Faculty Profiles - OZAKI Toshifumi

Papers - OZAKI Toshifumi

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市川千夏, 山川泰明, 根津智史, 斉藤太一, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 30 ( 3 ) 346 - 346 2018.10

An evaluation of anesthetic fade in motor evoked potential monitoring in spinal deformity surgeries. Reviewed International journal

Ugawa R, Takigawa T, Shimomiya H, Ohnishi T, Kurokawa Y, Oda Y, Shiozaki Y, Misawa H, Tanaka M, Ozaki T

Journal of orthopaedic surgery and research 13 ( 1 ) 227 - 227 2018.9

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

BACKGROUND: Intraoperative neuromonitoring using motor evoked potentials (MEP) satisfactorily detects motor tract integrity changes during spinal surgery. However, monitoring is affected by "anesthetic fade," in which the stimulation threshold increases because the waveform amplitude decreases with the accumulation of propofol. Therefore, the purpose of this study was to clarify the effect of anesthetic fade on transcranial MEPs by investigating the time-dependent changes of amplitude during spinal deformity surgeries. METHODS: We retrospectively reviewed medical records of 142 spinal deformity patients (66 patients with idiopathic scoliosis, 28 with adult spinal deformities, 19 with neuromuscular scoliosis, 17 with syndromic scoliosis, and 12 with congenital scoliosis). The average age was 28 years (range, 5 to 81 years). MEPs were recorded bilaterally from the abductor digiti minimi (ADM) and abductor hallucis (AH) muscles during spinal deformity surgeries. The Wilcoxon signed-rank test was used to investigate the time-dependent changes of amplitude after propofol infusion to evaluate anesthetic fade effects. RESULTS: The average time to baseline from initial propofol infusion was 113 min (range, 45 to 182 min). In the ADM, the amplitude was 52% at 1 h after initial propofol infusion, 102% at 2 h, 105% at 3 h, 101% at 4 h, 86% at 5 h, and 81% at 6 h. Compared to the 2-h time point, MEP decreased significantly by 16% at 5 h (P < 0.0005) and by 21% at 6 h (P < 0.05). In the AH, the amplitude was 49% at 1 h after initial infusion of propofol, 102% at 2 h, 102% at 3 h, 92% at 4 h, 71% at 5 h, and 63% at 6 h. Compared to the 2-h time point, MEP decreased significantly by 10% at 4 h (P < 0.005), by 31% at 5 h (P < 0.0000005), and by 39% at 6 h (P < 0.05). CONCLUSIONS: MEP amplitude significantly decreased in the upper limbs at 5 and 6 h and in the lower limbs at 4, 5, and 6 h after the initial infusion of propofol, respectively. The influence of anesthetic fade could influence false positive MEPs during long spinal surgeries.

DOI： 10.1186/s13018-018-0934-7

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Carbon ion radiotherapy for unresectable localized axial soft tissue sarcoma Reviewed

Reiko Imai, Tadashi Kamada, Nobuhito Araki, Satoshi Abe, Yukihide Iwamoto, Toshifumi Ozaki, Hirokazu Chuman, Hiroaki Hiraga, Toru Hiruma, Noriaki Kameda, Chihiro Kanehira, Mitsunori Kaya, Rikuo Machinami, Akihiko Matsumine, Seiichi Matsumoto, Hideo Morioka, Yoshihiro Nishida, Kazuhisa Takahashi, Masazumi Tsuneyoshi, Takehiko Yamaguchi, Tsukasa Yonemoto

Cancer Medicine 7 4308 - 4314 2018.9

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. Carbon ion radiotherapy is known for its high-precision dose distribution and high biological effectiveness. We evaluated the results of carbon ion radiotherapy in 128 patients with unresectable localized axial soft tissue sarcoma at a single institution. The patients’ median age was 54 years, and the median follow-up period was 49.4 (range 6.4-146.4) months. The median tumor volume was 356 cm3. The 5-year local control, overall survival, and disease-free survival rates were 65%, 46%, and 39%, respectively. In the univariate analysis, tumor volume, local control, and incidences of metastases were significantly related to overall survival. In the multivariate analysis, tumor volume and local control were significantly related to overall survival. We did not find any factors related to local control. Five patients required surgical intervention because of adverse events in the bones. Carbon ion radiotherapy may be a treatment option for unresectable axial soft tissue sarcoma.

