-1 beta (IL-1β) with or without different concentrations of AE. The effects of co-treatment with AE on intracellular signaling pathways and their downstream gene and protein expressions were examined using real-time PCR, Western blotting, and immunofluorescence staining. Rat AE prepared from inguinal adipose tissues was intra-articularly delivered to the knee joints of rats with experimental osteoarthritis (OA), and the effect of AE on cartilage destruction was evaluated histologically. In vitro, co-treatment with IL-1β combined with AE reduced activation of the p38 and ERK mitogen-activated protein kinase (MAPK) pathway and nuclear translocation of the p65 subunit of nuclear factor-kappa B (NF-κB), and subsequently downregulated the expressions of matrix metalloproteinase (MMP)-1, MMP-3, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4, IL-6, and IL-8, whereas it markedly upregulated the expression of IL-1 receptor type 2 (IL-1R2) in chondrocytes. Intra-articular injection of homologous AE significantly ameliorated cartilage destruction six weeks postoperatively in the rat OA model. These results suggested that AE may exert a chondroprotective effect, at least in part, through modulation of the IL-1β-induced inflammatory signaling pathway by upregulation of IL-1R2 expression.

DOI： 10.3390/ijms22189781

日本人関節リウマチ患者におけるボディイメージ・アセスメントツールの信頼性の検討

小橋靖子, 西田圭一郎, 堀田昌宏, 那須義久, 原田遼三, 渡辺美紀, 菊地真佑花, 片上香里, 中原龍一, 尾﨑敏文

臨床リウマチ 33 ( 3 ) 221 - 232 2021.9

Language：Japanese Publisher：(一社)日本臨床リウマチ学会

【目的】関節リウマチ(RA)患者におけるボディイメージ・アセスメントツール(BIAT)の信頼性と有効性を検証すること。【方法】本研究は横断的観察研究である。外来通院中(非手術群)および入院中(手術群)のRA患者265例および健常人62名を対象にBIAT質問用紙への回答を依頼した。信頼性の評価として、内部一貫法にはRA患者265例のbaselineのデータを、再テスト法には健常群62名のbaseline・3週後、および非手術群76例のbaseline・半年・1年後のデータを用いた。既存の評価法としてBDI-II(Beck Depression Inventory-II、ベック抑うつ質問票)を用いてBIATの臨床評価としての妥当性を検討した。RA患者265例をDAS28-CRPに基づき、寛解、低疾患活動性、中疾患活動性、高疾患活動性に群別し、BIATとの関連を検討した。さらに非手術群と手術群でBIATに差があるかどうかを検討した。【結果】BIATは全体の評価でも各構成概念の評価でもα係数は0.8以上を示しており、高い一貫性を有していた。再テスト法ではBIAT全体平均において、健常群のbaselineと3週後で相関係数0.75、非手術群のbaselineと半年後および1年後で相関係数0.79および0.78であり、比較的高い信頼性が確認できた。BIAT全体スコアはBDI-IIと有意な負の相関(r=-0.64、P<0.001)を示した。BIATは疾患活動性が高いほど低値となる傾向があることが示された。手術群でのbaselineの平均BIATの値はいずれの構成概念においても非手術群よりも有意に低値であった。【結論】RA患者に対するBIATは、高い一貫性、安定性を有する評価ツールであることが確認された。(著者抄録)

Comprehensive risk analysis of postoperative complications in patients with rheumatoid arthritis for the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis. International journal

Hiromu Ito, Koichi Murata, Yasumori Sobue, Toshihisa Kojima, Keiichiro Nishida, Isao Matsushita, Yutaka Kawahito, Masayo Kojima, Shintaro Hirata, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Masaaki Mori, Akio Morinobu, Atsuko Murashima, Yohei Seto, Takahiko Sugihara, Eiichi Tanaka, Takeo Nakayama, Masayoshi Harigai

Modern rheumatology 32 ( 2 ) 1 - 11 2021.8

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

OBJECTIVES: To examine the risk factors of surgical site infection (SSI), delayed wound healing, and death after orthopedic surgery in patients with rheumatoid arthritis (RA). METHODS: We identified articles indexed in the Cochrane Library, PubMed, and Japan Centra Revuo Medicina Web published from 2013 to 2019 and other articles. Articles fulfilling the predefined inclusion criteria were reviewed systematically and their quality was appraised according to the Grading of Recommendations Assessment, Development, and Evaluation system with some modifications. RESULTS: After inclusion and exclusion by full-text review, 29 articles were analyzed. Use of biological disease modifying antirheumatic drugs was a risk factor of SSI (risk ratio 1.66, 95% confidence interval 1.25-2.19), but not of delayed wound healing. RA itself was a risk factor of SSI, and oral glucocorticoid use was a risk factor of SSI in three of the four studies analyzed and of postoperative death. Age, male sex, comorbidities such as diabetes mellitus and chronic obstructive pulmonary disease, surgical factors such as foot/ankle and spine surgery and longer operative time were risk factors of those postoperative complications. CONCLUSION: Patients with those factors should be dealt with appropriate cautions to strike a risk-benefit balance of orthopedic surgeries.

DOI： 10.1080/14397595.2021.1913824

教師なし学習を用いたAIによる超音波画像撮像部位自動検出

中原龍一, 高橋康, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 品岡玲, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1726 - S1726 2021.8

A Novel Radiographic Measurement Method for the Evaluation of Metatarsophalangeal Joint Dislocation of the Lesser Toe in Patients with Rheumatoid Arthritis. International journal

Hideki Ohashi, Keiichiro Nishida, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Masahiro Horita, Shunji Okita, Toshifumi Ozaki

International journal of environmental research and public health 18 ( 14 ) 2021.7

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

Dorsal dislocation of metatarsophalangeal (MTP) joints of the lesser toe frequently occurs in patients with rheumatoid arthritis (RA), and may cause painful and uncomfortable plantar callosities and ulceration. The current study examined the reliability and clinical relevance of a novel radiographic parameter (the MTP overlap distance [MOD]) in evaluating the severity of MTP joint dislocation. The subjects of the current study were 147 RA patients (276 feet; 1104 toes). MOD, defined as the overlap distance of the metatarsal head and the proximal end of the phalanx, was measured on plain radiographs. The relationship between the MOD and clinical complaints (forefoot pain and/or callosity formation) was analyzed to create a severity grading system. As a result, toes with callosities had a significantly larger MOD. ROC analysis revealed that the MOD had a high AUC for predicting an asymptomatic foot (-0.70) and callosities (0.89). MOD grades were defined as follows: grade 1, 0 ≤ MOD < 5 mm; grade 2, 5 ≤ MOD < 10 mm; and grade 3, MOD ≥ 10 mm. The intra- and inter-observer reliability of the MOD grade had high reproducibility. Furthermore, the MOD and MOD grade improved significantly after joint-preserving surgeries for lesser toe deformities. Our results suggest that MOD and MOD grade might be useful tools for the evaluation of deformities of the lesser toe and the effect of surgical intervention for MTP joints in patients with RA.

DOI： 10.3390/ijerph18147520

Patients' perspectives of rheumatoid arthritis treatment: a questionnaire survey for the 2020 update of the Japan college of rheumatology clinical practice guidelines. International journal

Masayo Kojima, Mieko Hasegawa, Shintaro Hirata, Hiromu Ito, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Toshihisa Kojima, Isao Matsushita, Masaaki Mori, Akio Morinobu, Atsuko Murashima, Keiichiro Nishida, Yohei Seto, Yasumori Sobue, Takahiko Sugihara, Eiichi Tanaka, Takeo Nakayama, Yutaka Kawahito, Masayoshi Harigai

Modern rheumatology 32 ( 2 ) 1 - 6 2021.5

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

OBJECTIVES: This study aimed to evaluate patients' opinions regarding their rheumatoid arthritis (RA) therapy and to reflect the patients' perspectives in the 2020 update of the Japan College of Rheumatology clinical practice guidelines. METHODS: A self-administered questionnaire was mailed to 1600 members of the Japan Rheumatology Friendship Association, who were randomly selected by age and prefecture. RESULTS: A total of 1156 patients returned the questionnaire (response rate, 72.3%; mean age, 63.0 ± 11.9 years). Those who reported having discussed their treatment goals with their doctors (450 respondents, 38.9%) were more likely to be satisfied with their current medical care (odds ratio, 7.13; 95% CI 4.72-10.8) compared with those who had not discussed their goals nor had them explained (287 respondents, 24.8%). The benefits exceeded the adverse effects for all pharmacotherapy (methotrexate, corticosteroids, conventional synthetic antirheumatic drugs, biological agents, Janus kinase inhibitor, and anti-RANKL antibodies). However, while 74.2% of the respondents using biological agents perceived that 'the favorable aspects outweighed the unfavorable aspects,' most of those taking anti-RANKL antibodies (69.2%) felt uncertain. CONCLUSIONS: The questionnaire successfully collected information regarding patients' perceptions regarding their therapy. Further implementation of treat-to-target is necessary in Japan to improve patient satisfaction.

DOI： 10.1080/14397595.2021.1913276

Systematic review for the treatment of older rheumatoid arthritis patients informing the 2020 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis. International journal

Takahiko Sugihara, Yutaka Kawahito, Akio Morinobu, Yuko Kaneko, Yohei Seto, Toshihisa Kojima, Hiromu Ito, Masataka Kohno, Takeo Nakayama, Yasumori Sobue, Keiichiro Nishida, Isao Matsushita, Atsuko Murashima, Masaaki Mori, Eiichi Tanaka, Shintaro Hirata, Mitsumasa Kishimoto, Hisashi Yamanaka, Masayo Kojima, Masayoshi Harigai

Modern rheumatology 32 ( 2 ) 1 - 15 2021.5

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

OBJECTIVES: To provide an evidence base for clinical practice guidelines (CPG) for the management of rheumatoid arthritis (RA) in older adults. METHODS: PubMed, Cochrane library, and Japan Centra Revuo Medicina databases were searched for articles published between 1990 and 2019. Quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation system, with some modifications. RESULTS: Among 702 identified articles, there were 5 post-hoc analyses of randomized controlled trials and 10 observational studies. Meta-analysis of the former yielded a mean difference of the van der Heijde-modified total Sharp score of -2.79 (95% confidence interval [CI] - 3.74 to -1.84) for treatment with tumor necrosis factor inhibitors. The risk ratio (RR) for the American College of Rheumatology 50% response rate, and for serious adverse events was 2.83 (95%CI 1.90-4.21) and 1.32 (95%CI 0.53-3.31), respectively, for Janus kinase inhibitors. Meta-analysis of the observational studies yielded an RR for disease activity score-28 remission and serious infections of 0.76 (95%CI 0.64-0.91) and 1.92 (95%CI 1.31-2.81) for older-versus-younger patients receiving biological disease-modifying antirheumatic drugs, respectively. CONCLUSION: This systematic review provides the necessary evidence for developing CPG for the management of RA in older adults.

DOI： 10.1080/14397595.2021.1912922

Relationship between the physician-based clinical scale for foot and ankle surgery and patient-reported outcomes in patients with long-standing rheumatoid arthritis: Results from a multicenter prospective observational cohort study

Kojima, T., Ishikawa, H., Tanaka, S., Haga, N., Nishida, K., Yukioka, M., Hashimoto, J., Miyahara, H., Niki, Y., Kimura, T., Oda, H., Asai, S., Funahashi, K., Kojima, M., Ishiguro, N.

Modern Rheumatology 31 ( 3 ) 607 - 613 2021.5

運動器疼痛を対象とした医療体制腰痛に対するチームアプローチ

鉄永倫子, 鉄永智紀, 西田圭一郎

ペインクリニック 42 ( 別冊春 ) 247 - 254 2021.5

Language：Japanese Publisher：真興交易(株)医書出版部

腰痛、特に3ヵ月以上症状が持続する慢性腰痛においては、器質的な要因のみならず、心理社会的な因子(psychological and social factors)が少なからず影響している。したがって、治療にあたり生物心理社会モデルに沿って病態を評価し、多職種が連携したチームでの集学的アプローチが有用である。われわれは、2012年より運動器慢性痛に対する集学的アプローチとして「痛みリエゾン外来」を開設し、多角的集学的な外来を多職種で行っている。慢性腰痛の患者さんの一例を提示しながら当センターでのチームアプローチを紹介する。(著者抄録)

Risk factors of postoperative delayed wound healing in patients with rheumatoid arthritis treated with a biological agent. International journal

Shunji Okita, Hajime Ishikawa, Asami Abe, Satoshi Ito, Kiyoshi Nakazono, Akira Murasawa, Keiichiro Nishida, Toshifumi Ozaki

Modern rheumatology 31 ( 3 ) 587 - 592 2021.5

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

OBJECTIVES: This retrospective study aimed to investigate the risk factors associated with delayed wound healing (DWH) after orthopedic surgery in rheumatoid arthritis (RA) patients treated with biological disease-modifying antirheumatic drugs (bDMARDs). METHODS: We reviewed medical records of 276 orthopedic procedures for 187 RA patients treated with bDMARDs. As a preoperative nutritional status assessment, we evaluated body mass index, prognostic nutritional index (PNI), and controlling nutritional status (CONUT). We evaluated DAS28-CRP, DAS28-ESR, face scale, global health, and HAQ-DI to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for DWH. RESULTS: In 276 procedures, DWH was identified in 24 patients (8.7%). Disease duration, foot and ankle surgery, and preoperative use of tocilizumab were significant in the univariate analyses. These variables were entered into a multivariate model, and it was revealed that preoperative use of tocilizumab and procedures in the foot and ankle were associated with an increased risk of DWH. CONCLUSION: The current retrospective study suggested that preoperative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH.

DOI： 10.1080/14397595.2020.1790138

慢性疼痛患者に対するロコモティブシンドローム診断における診断時の特徴及び注意点

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 6 2021.5

65歳以下の慢性疼痛患者におけるロコモティブシンドロームと体組成及び運動機能評価

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 7 2021.5

慢性疼痛患者に対するロコモティブシンドローム診断における診断時の特徴及び注意点

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 6 2021.5

65歳以下の慢性疼痛患者におけるロコモティブシンドロームと体組成及び運動機能評価

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 7 2021.5

手根管症候群患者に対する神経伝導検査の術後成績予後予測能の検討

斎藤太一, 伊勢真人, 堀田佳史, 根津智史, 松橋美波, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 38 ( 1 ) O23 - 34 2021.4

母指CM関節症に対する関節鏡下腱挿入形成術の手術成績

橋詰博行, 竹下歩, 小坂義樹, 齋藤太一, 西田圭一郎

日本手外科学会雑誌 38 ( 1 ) O31 - 41 2021.4

母指CM関節症に対する関節鏡下腱挿入形成術の手術成績

橋詰博行, 竹下歩, 小坂義樹, 齋藤太一, 西田圭一郎

日本手外科学会雑誌 38 ( 1 ) O31 - 41 2021.4

Patient satisfaction with total joint replacement surgery for rheumatoid arthritis: a questionnaire survey for the 2020 update of the Japan college of rheumatology clinical practice guidelines. International journal

Yasumori Sobue, Masayo Kojima, Toshihisa Kojima, Hiromu Ito, Keiichiro Nishida, Isao Matsushita, Shintaro Hirata, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Atsuko Murashima, Akio Morinobu, Masaaki Mori, Takeo Nakayama, Takahiko Sugihara, Yohei Seto, Eiichi Tanaka, Mieko Hasegawa, Yutaka Kawahito, Masayoshi Harigai

Modern rheumatology 32 ( 1 ) 1 - 6 2021.3

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

OBJECTIVE: This study aimed to evaluate satisfaction with total joint replacement (TJR) surgery among patients with rheumatoid arthritis (RA). METHODS: We mailed questionnaires to randomly selected members of the Japan Rheumatism Friendship Association, stratified by age and prefecture, throughout Japan. The questionnaire collected demographic and clinical characteristics as well as patients' satisfaction with TJR and their current therapy. RESULTS: Of the 1156 patients who returned the questionnaire, 339 (29.3%) responded that they had had TJR of any type. The mean age was 66.6 years, and 94.4% were women. The mean time period from the hip and knee TJR was 14-15 years. Over half of the patients who had had TJR were satisfied with the results, especially those who had had hip (89.6%) and knee TJR (87.3%), who reported a high level of satisfaction. Multivariable linear regression analysis revealed that, in patients with knee TJR, satisfaction with current therapy was significantly related to whether they were satisfied with the results of the surgery. CONCLUSION: Most patients with RA who had undergone TJR were satisfied with the results even after a long period of time, and their level of satisfaction was associated with their satisfaction with current therapy.

DOI： 10.1080/14397595.2021.1892258

骨・関節・カルシウム代謝疾患変形性関節症

宮澤慎一, 西田圭一郎, 西原茂樹, 神崎浩孝, 千堂年昭

薬局 2021年増刊病気とくすり2021 72 ( 4 ) 870 - 887 2021.3

慢性疼痛患者を対象とした痛みリエゾン外来における活動能力の帰結の類型化に関する検討

太田晴之, 齋藤圭介, 原田和宏, 京極真, 鉄永倫子, 西田圭一郎, 千田益生

日本保健科学学会誌 23 ( 4 ) 176 - 186 2021.3

Language：Japanese Publisher：日本保健科学学会

[目的]慢性疼痛患者を対象とする、痛みリエゾン外来における治療後の活動能力の帰結を類型化し、各集団の開始時の属性と活動能力の回復推移の特徴を後方視的に検討すること。[対象と方法]当院の痛みリエゾン外来受診患者のうち、6ヵ月間の治療継続が可能であった112例。活動能力の指標にはPDAS修正因子構造モデル13項目を用い、治療終了時点のデータを基に潜在ランク理論を用い類型化した。また各ランク間で開始時の属性、活動能力得点の継時的推移を比較検討した。[結果]潜在ランク数の推定では、ランク3が適合度の許容水準を満たした。また各ランク間で開始時の身体的パフォーマンスと心理的属性に統計的有意差を認め、活動能能力の得点推移は開始時より各時点で統計的有意差を示した。[結語]痛みリエゾン外来における活動能力の帰結は3つの集団に類型化できる事、各集団は開始時の属性、活動能力の推移とともに異なる特徴を示す事を明らかにした。(著者抄録)

女性脊椎脊髄外科医の挑戦電気グループから岡山脊椎グループの異端児へ

鉄永倫子, 鉄永智紀, 西田圭一郎, 三澤治夫, 尾崎敏文

Journal of Spine Research 12 ( 3 ) 51 - 51 2021.3

65歳以下の慢性腰痛患者におけるロコモティブシンドローム有病率とその特徴

辻寛謙, 鉄永倫子, 三澤治夫, 鉄永智紀, 山根健太郎, 小田孔明, 高尾真一郎, 梶木裕矢, 西田圭一郎, 尾崎敏文

Journal of Spine Research 12 ( 3 ) 333 - 333 2021.3

神経障害性疼痛に対するアプローチミロガバリンへの期待

鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

Journal of Spine Research 12 ( 3 ) 238 - 238 2021.3

慢性疼痛患者におけるロコモティブシンドローム有病率とその特徴

辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S934 - S934 2021.3

慢性疼痛患者の自己効力感は介護者の介護負担度に影響を与える

辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S919 - S919 2021.3

関節リウマチ超音波検査におけるデジタルカメラ画像とAIを用いたボディーマーク付与

中原龍一, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 555 - 555 2021.3

生物学的製剤と手術当科におけるリウマチ外科手術1569例の患者背景

那須義久, 堀田佳史, 渡辺雅仁, 松橋美波, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 343 - 343 2021.3

Differences between the root and horn cells of the human medial meniscus from the osteoarthritic knee in cellular characteristics and responses to mechanical stress.

Yuki Okazaki, Takayuki Furumatsu, Yusuke Kamatsuki, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Taichi Saito, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 230 - 236 2021.3

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

BACKGROUND: Many histological, mechanical, and clinical studies have been performed on the medial meniscus posterior root attachment, as it often tears in patients with osteoarthritic knee. Medial meniscal root repair is recommended in clinical situations; however, to date, no studies have examined the differences between meniscal root and horn cells. The aim of this study was, therefore, to investigate the morphology, reaction to cyclic tensile strain, and gene expression levels of medial meniscal root and horn cells. METHODS: Meniscal samples were obtained from the medial knee compartments of 10 patients with osteoarthritis who underwent total knee arthroplasty. Root and horn cells were cultured in Dulbecco's modified Eagle's medium without enzymes. The morphology, distribution, and proliferation of medial meniscal root and horn cells, as well as the gene and protein expression levels of Sry-type HMG box 9 and type II collagen, were determined after cyclic tensile strain treatment. RESULTS: Horn cells had a triangular morphology, whereas root cells were fibroblast-like. The number of horn cells positive for Sry-type HMG box 9 and type II collagen was considerably higher than that of root cells. Although root and horn cells showed similar levels of proliferation after 48, 72, or 96 h of culture, more horn cells than root cells were lost following a 2-h treatment with 5% and 10% cyclic tensile. Sry-type HMG box 9 and α1(II) collagen mRNA expression levels were significantly enhanced in both cells after 2- and 4-h cyclic tensile strain (5%) treatment. CONCLUSIONS: Medial meniscal root and horn cells have distinct morphologies, reactions to mechanical stress, and cellular phenotypes. Our results suggest that physiological tensile strain is important to activate extracellular matrix production in horn cells.

DOI： 10.1016/j.jos.2020.02.015

骨折を伴ったリウマチ肘に対するPROSNAPを用いた人工肘関節全置換術の治療成績

堀田佳史, 西田圭一郎, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 602 - 602 2021.3

慢性疼痛患者の自己効力感は介護者の介護負担度に影響を与える

辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S919 - S919 2021.3

骨粗鬆症と骨代謝ロモソズマブ治療における関節リウマチの影響

原田遼三, 西田圭一郎, 那須義久, 中原龍一, 高杉幸司, 江澤和彦, 井上貴絵, 藤田慎一朗, 與座未来, 金谷麻未, 新名早希子, 山本渉

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 365 - 365 2021.3

慢性疼痛患者におけるロコモティブシンドローム有病率とその特徴

辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S934 - S934 2021.3

生物学的製剤と手術当科におけるリウマチ外科手術1569例の患者背景

那須義久, 堀田佳史, 渡辺雅仁, 松橋美波, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 343 - 343 2021.3

骨折を伴ったリウマチ肘に対するPROSNAPを用いた人工肘関節全置換術の治療成績

堀田佳史, 西田圭一郎, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 602 - 602 2021.3

関節リウマチ超音波検査におけるデジタルカメラ画像とAIを用いたボディーマーク付与

中原龍一, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 555 - 555 2021.3

ロモソズマブ治療において骨粗鬆症の前治療が与える影響、投与1年時の効果予測因子について

原田遼三, 西田圭一郎, 那須義久, 中原龍一, 高杉幸司, 江澤和彦, 井上貴絵, 藤田慎一朗, 與座未来, 金谷麻未, 新名早希子, 山本渉

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 610 - 610 2021.3

Does exercise therapy improve patient-reported outcomes in rheumatoid arthritis? A systematic review and meta-analysis for the update of the 2020 JCR guidelines for the management of rheumatoid arthritis. International journal

Yasumori Sobue, Toshihisa Kojima, Hiromu Ito, Keiichiro Nishida, Isao Matsushita, Yuko Kaneko, Mitsumasa Kishimoto, Masataka Kohno, Takahiko Sugihara, Yohei Seto, Eiichi Tanaka, Takeo Nakayama, Shintaro Hirata, Atsuko Murashima, Akio Morinobu, Masaaki Mori, Masayo Kojima, Yutaka Kawahito, Masayoshi Harigai

Modern rheumatology 2021.2

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

OBJECTIVES: This study aimed to evaluate the impact of exercise therapy on patient-reported outcomes (PROs) in rheumatoid arthritis (RA) as part of the process of updating the 2020 Japanese guidelines for the management of RA according to the Grading of Recommendations, Assessment, Development, and Evaluation system. METHODS: We searched PubMed, Japana Centra Revuo Medicina Web, and the Cochrane Library (from 2009 to 2018) to identify articles that evaluated PROs of exercise therapy and RA disease activity. RESULTS: A total of 662 articles were identified, including nine RCTs, and meta-analyses were performed on six RCTs on systemic exercise therapy and three RCTs on upper extremity exercise therapy. Analyzed exercise therapies were diverse, differing in target population, intervention method, and duration. Significant improvements were observed in the Health Assessment Questionnaire Disability Index (mean difference -0.35, 95% confidence interval (CI): -0.60 to -0.10), pain (standardized mean difference -2.04, 95% CI: -3.77 to -0.32), and SF-36. For upper extremity exercise therapy, significant improvements in PROs (Disabilities of the Arm, Shoulder, and Hand Questionnaire, Michigan Hand Outcome Questionnaire) were observed. CONCLUSION: Exercise therapy in RA treatment improves patient subjective assessment of pain, physical function, and quality of life.

DOI： 10.1080/14397595.2021.1886653

整形外科からみた treat to target - 何を重視するか -

西田圭一郎

整形・災害外科 64 ( 2 ) 131 - 140 2021.2

Efficacy and safety of tacrolimus in patients with rheumatoid arthritis – A systematic review and meta-analysis

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

Modern Rheumatology 31 ( 1 ) 61 - 69 2021.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Objectives: To evaluate the efficacy and safety of tacrolimus in adult patients with rheumatoid arthritis (RA) by using the GRADE approach. Methods: We searched PubMed, Japana Centra Revuo Medicina Web (Ichu-shi web), and the Cochrane Database of Systematic Reviews. Articles fulfilling the predefined inclusion criteria were appraised and used for meta-analysis. The primary outcomes were American College of Rheumatology 20 (ACR20) and serum creatinine elevation. Other outcomes included ACR50, ACR70, changes in C-reactive protein, modified Health Assessment Questionnaire Disability Index, gastrointestinal disorders, metabolic and nutritional disorders, and infections and infestations. Results: We identified five randomized controlled studies, four of which compared tacrolimus to placebo and were included in the meta-analysis. The risk ratio of ACR20 achievement was 1.71 (95% confidence interval [CI] 1.20-2.42) for 1-2 mg/day and 2.30 (95% CI 1.79-2.96) for 3 mg/day. The risk ratio of creatinine elevation was 1.95 (95% CI 1.18-3.23) for 1-2 mg/day and 3.81 (95% CI 2.43-5.99) for 3 mg/day. Conclusion: Tacrolimus is effective with acceptable safety in the management of RA.

DOI： 10.1080/14397595.2020.1719607

RANKL expression in chondrocytes and its promotion by lymphotoxin-α in the course of cartilage destruction during rheumatoid arthritis. International journal

Ayumu Takeshita, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Daisuke Kaneda, Hideki Ohashi, Toshifumi Ozaki

PloS one 16 ( 7 ) e0254268 2021

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

We investigated the expression and localization of the receptor activator nuclear factor κB ligand (RANKL) in cartilage from patients with rheumatoid arthritis (RA) of relevance to cartilage degeneration. We also examined the role of exogenous lymphotoxin (LT)-α on RANKL expression in human chondrocytes and its effect on in vitro osteoclast differentiation. Cartilage and synovial fluid samples were obtained from 45 patients undergoing total joint replacement surgery or joint puncture, including 24 patients with osteoarthritis (OA) and 21 patients with RA. RANKL expression in articular cartilage was examined by immunohistochemistry. LT-α concentrations in synovial fluid were measured using an enzyme-linked immunosorbent assay (ELISA). Normal human chondrocytes were stimulated with LT-α, and the relative mRNA levels of RANKL, osteoprotegerin (OPG), matrix metalloproteinase-9, and vascular endothelial growth factor were examined by real-time polymerase chain reaction. Soluble RANKL protein in culture media was measured using ELISA, and membrane-bound RANKL protein in cells was examined by western blotting. Co-cultures of human chondrocytes with peripheral blood mononuclear cells (PBMCs) were stimulated with macrophage-colony stimulating factor and LT-α, and osteoclast differentiation was evaluated by staining for tartrate-resistant acid phosphatase. LT-α concentrations were higher in RA synovial fluid than in OA samples. The population of RANKL-positive chondrocytes of RA cartilage was higher than that of OA cartilage, and correlated with cartilage degeneration. Stimulation of cultured human chondrocytes by LT-α increased RANKL expression, the RANKL/OPG ratio, and angiogenic factors. Membrane-bound RANKL in chondrocytes was up-regulated after stimulation of LT-α, whereas soluble RANKL in culture medium did not increase. Co-cultures of human chondrocytes and PBMCs demonstrated that LT-α stimulated human chondrocytes to produce RANKL and induced osteoclastic differentiation of PBMCs. RANKL produced by chondrocytes may contribute to cartilage destruction during RA and LT-α could promote the expression of RANKL in human chondrocytes.

DOI： 10.1371/journal.pone.0254268

Swanson型シリコンインプラントを用いた母指MP関節形成術後30年経過した1例

沖田駿治, 石川肇, 阿部麻美, 中園清, 村澤章, 西田圭一郎

関節の外科 48 ( 2 ) 72 - 72 2021

人工肘関節置換術〜unlinkedとlinkedの適応と課題〜岡山大式人工肘関節の開発の経緯と今後の課題

西田圭一郎, 那須義久, 橋詰謙三, 原田遼三, 中原龍一

関節の外科 48 ( 2 ) 47 - 47 2021

65歳以下の慢性疼痛患者におけるロコモティブシンドローム体組成及び身体機能評価

辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本サルコペニア・フレイル学会雑誌 4 ( Suppl. ) 150 - 150 2020.11

65歳以下の慢性疼痛患者におけるロコモティブシンドローム有病率及び特徴について

辻寛謙, 鉄永倫子, 鉄永智紀, 福岡史郎, 西田圭一郎, 尾崎敏文

日本サルコペニア・フレイル学会雑誌 4 ( Suppl. ) 149 - 149 2020.11

処方エキスパートへの道高齢者における抗不安薬の使い方

植田真司, 井上真一郎, 西田圭一郎

Loco Cure 6 ( 4 ) 357 - 360 2020.11

炎症と運動器疼痛特集運動器の痛み：どこから来るのか？どこへ行くのか？

西田圭一郎, 宮澤慎一

Bone Joint Nerve 10 ( 4 ) 529 - 534 2020.10

疼痛の集学的治療特集運動器の痛み：どこから来るのか？どこへ行くのか？

鉄永倫子, 鉄永智紀, 西田圭一郎

Bone Joint Nerve 10 ( 4 ) 643 - 650 2020.10

慢性疼痛患者におけるロコモティブシンドロームと身体機能及び体組成評価

辻寛謙, 鉄永倫子, 鉄永智紀, 福岡史朗, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 12 ( 4 ) S70 - S70 2020.10

慢性疼痛患者における同居者の介護負担度に与える因子の検討

辻寛謙, 鉄永倫子, 鉄永智紀, 福岡史朗, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 12 ( 4 ) S69 - S69 2020.10

65歳以下の慢性疼痛患者におけるロコモティブシンドローム有病率とその特徴

辻寛謙, 鉄永倫子, 鉄永智紀, 福岡史朗, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 12 ( 4 ) S71 - S71 2020.10

慢性疼痛患者における排便と疼痛関連因子との関連

福岡史朗, 梶木裕矢, 高尾真一郎, 小田孔明, 山根健太郎, 三澤治夫, 尾崎敏文, 辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎

Journal of Musculoskeletal Pain Research 12 ( 4 ) S82 - S82 2020.10

関節リウマチ診療における見逃し・誤診

西田圭一郎

39 ( 10月増刊 ) 132 - 140 2020.10

Cognitive factors associated with locomotive syndrome in chronic pain patients: A retrospective study.

Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Keiichiro Nishida, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 5 ) 896 - 901 2020.9

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

BACKGROUND: Prevention and treatment for locomotive syndrome (LS) are important for extending healthy life expectancy. The 25-question geriatric locomotive function scale (GLFS-25) was developed to diagnose LS. The Fear-Avoidance model was proposed to explain pain chronicity. LS and chronic pain decrease activities of daily living; however, the relationships between LS and factors related to chronic pain in the Fear-Avoidance model are unknown. Objective of the current study was to assess the prevalence of LS and examine the factors of the Fear-Avoidance model and the GLFS-25 that affect the prevalence of LS in patients with chronic pain. METHODS: Participants included 281 patients (99 men, 182 women) aged over 40 years with chronic pain who visited our outpatient clinic for chronic pain. All participants completed the GLFS-25, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), and Athene insomnia scale (AIS). According to a GLFS-25 cutoff point, participants were divided into three groups (LS-2; GLFS-25 ≥ 16, LS-1; 7 ≤ GLFS-25 < 16, and non-LS; GLFS-25 < 7 points) and each parameter was compared among the groups, followed by multiple logistic regression analysis. Next, multiple linear regression analysis was performed to determine the factors associated with the GLFS-25. RESULTS: Of all 281 patients, 241 (85.8%) patients were diagnosed with LS-2. Univariate analysis revealed there were significant differences in NRS, PCS, HADS anxiety, HADS depression, and AIS among groups. Multiple logistic regression analyses showed PCS was significantly associated with LS-2 prevalence. The GLFS-25 was positively correlated with NRS, HADS depression, AIS in multiple linear regression analysis. CONCLUSIONS: We found that patients with chronic pain in our outpatient clinic had a significant rate of LS-2. The prevalence of LS-2 was significantly correlate with pain catastrophizing, and the GLFS-25 was significantly correlated with higher pain intensity, depression, and insomnia.

DOI： 10.1016/j.jos.2020.08.007

AIを用いた関節リウマチの超音波動画評価

中原龍一, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 品岡玲, 尾崎敏文

日本関節病学会誌 39 ( 3 ) 192 - 192 2020.9

舟状骨偽関節に対する手術方法別の治療成績

堀田佳史, 齋藤太一, 近藤宏也, 根津智史, 松橋美波, 上原健敬, 島村安則, 野田知之, 西田圭一郎, 尾崎敏文

骨折 42 ( Suppl. ) S245 - S245 2020.9

関節リウマチ患者滑膜におけるCD30の検討

松橋美波, 西田圭一郎, 渡辺雅仁, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 94 ( 8 ) S1655 - S1655 2020.9

生物学的製剤とJAK阻害剤使用例の手術部位感染/創治癒遅延発生率の検討

那須義久, 木曽洋平, 堀田佳史, 渡辺雅仁, 松橋美波, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 39 ( 3 ) 229 - 229 2020.9

関節リウマチにおけるADAM12の役割

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 松橋美波, 堀田佳久, 尾崎敏文

日本関節病学会誌 39 ( 3 ) 191 - 191 2020.9

運動器慢性痛に対する多面的アプローチ

鉄永倫子, 鉄永智紀, 西田圭一郎

日本運動器疼痛学会誌 12 ( 3 ) 248 - 250 2020.9

Language：Japanese Publisher：(一社)日本運動器疼痛学会

運動器慢性痛に対しては,多職種連携のチームアプローチ,多面的なアプローチが有用であることが認識されつつある。運動器慢性痛の患者さんのゴールは生活であること,その目的を共有し実践するためには,いろいろな因子を多面的に評価し,食事,睡眠,運動,生活リズム,生活習慣に目を向けた多職種によるトータルマネージメントが重要である。そして,暗くなりがちな痛み診療を明るい医療を目指し,臨んでいきたいと考えている。(著者抄録)

SBi silicone人工指関節(旧AVANTA)を用いたMCP人工関節置換術の治療成績

松橋美波, 西田圭一郎, 中原龍一, 那須義久, 尾崎敏文

関節の外科 47 ( 2 ) 93 - 93 2020.8

リウマチ外科のアイデンティティーリウマチ肘・手関節手術の変化

那須義久, 西田圭一郎, 中原龍一, 堀田佳史, 渡辺雅仁, 松橋美波, 尾崎敏文

関節の外科 47 ( 2 ) 76 - 76 2020.8

似て非なるリウマチ手と足の手術関節リウマチに対する手指関節手術の現状

那須義久, 松橋美波, 渡辺雅仁, 木曽洋平, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 64回 239 - 239 2020.8

リウマチ性疾患の基礎研究 CD30をターゲットとした関節リウマチ新規治療の検討

松橋美波, 西田圭一郎, 渡辺雅仁, 木曽洋平, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 64回 521 - 521 2020.8

リウマチ性疾患の画像 AIを用いた関節リウマチ超音波検査における同一画像自動検出

中原龍一, 西田圭一郎, 松橋美波, 渡辺雅仁, 木曽洋平, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 64回 421 - 421 2020.8

関節リウマチの滑膜細胞増殖におけるADAM12の役割

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 木曽洋平, 松橋美波, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 64回 630 - 630 2020.8

処方エキスパートへの道高齢者の睡眠薬の使い方

植田真司, 井上真一郎, 西田圭一郎

Loco Cure 6 ( 3 ) 258 - 261 2020.8

生物学的製剤治療を行った関節リウマチ患者における関節破壊の解析

浅野澄恵, 高杉幸司, 江澤和彦, 原田遼三, 藤田慎一朗, 山本渉, 中原龍一, 那須義久, 西田圭一郎

日本リウマチ学会総会・学術集会プログラム・抄録集 64回 561 - 561 2020.8

バリシチニブを休薬せず行った整形外科手術の小経験

原田遼三, 西田圭一郎, 那須義久, 中原龍一, 高杉幸司, 浅野澄恵, 藤田慎一朗, 井上貴絵, 山本渉, 與座未来, 金谷麻未, 新名早希子, 江澤和彦

日本リウマチ学会総会・学術集会プログラム・抄録集 64回 574 - 574 2020.8

実臨床における早期関節リウマチに対する治療選択と短期成績多施設前向きコホート研究NICER-Jより

鈴木望人, 平野裕司, 祖父江康司, 原良太, 金子哲也, 辻成佳, 長嶺里美, 西梅剛, 吉岡裕, 乾健太郎, 岡邨興一, 藤林孝義, 渡部達生, 石川肇, 高窪祐弥, 西田圭一郎, 鳥養栄治, 高木英希, 金子敦史, 小口武, 寺部健哉, 浅井秀司, 石黒直樹, 小嶋俊久

日本リウマチ学会総会・学術集会プログラム・抄録集 64回 719 - 719 2020.8

地域包括ケア病棟における期限内退院可能な患者の特徴、予測モデルについて

原田遼三, 中原龍一, 那須義久, 西田圭一郎

The Japanese Journal of Rehabilitation Medicine 57 ( 特別号 ) 3 - 4 2020.7

Short-term outcomes of mirogabalin in patients with peripheral neuropathic pain: a retrospective study. International journal

Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Haruo Misawa, Tomoyuki Takigawa, Kentaro Yamane, Hironori Tsuji, Yoshitaka Takei, Toshifumi Ozaki

Journal of orthopaedic surgery and research 15 ( 1 ) 191 - 191 2020.5

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

BACKGROUND: Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the α2δ subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the α2δ-1 and α2δ-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin administration in patients with peripheral neuropathic pain who ceased treatment with pregabalin. METHODS: We retrospectively assessed peripheral neuropathic pain using the neuropathic pain screening questionnaire (NeP score) in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had switched from pregabalin to mirogabalin due to lack of efficacy or adverse events. Differences in the treatment course (i.e., numeric rating scale (NRS) scores) were compared using one-way analysis of variance with Bonferroni post hoc tests. RESULTS: The mean age of the patients was 72.3 years (range, 30-94 years), and the mean duration of disease was 37 months (range, 3-252 months). After treatment with mirogabalin for 1 week, NRS scores significantly decreased compared with baseline and continued to decrease over time. After 8 weeks, NRS scores improved by ≥ 30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin. CONCLUSIONS: The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain.

DOI： 10.1186/s13018-020-01709-3

TEA後に許容される運動と実態調査

橋詰謙三, 西田圭一郎

整形・災害外科 63 ( 6 ) 817 - 824 2020.5

Induction of CEMIP in Chondrocytes by Inflammatory Cytokines: Underlying Mechanisms and Potential Involvement in Osteoarthritis. Reviewed International journal

Takashi Ohtsuki, Omer F Hatipoglu, Keiichi Asano, Junko Inagaki, Keiichiro Nishida, Satoshi Hirohata

International journal of molecular sciences 21 ( 9 ) 2020.4

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

In patients with osteoarthritis (OA), there is a decrease in both the concentration and molecular size of hyaluronan (HA) in the synovial fluid and cartilage. Cell migration-inducing hyaluronidase 1 (CEMIP), also known as hyaluronan (HA)-binding protein involved in HA depolymerization (HYBID), was recently reported as an HA depolymerization-related molecule expressed in the cartilage of patients with OA. However, the underlying mechanism of CEMIP regulation is not well understood. We found that CEMIP expression was transiently increased by interleukine-1β (IL-1β) stimulation in chondrocytic cells. We also observed that ERK activation and NF-κB nuclear translocation were involved in the induction of CEMIP by IL-1β. In addition, both administration of HA and mechanical strain attenuated the CEMIP induction in IL-1β-stimulated chondrocytes. In conclusion, we clarified the regulatory mechanism of CEMIP in chondrocytes by inflammatory cytokines and suggested the potential involvement in osteoarthritis development.

