研究者詳細 - 尾﨑　敏文

論文 - 尾﨑　敏文

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脆弱性骨盤骨折の治療成績

中村大, 依光正則, 上原健敬, 福岡史朗, 奥田龍一郎, 佐々木和浩, 花川志郎, 尾崎敏文

骨折 46 ( Suppl. ) S247 - S247 2024年6月

寛骨臼骨折術後における臨床成績と予後因子の検討

福岡史朗, 依光正則, 志水紀之, 浪花崇一, 野田知之, 尾崎敏文

骨折 46 ( Suppl. ) S239 - S239 2024年6月

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

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

日本関節病学会誌 43 ( 2 ) 156 - 156 2024年6月

当院における関節リウマチに対する手部手術の変遷(2004-2022)

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

日本関節病学会誌 43 ( 2 ) 156 - 156 2024年6月

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

那須義久, 竹内孔一, 中原龍一, 長谷井嬢, 西田圭一郎, 尾崎敏文

日本関節病学会誌 43 ( 2 ) 251 - 251 2024年6月

マルチモーダル大規模言語を用いた自動病理画像解析

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

日本関節病学会誌 43 ( 2 ) 252 - 252 2024年6月

加速する骨・軟部腫瘍に対するゲノム医療: 現状と課題肉腫におけるゲノム医療の現状と課題

中田英二, 遠西大輔, 二宮貴一朗, 山本英喜, 冨田秀太, 藤原智洋, 国定俊之, 平沢晃, 豊岡伸一, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1457 - S1457 2024年6月

多職種から見た骨・軟部腫瘍治療の現状と課題肉腫発生ハイリスク患者に対する遺伝性骨・軟部腫瘍外来の取り組み

二川摩周, 中田英二, 山本英喜, 深野智華, 加藤芙美乃, 大住理沙, 藤原智洋, 国定俊之, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1579 - S1579 2024年6月

神経線維腫症1型を中心とした遺伝性骨・軟部腫瘍に対する専門外来の有用性

中田英二, 二川摩周, 平沢晃, 山本英喜, 国定俊之, 板野拓人, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1614 - S1614 2024年6月

Clinical Application of Unidirectional Porous Hydroxyapatite to Bone Tumor Surgery and Other Orthopedic Surgery

Toshiyuki Kunisada, Eiji Nakata, Tomohiro Fujiwara, Toshiaki Hata, Kohei Sato, Haruyoshi Katayama, Ayana Kondo, Toshifumi Ozaki

Biomimetics 9 ( 5 ) 294 - 294 2024年5月

掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI AG

Unidirectional porous hydroxyapatite (UDPHAp) was developed as a remarkable scaffold characterized by a distinct structure with unidirectional pores oriented in the horizontal direction and connected through interposes. We evaluated the radiographic changes, clinical outcomes, and complications following UDPHAp implantation for the treatment of bone tumors. Excellent bone formation within and around the implant was observed in all patients treated with intralesional resection and UDPHAp implantation for benign bone tumors. The absorption of UDPHAp and remodeling of the bone marrow space was observed in 45% of the patients at a mean of 17 months postoperatively and was significantly more common in younger patients. Preoperative cortical thinning was completely regenerated in 84% of patients at a mean of 10 months postoperatively. No complications related to the implanted UDPHAp were observed. In a pediatric patient with bone sarcoma, when the defect after fibular resection was filled with UDPHAp implants, radiography showed complete resorption of the implant and clear formation of cortex and marrow in the resected part of the fibula. The patient could walk well without crutches and participate in sports activities. UDPHAp is a useful bone graft substitute for the treatment of benign bone tumors, and the use of this material has a low complication rate. We also review and discuss the potential of UDPHAp as a bone graft substitute in the clinical setting of orthopedic surgery.

DOI： 10.3390/biomimetics9050294

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Accurate tibial tunnel position in transtibial pullout repair for medial meniscus posterior root tears delays the progression of medial joint space narrowing. 国際誌

Koki Kawada, Yuki Okazaki, Masanori Tamura, Yusuke Yokoyama, Toshifumi Ozaki, Takayuki Furumatsu

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2024年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: This study aimed to evaluate the association between the progression of medial joint space (MJS) narrowing, medial meniscus extrusion (MME) and clinical scores and the tibial tunnel position in pullout repairs for medial meniscus posterior root tears (MMPRTs). METHODS: This retrospective study examined 54 patients. Changes in MJS (ΔMJS), MME (ΔMME) and clinical scores and their relationship with the tibial tunnel position were evaluated using correlation coefficients. The distance from the anatomical to technical attachment position in the tibial tunnel position was measured in the anterior and medial directions, and the direct distance was measured using the Pythagorean theorem. RESULTS: The mean ΔMJS and ΔMME were 0.6 ± 0.8 and 1.3 ± 1.3 mm, respectively, and the mean anterior, medial and direct distances were 1.4 ± 2.3, 2.2 ± 1.7 and 3.4 ± 1.7 mm, respectively. ΔMJS had a significant positive correlation with the medial (r = 0.580, p < 0.001) and direct (r = 0.559, p < 0.001) distances, while ΔMME had a significant positive correlation with direct distance (r = 0.295, p = 0.030). Several clinical scores were significantly negatively correlated with these distances. CONCLUSION: In transtibial pullout repair for MMPRTs, accurate tibial tunnel position delayed the progression of MJS narrowing and MME, leading to improved clinical outcomes. The progression of MJS narrowing was associated with the mediolateral direction of the tibial tunnel position, while the clinical scores were associated with the anteroposterior direction of the tibial tunnel position. These findings indicate the need to orient the tip of the guide in a more posterolateral direction when creating the tibial tunnel. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1002/ksa.12229

