Faculty Profiles - OZAKI Toshifumi

Papers - OZAKI Toshifumi

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Methotrexate, Doxorubicin, and Cisplatin Versus Methotrexate, Doxorubicin, and Cisplatin + Ifosfamide in Poor Responders to Preoperative Chemotherapy for Newly Diagnosed High-Grade Osteosarcoma (JCOG0905): A Multicenter, Open-Label, Randomized Trial

Hiroaki Hiraga, Ryunosuke Machida, Akira Kawai, Toshiyuki Kunisada, Tsukasa Yonemoto, Makoto Endo, Yoshihiro Nishida, Akihito Nagano, Keisuke Ae, Shinichirou Yoshida, Kunihiro Asanuma, Junya Toguchida, Taisuke Furuta, Robert Nakayama, Toshihiro Akisue, Toru Hiruma, Takeshi Morii, Hideki Nishimura, Koji Hiraoka, Masanobu Takeyama, Makoto Emori, Satoshi Tsukushi, Hiroshi Hatano, Hiroyuki Kawashima, Kazuo Isu, Kazuhiro Tanaka, Tomoko Kataoka, Haruhiko Fukuda, Yukihide Iwamoto, Toshifumi Ozaki

Journal of Clinical Oncology 2025.3

Publishing type：Research paper (scientific journal) Publisher：American Society of Clinical Oncology (ASCO)

PURPOSE

Our previous NECO phase II studies on high-grade osteosarcoma suggested that administering ifosfamide (IF; 16 g/m ² [4g/m ² once on day 1, then 2g/m ² once on days 2-7] × six) to patients showing a poor response (PrRsp) to preoperative chemotherapy with methotrexate, doxorubicin, and cisplatin (MAP) improves their prognoses. In this Japan Clinical Oncology Group (JCOG) study, JCOG0905, we aimed to investigate the efficacy and safety of IF in patients with PrRsp.

METHODS

JCOG0905 is a multicenter, open-label, multi-institutional, randomized trial. Eligible patients (50 years and younger) had resectable, high-grade osteosarcoma (stage II or III, Union for International Cancer Control TNM) of the extremities, limb girdles, and thoracic wall. After two MAP cycles and tumor resection, patients with PrRsp were randomly assigned to either the MAP or MAP plus 15 g/m ² (3g/m ² once daily on days 1-5) × six IF (MAP + IF [MAPIF]) group. The primary end point was disease-free survival (DFS); secondary end points were overall survival (OS) and safety. The planned sample size was 100 patients with a one-sided α of .1 and a power of 0.7, assuming a 3-year DFS of 50% and 65% for MAP and MAPIF, respectively. This trial is registered with the Japan Registry of Clinical Trials (jRCT; jRCTs031180126).

RESULTS

Of the 287 patients registered between February 2010 and August 2020, 51 and 52 patients with PrRsp were assigned to the MAP and MAPIF groups, respectively. As of March 2022, DFS did not differ between groups (hazard ratio [HR], 1.05 [95% CI, 0.55 to 1.98]) and OS was numerically inferior in the MAPIF group (HR, 1.48 [95% CI, 0.68 to 3.22]). Nine and zero patients in the MAPIF and MAP groups discontinued treatment because of adverse events, respectively.

CONCLUSION

Evidence from JCOG0905 does not support the addition of IF for patients with PrRsp.

DOI： 10.1200/jco-24-01281

Empowering pediatric, adolescent, and young adult patients with cancer utilizing generative AI chatbots to reduce psychological burden and enhance treatment engagement: a pilot study

Joe Hasei, Mana Hanzawa, Akihito Nagano, Naoko Maeda, Shinichirou Yoshida, Makoto Endo, Nobuhiko Yokoyama, Motoharu Ochi, Hisashi Ishida, Hideki Katayama, Tomohiro Fujiwara, Eiji Nakata, Ryuichi Nakahara, Toshiyuki Kunisada, Hirokazu Tsukahara, Toshifumi Ozaki

Frontiers in Digital Health 7 2025.2

Publishing type：Research paper (scientific journal) Publisher：Frontiers Media SA

Background

Pediatric and adolescent/young adult (AYA) cancer patients face profound psychological challenges, exacerbated by limited access to continuous mental health support. While conventional therapeutic interventions often follow structured protocols, the potential of generative artificial intelligence (AI) chatbots to provide continuous conversational support remains unexplored. This study evaluates the feasibility and impact of AI chatbots in alleviating psychological distress and enhancing treatment engagement in this vulnerable population.

Methods

Two age-appropriate AI chatbots, leveraging GPT-4, were developed to provide natural, empathetic conversations without structured therapeutic protocols. Five pediatric and AYA cancer patients participated in a two-week intervention, engaging with the chatbots via a messaging platform. Pre- and post-intervention anxiety and stress levels were self-reported, and usage patterns were analyzed to assess the chatbots’ effectiveness.

Results

Four out of five participants reported significant reductions in anxiety and stress levels post-intervention. Participants engaged with the chatbot every 2–3 days, with sessions lasting approximately 10 min. All participants noted improved treatment motivation, with 80% disclosing personal concerns to the chatbot they had not shared with healthcare providers. The 24/7 availability particularly benefited patients experiencing nighttime anxiety.

Conclusions

This pilot study demonstrates the potential of generative AI chatbots to complement traditional mental health services by addressing unmet psychological needs in pediatric and AYA cancer patients. The findings suggest these tools can serve as accessible, continuous support systems. Further large-scale studies are warranted to validate these promising results.

DOI： 10.3389/fdgth.2025.1543543

Radiographic and Clinical Assessment of Unidirectional Porous Beta-Tricalcium Phosphate to Treat Benign Bone Tumors. International journal

Toshiyuki Kunisada, Eiji Nakata, Tomohiro Fujiwara, Haruyoshi Katayama, Takuto Itano, Takanao Kurozumi, Teruhiko Ando, Toshifumi Ozaki

Biomimetics (Basel, Switzerland) 10 ( 2 ) 2025.2

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

The purpose of this study was to evaluate radiographic changes, clinical outcomes, and complications following unidirectional porous beta-tricalcium phosphate (UDPTCP) implantation for the treatment of benign bone tumors. We retrospectively analyzed 46 patients who underwent intralesional resection. The patients were divided into two cohorts: Cohort 1 (n = 32), which included all bones except the phalanges and metacarpal/tarsal bones, and Cohort 2 (n = 14), which included the phalanges and metacarpal/tarsal bones. Radiographic changes were assessed at each reading based on resorption of the implanted UDPTCP and bone trabeculation through the defect. UDPTCP resorption and bone trabeculation were observed on radiographs within 3 months of surgery in all patients. Bone remodeling in the cavity progressed steadily for up to 3 years postoperatively. In Cohort 1, resorption and trabeculation progressed significantly in young patients, and trabeculation developed significantly in small lesions. The rates of resorption and trabeculation at 3 months postoperatively correlated statistically with their increased rates at one year. There was no statistical difference in resorption and trabeculation rates between Cohort 1 and Cohort 2. There were no cases of postoperative deep infections or allergic reactions related to the implant. UDPTCP is a useful bone-filling substitute for the treatment of benign bone tumors and has a low complication rate.

DOI： 10.3390/biomimetics10020101

Clinicopathological background of local recurrence in high grade sarcoma of the extremity with preoperative chemotherapy: a supplementary analysis of JCOG0304. International journal

Satoshi Tsukushi, Kazuhiro Tanaka, Toshiyuki Kunisada, Ryunosuke Machida, Satoshi Takenaka, Akira Kawai, Hirohisa Katagiri, Masanobu Takeyama, Makoto Endo, Katsuhiro Hayashi, Robert Nakayama, Hiroshi Hatano, Makoto Emori, Shinichirou Yoshida, Toshio Kojima, Akio Sakamoto, Jungo Imanishi, Ryosuke Kita, Toshifumi Ozaki, Yukihide Iwamoto

Japanese journal of clinical oncology 2025.2

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

BACKGROUND: The mainstay of treatment for soft-tissue sarcomas is complete resection with negative surgical margins. However, treatment strategies for local control including the frequency of adjuvant radiotherapy (RT) and surgical margin differ greatly between Japan and other countries, and the optimal strategy of local control remains controversial. METHODS: A total of 70 patients with high-grade sarcoma who underwent surgery of the 72 patients enrolled in JCOG0304, were included. The primary endpoint was the proportion of local recurrence, and we investigated the clinicopathological background of local recurrence cases, including the surgical margins according to the Japanese Orthopedic Association (JOA) margin classification or histological margin, and use of adjuvant RT. RESULTS: Local recurrence occurred in five patients, with a 5-year local recurrence proportion of 7.1% (95% confidence interval, 2.6%-14.8%) in 70 patients. The histological subtype were four cases of undifferentiated pleomorphic sarcoma (UPS) and 1 case of liposarcoma. The 5-year local recurrence proportions for UPS and non-UPS were 19.0% and 2.0%, respectively. Two of the five recurrent cases (40%) had adjuvant RT. The recurrent cases were four males and one female, median age 54 years (range: 33-66), JOA margin classification showed wide resection in four cases and marginal resection in one case, and histological margin showed negative in all five cases. CONCLUSION: Despite the low proportion of adjuvant RT, local control of high-grade soft tissue sarcoma with preoperative chemotherapy in JCOG0304 was good. However, more detailed surgical margin evaluation and the use of adjuvant RT should be further investigated in the future for UPS.

DOI： 10.1093/jjco/hyaf027

Could the Trabecular Bone Score Be a Complementary Tool for Evaluating Degenerative Lumbar Vertebrae?

Shinichiro Takao, Koji Uotani, Haruo Misawa, Tomoko Tetsunaga, Kensuke Shinohara, Kentaro Yamane, Yoshiaki Oda, Hironori Tsuji, Yuya Kajiki, Toshifumi Ozaki

Acta medica Okayama 79 ( 1 ) 39 - 45 2025.2

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

Evaluating vertebral bone mass and quality in the elderly poses challenges due to degenerative changes. This study aims to elucidate the usefulness of the trabecular bone score (TBS) by examining the relationship between bone mineral density (BMD), TBS, and Hounsfield unit (HU) values. A retrospective analysis of 599 vertebrae from 152 patients (mean age 69.0 years; range 44-89; 74 males and 78 females) undergoing dual-energy X-ray absorptiometry (DXA) and CT scans was conducted. Vertebrae were categorized into three grades based on the degree of degeneration. The TBS was calculated from DXA images, and the HU value was measured by placing a region of interest on an axial image of the vertebral mid-body. One-way analysis of variance and Pearson's correlation tests were employed to investigate the relationship between BMD and TBS or HU values. While lumbar BMD significantly increased (p<0.01) with degenerative changes, TBS and HU values showed no significant differences. The correlations between lumbar BMD and TBS values, and between BMD and HU values, were stronger without degenerative changes than with degenerative changes. Significantly different HU values were observed between the right and left sides of severely degenerated vertebrae. Severe degenerative changes, particularly those associated with sclerosis, may impact HU values. TBS exhibits greater potential than HU values as a complementary tool.

DOI： 10.18926/AMO/68360

LRP4 and Agrin Are Modulated by Cartilage Degeneration and Involved in β-Catenin Signaling in Human Articular Chondrocytes. International journal

Shuichi Naniwa, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Takashi Ohtsuki, Yoshifumi Hotta, Noriyuki Shimizu, Chinatsu Ichikawa, Deting Lin, Noriaki Otsuka, Toshifumi Ozaki

International journal of molecular sciences 26 ( 3 ) 2025.1

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

We investigated the roles of low-density lipoprotein receptor-related protein (LRP) 4 and its ligand Agrin in the pathophysiology of cartilage degeneration. Immunohistochemical analysis of human normal articular cartilage and cartilage tissues from patients with osteoarthritis (OA) obtained during surgery of the knee joint showed marked LRP4 expression in the early stages of OA, which then decreased with cartilage degeneration, whereas Agrin was consistently increased with cartilage degeneration. In normal human articular chondrocytes (NHACs), mild cyclic tensile strain (CTS) (0.5 Hz, 5% elongation, 2 h) increased the expression of LRP4 and aggrecan (ACAN), while intense CTS (0.5 Hz, 10% elongation, 6 h) increased the expression of Agrin without affecting LRP4 expression. Treatment with recombinant human (rh) Agrin downregulated the mRNA expression of LRP4 and ACAN, but upregulated the expression of LRP5/6, SRY-box transcription factor 9 (SOX9), Runt-related transcription factor 2 (RUNX2), and a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4). Immunocytochemistry and Western blot analysis showed that rhAgrin treatment upregulated the expression of β-catenin and SOX9. Agrin knockdown by siAGRN transfection partially reduced the nuclear protein expression of β-catenin, which was increased with intense CTS. LRP4 knockdown by siLRP4 transfection increased the expression of LRP5/6, SOX9, RUNX2, ADAMTS-4, and Agrin. These results suggested that intense CTS increases the expression of Agrin, which might interfere with the role of LRP4 in the inhibition of LRP5/6 and their downstream β-catenin signaling, leading to cartilage degeneration.

DOI： 10.3390/ijms26031007

The use of lateral wedge insoles delays osteoarthritis progression and improves clinical outcomes in medial meniscus posterior root repair. International journal

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

Journal of experimental orthopaedics 12 ( 1 ) e70141 2025.1

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

PURPOSE: The purpose of this retrospective study was to evaluate the efficacy of using a lateral wedge insole (LWI) during the first 3 months after medial meniscus posterior root (MMPR) repair. METHODS: Overall, 179 patients were categorized into LWI use (LWI group, 90 patients) and nonuse (control group, 89 patients) groups. Patients in the LWI group were instructed to wear an LWI from the initiation of load bearing up to 3 months postoperatively. Medial meniscus extrusion (MME) was evaluated preoperatively and 1 year postoperatively, Kellgren-Lawrence (KL) grade and clinical scores were evaluated preoperatively and 2 years postoperatively, and second-look arthroscopic meniscal healing scores were evaluated at 1 year postoperatively. RESULTS: The proportion of patients with KL grade progression at 2 years postoperatively was significantly lower in the LWI group than in the control group (23.3% vs. 39.3%; p = 0.024). Change in the MME at 1 year postoperatively was significantly smaller in the LWI group than in the control group (1.1 ± 1.2 vs. 1.6 ± 1.4 mm; p = 0.042). The Lysholm score (p = 0.003) and Knee Injury and Osteoarthritis Outcome Scores-sport and recreation function (p = 0.027) at 2 years postoperatively were significantly superior in the LWI group than in the control group. The arthroscopic meniscal healing score after 1 year was not significantly different between the LWI and control groups (total score, 7.6 ± 1.1 vs. 7.4 ± 1.3 points; p = 0.732). The anteroposterior width of the repaired posterior root at 1 year second-look evaluation was significantly broader in the LWI group than in the control group (7.7 ± 1.6 vs. 6.9 ± 1.6 mm; p = 0.001). CONCLUSIONS: The use of LWI is an effective way to delay postoperative osteoarthritis progression and improve clinical outcomes after MMPR repair. LEVEL OF EVIDENCE: Level III.

DOI： 10.1002/jeo2.70141

The Three-Class Annotation Method Improves the AI Detection of Early-Stage Osteosarcoma on Plain Radiographs: A Novel Approach for Rare Cancer Diagnosis. International journal

Joe Hasei, Ryuichi Nakahara, Yujiro Otsuka, Yusuke Nakamura, Kunihiro Ikuta, Shuhei Osaki, Tamiya Hironari, Shinji Miwa, Shusa Ohshika, Shunji Nishimura, Naoaki Kahara, Aki Yoshida, Tomohiro Fujiwara, Eiji Nakata, Toshiyuki Kunisada, Toshifumi Ozaki

Cancers 17 ( 1 ) 2024.12

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

Background/Objectives: Developing high-performance artificial intelligence (AI) models for rare diseases is challenging owing to limited data availability. This study aimed to evaluate whether a novel three-class annotation method for preparing training data could enhance AI model performance in detecting osteosarcoma on plain radiographs compared to conventional single-class annotation. Methods: We developed two annotation methods for the same dataset of 468 osteosarcoma X-rays and 378 normal radiographs: a conventional single-class annotation (1C model) and a novel three-class annotation method (3C model) that separately labeled intramedullary, cortical, and extramedullary tumor components. Both models used identical U-Net-based architectures, differing only in their annotation approaches. Performance was evaluated using an independent validation dataset. Results: Although both models achieved high diagnostic accuracy (AUC: 0.99 vs. 0.98), the 3C model demonstrated superior operational characteristics. At a standardized cutoff value of 0.2, the 3C model maintained balanced performance (sensitivity: 93.28%, specificity: 92.21%), whereas the 1C model showed compromised specificity (83.58%) despite high sensitivity (98.88%). Notably, at the 25th percentile threshold, both models showed identical false-negative rates despite significantly different cutoff values (3C: 0.661 vs. 1C: 0.985), indicating the ability of the 3C model to maintain diagnostic accuracy at substantially lower thresholds. Conclusions: This study demonstrated that anatomically informed three-class annotation can enhance AI model performance for rare disease detection without requiring additional training data. The improved stability at lower thresholds suggests that thoughtful annotation strategies can optimize the AI model training, particularly in contexts where training data are limited.

DOI： 10.3390/cancers17010029

Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up. International journal

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

Archives of orthopaedic and trauma surgery 145 ( 1 ) 64 - 64 2024.12

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

INTRODUCTION: The outcomes of unicompartmental knee arthroplasty (UKA) in the presence and absence of medial meniscus posterior root tears (MMPRTs) have not been compared. This study compared the characteristics and clinical outcomes of patients undergoing UKA with and without MMPRTs. MATERIALS AND METHODS: This study analyzed 68 patients. The presence or absence of MMPRTs was evaluated using preoperative magnetic resonance imaging. Patient characteristics, clinical scores before surgery and at the final evaluation, and imaging findings were compared between patients with and without MMPRTs. Multiple regression analysis was conducted on postoperative visual analog scale (VAS)-pain scores. RESULTS: MMPRTs were present in 64.7% (44/68) of patients. Patients with MMPRTs were significantly younger (67.8 ± 8.2 vs. 75.0 ± 7.1 years, p < 0.001) and had a shorter duration from the development of symptoms to the time of surgery than those without (6.8 ± 8.4 vs. 36.1 ± 38.9 months, p < 0.001). Component placement or lower-limb alignment did not significantly differ between the groups. Preoperative clinical scores were not significantly different between the groups; however, patients with MMPRTs showed significantly better postoperative VAS-pain scores than those without (10.0 ± 9.0 vs. 28.2 ± 26.0 points, p = 0.026). Multiple regression analysis of postoperative VAS-pain scores revealed the significant effect of duration from the development of symptoms to the time of surgery (p = 0.038). CONCLUSIONS: Patients undergoing UKA with MMPRTs were younger with less radiographic osteoarthritic changes compared to those without MMPRTs, and their postoperative VAS-pain scores were significantly superior. The duration from the development of symptoms to the time of surgery significantly influenced postoperative pain in patients undergoing UKA.

DOI： 10.1007/s00402-024-05671-1

Association between lower limb muscle strength and musculoskeletal ambulation disability symptom complex in patients with medial meniscus posterior root tears. International journal

Mikao Fukuba, Koki Kawada, Yuki Okazaki, Yoshimi Katayama, Masanori Hamada, Toshifumi Ozaki, Takayuki Furumatsu

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 35 ( 1 ) 40 - 40 2024.12

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

PURPOSE: In this study, we aimed to evaluate the changes in and the relationship between lower limb muscle strength and physical function before and after medial meniscus posterior root (MMPR) repair. METHODS: Thirty-three patients who underwent MMPR repair were evaluated. Pain was evaluated with the numerical rating scale (NRS), and knee flexor/extensor muscle strength was assessed using a handheld dynamometer. Physical function was evaluated using a timed up and go (TUG) test. The NRS, knee flexor/extensor muscle strength, and TUG were compared preoperatively and 1 year postoperatively using the Wilcoxon signed-rank test. The correlation of patient characteristics, NRS score, knee flexor/extensor muscle strength, and preoperative TUG with the postoperative TUG was analyzed using Spearman's correlation coefficient. RESULTS: NRS (3.5 ± 2.1 to 0.1 ± 0.5 points), knee flexor strength (111.9 ± 50.2 to 146.7 ± 51.5 Nm), knee extensor strength (181.9 ± 92.8 to 256.9 ± 107.1 Nm), and TUG (12.3 ± 5.7 to 9.2 ± 2.2 s) all improved significantly from preoperatively to 1 year postoperatively (p < 0.001). The postoperative TUG was negatively correlated with the preoperative TUG (r = 0.578, p < 0.001), preoperative knee flexor muscle strength (r = - 0.355, p = 0.042), preoperative knee extensor muscle strength (r = - 0.437, p = 0.010), and postoperative knee extensor muscle strength (r = - 0.478, p = 0.004). CONCLUSION: In patients undergoing MMPR repair, surgery and rehabilitation significantly improve lower limb muscle strength and physical function. There was a significant correlation between lower limb muscle strength and TUG, and further strengthening of the lower limb muscles from the preoperative level is desirable to improve patients' physical function further. LEVEL OF EVIDENCE: IV.

DOI： 10.1007/s00590-024-04158-4

関節リウマチ患者における内側半月板後根断裂に対する半月版修復術 ―関節温存をめざして

川田紘己, 古松毅之, 横山裕介, 岡﨑勇樹, 田村優典, 尾﨑敏文

臨床雑誌整形外科 75 ( 13 ) 1307 - 1311 2024.12

The role of C1orf50 in breast cancer progression and prognosis.

Yusuke Otani, Atsushi Tanaka, Masaki Maekawa, Tirso Peña, Anna Rogachevskaya, Teruhiko Ando, Takuto Itano, Haruyoshi Katayama, Eiji Nakata, Toshifumi Ozaki, Shinichi Toyooka, Hiroyoshi Doihara, Michael H Roehrl, Atsushi Fujimura

Breast cancer (Tokyo, Japan) 2024.11

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

Although the prognosis of breast cancer has significantly improved compared to other types of cancer, there are still some patients who expire due to recurrence or metastasis. Therefore, it is necessary to develop a method to identify patients with poor prognosis at the early stages of cancer. In the process of discovering new prognostic markers from genes of unknown function, we found that the expression of C1orf50 determines the prognosis of breast cancer patients, especially for those with Luminal A breast cancer. This study aims to elucidate the molecular role of C1orf50 in breast cancer progression. Bioinformatic analyses of the breast cancer dataset of TCGA, and in vitro analyses, reveal the molecular pathways influenced by C1orf50 expression. C1orf50 knockdown suppressed the cell cycle of breast cancer cells and weakened their ability to maintain the undifferentiated state and self-renewal capacity. Interestingly, upregulation of C1orf50 increased sensitivity to CDK4/6 inhibition. In addition, C1orf50 was found to be more abundant in breast cancer cells than in normal breast epithelium, suggesting C1orf50's involvement in breast cancer pathogenesis. Furthermore, the mRNA expression level of C1orf50 was positively correlated with the expression of PD-L1 and its related factors. These results suggest that C1orf50 promotes breast cancer progression through cell cycle upregulation, maintenance of cancer stemness, and immune evasion mechanisms. Our study uncovers the biological functions of C1orf50 in Luminal breast cancer progression, a finding not previously reported in any type of cancer.

DOI： 10.1007/s12282-024-01653-8

Transtibial pullout repair improved short-term clinical outcomes in patients with oblique medial meniscus posterior root tear comparable to radial root tear. International journal

Naohiro Higashihara, Takayuki Furumatsu, Yuki Okazaki, Yusuke Yokoyama, Masanori Tamura, Koki Kawada, Tsubasa Hasegawa, Toshiki Kohara, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 35 ( 1 ) 30 - 30 2024.11

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

PURPOSE: Medial meniscus (MM) posterior root tears (PRT) can lead to excessive knee loading and unsatisfactory clinical outcomes after non-operative treatment or meniscectomy. Although favourable clinical outcomes after MM posterior root (PR) repair have been reported, no study has specifically investigated the outcomes of different types of MMPRT. This study aimed to compare the clinical outcomes of patients with complete radial and oblique MMPRT following MMPR repair. METHODS: Forty patients who had undergone MMPR repair were retrospectively investigated. Patients with type 2 (20 knees) and 4 MMPRT (20 knees) were included in this study. The MMPRT type was classified according to the LaPrade classification. Plain radiographs, magnetic resonance images, arthroscopic findings, and pre- and postoperative clinical outcomes were evaluated. RESULTS: At 1 year postoperatively, clinical outcomes notably improved in patients with type 2 and 4 MMPRT. No significant differences were observed in any of the evaluations between these patients, both before and after the surgery. CONCLUSION: Patients with type 2 and type 4 MMPRT exhibited significantly improved clinical outcomes. MMPR repair is beneficial in treating type 2 and type 4 MMPRT. LEVEL OF EVIDENCE: IV.

DOI： 10.1007/s00590-024-04137-9

Genotypes and phenotypes of neurofibromatosis type 1 patients in Japan: A Hereditary Tumor Cohort Study. International journal

Mashu Futagawa, Tetsuya Okazaki, Eiji Nakata, Chika Fukano, Risa Osumi, Fumino Kato, Yusaku Urakawa, Hideki Yamamoto, Toshifumi Ozaki, Akira Hirasawa

Human genome variation 11 ( 1 ) 42 - 42 2024.11

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

Neurofibromatosis type 1 (NF1) presents with a broad spectrum of clinical manifestations, including an increased risk of tumor development and hypertension. Comprehensive data on genotype‒phenotype correlations in patients with NF1 are limited. Therefore, in this study, we aimed to elucidate the detailed genetic and clinical characteristics of NF1 in a hereditary tumor cohort. We performed sequencing and copy number assays in a clinical laboratory and analyzed the clinical data of 44 patients with suspected NF1. Germline pathogenic variants were detected in 36 patients (81.8%), and 20.7% of the variants were novel. Notably, 40.0% of adult patients presented with malignancies; female breast cancer occurred in 20.0% of patients, which was a higher rate than that previously reported. Hypertension was observed in 30.6% of the adult patients, with one patient experiencing sudden death and another developing pheochromocytoma. Three patients with large deletions in NF1 exhibited prominent cutaneous, skeletal, and neurological manifestations. These results highlight the importance of regular surveillance, particularly for patients with malignancies and hypertension. Our findings provide valuable insights for genetic counseling and clinical management, highlighting the multiple health risks associated with NF1 and the need for comprehensive and multidisciplinary care.

DOI： 10.1038/s41439-024-00299-4

Assessment of All-Inside Sutures to the Posteromedial Capsule in Medial Meniscus Posterior Root Repair: Findings From a Retrospective Three-Dimensional Magnetic Resonance Imaging Study

Yuki Okazaki, Takayuki Furumatsu, Keisuke Kintaka, Yusuke Yokoyama, Masanori Tamura, Koki Kawada, Tsubasa Hasegawa, Toshifumi Ozaki

Cureus 2024.11

Curve Progression After the Termination of Bracing for Adolescent Idiopathic Scoliosis: Usefulness of Combining the Proximal Femur Maturity Index (PFMI) and Risser Staging

Hisakazu Shitozawa, Haruo Misawa, Koji Uotani, Tomoko Tetsunaga, Kensuke Shinohara, Yoshiaki Oda, Masataka Ueda, Ryo Takatori, Kazutaka Yamashita, Toshifumi Ozaki

Cureus 2024.11

Study protocol: randomized phase III trial of neo-adjuvant and adjuvant chemotherapy vs. immediate surgery and adjuvant chemotherapy for localized soft tissue sarcoma: Japan Clinical Oncology Group study JCOG2102 (NACLESS). International journal

Yuki Funauchi, Satoshi Tsukushi, Hiroaki Hiraga, Akio Sakamoto, Toshiyuki Kunisada, Akihito Nagano, Koji Hiraoka, Kazutaka Kikuta, Tsukasa Yonemoto, Keisuke Ae, Akira Kawai, Makoto Endo, Yusuke Sano, Ryunosuke Machida, Tetsuya Sekita, Haruhiko Fukuda, Yoshinao Oda, Toshifumi Ozaki, Kazuhiro Tanaka

Japanese journal of clinical oncology 2024.11

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

The optimal timing of surgery and the number of courses of perioperative chemotherapy for high-risk soft tissue sarcoma patients are still controversial. Tumour growth during neoadjuvant chemotherapy led to limb amputation in some patients. This study aims to confirm the non-inferiority of surgery and three courses of adjuvant chemotherapy with adriamycin (30 mg/m2, days 1 and 2) plus ifosfamide (2 g/m2, days 1-5) compared with our standard treatment of three courses of neoadjuvant chemotherapy and surgery followed by two courses of adjuvant chemotherapy with adriamycin plus ifosfamide for localized high-risk soft tissue sarcoma patients. This is a multi-center, two-arm, open-label, randomized phase III trial. The primary aim is to confirm the non-inferiority in overall survival (margin: hazard ratio of 1.61). This is the first randomized controlled trial to compare neoadjuvant chemotherapy and immediate surgery for soft tissue sarcoma. This trial was initiated on 16 November 2022 and registered with the Japan Clinical Trials Registry (jRCTs031220446).

DOI： 10.1093/jjco/hyae160

Accuracy of Cup Alignment in Total Hip Arthroplasty: A Comparison Between Portable Navigation and Goniometer. International journal

Tomonori Tetsunaga, Tomoko Tetsunaga, Kazuki Yamada, Takashi Koura, Tomohiro Inoue, Ryuichiro Okuda, Yasutaka Masada, Sho Muguruma, Yuki Okazaki, Toshifumi Ozaki

Cureus 16 ( 11 ) e74176 2024.11

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

Background Navigation systems, including portable navigation systems, used for total hip arthroplasty (THA) are useful for achieving higher cup alignment accuracy. NAVBIT, a newly available portable navigation system, uses a unique registration method, the table tilt registration. However, its accuracy is unclear. This retrospective study aimed to investigate whether THA with a portable navigation system in the lateral position with the flip technique is more accurate than THA with a cup goniometer in the supine or lateral positions. Methodology This study included 96 consecutive patients (77 women, 19 men) who underwent primary cementless THA using either a portable navigation system in the lateral position with the flip technique or a cup goniometer in the supine or lateral positions. The average age of the patients was 66.8 years (range = 29-91) and the average body mass index was 24.6 kg/m2 (range = 17.5-39.9). The accuracy of cup orientation was compared among the three groups. Results The absolute values of the difference in cup inclination and anteversion with the NAVBIT (2.1 ± 1.7°, 2.0 ± 1.4°) were smaller than that with the cup goniometer in the supine (3.4 ± 2.4°, 3.4 ± 2.2°) and lateral decubitus positions (3.4 ± 2.5°, 5.0 ± 3.5°). Overall, 91%, 64.5%, and 56.3% were within 5° of the target angles in the navigation, supine goniometer, and lateral goniometer groups, respectively. Conclusions The accuracy of cup alignment with the portable navigation system using the flip technique was significantly higher than that with the cup goniometer in the supine and lateral decubitus positions.

DOI： 10.7759/cureus.74176

Quadriceps muscle strength of the affected limb in medial meniscus posterior root tears is negatively correlated with the progression of postoperative medial joint space narrowing. International journal

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

Journal of experimental orthopaedics 11 ( 4 ) e70057 2024.10

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

PURPOSE: The effect of quadriceps muscle strength on medial joint space (MJS) narrowing after repair for medial meniscus (MM) posterior root tears (MMPRTs) has not yet been determined. This study aimed to evaluate the effect of preoperative and postoperative quadriceps muscle strength on the change in MJS (ΔMJS) in MMPRTs. METHODS: Thirty patients who underwent pullout repair for MMPRTs were retrospectively evaluated. The MJS width using fixed-flexion view radiographs, MM extrusion (MME) using magnetic resonance imaging, quadriceps muscle strength using the Locomo Scan-II and clinical scores were measured and compared preoperatively and 1 year postoperatively. Correlations between the ΔMJS, change in MME (ΔMME), and preoperative and postoperative quadriceps muscle strength were evaluated using Spearman's rank correlation coefficient. RESULTS: MJS narrowing and MME progressed significantly at 1 year postoperatively (p < 0.001). Quadriceps muscle strength in MMPRT knees and all clinical scores significantly improved at 1 year postoperatively (p < 0.001). ΔMJS and ΔMME showed a significant positive correlation (0.50 ± 0.70 and 1.22 ± 0.92 mm, respectively; r = 0.516, p = 0.004). Both preoperative and postoperative quadriceps muscle strength in MMPRT knees showed significant negative correlations with ΔMJS (preoperative: r = -0.529, p = 0.003; postoperative: r = -0.477, p = 0.008) and ΔMME (preoperative: r = -0.431, p = 0.018; postoperative: r = -0.443, p = 0.014). CONCLUSIONS: In pullout repair for MMPRTs, preoperative and postoperative quadriceps muscle strength in MMPRT knees was negatively correlated with the progression of MJS narrowing and MME. Rehabilitation with a focus on quadriceps muscle strengthening, including preoperative rehabilitation, may delay knee-osteoarthritis progression after pullout repair for MMPRTs. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1002/jeo2.70057

Fast rehabilitation does not worsen clinical, radiological, and arthroscopic outcomes after medial meniscus posterior root repair: A retrospective comparative study. International journal

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

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology 38 29 - 35 2024.10

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

BACKGROUND/OBJECTIVE: The main surgical treatment for medial meniscus posterior root tear (MMPRT) has shifted from meniscectomy to meniscus repair; however, there is no clear consensus regarding the optimal postoperative management strategy after MMPRT repair. This study aimed to perform a comparative analysis of patients who received conventional rehabilitation or fast rehabilitation following MMPRT repair. METHODS: The current retrospective cohort study compared clinical, radiological, and arthroscopic outcomes after conventional rehabilitation (group A, January 2020 to April 2020, 24 patients) with those after fast rehabilitation (group B, May 2020 to August 2020, 24 patients) in patients who underwent pullout repair for MMPRT. Partial weight-bearing and range of motion exercises were allowed 2 weeks postoperatively in group A and 1 week postoperatively in group B. In patients with an average weight of approximately 60 kg, full weight bearing was allowed 4 weeks postoperatively in group A and 3 weeks postoperatively in group B. RESULTS: At 12 months postoperatively, the clinical scores, including International Knee Documentation Committee and Japanese Knee Injury and Osteoarthritis Outcome Score, significantly improved in both groups (p < 0.01). Although meniscus healing was achieved in both groups, medial meniscus extrusion significantly progressed by 0.9 mm in group A and 0.8 mm in group B (p < 0.01, compared with preoperative extrusion). There were no significant differences in clinical scores, arthroscopic meniscal healing status, or medial meniscus extrusion progression on magnetic resonance images between the groups. CONCLUSION: A fast rehabilitation protocol can be safely implemented without compromising patient outcomes after pullout repair for MMPRT.

DOI： 10.1016/j.asmart.2024.09.003

がん遺伝子パネルによるfusion gene同定の診断的意義

中田英二, 國定俊之, 板野拓人, 片山晴喜, 安藤輝彦, 藤原智洋, 尾崎敏文

中国・四国整形外科学会雑誌 36 ( 3 ) 361 - 361 2024.10

脛骨高原骨折の治療戦略脛骨近位端骨折に対するプレート固定単顆骨折および両顆骨折に対する使用の基本と応用

依光正則, 望月雄介, 長谷川翼, 奥田龍一郎, 安藤輝彦, 尾崎敏文

中部日本整形外科災害外科学会雑誌 68 ( 秋季学会 ) 59 - 59 2024.10

AIとメタバースを用いた骨軟部腫瘍診療革命早期診断から患者支援まで

長谷井嬢, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本癌治療学会学術集会抄録集 62回 PSP14 - 4 2024.10

Factors Affecting Dynamic Postural Control Ability in Adolescent Idiopathic Scoliosis.

Ryoko Yamawaki, Yoshiaki Oda, Shuhei Yamane, Koji Uotani, Haruo Misawa, Yoshimi Katayama, Masanori Hamada, Toshifumi Ozaki

Acta medica Okayama 78 ( 5 ) 357 - 362 2024.10

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

Research on postural control in patients with adolescent idiopathic scoliosis (AIS) has focused on static postural control, with few studies assessing dynamic postural control. We aimed to identify factors affecting index of postural stability (IPS), a dynamic postural control parameter, in patients with AIS. The participants comprised 50 female patients with AIS. We measured the IPS using stabilometry to evaluate dynamic postural control ability. We investigated age of the participants, major curve position (thoracic or thoracolumbar/lumbar), Cobb angle, and coronal balance. We then assessed the relationships between stabilometry parameters and other variables. IPS was analyzed with a linear regression model. Coronal balance, major curve position, and age each correlated with dynamic postural control ability. The Cobb angle showed no correlation with any of the parameters. Our results offer new insights into the assessment of postural control in patients with AIS.

DOI： 10.18926/AMO/67655

小児・AYA世代がんのゲノム医療小児・AYA世代の肉腫におけるゲノム医療の意義

中田英二, 遠西大輔, 二宮貴一朗, 冨田秀太, 山本英喜, 岡崎哲也, 平沢晃, 豊岡伸一, 尾崎敏文

日本癌治療学会学術集会抄録集 62回 OSY16 - 2 2024.10

The use of biologic disease-modifying antirheumatic drugs does not increase surgical site infection or delayed wound healing after orthopaedic surgeries for rheumatoid arthritis International journal

Yohei Kiso, Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Ryuichi Nakahara, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki

Modern Rheumatology 2024.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objective

To investigate the effect of the use of biologic disease-modifying antirheumatic drugs (bDMARDs) on surgical site infection (SSI) and delayed wound healing (DWH) in rheumatoid arthritis (RA) patients undergoing orthopaedic surgery.

Methods

We retrospectively reviewed the records of 965 elective orthopaedic procedures undertaken in RA patients. The incidences of SSI and DWH were compared between the bDMARDs user and nonuser groups. Subsequently, univariate and multivariate logistic regression analyses were performed to evaluate risk factors for SSI and DWH after propensity score matching. The incidence of postoperative flare-up was also examined.

Results

In 965 procedures, SSI and DWH were identified in 12 and 28 cases, respectively. SSI and DWH were identified in 3 and 17 of 414 procedures treated with bDMARDs, respectively. Flare-up occurred in 21 cases. Propensity score matching identified 315 cases in both groups, with no significant difference in incidence between the two groups. No risk factors for SSI were identified, whereas age, diabetes mellitus, foot and ankle surgery, and a history of musculoskeletal-related infection were identified as risk factors for DWH.

Conclusion

The use of bDMARDs was not associated with an increased incidence of SSI or DWH, with the incidence of flare-up being relatively low.

DOI： 10.1093/mr/roae089

Identification of ENO-1 positive extracellular vesicles as a circulating biomarker for monitoring of Ewing sarcoma. International journal

Koji Uotani, Tomohiro Fujiwara, Koji Ueda, Aki Yoshida, Shintaro Iwata, Takuya Morita, Masahiro Kiyono, Toshiyuki Kunisada, Ken Takeda, Joe Hasei, Yusuke Yoshioka, Takahiro Ochiya, Toshifumi Ozaki

Cancer science 2024.9

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

The lack of circulating biomarkers for tumor monitoring is a major problem in Ewing sarcoma management. The development of methods for accurate tumor monitoring is required, considering the high recurrence rate of drug-resistant Ewing sarcoma. Here, we describe a sensitive analytical technique for tumor monitoring of Ewing sarcoma by detecting circulating extracellular vesicles secreted from Ewing sarcoma cells. Proteomic analysis of Ewing sarcoma cell-derived extracellular vesicles identified 564 proteins prominently observed in extracellular vesicles from three Ewing sarcoma cell lines. Among these, CD99, SLC1A5, and ENO-1 were identified on extracellular vesicles purified from sera of patients with Ewing sarcoma before treatment but not on extracellular vesicles from those after treatment and healthy individuals. Notably, not only Ewing sarcoma-derived extracellular vesicles but also Ewing sarcoma cells demonstrated proteomic expression of CD99 and ENO-1 on their surface membranes. ENO-1+CD63+ extracellular vesicle detection was reduced after tumor resection while both CD99+CD63+ and ENO-1+CD63+ extracellular vesicles were detected in serum from Ewing sarcoma-bearing mice. Finally, the accuracy of liquid biopsy targeting these candidates was assessed using extracellular vesicles from the sera of patients with Ewing sarcoma. Elevated ENO-1+CD81+ extracellular vesicles in the serum of patients before treatments distinguished patients with Ewing sarcoma from healthy individuals with an area under the curve value of 0.92 (P < 0.001) and reflected the tumor burden in patients with Ewing sarcoma during multidisciplinary treatments. Collectively, circulating ENO-1+CD81+ extracellular vesicle detection could represent a novel tool for tumor monitoring of Ewing sarcoma.

DOI： 10.1111/cas.16343

p53-armed oncolytic virotherapy induces abscopal effect in osteosarcoma by promoting immunogenic cell death. International journal

Koji Demiya, Hiroshi Tazawa, Hiroya Kondo, Miho Kure, Yusuke Mochizuki, Tadashi Komatsubara, Aki Yoshida, Koji Uotani, Joe Hasei, Tomohiro Fujiwara, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Molecular therapy. Oncology 32 ( 3 ) 200845 - 200845 2024.9

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

Osteosarcoma (OS), the most frequent primary malignant tumor of bone in children and adolescents, is refractory to immune checkpoint inhibitors due to its poor antitumor immune response. Chemotherapy and virotherapy induce immunogenic cell death (ICD) and antitumor immune responses, leading to the abscopal effect in untreated tumors. We previously demonstrated the antitumor activity of the telomerase-specific replication-competent oncolytic adenoviruses OBP-301 and p53-armed OBP-702 in human OS cells. Here, we show the therapeutic potential of chemotherapeutic drugs (doxorubicin, cisplatin) and telomerase-specific oncolytic adenoviruses (OBP-301, p53-armed OBP-702) to induce ICD in human OS cells (U2OS, MNNG/HOS, SaOS-2) and murine OS cells (NHOS). OBP-702 induced more profound ICD via the secretion of adenosine triphosphate (ATP) and high-mobility group box protein B1 (HMGB1) compared with chemotherapy and OBP-301 in human OS cells. Murine NHOS cells were also more sensitive to OBP-702 than OBP-301. Subcutaneous NHOS tumor models demonstrated that intratumoral injection of OBP-702 significantly increased the tumor infiltration of cytotoxic CD8+ T cells and induced the abscopal effect against non-treated tumors compared with OBP-301. Our results suggest that OBP-702 is a promising antitumor reagent to induce ICD with secretion of ATP and HMGB1 and the abscopal effect against OS.

DOI： 10.1016/j.omton.2024.200845

High-quality expert annotations enhance artificial intelligence model accuracy for osteosarcoma X-ray diagnosis. International journal

Joe Hasei, Ryuichi Nakahara, Yujiro Otsuka, Yusuke Nakamura, Tamiya Hironari, Naoaki Kahara, Shinji Miwa, Shusa Ohshika, Shunji Nishimura, Kunihiro Ikuta, Shuhei Osaki, Aki Yoshida, Tomohiro Fujiwara, Eiji Nakata, Toshiyuki Kunisada, Toshifumi Ozaki

Cancer science 2024.9

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

Primary malignant bone tumors, such as osteosarcoma, significantly affect the pediatric and young adult populations, necessitating early diagnosis for effective treatment. This study developed a high-performance artificial intelligence (AI) model to detect osteosarcoma from X-ray images using highly accurate annotated data to improve diagnostic accuracy at initial consultations. Traditional models trained on unannotated data have shown limited success, with sensitivities of approximately 60%-70%. In contrast, our model used a data-centric approach with annotations from an experienced oncologist, achieving a sensitivity of 95.52%, specificity of 96.21%, and an area under the curve of 0.989. The model was trained using 468 X-ray images from 31 osteosarcoma cases and 378 normal knee images with a strategy to maximize diversity in the training and validation sets. It was evaluated using an independent dataset of 268 osteosarcoma and 554 normal knee images to ensure generalizability. By applying the U-net architecture and advanced image processing techniques such as renormalization and affine transformations, our AI model outperforms existing models, reducing missed diagnoses and enhancing patient outcomes by facilitating earlier treatment. This study highlights the importance of high-quality training data and advocates a shift towards data-centric AI development in medical imaging. These insights can be extended to other rare cancers and diseases, underscoring the potential of AI in transforming diagnostic processes in oncology. The integration of this AI model into clinical workflows could support physicians in early osteosarcoma detection, thereby improving diagnostic accuracy and patient care.

