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A rare course of scoliosis associated with chiari malformation and syringomyelia 査読

Masato Tanaka, Yoshihisa Sugimoto, Shinya Arataki, Tomoyuki Takigawa, Toshifumi Ozaki

Acta Medica Okayama 68 ( 5 ) 303 - 306 2014年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Okayama University

Spinal deformity is an important clinical manifestation of Chiari I malformation (CM-I) and syringomyelia. Here we report the result of an 8-year follow-up of a 13-year-old girl with severe scoliosis associated with Chiari malformation and a large syringomyelia. The patient presented at our hospital at the age of 13 with a 68° scoliosis. Magnetic resonance imaging showed Chiari malformation and a large syringomyelia. Neurosurgical treatment involved foramen magnum decompression and partial Cl laminectomy, but the scoliosis still progressed. We present the first case report of a rare course of scoliosis in a patient with CM-I and a large syringomyelia.

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鏡視下足関節固定術に径4.0mmの関節鏡は使用可能か？:―術前X 線ストレス撮影を用いた検討―

雑賀建多, 堀田昌宏, 横山裕介, 門田弘明, 森下嗣威, 尾﨑敏文

中部日本整形外科災害外科学会雑誌 57 ( 2 ) 419 - 420 2014年

成人上腕骨遠位端完全関節内骨折（AO type C）の治療戦略

今谷潤也, 森谷史朗, 前田和茂, 桐田由季子, 林正典, 尾﨑敏文

中部日本整形外科災害外科学会雑誌 57 ( 5 ) 1177 - 1178 2014年

外傷性後頭環椎脱臼後に内固定を行った1例

渡邉典行, 杉本佳久, 瀧川朋亨, 荒瀧慎也, 田中雅人, 尾崎敏文

中部日本整形外科災害外科学会雑誌 57 ( 5 ) 1013 - 1014 2014年

下腿血管腫により尖足を生じた1例

遠藤裕介, 渡邉典行, 長谷井嬢, 岡田芳樹, 尾﨑敏文

中部日本整形外科災害外科学会雑誌 57 ( 6 ) 1295 - 1296 2014年

頭部外傷を伴う未就学児の大腿骨骨幹部骨折に対してelastic nailingを施行した１例

杉生和久, 野田知之, 尾﨑敏文, 木浪陽, 大西学, 塚原紘平, 氏家良人

中国・四国整形外科学会雑誌 26 ( 2 ) 329 - 333 2014年

記述言語：日本語出版者・発行元：中国・四国整形外科学会

The standard treatment for femoral shaft fractures in preschool children is casting or traction. In this report, we present a case of femoral shaft fracture in a preschool child treated with the elastic nailing technique. The patient was a 4-year-old boy with a history of pervasive developmental disorder. He was brought to our hospital by ambulance after falling out of a second-story window at his house. He suffered severe head injury and a right femoral shaft fracture. We performed emergency surgery and treated the right femoral fracture by elastic nailing with a 2.4-mm Kirschner wire under general anesthesia. He started gait training at 4 weeks after surgery. Three months after surgery, we performed cranioplasty and removed the Kirschner wire from the right femur under general anesthesia. He had no leg length discrepancy or gait abnormality at 10 months after surgery. In this case, considering the benefit of patient management in an intensive care unit, we performed elastic nailing for the femoral shaft fracture. As a result, the patientʼs general condition improved rapidly and he started gait training at an early date. In conclusion, we recommend using elastic nailing for femoral shaft fractures in preschool children with head injury.