DOI： 10.3390/ijms21093140

関節リウマチによる高度拘縮肘に対するPROSNAP人工肘の使用経験

那須義久, 中原龍一, 松橋美波, 渡辺雅仁, 木曽洋平, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 32 ( 1 ) 184 - 184 2020.4

超音波ガイド下関節穿刺が診断治療に有用であった股関節偽痛風の2例

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 尾崎敏文, 原田遼三

中国・四国整形外科学会雑誌 32 ( 1 ) 1 - 7 2020.4

Language：Japanese Publisher：中国・四国整形外科学会

症例1は93歳女性で、右膝痛による体動困難を主訴とした。CT、超音波で右股関節包内前方に水腫と石灰化像を認め、超音波ガイド下に股関節穿刺吸引を施行した。関節液の検査結果は比重1.015、尿酸結晶(-)、CPPD結晶(+)、細胞数46325/μL(分画:Stab1%、Seg85%、Mono13%、Lymph1%)、糖77mg/dL、塗抹菌体(-)であり、股関節偽痛風と診断した。穿刺の際にキシロカインを投与し、症状が速やかに改善した。症例2は81歳女性で、誘因のない右股関節痛を主訴とした。CT、超音波で右股関節包内前方に水腫と石灰化像を認め、超音波ガイド下に股関節穿刺吸引を施行した。関節液の検査結果は比重1.020、尿酸結晶(-)、CPPD結晶(+)、細胞数20800/μL(分画:Stab0%、Seg82%、Mono13%、Lymph8%)、糖155mg/dL、塗抹菌体(-)であり、股関節偽痛風と診断した。穿刺の際にキシロカインを投与し、症状が速やかに改善した。以後、2例とも疼痛の再燃を認めなかった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J02438&link_issn=&doc_id=20200602230001&doc_link_id=%2Fcm4ortho%2F2020%2F003201%2F001%2F0001-0007%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2020%2F003201%2F001%2F0001-0007%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

橈骨遠位端骨折プレート橈骨遠位端骨折に対するDVRを使用した手術治療

島村安則, 斎藤太一, 西田圭一郎, 尾崎敏文, 近藤秀則, 森谷史郎, 今谷潤也

日本手外科学会雑誌 36 ( 6 ) 1068 - 1068 2020.4

舟状骨偽関節に対する低侵襲治療の術後成績

堀田佳史, 斎藤太一, 根津智史, 松橋美波, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 37 ( 1 ) O18 - 1 2020.4

外傷性母指ボタン穴変形に対し手術加療を行った2例

沖田駿治, 福田祥二, 門田康孝, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 37 ( 1 ) P48 - 2 2020.4

尺骨末端切除術(Darrach法)後に手指伸筋腱再断裂を生じた1例

那須義久, 大橋基秀, 木曽洋平, 沖田駿治, 渡辺雅仁, 松橋美波, 中原龍一, 西田圭一郎, 尾崎敏文

岡山医学会雑誌 132 ( 1 ) 48 - 48 2020.4

Does Abatacept Increase Postoperative Adverse Events in Rheumatoid Arthritis Compared with Conventional Synthetic Disease-modifying Drugs? International journal

Hiromu Ito, Shigeyoshi Tsuji, Masanori Nakayama, Yuichi Mochida, Keiichiro Nishida, Hajime Ishikawa, Toshihisa Kojima, Takumi Matsumoto, Ayako Kubota, Takeshi Mochizuki, Koji Sakuraba, Isao Matsushita, Arata Nakajima, Ryota Hara, Akihisa Haraguchi, Tsukasa Matsubara, Katsuaki Kanbe, Natsuko Nakagawa, Masahide Hamaguchi, Shigeki Momohara

The Journal of Rheumatology 47 ( 4 ) 502 - 509 2020.4

Language：English Publishing type：Research paper (scientific journal) Publisher：The Journal of Rheumatology

<sec><title>Objective.</title>To investigate whether abatacept (ABA) causes more adverse events (AE) than conventional synthetic disease-modifying antirheumatic drugs (csDMARD) after orthopedic surgery in patients with rheumatoid arthritis (RA).

</sec><sec><title>Methods.</title>A retrospective multicenter nested case–control study was performed in 18 institutions. Patients receiving ABA (ABA group) were matched individually with patients receiving csDMARD and/or steroids (control group). Postoperative AE included surgical site infection, delayed wound healing, deep vein thrombosis or pulmonary embolism, flare, and death. The incidence rates of the AE in both groups were compared with the Mantel-Haenszel test. Risk factors for AE were analyzed by logistic regression model.

</sec><sec><title>Results.</title>A total of 3358 cases were collected. After inclusion and exclusion, 2651 patients were selected for matching, and 194 patients in 97 pairs were chosen for subsequent comparative analyses between the ABA and control groups. No between-group differences were detected in the incidence rates of each AE or in the incidence rates of total AE (control vs ABA: 15.5% vs 20.7% in total, 5.2% vs 3.1% in death).

</sec><sec><title>Conclusion.</title>Compared with csDMARD and/or steroids without ABA, adding ABA to the treatment does not appear to increase the incidence rates of postoperative AE in patients with RA undergoing orthopedic surgery. Large cohort studies should be performed to add evidence for the perioperative safety profile of ABA.

</sec>

DOI： 10.3899/jrheum.181100

上肢の人工関節人工肘関節置換術の臨床成績

西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 94 ( 3 ) S528 - S528 2020.3

運動器慢性痛患者に対する就労支援のシステム構築を目指して

鉄永倫子, 鉄永智紀, 西田圭一郎, 松崎孝, 井上真一郎, 太田晴之, 尾崎敏文

日本整形外科学会雑誌 94 ( 2 ) S95 - S95 2020.3

慢性腰痛患者におけるデュロキセチン塩酸塩の効果は抑うつの有無により影響するか

鉄永倫子, 鉄永智紀, 三澤治夫, 瀧川朋亨, 山根健太郎, 西田圭一郎, 竹井義隆, 尾崎敏文

日本整形外科学会雑誌 94 ( 2 ) S297 - S297 2020.3

CD30をターゲットとした新規リウマチ治療の検討

松橋美波, 西田圭一郎, 渡辺雅仁, 木曽洋平, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 94 ( 2 ) S152 - S152 2020.3

人工知能を用いた超音波画像の同一画像自動検出

中原龍一, 西田圭一郎, 渡辺雅仁, 松橋美波, 木曽洋平, 那須義久, 尾崎敏文

日本整形外科学会雑誌 94 ( 3 ) S701 - S701 2020.3

骨・関節・カルシウム代謝疾患変形性関節症

宮澤慎一, 西田圭一郎, 西原茂樹, 神崎浩孝, 千堂年昭

薬局 2020年増刊病気とくすり2020 71 ( 4 ) 888 - 905 2020.3

Idiopathic Chondrolysis of the Hip Treated by Immunosuppressive Therapy and Arthroscopic Intervention.

Hirosuke Endo, Hirofumi Akazawa, Masato Yashiro, Kazuki Yamada, Tomoaki Sanki, Tomonori Tetsunaga, Keiichiro Nishida, Takayuki Furumatsu, Toshifumi Ozaki

Acta medica Okayama 74 ( 1 ) 77 - 81 2020.2

Language：English

Idiopathic chondrolysis of the hip (ICH), a very rare disorder of unknown etiology, occurs mainly in female adolescents. Characterized by pain, limp, stiffness and radiological narrowing joint space from the rapid destruction of the articular cartilage, ICH sometimes results in ankyloses. We present the case of a 10-year-old girl diagnosed with ICH based on arthroscopic inspection and synovium biopsy. The femoral deformity appeared gradually, like a cam-type femoroacetabular impingement. She was treated with intensive rehabilitation and immunosuppressive drug. We later performed an arthroscopic bumpectomy for residual symptoms. She achieved a favorable outcome as a 15-year-old at the latest follow-up.

DOI： 10.18926/AMO/57957

関節リウマチに対する小指MP人工指関節置換術の治療成績

松橋美波, 西田圭一郎, 那須義久, 齋藤太一, 木曽洋平, 尾崎敏文

日本手外科学会雑誌 36 ( 5 ) 784 - 787 2020.2

Language：Japanese Publisher：(一社)日本手外科学会

関節リウマチの人工指関節置換術において小指は十分な可動域が得られにくいという問題点がある.著者らは,シリコンインプラント(SBi Silicone人工指関節:旧AVANTA人工指関節)による人工指関節置換術を行っており,2014年以降小指に対してはプレフレックスタイプを使用している.ストレートタイプ(S群)27例とプレフレックスタイプ(P群)21例に対し,術後1年時の握力,可動域,HAND20,DASHを調査し,比較検討した.術後1年時のMP関節の屈曲角度はS群50.1度,及びP群67.4度であり,可動域もS群33.5度,及びP群60.7度(P<0.01)であり有意に大きかった.他の検討項目では有意差を認めなかった.屈曲角度に影響する因子は様々であるが,プレフレックスタイプの選択により小指の屈曲は有意に増加し,可動域が増加した.(著者抄録)

術前・術後ケアのための「既往症の知識」まとめシート関節リウマチ

西田圭一郎

月刊ナーシング 40 ( 3 ) 40 - 43 2020.2

Bone microarchitectural analysis using ultra-high-resolution CT in tiger vertebra and human tibia. International journal

Ryota Inai, Ryuichi Nakahara, Yusuke Morimitsu, Noriaki Akagi, Youhei Marukawa, Toshi Matsushita, Takashi Tanaka, Akihiro Tada, Takao Hiraki, Yoshihisa Nasu, Keiichiro Nishida, Toshifumi Ozaki, Susumu Kanazawa

European radiology experimental 4 ( 1 ) 4 - 4 2020.1

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

BACKGROUND: To reveal trends in bone microarchitectural parameters with increasing spatial resolution on ultra-high-resolution computed tomography (UHRCT) in vivo and to compare its performance with that of conventional-resolution CT (CRCT) and micro-CT ex vivo. METHODS: We retrospectively assessed 5 tiger vertebrae ex vivo and 16 human tibiae in vivo. Seven-pattern and four-pattern resolution imaging were performed on tiger vertebra using CRCT, UHRCT, and micro-CT, and on human tibiae using UHRCT. We measured six microarchitectural parameters: volumetric bone mineral density (vBMD), trabecular bone volume fraction (bone volume/total volume, BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp), and connectivity density (ConnD). Comparisons between different imaging resolutions were performed using Tukey or Dunnett T3 test. RESULTS: The vBMD, BV/TV, Tb.N, and ConnD parameters showed an increasing trend, while Tb.Sp showed a decreasing trend both ex vivo and in vivo. Ex vivo, UHRCT at the two highest resolutions (1024- and 2048-matrix imaging with 0.25-mm slice thickness) and CRCT showed significant differences (p ≤ 0.047) in vBMD (51.4 mg/cm3 and 63.5 mg/cm3 versus 20.8 mg/cm3), BV/TV (26.5% and 29.5% versus 13.8 %), Tb.N (1.3 l/mm and 1.48 l/mm versus 0.47 l/mm), and ConnD (0.52 l/mm3 and 0.74 l/mm3 versus 0.02 l/mm3, respectively). In vivo, the 512- and 1024-matrix imaging with 0.25-mm slice thickness showed significant differences in Tb.N (0.38 l/mm versus 0.67 l/mm, respectively) and ConnD (0.06 l/mm3 versus 0.22 l/mm3, respectively). CONCLUSIONS: We observed characteristic trends in microarchitectural parameters and demonstrated the potential utility of applying UHRCT for microarchitectural analysis.

DOI： 10.1186/s41747-019-0135-0

RA手指変形 MCP人工関節置換術後のリハビリテーションについて

松山宜之, 中原龍一, 那須義久, 岡佳純, 千田益生, 西田圭一郎

MEDICAL REHABILITATION ( 244 ) 1 - 7 2020.1

Language：Japanese Publisher：(株)全日本病院出版会

関節リウマチ(RA)手の障害は、スワンネック変形・ボタン穴変形・尺側偏位など多彩であり、一つの手に複数の変形が混在している。その中でも、中手指節(MCP)関節は早期から罹患率が高く関節変形が生じやすく、進行例ではシリコン製インプラントによるMCP人工関節置換術での良好な成績が報告されている。当院では、MCP人工関節置換術に対しては、スタンダードパスを用いて術後療法を行っている。しかし、RA手指においては隣接関節の障害や伸筋腱皮下断裂を伴っていることも多く、進行例の変形では必要に応じて追加手術が同時に実施される。本稿では、通常のMCP人工関節置換術からスワンネック変形・ボタン穴変形・若年者の関節変形の術後リハビリテーションについて概説する。(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J03505&link_issn=&doc_id=20200124130001&doc_link_id=%2Fap5meree%2F2020%2F000244%2F002%2F0001-0007%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fap5meree%2F2020%2F000244%2F002%2F0001-0007%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

The factors driving self-efficacy in intractable chronic pain patients: a retrospective study. International journal

Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Haruo Misawa, Toshifumi Ozaki

Journal of orthopaedic surgery and research 14 ( 1 ) 473 - 473 2019.12

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

BACKGROUND: The fear-avoidance model is a theoretical paradigm for explaining acute and chronic pain. In this model, pain catastrophizing plays an important role. On the other hand, self-efficacy influences whether patients view their pain optimistically, ultimately preventing the conversion of pain into intractable pain. The aim of the present study was to evaluate the factors that influence self-efficacy in patients with chronic pain. METHODS: Study participants included 147 outpatients (35 men, 112 women) with intractable chronic pain who visited our hospital between September 2014 and July 2015. Their mean age was 71.0 (range 32-92) years. Pain sites were as follows: low back, 97 patients; knee, 71 patients; shoulder, 34 patients; and hip, 15 patients. All patients were assessed using the following measures: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and Pain Self-Efficacy Questionnaire (PSEQ). All participants were further divided into two groups based on median PSEQ scores (group L: PSEQ of 35 points or less, n = 74; group H: PSEQ greater than 35 points, n = 73). The factors that influenced self-efficacy in these patients were analyzed using univariate and multiple linear regression analyses. RESULTS: Significant differences were observed in gender; pain duration; and NRS, PDAS, HADS, and PCS scores between group L and group H. Multiple linear regression analysis revealed that self-efficacy was correlated with PDAS score, HADS depression score, and pain duration. CONCLUSIONS: Patients with longer pain duration indicated greater self-efficacy and patients with higher pain disability and depression exhibited lower self-efficacy.

DOI： 10.1186/s13018-019-1535-9

関節リウマチに対するMCP関節人工関節置換術中に手関節部での腱剥離術を要した症例の検討

木曽洋平, 西田圭一郎, 松橋美波, 渡辺雅仁, 沖田駿治, 大橋秀基, 尾崎敏文, 那須義久, 中原龍一

日本関節病学会誌 38 ( 4 ) 471 - 477 2019.12

Language：Japanese Publisher：(一社)日本関節病学会

当院でRA(関節リウマチ)に対しMCP関節人工関節置換術を施行した72例(手術時平均年齢61.8歳±11.9歳)を対象に、術中に手関節背側部の腱剥離術を要した症例について検討した。その結果、術中に手関節背側部の腱剥離術を要した症例は12例(16.7%)であった。更に手関節部での手術歴を有している症例では、15例中6例(40.0%)で術中に腱剥離術の追加が必要であった。手関節手術歴のある例ではEDCの癒着が多い傾向にあり、手術歴のない例では全例でEDMの癒着がみられた。腱剥離(+)群、腱剥離(-)群ともにHAND20、DASHは術後改善傾向を示し、改善量は両群間で有意差は認められなかった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J05177&link_issn=&doc_id=20191220140007&doc_link_id=%2Ffd8kanse%2F2019%2F003804%2F007%2F0471-0477%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffd8kanse%2F2019%2F003804%2F007%2F0471-0477%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

患者の満足度を高める関節リウマチ手術関節リウマチの肘関節手術の現状と展望

那須義久, 西田圭一郎

臨床整形外科 54 ( 12 ) 1213 - 1219 2019.12

Language：Japanese Publisher：(株)医学書院

＜文献概要＞人工肘関節置換術(TEA)をはじめ,関節リウマチ(RA)では肘関節の障害に対して手術が必要となる例が以前は多くみられていた.薬物療法の進歩により減少はしているものの,手術適応症例がなくなることはない.本邦では優れた非連結型人工関節が開発され,特に最近いくつかの機種において10年以上にわたって90%を大きく上回るインプラント生存率など,優れた臨床成績が相次いで報告されている.今後は多関節罹患例や高度関節破壊例の減少と,インプラント性能・術式が改善されることでRA肘の手術成績はさらに向上するものと期待される.

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01554&link_issn=&doc_id=20191202070007&doc_link_id=10.11477%2Fmf.1408201534&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1408201534&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Two cases of high tibial osteotomy in patients with rheumatoid arthritis treated with biologic disease-modifying anti-rheumatic drugs

Takahara, Y., Nishida, K., Nakashima, H., Ochi, N., Uchida, Y., Kato, H., Itani, S., Nakamura, M., Iwasaki, Y., Tsujimura, Y.

Acta Medica Okayama 73 ( 6 ) 537 - 542 2019.12

A high incidence of extensor pollicis brevis insertion into the distal phalanx in rheumatoid arthritis patients who required the surgical reconstruction for thumb boutonnière deformity Reviewed International journal

Shunji Okita, Keiichiro Nishida, Aiji Ohtsuka, Toshifumi Ozaki

Modern Rheumatology 29 ( 6 ) 954 - 958 2019.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Objectives: The aim of the current study was to investigate the pattern of extensor pollicis brevis (EPB) insertion macroscopically and histologically using cadaveric thumbs, and to compare the incidence of different insertions with that of thumb boutonnière deformity in rheumatoid arthritis (RA) patients who required surgical reconstruction.Methods: We examined 103 thumbs of 58 adult cadavers with no evidence of RA, and reviewed the surgical records of 28 thumbs of 23 RA patients who underwent surgical reconstruction for thumb boutonnière deformity. The incidence of different insertion patterns of the cadaveric thumbs and the RA thumbs were compared using the Fisher's exact test.Results: Macroscopic and histologic examination revealed that the insertion patterns of EPB could be divided into three groups: insertion into the base of the proximal phalanx (Type P1), integration of EPB into the dorsal fibrocartilage of the MCP joint (Type P2), and insertion into the distal phalanx (Type D). The incidence of Type D was significantly higher in RA patients with thumb boutonnière deformity (64%) than that in the non-RA cadavers (29%; P < .05).Conclusion: EPB is inserted into the distal phalanx more frequently in RA patients who require surgery for thumb boutonnière deformity than non-RA cadavers, suggesting an additional possible mechanism of this deformity.

DOI： 10.1080/14397595.2018.1532484

慢性疼痛のFear-Avoidanceモデルにおける各因子とロコモ25との関連についての検討

辻寛謙, 鉄永倫子, 鉄永智紀, 辻暁里, 折田沙穂, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 11 ( 4 ) S61 - S61 2019.11

慢性疼痛患者における活動性及びQOLはロコモ25と相関するか

辻暁里, 鉄永倫子, 鉄永智紀, 辻寛謙, 折田沙穂, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 11 ( 4 ) S60 - S60 2019.11

再移植の実施と非実施による感染症の危険因子と感染率の比較(Risk Factors for Infection and Comparison of Infection Rate with and without Replantation)

斎藤太一, 根津智史, 松橋美波, 島村安則, 西田圭一郎, 湯本哲也, 中尾篤典, 尾崎敏文

日本マイクロサージャリー学会学術集会プログラム・抄録集 46回 127 - 127 2019.11

慢性疼痛外来において初診時付き添いの有無と各種疼痛スコアとの関連性

折田沙穂, 鉄永倫子, 鉄永智紀, 辻寛謙, 辻暁里, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 11 ( 4 ) S99 - S99 2019.11

Mechanical strain attenuates cytokine-induced ADAMTS9 expression via transient receptor potential vanilloid type 1. Reviewed International journal

Takashi Ohtsuki, Akira Shinaoka, Kanae Kumagishi-Shinaoka, Keiichi Asano, Omer Faruk Hatipoglu, Junko Inagaki, Ken Takahashi, Toshitaka Oohashi, Keiichiro Nishida, Keiji Naruse, Satoshi Hirohata

Experimental cell research 383 ( 2 ) 111556 - 111556 2019.10

Language：English

The synovial fluids of patients with osteoarthritis (OA) contain elevated levels of inflammatory cytokines, which induce the expression of a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) and of the matrix metalloproteinase (MMP) in chondrocytes. Mechanical strain has varying effects on organisms depending on the strength, cycle, and duration of the stressor; however, it is unclear under inflammatory stimulation how mechanical strain act on. Here, we show that mechanical strain attenuates inflammatory cytokine-induced expression of matrix-degrading enzymes. Cyclic tensile strain (CTS), as a mechanical stressor, attenuated interleukin (IL)-1β and tumor necrosis factor (TNF)-α-induced mRNA expression of ADAMTS4, ADAMTS9, and MMP-13 in normal chondrocytes (NHAC-kn) and in a chondrocytic cell line (OUMS-27). This effect was abolished by treating cells with mechano-gated channel inhibitors, such as gadolinium, transient receptor potential (TRP) family inhibitor, ruthenium red, and with pharmacological and small interfering RNA-mediated TRPV1 inhibition. Furthermore, nuclear factor κB (NF-κB) translocation from the cytoplasm to the nucleus resulting from cytokine stimulation was also abolished by CTS. These findings suggest that mechanosensors such as the TRPV protein are potential therapeutic targets in treating OA.

DOI： 10.1016/j.yexcr.2019.111556

関節リウマチ前足部手術に対する術式別の臨床成績の比較

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 木曽洋平, 松橋美波, 尾崎敏文

中国・四国整形外科学会雑誌 31 ( 3 ) 322 - 322 2019.10

DARTS人工手関節の短期成績

松橋美波, 西田圭一郎, 渡辺雅仁, 沖田駿治, 木曽洋平, 中原龍一, 那須義久, 尾崎敏文

中国・四国整形外科学会雑誌 31 ( 3 ) 321 - 321 2019.10

関節超音波画像を用いた人工知能教育システムの報告

中原龍一, 長谷井嬢, 渡辺雅仁, 松橋美波, 木曽洋平, 那須義久, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 31 ( 3 ) 396 - 396 2019.10

人工肘関節置換術後ゆるみを生じていた上腕骨コンポーネント周囲骨折に対し内固定術を行った1例

沖田駿治, 西田圭一郎, 松橋美波, 渡辺雅仁, 木曽洋平, 中原龍一, 那須義久, 尾崎敏文

中国・四国整形外科学会雑誌 31 ( 3 ) 348 - 348 2019.10

趾用Swansonインプラントを用いた母指MP関節形成術後29年経過した1例

沖田駿治, 石川肇, 阿部麻美, 谷口慎治, 黒澤陽一, 長谷川絵理子, 伊藤聡, 大谷博, 中園清, 村澤章, 西田圭一郎, 尾崎敏文

日本関節病学会誌 38 ( 3 ) 298 - 298 2019.10

RA外側足趾に対する治療戦略関節リウマチによる外側趾変形に対する中足骨遠位短縮骨切り術(スクリュー固定)

那須義久, 松橋美波, 渡辺雅仁, 木曽洋平, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 38 ( 3 ) 232 - 232 2019.10

関節リウマチに対する人工指関節置換術の臨床成績関節リウマチのMCP関節に対するシリコンインプラント形成術の臨床成績

西田圭一郎, 松橋美波, 木曽洋平, 沖田駿治, 渡辺雅仁, 中原龍一, 那須義久, 尾崎敏文

日本関節病学会誌 38 ( 3 ) 169 - 169 2019.10

関節超音波画像を用いた人工知能研究システムの開発

中原龍一, 西田圭一郎, 松橋美波, 渡辺雅仁, 木曽洋平, 那須義久, 尾崎敏文

日本関節病学会誌 38 ( 3 ) 156 - 156 2019.10

舟状骨偽関節に対して低侵襲手術により加療した一例

齋藤太一, 松橋美波, 内野崇彦, 島村安則, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 31 ( 2 ) 268 - 268 2019.9

軟骨細胞によるIL-1β誘導性蛋白分解酵素発現に対する脂肪由来抽出液の影響とその機序

大橋秀基, 西田圭一郎, 佐伯正典, 那須義久, 中原龍一, 木曽洋平, 渡辺雅仁, 松橋美波, 尾崎敏文

日本整形外科学会雑誌 93 ( 8 ) S1933 - S1933 2019.9

関節リウマチモデルマウスを用いたCD30阻害療法の検討

松橋美波, 西田圭一郎, 渡辺雅仁, 木曽洋平, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 93 ( 8 ) S1850 - S1850 2019.9

腱骨接合部の恒常性におけるメカニカルストレスの影響

斎藤太一, 根津智史, 松橋美波, 吉田晶, 島村安則, 古松毅之, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 93 ( 8 ) S1693 - S1693 2019.9

関節リウマチの滑膜細胞増殖におけるADAM12の役割とmiRNA-29bによる制御

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 大橋秀基, 木曽洋平, 沖田駿治, 松橋美波, 尾崎敏文

日本整形外科学会雑誌 93 ( 8 ) S1740 - S1740 2019.9

RA 手のリハビリテーション

松山宜之, 中原龍一, 那須義久, 西田圭一郎

臨床リウマチ 31 ( 3 ) 259 - 265 2019.9

Tuberosity-overlapping Fixation of the Humeral Shaft in Humeral Head Replacement Surgery.

Takaaki Hiranaka, Keiichiro Nishida, Taizo Konishiike, Toshifumi Ozaki, Motohiko Mikasa

Acta medica Okayama 73 ( 4 ) 299 - 305 2019.8

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

The fixation technique of bony fragments is crucial for the bone union of the tuberosities after humeral head replacement (HHR) for a comminuted fracture of the proximal humerus. To increase the bone union rate, we reduce tuberosities to overlap on the humeral shaft by approx. 1 cm and fix them with cable wire. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure. Twenty-six patients who underwent cementless HHR for the treatment of comminuted fractures of the proximal humerus were investigated. The Constant-Murley score, active shoulder mobility, and bone union rate were evaluated. The mean duration of follow-up was 56.3 months (range 24-197). At the final follow-up, the average Constant-Murley score was 58 (range 40-76). Forward elevation was 126° on average (range 35°-180°). Twenty-three cases (88%) showed bone union between the tuberosities and the shaft at an average follow-up of 4.1 months (range 4-5 months) after surgery. Non-union was noted in 1 case, and bone resorption was noted in 2 cases. The bone union rate and the clinical outcome of our procedure were relatively favorable.

DOI： 10.18926/AMO/56931

リウマチ肩関節外科の現状と将来展望解剖学的人工肩関節全置換術

西田圭一郎, 那須義久, 中原龍一, 尾崎敏文

関節の外科 46 ( 2 ) 40 - 40 2019.8

リウマチ肘における手術適応、手術法と将来展望 Unlinked TEAの利点と限界

那須義久, 松橋美波, 渡辺雅仁, 木曽洋平, 中原龍一, 西田圭一郎, 尾崎敏文

関節の外科 46 ( 2 ) 51 - 51 2019.8

Involvement of ADAM12 in Chondrocyte Differentiation by Regulation of TGF-β1-Induced IGF-1 and RUNX-2 Expressions. Reviewed International journal

Horita M, Nishida K, Hasei J, Furumatsu T, Sakurai M, Onodera Y, Fukuda K, Salter DM, Ozaki T

Calcified tissue international 105 ( 1 ) 97 - 106 2019.7

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

A disintegrin and metalloproteinase 12 (ADAM12) is known to be involved in chondrocyte proliferation and maturation; however, the mechanisms are not fully understood. In this study, expression and localization of ADAM12 during chondrocyte differentiation were examined in the mouse growth plate by immunohistochemistry. Adam12 expression during ATDC5 chondrogenic differentiation was examined by real-time PCR and compared with the expression pattern of type X collagen. The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 system was used to generate Adam12-knockout (KO) ATDC5 cells. Adam12-KO and Adam12 overexpressing cells were used for analyses of ADAM12 expression with or without TGF-β1 stimulation. ADAM12 was identified predominantly in chondrocytes of the proliferative zone in mouse growth plates by immunohistochemistry. Adam12 was upregulated prior to Col10a1 during chondrogenic differentiation in wild-type ATDC5 cells. In Adam12-KO ATDC5 cells, following initiation of chondrogenic differentiation, we observed a reduction in Igf-1 expression along with an upregulation of hypertrophy-associated Runx2, Col10a1, and type X collagen protein expressions. In ATDC5 wild-type cells, stimulation with TGF-β1 upregulated the expressions of Adam12 and Igf-1 and downregulated the expression of Runx2. In contrast, in Adam12-KO ATDC5 cells, these TGF-β1-induced changes were suppressed. Adam12 overexpression resulted in an upregulation of Igf-1 and downregulation of Runx2 expression in ATDC5 cells. The findings suggest that ADAM12 has important role in the regulation of chondrocyte differentiation, potentially by regulation of TGF-β1-dependent signaling and that targeting of ADAM12 may have a role in management of abnormal chondrocyte differentiation.

DOI： 10.1007/s00223-019-00549-6

慢性腰痛に対する「本音の」治療戦略慢性腰痛に対する集学的アプローチ

鉄永倫子, 西田圭一郎, 鉄永智紀, 井上真一郎, 太田晴之, 大倉和代, 宮本和子, 尾崎敏文

PAIN RESEARCH 34 ( 2 ) 120 - 120 2019.7

半月板からみた早期OAの予防と進行抑制

古松毅之, 西田圭一郎, 尾崎敏文

日本関節病学会誌 38 ( 2 ) 85 - 90 2019.7

Prevalence of and Risk Factors for the Progression of Upper Cervical Lesions in Patients with Rheumatoid Arthritis.

Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Sugimoto, Yoshihisa Nasu, Ryuichi Nakahara, Ryozo Harada, Toshifumi Ozaki

Acta medica Okayama 73 ( 3 ) 235 - 240 2019.6

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

We investigated the prevalence of and risk factors for the progression of upper cervical lesions (UCLs) in patients with rheumatoid arthritis (RA). A retrospective analysis of 49 patients with RA (4 males, 45 females) was conducted. The UCLs included atlanto-axial subluxation and vertical subluxation. We investigated the clinical factors including the Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) and the modified Health Assessment Questionnaire-Disability Index as well as radiographic changes between the baseline (at May 2010 to April 2013) and final follow-up. Forty patients (81.6%) were classified as the non-progressive group, and the other 9 patients (18.4%) comprised the progressive group. The progressive group's final CRP values, baseline or final MMP-3 levels, DAS28-CRP, and rate of pre-existing lesions at baseline were all significantly higher than those of the non-progressive group (p=0.017, p=0.043, p=0.002, p=0.008, p<0.001, and p=0.008 respectively). A multivariate logistic regression analysis demonstrated that DAS28-CRP at baseline was a risk factor for radiographic progression (p=0.018, odds ratio: 2.54, 95% confidence interval: 1.17-5.51). Our findings indicate that higher disease activity might influence the progression of UCLs in patients with RA.

DOI： 10.18926/AMO/56866

慢性疼痛患者の集学的治療における活動能力の経時的変動と特徴に関する基礎的検討

太田晴之, 齋藤圭介, 鉄永倫子, 堅山佳美, 西田圭一郎, 千田益生, 尾崎敏文

運動器リハビリテーション 30 ( 2 ) 216 - 216 2019.6

当院における人工肘関節置換術後の可動域訓練プログラム

松山宜之, 那須義久, 中原龍, 西田圭一郎, 尾崎敏文

運動器リハビリテーション 30 ( 2 ) 204 - 204 2019.6

Rasch分析を用いたRA患者における上肢機能評価の検討

原田遼三, 西田圭一郎, 那須義久, 中原龍一

運動器リハビリテーション 30 ( 2 ) 238 - 238 2019.6

ビスフォスフォネート製剤長期服用者に生じた尺骨非定型骨折の4例

沖田駿治, 斉藤太一, 松橋美波, 横尾賢, 望月雄介, 兼田大輔, 山本乃利男, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 36 ( 1 ) O23 - 6 2019.4

日本外傷データバンクからみる近年の日本における上肢切断に対する治療の傾向

斎藤太一, 沖田駿治, 松橋美波, 山川泰明, 湯本哲也, 島村安則, 西田圭一郎, 中尾篤典, 尾崎敏文

日本手外科学会雑誌 36 ( 1 ) O22 - 1 2019.4

関節リウマチに対する小指MP人工指関節置換術の治療成績

松橋美波, 那須義久, 木曽洋平, 斎藤太一, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 36 ( 1 ) O34 - 3 2019.4

その他の医原性免疫不全関連リンパ増殖性疾患

佐藤康晴, 祇園由佳, 西田圭一郎, 吉野正

病理と臨床 37 ( 4 ) 360 - 363 2019.4

サルコイドーシスの手指関節病変に対して外科的治療を行った2例

松橋美波, 那須義久, 中原龍一, 西田圭一郎

岡山医学会雑誌 131 ( 1 ) 61 - 61 2019.4

RA手術によるQOL向上のエビデンス QOLを高める手術のエビデンス肩・肘

那須義久, 原田遼三, 西田圭一郎, 松橋美波, 渡辺雅仁, 沖田駿治, 木曽洋平, 大橋秀基, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 63回 223 - 223 2019.3

関節リウマチ患者に対する連結型人工肘関節全置換術(PROSNAP)の臨床成績の検討

沖田駿治, 西田圭一郎, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 63回 638 - 638 2019.3

関節リウマチ診断における両手足造影MRI検査の有用性の検討

松橋美波, 中原龍一, 渡辺雅仁, 沖田駿治, 木曽洋平, 那須義久, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 63回 611 - 611 2019.3

関節リウマチの滑膜細胞増殖におけるADAM12の役割とmiRNA-29bによる制御

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 大橋秀基, 沖田駿治, 木曽洋平, 松橋美波, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 63回 743 - 743 2019.3

関節リウマチ手術後のPRO(ボディイメージ・抑うつ・機能)の改善は術前の疾患活動性に影響される

小橋靖子, 西田圭一郎, 堀田昌宏, 那須義久, 雑賀建多, 中原龍一, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 63回 659 - 659 2019.3

軟骨組織に対する濃縮脂肪由来抽出液の影響

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 尾崎敏文

移植 53 ( 6 ) 379 - 379 2019.3

岡山大学病院における運動器慢性痛患者に対する復職支援の取り組み

鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 93 ( 3 ) S1259 - S1259 2019.3

関節リウマチ前足部変形における外側趾中足骨短縮骨切りが外反母趾角に与える影響

那須義久, 松橋美波, 沖田駿治, 木曽洋平, 渡辺雅仁, 大橋秀基, 中原龍一, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 93 ( 3 ) S1115 - S1115 2019.3

結晶誘発性関節炎・痛風超音波ガイド下穿刺が診断治療に有用であった股関節偽痛風の2例

原田遼三, 西田圭一郎, 中原龍一, 那須義久, 高杉幸司, 藤森美鈴, 江澤和彦, 藤田慎一朗, 井上貴絵, 山本渉

日本リウマチ学会総会・学術集会プログラム・抄録集 63回 547 - 547 2019.3

変形性関節症:from bench to bedside 関節軟骨のバイオイメージング

大橋俊孝, 加来田博貴, 大野充昭, 西田圭一郎

日本整形外科学会雑誌 93 ( 2 ) S331 - S331 2019.3

Dupuytren拘縮に対する部分腱膜切除術の術後成績

齋藤太一, 島村安則, 松橋美波, 内野崇彦, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 35 ( 5 ) 898 - 901 2019.2

Language：Japanese Publisher：(一社)日本手外科学会

Dupuytren拘縮に対して長軸切開にて部分手掌腱膜切除を行い,Z形成を追加して閉創を行った症例と,Zigzag切開にて部分手掌腱膜切除を行った症例について治療成績を比較検討した.2年以上追跡可能であった病的腱膜切除を施行した17例22指を対象とした.最終観察時の平均屈曲拘縮角度はZigzag切開を行った症例群では術前61.1度から術後27.8度へ,長軸切開を行った症例群では術前87.7度から術後21.2度へと,どちらも術前に比べ有意な改善を認めた.DASHスコアについてもZigzag切開を行った群では術前10.3から術後1.5へ,長軸切開を行った群では術前6.3から術後1.2へとどちらも術前に比べ有意な改善を認めた.Zigzag切開を行った症例のうち2年後再発により再手術した症例を1例認め,長軸切開にてアプローチした症例のうちで皮膚移植を行った症例を1例認めた.術後に創離開や皮膚壊死を生じた例は認められなかった.両アプローチとも,中程度から高度屈曲拘縮例においても安定した中期成績を示した.長軸切開にZ形成を追加する術式はアプローチにしやすさという点から有用と思われた.(著者抄録)

関節リウマチ患者の高度拘縮肘に対する人工肘関節置換術

松橋美波, 那須義久, 沖田駿治, 木曽洋平, 西田圭一郎, 尾崎敏文

日本肘関節学会雑誌 26 ( 1 ) S141 - S141 2019.2

50歳未満の関節リウマチ患者に行った人工肘関節全置換術の臨床成績の検討

沖田駿治, 西田圭一郎, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 中原龍一, 那須義久, 尾崎敏文

日本肘関節学会雑誌 26 ( 1 ) S138 - S138 2019.2

小児整形外科における最新の超音波診断

青木清, 西田圭一郎, 赤澤啓史, 寺本亜留美

整形・災害外科 62 ( 1 ) 43 - 51 2019.1

Clinical features and treatment outcome of desmoid-type fibromatosis: based on a bone and soft tissue tumor registry in Japan Reviewed

Nishida Y, Kawai A, Toguchida J, Ogose A, Ae K, Kunisada T, Matsumoto Y, Matsunobu T, Takahashi K, Nishida K, Ozaki T

International Journal of Clinical Oncology 24 1498 - 1505 2019

High molecular weight hyaluronan protects cartilage from degradation by inhibiting aggrecanase expression. Reviewed International journal

Takashi Ohtsuki, Keiichi Asano, Junko Inagaki, Akira Shinaoka, Kanae Kumagishi-Shinaoka, Mehmet Z Cilek, Omer F Hatipoglu, Toshitaka Oohashi, Keiichiro Nishida, Issei Komatsubara, Satoshi Hirohata

Journal of orthopaedic research : official publication of the Orthopaedic Research Society 36 ( 12 ) 3247 - 3255 2018.12

Language：English

Hyaluronan (HA) is an extracellular matrix (ECM) component of articular cartilage and has been used to treat patients with osteoarthritis (OA). A disintegrin and metalloproteinases with thrombospondin motifs (ADAMTSs) play an important role in cartilage degradation in OA. We have previously reported that ADAMTS4 and ADAMTS9 were induced by cytokine stimulation. However, the effect of HA on the cytokine-inducible ADAMTS9 has never been investigated. Moreover, it is unclear whether HA protects cartilage by suppressing aggrecan degradation. Here, we examined the effects of HA on ADAMTS expression in vitro and on cartilage degradation in vivo. ADAMTS9 expression was higher than that of the other aggrecanases (ADAMTS4 and 5) in human chondrocytes, chondrocytic cells, and rat cartilage. ADAMTS4 and 9 mRNA levels were upregulated in cytokine-stimulated chondrocytes and chondrocytic cells. Pre-incubation with HA significantly inhibited ADAMTS9 mRNA expression in cytokine-stimulated cells. In a rat OA model, Adamts5 and 9 mRNA levels were transiently increased after surgery; intra-articular HA injections attenuated the induction of Adamts5 and 9 mRNA. HA also blocked aggrecan cleavage by aggrecanase in OA rats in a molecular size-dependent manner. These results demonstrate that HA attenuates induced aggrecanases expression in OA and thereby protects articular cartilage degradation by this enzyme. Our findings provide insight into the molecular basis for the beneficial effects of HA in OA. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 36:3247-3255, 2018.

