Faculty Profiles - OZAKI Toshifumi

Papers - OZAKI Toshifumi

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Limb salvage surgery for pelvic osteosarcoma Reviewed

Toshiyuki Kunisada, Ken Takeda, Tomohiro Fujiwara, Shinsuke Sugihara, Toshifumi Ozaki

Osteosarcoma 135 - 147 2016.1

Language：English Publishing type：Part of collection (book) Publisher：Springer Japan

Patients with pelvic osteosarcoma have a poor outcome
treatment is one of the most challenging problems for the orthopedic oncologist. The reconstructive approach varies according to anatomic location, extent of resection, the patient’s functional demands, and individual surgeon preference. The choice of optimal technique for reconstruction after acetabular tumor resection depends on numerous parameters and includes iliofemoral arthrodesis or pseudoarthrodesis, combined use of hip arthroplasty with massive allograft or recycled autograft, and pelvic and saddle prosthesis. The type of reconstruction modality can influence the rate of infection. Hip transposition resulted in the least incidence of complications after resection of the acetabulum, compared to the use of prosthesis or prosthesis and allograft. The absence of large implants and allografts helps reduce surgical time, facilitates closure, and may decrease the incidence of infection and late revision due to implant failure. These can lead to early postoperative systemic treatment and functional recovery and are critical for patients with a high incidence of local recurrence and distant metastases. We believe that resection arthroplasty should be indicated for the patient with acetabular osteosarcoma.

DOI： 10.1007/978-4-431-55696-1_11

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Outcome of treatment for osteosarcoma of the extremities over the last 20 years: Report from 11 referral centers in Japan Reviewed

Koichi Ogura, Hiroaki Hiraga, Takeshi Ishii, Toshifumi Ozaki, Yoshihiro Nishida, Hideo Morioka, Toru Hiruma, Takafumi Ueda, Nobuhito Araki, Norifumi Naka, Hirotaka Kawano, Akira Kawai

Osteosarcoma 45 - 57 2016.1

Language：English Publishing type：Part of collection (book) Publisher：Springer Japan

The survival of patients with osteosarcoma has improved dramatically due to the introduction of effective systemic chemotherapy. The key standard drugs for osteosarcoma chemotherapy are methotrexate, doxorubicin, and cisplatin, and multi-institutional trials based on these drugs have been conducted in Japan since the 1990s. However, there have been no nationwide data on treatment outcome, especially with regard to survival and prognostic factors. In this chapter, therefore, we present data from a large nationwide cohort of patients with osteosarcoma treated at 11 referral centers in Japan during the period 1990-2010 with special reference to survival and relevant prognostic factors. The 3-, 5-, and 10-year metastasis-free survival and overall survival rates for the 529 patients were 70 %, 64 %, and 62 % and 88 %, 83 %, and 77 %, respectively. The prognosis for patients with osteosarcoma in Japan was comparable to, or slightly better than, those reported in other countries. International collaboration should also be conducted in Asian countries including Japan to improve the outcome further and find the optimal treatment for osteosarcoma.

DOI： 10.1007/978-4-431-55696-1_4

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Minimally invasive spinopelvic fixation for unstable bilateral sacral fractures Reviewed

Koichiro Koshimune, Yasuo Ito, Yoshihisa Sugimoto, Takeshi Kikuchi, Takuya Morita, Shoichiro Mizuno, Toshifumi Ozaki

Clinical Spine Surgery 29 ( 3 ) 124 - 127 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：Lippincott Williams and Wilkins

Study Design: Retrospective case series. Objective: We present a minimally invasive spinopelvic fixation technique for unstable bilateral sacral fractures and describe a technical report. Summary of Background Data: Unstable sacral fractures are severe injuries with high mortality and morbidity due to pain and malunion. Galveston technique is useful for rigid fixation of an unstable sacral fracture. However, wound-related complications with this technique have been relatively common because of extensive contusion of the skin or poor blood supply after embolization. Materials and Methods: There were 34 patients with unstable pelvic fractures between 2005 and 2012. We performed conventional open surgery between 2005 and 2009. Minimally invasive spinopelvic fixation was performed between 2009 and 2012. Minimally invasive technique needs 4 small, lateral incisions for percutaneous lumbar pedicle screw insertion. We pushed a pure titanium rod into the paravertebral muscle. Results: The average surgical time was 345 minutes in the conventional fixation and 208 minutes with the minimally invasive fixation. The average intraoperative bleeding was 520mL in the conventional fixation and 290mL in minimally invasive fixation. When comparing deep wound infection, 3 of 8 (38%) patients who received conventional fixation had methicillin-resistant Staphylococcus aureus infections, whereas nobody who received the minimally invasive fixation acquired infection. Bony union was achieved in 15 of the 16 patients. Conclusions: In this study, minimally invasive spinopelvic fixation required a shorter surgical time, incurred less bleeding, and had a lower infection rate than fixation with the conventional Galveston technique.

