研究者詳細 - 尾﨑　敏文

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転移性骨肉腫細胞はCCL2によるM2マクロファージの腫瘍内浸潤を誘導して肺転移を促進する(Metastatic osteosarcoma cells facilitate lung metastasis by inducing CCL2-mediated tumor infiltration of M2 macrophages)

近藤宏也, 田澤大, 久禮美穂, 藤原智洋, 国定俊之, 尾崎敏文, 藤原俊義

日本癌学会総会記事 81回 J - 2087 2022年9月

悪性軟部腫瘍に対する抗CSF-1R阻害薬の有効性抗腫瘍効果と微小環境へ与える影響(Antitumor effect of CSF-1/CSF-1R blockade in soft-tissue sarcomas)

近藤彩奈, 藤原智洋, 吉田晶, 畑利彰, 近藤宏也, 国定俊之, 尾崎敏文

日本癌学会総会記事 81回 J - 1062 2022年9月

軟部肉腫に対する抗CSF-1R阻害薬の有効性抗腫瘍効果と微小環境へ与える影響

近藤彩奈, 藤原智洋, 吉田晶, 畑利彰, 近藤宏也, 片山晴喜, 佐藤浩平, たき平将太, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1765 - S1765 2022年9月

Cathepsin proteaseは浸潤型軟部肉腫における浸潤性発育および生存予後に相関する

藤原智洋, Zhang Lingxin, Chandler Andrew, Yakoub Mohamed, 中田英二, 国定俊之, 尾崎敏文, Hameed Meera, Healey John

日本整形外科学会雑誌 96 ( 8 ) S1769 - S1769 2022年9月

悪性末梢神経鞘腫瘍におけるPRRX1の悪性化因子としての役割

たき平将太, 山田大祐, 高尾知佳, 中田英二, 近藤宏也, 佐藤浩平, 畑利彰, 藤原智洋, 国定俊之, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 96 ( 8 ) S1768 - S1768 2022年9月

MPNSTの癌幹細胞性維持に対する腫瘍内のアドレナリン合成酵素の役割

片山晴喜, 藤村篤史, 中田英二, 大谷悠介, 藤原智洋, 国定俊之, 神谷厚範, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1768 - S1768 2022年9月

AIと診断・治療 AIによる骨肉腫X線読影システムの偽陽性対策

長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 木浪陽, 藤原一夫, 臼井正明, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1741 - S1741 2022年9月

浸潤型軟部肉腫におけるCathepsin Proteaseの発現の臨床病理学的意義(Clinicopathological significance of cathepsin protease expression in infiltrative soft-tissue sarcomas)

藤原智洋, Zhang Lingxin, Chandler Andrew, Yakoub Mohamed, Hameed Meera, 中田英二, 国定俊之, 尾崎敏文, Healey John

日本癌学会総会記事 81回 P - 1275 2022年9月

浸潤性軟部肉腫患者における腫瘍随伴マクロファージの浸潤および予後を予測する血中バイオマーカーの特定(Circulating cytokines as blood biomarker predictive of TAM infiltration and prognosis in patients with infiltrative STS)

畑利彰, 藤原智洋, 吉田晶, 近藤彩奈, 近藤宏也, 国定俊之, 尾崎敏文

日本癌学会総会記事 81回 J - 1065 2022年9月

腫瘍随伴マクロファージの浸潤割合および予後を予測する血中バイオマーカーの特定浸潤性軟部肉腫患者における検討

畑利彰, 藤原智洋, 吉田晶, 近藤彩奈, 近藤宏也, 佐藤浩平, たき平将太, 中田英二, 国定俊之, 箱崎道之, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1766 - S1766 2022年9月

内側楔状骨背側脱臼骨折の1例

福岡史朗, 依光正則, 佐藤浩平, 上原健敬, 野田知之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 65 ( 5 ) 705 - 706 2022年9月

記述言語：日本語出版者・発行元：(一社)中部日本整形外科災害外科学会

Tarsometatarsal joint(TMT関節)損傷例の中で、内側楔状骨の脱臼を伴った症例は極めて稀である。今回、内側楔状骨の背側脱臼骨折を伴ったTMT関節損傷の1例を経験した。症例は14歳女性で、自動車のタイヤが左足部を轢過して受傷した。手術では、脱臼した楔状骨を含めて内側カラムを再建するために、舟状骨から中足骨まで架橋する強固なプレート固定を行い、術後に損傷部の再転位は認めなかったが、術後徐々に外反母趾が進行した。その原因として、内側カラムの整復不良による第1中足骨の内反(M1-M2角の開大)が残存したことと、内側の軟部組織損傷による不安定性が残存したことが考えられた。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00831&link_issn=&doc_id=20221201050037&doc_link_id=10.11359%2Fchubu.2022.705&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2022.705&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