DOI： 10.1002/cam4.1679

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当科における股関節鏡の合併症

三喜知明, 遠藤裕介, 山田和希, 鉄永智紀, 河村涌志, 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 ) 112 - 112 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

治療に難渋した壊死性筋膜炎の1例

松橋美波, 齋藤太一, 山川泰明, 野田知之, 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 ) 135 - 135 2018.9

Prospective comparison of various radiological response criteria and pathological response to preoperative chemotherapy and survival in operable high-grade soft tissue sarcomas in the Japan Clinical Oncology Group study JCOG0304. Reviewed International journal

Kazuhiro Tanaka, Gakuto Ogawa, Junki Mizusawa, Norifumi Naka, Akira Kawai, Mitsuru Takahashi, Toru Hiruma, Yoshihiro Matsumoto, Hiroyuki Tsuchiya, Robert Nakayama, Hiroshi Hatano, Makoto Emori, Masami Hosaka, Yukihiro Yoshida, Junya Toguchida, Satoshi Abe, Kunihiro Asanuma, Ryohei Yokoyama, Hiroaki Hiraga, Tsukasa Yonemoto, Takeshi Morii, Seiichi Matsumoto, Akihito Nagano, Hideki Yoshikawa, Haruhiko Fukuda, Toshifumi Ozaki, Yukihide Iwamoto

World journal of surgical oncology 16 ( 1 ) 162 - 162 2018.8

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

BACKGROUND: Soft tissue sarcomas (STS) are rare malignant tumors. The efficacy of preoperative chemotherapy for STS is evaluated using various tumor size-based radiological response criteria. However, it is still unclear which set of criteria would show the best association with pathological response and survival of the patients with STS. METHODS: We compared radiological responses to preoperative chemotherapy for operable STS by the Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST, World Health Organization criteria, Japanese Orthopaedic Association criteria, and modified Choi criteria and analyzed the association with pathological response and survival using the data from the Japan Clinical Oncology Group (JCOG) study JCOG0304, a phase II clinical trial evaluating the efficacy of perioperative chemotherapy for STS in the extremities. RESULTS: Seventy eligible patients in JCOG0304 were analyzed. The results demonstrated that none of the size-based radiological response criteria showed significant association with pathological response to preoperative chemotherapy for STS. The difference between overall survival of the patients assessed as partial response and stable disease/progressive disease by RECIST was not significant (hazard ratio 1.37, p = 0.63), and calculated C-index was 0.50. All other response criteria also could not exhibit significant association between radiological responses and survival. CONCLUSION: In the present study, none of the radiological response criteria analyzed demonstrated association of response to preoperative chemotherapy with pathological response or survival of the patients with operable STS. Further prospective investigation is required to develop criteria to evaluate not only tumor shrinkage but biological effects of preoperative chemotherapy for the patients with localized STS. TRIAL REGISTRATION: UMIN Clinical Trials Registry C000000096. Registered 30 August, 2005 (retrospectively registered).

DOI： 10.1186/s12957-018-1462-y

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

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

Bone and Joint Journal 100B ( 8 ) 1066 - 1073 2018.8

Language：English Publishing type：Research paper (scientific journal) Publisher：British Editorial Society of Bone and Joint Surgery

Aims The aim of this study was to report the mid-term clinical outcome of cemented unlinked J-alumina ceramic elbow (JACE) arthroplasties when used in patients with rheumatoid arthritis (RA). Patients and Methods We retrospectively reviewed 87 elbows, in 75 patients with RA, which was replaced using a cemented JACE total elbow arthroplasty (TEA) between August 2003 and December 2012, with a follow-up of 96%. There were 72 women and three men, with a mean age of 62 years (35 to 79). The mean follow-up was nine years (2 to 14). The clinical condition of each elbow before and after surgery was assessed using the Mayo Elbow Performance Index (MEPI, 0 to 100 points). Radiographic loosening was defined as a progressive radiolucent line of &gt
1 mm that was completely circumferential around the prosthesis. Results The mean MEPI scores significantly improved from 40 (10 to 75) points preoperatively to 95 (30 to 100) points at final follow-up (p &lt
0.0001). Complications were noted in ten elbows (ten patients
11%). Two had an intraoperative humeral fracture which was treated by fixation and united. One had a postoperative fracture of the olecranon which united with conservative treatment and one had a radial neuropathy which resolved. Further surgery was required for one with a dislocation, three with an ulnar neuropathy and one with a postoperative humeral fracture. Revision with removal of the components was performed in one elbow due to deep infection. There was no radiographic evidence of loosening around the components.With any revision surgery or revision with implant removal as the endpoint, the rates of survival up to 14 years were 93% (95% confidence interval (CI), 83.9 to 96.6) and 99% (95% CI 91.9 to 99.8), respectively, as determined by Kaplan-Meier analysis. Conclusion With the appropriate indications, the mid-term clinical performance of the cemented JACE TEA is reliable and comparable to other established TEAs in the management of the elbow in patients with RA.