DOI： 10.11360/jcsoa.26.329

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Chiari Type I Malformation Caused by Craniometaphyseal Dysplasia 査読

Masato Tanaka, Shinya Arataki, Yoshihisa Sugimoto, Tomoyuki Takigawa, Tomoko Tetsunaga, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 67 ( 6 ) 385 - 389 2013年12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：OKAYAMA UNIV MED SCHOOL

Craniometaphyseal dysplasia is a rare genetic condition characterized by progressive thickening of bones in the skull and metaphyseal abnormalities in the long bones. This disorder often causes progressively symptomatic cranial nerve compression, but in rare cases foramen magnum stenosis may lead to quadriplegia. Chiari I malformation with craniometaphyseal dysplasia is extremely rare. The authors report on a 25-year-old woman with myelopathy due to Chiari I malformation along with craniometaphyseal dysplasia. There are only four previous case reports of this condition. The authors present here the fifth case report of this rare condition and summarize its characteristics.

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Factors Predicting Clinical Impairment after Surgery for Cervical Spinal Schwannoma 査読

Kentaro Yamane, Tomoyuki Takigawa, Masato Tanaka, Syuhei Osaki, Yoshihisa Sugimoto, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 67 ( 6 ) 343 - 349 2013年12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：OKAYAMA UNIV MED SCHOOL

Cervical spinal schwannoma is benign, and outcomes after surgical resection are generally excellent. A surgical dilemma sometimes arises as to whether to perform total tumor removal, which carries a risk of sacrificing the nerve root, or subtotal removal, where the risk can be tumor recurrence. The purpose of this study was to identify factors with the potential to predict clinical impairment after surgery for cervical spinal schwannomas. Thirty cases of cervical schwannomas treated surgically in our institute were retrospectively reviewed; initial symptoms, tumor location, Eden classification, surgical method, functional outcome, and tumor recurrence were investigated. All permanent motor deficits were the result of resecting functionally relevant nerve roots (i.e., C5-8). The rate of permanent sensory deficit was 11% after C1-4 nerve root resection, and 67% after C5-8 nerve root resection. Permanent neurological deficits occurred in 14% of patients younger than 40 years and 38% of those older than 40. Dumbbell tumors were associated with the need for total or ventral nerve root transection, as well as with a high incidence of tumor recurrence. The incidence of permanent neurological deficit was significantly higher in patients undergoing C5-8 nerve root resection, and tended to be higher in those over 40.

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Analysis of MicroRNAs Expressions in Chondrosarcoma 査読

Teruhito Yoshitaka, Akira Kawai, Shigeru Miyaki, Kunihiko Numoto, Kazutaka Kikuta, Toshifumi Ozaki, Martin Lotz, Hiroshi Asahara

JOURNAL OF ORTHOPAEDIC RESEARCH 31 ( 12 ) 1992 - 1998 2013年12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：WILEY-BLACKWELL

MicroRNAs (miRNAs) are small non-coding RNAs capable of inhibiting gene expression post-transcriptionally and expression profiling can provide therapeutic targets and tools for cancer diagnosis. Chondrosarcoma is a mesenchymal tumor with unknown cause and differentiation status. Here, we profiled miRNA expression of chondrosarcoma, namely clinical samples from human conventional chondrosarcoma tissue, established chondrosarcoma cell lines, and primary non-tumorous adult articular chondrocytes, by miRNA array and quantitative real-time PCR. A wide variety of miRNAs were differently downregulated in chondrosarcoma compared to non-tumorous articular chondrocytes; 27 miRNAs: miR-10b, 23b, 24-1*, 27b, 100, 134, 136, 136*, 138, 181d, 186, 193b, 221*, 222, 335, 337-5p, 376a, 376a*, 376b, 376c, 377, 454, 495, 497, 505, 574-3p, and 660, were significantly downregulated in chondrosarcoma and only 2: miR-96 and 183, were upregulated. We further validated the expression levels of miRNAs by quantitative real-time PCR for miR-181a, let-7a, 100, 222, 136, 376a, and 335 in extended number of chondrosarcoma clinical samples. Among them, all except miR-181a were found to be significantly downregulated in chondrosarcoma derived samples. The findings provide potential diagnostic value and new molecular understanding of chondrosarcoma. (c) 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:1992-1998, 2013

DOI： 10.1002/jor.22457

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神経血管損傷を合併した上腕骨近位端骨折2例と過去の報告例の検討