脛骨プラトー・骨幹部合併骨折3例の治療経験

福岡史朗, 依光正則, 近藤宏也, 佐藤浩平, 畑利彰, 上原健敬, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 2 ) 287 - 290 2022年9月

記述言語：日本語出版者・発行元：中国・四国整形外科学会

症例1は86歳女で、プラトー骨折のAO/OTA分類は41B2.1.、骨幹部骨折は42A3であった。治療方法は外側プレートと髄内釘を用いて固定した。症例2は74歳男で、プラトー骨折のAO/OTA分類は41C1.1.、骨幹部骨折は42A1で、治療方法はダブルプレート固定を行った。症例3は67歳女で、プラトー骨折は41B1.1.、骨幹部骨折は42B1で、スクリューと髄内釘による固定を計画したが、術中に髄内釘挿入部近傍の骨折が顕在化し、整復位の保持が困難となったためダブルプレート固定に変更した。3例とも骨癒合が得られた。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J02438&link_issn=&doc_id=20221011120020&doc_link_id=%2Fcm4ortho%2F2022%2F003402%2F020%2F0287-0290%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2022%2F003402%2F020%2F0287-0290%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Transtibial Pullout Repair of Lateral Meniscus Posterior Root Tear with Tissue Loss: A Case with Anterior Cruciate Ligament Injury and Medial Meniscus Tear

Masanori Tamura, Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Naohiro Higashihara, Yusuke Kamatsuki, Eiji Nakata, Toshifumi Ozaki

Case Reports in Orthopedics 2022 1 - 8 2022年8月

掲載種別：研究論文（学術雑誌）出版者・発行元：Hindawi Limited

Lateral meniscus (LM) posterior root tear (LMPRT) is mainly caused by trauma, especially trauma associated with anterior cruciate ligament (ACL) injuries. Although a transtibial pullout repair or a side-to-side repair is commonly performed for LMPRT, to the best of our knowledge, there is no clinical report of LMPRT with tissue loss using the pullout technique. Thus, the purpose of this report was to describe a clinical, radiographic, and arthroscopic outcome after pullout repair for a case of LMPRT with a large defect with a chronic ACL tear and complex medial meniscus (MM) tears. A 31-year-old man complained of knee pain and restricted range of motion after twisting his knee when he stepped on an iron pipe. The patient had a football-related injury to his right knee 14 years before presentation, and since then, the patient’s knee has given out more than 10 times but was left unassessed. Magnetic resonance imaging showed LMPRT with tissue loss, ACL tears, and complex MM tears. Transtibial pullout repair of the LMPRT with ACL reconstruction and MM repairs were performed. Following the pullout repair of the LMPRT, an approximately 6 mm gap remained between the LM posterior root and root insertion. However, magnetic resonance imaging and second-look arthroscopy at 1 year postoperatively revealed meniscal healing, gap filling with some regeneration tissue, of the LM posterior root. Furthermore, the lateral meniscus extrusion in the coronal plane improved from 3.1 mm (preoperative) to 1.6 mm (1 year postoperatively). Transtibial pullout repair with the remaining gap could be a viable treatment option for LMPRT with tissue loss, combined with ACL reconstruction.

DOI： 10.1155/2022/9776388

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その他リンク： http://downloads.hindawi.com/journals/crior/2022/9776388.xml

Association between Immediate Postoperative Radiographic Findings and Failed Internal Fixation for Trochanteric Fractures: Systematic Review and Meta-Analysis. 国際誌

Norio Yamamoto, Yasushi Tsujimoto, Suguru Yokoo, Koji Demiya, Madoka Inoue, Tomoyuki Noda, Toshifumi Ozaki, Takashi Yorifuji

Journal of clinical medicine 11 ( 16 ) 2022年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

Failed internal fixations for trochanteric fractures have a strong negative impact owing to increased postoperative mortality and high medical costs. However, evidence on the prognostic value of postoperative radiographic findings for failed internal fixations is limited. We aimed to clarify the association between comprehensive immediate postoperative radiographic findings and failed internal fixation using relative and absolute risk measures. We followed the meta-analysis of observational studies in epidemiology guidelines and the Cochrane handbook. We searched specific databases in November 2021. The outcomes of interest were failed internal fixation and cut-out. We pooled the odds ratios and 95% confidence intervals using a random-effects model and calculated the number needed to harm for each outcome. Thirty-six studies involving 8938 patients were included. The certainty of evidence in the association between postoperative radiographic findings and failed internal fixation or cut-out was mainly low or very low except for the association between intramedullary malreduction on the anteromedial cortex and failed internal fixation. Moderate certainty of evidence supported that intramedullary malreduction on the anteromedial cortex was associated with failed internal fixation. Most postoperative radiographic findings on immediate postoperative radiographs for trochanteric fractures were uncertain as prognostic factors for failed internal fixations.