DOI： 10.1111/cas.16330

p53-armed oncolytic virotherapy induces abscopal effect in osteosarcoma by promoting immunogenic cell death

Koji Demiya, Hiroshi Tazawa, Hiroya Kondo, Miho Kure, Yusuke Mochizuki, Tadashi Komatsubara, Aki Yoshida, Koji Uotani, Joe Hasei, Tomohiro Fujiwara, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Molecular Therapy: Oncology 32 ( 3 ) 200845 - 200845 2024.9

悪性末梢神経鞘腫瘍における悪性化を促進する新規メカニズム転写因子PRRX1とTOP2Aのタンパク質間相互作用の発見

たき平将太, 山田大祐, 大曽根達則, 高尾知佳, 板野拓人, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 98 ( 8 ) S1957 - S1957 2024.9

大腿骨変形癒合に対して一期的矯正骨切り術(三次元骨切り術)を行った1例

奥田龍一郎, 山田和希, 鉄永智紀, 小浦卓, 井上智博, 尾崎敏文

整形・災害外科 67 ( 10 ) 1291 - 1295 2024.9

Language：Japanese Publisher：金原出版(株)

＜文献概要＞右片側肥大症の男子で,6cmの脚長差に対して10歳時に左大腿骨延長術を施行し,7cm延長した。10ヵ月で抜釘したが骨延長部が骨折した。保存療法にて骨癒合を得たが,内反屈曲変形が残存したため,14歳時に一期的矯正骨切り術(三次元骨切り術)を施行した。3Dプリンターにより分割造形した骨モデルを用いて術前計画し,正確な手術が可能であった。術後9ヵ月で骨癒合を認め,スポーツ活動も可能となった。

関節軟骨におけるLRP4とAGRINの発現調節因子とβ-catenin signalへの影響

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

日本整形外科学会雑誌 98 ( 8 ) S1934 - S1934 2024.9

肉腫におけるゲノム医療の進歩 C-CATデータを用いた肉腫のゲノム解析

中田英二, 遠西大輔, 二宮貴一朗, 山本英喜, 冨田秀太, 国定俊之, 藤原智洋, 二川摩周, 平沢晃, 豊岡伸一, 尾崎敏文

日本整形外科学会雑誌 98 ( 8 ) S1727 - S1727 2024.9

Insomnia among patients with chronic pain: A retrospective study

Masataka Ueda, Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Ryo Takatori, Hisakazu Shitozawa, Koji Uotani, Kennsuke Shinohara, Yoshiaki Oda, Toshifumi Ozaki

Medicine 103 ( 32 ) e39113 - e39113 2024.8

Publishing type：Research paper (scientific journal) Publisher：Ovid Technologies (Wolters Kluwer Health)

Insomnia can coexist with chronic pain and is a major cause of rapidly increasing medical expenses. However, insomnia has not been fully evaluated in patients with chronic pain. This retrospective study aimed to identify the risk factors for insomnia in patients with chronic non-cancer pain. A total of 301 patients with chronic non-cancer pain were enrolled. Patients with the Athens insomnia scale scores ≥ 6 and < 6 were classified into insomnia (+) and insomnia (−) groups, respectively. All patients completed self-report questionnaires as part of their chronic pain treatment approach. Univariate and multivariate analyses were performed to predict insomnia. We found that 219 of 301 (72.8%) patients met the AIS criteria for insomnia. Significant differences were depicted between patients with and without insomnia in terms of body mass index, numeric rating scale, pain catastrophizing scale, hospital anxiety, and depression scale (HADS), pain disability assessment scale, EuroQol 5 dimension (EQ5D), and pain self-efficacy questionnaire. Multiple regression analysis identified the numeric rating scale, HADS, and EQ5D scores as factors related to insomnia in patients with chronic non-cancer pain. Anxiety, depression, and disability were associated with a greater tendency toward insomnia. HADS and EQ5D scores are useful screening tools for preventing insomnia in patients with chronic non-cancer pain.

DOI： 10.1097/md.0000000000039113

Navigation-Guided C-arm-Free Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Comparative Study of Cage Orientation and Screw Insertion Accuracy Against the Conventional C-arm-Assisted Technique. International journal

Koji Uotani, Masato Tanaka, Chetan Kumawat, Sharvari Gunjotikar, Yoshiaki Oda, Kensuke Shinohara, Tadashi Komatsubara, Shinya Arataki, Toshifumi Ozaki

Cureus 16 ( 8 ) e66070 2024.8

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

BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a widely utilized technique in spine surgery. This study compares the efficacy and safety of MIS-TLIF performed with traditional C-arm fluoroscopy and C-arm-free O-arm navigation. To the best of our knowledge, our study is the first to compare cage positioning between C-arm-free and C-arm techniques for MIS- TLIF. METHODS: A retrospective, comparative analysis was conducted on 43 patients undergoing MIS-TLIF. The group was divided based on the utilization of C-arm fluoroscopy or C-arm-free O-arm navigation. Key parameters analyzed included cage orientation, screw insertion accuracy, operative efficiency, and postoperative recovery. Radiographic measurements were used to assess surgical precision and perioperative complications were documented. RESULTS: The study encompassed 43 patients, with no significant differences in demographic characteristics between the two groups. Surgical time and blood loss were comparable between C-arm-free and C-arm groups. O-arm navigation significantly reduced pedicle screw misplacement (p=0.024). Cage positioning differed between groups (p=0.0063): O-arm cages were mostly mid-center, while C-arm cages were more anterior-center. Such differences in the cage location did not cause any impact on clinical outcome. No significant differences were observed in postoperative complications (screw loosenings, dural tears, surgical site infections) between groups. The Oswestry Disability Index scores at the final follow-up showed no significant difference between the O-arm and C-arm groups, indicating similar levels of postoperative disability. CONCLUSION: Despite the clinically insignificant difference in cage placement between C-arm-free and C-arm dependent, C-arm-free MIS-TLIF significantly improves screw placement accuracy and reduces radiation exposure to operating stuff. This suggests its potential as a valuable tool for safer and more precise spinal fusion surgery.

DOI： 10.7759/cureus.66070

Efficacy and safety of denosumab de‑escalation in giant cell tumor of bone. International journal

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

Oncology letters 28 ( 2 ) 387 - 387 2024.8

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

Giant cell tumor of bone (GCTB) is a locally aggressive intermediate bone tumor. Denosumab has shown effectiveness in GCTB treatment; however, the benefits of denosumab de-escalation for unresectable GCTB have not been well discussed. The present study investigated the efficacy and safety of denosumab de-escalation for GCTB. The medical records of 9 patients with unresectable GCTB or resectable GCTB not eligible for resection, who received de-escalated denosumab treatment at Okayama University Hospital (Okayama, Japan) between April 2014 and December 2021, were retrospectively reviewed. The denosumab treatment interval was gradually extended to every 8, 12 and 24 weeks. The radiographic changes and clinical symptoms during standard and de-escalated denosumab therapy were assessed. The denosumab interval was de-escalated after a median of 12 months of a standard 4-weekly treatment. Imaging showed that the re-ossification of osteolytic lesions obtained with the 4-weekly treatment were sustained with 8- and 12-weekly treatments. The extraskeletal masses reduced significantly with standard treatment, while tumor reduction was sustained during de-escalated treatment. During the 24-weekly treatment, 2 patients remained stable, while 2 patients developed local recurrence. The clinical symptoms improved significantly with standard treatment and remained improved during de-escalated treatment. There were severe adverse events including osteonecrosis of the jaw (2 patients), atypical femoral fracture (1 patient) and malignant transformation of GCTB (1 patient). In conclusion, 12-weekly de-escalated denosumab treatment showed clinical benefits as a maintenance treatment in patients with unresectable GCTB, in addition to sustained stable tumor control and improved clinical symptoms with standard treatment. A 24-weekly treatment can also be administered, with careful attention paid to detecting local recurrence.

DOI： 10.3892/ol.2024.14520

どうする?関節包切開股関節鏡手術における関節包切開

山田和希, 鉄永智紀, 小浦卓, 井上智博, 奥田龍一郎, 尾崎敏文

Hip Joint 50 ( 2 ) 7 - 7 2024.8

寛骨臼骨折術後障害に対するTHAの治療成績

奥田龍一郎, 鉄永智紀, 山田和希, 小浦卓, 井上智博, 尾崎敏文

Hip Joint 50 ( 1 ) 542 - 545 2024.8

Efficacy and safety of nivolumab monotherapy in patients with unresectable clear cell sarcoma and alveolar soft part sarcoma (OSCAR Trial/NCCH1510). International journal

Tadaaki Nishikawa, Shigeki Kakunaga, Kenji Tamura, Masashi Ando, Toshifumi Ozaki, Akira Kawai, Takafumi Ueda, Mamiko Kawasaki, Sawako Tomatsuri, Nobuko Okamura, Masahisa Kamikura, Akinobu Hamada, Akihiko Yoshida, Akihiro Hirakawa, Taro Shibata, Kenichi Nakamura, Kan Yonemori

Cancer 2024.7

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

BACKGROUND: Clear cell sarcoma (CCS) and alveolar soft part sarcoma (ASPS) are rare, and standard systemic therapy is not established except for sunitinib in ASPS. It is known that CCS and ASPS have a common biological feature of melanoma and Xp11.2/TFE3 translocation renal cell carcinoma, and immune-checkpoint inhibitors (ICIs) are effective in these tumors. The authors conducted a phase 2 trial to evaluate the efficacy and safety of nivolumab for CCS and ASPS. METHODS: The number of patients expected to be enrolled was 15-25 and was determined based on the Bayesian design. The primary end point was the confirmed objective response rate (ORR) according to the central review and the secondary end points included ORR, progression-free survival (PFS), overall survival (OS), and safety. RESULTS: A total of 26 patients (CCS, 12; ASPS, 14) were enrolled. Efficacy and safety were analyzed on 25 and 26 patients, respectively. The minimum number of responses required for a positive conclusion regarding the efficacy was four. However, only one patient (4.0%) with ASPS had a partial response. Complete response, stable disease, progression disease, and not evaluable were 0%, 60%, 32%, and 4.0%, respectively. Adverse events of grade 3 or 4 occurred in 57.7% (15 of 26). The median PFS was 4.9 months (95% confidence interval [CI], 3.7-8.6 months) and the median OS was 15.8 months (95% CI, 8.2-not reached). CONCLUSIONS: The primary end point of the ORR was not met for CCS and ASPS on the central review. Further studies are needed to evaluate ICIs in patients with ASPS.

DOI： 10.1002/cncr.35483

Utilizing the Metaverse to Provide Innovative Psychosocial Support for Pediatric, Adolescent, and Young Adult Patients with Rare Cancer

Joe Hasei, Hisashi Ishida, Hideki Katayama, Naoko Maeda, Akihito Nagano, Motoharu Ochi, Masako Okamura, Shintaro Iwata, Kunihiro Ikuta, Shinichirou Yoshida, Tomohiro Fujiwara, Eiji Nakata, Ryuichi Nakahara, Toshiyuki Kunisada, Toshifumi Ozaki

Cancers 16 ( 15 ) 2617 - 2617 2024.7

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

This study investigated the potential of the metaverse in providing psychological support for pediatric and AYA cancer patients, with a focus on those with rare cancers. The research involved ten cancer patients and survivors from four distinct regions in Japan, who participated in metaverse sessions using customizable avatars, facilitating interactions across geographical and temporal barriers. Surveys and qualitative feedback were collected to assess the psychosocial impact of the intervention. The results demonstrated that the metaverse enabled patients to connect with peers, share experiences, and receive emotional support. The anonymity provided by avatars helped reduce appearance-related anxiety and stigma associated with cancer treatment. A case study of a 19-year-old male with spinal Ewing’s sarcoma highlighted the profound emotional relief fostered by metaverse interactions. The findings suggest that integrating virtual spaces into healthcare models can effectively address the unique needs of pediatric and AYA cancer patients, offering a transformative approach to delivering psychosocial support and fostering a global patient community. This innovative intervention has the potential to revolutionize patient care in the digital age.

DOI： 10.3390/cancers16152617

A Characteristic Magnetic Resonance Imaging Finding to Identify Morton Neuroma: The Slug Sign

Masahiro Horita, Kenta Saiga, Tomohiro Fujiwara, Eiji Nakata, Toshifumi Ozaki

Foot & Ankle Orthopaedics 9 ( 3 ) 2024.7

Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Background:

Morton neuroma is a common cause of forefoot pain and sensory disturbances, but it is difficult to identify on magnetic resonance imaging (MRI). The aim of this study was to verify the usefulness of a characteristic MRI finding (slug sign) for identifying Morton neuroma and to clarify the relationship between excised neuroma characteristics and preoperative MRI findings.

Methods:

Twenty-two web spaces were retrospectively assessed from the second and third intermetatarsal spaces of 11 feet of 10 patients (7 women and 3 men, aged average 59.5 years) who underwent surgical excision of Morton neuroma between 2017 and 2022. Asymptomatic web spaces were used as control. Neuromas with 2 branches of the plantar digital nerves on axial T1-weighted MRI (MRI-T1WI) were considered the slug sign. We investigated the preoperative presence of the slug sign in Morton neuroma and asymptomatic control web spaces. We also investigated the relationship between the maximum transverse diameter of the excised specimen and that estimated on coronal MRI-T1WI.

Results:

A total of 15 Morton neuromas were excised and assessed. The slug signs were present in 10 intermetatarsal spaces in 15 web spaces with Morton neuroma whereas the sign was found in 1 intermetatarsal space in 7 asymptomatic web spaces. The sensitivity and specificity for the slug sign to diagnose Morton neuroma was 66.7% and 85.7%, respectively. The positive and negative predictive values were 90.9% and 54.5%, respectively. The mean maximum transverse diameter of excised neuromas was 4.7 mm. The mean maximum transverse diameter of neuromas on coronal MRI-T1WI was 3.4 mm. A significant positive correlation was found between the maximum transverse diameters of excised specimens and diameters estimated on coronal MRI-T1WI ( r = 0.799, P < .001).

Conclusion:

The slug sign may be a useful indicator of Morton neuroma on MRI to confirm nerve involvement after bifurcation.

Level of Evidence:

Level IV, retrospective series.

DOI： 10.1177/24730114241268285

Other Link： https://journals.sagepub.com/doi/full-xml/10.1177/24730114241268285

悪性末梢神経鞘腫瘍におけるPRRX1とTOP2Aの相互作用による悪性化メカニズムの新規解明

たき平将太, 中田英二, 板野拓人, 藤原智洋, 国定俊之, 大曽根達則, 山田大祐, 高尾知佳, 宝田剛志, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1529 - S1529 2024.6

非典型的な好酸性細胞とDDIT3遺伝子再構成を示す粘液型脂肪肉腫の1例

綾田善行, 中田英二, 尾崎敏文, 山元英崇

日本整形外科学会雑誌 98 ( 6 ) S1551 - S1551 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

骨・軟部肉腫に対する腫瘍用人工関節再建後に深部感染を起こした症例の検討

片山晴喜, 中田英二, 黒住尭巨, 板野拓人, 近藤彩奈, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1623 - S1623 2024.6

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 2024.6

骨肉腫患者における肉腫専門病院受診前因子の実態調査生命予後の改善を目指す"4-week ruleの提言"

黒住尭巨, 藤原智洋, 板野拓人, 片山晴喜, 近藤彩奈, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1607 - S1607 2024.6

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 2024.6

若年者に対する人工関節手術:克服すべき困難と成功の秘訣若年例に対する人工肘関節置換術

那須義久, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 43 ( 2 ) 213 - 213 2024.6

下腿軟部肉腫切除術後の機能低下リスク因子の検討

板野拓人, 中田英二, 片山晴喜, 近藤彩奈, 黒住尭巨, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1517 - S1517 2024.6

周術期がん患者のロコモ併存率の検討

堅山佳美, 中田英二, 明崎禎輝, 近藤彩奈, 濱田全紀, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1501 - S1501 2024.6

軟部肉腫患者における治療前全身状態と運動機能は生存予後および合併症の発生に関連するか

近藤彩奈, 藤原智洋, 堅山佳美, 黒住尭巨, 板野拓人, 片山晴喜, 濱田全紀, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1501 - S1501 2024.6

骨・軟部腫瘍の基礎研究の新展開骨・軟部肉腫に対する全身治療および局所治療の新規治療モダリティーの創出を目指して

藤原智洋, 近藤彩奈, 福岡史朗, 吉田晶, 大島修吾, 黒住尭巨, 板野拓人, 片山晴喜, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 6 ) S1463 - S1463 2024.6

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 2024.6

大腿骨転子下骨折の順行性髄内釘術後回旋変形に関する多施設共同研究

奥田龍一郎, 依光正則, 福岡史朗, 山田和希, 上原健敬, 山川泰明, 鉄永智紀, 松本俊之, 尾崎敏文

骨折 46 ( Suppl. ) S135 - S135 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.6

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 2024.5

Publishing type：Research paper (scientific journal) Publisher：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

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

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

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2024.5

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

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

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

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

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2024.5

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

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

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 2024.5

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

Shin Tanaka, Eiji Nakata, Toshifumi Ozaki, Shinichi Toyooka

Journal of cardiothoracic surgery 19 ( 1 ) 245 - 245 2024.4

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

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

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

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

BMC musculoskeletal disorders 25 ( 1 ) 251 - 251 2024.4

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

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

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 2024.4

THAのカップ打ち込み時に迷走神経反射を生じた1例

奥田龍一郎, 山田和希, 鉄永智紀, 小浦卓, 井上智博, 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 ) 110 - 110 2024.4

診断に難渋した強直性脊椎炎の女子高校生の1例

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 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 ) 244 - 244 2024.4

診断に難渋した強直性脊椎炎の女子高校生の1例

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 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 ) 244 - 244 2024.4

腫瘍切除後に遠位脛腓間固定を行った多発性外骨腫の1例

井上智博, 鉄永智紀, 赤澤啓史, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

中国・四国整形外科学会雑誌 36 ( 1 ) 165 - 165 2024.4

腫瘍 ⑵ 骨転移の画像診断

中田英二, 國定俊之, 藤原智洋, 尾﨑敏文

関節外科 43 143 - 154 2024.4

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 2024.4

岡山大学病院における脊椎内視鏡補助下手術の現状

魚谷弘二, 鉄永倫子, 篠原健介, 小田孔明, 尾崎敏文

中国・四国整形外科学会雑誌 36 ( 1 ) 173 - 173 2024.4

骨接合術を行い椎間可動域の温存を試みたが椎体間固定術を要した椎弓根骨折の1例

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 志渡澤央和, 植田昌敬, 鷹取亮, 尾崎敏文

中国・四国整形外科学会雑誌 36 ( 1 ) 93 - 97 2024.4

胸椎後縦靱帯骨化症に対する脊椎手術後に生じた下肢麻痺に対してステロイド大量療法にて改善が得られた一例

篠原健介, 魚谷弘二, 小田孔明, 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 ) 246 - 246 2024.4

【小児整形外科up-to-date】体幹疾患環軸関節回旋位固定環軸関節回旋位固定のup-to-date

魚谷弘二, 鉄永倫子, 篠原健介, 小田孔明, 尾崎敏文

別冊整形外科 ( 85 ) 154 - 159 2024.4

Language：Japanese Publisher：(株)南江堂

＜文献概要＞はじめに環軸関節回旋位固定(atlantoaxial rotatory fixation:AARF)は,主に上気道炎などの後に斜頸を起こし受診することが多い.急性期に適切な治療を行えば経過は一般的に良好であるが,斜頸の見過ごしや治療の適切なタイミングを逃すと環軸関節の癒合や変形をきたし,難治例となる.難治例となった場合には外科的介入が主に行われてきたが,近年ではhalo fixationを数ヵ月行うことで環軸関節のリモデリングを狙うという治療戦略もとられている.本稿ではAARFに関する知識の整理と最近の知見をまとめ,報告する.

Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J04037&link_issn=&doc_id=20240517380031&doc_link_id=10.15106%2Fj_besei85_154&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_besei85_154&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

広範な脊椎強直を伴うL5/S1シャルコー脊椎の1例

植田昌敬, 小田孔明, 魚谷弘二, 鉄永倫子, 篠原健介, 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 ) 119 - 119 2024.4

腰椎脊柱管内硬膜外嚢腫により右下肢痛を呈した一例

坂田慎一郎, 篠原健介, 魚谷弘二, 小田孔明, 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 ) 122 - 122 2024.4

p53-Armed Oncolytic Virotherapy Improves Radiosensitivity in Soft-Tissue Sarcoma by Suppressing BCL-xL Expression.

Tadashi Komatsubara, Hiroshi Tazawa, Joe Hasei, Toshinori Omori, Kazuhisa Sugiu, Yusuke Mochizuki, Koji Demiya, Aki Yoshida, Tomohiro Fujiwara, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Acta medica Okayama 78 ( 2 ) 151 - 161 2024.4

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

Soft-tissue sarcoma (STS) is a heterogeneous group of rare tumors originating predominantly from the embryonic mesoderm. Despite the development of combined modalities including radiotherapy, STSs are often refractory to antitumor modalities, and novel strategies that improve the prognosis of STS patients are needed. We previously demonstrated the therapeutic potential of two telomerase-specific replication-competent oncolytic adenoviruses, OBP-301 and tumor suppressor p53-armed OBP-702, in human STS cells. Here, we demonstrate in vitro and in vivo antitumor effects of OBP-702 in combination with ionizing radiation against human STS cells (HT1080, NMS-2, SYO-1). OBP-702 synergistically promoted the antitumor effect of ionizing radiation in the STS cells by suppressing the expression of B-cell lymphoma-X large (BCL-xL) and enhancing ionizing radiation-induced apoptosis. The in vivo experiments demonstrated that this combination therapy significantly suppressed STS tumors' growth. Our results suggest that OBP-702 is a promising antitumor reagent for promoting the radiosensitivity of STS tumors.

DOI： 10.18926/AMO/66924

Longitudinal changes in medial meniscus extrusion and clinical outcomes following pullout repair for medial meniscus posterior root tears: a 3-year evaluation. International journal

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

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2024.3

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

PURPOSE: We aimed to evaluate the longitudinal changes in medial meniscus extrusion (MME) and clinical scores at multiple time points up to 3 years after pullout repair for medial meniscus posterior root tears (MMPRTs). METHODS: This retrospective case series study included 64 patients who underwent pullout repair for MMPRTs and four MRI evaluations (preoperatively and at 3 months, 1 year, and 3 years postoperatively). MME was measured during the same time points. Clinical scores were assessed four times: preoperatively and at 1, 2, and 3 years postoperatively. Additionally, a multivariate analysis was performed on the change in MME (ΔMME) from the preoperative measurement point to 3 years postoperatively. RESULTS: The ΔMME per month from the preoperative measurement point to 3 months postoperatively, from 3 months to 1 year postoperatively, and from 1 to 3 years postoperatively were 0.30, 0.05, and 0.01 mm/month, respectively. All clinical scores significantly improved 3 years postoperatively (p < 0.001). In a multiple regression analysis for ΔMME from the preoperative measurement point to 3 years postoperatively, sex significantly affected the outcome (p = 0.039). CONCLUSION: Following pullout repair for MMPRTs with well-aligned lower extremities, although MME progression could not be entirely prevented, the rate of progression decreased over time, and clinical scores improved. In particular, MME progressed markedly during the first 3 months postoperatively. Additionally, sex had a significant influence on MME progression, suggesting that males may be able to expand the indications of pullout repair for MMPRTs.

DOI： 10.1007/s00590-024-03889-8

An osteoinductive surface by adhesive bone morphogenetic protein-2 prepared using the bioorthogonal approach for tight binding of titanium with bone. Reviewed International journal

Xueli Ren, Hironori Tsuji, Takahiko Uchino, Izumi Kono, Takashi Isoshima, Akimitsu Okamoto, Noriyuki Nagaoka, Toshifumi Ozaki, Akihiro Matsukawa, Hideyuki Miyatake, Yoshihiro Ito

Journal of materials chemistry. B 12 ( 12 ) 3006 - 3014 2024.3

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

Inorganic biomaterials are used in various orthopedic and dental implants. Nevertheless, they cause clinical issues such as loosening of implants and patient morbidity. Therefore, inspired by mussel adhesive proteins, we aimed to design an adhesive and dimer-forming highly active bone morphogenetic protein-2 (BMP-2) using bioorthogonal chemistry, in which recombinant DNA technology was combined with enzymatic modifications, to achieve long-term osseointegration with titanium. The prepared BMP-2 exhibited substantially higher binding activity than wild-type BMP-2, while the adhered BMP-2 was more active than soluble BMP-2. Therefore, the adhesive BMP-2 was immobilized onto titanium wires and screws and implanted into rat bones, and long-term osteogenesis was evaluated. Adhesive BMP-2 promoted the mechanical binding of titanium to bones, enabling efficient bone regeneration and effective stabilization of implants. Thus, such adhesive biosignaling proteins can be used in regenerative medicine.

DOI： 10.1039/d3tb02838k

Signal intensity of repaired posterior roots after transtibial pullout repair for medial meniscus posterior root tears in stable knees: Magnetic resonance imaging evaluations at 3 years postoperatively. Reviewed International journal

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

The Knee 48 22 - 29 2024.3

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

BACKGROUND: Only a few studies have assessed signal intensity after pullout repair for medial meniscus posterior root (MMPR) tears (MMPRTs) based on mid-term magnetic resonance imaging (MRI) evaluations. Therefore, this study aimed to assess the quantitative signal intensity of repaired posterior roots over time, up to 3 years postoperatively, and the related factors. METHODS: This study included 36 patients who underwent pullout repair for MMPRTs and MRI examinations using the same MRI system. The signal intensity of the repaired posterior roots was quantitatively evaluated using the signal-to-noise quotient (SNQ). Medial meniscus extrusion (MME), the SNQ for MMPR, and clinical scores were assessed over 3 years postoperatively. RESULTS: MME progressed over time until 3 years postoperatively, and its progression during this period was 1.61 ± 1.44 mm. The SNQ for MMPR decreased over time until 3 years postoperatively, and the change in the SNQ from 3 months to 3 years postoperatively (ΔSNQ) was 2.69 ± 1.69. All clinical scores significantly improved (p < 0.001). ΔSNQ was significantly correlated with body weight (correlation coefficient = -0.424, p = 0.010) and body mass index (correlation coefficient = -0.330, p = 0.050). However, ΔSNQ was not significantly correlated with preoperative or postoperative clinical scores. CONCLUSION: After pullout repair for MMPRTs, MME progressed to 3 years postoperatively. However, the signal intensity of the repaired posterior roots decreased, and clinical scores improved over time until 3 years postoperatively. Patient weight and body mass index were significantly correlated with the reduced signal intensity of the repaired posterior roots, suggesting that weight assessment in patients with MMPRTs is crucial. LEVEL OF EVIDENCE: IV.

DOI： 10.1016/j.knee.2024.02.014

PRRX1-TOP2A interaction is a malignancy-promoting factor in human malignant peripheral nerve sheath tumours

Shota Takihira, Daisuke Yamada, Tatsunori Osone, Tomoka Takao, Masakiyo Sakaguchi, Michiyuki Hakozaki, Takuto Itano, Eiji Nakata, Tomohiro Fujiwara, Toshiyuki Kunisada, Toshifumi Ozaki, Takeshi Takarada

British Journal of Cancer 130 ( 9 ) 1493 - 1504 2024.3

Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Background

Paired related-homeobox 1 (PRRX1) is a transcription factor in the regulation of developmental morphogenetic processes. There is growing evidence that PRRX1 is highly expressed in certain cancers and is critically involved in human survival prognosis. However, the molecular mechanism of PRRX1 in cancer malignancy remains to be elucidated.

Methods

PRRX1 expression in human Malignant peripheral nerve sheath tumours (MPNSTs) samples was detected immunohistochemically to evaluate survival prognosis. MPNST models with PRRX1 gene knockdown or overexpression were constructed in vitro and the phenotype of MPNST cells was evaluated. Bioinformatics analysis combined with co-immunoprecipitation, mass spectrometry, RNA-seq and structural prediction were used to identify proteins interacting with PRRX1.

Results

High expression of PRRX1 was associated with a poor prognosis for MPNST. PRRX1 knockdown suppressed the tumorigenic potential. PRRX1 overexpressed in MPNSTs directly interacts with topoisomerase 2 A (TOP2A) to cooperatively promote epithelial-mesenchymal transition and increase expression of tumour malignancy-related gene sets including mTORC1, KRAS and SRC signalling pathways. Etoposide, a TOP2A inhibitor used in the treatment of MPNST, may exhibit one of its anticancer effects by inhibiting the PRRX1–TOP2A interaction.

Conclusion

Targeting the PRRX1–TOP2A interaction in malignant tumours with high PRRX1 expression might provide a novel tumour-selective therapeutic strategy.

DOI： 10.1038/s41416-024-02632-8

Other Link： https://www.nature.com/articles/s41416-024-02632-8

非転位型の橈骨遠位端骨折において骨折部位,Lister結節形状は長母指伸筋腱断裂に影響する

斎藤太一, 近藤秀則, 古谷友希, 中道亮, 島村安則, 西田圭一郎, 今谷潤也, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S781 - S781 2024.3

PIEZO1ノックアウトが腱に及ぼす影響の解析

中道亮, 藤井雄太, 尾崎敏文, 淺原弘嗣

日本整形外科学会雑誌 98 ( 2 ) S74 - S74 2024.3

内側半月板後根部分断裂に対する経脛骨pullout修復術完全断裂との比較

田村優典, 古松毅之, 横山裕介, 東原直裕, 川田紘己, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1298 - S1298 2024.3

内側半月板後根断裂に対するプルアウト修復術後の経時的MRI画像評価

川田紘己, 古松毅之, 横山裕介, 東原直裕, 田村優典, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1256 - S1256 2024.3

当院におけるGS cupとAnasta cupのX線学的短期成績の比較

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

日本整形外科学会雑誌 98 ( 2 ) S265 - S265 2024.3

側臥位と仰臥位における大腿神経・大腿動脈の解剖学的位置変化側臥位・仰臥位CTでの検討

奥田龍一郎, 鉄永智紀, 山田和希, 小浦卓, 井上智博, 宇川諒, 小松原将, 生熊久敬, 松本俊之, 川崎啓介, 尾崎敏文

日本整形外科学会雑誌 98 ( 2 ) S450 - S450 2024.3

THAにおける大腿神経麻痺を避けるための解剖学的研究単純X線で大腿神経の位置を予測できるか

小浦卓, 鉄永智紀, 山田和希, 井上智博, 奥田龍一郎, 尾崎敏文

日本整形外科学会雑誌 98 ( 2 ) S450 - S450 2024.3

股関節鏡手術におけるアンカーの骨外穿孔に関与する因子の検討

山田和希, 鉄永智紀, 小浦卓, 井上智博, 奥田龍一郎, 遠藤裕介, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S989 - S989 2024.3

ポータブルナビゲーションとアライメントガイドのカップアライメント精度の比較検討

鉄永智紀, 山田和希, 小浦卓, 井上智博, 奥田龍一郎, 六車将, 廣瀬一樹, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1346 - S1346 2024.3

悪性末梢神経鞘腫瘍において転写因子PRRX1はTOP2Aと相互作用し悪性化を促進させる

たき平将太, 中田英二, 板野拓人, 藤原智洋, 国定俊之, 大曽根達則, 山田大祐, 高尾知佳, 宝田剛志, 尾崎敏文

日本整形外科学会雑誌 98 ( 2 ) S76 - S76 2024.3

肉腫におけるがん遺伝子パネルによるfusion gene同定の意義

中田英二, 藤原智洋, 板野拓人, 片山晴喜, 二川摩周, 山元英崇, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1246 - S1246 2024.3

AIとDXを用いた骨・軟部腫瘍診療への新たな挑戦

長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1371 - S1371 2024.3

悪性末梢神経鞘腫瘍において転写因子PRRX1はTOP2Aと相互作用し悪性化を促進させる

たき平将太, 中田英二, 板野拓人, 藤原智洋, 国定俊之, 大曽根達則, 山田大祐, 高尾知佳, 宝田剛志, 尾崎敏文

日本整形外科学会雑誌 98 ( 2 ) S76 - S76 2024.3

セメントレス人工股関節全置換術の術後疼痛の検討

廣瀬一樹, 鉄永智紀, 山田和希, 小浦卓, 井上智博, 尾﨑敏文

日本人工関節学会誌 54 155 - 156 2024.3

術中ナビゲーションの屈曲ギャップの内外側差は TKA 術後短期の臨床スコアと相関する

田村優典、横山裕介、古松毅之、東原直裕、川田紘己、宮澤慎一、尾﨑敏文

日本人工関節学会誌 54 103 - 104 2024.3

人工股関節周囲感染に対する持続局所抗菌薬灌流（CLAP）の短期成績

奥田龍一郎、鉄永智紀、山田和希、小浦卓、井上智博、尾﨑敏文

日本人工関節学会誌 54 33 - 34 2024.3

病態の進行した内側半月板後根断裂に対して人工膝関節単顆置換術は良い適応となる

川田紘己, 古松毅之, 横山裕介, 東原直裕, 田村優典, 尾﨑敏文

日本人工関節学会誌 54 287 - 288 2024.3

リウマチ性疾患の手術(上肢) 関節リウマチに対するMCP人工関節置換術と手関節・手指伸筋腱同時手術症例の検討

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

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 532 - 532 2024.3

3DCTを用いた載距突起への至適なscrew設置の解剖学的ランドマークの検討

福岡史朗, 依光正則, 志水紀之, 浪花崇一, 上原健敬, 尾崎敏文

骨折 46 ( 2 ) 520 - 523 2024.3

Language：Japanese Publisher：(一社)日本骨折治療学会

【背景】踵骨関節内骨折の治療において,後距踵関節の解剖学的整復とその安定化が重要である.しかし,距骨下関節の特殊な解剖学的特徴のためスクリューの至適な位置への挿入には明確な指標がない.【目的】3DCTを用いて載距突起へのスクリューの挿入点および挿入角度を検討すること.【対象】当院整形外科にてCT撮像を受けた男性10足,女性10足の計20足のCTデータを使用した.骨折の既往,変形性足関節症を認める場合は除外した.【方法】画像再構築にFujifilm社製SYNAPSE VINCENTワークステーションを用いて,踵骨と第1,5中足骨頭を含む平面と踵骨外側壁を基準面とした.3DCTおよびMPR画像上で直径3.5mm円柱を仮想スクリューとして作成し,挿入点から載距突起中心に挿入可能な角度を測定した.挿入点は後距踵関節面を3等分し,関節面に対して垂直方向に5mm,10mm,15mmで3点プロットし計9点とした.各々の挿入点から冠状面(+:頭側,-:足底側)における挿入角度と水平面(+:足趾側,-:踵骨隆起側)における挿入角度範囲を測定した.【結果】挿入点が前方かつ後距踵関節からの距離が大きいほど,冠状面における挿入角度が大きくなる傾向があった.また水平面における挿入角度は挿入点が後方かつ後距踵関節からの距離が大きいほど前方に傾斜させる必要がある.【結論】載距突起への至適なスクリュー挿入点と角度を検討した.(著者抄録)

自動統計のための日本語大規模言語モデルを用いたカルテサマリーからの情報抽出

中原龍一, 西田圭一郎, 那須義久, 原田遼三, 浪花崇一, 志水紀之, 市川千夏, 高橋康, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 714 - 714 2024.3

リウマチ性疾患の手術(上肢) AVANTAとINTEGRAを用いたMCP人工指関節置換術の術後短期成績の比較

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

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 532 - 532 2024.3

人工膝関節置換術後の関節リウマチ患者における生物学的製剤・JAK阻害剤使用とD-dimer値の関係

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

日本リウマチ学会総会・学術集会プログラム・抄録集 68回 846 - 846 2024.3

脛骨骨折に対する異なるアプローチ間での髄内釘の挿入位置の検討

福岡史朗, 依光正則, 浪花崇一, 上原健敬, 尾崎敏文, 寺田忠司

骨折 46 ( 2 ) 503 - 505 2024.3

Language：Japanese Publisher：(一社)日本骨折治療学会

【背景】脛骨骨幹部骨折に対する髄内釘手術は標準的な治療法であり,近年では膝を半伸展位で挿入するアプローチ方法,なかでもlateral parapatellar approachの使用頻度が増加している.【目的】脛骨骨幹部骨折に対する髄内釘固定において,膝屈曲位で行うinfra-patellar approach(IP群)と半伸展位で行うlateral parapatellar approach(LP群)のアプローチ間で,髄内釘挿入位置の比較を行うこと.【研究デザイン】過去起点コホート研究.【設定】大学附属病院と関連病院の2施設.【対象】2012～21年において,脛骨骨幹部骨折に対し髄内釘固定を行った71例(男性51名,女性20名)を対象とした.使用インプラントや免荷期間は各施設の判断に委ねた.【方法】脛骨骨幹部骨折に対する2つのアプローチ間での髄内釘挿入位置を比較検討した.正面像で外側顆間隆起から挿入位置までの距離(AP)を測定し,挿入点が外側顆間隆起より内側の場合を+とし,外側の場合を-とした.側面像では関節面前縁から挿入位置までの距離(LM)を測定し,関節面前縁より前方を+,後方を-とした.統計学的検討はFisher正確検定,Mann-Whitney U検定,Spearmanの順位相関係数を用いた.【結果】IP群42例,LP群29例であり,髄内釘挿入点(AP,LM)において2群間で有意差を認めた(IP群:AP5.5mm,LM2.3mm,LP群:AP2.4mm,LM4.7mm,p<0.05).またLP群におけるAPと髄内釘径(r=0.449,p<0.05),LMと年齢(r=0.49,p<0.01)において中等度の正の相関関係を認めた.【結論】脛骨骨幹部骨折における髄内釘固定において,手術アプローチと髄内釘挿入位置の検討を行った.(著者抄録)

Angiosomeを考慮した下肢手術のアプローチ法-骨折を中心に- Angiosomeを考慮した膝関節周囲外傷に対するアプローチ法

依光正則, 上原健敬, 志水紀之, 浪花崇一, 福岡史郎, 尾崎敏文

日本整形外科学会雑誌 98 ( 2 ) S144 - S144 2024.3

PFMI(proximal femur maturity index)は側彎症装具終了時期判断に有用か

志渡澤央和, 三澤治夫, 小田孔明, 鉄永倫子, 篠原健介, 魚谷弘二, 植田昌敬, 鷹取亮, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1043 - S1043 2024.3

思春期特発性側彎症に対する脊椎後方固定術において術中低体温は術中出血量を増加させるのか

篠原健介, 三澤治夫, 魚谷弘二, 小田孔明, 鉄永倫子, 志渡澤央和, 植田昌敬, 鷹取亮, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1078 - S1078 2024.3

AIを用いた単純CTによる転移性脊髄圧迫のスクリーニングの可能性

魚谷弘二, 鷹取亮, 植田昌敬, 志渡澤央和, 小田孔明, 篠原健介, 鉄永倫子, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S749 - S749 2024.3

外傷性頸髄損傷患者の転院後の経過調査

植田昌敬, 三澤治夫, 魚谷弘二, 鉄永倫子, 篠原健介, 小田孔明, 志渡澤央和, 鷹取亮, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S968 - S968 2024.3

椎体に浸潤した非小細胞肺癌に対する根治的手術の治療成績

鷹取亮, 三澤治夫, 鉄永倫子, 魚谷弘二, 篠原健介, 小田孔明, 志渡澤央和, 植田昌敬, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1294 - S1294 2024.3

術前がん患者の各ロコモ度テストにおける関連因子

堅山佳美, 中田英二, 近藤彩奈, 濱田全紀, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1321 - S1321 2024.3

股関節鏡手術におけるアンカーの骨外穿孔に関与する因子の検討

山田和希, 鉄永智紀, 小浦卓, 井上智博, 奥田龍一郎, 遠藤裕介, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S989 - S989 2024.3

ポータブルナビゲーションとアライメントガイドのカップアライメント精度の比較検討

鉄永智紀, 山田和希, 小浦卓, 井上智博, 奥田龍一郎, 六車将, 廣瀬一樹, 尾崎敏文

日本整形外科学会雑誌 98 ( 3 ) S1346 - S1346 2024.3

術前化学療法を受ける進行食道癌患者の身体活動と腫瘍退縮との関連探索的研究

池田朋大, 野間和広, 小沼正典, 濱田全紀, 尾崎敏文

日本がん・リンパ浮腫理学療法学会誌 1 ( Suppl.1 ) 24 - 24 2024.3

Role of catecholamine synthases in the maintenance of cancer stem-like cells in malignant peripheral nerve sheath tumors. International journal

Haruyoshi Katayama, Atsushi Fujimura, Rongsheng Huang, Yusuke Otani, Takuto Itano, Tomohiro Fujiwara, Toshiyuki Kunisada, Eiji Nakata, Toshifumi Ozaki

Cancer science 115 ( 3 ) 871 - 882 2024.3

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

Malignant peripheral nerve sheath tumors (MPNSTs) are malignant tumors that are derived from Schwann cell lineage around peripheral nerves. As in many other cancer types, cancer stem cells (CSCs) have been identified in MPNSTs, and they are considered the cause of treatment resistance, recurrence, and metastasis. As an element defining the cancer stemness of MPNSTs, we previously reported a molecular mechanism by which exogenous adrenaline activates a core cancer stemness factor, YAP/TAZ, through β2 adrenoceptor (ADRB2). In this study, we found that MPNST cells express catecholamine synthases and that these enzymes are essential for maintaining cancer stemness, such as the ability to self-renew and maintain an undifferentiated state. Through gene knockdown and inhibition of these enzymes, we confirmed that catecholamines are indeed synthesized in MPNST cells. The results confirmed that catecholamine synthase knockdown in MPNST cells reduces the activity of YAP/TAZ. These data suggest that a mechanism of YAP/TAZ activation by de novo synthesized adrenaline, as well as exogenous adrenaline, may exist in the maintenance of cancer stemness of MPNST cells. This mechanism not only helps to understand the pathology of MPNST, but could also contribute to the development of therapeutic strategies for MPNST.

DOI： 10.1111/cas.16077

Prognostic evaluation of the Ki-67 labeling system in histological grading of non-small round cell sarcoma: a supplementary analysis of a randomized controlled trial, JCOG1306

Shintaro Sugita, Kazuhiro Tanaka, Yoshinao Oda, Takayuki Nojima, Naomi Konishi, Ryunosuke Machida, Ryosuke Kita, Haruhiko Fukuda, Toshifumi Ozaki, Tadashi Hasegawa

Japanese Journal of Clinical Oncology 54 ( 6 ) 675 - 680 2024.2

Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Background

Soft tissue sarcoma (STS) has various histological types and is rare, making it difficult to evaluate the malignancy of each histological type. Thus, comprehensive histological grading is most important in the pathological examination of STS. The Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grading system is most commonly used in daily pathological analysis of STS. Among the FNCLCC grading system parameters, mitotic count is a key morphological parameter reflecting the proliferative activity of tumor cells, although its reproducibility may be lacking. Here, we compared the prognostic utility of the conventional and modified FNCLCC grading systems in JCOG1306.

Methods

We analyzed 140 patients with non-small round cell sarcoma. We performed Ki-67 immunostaining using open biopsy specimens before preoperative chemotherapy in all patients. We assessed histological grade in individual cases by conventional FNCLCC grading (tumor differentiation, mitotic count, and necrosis) and modified FNCLCC grading using the Ki-67 labeling index instead of mitotic count. We conducted univariable and multivariable Cox regression analyses to investigate the influence of grade on overall survival.

Results

In univariable analysis, prognosis was worse for patients with conventional FNCLCC Grade 3 tumors compared with Grade 1 or 2 tumors (hazard ratio [HR] 4.21, 95% confidence interval [CI] 1.47–12.05, P = 0.008). Moreover, prognosis was worse in patients with modified FNCLCC Grade 3 tumors compared with Grade 1 or 2 tumors (HR 4.90, 95% CI 1.64–14.65, P = 0.004). In multivariable analysis including both conventional and modified FNCLCC grading, the modified grading more strongly affected overall survival (HR 6.70, 95% CI 1.58–28.40, P = 0.010).

Conclusions

The modified FNCLCC grading system was superior to the conventional system in predicting the prognosis of patients with non-small round cell sarcoma according to this supplementary analysis of data from the randomized controlled trial JCOG1306.