中道亮, 尾崎敏文, 川上幸雄

骨折 35 ( 4 ) 837 - 840 2013年12月

記述言語：日本語出版者・発行元：(一社)日本骨折治療学会

閉鎖性上腕骨近位端骨折に神経血管損傷を合併し、手術加療を行った2例を経験した。この2例に加え、過去の文献で単純X線が記載されている23文献26例を併せて調査・検討を行った。骨折型はAO分類でA3が17例、B2が7例と多く、また遠位骨片が内側転位している例が多かった。また損傷部位は腋窩動脈の回旋枝より遠位の損傷が19例であった。神経血管損傷は外科頸骨折で遠位骨片が不安定なものに生じやすい傾向にあり、損傷原因は遠位骨片が関係していると考えられた。血管損傷に神経損傷を合併した例は20例であり、感覚麻痺のみ生じた例と比較し運動麻痺を呈した例は術後1年の時点でも麻痺が残存する傾向にあった。上腕骨近位端骨折において、外科頸骨折で遠位骨片が内側転位している例は神経血管損傷を念頭におき治療に当たる必要があると考える。(著者抄録)

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Occult Compression Fracture of Metacarpal Head without Evidence of Avascular Necrosis 査読

Keiichiro Nishida, Hiroyuki Hashizume, Akihiro Matsukawa, Kenzo Hashizume, Yasunori Shimamura, Yasuyaki Torigoe, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 67 ( 5 ) 311 - 317 2013年10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：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.

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Does laminoplasty really improve neurological status in patients with cervical spinal cord injury without bone and disc injury? A prospective study about neurological recovery and early complications 査読

Tetsuro Mazaki, Yasuo Ito, Yoshihisa Sugimoto, Koichiro Koshimune, Masato Tanaka, Toshifumi Ozaki

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 133 ( 10 ) 1401 - 1405 2013年10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

Cervical spinal cord injury without bone and disc injury in patients with spinal cord compression is a fairly common problem in Japan. Because elderly Japanese population tend to have cervical spinal canal stenosis. However, there has been no consensus in the treatment of these patients. We conducted a prospective study to evaluate treatment outcomes and complications of these patients.
Twenty-five patients had been enrolled in this study. Patients who had paralysis of ASIA impairment scale (AIS) A, B or C were included. With each new patient, we alternated whether he/she received surgical treatment (group S) or conservative treatment (group C). Eleven patients were assigned to each group. We compared the two groups' courses of treatment and complications by evaluating their neurological symptoms using the AIS and ASIA motor score (MS) documenting them at the time of injury and 3 months later.
The majority of clinical paralysis was found at the C3/4 level for both the groups. According to complications, there were seven urinary tract infections and four pneumonias in group S and one urinary tract infection and three pneumonias in group C. Both groups had an average MS of 42 at the time of injury. Three months later, the average MSs were 59 points in group S and 65 points in group C.
In the present study, we found no significant difference in paralysis improvement between surgical and conservative treatment, although we observed a higher frequency of complications with surgery.

DOI： 10.1007/s00402-013-1810-x

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埋込型中心静脈カテーテルの断裂を来した2例

上原健敬, 武田健, 兒島聡一, 長谷井嬢, 郷原英夫, 国定俊之, 尾崎敏文

中国・四国整形外科学会雑誌 25 ( 3 ) 509 - 509 2013年10月

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年10月

骨線維性異形成の治療成績

武田健, 国定俊之, 上原健敬, 大森敏規, 長谷井嬢, 尾崎敏文

中部日本整形外科災害外科学会雑誌 56 ( 秋季学会 ) 56 - 56 2013年9月

Dual Energy CTを用いた骨組織と軟部組織の分離

上原健敬, 中原龍一, 木浪陽, 島村安則, 野田知之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 56 ( 秋季学会 ) 173 - 173 2013年9月