DOI： 10.3390/jcm11164879

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Steep posterior slope of the medial tibial plateau and anterior cruciate ligament degeneration contribute to medial meniscus posterior root tears in young patients. 国際誌

Yuya Kodama, Takayuki Furumatsu, Masanori Tamura, Yuki Okazaki, Takaaki Hiranaka, Yusuke Kamatsuki, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2022年8月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Medial meniscus posterior root tears (MMPRTs) occur most frequently in middle-aged and older adults. However, this serious condition can also occur in younger patients. The purpose of this study was to compare anterior cruciate ligament (ACL) degeneration and sagittal medial tibial slope in young adults with and without MMPRT. METHODS: Eighteen healthy volunteers, 18 young patients (20-49 years of age), and 30 middle-aged and older patients (50-70 years of age) with MMPRT repair were included in the study. Sex, body mass index (BMI), femorotibial angle, ACL degeneration, and medial tibial slope angle were compared among the groups. ACL degeneration and medial tibial slope angle were assessed using magnetic resonance imaging. RESULTS: In the healthy volunteer group, the young patient group, and the older patient group, the medial tibial slopes were 3.5° ± 1.4°, 6.1° ± 2.7°, and 7.2° ± 1.9°, respectively, and the ACL degeneration rates were 5.6%, 38.9%, and 43.3%, respectively. Young patients with MMPRT had significantly steeper medial tibial slopes and ACL degeneration compared to those of the healthy volunteers (P < 0.05). The parameters of young patients were similar to those of older patients with MMPRT. In the multivariate logistic regression analysis, BMI, medial tibial slope, and ACL degeneration were significantly associated with MMPRT in young patients. CONCLUSION: BMI, steep medial tibial slope, and ACL degeneration contribute to MMPRT development in younger patients. LEVEL OF EVIDENCE: Level III.

DOI： 10.1007/s00167-022-07095-z

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Coronal shear fractures of the femoral neck: a comparison with basicervical fractures

Yasuaki Yamakawa, Norio Yamamoto, Yosuke Tomita, Tomoyuki Noda, Tomoo Inoue, Toshiyuki Matsumoto, Keisuke Kawasaki, Toshifumi Ozaki

European Journal of Trauma and Emergency Surgery 2022年8月

Effect of bacterium in the malignant wounds of soft tissue sarcoma 国際誌

Eiji Nakata, Tomohiro Fujiwara, Haruyoshi Katayama, Takuto Itano, Toshiyuki Kunisada, Toshifumi Ozaki

Oncology Letters 24 ( 4 ) 345 - 345 2022年8月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Spandidos Publications

Malignant wounds (MWs) are rare skin lesions, which accompany ulceration, necrosis and infection caused by infiltration or damage by malignant tumor. The present study aimed to investigate the bacterial etiology implicated in MW in soft tissue sarcoma (STS), and the effectiveness of culture-guided perioperative antibacterial administration. A retrospective evaluation was conducted on medical records of patients who presented with MW between 2006 and 2020. A total of seven patients were included in the present study, in whom all tumors were relatively large (>5 cm) and high-grade. Subsequently, five patients underwent limb-sparing surgery, and three patients had distant metastases with a 5-year overall survival of 71%. Preoperative microbiological sampling from the wound identified 11 different bacterial strains in five patients. The infections were polymicrobial with an average of 2.6 strains isolated per patient (1 aerobic, 1.6 anaerobic bacteria). They were predominantly methicillin-sensitive Staphylococcus aureus. Patients with MWs from STS reported symptoms, including bleeding (71%), exudation (71%) and malodorous wound (43%) at the initial presentation; these completely resolved after surgery. All but one patient reported pain at the MW site with an average numeric rating scale of 4.4 at presentation that decreased to 1.4 (P=0.14) and 0.6 (P=0.04) one and two weeks after surgery, respectively. The patients had elevated C-reactive protein (71%), anemia (57%), low albumin (86%) and renal/liver dysfunction (14-29%). One patient was diagnosed with sepsis. Surgical resection afforded symptomatic relief and resolution of abnormal laboratory values. Although selected antibiotics were administered in four patients based on the preoperative antibiotic sensitivity test, surgical site infection (SSI) occurred in three patients. Therefore, the effectiveness of the selected antibiotics based on the results of the preoperative culture in preventing SSI needs to be investigated in the future. In conclusion, physicians should keep in mind that although surgical resection can improve the symptoms and abnormal values in laboratory examination form MW, it is accompanied with a high rate of SSI and poor prognosis.