DOI： 10.1093/jjco/hyae020

Superior outcomes of pullout repairs for medial meniscus posterior root tears in partial tear compared to complete radial tear. International journal

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

Knee surgery & related research 36 ( 1 ) 8 - 8 2024.2

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

PURPOSE: To reveal the outcomes of partial medial meniscus posterior root tears following transtibial pullout repair compared with the outcomes of complete radial meniscus posterior root tears. MATERIALS AND METHODS: We retrospectively evaluated 15 consecutive patients (male/female, 5/10; average age, 64.4 years) who underwent transtibial pullout repair for partial medial meniscus posterior root tears and compared their results with those of 86 consecutive patients who underwent the same surgery for complete medial meniscus posterior root tears. All patients underwent second-look arthroscopy on average 1 year postoperatively, and a semi-quantitative meniscal healing score (anteroposterior width, stability, and synovial coverage, total 10 points) was evaluated. Medial meniscus extrusion was evaluated preoperatively and at second-look arthroscopy. RESULTS: Postoperative clinical scores were not significantly different in the short term. However, second-look arthroscopy revealed a significant difference in repaired meniscal stability (partial tear; 3.3 points, complete tear; 2.3 points, p < 0.001) and total meniscal healing scores (partial tear; 8.3 points, complete tear; 7.1 points, p < 0.001). Medial meniscus extrusion progression was significantly different (partial tear; 0.4 mm, complete tear; 1.0 mm, p < 0.001). CONCLUSION: Partial medial meniscus posterior root tears showed better meniscal healing and less medial meniscus extrusion progression following pullout repair than complete medial meniscus posterior root tears.

DOI： 10.1186/s43019-023-00206-1

Longitudinal changes in medial knee joint space narrowing after medial meniscus posterior root repair: A 2-year follow-up study. Reviewed International journal

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

The Knee 47 92 - 101 2024.2

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

BACKGROUND: Despite good clinical results, repair of medial meniscus (MM) posterior root tears (MMPRTs) may not completely prevent knee osteoarthritis progression. This study evaluated changes in the medial joint space (MJS) during the first and second years after repair, compared to narrowing in the contralateral knee, using fixed-flexion view (FFV) radiographs. METHODS: Fifty-four patients who underwent pull-out repair for a unilateral MMPRT were included. FFV radiographs were obtained pre-operatively and at the 1- and 2-year post-repair timepoints to evaluate changes in the MJS and Kellgren-Lawrence grade bilaterally. Clinical outcomes were also evaluated. RESULTS: The change in the MJS was greater in MMPRT knees than in contralateral knees during the first year (0.48 ± 0.80 mm vs. 0.09 ± 0.49 mm, p < 0.001), but this difference lessened in the second year (0.09 ± 0.36 mm vs. 0.07 ± 0.38 mm, p = 0.285). Kellgren-Lawrence grade progression in MMPRT knees was less in the second year. Clinical outcomes significantly improved at both 1 and 2 years post-repair than the pre-operative values (p < 0.001), with continued improvement in clinical outcomes in the second year. There was no significant correlation between patient characteristics and the change in the MJS from preoperatively to 2 years postoperatively. CONCLUSION: Pull-out repair for MMPRTs did not completely prevent MJS narrowing, but the rate of narrowing decreased in the second year (mean, 0.09 mm) compared to that in the first year (mean, 0.48 mm). MJS narrowing in the second year after MM posterior root repair was comparable to that of the contralateral knee. Clinical outcomes further improved over the second year after repair. LEVEL OF EVIDENCE: IV.

DOI： 10.1016/j.knee.2024.01.005

自宅でできるリハビリテーション(第17回) 股関節唇損傷に対するリハビリテーション Reviewed

山田和希, 山根秀平, 西井彩, 福場美賀夫, 太田晴之, 濱田全紀, 堅山佳美, 鉄永智紀, 尾崎敏文

Loco Cure 10 ( 1 ) 84 - 88 2024.2

Language：Japanese Publisher：(株)先端医学社

＜ポイント＞・股関節唇損傷におけるリハビリテーションでは,骨盤,脊椎,胸郭,肩甲帯をはじめとした全身の機能障害に対するアプローチが重要である.・インナーコアユニットを構成する横隔膜,腹横筋,多裂筋,骨盤底筋や,腹斜筋および前鋸筋の賦活化を目的としたエクササイズが有効である.(著者抄録)

遺伝性骨・軟部腫瘍外来における肉腫発生at-risk者への取り組み

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

日本レックリングハウゼン病学会学術大会プログラム・抄録集 15回 25 - 25 2024.2

神経線維腫症1型患者由来ヒトiPS細胞株の樹立

大澤太郎, 中田英二, 岡本真幸, 山田大祐, 二川摩周, 高尾知佳, 平沢晃, 尾崎敏文, 宝田剛志

日本レックリングハウゼン病学会学術大会プログラム・抄録集 15回 24 - 24 2024.2

神経線維腫症1型患者由来ヒトiPS細胞株の樹立

大澤太郎, 中田英二, 岡本真幸, 山田大祐, 二川摩周, 高尾知佳, 平沢晃, 尾崎敏文, 宝田剛志

日本レックリングハウゼン病学会学術大会プログラム・抄録集 15回 24 - 24 2024.2

Assessing the Frequency and Effectiveness of Various Arthroscopic Treatments in the Management of Symptomatic Isolated Medial Meniscus Injuries Including Medial Meniscus Posterior Root Tear: A Retrospective Observational Cohort Study. Reviewed

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

Acta medica Okayama 78 ( 1 ) 21 - 27 2024.2

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

The use of various strategies for arthroscopic meniscal repairs to save the meniscus and prevent the progression of knee osteoarthritis has gradually increased. We investigated the frequency of various arthroscopic treatments and the short-term clinical outcomes of symptomatic isolated medial meniscus (MM) injuries. This retrospective observational study included 193 patients (197 knees) who underwent arthroscopic meniscal treatment for isolated MM injuries between January 2016 and April 2019. Arthroscopic meniscal repairs were divided into two groups: transtibial pullout repairs of MM posterior root tears (MMPRTs) and arthroscopic meniscal repairs for other types of MM injuries. MMPRT pullout repair, other meniscal repairs, and partial meniscectomy were performed in 71.0%, 16.8%, and 12.2% of the knees, respectively. The ratio of women to men and the patient age were higher in the pullout-repair group than the meniscal-repair group. The Preoperative Knee Injury and Osteoarthritis Outcome Score subscale (as an index of daily living activities) was significantly lower in the pullout-repair group than the meniscus-repair group. However, no significant differences were observed in these scores among the two groups postoperatively. Our results suggest that familiarity with the diagnosis and treatment of MMPRTs is necessary for orthopedic surgeons to manage isolated MM injuries.

DOI： 10.18926/AMO/66667

High Fracture Rate of AVANTA Silicone Implant Following Arthroplasty of the Thumb MCP Joint of Rheumatoid Arthritis Patients with Boutonniere Deformities. Reviewed

Daisuke Kaneda, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Ryozo Harada, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki

Acta medica Okayama 78 ( 1 ) 71 - 78 2024.2

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

We retrospectively investigated the mid-term outcomes of arthroplasty using the AVANTA silicone implant for thumb metacarpophalangeal (MCP) joints with boutonniere deformity in patients with rheumatoid arthritis (RA). This study involved 36 thumbs of 33 RA patients with a mean follow-up period of 5.1 years (range, 2.0-13.3). Postoperatively, the mean extension was significantly increased and the mean flexion was significantly decreased (p<0.001, p<0.001, respectively), resulting in the mean arc of range of motion (ROM) shifting in the direction of extension after surgery. Implant fracture was observed in 10 thumbs (28%), and 4 of these (11%) underwent revision surgery. The survivorship with implant fracture and revision surgery as endpoints were 73.4% and 91.8% at 5 years, respectively. The preoperative arc of ROM and the postoperative flexion range of the implant-fracture group were significantly greater than those in the no-implant-fracture group (p=0.039, 0.034, respectively). These results suggest the importance of patient education and careful rehabilitation to prevent excessive flexion. Overall, the AVANTA silicone implant showed a relatively high rate of implant fracture at our institute.

DOI： 10.18926/AMO/66673

Inhibitory Effect of a Tankyrase Inhibitor on Mechanical Stress-Induced Protease Expression in Human Articular Chondrocytes. International journal

Yoshifumi Hotta, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Shuichi Naniwa, Noriyuki Shimizu, Chinatsu Ichikawa, Deting Lin, Tomohiro Fujiwara, Toshifumi Ozaki

International journal of molecular sciences 25 ( 3 ) 2024.1

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

We investigated the effects of a Tankyrase (TNKS-1/2) inhibitor on mechanical stress-induced gene expression in human chondrocytes and examined TNKS-1/2 expression in human osteoarthritis (OA) cartilage. Cells were seeded onto stretch chambers and incubated with or without a TNKS-1/2 inhibitor (XAV939) for 12 h. Uni-axial cyclic tensile strain (CTS) (0.5 Hz, 8% elongation, 30 min) was applied and the gene expression of type II collagen a1 chain (COL2A1), aggrecan (ACAN), SRY-box9 (SOX9), TNKS-1/2, a disintegrin and metalloproteinase with thrombospondin motifs-5 (ADAMTS-5), and matrix metalloproteinase-13 (MMP-13) were examined by real-time PCR. The expression of ADAMTS-5, MMP-13, nuclear translocation of nuclear factor-κB (NF-κB), and β-catenin were examined by immunocytochemistry and Western blotting. The concentration of IL-1β in the supernatant was examined by enzyme-linked immunosorbent assay (ELISA). TNKS-1/2 expression was assessed by immunohistochemistry in human OA cartilage obtained at the total knee arthroplasty. TNKS-1/2 expression was increased after CTS. The expression of anabolic factors were decreased by CTS, however, these declines were abrogated by XAV939. XAV939 suppressed the CTS-induced expression of catabolic factors, the release of IL-1β, as well as the nuclear translocation of NF-κB and β-catenin. TNKS-1/2 expression increased in mild and moderate OA cartilage. Our results demonstrated that XAV939 suppressed mechanical stress-induced expression of catabolic proteases by the inhibition of NF-κB and activation of β-catenin, indicating that TNKS-1/2 expression might be associated with OA pathogenesis.

DOI： 10.3390/ijms25031443

Initial tension at suture fixation affects the suture breakage following medial meniscus posterior root repair: a retrospective cohort study. International journal

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

Journal of ISAKOS : joint disorders & orthopaedic sports medicine 2024.1

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

OBJECTIVES: This study aimed to investigate whether the initial suture tension when pullout sutures are fixed affects postoperative clinical outcomes following medial meniscus posterior root repair. METHODS: The data of 48 patients who underwent transtibial pullout repair using two simple stitches (outer and inner sutures) with an additional all-inside posteromedial pullout were retrospectively investigated. The patients were sequentially divided into two groups to compare the clinical efficacy of the initial pullout tension when pullout sutures were fixed: the 30N Group (April 2019 to September 2019, 24 patients) and the 15N group (October 2019 to February 2020, 24 patients). The rate of suture breakage (suture cutout or rupture) at the second-look arthroscopy at 1 year postoperatively and clinical outcomes at 2 years postoperatively were compared between the two groups. RESULTS: In both groups, each clinical score significantly improved at 2 years postoperatively. At the second-look arthroscopy, the rate of posteromedial suture breakage was significantly higher in the 30 N Group (19 patients, 79%) than in the 15 N Group (10 patients, 42%); the rate of outer suture breakage was also higher in the 30 N group (five patients, 21%) than in the 15 N group (no patients). On comparing 2 years of preoperative clinical scores between the groups categorized according to posteromedial suture breakage, the pain score was significantly higher in the suture breakage group. CONCLUSION: The initial tension of pullout repair of the medial meniscus posterior root tear is related to suture breakages. To prevent suture breakage, 15 N is a more initially suitable condition than 30 N. LEVEL OF EVIDENCE: Level III.

DOI： 10.1016/j.jisako.2024.01.004

Weight loss enhances meniscal healing following transtibial pullout repair for medial meniscus posterior root tears. Reviewed International journal

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

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 32 ( 1 ) 143 - 150 2024.1

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

PURPOSE: This study investigated the impact of weight change on the success of transtibial pullout repair for medial meniscus (MM) posterior root tears (MMPRTs). METHODS: The study included 129 patients diagnosed with MMPRTs who had undergone transtibial pullout repair. The patients were screened between July 2018 and November 2021. Patient-reported outcomes were assessed preoperatively and at 12 months postoperatively using the Knee injury and Osteoarthritis Outcome Score (KOOS). MM extrusion (MME) and ΔMME (postoperative MME - preoperative MME) were calculated preoperatively and at 12 months postoperatively using magnetic resonance imaging. RESULTS: Patients were divided into weight loss (body mass index [BMI] decrease of at least 0.5 kg/m2 after primary repair; n = 63) and weight gain (BMI increase of at least 0.5 kg/m2 ; n = 66) groups. Both groups had similar demographic variables and preoperative clinical scores; patient-reported outcomes significantly improved postoperatively. The weight loss group had significantly greater improvement in KOOS-quality of life (weight loss, 29.4 ± 23.7; weight gain, 23.9 ± 27.6; p = 0.034), lower postoperative MME (weight loss, 3.9 ± 1.7 mm; weight gain, 4.2 ± 1.2 mm; p = 0.043) and lower ΔMME (weight loss, 0.8 ± 0.8 mm; weight gain, 1.2 ± 0.9 mm; p = 0.002) than the weight gain group. Total arthroscopic healing scores (weight loss, 7.6 ± 1.0; weight gain, 7.2 ± 1.5; p = 0.048) and associated subscales, including anteroposterior bridging tissue width (weight loss, 4.0 ± 0.0; weight gain, 3.8 ± 0.7; p = 0.004) and MM posterior root stability (weight loss, 2.6 ± 0.7; weight gain, 2.4 ± 0.7; p = 0.041), significantly differed between the groups. CONCLUSIONS: Weight loss was associated with better meniscal healing and less MME progression after MMPRT repair, highlighting the significance of weight management in individuals undergoing meniscal surgery. These findings provide valuable insights into the clinical significance of weight loss in the success of transtibial pullout repair for MMPRTs. LEVEL OF EVIDENCE: Level III.

DOI： 10.1002/ksa.12037

内側半月板後根断裂に対するプルアウト修復術大腿四頭筋筋力の改善は内側半月板逸脱の進行を抑制する Reviewed

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 ( 1 ) 93 - 94 2024.1

内側半月板後根断裂に対するプルアウト修復術大腿四頭筋筋力の改善は内側半月板逸脱の進行を抑制する

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 ( 1 ) 93 - 94 2024.1

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

内側半月板後根断裂に対しプルアウト修復術を施行した38例を対象に、術前・術後1年の大腿四頭筋筋力を計測し、臨床スコアや内側半月板内方逸脱(MME)との関連について検討した。その結果、大腿四頭筋筋力は術前と比べ、術後1年で有意な改善が認められた。また、術後の大腿四頭筋筋力はMME変化量、術後の臨床スコアと有意な相関がみられ、術後大腿四頭筋筋力が大きい患者ほど、MME増加量が小さく、臨床スコアも良好なことが明らかになった。

Five cases of atypical ulnar fractures associated with long-term bisphosphonate use: An anatomical and mechanical analysis using a finite element model

Shunji Okita, Taichi Saito, Norio Yamamoto, Yusuke Mochizuki, Ryuichi Nakahara, Yasunori Shimamura, Toshiyuki Kunisada, Keiichiro Nishida, Toshifumi Ozaki

Journal of Orthopaedic Science 29 ( 1 ) 449 - 453 2024.1

Prosthetic joint infection after total talar replacement: An implant-retained case treated with combined continuous local antibiotic perfusion (CLAP)

Kohei Iwamoto, Norio Yamamoto, Kenta Saiga, Akihiro Maruo, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Journal of Orthopaedic Science 29 ( 1 ) 349 - 353 2024.1

Changes in Spinal Instability After Conventional Radiotherapy for Painful Vertebral Bone Metastases

Eiji Nakata, Shinsuke Sugihara, Ryuichi Nakahara, Haruyoshi Katayama, Takuto Itano, Toshifumi Ozaki

Cancer Control 31 2024.1

Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Objective: Precise assessment of spinal instability is critical before and after radiotherapy (RT) for evaluating the effectiveness of RT. Therefore, we retrospectively evaluated the efficacy of RT in spinal instability over a period of 6 months after RT, utilizing the spinal instability neoplastic score (SINS) in patients with painful spinal metastasis. We retrospectively evaluated 108 patients who received RT for painful vertebral metastasis in our institution. Mechanical pain at metastatic vertebrae, radiological responses of irradiated vertebrae, and spinal instability were assessed. Follow-up assessments were done at the start of and at intervals of 1, 2, 3, 4, and 6 months after RT, with the pain disappearing in 67%, 85%, 93%, 97%, and 100% of the patients, respectively. The median SINS were 8, 6, 6, 5, 5, and 4 at the beginning and after 1, 2, 3, 4, and 6 months of RT, respectively. Multivariate analysis revealed that posterolateral involvement of spinal elements (PLISE) was the only risk factor for continuous potentially unstable/unstable spine at 1 month. In conclusion, there was improvement of pain, and recalcification results in regaining spinal stability over time after RT although vertebral body collapse and malalignment occur in some irradiated vertebrae. Clinicians should pay attention to PLISE in predicting continuous potentially unstable/unstable spine.

DOI： 10.1177/10732748241250219

Other Link： https://journals.sagepub.com/doi/full-xml/10.1177/10732748241250219

Intercondylar notch width and osteophyte width impact meniscal healing and clinical outcomes following transtibial pullout repair of medial meniscus posterior root tears. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yusuke Yokoyama, Naohiro Higashihara, Masanori Tamura, Koki Kawada, Haowei Xue, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 32 ( 1 ) 116 - 123 2024.1

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

PURPOSE: This retrospective study aimed to investigate the relationship between intercondylar notch width (ICNW), osteophyte width (OW), and the healing of medial meniscus posterior root tears (MMPRTs) following arthroscopic pullout repair. METHODS: The study included 155 patients diagnosed with MMPRTs who underwent transtibial pullout repair. Meniscal healing status was evaluated on second-look arthroscopy using a previously reported meniscus healing score. Patients were divided into two groups based on this score: the high healing score (group HH, healing score ≥ 8 points) and suboptimal healing score (group SO, healing score ≤ 6 points) groups. Computed tomography scans were performed on patients 1 week postsurgery. ICNW and OW widths were measured and relatively evaluated based on their ratio to the intercondylar distance (ICD), represented as the ICNW/ICD ratio (%) and OW/ICD ratio (%), respectively. Patient-reported outcomes were assessed preoperatively and on second-look arthroscopy using the Knee injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS). RESULTS: There were no significant demographic differences between the SO and HH group (n = 35 and 120 patients, respectively). Regarding radiographic measurements, significant differences were observed in the ICNW/ICD ratio (group SO, 24.2%; group HH, 25.2%; p = 0.024), OW (group SO, 2.6 mm; group HH, 2.0 mm; p < 0.001), and OW/ICD ratio (group SO, 3.5%; group HH, 2.7%; p < 0.001). Both groups had similar preoperative clinical scores, but postoperative clinical scores, including KOOS-activities of daily living (group SO, 83.4; group HH, 88.7; p = 0.035) and VAS (group SO, 19.1; group HH, 11.3; p = 0.005), were significantly better in group HH. CONCLUSION: The study suggests that ICNW and OW may play a crucial role in MMPRT healing following arthroscopic pullout repair, as evidenced by the worse clinical outcomes associated with a narrower ICNW and wider OW. These findings highlight the potential significance of ICNW and OW assessments when evaluating meniscal repair indications. LEVEL OF EVIDENCE: Level III.

DOI： 10.1002/ksa.12032

Fluorescence-guided assessment of bone and soft-tissue sarcomas for predicting the efficacy of telomerase-specific oncolytic adenovirus. International journal

Koji Uotani, Hiroshi Tazawa, Joe Hasei, Tomohiro Fujiwara, Aki Yoshida, Yasuaki Yamakawa, Toshinori Omori, Kazuhisa Sugiu, Tadashi Komatsubara, Hiroya Kondo, Takuya Morita, Masahiro Kiyono, Suguru Yokoo, Toshiaki Hata, Toshiyuki Kunisada, Ken Takeda, Yasuo Urata, Toshiyoshi Fujiwara, Toshifumi Ozaki

PloS one 19 ( 2 ) e0298292 2024

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

Bone and soft-tissue sarcomas are rare malignancies with histological diversity and tumor heterogeneity, leading to the lack of a common molecular target. Telomerase is a key enzyme for keeping the telomere length and human telomerase reverse transcriptase (hTERT) expression is often activated in most human cancers, including bone and soft-tissue sarcomas. For targeting of telomerase-positive tumor cells, we developed OBP-301, a telomerase-specific replication-competent oncolytic adenovirus, in which the hTERT promoter regulates adenoviral E1 gene for tumor-specific viral replication. In this study, we present the diagnostic potential of green fluorescent protein (GFP)-expressing oncolytic adenovirus OBP-401 for assessing virotherapy sensitivity using bone and soft-tissue sarcomas. OBP-401-mediated GFP expression was significantly associated with the therapeutic efficacy of OBP-401 in human bone and soft-tissue sarcomas. In the tumor specimens from 68 patients, malignant and intermediate tumors demonstrated significantly higher expression levels of coxsackie and adenovirus receptor (CAR) and hTERT than benign tumors. OBP-401-mediated GFP expression was significantly increased in malignant and intermediate tumors with high expression levels of CAR and hTERT between 24 and 48 h after infection. Our results suggest that the OBP-401-based GFP expression system is a useful tool for predicting the therapeutic efficacy of oncolytic virotherapy on bone and soft-tissue sarcomas.

DOI： 10.1371/journal.pone.0298292

Real-world Referral Pattern of Unplanned Excision in Patients With Soft-tissue Sarcoma: A Multicenter Study Conducted by the Bone and Soft-tissue Tumor Study Group of the Japan Clinical Oncology Group. International journal

Tomoki Nakamura, Koichi Ogura, Keiko Hayakawa, Kunihiro Ikuta, Yutaka Nezu, Shinji Miwa, Shinichiro Yoshida, Sho Nakai, Hideyuki Kinoshita, Yusuke Kawabata, Shunsuke Hamada, Akira Nabeshima, Hidetatsu Outani, Hiroshi Kobayashi, Hitomi Hara, Masanori Tsugita, Hirotaka Koyanagi, Nokitaka Setsu, Akira Maekawa, Akihiro Daisaku, Tomoaki Mori, Naoki Oike, Yuta Kubota, Takaaki Tanaka, Takashi Noguchi, Takashi Tajima, Kazuhiro Tanaka, Toshifumi Ozaki

In vivo (Athens, Greece) 38 ( 6 ) 2712 - 2717 2024

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

BACKGROUND/AIM: Despite the well-publicized clinical outcomes after unplanned excision (UE) and re-excision (re-excision) in patients with soft-tissue sarcoma (STS), there is little information about the real-life referral patterns for UE, such as patient profile, details of procedures, and subsequent management after UE. We aimed to investigate the characteristics of patients with UE who were referred to sarcoma-specific centers. PATIENTS AND METHODS: Between May 2022 and June 2023, we registered 97 patients who underwent UE and were referred to sarcoma-specific centers in Japan. We excluded those with well-differentiated liposarcomas and dermatofibrosarcoma protuberances. We investigated the details of UE and additional treatment after UE. RESULTS: There were 49 men and 48 women, with a mean age of 62 years. A broad range of surgeons performed UE; 36 plastic surgeons, 22 orthopedic surgeons, 17 general surgeons, 17 dermatologists, and 5 others. The mean tumor size was 4.1 cm. Local anesthesia was administered to 58 patients. Forty-five patients underwent UE without prior magnetic resonance imaging. Inappropriate transverse skin incisions were performed in 42 patients. Of the 97 patients, 82 underwent re-excision after UE. The mean time between UE and date of initial presentation at the referral hospital was 46 days. The mean interval between UE and re-excision was 96 days. Of the 82 patients, 59 underwent soft-tissue reconstruction after re-excision. CONCLUSION: A broad range of surgeons performed UE. Continuous education about STS should be considered for all surgeons. UE should be avoided because residual tumors are common, and reconstructive surgery may be necessary.

DOI： 10.21873/invivo.13749

Unlinked TEAを第一選択とする治療戦略

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

関節の外科 51 ( 2 ) 51 - 51 2024

関節リウマチ患者における人工関節置換術のリスクファクターの検討

志水紀之, 大塚憲昭, 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

関節の外科 51 ( 2 ) 70 - 70 2024

前方及び後方アプローチを併用した尺骨鉤状突起および肘頭骨折を伴う肘関節脱臼開放骨折の1例

古谷友希, 齋藤太一, 中道亮, 島村安則, 西田圭一郎, 尾崎敏文

日本肘関節学会雑誌 31 ( 1 ) S84 - S84 2024

Ideal insertion point and projection of the infra-acetabular screw in acetabular fracture surgery. International journal

Shiro Fukuoka, Masanori Yorimitsu, Takenori Uehara, Shuichi Naniwa, Toshiaki Hata, Kohei Sato, Tomoyuki Noda, Toru Sato, Toshifumi Ozaki

Injury 111264 - 111264 2023.12

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

BACKGROUND: In acetabular fracture surgery, an infra-acetabular screw (IAS) is inserted from the anterior to the posterior column through the infra-acetabular corridor to stabilize both columns. Although the IAS is useful for increasing fixation strength, proper placement requires proficiency and often results in extraosseous screw penetration. The complex anatomy of the infra-acetabular corridor and difficult intraoperative detection of the ideal insertion point and angle make proper placement of the IAS challenging. This study aimed to detect the ideal insertion point and angle of the IAS based on anatomical landmarks that can be directly identified intraoperatively. METHODS: We retrospectively reviewed the pelvic CT of 50 adults who underwent serial slice CT imaging. The pelvic inlet plane (PIP), which contains the anterior border of both the sacroiliac joint and posterior superior edge of the pubic symphysis, was used as the reference plane for the pelvic coordinate system to simulate the ideal insertion of IAS. The distance from the posterior superior edge of the pubic symphysis to the ideal insertion point of the IAS (IAS distance) and the angle and length of the IAS that could be inserted from the ideal insertion point were measured. RESULTS: The mean IAS distance was 61.0 ± 5.7 mm (57.6 ± 4.3 mm in men and 64.4 ± 4.9 mm in women). The mean angle between ideal IAS and yz-plane on the outlet view (α-angle) was 8.4 ± 6.6 ° (6.4 ± 5.6° in men and 10.5 ± 7.0° in women). The mean angle between ideal IAS and y-axis on the yz-plane (β-angle) was 86.5 ± 10.6 ° (86.0 ± 10.3° in men and 87.0 ± 10.9° in women). The length of IAS was 97.1 ± 4.7 mm in men and 89.2 ± 3.6 mm in women. CONCLUSION: The IAS ideal insertion point detected as a distance from the pubic symphysis may aid in the proper insertion of the IAS during surgery. The insertion angle was parallel or tilted 10 ° laterally to the longitudinal axis in the pelvic outlet plane and almost perpendicular to the PIP in the sagittal plane when inserted from the ideal insertion point.

DOI： 10.1016/j.injury.2023.111264

ヒトiPS細胞由来肢芽間葉系細胞から作製した軟骨組織体を用いた骨再生

中田英二, 佐藤浩平, 高尾知佳, 藤澤祐樹, 山田大祐, 上原健敬, 藤原智洋, 尾崎敏文, 宝田剛志

移植 58 ( 3 ) 293 - 293 2023.12

Comparison between Cases of Total Hip Arthroplasty Followed by Colonna Capsular Arthroplasty and Lorenz Cast Reduction in Patients with Developmental Dysplasia of the Hip.

Hirosuke Endo, Kazuki Yamada, Tomonori Tetsunaga, Yoshifumi Namba, Yoshihisa Sugimoto, Shigeru Mitani, Eiji Nakata, Toshifumi Ozaki

Acta medica Okayama 77 ( 6 ) 655 - 663 2023.12

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

Most patients with developmental dysplasia of the hip (DDH) now receive closed-reduction treatment within 6 months after birth. The long-term outcomes of patients with late-detection DDH have remained unclear. We reviewed the clinical records of 18 patients who underwent Colonna capsular arthroplasty (n=8) or closed reduction (n=10) for developmental dysplasia of the hip as infants or young children and underwent total hip arthroplasty approximately in midlife. Both the Colonna capsular arthroplasty and closed reduction groups achieved good clinical results after total hip arthroplasty. However, the operating time was longer and the improvements of hip range of motion and clinical score were significantly worse in the Colonna capsular arthroplasty group than in the closed reduction group.

DOI： 10.18926/AMO/66159

【がん時代の整形外科必携! 骨転移診療アップデート】骨転移治療総論骨転移におけるロコモティブシンドローム

中田英二, 堅山佳美, 明崎禎輝, 濱田全紀, 藤原智洋, 国定俊之, 尾崎敏文

臨床整形外科 58 ( 12 ) 1431 - 1438 2023.12

Language：Japanese Publisher：(株)医学書院

＜文献概要＞がんは高齢者に多いため,ロコモティブシンドロームが発生しやすい.がんの切除を行う患者の約9割は,ロコモを合併している.したがって,がん患者では,適切ながんロコモのスクリーニングが重要である.また,最近,がん治療は外来に移行しつつあり,がん患者が日常生活動作を維持することが求められ,がんロコモ予防に対する社会のニーズが増えている.したがって,各施設において,診療科横断的にがんロコモ予防に取り組む体制を構築することが重要である.

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J01554&link_issn=&doc_id=20231129020009&doc_link_id=10.11477%2Fmf.1408202843&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1408202843&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

The Effectiveness of Rehabilitation after Open Surgical Release for Trigger Finger: A Prospective, Randomized, Controlled Study

Taichi Saito, Ryo Nakamichi, Ryuichi Nakahara, Keiichiro Nishida, Toshifumi Ozaki

Journal of Clinical Medicine 12 ( 22 ) 7187 - 7187 2023.11

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Background: It is not clear whether rehabilitation after surgery for trigger finger is effective. The aim of this study was to reveal its effectiveness for trigger finger. Methods: This study was a randomized, controlled trial that included patients who underwent operations for trigger fingers. The patients in the rehabilitation group had postoperative occupational therapy (OT) for 3 months, while the patients in the control group were not referred for rehabilitation but received advice for a range of motion exercises. We evaluated the severity of trigger finger, Disability of Arm-Shoulder-Hand (DASH) score, pain-visual analogue scale (VAS), grip strength, whether they gained a full range of motion (ROM), and complications before and after surgery. Results: Finally, 29 and 28 patients were included in the control and rehabilitation groups, respectively. At final follow-up, the DASH score, grip strength, and ROM were significantly improved in the rehabilitation group compared to that preoperatively. At final follow-up, pain was significantly improved in both groups from that preoperatively. There were no significant differences in the results, including the DASH score, grip strength, ROM and pain-VAS between the control and rehabilitation groups at the final follow-up. Subgroup analysis showed that there is a significant difference in the DASH score of patients doing housework or light work and those with a duration of symptoms >12 months between the control and rehabilitation groups at the final follow-up.

DOI： 10.3390/jcm12227187

Factors associated with survival in patients with clear cell sarcoma. Reviewed International journal

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

The bone & joint journal 105-B ( 11 ) 1216 - 1225 2023.11

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

AIMS: Clear cell sarcoma (CCS) of soft-tissue is a rare melanocytic subtype of mesenchymal malignancy. The aim of this study was to investigate the clinical and therapeutic factors associated with increased survival, stratified by clinical stage, in order to determine the optimal treatment. METHODS: The study was a retrospective analysis involving 117 patients with histologically confirmed CCS, between July 2016 and November 2017, who were enrolled in the Bone and Soft Tissue Tumour Registry in Japan. RESULTS: The five- and ten-year survival rates were 41% (95% confidence interval (CI) 29 to 52) and 37% (95% CI 25 to 49), respectively. On multivariable analysis, the size of the tumour of > 10 cm (p = 0.006), lymph node metastasis at the time of diagnosis (p < 0.001), distant metastases at the time of diagnosis (p < 0.001), and no surgery for the primary tumour (p = 0.019) were independently associated with a poor survival. For N0M0 CCS (n = 68), the development of distant metastases was an independent prognostic factor for survival (early (< 12 months), hazard ratio (HR) 116.78 (95% CI 11.69 to 1,166.50); p < 0.001; late (> 12 months), HR 14.79 (95% CI 1.66 to 131.63); p = 0.016); neoadjuvant/adjuvant chemotherapy (p = 0.895) and/or radiotherapy (p = 0.216) were not significantly associated with survival. The five-year cumulative incidence of local recurrence was 19% (95% CI 8 to 35) and the size of the tumour was significantly associated with an increased rate of local recurrence (p = 0.012). For N1M0 CCS (n = 18), the risk of mortality was significantly lower in patients who underwent surgery for both the primary tumour and lymph node metastases (HR 0.03 (95% CI 0.00 to 0.56); p = 0.020). For M1 CCS (n = 31), excision of the primary tumour was independently associated with better survival (HR 0.26 (95% CI 0.09 to 0.76); p = 0.013). There was no significant difference in survival between the different types of systemic treatment (p = 0.523). CONCLUSION: Complete excision of the primary tumour and lymph nodes is associated with a better survival in patients with CCS. Systemic treatment appears to provide limited benefits, demonstrating a pressing need for novel systemic agents.

DOI： 10.1302/0301-620X.105B11.BJJ-2022-0743.R3

みんなで行う骨転移診療-診療均てん化を目指した整形外科キャリアステージ別スキルの再確認- 骨転移診療のスキル外傷整形外科医編 Reviewed

野田知之, 阿部信寛, 尾崎敏文, 中田英二, 依光正則, 上原健敬

日本整形外科学会雑誌 97 ( 11 ) 993 - 997 2023.11

思春期特発性側彎症に対する脊椎後方固定術において術中低体温は入院期間を延長させる

篠原健介, 三澤治夫, 魚谷弘二, 小田孔明, 鉄永倫子, 志渡澤央和, 植田昌敬, 鷹取亮, 尾崎敏文

西日本脊椎研究会抄録集 98回 21 - 21 2023.11

内側半月板後根断裂に対する経脛骨pullout修復術術後1週からの部分荷重は治療成績を悪化させない

田村優典, 古松毅之, 横山裕介, 東原直裕, 川田紘己, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 417 - 417 2023.11

内側半月板後根断裂はUKAのよい適応となるか? MMPRT群とnon-MMPRT群の比較

川田紘己, 古松毅之, 横山裕介, 東原直裕, 田村優典, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 409 - 409 2023.11

腫瘍切除後に遠位脛腓間固定を行った多発性外骨腫症の1例

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S160 - S160 2023.11

内側半月板後根断裂に対する経脛骨pullout修復術術後1週からの部分荷重は治療成績を悪化させない

田村優典, 古松毅之, 横山裕介, 東原直裕, 川田紘己, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 417 - 417 2023.11

内側半月板後根断裂はUKAのよい適応となるか? MMPRT群とnon-MMPRT群の比較

川田紘己, 古松毅之, 横山裕介, 東原直裕, 田村優典, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 409 - 409 2023.11

小児下肢疾患の診断・治療運動器検診も含めて

鉄永智紀, 赤澤啓史, 山田和希, 小浦卓, 井上智博, 奥田龍一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 333 - 333 2023.11

当院におけるOrthoMasterのカップアライメント精度

井上智博, 鉄永智紀, 山田和希, 小浦卓, 奥田龍一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 430 - 430 2023.11

10代の若年者に対するTHAの検討

奥田龍一郎, 鉄永智紀, 山田和希, 小浦卓, 井上智博, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S76 - S76 2023.11

小児期股関節MRIで将来の関節適合性を予測する新たな指標

小浦卓, 鉄永智紀, 山田和希, 井上智博, 奥田龍一郎, 赤澤啓史, 尾崎敏文

日本小児整形外科学会雑誌 32 ( 3 ) S68 - S68 2023.11

肩甲骨体部骨折に対しスクリューおよび鋼線固定を行った1例

古谷友希, 齋藤太一, 中道亮, 島村安則, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 376 - 376 2023.11

骨接合術を行い椎間可動域を温存しえた椎弓根骨折の1例

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 志渡澤央和, 植田昌敬, 鷹取亮, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 407 - 407 2023.11

著明な疼痛を伴う椎間板発生の仙骨脊索腫の一例

藤原智洋, 魚谷弘二, 国定俊之, 中田英二, 小田孔明, 三澤治夫, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 423 - 423 2023.11

骨粗鬆症性椎体骨折と椎弓根骨折合併例に骨接合術を行い椎間可動性温存を試みた1例

小田孔明, 三澤治夫, 魚谷弘二, 志渡澤央和, 植田昌敬, 鷹取亮, 尾崎敏文

日本最小侵襲整形外科学会プログラム・抄録集 29回 73 - 73 2023.11

腰部脊柱管狭窄症と併存した脊髄動静脈奇形の一例

志渡澤央和, 三澤治夫, 鉄永倫子, 魚谷弘二, 小田孔明, 植田昌敬, 鷹取亮, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 3 ) 342 - 342 2023.11

The current management of clear cell sarcoma Reviewed

Kunihiro Ikuta, Yoshihiro Nishida, Shiro Imagama, Kazuhiro Tanaka, Toshifumi Ozaki

Japanese Journal of Clinical Oncology 2023.10

Associations among Preoperative Malnutrition, Muscle Loss, and Postoperative Walking Ability in Intertrochanteric Fractures: A Retrospective Study. Reviewed

Kohei Sato, Hironori Tsuji, Masanori Yorimitsu, Takenori Uehara, Yuki Okazaki, Shinichiro Takao, Toshiaki Hata, Shiro Fukuoka, Tomoyuki Noda, Hideyuki Kanda, Toshifumi Ozaki

Acta medica Okayama 77 ( 5 ) 511 - 516 2023.10

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

Sarcopenia and malnutrition are increasing in older adults and are reported risk factors for functional impairment after hip fracture surgery. This study aimed to investigate the associations between skeletal muscle mass loss, malnutrition, and postoperative walking ability in patients with hip fracture. We retrospectively reviewed patients who underwent intertrochanteric fracture surgery at our institute. The psoas muscle index, controlling nutritional status score, and functional ambulation category (FAC) were used to evaluate skeletal muscle mass, nutritional status, and walking ability, respectively. Six months after surgery, walking ability was assessed as either "gait disturbance" or "independent gait". Multivariate binomial logistic regression analysis, with skeletal muscle mass, nutritional status, and other factors, was used to predict the risk of being assigned to the gait disturbance group. This study included 95 patients (mean age, 85.2 years; 70 women). Sixty-six patients had low skeletal muscle mass, 35 suffered from malnutrition, and 28 had both. Malnutrition and low skeletal muscle mass were significantly associated with postoperative gait disturbance (FAC < 3). Preoperative low skeletal muscle mass and malnutrition were risk factors for postoperative poor walking ability. Further preventive interventions focusing on skeletal muscle mass and nutritional status are required.

DOI： 10.18926/AMO/65973

Time-Dependent Increase in Medial Meniscus Extrusion Predicts the Need for Meniscal Repair in Patients with Partial Medial Meniscus Posterior Root Tears: A Case-Control Study. Reviewed International journal

Koki Kawada, Takayuki Furumatsu, Masanori Tamura, Haowei Xue, Naohiro Higashihara, Keisuke Kintaka, Yusuke Yokoyama, Toshifumi Ozaki

Indian journal of orthopaedics 57 ( 10 ) 1633 - 1639 2023.10

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

PURPOSE: This study aimed to compare medial meniscus extrusion (MME) in patients with partial medial meniscus posterior root tears (MMPRTs) through magnetic resonance imaging (MRI) conducted at two-time points and to determine whether patient characteristics or MME measurements differ in patients who respond to nonoperative treatment compared with those who require surgical treatment. METHODS: Thirty-seven patients with partial MMPRTs underwent two MRI scans during nonoperative management or before pull-out repair. Among these, 17 patients received nonoperative management, and 20 underwent pull-out repair. Partial MMPRTs were diagnosed based on the MRI findings. MME measurements were performed on both MRI scans. Statistical and receiver operating curve (ROC) analyses were performed. RESULTS: The duration between the two MRI scans was significantly shorter in the pull-out repair group than in the nonoperative management group. The increase in MME (ΔMME) on MRI scans was significantly greater in the pull-out repair group than in the nonoperative management group. Linear regression analysis revealed a weak correlation between the MRI interval and ΔMME in the nonoperative management group and a moderate correlation in the pull-out repair group. In the ROC construction, the cut-off value for ΔMME that requires surgical intervention was 0.41 mm, with a sensitivity and specificity of 85.0% and 52.9%, respectively. CONCLUSION: Patients with partial MMPRTs requiring surgical treatment had greater MME progression in a shorter time and a time-dependent increase in MME. Therefore, a ΔMME of ≥ 0.41 mm may be useful in deciding surgical intervention based on MRI retests. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s43465-023-00987-3

Medial joint space narrowing progresses after pullout repair of medial meniscus posterior root tear. Reviewed International journal

Koki Kawada, Takayuki Furumatsu, Masanori Tamura, Haowei Xue, Naohiro Higashihara, Keisuke Kintaka, Yusuke Yokoyama, Toshifumi Ozaki

International orthopaedics 47 ( 10 ) 2401 - 2407 2023.10

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

PURPOSE: The extent to which arthropathic changes progress after medial meniscus posterior root tear (MMPRT) repair remains controversial. This retrospective study assessed medial joint space (MJS) narrowing progression after pullout repair for MMPRT and identified the correlating factors. METHODS: We included 56 patients who underwent pullout repair for MMPRT. The MJS of the bilateral knees was assessed with radiography using the fixed-flexion view. A second-look arthroscopy was performed one year post-operatively for all patients. The baseline characteristics, clinical scores, Kellgren-Lawrence (KL) grade, and medial meniscus extrusion (MME) were identified. Statistical comparisons and correlation analyses were conducted. RESULTS: The MJS narrowing width was significantly larger in MMPRT knees than in contralateral knees (0.51 ± 0.85 mm vs. 0.09 ± 0.49 mm, p < 0.001). KL grade progression was observed in 23.2% (13/56) of patients. There was a significant difference between pre- and post-operative MME values, indicating MME progression (p < 0.001). Each clinical score showed significant improvement one year post-operatively (p < 0.001). Positive correlations were found between MJS narrowing and pre-operative MJS (coefficient = 0.510, p < 0.001), rate of change in MJS (coefficient = 0.929, p < 0.001), and increase in MME (ΔMME) (coefficient = 0.506, p < 0.001). CONCLUSION: Knees that underwent pullout repair for MMPRT showed progression of MJS narrowing by 0.51 mm at one year post-operatively, although clinical scores markedly improved. Correlating factors for MJS narrowing were pre-operative MJS, rate of change in MJS, and ΔMME. Preventing MME progression is essential for preventing arthropathic changes.

DOI： 10.1007/s00264-023-05701-4

Concomitant posterior anchoring further reduces posterior meniscal extrusion during pullout repair of medial meniscus posterior root tears: a retrospective study. Reviewed International journal

Haowei Xue, Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Ximing Zhang, Toshifumi Ozaki

International orthopaedics 47 ( 10 ) 2391 - 2400 2023.10

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

PURPOSE: Transtibial pullout repair improves the clinical outcomes of medial meniscus (MM) posterior root tears (PRTs); however, reducing MM extrusion remains challenging. Thus, the purpose of this study was to examine the role of additional posterior anchoring (PA) during pullout repair in reducing the severity of MM extrusion compared to pullout repair alone. METHODS: Patients who underwent pullout repair with two-cinch stitches (TCS) only or TCS combined with PA (TCS-PA)-deployment of an additional suture anchor in the posteromedial corner of MM-were included retrospectively. MM medial and posterior extrusion (MMME and MMPE), MM extrusion and remaining volume (MMEV and MMRV), and corresponding ratios were evaluated pre-operatively and three months post-operatively using a three-dimensional meniscal model at 10° and 90° of knee flexion and compared within and between groups. RESULTS: A total of 15 and 16 patients treated with TCS and TCS-PA, respectively, were enrolled. At 90° knee flexion, both techniques significantly reduced MMPE (TCS: 4.2 ± 0.7 mm to 3.5 ± 0.6 mm, p < 0.05; TCS-PA: 3.7 ± 0.8 mm to 2.8 ± 0.7 mm, p < 0.05) at three months post-operatively. TCS-PA reduced MMPE more significantly than TCS alone (p < 0.05). Only TCS-PA significantly improved the MMEV and MMRV ratios (39.6 ± 8.9% to 28.1 ± 6.0%, p < 0.05 and 60.4 ± 8.9% to 71.9 ± 6.0%, p < 0.05, respectively). Significance was not found in all other comparisons. CONCLUSIONS: Both techniques improved MMPE at knee flexion at the three month follow-up, with TCS-PA providing significantly superior results. Our findings support the evidence that the application of PA may be an effective surgical option for alleviating persistent MMPE.