DOI： 10.1302/0301-620X.100B8.BJJ-2017-1451.R1

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Venous Thromboembolism in Patients with Acute Thoracolumbar Spinal Cord Injury. Reviewed

Morita T, Sugimoto Y, Takigawa T, Misawa H, Ito Y, Ozaki T

Acta medica Okayama 72 ( 4 ) 375 - 378 2018.8

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

Venous thromboembolism (VTE) is a major complication in patients with acute spinal cord injury. There are few reports of VTE with acute thoracolumbar spinal cord injury (TLSCI). We assessed the incidence of VTE with acute TLSCI using color Doppler ultrasonography. We retrospectively assessed 75 patients with acute TLSCI (T1 to L1). All patients were surgically treated. VTE of the lower extremity and pelvis was assessed using color Doppler ultrasound regardless of whether symptoms were present. This retrospective study included patients who were assessed between 6 and 10 days (mean 8.1 days) after injury. VTE was detected in 27 of the 75 patients (35.7%) with or without paralysis. Of the 13 patients who had complete motor paralysis, 8 (62%) had VTE; of the 31 patients with incomplete motor paralysis, 10 (32%) had VTE, and of the 31 patients without motor paralysis, 9 (29%) had VTE. Among the patients with TLSCI, those with VTE had a significantly higher mean age than those without. The incidence of VTE in TLSCI patients is not related to the severity of paralysis in a Japanese population. The incidence appears to be related primarily to age.

DOI： 10.18926/AMO/56173

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Clinical outcome of primary giant cell tumor of bone after curettage with or without perioperative denosumab in Japan: from a questionnaire for JCOG 1610 study. Reviewed International journal

Urakawa H, Yonemoto T, Matsumoto S, Takagi T, Asanuma K, Watanuki M, Takemoto A, Naka N, Matsumoto Y, Kawai A, Kunisada T, Kubo T, Emori M, Hiraga H, Hatano H, Tsukushi S, Nishida Y, Akisue T, Morii T, Takahashi M, Nagano A, Yoshikawa H, Sato K, Kawano M, Hiraoka K, Tanaka K, Iwamoto Y, Ozaki T

World journal of surgical oncology 16 ( 1 ) 160 - 160 2018.8

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

BACKGROUND: Giant cell tumor of bone (GCTB) is an intermediate tumor known to be locally aggressive, but rarely metastasizing. To plan a prospective study of GCTB, we performed a questionnaire survey for institutions participating in the Bone and Soft Tissue Tumor Study Group (BSTTSG) in the Japan Clinical Oncology Group (JCOG) in 2015. METHODS: We reviewed 158 consecutive patients with primary GCTB treated with curettage without perioperative denosumab from 2008 to 2010 in Japan. We investigated local and distant recurrence rates after definitive curettage. We also investigated the recurrence rate after treatment with preoperative and/or postoperative denosumab with curettage in recent years. There were 40 patients treated with perioperative denosumab, and the factors affecting recurrence in them were investigated. RESULTS: Answers were available from 24 of 30 institutions (80.0%) participating in JCOG BSTTSG. Thirty (19.0%) and 4 (2.5%) of 158 patients developed local and distant recurrence after curettage without perioperative denosumab from 2008 to 2010, respectively. Campanacci grade and embolization before surgery were significantly associated with increasing incidence of local recurrence after curettage (p = 0.034 and p = 0.022, respectively). In patients treated with perioperative desnosumab, 120 mg denosumab was administered subcutaneously for a median 6 (2-41) and 6 (1-14) times in preoperative and postoperative settings, respectively. The recurrence rates were 6 of 21 (28.6%), 2 of 9 (22.2%), and 0 of 10 (0.0%) in the preoperative, postoperative, and both pre- and postoperative denosumab treatment groups, respectively. With all of the preoperative treatments, administration exceeding five times was significantly associated with a decreased incidence of local recurrence after curettage (p < 0.001). CONCLUSION: The recurrence rate of GCTB was still high after curettage, especially in Campanacci grade III, and improvements in the therapeutic strategy are needed in this cohort. There is a possibility that a sufficient dose of preoperative denosumab can reduce recurrence after curettage. Recently, we have started a clinical trial, JCOG1610, to investigate the efficacy of preoperative denosumab in patients who can be treated with curettage in GCTB.