DOI： 10.1002/jor.24126

関節リウマチに対する尺骨遠位端切除術を併用した手関節部分固定術の中・長期治療成績

竹下歩, 西田圭一郎, 那須義久, 沖田駿治, 橋詰博行, 尾崎敏文

日本手外科学会雑誌 35 ( 3 ) 434 - 436 2018.12

Language：Japanese Publisher：(一社)日本手外科学会

関節リウマチに対する尺骨遠位端切除術を併用した手関節部分固定術の治療成績を検討した.術後5年以上経過観察可能であった19例23手を対象とした.症例は全て女性で,手術時年齢は平均50.7歳,経過観察期間は平均9.9年であった.手術は橈骨月状骨間固定術が21手,橈骨月状骨三角骨間固定術が2手であり,術前のSchulthess分類はType IIが15手,Type IIIが8手であった.良好な除痛効果と手関節アライメントの矯正・維持が獲得されていた.最終調査時には掌背屈可動域に減少を認めたが,術後月状骨周囲に骨性硬直を生じた群で顕著であり,その頻度はSchulthess分類Type IIIの手関節で高かった.そのため手根中央関節の破壊が高度である場合は,手関節部分固定術後に月状骨周囲骨性強直が発生し,手関節アライメント異常の矯正は獲得される一方で,掌背屈可動域減少が生じる可能性が高いと考える.(著者抄録)

【腰痛治療の最前線】腰痛の治療腰痛のリエゾン療法

鉄永倫子, 西田圭一郎, 鉄永智紀, 尾崎敏文

関節外科 37 ( 12 ) 1350 - 1356 2018.12

プレガバリンの処方実態調査腎機能と用法・用量を基にした適正使用に関する考察

神崎浩孝, 鉄永倫子, 田中雄太, 槇田崇志, 西原茂樹, 鉄永智紀, 北村佳久, 西田圭一郎, 千堂年昭

Journal of Musculoskeletal Pain Research 10 ( 3 ) S153 - S153 2018.11

【慢性運動器疼痛整形外科のペインマネジメント徹底解説】慢性運動器疼痛治療における薬学管理の実践ポイント! 慢性運動器疼痛治療薬の副作用マネジメント

神崎浩孝, 鉄永倫子, 西田圭一郎, 千堂年昭

薬局 69 ( 12 ) 3361 - 3367 2018.11

Language：Japanese Publisher：(株)南山堂

＜Key Points＞◎慢性疼痛の治療は、個人差の大きいことから、その背景を十分に理解した上で、個別化した治療(医療)を提供する必要がある。◎慢性疼痛治療の目標は、「ADLとQOLの改善」であり、「痛みゼロ」を最重要目標としていない点でがん性疼痛治療と大きく異なっている。◎薬物療法マネジメントにおいて、薬剤使用の見極め(減量、中止や別の薬への変更)と副作用の発現リスクへの配慮が重要である。◎副作用マネジメントにおいて、漫然とした処方継続の回避と定期的な血液検査の奨励が必須である。◎高齢で慢性疼痛を呈する患者も多く、高齢者は副作用リスクも高いことから注意が必要である。(著者抄録)

岡山大学病院における運動器慢性痛患者に対する復職支援の取り組み

鉄永倫子, 西田圭一郎, 鉄永智紀, 井上真一郎, 松崎孝, 太田晴之, 神崎浩孝, 大倉和代, 石橋京子, 宮本和子

Journal of Musculoskeletal Pain Research 10 ( 3 ) S74 - S74 2018.11

Drug dependence in patients with chronic pain: A retrospective study. Reviewed International journal

Tetsunaga T, Tetsunaga T, Nishida K, Kanzaki H, Misawa H, Takigawa T, Shiozaki Y, Ozaki T

Medicine 97 ( 40 ) e12748 2018.10

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

Drug dependence, which can exist concurrently with chronic pain, is seen as one of the major causes of rapidly increasing medical expenses. However, drug dependence in patients with chronic pain has not been evaluated. The aim of this study was to identify the risk factors for drug dependence in patients with chronic noncancer pain.This retrospective study included 151 patients with chronic noncancer pain (43 males, 108 females; mean age, 72 years). Low back pain (LBP) occurred in 96 patients, whereas 22 had shoulder pain, 8 had hip pain, and 77 had knee pain. Patients were divided into drug dependence and nondrug dependence groups based on the Severity of Dependence Scale (SDS) scores. Patients with SDS scores ≥5 and <5 were classified into drug dependence and nondrug dependence groups, respectively. All patients completed self-report questionnaires. Factors that predict drug dependence were identified by performing univariate and multivariate analyses.Sixty (40%) of the 151 patients met the SDS criteria for drug dependence. Significant differences were found between patients with and without drug dependence for the LBP, hip pain, number of medications, and for the Numerical Rating Scale, Pain Disability Assessment Scale (PDAS), Hospital Anxiety and Depression Scale, and Pain Catastrophizing Scale (PCS) scores. Multiple regression analysis identified LBP, hip pain, PCS, and PDAS scores as factors related to drug dependence in patients with chronic noncancer pain.Drug dependence tends to differ in patients based on the location of their chronic pain. Pain catastrophizing and disability indicated a greater tendency for drug dependence. Thus, PCS and PDAS scores are useful screening tools for predicting drug dependence in patients with chronic pain.

DOI： 10.1097/MD.0000000000012748

リウマチ足の治療成績を左右する因子関節リウマチ患者の前足部変形に対する手術における術式選択と治療成績の検討

堀田昌宏, 西田圭一郎, 橋詰謙三, 那須義久, 雑賀建多, 中原龍一, 大橋秀基, 林充, 尾崎敏文

日本足の外科学会雑誌 39 ( Suppl. ) S286 - S286 2018.10

【しびれ・痛みに対する整形外科診療の進歩】薬物療法セロトニン・ノルアドレナリン再取り込み阻害薬の使用方法効果は抑うつの有無により影響するか

鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

別冊整形外科 ( 74 ) 23 - 26 2018.10

関節リウマチに対するMCP関節人工関節置換術中に手関節部での腱処置剥離術を要した症例の検討

木曽洋平, 那須義久, 松橋美波, 渡辺雅仁, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 199 - 199 2018.10

人工肘関節全置換術(TEA)術後の肘関節機能回復のアプローチとその角度変化

松山宜之, 中原龍一, 鍋倉由佳, 小川加苗, 藤岡晃, 岡佳純, 那須義久, 堅山佳美, 西田圭一郎, 千田益生

日本RAのリハビリ研究会誌 32 ( 1 ) 43 - 46 2018.10

関節リウマチ外側趾MTP関節背屈変形の重症度分類

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 雑賀建多, 堀田昌宏

日本足の外科学会雑誌 39 ( Suppl. ) S370 - S370 2018.10

関節リウマチにおけるPDスコアの関節破壊予測能の検討

沖田駿治, 中原龍一, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 那須義久, 西田圭一郎, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 306 - 306 2018.10

深層学習を用いた超音波画像の関節部位推定

中原龍一, 西田圭一郎, 沖田駿治, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 那須義久, 野田知之, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 305 - 305 2018.10

RA手の障害に対する手指人工関節における角速度の術後経過

松山宜之, 中原龍一, 松岡玲衣, 藤岡晃, 鍋倉由佳, 小川加苗, 岡佳純, 那須義久, 堅山佳美, 西田圭一郎, 千田益生, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 271 - 271 2018.10

人工手関節全置換術(TWA)を受ける関節リウマチ患者の看護

小橋靖子, 西田圭一郎, 宮地亜美, 鍋倉由佳, 藤岡晃, 那須義久, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 216 - 216 2018.10

関節リウマチに対するAVANTAとAVANTA preflexによる小指MP人工指関節置換術の治療成績

松橋美波, 那須義久, 渡辺雅仁, 沖田駿治, 木曽洋平, 大橋秀基, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 216 - 216 2018.10

人工肘関節置換術施行後に隣接関節の運動機能が変化し追加にて「排泄動作自立」の目標設定が可能となった一症例

藤岡晃, 鍋倉由佳, 小川加苗, 松山宜之, 岡佳純, 中原龍一, 那須義久, 西田圭一郎, 千田益生

日本RAのリハビリ研究会誌 32 ( 1 ) 47 - 50 2018.10

短母指伸筋腱の停止様式が母指ボタン穴変形発症に与える影響

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 尾崎敏文, 中原龍一, 那須義久

中国・四国整形外科学会雑誌 30 ( 2 ) 291 - 291 2018.9

関節リウマチによる高度手関節破壊に対して人工手関節置換術を施行した2例

那須義久, 中原龍一, 西田圭一郎, 尾崎敏文

中部日本整形外科災害外科学会雑誌 61 ( 秋季学会 ) 249 - 249 2018.9

A Multidisciplinary Approach to the Management of Chronic Pain through a Self-managed Behavioral Exercise Program : A Pilot Study in Japan. Reviewed

Nishie H, Tetsunaga T, Kanzaki H, Oda K, Inoue S, Ryuo Y, Ota H, Miyawaki T, Arakawa K, Tetsunaga T, Kitamura Y, Sendo T, Morimatsu H, Ozaki T, Nishida K

Acta medica Okayama 72 ( 4 ) 343 - 350 2018.8

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

We conducted this study to determine the short-term treatment outcomes of multidisciplinary approaches to chronic pain management for outpatients in Japan. We evaluated pain reduction and improvement in quality of life (QOL) after treatment. We analyzed 32 patients who had experienced intractable chronic pain for > 3 months. The patients received multidisciplinary therapeutic self-managed exercise instructions and then underwent evaluations 1 and 3 months after the treatment. We used the Pain Disability Short Form-36 (SF-36), Pain Catastrophizing Scale (PCS), and Pain Disability Assessment Scale (PDAS) to evaluate QOL. Although the pain levels were the same before and after the physical exercise program, the patients showed significant improvements in physical function on the SF-36 (48.5 vs. 54.5, 3 months vs. 1 month; p=0.0124), the magnification subscale on the PCS (6.8 vs. 5.9, 1 month vs. before; p=0.0164) and the PDAS (29.2 vs. 23.4, 3 months vs. before; p=0.0055). Chronic pain should be treated with a biopsychosocial approach, but time constraints and costs have limited the implementation of multidisciplinary and behavioral approaches to chronic pain management. Our findings demonstrate that clinical improvements are possible for patients with chronic pain, using multidisciplinary team resources widely available in Japanese clinical practice.

DOI： 10.18926/AMO/56169

濃縮脂肪由来抽出液によるOAモデルラットの軟骨破壊抑制とその機序の解明

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 木曽洋平, 沖田駿治, 渡辺雅仁, 松橋美波, 尾崎敏文

日本整形外科学会雑誌 92 ( 8 ) S2018 - S2018 2018.8

超音波診療の進歩のための基礎研究超音波3D評価

中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 92 ( 8 ) S1712 - S1712 2018.8

LT-α刺激による軟骨細胞由来RANKLの発現亢進と破骨細胞分化促進効果

竹下歩, 西田圭一郎, 那須義久, 中原龍一, 兼田大輔, 大橋秀基

日本整形外科学会雑誌 92 ( 8 ) S1659 - S1659 2018.8

高度の緩みを有する人工肘関節周囲骨折に対して骨接合術を施行した1例

沖田駿治, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

岡山医学会雑誌 130 ( 2 ) 99 - 99 2018.8

関節リウマチ下肢手術において止血帯が無効であった症例の検討

原田遼三, 西田圭一郎, 那須義久, 棗田将光, 藤森美鈴, 高杉幸司, 斎藤大輔, 江澤和彦, 竹本美由紀, 藤田慎一朗, 山本渉

岡山医学会雑誌 130 ( 2 ) 99 - 99 2018.8

関節リウマチにおける手指・手関節の超音波PDスコアと関節破壊の関連

沖田駿治, 中原龍一, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 那須義久, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 92 ( 8 ) S2052 - S2052 2018.8

リウマチ性疾患治療中に発症し診断に難渋した手指屈筋腱腱鞘滑膜炎の3例

沖田駿治, 那須義久, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 中原龍一, 西田圭一郎, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 41回 126 - 126 2018.7

関節リウマチ前足部手術における術式別のTUGおよびJSSF-RA scaleの検討とX線学的解析

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 大橋秀基, 木曽洋平, 沖田駿治, 松橋美波, 尾崎敏文

関節の外科 45 ( 2 ) 96 - 96 2018.7

生物学的製剤使用下における上肢手術〜現状と今後の展望〜生物学的製剤使用下の関節リウマチ手関節・手指手術の傾向

那須義久, 西田圭一郎

関節の外科 45 ( 2 ) 38 - 38 2018.7

The role of lymphotoxin-α in rheumatoid arthritis

Tomohiro Hirose, Yuri Fukuma, Ayumu Takeshita, Keiichiro Nishida

Inflammation Research 67 ( 6 ) 495 - 501 2018.6

Language：English Publisher：Birkhauser Verlag AG

Background: The role of tumor necrosis factor (TNF) in the inflammatory response in rheumatoid arthritis (RA) is well established, whereas less is known about the role of TNF’s close homolog, lymphotoxin alpha (LTα). Findings: Increased levels of LTα are found in the serum and synovial tissue of patients with RA, and in vitro studies found that LTα-induced proliferation of RA fibroblast-like synoviocytes was at a similar level to TNF. These findings support the idea that anti-LTα treatment could be beneficial in patients with RA, but pateclizumab, an anti-LTα antibody, was not as efficacious as the anti-TNF agent adalimumab in reducing symptoms of RA in a head-to-head study, suggesting that anti-LTα therapies might not represent a valid alternative treatment option in patients with RA. However, suppression of LTα activity might be relevant in the context of RA-related comorbidities, as patients with RA have an increased risk of myocardial infarction (MI) compared with the general population, and specific polymorphisms of the LTα gene have been linked to increased MI risk. Conclusions: In this review, we summarize the key characteristics of LTα and the most recent findings on the role of LTα in RA.

DOI： 10.1007/s00011-018-1139-6

SETTING TREATMENT TARGET FOR JOINT SURGERY IN LOWER LIMBS IN PATIENTS WITH LONG-STANDING RHEUMATOID ARTHRITIS BASED ON MULTICENTER PROSPECTIVE COHORT STUDY; VALIDATION AND RELIABILITY OF OBJECTIVE INDEX OF ACTIVITY SPEED, TIMED UP AND GO TEST, FOR MEASURI

Kojima T, Ishikawa H, Tanaka S, Haga N, Nishida K, Yukioka M, Hashimoto J, Miyahara H, Niki Y, Kimura T, Oda H, Funahashi K, Asai S, Kojima M, Ishiguro N

ANNALS OF THE RHEUMATIC DISEASES 77 1333-1334 2018.6

Characteristics of functional impairment in patients with long-standing rheumatoid arthritis based on range of motion of joints: Baseline data from a multicenter prospective observational cohort study to evaluate the effectiveness of joint surgery in the treat-to-target era Reviewed

Toshihisa Kojima, Hajime Ishikawa, Sakae Tanaka, Nobuhiko Haga, Keiichiro Nishida, Masao Yukioka, Jun Hashimoto, Hisaaki Miyahara, Yasuo Niki, Tomoatsu Kimura, Hiromi Oda, Shuji Asai, Koji Funahashi, Masayo Kojima, Naoki Ishiguro

Modern Rheumatology 28 ( 3 ) 474 - 481 2018.5

Language：English Publishing type：Research paper (scientific journal) Publisher：Taylor and Francis Ltd

Objective: To explore the characteristics of functional impairment in patients with established rheumatoid arthritis (RA) based on the range of motion (ROM) of joints in a prospective observational study of RA patients undergoing joint surgery. Methods: We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and the ROM of large joints including the shoulder, elbow, wrist, hip, knee, and ankle. Associations between the ROM of each joint and disability in the eight HAQ-DI categories were determined using receiver operating characteristic (ROC) and logistic regression analyses. ROM cut-off values of each joint for the absence of disability in each HAQ-DI category were determined using ROC curves. Results: A total of 460 patients were enrolled and analyzed in this study. Based on ROC analysis, the ROM of each joint was significantly associated with disability in each category. After adjusting for disease activity, age, and sex, shoulder abduction had the highest independent impact on disability in activity [cut-off: 139 degrees (OR: 5.26)], elbow flexion-extension in dressing [121 degrees (OR: 2.22)], wrist flexion-extension in reach [86 degrees (OR: 2.71)], hip flexion-extension in walking [126 degrees (OR: 3.42)], and knee flexion-extension in walking [134 degrees (OR: 2.97)]. Conclusions: Limited ROM of multiple joints was significantly associated with functional impairment in patients with long-standing RA. Motion in daily activity involves multiple joints, and at least two joints were independently involved in disability.

DOI： 10.1080/14397595.2017.1349593

IL-6 is an independent predictive factor of drug survival after dose escalation of infliximab in patients with rheumatoid arthritis Reviewed

Koji Takasugi, Keiichiro Nishida, Masamitsu Natsumeda, Misuzu Yamashita, Wataru Yamamoto, Kazuhiko Ezawa

Modern Rheumatology 28 ( 3 ) 452 - 460 2018.5

Language：English Publishing type：Research paper (scientific journal) Publisher：Taylor and Francis Ltd

Objective: We aimed to investigate factors predictive of increased serum infliximab (IFX) concentration with improvement of disease activity, as well as better 1-year continuation rate after dose escalation, in patients with rheumatoid arthritis (RA) who showed inadequate response to 3 mg/kg IFX. Methods: Among 42 patients allotted to receive 3 mg/kg IFX, 13 patients showed adequate response (DAS28 &lt
3.2) and 29 patients required dose escalation to 4.5 or 6 mg/kg after inadequate response (DAS28 ≥ 3.2) to 3 mg/kg IFX. DAS28, mHAQ, serum level of CRP, interleukin (IL)-6, IL-17, anti-infliximab antibody (AIA) titers and IFX concentration before and on average 2.7 months after dose escalation were examined to explore the baseline factors predictive of a clinically beneficial increase of serum IFX concentration and drug survival. Results: One year after IFX dose escalation, 25 patients completed the study protocol, and 16 patients (64%) continued to show a good response for one year, while 9 patients (36%) required switching of biologics because of inadequate response. Multivariate analyses revealed that a serum IL-6 level of less than 4.0 pg/mL at baseline was the only factor predictive of a clinically beneficial increase of serum IFX concentration in patients who required dose escalation. Receiver operating characteristic analysis revealed that 5.16 pg/mL of IL-6 was the cut-off value with sensitivity 0.833 and specificity of 0.769 (95%CI for AUC: 0.712–1.006). In patients with IL-6 levels of less than 5.16 pg/mL at baseline, the serum IFX concentration significantly increased after dose escalation with adequate response. The 1-year drug survival rates of patients with IL-6 levels less than 5.16 pg/mL and in those with levels greater than or equal to 5.16 pg/mL at baseline were 83.3% and 30.8%, respectively (log-rank test, p =.011). Conclusions: The results of our study indicated that a baseline serum level of IL-6 below 5.16 pg/mL might be a predictive factor for a clinically beneficial increase of serum IFX concentration with improvement of disease activity and better 1-year continuation rate after IFX dose escalation.

DOI： 10.1080/14397595.2017.1361802

関節リウマチ患者のボディイメージに対する手術治療の影響

堀田昌宏, 西田圭一郎, 那須義久, 中原龍一, 林充, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 55 ( 特別号 ) 2 - 5 2018.5

RAにおける大関節破壊の予測と評価関節リウマチの罹病期間・疾患活動性と関節破壊 modified Total Sharp ScoreとARASHI score

那須義久, 橋詰謙三, 西田圭一郎

日本整形外科学会雑誌 92 ( 5 ) 364 - 368 2018.5

Language：Japanese Publisher：(公社)日本整形外科学会

生物学的製剤を投与中で、1年以上の間隔をあけて評価に必要な単純X線画像および臨床評価が得られた75例(平均62.6歳)を対象とした。調査期間中の大関節破壊の進行と患者背景との関係を調査するために、ARASHI change score(ACS)を大関節破壊進行群(ACS>0群)と非進行/改善群(ACS≦0群)の2群にわけて比較した。調査期間中、対象のCRP、modified Health assessment questionnaire(mHAQ)、DAS28-CRP、modified Total Sharp Score(mTSS)の平均値に有意な変化はなかった。調査開始時の平均mTSSとASSは、大関節と小関節の破壊の程度と有意な相関があった。ASSはDAS28-CRPなどの疾患活動性とは弱い有意な正の相関があった。最終調査時迄の変化はΔmTSSが平均2.25±9.93、ARASHI change score(ACS)が平均0.03±2.30であった。ACSで評価した大関節破壊の進行は16例(21.3%)に認めた。ACSはΔDAS28-CRP、ΔmHAQと有意な相関を示し、ACS>0群はACS≦0群よりも有意にΔDAS28-CRP、ΔCRP、ΔmHAQが高かった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01133&link_issn=&doc_id=20180607020002&doc_link_id=%2Ffj2ortho%2F2018%2F009205%2F003%2F0364-0368%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffj2ortho%2F2018%2F009205%2F003%2F0364-0368%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

サルコイドーシスの関節病変に対して外科的治療を行なった2例

松橋美波, 那須義久, 渡辺雅仁, 斎藤太一, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 35 ( 1 ) S774 - S774 2018.4

RAに対する手関節部分固定術の中・長期治療成績

竹下歩, 西田圭一郎, 島村安則, 那須義久, 斎藤太一, 中道亮, 沖田駿治, 尾崎敏文

日本手外科学会雑誌 35 ( 1 ) S220 - S220 2018.4

Dupuytren拘縮の術後成績

斎藤太一, 島村安則, 中道亮, 竹下歩, 沖田駿治, 松橋美波, 岡崎勇樹, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 35 ( 1 ) S147 - S147 2018.4

【運動器画像診療の最前線】部位別・疾患別画像診療の最前線関節リウマチの画像診療

中原龍一, 西田圭一郎

関節外科 37 ( 4月増刊 ) 106 - 119 2018.4

Language：Japanese Publisher：(株)メジカルビュー社

＜画像診療のポイント＞●関節リウマチ診療においては、それぞれの画像検査の特徴と使いどころを知ることが重要である。●単純X線検査は最も基本的な画像検査であり、定期的に撮影すれば微小な変化の検出に役立つ。●MRIは骨髄浮腫や滑膜炎の診断が可能であるが、コストが高く造影剤投与が必要であるため、超音波検査との使い分けが必要である。●超音波検査は近年注目されている画像検査であり、外来で簡便に関節評価が可能であるため、使い方に習熟すべきである。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00282&link_issn=&doc_id=20180406150011&doc_link_id=10.18885%2FJ00282.2018192549&url=https%3A%2F%2Fdoi.org%2F10.18885%2FJ00282.2018192549&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Outcomes of Resection and Joint-Preserving Arthroplasty for Forefoot Deformities for Rheumatoid Arthritis Reviewed

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

Foot and Ankle International 39 ( 3 ) 292 - 299 2018.3

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications Inc.

Background: We investigated the clinical outcomes of resection and joint-preserving arthroplasty for forefoot deformities in patients with rheumatoid arthritis. Methods: Sixteen feet of 14 women (average age, 67.1 years
range, 53-82) underwent resection arthroplasty of the metatarsal head (resection group), and 18 feet of 15 women (average age, 61.3 years
range, 40-73) underwent a metatarsophalangeal joint-preserving procedure with shortening oblique metatarsal osteotomies of the lesser toes (joint preservation group). The mean disease duration in the resection and joint preservation groups was 23.6 and 19.1 years, and the average follow-up period was 37.3 and 33.5 months, respectively. The classification of Larsen was used to assess the severity of destruction of the metatarsophalangeal (MTP) joint. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) score and postoperative complications. Results: The number of preoperative radiographic destruction of the MTP joints (Larsen grade II, III, IV, and V) was 0, 29, 39, and 12 joints in the resection group and 13, 67, 9, and 1 joints in the joint preservation group. The mean JSSF score improved significantly from 61.3 to 83.9 points in the resection group (P &lt
.001) and from 62.2 to 90.8 points in the joint preservation group (P &lt
.001). In the resection group, recurrence of callosities and claw toe deformity was observed in 6 and 3 feet, respectively. In the joint-preserving group, recurrence of callosities and hammer toe deformity was observed in 1 foot each. Conclusion: The resection arthroplasty and joint-preserving procedure showed satisfactory clinical outcomes. However, whether both procedures can maintain the good clinical results without the recurrence of forefoot deformity will require longer follow-up. Level of Evidence: Level III, retrospective comparative series.

DOI： 10.1177/1071100717743996

関節リウマチの手術4:上肢・その他関節リウマチによる手指伸筋腱断裂症例の患者背景近年の傾向と薬物療法との関係

那須義久, 渡辺雅仁, 木曽洋平, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 586 - 586 2018.3

関節リウマチ肘に対するLinked人工肘関節(PROSNAP)の臨床成績の検討

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 734 - 734 2018.3

関節リウマチに対するMCP関節人工関節置換術中に手関節部での腱剥離術を要した症例の検討

木曽洋平, 那須義久, 渡辺雅仁, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 729 - 729 2018.3

関節リウマチ患者におけるTimed UP and GO(TUG)testを用いた下肢機能、QOLの検討

原田遼三, 西田圭一郎, 那須義久, 中原龍一, 江澤和彦, 高杉幸司, 藤森美鈴, 藤田慎一朗, 井上貴絵, 山本渉

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 710 - 710 2018.3

関節リウマチの手術4:上肢・その他関節リウマチの手術が患者のボディイメージに与える影響

小橋靖子, 西田圭一郎, 堀田昌宏, 那須義久, 橋詰謙三, 中原龍一, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 587 - 587 2018.3

関節リウマチの手術4:上肢・その他短母指伸筋腱の停止様式と母指ボタン穴変形との関連について

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 586 - 586 2018.3

術後早期に復職できたが機能回復には長期間を要したRA患者の一症例

松山宜之, 坂口和輝, 鍋倉由佳, 小川加苗, 藤岡晃, 岡佳純, 堅山佳美, 西田圭一郎, 千田益生

作業療法おかやま 27 54 - 54 2018.3

リウマチ性疾患の画像1:関節エコーRA 動画画像を教師画像とした深層学習を用いた関節リウマチ患者の超音波画像自動分類

中原龍一, 西田圭一郎, 木曽洋平, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 455 - 455 2018.3

リウマチ上肢のリハビリと手術〜真の寛解を目指して〜リウマチ上肢のリハビリと手術人工肘関節置換術で社会的・精神的寛解をえられるか

西田圭一郎, 那須義久, 小橋靖子, 橋詰謙三, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 231 - 231 2018.3

関節リウマチ患者のQOL向上を目指した薬物・手術のcombined therapy 疾患活動性からみた整形外科手術が患者Body Imageに与える影響

西田圭一郎, 小橋靖子, 堀田昌宏, 那須義久, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 220 - 220 2018.3

単純X線足荷重位正面像における外側趾MTP関節背側脱臼の重症度スコア

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 木曽洋平, 沖田駿治, 渡辺雅仁, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1169 - S1169 2018.3

関節リウマチに対する手術加療の傾向初回手術例の患者背景

那須義久, 渡辺雅仁, 沖田駿治, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1041 - S1041 2018.3

関節リウマチ前足部手術における術式別のTUGおよびJSSF-RA scaleの検討

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 大橋秀基, 木曽洋平, 沖田駿治, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1028 - S1028 2018.3

関節リウマチ診療における超音波多関節評価・検査時間の短縮の研究

中原龍一, 西田圭一郎, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 那須義久, 尾崎敏文

日本整形外科学会雑誌 92 ( 2 ) S313 - S313 2018.3

短母指伸筋腱の停止様式が母指ボタン穴変形発症に与える影響

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 92 ( 2 ) S175 - S175 2018.3

アバタセプトは関節リウマチにおける周術期合併症を増やすか多施設コホート研究に基づく入れ子型ケースコントロール研究より

伊藤宣, 辻成佳, 中山政憲, 持田勇一, 西田圭一郎, 石川肇, 小嶋俊久, 松本卓巳, 窪田綾子, 望月猛, 桃原茂樹

日本整形外科学会雑誌 92 ( 3 ) S595 - S595 2018.3

関節リウマチの自己血輸血関節リウマチに対する整形外科手術施行時の術前Hb値と疾患活動性、使用薬剤との関係

那須義久, 西田圭一郎

自己血輸血 31 ( 学術総会 ) S32 - S32 2018.2

The clinical course of patients with rheumatoid arthritis who underwent orthopaedic surgeries under disease control by tofacitinib. Reviewed International journal

Nishida K, Harada R, Nasu Y, Takeshita A, Nakahara R, Matsumeda M, Ozaki T

Modern rheumatology 28 ( 6 ) 1 - 8 2018.1

Identification of specific protein markers of rheumatoid arthritis in synovial fluid and serum Reviewed

Keisuke Mihara, Sayuki Kohno, Shiho Hatanaka, Tsutomu Yamasaki, Kei-Ichiro Nishida, Tohru Nakanishi

Journal of Hard Tissue Biology 27 ( 1 ) 55 - 58 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Society of Hard Tissue Regenerative Biology

Rheumatoid arthritis (RA) is a common articular disease characterized by chronic inf lammation, hyperproliferation of synovial cells, and bone destruction. Recently, we showed that small interfering RNA targeting CD81 (siCD81) is therapeutically effective for RA. CD81 belongs to a family of cell-surface proteins (tetraspanins) known to be up-regulated in RA synoviocytes, and siCD81 decreases the expression of synoviolin and TNF-α at the cellular level. We also previously established a highly sensitive sandwich ELISA system using monoclonal antibodies (MAbs) against CD81 by immunization with the outer membrane region of CD81 (LEL), which was overexpressed as a recombinant protein. This assay can be used to detect CD81 in synovial fluids and serum. Here, we identified several specific marker proteins and peptides for diagnosis of RA, including CD81 by using a protein chip system, 2D-gels, and western blotting. These markers can be used for early diagnosis of RA and might contribute to further effective treatment.

DOI： 10.2485/jhtb.27.55

Mast Cells Exhibiting Strong Cytoplasmic Staining for IgE and High Affinity IgE Receptor are Increased in IgG4-Related Disease. Reviewed International journal

Kenji Nishida, Yuka Gion, Mai Takeuchi, Takehiro Tanaka, Tatsuki R Kataoka, Tadashi Yoshino, Yasuharu Sato

Scientific reports 8 ( 1 ) 4656 - 4656 2018

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

Immunoglobulin G4 (IgG4)-related disease is characterized by elevated serum IgG4 levels and increased numbers of IgG4-positive cells. However, its pathogenesis is not fully understood. We previously suggested that mast cells may play an important role in IgG4-related disease. In this study, we confirmed the characteristics of mast cells in IgG4-related lymphadenopathy by using immunohistochemistry and dual immunofluorescence. We analyzed 23 cases of IgG4-related lymphadenopathy and compared them with 23 cases of non-specific lymphoid hyperplasia. The majority of patients with IgG4-related lymphadenopathy had cervical lesions with involvement of other organs. Immunohistologically, mast cells with strong cytoplasmic staining for immunoglobulin E and high affinity immunoglobulin E receptor were significantly increased in IgG4-related lymphadenopathy as compared to those in non-specific lymphoid hyperplasia (mean: 3.83 ± 3.99 cells per high power field and 7.14 ± 8.21 cells per high power field, respectively; P = 0.007 and P = 0.011). In addition, dual immunofluorescence assay showed that immunoglobulin E and high affinity immunoglobulin E receptor staining exhibited a cytoplasmic granular pattern in IgG4-related lymphadenopathy, suggesting internalization of the antibodies and receptors. Our findings showed that mast cell activation might be involved in the pathogenesis of IgG4-related disease.

DOI： 10.1038/s41598-018-23043-9.

Target setting for lower limb joint surgery using the Timed Up and Go test in patients with rheumatoid arthritis: A prospective cohort study

Kojima, T., Ishikawa, H., Tanaka, S., Haga, N., Nishida, K., Yukioka, M., Hashimoto, J., Miyahara, H., Niki, Y., Kimura, T., Oda, H., Asai, S., Funahashi, K., Kojima, M., Ishiguro, N.

International Journal of Rheumatic Diseases 21 ( 10 ) 2018

Mid-term results of alumina ceramic unlinked total elbow arthroplasty with cement fixation for patients with rheumatoid arthritis

Nishida, K., Hashizume, K., Nasu, Y., Ozawa, M., Fujiwara, K., Inoue, H., Ozaki, T.

Bone and Joint Journal 100B ( 8 ) 2018

Inhibitory effect of JAK inhibitor on mechanical stress-induced protease expression by human articular chondrocytes Reviewed

Takahiro Machida, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Masatsugu Ozawa, Ryozo Harada, Masahiro Horita, Ayumu Takeshita, Daisuke Kaneda, Aki Yoshida, Toshifumi Ozaki

INFLAMMATION RESEARCH 66 ( 11 ) 999 - 1009 2017.11

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

To investigate whether janus kinase (JAK) inhibitor exhibits a chondro-protective effect against mechanical stress-induced expression of a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) and matrix metalloproteinase (MMPs) in human chondrocytes.
Normal human articular chondrocytes were seeded onto stretch chambers and incubated with or without tofacitinib (1000 nM) for 12 h before mechanical stimulation or cytokine stimulation. Uni-axial cyclic tensile strain (CTS) (0.5 Hz, 10% elongation, 30 min) was applied and the gene expression levels of type II collagen alpha 1 chain (COL2A1), aggrecan (ACAN), ADAMTS4, ADAMTS5, MMP13, and runt-related transcription factor 2 (RUNX-2) were examined by real-time polymerase chain reaction. Nuclear translocation of RUNX-2 and nuclear factor-kappa B (NF-kappa B) was examined by immunocytochemistry, and phosphorylation of mitogen-activated protein kinase (MAPK) and signaling transducer and activator of transcription (STAT) 3 was examined by western blotting. The concentration of interleukin (IL)-1 beta, IL-6, and tumor necrosis factor-alpha in the supernatant was examined by enzyme-linked immunosorbent assay.
COL2A1 and ACAN gene expression levels were decreased by CTS, but these catabolic effects were canceled by tofacitinib. Tofacitinib significantly down-regulated CTS-induced expression of ADAMTS4, ADAMTS5, MMP13, and RUNX2, and the release of IL-6 in supernatant by chondrocytes. Tofacitinib also reduced CTS-induced nuclear translocation of RUNX-2 and NF-kappa B, and phosphorylation of MAPK and STAT3.
Tofacitinib suppressed mechanical stress-induced expression of ADAMTS4, ADAMTS5, and MMP13 by human chondrocytes through inhibition of the JAK/STAT and MAPK cascades.

DOI： 10.1007/s00011-017-1083-x

Integrating patients' perceptions into clinical practice guidelines for the management of rheumatoid arthritis in Japan. Reviewed International journal

Masayo Kojima, Takeo Nakayama, Takashi Otani, Mieko Hasegawa, 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, Nobuyuki Miyasaka, Hisashi Yamanaka

Modern rheumatology 27 ( 6 ) 924 - 929 2017.11

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

OBJECTIVE: Patients' values and preferences are among the key factors that determine the strength of recommendations presented in clinical practice guidelines (CPG). The aim of this study was to summarize the integration process for patients' perceptions into the development of CPG for rheumatoid arthritis (RA) management in Japan. METHODS: We used a mixed-methods approach. Questionnaires that could be self-administered were mailed to 2222 RA patients randomly selected from the Japan Rheumatism Friendship Association (JRFA) membership list that was age- and prefecture-stratified. A focus group with five JRFA executive members was formed to verify the results of the questionnaire. RESULTS: A total of 1470 patients aged 20-79 years old returned the questionnaire. Analysis of the questionnaire data revealed that the topics selected by the CPG task force met the patients' needs. The focus group participants showed reluctance to use the term 'preference' because patients would not want to take any medications but would have to take them out of necessity. CONCLUSIONS: We confirmed that the new CPG successfully addressed clinical issues that were important to both rheumatologists and patients. Clinicians should understand patients' reluctance to take medications and explain the role of each medication well to increase adherence.

DOI： 10.1080/14397595.2016.1276511

Rasch分析を用いたRA患者における上肢機能評価の検討

原田遼三, 西田圭一郎, 那須義久, 中原龍一, 兼田大輔, 竹下歩, 大橋秀基, 木曾洋平, 沖田駿治, 渡辺雅仁, 高杉幸司, 藤森美鈴, 江澤和彦

日本関節病学会誌 36 ( 3 ) 263 - 263 2017.10

関節リウマチ肘に対するlinked人工肘関節(PROSNAP)の治療成績の検討

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 367 - 367 2017.10

深層学習を用いた関節リウマチ患者の超音波画像分類における動画データ利用

中原龍一, 西田圭一郎, 木曽洋平, 大橋秀樹, 兼田大輔, 竹下歩, 那須義久, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 366 - 366 2017.10

関節リウマチ新時代の手術療法 50歳未満のRA患者に対する人工肘関節全置換術

西田圭一郎, 沖田駿治, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 大橋秀基, 木曽洋平, 尾崎敏文, 橋詰謙三

日本関節病学会誌 36 ( 3 ) 362 - 362 2017.10

中足骨遠位斜め骨切り短縮術を行った関節リウマチ外側趾のX線学的経時変化

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 木曽洋平, 沖田駿治, 渡辺雅仁, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 360 - 360 2017.10

関節リウマチ前足部手術における足長変化に関する検討

木曽洋平, 那須義久, 渡辺雅仁, 沖田瞬治, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 雑賀健多, 西田圭一郎, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 359 - 359 2017.10

関節リウマチ前足部変形における外側趾中足骨短縮骨切りが外反母趾角に与える影響

那須義久, 渡辺雅仁, 木曽洋平, 沖田駿治, 大橋基広, 兼田大輔, 竹下歩, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 358 - 358 2017.10

外側型肘離断性骨軟骨炎に対する膝外側壁を含む骨軟骨柱移植術

島村安則, 内野崇彦, 名越充, 島村好信, 中道亮, 野田知之, 西田圭一郎, 尾崎敏文

日本肩関節学会抄録集 44回 161 - 161 2017.10

関節リウマチ治療手術のタイミングと工夫リウマチ肘関節に対する人工関節置換術の適応とインプラント選択

那須義久, 西田圭一郎, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 秋季学会 ) 55 - 55 2017.9

RA軟骨におけるRANKL発現とその誘導因子の検討

竹下歩, 西田圭一郎, 那須義久, 中原龍一, 兼田大輔, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1515 - S1515 2017.8

軟骨細胞によるIL-1β誘導性蛋白分解酵素発現に対する脂肪由来抽出液の影響

大橋秀基, 那須義久, 竹下歩, 兼田大輔, 木曽洋平, 沖田駿治, 渡辺雅仁, 中原龍一, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1758 - S1758 2017.8

メカニカルストレスによる軟骨細胞におけるRANKLの発現

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 大橋秀基, 沖田駿治, 木曽洋平, 渡辺雅仁, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1617 - S1617 2017.8

軟骨分化制御による骨棘形成過程へのADAM12の関与

堀田昌宏, 西田圭一郎, 長谷井嬢, 古松毅之, 宮澤慎一, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1597 - S1597 2017.8

深層学習を用いた自動学習に必要な教師画像数の検討関節リウマチ患者の単純X線画像の自動学習

中原龍一, 西田圭一郎, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 那須義久, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1550 - S1550 2017.8

関節リウマチ患者のボディイメージに対する手術治療の影響

堀田昌宏, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 林充, 尾崎敏文

関節の外科 44 ( 2 ) 67 - 67 2017.7

足関節・足部最良の機能再建とQOL向上を目指して関節リウマチ前足部手術における足長変化に関する検討

木曽洋平, 那須義久, 渡辺雅仁, 沖田駿治, 大橋秀基, 竹下歩, 兼田大輔, 堀田昌宏, 中原龍一, 雑賀健多, 西田圭一郎, 尾崎敏文

関節の外科 44 ( 2 ) 36 - 36 2017.7

空気圧迫止血帯が無効であった関節リウマチ下肢手術の2例

原田遼三, 西田圭一郎, 那須義久, 棗田将光, 藤森美鈴, 高杉幸司, 江澤和彦

関節の外科 44 ( 2 ) 79 - 79 2017.7

Clinicopathological analysis of methotrexate-associated lymphoproliferative disorders: Comparison of diffuse large B-cell lymphoma and classical Hodgkin lymphoma types Reviewed

Yuka Gion, Noriko Iwaki, Katsuyoshi Takata, Mai Takeuchi, Keiichiro Nishida, Yorihisa Orita, Tomoyasu Tachibana, Tadashi Yoshino, Yasuharu Sato

Cancer Science 108 ( 6 ) 1271 - 1280 2017.6

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

Patients with rheumatoid arthritis often develop methotrexate-associated lymphoproliferative disorders (MTX-LPD) during MTX treatment. MTX-LPD occasionally regresses spontaneously after simply discontinuing MTX treatment. In patients without spontaneous regression, additional chemotherapy is required to avoid disease progression. However, the differences between spontaneous and non-spontaneous regression have yet to be elucidated. To clarify the factors important for spontaneous regression, we analyzed the clinicopathological features of 51 patients with rheumatoid arthritis who developed MTX-LPD (diffuse large B-cell lymphoma [DLBCL]-type [n = 34] and classical Hodgkin lymphoma [CHL]-type [n = 17]). We examined the interval from MTX discontinuation to the administration of additional chemotherapy. The majority of DLBCL-type MTX-LPD patients (81%) exhibited remission with MTX discontinuation alone. In contrast, the majority of CHL-type MTX-LPD patients (76%) required additional chemotherapy. This difference was statistically significant (P = 0.001). However, overall survival was not significantly different between DLBCL-type and CHL-type (91% vs 94%, respectively
P &gt
0.05). Thus, the morphological differences in the pathological findings of MTX-LPD may be a factor for spontaneous or non-spontaneous regression after discontinuation of MTX.