DOI： 10.1097/BSD.0000000000000090

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Postoperative change in the length and extrusion of the medial meniscus after anterior cruciate ligament reconstruction Reviewed

Shinji Narazaki, Takayuki Furumatsu, Takaaki Tanaka, Masataka Fujii, Shinichi Miyazawa, Hiroto Inoue, Yasunori Shimamura, Kenta Saiga, Toshifumi Ozaki

INTERNATIONAL ORTHOPAEDICS 39 ( 12 ) 2481 - 2487 2015.12

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

Purpose The medial meniscus is a secondary stabilizer of anterior tibial translation in anterior cruciate ligament (ACL)-deficient knees. ACL reconstruction effectively restores an increased anterior tibial translation in the ACL-deficient knee. However, knee osteoarthritis sometimes develops in ACL-reconstructed patients during a long-term follow-up period. We hypothesized that the medial meniscal position would be different between the ACL-deficient and reconstructed knees. The aim of this study was to investigate pre-operative and postoperative location of the medial meniscus in patients who underwent ACL reconstruction.
Methods ACL-reconstructed knees (28 knees) and normal knees (27 knees) were investigated. Medial tibial plateau length (MTPL) and medial tibial plateau width (MTPW) were determined using radiographic images. Magnetic resonance imaging (MRI)-based medial meniscal length (MML), medial meniscal width (MMW), and medial meniscal extrusion (MME) were measured. Postoperative change in the MML, MMW, and MME were evaluated and compared with those in normal knees.
Results No significant differences between the ACL-deficient (pre-operative) and normal groups were noted. The ACL-reconstructed (postoperative) group showed an increase in the MML, in the percentage of the MML (%MML = 100 MML/MTPL), and in the MME. Significant differences between postoperative and normal groups were observed in the MML, %MML, and MME. MMW and MMW percentage (100 MMW/MTPW) were similar in all groups.
Conclusions The anteroposterior length and radial extrusion of the medial meniscus increased after ACL reconstruction. Transposition of the medial meniscus may be a possible cause of developing further degenerative knee joint disorders after ACL reconstruction.

DOI： 10.1007/s00264-015-2704-z

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Contrast-enhanced Computed Tomography Screening Is Effective for Detecting Venous Thromboembolism not Prevented by Prophylaxis after Total Knee Arthroplasty Reviewed

Yukimasa Okada, Takayuki Furumatsu, Shinichi Miyazawa, Takaaki Tanaka, Masataka Fujii, Toshifumi Ozaki, Nobuhiro Abe

ACTA MEDICA OKAYAMA 69 ( 6 ) 355 - 359 2015.12

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

Venous thromboembolism (VTE) is a potential complication occurring after total knee arthroplasty (TKA). We investigated the incidence of VTE after TKA using contrast-enhanced computed tomography (CT), and assessed the efficacy of VTE prophylaxis (fondaparinux and enoxaparin). At our hospital, 189 patients (225 knees) underwent TKA between April 2007 and October 2011. The 225 knees were divided into a control group with no VTE prophylaxis (31 cases), a fondaparinux group (107 cases), and an enoxaparin group (87 cases). Contrast-enhanced CT screening for VTE was performed in all cases on day 5 or 6 after TKA. D-dimer levels were measured on day 5 after TKA, and were significantly lower in the fondaparinux (9.8 +/- 3.8) and enoxaparin groups (9.4 +/- 4.9) than in the control group (15.6 +/- 9.8) (p < 0.001). However, no statistically significant difference in the incidence of VTE was observed among the groups (control, 61.3%; fondaparinux, 49.5%; enoxaparin, 50.6%). Prophylaxis was not effective for the prevention of VTE as detected by contrast-enhanced CT after TKA. CT should be performed after TKA, even when VTE prophylaxis is used.

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股関節固定術30年後に人工股関節置換術を施行した1例

遠藤裕介, 香川洋平, 上原健敬, 藤原一夫, 藤井洋佑, 尾崎敏文

日本人工関節学会誌 45 865 - 866 2015.12

Language：Japanese Publisher：(一社)日本人工関節学会

症例は57歳の女性で、両側の先天性股関節脱臼に対するギプス固定歴があり、左の末期股関節症に対し27歳時に股関節固定術を受け、47歳頃より腰痛と膝痛の隣接関節障害が生じていた。初診時のX線像では、右は末期股関節症、左股関節は完全に骨癒合した固定状態で、代償性の腰椎前彎と変性所見を認め、脚長差が2cm存在した。JOAスコアは右36点、左59点であった。右股関節に対しセメントレスカップとセメントステムによるハイブリッド人工股関節置換術(THA)を施行した。術後に右股関節痛は改善し、JOAスコアは68点となったが、腰痛と左膝関節痛が残存したため、術後10ヵ月に左ハイブリッドTHAを施行した。術後経過は良好で、JOAスコアは78点に改善し、腰痛や膝痛はなく、腰椎前彎も改善し、機能的脚長差も消失した。