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Meniscal healing status after medial meniscus posterior root repair negatively correlates with a midterm increase in medial meniscus extrusion. 国際誌

Koki Kawada, Takayuki Furumatsu, Yusuke Yokoyama, Naohiro Higashihara, Masanori Tamura, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2024年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: The second-look arthroscopic score of pullout repair for medial meniscus posterior root tears (MMPRTs) is associated with contemporaneous clinical scores and progression of cartilage damage. However, the relationship among these scores, midterm clinical scores and magnetic resonance imaging (MRI) evaluations is unknown. The relationship between the second-look arthroscopic score at 1 year and the clinical scores or MRI at 3 years was evaluated. METHODS: Sixty-three patients were included. Medial meniscus extrusion (MME) was evaluated preoperatively and at 3 years postoperatively. Clinical scores were evaluated preoperatively, and 1 and 3 years postoperatively. Meniscal healing status was assessed using the semiquantitative second-look arthroscopic score at 1 year postoperatively. Correlation coefficients between patient characteristics, postoperative clinical scores or second-look arthroscopic score and the change in MME (ΔMME) were evaluated. Multiple regression analysis was performed on the ΔMME to evaluate the effects of patient characteristics and second-look arthroscopic scores. RESULTS: No significant correlation was observed between patient characteristics and ΔMME. In contrast, a significant correlation was found between the second-look arthroscopic score and ΔMME (p < 0.001) and visual analogue scale pain score (p = 0.016) at 3 years postoperatively. In the subitems of the second-look arthroscopic score, width (p < 0.001) and stability (p = 0.009) scores also showed significant correlations with ΔMME. Multiple regression analysis showed a significant association between the second-look arthroscopic score and ΔMME (p = 0.001). CONCLUSIONS: The second-look arthroscopic score at 1 year postoperatively correlated with the ΔMME and clinical score at 3 years postoperatively. Second-look arthroscopic scores predict midterm meniscal function after pullout repair of MMPRTs. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1002/ksa.12245

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骨転移による長管骨病的骨折に対する治療のコツとピットフォール

中田英二, 國定俊之, 杉原進介, 藤原智洋, 尾﨑敏文

Loco Cure 10 ( 2 ) 135 - 144 2024年5月

Reconstruction method for massive lateral chest wall sarcoma using titanium plates and mesh: a case report. 国際誌

Shin Tanaka, Eiji Nakata, Toshifumi Ozaki, Shinichi Toyooka

Journal of cardiothoracic surgery 19 ( 1 ) 245 - 245 2024年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Very large chest wall resections can lead to acute thoracic insufficiency syndrome due to the interdependence of lung expansion and thoracic volume. Chest wall tumor surgeries often encounter complications, with the size of the chest wall defect being a significant predictor. Several methods for large chest wall reconstruction have been described, aiming to provide stability, prevent flail chest, and ensure airtight closure. However, no single method fulfills all requirements. Composite chest wall reconstruction using titanium plates and Gore-Tex patches has shown the potential to minimize physiologic abnormalities caused by extensive defects. CASE PRESENTATION: A 42-year-old man with myxofibrosarcoma underwent multiple surgeries, chemotherapies, and radiation therapies due to repeated local recurrences. After right arm amputation and resection of the right third to fifth ribs, a local recurrence was detected. A 30 × 40 cm chest wall defect was resected en bloc, and a titanium plate was used for three-dimensional formability, preventing flail chest and volume loss. The Gore-Tex patch was then reconstructed into an arch shape, allowing lateral thoracic mobility. The patient recovered well and did not experience respiratory dysfunction or local recurrence but later succumbed to distant metastasis. CONCLUSIONS: In this case, the combination of a titanium plate and a Gore-Tex patch proved effective for reconstructing massive lateral chest wall defects. The approach provided stability, preserved thoracic volume, and allowed for lateral mobility. While the patient achieved a successful outcome in terms of local recurrence and respiratory function, distant metastasis remained a challenge for myxofibrosarcoma patients, and its impact on long-term prognosis requires further investigation. Nevertheless, the described procedure offers promise for managing extensive chest wall defects.

DOI： 10.1186/s13019-024-02639-5

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

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

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

記述言語：英語掲載種別：研究論文（学術雑誌）

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

DOI： 10.1186/s12891-023-07151-w

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内側半月板後根プルアウト修復術膝内側関節裂隙狭小化の縦断的評価

川田紘己, 古松毅之, 横山裕介, 東原直裕, 田村優典, 尾崎敏文

中部日本整形外科災害外科学会雑誌 67 ( 春季学会 ) 86 - 86 2024年4月