DOI： 10.1111/cas.13249

関節リウマチの痛みと治療アプローチ

西田圭一郎, 小橋靖子, 鉄永倫子

Journal of Musculoskeletal Pain Research 9 ( 1 ) 7 - 14 2017.6

Language：Japanese Publisher：(一社)日本運動器疼痛学会

関節リウマチ(RA)の治療は生物学的製剤の導入と新しい治療戦略により、過去14年で大きく変化した。近代のリウマチ治療は局所あるいは全身性の炎症抑制に傾注してきたが、一方で患者による全般的疾患活動性評価は、しばしば寛解達成のための障害因子であり、疼痛が最も影響を与える因子であることが知られている。RAにおける疼痛は炎症や、末梢性および中枢性の疼痛感作、抑うつ、関節の構造的変化など様々な機序によって引き起こされる。これらは疾患経過や炎症の沈静化と再燃、あるいは個人によって異なるが、それぞれに応じた適切な治療を選択しなければならない。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05881&link_issn=&doc_id=20170707070001&doc_link_id=%2Feg5undok%2F2017%2F000901%2F004%2F0007-0014%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feg5undok%2F2017%2F000901%2F004%2F0007-0014%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Short-term outcomes of patients being treated for chronic intractable pain at a liaison clinic and exacerbating factors of prolonged pain after treatment Reviewed

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

JOURNAL OF ORTHOPAEDIC SCIENCE 22 ( 3 ) 554 - 559 2017.5

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

Background: Although a multidisciplinary approach is often recommended to treat intractable pain, this approach does not completely prevent uncontrolled pain in some patients. The aim of this retrospective study was to investigate the exacerbating factors of prolonged, intractable pain among patients being treated at a pain liaison clinic.
Methods: The participants of this study were 94 outpatients (32 men, 62 women) with chronic intractable pain who visited our hospital between April 2013 and February 2015. Demographic and clinical information was obtained from all patients at baseline. Experts in various fields, including anesthesia, orthopedic surgery, psychiatry, physical therapy, and nursing, were involved in the treatment procedures. All patients were assessed before and after a 6-month treatment period using the following measures: the Numeric Rating Scale (NRS); the Pain Catastrophizing Scale (PCS); the Hospital Anxiety and Depression Scale (HADS); the Pain Disability Assessment Scale (PDAS); and the Oswestry Disability Index (ODI). All participants were then divided into two groups based on their self-reported pain after treatment: a pain relief group (n = 70) and a prolonged pain group (n = 24). The exacerbating factors of prolonged pain after treatment in the pain liaison outpatient clinic were analyzed using univariate and multiple logistic regression analysis.
Results: A significant improvement in NRS scores was observed after the 6-month follow-up period. After treatment, 24 (25.5%) of the 94 patients reported having prolonged pain. Significant improvements were seen in the PCS, PDAS, and ODI scores in the pain relief group, and in the HADS depression scores in the prolonged pain group. On univariate and multiple regression analysis, HADS depression scores were identified as a factor related to prolonged pain after treatment.
Conclusions: The results of the present study suggest that severe depression at the initial visit to the liaison outpatient clinic was an exacerbating factor for prolonged pain after treatment. (C) 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.jos.2017.01.004

Sauve-Kapandji法術後掌屈可動域減少例の検討

竹下歩, 西田圭一郎, 島村安則, 那須義久, 尾崎敏文

日本手外科学会雑誌 34 ( 1 ) S415 - S415 2017.4

RAにおける手関節形成術の検討

竹下歩, 西田圭一郎, 那須義久, 中原龍一, 町田崇博, 堀田昌宏, 兼田大輔, 尾崎敏文

岡山医学会雑誌 129 ( 1 ) 65 - 65 2017.4

関節リウマチ患者の前足部変形に対する切除関節形成術と関節温存手術の治療成績の比較

堀田昌宏, 雑賀建多, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一

中国・四国整形外科学会雑誌 29 ( 1 ) 157 - 157 2017.4

Denosumab and alendronate treatment in patients with back pain due to fresh osteoporotic vertebral fractures Reviewed

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

JOURNAL OF ORTHOPAEDIC SCIENCE 22 ( 2 ) 230 - 236 2017.3

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

Introduction: Denosumab specifically inhibits the receptor activator for nuclear factor-kappa B ligand (RANKL), and prevents osteoporotic fractures. Several reports have analyzed the effects of denosumab and alendronate alone on bone mineral density (BMD) or reduction of fracture risk. The objective of this study was to analyze the effects of antiresorptive osteoporosis pharmacotherapy on pain relief in patients with fresh vertebral fracture.
Methods: This retrospective, single-center study included 80 patients (10 males, 70 females) with fresh osteoporotic vertebral fractures treated using denosumab at a dose of 60 mg subcutaneously every 6 months (40 patients) or alendronate at a dose of 35 mg orally every week (40 patients) for 6 months in our hospital. The mean age of subjects was 77 years (range, 55-92 years). The primary outcome was duration of back pain. Secondary outcomes included changes in BMD, serum type 1 collagen cross-linked N-telopeptide (NTX), and serum N-terminal propeptide of type 1 collagen (P1NP) from baseline to 6 months. Pain catastrophizing due to back pain was assessed using the Pain Catastrophizing Scale (PCS). The incidences of further vertebral fracture and adverse events were also assessed.
Results: Pain relief was obtained at a mean of 3.3 weeks with denosumab and 5.4 weeks with alendronate. Pain relief was achieved significantly earlier with denosumab than with alendronate. At 6 months, change in BMD was higher with denosumab (6.1%) than with alendronate (0.8%). No significant differences in changes in NTX and P1NP were observed between groups. Scores for PCS were significantly lower for denosumab than for alendronate. The incidence of further vertebral fractures was 5% with denosumab and 10% with alendronate. Adverse event rates were similar between groups.
Conclusions: Denosumab enabled earlier pain relief than alendronate and avoided catastrophizing in patients with osteoporotic vertebral fractures after 6 months of treatment. (C) 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.jos.2016.11.017

リウマチ性疾患に合併する感染症の対策と克服手術部位感染症とDMARDsの管理

那須義久, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 246 - 246 2017.3

関節リウマチ中後足部変形に対する選択的固定術の短・中期成績

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 兼田大輔, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S863 - S863 2017.3

SAFE-Qを用いた関節リウマチ足部手術成績の評価

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 雑賀建多, 堀田昌宏, 竹下歩, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S863 - S863 2017.3

関節リウマチ患者の前足部変形に対する切除関節形成術と関節温存手術の治療成績

堀田昌宏, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 雑賀建多, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S860 - S860 2017.3

関節リウマチ患者における足部障害の評価

吉村将秀, 雑賀建多, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S845 - S845 2017.3

関節リウマチの罹病期間・疾患活動性と関節破壊 modified Total Sharp ScoreとARASHI scoreの比較検討

那須義久, 橋詰謙三, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌弘, 中原龍一, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S712 - S712 2017.3

QOL向上を目指したRA薬物療法と手術療法の融合リウマチ患者のbody imageに対する手術治療の影響

西田圭一郎, 堀田昌宏, 那須義久, 中原龍一, 大橋秀基, 竹下歩, 兼田大輔, 沖田駿治, 尾崎敏文

日本整形外科学会雑誌 91 ( 2 ) S415 - S415 2017.3

トファシチニブ投与中に行った整形外科手術の周術期経過

竹下歩, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 兼田大輔, 大橋秀基, 沖田駿治, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 641 - 641 2017.3

リウマチ性疾患の画像深層学習を用いた関節リウマチ患者単純X線写真の骨びらん解析教師データの最適化

中原龍一, 西田圭一郎, 那須義久, 堀田昌宏, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 579 - 579 2017.3

RAの手術上肢 Patient-related elbow evaluation(PREE)によるRA人工肘関節置換術の臨床評価

原田遼三, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 兼田大輔, 大橋秀基, 沖田駿治, 棗田将光, 山下美鈴, 高杉幸司, 斎藤大輔, 江澤和彦, 藤田慎一朗, 竹本美由紀, 山本渉

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 539 - 539 2017.3

RAの手術上肢 50歳未満の比較的若年者に行った人工肘関節全置換術の臨床成績の検討

沖田駿治, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 538 - 538 2017.3

膠原病と妊娠関節リウマチ(RA)の手術が患者のボディイメージ(BI)に与える影響

小橋靖子, 西田圭一郎, 堀田昌宏, 那須義久, 橋詰謙三, 中原龍一, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 521 - 521 2017.3

RAの手術下肢 RA前足部手術における術式選択と治療成績の検討

兼田大輔, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 原田遼三, 町田崇博, 堀田昌宏, 竹下歩, 大橋秀基, 沖田駿治, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 501 - 501 2017.3

RAの手術下肢関節リウマチ(RA)患者における足部・足関節手術と抑うつ傾向の関係性

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 兼田大輔, 小橋靖子, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 501 - 501 2017.3

関節リウマチ診療における患者立脚型評価患者立脚型評価からみたRA手術の有用性

堀田昌宏, 西田圭一郎, 小橋靖子, 橋詰謙三, 那須義久, 中原龍一, 町田崇博, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 258 - 258 2017.3

膠原病・リウマチ性疾患の診療ガイドライン関節リウマチ診療ガイドライン JCR2014に基づく一般医向け診療ガイドラインの作成

山中寿, 伊藤宣, 遠藤平仁, 金子祐子, 川人豊, 岸本暢将, 小嶋俊久, 小嶋雅代, 瀬戸洋平, 中山健夫, 西田圭一郎, 平田信太郎, 松下功, 宮坂信之

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 237 - 237 2017.3

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.

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

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

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)

【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

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

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

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

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

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

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

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

メカニカルストレスに対するJAK阻害薬tofacitinibの軟骨破壊抑制効果

町田崇博, 西田圭一郎, 中原龍一, 那須義久, 斎藤太一, 堀田昌宏, 竹下歩, 兼田大輔, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1718 - S1718 2015.9

Postoperative complications in patients with rheumatoid arthritis using a biological agent - A systematic review and meta-analysis. Reviewed International journal

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

Modern rheumatology 25 ( 5 ) 672 - 8 2015.9

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

OBJECTIVES: To evaluate, through a systematic review of the literature, the association between the use of biological disease-modifying antirheumatic drugs (bDMARDs) and surgical site infection (SSI) or wound healing delay after orthopedic surgery in patients with rheumatoid arthritis (RA). METHODS: A systematic review of articles indexed in the Cochrane Library, PubMed, and Web of Science from 1992 to 2012 was performed. The search aimed to identify studies describing SSI or wound healing delay in patients with RA treated with or without bDMARDs. Articles fulfilling the predefined inclusion criteria were reviewed systematically and their quality was appraised. RESULTS: There was no Cochrane review on this subject. We found 75 articles through specific searches of PubMed and Web of Science, and hand searching. After inclusion and exclusion by full-text review, 10 articles were found for SSI, and 5 articles for delayed wound healing. The use of bDMARDs appeared to increase the rate of SSI slightly, especially in large joint-replacement surgery. Delayed wound healing was not increased by the use of bDMARDs. However, the definitions of SSI and delayed wound healing varied between the reviewed articles. Most of the articles focused on tumor necrosis factor-α inhibitors. CONCLUSION: bDMARDs slightly increase the relative risk of SSI but not that of delayed wound healing after orthopedic surgery and should be used with appropriate caution.

DOI： 10.3109/14397595.2015.1014302

キーンベック病に対する手術治療長期経過の1例

原田遼三, 島村安則, 井上円加, 小澤正嗣, 山川泰明, 柏原尚子, 雑賀建多, 魚谷弘二, 中原龍一, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 2 ) 379 - 379 2015.9

健常人の横隔神経伝導検査における左右差の検討

堅山佳美, 千田益生, 原田遼三, 上原健敬, 西田圭一郎, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 52 ( Suppl. ) S198 - S198 2015.5

Hyaluronan suppresses mechanical stress-induced expression of catabolic enzymes by human chondrocytes via inhibition of IL-1 beta production and subsequent NF-kappa B activation Reviewed

Masatsugu Ozawa, Keiichiro Nishida, Aki Yoshida, Taichi Saito, Ryozo Harada, Takahiro Machida, Toshifumi Ozaki

INFLAMMATION RESEARCH 64 ( 3-4 ) 243 - 252 2015.4

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

To investigate the inhibitory effect of hyaluronan (HA) on mechanical stress- induced expression of a disintegrin and metalloproteinase with thrombospondin type1 motifs (ADAMTS)-4, -5 and matrix metalloproteinase (MMP)-13 by human chondrocytes.
Normal human articular chondrocytes were pre-incubated with or without 1.0 mg/mL HA (2700 kDa) for 12 h at 37 A degrees C in stretch chambers, then they were exposed to uni-axial cyclic tensile strain (CTS, 0.5 Hz, 10 % elongation). The expression of ADAMTS-4, -5, and MMP-13 were analyzed by real-time polymerase chain reaction and Immunocytochemistry. The concentration of IL-1 beta in the supernatant was measured using enzyme-linked immunosorbent assay (ELISA). The nuclear translocation of runt-related transcription factor 2 (RUNX-2) and nuclear factor-kappa B (NF-kappa B) was examined by ELISA and immunocytochemistry, and phosphorylation of NF-kappa B was examined by western blotting.
HA inhibited mRNA expression of ADAMTS-4, -5, and MMP13 after 24 h CTS via inhibition of IL-1 beta secretion and NF-kappa B activation. However, HA failed to inhibit CTS-induced RUNX-2 expression and subsequent expression of ADAMTS-5 and MMP-13 1 h after CTS.
Our results demonstrated that HA significantly suppressed mechanical stress-induced expression of catabolic proteases by inhibition of the NF-kappa B-IL-1 beta pathway, but did not suppress mechanical stress-induced RUNX-2 signaling.

DOI： 10.1007/s00011-015-0804-2

関節リウマチ患者におけるARASHIスコアを用いた大関節破壊評価

元村拓, 松下功, 金子敦史, 神戸克明, 荒井勝光, 久我芳昭, 阿部麻美, 松本雄, 中川夏子, 西田圭一郎, 木村友厚

日本整形外科学会雑誌 89 ( 3 ) S568 - S568 2015.3

MRI of Rheumatoid Arthritis: Comparing the Outcome Measures in Rheumatology Clinical Trials (OMERACT) Scoring and Volume of Synovitis for the Assessment of Biologic Therapy Reviewed

Ryuichi Nakahara, Keiichiro Nishida, Kenzo Hashizume, Ryouzou Harada, Takahiro Machida, Masahiro Horita, Aiji Ohtsuka, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 69 ( 1 ) 29 - 35 2015.2

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

The outcome measures in rheumatology clinical trials (OMERACT) scores are the most mature quantitation system for rheumatoid arthritis (RA) on magnetic resonance imaging (MRI). Direct measuring techniques of synovial volume have been reported with good reproducibility, although few reports have demonstrated the changes of these measures in response to treatment. To assess these clinical responses, we evaluated the correlation of the changes of clinical activity score 28-joints disease activity score (DAS28-CRP) with the changes of OMERACT scores and with synovial volume measurements. Eight RA patients who were treated by biologic agents were examined with MRI of the dominant affected wrist and finger joints before and one year after the treatment. The total OMERACT score was reduced from 48.0 to 41.3, and synovial volume was reduced from 15.4 to 8.8 milliliters. Positive correlations were seen between the changes of DAS28-CRP and the changes of OMERACT synovitis score (r = 0.27), OMERACT total score (r = 0.43) and synovial volume (r = 0.30). Limited to synovium assessment, synovial volume showed a better correlation with DAS28-CRP than the OMERACT synovitis score. On the other hand, the OMERACT total score showed a higher correlation with DAS28-CRP than synovial volume, probably because the OMERACT total score includes scores for bone erosion and bone edema as well.

Tocilizumab, a humanized anti-IL-6R antibody, as an emerging therapeutic option for rheumatoid arthritis: Molecular and cellular mechanistic insights

Hashizume, M., Tan, S.-L., Takano, J., Ohsawa, K., Hasada, I., Hanasaki, A., Ito, I., Mihara, M., Nishida, K.

International Reviews of Immunology 34 ( 3 ) 2015

Analysis of Musculoskeletal Systems and Their Diseases. Pathology and treatment for injuries of the tendon and ligament

Furumatsu, T., Shimamura, Y., Nishida, K.

Clinical calcium 25 ( 8 ) 2015

Loss of SH3 domain-binding protein 2 function suppresses bone destruction in tumor necrosis factor-driven and collagen-induced arthritis in mice

Mukai, T., Gallant, R., Ishida, S., Kittaka, M., Yoshitaka, T., Fox, D.A., Morita, Y., Nishida, K., Rottapel, R., Ueki, Y.

Arthritis and Rheumatology 67 ( 3 ) 2015

関節リウマチ(RA)に対するSwansonとAVANTAによるMP人工指関節置換術の治療成績

原田遼三, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文, 西田圭一郎

日本関節病学会誌 33 ( 2 ) 175 - 182 2014.7

Language：Japanese Publisher：(一社)日本関節病学会

関節リウマチに対しSwansonおよびAVANTAインプラントを用いてMP人工指関節置換術を行い、半年以上経過観察し得た34例118指について治療成績を検討した。Swanson群は48指、AVANTA群は70指であった。治療成績として、MP関節可動域、握力、ピンチ力、health assessment questionnaire、Hand20、Disabilities of the Arm, Shoulder and Handを調査した。また、画像評価として、インプラント周囲の骨透亮像と硬化像を計測し、更に尺側偏位、破損等についても検討を行なった。その結果、術後の臨床成績においてAVANTA群が優れる傾向にあったが、明らかな有意差はなかった。インプラント破損をSwanson群の3指に認めたが、シリコンインプラントの耐久性として経過観察期間(Swanson群60.7±20.5ヵ月、AVANTA群21.3±9.1ヵ月)の影響が考えられた。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J05177&link_issn=&doc_id=20140813110010&doc_link_id=%2Ffd8kanse%2F2014%2F003302%2F011%2F0175-0182%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffd8kanse%2F2014%2F003302%2F011%2F0175-0182%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Short-term results of the PROSNAP linked elbow prosthesis with a snap-in structure and modular flange for the reconstruction of severely damaged rheumatoid elbows. International journal

Keiichiro Nishida, Kenzo Hashizume, Ryuichi Nakahara, Masatsugu Ozawa, Ryozo Harada, Takahiro Machida, Yoshihisa Nasu, Toshihumi Ozaki, Hajime Inoue

Journal of shoulder and elbow surgery 23 ( 6 ) 837 - 42 2014.6

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

BACKGROUND: We aimed to evaluate the early clinical results of the reconstruction of problematic elbow joints due to rheumatoid arthritis (RA) using a PROSNAP linked elbow prosthesis (Kyocera Medical, Osaka, Japan) for total elbow arthroplasty. METHODS: Seventeen elbows in 14 RA patients were replaced with a PROSNAP elbow with cement fixation. The patients comprised 1 man and 13 women, with a mean age of 63.9 years (range, 52-83 years) at the time of surgery. The preoperative conditions of the elbows were arthritis mutilans (n = 10), an ankylosed or stiff elbow with a preoperative range of motion of 45° or less (n = 4), and loosening of a primary total elbow arthroplasty (n = 3). The mean follow-up period was 47.7 months (range, 32-69 months), with a 100% follow-up rate. The clinical outcome of the elbows was evaluated by the Mayo Elbow Performance Index (maximum, 100 points). RESULTS: The mean postoperative Mayo Elbow Performance Index score improved from 57.6 points to 97.1 points. Preoperatively, 3 of the 17 elbows were judged as good, 7 as fair, and 7 as poor; at final follow-up, 16 elbows were judged as excellent and 1 as good. Complications were noted in 1 elbow (6%), which had undergone a postoperative fracture. CONCLUSIONS: The PROSNAP elbow prosthesis can be safely implanted through a relatively easy procedure and provides satisfactory short-term clinical outcomes for the reconstruction of severely damaged RA elbows. LEVEL OF EVIDENCE: Level IV, case series, treatment study.

DOI： 10.1016/j.jse.2013.12.031

Abatacept management during the perioperative period in patients with rheumatoid arthritis: report on eight orthopaedic procedures. International journal

Keiichiro Nishida, Yoshihisa Nasu, Kenzo Hashizume, Ryuichi Nakahara, Masatsugu Ozawa, Ryozo Harada, Takahiro Machida, Toshihumi Ozaki

Modern rheumatology 24 ( 3 ) 544 - 5 2014.5

タクロリムス使用下の整形外科手術

町田崇博, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文, 那須義久

岡山医学会雑誌 126 ( 1 ) 76 - 77 2014.4

橈骨遠位部骨折に対するMIPO法による治療成績

島村安則, 野田知之, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 井上円加, 尾崎敏文, 西田圭一郎

中国・四国整形外科学会雑誌 26 ( 1 ) 149 - 149 2014.4

Ultrasound Assessment of Synovial Pathologic Features in Rheumatoid Arthritis Using Comprehensive Multiplane Images of the Second Metacarpophalangeal Joint Reviewed

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

ARTHRITIS & RHEUMATOLOGY 66 ( 3 ) 523 - 532 2014.3

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Objective. The aim of this pilot study was to provide groundwork that could be utilized to optimize the global ultrasound (US) assessment of the whole joint for synovial pathologic features in patients with rheumatoid arthritis (RA).
Methods. US images of the second metacarpophalangeal joint in 8 predefined imaging planes, comprising regions that comprehensively capture the synovial pathologic features of the whole joint, were obtained from 30 patients with RA. Twelve experienced sonographers evaluated these images at the level of both the individual image and the whole joint, using a visual analog scale (VAS) to assess pathologic severity. Interrater reproducibility of the VAS scores was evaluated with intraclass correlation coefficients (ICCs), and factors that independently influenced the global assessment of the whole joint were identified using multiple linear regression analysis.
Results. A total of 14,276 VAS scores were analyzed. Interrater reproducibility of any eligible VAS assessment of synovial pathologic features was good (ICC 0.65). US assessment of synovial pathologic features in joints with mild inflammation was less reproducible than that in joints with severe inflammation. Although the most severely affected region in a joint did not always represent the average pathologic severity among the 8 regions, global assessment of the whole joint strongly correlated with assessment of the most severely affected region (P < 0.001). Importantly, the standard, midline imaging plane was not the most influential plane on the global assessment of the whole joint. Assessment of synovial fluid accumulation was not reproducible (ICCs 0.20-0.42) and did not substantially influence the global assessment of synovial inflammation (beta = 0.06).
Conclusion. The results of this study provide a unique data set that could be utilized to optimize the global US assessment of synovial pathologic features of the whole joint in patients with RA.

DOI： 10.1002/art.38280

【手指の変形性関節症】Hand OAのMRI所見

中原龍一, 西田圭一郎

リウマチ科 51 ( 2 ) 174 - 179 2014.2

Light and electron microscopic detection of inflammation-targeting liposomes encapsulating high-density colloidal gold in arthritic mice

Ami Maehara, Keiichiro Nishida, Masumi Furutani, Emi Matsumoto, Aiji Ohtsuka, Yoshifumi Ninomiya, Toshitaka Oohashi

INFLAMMATION RESEARCH 63 ( 2 ) 139 - 147 2014.2

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

We have previously demonstrated the efficient and time-dependent transvascular localization of Sialyl Lewis X (SLX)-liposomes to inflammatory sites, but the final target of the SLX-liposomes remained uncertain. The aim of this study was to identify the target cells of the liposomes within the inflamed joints of collagen antibody-induced arthritis (CAIA) model mice.SLX-liposomes and unlabeled liposomes encapsulating high-density colloidal gold were administered intravenously into the caudal vein of CAIA mice on day 5 after induction of arthritis when the inflammatory score was maximal (n = 6 per group). Six hours or 24 h after liposome administration, animals were euthanized and hind limbs and ankles were excised without perfusion. After fixation, synovial tissues were examined by light microscopy after silver enhancement of colloidal gold or by transmission electron microscopy.Silver-enhanced signals were detected within the cells around E-selectin-positive blood vessels in the synovium of the SLX-liposome group. These cells were positive for the macrophage/monocyte marker F4/80 or neutrophil marker Ly-6G. Transmission electron microscopy detected the colloidal gold signals together with liposome-like structures within the phagosomes of synovial macrophages. Transmission electron microscopy and energy dispersive X-ray spectrometry could determine gold elements in the lysosomes of synovial macrophages.The results of the current study demonstrate that SLX-liposomes primarily targeting E-selectin in activated endothelial cells could potentially deliver their contents into inflammatory cells around synovial blood vessels in arthritic joints.

DOI： 10.1007/s00011-013-0682-4

A 5-22-year follow-up study of stemmed alumina ceramic total elbow arthroplasties with cement fixation for patients with rheumatoid arthritis Reviewed

Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Makoto Kishimoto, Toshifumi Ozaki, Hajime Inoue

JOURNAL OF ORTHOPAEDIC SCIENCE 19 ( 1 ) 55 - 63 2014.1

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

We determined mid to long-term results of total elbow arthroplasty (TEA) by use of unlinked elbow prostheses with solid alumina ceramic trochleae, and ceramic ulnar stems (stemmed Kyocera type I; SKC-I) for patients with rheumatoid arthritis.
Fifty-four elbows of 39 patients were available for detailed clinical and radiographic review after a follow-up period of at least 5 years. The mean follow-up period was 12.6 years (range 5-22 years). Clinical condition before and after surgery was assessed by use of a modified version of the Mayo Elbow Performance Score (MEPS; 0-100 points) and a Japan Orthopaedic Association Elbow score (JOA score; 0-100 points). The radiographs were reviewed and loosening was defined as a progressive radiolucent line > 1 mm wide that was completely circumferential around the prosthesis. Clinical records of post-operative events affecting the elbows were used for survival analysis of the prostheses using the Kaplan-Meier method.
The average modified MEPS and JOA scores improved significantly from 39.7 +/- A 14.3 to 44.7 +/- A 9.4, respectively, pre-operatively, to 89.7 +/- A 15.4 and 83.1 +/- A 12.8, respectively, post-operatively (P < 0.0001). The functional assessment score also improved from 4.9 +/- A 2.8 to 8.5 +/- A 3.3 points (P < 0.0001). With loosening or implant revision defined as end points, the likelihood of survival of the prosthesis for up to 20 years was 92.6 % (95 % confidence interval (CI), 85.6-100.0) or 86.3 % (95 % CI 75.0-97.6), respectively.
Satisfactory clinical results were obtained after TEA using SKC-I prostheses, which provided excellent pain relief and functional range of motion. The results of our study reveal the high reliability over a long period of the cemented SKC-I prosthesis with an alumina ceramic component.

DOI： 10.1007/s00776-013-0492-0

Clinical Results of Total Shoulder Arthroplasty for Osteoarthritis and Rheumatoid Arthritis

KANAZAWA Tomoko

Japanese Journal of Joint Diseases 33 ( 4 ) 479 - 485 2014

Language：English Publisher：Japanese Society for Joint Diseases

Objective: To investigate the clinical and radiographic results of total shoulder arthroplasty (TSA) for damaged shoulder joints with osteoarthritis (OA) and rheumatoid arthritis (RA).Patients and Methods: From 1999 to 2012 inclusive, we performed 19 total shoulder arthroplasties in 17 patients. A total of sixteen shoulders, five with OA and 11 with RA, from 15 patients were followed up for more than six months. All patients were female, with an average age of 71 years, and an average follow-up period of three years. Preoperative magnetic resonance imaging showed that the supraspinatus tendon was intact in five shoulders (intact group), and torn or thin in 11 shoulders (damaged group), respectively. Clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score, Disabilities of the Arm, Shoulder and Hand (DASH) score and range of motion (ROM). Radiographic loosening of the humeral stem and glenoid component was evaluated according to the criteria described by Stewart.Results: The average JOA score improved from 39.9 points preoperatively to 80.3 points at the final follow-up. The average DASH score improved from 70.1 points to 56.0 points. The range of active flexion, abduction and external rotation significantly improved postoperatively. Radiolucent line evaluation around the glenoid component was observed in two shoulders. There was no significant difference in the improvement of the JOA score between the intact group and the damaged group. In both groups, pain relief was experienced postoperatively, but the improvement in ROM consisting of flexion, abduction and external rotation, was significantly greater in the intact group than in the damaged group. The postoperative JOA score showed a strong inverse correlation with the preoperative DASH score.Conclusion: The results of the current study showed satisfactory clinical outcomes of TSA for OA and RA, particularly with the treatment effect of good postoperative pain relief. Clinical outcome may depend on the preoperative status of the rotator cuff and the function of the upper extremity.

DOI： 10.11551/jsjd.33.479

Other Link： https://jlc.jst.go.jp/DN/JLC/20002300823?from=CiNii

Total Hip Arthroplasty Without Blood Transfusion in a Jehovah's Witness : A Case Report

Tanaka Takaaki, Okada Yoshiki, Ozaki Toshifumi, Fujiwara Kazuo, Endo Hirosuke, Nishida Keiichiro

The Journal of the Chugoku-Shikoku Orthopaedic Association 26 ( 2 ) 255 - 259 2014

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Jehovah's Witnesses refuse blood transfusions on the basis of their religious belief. We report our experience with total hip arthroplasty without blood transfusion in a Jehovah's Witness.<br>The patient was a 70-year-old woman who had been receiving treatment for rheumatoid arthritis for 34 year and had been taking anti-platelet agents for atrial fibrillation and hypertension. Plain radiographs revealed severe erosions (Larsen Grade 4) in the right hip. We used a cemented femoral component and reamed the acetabulum gently to minimize any bleeding, while performing intraoperative blood-salvaging autotransfusion.<br>We carried out hybrid total hip arthroplasty with a cementless acetabular component and a cemented femoral component. The operation time was 62 minutes, intraoperative blood loss was 50ml, and postoperative blood loss was 90ml. The preoperative hemoglobin level was 9.9g/dl, and the lowest hemoglobin level was 6.8g/dl after surgery. At the final follow-up, the patient was able to walk with a T-shaped walking stick, and her Japanese Orthopaedics Association score (right/left) was 80 points/81 points on.<br>We considered that the use of a cemented femoral component and gentle reaming of the acetabulum were factors that reduced bleeding during total hip arthroplasty.

DOI： 10.11360/jcsoa.26.255

Waddington's epigenetic landscape and etiology of rheumatoid arthritis

Nishida Keiichiro

Clinical Rheumatology and Related Research 26 ( 1 ) 5 - 8 2014

Light and electron microscopic detection of inflammation-targeting liposomes encapsulating high-density colloidal gold in arthritic mice.

Maehara A, Nishida K, Furutani M, Matsumoto E, Ohtsuka A, Ninomiya Y, Oohashi T

Inflamm Res. 63 ( 2 ) 139 - 147 2014

SH3BP2 gain-of-function mutation exacerbates inflammation and bone loss in a murine collagen-induced arthritis model

Mukai, T., Gallant, R., Ishida, S., Yoshitaka, T., Kittaka, M., Nishida, K., Fox, D.A., Morita, Y., Ueki, Y.

PLoS ONE 9 ( 8 ) 2014

Development and validation of a new radiographic scoring system to evaluate bone and cartilage destruction and healing of large joints with rheumatoid arthritis: ARASHI (Assessment of rheumatoid arthritis by scoring of large joint destruction and healing in radiographic imaging) study. International journal

Atsushi Kaneko, Isao Matsushita, Katsuaki Kanbe, Katsumitsu Arai, Yoshiaki Kuga, Asami Abe, Takeshi Matsumoto, Natsuko Nakagawa, Keiichiro Nishida

Modern rheumatology 23 ( 6 ) 1053 - 62 2013.11

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

OBJECTIVE: To assess the reliability and sensitivity of a novel scoring method to evaluate the radiographic appearance of and longitudinal changes including joint remodeling in large joints with early and established rheumatoid arthritis (RA). METHODS: The ARASHI study group devised new radiographic scoring systems (Status score; range 0-16 points, and Change score; range -11 to 12 points) for evaluation of large joints with RA. Radiographs showing anterior/posterior views of large joints (shoulder, elbow, hip, knee, and ankle joints) taken at two time points (mean interval 2.3 years) were collected from 25 patients with established RA (5 patients for each of the 5 joints, 50 films in total), and an additional 5 films of each joint with severe joint destruction were collected from 5 different sets of RA patients. After consensus on the definition of each component and reader training, images were evaluated using the Larsen's grading system and the ARASHI Status and Change score by 9 independent senior orthopedic surgeons. The reliability was estimated by intra-class correlation coefficients (ICCs) and measurement error by 95% confidence intervals of minimum detectable change (MDC95). RESULTS: ARASHI Status score and Change score significantly correlated with Larsen's grade (r = 0.89, P < 0.0001) and follow-up-baseline differences in Larsen's grade (r = 0.83, P < 0.0001), respectively. Inter-reader ICCs were very high for both Status score (0.88, 95% confidence interval [CI], 0.83-0.92, P < 0.001) and Change score (0.92, 95% CI, 0.87-0.96, P < 0.001). Intra-reader ICCs were also very high for both Status score (0.92, 95% CI, 0.71-0.98, P < 0.001) and Change score (0.97, 95% CI, 0.91-0.99, P < 0.001). The MDC95 for inter-reader agreement were 4.18 (25% of maximum obtainable score, MOS) and 4.99 (21% of MOS) for Status score and Change score, respectively. The MDC95 for intra-reader agreement was acceptable with 2.82 (17% of MOS) and 3.02 (13% of MOS) for Status score and Change score, respectively. CONCLUSION: The ARASHI scoring method showed good inter-/intra-reader reliability with high ICCs and acceptable MDC95 with respect to each large joint and the components of both Status and Change scores. The results suggest that the ARASHI scoring method might be useful for the assessment of status, as well as longitudinal monitoring of destruction and remodeling of large joints with RA.

DOI： 10.1007/s10165-012-0823-6

Occult Compression Fracture of Metacarpal Head without Evidence of Avascular Necrosis Reviewed

Keiichiro Nishida, Hiroyuki Hashizume, Akihiro Matsukawa, Kenzo Hashizume, Yasunori Shimamura, Yasuyaki Torigoe, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 67 ( 5 ) 311 - 317 2013.10

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

We report a case of 4th metacarpal head collapse of a 19-year-old healthy man. MRI revealed T1 low and T2 high regions in the collapsed 4th metacarpal head, as well as in the right 3rd and left 4th metacarpal head. Our initial diagnosis was occult compression fracture due to avascular necrosis, known as Dieterich's disease. However, pathological findings of surgically resected right 4th metacarpal head were compatible with transient osteoporosis and metacarpal head fracture followed by active tissue repair. The autologous osteochondral transplants from costchondral junction survived and maintained their size and shape even at 10-year follow-up.

メカニカルストレスに対するヒアルロン酸の軟骨破壊抑制効果の機序の解析

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 齋藤太一, 金澤智子, 原田遼三, 町田崇博, 尾崎敏文

日本関節病学会誌 32 ( 3 ) 380 - 380 2013.10

【早期関節リウマチ治療を考える】関節リウマチにおける画像診断の進歩とその役割核磁気共鳴画像(MRI) MRIの早期診断と疾患活動性評価の有用性、その問題点について

中原龍一, 西田圭一郎

Progress in Medicine 33 ( 9 ) 1901 - 1904 2013.9

メカニカルストレスに対するヒアルロン酸の軟骨破壊抑制効果の機序の解析

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 原田遼三, 町田崇博, 尾崎敏文

日本整形外科学会雑誌 87 ( 8 ) S1321 - S1321 2013.8

PROSNAP人工肘関節置換術の短期成績

那須義久, 西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

岡山医学会雑誌 125 ( 2 ) 183 - 184 2013.8

【上肢のリウマチ診断と治療】治療生物学的製剤が与えたリウマチ関節外科手術の変化

那須義久, 西田圭一郎

関節外科 32 ( 4 ) 382 - 388 2013.4

関節リウマチの評価法を学ぶ(第2回) 関節レントゲン写真の見方と評価法

原田遼三, 西田圭一郎, 中原龍一, 橋詰謙三

Rheumatology Clinical Research 2 ( 1 ) 53 - 57 2013.4

Language：Japanese Publisher：(株)先端医学社

関節リウマチ(RA)の診断治療において、単純X線による関節病変の評価はその所見に特徴的なものが多く、また病態を反映していることなどもあり有用なツールとして広く使用されている。しかし、生物学的製剤の導入を契機に早期診断また治療効果、寛解評価のための鋭敏な検査が必須となり、単純X線のlimitationのためMRIや超音波検査など他のmodalityとの併用が提唱されている。早期診断には不向きであるが、網羅的評価に長けること、reproducibleであるなど利点も多いため単純X線の見方や評価法について熟慮しておく必要がある。多種の評価法が報告されており、どの評価法を用いるかについては各検査法の長所短所を考慮し、目的に応じた評価法の選択を検討する必要がある。(著者抄録)

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再発した手関節尺側部痛の1例

金澤智子, 島村安則, 大森敏規, 篠原健介, 原田遼三, 山川泰明, 小澤正嗣, 井上円加, 斉藤太一, 中原龍一, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 25 ( 1 ) 245 - 245 2013.4

JACE型人工肘関節置換術の中期成績

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 那須義久, 齋藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 3 ) S818 - S818 2013.3

関節リウマチ肘に対するPROSNAP型人工肘関節の術後成績

齋藤太一, 西田圭一郎, 橋詰謙三, 中原龍一, 小澤正嗣, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 3 ) S733 - S733 2013.3

関節リウマチにおける生物学的製剤と各関節に対する手術の役割 Bio使用中関節リウマチ患者に対する肘関節手術の有用性

西田圭一郎, 金澤智子, 中原龍一, 橋詰謙三, 齋藤太一, 小澤正嗣, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 2 ) S251 - S251 2013.3

RAに対するSwansonとAVANTAによるMP人工指関節置換術の治療成績

原田遼三, 西田圭一郎, 橋詰謙三, 中原龍一, 齋藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本整形外科学会雑誌 87 ( 2 ) S83 - S83 2013.3

臨床研究支援のためのスコア入力・自動統計システムの開発

中原龍一, 西田圭一郎, 橋詰謙三, 小澤正嗣, 齋藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 3 ) S910 - S910 2013.3

関節リウマチの手術上肢 RAにおけるNalebuff type I(ボタン穴変形)の治療成績

原田遼三, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 57回・22回 403 - 403 2013.3

骨・軟骨・滑膜細胞伸展装置を用いたメカニカルストレスに対するヒアルロン酸のヒト軟骨破壊抑制効果

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 57回・22回 317 - 317 2013.3

RAに対するBio製剤使用中の整形外科手術 Bio使用中患者の整形外科手術の適応

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 町田崇博, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 57回・22回 204 - 204 2013.3

Multiple Regression Analysis for Grading and Prognosis of Cubital Tunnel Syndrome: Assessment of Akahori's Classification Reviewed

Masutaka Watanabe, Seizaburo Arita, Hiroyuki Hashizume, Mitsugi Honda, Keiichiro Nishida, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 67 ( 1 ) 35 - 44 2013.2

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

The purpose of this study was to quantitatively evaluate Akahori's preoperative classification of cubital tunnel syndrome. We analyzed the results for 57 elbows that were treated by a simple decompression procedure from 1997 to 2004. The relationship between each item of Akahori's preoperative classification and clinical stage was investigated based on the parameter distribution. We evaluated Akahori's classification system using multiple regression analysis, and investigated the association between the stage and treatment results. The usefulness of the regression equation was evaluated by analysis of variance of the expected and observed scores. In the parameter distribution, each item of Akahori's classification was mostly associated with the stage, but it was difficult to judge the severity of palsy. In the mathematical evaluation, the most effective item in determining the stage was sensory conduction velocity. It was demonstrated that the established regression equation was highly reliable (R = 0.922). Akahori's preoperative classification can also be used in postoperative classification, and this classification was correlated with postoperative prognosis. Our results indicate that Akahori's preoperative classification is a suitable system. It is reliable, reproducible and well-correlated with the postoperative prognosis. In addition, the established prediction formula is useful to reduce the diagnostic complexity of Akahori's classification.

Histone deacetylase inhibitors suppress mechanical stress-induced expression of RUNX-2 and ADAMTS-5 through the inhibition of the MAPK signaling pathway in cultured human chondrocytes

Saito T., Nishida K., Furumatsu T., Yoshida A., Ozawa M., Ozaki T.

Osteoarthritis and Cartilage 21 ( 1 ) 165 - 174 2013.1

Reliability, validity, and responsiveness of the Japanese version of the patient-rated elbow evaluation

Hanyu, T., Watanabe, M., Masatomi, T., Nishida, K., Nakagawa, T., Nishiura, Y., Ohi, H.