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Cobalt G-HVの使用経験

三宅孝昌, 遠藤裕介, 中原龍一, 香川洋平, 藤井洋佑, 尾崎敏文

日本人工関節学会誌 45 885 - 886 2015.12

Language：Japanese Publisher：(一社)日本人工関節学会

症例は発熱を主訴とする69歳女性で、右股関節痛が増悪、歩行困難となり前医に入院した。血液培養にて大腸菌が検出され、股関節の切開洗浄、デブリードマン、セメントビーズ留置が行われた。しかし、右股関節痛は軽快せず、X線像では末期股関節症の状態で、前医において後方アプローチから骨頭切除し、セメントビーズ留置が行われた。骨頭切除6週間後に人工股関節置換術を施行した。後方アプローチでセメントビーズを抜去して再度郭清し、ナビゲーション下に抗菌薬含有セメントCobalt G-HVを用いてセメントカップを設置、ステムを挿入した。術後は神経麻痺などの合併症はなく、術後6ヵ月には屋内は杖なし歩行可能で、X線上は問題なく、JOAスコアは術前12点から64点に改善した。

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骨腫瘍切除後の骨欠損に対する配向連通気孔構造を有した新しい人工骨移植の治療成績

武田健, 国定俊之, 藤原智洋, 尾崎敏文

移植 50 ( 6 ) 666 - 666 2015.12

転写因子Mohawkホメオボックス遺伝子は椎間板線維輪外輪の発生と再生に重要である

中道亮, 尾崎敏文, 浅原弘嗣

移植 50 ( 6 ) 668 - 668 2015.12

Development and external validation of nomograms predicting distant metastases and overall survival after neoadjuvant chemotherapy and surgery for patients with nonmetastatic osteosarcoma: A multi-institutional study Reviewed

Koichi Ogura, Tomohiro Fujiwara, Hideo Yasunaga, Hiroki Matsui, Dae-Geun Jeon, Wan Hyeong Cho, Hiroaki Hiraga, Takeshi Ishii, Tsukasa Yonemoto, Hiroto Kamoda, Toshifumi Ozaki, Eiji Kozawa, Yoshihiro Nishida, Hideo Morioka, Toru Hiruma, Shigeki Kakunaga, Takafumi Ueda, Yusuke Tsuda, Hirotaka Kawano, Akira Kawai

CANCER 121 ( 21 ) 3844 - 3852 2015.11

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

BACKGROUNDIn this era of individualized cancer treatment, data that could be applied to predicting the survival of patients with osteosarcoma are still limited because of the rarity of the disease and the difficulty in accumulating a sufficient number of patients. Therefore, a multi-institutional collaboration was implemented to develop and externally validate nomograms that would predict metastasis-free survival (MFS) and overall survival (OAS) for patients with nonmetastatic osteosarcoma.
METHODSThis study retrospectively examined 1070 patients treated with neoadjuvant chemotherapy and surgery for nonmetastatic osteosarcoma. Data from Japanese patients (n = 557) were used to develop multivariate nomograms based on Cox regression. Six clinical and pathologic variables were built into nomograms estimating the probability of MFS and OAS 3 and 5 years after diagnosis. The model was internally validated for discrimination and calibration with bootstrap resampling and was externally validated with an independent patient cohort from Korea (n = 513).
RESULTSA patient's age, tumor site, and histologic response were found to have a stronger influence on MFS and OAS in the model than sex, tumor size, or pathologic fracture. The nomograms and calibration plots based on these results well predicted the probability of MFS (concordance index, 0.631) and OAS (concordance index, 0.679). The concordance indices for external validation were 0.682 for MFS and 0.665 for OAS.
CONCLUSIONSThe nomograms were externally validated and verified to be useful for the prediction of MFS and OAS and for the assessment of the postoperative prognosis. They can be used for counseling patients and for establishing appropriate surveillance strategies after surgery. Cancer 2015;121:3844-3852. (c) 2015 American Cancer Society.
Prognostic nomograms for osteosarcoma have been developed and externally validated through multi-institutional collaboration. These prognostic nomograms are the first to be developed and externally validated for osteosarcoma.