脛骨近位端の外側プレート設置に関する検討

山川泰明, 中原龍一, 野田知之, 尾崎敏文, 木浪陽

骨折 35 ( 3 ) 711 - 714 2013年9月

記述言語：日本語出版者・発行元：(一社)日本骨折治療学会

CT撮影した平均年齢86.2歳の日本人解剖屍体下腿28肢のデータを、脛骨近位外側骨形状を中心に計測し、脛骨近位外側用プレートと比較検討した。脛骨近位外側カーブ形状には様々なバリエーションが存在し、その中でも典型パターンと非典型パターンが存在した。また5種類の脛骨近位外側用プレートと比較すると、どのプレートも合わない脛骨近位外側カーブ形状も存在した。脛骨近位外側カーブ形状にはバリエーションが多く、単一の脛骨近位外側用プレートですべての脛骨近位外側カーブ形状に対応することは不可能である。プレートの設置不良が予想される場合、プレートベンディングや三次元テンプレートはその対策として有用と考える。(著者抄録)

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RNA干渉核酸医薬による骨肉腫がん幹細胞様形質の制御を基盤とした新規治療戦略

藤原智洋, 小坂展慶, 窪田大介, 川井章, 尾崎敏文, 落谷孝広

中部日本整形外科災害外科学会雑誌 56 ( 秋季学会 ) 174 - 174 2013年9月

Transcription factor Mohawk and the pathogenesis of human anterior cruciate ligament degradation. 国際誌

Hiroyuki Nakahara, Akihiko Hasegawa, Koji Otabe, Fumiaki Ayabe, Tetsuya Matsukawa, Naoko Onizuka, Yoshiaki Ito, Toshifumi Ozaki, Martin K Lotz, Hiroshi Asahara

Arthritis and rheumatism 65 ( 8 ) 2081 - 9 2013年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: To investigate the expression and function of Mohawk (MKX) in human adult anterior cruciate ligament (ACL) tissue and ligament cells from normal and osteoarthritis (OA)-affected knees. METHODS: Knee joints were obtained at autopsy (within 24-48 hours postmortem) from 13 donors with normal knees (mean ± SD age 36.9 ± 11.0 years), 16 donors with knee OA (age 79.7 ± 11.4 years), and 8 aging donors without knee OA (age 76.9 ± 12.9 years). All cartilage surfaces were graded macroscopically. MKX expression was analyzed by immunohistochemistry and quantitative polymerase chain reaction. ACL-derived cells were used to study regulation of MKX expression by interleukin-1β (IL-1β). MKX was knocked down with small interfering RNA (siRNA) to analyze the function of MKX in extracellular matrix (ECM) production and differentiation in ACL-derived cells. RESULTS: The expression of MKX was significantly decreased in ACL-derived cells from OA knees compared with normal knees. Consistent with this finding, immunohistochemistry analysis showed that MKX-positive cells were significantly reduced in ACL tissue from OA donors, in particular in cells located in disorientated fibers. In ACL-derived cells, IL-1β strongly suppressed MKX expression and reduced expression of the ligament ECM genes COL1A1 and TNXB. In contrast, SOX9, a chondrocyte master transcription factor, was up-regulated by IL-1β treatment. Importantly, knockdown of MKX expression with siRNA up-regulated SOX9 expression in ACL-derived cells, whereas the expression of COL1A1 and TNXB was reduced. CONCLUSION: Reduced expression of MKX is a feature of degenerated ACL in OA-affected joints, and this may be mediated in part by IL-1β. MKX appears necessary to maintain the tissue-specific cellular differentiation status and ECM production in adult human tendons and ligaments.

DOI： 10.1002/art.38020

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可視光硬化ゼラチンとcollagen binding domain(CBD)-BMP4の併用による家兎骨軟骨組織修復効果

馬崎哲朗, 塩崎泰之, 山根健太郎, 香川洋平, 篠原健介, 吉田晶, 松川昭博, 中村真理子, 吉田靖弘, 北嶋隆, 伊藤嘉浩, 尾崎敏文

日本整形外科学会雑誌 87 ( 8 ) S1606 - S1606 2013年8月

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