Journal of Orthopaedic Science 18 ( 5 ) 2013

メカニカルストレスによる軟骨基質分解酵素発現に対するヒストン脱アセチル化酵素阻害剤の抑制効果

斎藤太一, 西田圭一郎, 古松毅之, 小澤正嗣, 金澤智子, 原田遼三, 尾崎敏文

移植 47 ( 6 ) 499 - 499 2012.12

Cyclic tensile strain inhibits interleukin-1 beta and tumor ncerosis factor-alpha-induced aggrecanase in human chondrosarcoma cell line OUMS-27 by stretch-activated channles

Takashi Ohtsuki, Keiichiro Nishida, Satoshi Hirohata, Yoshifumi Ninomiya

GLYCOBIOLOGY 22 ( 11 ) 1582 - 1583 2012.11

当科における人工肩関節置換術(TSA)の治療成績の検討

金澤智子, 西田圭一郎, 橋詰謙三, 島村安則, 中原龍一, 斉藤太一, 小澤正嗣, 那須義久, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 317 - 317 2012.10

【運動器疾患の画像診断】超音波診断関節リウマチの超音波画像診断

中原龍一, 西田圭一郎

別冊整形外科 ( 62 ) 175 - 179 2012.10

関節リウマチの足関節、中後足部変形に対する治療成績

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 371 - 371 2012.10

RAにおけるSwansonとAvantaによるMP人工指関節置換術の治療成績

原田遼三, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 317 - 317 2012.10

バイオ製剤使用のストラテジー並びにバイオ製剤無効例への対応と展望 Bio製剤効果不十分例に対する整形外科手術の有効性

西田圭一郎, 金澤智子, 中原龍一, 橋詰謙三, 斎藤太一, 小澤正嗣, 原田遼三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 259 - 259 2012.10

Dual Energy CTを用いた骨抽出性能の向上

中原龍一, 西田圭一郎, 金澤智子, 原田遼三, 小澤正嗣, 斎藤太一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 243 - 243 2012.10

人工関節再置換術原因と成否のポイント<パート1.肘 TEA> 岡山大式人工肘関節再置換術例の検討

西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 314 - 314 2012.10

Radiographic remodeling of the shoulder joint in a patient with rheumatoid arthritis after 4 years of treatment with etanercept Reviewed

Toshifumi Ozaki, Kenzo Hashizume, Ryuichi Nakahara, Keiichiro Nishida

MODERN RHEUMATOLOGY 22 ( 4 ) 635 - 637 2012.8

メカニカルストレスによる軟骨基質分解酵素発現に対するヒストン脱アセチル化酵素阻害薬の抑制効果

斎藤太一, 西田圭一郎, 古松毅之, 小澤正嗣, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 86 ( 8 ) S1219 - S1219 2012.8

3D-CADシステムを用いた鎖骨の三次元形状比較

中原龍一, 野田知之, 島村安則, 橋詰謙三, 西田圭一郎, 尾崎敏文

骨折 34 ( 2 ) 265 - 268 2012.5

Language：Japanese Publisher：(一社)日本骨折治療学会

【目的】当院では骨折症例に対してCT画像をもとに健側鏡像の立体模型か実寸大の左右反転図を作成し、プレベンディングを行っている。この方法は骨の左右差が少ないことを前提としているが、どの程度骨の左右差があるかは不明であった。そこでCADソフトを用いてCT画像を三次元的に比較するシステムを構築し、プレベンディング法を最も利用している鎖骨を対象に左右差を検討した。【方法と対象】解剖実習で摘出した屍体の左右の鎖骨16対をCTで撮影し、CADソフトを用いて三次元的な左右差を検討した。【結果】骨幹部のカーブ形状に左右差は少なかったが、径の左右差は認められた。【考察】径の左右差はあるがカーブ形状に左右差はなかったため、鎖骨に関してプレベンディングは有用であると考えられた。(著者抄録)

【関節リウマチの最新治療】(PART.1)関節リウマチの基礎関節リウマチの画像検査の進歩

中原龍一, 西田圭一郎

からだの科学 ( 273 ) 31 - 35 2012.5

【RAの新分類基準の時代におけるリウマチ性疾患の鑑別】非結核性抗酸菌による関節炎・腱滑膜炎

那須義久, 西田圭一郎

リウマチ科 47 ( 4 ) 379 - 384 2012.4

リウマチ性疾患の画像(1) T2マッピング解析法複数シークエンス画像を用いた軟骨半自動抽出法

中原龍一, 西田圭一郎, 橋詰謙三, 小澤正嗣, 斉藤太一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 292 - 292 2012.3

関節リウマチ手術の長期成績関節リウマチ手術の長期成績人工肘関節置換術 linked vs.unlinked

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 214 - 214 2012.3

関節リウマチの手術下肢(1) 関節リウマチ(RA)患者の外反母趾に対する切除関節形成術の治療成績

金澤智子, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 小澤正嗣, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 393 - 393 2012.3

リウマチ性疾患の画像(1) 関節リウマチにおける大関節破壊の新たな画像評価基準(ARASHI status score)に関する検討

那須義久, 西田圭一郎, 高杉幸司, 山下美鈴, 棗田将光, 江澤香代, 江澤和彦, 金澤智子, 斉藤太一, 小澤正嗣, 中原龍一, 橋詰謙三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 292 - 292 2012.3

メカニカルストレス下におけるヒストン脱アセチル化酵素阻害薬による軟骨破壊抑制効果

斉藤太一, 西田圭一郎, 橋詰謙三, 中原龍一, 小澤正嗣, 金澤智子

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 551 - 551 2012.3

関節リウマチの手術下肢(1) 関節リウマチの足関節、中後足部変形に対する治療成績

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 393 - 393 2012.3

MTXの有効性と安全性画像的にみたMTXの有効性と限界への対応

西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 168 - 168 2012.3

関節リウマチの手関節に対する部分固定術の術後成績

斎藤太一, 西田圭一郎, 橋詰謙三, 島村安則, 尾崎敏文

日本手外科学会雑誌 29 ( 1 ) S134 - S134 2012.3

当院における人工肘関節再置換術の術後成績

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本肘関節学会雑誌 19 ( 1 ) S24 - S24 2012.1

Gene Expression and Localization of High-mobility Group Box Chromosomal Protein-1 (HMGB-1) in Human Osteoarthritic Cartilage

Chuji Terada, Aki Yoshida, Yoshihisa Nasu, Shuji Mori, Yasuko Tomono, Masato Tanaka, Hideo K. Takahashi, Masahiro Nishibori, Toshifumi Ozaki, Keiichiro Nishida

ACTA MEDICA OKAYAMA 65 ( 6 ) 369 - 377 2011.12

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

We investigated the expression and localization of high-mobility group box chromosomal protein-1 (HMGB-1) in human osteoarthritic (OA) cartilage in relation to the histopathological grade of cartilage destruction, and examined the role of HMGB-1 in the regulation of proinflammatory cytokine expression in chondrocytes. An immunohistochemical study demonstrated that total HMGB-1-positive cell ratios increase as the Osteoarthritis Research Society International (OARSI) histological grade increased. The population of cytoplasmic HMGB-1-positive chondrocytes was especially increased in the deep layers of higher-grade cartilage. The ratios and localization of receptors for advanced glycation end products (RAGE) expression by chondrocytes in Grade 2, 3, and 4 were significantly higher than those in Grade 1. In vitro stimulation with IL-1 beta, but not TNF alpha, significantly upregulated the expression of HMGB-1 mRNA by human OA chondrocytes. Both IL-1 beta and TNFa promoted the translocation of HMGB-1 from nuclei to cytoplasm. IL-1 beta and TNF alpha secretions were stimulated at higher levels of HMGB-1. The results of our study suggest the involvement of HMGB-1 in the pathogenesis of cartilage destruction in OA.

DOI： 10.18926/AMO/47262

Risk of postoperative complications in rheumatoid arthritis relevant to treatment with biologic agents: a report from the Committee on Arthritis of the Japanese Orthopaedic Association

Masahiko Suzuki, Keiichiro Nishida, Satoshi Soen, Hiromi Oda, Hiroshi Inoue, Atsushi Kaneko, Kenji Takagishi, Takaaki Tanaka, Tsukasa Matsubara, Naoto Mitsugi, Yuichi Mochida, Shigeki Momohara, Toshihito Mori, Toru Suguro

JOURNAL OF ORTHOPAEDIC SCIENCE 16 ( 6 ) 778 - 784 2011.11

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

Since biologic agents were introduced to treat rheumatoid arthritis (RA) in 2003, the number of orthopedic surgical procedures under treatment with biologic agents has been increasing in Japan. However, whether biologic agents cause an increase in the prevalence of postoperative complications is as yet unknown. The Committee on Arthritis of the Japanese Orthopedic Association investigated the prevalence of postoperative complications in patients with RA in teaching hospitals in Japan.
Between January 2004 and November 2008, surveillance forms about medications and surgical procedures in patients with RA were sent to 2,019 teaching hospitals. Data were analyzed by the Rheumatoid Arthritis Committee.
Biologic agents were administered to RA patients in 632 of 1,245 hospitals (50.8%); 430 of the 1,245 hospitals (34.5%) used surgical intervention under treatment with biologic agents. The number of surgical procedures under treatment with biologic agents was 3,468, and the prevalence of infection was 1.3% (46 cases). The prevalence of infection was 1.0% (567 procedures) in 56,339 procedures under treatment with nonbiologic disease-modifying anti-rheumatic drugs. There were no significant differences between biological and nonbiological treatment groups with respect to the prevalence of infection. In the joint arthroplasty group, the number of procedures under biological and nonbiological treatment was 1,626 and 29,903, and the prevalence of infection was 2.1% (34 procedures) and 1.0% (298 procedures), respectively. There was a significant difference between groups. The odds ratio was 2.12 (95% confidence interval 1.48-3.03, P < 0.0001).
The chance of having biological treatment with joint arthroplasty was more than twofold greater in patients with surgical-site infections compared with those treated with nonbiologic agents. Caution is required for surgical procedure, perioperative course, and obtaining consent for joint arthroplasty for patients with RA undergoing surgery under biological agents.

DOI： 10.1007/s00776-011-0142-3

関節リウマチ(RA)患者の外反母趾に対する切除関節形成術の治療成績

金澤智子, 橋詰謙三, 西田圭一郎, 中原龍一, 斉藤太一, 小澤正嗣, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 264 - 264 2011.10

整形外科CT画像の三次元ディスプレー表示システムの有用性

中原龍一, 西田圭一郎, 金澤智子, 小澤正嗣, 斎藤太一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 368 - 368 2011.10

生物学的製剤導入とRAの手術 RA上肢の手術

西田圭一郎, 橋詰謙三, 中原龍一, 金澤智子, 斎藤太一, 小澤正嗣, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 250 - 250 2011.10

関節リウマチにおける大関節破壊の新たな画像評価(ARASHI status score)に関する検討

那須義久, 西田圭一郎, 金澤智子, 斎藤太一, 中原龍一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 372 - 372 2011.10

タクロリムス使用下に術後感染症を生じた関節リウマチの3例

橋詰謙三, 西田圭一郎, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 374 - 374 2011.10

骨折治療への三次元実体模型の応用

中原龍一, 野田知之, 島村安則, 西山武, 西田圭一郎, 尾崎敏文

骨折 33 ( 3 ) 738 - 742 2011.9

Language：Japanese Publisher：(一社)日本骨折治療学会

【目的】CT画像から作製された三次元実体模型が手術に利用されるようになった。しかし、発注が煩雑で作製時間が長いことが問題であった。当院では作製過程に医師が加わることで作業効率を改善し、骨折などの緊急症例に対応可能な院内発注システムを構築したので報告する。【方法】当院には三次元プリンターが設置されており、歯科技工士が実体模型を作製していた。医師がCTデータから領域抽出を行いDICOMデータとして保存したものを、作製期限を設けてデータを蓄積し、作製期限に間に合うように一度にまとめて作製するシステムを構築した。【結果】作業効率が改善され緊急作製に対応可能となった。2009年度は緊急作製を必要とした骨折症例7例で48時間以内にプレベンディング用の健側骨の左右反転模型を作製した。【結語】領域抽出と作製を分離することで作製効率が向上し、緊急症例に対応可能となった。(著者抄録)

Recent trends in orthopedic surgery performed in Japan for rheumatoid arthritis

Shigeki Momohara, Sakae Tanaka, Hiroshi Nakamura, Junya Mibe, Takuji Iwamoto, Katsunori Ikari, Jinju Nishino, Yuho Kadono, Tetsuro Yasui, Kenji Takahashi, Kenji Takenouchi, Kenzo Hashizume, Ryuichi Nakahara, Ayako Kubota, Takashi Nakamura, Keiichiro Nishida, Toru Suguro

MODERN RHEUMATOLOGY 21 ( 4 ) 337 - 342 2011.8

Language：English Publisher：SPRINGER

The aim of this report was to review the use of orthopedic surgeries performed to manage rheumatoid arthritis (RA). Our review of studies published in English indicates that there has been a decrease in RA-associated surgeries in Western countries. Improvements in medical treatment may partly explain the reduction in numbers of orthopedic joint surgeries, which also suggests a worldwide trend toward improved long-term outcomes. However, the results of our multicenter study in Japan indicate that the number of RA-associated operations has not decreased, and that the numbers of operations performed annually have been relatively stable from 1998 to 2008. Although there definitely has been a decline in the numbers of synovectomy surgeries, the numbers of operations on the upper limbs and foot arthroplasties have increased. With the trend toward milder disease because of improved medical treatment, we speculate that RA patients may want and need better function for the activities of daily living. The combination of medical treatment and surgical intervention is thought to improve outcomes in RA patients who will develop joint destruction. Additional studies, including analyses of RA databases containing long-term data on a variety of surgical interventions, are needed.

DOI： 10.1007/s10165-011-0426-7

MRI画像表示法カラー表示を用いて異なるシークエンス画像を同時に表示させる方法

中原龍一, 金澤智子, 齋藤太一, 橋詰謙三, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 85 ( 8 ) S1226 - S1226 2011.8

リウマチ手変形に対する治療関節リウマチ手指MP関節に対する人工指関節置換術の成績

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

関節の外科 38 ( 2 ) 47 - 47 2011.8

メカニカルストレス下におけるヒストン脱アセチル化酵素阻害薬による軟骨破壊抑制効果

齋藤太一, 西田圭一郎, 小澤正嗣, 古松毅之, 鉄永智紀, 尾崎敏文

日本整形外科学会雑誌 85 ( 8 ) S1158 - S1158 2011.8

リウマチ外科治療up-to-date(新評議員報告) PROSNAP人工肘関節の短期臨床成績

西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 那須義久, 尾崎敏文

関節の外科 38 ( 2 ) 58 - 58 2011.8

上腕骨通顆骨折に対する内固定法の力学的比較 ONI plate対従来固定法

島村安則, 今谷潤也, 野田知之, 中原龍一, 齋藤太一, 金澤智子, 井上円加, 小澤正嗣, 古松毅之, 国定俊之, 西田圭一郎, 橋詰博行, 尾崎敏文

日本整形外科学会雑誌 85 ( 8 ) S1338 - S1338 2011.8

橈骨遠位掌側面の横断面での傾きの変化

清水弘毅, 今谷潤也, 竹下歩, 堀田昌宏, 大塚亮介, 中道亮, 山川泰明, 川上幸雄, 林正典, 西田圭一郎

骨折 33 ( Suppl. ) S55 - S55 2011.7

[Cutting edge on research of cartilage metabolism. Recent progress in bio-molecular imaging of articular cartilage]. Reviewed

Toshitaka Oohashi, Keiichiro Nishida

Clinical calcium 21 ( 6 ) 896 - 902 2011.6

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

In the process of cartilage degeneration seen in osteoarthritis, loss of proteoglycan from articular cartilage has been widely accepted as a critical early event, followed by collagen degradation designated as a point of no return. Recent advance in the development of targeted molecular probes and new imaging modalities enabled the detection of qualitative and functional change of articular cartilage. In this paper, we describe the recent progress of bio-molecular imaging of articular cartilage including our fluorescent-labeled glycosaminoglycan-binding octaarginine.

ENU-induced missense mutation in the C-propeptide coding region of Col2a1 creates a mouse model of platyspondylic lethal skeletal dysplasia, Torrance type

Tatsuya Furuichi, Hiroshi Masuya, Tomohiko Murakami, Keiichiro Nishida, Gen Nishimura, Tomohiro Suzuki, Kazunori Imaizumi, Takashi Kudo, Kiyoshi Ohkawa, Shigeharu Wakana, Shiro Ikegawa

MAMMALIAN GENOME 22 ( 5-6 ) 318 - 328 2011.6

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

The COL2A1 gene encodes the alpha 1(II) chain of the homotrimeric type II collagen, the most abundant protein in cartilage. In humans, COL2A1 mutations create many clinical phenotypes collectively termed type II collagenopathies; however, the genetic basis of the phenotypic diversity is not well elucidated. Therefore, animal models corresponding to multiple type II collagenopathies are required. In this study we identified a novel Col2a1 missense mutation-c.44406A > C (p.D1469A)-produced by large-scale N-ethyl-N-nitrosourea (ENU) mutagenesis in a mouse line. This mutation was located in the C-propeptide coding region of Col2a1 and in the positions corresponding to a human Col2a1 mutation responsible for platyspondylic lethal skeletal dysplasia, Torrance type (PLSD-T). The phenotype was inherited as a semidominant trait. The heterozygotes were mildly but significantly smaller than wild-type mice. The homozygotes exhibited lethal skeletal dysplasias, including extremely short limbs, severe spondylar dysplasia, severe pelvic hypoplasia, and brachydactyly. As expected, these skeletal defects in the homozygotes were similar to those in PLSD-T patients. The secretion of the mutant proteins into the extracellular space was disrupted, accompanied by abnormally expanded rough endoplasmic reticulum (ER) and upregulation of ER stress-related genes, such as Grp94 and Chop, in chondrocytes. These findings suggested that the accumulation of mutant type II collagen in the ER and subsequent induction of ER stress are involved, at least in part in the PLSD-T-like phenotypes of the mutants. This mutant should serve as a good model for studying PLSD-T pathogenesis and the mechanisms that create the great diversity of type II collagenopathies.

DOI： 10.1007/s00335-011-9329-3

生物学的製剤と外科治療生物学的製剤使用患者の手術のタイミング

西田圭一郎, 金澤智子, 中原龍一, 橋詰謙三, 那須義久, 斎藤太一, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 147 - 147 2011.6

関節リウマチの手術上肢関節リウマチ(RA)に対するSauve-Kapandji法の治療成績

金澤智子, 橋詰謙三, 西田圭一郎, 中原龍一, 斉藤太一, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 383 - 383 2011.6

関節リウマチの手術上肢 RA手関節に対する部分固定術の術後成績

斉藤太一, 西田圭一郎, 橋詰謙三, 中原龍一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 312 - 312 2011.6

関節リウマチの手術上肢関節リウマチ手指MP関節に対する人工指関節置換術の成績

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 310 - 310 2011.6

炎症標的化金コロイド内包リポソームのリウマチ関節炎症部位への集積

古谷満寿美, 松本衣未, 美名口順, 小川弘子, 古松毅之, 廣畑聡, 二宮善文, 西田圭一郎, 大塚愛二, 大橋俊孝

日本結合組織学会学術大会・マトリックス研究会大会合同学術集会プログラム・抄録集 43回・58回 118 - 118 2011.5

Increased level of heme oxygenase-1 in rheumatoid arthritis synovial fluid

Ai Kitamura, Keiichiro Nishida, Takamitsu Komiyama, Hideyuki Doi, Yasutaka Kadota, Aki Yoshida, Toshifumi Ozaki

MODERN RHEUMATOLOGY 21 ( 2 ) 150 - 157 2011.4

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

We investigated the expression and localization of heme oxygenase-1 (HO-1) in synovial fluid and synovial tissue, and examined the stimulation of HO-1 production in rheumatoid synovial fibroblasts (RASFs). Synovial fluid samples were obtained from knee joints of 20 rheumatoid arthritis (RA) and 20 osteoarthritis (OA) patients, and concentration of HO-1 and matrix metalloproteinase-3 (MMP-3) were measured by enzyme-linked immunosorbent assay (ELISA). Synovial tissues obtained from RA or OA patients during total knee arthroplasty (TKA) were used for immunohistochemical analysis of HO-1. HO-1 production by RASFs in response to various cytokines was examined by ELISA. HO-1 levels in synovial fluid were higher in the RA group than in the OA group with significant difference (P < 0.001), and correlated with serum C-reactive protein (CRP) level (r = 0.80, P < 0.01) in the RA group. Higher levels of HO-1 were seen in the RA-L group (Larsen grade III-V) than in the RA-E (Larsen grade 0-II) group (P < 0.001). There was weak correlation between the levels of HO-1 protein and MMP-3 in synovial fluid in the RA group (r = 0.31, P < 0.01), while no positive correlation was observed in OA. Positive immunoreaction for HO-1 was observed in cells of synovial tissue including synovial fibroblasts and cells in synovial pannus. HO-1 protein levels in cultured media of RASFs were increased by stimulation by interleukin-1 beta at 6 h and tumor necrosis factor-alpha at 12 h, but suppressed by interferon-gamma at 12 and 24 h. These results indicated that HO-1 expression in synovial tissue might be stimulated by inflammatory cytokines. The correlation of HO-1 concentration in synovial fluid with serum CRP and MMP-3 in joint fluid indicated that HO-1 might be useful as a marker of joint inflammation in RA patients.

DOI： 10.1007/s10165-010-0372-9

ハンドル外傷による舟状骨骨折の1例

金澤智子, 島村安則, 西田圭一郎, 斎藤太一, 中原龍一, 雑賀建多, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 1 ) 253 - 253 2011.4

掌側プレート固定を行った橈骨遠位端骨折における抜釘術の重要性

島村安則, 井上円加, 小澤正嗣, 斎藤太一, 金澤智子, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 1 ) 258 - 258 2011.4

RA手関節に対する部分固定術の術後成績

斎藤太一, 西田圭一郎, 橋詰謙三, 島村安則, 尾崎敏文

日本手外科学会雑誌 28 ( 1 ) S138 - S138 2011.3

ANTERIOR TRANSPOSITION OF THE ULNAR NERVE WITH ENDOSCOPIC ASSISTANCE

T. Konishiike, K. Nishida, M. Ozawa, T. Ozaki

JOURNAL OF HAND SURGERY-EUROPEAN VOLUME 36E ( 2 ) 126 - 129 2011.2

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE PUBLICATIONS LTD

We treated 20 patients with cubital tunnel syndrome by anterior transposition of the ulnar nerve with endoscopic assistance. Five elbows were classified preoperatively as McGowan's stage 1, 11 as stage 2 and four as stage 3. Excellent outcomes were obtained in nine and good in eight patients. Three patients had fair results. Improvement of symptoms occurred in all patients. There were no serious complications. All ulnar nerves remained anteriorly transposed.

DOI： 10.1177/1753193410381675

Prenatal diagnosis of short-rib polydactyly syndrome type 3 (Verma-Naumoff type) by three-dimensional helical computed tomography

Takahiro Yamada, Gen Nishimura, Keiichiro Nishida, Hideaki Sawai, Tokuhiko Omatsu, Taichi Kimura, Hiroshi Nishihara, Rina Shono, Shigeki Shimada, Mamoru Morikawa, Masato Mizushima, Takashi Yamada, Kazutoshi Cho, Shinya Tanaka, Hiroki Shirato, Hisanori Minakami

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 37 ( 2 ) 151 - 155 2011.2

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL PUBLISHING, INC

We present a case of short-rib polydactyly syndrome (SRPs) type 3 in which accurate prenatal diagnosis was feasible using both ultrasonography and 3D-CT. SRP encompass a heterogeneous group of lethal skeletal dysplasias. However, the phenotypes overlap with those of nonlethal skeletal dysplasias (i.e. Ellis-van Creveld syndrome and Jeune syndrome). As accurate prenatal diagnosis of SRP is helpful for parents, we used 3D-CT in the early third trimester to examine a fetus suggested to have phenotypes of 'short-rib dysplasia group' on ultrasonography. 3D-CT showed mild modification of the vertebral bodies, small ilia with horizontal acetabula and triangular partial ossification defects, and subtle metaphyseal irregularities of the femora. These CT findings and an extensive literature search regarding the phenotypes of various diseases categorized as short-rib dysplasia group led to a correct prenatal diagnosis of SRP type 3. This case exemplified the usefulness of 3D-CT for the precise prenatal diagnosis of skeletal dysplasias.

DOI： 10.1111/j.1447-0756.2010.01324.x

Regulation of mechanical stress-induced MMP-13 and ADAMTS-5 expression by RUNX-2 transcriptional factor in SW1353 chondrocyte-like cells

T. Tetsunaga, K. Nishida, T. Furumatsu, K. Naruse, S. Hirohata, A. Yoshida, T. Saito, T. Ozaki

OSTEOARTHRITIS AND CARTILAGE 19 ( 2 ) 222 - 232 2011.2

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO LTD

Objective: To investigate the mechanism of mechanical stress-induced expression and regulation of aggrecanases and examine the role of runt-related transcription factor 2 (RUNX-2) in chondrocyte-like cells.
Methods: SW1353 cells were seeded onto stretch chambers at a concentration of 5 x 10(4) cells/chamber, and a uni-axial cyclic tensile strain (CTS) (0.5 Hz, 10% stretch) was applied for 30 min. Total RNA was extracted, reverse transcribed, and analyzed by polymerase chain reaction (PCR) and real-time PCR. RUNX-2 overexpression and small interfering RNA (siRNA) targeting RUNX-2 were used to investigate the role of RUNX-2 in CTS-induced gene expression. The involvement of diverse mitogen-activated protein kinase (MAPK) pathways in the activation of RUNX-2, MMP-13 and ADAMTS-5 during CTS was examined by Western blotting.
Results: CTS induced expression of RUNX-2, MMP-13, ADAMTS-4, -5, and -9. Overexpression of RUNX-2 up-regulated expression of MMP-13 and ADAMTS-5, whereas RUNX-2 siRNA resulted in significant down-regulation of mechanically-induced MMP-13 and ADAMTS-5 expression. CTS induced activation of p38 MAPK, and CTS induction of RUNX-2. MMP-13 and ADAMTS-5 mRNA was down-regulated by the selective p38 MAPK inhibitor SB203580 but not by the p44/42 MAPK inhibitor U0126, or the JNK MAPK inhibitor JNK inhibitor II.
Conclusions: RUNX-2 might have a role as a key downstream mediator of p38's ability to regulate mechanical stress-induced MMP-13 and ADAMTS-5 expression. (C) 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.joca.2010.11.004

Well leg compartment syndrome following radical cystectomy: A case report

OKADA Yoshiki

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 4 ) 869 - 870 2011

Time-concentration profile of serum etanercept in Japanese patients with rheumatoid arthritis after treatment discontinuation before orthopedic surgery

Keiichiro Nishida, Kenzo Hashizume, Yasutaka Kadota, Masamitsu Natsumeda, Ryuichi Nakahara, Taichi Saito, Tomoko Kanazawa, Kazuhiko Ezawa, Toshihumi Ozaki

MODERN RHEUMATOLOGY 20 ( 6 ) 637 - 639 2010.12

長橈側手根伸筋(ECRL)腱を用いて母指手根中手骨(CM)関節形成術を行った1例

井上円加, 西田圭一郎, 橋詰謙三, 島村安則, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

岡山医学会雑誌 122 ( 3 ) 279 - 279 2010.12

【関節リウマチ明確な治療目標の達成をめざす診療】パラダイムシフト後の関節外科治療

那須義久, 中原龍一, 西田圭一郎

治療学 44 ( 10 ) 1127 - 1130 2010.10

RA上肢変形の治療関節リウマチ(RA)に対するSauve-Kapandji(S-K)法の治療成績

金澤智子, 橋詰謙三, 西田圭一郎, 中原龍一, 斎藤太一, 尾崎敏文

日本関節病学会誌 29 ( 3 ) 398 - 398 2010.10

周術期の管理エタネルセプト使用症例の周術期感染頻度の検討

中原龍一, 西田圭一郎, 金澤智子, 斎藤太一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 29 ( 3 ) 340 - 340 2010.10

関節病に対する上肢人工関節置換術関節リウマチ肘関節破壊に対するJACE型人工肘関節置換術の中期成績

橋詰謙三, 西田圭一郎, 中原龍一, 斎藤太一, 金澤智子, 尾崎敏文

日本関節病学会誌 29 ( 3 ) 409 - 409 2010.10

橈骨遠位端掌側部の組織学的検討いわゆるWatershed Lineを中心に

今谷潤也, 清水弘毅, 高田逸朗, 西田圭一郎, 秋田恵一

日本手外科学会雑誌 26 ( 5 ) 466 - 468 2010.9

三次元実体石膏模型を利用して治療した反復性肩関節脱臼の1例

井上円加, 中原龍一, 斎藤太一, 金澤智子, 島村安則, 小澤正嗣, 阿部信寛, 野田知之, 西田圭一郎, 尾崎敏文

肩関節 35 ( 1 ) 176 - 176 2010.9

鎖骨骨幹部骨折に対する前下方プレート法による治療成績

島村安則, 野田知之, 中原龍一, 金澤智子, 井上円加, 斎藤太一, 小澤正嗣, 雑賀建多, 西田圭一郎, 尾崎敏文

肩関節 35 ( 1 ) 75 - 75 2010.9

橈骨遠位端掌側ロッキングプレートにおける屈筋腱障害の発生要因解剖学的検討を基に

清水弘毅, 今谷潤也, 高田逸朗, 中道亮, 山川泰明, 大塚亮介, 岡田幸正, 井上円加, 川上幸雄, 林正典, 西田圭一郎

中国・四国整形外科学会雑誌 22 ( 2 ) 496 - 496 2010.9

ヒト軟骨細胞様細胞においてADAMTS-5はRUNX-2を介してメカノセンシティブに機能するアグリカナーゼである

鉄永智紀, 西田圭一郎, 古松毅之, 斎藤太一, 成瀬恵治, 尾崎敏文

日本整形外科学会雑誌 84 ( 8 ) S1230 - S1230 2010.8

Increased activity and expression of histone deacetylase 1 in relation to tumor necrosis factor-alpha in synovial tissue of rheumatoid arthritis

Tomoko Kawabata, Keiichiro Nishida, Koji Takasugi, Hiroko Ogawa, Kenei Sada, Yasutaka Kadota, Junko Inagaki, Satoshi Hirohata, Yoshifumi Ninomiya, Hirofumi Makino

Arthritis Research and Therapy 12 ( 4 ) 637 - 639 2010.7

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

Introduction: The purpose of this study was to investigate the profile of histone deacetylase (HDAC) expression in the synovial tissue of rheumatoid arthritis (RA) compared with that of normal control and osteoarthritis (OA), and to examine whether there is a link between HDAC activity and synovial inflammation.Methods: HDAC activity and histone acetyltransferase (HAT) activity were determined in nuclear extracts of total synovial tissue surgically obtained from normal, OA and RA joints. The level of cytoplasmic tumor necrosis factor a (TNFα) fraction was measured by ELISA. Total RNA of synovial tissue was used for RT-PCR of HDAC1-8. In synovial fibroblasts from RA (RASFs), the effects of TNFα on nuclear HDAC activity and class I HDACs (1, 2, 3, 8) mRNA expressions were examined by quantitative real-time PCR. The protein expression and distribution of class I HDACs were examined by Western blotting.Results: Nuclear HDAC activity was significantly higher in RA than in OA and normal controls and correlated with the amount of cytoplasmic TNFα. The mRNA expression of HDAC1 in RA synovial tissue was higher than in OA and normal controls, and showed positive correlation with TNFα mRNA expression. The protein level of nuclear HDAC1 was higher in RA synovial tissue compared with OA synovial tissue. Stimulation with TNFα significantly increased the nuclear HDAC activity and HDAC1 mRNA expression at 24 hours and HDAC1 protein expression at 48 hours in RASFs.Conclusions: Our results showed nuclear HDAC activity and expression of HDAC1 were significantly higher in RA than in OA synovial tissues, and they were upregulated by TNFα stimulation in RASFs. These data might provide important clues for the development of specific small molecule HDAC inhibitors. © 2010 Kawabata et al.
licensee BioMed Central Ltd.

DOI： 10.1186/ar3071

Radiographic measurements in the evaluation and classification of elbow joint destruction in patients with rheumatoid arthritis

Kenzo Hashizume, Keiichiro Nishida, Kazuo Fujiwara, Yasutaka Kadota, Ryuichi Nakahara, Kazuhiko Ezawa, Hajime Inoue, Toshifumi Ozaki

CLINICAL RHEUMATOLOGY 29 ( 6 ) 637 - 643 2010.6

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

We developed two new radiographic parameters-the humeral surface height ratio and ulnar surface height ratio-to precisely detect changes in the bony structure of rheumatoid elbows. Of the 59 patients with rheumatoid arthritis, 101 elbows were classified into four types (osteoarthritis, ankylosis, erosive, and resorptive) according to the radiographic appearance. Clinically, osteoarthritis type and ankylosis type were considered to be stable form, and erosive type and resorptive type were unstable form. Patients' clinical data and yearly radiographic changes in the bony structure evaluated by the humeral surface height ratio and ulnar surface height ratio were compared among the four types and between the two forms. There were significant differences between the two forms and among the three types except for the ankylosis type in yearly radiographic changes in the bony structure evaluated by the humeral surface height ratio and ulnar surface height ratio. Stable and unstable forms were distinguished by a cut-off point of 0.65 and 2.58 in yearly radiographic changes in the bony structure evaluated by the humeral surface height ratio and the ulnar surface height ratio, respectively. These parameters might be useful for monitoring the structural changes of the elbow joint in rheumatoid arthritis.

DOI： 10.1007/s10067-010-1381-y

Preoperative Time Required for the Timed "Up and Go" Test in Women with Hip Osteoarthritis Could Predict a Deep Venous Thrombosis Complication after Total Hip Arthroplasty

Kentaro Sasaki, Masuo Senda, Keiichiro Nishida, Haruyuki Ota

ACTA MEDICA OKAYAMA 64 ( 3 ) 197 - 201 2010.6

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

We examined whether the preoperative time required for the Timed "Up and Go" (TUG) test could predict the risk for deep venous thrombosis (DVT) in patients with hip osteoarthritis after total hip arthroplasty (THA). Eighteen patients with DVT diagnosed by venography were selected, and 18 without DVT of the same age and sex and with the same operated side as the DVT group were selected as a control group. We evaluated the 5 preoperative factors that might affect the occurrence of DVT complications, as follows: disease duration, body mass index, serum total cholesterol, subjective pain evaluated by the visual analog scale, and TUG. The JOA hip score (pain, range of motion, walking ability, and daily life) was also evaluated before surgery. As a postoperative factor, we checked the postoperative day when weight-bearing was initiated. As a result, TUG (DVT, 18.4 +/- 4.0 sec vs. control, 15.0 +/- 3.2 sec; p < 0.01) was only significantly different between the 2 groups. The ROC curve revealed that the cut-off point of 15.3 sec in preoperative time for TUG was sensitive (83.3%) and specific (61.1%) for DVT after THA (odds ratio = 7.0; 95% confidence interval, 1.6-30.8). These results suggested that low preoperative ambulatory ability in patients with hip osteoarthritis might be associated with DVT after THA. An improvement in TUG before surgery might contribute to a decrease in the occurrence of DVT after THA.

DOI： 10.18926/AMO/40012

The Mohawk homeobox gene is a critical regulator of tendon differentiation

Yoshiaki Ito, Naoya Toriuchi, Teruhito Yoshitaka, Hiroe Ueno-Kudoh, Tempei Sato, Shigetoshi Yokoyama, Keiichiro Nishida, Takayuki Akimoto, Michiko Takahashi, Shigeru Miyaki, Hiroshi Asahara

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA 107 ( 23 ) 10538 - 10542 2010.6

Language：English Publishing type：Research paper (scientific journal) Publisher：NATL ACAD SCIENCES

Mohawk(Mkx) is a member of the Three Amino acid Loop Extension superclass of atypical homeobox genes that is expressed in developing tendons. To investigate the in vivo functions of Mkx, we generated Mkx(-/-) mice. These mice had hypoplastic tendons throughout the body. Despite the reduction in tendon mass, the cell number in tail tendon fiber bundles was similar between wild-type and Mkx(-/-) mice. We also observed small collagen fibril diameters and a down-regulation of type I collagen in Mkx(-/-) tendons. These data indicate that Mkx plays a critical role in tendon differentiation by regulating type I collagen production in tendon cells.

DOI： 10.1073/pnas.1000525107

Biomechanical Evaluation of the Fixation Methods for Transcondylar Fracture of the Humerus: ONI Plate Versus Conventional Plates and Screws

Yasunori Shimamura, Keiichiro Nishida, Junya Imatani, Tomoyuki Noda, Hiroyuki Hashizume, Aiji Ohtsuka, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 64 ( 2 ) 115 - 120 2010.4

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

We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I) during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 conventional fixation methods: an LCP reconstruction plate 3.5 using a locking mechanism (Group II), a conventional reconstruction plate 3.5 (CRP) with a cannulated cancellous screw (Group III), and a CRP with 2 cannulated cancellous screws (CS) in a crisscross orientation (Group IV). In the axial loading test, the mean failure loads were: Group I, 98.9 +/- 32.6; Group II, 108.5 +/- 27.2; Group III, 50.0 +/- 7.5; and Group IV, 34.5 +/- 12.2 (N). Group I fixations failed at a significantly higher load than those of Groups III and IV (p < 0.05). In the extension loading test, the mean failure loads were: Group I, 34.0 +/- 12.4; Group II, 51.0 +/- 14.8; Group III, 19.3 +/- 6.0; and Group IV, 14.7 +/- 3.1 (N). Group IV fixations showed a significantly lower failure load than those of Group I (p < 0.05). The fixation rigidities against mechanical loading by the ONI plate and LCP plate were comparable. These results suggested that an ONI system might be superior to the CRP and CS method, and comparable to the LCP method in terms of fixation rigidity for distal humerus fractures.

掌側ロッキングプレートを用いて加療した橈骨遠位部骨折における抜釘術の検討

島村安則, 斎藤太一, 金澤智子, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 22 ( 1 ) 199 - 199 2010.4

橈骨遠位端部掌側の解剖的研究 Watershed Lineを中心に

清水弘毅, 今谷潤也, 中道亮, 井上円加, 岡田幸正, 高田逸朗, 高橋欣吾, 川上幸雄, 林正典, 西田圭一郎, 吉田晶

中国・四国整形外科学会雑誌 22 ( 1 ) 260 - 260 2010.4

生物学的製剤使用下の手術治療について生物学的製剤の限界

西田圭一郎, 橋詰謙三, 門田康孝, 中原龍一, 斎藤太一, 尾崎敏文

日本整形外科学会雑誌 84 ( 3 ) S228 - S228 2010.3

掌側ロッキングプレートを用いて加療した橈骨遠位部骨折における抜釘術の検討

島村安則, 斎藤太一, 野田知之, 西田圭一郎, 尾崎敏文

日本手の外科学会雑誌 27 ( 1 ) S138 - S138 2010.3

生物学的製剤時代における手術の変遷画像診断と外科的治療画像からみた手術の適応とタイミングどの時期に手術が必要か

西田圭一郎, 橋詰謙三, 中原龍一, 門田康孝, 那須義久, 斎藤太一, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 54回・19回 219 - 219 2010.3

関節リウマチに対する手術療法の進歩と今後関節リウマチに対する上肢手術の進歩と今後

西田圭一郎, 橋詰謙三, 門田康孝, 中原龍一, 斎藤太一, 尾崎敏文

日本整形外科学会雑誌 84 ( 3 ) S231 - S231 2010.3

Frequent methylation of RASSF1A in synovial sarcoma and the anti-tumor effects of 5-aza-2'-deoxycytidine against synovial sarcoma cell lines

Kunihiko Numoto, Aki Yoshida, Shinsuke Sugihara, Toshiyuki Kunisada, Yuki Morimoto, Yasushi Yoneda, Yasuko Fujita, Keiichiro Nishida, Mamoru Ouchida, Toshifumi Ozaki

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 136 ( 1 ) 17 - 25 2010.1

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

In this study, the methylation status of RASSF1A in synovial sarcomas and the effect of de-methylation on synovial sarcoma were examined.
The methylation status in 74 soft tissue sarcomas (STSs) including 21 synovial sarcomas was determined by methylation specific PCR. The effect of the de-methylating agent 5-aza-2'-deoxycytidine (5-Aza-dC) on synovial sarcoma was examined using synovial sarcoma cell lines (SYO-1 and HS-SY-II).
RASSF1A methylation was observed in 10 (47.6%) of 21 synovial sarcomas and in 10 (18.9%) of 53 the other STSs (P = 0.0295). De-methylation of the cells by treatment with 5-Aza-dC induced re-expression of RASSF1A and growth suppression of the cells. The calculated IC50 of 5-Aza-dC against the SYO-1 and the HS-SY-II cells were 0.9 and 1.3 mu M (96 h), respectively. With twice weekly administration of 1 or 10 mg/kg 5-Aza-dC, the growth of the mouse xenograft tumors of SYO-1 was significantly suppressed in comparison to the controls (P < 0.01).
This is the first report showing the anti-tumor effect of 5-Aza-dC on synovial sarcoma. 5-Aza-dC is suggested to have a good therapeutic potential against synovial sarcoma.

DOI： 10.1007/s00432-009-0632-2

Inflammatory Cytokine-induced Expression of Vasohibin-1 by Rheumatoid Synovial Fibroblasts

Kohei Miyake, Keiichiro Nishida, Yasutaka Kadota, Hiroko Yamasaki, Tatsuyo Nasu, Daisuke Saitou, Katsuyuki Tanabe, Hikaru Sonoda, Yasufumi Sato, Yohei Maeshima, Hirofumi Makino

ACTA MEDICA OKAYAMA 63 ( 6 ) 349 - 358 2009.12

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

Angriogenesis is an essential event in the development of synovial inflammation in rheumatoid arthritis (RA). The aim of the current study was to investigate the expression of vasohibin-1, a novel endothelium-derived vascular endothelial growth factor (VEGF)-inducible angiogenesis inhibitor, in the RA synovium, and to test the effect of inflammatory cytokines on the expression of vasohibin-1 by RA synovial fibroblasts (RASFs). Synovial tissue samples were obtained at surgery from patients with osteoarthritis (OA) and RA, and subjected to immunohistochemistry to investigate the expression and distribution of vasohibin-1 relevant to the degree of synovial inflammation. In an in vitro analysis, RASFs were used to examine the expression of vasohibin-1 and VEGF mRNA by real-time PCR after stimulation with VEGF or inflammatory cytokines under normoxic or hypoxic conditions. The immunohistochemical results showed that vasohibin-1 was expressed in synovial lining cells, endothelial cells, and synovial fibroblasts. In synovial tissue, there was a significant correlation between the expression of vasohibin-1 and histological inflammation score (p = 0.002, r = 0.842). In vitro, stimulation with VEGF induced the expression of vasohibin-1 mRNA in RASFs under normoxic conditions, and stimulation with cytokines induced vasohibin-1 mRNA expression under a hypoxic condition. These results suggest that vasohibin-1 was expressed in RA synovial tissue and might be regulated by inflammatory cytokines.