DOI： 10.1007/s00264-022-05660-2

Epidemiological features of acute medial meniscus posterior root tears. Reviewed International journal

Yusuke Kamatsuki, Takayuki Furumatsu, Takaaki Hiranaka, Yuki Okazaki, Keisuke Kintaka, Yuya Kodama, Shinichi Miyazawa, Toshifumi Ozaki

International orthopaedics 47 ( 10 ) 2537 - 2545 2023.10

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

PURPOSE: Untreated or overlooked medial meniscus posterior root tears (MMPRTs) induce sequential knee joint degradation. We evaluated epidemiological features of acute MMPRT for its early detection and accurate diagnosis. METHODS: Among 330 MMPRT patients from 2018 to 2020, those who underwent arthroscopic pullout repairs were enrolled. Patients who underwent non-operative treatment or knee arthroplasty, those with a cruciate ligament-deficient knee or advanced osteoarthritis of the knee, and those with insufficient data were excluded. Finally, we retrospectively evaluated data from 234 MMPRTs (female: 79.9%, complete tears: 92.7%, mean age: 65 years). Welch's t-test and Chi-squared test were used for pairwise comparisons. Spearman's rank correlation analysis was performed between age at surgery and body mass index (BMI). Multivariable logistic regression analysis with stepwise backward elimination was applied to the values as risk factors for painful popping events. RESULTS: In both sexes, there were significant differences in height, weight, and BMI. In all patients, there was a significant negative correlation between BMI and age (ρ = - 0.36, p < 0.001). The BMI cutoff value of 27.7 kg/m2 had a 79.2% sensitivity and a 76.9% specificity for detecting MMPRT patients aged < 50 years. A painful popping event was confirmed in 187 knees (79.9%), and the frequency was significantly reduced in partial tears as compared to complete tears (odds ratio: 0.080, p < 0.001). CONCLUSION: Higher BMI was associated with a significantly younger age of MMPRT onset. Partial MMPRTs had a low frequency of painful popping events (43.8%).

DOI： 10.1007/s00264-023-05848-0

【整形外科外来Red Flags 2023】脊椎転移におけるRed Flags Reviewed

中田英二, 藤原智洋, 国定俊之, 尾崎敏文

Orthopaedics 36 ( 10 ) 69 - 80 2023.10

Language：Japanese Publisher：(株)全日本病院出版会

椎体転移では腫瘍が増大すると腫瘍が直接神経を圧迫したり,椎体圧潰により脊髄が圧迫され,知覚障害や運動麻痺が生じることがある.ほとんどの骨転移患者は,麻痺が発生する前に脊椎転移部に痛みを自覚している.したがって,痛みは麻痺の危険信号であり,脊椎転移部に痛みが出現した場合,早急に治療を開始することが重要である.麻痺を予防するために,最も基本的で重要な対処法は,脊椎転移部に痛みが出現した場合,脊椎SREsの発生も考え,早急に画像検査を行い,痛みの原因と考えられる著しい椎体破壊や脊髄圧迫を認めた場合,早急に治療(RTなど)を行うことである(Red Flag).なお,早急に画像検査が行えない場合,直近のCT等を見直し,椎体破壊の有無を確認すべきである.Red Flagに対して早急に対処し,麻痺が出現する前に治療が開始できれば,麻痺発生数を減らすことができる.(著者抄録)

慢性疼痛患者の破局的思考が身体的機能と活動能力に与える影響 1年間の継時的推移の特徴

太田晴之, 齋藤圭介, 横山暁大, 堅山佳美, 濱田全紀, 鉄永倫子, 西田圭一郎, 尾崎敏文

日本運動器理学療法学会学術大会抄録集 11回 348 - 348 2023.10

内側半月板後根修復後の大腿四頭筋筋力の向上は内側半月板内方逸脱進行を抑制する

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 66 ( 秋季学会 ) 236 - 236 2023.10

内側半月板後根断裂に対するpullout修復術 posterior anchoring追加効果の検討

横山裕介, 古松毅之, 川田紘己, 田村優典, 東原直裕, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 秋季学会 ) 236 - 236 2023.10

大腿骨延長後骨折の変形癒合に対して一期的矯正骨切り術(3次元骨切り術)を施行した片側肥大の1例

奥田龍一郎, 山田和希, 鉄永智紀, 井上智博, 小浦卓, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 秋季学会 ) 367 - 367 2023.10

観血的整復術を施行した発育性股関節形成不全患者の寛骨臼と大腿骨頭の解剖学的位置関係の検討

小浦卓, 鉄永智紀, 山田和希, 井上智博, 奥田龍一郎, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 秋季学会 ) 280 - 280 2023.10

Increased quadriceps muscle strength after medial meniscus posterior root repair is associated with decreased medial meniscus extrusion progression. International journal

Koki Kawada, Takayuki Furumatsu, Mikao Fukuba, Masanori Tamura, Naohiro Higashihara, Yuki Okazaki, Yusuke Yokoyama, Yoshimi Katayama, Masanori Hamada, Toshifumi Ozaki

BMC musculoskeletal disorders 24 ( 1 ) 727 - 727 2023.9

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

BACKGROUND: This study aimed to assess quadriceps muscle strength after medial meniscus (MM) posterior root repair and determine its relationship with clinical scores and MM extrusion (MME). METHODS: Thirty patients who underwent pullout repair for MM posterior root tear and were evaluated for quadriceps muscle strength preoperatively and at 1 year postoperatively were included in this study. Quadriceps muscle strength was measured using the Locomo Scan-II instrument (ALCARE, Tokyo, Japan). MME and clinical scores (i.e., Knee Injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee score, Lysholm score, Tegner score, and visual analog scale pain score) were evaluated preoperatively and at 1 year postoperatively, and second-look arthroscopy was performed at 1 year postoperatively. Wilcoxon's signed-rank test was used to compare each measure pre- and postoperatively. Pearson's correlation coefficient was used to assess the correlation with quadriceps muscle strength values. Multiple regression analysis was performed to identify factors associated with the change in MME (ΔMME). RESULTS: Second-look arthroscopy confirmed continuity of the posterior root in all patients. The quadriceps muscle strength measured at 1 year postoperatively (355.1 ± 116.2 N) indicated significant improvement relative to the quadriceps muscle strength measured preoperatively (271.9 ± 97.4 N, p < 0.001). The MME at 1 year postoperatively (4.59 ± 1.24 mm) had progressed significantly relative to the MME preoperatively (3.63 ± 1.01 mm, p < 0.001). The clinical scores at 1 year postoperatively were improved significantly relative to the scores preoperatively (p < 0.001). The postoperative quadriceps muscle strength was correlated with ΔMME (correlation coefficient = -0.398, p = 0.030), and the change in quadriceps muscle strength was correlated with the KOOS-Quality of Life (correlation coefficient = 0.430, p = 0.018). Multiple regression analysis showed that the postoperative quadriceps muscle strength had a significant effect on ΔMME even when the body mass index and time from injury to surgery were included. CONCLUSIONS: After MM posterior root repair, patients with greater quadriceps muscle strength showed less MME progression. In addition, patients with greater improvement in quadriceps muscle strength had better clinical scores; therefore, continued rehabilitation aimed at improving quadriceps muscle strength after MM posterior root repair is recommended. LEVEL OF EVIDENCE: IV.

DOI： 10.1186/s12891-023-06858-0

完全Web化された医工連携の試み関節可動域自動計測システムの開発 Reviewed

速川湧気, 吉岡健太郎, 鈴木諒, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 2 ) 225 - 230 2023.9

深層学習と民生用3Dセンサを用いた低コスト高精度肘関節可動域自動計測システムの試み Reviewed

鈴木諒, 吉岡健太郎, 速川湧気, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 2 ) 219 - 224 2023.9

大腿骨頸部骨折を合併した寛骨臼両柱骨折の1例 Reviewed

福岡史朗, 佐藤浩平, 畑利彰, 尾崎敏文, 依光正則, 上原健敬

中国・四国整形外科学会雑誌 35 ( 2 ) 285 - 288 2023.9

Advances in treatment of alveolar soft part sarcoma: an updated review. International journal

Tomohiro Fujiwara, Toshiyuki Kunisada, Eiji Nakata, Kenji Nishida, Hiroyuki Yanai, Tomoki Nakamura, Kazuhiro Tanaka, Toshifumi Ozaki

Japanese journal of clinical oncology 2023.8

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

Alveolar soft part sarcoma is a rare neoplasm of uncertain histogenesis that belongs to a newly defined category of ultra-rare sarcomas. The neoplasm is characterized by a specific chromosomal translocation, der (17) t(X; 17)(p11.2;q25), that results in ASPSCR1-TFE3 gene fusion. The natural history of alveolar soft part sarcoma describes indolent behaviour with slow progression in deep soft tissues of the extremities, trunk and head/neck in adolescents and young adults. A high rate of detection of distant metastasis at presentation has been reported, and the most common metastatic sites in decreasing order of frequency are the lung, bone and brain. Complete surgical resection remains the standard treatment strategy, whereas radiotherapy is indicated for patients with inadequate surgical margins or unresectable tumours. Although alveolar soft part sarcoma is refractory to conventional doxorubicin-based chemotherapy, monotherapy or combination therapy using tyrosine kinase inhibitors and immune checkpoint inhibitors have provided antitumor activity and emerged as new treatment strategies. This article provides an overview of the current understanding of this ultra-rare sarcoma and recent advancements in treatments according to the clinical stage of alveolar soft part sarcoma.

DOI： 10.1093/jjco/hyad102

Wrist arthrodesis combined with a bulk bone allograft for implant loosening after total wrist arthroplasty: a case report. International journal

Yoshihisa Nasu, Keiichiro Nishida, Masamitsu Natsumeda, Ryuichi Nakahara, Ryozo Harada, Toshifumi Ozaki

Modern rheumatology case reports 2023.8

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

Total wrist arthroplasty is a challenging procedure for wrist joints severely destroyed by rheumatoid arthritis. The most common postoperative complication of total wrist arthroplasty is the loosening of the carpal component. Revision surgeries for failed total wrist arthroplasties can be complicated owing to severe bone loss and concomitant soft-tissue problems. Here we report a case (68-year-old woman with a history of rheumatoid arthritis for 24 years) of severe aseptic loosening of semi-constrained total wrist arthroplasty and its salvage surgery. During the primary arthroplasty procedure, severe instability at the second through fifth carpometacarpal joints was observed, and arthrodesis of these joints was required. The radiographs obtained nine months after surgery showed loosening of the carpal component. Subsequently, she suffered a stroke, resulting in a loss of follow-up, and higher stress was loaded on her upper extremities during standing and walking. In the radiograph taken at her revisit 25 months after the primary surgery, the subsidence of the carpal component progressed, and loosening of the radial component was observed. Total wrist arthrodesis was performed using a bulk bone allograft of the femoral head, combined with a penetrating Wrist Fusion Rod®. Rapid bone union was achieved without soft tissue irritation. We conclude that wrist arthrodesis with a bulk bone allograft combined with an intramedullary nail is a reasonable option for failed total wrist arthroplasty.

DOI： 10.1093/mrcr/rxad048

ヒトiPS細胞由来肢芽間葉系細胞の発生機序の検討

高尾知佳, 大曽根達則, 山田大祐, 中田英二, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 97 ( 8 ) S1599 - S1599 2023.8

内側半月板後根修復術後の早期部分荷重は半月板修復状態を悪化させない

田村優典, 古松毅之, 横山裕介, 金高圭甫, 東原直裕, 川田紘己, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1643 - S1643 2023.8

テロメラーゼ依存性腫瘍融解アデノウイルスの骨・軟部腫瘍への応用を目指した蛍光タンパクによるウイルスの治療効果予測

魚谷弘二, 藤原智洋, 田澤大, 植田昌敬, 志渡澤央和, 小田孔明, 鉄永倫子, 三澤治夫, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1714 - S1714 2023.8

軟部組織再建への応用を目指した脱細胞化骨格筋の作製法の確立

福岡史朗, 藤原智洋, 澤田和也, 依光正則, 上原健敬, 尾崎敏文, 藤里俊哉

日本整形外科学会雑誌 97 ( 8 ) S1900 - S1900 2023.8

肉腫診療におけるがん遺伝子パネルの有用性

中田英二, 藤原智洋, 国定俊之, 遠西大輔, 山本英喜, 二宮貴一朗, 冨田秀太, 二川摩周, 平沢晃, 豊岡伸一, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1894 - S1894 2023.8

肉腫に対する微小環境改善薬の開発ナノキャリア修飾によるCSF-1/CSF-1R阻害剤の安全性の向上

藤原智洋, Yakoub Mohamed, 吉田晶, 近藤彩奈, 板野拓人, 片山晴喜, 中田英二, 国定俊之, 尾崎敏文, Ouerfelli Ouerthek, Healey John

日本整形外科学会雑誌 97 ( 8 ) S1892 - S1892 2023.8

Computer assisted orthopaedic surgeryがもたらす整形外科の次世代診療希少疾患に対するAI開発戦略

長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1783 - S1783 2023.8

血中CSF-1濃度は浸潤性軟部肉腫における腫瘍随伴マクロファージの浸潤と相関し生存予後と相関する

畑利彰, 藤原智洋, 吉田晶, 近藤彩奈, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1886 - S1886 2023.8

肉腫細胞と肉腫微小環境の双方を標的とする複合治療の開発軟部肉腫に対する新しい治療アプローチ

近藤彩奈, 藤原智洋, 吉田晶, 畑利彰, 板野拓人, 片山晴喜, 佐藤浩平, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1885 - S1885 2023.8

MPNST腫瘍細胞内のカテコラミン合成経路の阻害ががん幹細胞性に与える影響と治療薬としての可能性

片山晴喜, 藤村篤史, 中田英二, 板野拓人, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1884 - S1884 2023.8

翻訳制御機構を標的とした横紋筋肉腫の新規治療法の開発

板野拓人, 中田英二, 藤村篤史, 黄栄生, 片山晴喜, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1884 - S1884 2023.8

ヒトiPS細胞由来肢芽間葉系細胞を用いた骨再建法の開発

佐藤浩平, 高尾知佳, 中田英二, 藤澤佑樹, 山田大祐, 上原健敬, 藤原智洋, 依光正則, 国定俊之, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 97 ( 8 ) S1868 - S1868 2023.8

テロメラーゼ依存性腫瘍融解アデノウイルスの骨・軟部腫瘍への応用を目指した蛍光タンパクによるウイルスの治療効果予測

魚谷弘二, 藤原智洋, 田澤大, 植田昌敬, 志渡澤央和, 小田孔明, 鉄永倫子, 三澤治夫, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1714 - S1714 2023.8

Index of postural stability(IPS)を用いた思春期特発性側彎症患者における動的姿勢制御能力の検討

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 志渡澤央和, 植田昌敬, 山脇諒子, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1839 - S1839 2023.8

翻訳制御機構を標的とした横紋筋肉腫の新規治療法の開発

板野拓人, 中田英二, 藤村篤史, 黄栄生, 片山晴喜, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1884 - S1884 2023.8

内側半月板後根修復術後の早期部分荷重は半月板修復状態を悪化させない

田村優典, 古松毅之, 横山裕介, 金高圭甫, 東原直裕, 川田紘己, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1643 - S1643 2023.8

整形外科医の手による骨・軟部腫瘍の医師主導治験への道腱滑膜巨細胞腫に対するザルトプロフェンを用いた医師主導治験(REALIZE study)の立案と実施

武内章彦, 遠藤誠, 川井章, 西田佳弘, 寺内竜, 松峯昭彦, 相羽久輝, 中村知樹, 尾崎敏文, 星学, 土屋弘行

日本整形外科学会雑誌 97 ( 8 ) S1557 - S1557 2023.8

ヒトiPS細胞由来肢芽間葉系細胞の発生機序の検討

高尾知佳, 大曽根達則, 山田大祐, 中田英二, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 97 ( 8 ) S1599 - S1599 2023.8

ヒトiPS細胞由来肢芽間葉系細胞を用いた骨再建法の開発

佐藤浩平, 高尾知佳, 中田英二, 藤澤佑樹, 山田大祐, 上原健敬, 藤原智洋, 依光正則, 国定俊之, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 97 ( 8 ) S1868 - S1868 2023.8

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, 中田英二, 板野拓人, 片山晴喜, 藤原智洋, 国定俊之, 山田大祐, 高尾知佳, 宝田剛志, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1890 - S1890 2023.8

Computer assisted orthopaedic surgeryがもたらす整形外科の次世代診療希少疾患に対するAI開発戦略

長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1783 - S1783 2023.8

【がん患者の運動器マネージメント-がんであっても歩けることの重要性】がん運動器マネージメントに必要ながん医療の基礎知識

堅山佳美, 中田英二, 濱田全紀, 尾崎敏文

Journal of Clinical Rehabilitation 32 ( 9 ) 841 - 847 2023.8

Index of postural stability(IPS)を用いた思春期特発性側彎症患者における動的姿勢制御能力の検討

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 志渡澤央和, 植田昌敬, 山脇諒子, 尾崎敏文

日本整形外科学会雑誌 97 ( 8 ) S1839 - S1839 2023.8

LRRC15 expression indicates high level of stemness regulated by TWIST1 in mesenchymal stem cells. International journal

Kensuke Toriumi, Yuta Onodera, Toshiyuki Takehara, Tatsufumi Mori, Joe Hasei, Kanae Shigi, Natsumi Iwawaki, Toshifumi Ozaki, Masao Akagi, Mahito Nakanishi, Takeshi Teramura

iScience 26 ( 7 ) 106946 - 106946 2023.7

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

Mesenchymal stem cells (MSCs) are used as a major source for cell therapy, and its application is expanding in various diseases. On the other hand, reliable method to evaluate quality and therapeutic properties of MSC is limited. In this study, we focused on TWIST1 that is a transcription factor regulating stemness of MSCs and found that the transmembrane protein LRRC15 tightly correlated with the expression of TWIST1 and useful to expect TWIST1-regulated stemness of MSCs. The LRRC15-positive MSC populations in human and mouse bone marrow tissues highly expressed stemness-associated transcription factors and therapeutic cytokines, and showed better therapeutic effect in bleomycin-induced pulmonary fibrosis model mice. This study provides evidence for the important role of TWIST1 in the MSC stemness, and for the utility of the LRRC15 protein as a marker to estimate stem cell quality in MSCs before cell transplantation.

DOI： 10.1016/j.isci.2023.106946

Influence of Janus kinase inhibitors on early postoperative complications in patients with rheumatoid arthritis undergoing orthopaedic surgeries

Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Shuichi Naniwa, Ryuichi Nakahara, Yoshifumi Hotta, Noriyuki Shimizu, Deting Lin, Toshifumi Ozaki

Modern Rheumatology 34 ( 3 ) 466 - 473 2023.6

Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

ABSTRACT

Objective

We retrospectively reviewed the records of rheumatoid arthritis (RA) patients who underwent orthopaedic surgery to examine the influence of the perioperative use of Janus kinase (JAK) inhibitors on early postoperative complications.

Patients and Methods

Thirty-two patients with RA under disease control with JAK inhibitors who underwent 49 orthopaedic procedures were included in the study. Patient records after surgery were investigated for surgical site infection (SSI), delayed wound healing (DWH), a flare-up of the disease, preoperative and postoperative absolute lymphocyte counts (ALCs), venous thromboembolism, and other postoperative complications.

Results

JAK inhibitors were continued during the perioperative period in 31 procedures. In the remaining 18 procedures, JAK inhibitors were discontinued perioperatively with a mean discontinuation period of 2.4 days. No instances of SSI were identified in any patient during at least 90 days’ follow-up, while DWH was seen in one patient. Disease flare-up was noted in two patients after 3 and 9 days of discontinuation of JAK inhibitors, respectively. The ALCs significantly decreased on postoperative Day 1 (P &lt; .0001), and there was a significant correlation between pre- and post-one-day ALCs (r = 0.75, P &lt; .0001).

Conclusion

JAK inhibitors seem to be safe during the perioperative period of orthopaedic surgery.

DOI： 10.1093/mr/road047

Other Link： https://academic.oup.com/mr/article-pdf/34/3/466/57109151/road047.pdf

悪性末梢神経鞘腫瘍における治療標的PRRX1の同定と新規創薬開発の可能性

たき平将太, 山田大祐, 岡本真幸, 高尾知佳, 中田英二, 板野拓人, 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 97 ( 6 ) S1428 - S1428 2023.6

非転位型の橈骨遠位端骨折において骨折部位,Lister結節形状は長母指伸筋腱断裂に影響する

斎藤太一, 近藤秀則, 福岡史朗, 佐藤浩平, 畑利彰, 中道亮, 依光正則, 島村安則, 尾崎敏文

骨折 45 ( Suppl. ) S301 - S301 2023.6

術前化学療法を併用した四肢高悪性度肉腫に対する局所再発の臨床病理学的背景 JCOG0304副次的解析

筑紫聡, 田仲和宏, 国定俊之, 町田龍之介, 竹中聡, 川井章, 片桐浩久, 比留間徹, 松本嘉寛, 土屋弘行, 中山ロバート, 畠野宏史, 江森誠人, 吉田新一郎, 大幸英至, 坂本昭夫, 今西淳悟, 喜多亮介, 尾崎敏文, 岩本幸英

日本整形外科学会雑誌 97 ( 6 ) S1459 - S1459 2023.6

腫瘍軟部腫瘍に対する放射線治療後の病的大腿骨骨折術後感染に対する治療戦略

斎藤太一, 上原健敬, 中道亮, 依光正則, 島村安則, 野田知之, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 46回 82 - 82 2023.6

The clinical and radiographic outcomes of type 2 medial meniscus posterior root tears following transtibial pullout repair. Reviewed International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yusuke Yokoyama, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Koki Kawada, Haowei Xue, Masanori Hamada, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 31 ( 6 ) 2323 - 2330 2023.6

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

PURPOSE: The aim of this study was to compare the clinical outcomes of different subtypes of type 2 medial meniscus posterior root tears following transtibial pullout repair. METHODS: In total, 147 patients (mean age: 66.2 ± 8.3 years) who were diagnosed with type 2 medial meniscus posterior root tears and underwent transtibial pullout repair were included. Patients were divided into 2A (n = 31), 2B (n = 90), and 2C (n = 26) groups according to tear type. Clinical outcomes were assessed pre-operatively and at second-look arthroscopy using the Knee injury and Osteoarthritis Outcome Score. The meniscal healing status was evaluated at second-look arthroscopy. Medial meniscus extrusion was calculated using magnetic resonance imaging pre-operatively and at second-look arthroscopy. RESULTS: No significant differences in pre-operative or post-operative clinical scores were observed between each subtype, although clinical scores improved post-operatively for each subtype. Significant differences were noted in the anteroposterior width of the bridging tissues at second-look arthroscopy (2A, 7.1 ± 1.2; 2B, 6.2 ± 1.7; and 2C, 6.2 ± 1.7 mm; p = 0.045); type 2A tears were the widest. There was a significant difference in post-operative medial meniscus extrusion (2A, 3.2 ± 0.9; 2B, 4.0 ± 1.2; and 2C, 4.0 ± 1.4 mm; p = 0.004) and its progression (2A, 0.7 ± 0.6; 2B, 1.2 ± 0.8; and 2C, 1.2 ± 0.8 mm; p = 0.008), and type 2A tears were the shortest. CONCLUSION: Although there was no significant difference in the post-operative clinical scores among different type 2 tears in the short term, type 2A tears showed better healing and medial meniscus extrusion progression prevention, thus indicating the usefulness of classifying tear type in estimating post-operative outcomes. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-022-07293-9

J-SC人工肘関節の連結部に破損を生じた1例

那須義久, 西田圭一郎, 志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 270 - 270 2023.6

関節リウマチ患者に対する前足部切除関節形成術後の骨棘切除術

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 249 - 249 2023.6

両手関節炎様の所見を呈した腱黄色腫の1例

浪花崇一, 志水紀之, 林徳てい, 堀田佳史, 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 42 ( 3 ) 214 - 214 2023.6

大規模言語モデル(ChatGPT)による医師国家試験解答解析

中原龍一, 西田圭一郎, 高橋康, 那須義久, 堀田佳史, 浪花崇一, 志水紀之, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 191 - 191 2023.6

切除不能な骨巨細胞腫に対するデノスマブのde-escalation

片山晴喜, 中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1347 - S1347 2023.6

骨転移とどう向き合うか骨転移診療システムにおける脊椎転移の保存的治療とリハビリテーション診療

杉原進介, 近藤宏也, 中田英二, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1422 - S1422 2023.6

MPNST腫瘍細胞内のカテコラミン合成経路とその腫瘍幹細胞性維持に対する役割

片山晴喜, 藤村篤史, 中田英二, 板野拓人, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1493 - S1493 2023.6

手術予定がん患者のロコモティブシンドロームと関連因子

堅山佳美, 中田英二, 濱田全紀, 国定俊之, 藤原智洋, 近藤彩奈, 千田益生, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1477 - S1477 2023.6

軟部肉腫患者における地理的因子の臨床的意義肉腫専門施設受診前因子の改善を目指して

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

日本整形外科学会雑誌 97 ( 6 ) S1467 - S1467 2023.6

骨・軟部腫瘍の教育と専門医育成骨・軟部腫瘍における基礎・トランスレーショナル研究の魅力

藤原智洋, 中田英二, 国定俊之, 川井章, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1302 - S1302 2023.6

周術期がん患者におけるがんロコモティブシンドローム

尾崎敏文, 堅山佳美, 濱田全紀, 国定俊之, 藤原智洋, 千田益生, 中田英二

運動器リハビリテーション 34 ( 2 ) 155 - 155 2023.6

高齢軟部肉腫患者において年代別で生存予後因子および合併症リスク因子は異なるか

近藤彩奈, 藤原智洋, 畑利彰, 板野拓人, 片山晴喜, 佐藤浩平, 吉田晶, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1465 - S1465 2023.6

肉腫診療におけるゲノム医療

板野拓人, 中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1449 - S1449 2023.6

骨盤悪性骨腫瘍に対する股関節包内切除術と包外切除術の腫瘍学的予後および機能的予後の比較検討

藤原智洋, Stevenson Jonathan, Parry Michael, Grimer Robert, 津田祐輔, 長谷井嬢, 中田英二, 国定俊之, 尾崎敏文, Jeys Lee

日本整形外科学会雑誌 97 ( 6 ) S1443 - S1443 2023.6

小児骨・軟部腫瘍の治療:進歩と課題小児悪性骨腫瘍の再建の工夫と問題点

国定俊之, 中田英二, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1424 - S1424 2023.6

前腕の軟部肉腫の治療成績

中田英二, 国定俊之, 藤原智洋, 片山晴喜, 板野拓人, 近藤彩奈, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1380 - S1380 2023.6

外傷性足関節症に至った脛骨ピロン骨折の一例

上原健敬, 志水紀之, 浪花崇一, 福岡史朗, 依光正則, 尾崎敏文

骨折 45 ( Suppl. ) S188 - S188 2023.6

踵骨骨折に対するBest Practice 2023 in Japan Sinus tarsi approachの実際と固定法

依光正則, 佐藤浩平, 福岡史朗, 上原健敬, 尾崎敏文

骨折 45 ( Suppl. ) S167 - S167 2023.6

脛骨プラトー骨折における後外側骨片アプローチと固定の是非

依光正則, 福岡史朗, 上原健敬, 尾崎敏文

骨折 45 ( Suppl. ) S127 - S127 2023.6

腫瘍軟部腫瘍に対する放射線治療後の病的大腿骨骨折術後感染に対する治療戦略

斎藤太一, 上原健敬, 中道亮, 依光正則, 島村安則, 野田知之, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 46回 82 - 82 2023.6

脛骨々幹部骨折に対する異なるアプローチ間での髄内釘の挿入位置の検討

福岡史朗, 依光正則, 上原健敬, 寺田忠司, 尾崎敏文

骨折 45 ( Suppl. ) S356 - S356 2023.6

3DCTを用いた載距突起への至適なscrew設置の解剖学的ランドマークの検討

福岡史朗, 依光正則, 上原健敬, 尾崎敏文

骨折 45 ( Suppl. ) S264 - S264 2023.6

当科における下肢長管骨偽関節の治療成績

上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 依光正則, 野田知之, 尾崎敏文

骨折 45 ( Suppl. ) S242 - S242 2023.6

Floating Hip術後に対してTHAを行い感染した1例

福岡史朗, 依光正則, 上原健敬, 鉄永智紀, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 46回 186 - 186 2023.6

踵骨開放骨折術後の深部感染に対しCLAP療法を行った1例

志水紀之, 依光正則, 福岡史朗, 上原健敬, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 46回 125 - 125 2023.6

J-SC人工肘関節の連結部に破損を生じた1例

那須義久, 西田圭一郎, 志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 270 - 270 2023.6

大規模言語モデル(ChatGPT)による医師国家試験解答解析

中原龍一, 西田圭一郎, 高橋康, 那須義久, 堀田佳史, 浪花崇一, 志水紀之, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 191 - 191 2023.6

両手関節炎様の所見を呈した腱黄色腫の1例

浪花崇一, 志水紀之, 林徳てい, 堀田佳史, 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 42 ( 3 ) 214 - 214 2023.6

関節リウマチ患者に対する前足部切除関節形成術後の骨棘切除術

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本関節病学会誌 42 ( 3 ) 249 - 249 2023.6

肉腫診療におけるゲノム医療

板野拓人, 中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 6 ) S1449 - S1449 2023.6

悪性末梢神経鞘腫瘍における治療標的PRRX1の同定と新規創薬開発の可能性

たき平将太, 山田大祐, 岡本真幸, 高尾知佳, 中田英二, 板野拓人, 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 97 ( 6 ) S1428 - S1428 2023.6

術前化学療法を併用した四肢高悪性度肉腫に対する局所再発の臨床病理学的背景 JCOG0304副次的解析

筑紫聡, 田仲和宏, 国定俊之, 町田龍之介, 竹中聡, 川井章, 片桐浩久, 比留間徹, 松本嘉寛, 土屋弘行, 中山ロバート, 畠野宏史, 江森誠人, 吉田新一郎, 大幸英至, 坂本昭夫, 今西淳悟, 喜多亮介, 尾崎敏文, 岩本幸英

日本整形外科学会雑誌 97 ( 6 ) S1459 - S1459 2023.6

骨盤悪性骨腫瘍に対する股関節包内切除術と包外切除術の腫瘍学的予後および機能的予後の比較検討

藤原智洋, Stevenson Jonathan, Parry Michael, Grimer Robert, 津田祐輔, 長谷井嬢, 中田英二, 国定俊之, 尾崎敏文, Jeys Lee

日本整形外科学会雑誌 97 ( 6 ) S1443 - S1443 2023.6

軟部肉腫に対する広範切除後の機能回復は成人患者と高齢患者でどのように異なるか? 下肢発生肉腫の検討

藤原智洋, 中田英二, 近藤彩奈, 堅山佳美, 濱田全紀, 国定俊之, 尾崎敏文, 千田益生

The Japanese Journal of Rehabilitation Medicine 60 ( 特別号 ) 3 - 3 2023.5

軟部肉腫に対する広範切除後の機能回復は成人患者と高齢患者でどのように異なるか? 下肢発生肉腫の検討

藤原智洋, 中田英二, 近藤彩奈, 堅山佳美, 濱田全紀, 国定俊之, 尾崎敏文, 千田益生

The Japanese Journal of Rehabilitation Medicine 60 ( 特別号 ) 3 - 3 2023.5

Double plating via anterolateral and posterolateral approach for distal femoral fracture. International journal

Yasuaki Yamakawa, Yasutaka Masada, Ryuichiro Okuda, Toshiyuki Matsumoto, Takenori Uehara, Masanori Yorimitsu, Tomoyuki Noda, Toshifumi Ozaki

Trauma case reports 44 100803 - 100803 2023.4

Language：English

Although there are some reports highlighting the applicability of double plates in distal femoral fractures, there is no standard approach or fixation method for supracondylar fractures combined with posterior coronal shear fractures. We report a case of distal femoral fracture treated with a lateral locking plate and posterior buttress plate using anterolateral and posterolateral approaches from one incision. A 70-year-old man was hit by a motorcycle and had an intra-articular distal femoral fracture involving a long medial proximal spike and a single lateral condyle fragment, with the lateral condyle fragment posteriorly displaced. A 12-cm lateral skin incision was made, and the joint was developed using a para-patellar approach from the anterior to iliotibial band. Posterior buttress plate fixation was successfully performed from behind the iliotibial band using a posterolateral approach, followed by cannulated cancellous screw and lateral locking plate fixation from the anterolateral window. Combined anterolateral and posterolateral approaches from one incision enable intra-articular exposure and fixation based on fixation principles for lateral condyle fragments combined with supracondylar fracture.

DOI： 10.1016/j.tcr.2023.100803

ヒト多能性幹細胞から誘導した肢芽間葉系細胞と、その拡大培養法の開発

中田英二, 山田大祐, 高尾知佳, たき平将太, 藤原智洋, 尾崎敏文, 宝田剛志

移植 57 ( 4 ) 363 - 363 2023.4

ヒトiPS細胞から誘導した肢芽間葉系細胞による軟骨シートの作製

藤澤佑樹, 高尾知佳, 佐藤正人, 豊田恵利子, 山田大祐, 中田英二, 尾崎敏文, 宝田剛志

移植 57 ( 4 ) 362 - 362 2023.4

Accuracy of the newly developed Zimmer Biomet Root Aiming guide in tibial tunnel creation compared with that of conventional guides. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Eiji Nakata, Toshifumi Ozaki

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology 32 1 - 6 2023.4

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

BACKGROUND/OBJECTIVE: Accurate tibial tunnel creation is crucial for successful transtibial pullout repair of medial meniscus (MM) posterior root tears (MMPRTs). This study aimed to evaluate the accuracy of the newly developed Zimmer Biomet Root Aiming (ZeBRA) guide for transtibial pullout repair of MMPRTs. METHODS: This study included 50 patients who underwent transtibial pullout repair using the Unicorn Meniscal Root (UMR) (n = 25) and ZeBRA (n = 25) guides. The expected anatomic centre (AC) and tibial tunnel centre (TC) were assessed using three-dimensional postoperative computed tomography (CT) images. The expected AC was defined as the centre of the circle tangent to the triangular footprint of the MM posterior root. The expected AC and TC on the tibial surface were assessed using the percentage-based posterolateral location on the tibial surface. The absolute distance between the AC and TC (mm) was evaluated. RESULTS: The mean AC location was 76.1% ± 3.1% posterior and 40.8% ± 2.1% lateral, whereas the mean TC location was 76.7% ± 5.3% posterior and 37.2% ± 3.6% lateral using the UMR guide and 75.8% ± 3.1% posterior and 36.5% ± 2.4% lateral using the ZeBRA guide. No significant difference was observed in the absolute distance between the UMR and ZeBRA guides (3.9 ± 1.4 and 3.8 ± 1.3 mm, respectively; p = 0.617). CONCLUSIONS: The newly developed ZeBRA guide allows accurate tibial tunnel creation, and its accuracy is comparable to that of the conventional UMR guide. Tibial tunnels were created at optimal positions using both guides, and the choice of the guide would depend on the surgeon's preference.

DOI： 10.1016/j.asmart.2023.03.001

野球選手における有鉤骨骨折に対する皮皺に沿った掌側進入法における手術治療成績

島村安則, 根津智史, 斎藤太一, 中道亮, 山脇正, 久禮美穂, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 40 ( 1 ) O38 - 5 2023.4

Fracture Line Distributions of Undisplaced Distal Radius Fractures in Relation to Rupture of the Extensor Pollicis Longus Tendon. Reviewed

Hidenori Kondo, Taichi Saito, Ryuichi Nakahara, Ryo Nakamichi, Yasunori Shimamura, Ryozo Harada, Junya Imatani, Toshifumi Ozaki

Acta medica Okayama 77 ( 2 ) 179 - 184 2023.4

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

Rupture of the extensor pollicis longus (EPL) tendon is a known complication after undisplaced distal radius fracture (DRF). However, no report has revealed the relationship between EPL tendon rupture and the fracture pattern. Thus, this study aimed to investigate the characteristics of fractures at risk of EPL tendon rupture using fracture line mapping of undisplaced DRFs. This study used computed tomography imaging data of undisplaced DRFs with (n=18) and without EPL tendon rupture (n=52). Fracture lines obtained from 3D reconstruction data were drawn manually after matching with a 2D template wrist model. Fracture maps represented the fracture line distribution by superimposing the fracture lines of all 70 patients. Heat maps showed the relative frequency of the fracture lines as a gradual color change. Fracture lines of cases with EPL tendon rupture were concentrated in the proximal border of Lister's tubercle. By contrast, fracture lines of cases without EPL tendon rupture were relatively dispersed.

DOI： 10.18926/AMO/65147

鏡視下手根管開放術と小切開手根管開放術の短期成績の比較検討

中道亮, 斎藤太一, 島村安則, 尾崎敏文

日本手外科学会雑誌 40 ( 1 ) O25 - 2 2023.4

弾発指に対する術後リハビリテーションの有効性

斎藤太一, 中道亮, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 40 ( 1 ) O32 - 2 2023.4

内側半月板後根プルアウト修復術後の外側楔状足底板の使用は術後成績を改善する

川田紘己, 古松毅之, 横山裕介, 金高圭甫, 東原直裕, 田村優典, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 1 ) 186 - 186 2023.4

片側下腿に発生した多発性グロムス腫瘍の一例 Reviewed

徳田貴大, 藤原智洋, 近藤彩奈, 国定俊之, 中田英二, 西村碧フィリーズ, 柳井広之, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 1 ) 47 - 51 2023.4

Language：Japanese Publisher：中国・四国整形外科学会

症例は21歳男性で、左下腿脛骨外側部のグロムス腫瘍切除術後2ヵ月経過した時点で左下腿の疼痛が再燃した。MRIでは左脛骨前面、脛骨後面、脛腓間、腓骨周囲に多発性の腫瘤を認め、これら全病変を辺縁切除した。病理検査では全てグロムス腫瘍と診断され、術後1年の時点で疼痛の再燃や腫瘍の再発は認めず、趣味のダンスも再開している。

重度骨粗鬆症性椎体骨折に対するCement catching screwの有用性

三澤治夫, 魚谷弘二, 小田孔明, 志渡澤央和, 植田昌敬, 尾崎敏文

Journal of Spine Research 14 ( 3 ) 680 - 680 2023.4

Lenke type 1思春期特発性側彎症におけるHybrid法とSegmental Pedicle screw法による治療効果の検討

魚谷弘二, 三澤治夫, 鉄永倫子, 小田孔明, 志渡澤央和, 植田昌敬, 尾崎敏文

Journal of Spine Research 14 ( 3 ) 283 - 283 2023.4

骨粗鬆症治療を導入すべき脊椎手術を受ける患者の現状

高尾真一郎, 三澤治夫, 小田孔明, 魚谷弘二, 鉄永倫子, 山根健太郎, 竹内一裕, 尾崎敏文, 中原進之介

Journal of Spine Research 14 ( 3 ) 651 - 651 2023.4

Malignant spinal Cord Compression(MSCC)を伴う転移性脊椎腫瘍患者に対する手術介入は生命予後を改善するのか

志渡澤央和, 魚谷弘二, 三澤治夫, 鉄永倫子, 小田孔明, 植田昌敬, 尾崎敏文

Journal of Spine Research 14 ( 3 ) 243 - 243 2023.4

内側半月板後根プルアウト修復術後の外側楔状足底板の使用は術後成績を改善する

川田紘己, 古松毅之, 横山裕介, 金高圭甫, 東原直裕, 田村優典, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 1 ) 186 - 186 2023.4

Meniscus extrusion is a predisposing factor for determining arthroscopic treatments in partial medial meniscus posterior root tears. International journal

Takayuki Furumatsu, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Koki Kawada, Haowei Xue, Toshifumi Ozaki

Knee surgery & related research 35 ( 1 ) 8 - 8 2023.3

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

BACKGROUND: Patients with partial medial meniscus posterior root tears (MMPRTs) sometimes require arthroscopic pullout repair because of their intolerable/repeated knee pains and continuous disturbance in gait during activities of daily living. However, the predisposing factors for future knee surgery in patients with partial MMPRTs remain unclear. We compared the findings of magnetic resonance imaging (MRI) between patients who underwent pullout repair and nonoperative management following partial MMPRTs. METHODS: Twenty-five patients who required arthroscopic repair for partial MMPRTs and 23 patients who were managed nonoperatively were evaluated during a mean follow-up period of 27.1 months. Sex, age, height, body weight, body mass index, duration from onset to initial MRI, MRI findings, and medial meniscus (MM) extrusion were compared between the two groups. Linear regression analysis was used to assess the correlation between MM extrusion and duration from onset to MRI examination. RESULTS: No significant differences were observed between the pullout repair and nonoperative management groups in terms of patient demographics and the positive ratio of MRI-based root tear signs. However, absolute MM extrusion in the pullout repair group (3.49 ± 0.82 mm) was larger than that in the nonoperative management group (2.48 ± 0.60 mm, P < 0.001). Extrusion of the MM (> 3 mm) was detected more frequently in the pullout repair group than in the nonoperative management group (P < 0.001). The odds ratio in the pullout repair and MM extrusion > 3 mm cases was 9.662. Linear regression analysis revealed a fair correlation between the duration from onset to MRI and MM extrusion only in the pullout repair group (0.462 mm/month increase in MM extrusion). CONCLUSIONS: This study demonstrated that more severe MM extrusions were observed in the pullout repair group than in the nonoperative management group. Major extrusion (> 3 mm) was also observed more in the pullout repair group than in the nonoperative group. Assessing MM extrusion and its severity can help determine a valid treatment for patients with partial MMPRTs. LEVEL OF EVIDENCE: IV, Retrospective comparative study.

DOI： 10.1186/s43019-023-00182-6

Protocol for the 2ND-STEP study, Japan Clinical Oncology Group study JCOG1802: a randomized phase II trial of second-line treatment for advanced soft tissue sarcoma comparing trabectedin, eribulin and pazopanib. International journal

Makoto Endo, Tomoko Kataoka, Toshifumi Fujiwara, Satoshi Tsukushi, Masanobu Takahashi, Eisuke Kobayashi, Yoko Yamada, Takaaki Tanaka, Yutaka Nezu, Hiroaki Hiraga, Junji Wasa, Akihito Nagano, Kenji Nakano, Robert Nakayama, Tetsuya Hamada, Masanori Kawano, Tomoaki Torigoe, Akio Sakamoto, Kunihiro Asanuma, Takeshi Morii, Ryunosuke Machida, Yuta Sekino, Haruhiko Fukuda, Yoshinao Oda, Toshifumi Ozaki, Kazuhiro Tanaka

BMC cancer 23 ( 1 ) 219 - 219 2023.3

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

BACKGROUND: Soft tissue sarcomas (STS) are a rare type of malignancy comprising a variety of histological diagnoses. Chemotherapy constitutes the standard treatment for advanced STS. Doxorubicin-based regimens, which include the administration of doxorubicin alone or in combination with ifosfamide or dacarbazine, are widely accepted as first-line chemotherapy for advanced STS. Trabectedin, eribulin, pazopanib, and gemcitabine plus docetaxel (GD), which is the empirical standard therapy in Japan, are major candidates for second-line chemotherapy for advanced STS, although clear evidence of the superiority of any one regimen is lacking. The Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group (JCOG) conducts this trial to select the most promising regimen among trabectedin, eribulin, and pazopanib for comparison with GD as the test arm regimen in a future phase III trial of second-line treatment for patients with advanced STS. METHODS: The JCOG1802 study is a multicenter, selection design, randomized phase II trial comparing trabectedin (1.2 mg/m2 intravenously, every 3 weeks), eribulin (1.4 mg/m2 intravenously, days 1 and 8, every 3 weeks), and pazopanib (800 mg orally, every day) in patients with unresectable or metastatic STS refractory to doxorubicin-based first-line chemotherapy. The principal eligibility criteria are patients aged 16 years or above; unresectable and/or metastatic STS; exacerbation within 6 months prior to registration; histopathological diagnosis of STS other than Ewing sarcoma, embryonal/alveolar rhabdomyosarcoma, well-differentiated liposarcoma and myxoid liposarcoma; prior doxorubicin-based chemotherapy for STS, and Eastern Cooperative Oncology Group performance status 0 to 2. The primary endpoint is progression-free survival, and the secondary endpoints include overall survival, disease-control rate, response rate, and adverse events. The total planned sample size to correctly select the most promising regimen with a probability of > 80% is 120. Thirty-seven institutions in Japan will participate at the start of this trial. DISCUSSION: This is the first randomized trial to evaluate trabectedin, eribulin, and pazopanib as second-line therapies for advanced STS. We endeavor to perform a subsequent phase III trial comparing the best regimen selected by this study (JCOG1802) with GD. TRIAL REGISTRATION: This study was registered with the Japan Registry of Clinical Trials ( jRCTs031190152 ) on December 5, 2019.