DOI： 10.1186/s12957-018-1459-6

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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

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股関節鏡手術に際し電気凝固メスの破損を生じた2例

遠藤裕介, 山田和希, 三喜知明, 三宅孝昌, 尾崎敏文

Hip Joint 44 ( 2 ) 725 - 729 2018.8

Language：Japanese Publisher：日本股関節学会

症例1は初診時46歳女性で、特に誘因なく左股関節痛が出現し、49歳時に手術加療を希望された。X線上CE角0°と形成不全股であり、左寛骨臼回転骨切り術(RAO)前に股関節鏡を施行し関節唇断裂に対して電気凝固メス(VAPR)でシュリンケージを施行した。その後、スロットカニューラからVAPRを出す際に先端を回転させ破損した。関節内には破損片は認められず、関節内洗浄後にイメージで確認したところ外側ポータルの関節外に破損片が認められた。イメージ下にコッヘルでつかんで除去できており、器具が破損したが摘出できた旨を説明し、予定通り4週後に左RAOを施行した。症例2は初診時39歳女性で、特に誘因なく両股関節痛が出現し、40歳時に右RAOを施行、左側も41歳時に手術を希望された。骨切り術前に股関節鏡を施行し関節唇断裂に対してVAPRでシュリンケージを施行したが、ポータルの入れ替え時に助手がVAPRを入れる際に完全に先端がカニューラ先から出る前に回転させ破損した。関節内には破損片は認められたが深部へと落ち込み、器具が到達できない部位へ移動した。2週後の再入院時のX線像で破損片の関節内の移動を認め、RAO手術時に一部関節包を切開し破片を回収した。予定とおり左RAOを施行し、摘出した破損片は2.5mmのサイズで破損部に合致し術後X線像からも完全に除去できたと考えられた。

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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

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

新体操選手に生じた股関節症の1例

三喜知明, 遠藤裕介, 三宅孝昌, 赤澤啓史, 鉄永智紀, 尾崎敏文

Hip Joint 44 ( 2 ) 7 - 7 2018.8

骨・軟部腫瘍における新規分子・細胞標的粘液線維肉腫における分泌型microRNA-1260bは腫瘍周囲微小環境に作用し浸潤を促進する

森田卓也, 藤原智洋, 吉田晶, 清野正普, 横尾賢, 小松原将, 望月雄介, 長谷井嬢, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 92 ( 8 ) S1709 - S1709 2018.8

骨肉腫における細胞内外microRNA-25-3p発現の機能解析

吉田晶, 藤原智洋, 魚谷弘二, 森田卓也, 清野正普, 横尾賢, 長谷井嬢, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 92 ( 8 ) S1813 - S1813 2018.8

Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees. Reviewed International journal

Kamatsuki Y, Furumatsu T, Fujii M, Kodama Y, Miyazawa S, Hino T, Ozaki T

Journal of orthopaedic research : official publication of the Orthopaedic Research Society 36 ( 7 ) 1894 - 1900 2018.7

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

This study aimed to evaluate the relationship between preoperative lateral meniscal extrusion (LME) and arthroscopic findings of lateral meniscus posterior root tear (LMPRT) in knees with anterior cruciate ligament (ACL) tear. Thirty-five knees that had LMPRTs with concomitant ACL tears on arthroscopy were evaluated. Patients were divided into two groups, partial and complete root tears, via arthroscopic findings at the time of ACL reconstruction. For comparison, we added two groups, using the same database; 20 normal knees (normal group) and 20 ACL-injured knees without LM injury (intact LM group). We retrospectively measured preoperative LMEs using magnetic resonance imaging (MRI). Twenty-three knees had partial LMPRTs. Complete LMPRTs were observed in 12 knees. The average LME was -0.1 ± 0.4 mm in the normal group, 0.2 ± 0.5 mm in the intact LM group, 0.4 ± 0.8 mm in the partial LMPRT group, and 2.0 ± 0.6 mm in the complete LMPRT group. A significant difference in preoperative LMEs was observed between the complete LMPRT group and the other groups (p < 0.001). The receiver operating curve analysis, which distinguishes a partial tear from a complete tear, identified an optimal cut-off point of 1.1 mm for preoperative LME. This LME cut-off had a sensitivity of 100% and specificity of 83% for complete LMPRT. We found that preoperative LMEs were larger in complete LMPRTs associated with ACL injuries than in partial LMPRTs. Our results suggest that preoperative MRI-detected LME may be a useful indicator for estimating LMPRT severity in ACL-injured knees. LEVEL OF EVIDENCE: Retrospective comparative study level IV. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1894-1900, 2018.

DOI： 10.1002/jor.23861

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