DOI： 10.18926/AMO/31820

Computer Navigation-Assisted Spinal Fusion with Segmental Pedicle Screw Instrumentation for Scoliosis with Rett Syndrome: A Case Report

Masato Tanaka, Kazuo Nakanishi, Yoshihisa Sugimoto, Haruo Misawa, Tomoyuki Takigawa, Keiichiro Nishida, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 63 ( 6 ) 373 - 377 2009.12

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

Scoliosis is a common clinical manifestation of Rett syndrome, a neurodevelopmental disorder that almost exclusively affects females. The spinal curve in patients with Rett syndrome is typically a long C curve of a neuromuscular type. As the onset of the scoliosis is very early and shows rapid progression, early surgical intervention has been recommended to prevent a life-threatening collapsing spine syndrome. However, there are high perioperative risks in Rett syndrome patients who undergo spinal surgery, such as neurological compromise and respiratory dysfunction due to rigrid spinal curve. We herein report the surgical result of treating severe rapid progressive thoracic scoliosis in a 16-year-old girl with Rett syndrome. Posterior segmental pedicle screw fixation was performed from T1 to L3 using a computer-assisted technique. Post-operative radiography demonstrated a good correction of the curve in both the sagittal and coronal alignment. There were no postoperative complications such as neurological compromise. The patient had maintained satisfactory spinal balance as of the 3-year follow-up examination.

DOI： 10.18926/AMO/31823

A disintegrin and metalloproteinase with thrombospondin motifs 9 (ADAMTS9) expression by chondrocytes during endochondral ossification

Kanae Kumagishi, Keiichiro Nishida, Tomoichiro Yamaai, Ryusuke Momota, Shigeru Miyaki, Satoshi Hirohata, Ichiro Naito, Hiroshi Asahara, Yoshifumi Ninomiya, Aiji Ohtsuka

ARCHIVES OF HISTOLOGY AND CYTOLOGY 72 ( 3 ) 175 - 185 2009.11

Language：English Publishing type：Research paper (scientific journal) Publisher：INT SOC HISTOLOGY & CYTOLOGY

A disintegrin and metalloproteinase with thrombospondin motifs 9 (ADAMTS9) is known to influence aggrecan degradation in endochondral ossification, but its role has not been well understood. In the present study, in vitro gene expression of ADAMTS9 was investigated by RT-PCR in ATDC5 cells in which experimentally chondrogenic differentiation had been induced. We also investigated the protein localization and gene expression pattern of ADAMTS9 in the tibia growth plate cartilage of male mice in a day 1 neonate, 7-week-old young adult, and a 12-week-old adult by immunohistochemistry and in situ hybridization and compared the results with the expression of proliferating cell nuclear antigen (PCNA) and type X collagen for the identification of proliferative and hypertrophic chondrocyte phenotypes, respectively. We found the gene expression of ADAMTS9 by ATDC5 cells as a dual mode, both before the expression of type X collagen and after hypertrophic differentiation. The immunoreactivity of ADAMTS9 was observed in chondrocytes of proliferative and hypertrophic zones in the growth plate. The population of ADAMTS9 positive cells decreased with age. The results of the present study suggest that ADAMTS9 might have a role in aggrecan cleavage around the chondrocytes to allow chondrocyte proliferation and hypertrophy.

DOI： 10.1679/aohc.72.175

Mechanical stretch stimulates integrin alpha V beta 3-mediated collagen expression in human anterior cruciate ligament cells

Tomonori Tetsunaga, Takayuki Furumatsu, Nobuhiro Abe, Keiichiro Nishida, Keiji Naruse, Toshifumi Ozaki

JOURNAL OF BIOMECHANICS 42 ( 13 ) 2097 - 2103 2009.9

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Biomechanical stimuli have fundamental roles in the maintenance and remodeling of ligaments including collagen gene expressions. Mechanical stretching signals are mainly transduced by cell adhesion molecules such as integrins. However. the relationships between stress-induced collagen expressions and integrin-mediated cellular behaviors are still unclear in anterior cruciate ligament cells. Here, we focused on the stretch-related responses of different cells derived from the ligament-to-bone interface and midsubstance regions of human anterior cruciate ligaments. Chondroblastic interface cells easily lost their potential to produce collagen genes in non-stretched conditions, rather than fibroblastic midsubstance cells. Uni-axial mechanical stretches increased the type I collagen gene expression of interface and midsubstance cells up to 14- and 6-fold levels of each non-stretched control, respectively. Mechanical stretches also activated the stress fiber formation by shifting the distribution of integrin alpha V beta 3 to the peripheral edges in both interface and midsubstance cells. In addition, integrin alpha V beta 3 colocalized with phosphorylated focal adhesion kinase in stretched cells. Functional blocking analyses using anti-integrin antibodies revealed that the stretch-activated collagen gene expressions on fibronectin were dependent on integrin alpha V beta 3-mediated cellular adhesions in the interface and midsubstance cells. These findings suggest that the integrin alpha V beta 3-mediated stretch signal transduction might have a key role to stimulate collagen gene expression in human anterior cruciate ligament, especially in the ligament-to-bone interface. (C) 2009 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jbiomech.2009.06.016

Optical imaging of mouse articular cartilage using the glycosaminoglycans binding property of fluorescent-labeled octaarginine

K. Inagawa, T. Oohashi, K. Nishida, J. Minaguchi, T. Tsubakishita, K. O. Yaykasli, A. Ohtsuka, T. Ozaki, T. Moriguchi, Y. Ninomiya

OSTEOARTHRITIS AND CARTILAGE 17 ( 9 ) 1209 - 1218 2009.9

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO LTD

Objective: The aim of the current study was to examine the cartilage-specific binding property of polyarginine peptides (R4, 8, 12, and 16) and specifically to test octaarginine peptides for the optical imaging of articular cartilage in experimentally induced arthritis in mice.
Methods: Four rhodamine-labeled polyarginine peptides each with a different-length arginine chain (R4, 8, 12, or 16) were injected into the knee joints of C57BL/6J mice (n = 20). The joints were excised 1 h later and the fluorescent signal intensity in cartilage cryosections was compared for the four peptides. To examine the substrate of R8 in cartilage, femoral condyles obtained from another set of mice were treated with chondroitinase ABC (Ch'ase ABC), keratanase or heparitinase then immersed in R8-rhodamine. Fluorescent signals were examined by fluorescent microscopy. Next, R8-rhodamine was injected into the right knee joints of three control and three collagen antibody-induced arthritis (CAIA) mice, and fluorescent intensity in normal and degenerative cartilage was semi-quantitatively analysed on the histological sections using image software. Finally, femoral condyles from normal mice (n = 2) and CAIA mice (n = 2) were immersed in R8-rhodamine and calcein, then imaged using optical projection tomography (OPT).
Results: Fluorescent signals were specifically detected in the cartilage pericellular matrix from the surface to the tide mark but were completely absent in the calcified layer or bone marrow. The number of arginine residues significantly influenced peptide accumulation in articular cartilage, with R8 accumulating the most. The fluorescent signal in the femoral condylar cartilage diminished when it was treated with Ch'ase ABC. R8 accumulation was significantly decreased in the degenerative cartilage of CAIA mice, and this was demonstrated both histologically and in three-dimensional (3D)-reconstruction image by OPT.
Conclusion: R8 may be a useful new experimental probe for optical imaging of normal and arthritic articular cartilage. (C) 2009 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.joca.2009.03.010

【整形外科関節リウマチ保存治療の実際】RA診断・治療におけるMRIの有用性

中原龍一, 西田圭一郎

Orthopaedics 22 ( 9 ) 31 - 38 2009.8

Language：Japanese Publisher：(株)全日本病院出版会

関節リウマチ(RA)に対する治療ガイドラインが策定され、生物学的製剤の登場やメトトレキサートの積極的使用により、早期診断、薬効評価における画像診断の重要性が大きくなりつつある。MRI画像によって得られるRAに特徴的な所見としては、滑膜炎、骨びらん、骨髄浮腫、腱鞘滑膜炎などがあり、補助診断としてRAを早期に診断し、予後不良因子などをもとに治療法を決定し、寛解・薬剤中止を目指すためのツールとしてのエビデンスが蓄積されつつある。早期診断においてはfalse positiveの除外を含めた正しい評価方法を知ることが重要であり、薬効判定においては滑膜体積や最大造影速度などを用いた定量的判定が求められている。(著者抄録)

マウス成長軟骨におけるADAMTS-9発現とその役割について

熊岸加苗, 西田圭一郎, 百田龍輔, 山合友一朗, 廣畑聡, Kadir Demircan, 内藤一郎, 二宮善文, 大塚愛二

解剖学雑誌 84 ( Suppl. ) 139 - 139 2009.3

Target-tropic accumulation of SLX-liposome in arthritis mouse Reviewed

Minaguchi JA, Minematsu H, Oohashi T, Otani T, Inagawa K, Oie K, Nishida K, Ohtsuka A, Ninomiya Y, Igarashi K

Matrix Biology 27 43 - 43 2008.12

The expression of microRNA424 in rheumatoid arthritis

Yoshitaka, Teruhito, Nakasa, Tomoyuki, Inoue, Atsushi, Okubo, Atsuko, Takemoto, Fuko, Miyaki, Shigeru, Nishida, Keiichiro, Ochi, MitStio, Ozaki, Toshifumi, Sumida, Takayuki, Asahara, Hiroshi

ARTHRITIS AND RHEUMATISM 58 ( 9::Suppl. S ) 0 - 0 2008.9

Disease-specific screening for deep venous thrombosis and pulmonary thromboembolism using plasma D-dimer values after total knee arthroplasty

Teruhito Yoshitaka, Nobuhiro Abe, Hiroshi Minagawa, Hirokazu Date, Yoshimasa Sakoma, Keiichiro Nishida, Toshifumi Ozaki

MODERN RHEUMATOLOGY 18 ( 4 ) 359 - 365 2008.8

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

We prospectively evaluated the disease-specific features of the early postoperative plasma D-dimer value and the relationship with deep venous thrombosis and/or pulmonary thromboembolism (DVT/PE) in 95 patients following total knee arthroplasty. Patients in whom DVT/PE was highly suspected were diagnosed by high-resolution multi-detector row computed tomography scanning (MDCT). Forty-nine knees in 46 patients with rheumatoid arthritis (RA, 24 knees) or osteoarthritis (OA, 25 knees) were finally recruited. DVT/PE was detected in 28 (57.1%) of the 49 cases examined by diagnostic MDCT: 12 (50.0%) of the 24 cases of RA, and 16 (64.0%) of the 25 cases of OA. Of these, PE was found in 11 cases (39.2%), but none of them showed clinical symptomatic signs of dyspnea or chest pain. In both RA and OA cases, there were statistically significant differences in the D-dimer value on postoperative day 3 (P = 0.027) and after day 28 (P = 0.037) between the groups with and without DVT/PE. In OA cases, there were significant differences between the two groups on postoperative days 1 (P = 0.034), 3 (P = 0.020), 5 (P = 0.005), and 7 (P = 0.045), respectively. At the baseline, perioperative D-dimer levels in the RA group without DVT/PE were higher than in the OA group. However, multivariate logistic regression analysis showed that RA was not a significant risk factor of DVT/PE in comparison with OA. In conclusion, individual evaluation of the D-dimer level between RA and OA should provide a more precise predictive indicator of early postoperative DVT/PE.

DOI： 10.1007/s10165-008-0068-6

Intra-articular injection of interleukin-4 decreases nitric oxide production by chondrocytes and ameliorates subsequent destruction of cartilage in instability-induced osteoarthritis in rat knee joints

M. Yorimitsu, K. Nishida, A. Shimizu, H. Doi, S. Miyazawa, T. Komiyama, Y. Nasu, A. Yoshida, S. Watanabe, T. Ozaki

OSTEOARTHRITIS AND CARTILAGE 16 ( 7 ) 764 - 771 2008.7

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Objective: To investigate the in vitro and in vivo effects of interleukin (IL)-4 on mechanical stress-induced nitric oxide (NO) expression by chondrocytes, and destruction of cartilage and NO production in an instability-induced osteoarthritis (OA) model in rat knee joints, respectively.
Materials and methods: Cyclic tensile stress (CTS; 0.5 Hz and 7% elongation) was applied to cultured normal rat chondrocytes with or without pre-incubation with recombinant rat IL-4 (rrIL-4). Inducible NO synthase (iNOS) mRNA expression and NO production were examined with real-time polymerase chain reaction and the Griess reaction, respectively. OA was induced in rat knee joints by transection of the anterior cruciate and medial collateral ligaments and resection of the medial meniscus. rrIL-4 (10, 50, and 100 ng/joint/day) was injected intra-articularly, and knee joint samples were collected 2, 4, and 6 weeks after surgery. Cartilage destruction was evaluated by the modified Mankin score and Osteoarthritis Research Society International scoring system on paraffin-embedded sections stained with safranin O. Cleavage of aggrecan and NO production were examined by immunohistochemistry for aggrecan neoepitope (NITEGE) and of nitrotyrosine (NT), respectively.
Results: rrIL-4 down-regulated CTS-induced iNOS mRNA expression and NO production by chondrocytes. The intra-articular injection of rrIL-4 gave rise to a limited, but significant amelioration of cartilage destruction, prevention of loss of aggrecan, and decrease in the number of NT-positive chondrocytes, an effect that was not dose-dependent.
Conclusion: The present study suggests that IL-4 may exert chondroprotective properties against mechanical stress-induced cartilage destruction, at least in part, by inhibiting NO production by chondrocytes. (C) 2007 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.joca.2007.11.006

Novel magnetic resonance imaging evaluation for valgus instability of the knee caused by medial collateral ligament injury

Hisanori Ikuma, Nobuhiro Abe, Youichiro Uchida, Takayuki Furumatsu, Kazuo Fujiwara, Keiichiro Nishida, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 62 ( 3 ) 185 - 191 2008.6

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

Instability of the knee after the medial collateral ligament (MCL) injury is usually assessed with the manual valgus stress test, even though, in recent years, it has become possible to apply magnetic resonance imaging (MRI) to the assessment of the damage of the ligament. The valgus instability of 24 patients (12 isolated injuries and 12 multiple ligament injuries) who suffered MCL injury between 1993 and 1998 was evaluated with the Hughston and Eilers classification, which involves radiographic assessment under manual valgus stress to the injured knees. We developed a novel system for classifying the degree of injury to the MCL by calculating the percentage of injured area based on MRI and investigated the relationship between this novel MRI classification and the magnitude of valgus instability by the Hughston and Eilers classification. There was a significant correlation between the 2 classifications (p = 0.0006). On the other hand, the results using other MRI based classification systems, such as the Mink and Deutsch classificaiton and the Petermann classification, were not correlated with the findings by the Hughston and Eilers classification in these cases (p > 0.05). Since MRI is capable of assessing the injured ligament in clinical practice, this novel classification system would be useful for evaluating the stability of the knee and choosing an appropriate treatment following MCL injury.

DOI： 10.18926/AMO/30974

Expression of MicroRNA-146 in rheumatoid arthritis synovial tissue

Tomoyuki Nakasa, Shigeru Miyaki, Atsuko Okubo, Megumi Hashimoto, Keiichiro Nishida, Mitsuo Ochi, Hiroshi Asahara

ARTHRITIS AND RHEUMATISM 58 ( 5 ) 1284 - 1292 2008.5

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-LISS

Objective. Several microRNA, which are similar to 22-nucleotide noncoding RNAs, exhibit tissue-specific or developmental stage-specific expression patterns and are associated with human diseases. The objective of this study was to identify the expression pattern of microRNA-146 (miR-146) in synovial tissue from patients with rheumatoid arthritis (RA).
Methods. The expression of miR-146 in synovial tissue from 5 patients with RA, 5 patients with osteoarthritis (OA), and 1 normal subject was analyzed by quantitative reverse transcription-polymerase chain reaction (RT-PCR) and by in situ hybridization and immunohistochemistry of tissue sections. Induction of miR-146 following stimulation with tumor necrosis factor alpha (TNF alpha) and interleukin-1 beta (IL-1 beta) of cultures of human rheumatoid arthritis synovial fibroblasts (RASFs) was examined by quantitative PCR and RT-PCR.
Results. Mature miR-146a and primary miR146a/b were highly expressed in RA synovial tissue, which also expressed TNF alpha, but the 2 microRNA were less highly expressed in OA and normal synovial tissue. In situ hybridization showed primary miR-146a expression in cells of the superficial and sublining layers in synovial tissue from RA patients. Cells positive for miR-146a were primarily CD68+ macrophages, but included several CD3+ T cell subsets and CD79a+ B cells. Expression of miR-146a/b was markedly upregulated in RASFs after stimulation with TNF alpha and IL-1 beta.
Conclusion. This study shows that miR-146 is expressed in RA synovial tissue and that its expression is induced by stimulation with TNF alpha and IL-1 beta. Further studies are required to elucidate the function of miR-146 in these tissues.

DOI： 10.1002/art.23429

Interleukin-4 downregulates the cyclic tensile stress-induced matrix metalloproteinases-13 and cathepsin B expression by rat normal chondrocytes

Hideyuki Doi, Keiichiro Nishida, Masanori Yorimitsu, Takamitsu Komiyama, Yasutaka Kadota, Tomonori Tetsunaga, Aki Yoshida, Satoshi Kubota, Masaharu Takigawa, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 62 ( 2 ) 119 - 126 2008.4

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

Mechanical stress plays a key role in the pathogenesis of cartilage destruction seen in osteoarthritis (OA). We investigated the effect of cyclic tensile stress (CTS) on the anabolic and catabolic gene expression of rat cultured normal chondrocytes using the Flexercell strain unit. The effects of interleukin (IL)-4, a chondroprotective cytokine, on the changes in gene expression induced by CTS were also investigated. CTS (7% elongation at 0.5 Hz) for 24 h did not affect the expression of aggrecan and type 11 collagen, whereas CTS significantly upregulated matrix metalloproteinase (MMP)-13 and cathepsin B mRNA expression by chondrocytes. IL-1 beta expression was also significantly upregulated by CTS up to 12 h. The upregulation of MMP-13 was observed at 3 h, which was earlier than that of IL-1 beta. Furthermore, pre-treatment with IL-4 (10 ng/ml) suppressed both MMP-13 and cathepsin B induction by mechanical stress, as well as CTS-induced IL-1 beta expression. Our results suggest that IL-4 might have a therapeutic value in the treatment of OA by downregulation of mechanical stress-induced MMP-13 and cathepsin B expression by chondrocytes.

DOI： 10.18926/AMO/30956

Application of laminar screws to posterior fusion of cervical spine

Kazuo Nakanishi, Masato Tanaka, Yoshihisa Sugimoto, Haruo Misawa, Tomoyuki Takigawa, Kazuo Fujiwara, Keiichiro Nishida, Toshifumi Ozaki

SPINE 33 ( 6 ) 620 - 623 2008.3

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Study Design. Morphometric analysis.
Objective. For safe and solid fixation, it is necessary to measure the diameter of the vertebral arch to ascertain whether or not screws can be used and if so, the appropriate size of screws to be used.
Summary of Background Data. Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion. In 2004, a new method to avoid such vertebral artery injuries was reported by insertion of screws with crosswise to the lamina of C2. For safe and solid fixation, it is necessary to measure the diameter of the vertebral arch to ascertain whether or not screws can be used and if so, the appropriate size of screws to be used. There is no report of the diameter of the vertebral arch by a navigation system.
Methods. Morphometric analysis was performed on 42 patients who had undergone a CT scan of the cervical spine for either surgery or diagnostic purposes. To examine the possibilities to insert laminar screws, the diameter of the vertebral arch was measured using a navigation system.
Results. The diameter of the vertebral arch in C2 was the largest in the cervical spine, individual differences ranging between 0.8 and 8.4 mm. In C2, insertion of screws with a diameter of 3 mm was possible in 80% of males and 63% of females. As for screws with a diameter of 4 mm, insertion was possible in 50% of the males and 24% of the females in C2. In C2, gender had a significant effect, but left-right differences and height did not.
Conclusion. Laminar screws are useful as they can prevent vascular injuries, but a preoperative evaluation is necessary.

DOI： 10.1097/BRS.0b013e318166aa76

Inhibition of histone deacetylase down-regulates the expression of hypoxia-induced vascular endothelial growth factor by rheumatoid synovial fibroblasts

H. Manabe, Y. Nasu, T. Komiyama, T. Furumatsu, A. Kitamura, S. Miyazawa, Y. Ninomiya, T. Ozaki, H. Asahara, K. Nishida

INFLAMMATION RESEARCH 57 ( 1 ) 4 - 10 2008.1

Language：English Publishing type：Research paper (scientific journal) Publisher：BIRKHAUSER VERLAG AG

Objective: To investigate the effect of FK228 on the in vitro expression of hypoxia-inducible factor-1 alpha (HIF-1 alpha) and vascular endothelial growth factor (VEGF) by rheumatoid arthritis synovial fibroblasts (RASFs), and on the in vivo expression of VEGF and angiogenesis in the synovial tissue of mice with collagen-antibody-induced arthritis (CAIA).
Methods: RASFs were stimulated with IL-1 beta and TNF alpha and then incubated under hypoxia (1 % O-2) with various concentrations of FK228. The effects of FK228 on the expression of HIF-1 alpha and VEGF mRNA were examined by quantitative real-time PCR. Changes in HIF-1 alpha protein expression and the secretion of VEGF protein into the culture medium were examined by Western blot analysis and ELISA, respectively. Immunohistochemical analysis was carried out to investigate the expression and distribution of VEGF in synovial tissues of CAIA mice.
Results: The cytokine-stimulated expression of HIF-1 alpha and VEGF mRNA was inhibited by FK228 in a dose-dependent manner. FK228 also reduced the expression of HIF-1 alpha and VEGF protein. Intravenous administration of FK228 (2.5 mg/kg) suppressed VEGF expression, and also blocked angiogenesis in the synovial tissue of CAIA.
Conclusion: FK228 may exhibit a therapeutic effect on RA by inhibition of angiogenesis through down-regulation of angiogenesis related factors, HIF-1 alpha and VEGF.

DOI： 10.1007/s00011-007-7036-z

Isolation of a mRNA preferentially expressed in synoviocytes from rheumatoid arthritis that is identical with lumican, which encodes a collagen binding Extracellular Matrix Protein Reviewed

Hiroki Mori, Keiichiro Nishida, Toshifumi Ozaki, Hajime Inoue, Tohru Nakanishi

Journal of Hard Tissue Biology 17 ( 3 ) 125 - 130 2008

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

Rheumatoid arthritis (RA) is a complex disease including autoimmune disorder and resulting in inflammation. It also shows progressive proliferation of synoviocytes, and these synoviocytes destroys articular structure. In order to understand the mechanism of this abnormal proliferation of RA-originated synoviocytes in molecular level, we analyzed the gene expression profiles by using DNA chips that contain more than 10,000 genes. Comparing the expression profiles of normal and RA-originated synoviocytes, we found several genes that are highly expressed in RA-originated synoviocytes than normal synoviocytes. Among these genes, we focused on one hypothetical protein, cDNA of which contains one reading frame in its DNA fragment, indicating that this fragment is a part of large mRNA structure. The expression of this gene in RA-originated synoviocytes is about three times higher than that in normal synoviocytes by DNA chip analysis. After cDNA cloning of this mRNA, we found that the gene is identical with lumican, which encodes a collagen binding, extracellular matrix protein. This mRNA was widely distributed in many tissues but its alternatively spliced forms are differently expressed in various tissues. ©2008 The Hard Tissue Biology Network Association Printed in Japan, All rights reserved.

DOI： 10.2485/jhtb.17.125

Chondrosarcoma and Peroxisome Proliferator-Activated Receptor

K. Nishida, T. Kunisada, Z. N. Shen, Y. Kadota, K. Hashizume, T. Ozaki

PPAR RESEARCH 2008 1 - 7 2008

Language：English Publisher：HINDAWI PUBLISHING CORPORATION

Induction of differentiation and apoptosis in cancer cells by ligands of PPAR gamma is a novel therapeutic approach to malignant tumors. Chondrosarcoma (malignant cartilage tumor) and OUMS-27 cells (cell line established from grade III human chondrosarcoma) express PPAR gamma. PPAR gamma ligands inhibited cell proliferation in a dose-dependent manner, and induced apoptosis of OUMS-27. The higher-grade chondrosarcoma expressed a higher amount of antiapoptotic Bcl-xL in vivo. The treatment of OUMS-27 by 15d-PGJ(2), the most potent endogenous ligand for PPAR gamma, downregulated expression of Bcl-xL and induced transient upregulation of proapoptotic Bax, which could accelerate cytochrome c release from mitochondria to the cytosol, followed by induction of caspase-dependent apoptosis. 15d-PGJ(2) induced the expression of CDK inhibitor p21 protein in human chondrosarcoma cells, which appears to be involved in the mechanism of inhibition of cell proliferation. These findings suggest that targeted therapy with PPAR gamma ligands could be a novel strategy against chondrosarcoma. Copyright (C) 2008 K. Nishida et al.

DOI： 10.1155/2008/250568

Trichostatin A, a histone deacetylase inhibitor, suppresses synovial inflammation and subsequent cartilage destruction in a collagen antibody-induced arthritis mouse model

Y. Nasu, K. Nishida, S. Miyazawa, T. Komiyama, Y. Kadota, N. Abe, A. Yoshida, S. Hirohata, A. Ohtsuka, T. Ozaki

Osteoarthritis and Cartilage 16 ( 6 ) 723 - 732 2008

Publishing type：Research paper (scientific journal)

Objective: To investigate the effect of the histone deacetylase (HDAC) inhibitor, trichostatin A (TSA), on joint inflammation and cartilage degeneration in a collagen antibody-induced arthritis (CAIA) mouse model. Methods: CAIA mice were given daily subcutaneous injections of various concentrations of TSA (0, 0.5, 1.0, and 2.0 mg/kg) and various parameters were monitored for 14 days. On Day 15, the hind paws were examined histologically. To investigate the effects of TSA on the expressions of matrix metalloproteinase (MMP)-3, MMP-13, tissue inhibitor of MMP-1 (TIMP-1), and acetyl-H4 by chondrocytes, another group of mice was sacrificed on Day 6. In vitro direct effect of TSA was examined by real-time PCR for mRNA of type II collagen, aggrecan, MMP-3, and MMP-13 in murine chondrogenic ATDC5 cells after pro-inflammatory cytokine stimulation. Results: In the TSA-treated group, clinical arthritis was significantly ameliorated in a dose-dependent manner. The severity of synovial inflammation and the cartilage destruction score were significantly lower in the TSA 2.0 mg/kg group compared to the other TSA-treated groups. On immunohistochemistry, the number of MMP-3 and MMP-13-positive chondrocytes was significantly lower in the TSA 2.0 mg/kg group than in the control group. In contrast, the number of TIMP-1-positive cells and acetyl-histone H4-positive cells was significantly higher in the TSA 2.0 mg/kg group than in the control group. TSA suppressed interleukin 1-β and tumor necrosis factor-α-stimulated up-regulation of MMP-3, but not MMP-13 mRNA expression by ATDC5. Conclusion: The systemic administration of TSA ameliorated synovial inflammation in CAIA mice. Subsequently cartilage destruction was also suppressed by TSA, at least in part, by modulating chondrocyte gene expression. © 2007 Osteoarthritis Research Society International.

DOI： 10.1016/j.joca.2007.10.014

The distributions of type IV collagen alpha chains in basement membranes of human epidermis and skin appendages

Haruko Hasegawa, Ichiro Naito, Kazuyo Nakano, Ryusuke Momota, Keiichiro Nishida, Takehito Taguchi, Yoshikazu Sado, Yoshifumi Ninomiya, Aiji Ohtsuka

ARCHIVES OF HISTOLOGY AND CYTOLOGY 70 ( 4 ) 255 - 265 2007.11

Language：English Publishing type：Research paper (scientific journal) Publisher：INT SOC HISTOLOGY & CYTOLOGY

Distributions of type IV collagen a chains in the basement membrane (BM) of human skin and its appendages were analyzed by immunofluorescent microscopy using chain-specific monoclonal antibodies. The basement membrane beneath the epidermis contained [alpha 1(IV)]2 alpha 2(IV) and [ alpha 5(IV)]2 alpha 6(IV) but no alpha 3(IV) alpha 4(IV) alpha 5(IV); this held true for at the eccrine sweat glands and glandular ducts, sebaceous glands, hair follicles, and arrector muscles of hair. The secretary portion of the eccrine sweat glands was rich in [alpha 1(IV)]2 alpha 2(IV) and had less [ alpha 5(IV)]2 alpha 6(IV), while [alpha 5(IV)]2 alpha 6(IV) was abundant in the ductal portion. In the subepidermal zone, alpha 5(IV)/ alpha 6(IV) chain negative spots (1.9-15.0 mu m) were frequently observed. Triple staining samples (Mel.2, alpha 2(IV) and alpha 5(IV) chains) showed that about 50% of epidermal melanocytes colocalized with such spots. Results suggest that these alpha 5(IV)/ alpha 6(IV) chain negative spots of the subepidermal basement membrane have a particular relationship with melanocytes and are sites for certain interactions between the two.

DOI： 10.1679/aohc.70.255

New approach for assessing vascular distribution within bone tumors using dynamic contrast-enhanced MRI

Yukio Kawakami, Toshiyuki Kunisada, Shinsuke Sugihara, Atsushi Ono, Keiichiro Nishida, Nobuhiro Abe, Akira Kawai, Kazuo Fujiwara, Yuki Morimoto, Toshifumi Ozaki

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 133 ( 10 ) 697 - 703 2007.10

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

Purpose To differentiate benign from malignant bone tumors by analyzing the vascular distribution within bone tumors with dynamic contrast-enhanced MRI.
Methods We studied dynamic contrast-enhanced MRI for 49 bone tumors (22 malignant and 27 benign tumors). Seven small regions of interest (ROI) were set inside the largest portion of each tumor. Four ROI were placed evenly on the periphery and three ROI were placed evenly on the line of the longest breadth within the tumor. The slope of the curve (%Slope) was calculated on the time-intensity curves of the whole tumor and of each ROI. The variance values for the %Slope of the ROI were calculated to assess the dispersion of the intensity change at each ROI within the tumor.
Results Mean value of the %Slopes of whole tumor regions for malignant bone tumors (70.4 +/- 60.3%) was significantly higher than that for benign bone tumors (37.6 +/- 52.9%) (P = 0.015), although giant cell tumor (GCT), a locally aggressive tumor, had a relatively higher %Slope. Mean value of the variance of %Slopes for malignant bone tumors (3485.9 +/- 5942.5) was significantly higher than that for all benign tumors (470.4 +/- 583.9) (P = 0.012), indicating that the %Slope values of seven ROI within malignant bone tumors varied more widely compared with the ROI inside benign bone tumors. GCT also demonstrated a lower value.
Conclusion Our method of analyzing the signal intensity change at seven separate regions that evaluates the vascular distribution within a tumor could be a useful tool for differentiating between benign and malignant bone tumors.

DOI： 10.1007/s00432-006-0190-9

A novel dominant-negative mutation in Gdf5 generated by ENU mutagenesis impairs joint formation and causes osteoarthritis in mice

Hiroshi Masuya, Keiichiro Nishida, Tatsuya Furuichi, Hideaki Toki, Gen Nishimura, Hidehiko Kawabata, Haruka Yokoyama, Aki Yoshida, Sayaka Tominaga, Junko Nagano, Aya Shimizu, Shigeharu Wakana, Yoichi Gondo, Tetsuo Noda, Toshihiko Shiroishi, Shiro Ikegawa

HUMAN MOLECULAR GENETICS 16 ( 19 ) 2366 - 2375 2007.10

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS

Growth and differentiation factor 5 (GDF5) has been implicated in chondrogenesis and joint formation, and an association of GDF5 and osteoarthritis (OA) has been reported recently. However, the in vivo function of GDF5 remains mostly unclarified. Although various human GDF5 mutations and their phenotypic consequences have been described, only loss-of-function mutations that cause brachypodism (shortening and joint ankylosis of the digits) have been reported in mice. Here, we report a new Gdf5 allele derived from a large-scale N-ethyl-N-nitrosourea mutagenesis screen. This allele carries an amino acid substitution (W408R) in a highly conserved region of the active signaling domain of the GDF5 protein. The mutation is semi-dominant, showing brachypodism and ankylosis in heterozygotes and much more severe brachypodism, ankylosis of the knee joint and malformation with early-onset OA of the elbow joint in homozygotes. The mutant GDF5 protein is secreted and dimerizes normally, but inhibits the function of the wild-type GDF5 protein in a dominant-negative fashion. This study further highlights a critical role of GDF5 in joint formation and the development of OA, and this mouse should serve as a good model for OA.

DOI： 10.1093/hmg/ddm195

Comparative biomechanical analysis of an improved novel pedicle screw with sheath and bone cement

Tomoyuki Takigawa, Masato Tanaka, Hitoshi Konishi, Hisanori Ikuma, Haruo Misawa, Yoshihisa Sugimoto, Kazuo Nakanishi, Koichi Kuramoto, Keiichiro Nishida, Toshifumi Ozaki

JOURNAL OF SPINAL DISORDERS & TECHNIQUES 20 ( 6 ) 462 - 467 2007.8

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Study Design: A human cadaveric biomechanical study of fixation strength of an improved novel pedicle screw (NPS) with cement and a conventional screw.
Objective: To clarify whether the NPS has adequate fixation strength without leakage in vertebrae with low bone quality.
Summary of Background Data: The fixation strength of pedicle screws decreases in frail spines of elderly osteoporotic patients. Augmentation of screw fixation with bone cement must be balanced against increased difficulty of screw removal and risk of cement leakage. We developed the NPS consisting of an internal screw and an outer sheath to mitigate the disadvantages of cement augmentation.
Methods: The T12 and L1 vertebrae obtained from 18 formalin preserved cadavers (11 males and 7 females; mean age, 82.7y) were used. The mean bone mineral density was 0.39 +/- 0.14 g/cm(2). The NPS was inserted into one pedicle of each vertebra and the control screw, a Compact CD2 screw, was inserted into the contralateral pedicle. Both screws were 6 mm in diameter and 40 mm in length. Pull-out tests were performed at a crosshead speed of 10 mm/min. Cyclic loading tests were performed with a maximum 250 N load at 2 Hz until 30,000 cycles.
Results: Cement leakage did not occur in any of the specimens tested. The mean maximum force at pull-out was 760 +/- 344 N for the NPS and 346 172 N for the control screw (P < 0.01). Loosening of 50% of the screws was observed after 17,000 cycles of the NPS and after 30 cycles of the control screw. The hazard ratio of loosening was 19.6 (95% confidence interval 19.3-19.9) (P < 0.001).
Conclusions: The NPS showed a significantly higher mechanical strength than the control screw in both pull-out tests and cyclic loading test than the control screw in both pull-out tests and cyclic loading test. The NPS showed more than adequate strength without cement leakage.

DOI： 10.1097/BSD.0b013e318030d2d6

The association of C-reactive protein with an oxidative metabolite of LDL and its implication in atherosclerosis

Masako Tabuchi, Katsumi Inoue, Hitomi Usui-Kataoka, Kazuko Kobayashi, Misako Teramoto, Koji Takasugi, Kenichi Shikata, Masahiro Yamamura, Kenji Ando, Keiichiro Nishida, Junko Kasahara, Noriaki Kume, Luis R. Lopez, Kazuaki Mitsudo, Masakiyo Nobuyoshi, Tatsuji Yasuda, Toru Kita, Hirofumi Makino, Eiji Matsuura

JOURNAL OF LIPID RESEARCH 48 ( 4 ) 768 - 781 2007.4

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC

C-reactive protein (CRP) is one of the strongest independent predictors of cardiovascular disease. We have previously reported that oxidized LDL (oxLDL) interacts with beta 2-glycoprotein I (beta 2GPI), implicating oxLDL/P2GPI complexes as putative autoantigens in autoimmune-mediated atherosclerotic vascular disease. In this study, we investigated the interaction of CRP with oxLDL/beta 2GPI complexes and its association with atherosclerosis in patients with diabetes mellitus (DM). CRP/oxLDL/R2GPI complexes were predominantly found in sera of DM patients with atherosclerosis. In contrast, noncomplexed CRP isoforms were present in sera of patients with acute/chronic inflammation, i.e., various pyrogenic diseases, rheumatoid arthritis (RA), and DM. Immunohistochemistry staining colocalized CRP and beta 2GPI together with oxLDL in carotid artery plaques but not in synovial tissue from RA patients, strongly suggesting that complex formation occurs during the development of adierosclerosis. Serum levels of CRP correlated with soluble forms of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1, and oxLDL/beta 2GPI complexes correlated with total cholesterol and hemoglobin Al c. Thus, the generation of CRP/oxLDL/beta 2GPI complexes seems to be associated with arterial inflammation, hyperglycemia, and hypercholesterolemia. CRP/oxLDL/R2GPI complexes can be distinguished from pyrogenic noncomplexed CRP isoforms and may represent a more specific and predictive marker for atherosclerosis.

DOI： 10.1194/jlr.M600414-JLR200

マウス成長軟骨におけるADAMTS-9発現の検討

熊岸加苗, 西田圭一郎, 百田龍輔, 山合友一朗, 広畑聡, Demircan Kadir, 内藤一郎, 二宮善文, 大塚愛二

解剖学雑誌 82 ( Suppl. ) 150 - 150 2007.3

A new Gdf5 allele with fusion of knee joint Reviewed

Masuya Hiroshi, Furuichi Tatsuya, Nishida Keiichirou, Nagano Junko, Yokoyama Haruka, Miura Ikuo, Wakana Shigeharu, Ikegawa Shirou, Shiroishi Toshihiko

GENES & GENETIC SYSTEMS 81 ( 6 ) 447 2006.12

IV型コラーゲンα鎖特異抗体を用いた血管基底膜の三次元観察

森本尊雅, 内藤一郎, 田口勇仁, 芳原成美, 長谷川治子, 中野和代, 佐渡義一, 西田圭一郎, 二宮善文, 大塚愛二

解剖学雑誌 81 ( 3 ) 96 - 96 2006.9

Decreased levels of insulin-like growth factor-1 and vascular endothelial growth factor relevant to the ossification disturbance in femoral heads spontaneous hypertensive rats

Takamitsu Komiyama, Keiichiro Nishida, Masanori Yorimitsu, Hideyuki Doi, Shinichi Miyazawa, Ai Kitamura, Aki Yoshida, Yoshihisa Nasu, Nobuhiro Abe, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 60 ( 3 ) 141 - 148 2006.6

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

Ossification disturbance in femoral head reportedly is seen in the Spontaneously Hypertensive rats (SHR) between ages of 10 and 20 weeks. We investigated serum and tissue levels of insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VIEGF) in SHR relevant to the ossification disturbance and osteonecrosis of the femoral head. Serum levels of IGF-1 and VEGF were significantly lower in SHR than in Wistar Kyoto rats (WKY) at weeks 5, 10, 15 and 20 (P < 0.005). The incidence of histological ossification disturbance of the femoral head was higher in SHR (59%) than in WKY (40%) at week 20. Lower serum and local levels of VEGF in SHR appeared to be related to the incomplete ossification of the femoral heads. Immunohistochemical study showed significantly lower numbers of IGF-1 and VEGF positive chondrocytes in the femoral epiphyseal cartilage of SHR than in those of WKY at weeks 10, 15 and 20. Our results suggest that local and/or systemic levels of IGF-1 and VEGF between ages of 5 and 20 weeks might play roles in the pathogenesis of ossification disturbance of the femoral head in SHR.

DOI： 10.18926/AMO/30749

血管基底膜IV型コラーゲンの免疫組織学的解析共焦点レーザー顕微鏡を用いた三次元観察

森本尊雅, 内藤一郎, 百田龍輔, 芳原成美, 長谷川治子, 田口勇仁, 西田圭一郎, 佐渡義一, 二宮善文, 大塚愛二

解剖学雑誌 81 ( Suppl. ) 155 - 155 2006.3

In situ preparation of colloidal iron by microwave irradiation for transmission electron microscopy

S Nakatani, Naito, I, R Momota, N Hinenoya, K Horiuchi, K Nishida, A Ohtsuka

ACTA MEDICA OKAYAMA 60 ( 1 ) 59 - 64 2006.2

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

We attempted to prepare colloidal iron within tissues by means of microwave irradiation. Mouse tissue blocks were fixed with a mixture of paraformaldehyde and ferric chloride in a cacodylate buffer, immersed in a cacodylate buffered ferric chloride solution, and irradiated in a microwave processor. Colloidal iron was prepared within tissues or cells, and was observed in the form of electron dense fine granules (1-2 nm in diameter) by transmission electron microscopy. Collagen fibrils in the connective tissue showed colloidal iron deposition at regular periodical intervals. Cells in the splenic tissue showed that fine colloidal granules were deposited on the ribosomes but not on the nuclear chromatin. This finding suggests that ferric ions could not diffuse into the nucleus, which was surrounded by the nuclear envelope. The podocyte processes of the renal glomerulus were stained diffusedly. Though this microwave in situ colloidal iron preparation method has some limitations, it is convenient for use in biomedical specimen preparation in transmission electron microscopy.

Novel transdermal photodynamic therapy using ATX-S10·Na(II) induces apoptosis of synovial fibroblasts and ameliorates collagen antibody-induced arthritis in mice

Miyazawa, S., Nishida, K., Komiyama, T., Nakae, Y., Takeda, K., Yorimitsu, M., Kitamura, A., Kunisada, T., Ohtsuka, A., Inoue, H.