DOI： 10.1186/s12885-023-10693-w

腱滑膜巨細胞腫に対するザルトプロフェンのプラセボ対照無作為化二重盲検比較試験(第II相試験) The REALIZE study

武内章彦, 遠藤誠, 川井章, 西田佳弘, 寺内竜, 松峯昭彦, 相羽久輝, 中村知樹, 丹代晋, 尾崎敏文, 土屋弘行

日本整形外科学会雑誌 97 ( 2 ) S88 - S88 2023.3

悪性末梢神経鞘腫瘍におけるPRRX1の治療標的分子としての可能性

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

日本整形外科学会雑誌 97 ( 3 ) S1040 - S1040 2023.3

生物学的製剤の使用は手術部位感染と創傷治癒遅延のリスク因子となるか

木曽洋平, 西田圭一郎, 原田遼三, 那須義久, 中原龍一, 渡辺雅仁, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S1022 - S1022 2023.3

[Ⅲ. The Role of Comprehensive Genomic Profiling in Sarcoma].

Eiji Nakata, Tomohiro Fujiwara, Toshiyuki Kunisada, Toshifumi Ozaki, Shinichi Toyooka, Daisuke Ennishi, Hideki Yamamoto, Kiichiro Ninomiya, Shuta Tomida, Akira Hirasawa, Mashu Futagawa, Masahiro Tabata

Gan to kagaku ryoho. Cancer & chemotherapy 50 ( 3 ) 314 - 320 2023.3

人工肘関節置換術-合併症に対する創意と工夫- 人工肘関節周囲骨折の治療戦略

那須義久, 志水紀之, 浪花崇一, 堀田佳史, 原田遼三, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S565 - S565 2023.3

リウマチ性疾患における画像検査教師なしAIを用いたトポロジー学習・関節リウマチ超音波画像同一断面自動検出

中原龍一, 西田圭一郎, 那須義久, 浪花崇一, 堀田佳史, 志水紀之, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 67回 718 - 718 2023.3

リウマチ性疾患の手術:周術期管理・手術関連諸問題関節リウマチに対する整形外科手術後の手術部位感染・創傷治癒遅延の発生頻度と治癒過程はb/tsDMARD使用に影響されるか?

浪花崇一, 志水紀之, 堀田佳史, 中原龍一, 那須義久, 尾崎敏文, 西田圭一郎

日本リウマチ学会総会・学術集会プログラム・抄録集 67回 691 - 691 2023.3

生物学的製剤の使用は手術部位感染と創傷治癒遅延のリスク因子となるか

木曽洋平, 西田圭一郎, 原田遼三, 那須義久, 中原龍一, 渡辺雅仁, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S1022 - S1022 2023.3

肉腫におけるがんゲノム医療の現状と未来がん遺伝子パネル検査から同定されるGermline Findingsへの対応

二川摩周, 中田英二, 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 97 ( 2 ) S446 - S446 2023.3

Musculoskeletal Tumor 骨・軟部腫瘍骨・軟部腫瘍におけるがん遺伝子プロファイリング検査骨・軟部腫瘍診療におけるがん遺伝子パネルの役割

中田英二, 藤原智洋, 国定俊之, 尾崎敏文, 豊岡伸一, 遠西大輔, 山本英喜, 二宮貴一朗, 冨田秀太, 平沢晃, 二川摩周, 田端雅弘

癌と化学療法 50 ( 3 ) 314 - 320 2023.3

成長期の関節疾患治療アップデート上腕骨小頭離断性骨軟骨炎の手術治療

島村安則, 斉藤太一, 中道亮, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S505 - S505 2023.3

TSS法へのall-inside sutureの追加は内側半月板逸脱体積の抑制効果に乏しい

金高圭甫, 古松毅之, 横山裕介, 田村優典, 川田紘己, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 春季学会 ) 250 - 250 2023.3

内側半月板後根断裂に対する経脛骨pullout修復術男女別比較

東原直裕, 古松毅之, 横山裕介, 金高圭甫, 田村優典, 川田紘己, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S577 - S577 2023.3

内側半月板後根断裂に対するpullout修復術術後早期からの部分荷重および可動域訓練は治療成績を悪化させない

田村優典, 古松毅之, 横山裕介, 金高圭甫, 東原直裕, 川田紘己, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S856 - S856 2023.3

内側半月板後根プルアウト修復術関節裂隙の狭小化はどの程度進行するのか

川田紘己, 古松毅之, 田村優典, Xue Haowei, 東原直裕, 金高圭甫, 横山裕介, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S571 - S571 2023.3

TSS法へのall-inside sutureの追加は内側半月板逸脱の抑制効果に乏しい

金高圭甫, 古松毅之, 横山裕介, 東原直裕, 田村優典, 川田紘己, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S575 - S575 2023.3

内側半月板後根プルアウト修復術後における関節裂隙狭小化の定量的評価

川田紘己, 古松毅之, 横山裕介, 金高圭甫, 東原直裕, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 春季学会 ) 250 - 250 2023.3

Vertebral body collapse after radiotherapy for spinal metastases. International journal

Eiji Nakata, Ryuichi Nakahara, Haruyoshi Katayama, Takuto Itano, Shinsuke Sugihara, Toshifumi Ozaki

Oncology letters 25 ( 3 ) 109 - 109 2023.3

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

Spinal metastases are common in patients with advanced stages of cancer and frequently cause vertebral body collapse (VBC). Although conventional radiotherapy (RT) is used for spinal metastases, the rates of occurrence of new VBC and progression of VBC at RT initiation have not been fully investigated. The present retrospective study assessed VBC and its associated risk factors after RT over time and evaluated new VBC and progression of VBC in patients who presented with VBC at RT initiation. The study evaluated 177 patients who received RT for vertebral metastases without paralysis between July 2012 and November 2016. Radiological responses of the irradiated vertebrae were assessed using computed tomography. Follow-up assessments were performed at RT initiation and 1, 2, 3, 4 and 6 months after RT. New VBC occurred in 12% of patients with no prior VBC within 1 month of RT. Multivariate analysis revealed that numeric rating scale (NRS) score (≥4) [relative risk (RR), 27.1; 95% confidence interval (CI), 1.86 to 394.9; P=0.016] was associated with the occurrence of new VBC at the 1 month follow-up time point. VBC progression occurred in 51% of the patients with collapse at RT initiation. Multivariate analysis revealed that bone quality (lytic metastases) (RR, 3.1; 95% CI, 1.28 to 7.70; P=0.013), NRS score (≥4) (RR, 3.0; 95% CI, 1.18 to 7.45; P=0.021) and tumor involvement of posterolateral elements of the spine (RR, 2.7; 95% CI, 1.03 to 7.29; P=0.04) were associated with the progression of VBC at the 1 month follow-up time point. The current study findings suggested that clinicians should pay attention to the factors that predict the occurrence of new VBC and VBC progression to ensure proper evaluation of conservative treatment effectiveness and facilitate the determination of patients who need close monitoring.

DOI： 10.3892/ol.2023.13695

骨軟部腫瘍診療のサステナビリティ原発性悪性骨腫瘍患者の居住地と診療施設間の地理的因子は予後と相関するか?米国の診療体制の現状と課題

藤原智洋, 中田英二, 国定俊之, 尾崎敏文, 小倉浩一, Healey John

中部日本整形外科災害外科学会雑誌 66 ( 春季学会 ) 54 - 54 2023.3

多診療科で考える脊椎転移の治療骨転移診療システムによる麻痺予防の取り組み

杉原進介, 近藤宏也, 中田英二, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S618 - S618 2023.3

骨巨細胞腫に対するデノスマブのde-escalationの有効性

板野拓人, 中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S959 - S959 2023.3

骨・軟部腫瘍診療におけるデジタルトランスフォーメーションとプレシジョン・メディシン Liquid biopsyを用いた骨・軟部腫瘍診療におけるプレシジョン・メディシンへの期待と課題

藤原智洋, 中田英二, 畑利彰, 近藤彩奈, 板野拓人, 吉田晶, 片山晴喜, 佐藤浩平, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S613 - S613 2023.3

骨・軟部腫瘍診療におけるデジタルトランスフォーメーションとプレシジョン・メディシン AIを用いた骨肉腫X線読影における転移学習の効果

長谷井嬢, 中原龍一, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S611 - S611 2023.3

肉腫におけるがんゲノム医療の現状と未来肉腫におけるがん遺伝子パネルの意義

中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S445 - S445 2023.3

骨盤の悪性腫瘍を究める骨盤腫瘍に対する創外固定を併用したhip transposition法

国定俊之, 藤原智洋, 中田英二, 千田益生, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S437 - S437 2023.3

前腕に発生した肉腫の治療成績

片山晴喜, 中田英二, 板野拓人, 近藤彩奈, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S321 - S321 2023.3

高齢軟部肉腫患者において術後合併症の発生は生存予後に影響を与えるか

近藤彩奈, 藤原智洋, 吉田晶, 板野拓人, 片山晴喜, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S320 - S320 2023.3

老年学的因子は浸潤性軟部肉腫患者の生存予後と相関するか

畑利彰, 藤原智洋, 柳井広之, 吉田晶, 板野拓人, 近藤彩奈, 片山晴喜, 佐藤浩平, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S80 - S80 2023.3

がんロコモ診療の課題と展望周術期患者のがんロコモ・サルコペニア・フレイル

堅山佳美, 中田英二, 濱田全紀, 国定俊之, 藤原智洋, 千田益生, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S18 - S18 2023.3

小児AYA世代骨軟部腫瘍の課題と対策遺伝性骨・軟部腫瘍外来の取り組み

中田英二, 藤原智洋, 国定俊之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 春季学会 ) 58 - 58 2023.3

脛骨遠位骨幹部骨折に対するsemi-extended approachは術後足関節アライメントを悪化させない

福岡史朗, 依光正則, 佐藤浩平, 上原健敬, 尾崎敏文, 寺田忠司

骨折 45 ( 2 ) 520 - 522 2023.3

Language：Japanese Publisher：(一社)日本骨折治療学会

【背景】脛骨骨幹部骨折に対しては髄内釘固定が標準的治療である.しかしながら,脛骨近位および遠位骨幹部骨折においては,髄腔径が広いことや膝屈曲位での整復位の獲得およびその確認が困難なことから,変形癒合の報告が散見される.【目的】脛骨遠位骨幹部骨折における髄内釘固定において,infra-patellar approachとsemi-extended approachの2つのアプローチ間で術後整復位の比較を行い,適したアプローチを選択する.【研究デザイン】過去起点コホート研究.【設定】大学附属病院と関連病院の2施設.【対象】2012～21年において,脛骨遠位骨幹部骨折に対し髄内釘固定を行い,小児や骨癒合までフォローできなかった症例などを除外した56例(男性36例,女性20例)を対象とした.使用インプラントや免荷期間は各施設の判断に委ねた.【方法】2つのアプローチ間での術後整復位(正面天蓋角を測定し,内外反角の絶対値を計測)を比較検討した.また,年齢,性別,BMI,骨折型(AO/OTA分類),nail径,最峡部径,骨癒合期間についても比較を行った.各々の検討項目をFisher's exact test,Mann-Whitney U testを用い有意水準5%で群間比較検討した.【結果】Infra-patellar approach 37例,semi-extended approach 19例であり,内外反変形において有意差を認めた(infra-patellar:3.65°,semi-extended:2.11°,p<0.05).足関節アライメント以外の検討項目においてはアプローチ間での有意差は認めなかった.【結論】脛骨遠位骨幹部骨折における髄内釘固定後の足関節アライメントは,semi-extended approachの方がinfra-patellar approachよりも良好であった.(著者抄録)

思春期特発性側彎症(Lenke type 1)におけるHybrid法とSegmental Pedicle screw法による治療効果の検討

魚谷弘二, 植田昌敬, 志渡澤央和, 小田孔明, 三澤治夫, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 春季学会 ) 329 - 329 2023.3

Malignant spinal cord compression(MSCC)を伴う転移性脊椎腫瘍患者に対する手術介入は生命予後に影響するか

志渡澤央和, 魚谷弘二, 三澤治夫, 鉄永倫子, 小田孔明, 植田昌敬, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S287 - S287 2023.3

転移性骨腫瘍キャンサーボードの運用と課題 Malignant spinal Cord Compression(MSCC)を伴う転移性脊椎腫瘍患者に対する手術介入と生命予後の関係

志渡澤央和, 魚谷弘二, 三澤治夫, 小田孔明, 植田昌敬, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 春季学会 ) 106 - 106 2023.3

脛骨プラトー骨折と骨幹部骨折の合併骨折の手術的治療

福岡史朗, 依光正則, 佐藤浩平, 畑利彰, 上原健敬, 尾崎敏文

骨折 45 ( 2 ) 508 - 511 2023.3

Language：Japanese Publisher：(一社)日本骨折治療学会

【背景】脛骨プラトーおよび骨幹部の合併骨折は高エネルギー外傷に伴って認められることが多い.単一のインプラント固定では治療困難である場合も認められ,骨折型や軟部状態に応じて内固定方法の選択が重要である.【目的】比較的稀な脛骨プラトーおよび骨幹部骨折を合併した9例を経験し,骨折型による内固定方法の選択を検討したので報告する.【方法】2009～20年において,高エネルギー外傷で受傷した脛骨プラトーおよび骨幹部合併骨折に対して内固定を行い,骨癒合まで経過観察可能であった9例(男性5名,女性4名)を対象とし,骨折型と内固定方法を後ろ向きに検討した.【結果】平均年齢66(45～86)歳,受傷機転は交通外傷6例,転落外傷3例であった.そのうち開放骨折2例,コンパートメント症候群2例を認めた.内固定方法の内訳として,外側プレート固定1例,内側と外側のプレート固定(以下,ダブルプレート固定)3例,外側(内側)プレートおよび髄内釘固定4例,関節面スクリューおよび髄内釘固定1例であった.また外側プレートおよび髄内釘固定を予定していた1例において,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.【結論】脛骨プラトー・骨幹部合併骨折の内固定方法として,外側プレート固定,ダブルプレート固定,外(内)側プレート(またはスクリュー)および髄内釘固定が報告されており,骨折型や骨幹部骨折の位置,軟部組織の状態が内固定方法の選択要因となっている.今回我々が経験した症例のなかで,術中の整復不良により内固定方法を変更した1例は,後方で脛骨プラトーと骨幹部にかけて骨折線が連続しており,髄内釘挿入のアプローチはinfrapatellar approachであった.他の同様な骨折型に対して髄内釘固定を行った症例では,suprapatellar approachが選択されていた.脛骨プラトーと骨幹部の骨折線が連続している不安定な骨折の場合には,suprapatellar approachが選択されるべきである.(著者抄録)

解剖学的ランドマークを指標にした理想的なIAS挿入の位置と挿入角度の検討

福岡史朗, 依光正則, 佐藤浩平, 畑利彰, 上原健敬, 尾崎敏文

日本整形外科学会雑誌 97 ( 2 ) S244 - S244 2023.3

脛骨骨折に対する異なるアプローチ間での髄内釘の挿入位置の検討

福岡史朗, 依光正則, 上原健敬, 寺田忠司, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 春季学会 ) 195 - 195 2023.3

人工肘関節置換術-合併症に対する創意と工夫- 人工肘関節周囲骨折の治療戦略

那須義久, 志水紀之, 浪花崇一, 堀田佳史, 原田遼三, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 97 ( 3 ) S565 - S565 2023.3

日常生活中の筋電図記録に混入し得るノイズ信号に関する研究

皆木省吾, 兒玉直紀, 中原龍一, 尾崎敏文, 古寺寛志, 北川佳祐, 萬田陽介, 田中祐貴, 杉本皓, 森慧太朗, 山田蘭子, 松岸諒, 桑原実穂

日本顎口腔機能学会雑誌 29 ( 2 ) 124 - 125 2023.3

日常生活中の筋電図記録に混入し得るノイズ信号に関する研究

皆木省吾, 兒玉直紀, 中原龍一, 尾崎敏文, 古寺寛志, 北川佳祐, 萬田陽介, 田中祐貴, 杉本皓, 森慧太朗, 山田蘭子, 松岸諒, 桑原実穂

日本顎口腔機能学会雑誌 29 ( 2 ) 124 - 125 2023.3

A novel chondrocyte sheet fabrication using human-induced pluripotent stem cell-derived expandable limb-bud mesenchymal cells. International journal

Tomoka Takao, Masato Sato, Yuki Fujisawa, Eriko Toyoda, Daisuke Yamada, Yukio Hitsumoto, Eiji Nakata, Toshifumi Ozaki, Takeshi Takarada

Stem cell research & therapy 14 ( 1 ) 34 - 34 2023.2

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

BACKGROUND: Cell sheet fabrication for articular cartilage regenerative medicine necessitates a large number of chondrocytes of consistent quality as a cell source. Previously, we have developed human-induced pluripotent stem cell (iPSC)-derived expandable PRRX1+ limb-bud mesenchymal cells (ExpLBM) with stable expansion and high chondrogenic capacity, while in this study; our ExpLBM technology was combined with cell sheet engineering to assess its potential as a stable cell source for articular cartilage regeneration. METHODS: ExpLBM cells derived from human-induced pluripotent stem cells (hiPSCs), including 414C2 and Ff-KVs09 (HLA homozygous), were seeded onto a culture plate and two-dimensional chondrogenic induction (2-DCI) was initiated. After 2-DCI, ExpLBM-derived chondrocytes were stripped and transferred to temperature-responsive culture inserts and the chondrocyte sheets were histologically examined or transplanted into osteochondral knee defects of immunodeficient rats. RESULTS: Immunohistochemistry revealed that ExpLBM-derived cell sheets were positive for Safranin O, COL2, and ACAN but that they were negative for COL1 and RUNX2. Furthermore, the engrafted tissues in osteochondral knee defects in immunodeficient rats were stained with SafO, human VIMENTIN, ACAN, and COL2. CONCLUSIONS: The present study is the first to report the chondrocyte sheet fabrication with hiPSC-derived cell source. hiPSC-derived ExpLBM would be a promising cell source for cell sheet technology in articular cartilage regenerative medicine.

DOI： 10.1186/s13287-023-03252-4

CDKAL1 Drives the Maintenance of Cancer Stem-Like Cells by Assembling the eIF4F Translation Initiation Complex. International journal

Rongsheng Huang, Takahiro Yamamoto, Eiji Nakata, Toshifumi Ozaki, Kazuhiko Kurozumi, Fanyan Wei, Kazuhito Tomizawa, Atsushi Fujimura

Advanced science (Weinheim, Baden-Wurttemberg, Germany) e2206542 2023.2

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

Cancer stem-like cells (CSCs) have a unique translation mode, but little is understood about the process of elongation, especially the contribution of tRNA modifications to the maintenance of CSCs properties. Here, it is reported that, contrary to the initial aim, a tRNA-modifying methylthiotransferase CDKAL1 promotes CSC-factor SALL2 synthesis by assembling the eIF4F translation initiation complex. CDKAL1 expression is upregulated in patients with worse prognoses and is essential for maintaining CSCs in rhabdomyosarcoma (RMS) and common cancers. Translatome analysis reveals that a group of mRNAs whose translation is CDKAL1-dependent contains cytosine-rich sequences in the 5' untranslated region (5'UTR). Mechanistically, CDKAL1 promotes the translation of such mRNAs by organizing the eIF4F translation initiation complex. This complex formation does not require the enzyme activity of CDKAL1 but requires only the NH2 -terminus domain of CDKAL1. Furthermore, sites in CDKAL1 essential for forming the eIF4F complex are identified and discovered candidate inhibitors of CDKAL1-dependent translation.

DOI： 10.1002/advs.202206542

Association of phase angle with sarcopenia in chronic musculoskeletal pain patients: a retrospective study. International journal

Hironori Tsuji, Tomoko Tetsunaga, Haruo Misawa, Keiichiro Nishida, Toshifumi Ozaki

Journal of orthopaedic surgery and research 18 ( 1 ) 87 - 87 2023.2

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

BACKGROUND: In chronic musculoskeletal pain patients, detection of sarcopenia is of significant clinical interest. Phase angle, which can be measured through bioelectrical impedance analysis (BIA), can detect sarcopenia; however, the evidence in chronic musculoskeletal pain patients is limited. This study aimed to assess the relationship between phase angle and sarcopenia in patients with chronic musculoskeletal pain. Our hypothesis was that phase angle would be a useful indicator to identify sarcopenia in patients with chronic musculoskeletal pain. METHODS: A total of 190 patients (51 men and 139 women) with chronic musculoskeletal pain were included in this retrospective cross-sectional study. Patient data of backgrounds, numeric rating scale score for pain, skeletal muscle index, and phase angle assessed using BIA were retrospectively reviewed. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. RESULTS: A total of 51 patients (26.7%), including 10 men (19.6%) and 41 women (29.5%), were diagnosed with sarcopenia. Phase angle, sarcopenia-related factors, age, and body mass index (BMI) differed significantly in patients with and without sarcopenia. On multiple logistic regression analysis, the prevalence of sarcopenia was significantly correlated with phase angle and BMI. The areas under the curve exhibited high accuracy in discriminating sarcopenia in men and moderate accuracy in both sexes and in women. CONCLUSIONS: Phase angle may be a valid discriminator of sarcopenia in patients with chronic musculoskeletal pain.

DOI： 10.1186/s13018-023-03567-1

Expression of Acetabular Labral Vascular Endothelial Growth Factor and Nerve Growth Factor Is Directly Associated with Hip Osteoarthritis Pain: Investigation by Immunohistochemical Staining. International journal

Yoshihiro Sato, Tomonori Tetsunaga, Kazuki Yamada, Yoshi Kawamura, Aki Yoshida, Toshifumi Ozaki

International journal of molecular sciences 24 ( 3 ) 2023.2

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

The acetabular labrum enhances hip joint stability and plays a key role in osteoarthritis (OA) progression. Labral nerve endings contribute to hip OA pain. Moreover, vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) are associated with pain. Consequently, we analysed VEGF and NGF expression levels in the labrum and their roles in OA. Labra obtained from OA patients were stained immunohistochemically, and labral cells were cultured and subjected to a reverse transcription (RT)-polymerase chain reaction (PCR) to analyse VEGF and NGF mRNA expression. VEGF and NGF expression were compared in each region of the labrum. Correlations between VEGF and NGF expression and age, body mass index, Kellgren-Lawrence grade, Harris Hip Score, the visual analogue scale (VAS), and Krenn score were analysed, and the RT-PCR confirmed the findings. VEGF and NGF expression were high on the labral articular side, negatively correlated with the Krenn score, and positively correlated with the VAS in early OA. VEGF and NGF mRNA expression increased significantly in patients with severe pain and decreased significantly in severely degenerated labra. In early OA, VEGF and NGF expression in the acetabular labrum was associated with the occurrence of hip pain; therefore, these factors could be effective targets for pain management.

DOI： 10.3390/ijms24032926

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, 中田英二, 山田大祐, 片山晴喜, 畑利彰, 藤原智洋, 高尾知佳, 国定俊之, 宝田剛志, 尾崎敏文

日本レックリングハウゼン病学会学術大会プログラム・抄録集 14回 16 - 16 2023.2

神経線維腫症1型における院内レジストリの構築と定期的なサーベイランスの実施

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 山本英喜, 藤原智洋, 国定俊之, 平沢晃, 尾崎敏文

日本レックリングハウゼン病学会学術大会プログラム・抄録集 14回 34 - 34 2023.2

遺伝性骨・軟部腫瘍外来におけるNF-1の診療

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

日本レックリングハウゼン病学会学術大会プログラム・抄録集 14回 33 - 33 2023.2

Panner病の治療成績

石原健嗣, 島村安則, 中道亮, 齋藤太一, 尾崎敏文

日本肘関節学会雑誌 30 ( 1 ) S312 - S312 2023.2

Self-controlled case seriesを用いた内側型野球肘からTommy John手術へのリスク比

根津智史, 島村安則, 中道亮, 齋藤太一, 三橋利晴, 尾崎敏文

日本肘関節学会雑誌 30 ( 1 ) S80 - S80 2023.2

関節面再建・温存手術上腕骨滑車部骨軟骨障害に対する鏡視下骨軟骨柱移植の治療成績

島村安則, 根津智史, 中道亮, 齋藤太一, 名越充, 尾崎敏文

日本肘関節学会雑誌 30 ( 1 ) S89 - S89 2023.2

Effectivity of the Outside-In Pie-Crusting Technique and an All-Inside Meniscal Repair Device in the Repair of Ramp Lesions. International journal

Koki Kawada, Takayuki Furumatsu, Masanori Tamura, Haowei Xue, Naohiro Higashihara, Keisuke Kintaka, Yusuke Yokoyama, Toshifumi Ozaki

Arthroscopy techniques 12 ( 2 ) e273-e278 2023.2

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

Ramp lesions are characteristic medial meniscus injuries seen in anterior cruciate ligament-injured knees. Anterior cruciate ligament injuries combined with ramp lesions increase the amount of anterior tibial translation and tibial external rotation. Therefore, the diagnosis and treatment of ramp lesions have received increasing attention. However, ramp lesions can be difficult to diagnose on preoperative magnetic resonance imaging. Additionally, ramp lesions are difficult to observe and treat intraoperatively in the posteromedial compartment. Although good results have been reported with the use of a suture hook through the posteromedial portal in the treatment of ramp lesions, the complexity and difficulty of the technique are further problems. The outside-in pie-crusting technique is a simple procedure that can enlarge the medial compartment and facilitate the observation and repair of ramp lesions. After this technique, ramp lesions can be properly sutured, using an all-inside meniscal repair device, without damaging the surrounding cartilage. A combination of the outside-in pie-crusting technique and an all-inside meniscal repair device (with only anterior portals) is effective in the repair of ramp lesions. This Technical Note aims to report in detail the flow of a series of techniques, including our diagnostic and therapeutic methods.

DOI： 10.1016/j.eats.2022.11.002

移植腱固定法の違いとmicrofracture手技が腱-骨接合部の癒合に与える影響

根津智史, 齋藤太一, 島村安則, 尾崎敏文

日本肘関節学会雑誌 30 ( 1 ) S16 - S17 2023.2

Comparison of screw versus locking plate fixation via sinus tarsi approach for displaced intra-articular calcaneal fractures. International journal

Kohei Sato, Masanori Yorimitsu, Takenori Uehara, Shiro Fukuoka, Toshiaki Hata, Kenta Saiga, Tomoyuki Noda, Toshifumi Ozaki

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons 29 ( 1 ) 97 - 102 2023.1

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

BACKGROUND: The optimal treatment of displaced intra-articular calcaneal fractures (DIACF) is controversial. This study compared the fixation stability of screws and locking plates in DIACF treated via the sinus tarsi approach (STA). METHODS: We retrospectively evaluated 118 DIACF cases treated via STA and extracted data that could affect treatment outcomes. Loss of Böhler's angle after surgery was measured to compare fixation stability. RESULTS: The loss of Böhler's angles was significantly smaller in the locking plate group than in the screw group (2.6 ± 2.7º vs. 5.6 ± 5.3º, P < 0.01). There was no difference in the clinical outcomes between the groups. On multivariate logistic regression analysis, screw fixation was significantly associated with loss of Böhler's angle by> 10º (odds ratio, 8.63; 95% confidence interval, 1.16-64.4; P < 0.05). CONCLUSIONS: Locking plate fixation is more reliable than screw fixation for preventing correction loss in DIACF treated via STA. LEVEL OF EVIDENCE: III.

DOI： 10.1016/j.fas.2022.11.002

関節リウマチにおける手指関節・手関節の超音波パワードプラスコアと関節破壊の関連

沖田駿治, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 4 ) 524 - 527 2023.1

Language：Japanese Publisher：(一社)日本手外科学会

関節リウマチ患者において,関節超音波検査(以下US)で滑膜炎を認めた関節と関節破壊が進行する関節は必ずしも一致しないことが報告されている.USで評価を行った手指・手関節の関節破壊に対する予後を検討した.調査開始時にUSによるパワードプラ(以下PD)スコアの計測が行われ,調査開始時および調査開始後1年以上経過時に両手単純X線写真による関節破壊の進行が評価可能であった関節リウマチ患者70例を対象とした.多変量解析ではPDスコアの合計値のみが関節破壊の有意な危険因子として同定された(オッズ比1.19,P=0.010).両手のPDスコアの合計値は手関節の関節破壊(P=0.001)およびMCP関節の関節破壊(P<0.001)と相関を認めた.各関節のPDスコアは同関節の関節破壊と相関を認めた(P<0.001).諸家の報告と異なりUSで滑膜炎を認めた関節は関節破壊が進行しやすい結果であった.(著者抄録)

Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old. International journal

Keiichiro Nishida, Yoshihisa Nasu, Kenzo Hashizume, Shunji Okita, Ryuichi Nakahara, Taichi Saito, Toshifumi Ozaki, Hajime Inoue

Bone & joint open 4 ( 1 ) 19 - 26 2023.1

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

AIMS: There are concerns regarding complications and longevity of total elbow arthroplasty (TEA) in young patients, and the few previous publications are mainly limited to reports on linked elbow devices. We investigated the clinical outcome of unlinked TEA for patients aged less than 50 years with rheumatoid arthritis (RA). METHODS: We retrospectively reviewed the records of 26 elbows of 21 patients with RA who were aged less than 50 years who underwent primary TEA with an unlinked elbow prosthesis. The mean patient age was 46 years (35 to 49), and the mean follow-up period was 13.6 years (6 to 27). Outcome measures included pain, range of motion, Mayo Elbow Performance Score (MEPS), radiological evaluation for radiolucent line and loosening, complications, and revision surgery with or without implant removal. RESULTS: The mean MEPS significantly improved from 47 (15 to 70) points preoperatively to 95 (70 to 100) points at final follow-up (p < 0.001). Complications were noted in six elbows (23%) in six patients, and of these, four with an ulnar neuropathy and one elbow with postoperative traumatic fracture required additional surgeries. There was no revision with implant removal, and there was no radiological evidence of loosening around the components. With any revision surgery as the endpoint, the survival rates up to 25 years were 78.1% (95% confidence interval 52.8 to 90.6) as determined by Kaplan-Meier analysis. CONCLUSION: The clinical outcome of primary unlinked TEA for young patients with RA was satisfactory and comparable with that for elderly patients. A favourable survival rate without implant removal might support the use of unlinked devices for young patients with this disease entity, with a caution of a relatively high complication rate regarding ulnar neuropathy.Level of Evidence: Therapeutic Level IVCite this article: Bone Jt Open 2023;4(1):19-26.

DOI： 10.1302/2633-1462.41.BJO-2022-0151.R1

踵骨関節内骨折に対する低侵襲ロッキングプレート固定は早期荷重を可能とさせる

國富康資, 依光正則, 上原健敬, 福岡史朗, 佐藤浩平, 尾崎敏文

中部日本整形外科災害外科学会雑誌 66 ( 1 ) 139 - 140 2023.1

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

当院で踵骨関節内骨折に対し治療を行った24例を対象に、これらをスクリュー固定を行った11例(S群)とロッキングプレート固定を行った14例(LP群)に分け、臨床成績を比較検討した。その結果、S群と比べ、LP群では最終調査時のBoehler角が有意に良好で、Boehler角の矯正損失は有意に少なかった。最終調査時のAOFAS score(AOFAS)は両群間で有意差がなかったものの、LP群の方がscoreが高い傾向がみられた。また、最終のBoehle角とAOFASの間には相関は認められなかったが、術後の横径とAOFASの間には有意な相関が認められた。以上より、踵骨関節内骨折に対するロッキングプレート固定は術後成績を低下させず、荷重時期を短縮する上で有用と考えられた。

Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00831&link_issn=&doc_id=20230519070065&doc_link_id=10.11359%2Fchubu.2023.139&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2023.139&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

The Evaluation of Meniscus Regenerative Effects 2 of LIPUS-Induced CCN Proteins: Induction by LIPUS of CCN2 3 and Meniscus-Related Genes in Cultured Meniscus Cells 4 and Meniscus Tissues

Yusuke Kamatsuki, Eriko Aoyama, Takayuki Furumatsu, Toshifumi Ozaki, Masaharu Takigawa

Methods in Molecular Biology 2582 223 - 235 2023

関節リウマチによる高度手関節変形に対して手関節全固定術あるいは人工手関節置換術を行った8例の術後経過

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

関節の外科 50 ( 2 ) 122 - 122 2023

関節リウマチ患者に対するSauve-Kapandji法の臨床成績の検討

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

関節の外科 50 ( 2 ) 121 - 121 2023

Panner病の治療成績と単純X線画像での離断性骨軟骨炎との鑑別

石原健嗣, 島村安則, 中道亮, 斎藤太一, 尾崎敏文

日本肘関節学会雑誌 30 ( 2 ) 222 - 228 2023

関節リウマチ患者に対するSauve-Kapandji法の臨床成績の検討

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

関節の外科 50 ( 2 ) 121 - 121 2023

関節リウマチによる高度手関節変形に対して手関節全固定術あるいは人工手関節置換術を行った8例の術後経過

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

関節の外科 50 ( 2 ) 122 - 122 2023

Elevated Expression of CCN3 in Articular Cartilage Induces Osteoarthritis in Hip Joints Irrespective of Age and Weight Bearing. International journal

Kazuki Hirose, Miho Kuwahara, Eiji Nakata, Tomonori Tetsunaga, Kazuki Yamada, Kenta Saiga, Masaharu Takigawa, Toshifumi Ozaki, Satoshi Kubota, Takako Hattori

International journal of molecular sciences 23 ( 23 ) 2022.12

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

Osteoarthritis (OA) occurs not only in the knee but also in peripheral joints throughout the whole body. Previously, we have shown that the expression of cellular communication network factor 3 (CCN3), a matricellular protein, increases with age in knee articular cartilage, and the misexpression of CCN3 in cartilage induces senescence-associated secretory phenotype (SASP) factors, indicating that CCN3 promotes cartilage senescence. Here, we investigated the correlation between CCN3 expression and OA degenerative changes, principally in human femoral head cartilage. Human femoral heads obtained from patients who received total hip arthroplasty were categorized into OA and femoral neck fracture (normal) groups without significant age differences. Gene expression analysis of RNA obtained from femoral head cartilage revealed that CCN3 and MMP-13 expression in the non-weight-bearing part was significantly higher in the OA group than in the normal group, whereas the weight-bearing OA parts and normal cartilage showed no significant differences in the expression of these genes. The expression of COL10A1, however, was significantly higher in weight-bearing OA parts compared with normal weight-bearing parts, and was also higher in weight-bearing parts compared with non-weight-bearing parts in the OA group. In contrast, OA primary chondrocytes from weight-bearing parts showed higher expression of CCN3, p16, ADAMTS4, and IL-1β than chondrocytes from the corresponding normal group, and higher ADAMTS4 and IL-1β in the non-weight-bearing part compared with the corresponding normal group. Acan expression was significantly lower in the non-weight-bearing group in OA primary chondrocytes than in the corresponding normal chondrocytes. The expression level of CCN3 did not show significant differences between the weight-bearing part and non-weight-bearing part in both OA and normal primary chondrocytes. Immunohistochemical analysis showed accumulated CCN3 and aggrecan neoepitope staining in both the weight-bearing part and non-weight-bearing part in the OA group compared with the normal group. The CCN3 expression level in cartilage had a positive correlation with the Mankin score. X-ray analysis of cartilage-specific CCN3 overexpression mice (Tg) revealed deformation of the femoral and humeral head in the early stage, and immunohistochemical analysis showed accumulated aggrecan neoepitope staining as well as CCN3 staining and the roughening of the joint surface in Tg femoral and humeral heads. Primary chondrocytes from the Tg femoral head showed enhanced expression of Ccn3, Adamts5, p16, Il-6, and Tnfα, and decreased expression of Col2a1 and -an. These findings indicate a correlation between OA degenerative changes and the expression of CCN3, irrespective of age and mechanical loading. Furthermore, the Mankin score indicates that the expression level of Ccn3 correlates with the progression of OA.

DOI： 10.3390/ijms232315311

Standardization of evaluation method and prognostic significance of histological response to preoperative chemotherapy in high-grade non-round cell soft tissue sarcomas International journal

Yoshinao Oda, Kazuhiro Tanaka, Takanori Hirose, Tadashi Hasegawa, Nobuyuki Hiruta, Masanori Hisaoka, Masato Yoshimoto, Hiroshi Otsuka, Hirofumi Bekki, Takeaki Ishii, Makoto Endo, Toshiyuki Kunisada, Toru Hiruma, Hiroyuki Tsuchiya, Hirohisa Katagiri, Yoshihiro Matsumoto, Akira Kawai, Robert Nakayama, Hiroyuki Kawashima, Satoshi Takenaka, Makoto Emori, Munenori Watanuki, Yukihiro Yoshida, Takeshi Okamoto, Junki Mizusawa, Haruhiko Fukuda, Toshifumi Ozaki, Yukihide Iwamoto, Takayuki Nojima

BMC Cancer 22 ( 1 ) 94 - 94 2022.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Background

Preoperative chemotherapy is widely applied to high-grade localized soft tissue sarcomas (STSs); however, the prognostic significance of histological response to chemotherapy remains controversial. This study aimed to standardize evaluation method of histological response to chemotherapy with high agreement score among pathologists, and to establish a cut-off value closely related to prognosis.

Methods

Using data and specimens from the patients who had registered in the Japan Clinical Oncology Group study, JCOG0304, a phase II trial evaluating the efficacy of perioperative chemotherapy with doxorubicin (DOX) and ifosfamide (IFO), we evaluated histological response to preoperative chemotherapy at the central review board.

Results

A total of 64 patients were eligible for this study. The percentage of viable tumor area ranged from 0.1% to 97.0%, with median value of 35.7%. Regarding concordance proportion between pathologists, the weighted kappa coefficient (κ) score in all patients was 0.71, indicating that the established evaluation method achieved substantial agreement score. When the cut-off value of the percentage of the residual tumor area was set as 25%, the p-value for the difference in overall survival showed the minimum value. Hazard ratio of the non-responder with percentage of the residual tumor < 25%, to the responder was 4.029 (95% confidence interval 0.893–18.188, p = 0.070).

Conclusion

The standardized evaluation method of pathological response to preoperative chemotherapy showed a substantial agreement in the weighted κ score. The evaluation method established here was useful for estimating of the prognosis in STS patients who were administered perioperative chemotherapy with DOX and IFO.

Trial registration

UMIN Clinical Trials Registry C000000096. Registered 30 August, 2005 (retrospectively registered).

DOI： 10.1186/s12885-022-09195-y

Other Link： https://link.springer.com/article/10.1186/s12885-022-09195-y/fulltext.html

Large flexion contracture angle predicts tight extension gap during navigational posterior stabilized-type total knee arthroplasty with the pre-cut technique: a retrospective study

Takaaki Hiranaka, Shinichi Miyazawa, Takayuki Furumatsu, Yuya Kodama, Yusuke Kamatsuki, Shin Masuda, Yuki Okazaki, Keisuke Kintaka, Toshifumi Ozaki

BMC Musculoskeletal Disorders 23 ( 1 ) 2022.12

Authorship：Last author Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Background

This study aimed to determine the predictors of tight extension gap (EG) compared with the flexion gap (FG) during navigational posterior stabilized-type total knee arthroplasty using the pre-cut technique.

Methods

Nineteen patients with tight EG (defined as FG-EG ≥2 mm after pre-cut; group T) and 84 patients with an approximately equal gap (defined as FG-EG = 0–1 mm after pre-cut; group E) were enrolled. Medial tibial slope angle, hip knee ankle angle, flexion contracture angle, and active maximum flexion angle were compared between the two groups.

Results

The multivariate logistic regression model indicated that the probability of tight EG increased with flexion contracture angle (odds ratio, 1.13; 95% confidence interval 1.05–1.20; P ≤ 0.001). According to the receiver operating characteristic analysis, the flexion contracture angle cut-off value associated with tight EG was 15.0° (sensitivity, 85%; specificity, 78%).

Conclusion

This study demonstrated that a large flexion contracture angle (cut-off 15.0°) was associated with tight EG after pre-cut osteotomy during posterior stabilized-type total knee arthroplasty. Awareness of this risk factor may help improve preoperative predictability of tight EGs and preparedness for additional procedures, such as soft tissue release or capsulotomy, to correct them.

Level of evidence

Level III.

DOI： 10.1186/s12891-022-05035-z

Other Link： https://link.springer.com/article/10.1186/s12891-022-05035-z/fulltext.html

尺骨突き上げ症候群に対する尺骨骨幹部短縮骨切り術と遠位部短縮骨切り術の治療成績の比較

齋藤太一, 中道亮, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 3 ) 315 - 318 2022.12

Language：Japanese Publisher：(一社)日本手外科学会

当院では以前より尺骨突き上げ症候群に対しては尺骨骨幹部での短縮骨切りを施行してきたが,近年皮膚切開量が短く,骨癒合が有利な尺骨遠位部での骨切りをおこなっている.今回骨切り部位別に治療成績を比較検討したので報告する.尺骨突き上げ症候群に対して骨切り術を行い,術後評価可能であった37例を対象とした.骨幹部骨切り症例は15例,遠位部骨切り症例は,22例含まれていた.これらの群に対して平均の骨癒合期間,握力,手関節可動域,DASH,Pain-VAS,および術後合併症をそれぞれ比較した.平均骨癒合期間は骨幹部骨切り群では3.3ヵ月,遠位部骨切り群では2.6ヵ月,術後1年経過時の握力については骨幹部,遠位部骨切り群それぞれ平均31.7kg,30.2kgであった.術後1年経過時の掌背屈可動域は骨幹部,遠位部骨切り群それぞれ150.0度,152.7度,回内外可動域は骨幹部,遠位部骨切り群それぞれ155.0度,170.1度であり,平均術後成績に有意差は認められなかった.DASHに関しては骨幹部骨切りでは23.9から20.1,遠位部骨切りでは33.3から9.9へと遠位部骨切りに関してのみ術後有意差をもって改善していた.またVASを用いた痛み評価では骨幹部骨切りでは7.2から1.0,遠位部骨切りでは5.8から1.2へとどちらの群も有意差をもって改善していた.(著者抄録)

後期高齢者頸椎損傷の急性期手術介入のタイミングにコロナ禍は影響したか

魚谷弘二, 植田昌敬, 志渡澤央和, 小田孔明, 鉄永倫子, 三澤治夫, 尾崎敏文

西日本脊椎研究会抄録集 96回 21 - 21 2022.12

野球選手における肘頭疲労骨折のtransitional typeに対する骨釘固定法の治療成績

根津智史, 島村安則, 齋藤太一, 尾崎敏文

日本肘関節学会雑誌 29 ( 2 ) 190 - 193 2022.12

Language：Japanese Publisher：日本肘関節学会

【目的】transitional typeは移行型とされる骨折型であるが内固定方法には議論の余地がある.本研究の目的はOSFのtransitional typeに対する骨釘固定法の成績と癒合に関連する因子を調査すること.【対象と方法】骨釘固定を行った22例の野球選手を対象とした.調査項目は癒合期間,2方向での骨釘固定角度,プレー復帰期間,合併症である.【結果】全例男性,手術時平均年齢は15.8歳,癒合期間は平均2.3ヵ月で全例骨癒合が得られた.骨釘固定角度は正面像で83.1度,側面像で78.6度で復帰には平均4.6ヵ月,合併症は術後再発が1例,骨釘の追加処置が1例であった.【結語】OSFのtransitional typeに対する骨釘固定術は早期より全例骨癒合が得られた.骨移植に加え適切な骨釘固定角度が良好な成績の要因と考える.(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J04263&link_issn=&doc_id=20230310380046&doc_link_id=10.24810%2Fjelbow.29.2_190&url=https%3A%2F%2Fdoi.org%2F10.24810%2Fjelbow.29.2_190&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Clinical evaluation of suture materials for transtibial pullout repair of medial meniscus posterior root tear International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Keisuke Kintaka, Yusuke Kamatsuki, Ximing Zhang, Haowei Xue, Masanori Hamada, Toshifumi Ozaki

Knee Surgery & Related Research 34 ( 1 ) 39 - 39 2022.10

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Background

There are no recommendations for specific suture materials in transtibial pullout repair of medial meniscus posterior root tears. This study aimed to evaluate the clinical outcomes of transtibial pullout repair of medial meniscus posterior root tears using ultrahigh-molecular-weight polyethylene sutures and suture tape.