DOI： 10.3892/ol.2022.13465

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Alveolar soft part sarcoma: progress toward improvement in survival? A population-based study. 国際誌

Tomohiro Fujiwara, Eiji Nakata, Toshiyuki Kunisada, Toshifumi Ozaki, Akira Kawai

BMC cancer 22 ( 1 ) 891 - 891 2022年8月

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

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare histological subtype of soft-tissue sarcoma, which remains refractory to conventional cytotoxic chemotherapy. We aimed to characterize ASPS and investigate whether the oncological outcome has improved over the past decade. METHODS: One hundred and twenty patients with newly diagnosed ASPS from 2006 to 2017, identified from the Bone and Soft-Tissue Tumor Registry in Japan, were analyzed retrospectively. RESULTS: The study cohort comprised 34 (28%) patients with localized ASPS and 86 (72%) with metastatic disease at presentation. The 5-year disease-specific survival (DSS) was 68% for all patients and 86% and 62% for localized and metastatic disease, respectively (p = 0.019). Metastasis at presentation was the only adverse prognostic factor for DSS (hazard ratio [HR]: 7.65; p = 0.048). Patients who were > 25 years (80%; p = 0.023), had deep-seated tumors (75%; p = 0.002), and tumors > 5 cm (5-10 cm, 81%; > 10 cm, 81%; p < 0.001) were more likely to have metastases at presentation. In patients with localized ASPS, adjuvant chemotherapy or radiotherapy did not affect survival, and 13 patients (45%) developed distant metastases in the lung (n = 12, 92%) and brain (n = 2, 15%). In patients with metastatic ASPS (lung, n = 85 [99%]; bone, n = 12 [14%]; and brain n = 9 [11%]), surgery for the primary or metastatic site did not affect survival. Prolonged survival was seen in patients who received pazopanib treatment (p = 0.045), but not in those who received doxorubicin-based cytotoxic chemotherapy. Overall, improved DSS for metastatic ASPS has been observed since 2012 (5-year DSS, from 58 to 65%) when pazopanib was approved for advanced diseases, although without a statistically significant difference (p = 0.117). CONCLUSION: The national study confirmed a unique feature of ASPS with frequent metastasis to the lung and brain but an indolent clinical course. An overall trend toward prolonged survival after the introduction of targeted therapy encourages continuous efforts to develop novel therapeutic options for this therapeutically resistant soft-tissue sarcoma.

DOI： 10.1186/s12885-022-09968-5

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その他リンク： https://link.springer.com/article/10.1186/s12885-022-09968-5/fulltext.html

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

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

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

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

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

DOI： 10.1142/S2424835522500709

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Late-onset implant-related neuropathy: Three years after proximal humeral fracture. 国際誌

Yasuaki Yamakawa, Yusuke Kamatsuki, Toshiyuki Matsumoto, Tomoyuki Noda, Toshifumi Ozaki

Trauma case reports 40 100670 - 100670 2022年8月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

There are currently no reports of implant-related neuropathy associated with humeral proximal fracture surgery. Herein, we report a case of implant-related late-onset neuropathy that developed 3 years after proximal humeral fracture surgery. A 51-year-old man underwent minimally invasive plate osteosynthesis for a left proximal humeral fracture 3 years prior. Left upper limb pain and reduced angle of elevation of the shoulder were recognized 1 month before the outpatient consultation. Numbness was noted on the ulnar side of the hand, and radiating pain to the ulnar nerve region was noted during shoulder abduction and compression of the medial side of the upper arm. Computed tomography revealed close proximity of the neurovascular bundle to the locking screw along with muscle atrophy around the shoulder. Hence, the patient was diagnosed with neuropathy. After implant removal, the pain in the ulnar nerve region improved, and the upper arm could be elevated. In our case, the cause of muscle atrophy was axillary nerve manipulation and cervical myelopathy caused by the operation. When late-onset neuropathy occurs, implant-related neuropathy with muscle atrophy should be considered.

DOI： 10.1016/j.tcr.2022.100670

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