Rheumatology International 26 ( 8 ) 2006

Expression of WISP-1 (ccn4), WISP-2 (ccn5) and WISP-3 (ccn6) in Rheumatoid Arthritic Synovium Evaluated by DNA Microarrays

Mori Hiroki, Nishida Keiichiro, Ozaki Toshifumi, Inoue Hajime, Setsu Kojun, Tsujigiwa Hidetsugu, Nagatsuka Hitoshi, Gunduz Mehmet, Nakanishi Tohru

Journal of hard tissue biology 15 ( 3 ) 89 - 95 2006

Language：English Publisher：The Society of Hard Tissue Biology

Rheumatoid disease (RA) is one of the complex diseases that showed multiple progression stages. At first inflammatory response is occurred by self antibodies, and then the proliferation of synoviocytes is abnormally promoted. These synoviocytes invade into articular structures and finally articular cartilage is destroyed. In order to analyze growth-promoting factors in synovial cells from articular tissues of RA, we performed DNA microarray analysis and compared the expression patterns of their mRNA to that of synoviocytes from osteoarthritis (OA). The results showed that the expression of many genes was up-regulated in RA synoviocytes comparing with OA synoviocytes. Among these genes, RT-PCR analysis revealed that Wnt-1-induced secreted protein 2 (WISP-2, CCN5) and protein 3 (WISP-3, CCN6) which are belong to the novel gene family, CCN, were highly up-regulated in RA synoviocytes. In addition, one truncated isoform of WISP-3 which may be related to the ongoing of some type of RA, was detected in RA synoviocytes. Furthermore, immunohistochemical analysis showed that the products of both CCN genes were highly distributed in active synoviocytes of articular tissues of RA. These results indicate that both CCN genes and their products play some roles in the progression of RA.

DOI： 10.2485/jhtb.15.89

Other Link： http://search.jamas.or.jp/link/ui/2007191489

Accuracy of a portable electroneurometer for measuring distal motor latency

H Tanaka, H Hashizume, C McCown, M Senda, K Nishida, H Inoue

JOURNAL OF ORTHOPAEDIC SCIENCE 10 ( 5 ) 445 - 450 2005.9

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

Background A facile electromyographic test in the outpatient clinic is needed to evaluate the outcome of screening for carpal tunnel syndrome. The purpose of the current prospective study was to compare the accuracy of Nervepace digital electroneurometer (Nervepace) and Dantec Neuromatic 2000M (Dantec) measurements of a wide range of distal motor latency (DML) of the median nerve.
Methods. The DML values for 112 of 126 median nerves examined with Nervepace and conventional electromyography, Dantec were statistically analyzed in this prospective study. The 30 hands of 15 clinically healthy adults 20-24 years old served as the reference group. Sixty consecutive patients (96 hands) with idiopathic carpal tunnel syndrome provided a wider range of DML values. All of the patients had standard clinical tests and standard motor (Dantec and Nervepace) and sensory (Dantec) electrodiagostic tests before endoscopic carpal tunnel release.
Results. The DML was measurable in all 30 hands of the reference group, in all 96 hands of the patients by Dantec, but in only 82 hands (52 patients) by Nervepace. Nervepace and Dantec DML values of 6.0 ms or less had high correlation and agreement.
Conclusions. Correlation and agreement decreased significantly among values greater than 6.0ms.

DOI： 10.1007/s00776-005-0928-2

ADAMTS-9 is synergistically induced by interleukin-1 beta and tumor necrosis factor alpha in OUMS-27 chondrosarcoma cells and in human chondrocytes

K Demircan, S Hirohata, K Nishida, OF Hatipoglu, T Oohashi, T Yonezawa, SS Apte, Y Ninomiya

ARTHRITIS AND RHEUMATISM 52 ( 5 ) 1451 - 1460 2005.5

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-LISS

Objective. To compare induction of the aggrecanases (ADAMTS-1, ADAMTS-4, ADAMTS-5, ADAMTS-8, ADAMTS-9, and ADAMTS-15) by interleukin-1β (IL-1β) and tumor necrosis factor a (TNFα) in chondrocyte-like OUMS-27 cells and human chondrocytes, and to determine the mechanism of induction of the most responsive aggrecanase gene.
Methods. OUMS-27 cells were stimulated for different periods of time and with various concentrations of IL-1β and/or TNFa. Human chondrocytes obtained from osteoarthritic joints and human skin fibroblasts were also stimulated with IL-1β and/or TNFα. Total RNA was extracted, reverse transcribed, and analyzed by quantitative real-time polymerase chain reaction and Northern blotting. ADAMTS-9 protein was examined by Western blotting, and the role of the MAPK signaling pathway for ADAMTS9 induction in IL-1β-stimulated OUMS-27 cells was investigated.
Results. IL-1β increased messenger RNA (mRNA) levels of ADAMTS4, ADAMTS5, and ADAMTS9 but not ADAMTS1 and ADAMTS8. The fold increase for ADAMTS9 mRNA was greater than that for mRNA of the other aggrecanase genes. The increase of ADAMTS9 mRNA by IL-1β stimulation was greater in chondrocytes than in fibroblasts. The combination of IL-1β and TNFα had a synergistic effect, resulting in a considerable elevation in the level of ADAMTS9 mRNA. ADAMTS-9 protein was also induced in IL-1β-stimulated OUMS-27 cells. The MAPK inhibitors SB203580 and PD98059 decreased ADAMTS9 upregulation in OUMS-27 cells.
Conclusion. ADAMTS9 is an IL-1β- and TNFα-inducible gene that appears to be more responsive to these proinflammatory cytokines than are other aggrecanase genes. Furthermore, these cytokines had a synergistic effect on ADAMTS9. Together with the known ability of ADAMTS-9 to proteolytically degrade aggrecan and its potential to cleave other cartilage molecules, the data suggest that ADAMTS-9 may have a pathologic role in arthritis.

DOI： 10.1002/art.21010

Calpain inhibitors prevent neuronal cell death and ameliorate motor disturbances after compression-induced spinal cord injury in rats

S Arataki, K Tomizawa, A Moriwaki, K Nishida, M Matsushita, T Ozaki, T Kunisada, A Yoshida, H Inoue, H Matsui

JOURNAL OF NEUROTRAUMA 22 ( 3 ) 398 - 406 2005.3

Language：English Publishing type：Research paper (scientific journal) Publisher：MARY ANN LIEBERT INC

Traumatic spinal cord injury (SCI) results in widespread neuronal cell death. Recent studies have suggested that activated calpain mediates neuronal cell death in the central nervous system. We conducted a study to determine whether calpain mediates neuronal cell death in the motor neurons of the spinal cord after SCI, and whether postinjury administration of the calpain inhibitors N-acetyl-Leu-Leu-Met-CHO (ALLM) and calpain inhibitor III (CI III) (MDL28170) reduces the motor disturbances in rats with a model of SCI. Adult male Wistar rats were subjected to SCI by application of a 20-g weight impactor probe to the spinal cord at T12 for 20 min. The rats were divided into three groups according to whether they were injected intravenously with 0.05-2.5 mg/kg ALLM, 10 mg/kg CI III, or 0.1% DMSO as a control every 24 h for I week after SCI. Calpain was activated in the spinal cord at 8 h, 24 h, and 5 days after SCI, and administration of ALLM inhibited its activation. ALLM, as compared to the DMSO vehicle alone, also significantly reduced the number of motor neurons in spinal-cord lesions that were positively labeled at 24 h after SCI with the terminal deoxynucleotidyl transferase-uridine nucleotide end-labeling (TUNEL) technique. Additionally, both the inclined plane test and footprint analysis showed markedly better motor activity after 4 weeks in rats injected with ALLM or CI III than in rats given vehicle only. These results suggest that activation of calpain plays a critical role in the neuronal cell death that follows SCI, and that calpain inhibitors may have benefit in treating the motor disturbances that follow SCI.

DOI： 10.1089/neu.2005.22.398

Suppression of chondrosarcoma cells by 15-deoxy-Delta (12,14)-prostaglandin J(2) is associated with altered expression of Bax/Bcl-xL and p21

ZN Shen, K Nishida, H Doi, T Oohashi, S Hirohata, T Ozaki, A Yoshida, Y Ninomiya, H Inoue

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 328 ( 2 ) 375 - 382 2005.3

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

We previously reported that 15-deoxy-Delta(12,14)-prostaglandin J(2) (15d-PGJ(2)), the most potent agonist for peroxisome proliferator-activated receptor gamma (PPARgamma), induces apoptosis of human chondrosarcoma cell line OUMS-27. The current study aimed to explore the mechanism of 15d-PGJ(2)-induced apoptosis and inhibition of cell proliferation in OUMS-27 cells. The preliminary results of cDNA microarray analysis showed the down-regulation of anti-apoptotic Bcl-xL and up-regulation of pro-apoptotic Bax in the process of 15d-PGJ2-induced apoptosis. These changes were further confirmed at mRNA and protein levels by RT-PCR and Western blot analysis, respectively. Among cyclin-dependent kinase inhibitors, p21 was induced and up-regulated by 15d-PGJ2, but p 16 and p27 were not changed, suggesting that the involvement of p21 in inhibition of cell proliferation. Activation of caspase-3 by 15d-PGJ2 was partly, but not completely, blocked by PPARgamma antagonist (GW9662) suggesting the 15d-PGJ2 exerted its effect by PPARgamma-dependent and -independent pathways. Interestingly, immunohistochemical study on human chondrosarcoma samples revealed that Bcl-xL is frequently expressed by tumor cells. The results of the current study suggest that the potential ability of 15d-PGJ2 in regulation of cell cycle and inhibition of Bcl-xL expression might be beneficial in the development of novel pharmacological agents for chondrosarcoma. (C) 2005 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2004.12.186

ヒト皮膚とその付属器の基底膜を構成するIV型コラーゲン分子のα鎖構成

長谷川治子, 内藤一郎, 中野和代, 米澤朋子, 西田圭一郎, 田口勇仁, 佐渡義一, 二宮善文, 大塚愛二

解剖学雑誌 80 ( Suppl. ) 151 - 151 2005.3

ヒト皮膚および付属器の基底膜IV型コラーゲンα鎖構成

長谷川治子, 内藤一郎, 中野和代, 米澤朋子, 西田圭一郎, 田口勇仁, 佐渡義一, 二宮善文, 大塚愛二

解剖学雑誌 80 ( 1 ) 20 - 20 2005.3

Hoechst 33342は関節軟骨修復の長期研究において細胞標識物質として有用である

川崎啓介, 杉原進介, 大塚愛二, 西田圭一郎, 尾崎敏文, 吉田晶, 井上一

移植 40 ( 1 ) 78 - 79 2005.2

Three-dimensional ultrastructure of the brush border glycocalyx in the mouse small intestine: a high resolution scanning electron microscopic study

K Horiuchi, Naito, I, K Nakano, S Nakatani, K Nishida, T Taguchi, A Ohtsuka

ARCHIVES OF HISTOLOGY AND CYTOLOGY 68 ( 1 ) 51 - 56 2005

Language：English Publishing type：Research paper (scientific journal) Publisher：INT SOC HISTOLOGY & CYTOLOGY

The three-dimensional ultrastructure of the filamentous glycocalyx of the brush border in the mouse small intestine was successfully demonstrated by high resolution scanning electron microscopy (SEM). The specimens were fixed with 2% glutaraldehyde in a 0.1 M phosphate buffer (pH 7.4), and rinsed with buffered solutions with differently adjusted pH values (pH 3.0, 7.0 or 11.0). They were then osmicated, dried, spatter-coated with gold (1.0-1.5 nm), and observed under a high resolution SEM. The glycocalyx on the luminal surface of the intestinal villi covered the top of the microvilli of the epithelial cells and were well preserved in the specimens treated with an alkaline buffer (pH 11.0). The glycocalyx was observed as filamentous structures, 7 to 15 nm thick in diameter. These filaments repeatedly branched and anastomosed with neighboring ones to form an actual network or plexus as a whole, in contrast with superimposed images in transmission electron microscopy (TEM) which suggested that such anastomoses were pseudo-networks. The filaments thickened globularly at the sites of the filament bifurcation or branching. On the other hand, specimens rinsed with an acid or neutral buffer showed no glycocalyx on their microvilli, whose naked top had knob-like structures. Thus, the pH values of the washing buffer solutions were considered to affect the preservation of the surface coat due to molecular characteristics.

DOI： 10.1679/aohc.68.51

Expression and localization of connective tissue growth factor (CTGF/Hcs24/CCN2) in osteoarthritic cartilage

S Omoto, K Nishida, Y Yamaai, M Shibahara, T Nishida, T Doi, H Asahara, T Nakanishi, H Inoue, M Takigawa

OSTEOARTHRITIS AND CARTILAGE 12 ( 10 ) 771 - 778 2004.10

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO LTD

Objective: The investigation of the expression and localization of connective tissue growth factor/hypertrophic chondrocyte-specific gene product 24/CCN family member 2 (CTGF/Hcs24/CCN2) in normal and osteoarthritic (OA) cartilage, and quantification of CTGF/Hcs24-positive cells.
Methods: Cartilage samples of patients (n = 20) with late stage CA were obtained at total joint replacement surgery. Morphologically normal cartilage was harvested for comparison purposes from the femoral heads of 6 other patients with femoral neck fracture. Paraffin -embedded sections were stained by Safranin O. The severity of the OA lesions was divided into four stages (normal, early, moderate, and severe). The localization of protein and mRNA for CTGF/Hcs24 was investigated by immunohistochemistry and in situ hybridization, respectively. The population of CTGF/Hcs24-positive chondrocytes in CA cartilage and chondro-osteophyte was quantified by counting the number of the cells under light microscopy.
Results: Signals for CTGF/Hcs24 were detected in a small percentage of chondrocytes throughout the layers of normal cartilage. In early stage CA cartilage, the CTGF/Hcs24-positive chondrocytes were localized mainly in the superficial layer. In moderate to severe OA cartilage, intense staining for CTGF/Hcs24 was observed in proliferating chondrocytes forming cell clusters next to the cartilage surface. In chondro-osteophyte, strong signals were found in the chondrocytes of the proliferative and hypertrophic zones.
Conclusion: CTGF/Hcs24 expression was detected in both normal and OA chondrocytes of human samples. The results of the current study suggested that expression of CTGF/Hcs24 was concomitant with development of CA lesions and chondrocyte differentiation in chondro-osteophyte. (C) 2004 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.joca.2004.06.009

Histone deacetylase inhibitor suppression of auto antibody-mediated arthritis in mice via regulation of p16(INK4a) and p21(WAF1/Cip1) expression

K Nishida, T Komiyama, S Miyazawa, ZN Shen, T Furumatsu, H Doi, A Yoshida, J Yamana, M Yamamura, Y Ninomiya, H Inoue, H Asahara

ARTHRITIS AND RHEUMATISM 50 ( 10 ) 3365 - 3376 2004.10

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-LISS

Objective. To examine whether depsipeptide (FK228), a histone deacetylase (HDA) inhibitor, has inhibitory effects on the proliferation of synovial fibroblasts from rheumatoid arthritis (RA) patients, and to examine the effects of systemic administration of FK228 in an animal model of arthritis.
Methods. Antoantibody-mediated arthritis (AMA) was induced in 19 male DBA/1 mice (6-7 weeks old); 10 of them were treated by intravenous administration of FK228 (2.5 mg/kg), and 9 were used as controls. The effects of FK228 were examined by radiographic, histologic, and immunohistochemical analyses and arthritis scores. RA synovial fibroblasts (RASFs) were obtained at the time of joint replacement surgery. In vitro effects of FK228 on cell proliferation were assessed by MTT assay. Cell morphology was examined by light and transmission electron microscopy. The effects on the expression of the cell cycle regulators p16(INK4a) and p21(WAF1/Cip1) were examined by real-time polymerase chain reaction and Western blot analysis. The acetylation status of the promoter regions of p16(INK4a) and p21(WAF1/Cip1) were determined by chromatin immunoprecipitation assay.
Results. A single intravenous injection of FK228 (2.5 mg/ml) successfully inhibited joint swelling, synovial inflammation, and subsequent bone and cartilage destruction in mice with AMA. FK228 treatment induced histone hyperacetylation in the synovial cells and decreased the levels of tumor necrosis factor a and interleukin-1beta in the synovial tissues of mice with AMA. FK228 inhibited the in vitro proliferation of RASFs in a dose-dependent manner. Treatment of cells with FK228 induced the expression of p16(INK4a) and up-regulated the expression of p21(WAF1/Cip1). These effects of FK228 on p16(INK4a) and p21(WAF1/Cip1) were related to the acetylation of the promoter region of the genes.
Conclusion. Our findings strongly suggest that systemic administration of HDA inhibitors may represent a novel therapeutic target in RA by means of cell cycle arrest in RASFs via induction of p16(INK4a) expression and increase in p21(WAF1/Cip1) expression.

DOI： 10.1002/art.20709

Influence of telomerase activity on bone and soft tissue tumors

N Umehara, T Ozaki, S Sugihara, T Kunisada, Y Morimoto, A Kawai, K Nishida, A Yoshida, T Murakami, H Inoue

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 130 ( 7 ) 411 - 416 2004.7

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

Purpose. Telomeres consisting of a repeating nucleotide sequence (TTAGGG)n are shortened in normal somatic cells. Telomerase is an enzyme that elongates the telomere sequence and is detected in most human cancers and usually not in normal somatic cells. Little is known about telomerase activity in bone and soft tissue tumors. The aim of this study was to investigate the relationship between telomerase activity and clinical factors in bone and soft tissue tumors. Methods. Telomerase activity was measured using the modified telomeric repeat amplification protocol (TRAP) assay in 115 bone and soft tissue tumors obtained through open biopsy or resection. Results. Telomerase activity was detected in 10% of benign tumors and 44% of malignant tumors (p<0.001). A higher incidence of telomerase activity was detected in high-grade tumors than in low-grade tumors (p=0.002). The cumulative metastasis-free and overall survival in telomerase-positive patients was significantly worse than in telomerase-negative patients (p=0.045 and p=0.048). Conclusion. Our study suggests that telomerase activity is associated with tumor aggressiveness and may be a useful parameter to predict the prognosis of patients with malignant bone and soft tissue tumors.

DOI： 10.1007/s00432-004-0553-z

抗炎症薬・抗アレルギー薬開発の最前線ヒストン脱アセチル化酵素阻害剤を用いた細胞周期制御による実験的関節炎の抑制

西田圭一郎, 小見山貴充, 宮澤慎一, 北村亜似, 申正男, 真鍋博規, 土井英之, 浅原弘嗣, 二宮善文, 大塚愛二, 井上一

炎症・再生 24 ( 4 ) 425 - 425 2004.7

Radiological follow-up study of rheumatoid wrists after radio-lunate limited arthrodesis with ulnar head resection

Kensuke Uchida, Keiichiro Nishida, Hiroyuki Hashizume, Shunsuke Omoto, Masutaka Watanabe, Yusuke Ota, Hajime Inoue

Modern Rheumatology 14 ( 1 ) 31 - 36 2004.3

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

Radio-lunate limited arthrodesis (RLA) is an established surgical intervention for damaged rheumatoid arthritis (RA) wrists. The goal of RLA is to conserve the range of motion (ROM) and level of activities of daily life (ADL) by delaying more extensive fusion. In this study, we retrospectively reviewed the outcome of RLA with ulnar head resection (UHR) in terms of pain score, ROM, and radiographic parameters, including carpal height ratio, ulnar translation ratio, and palmar subluxation. The clinical factors, such as dose of corticosteroids per day and laboratory examination data before surgery, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF), did not influence the results of the surgery. The changes in these clinical factors were also statistically analyzed in relation to the Schulthess classification of preoperative radiographs of wrists reported by Simmen and Huber: Type I (ankylosis type), Type II (osteoarthritis type), and Type III (disintegration type). This study hypothesized that RLA with UHR would provide no significant improvement in Type III wrists. The results showed that RLA with UHR resulted in stable wrists with excellent pain relief and with limited, but temporary, functional ROM, suggesting that this procedure seems to be applicable for all types of wrists within this group of patients. © Springer-Verlag Tokyo 2004.

DOI： 10.1007/s10165-003-0262-5

Spontaneous "spaghetti" flexor tendon ruptures in the rheumatoid wrist

Hiroyuki Hashizume, Keiichiro Nishida, Kazuo Fujiwara, Hajime Inoue

Modern Rheumatology 14 ( 3 ) 257 - 259 2004

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

A 54-year-old woman who had been treated for rheumatoid arthritis for 12 years developed spontaneous multiple flexor tendon ruptures during a 5-month period. Radiography revealed volar subluxation of the lunate bone. Surgery was performed 5 months after the first onset of tendon rupture. All eight flexors, except the flexor pollicis longus tendons, had ruptured, and the damage resembled spaghetti. Four flexor digitorum profundus tendons were reconstructed by bridge graft using their respective sublimis tendons. Wrist joint fusion and tenolysis were performed 3 months after the first operation. Each finger achieved a good range of motion 2 years and 6 months after be second operation. © Japan College of Rheumatology and Springer-Verlag Tokyo 2004.

DOI： 10.3109/s10165-004-0303-8

Biomechanical analysis of the mechanism of elbow fracturedislocations by compression force

H Wake, H Hashizume, K Nishida, H Inoue, N Nagayama

JOURNAL OF ORTHOPAEDIC SCIENCE 9 ( 1 ) 44 - 50 2004

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

Fracture-dislocations of the coronoid and olecranon were produced experimentally, and their onset mechanisms were analyzed to clarify the effects of compression force on the coronoid and olecranon. The study used two-dimensional finite element method (2D-FEM) simulations and static loading experiments. The latter applied axial force distally to 40 cadaveric elbows. Posterior fracture-dislocations occurred between 15degrees of extension and 30degrees of flexion, anterior or posterior fracture-dislocations at 60degrees, and only anterior fracture-dislocations at 90degrees. Injuries were mainly to anterior or posterior support structures. The 2D-FEM simulations showed that the stress concentration areas moved from the coronoid process to the olecranon as position changed from extension to flexion. The very high frequency of concurrent fracture-dislocations of radial head or neck in the current study indicated that the radial head may also function as a stabilizer in the anterior support system.

DOI： 10.1007/s00776-003-0735-6

Arthroscopic surgery for traumatic triangular fibrocartilage complex injury

H Miwa, H Hashizume, K Fujiwara, K Nishida, H Inoue

JOURNAL OF ORTHOPAEDIC SCIENCE 9 ( 4 ) 354 - 359 2004

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

Clinical characteristics, diagnostic imaging, arthroscopic findings, and surgical results of arthroscopic treatment are reported in 62 hands with traumatic triangular fibrocartilage complex (TFCC) injury treated between 1995 and 2002. This retrospective study also describes and compares the results of a novel arthroscopic suture technique for repairing tears with Palmer's class 1B and 1D tears. According to Palmer's classification, there were 10 class 1A, 27 1B, 81C, and 17 1D injuries. The arthroscopic suture and debridement treatments were done under brachial plexus block as a L-day in-hospital procedure. Class ID tears required transradial fixation to anchor the TFCC. Surgical results of suture groups according to Minami's criteria were excellent in 16 hands, good in 15 hands, fair in 1 hand, and poor in 1 hand. The results of the debridement group were excellent in 16 hands, good in 10 hands, fair in 2 hands, and poor in 1 hand. The results of the current study indicate that the novel suture technique were easy to perform, provided strong, tight repair for class 1D injuries, and was applicable for class 1B injuries in this small case series.

DOI： 10.1007/s00776-004-0796-1

Hoechst 33342 is a useful cell tracer for a long-term investigation of articular cartilage repair.

Keisuke Kawasaki, Shinsuke Sugihara, Keiichiro Nishida, Toshifumi Ozaki, Aki Yoshida, Aiji Ohtsuka, Hajime Inoue

Archives of histology and cytology 67 ( 1 ) 13 - 9 2004

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

The repair process of a full-thickness osteochondral defect was observed in a rat model using Hoechst 33342 as a cell tracer. The osteochondral defect was created at the medial femoral condyle of the right knee joints of twelve 11 week old male rats. Three weeks after the surgery, Hoechst 33342 was injected into the same knee joints. Calcein, a marker of the mineralization front, was then injected subcutaneousely twice at seven days and one day before harvesting of the tissue. At six, ten, and fourteen weeks and one year after the surgery, femoral condyles were obtained from the operated knee joints, fixed by alcohol, and embedded in polymethylmethacrylate. The sections were examined by fluorescent and then light microscopy. In the lateral femoral condyle cartilage, Hoechst 33342 labeling of chondrocyte nuclei was observed in all layers of the intact cartilage, and the dye never infiltrated beneath the subchondral bone plate. At 6 weeks after the surgery, Hoechst 33342-positive cells were observed not only in the regenerated fibrous cartilage, but also in the newly formed mineralized tissue in the medial femoral condyle. Interestingly, Hoechst 33342 labeling remained undiminished even one year after the intra-articular injection. The findings of the present study suggest that intra-articular injection of Hoechst 33342 is a useful tracer for long-term investigations of chondrocyte differentiation in vivo.

DOI： 10.1679/aohc.67.13

Development of a bone cutting robot for total knee arthroplasty. Reviewed

Mamoru Mitsuishi, Shin'ichi Warisawa, Naohiko Sugita, N. Suzuki, Masahiko Suzuki, Hideshige Moriya, Kazuo Fujiwara, Nobuhiro Abe, Keiichiro Nishida, Hiroyuki Hashizume, H. Inoue, Takayuki Inoue, Koichi Kuramoto, Yoshio Nakashima

2004 IEEE/RSJ International Conference on Intelligent Robots and Systems, Sendai, Japan, September 28 - October 2, 2004 4 3302 - 3308 2004

Publishing type：Research paper (international conference proceedings) Publisher：IEEE

In total knee joint replacement, the femur and the tibia must be precisely shaped to ensure that they firmly mate with the artificial joint. The normal procedure is to manually cut the bones using a bone saw and mechanical jigs. A 9-axis bone cutting machine tool has been developed by the authors to increase cutting accuracy and reduce the hospital stay required for recuperation. As developed, the cut plane is determined by a 5 degree-of-freedom mechanism and the femur and tibia are cut by moving two translational and one rotational degrees of freedom, a system that provides a cutter path which avoids cutting the ligament. A preoperative planning system based on CAD/CAM principles and an overview of a system for total knee arthroplasty are also discussed. Experimental results showed the effectiveness of the developed robot and the system.

DOI： 10.1109/IROS.2004.1389926

Blood loss in patients for total knee arthroplasty

N Abe, H Fujimoto, T Ozaki, K Asaumi, H Kato, K Nishida, Y Takahara, H Inoue

ANNALS OF THE RHEUMATIC DISEASES 62 497 - 497 2003.7

Vascular endothelial growth factor principally acts as the main angiogenic factor in the early stage of human osteoblastogenesis

T Furumatsu, ZN Shen, A Kawai, K Nishida, H Manabe, T Oohashi, H Inoue, Y Ninomiya

JOURNAL OF BIOCHEMISTRY 133 ( 5 ) 633 - 639 2003.5

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPANESE BIOCHEMICAL SOC

Vascular endothelial growth factor (VEGF)-mediated angiogenesis is essential for bone formation. However, the effect of VEGF on osteoblastic cells during osteoblastogenesis is still controversial. The aim of this,study was to clarify the relationship between osteoblastic cells derived from human mesenchymal stem cells (MSCs). and VEGF -in the early stage of osteoblastic differentiation. Continuous dexamethasone treatment with a low concentration stimulated osteoblastogenesis of MSCs and the expression of VEGF121 mRNA. The VEGF secretion from osteoblastic cells also increased along with osteoblastogenesis. Neuropilin-1, which mainly binds VEGF165, was detected at all stages during early osteoblastogenesis, but VEGF receptor-1 and -2 were not detected on RT-PCR analyses. In this study, VEGF had no direct effect on the proliferation of osteoblastic cells. However, the secreted VEGF in the conditioned medium of osteoblastic cells exhibited high angiogenic power as to endothelial cell proliferation. Our findings indicated that VEGF121 principally acts as the main angiogenic factor in the early stage of human osteoblastogenesis. The present study also demonstrated the differential expression of VEGF121 during osteoblastogenesis. The increase of VEGF in the early stage might be a useful marker of induction of bone formation due to human MSCs.

DOI： 10.1093/jb/mvg081

リウマチ教室の経験

篠田潤子, 西田圭一郎, 千田益生, 濱田全紀, 堅山佳美, 井上一, 難波良文

リハビリテーション医学 40 ( Suppl. ) S292 - S292 2003.5

Effect of NOS2 gene deficiency on the development of autoantibody mediated arthritis and subsequent articular cartilage degeneration

H Kato, K Nishida, A Yoshida, Takada, I, C McCown, M Matsuo, T Murakami, H Inoue

JOURNAL OF RHEUMATOLOGY 30 ( 2 ) 247 - 255 2003.2

Language：English Publishing type：Research paper (scientific journal) Publisher：J RHEUMATOL PUBL CO

Objective. To determine the effect of NOS2 gene deletion on articular cartilage degradation in autoantibody mediated arthritis (AMA).
Methods. Female C57BL/6Ai-[ko] NOS2 N5 (NOS2-/-) mice (7-8 weeks old) and the counterpart C57/B16 Crj mice (wild-type, WT) were studied, Arthritis was induced by intraperitoneal injection of 4 mg of an arthritogenic cocktail of 4 monoclonal antibodies raised against type II collagen twice on Day 0 and Day 1 followed by intraperitoneal injection of 50 mug of lipopolysaccharide on Day 2. Individual limbs were scored for arthritis in 4 grades; the total maximum score per mouse was 16. Femoral condyles and tibial plateaus of both knee joints were collected on Day 15 for immunohistological studies on nitrotyrosine and matrix metalloproteinase (MMP)-3 and -9. DNA fragmentation in chondrocytes was detected by the nick-end labeling (TUNEL) method. Blood was also collected on Day 15 to determine serum levels of nitrite/nitrate and interleukin 1beta (IL-1beta).
Results. Both NOS2-/- and WT mice with AMA developed clinically apparent arthritis. In WT mice, the arthritis progressed rapidly and reached the peak score 11.4 +/- 2.9 on Day 12, whereas the arthritis in NOS2-/- mice was milder and the peak score was 7.7 +/- 2.8 on Day 13 (p < 0.05). The serum nitrite/nitrate levels, histological grades of articular cartilage degradation, and numbers of apoptotic chondrocytes and nitrotyrosine positive chondrocytes were significantly lower in NOS2-/- mice with AMA than in WT mice with AMA. Conversely, significant differences were not observed in MMP-3 or -9 expression in chondrocytes, or in serum IL-1β levels between these 2 groups of mice.
Conclusion. NOS2 gene deletion did not affect the inflammatory responses, but reduced the cartilage degradation.

Blood loss in patients for total knee arthroplasty

Fujimoto, H., Ozaki, T., Asaumi, K., Kato, H., Nishida, K., Takahara, Y., Abe, N., Inoue, H.

Knee Surgery, Sports Traumatology, Arthroscopy 11 ( 3 ) 2003

Hepatopancreatic arterial ring: Bilateral symmetric typology in human celiaco-mesenteric arterial system

M Kosaka, K Horiuchi, K Nishida, T Taguchi, T Murakami, A Ohtsuka

ACTA MEDICA OKAYAMA 56 ( 5 ) 245 - 253 2002.10

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

The celiac and mesenteric arterial system including the left gastric, splenic, common hepatic, and superior mesenteric arteries shows various types of origins, courses, ramifications and anastomoses. In order to explain the various expressions of this system, we have proposed a typological model, in which celiacomesenteric arteries develop as paired or bilaterally symmetrical primordial vessels originated from the anterior aspect of the aorta, and these vessels anastomose each other with longitudinal and horizontal pathways. Here, we report 3 unusual cases characterized by arterial rings, formed by the left gastric, left accessory hepatic, proper hepatic, anterior pancreaticoduodenal, and dorsal pancreatic arteries. The dorsal pancreatic and anterior pancreaticoduodenal arteries are located to the right and left of the embryonic pancreas developing in the dorsal mesentery, respectively. Such hepatopancreatic arterial rings simultaneously containing right and left elements can only be explained using our typological model, in which the concept of paired arteries or bilateral symmetry is introduced.

DOI： 10.18926/AMO/31711

Inhibition of human chondrosarcoma cell growth via apoptosis by peroxisome proliferator-activated receptor-gamma

K Nishida, T Furumatsu, Takada, I, A Kawai, A Yoshida, T Kunisada, H Inoue

BRITISH JOURNAL OF CANCER 86 ( 8 ) 1303 - 1309 2002.4

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

A rare immunohistochemical study using 28 surgical sections of human chondrosarcoma revealed that 67.9% of tumour cells had weak (10-40%) or strong (> 40%) positive immunoreaction for peroxisome proliferator-activated receptor-gamma. The expression of peroxisome proliferator-activated receptor-mRNA and protein in human chondrosarcoma cell line OUMS-27 was also determined by reverse transcription-polymerase chain reaction and immunocytochemistry, respectively. Furthermore, the effects of peroxisome proliferator-activated receptor-gamma ligands on cell proliferation and survival were investigated in OUMS-27 cells. Pioglitazone, a selective ligand for peroxisome proliferator-activated receptor-gamma, and 15-deoxy-Delta(12,14)-prostaglandin J(2) (15d-PGJ(2)), a putative endogenous ligand for peroxisome proliferator-activated receptor-gamma, inhibited the proliferation of OUMS-27 cells in a dose-dependent manner. The mechanism of cytotoxic effects of 15d-PGJ(2) was via apoptosis as shown by DNA fragmentation using TUNEL stain and DNA ladder formation, and by ultrastructural analysis using transmission electron microscopy. Flow-cytometric analysis using annexin-V-fluorescein and propidium iodide detected the early change of apoptosis, as well as necrosis of OUMS-27 cells at 4 h after co-incubation with 15d-PGJ(2). These results suggest that peroxisome proliferator-activated receptor-gamma may play a significant role in the pathogenesis of chondrosarcoma, and peroxisome proliferator-activated receptor-gamma ligands, especially 15d-PGJ(2), may be of therapeutic value in the treatment of human chondrosarcoma. (C) 2002 dCancer Research UK.

DOI： 10.1038/sj/bjc/6600241

Endostatin inhibits adhesion of endothelial cells to collagen I via alpha(2)beta(1) integrin, a possible cause of prevention of chondrosarcoma growth

T Furumatsu, N Yamaguchi, K Nishida, A Kawai, T Kunisada, M Namba, H Inoue, Y Ninomiya

JOURNAL OF BIOCHEMISTRY 131 ( 4 ) 619 - 626 2002.4

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPANESE BIOCHEMICAL SOC

Endostatin derived from collagen XVIII is a potent endogenous anti-angiogenic factor that induces regression of various tumors of epithelial origin. Endostatin has been shown to inhibit endothelial cell functions, however, its effect remains controversial. We first attempted here to apply the inhibitory effect of recombinant human endostatin on chondrosarcomas, which originate from the mesenchyme, in nude mice. Endostatin induced reduction of chondrosarcoma growth and tumor angiogenesis in vivo. However, endostatin showed no effect on the proliferation and migration of chondrosarcoma cells in vitro. Next, we investigated the interactions between endostatin and endothelial cells in detail. Endostatin inhibited the migration on and attachment to collagen I but did not affect the proliferation of endothelial cells. Although the migration of endothelial cells was stimulated by angiogenic factors such as basic fibroblast growth factor and vascular endothelial growth factor, endostatin showed similar inhibitory effects on it in the presence and absence of the stimulants. Moreover, the inhibitory effect against endothelial cell attachment to collagen I was attenuated or modulated in the presence of neutralizing antibodies of alpha(2), alpha(5)beta(1), and alpha(V)beta(3) integrins but not that of alpha(1) integrin. Our results suggest that endostatin might suppress the alpha(2)beta(1) integrin function of endothelial cells via alpha(5)beta(1), or alpha(V)beta(3), integrin. We propose here that endostatin might be effective for anti-angiogenic therapy for human chondrosarcomas through the suppression of alpha(2)beta(1) integrin functions in endothelial cells.

DOI： 10.1093/oxfordjournals.jbchem.a003142

Human chondrosarcoma secretes vascular endothelial growth factor to induce tumor angiogenesis and stores basic fibroblast growth factor for regulation of its own growth

T Furumatsu, K Nishida, A Kawai, M Namba, H Inoue, Y Ninomiya

INTERNATIONAL JOURNAL OF CANCER 97 ( 3 ) 313 - 322 2002.1

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-LISS

Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) are well-known factors that induce neovascularization in many tumors. The molecular mechanisms that regulate tumor angiogenesis in human chondrosarcoma are not clear. We assessed in this work the angiogenic activities of a human chondrosarcoma cell line (OUMS-27) In vivo and determined the efficacies of angiogenic factors derived from OUMS-27 cells on human umbilical vein endothelial cells (HUVECs) in vitro. Tumor xenografts induced an increase in the formation of neovessels, but the distributions of Ki-67 antigen, VEGF and bFGF were unaffected. We also demonstrated that OUMS-27 cells secreted VEGF(165) into the culture medium and that it was the maximal angiogenic factor to stimulate endothelial proliferation and migration in chondrosarcoma. Anti-VEGF antibodies induced an approximately 70% inhibition of these responses of HUVECs, but did not have any effect on OUMS-27 cells. Anti-bFGF antibodies suppressed not only the activities of HUVECs but also the growth of tumor cells in vitro. We indicate that angiogenesis is principally elicited by VEGF(165) and that tumorigenesis is mainly regulated by bFGF stored in the extracellular matrix of OUMS-27 cells. The present study may offer the availability of combination therapies for inhibition of VEGF and bFGF action on vascular endothelial cells and chondrosarcoma cells, respectively. (C) 2002 Wiley-Liss, Inc.

DOI： 10.1002/ijc.1607

Changes in LPIA D-dimer levels after total hip or knee arthroplasty relevant to deep-vein thrombosis diagnosed by bilateral ascending venography

Naofumi Shiota, Toru Sato, Keiichiro Nishida, Masatsugu Matsuo, Yasuhiro Takahara, Shigeru Mitani, Takuro Murakami, Hajime Inoue

Journal of Orthopaedic Science 7 ( 4 ) 444 - 450 2002

Language：English Publishing type：Research paper (international conference proceedings) Publisher：Springer Japan

The purpose of the current retrospective study was to determine the most sensitive and specific cutoff value of plasma D-dimer level associated with deep-vein thrombosis (DVT) after total hip (THA) or knee (TKA) joint arthroplasty. Diagnosis of DVT was determined by bilateral ascending venography pre- and postoperatively. Plasma D-dimer levels were measured by a latex photometric immunoassay system (LPIA) preoperatively and postoperatively on days 1, 3, 7, 10, 14, and 21. Postoperative DVT diagnosed by venography was found in 22 patients (40.1%) after THA and in 18 patients (64.3%) after TKA. Plasma D-dimer levels were significantly higher (P &lt
0.01) in patients with DVT than in those without DVT on days 1, 7, and 10 after THA, but only on day 7 after TKA. Statistical analysis confirmed that a cutoff value of 10.0 μg/ml for D-dimer on day 7 was most sensitive (THA, 95.5%
TKA, 94.4%) and most specific (THA, 96.9%
TKA, 90.0%) in the diagnosis of DVT after THA as well as TKA. It was concluded that over 10 μg/ml of LPIA D-dimer on post-operative day 7 appears to be an indication of the occurrence of DVT after THA and TKA.

DOI： 10.1007/s007760200077

Carpal tunnel syndrome grading system in rheumatoid arthritis

Junko Shinoda, Hiroyuki Hashizume, Cherie McCown, Masuo Senda, Keiichiro Nishida, Takeshi Doi, Hajime Inoue

Journal of Orthopaedic Science 7 ( 2 ) 188 - 193 2002

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

The grading system of Hashizume and Hirooka for carpal tunnel syndrome (CTS) was modified to refine the system for surgical treatment selection for specific subsets of CTS in patients with rheumatoid arthritis (RA). The grading system uses clinical signs and symptoms of CTS, including pain indications, to identify surgical subsets of patients to facilitate treatment selection. Retrospective analysis of the system included radiographic and electromyographic findings. Twenty-nine hands of 21 adult patients with CTS in RA were graded in the current study. Eight hands with mild synovitis received conservative treatment only. Endoscopic carpal tunnel release (ECTR), using Okutsu's universal subcutaneous endoscopic system with a clear cannula, was performed in 11 hands with moderate synovitis. Open carpal tunnel release (OCTR) combined with flexor tenosynovectomy was performed in 9 hands with severe synovitis. One more hand required OCTR after ECTR when malignant RA was diagnosed. Clinical results, evaluated using Kelly's criteria, were: excellent in 19 hands, good in 5, fair in 4, and poor in the 1 patient with malignant RA. Clinical symptoms of CTS improved in all but the latter patient. Although the sample size in the current study is small, the results appear to warrant further study to determine the clinical utility of the grading system.

DOI： 10.1007/s007760200032

Evidence of oncotic cell death and DNA fragmentation in human hypertropic chondrocytes in chondro-osteophyte

Doi, T., Nishida, K., Matsuo, M., Yoshida, A., Murakami, T., Inoue, H.