Methods

We retrospectively reviewed the data of 36 patients (27 women and 9 men, mean age 64.1 years) who had undergone transtibial pullout repair of medial meniscus posterior root tears between November 2018 and December 2019. Two groups of 18 patients each received either two different cord-like sutures or suture tape. Clinical parameters were assessed preoperatively and on second-look arthroscopy (mean postoperative period 12 months). The meniscal healing status was assessed using a previously published scoring system (ranging from 0 to 10), and the incidence rate of suture cut-out was assessed on second-look arthroscopy.

Results

All clinical scores significantly improved in both groups, with no significant between-group differences on second-look arthroscopy. The arthroscopic meniscal healing scores significantly differed between sutures (mean 6.7 points) and suture tape (mean 7.4 points; p = 0.044). No significant between-group difference in the suture cut-out rate was observed.

Conclusions

This study found no significant differences in the clinical outcomes between ultrahigh-molecular-weight polyethylene sutures and suture tape. Favorable clinical outcomes were obtained using both types of suture; however, the usefulness of suture tape appears to be limited.

DOI： 10.1186/s43019-022-00167-x

Other Link： https://link.springer.com/article/10.1186/s43019-022-00167-x/fulltext.html

Clinical outcomes of medial meniscus posterior root repair: A midterm follow-up study

Takayuki Furumatsu, Shinichi Miyazawa, Yuya Kodama, Yusuke Kamatsuki, Yoshiki Okazaki, Takaaki Hiranaka, Yuki Okazaki, Keisuke Kintaka, Toshifumi Ozaki

The Knee 38 141 - 147 2022.10

運動器慢性疼痛患者において生理的インピーダンス法における位相角はサルコペニア検出に有用である

辻寛謙, 鉄永倫子, 鉄永智紀, 高尾真一郎, 西田圭一郎, 尾崎敏文

Journal of Musculoskeletal Pain Research 14 ( 4 ) S49 - S49 2022.10

当院におけるAR Hip Navigation Systemのカップアライメント精度

井上智博, 鉄永智紀, 山田和希, 廣瀬一樹, 小浦卓, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 388 - 388 2022.10

人工股関節全置換術における軟部組織保護に対する取り組み

小浦卓, 鉄永智紀, 山田和希, 廣瀬一樹, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 389 - 389 2022.10

THA後の腸腰筋障害とその対策

廣瀬一樹, 山田和希, 鉄永智紀, 小浦卓, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 392 - 392 2022.10

THA後の腸腰筋障害に対する股関節鏡下腸腰筋腱部分切離術の治療経験

安藤輝彦, 山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 392 - 392 2022.10

がん遺伝子パネルに基づく肉腫診療

中田英二, 藤原智洋, 平沢晃, 二川摩周, 遠西大輔, 山本英喜, 冨田秀太, 久保寿夫, 田端雅弘, 国定俊之, 豊岡伸一, 尾崎敏文

日本癌治療学会学術集会抄録集 60回 O49 - 4 2022.10

軟部肉腫に対する薬物療法がん遺伝子パネルに基づく肉腫診療

中田英二, 藤原智洋, 国定俊之, 平沢晃, 遠西大輔, 尾崎敏文

中部日本整形外科災害外科学会雑誌 65 ( 秋季学会 ) 77 - 77 2022.10

脆弱性骨盤輪骨折患者の急性期リハビリテーション医療

浪花崇一, 佐藤浩平, 畑利彰, 福岡史朗, 上原健敬, 堅山佳美, 依光正則, 濱田全紀, 尾崎敏文, 千田益生

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S355 - S355 2022.10

両側の人工肘関節置換術術後に異所性骨化を生じた1例

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 406 - 406 2022.10

骨盤下肢外傷患者における静脈血栓塞栓症スクリーニングとしてのD-ダイマー値の妥当性

佐藤浩平, 上原健敬, 浪花崇一, 福岡史朗, 畑利彰, 依光正則, 堅山佳美, 濱田全紀, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S354 - S354 2022.10

AIを用いた超音波画像同一断面自動保存機能の開発

中原龍一, 西田圭一郎, 那須義久, 堀田佳史, 浪花崇一, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 375 - 375 2022.10

がん遺伝子パネルに基づく肉腫診療

中田英二, 藤原智洋, 平沢晃, 二川摩周, 遠西大輔, 山本英喜, 冨田秀太, 久保寿夫, 田端雅弘, 国定俊之, 豊岡伸一, 尾崎敏文

日本癌治療学会学術集会抄録集 60回 O49 - 4 2022.10

機械刺激応答性チャネルPIEZO1は運動刺激を感知して腱の成長を促進する

中道亮, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 374 - 374 2022.10

骨軟部腫瘍の治療と予後因子についての考察

中村伸子, 長谷部晋士, 山中伸太郎, 藤井知美, 藤渕剛次, 木谷彰岐, 佐藤康史, 新藤芳太郎, 西庄俊彦, 尾崎敏文, 田端雅弘, 薬師神芳洋

日本癌治療学会学術集会抄録集 60回 P68 - 5 2022.10

内側半月板後根断裂に対する経脛骨pullout修復術脛骨固定時の膝屈曲角度と初期固定張力の違いによる臨床成績の比較

田村優典, 古松毅之, 横山裕介, 金高圭甫, 東原直裕, 川田紘己, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 379 - 379 2022.10

がんロコモを予防するための骨転移患者のマネージメントデータに基づく骨転移診療

中田英二, 濱田全紀, 国定俊之, 藤原智洋, 堅山佳美, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S322 - S322 2022.10

小児固形腫瘍における基礎・トランスレーショナル研究の現状と展望骨軟部肉腫における基礎・トランスレーショナル研究の現状と展望

藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本小児血液・がん学会雑誌 59 ( 4 ) 169 - 169 2022.10

片側下腿に発生した多発性グロムス腫瘍の一例

徳田貴大, 藤原智洋, 国定俊之, 中田英二, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 395 - 395 2022.10

下肢長幹骨発生の原発性悪性骨腫瘍に対する広範切除術後の機能回復は再建法によりどのように異なるか?

藤原智洋, 中田英二, 堅山佳美, 濱田全紀, 国定俊之, 尾崎敏文, 千田益生

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S364 - S364 2022.10

骨盤悪性腫瘍に対するHip transposition法の術後機能・歩行能力

国定俊之, 中田英二, 藤原智洋, 尾崎敏文, 堅山佳美, 濱田全紀, 千田益生

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S364 - S364 2022.10

60歳以上の術前がん患者のがんロコモとサルコペニア,フレイルの有病率

堅山佳美, 中田英二, 藤原智洋, 國定俊之, 濱田全紀, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S363 - S363 2022.10

THA後の腸腰筋障害に対する股関節鏡下腸腰筋腱部分切離術の治療経験

安藤輝彦, 山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 井上智博, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 392 - 392 2022.10

踵骨関節内骨折に対する低侵襲ロッキングプレート固定は早期荷重を可能とさせる

國富康資, 依光正則, 上原健敬, 福岡史朗, 佐藤浩平, 尾崎敏文

中部日本整形外科災害外科学会雑誌 65 ( 秋季学会 ) 194 - 194 2022.10

生理的インピーダンス法におけるPhase angleは運動器慢性疼痛患者においてサルコペニア検出に有用である

辻寛謙, 三澤治夫, 鉄永智紀, 濱田全紀, 堅山佳美, 小田孔明, 西田圭一朗, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S343 - S343 2022.10

ポータブル筋音筋電計を用いた膝蓋腱反射の定量化

辻寛謙, 三澤治夫, 小田孔明, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S392 - S392 2022.10

岡山大学病院における頸椎損傷の急性期手術介入のタイミングに関する検討

魚谷弘二, 植田昌敬, 志渡澤央和, 小田孔明, 鉄永倫子, 三澤治夫, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 437 - 437 2022.10

踵骨関節内骨折の固定法の変化と術後荷重開始時期の短縮

依光正則, 上原健敬, 佐藤浩平, 福岡史朗, 濱田全紀, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S353 - S353 2022.10

大腿骨頸部骨折を合併した寛骨臼両柱骨折の1例

福岡史朗, 依光正則, 畑利彰, 佐藤浩平, 上原健敬, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 417 - 417 2022.10

Factors influencing caregiver burden in chronic pain patients: A retrospective study International journal

Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Yoshiaki Oda, Shinichiro Takao, Keiichiro Nishida, Toshifumi Ozaki

Medicine 101 ( 39 ) e30802 - e30802 2022.9

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Ovid Technologies (Wolters Kluwer Health)

Chronic pain coexists with disability, anxiety, depression, and sleep disturbances, which are factors of pain chronicity in the fear-avoidance model. Self-efficacy for managing pain plays a protective role against pain chronicity. For chronic pain sufferers, social support from caregivers is important. However, such caregivers face enormous physical and mental burdens. This study aimed to assess how self-efficacy and factors related to the fear-avoidance model affect caregiver burden. Participants were 135 chronic pain patients and their caregivers who visited our outpatient pain special clinic. In clinical assessments, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), Athens insomnia scale (AIS), pain disability assessment scale (PDAS), pain self-efficacy questionnaire (PSEQ) for the patients and Zarit Burden Interview (ZBI) for their caregivers were evaluated. Participants were divided into 2 groups (L group ZBI < 24 points and H group ZBI ≥ 24 points) and compared. Regression analyses were conducted to identify factors correlated with the ZBI scores. Compared to L group, H group showed significantly higher NRS and HADs depression scores, and lower PSEQ scores. In univariate regression analysis, ZBI scores were significantly correlated with NRS, PCS, HADS anxiety, HADS depression, PDAS and PSEQ. Multiple linear regression analysis revealed that ZBI scores were significantly correlated with PSEQ. The caregivers who perceived high caregiver burden had significantly higher patients' pain intensity, depression, and lower self-efficacy than those who perceived low caregiver burden. Caregiver burden correlated with the pain intensity, pain catastrophizing, anxiety, depression, disability, and self-efficacy of chronic pain patients. Among these factors, self-efficacy was the most negatively correlated with caregiver burden. Treatments focused on increasing self-efficacy for managing pain have the potential to reduce caregiver burden.

DOI： 10.1097/md.0000000000030802

DevOpsを用いた機械学習・医療アプリケーションの開発効率の改善

中原龍一, 西田圭一郎, 高橋康, 那須義久, 原田遼三, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1796 - S1796 2022.9

Clinicopathological and histological analysis of secondary malignant giant cell tumors of bone without radiotherapy. International journal

Eiji Nakata, Hotaka Kawai, Tomohiro Fujiwara, Toshiyuki Kunisada, Hirofumi Inoue, Mashu Futagawa, Haruyoshi Katayama, Takuto Itano, Toshifumi Ozaki

Oncology letters 24 ( 3 ) 319 - 319 2022.9

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Giant cell tumor of bone (GCTB) is an intermediate bone tumor that rarely undergoes malignant transformation. Secondary malignant GCTB (SMGCTB) is defined as a lesion in which high-grade sarcoma occurs at the site of previously treated GCTB. The present study retrospectively reviewed the medical records of patients with GCTB treated at Okayama University Hospital between April 1986 and April 2020. The clinicopathological and histological features of patients with SMGCTB without prior radiotherapy were investigated. A total of three patients (4%) with SMGCTB were detected, and the tumor sites were the distal ulna, distal femur and sacrum. Two of the patients had been treated with curettage and bone graft, and one had been treated with denosumab. In all cases, the lesions were made up of two components, the conventional GCTB component and the malignant component. The Ki67 labeling index was higher in the malignant components of SMGCTB and metastatic lesions compared with that in primary and recurrent conventional GCTB, or the conventional GCTB component of SMGCTB. Moreover, p53 expression was higher in these same components in patients who underwent curettage and bone grafting; however, there was no difference in the patient that received denosumab treatment. In this patient, clinical cancer genomic profiling revealed loss of CDKN2A, CDKN2B and MTAP expression. All three patients developed distant metastasis. The patients with SMGCTB in the ulna and femur died 13 and 54 months after detection of malignant transformation, respectively. The patient with SMGCTB in the sacrum received carbon-ion radiotherapy to the sacrum and pazopanib; the treatment was effective and the patient was alive at the last follow-up 3 years later. In conclusion, p53 may be associated with malignant transformation in GCTB. Future studies should investigate the association of between denosumab treatment and malignant transformation, as well as molecular targeted therapy to improve the clinical outcomes of SMGCTB.

DOI： 10.3892/ol.2022.13439

骨・軟部腫瘍の基礎科学のトピックスクリニカルシークエンスによる肉腫のゲノム医療

中田英二, 藤原智洋, 国定俊之, 二川摩周, 遠西大輔, 久保寿夫, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1533 - S1533 2022.9

骨・軟部肉腫に対するがんゲノムプロファイリング検査から検出されるpresumed germline pathogenic variantsの意義

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 河内麻里子, 山本英喜, 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 96 ( 8 ) S1770 - S1770 2022.9

The stability of repaired meniscal root can affect postoperative cartilage status following medial meniscus posterior root repair

Ximing Zhang, Takayuki Furumatsu, Takaaki Hiranaka, Yuki Okazaki, Haowei Xue, Keisuke Kintaka, Shinichi Miyazawa, Toshifumi Ozaki

Journal of Orthopaedic Science 2022.9

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 2022.9

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 2022.9

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 2022.9

変形性股関節症とCCN3発現の相関

廣瀬一樹, 中田英二, 鉄永智紀, 山田和希, 佐藤嘉洋, 小浦卓, 服部高子, 桑原実穂, 滝川正春, 久保田聡, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1583 - S1583 2022.9

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 2022.9

がんゲノム医療において遺伝性骨・軟部肉腫を同定する臨床的意義(Clinical significance of identifying hereditary bone and soft tissue sarcomas in precision medicine)

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 植野さやか, 山本英喜, 藤原智洋, 国定俊之, 尾崎敏文, 平沢晃

日本癌学会総会記事 81回 P - 3121 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

骨・軟部腫瘍の基礎科学のトピックス転移性骨肉腫は臓器指向性サイトカインの分泌を介して微小環境を変化させ前転移ニッチを形成する

近藤宏也, 田澤大, 藤原智洋, 近藤彩奈, 片山晴喜, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1532 - S1532 2022.9

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 2022.9

ヒトiPS細胞来肢芽間葉系細胞を用いた硝子軟骨シートの作製

高尾知佳, 佐藤正人, 豊田恵利子, 山田大祐, 中田英二, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 96 ( 8 ) S1557 - S1557 2022.9

当院におけるAR Hip Navigation Systemを用いたカップ設置の精度の検討

小浦卓, 鉄永智紀, 山田和希, 佐藤嘉洋, 廣瀬一樹, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1711 - S1711 2022.9

大腿骨延長後骨折の変形治癒に対して3次元骨切り術を施行した片側肥大の1例

山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 井上智博, 尾崎敏文, 赤澤啓史, 青木清, 寺本亜留美, 田中千晴

中国・四国整形外科学会雑誌 34 ( 2 ) 325 - 325 2022.9

がんゲノム医療において遺伝性骨・軟部肉腫を同定する臨床的意義(Clinical significance of identifying hereditary bone and soft tissue sarcomas in precision medicine)

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 植野さやか, 山本英喜, 藤原智洋, 国定俊之, 尾崎敏文, 平沢晃

日本癌学会総会記事 81回 P - 3121 2022.9

骨・軟部肉腫に対するがんゲノムプロファイリング検査から検出されるpresumed germline pathogenic variantsの意義

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 河内麻里子, 山本英喜, 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 96 ( 8 ) S1770 - S1770 2022.9

骨・軟部腫瘍の基礎科学のトピックスクリニカルシークエンスによる肉腫のゲノム医療

中田英二, 藤原智洋, 国定俊之, 二川摩周, 遠西大輔, 久保寿夫, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1533 - S1533 2022.9

両側の人工肘関節置換術術後に異所性骨化を生じた1例

志水紀之, 浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本関節病学会誌 41 ( 3 ) 165 - 165 2022.9

DevOpsを用いた機械学習・医療アプリケーションの開発効率の改善

中原龍一, 西田圭一郎, 高橋康, 那須義久, 原田遼三, 堀田佳史, 浪花崇一, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1796 - S1796 2022.9

関節リウマチにおけるMCP人工指関節再置換術の短期成績

浪花崇一, 堀田佳史, 志水紀之, 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 41 ( 3 ) 167 - 167 2022.9

ヒトiPS細胞来肢芽間葉系細胞を用いた硝子軟骨シートの作製

高尾知佳, 佐藤正人, 豊田恵利子, 山田大祐, 中田英二, 尾崎敏文, 宝田剛志

日本整形外科学会雑誌 96 ( 8 ) S1557 - S1557 2022.9

骨・軟部腫瘍の基礎科学のトピックス転移性骨肉腫は臓器指向性サイトカインの分泌を介して微小環境を変化させ前転移ニッチを形成する

近藤宏也, 田澤大, 藤原智洋, 近藤彩奈, 片山晴喜, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 96 ( 8 ) S1532 - S1532 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

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 2022.9

Language：Japanese Publisher：(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。

Other Link： 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 2022.9

Language：Japanese Publisher：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。

Other Link： 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 2022.8

Publishing type：Research paper (scientific journal) Publisher：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

Other Link： 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. International journal

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

Journal of clinical medicine 11 ( 16 ) 2022.8

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

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

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

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

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2022.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

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

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 2022.8

Effect of bacterium in the malignant wounds of soft tissue sarcoma International journal

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

Oncology Letters 24 ( 4 ) 345 - 345 2022.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：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

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

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

BMC cancer 22 ( 1 ) 891 - 891 2022.8

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

Other Link： 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. International journal

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

The journal of hand surgery Asian-Pacific volume 27 ( 4 ) 691 - 697 2022.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

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

Late-onset implant-related neuropathy: Three years after proximal humeral fracture. International journal

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

Trauma case reports 40 100670 - 100670 2022.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

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

Perioperative Adriamycin plus ifosfamide vs. gemcitabine plus docetaxel for high-risk soft tissue sarcomas: randomised, phase II/III study JCOG1306. International journal

Kazuhiro Tanaka, Ryunosuke Machida, Akira Kawai, Robert Nakayama, Satoshi Tsukushi, Kunihiro Asanuma, Yoshihiro Matsumoto, Hiroaki Hiraga, Koji Hiraoka, Munenori Watanuki, Tsukasa Yonemoto, Satoshi Abe, Hirohisa Katagiri, Yoshihiro Nishida, Akihito Nagano, Yoshiyuki Suehara, Hiroyuki Kawashima, Masanori Kawano, Takeshi Morii, Hiroshi Hatano, Junya Toguchida, Tomotake Okuma, Masanobu Takeyama, Satoshi Takenaka, Toshihiro Akisue, Taisuke Furuta, Makoto Emori, Toru Hiruma, Hidetatsu Outani, Tetsuji Yamamoto, Tomoko Kataoka, Haruhiko Fukuda, Toshifumi Ozaki, Yukihide Iwamoto

British journal of cancer 127 ( 8 ) 1487 - 1496 2022.7

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

BACKGROUND: This randomised phase II/III trial aimed to determine whether perioperative chemotherapy with gemcitabine plus docetaxel (GD) is non-inferior to the standard Adriamycin plus ifosfamide (AI) in terms of overall survival (OS) in patients with soft tissue sarcoma (STS). METHODS: Patients with localised high-risk STS in the extremities or trunk were randomised to receive AI or GD. The treatments were repeated for three preoperative and two postoperative courses. The primary endpoint was OS. RESULTS: Among 143 enrolled patients who received AI (70 patients) compared to GD (73 patients), the estimated 3-year OS was 91.4% for AI and 79.2% for GD (hazard ratio 2.55, 95% confidence interval: 0.80-8.14, P = 0.78), exceeding the prespecified non-inferiority margin in the second interim analysis. The estimated 3-year progression-free survival was 79.1% for AI and 59.1% for GD. The most common Grade 3-4 adverse events in the preoperative period were neutropenia (88.4%), anaemia (49.3%), and febrile neutropenia (36.2%) for AI and neutropenia (79.5%) and febrile neutropenia (17.8%) for GD. CONCLUSIONS: Although GD had relatively mild toxicity, the regimen-as administered in this study-should not be considered a standard treatment of perioperative chemotherapy for high-risk STS in the extremities and trunk. CLINICAL TRIAL REGISTRATION: jRCTs031180003.

DOI： 10.1038/s41416-022-01912-5

Evaluation of SARC-F and SARC-CalF for sarcopenia screening in patients with chronic musculoskeletal pain: A prospective cross-sectional study. International journal

Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Yoshiaki Oda, Shinichiro Takao, Keiichiro Nishida, Toshifumi Ozaki

Medicine 101 ( 29 ) e29568 2022.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: Early sarcopenia detection using screening tools, such as SARC-F and SARC-CalF, has been proven reliable. However, the relationship between chronic musculoskeletal pain with sarcopenia is unknown. This study assessed sarcopenia morbidity as well as the reliability of sarcopenia screening with SARC-F and SARC-CalF in patients with chronic musculoskeletal pain. METHODS: Overall, 172 patients with chronic musculoskeletal pain were included in this cross-sectional study. All participants completed the SARC-F, SARC-CalF, numeric rating scale (NRS), and pain disability assessment scale (PDAS) assessments. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. Correlations between SARC-F and SARC-CalF scores and each measured variable were evaluated using univariate and multiple linear regression analyses. A receiver operating characteristic curve analysis was conducted, and reliabilities of SARC-F and SARC-CalF scores for diagnosing sarcopenia were compared. RESULTS: Thirty-nine patients were diagnosed with sarcopenia. Among these, 10 patients were <65 years old, and 29 were >65 years old. Both SARC-F and SARC-CalF scores significantly correlated with grip power, gait speed, skeletal mass index, numeric rating scale score, and PDAS score. In multiple linear regression analysis, SALC-F and SALC-CalF scores significantly correlated with PDAS score, skeletal mass index, and gait speed. The area under the curve were 0.70 for SARC-F and 0.88 for SARC-CalF; SARC-CalF had a significantly higher area under the curve than SARC-F. DISCUSSION: Sarcopenia was diagnosed in patients aged <65 years with chronic musculoskeletal pain. SALC-F and SARC-CalF scores showed a significant correlation with disability due to pain and were reliable sarcopenia screening tools for chronic musculoskeletal pain. SARC-CalF was more reliable than SARC-F.

DOI： 10.1097/MD.0000000000029568

Arthroscopic Meniscal Healing following Medial Meniscus Posterior Root Repair: A Comparison between Two Suture Materials. International journal

Yuki Okazaki, Takayuki Furumatsu, Takaaki Hiranaka, Ximing Zhang, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

The journal of knee surgery 2022.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Recently, transtibial pullout repair of the medial meniscus (MM) posterior root tear (PRT) has become widely accepted and provides satisfactory clinical outcomes. Widening after cyclic loading or ultimate failure load using different suture materials and configurations has been studied. However, no study has compared the clinical outcomes using different suture materials. This study aimed to evaluate the clinical outcomes after performing MMPRT pullout repair using different suture materials. We hypothesized that better clinical outcomes would be achieved using ultra-high molecular weight polyethylene (UHMWPE) tape compared with a normal polyester suture. Thirty-seven patients who underwent MM posterior root repair between November 2019 and May 2020 were retrospectively investigated. Pullout repair was performed using a hollow no. 0 polyester suture (n = 14) and UHMWPE tape (n = 23). Clinical outcomes were assessed preoperatively and at 1 year postoperatively, using the Lysholm knee score, Knee Injury and Osteoarthritis Outcome Score, and visual analogue scale (VAS) pain score. The meniscal healing status was assessed using an arthroscopic scoring system (range: 0-10). All clinical scores were improved significantly in both groups. However, significantly higher meniscal healing scores and decreased VAS pain scores were observed in the UHMWPE group (7.3 ± 0.9 and 7.7 ± 11.3, respectively) than in the polyester group (5.6 ± 2.1 and 18.4 ± 18.6, respectively; p < 0.01). Suture cut-out and loss of the root continuity were observed in some cases (three cases [21.4%] in the polyester suture group and one case [4.3%] in the UHMWPE tape group). Both suture materials led to satisfactory clinical outcomes at 1 year postoperatively, whereas the UHMWPE tape was useful for obtaining good meniscal healing and decreasing the VAS pain score.

DOI： 10.1055/s-0042-1750047

モジュラー型人工関節・骨軟部腫瘍領域感染腫瘍用人工関節の術後感染

中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 45回 108 - 108 2022.7

小児化膿性股関節炎に対するα-ディフェンシン検出キットの使用経験

小浦卓, 鉄永智紀, 山田和希, 佐藤嘉洋, 廣瀬一樹, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 45回 224 - 224 2022.7

Larger sagittal inter-screw distance/tibial width ratio reduces delayed union or non-union after arthroscopic ankle arthrodesis. International journal

Suguru Yokoo, Kenta Saiga, Koji Demiya, Hideki Ohashi, Masahiro Horita, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2022.6

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Arthroscopic ankle arthrodesis (AAA) has risks of complications, such as delayed union and non-union. The number and direction of the inserted screws have been reported as important factors affecting the time to union of AAA. However, the ratio of inter-screw distance (ISD) to tibial width (TW) in different planes has not been investigated. Therefore, we aimed to explore the effect of this ratio on bone union following AAA. METHODS: We retrospectively enrolled 63 patients (64 ankles) undergoing AAA from 2013 to 2019. Then, their age, body mass index (BMI), sex, diabetes mellitus (DM) status, Takakura-Tanaka classification, number of screws and radiographic parameters were analysed. RESULTS: The patients had a mean age of 70.3 (range, 45-91) years. Bone fusion was achieved in 57 ankles (89%) in a mean period of 3.3 (range, 2-6) postoperative months. There were four cases of delayed union and three of non-union. No significant differences in age, BMI, sex, DM, Takakura-Tanaka classification, and number of screws could be detected between the groups. However, the sagittal ISD/TW ratio was significantly larger in the union group than in the delayed/non-union group with a cut-off value of 57.0%. CONCLUSION: Larger sagittal ISD/TW ratios result in reduced post-AAA delayed union or non-union. The surgeon should be aware that the anterior and posterior screw widths should be approximately 60% or more of the anteroposterior width of the tibia.

DOI： 10.1007/s00590-022-03307-x

脛骨プラトー・骨幹部合併骨折の治療経験

福岡史朗, 依光正則, 佐藤浩平, 畑利彰, 上原健敬, 尾崎敏文

骨折 44 ( Suppl. ) S285 - S285 2022.6

The mechanosensitive ion channel PIEZO1 is expressed in tendons and regulates physical performance

Ryo Nakamichi, Shang Ma, Takayuki Nonoyama, Tomoki Chiba, Ryota Kurimoto, Hiroki Ohzono, Merissa Olmer, Chisa Shukunami, Noriyuki Fuku, Guan Wang, Errol Morrison, Yannis P. Pitsiladis, Toshifumi Ozaki, Darryl D’Lima, Martin Lotz, Ardem Patapoutian, Hiroshi Asahara

Science Translational Medicine 14 ( 647 ) 2022.6

Publishing type：Research paper (scientific journal) Publisher：American Association for the Advancement of Science (AAAS)

How mechanical stress affects physical performance via tendons is not fully understood. Piezo1 is a mechanosensitive ion channel, and E756del PIEZO1 was recently found as a gain-of-function variant that is common in individuals of African descent. We generated tendon-specific knock-in mice using R2482H Piezo1 , a mouse gain-of-function variant, and found that they had higher jumping abilities and faster running speeds than wild-type or muscle-specific knock-in mice. These phenotypes were associated with enhanced tendon anabolism via an increase in tendon-specific transcription factors, Mohawk and Scleraxis, but there was no evidence of changes in muscle. Biomechanical analysis showed that the tendons of R2482H Piezo1 mice were more compliant and stored more elastic energy, consistent with the enhancement of jumping ability. These phenotypes were replicated in mice with tendon-specific R2482H Piezo1 replacement after tendon maturation, indicating that PIEZO1 could be a target for promoting physical performance by enhancing function in mature tendon. The frequency of E756del PIEZO1 was higher in sprinters than in population-matched nonathletic controls in a small Jamaican cohort, suggesting a similar function in humans. Together, this human and mouse genetic and physiological evidence revealed a critical function of tendons in physical performance, which is tightly and robustly regulated by PIEZO1 in tenocytes.

DOI： 10.1126/scitranslmed.abj5557

人工知能による骨肉腫X線読影システムの開発と骨端線認識への挑戦

長谷井嬢, 中原龍一, 国定俊之, 中澤慎二, 韓昌煕, 藏品豊, 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 ( 6 ) S1333 - S1333 2022.6

Hip Fractures after Intramedullary Nailing Fixation for Atypical Femoral Fractures: Three Cases.

Norio Yamamoto, Tomoo Inoue, Yusuke Mochizuki, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Acta medica Okayama 76 ( 3 ) 317 - 321 2022.6

Authorship：Last author Language：English Publishing type：Research paper (bulletin of university, research institution)

Secondary hip fractures (SHFs) rarely occur after intramedullary nailing (IMN) fixation without femoral neck fixation for atypical femoral fractures (AFFs). We report three cases of older Japanese women who sustained SHFs presumably caused by osteoporosis and peri-implant stress concentration around the femoral neck after undergoing IMN without femoral neck fixation for AFF. All cases were fixed with malalignment. In AFF patients, postoperative changes due to postoperative femoral bone malalignment may affect the peri-implant mechanical environment around the femoral neck, which can result in insufficiency fractures. At the first AFF surgery, we recommend femoral neck fixation after adequate reduction is achieved.

DOI： 10.18926/AMO/63741

遺伝性骨・軟部腫瘍外来の取り組み

中田英二, 藤原智洋, 国定俊之, 二川摩周, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1315 - S1315 2022.6

遺伝性骨・軟部腫瘍に対する遺伝学的検査の臨床的意義

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 河内麻里子, 山本英喜, 藤原智洋, 国定俊之, 尾崎敏文, 平沢晃

日本整形外科学会雑誌 96 ( 6 ) S1301 - S1301 2022.6

ゲノム医療時代の骨・軟部腫瘍医骨・軟部腫瘍診療におけるがん遺伝子パネルの意義

中田英二, 藤原智洋, 国定俊之, 二川摩周, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1286 - S1286 2022.6

高悪性度非円形細胞軟部肉腫における術前化学療法の組織学的効果判定法の標準化と予後的意義 JCOG0304附随研究

遠藤誠, 小田義直, 田仲和宏, 廣瀬隆則, 長谷川匡, 蛭田啓之, 久岡正典, 国定俊之, 比留間徹, 土屋弘行, 片桐浩久, 松本嘉寛, 川井章, 中山ロバート, 川島寛之, 水澤純基, 福田治彦, 尾崎敏文, 岩本幸英, 野島孝之

日本整形外科学会雑誌 96 ( 6 ) S1423 - S1423 2022.6

観血的治療を行った不安定型骨盤輪損傷の治療成績

上原健敬, 依光正則, 福岡史朗, 佐藤浩平, 畑利彰, 近藤宏也, 齋藤太一, 島村安則, 野田知之, 尾崎敏文

骨折 44 ( Suppl. ) S191 - S191 2022.6

消化器がん患者の術前がんロコモ年齢別の検討

堅山佳美, 中田英二, 千田益生, 濱田全紀, 藤原智洋, 国定俊之, 尾崎敏文

運動器リハビリテーション 33 ( 2 ) 136 - 136 2022.6

下肢悪性骨・軟部腫瘍に対する広範切除後の機能回復

濱田全紀, 中田英二, 堅山佳美, 藤原智洋, 国定俊之, 千田益生, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1433 - S1433 2022.6

消化器がん患者の術前がんロコモ

堅山佳美, 中田英二, 千田益生, 濱田全紀, 国定俊之, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1440 - S1440 2022.6

80歳以上の超高齢軟部肉腫患者の治療における老年学的因子の意義

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

日本整形外科学会雑誌 96 ( 6 ) S1298 - S1298 2022.6

人工知能による骨肉腫X線読影システムの開発と骨端線認識への挑戦

長谷井嬢, 中原龍一, 国定俊之, 中澤慎二, 韓昌煕, 藏品豊, 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 ( 6 ) S1333 - S1333 2022.6

遺伝性骨・軟部腫瘍に対する遺伝学的検査の臨床的意義

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 河内麻里子, 山本英喜, 藤原智洋, 国定俊之, 尾崎敏文, 平沢晃

日本整形外科学会雑誌 96 ( 6 ) S1301 - S1301 2022.6

ゲノム医療時代の骨・軟部腫瘍医骨・軟部腫瘍診療におけるがん遺伝子パネルの意義

中田英二, 藤原智洋, 国定俊之, 二川摩周, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1286 - S1286 2022.6

遺伝性骨・軟部腫瘍外来の取り組み

中田英二, 藤原智洋, 国定俊之, 二川摩周, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1315 - S1315 2022.6

骨巨細胞腫に対するデノスマブのde-escalationの有効性

板野拓人, 中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1368 - S1368 2022.6

浸潤性軟部肉腫における放射線療法の治療効果の検討

畑利彰, 藤原智洋, 吉田晶, 近藤宏也, 近藤彩奈, 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 ( 6 ) S1365 - S1365 2022.6

大腿骨近位部転移性骨腫瘍に対する手術療法

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

日本整形外科学会雑誌 96 ( 6 ) S1461 - S1461 2022.6

臓器指向性分泌サイトカイン/細胞外小胞を介したcell-cell communicationによる骨肉腫の新しい肺転移形成機構の同定

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

日本整形外科学会雑誌 96 ( 6 ) S1424 - S1424 2022.6

消化器がん患者の術前がんロコモ

堅山佳美, 中田英二, 千田益生, 濱田全紀, 国定俊之, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1440 - S1440 2022.6

下肢悪性骨・軟部腫瘍に対する広範切除後の機能回復

濱田全紀, 中田英二, 堅山佳美, 藤原智洋, 国定俊之, 千田益生, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1433 - S1433 2022.6

ナビゲーション支援手術は補助療法の効果を期待しにくい骨盤軟骨肉腫の腫瘍学的予後を改善させるか

藤原智洋, 金内洋一, 津田祐輔, Stevenson Jonathan, Parry Michael, Grimer Robert, Jeys Lee, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1288 - S1288 2022.6

ビッグデータと骨・軟部腫瘍-全国骨軟部腫瘍登録- National Cancer Databaseを利用した骨・軟部腫瘍研究社会経済的・地理的データから骨・軟部腫瘍診療の実態と課題を読み取る

藤原智洋, 小倉浩一, 中田英二, 国定俊之, 尾崎敏文, 川井章, Healey John H.

日本整形外科学会雑誌 96 ( 6 ) S1269 - S1269 2022.6

骨盤周囲深部発生軟部肉腫の治療成績

片山晴喜, 藤原智洋, 国定俊之, 中田英二, 尾崎敏文

日本整形外科学会雑誌 96 ( 6 ) S1363 - S1363 2022.6

転移性骨腫瘍(切迫骨折の治療) 大腿骨近位部転移性骨腫瘍に対する手術療法

佐藤浩平, 依光正則, 福岡史朗, 畑利彰, 近藤宏也, 上原健敬, 中田英二, 国定俊之, 野田知之, 尾崎敏文

骨折 44 ( Suppl. ) S70 - S70 2022.6

脛骨遠位骨幹部骨折に対するSemiextended approachは術後足関節アライメントを悪化させない

福岡史朗, 依光正則, 佐藤浩平, 畑利彰, 上原健敬, 寺田忠司, 尾崎敏文

骨折 44 ( Suppl. ) S292 - S292 2022.6

TKA後に生じた大腿骨非定型骨折の2例

畑利彰, 依光正則, 島村安則, 上原健敬, 福岡史朗, 佐藤浩平, 近藤宏也, 野田知之, 尾崎敏文

骨折 44 ( Suppl. ) S249 - S249 2022.6

Complex fractures around the knee 高エネルギー脛骨プラトー骨折(High Energy Tibial Plateau Fracture)

依光正則, 上原健敬, 畑利彰, 佐藤浩平, 福岡史朗, 野田知之, 尾崎敏文

骨折 44 ( Suppl. ) S21 - S21 2022.6

Medial meniscus posterior root repair influences sagittal length and coronal inclination of the anterior cruciate ligament: a retrospective study. International journal

Yuki Okazaki, Takayuki Furumatsu, Yuya Kodama, Takaaki Hiranaka, Keisuke Kintaka, Yusuke Kamatsuki, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2022.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Medial meniscus (MM) posterior root tears (PRTs) lead to abnormal kinematic changes in the knee and may induce pathological external rotation of the tibia during knee flexion. This study aimed to investigate changes in the length and inclination of the anterior cruciate ligament (ACL) after MM posterior root repair using magnetic resonance imaging (MRI). METHODS: This retrospective study included 44 patients who underwent MM posterior root repair between 2016 and 2019. Clinical outcomes were evaluated before and after surgery. MRI examinations were performed at 10°/90° of knee flexion preoperatively and 3 months postoperatively. The ACL length, proximal angle, and distal angle were determined using the sagittal view. MM extrusion and ACL inclination angle were determined using the coronal view. RESULTS: Clinical outcomes significantly improved 1 year after surgery. The postoperative ACL length (29.7 ± 2.4 mm) and proximal angle (47.0 ± 7.4°) at 90° of knee flexion decreased relative to the preoperative values (31.5 ± 2.3 mm and 51.8 ± 8.7°, P < 0.01). The postoperative ACL inclination (64.9 ± 5.6°) at 10° of knee flexion decreased relative to the preoperative value (69.7 ± 5.6°, P < 0.01). CONCLUSION: Pathologically-stretched linear ACL at 90° of knee flexion and a steep ACL inclination at 10° of knee flexion could be reduced after MM posterior root repair. This suggests that pullout repair could restore MM function as a secondary stabilizer, thereby preventing meniscal and cartilage degeneration.

DOI： 10.1007/s00590-022-03285-0

Current management of giant-cell tumor of bone in the denosumab era International journal

Akihito Nagano, Hiroshi Urakawa, Kazuhiro Tanaka, Toshifumi Ozaki

Japanese Journal of Clinical Oncology 52 ( 5 ) 411 - 416 2022.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Giant-cell tumor of bone is a rare, locally aggressive and rarely metastasizing primary bone tumor. The mainstay of treatment remains controversial and is decided by the balance between adequate surgical margin and sufficient adjacent joint function. Although curettage with a high-speed burr and local adjuvants can maintain normal joint function, many reports have revealed a high local recurrence rate. Conversely, en bloc resection and reconstruction with prostheses for highly aggressive lesions have reportedly lower local recurrence rates and poorer functional outcomes. Denosumab—a full human monoclonal antibody that inhibits receptor activator of nuclear factor-kappa β ligand—was approved by the Food and Drug Authority in 2013 for use in surgically unresectable or when resection is likely to result in severe morbidity for skeletally mature adolescents and adults with giant-cell tumor of bone. However, subsequent studies have suggested that the local recurrence rate would be increased by preoperative use of denosumab. In systematic reviews of the local recurrence rate after preoperative use of denosumab, conclusions vary due to the small sample sizes of the studies reviewed. Therefore, controversy regarding the treatment of giant-cell tumor of bone is ongoing. Here, this review elucidates the management of giant-cell tumor of bone, especially with the local adjuvant and neoadjuvant use of denosumab, and presents the current, evidence-based treatment for giant-cell tumor of bone.

DOI： 10.1093/jjco/hyac018

Increased cleft width during knee flexion is useful for the diagnosis of medial meniscus posterior root tears. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Shinichi Miyazawa, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Ximing Zhang, Haowei Xue, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2022.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: This study aimed to evaluate changes in the cleft width, defined as the distance between the lateral edge of the medial tibial plateau and that of the medial meniscus (MM) posterior root, using open magnetic resonance imaging (MRI) in patients with MM posterior root tear (MMPRT). METHODS: This study included 25 patients (20 women and 5 men; mean age: 65.2 years) who were diagnosed with MMPRT and underwent pullout repair. Upon coronal imaging, the cleft width was evaluated at the 10° and 90° flexed knee positions. The difference in the cleft width (defined as the cleft width at 90° minus the cleft width at 10°) was also calculated. Upon sagittal imaging, the MM posterior extrusion (MMPE) at 90° was also evaluated. Separate univariate linear regression models were used to determine the association between the time from injury to MRI and radiographic measurements. RESULTS: The mean cleft width at 10° and 90° was 4.9 ± 2.6 mm and 7.4 ± 3.7 mm, respectively; the mean difference in cleft width was 2.5 ± 1.5 mm, and the mean MMPE at 90° was 3.7 ± 1.3 mm. There was a significant difference in cleft width at 10° and 90° (p < 0.001). The time from injury to MRI was significantly associated with the cleft width at 10° (R = 0.42; p = 0.023), cleft width at 90° (R = 0.59; p = 0.002), the difference in the cleft width (R = 0.62; p = 0.008), and MMPE at 90° (R = 0.53; p = 0.008). CONCLUSION: This study demonstrates that the cleft width is significantly larger during knee flexion than during knee extension. Increased cleft width during knee flexion ("graben" sign) may help diagnose MMPRT, especially in cases where the cleft sign is unclear during knee extension. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-022-06983-8

Application of mesh plate for the treatment of an osteochondral fracture of the medial femoral condyle with medial wall fracture: A case report. International journal

Yusuke Mochizuki, Norio Yamamoto, Tomoyuki Noda, Toshifumi Ozaki

Acta orthopaedica et traumatologica turcica 56 ( 3 ) 228 - 231 2022.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Osteochondral fractures of the medial femoral condyle accompanied by medial wall fracture are rare. Surgeons often have difficulty in selecting the most appropriate treatment, especially the plating technique for internal fixation since the available femoral locking plates are made to fit the femoral lateral condyle and there is no anatomical plate for the medial condyle. We, herein, report a case of a 44-year- old female patient who suffered from an osteochondral fracture of the medial femoral condyle accompanied by medial wall fracture treated by a low-profile mesh plate contoured to fit around the fracture site. Bone union was achieved at postoperative week 12 and the patient was able to return to her normal activities. At the 16-month follow-up exam, the patient's functional and clinical outcomes were satisfactory. Her Oxford knee score was 47 points, and the Western Ontario and McMaster Universities Arthritis Index scores were 2 points for pain and 5 points for physical function. We believe that the mesh plate has several advantages. This is the first report of using a mesh plate for the femur, and we were able to achieve good results. We conclude that treatment with a mesh plate can be applied in well- selected patients with medial femoral condyle osteochondral fracture and has the potential to be applied to the treatment of fractures in various regions in the future.