DOI： 10.1002/cncr.29575

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Bone engineering by phosphorylated-pullulan and β-TCP composite. Reviewed

Takahata T, Okihara T, Yoshida Y, Yoshihara K, Shiozaki Y, Yoshida A, Yamane K, Watanabe N, Yoshimura M, Nakamura M, Irie M, Van Meerbeek B, Tanaka M, Ozaki T, Matsukawa A

Biomedical materials (Bristol, England) 10 ( 6 ) 065009 2015.11

腫瘍局所のmyeloid-derived suppressor cells(MDSCs)に与えるメトホルミン投与の効果

上原健敬, 榮川伸吾, 國定勇希, 渡邉元嗣, 一柳朋子, 山崎千尋, 尾崎敏文, 鵜殿平一郎

日本癌学会総会記事 74回 P - 2109 2015.10

成年男性の横隔神経伝導速度の左右差の検討

堅山佳美, 千田益生, 上原健敬, 尾崎敏文

臨床神経生理学 43 ( 5 ) 438 - 438 2015.10

滑膜肉腫患者における分泌型microRNAの特定と新規バイオマーカーとしての実験的検証

吉田晶, 藤原智洋, 魚谷弘二, 根津悠, 武田健, 国定俊之, 川井章, 落谷孝広, 尾崎敏文

日本癌学会総会記事 74回 P - 3280 2015.10

骨肉腫に対するドキソルビシンとp53発現腫瘍融解アデノウイルス製剤の併用療法

杉生和久, 田澤大, 長谷井嬢, 尾崎修平, 山川泰明, 大森敏規, 小松原将, 魚谷弘二, 藤原智洋, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 74回 P - 1382 2015.10

骨軟部肉腫細胞に対する腫瘍融解ウイルスの放射線増感作用

大森敏規, 山川泰明, 長谷井嬢, 田澤大, 尾崎修平, 佐々木剛, 杉生和久, 魚谷弘二, 藤原智洋, 国定俊之, 浦田泰生, 尾崎敏文, 藤原俊義

日本癌学会総会記事 74回 E - 1276 2015.10

Ewing肉腫に対する新しい診断法のためのエクソソーム表面マーカーの網羅的解析

魚谷弘二, 藤原智洋, 吉田晶, 森田卓也, 武田健, 国定俊之, 吉岡祐亮, 植田幸嗣, 落谷孝広, 尾崎敏文

日本癌学会総会記事 74回 P - 1356 2015.10

RPN2は骨肉腫の様々な悪性形質を制御し臨床予後を規定する

藤原智洋, 根津悠, 吉田晶, 魚谷弘二, 国定俊之, 武田健, 森田卓也, 小松原将, 杉生和久, 大森敏規, 川井章, 落谷孝広, 尾崎敏文

日本癌学会総会記事 74回 P - 3207 2015.10

Prominent thallium-201 uptake of giant cell tumor of bone : comparison with osteosarcoma

R. Inai, S. Takayoshi, T. Tanaka, Y. Tsuboi, S. Norikane, K. Kojima, A. Tada, T. Kunisada, S. Sato, T. Ozaki, S. Kanazawa

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 42 S783 - S784 2015.10

Establishment of a liaison clinic for patients with intractable chronic pain Reviewed

Tomoko Tetsunaga, Tomonori Tetsunaga, Hiroyuki Nishie, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC SCIENCE 20 ( 5 ) 907 - 913 2015.9

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

Background A multidisciplinary approach has been shown to be effective for the treatment of intractable pain. However, few hospitals in Japan have established liaison clinics for such patients. In this study, we investigated the short-term results of a liaison clinic for patients with intractable chronic pain.
Methods Study participants comprised 53 outpatients (20 men, 33 women) with intractable chronic pain who visited our hospital between April 2012 and March 2013. At baseline, patients completed a self-reported questionnaire and provided demographic and clinical information. Experts in various fields (anesthesia, orthopedic surgery, psychiatry, physical therapy, and nursing) conducted examinations of patients and attended a weekly conference during which patients' physical, psychological, and social problems were discussed and courses of treatment were determined. All patients were assessed using the Numerical Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Pain Disability Assessment Scale (PDAS). Eligibility for the pain liaison outpatient clinic was evaluated using multiple logistic regression analysis.
Results After a 6-month follow-up period, no significant changes were seen in scores for the NRS, PDAS, or HADS for depression. In contrast, scores for both the PCS and HADS for anxiety were significantly reduced after 6 months of treatment (p < 0.05). HADS for anxiety was identified as a factor related to patient resistance to attending the pain liaison outpatient clinic (p < 0.05).
Conclusions This liaison clinic for patients with intractable chronic pain was able to improve patient anxiety. Severe anxiety at the initial visit represented a risk factor for dropout from the clinic.

DOI： 10.1007/s00776-015-0748-y

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