Osteoarthritis and Cartilage 10 ( 4 ) 2002

Expression of caspase-3 and-9 relevant to cartilage destruction and chondrocyte apoptosis in human osteoarthritic cartilage

M Matsuo, K Nishida, A Yoshida, T Murakami, H Inoue

ACTA MEDICA OKAYAMA 55 ( 6 ) 333 - 340 2001.12

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

To clarify the involvement of the caspase family in the pathway of NO-induced chondrocyte apoptosis, osteoarthritis (OA) cartilage obtained from 8 patients undergoing total hip arthroplasty were used for histopathological study. Cartilage samples taken from non-fibrillated areas of femoral head resected during surgery for femoral neck fracture were used for comparison. DNA fragmentation of chondrocytes was detected by the nick end-labeling (TUNEL) method. Apoptosis was further confirmed by transmission electron microscopy. The distributions of nitrotyrosine (NT), caspase-3, and -9 were examined immunohistochemically. The populations of apoptotic as wen as NT-, caspase-3-, and -9-positive cells were quantified by counting the number of cells in the superficial, middle, and deep layers, respectively. The TUNEL-positive cells were observed primarily in superficial proliferating chondrocytes, clustering chondrocytes, and deep-layer chondrocytes of OA cartilage. Few positive cells were seen in the proliferating chondrocytes in the middle layer. Positive reactions for caspase-3 and -9 were observed in chondrocytes in similar areas. Histological OA grade showed significant correlations with the mean populations of apoptotic chondrocytes (% apoptosis) over the 3 areas. The populations of NT-positive cells (% NT) over the same areas also showed significant correlation with OA grade. Positivity for caspase-3 closely correlated with the OA grade, % apoptosis and %NT. It was concluded that caspase-3 and -9 could play a role in NO-induced chondrocyte apoptosis in OA cartilage.

Involvement of nitric oxide in chondrocyte cell death in chondro-osteophyte formation

K Nishida, T Doi, M Matsuo, Y Ishiwari, H Tsujigiwa, A Yoshida, M Shibahara, H Inoue

OSTEOARTHRITIS AND CARTILAGE 9 ( 3 ) 232 - 237 2001.4

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO LTD

Objective: To examine the nitric oxide (NO) production relevant to chondrocyte cell death in order to elucidate the mechanism of chondro-osteophyte formation in osteoarthrotic joints.
Design: Human chondra-osteophytes were obtained during total hip arthroplasty. Expression of inducible nitric oxide synthase (iNOS) mRNA was determined by in-situ hybridization. Localization of iNOS and nitrotyrosine at protein level were examined by immunohistochemistry. Cell death of chondrocytes were confirmed by both TUNEL method and transmission electron microscopy.
Results: The various populations of proliferative and hypertrophic chondrocytes expressed iNOS mRNA and iNOS as well as nitrotyrosine protein. Approximately 30% at hypertrophic chondrocytes forming chondro-osteophyte showed positive reaction to TUNEL staining. Electron microscopy confirmed both disintegrated and apoptotic chondrocytes in these zones. In the deep hypertrophic zone calcification was seen around each of the matrix vesicles and some masses of cell debris.
Conclusion: Chondro-osteophyte formation involves NO production by chondrocytes. The expression and localization of iNOS and nitrotyrosine in chondro-osteophytes suggest the significant role of NO in chondrocyte hypertrophy and apoptosis. (C) 2001 OsteoArthritis Research Society international.

DOI： 10.1053/joca.2000.0380

Reconstruction using clavicle afre resection of arcoma of the proximal humerus.

Ozaki T, Hashizume H, Nishida K, Kawai A, Inoue H

Clin Orthop 2001

Reconstruction of the proximal humerus with the clavicle after tumor resection: A case report

Ozaki, T., Hashizume, H., Kunisada, T., Kawai, A., Nishida, K., Sugihara, S., Inoue, H.

Clinical Orthopaedics and Related Research ( 385 ) 2001

Expression of connective tissue growth factor in cartilaginous tumors

Toshihiko Shakunaga, Toshifumi Ozaki, Nobuya Ohara, Koji Asaumi, Takeshi Doi, Keiichiro Nishida, Akira Kawai, Tohru Nakanishi, Masaharu Takigawa, Hajime Inoue

Cancer 89 ( 7 ) 1466 - 1473 2000.10

Language：English Publishing type：Research paper (international conference proceedings) Publisher：FREUND PUBL HOUSE LTD

BACKGROUND. Connective tissue growth factor (CTGF) predominantly is expressed in hypertrophic chondrocytes and its specific receptors are demonstrated on chondrocytic cells. Therefore, CTGF may be involved in the proliferation and/or differentiation of cartilage cells. In the current study, CTGF expression was examined both in chondrosarcoma and enchondroma to clarify the relation between the expression of CTGF and the grade of malignancy. METHODS. The expression of CTGF and proliferating cell nuclear antigen (PCNA) were analyzed immunohistochemically in 34 cartilaginous tumor specimens. Eighteen tumors were determined to be chondrosarcoma including 8 Grade 1 tumors, 6 Grade 2 tumors, and 4 Grade 3 tumors. The percentage of CTGF positive and PCNA positive cells was quantified using at least 500 cells. RESULTS. CTGF was expressed in 70.1% of enchondroma cells, 84.0% of Grade 1 chondrosarcoma cells, 53.7% of Grade 2 tumor cells, and 26.8% of Grade 3 tumor cells (ρ = -0.501
P = 0.0053). In chondrosarcoma cases, CTGF expression was correlated closely with tumor grade (ρ = -0.920
P = 0.0001). There was a strong correlation between PCNA expression and tumor grade (ρ = 0.907
P &lt
0.0001) and a strong negative correlation between CTGF and PCNA expression (ρ = -0.493
P = 0.0061). In chondrosarcoma cases, patients with high expression of CTGF (≥ 30%) showed higher overall survival compared with those with low expression (&lt
30%) (P = 0.004). CONCLUSIONS. The current study revealed a correlation between the histologic grade of chondrosarcoma and prognosis, and the concomitant association between CTGF immunostaining and tumor grade and prognosis. Therefore, immunohistochemical staining with CTGF is a useful procedure for assessing the tumor grade anti clinical course in patients with chondrosarcoma. (C) 2000 American Cancer Society.

DOI： 10.1002/1097-0142(20001001)89:7<1466::AID-CNCR8>3.0.CO;2-G

CD44 expression in soft tissue sarcomas

N Kahara, T Ozaki, T Doi, K Nishida, A Kawai, M Shibahara, H Inoue

VIRCHOWS ARCHIV-AN INTERNATIONAL JOURNAL OF PATHOLOGY 436 ( 6 ) 574 - 578 2000.6

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

Recent studies have shown that expression of alternatively splicing variants of CD44 is correlated with prognosis for several kinds of malignant tumors. However, little is known about the expression of CD44 standard and variant isoforms in soft tissue sarcomas. In this study 47 cases of soft tissue sarcoma [18 malignant fibrous histiocytomas (MFHs), 13 synovial sarcomas (SSs), 7 malignant schwannomas (MSs), and 9 liposarcomas (LSs)] were examined immunohistochemically. The monoclonal antibodies to the standard form of CD44 (CD44H) and variant exons of CD44v3, 4, 5, 6, 7, 9, and v10 were used. We analyzed the membranous expression pattern of CD44H and CD44 variant exons and assessed the relation between expression of CD44s and metastasis-free survival rates (MFSR) of patients with soft tissue sarcoma. A few sarcomas expressed CD44v3 (2/47) and v7 (2/47), but none of the sarcomas expressed CD44v10. CD44v4 (5/47), v5 (4/47), v6 (10/47), and v9 (9/47) are relatively common types of variant isoforms in soft tissue sarcomas. Expression of CD44v6 is more frequently detected in high-grade than in low-grade tumors. CD44v6 or CD44v9 expression was correlated with metastasis-free survival of patients with soft tissue sarcomas.

Increased osteocyte apoptosis during the development of femoral head osteonecrosis in spontaneously hypertensive rats

M Shibahara, K Nishida, H Asahara, T Yoshikawa, S Mitani, Y Kondo, H Inoue

ACTA MEDICA OKAYAMA 54 ( 2 ) 67 - 74 2000.4

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

We investigated the presence of osteocyte apoptosis in the necrotic trabeculae of the femoral head of spontaneously hypertensive rat (SHR) using the in situ nick end labeling (TUNEL) method and transmission electron microscopy. The occurrence of osteonecrosis and ossification disturbance was significantly higher in SHR compared with Wistar Kyoto (WKY) rats, and Wistar (WT) rats used as control animals (P < 0.01). A high population of TUNEL positive osteocytes was detected mainly in 10- and 15-week-old SHRs. Sectioned examination of the femoral head of SHRs and WKY rats by electron microscopy revealed apoptotic cell appearances such as aggregation of chromatin particles and lipid formation. In contrast, a positive reaction was significantly lower in osteocytes in the femoral heads of WT rats (P < 0.01). Our results indicate that apoptosis forms an important component of the global pathologic process affecting the femoral head of SHR, which leads to osteonecrosis in this region.

DOI： 10.18926/AMO/32287

The role of nitric oxide in arthritic joints: A therapeutic target?

K. Nishida, T. Doi, H. Inoue

Modern Rheumatology 10 ( 2 ) 63 - 67 2000.1

Language：English

Nitric oxide (NO) is produced by many cell types in the joint, and its expression is delicately regulated. Depending on its concentration and cellular origin, NO appears to have both pro- and anti-inflammatory potential in the joint. Constitutively expressed nitric oxide synthase (NOS) produces small amounts of NO, which is essential for normal physiological homeostasis. However, inflammatory stimuli such as endotoxins, cytokines, and growth factors promote inducible NOS (iNOS) expression, initially as an anti-inflammatory response, and catalyse a high output of NO. Excessive NO can amplify inflammatory pathways and contribute to the development and maintenance of arthritis. Consequently, proper regulation of NO synthesis can lead to a novel therapeutic approach for inflammatory joint diseases. Further careful study will be necessary to develop new drugs to regulate the NO pathway and to determine the dosage, timing of administration, and duration of treatment in order to avoid both undesirable immunostimulatory effects and immunosuppressive effects. © 2000, The Japan Rheumatism Association and Springer-Verlag Tokyo. All rights reserved.

DOI： 10.3109/s101650050001

Simultaneous fracture-dislocations of the distal and proximal interphalangeal joints

K Nakago, H Hashizume, M Senda, K Nishida, S Masaoka, H Inoue

JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME 24B ( 6 ) 699 - 702 1999.12

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

Sixteen cases of simultaneous fracture-dislocations of both the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints in the same finger that were treated during the past 10 years were classified into three types: the swan-neck injury (dorsal fragment of the base of the distal phalanx at the DIP joint and palmar fragment of the base of the middle phalanx at the PIP joint); the double-hyperextension injury (palmar fragments at the DIP and PIP joints); and the straight-finger injury (with dorsal and palmar bone fragments at the DIP joint). The results of treatment were more satisfactory in PIP joints than in DIP joints.

DOI： 10.1054/jhsb.1999.0228

Ultrasonographic analysis of shoulder rotator cuff tears

S Masaoka, H Hashizume, M Senda, K Nishida, M Nagoshi, H Inoue

ACTA MEDICA OKAYAMA 53 ( 2 ) 81 - 89 1999.4

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

Seventy-nine shoulders suspected of rotator cuff tears were examined by ultrasonography (US) and forty-three received surgery. Long and short axis scans were performed and findings of each were separately classified according to a five-grade system, and the results were correlated with the actual extent of tear observed during surgery. Internal echogenicity and subacromial impingement were analyzed before and after surgery. A accuracy of US in detecting rotator cuff tears was analyzed. In addition, the correlation between cuff shape observed by US before surgery and actual shape observed during surgery was assessed. It was noted that cuff thinning and abnormalities in shape did not recover to normal after surgery. However, in the cases of discontinuities observed by US before surgery, US findings indicated that the torn cuff was anchored to the greater tuberosity and functional during active motion. Although post-operative US findings were not normal, clinical results were good in most cases. Sensitivity of US for detecting rotator cuff tear was 100% and specificity 94%. US is non-invasive, cost effective and allows the physician to examine the joint while it is in motion. Therefore, at this time, we use US as a screening method for detecting rotator cuff tears. Furthermore, US allows us to check for re-tears while the joint is in motion, which is essential for accurate diagnosis.

Expression of CD44 variants in osteosarcoma

M. Kuryu, T. Ozaki, K. Nishida, M. Shibahara, A. Kawai, H. Inoue

Journal of Cancer Research and Clinical Oncology 125 ( 11 ) 646 - 652 1999

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

The standard form of CD44 (CD44H) is a transmembranous glycoprotein, widely distributed on a variety of human lymphoid cells, epithelial cells and tumours. CD44 has many variant forms, which are generated by alternative splicing. In recent years, CD44 has been reported to be related to the degree of tumour differentiation, tumour cell invasion, and metastasis. We investigated 44 tumour specimens in 39 patients with osteosarcoma immunochemically to analyze the expression of CD44 standard (CD44H) and variant exon-encoded gene products (CD44v3, v4, v5, v6, v7, v9, and v10). Furthermore, the relationship between CD44 expression and the clinical outcome of patients with osteosarcoma was analyzed. Membrane accentuation and exclusive cytoplasmic reactivity were analyzed as separate staining patterns. Tumour cells and some multinucleated giant cells were markedly stained. CD44H, v3, v4, v5, v6, v7, v9, and v10 were expressed in 85%, 49%, 54%, 59%, 46%, 5%, 28%, and 10% of the specimens respectively. The cumulative 5-year metastasis-free survival was 58% in CD44v6-negative cases and 24% in CD44v6-positive cases (P = 0.046). However, the cumulative 5-year metastasis-free survival was not significantly different between cases positive and negative for other variants of CD44. Multivariate analysis (Cox proportional-hazard model) with CD44v6 expression (positive or negative), chemotherapy (intensive or non-intensive), tumour site (proximal or distal), and age (at least 30 years or less than 30 years) showed that expression of CD44v6 and chemotherapy were important prognostic factors in patients with osteosarcoma. Overexpression of CD44 isoforms containing variant v6 is correlated with poor prognosis in patients with osteosarcoma.

DOI： 10.1007/s004320050329

Ultrasonographic analysis of shoulder cuff tearsUltrasonographic analysis of shoulder cuff tears

Masaoka S, Hashizume H, Senda M, Nishida K

Acta MEd Okayama 1999

Integrin-regulated sevreton of interleukin 4: A novel pathway of mechanotransduction in human articular chondrocytes

145 183 - 189 1999

Evaluation of Rheumatoid Arthritis Using a Scoring System Devised from Magnetic Resonance Imaging of Rheumatoid Knees

Takeuchi Kazuhiro, Inoue Hajime, Yokoyama Yoshiki, Senda Masuo, Ota Yusuke, Abe Nobuhiro, Nishida Keiichiro

Acta Medica Okayama 52 ( 4 ) 211 - 224 1998.8

Fibrous structure and connection surrounding the metacarpophalangeal joint

H Takagoshi, H Hashizume, K Nishida, S Masaoka, H Asahara, H Inoue

ACTA MEDICA OKAYAMA 52 ( 1 ) 19 - 26 1998.2

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

The fibrous components of the metacarpophalangeal (MP) joint including the palmar plate, the collateral ligament and the dorsal plate were studied with particular attention paid to the fibrous structure of the fibrous tendon sheath and the deep transverse metacarpal ligament. The tough fibrillar structure around the MP joint, especially the force nucleus, consisted of three types of mixed fibers: the fibrous tendon sheath of the A, pulley, the deep transverse metacarpal ligament, and the palmar plate. The tendon sheath was located on the ulnar side in the index and middle fingers, on the central position in the ring finger, and on the radial side in the little finger. These fibrous connections among the fingers formed a transverse arch in the hand. The palmar plate of the MP joint was relatively rigid and appears to function as a cushion when flexed. A fold-like protrusion of the synovial layer of the palmar plate of the MP joint had a meniscoid function, which was larger than that of the proximal interphalangeal joint. The capsule of the MP joint was thicker at the dorsal area, forming a dorsal plate, which is a sliding floor of the extensor mechanism and has a meniscoid function for joint congruity. The main lateral stabilizer consisted of collateral ligaments and accessory collateral ligaments anchored to the palmar plate. These structures act together as a "phalangeal cuff", connecting the proximal phalanx to the metacarpal head and stabilizing the MP joint.

Mast cells in osteoarthritic and rheumatoid arthritic synovial tissues of the human knee

J Pu, K Nishida, H Inoue, H Asahara, A Ohtsuka, T Murakami

ACTA MEDICA OKAYAMA 52 ( 1 ) 35 - 39 1998.2

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

The distribution and density of mast cells in the normal and diseased synovial membranes were investigated. The mast cell count (MCC) in the osteoarthritic (OA) synovium (36.9 +/- 26.9 cells/mm(2)) was significantly higher than that in the rheumatoid arthritic (RA) synovium (18 +/- 12.3 cells/mm(2)). There was a marked positive correlation between the MCC and the volume of joint fluid in OA (r = 0.544). There was a marked negative correlation between the MCC and the volume of joint fluid in RA (r = -0.478). The synovial inflammatory score had a poor correlation with the MCC in OA (r = 0.377) and RA (r = 0.305). No correlation was noted between MCC and age, sex, roentgenographic grades, disease duration, C-reactive protein or leucocyte number in synovial fluid. Our data suggests, thus, that mast cells could be involved in the pathogenesis of inflammatory diseases of the synovium, especially in the mechanism of hydroarthrosis.

A Pathogenic role for IL-12 in maintaining Th1 immuneresponses in rheumatoid arthritis.

Morita Y, Yamamura M*, Nishida K, Harada S, Okamoto H, Inoue H, Ohmoto Y, Modlin RL, Makino H

Arthritis Rheum 41 306 - 314 1998

慢性関節リウマチの手指屈筋腱腱鞘炎

太田裕介, 井上一, 橋詰博行, 西田圭一郎, 浅原弘嗣, 臼井正明, 阿部信寛

岡山県立大学短期大学部研究紀要 ( 5 ) 37 - 44 1998

Language：Japanese Publisher：岡山県立大学短期大学部

［概要］慢性関節リウマチ（RA）において手指屈筋腱腱鞘炎（腱鞘炎）を起こす例をしばしば認めるため，横断調査を行った。［対象，方法］岡山大学整形外科リウマチ外来に通院している52例（男６例，女46例）で平均年齢59.5歳（24～85歳），平均罹病期間9.2年（2～30年）を対象とし，視診および触診にて腱鞘炎，弾発現象，ロッキングの有無，および弾発現象の既往につき調査した。調査期間は平成９年４月～５月の２ヵ月間であった。［結果］腱鞘炎を25例（48％）63指に認めた。全63指中，母指～小指が各々4，12，14，19，14指と環指に多かった。１指発生が10例と最も多かったが８指発生も２例あり，うち１例は両手指廃用であった。弾発現象を９例（17％）11指に認め，中指２指，環指５指，小指４指と環指に多い傾向を認めた。ロッキングは４例（８％）５指に認め，手指基節掌側に３例，母指基節掌側に１例認めたが，痛みはなく，日常生活動作の障害はわずかであった。弾発現象の既往のある25例中２例が手術を受けていたが９例（17％）が放置にて治癒していた。また４例はRAの初発症状として弾発現象を認めた。［考察］弾発現象は放置しても自然に消失することが多いので，短期的には経過観察でもよいが，腱断裂を起こす例もあるので，注意が必要と思われた。［まとめ］日常診療において手指屈筋腱腱鞘炎の存在に留意し，腱鞘内注射が有効でない場合は手術的治療も考慮すべきと思われた。

DOI： 10.15009/00000959

Other Link： http://id.nii.ac.jp/1212/00000959/

Magnetic Resonance Imaging of Rheumatoid Wrists.

MASAOKA Shunji, HASHIZUME Hiroyuki, NISHIDA Keiichiro, ASAHARA Hiroshi, INOUE Hajime

The Journal of the Chugoku-Shikoku Orthopaedic Association 10 ( 2 ) 325 - 329 1998

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Magnetic resonance imaging (MRI) was performed in 71 wrists of 39 rheumatoid arthritis patients. There were 2 males (3 wrists) and 37 females (68 wrists) with an average age of 55.4 years. Synovial proliferation and bone erosion appeared as low intensity areas on T1-weighted MRIs and as high intensity areas on T2-weighted images. Discrimination of synovial proliferation was improved by Gd-DTPA enhancement. These lesions could be detected in early rheumatoid arthritis patients whose plain X-ray images lacked abnormal findings. We found MRI to be a useful method for detecting bone and soft tissue lesions of RA, especially of early RA patients. MRI is also useful in evaluation of drug therapy and pre-operative planning.

DOI： 10.11360/jcsoa1989.10.325

Expression of interleukin-12 in synovial tissue from patients with rheumatoid arthritis

Morita, Y., Yamamura, M., Nishida, K., Harada, S., Okamoto, H., Inoue, H., Ohmoto, Y., Modlin, R.L., Makino, H.

Arthritis and Rheumatism 41 ( 2 ) 1998

Negative charges bound to collagen fibrils in the rabbit articular cartilage: A light and electron microscopic study using cationic colloidal iron

T Yoshikawa, K Nishida, T Doi, H Inoue, A Ohtsuka, T Taguchi, T Murakami

ARCHIVES OF HISTOLOGY AND CYTOLOGY 60 ( 5 ) 435 - 443 1997.12

Language：English Publishing type：Research paper (scientific journal) Publisher：INT SOC HISTOLOGY & CYTOLOGY

Negative charged sites in the normal rabbit articular cartilage were investigated using cationic colloidal iron methods, In light microscopy of the cartilage stained with the colloidal iron at pH 1.5, a distinct Prussian blue reaction was observed in the pericellular matrix, and a weak blue reaction in the territorial and interterritorial matrices, At pH 7.0, a diffuse Prussian blue reaction was observed in the pericellular and interterritorial matrices.
Digestion with chondroitinase ABC, hyaluronidase and keratanase could not erase the Prussian blue reaction. However, the sections digested with collagenase followed by chondroitinase ABC showed significant elimination of the Prussian blue reaction.
Electron microscopy of ultrathin sections stained with the colloidal iron at pH 1.5 revealed that the cationic colloid particles were deposited abundantly in the pericellular matrix and dotted along collagen fibrils in the territorial and interterritorial matrices.
The present results suggest that negatively charged sites in the articular cartilage derive mostly from chondroitin sulfate, whose proteoglycans firmly bind to collagen fibrils, Such an ultrastructure may maintain the electrostatic microenvironment in the collagen plexus, holding much water in the cartilage matrix, and also producing biomechanical properties such as tensile strength and elasticity of the cartilage.

DOI： 10.1679/aohc.60.435

Expression of osteonectin in articular cartilage of osteoarthritic knees

Y Nanba, K Nishida, T Yoshikawa, T Sato, H Inoue, Y Kuboki

ACTA MEDICA OKAYAMA 51 ( 5 ) 239 - 243 1997.10

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

The expression of osteonectin (ON) in osteoarthritic articular cartilage was investigated by enzyme immunohistochemistry and colloidal gold immunoelectron microscopy. A total of 96 specimens from 9 knees of 8 patients with osteoarthritis (OA) were examined. In OA cartilage, ON-positive cells varied in distribution and were not seen in all the specimens obtained from the same patient. However, in over half of the specimens (56 of 96), especially in the specimens of Mankin's grades from 4 to 9, which corresponds to relatively early stages of OA, ON was expressed in the cartilage above the calcified layer. On the other hand, ON was detected only in the calcified layer below the tidemark in normal articular cartilage. In addition, colloidal gold immunoelectron microscopy revealed ON in chondrocytes and matrix vesicles (MVs). These findings suggest that ON acts through MVs in the early stages of OA as a significant pathogenetic factor involved in intracartilage calcification, which is known to have a close relationship to the progression of OA.

DOI： 10.18926/AMO/30790

Hyperpolarisation of cultured human chondrocytes following cyclical pressure-induced strain: Evidence of a role for alpha 5 beta 1 integrin as a chondrocyte mechanoreceptor

MO Wright, K Nishida, C Bavington, JL Godolphin, E Dunne, S Walmsley, P Jobanputra, G Nuki, DM Salter

JOURNAL OF ORTHOPAEDIC RESEARCH 15 ( 5 ) 742 - 747 1997.9

Language：English Publishing type：Research paper (scientific journal) Publisher：JOURNAL BONE JOINT SURGERY INC

Mechanical stimuli influence chondrocyte metabolism, inducing changes in intracellular cyclic adenosine monophosphate and proteoglycan production. We have previously demonstrated that primary monolayer cultures of human chondrocytes have an electrophysiological response after intermittent pressure-induced strain characterised by a membrane hyperpolarisation of approximately 40%. The mechanisms responsible far these changes are not fully understood but potentially involve signalling molecules such as integrins that link extracellular matrix with cytoplasmic components. The results reported in this paper demonstrate that the transduction pathways involved in the hyperpolarisation response of human articular chondrocytes in vitro after cyclical pressure-induced strain involve alpha 5 beta 1 integrin, We have demonstrated, using pharmacological inhibitors of a variety of intracellular signalling pathways. that the actin cytoskeleton, the phospholipase C calmodulin pathway, and both tyrosine protein kinase and protein kinase C activities are important in the transduction of the electrophysiological response. These results suggest that alpha 5 beta 1 is an important chondrocyte mechanoreceptor and a potential regulator of chondrocyte function.

DOI： 10.1002/jor.1100150517

Percutaneous release for trigger finger in idiopathic and hemodialysis patients

M Nagoshi, H Hashizume, K Nishida, H Takagoshi, J Pu, H Inoue

ACTA MEDICA OKAYAMA 51 ( 3 ) 155 - 158 1997.6

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

Sixty-seven trigger fingers of 58 idiopathic and hemodialysis patients were treated by percutaneous A 1-pulley release technique. Severity of triggering was classified into five grades for treatment selection and prediction of possible results. Results were excellent in 41 fingers, good in 9, fair in 7, and poor in 10, requiring additional treatment. The results of the lower grades were better, and those of the higher grades were poor. Excellent or good results appeared to depend on the proper selection of the patients according to the grading system and confirmation of triggering disappearance just after the release. There were neither infections nor neuro-vascular deficits after treatment. Compared to conventional open release, this treatment was found to be more useful from the standpoints of ease and safety of the technique, and the patients' quick return to normal life.

Histopathology and clinical results of carpal tunnel syndrome in idiopathic cases and hemodialysis patients

K Kinugasa, H Hashizume, K Nishida, Y Shigeyama, H Inoue

ACTA MEDICA OKAYAMA 51 ( 2 ) 63 - 70 1997.4

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

The results of the histological examinations of specimens of the tenosynovium of the flexor tendon, the epineurium and the transverse carpal ligament from two groups of Japanese patients with carpal tunnel syndrome (idiopathic and hemodialysis) were compared. Amyloid deposits, positively identified as beta(2)-microglobulin, appeared in all patients in the long-term hemodialysis group, but in no patients in the idiopathic group. Although the pathogenesis differed between the two groups, both resulted in nerve compression in the carpal tunnel. Therefore, surgical release is considered beneficial for both groups.

Non-traumatic paralysis of the posterior interosseous nerve

H Hashizume, K Nishida, Y Nanba, Y Shigeyama, H Inoue, Y Morito

JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME 78B ( 5 ) 771 - 776 1996.9

Language：English Publishing type：Research paper (scientific journal) Publisher：BRITISH EDITORIAL SOC BONE JOINT SURGERY

We treated 31 patients with non-traumatic paralysis of the posterior interosseous nerve over 15 years, There were 10 men and 21 women of mean age 40.3 years (17 to 71), Six were managed conservatively, and 25 by operation,
In 14 patients entrapment occurred at the supinator, including three who had double compression at both the entrance and exit from the muscle. In four it was caused by a ganglion, in one by a lipoma, in one by a dislocated radial head and in two by a marked constriction in the nerve of unknown cause, The remaining three patients mere retrospectively diagnosed as having neuralgic amyotrophy, the only observable change at operation being slight oedema of the nerve,
Paralysis recovered in 24 out of the 25 patients at between 2 to 18 months (mean 5.6) after operation, and the one failure was treated later by tendon transfer.

Shoulder pain in long-term haemodialysis patients - A clinical study of 166 patients

T Konishiike, H Hashizume, K Nishida, H Inoue, M Nagoshi

JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME 78B ( 4 ) 601 - 605 1996.7

Language：English Publishing type：Research paper (scientific journal) Publisher：BRITISH EDITORIAL SOC BONE JOINT SURGERY

We reviewed 166 adult patients on long-term haemodialysis, dividing them into three groups according to the presence and type of shoulder pain, The 24 patients in group A, with spontaneous pain related to a supine posture, had been under haemodialysis for significantly longer than the others, and had a much higher incidence of carpal tunnel syndrome,
Open or arthroscopic resection of the coracoacromial ligament in 21 shoulders relieved pain during haemodialysis and night pain, and histological examination showed amyloid deposits and inflammatory-cell infiltration in the subacromial bursa in almost all cases, and in the tenosynovium of the bicipital groove in some,
We conclude that one type of shoulder pain experienced by patients on long-term haemodialysis is caused by the subacromial impingement of amyloid deposits, This should be distinguished from other types of shoulder pain, because it can be relieved by resection of the coracoacromial ligament.

Ulnar buttress arthroplasty for reconstruction after resection of the distal ulna for giant cell tumor Reviewed

H Hashizume, A Kawai, K Nishida, K Sasaki, H Inoue

JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME 21B ( 2 ) 213 - 215 1996.4

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

A giant cell tumour of the distal end of the ulna was treated by en bloc resection, The resected distal end of the ulna was replaced by an iliac bone graft, preserving the triangular fibrocartilage complex, The wrist was pain-free and had a full range of motion 6 months postoperatively.

Histopathology of Kienbock's disease. Correlation with magnetic resonance and other imaging techniques

H. Hashizume, H. Asahara, K. Nishida, H. Inoue, T. Konishiike

Journal of Hand Surgery 21 ( 1 ) 89 - 93 1996

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

Histopathological studies of extracted whole lunate bones obtained from 10 patients with Stage 3 Kienbock's disease at surgery for tendon-ball replacement were correlated with magnetic resonance imaging (MRI), computed tomography (CT) and tomography images made prior to surgery. A reforming zone, or a reactive interface between the reactive new bone and granulation tissue formation, and new vascularization were observed surrounding the bone necrosis area showing empty lacunae, fatty necrosis, and disappearance of osteoid. Findings of CT, tomography and microradiography of slices of extracted lunate bone confirmed that fractures of the articular cartilage and the subchondral bone occurred secondarily by overloading, and showed the extent of the collapsed area of the lunate. MRI showed complete loss of signal intensity in T1 images of the lesion of the lunate in advanced Stage 3 Kienbock's disease. MRI is at present unable to distinguish bone necrosis, the histological reactive interface or surrounding hyperaemia in detail. However, the low-intensity are, or the reactive interface present on MRI in early Stage 3, sometimes correlates with the histological findings of osteoid and granulation zones.

DOI： 10.1016/S0266-7681(96)80019-2

Dorsally displaced epiphyseal fracture of the phalangeal base

H. Hashizume, K. Nishida, D. Mizumoto, H. Takagoshi, H. Inoue

Journal of Hand Surgery 21 ( 1 ) 136 - 138 1996

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

A dorsally displaced epiphyseal fracture of the middle phalanx (Salter-Harris Type I) is described. The epiphyseal fragments were attached to the central slip of the extensor tendon and collateral ligaments. The articular surface of the PIP joint was intact and smooth. The epiphysis was reduced and fixed without cutting the central slip or the collateral ligaments 8 months after injury. This kind of fracture can occur in the PIP and DIP joints, and presents special diagnostic difficulties. Open reduction is evidently necessary to correct the displacement.

DOI： 10.1016/S0266-7681(96)80030-1

The Galeazzi-equivalent lesion in children revisited

J. Imatani, H. Hashizume, K. Nishida, Y. Morito, H. Inoue

Journal of Hand Surgery: European Volume 21 ( 4 ) 455 - 457 1996

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications Ltd

A fracture at the medial end of the distal third of the radius with an epiphyseal separation of the distal ulna in a 16-year-old boy is described. This injury, known as the Galeazzi-equivalent lesion in children, is characterized by complete distal ulnar epiphyseal separation without rupture of the distal ligamentous stabilizing system between the radius and ulna, which includes the triangular fibrocartilage complex, interosseous ligaments and periosteal tube of the ulnar. The Galeazzi fracture-dislocation and the Galeazzi-equivalent lesion appear to be completely dissimilar in their pathological anatomy. We suggest calling the latter a "pseudo-Galeazzi injury".

DOI： 10.1016/S0266-7681(96)80045-3

Histological and scanning electron microscopic study on the glenoid labrum of cadavers.

Nishida K, Hashizume H, Toda K, Inoue H

Journal of Shoulder and Elbow Surgery 5 ( 2 ) 132 - 138 1996

Localization of the glycosaminoglycans in the synovial tissues from osteoarthritic knees

K Nishida, H Inoue, K Toda, T Murakami

ACTA MEDICA OKAYAMA 49 ( 6 ) 287 - 294 1995.12

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

Localization of the glycosaminoglycans (GAG) was examined in the synovial membranes of petients with osteoarthritis under light microscopy using a fine cationic colloidal iron staining method combined with enzymatic digestion. Our staining method was very useful for demonstrating the difference in the localization of GAG in regions of the inflammatory site in the osteoarthritic synovial membrane. Hyarulonic acid was mainly located in connective tissues in the surface intercellular and perivascular spaces, chondroitin sulfate A/C in the highly fibrous part of and connective tissue around blood vessels, dermatan sulfate (chondroitin sulfate B) in the subsurface interstitium and vascular endothelial cells and heparan sulfate in part of vascular endothelial cells. No keratan sulfate was detected. GAG is reported to have an important role in cell movement, adherence and aggregation in the inflammatory sites. These findings should be useful for understanding the role of GAG in physiological and pathologic processes of secondary synovitis.

DOI： 10.18926/AMO/30384

IMMUNOHISTOCHEMICAL DEMONSTRATION OF FIBRONECTIN IN THE MOST SUPERFICIAL LAYER OF NORMAL RABBIT ARTICULAR-CARTILAGE

K NISHIDA, H INOUE, T MURAKAMI

ANNALS OF THE RHEUMATIC DISEASES 54 ( 12 ) 995 - 998 1995.12

Language：English Publisher：BRITISH MED JOURNAL PUBL GROUP

Objective-To locate fibronectin ultrastructurally in the most superficial layer of normal articular cartilage of rabbits, in order to clarify its role in joint physiology.
Methods-Articular cartilage was obtained from the femoral condyle of seven normal adult rabbits and prepared by a method that included tannic acid fixation. Polyclonal antibodies against rabbit fibronectin were used in an immunohistochemical electron microscopic study, without any enzymic digestion but with a pre-embedding method for the transmission electron microscopy.
Results-The cartilage surface was successfully preserved by tannic acid fixation. The most superficial layer in electron photomicrographs was approximately 200-300 nm thick, cell free, and appeared to have two parallel components: the more superficial lamina and the deeper lamina. Gold labelled fibronectin lined this layer in immunohistochemical electron photomicrographs.
Conclusions-Fibronectin covering the surface of the articular cartilage may have a role in joint lubrication and protection of the cartilage by binding with the collagenous matrix and hyaluronic acid in synovial fluid. Chondroitin sulphates may act as a charge barrier in close relationship with the collagen fibrils in the deeper lamina. Significant alteration in these functions may be one of the first causal steps leading to destruction of the articular cartilage.

DELAYED POSTERIOR INTEROSSEOUS NERVE PALSY

H HASHIZUME, K NISHIDA, K YAMAMOTO, T HIROOKA, H INOUE

JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME 20B ( 5 ) 655 - 657 1995.10

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

A rare case of delayed posterior interosseous nerve palsy that developed 39 years after an unreduced anterior dislocation of the radial head is reported. The posterior interosseous nerve was compressed and narrowed at the arcade of Frohse. Radial head resection and release of the arcade was done. The paralysis continued to recover 6 weeks after operation. The nerve, at the arcade of Frohse, was susceptible to compression by the dislocated radial head, especially in the supinated position, Repeated supination and pronation movement over time may have led to developmental changes that caused the delayed nerve palsy.

STRONGLY ANIONIC SITES IN PERIPHERAL AXONS OF THE RAT SCIATIC-NERVE - LIGHT AND ELECTRON-MICROSCOPIC DETECTION USING CATIONIC COLLOIDAL IRON

K TODA, K NISHIDA, H INOUE, A OHTSUKA, T MURAKAMI

ARCHIVES OF HISTOLOGY AND CYTOLOGY 58 ( 4 ) 485 - 492 1995.10

Language：English Publishing type：Research paper (scientific journal) Publisher：INT SOC HISTOLOGY & CYTOLOGY

Anionic sites in the rat sciatic nerve mere studied by light and electron microscopy using a fine-granular cationic colloidal iron staining method (Mu-RAKAMI et al., 1986). The axon, as well as the endoneurium, the epineurium and the basement membrane of Schwann cells, were all confirmed to react strongly to the cationic colloidal iron even at a pH value of 1.0-2.0. Prior hyaluronidase digestion decreased the colloidal stain of the epineurium; chondroitinase ABC weakened that of the endoneurium and the basement membrane of Schwann cells. However, as axons retained stainability with cationic colloidal iron even after combined digestion with hyaluronidase, chondroitinase ABC, heparitinase and keratanase, the authors consider sulfated glycoconjugates and not those substances which are digestible with such common enzymes. The acid groups ionized at pH 1.0 are most likely sulfate groups. Methylation deprived the axon of the reactivity to cationic colloidal iron staining, and even subsequent saponification could not recover this reactivity to its full extent. All these suggested the presence of sulfate groups. In the axon, electron microscopy revealed a deposition of colloidal iron on the external surfaces of microtubules and neurofilaments in the axoplasm and of very fine filaments connecting them. This highly negatively charged intra-axonal network could also serve toward a supportive function in maintaining the spatial distribution of microtubules either mechanically or through electrostatic repulsion or, possibly, serve as an intra-axonal cation exchange reservoir.

DOI： 10.1679/aohc.58.485

Intraneural ganglion of the posterior interosseous nerve with lateral elbow pain

H. Hashizume, K. Nishida, Y. Nanba, H. Inoue, T. Konishiike

Journal of Hand Surgery (British and European Volume) 20 ( 5 ) 649 - 651 1995

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

We report an intraneural ganglion of the posterior interosseous nerve causing lateral elbow pain. The cystic lesion was identified by magnetic resonance imaging, and surgical exploration using the microscope permitted complete extirpation of the cyst without damage to nerve tissue. The patient experienced complete relief from pain, with full preservation of function. © 1995, SAGE Publications. All rights reserved.

DOI： 10.1016/S0266-7681(05)80127-5

Result of Hydroxyapatite Grafting for Treatment of Benign Bone Tumors.

KUNISADA Toshiyuki, KAWAI Akira, SUGIHARA Shinsuke, NISHIDA Keiichirou, HAMADA Masanori, INOUE Hajime

The Journal of the Chugoku-Shikoku Orthopaedic Association 7 ( 1 ) 7 - 12 1995

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We applied hydroxyapatite (HAP) grafting clinically for 10 patients with defects produced by a curettage of benign bone tumors. The average follow up after surgery was 29 months (range 4 to 53 months). Physical and hematological findings during this period did not show any abnormalities. The radiographic evaluation of the incorporation of the implant was divided into four stages based on marginal findings and homogeneity of the grafted HAP. The margin of HAP became possibly unclear (stage II) an average of 3 months after surgery, and almost homogeneous with the surrounding bone (stage III) 11 months after surgery.

DOI： 10.11360/jcsoa1989.7.7

CYSTIC RADIO-LUCENCY OF CARPAL BONES IN HEMODIALYSIS-PATIENTS - AN EARLY INDICATOR OF THE ONSET OF CARPAL-TUNNEL SYNDROME

T KONISHIIKE, H HASHIZUME, K NISHIDA, H INOUE, T NANBA

JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME 19B ( 5 ) 630 - 635 1994.10

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

Patients receiving haemodialysis for more than 10 years were selected for this study in order to clarify an apparent sequential association of cystic lesions of carpal bones and carpal tunnel syndrome. X-rays and computed tomographs of 138 hands of 69 patients revealed cystic radiolucency of carpal bones in 35% of the hands. Radiographs were classified into three groups: Group A-cyst growing, Group B-cyst not growing, and Group C-cyst absent. The prevalence of carpal tunnel syndrome was 100% (27/27) in Group A, 5.6% (1/18) in Group B, and 6.5% (6/93) in Group C. Growth of the cyst precedes the development of carpal tunnel syndrome by about 2 or 3 years. Growth of the bone cyst indicates that inflammation had already extended to the tenosynovium and median nerve. Cystic radio-lucency of the carpal bones appears to be a useful indicator of the onset of carpal tunnel syndrome.

Cubital tunnel syndrome in a patient in long-term haemodialysis

T. Konishiike, H. Hashizume, K. Nishida, H. Inoue, K. Moriwaki

Journal of Hand Surgery 19 ( 5 ) 636 - 637 1994

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

The onset mechanism of cubital tunnel syndrome and carpal tunnel syndrome may be similar in haemodialysis patients. Carpal tunnel syndrome is well recognized as a consequence of dialysis-associated amyloidosis. This case report documents the development of cubital tunnel syndrome in a patient on haemodialysis treatment for 10 years. Proliferating granulation tissue at the elbow had entrapped and displaced the ulnar nerve. This was corrected surgically, and the patient experienced immediate relief of the numbness and the "tingling", but the muscular atrophy had not improved after 8 months. © 1994.

DOI： 10.1016/0266-7681(94)90133-3

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