DOI： 10.5152/j.aott.2022.21325

臓器移植とリハビリテーション医療

千田益生, 濱田全紀, 堅山佳美, 濱崎比果瑠, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( 特別号 ) S277 - S277 2022.5

術前肺がん患者のサルコペニア・がんロコモと術後合併症の関連性

堅山佳美, 千田益生, 中田英二, 濱田全紀, 国定俊之, 藤原智洋, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( 特別号 ) S35 - S35 2022.5

リハビリテーション専門病院での両下肢切断者の治療結果

濱田全紀, 堅山佳美, 千田益生, 茂山幸雄, 坂本吉宏, 徳弘昭博, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( 特別号 ) S255 - S255 2022.5

臓器移植とリハビリテーション医療

千田益生, 濱田全紀, 堅山佳美, 濱崎比果瑠, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( 特別号 ) S277 - S277 2022.5

リハビリテーション専門病院での両下肢切断者の治療結果

濱田全紀, 堅山佳美, 千田益生, 茂山幸雄, 坂本吉宏, 徳弘昭博, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( 特別号 ) S255 - S255 2022.5

術前肺がん患者のサルコペニア・がんロコモと術後合併症の関連性

堅山佳美, 千田益生, 中田英二, 濱田全紀, 国定俊之, 藤原智洋, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( 特別号 ) S35 - S35 2022.5

骨軟部腫瘍患者の術前ストレススクリーニング

伊勢真人, 藤原智洋, 堅山佳美, 中田英二, 濱田全紀, 國定俊之, 千田益生, 尾崎敏文, 田島文博

The Japanese Journal of Rehabilitation Medicine ( 特別号 ) S629 - S629 2022.5

Mechanical Study of Various Pedicle Screw Systems including Percutaneous Pedicle Screw in Trauma Treatment. International journal

Yoshiaki Oda, Tomoyuki Takigawa, Yasuo Ito, Haruo Misawa, Tomoko Tetsunaga, Koji Uotani, Toshifumi Ozaki

Medicina (Kaunas, Lithuania) 58 ( 5 ) 2022.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Background and Objectives: Spine surgery using a percutaneous pedicle screw placement (PPSP) is widely implemented for spinal trauma. However, percutaneous systems have been reported to have weak screw-rod connections. In this study, conventional open and percutaneous systems were biomechanically evaluated and compared. Material and Methods: The experiments were performed in two stages: the first stage was a break test, whereas the second stage was a fatigue test. Four systems were used for the experiments. System 1 was intended for conventional open surgery (titanium rod with a 6.0 mm diameter, using a clamp connecting mechanism). System 2 was a percutaneous pedicle screw (PPS) system for trauma (titanium alloy rod with a 6.0 mm diameter, using ball ring connections). System 3 was a PPS system for trauma (cobalt-chromium alloy rod with a 6.0 mm diameter, using sagittal adjusting screw connections). System 4 was a general-purpose PPS system (titanium alloy rod with a 5.5 mm diameter, using a mechanism where the adapter in the head holds down the screw). Results: Stiffness values of 54.8 N/mm, 43.1 N/mm, 90.9 N/mm, and 39.3 N/mm were reported for systems 1, 2, 3, and 4, respectively. The average number of load cycles in the fatigue test was 134,393, 40,980, 1,550,389, and 147,724 for systems 1 to 4, respectively. At the end of the test, the displacements were 0.2 mm, 16.9 mm, 1.2 mm, and 8.6 mm, respectively. System 1, with a locking mechanism, showed the least displacement at the end of the test. Conclusion: A few PPS systems showed better results in terms on stiffness and life than the open system. The experiments showed that mechanical strength varies depending on the spinal implant. The experiments conducted are essential and significant to provide the mechanical strength required for surgical reconstruction.

DOI： 10.3390/medicina58050565

A randomized phase III trial of denosumab before curettage for giant cell tumor of bone. JCOG1610

Hiroshi Urakawa, Akihito Nagano, Ryunosuke Machida, Kazuhiro Tanaka, Tomoko Kataoka, Yuta Sekino, Yoshihiro Nishida, Mitsuru Takahashi, Toshiyuki Kunisada, Masanori Kawano, Yukihiro Yoshida, Tatsuya Takagi, Kenji Sato, Toru Hiruma, Hiroshi Hatano, Satoshi Tsukushi, Akio Sakamoto, Toshihiro Akisue, Koji Hiraoka, Toshifumi Ozaki

JAPANESE JOURNAL OF CLINICAL ONCOLOGY 2022.4

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS

Though JCOG1610 gave only descriptive results, the superiority of preoperative denosumab was not observed in patients with giant cell tumor of bone without possible post-operative large bone defect in terms of relapse-free survival.Objectives The aim of JCOG1610 (randomized controlled phase III trial) was to confirm the superiority of preoperative denosumab to curettage with adjuvant local therapy for patients with giant cell tumor of bone without possible post-operative large bone defect. Methods The primary endpoint was relapse-free survival and the total sample size was set at 106 patients. Patient accrual began in October 2017. However, the accrual was terminated in December 2020 due to a recommendation from the Data and Safety Monitoring Committee because of poor patient accrual. Now, we report the descriptive results obtained in this study. Results A total of 18 patients had been registered from 13 Japanese institutions at the time of termination on December 2020. Eleven patients were assigned to Arm A (curettage and adjuvant local therapy) and 7 to Arm B (preoperative denosumab, curettage and adjuvant local therapy). Median follow-up period was 1.6 (range: 0.5-2.8) years. Protocol treatment was completed in all but one patient in Arm A who had a pathological fracture before surgery. All patients in Arm B were treated with five courses of preoperative denosumab. Relapse-free survival proportions in Arm A and B were 90.0% (95% confidence interval: 47.3-98.5) and 100% (100-100) at 1 year, and 60.0% (19.0-85.5) and 62.5% (14.2-89.3) at 2 years, respectively [hazard ratio (95% confidence interval): 1.51 (0.24-9.41)]. Conclusion In terms of relapse-free survival, the superiority of preoperative denosumab was not observed in patients with giant cell tumor of bone without possible post-operative large bone defect.

DOI： 10.1093/jjco/hyac071

Grade of Subchondral Insufficiency Fracture of the Knee and the Presence of a Posterior Shiny-Corner Lesion are Correlated with Duration of Medial Meniscus Posterior Root Tear in Women.

Yuki Okazaki, Takayuki Furumatsu, Takaaki Hiranaka, Yusuke Kamatsuki, Eiji Nakata, Tomonori Tetsunaga, Kentaro Yamane, Toshifumi Ozaki

Acta medica Okayama 76 ( 2 ) 121 - 127 2022.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Bone marrow edema (BME) after meniscus injury and risk factors for subchondral insufficiency fracture of the knee (SIFK) have been reported. However, their association with medial meniscus posterior root tear (MMPRT) remains unknown. We investigated the association of BME volume (BME-V), posterior shinycorner lesion (PSCL), and SIFK with MMPRT to examine the correlations between BME-V and medial meniscus extrusion (MME), PSCL and duration from injury to the time of magnetic resonance imaging (duration), and SIFK and duration. Twenty-nine patients who underwent surgery for MMPRT were included (mean age, 59.2; range, 39-84). The presence of PSCL, femoral BME-V (cm3), and SIFK grade (1-4) were evaluated. Preoperative factors, such as MME (mm) and duration (weeks), were investigated using multivariate linear/ logistic regression analyses. Multivariate linear regression analysis revealed duration as a significant factor for high-grade SIFK (p<0.01). Multivariate logistic regression analysis revealed duration as a significant factor for the presence of PSCL (odds ratio=0.94, p<0.05). A long duration of MMPRT leads to severe MME and highgrade SIFK (3 and 4), often resulting in knee arthroplasty. Early diagnosis of MMPRT and pullout repair can prevent severe MME and high-grade SIFK.

DOI： 10.18926/AMO/63405

The role of perioperative chemotherapy in primary high-grade extremity soft tissue sarcoma: a risk-stratified analysis using PERSARC

Ibtissam Acem, Winan J. van Houdt, Dirk J. Grünhagen, Winette T.A. van der Graaf, Anja J. Rueten-Budde, Hans Gelderblom, Cornelis Verhoef, Michiel A.J. van de Sande, Will Aston, Han Bonenkamp, Ingrid M.E. Desar, Peter C. Ferguson, Marta Fiocco, Robert J. van Ginkel, Anthony M. Griffin, Rick L. Haas, Jos A. van der Hage, Andrew J. Hayes, Lee M. Jeys, Akira Kawai, Johnny Keller, Minna K. Laitinen, Katja Maretty-Kongstad, Koichi Ogura, Toshifumi Ozaki, Rob Pollock, Veroniek M. van Praag, Stefan Sleijfer, Myles J. Smith, Maria A. Smolle, Emelie Styring, Joanna Szkandera, Kazuhiro Tanaka, Per-Ulf Tunn, Madeleine Willegger, Reinard Windhager, Jay S. Wunder, Olga Zaikova

European Journal of Cancer 165 71 - 80 2022.4

骨軟部腫瘍患者におけるがん遺伝子パネル検査によるgermline findingの同定

中田英二, 藤原智洋, 国定俊之, 二川摩周, 平沢晃, 尾崎敏文

中部日本整形外科災害外科学会雑誌 65 ( 春季学会 ) 125 - 125 2022.4

術前術後CTと術中に計測した骨盤傾斜の角度の差についての比較検討

小浦卓, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 尾崎敏文, 山田和希

中国・四国整形外科学会雑誌 34 ( 1 ) 1 - 5 2022.4

Language：Japanese Publisher：中国・四国整形外科学会

Zimmer Biomet社Augmented Reality Hip Navigation System(AR Hip Navi)を用いてTHAを施行した11例11股を対象に検討した。骨盤傾斜角の計測方法は、術前・術後はCTデータをもとに三次元術前計画ソフトZedHipを用いて計測し、術中はAR Hip Naviを用いて計測した。結果、術前CTでの計測値は平均3.8度、術中AR Hip Naviでの計測値は平均-2.6度、術後CTでの計測値は平均4.1度であった。術前計測値と術中計測値との差の絶対値(術前-術中)は10.1度、術中計測値と術後計測値との差の絶対値(術中-術後)は9.9度、術前計測値と術後計測値との差の絶対値(術前-術後)は2.3度であり、術前-術後の計測値差に比べて術前-術中の計測値差と術中-術後の計測値差は有意に大きかった。

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脊椎手術を受ける患者から骨粗鬆症治療が必要な患者を見つけ出す

高尾真一郎, 三澤治夫, 鉄永倫子, 魚谷弘二, 小田孔明, 尾崎敏文

中部日本整形外科災害外科学会雑誌 65 ( 春季学会 ) 111 - 111 2022.4

内側楔状骨背側脱臼骨折の1例

福岡史朗, 依光正則, 畑利彰, 佐藤浩平, 上原健敬, 尾崎敏文

中部日本整形外科災害外科学会雑誌 65 ( 春季学会 ) 199 - 199 2022.4

尺骨突き上げ症候群に対する尺骨骨幹部短縮骨切り術と遠位部短縮骨切り術の治療成績の比較

齋藤太一, 根津智史, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 39 ( 1 ) O66 - 5 2022.4

Management of elderly patients with bone and soft tissue sarcomas: JCOG Bone and Soft Tissue Tumor Study Group International journal

Kazuhiro Tanaka, Toshifumi Ozaki

Japanese Journal of Clinical Oncology 52 ( 6 ) 526 - 530 2022.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press (OUP)

Abstract

Approximately, 40% of bone sarcomas and 60% of soft tissue sarcoma arise in patients aged ≥65 years. However, because sarcoma is very rare, there is little evidence regarding the management of elderly patients with sarcoma. Age has been reported as a prognostic factor in patients with sarcomas. The standard therapy for all localized bone and soft tissue sarcomas is surgical resection, even in elderly patients. Radiation or ion-beam therapy can be considered for unresectable sarcomas. Although adjuvant chemotherapy is standard for osteosarcoma, the usefulness of adjuvant chemotherapy for elderly patients has not been verified; therefore, it may not be recommended for elderly patients with osteosarcoma. For elderly patients with advanced osteosarcoma, if general conditions permit, doxorubicin- and/or ifosfamide-based regimens as well as molecular-targeted therapies, including sorafenib, regorafenib and everolimus, may be considered, although these drugs have not been approved for sarcoma in Japan. Adjuvant chemotherapy with doxorubicin plus ifosfamide is recommended for patients with high-risk localized soft tissue sarcoma if they are aged ≤70 years. For first-line treatment of advanced soft tissue sarcoma in elderly patients, doxorubicin monotherapy is considered to be the standard regimen, and pazopanib can be an alternative. For second-line treatment, gemcitabine-based regimens, pazopanib, trabectedin and eribulin may be options for elderly patients with advanced soft tissue sarcoma.

DOI： 10.1093/jjco/hyac027

Cumulated ambulation score as predictor of postoperative mobility in patients with proximal femur fractures

Norio Yamamoto, Yosuke Tomita, Arisa Ichinose, Shintaro Sukegawa, Shigeki Yokoyama, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Archives of Orthopaedic and Trauma Surgery 2022.3

Japanese Orthopaedic Association (JOA) clinical practice guidelines on the management of soft tissue tumors 2020 - Secondary publication

Akira Kawai, Nobuhito Araki, Keisuke Ae, Toru Akiyama, Toshifumi Ozaki, Hirotaka Kawano, Toshiyuki Kunisada, Minako Sumi, Shunji Takahashi, Kazuhiro Tanaka, Satoshi Tsukushi, Norifumi Naka, Yoshihiro Nishida, Mitsuru Miyachi, Norio Yamamoto, Akihiko Yoshida, Tsukasa Yonemoto, Masahiro Yoshida, Shintaro Iwata

Journal of Orthopaedic Science 27 ( 3 ) 533 - 550 2022.3

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

BACKGROUND: These clinical practice guidelines are intended to provide recommendations based on the best evidence obtained to date on key issues in clinical practice to improve the prognosis, diagnostic and therapeutic processes for patients with soft tissue tumors. METHODS: The Guidelines Development Committee and Systematic Review Committee were composed of a multidisciplinary team of specialists who play an important role in soft tissue tumor care. Clinical questions (CQs) were determined by choosing key decision-making points based on Algorithms for the diagnosis and treatment of soft tissue tumors. The guidelines were developed according to the "Medical Information Network Distribution Service (Minds) Handbook for Clinical Practice Guideline Development 2014" and "Minds Manual for Clinical Practice Guideline Development 2017." Recommendation strength was rated on two levels and the strength of evidence was rated on four levels. The recommendations were decided based on agreement by 70% or more voters. RESULTS: Twenty-two CQs were chosen by the Guidelines Development Committee. The Systematic Review Committee reviewed the evidence concerning each CQ, a clinical value judgment was added by experts, and the text of each recommendation was determined. CONCLUSION: We established 22 CQs and recommendations for key decision-making points in the diagnosis and treatment of soft tissue tumors according to the Minds Clinical Practice Guideline development methods. We hope that these guidelines will assist the decision-making of all medical staff engaged in the treatment and diagnosis of soft tissue tumors, and eventually lead to improved soft tissue tumor care in the country.

DOI： 10.1016/j.jos.2021.11.023

Pre-and postoperative factors associated with functional outcomes in patients with posterior malleolar fractures

Norio Yamamoto, Kohei Iwamoto, Yosuke Tomita, Yuki Iwamoto, Masahiro Kiyono, Masahide Yoshimura, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Injury 2022.3

慢性疼痛はコロナ禍における身体機能低下に与える影響は少ない

鉄永智紀, 鉄永倫子, 三澤治夫, 魚谷弘二, 小田孔明, 高尾真一郎, 梶木裕矢, 井上忠俊, 尾崎敏文, 田淵貴大

日本整形外科学会雑誌 96 ( 3 ) S781 - S781 2022.3

がんゲノム中核拠点病院における、がん遺伝子パネルで同定されたGermline Findingsに対する診療システムの構築

中田英二, 二川摩周, 国定俊之, 藤原智洋, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S439 - S439 2022.3

リウマチ肘に対するPROSNAP人工肘関節置換術の短期成績

堀田佳史, 西田圭一郎, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S247 - S247 2022.3

人工肘関節全置換術を施行した関節リウマチ患者の上肢機能に影響を与える因子の検討

松山宜之, 那須義久, 原田遼三, 中原龍一, 西田圭一郎, 尾崎敏文, 千田益生

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 636 - 636 2022.3

関節リウマチ患者に対する連結型人工肘関節全置換術(PROSNAP)の臨床成績の検討

堀田佳史, 西田圭一郎, 浪花崇一, 原田遼三, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 618 - 618 2022.3

人工手関節置換術後のゆるみに対して他家骨移植を併用した全人工手関節固定術を施行した1例

那須義久, 西田圭一郎, 中原龍一, 浪花崇一, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 616 - 616 2022.3

骨・軟部腫瘍診療の未来骨・軟部腫瘍診療におけるAI診断の現状と未来

長谷井嬢, 中原龍一, 国定俊之, 中澤慎二, 韓昌煕, 藏品豊, 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 ( 2 ) S479 - S479 2022.3

AIを用いた骨端線の年齢変化の学習と単純X線画像自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S427 - S427 2022.3

リウマチ性疾患の上肢手術関節リウマチに対するAVANTAとINTEGRAを用いたMCP人工指関節置換術の術後可動域の比較

浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 353 - 353 2022.3

関節リウマチにおける外科的治療の意義-機能障害の回復を目指して- RA患者に対する人工肘関節全置換術による機能回復

西田圭一郎, 松山宜之, 原田遼三, 那須義久, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 251 - 251 2022.3

関節リウマチ治療のパラダイムシフトに伴う上肢手術とリハビリテーション-変遷と展望- 人工肘関節全置換術後のリハビリテーションの変遷と展望

西田圭一郎, 松山宜之, 那須義久, 原田遼三, 中原龍一, 千田益生, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S413 - S413 2022.3

その他の(多彩な)膠原病機械学習を用いたサマリー自動可視化システムによるサマリー記載の標準化

中原龍一, 西田圭一郎, 高橋康, 浪花崇一, 堀田佳史, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 477 - 477 2022.3

肉腫におけるがん遺伝子パネルの有用性

中田英二, 国定俊之, 藤原智洋, 二川摩周, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S626 - S626 2022.3

A posterior anchoring method decreases pullout suture translation of the medial meniscus posterior root repair during knee flexion

Yuki Okazaki, Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Naohiro Higashihara, Masanori Tamura, Toshifumi Ozaki

The Knee 35 71 - 80 2022.3

Hip fractures following intramedullary nailing fixation for femoral fractures

Norio Yamamoto, Yasuaki Yamakawa, Takashi Inokuchi, Yuki Iwamoto, Tomoo Inoue, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Injury 53 ( 3 ) 1190 - 1195 2022.3

腱骨接合部の恒常性におけるメカニカルストレスの影響

齋藤太一, 根津智史, 吉田晶, 島村安則, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S315 - S315 2022.3

大腿骨転子部骨折患者における術前栄養状態、骨格筋量と術後歩行能力との関連性の検討

佐藤浩平, 依光正則, 福岡史朗, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 島村安則, 野田知之, 東原信七郎, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S693 - S693 2022.3

寛骨臼骨折における術後臨床成績評価方法の比較 Matta scoreとJHEQの比較検討

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 齋藤太一, 雑賀建多, 島村安則, 依光正則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S874 - S874 2022.3

寛骨臼骨折前方アプローチ術後の腹部ヘルニア発生例の検討

畑利彰, 野田知之, 上原健敬, 依光正則, 齋藤太一, 島村安則, 福岡史朗, 佐藤浩平, 近藤宏也, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S875 - S875 2022.3

脛骨髄内釘治療における術中X線透視を用いた近位回旋変形評価指標は何が適切か

畑利彰, 野田知之, 上原健敬, 依光正則, 齋藤太一, 島村安則, 福岡史朗, 佐藤浩平, 近藤宏也, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S1029 - S1029 2022.3

骨・軟部腫瘍診療の未来骨・軟部腫瘍診療におけるAI診断の現状と未来

長谷井嬢, 中原龍一, 国定俊之, 中澤慎二, 韓昌煕, 藏品豊, 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 ( 2 ) S479 - S479 2022.3

60歳以上の術前がん患者のがんロコモとサルコペニアの有病率

堅山佳美, 中田英二, 藤原智洋, 国定俊之, 濱田全紀, 千田益生, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S120 - S120 2022.3

AIを用いた骨端線の年齢変化の学習と単純X線画像自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S427 - S427 2022.3

リウマチ性疾患の上肢手術関節リウマチに対するAVANTAとINTEGRAを用いたMCP人工指関節置換術の術後可動域の比較

浪花崇一, 堀田佳史, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 353 - 353 2022.3

診療ガイドラインに基づく治療は生存予後に寄与するか軟部肉腫に対する補助化学療法の観点から米国における治療実態を検証する

藤原智洋, 小倉浩一, Alaqeel Motaz, 尾崎敏文, Healey John H.

日本整形外科学会雑誌 96 ( 3 ) S601 - S601 2022.3

肉腫におけるがん遺伝子パネルの有用性

中田英二, 国定俊之, 藤原智洋, 二川摩周, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S626 - S626 2022.3

関節リウマチ患者に対する連結型人工肘関節全置換術(PROSNAP)の臨床成績の検討

堀田佳史, 西田圭一郎, 浪花崇一, 原田遼三, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 618 - 618 2022.3

人工手関節置換術後のゆるみに対して他家骨移植を併用した全人工手関節固定術を施行した1例

那須義久, 西田圭一郎, 中原龍一, 浪花崇一, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 616 - 616 2022.3

がんゲノム中核拠点病院における、がん遺伝子パネルで同定されたGermline Findingsに対する診療システムの構築

中田英二, 二川摩周, 国定俊之, 藤原智洋, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S439 - S439 2022.3

人工肘関節全置換術を施行した関節リウマチ患者の上肢機能に影響を与える因子の検討

松山宜之, 那須義久, 原田遼三, 中原龍一, 西田圭一郎, 尾崎敏文, 千田益生

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 636 - 636 2022.3

リウマチ肘に対するPROSNAP人工肘関節置換術の短期成績

堀田佳史, 西田圭一郎, 浪花崇一, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S247 - S247 2022.3

本邦の胞巣状軟部肉腫に対する治療実態とその成績全国骨・軟部腫瘍登録を用いた研究

藤原智洋, 中田英二, 国定俊之, 尾崎敏文, 川井章

日本整形外科学会雑誌 96 ( 3 ) S1156 - S1156 2022.3

関節リウマチにおける外科的治療の意義-機能障害の回復を目指して- RA患者に対する人工肘関節全置換術による機能回復

西田圭一郎, 松山宜之, 原田遼三, 那須義久, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 251 - 251 2022.3

関節リウマチ治療のパラダイムシフトに伴う上肢手術とリハビリテーション-変遷と展望- 人工肘関節全置換術後のリハビリテーションの変遷と展望

西田圭一郎, 松山宜之, 那須義久, 原田遼三, 中原龍一, 千田益生, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S413 - S413 2022.3

その他の(多彩な)膠原病機械学習を用いたサマリー自動可視化システムによるサマリー記載の標準化

中原龍一, 西田圭一郎, 高橋康, 浪花崇一, 堀田佳史, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 66回 477 - 477 2022.3

発育性股関節形成不全に対する広範囲展開法術後の三次元動態解析

山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 遠藤裕介, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S312 - S312 2022.3

DDH加療後のColonna手術後症例と保存的cast加療後の症例に対するTHAの手術成績比較半世紀の経過観察

遠藤裕介, 山田和希, 鉄永智紀, 難波良文, 三谷茂, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S788 - S788 2022.3

慢性疼痛はコロナ禍における身体機能低下に与える影響は少ない

鉄永智紀, 鉄永倫子, 三澤治夫, 魚谷弘二, 小田孔明, 高尾真一郎, 梶木裕矢, 井上忠俊, 尾崎敏文, 田淵貴大

日本整形外科学会雑誌 96 ( 3 ) S781 - S781 2022.3

2ステップテストにおける体幹と下肢の三次元動作解析

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 高尾真一郎, 梶木裕矢, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 318 - 318 2022.3

転移性脊椎腫瘍脊柱管内進展の単純CTによる早期発見の可能性について

魚谷弘二, 小田孔明, 三澤治夫, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S761 - S761 2022.3

みんなで行う骨転移診療-診療均てん化を目指した整形外科キャリアステージ別スキルの再確認- 骨転移診療のスキル外傷整形外科医編

野田知之, 阿部信寛, 尾崎敏文, 中田英二, 依光正則, 上原健敬

日本整形外科学会雑誌 96 ( 2 ) S477 - S477 2022.3

集学的アプローチを用いた小児外傷患者に対する保護活動の実際

上原健敬, 依光正則, 福岡史朗, 佐藤浩平, 畑利彰, 島村安則, 塚原紘平, 中尾篤典, 尾崎敏文

日本整形外科学会雑誌 96 ( 2 ) S311 - S311 2022.3

SER Stage IV Equivalent足関節外果骨折における三角靱帯深層線維損傷の有無の評価

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

日本整形外科学会雑誌 96 ( 3 ) S1030 - S1030 2022.3

大腿骨骨幹部骨折における骨癒合期間に影響する因子の検討

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

日本整形外科学会雑誌 96 ( 3 ) S883 - S883 2022.3

CT画像における腸腰筋評価と最大握力 DXAによる骨密度、骨折リスクとの関連

梶木裕矢, 三澤治夫, 鉄永倫子, 魚谷弘二, 小田孔明, 高尾真一郎, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 568 - 568 2022.3

関節リウマチ患者における胸腰椎手術後の術後合併症および再手術の検討

三澤治夫, 小田孔明, 魚谷弘二, 鉄永倫子, 高尾真一郎, 梶木裕矢, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 672 - 672 2022.3

骨密度と腸腰筋の各パラメーターとの関連 CT画像データを用いた検討

高尾真一郎, 三澤治夫, 鉄永倫子, 魚谷弘二, 小田孔明, 尾崎敏文, 梶木裕矢

日本整形外科学会雑誌 96 ( 3 ) S919 - S919 2022.3

単純CTによる脊椎転移脊柱管内進展の早期発見の可能性について

魚谷弘二, 三澤治夫, 梶木裕矢, 高尾真一郎, 小田孔明, 鉄永倫子, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 299 - 299 2022.3

Three-Dimensional Analysis of the Ideal Entry Point for Sacral Alar Iliac Screws. International journal

Noriyuki Watanabe, Tomoyuki Takigawa, Koji Uotani, Yoshiaki Oda, Haruo Misawa, Masato Tanaka, Toshifumi Ozaki

Asian spine journal 16 ( 6 ) 874 - 881 2022.2

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

STUDY DESIGN: This is a virtual three-dimensional (3D) imaging study examining computed tomography (CT) data to investigate instrumentation placement. PURPOSE: In this study, we aim to clarify the ideal entry point and trajectory of the sacral alar iliac (SAI) screw in relationship to the dorsal foramen at S1 and the respective nerve root. OVERVIEW OF LITERATURE: To the best of our knowledge, there is yet no detailed 3D imaging study on the ideal entry point of the SAI screw. Despite the evidence suggesting that the dorsal foramen at S1 is a landmark on the sacrum, the S1 nerve root disruption is a general concern during the insertion of SAI screws. No other study has been published examining the nerve root location at the S1and SAI screw insertions. METHODS: Preoperative CT data from 26 patients pertaining to adult spinal deformities were investigated in this study. We applied a 3D image processing method for a detailed investigation. Virtual cylinders were used to mimic SAI screws. These were placed to penetrate the sacral iliac joint without violating the other cortex. We then assessed the trajectory of the longest SAI screw and the ideal entry point of SAI using a color mapping method on the surface of the sacrum. We measured the location of the nerve root at S1 in relation to the foramen at S1 and the sacral surface. RESULTS: As per the results of our color mapping, it was determined that areas that received high scores are located medially and caudally to the dorsal foramen of S1. The mean angle between a horizontal line and a line connecting the medial edge of the foramen and nerve root at S1 was 93.5°. The mean distances from the dorsal medial edge of the foramen and sacral surface to S1 nerve root were 21.8 mm and 13.9 mm, respectively. CONCLUSIONS: The ideal entry point of the SAI screw is located medially and caudally to the S1 dorsal foramen based on 3D digital mapping. It is also shown that this entry point spares the S1 nerve root from possible iatrogenic injuries.

DOI： 10.31616/asj.2021.0268

Preoperative and perioperative factors are related to the early postoperative Barthel Index score in patients with trochanteric fracture

Yosuke Tomita, Norio Yamamoto, Tomoo Inoue, Arisa Ichinose, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

International Journal of Rehabilitation Research Publish Ahead of Print 2022.2

Association between Overall Survival and Activities of Daily Living in Patients with Spinal Bone Metastases International journal

Yoshiteru Akezaki, Eiji Nakata, Masato Kikuuchi, Shinsuke Sugihara, Yoshimi Katayama, Haruyoshi Katayama, Masanori Hamada, Toshifumi Ozaki

Healthcare 10 ( 2 ) 350 - 350 2022.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Objective: This study aimed to investigate the association between overall survival (OS) and activities of daily living (ADL) in patients with skeletal-related events. In this study, 265 patients whose clinical parameters were available before radiotherapy were investigated. Methods: Age, sex, ADL, pain, the primary site, spinal level of bone metastases, spinal instability, treatment strategy, including chemotherapy or palliative treatment, and OS were investigated. ADL patients with a Barthel index of ≥90 were classified as the high ADL group, while those with a score < 90 were classified as the low ADL group. For OS, patients surviving ≥160 days were classified as the non-poor prognosis group, and those who survived <160 days were classified as the poor prognosis group. Results: Age, sex, ADL, pain, the primary site, and treatment strategy for OS were different between the two groups (p < 0.1). Logistic regression analysis revealed that ADL, the primary site, and treatment strategy were significant predictors of OS (p < 0.05). High ADL, breast cancer, and chemotherapy had a positive effect on OS. Conclusions: It is suggested that improvements may be obtained by performing rehabilitation interventions to maintain and improve ADL, by constructing a system for monitoring spinal bone metastases with images before ADL decreases, and by performing interventions such as changes in treatment methods such as RT or surgery at appropriate times.

DOI： 10.3390/healthcare10020350

Intraoperative fractures in cephalomedullary nailing for trochanteric fractures

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

Injury 53 ( 2 ) 561 - 568 2022.2

CD30-targeted therapy induces apoptosis of inflammatory cytokine-stimulated synovial fibroblasts and ameliorates collagen antibody-induced arthritis in mice. International journal

Minami Matsuhashi, Keiichiro Nishida, Misa Sakamoto, Yuka Gion, Aki Yoshida, Takayuki Katsuyama, Ryuichi Nakahara, Yoshihisa Nasu, Yoshinori Matsumoto, Yasuharu Sato, Toshifumi Ozaki

Inflammation research : official journal of the European Histamine Research Society ... [et al.] 71 ( 2 ) 215 - 226 2022.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: It has been reported that levels of soluble CD30 in serum and joint fluid are significantly elevated in patients with rheumatoid arthritis (RA). This study aimed to investigate whether CD30 could be a therapeutic target for RA. METHODS: The expression and localization of CD30 were examined by immunohistochemical and double immunofluorescence staining on synovial tissue samples obtained from patients with RA or osteoarthritis (OA) during surgery. Changes in CD30 expression of fibroblast-like synoviocytes (FLS) from RA patients with or without TNFα and IL-1β stimulation were examined by the polymerase chain reaction (PCR) and flow cytometry. Collagen antibody-induced arthritis (CAIA) was created in DBA/1 mice, and the therapeutic effect of brentuximab vedotin (BV) was examined by clinical score, histological findings and measurement of serum levels of SAA, IL-6, and TNFα. RESULTS: CD30 expression was significantly higher in samples from patients with RA than from those with OA. Double immunofluorescence showed a low rate of co-localization of CD30 with CD20 or CD90, but a high rate of co-localization of CD30 and CD138. CD30 mRNA expression was upregulated 11.7-fold in FLS following stimulation by inflammatory cytokines. The clinical scores of CAIA mice were significantly lower following both BV treatments, however, the histological scores of CAIA mice were significantly lower only following treatment with high dose BV (70 mg/kg). CONCLUSIONS: CD30 was expressed on immunocompetent cells in synovial tissue from RA patients and in cytokine-stimulated FLS in vitro. High dose BV (70 mg/kg) showed significant therapeutic effects in ameliorating inflammation and joint destruction in CAIA mice, but low dose BV (30 mg/kg) was insufficient.

DOI： 10.1007/s00011-021-01537-z

Corrigendum to ‘Age-related differences of oncological outcomes in primary extremity soft tissue sarcoma: a multistate model including 6260 patients’ [Eur J Cancer 141 (2020) 128-136]

Ibtissam Acem, Cornelis Verhoef, Anja J. Rueten-Budde, Dirk J. Grünhagen, Winan J. van Houdt, Michiel A.J. van de Sande, Will Aston, Han Bonenkamp, Ingrid M.E. Desar, Peter C. Ferguson, Marta Fiocco, Hans Gelderblom, Robert J. van Ginkel, Winette van der Graaf, Anthony M. Griffin, Rick L. Haas, Jos A. van der Hage, Andrew J. Hayes, Lee M. Jeys, Johnny Keller, Minna K. Laitinen, Andreas Leithner, Katja Maretty-Kongstad, Toshifumi Ozaki, Rob Pollock, Veroniek M. van Praag, Myles J. Smith, Maria A. Smolle, Emelie Styring, Joanna Szkandera, Kazuhiro Tanaka, Per-Ulf Tunn, Madeleine Willegger, Reinard Windhager, Jay S. Wunder, Olga Zaikova

European Journal of Cancer 162 247 - 249 2022.2

骨腫瘍切除後の配向連通孔構造を持つβ-TCPによる再建

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

移植 56 ( 4 ) 456 - 456 2022.2

変形性肩関節症とCCN3発現上昇との相関について

廣瀬一樹, 中田英二, 服部高子, 鉄永智紀, 山田和希, 佐藤嘉洋, 桑原実穂, 滝川正春, 久保田聡, 尾崎敏文

移植 56 ( 4 ) 455 - 455 2022.2

Soft-tissue sarcoma in adolescents and young adults

Toshiyuki Kunisada, Eiji Nakata, Tomohiro Fujiwara, Ako Hosono, Shota Takihira, Hiroya Kondo, Toshifumi Ozaki

International Journal of Clinical Oncology 2022.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Soft-tissue sarcoma is a rare cancer that accounts for approximately 1% of all malignant tumors. Although they occur in various age groups, soft-tissue sarcomas account for 8% of all malignant tumors developing in adolescents and young adults, suggesting that they are not rare in this age group. This study aimed to evaluate the clinical and pathological characteristics of soft-tissue sarcoma in adolescents and young adults. According to the Bone and Soft-Tissue Tumor Registry in Japan, myxoid liposarcoma is the most common type of soft-tissue sarcoma found in adolescents and young adults; alveolar soft part sarcoma, extraskeletal Ewing sarcoma, epithelioid sarcoma, clear cell sarcoma and synovial sarcoma occur predominantly in this age group among soft-tissue sarcomas. The analysis based on this registry demonstrated that age was not a prognostic factor for poor survival of soft-tissue sarcoma, although the prognosis in adolescents and young adults was better than that in older patients in the US and Scandinavia. Adolescent and young adult patients with soft-tissue sarcoma have age-specific problems, and a multidisciplinary approach to physical, psychological, and social issues is necessary to improve the management of these young patients both during and after treatment.

DOI： 10.1007/s10147-022-02119-7

Other Link： https://link.springer.com/article/10.1007/s10147-022-02119-7/fulltext.html

Outcome after resection arthroplasty or shortening oblique osteotomy of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal joint for severe rheumatoid forefoot deformities

Masahiro Horita, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Masanori Hamada, Toshifumi Ozaki

Journal of Orthopaedic Surgery 30 ( 2 ) 102255362211179 - 102255362211179 2022.1

Authorship：Last author Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Purpose

We investigated objective and patient-reported outcomes after resection arthroplasty or shortening oblique osteotomy (SOO) of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal (MTP) joint for severe rheumatoid forefoot deformities.

Methods

17 feet from 14 women (mean age, 67.8 years) underwent resection arthroplasty of the lesser metatarsal heads (MTH resection group), while 13 feet from nine women and two men (mean age, 68.7 years) underwent SOO of the lesser metatarsals (MTH preservation group). Arthrodesis of the first MTP joint was performed in all cases. Mean follow-up in the MTH resection and preservation groups was 25.0 and 21.3 months, respectively. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) scale and self-administered foot evaluation questionnaire (SAFE-Q) scores.

Results

Mean total JSSF scale significantly improved from 53.4 to 76.4 in the MTH resection group ( p < .001) and from 50.1 to 74.2 in the MTH preservation group ( p = .002). Pain and pain-related and shoe-related SAFE-Q subscale scores significantly improved after surgery in both groups. In the MTH resection group, recurrence of painful callosities and claw toe deformity was observed in four and three feet, respectively. In the MTH preservation group, one patient experienced recurrence of painful callosities and one underwent revision surgery for IP joint dislocation.

Conclusion

Resection arthroplasty or SOO of the lesser metatarsals combined with arthrodesis of the first MTP joint achieved significant improvement with respect to pain relief, deformity correction, and footwear comfort.

DOI： 10.1177/10225536221117903

Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/10225536221117903

Effect of difference in fixation methods of tendon graft and the microfracture procedure on tendon-bone junction healing

Satoshi Nezu, Taichi Saito, Aki Yoshida, Shinji Narazaki, Yasunori Shimamura, Takayuki Furumatsu, Toshifumi Ozaki

JSES International 6 ( 1 ) 155 - 166 2022.1

Publishing type：Research paper (scientific journal)

Background: There are generally two methods of fixation for tendon grafts used in ligament reconstruction: bone tunnel fixation and anchor fixation. The microfracture (Mf) procedure is a technique to induce bleeding from the bone marrow, and the bleeding may contain cells with differentiation potential. However, few studies have compared the effects of the Mf procedure with those of the fixation methods. This study aimed to evaluate the effectiveness of the Mf procedure on two tendon graft fixation methods: histological, gene expression, tendon graft thickness, and mechanical. We especially focused our investigation on junction healing of tendon grafts and bone in the two fixation methods. Methods: We used 20 rabbits to evaluate tendon and bone healing in a peroneal tendon graft model. The rabbit models were divided into five groups according to the combination of peroneal tendon graft fixation method and Mf technique as follows: control group (C, n = 4), bone tunnel fixation without Mf procedure group (BT − Mf, n = 4), bone tunnel fixation with Mf procedure group (BT + Mf, n = 4), anchor fixation without Mf procedure group (A − Mf, n = 4), and anchor fixation with Mf procedure group (A + Mf, n = 4). All animals were sacrificed at 4 weeks postoperatively. The specimens underwent histological evaluation, mRNA analysis, tendon graft thickness at the tendon-bone junction, and biomechanical testing. Results: Histological evaluation of the BT + Mf and A + Mf groups showed healing with fibrocartilage formation at the tendon graft-bone junction. The mRNA expression showed significant increase in type 2 collagen, Scleraxis, and SRY-box9 in the BT + Mf and A + Mf groups. In biomechanical tests, the BT + Mf and A + Mf groups showed significantly increased tensile strength compared with the BT − Mf and A − Mf groups (BT + Mf group, 21.6 ± 1.7 N; A + Mf group, 22.5 ± 2.3 N vs. BT − Mf group, 12.3 ± 2.4 N; A − Mf group, 11 ± 2.3 N). Conclusion: The Mf procedure resulted in fibrocartilage formation at the tendon-bone junction in the BT and anchor fixation and improved the fixation strength at 4 weeks.

DOI： 10.1016/j.jseint.2021.10.001

上腕筋三頭筋温存アプローチ用いてPROSNAP人工肘関節置換術を施行した症例

堀田佳史, 西田圭一郎, 志水紀之, 中原龍一, 那須義久, 尾崎敏文

関節の外科 49 ( 2 ) 106 - 106 2022

生物学的製剤の使用は手術部位感染と創傷治癒遅延のリスク因子となるか

木曽洋平, 西田圭一郎, 原田遼三, 那須義久, 中原龍一, 堀田佳史, 浪花崇一, 尾崎敏文

関節の外科 49 ( 2 ) 59 - 59 2022

Randomized placebo-controlled double-blind phase II study of zaltoprofen for patients with diffuse-type and unresectable localized tenosynovial giant cell tumors: The REALIZE study. International journal

Akihiko Takeuchi, Makoto Endo, Akira Kawai, Yoshihiro Nishida, Ryu Terauchi, Akihiko Matsumine, Hisaki Aiba, Tomoki Nakamura, Susumu Tandai, Toshifumi Ozaki, Manabu Hoshi, Daiki Kayano, Miho Okuda, Norio Yamamoto, Katsuhiro Hayashi, Shinji Miwa, Kentaro Igarashi, Kenichi Yoshimura, Akihiro Nomura, Toshinori Murayama, Hiroyuki Tsuchiya

Frontiers in oncology 12 900010 - 900010 2022

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

BACKGROUND: A tenosynovial giant cell tumor (TGCT) is a locally aggressive benign neoplasm arising from intra- or extra-articular tissue, categorized as localized (L-TGCT, solitary lesion) and diffuse (D-TGCT, multiple lesions) TGCT. Surgical excision is the mainstay of the treatment, and a high local recurrence rate of approximately 50% has been reported. We focused on zaltoprofen, a nonsteroidal anti-inflammatory drug that can activate peroxisome proliferator-activated receptor gamma (PPARγ) and inhibit the proliferation of TGCT stromal cells. Therefore, we conducted a randomized trial to evaluate the safety and effectiveness of zaltoprofen in patients with D-TGCTs or unresectable L-TGCTs. METHODS: This randomized, placebo-controlled, double-blind, multicenter trial evaluated the safety and efficacy of zaltoprofen. In the treatment group, zaltoprofen (480 mg/day) was administered for 48 weeks; the placebo group received similar dosages without zaltoprofen. The primary outcome was progression-free rate (PFR) 48 weeks after treatment administration. Disease progression was defined as the following conditions requiring surgical intervention: 1) repetitive joint swelling due to hemorrhage, 2) joint range of motion limitation, 3) invasion of the adjacent cartilage or bone, 4) severe joint space narrowing, and 5) increased tumor size (target lesion). RESULTS: Forty-one patients were allocated to the zaltoprofen (n=21) or placebo (n=20) groups. The PFR was not significant between the zaltoprofen group and the placebo group at 48 weeks (84.0% and 90.0%, respectively; p=0.619). The mean Japanese Orthopedic Association knee score significantly improved from baseline to week 48 in the zaltoprofen group (85.38 versus 93.75, p=0.027). There was a significant difference between the values at 48 weeks of placebo and zaltoprofen group (p=0.014). One severe adverse event (grade 3 hypertension) was observed in the zaltoprofen group. DISCUSSION: This is the first study to evaluate the efficacy and safety of zaltoprofen in patients with TGCT. No significant differences in PFR were observed between the groups at 48 weeks. Physical function significantly improved after zaltoprofen treatment. The safety profile of zaltoprofen was acceptable. This less invasive and safer treatment with zaltoprofen, compared to surgical removal, could be justified as a novel approach to treating TGCT. Further analysis of long-term administration of zaltoprofen should be considered in future studies. CLINICAL TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry, identifier (UMIN000025901).

DOI： 10.3389/fonc.2022.900010

BAPGAN: GAN-based bone age progression of femur and phalange x-ray images.

Shinji Nakazawa, Changhee Han, Joe Hasei, Ryuichi Nakahara, Toshifumi Ozaki

Medical Imaging: Computer-Aided Diagnosis 2022

The impact of system and diagnostic errors for medical litigation outcomes in orthopedic surgery.

Norio Yamamoto, Takashi Watari, Ayako Shibata, Tomoyuki Noda, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2021.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Medical litigation resulting from medical errors has a negative impact on health economics for both patients and medical practitioners. In medical litigation involving orthopedic surgeons, we aimed to identify factors contributing to plaintiff victory (orthopedic surgeon loss) through a comprehensive assessment. METHODS: This retrospective study included 166 litigation claims against orthopedic surgeons using a litigation database in Japan. We evaluated the sex and age of the patient (plaintiff), initial diagnosis, diagnostic error, system error, the time and place of each claim that led to malpractice litigation, the institution's size, and clinical outcomes. The main outcome was the litigation outcome (acceptance or rejection) in the final judgment. Acceptance meant that the orthopedic surgeon lost the malpractice lawsuit. We conducted multivariable logistic regression analyses to examine the association of factors with an accepted claim. RESULTS: The median age of the patients was 42 years, and 65.7% were male. The litigation outcome of 85 (51.2%) claims was acceptance. The adjusted median indemnity paid was $151,818. The multivariable analysis showed that diagnostic error, system error, sequelae, inadequate medical procedure, and follow-up observation were significantly associated with the orthopedic surgeon losing the lawsuit. In particular, claims involving diagnostic errors were more likely to be acceptance claims, in which the orthopedic surgeon lost (adjusted odds ratio 16.7, 95% confidence intervals: 4.7 to 58.0, p < 0.001). All of the claims in which the orthopedic surgeon lost were associated with a diagnostic or system error, with the most common one being system error. CONCLUSIONS: System errors and diagnostic errors were significantly associated with acceptance claims (orthopedic surgeon losses). Since these are modifiable factors, it is necessary to take measures not only for individual physicians but also for the overall medical management system to enhance patient safety and reduce the litigation risk of orthopedic surgeons.

DOI： 10.1016/j.jos.2021.11.006

Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome International journal

Masato Ise, Taichi Saito, Yoshimi Katayama, Ryuichi Nakahara, Yasunori Shimamura, Masanori Hamada, Masuo Senda, Toshifumi Ozaki

BMC Musculoskeletal Disorders 22 ( 1 ) 882 - 882 2021.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

<title>Abstract</title><sec>
<title>Background</title>
Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS.

</sec><sec>
<title>Method</title>
Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months postoperatively. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement.

</sec><sec>
<title>Results</title>
The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6–12 months, <italic>r</italic> = 0.67; 0–12 months, <italic>r</italic> = 0.60) and DASH (0–12 months, <italic>r</italic> = 0.77). Moreover, postoperative DML correlated with the change in DASH (6–12 months, <italic>r</italic> = − 0.33; 0–12 months, <italic>r</italic> = − 0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below.

</sec><sec>
<title>Conclusion</title>
NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS.

</sec>

DOI： 10.1186/s12891-021-04771-y

Other Link： https://link.springer.com/article/10.1186/s12891-021-04771-y/fulltext.html

A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign

Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Yuki Okazaki, Naohiro Higashihara, Masanori Tamura, Toshifumi Ozaki

Knee Surgery & Related Research 33 ( 1 ) 2021.12

Authorship：Last author Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

<title>Abstract</title><sec>
<title>Background</title>
Diagnosing partial tears of the medial meniscus (MM) posterior root is difficult. The aim of this study was to evaluate diagnostic values involved in conventional magnetic resonance imaging (MRI) features of MM posterior root tears (MMPRTs) and find other MRI-based findings in patients with partial MMPRTs.

</sec><sec>
<title>Methods</title>
Eighteen patients who had arthroscopically confirmed partial MMPRTs were included. As a control, 18 patients who underwent partial meniscectomy for other types of MM tears were evaluated. Isolated partial MMPRTs were classified into the following three types: type A, accurate partial stable tear (cleavage < 1/2 of root width); type B, bridged unstable root tear (cleavage ≥ 1/2 of root width); type C, complex horn tear expanded to the root. Conventional MRI-based findings of MMPRTs were evaluated between two groups (<italic>n</italic> = 23). Posterior root irregularity, bone marrow spot, and ocarina-like appearance showing several condensed circles in triangular meniscal horn (ocarina sign) were also evaluated.

</sec><sec>
<title>Results</title>
Posterior root irregularity and bone marrow spot were frequently observed in the partial MMPRTs (47.8%), compared with the other MM tears (<italic>P</italic> = 0.007 and 0.023, respectively). The ocarina sign was detected in 69.6% of patients with partial MMPRTs. A significant difference between two groups was observed in a positive ratio of ocarina sign (<italic>P</italic> < 0.001). Types A, B, and C of the partial tear/damage were observed in three, eight, and seven patients, respectively. The ocarina sign was the most common MRI finding in each type of partial MMPRT.

</sec><sec>
<title>Conclusions</title>
This study demonstrated that a characteristic MRI finding, “ocarina sign,” was frequently observed in patients with partial tear/damage of the MM posterior root. The ocarina sign was the most common MRI finding in several types of partial MMPRTs. Our results suggest that the ocarina sign may be useful to diagnose unnoticed partial MMPRTs.

<italic>Level of evidence:</italic> IV, retrospective comparative study.

</sec>

DOI： 10.1186/s43019-021-00120-4

Other Link： https://link.springer.com/article/10.1186/s43019-021-00120-4/fulltext.html

股関節痛を契機に診断された強直性脊椎炎の1例

山田和希, 那須義久, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 中原龍一, 西田圭一郎, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 2 ) 166 - 170 2021.12

Authorship：Last author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本小児整形外科学会

股関節痛を契機に診断に至った、強直性脊椎炎:ankylosing spondylitis(以下、AS)の1例を経験したので報告する。症例は16歳男子で、右股関節痛のため近医を受診した。大腿骨寛骨臼インピンジメントの診断で当科に紹介された。当科初診時、右股関節痛は安静時と夜間に強く、運動時には感じなかった。右股関節の可動域制限を認め疼痛誘発テストは陽性であった。詳細に問診したところ、過去に腰臀部痛と両股関節痛を繰り返していた。単純X線では左仙腸関節に硬化像を認め、MRIでは右股関節水腫と両仙腸関節周囲の骨髄浮腫像を認めた。血液検査では炎症反応が上昇し、HLA-B27は陽性であった。ASと診断し、疾患活動性が高かったため、Infliximabの適応とした。治療は奏効し、現在も継続している。詳細な病歴聴取により早期の診断と治療が行えたため、短期の成績ではあるが経過良好であった。(著者抄録)

骨盤骨折に伴った腰仙骨神経叢損傷の1例

伊勢真人, 本郷匡一, 堅山佳美, 濱田全紀, 千田益生, 池田吉宏, 茂山幸雄, 徳弘昭博, 尾崎敏文

末梢神経 32 ( 2 ) 346 - 346 2021.12

Novel Technique for Removing a Well-Fixed Cemented Cup with a Dedicated Original Device during Revision Total Hip Arthroplasty: Surgical Technique.

Hirosuke Endo, Kazuki Yamada, Tomonori Testunaga, Takayuki Furumatsu, Shigeru Mitani, Toshifumi Ozaki

Acta medica Okayama 75 ( 6 ) 751 - 754 2021.12

Language：English

The improved cemented cup technique has attained excellent long-term results in primary total hip arthroplasty. When cup revision surgery was performed, the cemented cup, which was loosened at the bone-cement interface, was easily removed. However, with a well-fixed bone-cement interface, it remains difficult to remove the cemented cup for a revision in the event of a recurring dislocation. In addition, protrusions in the cement can cause unpredictable bone defects. A new removal device was created and used successfully to remove a well-fixed cemented cup safely and efficiently. This report introduces the device and the technique used in cemented cup removal.

DOI： 10.18926/AMO/62817

The Japanese Version of the Patient-Rated Elbow Evaluation is a Useful Outcome Measure that Potentially Reflects Hand Function in Patients with Rheumatoid Arthritis who Underwent Total Elbow Arthroplasty. International journal

Ryozo Harada, Keiichiro Nishida, Yoshiyuki Matsuyama, Kenzo Hashizume, Takuro Wada, Yoshihisa Nasu, Ryuichi Nakahara, Masahiro Horita, Masuo Senda, Toshifumi Ozaki

Modern rheumatology 32 ( 6 ) 1041 - 1046 2021.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: We examined the relationship between The Japanese version of Patient-Related Elbow Evaluation (PREE-J) and other established subjective and objective outcome measures in Japanese patients with rheumatoid arthritis (RA) who underwent total elbow arthroplasty (TEA). PATIENTS AND METHODS: This study involved 46 elbows of 40 RA patients. We collected clinical data one year after surgery, including the PREE-J, the Mayo Elbow Performance Score (MEPS), Disability of the Arm, Shoulder, and Hand (DASH), and Hand20. The correlation and responsiveness to PREE-J were evaluated compared with other outcome measures pre-and postoperatively. RESULTS: Almost all outcome measures were improved significantly after surgery. Preoperative PREE-J was significantly correlated with preoperative DASH, Hand20, and MEPS. Interestingly, postoperative PREE-J did not correlate with postoperative MEPS. Multiple regression analyses revealed that preoperative grip strength (B = -0.09; 95% CI -0.17 to -0.01, p = 0.03) and preoperative Hand20 (B = 0.31, 95% CI 0.03 - 0.58, p = 0.03) were significant factors those might influenced the postoperative PREE-J. CONCLUSIONS: The PREE-J was shown to correlate well with other preoperative outcome measures among the RA patients included in the current study. The postoperative PREE-J after TEA was influenced by the preoperative grip strength and function of the hand.

DOI： 10.1093/mr/roab100

The effect of mechanical stress on enthesis homeostasis in a rat Achilles enthesis organ culture model

Taichi Saito, Ryo Nakamichi, Aki Yoshida, Takaaki Hiranaka, Yuki Okazaki, Satoshi Nezu, Minami Matsuhashi, Yasunori Shimamura, Takayuki Furumatsu, Keiichiro Nishida, Toshifumi Ozaki

Journal of Orthopaedic Research 40 ( 8 ) 1872 - 1882 2021.11

What are the Results of Resection of Forearm Soft Tissue Sarcoma?

Eiji Nakata, Tomohiro Fujiwara, Toshiyuki Kunisada, Ryuichi Nakahara, Toshiyuki Watanabe, Toshifumi Ozaki

2021.11

Publisher：Research Square Platform LLC

Abstract

Only few reports have assessed the characteristics and oncological and functional outcomes of forearm soft tissue sarcomas (STS). Then, we aimed to investigate the clinical features and survival-related factors for forearm STS who underwent surgical excision at our institution. There were 38 patients. Fourteen patients (41%) were referred to our institution after an unplanned excision and tumor size and grade were significantly associated with the receipt of it. The postoperative median Musculoskeletal Tumor Society rating scale (MSTS) score was 28. Bone resection or major nerve palsy was the only factor influencing the postoperative MSTS score (P < 0.001). There was no significant difference in MSTS scores according to the reconstruction procedures (the use of flap or tendon reconstruction). The 5-year local recurrence-free survival (LRFS) rate was 86%. Univariate analysis revealed that the histological diagnosis of myxofibrosarcoma was the only factor that influenced LRFS (P = 0.047). The 5-year metastasis-free survival rate was 77%. The 5-year overall survival (OS) rate was 94%. Age was the only factor that influenced OS (P = 0.01). In conclusion, reconstruction of the skin and tendon can compensate for function. Careful follow-up is important, especially in patients with myxofibrosarcoma, due to its likelihood of local recurrence.

DOI： 10.21203/rs.3.rs-1028963/v1

Other Link： https://www.researchsquare.com/article/rs-1028963/v1.html

Factors affecting the quality of life of patients with painful spinal bone metastases

Yoshiteru Akezaki, Eiji Nakata, Masato Kikuuchi, Shinsuke Sugihara, Yoshimi Katayama, Haruki Katayama, Masanori Hamada, Toshifumi Ozaki

Healthcare (Switzerland) 9 ( 11 ) 2021.11

Authorship：Last author Publishing type：Research paper (scientific journal)

This study examined changes in the quality of life (QOL), as well as the factors affecting QOL, among patients with painful spinal bone metastases without paralysis for 1 month after radiotherapy. Methods: This study included 79 participants (40 male and 39 female; median age, 65 (42–88) years) who had undergone radiotherapy for painful spinal bone metastases without paralysis. Patients’ age, sex, activities of daily living (Barthel index), pain, spinal instability (spinal instability neoplastic score [SINS]), and QOL (EORTC QLQ-C30) were investigated. Results: Having an unstable SINS score was a positive factor for global health status (p < 0.05). The improvement in activities of daily living and response to pain were positive factors for physical function (p < 0.05). A positive effect on emotional function was confirmed among female patients (p < 0.05). Conclusion: Engaging in rehabilitation along with radiotherapy leads to improvements in QOL for patients with spinal bone metastases.

DOI： 10.3390/healthcare9111499

AIを用いた単純X線画像における骨端線変化の自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本関節病学会誌 40 ( 3 ) 308 - 308 2021.11

良性腫瘍に対する低侵襲治療類骨骨種に対するRFA

冨田晃司, 馬越紀行, 宇賀麻由, 藤原智洋, 松井裕輔, 中田英二, 生口俊浩, 国定俊之, 平木隆夫, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 3 ) S39 - S39 2021.11

AIを用いた単純X線画像における骨端線変化の自動生成

中原龍一, 西田圭一郎, 長谷井嬢, 中澤慎二, 韓昌煕, 藏品豊, 那須義久, 尾崎敏文

日本関節病学会誌 40 ( 3 ) 308 - 308 2021.11

良性腫瘍に対する低侵襲治療術中CTナビゲーションを用いた類骨骨腫に対する低侵襲手術

藤原智洋, 国定俊之, 中田英二, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 3 ) S38 - S38 2021.11

発育性股関節形成不全に対するSalter innominate osteotomyの短期成績

廣瀬一樹, 鉄永智紀, 山田和希, 佐藤嘉洋, 小浦卓, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 3 ) S84 - S84 2021.11

腰仙椎の癒合がpincer lesionの原因と考えられた若年アスリートに発症した大腿骨寛骨臼インピンジメントの1例

山田和希, 鉄永智紀, 佐藤嘉洋, 廣瀬一樹, 小浦卓, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 3 ) S131 - S131 2021.11

麻痺性側彎側彎症を伴う重症脳性麻痺児のQOL評価

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 赤澤啓史, 青木清, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 3 ) S19 - S19 2021.11

Postoperative clinical outcomes of unicompartmental knee arthroplasty in patients with isolated medial compartmental osteoarthritis following medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Takaaki Tanaka, Masatsugu Ozawa, Kenji Masuda, Noritaka Seno, Haowei Xue, Toshifumi Ozaki

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology 26 15 - 20 2021.10

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Background: Cartilage degradation progresses rapidly following medial meniscus posterior root tear (MMPRT). Unicompartmental knee arthroplasty (UKA) has been performed for medial compartmental osteoarthritis following MMPRT. We evaluated the clinical and radiographic outcomes of UKA for medial compartmental osteoarthritis after an untreated MMPRT. Methods: Twenty-one patients who underwent UKA for isolated medial compartment osteoarthritis following MMPRT were retrospectively investigated. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score and knee range of motion. The posterior tibial slope and tibial component inclination were evaluated using plain radiographs. Results: The mean follow-up periods were 25.5 ± 13.8 months. Clinical outcomes improved significantly postoperatively. The mean postoperative knee extension angle was -1.1° ± 2.1°, and the knee flexion angle was 134.3° ± 4.9°. The posterior tibial slope angle decreased from 9.0° ± 2.0° preoperatively to 5.4° ± 1.8° postoperatively, and postoperative tibial component inclination at the final follow-up was 2.9° ± 1.1° varus. No aseptic loosening or deep infections were observed. Conclusion: UKA significantly improved clinical outcomes and could be a viable surgical option for treating isolated medial compartmental osteoarthritis accompanied by untreated MMPRT.

DOI： 10.1016/j.asmart.2021.07.005

変形性肩関節症モデルとしてのCCN3過剰発現マウス

廣瀬一樹, 服部高子, 中田英二, 鉄永智紀, 山田和希, 佐藤嘉洋, 桑原実穂, 尾崎敏文, 滝川正春, 久保田聡

日本骨代謝学会学術集会プログラム抄録集 39回 151 - 151 2021.10

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 33 ( 3 ) 330 - 330 2021.10

術前がん患者におけるがんロコモ・サルコペニアの有病率

堅山佳美, 中田英二, 濱田全紀, 国定俊之, 藤原智洋, 千田益生, 尾崎敏文

中国・四国整形外科学会雑誌 33 ( 3 ) 324 - 324 2021.10

リハビリテーション関連機器の現状と課題

千田益生, 濱田全紀, 堅山佳美, 伊勢真人, 本郷匡一, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 秋季特別号 ) S185 - S185 2021.10

術前肺がん患者の筋肉量と術後合併症の関連性

堅山佳美, 千田益生, 濱田全紀, 濱崎比果瑠, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 秋季特別号 ) S374 - S374 2021.10

内側半月板後根断裂患者における術前と術後1年の下肢機能の比較検討

濱崎比果瑠, 千田益生, 濱田全紀, 堅山佳美, 宮澤慎一, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 秋季特別号 ) S372 - S372 2021.10

Mechanical stretching induces calcification and cartilage matrix metabolism, causing degeneration of the acetabular labrum International journal

Yoshi Kawamura, Tomonori Tetsunaga, Kazuki Yamada, Tomoaki Sanki, Yoshihiro Sato, Aki Yoshida, Takayuki Furumatsu, Toshifumi Ozaki

HIP International 112070002110446 - 112070002110446 2021.9

Authorship：Last author Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

<sec><title>Purpose:</title> The acetabular labrum plays an important role in joint lubrication, and damage to this structure leads to osteoarthritis. This study aimed to histologically classify the degree of degeneration of the acetabular labrum and to investigate the changes in gene expression induced by mechanical stretching.

</sec><sec><title>Methods:</title> We obtained acetabular labrum cells from patients with hip osteoarthritis during total hip arthroplasty ( n = 25). The labrum was stained with safranin O, and images were histologically evaluated using a new parameter, the red/blue (R/B) value. The samples were divided into the degenerated group (D group: n = 18) and the healthy group (H group: n = 7) in accordance with the Kellgren-Lawrence (KL) grade. The cultured acetabular labral cells were subjected to loaded uniaxial cyclic tensile strain (CTS). After CTS, changes in gene expression were examined in both groups.

</sec><sec><title>Results:</title> Spearman’s correlation analysis revealed that the R/B value was significantly correlated with the KL grade and the Krenn score. The expression levels of genes related to cartilage metabolism, osteogenesis and angiogenesis significantly increased after CTS in the H group, while gene expression in the D group showed weaker changes after CTS than that in the H group compared to the nonstretched control group.

</sec><sec><title>Conclusions:</title> The degree of labral degeneration could be classified histologically using the R/B value and the KL grade. Mechanical stretching caused changes in gene expression that support the pathological features of labral degeneration.

</sec>

DOI： 10.1177/11207000211044675

Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/11207000211044675

Adipose-Derived Extract Suppresses IL-1β-Induced Inflammatory Signaling Pathways in Human Chondrocytes and Ameliorates the Cartilage Destruction of Experimental Osteoarthritis in Rats

Hideki Ohashi, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Yoshinori Matsumoto, Ayumu Takeshita, Daisuke Kaneda, Masanori Saeki, Toshifumi Ozaki

International Journal of Molecular Sciences 22 ( 18 ) 9781 - 9781 2021.9

Authorship：Last author Publishing type：Research paper (scientific journal) Publisher：MDPI AG

We investigated the effects of adipose-derived extract (AE) on cultured chondrocytes and in vivo cartilage destruction. AE was prepared from human adipose tissues using a nonenzymatic approach. Cultured human chondrocytes were stimulated with interleukin-1 beta (IL-1β) with or without different concentrations of AE. The effects of co-treatment with AE on intracellular signaling pathways and their downstream gene and protein expressions were examined using real-time PCR, Western blotting, and immunofluorescence staining. Rat AE prepared from inguinal adipose tissues was intra-articularly delivered to the knee joints of rats with experimental osteoarthritis (OA), and the effect of AE on cartilage destruction was evaluated histologically. In vitro, co-treatment with IL-1β combined with AE reduced activation of the p38 and ERK mitogen-activated protein kinase (MAPK) pathway and nuclear translocation of the p65 subunit of nuclear factor-kappa B (NF-κB), and subsequently downregulated the expressions of matrix metalloproteinase (MMP)-1, MMP-3, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4, IL-6, and IL-8, whereas it markedly upregulated the expression of IL-1 receptor type 2 (IL-1R2) in chondrocytes. Intra-articular injection of homologous AE significantly ameliorated cartilage destruction six weeks postoperatively in the rat OA model. These results suggested that AE may exert a chondroprotective effect, at least in part, through modulation of the IL-1β-induced inflammatory signaling pathway by upregulation of IL-1R2 expression.

DOI： 10.3390/ijms22189781

Transtibial pullout repair of medial meniscus posterior root tears: effects on the meniscus healing score and ICRS grade among patients with mild osteoarthritis of the knee. International journal

Yuya Kodama, Takayuki Furumatsu, Yuki Okazaki, Shota Takihira, Takaaki Hiranaka, Shinichi Miyazawa, Yusuke Kamatsuki, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 9 ) 3001 - 3009 2021.9

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To assess the effects of transtibial pullout repair for medial meniscus posterior root tears (MMPRTs) among patients with early osteoarthritis of the knee as measured by the meniscus healing score and to determine whether the meniscus healing score correlates with the International Cartilage Repair Society (ICRS) grade progression. METHODS: Forty-seven patients with mild osteoarthritic knees (Kellgren-Lawrence grade ≤ 2 and varus alignment < 5°) who underwent transtibial pullout repair less than 3 months after MMPRT onset were assessed. The association between meniscus healing scores at 1 year postoperatively and cartilage damage of the medial compartment (medial femoral condyle [MFC] and medial tibial plateau [MTP]) were evaluated. The MFC was divided into six zones (A to F) and the MTP into two zones (G and H). The mean ICRS grade for each zone was compared between the primary surgery and second-look arthroscopy. The correlation between cartilage damage and meniscus healing status at the time of second-look arthroscopy in each zone was analysed. RESULTS: The mean time interval from injury to surgery was 63 days, and all clinical scores showed significant improvement. There were no significant differences in the extent of cartilage damage in areas B, C, E, or F (n.s.) for MFC or in areas G and H (n.s.) for MTP. The meniscus healing score and cartilage damage were correlated in the loading areas (B, C, E, and H; - 0.53, - 0.45, - 0.33, and - 0.38, respectively; p < 0.05). CONCLUSION: Transtibial pullout repair of MMPRTs among patients with mild osteoarthritic knees improved the clinical outcomes and showed a negative correlation between high meniscus healing scores and ICRS grades in the medial compartment loading area. This study suggests that early surgery should be undertaken for patients with mild osteoarthritic knee who develop MMPRTs. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1007/s00167-020-06332-7

Oncolytic virotherapy reverses chemoresistance in osteosarcoma by suppressing MDR1 expression. International journal

Kazuhisa Sugiu, Hiroshi Tazawa, Joe Hasei, Yasuaki Yamakawa, Toshinori Omori, Tadashi Komatsubara, Yusuke Mochizuki, Hiroya Kondo, Shuhei Osaki, Tomohiro Fujiwara, Aki Yoshida, Toshiyuki Kunisada, Koji Ueda, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Cancer chemotherapy and pharmacology 88 ( 3 ) 513 - 524 2021.9

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

BACKGROUND: Osteosarcoma (OS) is a malignant bone tumor primarily affecting children and adolescents. The prognosis of chemotherapy-refractory OS patients is poor. We developed a tumor suppressor p53-expressing oncolytic adenovirus (OBP-702) that exhibits antitumor effects against human OS cells. Here, we demonstrate the chemosensitizing effect of OBP-702 in human OS cells. MATERIALS AND METHODS: The in vitro and in vivo antitumor activities of doxorubicin (DOX) and OBP-702 were assessed using parental and DOX-resistant OS cells (U2OS, MNNG/HOS) and a DOX-resistant MNNG/HOS xenograft tumor model. RESULTS: DOX-resistant OS cells exhibited high multidrug resistant 1 (MDR1) expression, which was suppressed by OBP-702 or MDR1 siRNA, resulting in enhanced DOX-induced apoptosis. Compared to monotherapy, OBP-702 and DOX combination therapy significantly suppressed tumor growth in the DOX-resistant MNNG/HOS xenograft tumor model. CONCLUSION: Our results suggest that MDR1 is an attractive therapeutic target for chemoresistant OS. Tumor-specific virotherapy is thus a promising strategy for reversing chemoresistance in OS patients via suppression of MDR1 expression.

DOI： 10.1007/s00280-021-04310-5

Semi-quantitative arthroscopic scoring system is related to clinical outcomes in patients after medial meniscus posterior root repair

Ximing Zhang, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Keisuke Kintaka, Haowei Xue, Shinichi Miyazawa, Toshifumi Ozaki

Journal of Orthopaedic Science 2021.9

Comparison of two simple stitches and modified Mason-Allen suture for medial meniscus posterior root tear based on the progression of meniscal posterior extrusion: A retrospective cohort study

Keisuke Kintaka, Takayuki Furumatsu, Yuki Okazaki, Shin Masuda, Takaaki Hiranaka, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Journal of Orthopaedic Surgery 29 ( 3 ) 230949902110495 - 230949902110495 2021.9

Authorship：Last author Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Purpose: Medial meniscus (MM) posterior root (PR) tear leads to severe MM posterior extrusion (PE), resulting in rapid knee cartilage degeneration. MMPR repairs are recommended to reduce MMPE, especially during knee flexion. However, the difference in MMPE between different repair techniques remains unknown. This study aimed to investigate preoperative and postoperative MMPE following several pullout repair techniques. We hypothesized that a technique using two simple stitches (TSS) would be more useful than FasT-Fix-dependent modified Mason-Allen suture (F-MMA) to prevent the progression of MMPE in knee extension. Methods: This retrospective study included 35 patients who underwent MMPR repair. To compare MMPE, patients were divided into two groups according to the use of F-MMA while grasping the posterior capsule and TSS without grasping it. Open magnetic resonance imaging was performed at 10° and 90° knee flexion preoperatively, and at 3 and 12 months postoperatively, and the MMPE of both groups was evaluated. Results: A significant difference was observed between preoperative and 3-month postoperative MMPE at 90° knee flexion in both groups ( p < .01). A significant difference was observed in 3- and 12-month postoperative MMPE at 10° knee flexion between both groups ( p = .04/.02), whereas no significant difference in the preoperative MMPE at 10° knee flexion was observed between them ( p = .45). Conclusions: Both repairs were found to be useful to reduce MMPE in knee flexion. Further, F-MMA repair increased MMPE in knee extension, unlike TSS repair. These findings suggest that TSS might have more advantages for load distribution when standing or walking.

DOI： 10.1177/23094990211049569

Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/23094990211049569

尺骨非定型骨折の2例

望月雄介, 齋藤太一, 尾崎敏文

中国・四国整形外科学会雑誌 33 ( 2 ) 216 - 216 2021.9

肉腫におけるがん遺伝子パネルによる融合遺伝子の検出

中田英二, 国定俊之, 藤原智洋, 遠西大輔, 冨田秀太, 尾崎敏文

中部日本整形外科災害外科学会雑誌 64 ( 秋季学会 ) 107 - 107 2021.9

肺転移能を有する骨肉腫細胞はM2様マクロファージへの分化を強力に誘導する

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 80回 [J14 - 4] 2021.9

尺骨非定型骨折の2例

望月雄介, 齋藤太一, 尾崎敏文

中国・四国整形外科学会雑誌 33 ( 2 ) 216 - 216 2021.9

Effect of Patient Clinical Variables in Osteoporosis Classification Using Hip X-rays in Deep Learning Analysis. International journal

Norio Yamamoto, Shintaro Sukegawa, Kazutaka Yamashita, Masaki Manabe, Keisuke Nakano, Kiyofumi Takabatake, Hotaka Kawai, Toshifumi Ozaki, Keisuke Kawasaki, Hitoshi Nagatsuka, Yoshihiko Furuki, Takashi Yorifuji

Medicina (Kaunas, Lithuania) 57 ( 8 ) 2021.8

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

Background and Objectives: A few deep learning studies have reported that combining image features with patient variables enhanced identification accuracy compared with image-only models. However, previous studies have not statistically reported the additional effect of patient variables on the image-only models. This study aimed to statistically evaluate the osteoporosis identification ability of deep learning by combining hip radiographs with patient variables. Materials andMethods: We collected a dataset containing 1699 images from patients who underwent skeletal-bone-mineral density measurements and hip radiography at a general hospital from 2014 to 2021. Osteoporosis was assessed from hip radiographs using convolutional neural network (CNN) models (ResNet18, 34, 50, 101, and 152). We also investigated ensemble models with patient clinical variables added to each CNN. Accuracy, precision, recall, specificity, F1 score, and area under the curve (AUC) were calculated as performance metrics. Furthermore, we statistically compared the accuracy of the image-only model with that of an ensemble model that included images plus patient factors, including effect size for each performance metric. Results: All metrics were improved in the ResNet34 ensemble model compared with the image-only model. The AUC score in the ensemble model was significantly improved compared with the image-only model (difference 0.004; 95% CI 0.002-0.0007; p = 0.0004, effect size: 0.871). Conclusions: This study revealed the additional effect of patient variables in identification of osteoporosis using deep CNNs with hip radiographs. Our results provided evidence that the patient variables had additive synergistic effects on the image in osteoporosis identification.

DOI： 10.3390/medicina57080846

CSF1/CSF1R Signaling Inhibitor Pexidartinib (PLX3397) Reprograms Tumor-Associated Macrophages and Stimulates T-cell Infiltration in the Sarcoma Microenvironment. International journal

Tomohiro Fujiwara, Mohamed A Yakoub, Andrew Chandler, Alexander B Christ, Guangli Yang, Ouathek Ouerfelli, Vinagolu K Rajasekhar, Aki Yoshida, Hiroya Kondo, Toshiaki Hata, Hiroshi Tazawa, Yildirim Dogan, Malcolm A S Moore, Toshiyoshi Fujiwara, Toshifumi Ozaki, Ed Purdue, John H Healey

Molecular cancer therapeutics 20 ( 8 ) 1388 - 1399 2021.8

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

Colony-stimulating factor 1 (CSF1) is a primary regulator of the survival, proliferation, and differentiation of monocyte/macrophage that sustains the protumorigenic functions of tumor-associated macrophages (TAMs). Considering current advances in understanding the role of the inflammatory tumor microenvironment, targeting the components of the sarcoma microenvironment, such as TAMs, is a viable strategy. Here, we investigated the effect of PLX3397 (pexidartinib) as a potent inhibitor of the CSF1 receptor (CSF1R). PLX3397 was recently approved by the Food and Drug Administration (FDA) to treat tenosynovial giant cell tumor and reprogram TAMs whose infiltration correlates with unfavorable prognosis of sarcomas. First, we confirmed by cytokine arrays of tumor-conditioned media (TCM) that cytokines including CSF1 are secreted from LM8 osteosarcoma cells and NFSa fibrosarcoma cells. The TCM, like CSF1, stimulated ERK1/2 phosphorylation in bone marrow-derived macrophages (BMDMs), polarized BMDMs toward an M2 (TAM-like) phenotype, and strikingly promoted BMDM chemotaxis. In vitro administration of PLX3397 suppressed pERK1/2 stimulation by CSF1 or TCM, and reduced M2 polarization, survival, and chemotaxis in BMDMs. Systemic administration of PLX3397 to the osteosarcoma orthotopic xenograft model significantly suppressed the primary tumor growth and lung metastasis, and thus improved metastasis-free survival. PLX3397 treatment concurrently depleted TAMs and FOXP3+ regulatory T cells and, surprisingly, enhanced infiltration of CD8+ T cells into the microenvironments of both primary and metastatic osteosarcoma sites. Our preclinical results show that PLX3397 has strong macrophage- and T-cell-modulating effects that may translate into cancer immunotherapy for bone and soft-tissue sarcomas.

DOI： 10.1158/1535-7163.MCT-20-0591

Induction and expansion of human PRRX1+ limb-bud-like mesenchymal cells from pluripotent stem cells. International journal

Daisuke Yamada, Masahiro Nakamura, Tomoka Takao, Shota Takihira, Aki Yoshida, Shunsuke Kawai, Akihiro Miura, Lu Ming, Hiroyuki Yoshitomi, Mai Gozu, Kumi Okamoto, Hironori Hojo, Naoyuki Kusaka, Ryosuke Iwai, Eiji Nakata, Toshifumi Ozaki, Junya Toguchida, Takeshi Takarada

Nature biomedical engineering 5 ( 8 ) 926 - 940 2021.8

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

Current protocols for the differentiation of human pluripotent stem cells (hPSCs) into chondrocytes do not allow for the expansion of intermediate progenitors so as to prospectively assess their chondrogenic potential. Here we report a protocol that leverages PRRX1-tdTomato reporter hPSCs for the selective induction of expandable and ontogenetically defined PRRX1+ limb-bud-like mesenchymal cells under defined xeno-free conditions, and the prospective assessment of the cells' chondrogenic potential via the cell-surface markers CD90, CD140B and CD82. The cells, which proliferated stably and exhibited the potential to undergo chondrogenic differentiation, formed hyaline cartilaginous-like tissue commensurate to their PRRX1-expression levels. Moreover, we show that limb-bud-like mesenchymal cells derived from patient-derived induced hPSCs can be used to identify therapeutic candidates for type II collagenopathy and we developed a method to generate uniformly sized hyaline cartilaginous-like particles by plating the cells on culture dishes coated with spots of a zwitterionic polymer. PRRX1+ limb-bud-like mesenchymal cells could facilitate the mass production of chondrocytes and cartilaginous tissues for applications in drug screening and tissue engineering.

DOI： 10.1038/s41551-021-00778-x

Letter regarding "Clinical outcomes and trans-syndesmotic screw frequency after posterior malleolar fracture osteosynthesis". International journal

Norio Yamamoto, Yosuke Tomita, Tomoyuki Noda, Kohei Iwamoto, Toshifumi Ozaki

Injury 52 ( 8 ) 2479 - 2480 2021.8

Two simple stitches for medial meniscus posterior root repair prevents the progression of meniscal extrusion and reduces intrameniscal signal intensity better than modified Mason-Allen sutures. International journal

Yuki Okazaki, Takayuki Furumatsu, Takaaki Hiranaka, Yuya Kodama, Yusuke Kamatsuki, Keisuke Kintaka, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 31 ( 6 ) 1005 - 1013 2021.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Medial meniscus posterior root tears (MMPRTs) can cause severe medial extrusion of the medial meniscus (MMME) and the progression of knee degenerative changes, inducing a high signal intensity of the meniscus on magnetic resonance imaging (MRI). Although MMME and intrameniscal signal intensity (IMSI) reportedly decreased within 3 months after MMPRT repair, no previous studies have reported these changes after a 1-year follow-up. This study aimed to investigate the 1-year postoperative changes in MMME and IMSI on MRI after using different suture techniques. METHODS: Overall, 33 patients with MMPRT were evaluated, 22 underwent FasT-Fix-dependent modified Mason-Allen suture (F-MMA) repair, and 11 underwent two simple stitches (TSS) repair. MRI examinations were performed preoperatively and 1 year postoperatively. MMME and IMSI were determined using MRI. RESULTS: A significant decrease in postoperative MMME was observed in the TSS group (4.1 ± 1.0) relative to that in the F-MMA group (5.1 ± 1.4, P = 0.03). A significant decrease in postoperative IMSI (0.75 ± 0.14) was observed relative to preoperative IMSI in the TSS group (P < 0.01), whereas postoperative IMSI (0.94 ± 0.25) was similar to preoperative IMSI in the F-MMA group (P = 0.06). Furthermore, a significant decrease in postoperative IMSI was observed in the TSS group relative to that in the F-MMA group (P < 0.01). CONCLUSIONS: The most important finding of this study is that TSS repair yielded a greater decrease in MMME and IMSI than F-MMA repair in patients with MMPRT. These results suggest that TSS repair is more useful for restoring loading stress to the posterior horn of the medial meniscus.

DOI： 10.1007/s00590-020-02830-z

Assessment of the concordance rate between intraoperative pathological diagnosis and the final pathological diagnosis of spinal cord tumors

Muraoka S, Yamane K, Misawa H, Takigawa T, Tetsunaga T, Oda Y, Nakanishi K, Ozaki T, Tanaka T

Acta Med Okayama 75 ( 4 ) 455 - 460 2021.8

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

The intraoperative pathological diagnosis (IPD) plays an important role in determining the optimal surgical treatment for spinal cord tumors. The final pathological diagnosis (FPD) is sometimes different from the IPD. Here, we sought to identify the accuracy of the IPD of spinal cord tumors compared to the FPD. We retrospec-tively analyzed the cases of 108 patients with spinal cord tumors treated surgically in our institute; the IPD, FPD, mismatched cases, and concordance rate between the IPD and FPD were investigated. Five cases involved a mismatch between the IPD and FPD. The overall concordance rate was 95.4%, with 90.9% for extra-dural lesions, 98.5% for intradural extramedullary lesions, 84.2% for intramedullary lesions, and 100% for dumbbell-type tumors. The concordance rate of intramedullary lesions tended to be lower than that of other lesions (p = 0.096). A lower concordance rate was revealed for intramedullary lesions compared to the other lesions. Despite the IPD clearly remaining a valuable tool during operative procedures, surgeons should recog-nize the limitations of IPDs and make comprehensive decisions about surgical treatments.

DOI： 10.18926/AMO/62397

Medial meniscus posterior root repair using a modified Mason-Allen suture can prevent the progression of cartilage degeneration on the loading surface of the medial compartment: a second-look arthroscopic evaluation

Takihira S, Furumatsu T, Okazaki Yuki, Hiranaka T, Kintaka K, Kodama Y, Kamatsuki Y, Miyazawa S, Ozaki T

Acta Med Okayama 75 ( 4 ) 423 - 430 2021.8

変形性肩関節症とCCN3発現上昇との相関について

廣瀬一樹, 中田英二, 服部高子, 鉄永智紀, 山田和希, 佐藤嘉洋, 桑原実穂, 滝川正春, 久保田聡, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1506 - S1506 2021.8

がん患者における周術期のがんロコモの発生率とそのリスクファクター

堅山佳美, 中田英二, 明崎禎輝, 千田益生, 国定俊之, 濱田全紀, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1580 - S1580 2021.8

ISB座標系と後顆平面座標系を用いた3D-CT計測と従来法による大腿骨骨幹部骨折術後の回旋変形の比較

佐藤浩平, 上原健敬, 福岡史朗, 近藤宏也, 畑利彰, 齋藤太一, 島村安則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1688 - S1688 2021.8

移植腱固定法の違いとmicrofracture手技が腱骨接合部癒合に与える影響

根津智史, 齋藤太一, 吉田晶, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1828 - S1828 2021.8

ISB座標系と後顆平面座標系を用いた3D-CT計測と従来法による大腿骨骨幹部骨折術後の回旋変形の比較

佐藤浩平, 上原健敬, 福岡史朗, 近藤宏也, 畑利彰, 齋藤太一, 島村安則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1688 - S1688 2021.8

教師なし学習を用いたAIによる超音波画像撮像部位自動検出

中原龍一, 高橋康, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 品岡玲, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1726 - S1726 2021.8

人工知能を用いた骨肉腫X線像読影ツールの開発

長谷井嬢, 中原龍一, 沖田駿治, 三宅孝昌, 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 95 ( 8 ) S1475 - S1475 2021.8

移植腱固定法の違いとmicrofracture手技が腱骨接合部癒合に与える影響

根津智史, 齋藤太一, 吉田晶, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1828 - S1828 2021.8

変形性肩関節症とCCN3発現上昇との相関について

廣瀬一樹, 中田英二, 服部高子, 鉄永智紀, 山田和希, 佐藤嘉洋, 桑原実穂, 滝川正春, 久保田聡, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1506 - S1506 2021.8

Pexidartinibの骨肉腫に対する前臨床的検討 CSF-1/CSF-1R阻害は肉腫微小環境の免疫細胞構成分画を変化させ抗腫瘍効果を発揮する

藤原智洋, Yakoub Mohamed, 吉田晶, 近藤宏也, 畑利彰, 佐藤浩平, たき平将太, 中田英二, 国定俊之, 尾崎敏文, Healey John

日本整形外科学会雑誌 95 ( 8 ) S1557 - S1557 2021.8

肉腫におけるがんゲノム医療の意義

中田英二, 国定俊之, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1549 - S1549 2021.8

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 95 ( 8 ) S1554 - S1554 2021.8

腫瘍関連マクロファージを誘導するCSF-1の分泌と血中発現の解析浸潤性軟部肉腫における検討

畑利彰, 藤原智洋, 吉田晶, 近藤彩奈, 片山晴喜, 佐藤浩平, 近藤宏也, 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 95 ( 8 ) S1552 - S1552 2021.8

骨肉腫における腫瘍関連マクロファージの役割とin vitro実験による検証

近藤宏也, 田澤大, 久禮美穂, 藤原智洋, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1556 - S1556 2021.8

がん患者における周術期のがんロコモの発生率とそのリスクファクター

堅山佳美, 中田英二, 明崎禎輝, 千田益生, 国定俊之, 濱田全紀, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1580 - S1580 2021.8

Adjuvant and neoadjuvant chemotherapy for osteosarcoma: JCOG Bone and Soft Tissue Tumor Study Group. International journal

Hiroaki Hiraga, Toshifumi Ozaki

Japanese journal of clinical oncology 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

The usefulness of adjuvant chemotherapy for high-grade osteosarcoma was established by two randomized, controlled trials conducted in the 1980s, which used six drugs, doxorubicin, cisplatin, high-dose methotrexate, bleomycin, cyclophosphamide and actinomycin D. Since then, development has been promoted in the direction of introducing preoperative chemotherapy, changing post-operative adjuvant chemotherapy according to histological effects, adding ifosfamide as a key drug and strengthening adjuvant chemotherapy. No clinical trials, however, have shown the effectiveness of study treatment, and the improvement of treatment results during that time has been slight, although the JCOG0905 study is now going to verify the effectiveness of introducing ifosfamide for patients who experienced limited preoperative therapeutic effects. We are desperately looking for a breakthrough.

DOI： 10.1093/jjco/hyab120

Psoas muscle index predicts osteoporosis and fracture risk in individuals with degenerative spinal disease. International journal

Yuya Kajiki, Hironori Tsuji, Haruo Misawa, Ryuichi Nakahara, Tomoko Tetsunaga, Kentaro Yamane, Yoshiaki Oda, Shinichiro Takao, Toshifumi Ozaki

Nutrition (Burbank, Los Angeles County, Calif.) 93 111428 - 111428 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: Skeletal muscle loss and osteoporosis are major medical and socioeconomic concerns as the global population ages. Studies have reported that skeletal muscle mass correlates to bone mineral density (BMD). The psoas muscle index (PMI), measured as the L3 cross-sectional areas of the right and left psoas divided by the square of height, has a positive correlation with the total volume of skeletal muscle in the body. This study aimed to evaluate relationships between PMI and BMD and fracture risk estimated by the Fracture Risk Assessment Tool (FRAX). METHODS: Preoperatively acquired, plain computed tomography images at the L3 level were used to measure PMI in 87 people with degenerative spinal diseases. We evaluated the correlation between PMI and BMD and fracture risk estimated by FRAX. RESULTS: PMI was significantly correlated with BMD in the entire lumbar spine and femoral neck (r = 0.413 and 0.525, both P < 0.001). People with osteoporosis showed significantly lower PMI than those without (P < 0.05). PMI was also significantly correlated with FRAX score (r = -0.545, P < 0.001). Furthermore, based on the recommendation of osteoporosis treatment, participants were divided into two groups: FRAX ≥15% (R group) and FRAX <15% (C group). The R group showed significantly lower PMI than the C group (P < 0.001). Receiver operating characteristic curve analysis revealed that PMI has moderate accuracy in diagnosing osteoporosis and FRAX ≥15%. CONCLUSIONS: PMI was significantly associated with BMD and fracture risk. PMI measurement is straightforward and may increase the diagnosis rate of osteoporosis and fracture risk.

DOI： 10.1016/j.nut.2021.111428

A Novel Radiographic Measurement Method for the Evaluation of Metatarsophalangeal Joint Dislocation of the Lesser Toe in Patients with Rheumatoid Arthritis. International journal

Hideki Ohashi, Keiichiro Nishida, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Masahiro Horita, Shunji Okita, Toshifumi Ozaki

International journal of environmental research and public health 18 ( 14 ) 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Dorsal dislocation of metatarsophalangeal (MTP) joints of the lesser toe frequently occurs in patients with rheumatoid arthritis (RA), and may cause painful and uncomfortable plantar callosities and ulceration. The current study examined the reliability and clinical relevance of a novel radiographic parameter (the MTP overlap distance [MOD]) in evaluating the severity of MTP joint dislocation. The subjects of the current study were 147 RA patients (276 feet; 1104 toes). MOD, defined as the overlap distance of the metatarsal head and the proximal end of the phalanx, was measured on plain radiographs. The relationship between the MOD and clinical complaints (forefoot pain and/or callosity formation) was analyzed to create a severity grading system. As a result, toes with callosities had a significantly larger MOD. ROC analysis revealed that the MOD had a high AUC for predicting an asymptomatic foot (-0.70) and callosities (0.89). MOD grades were defined as follows: grade 1, 0 ≤ MOD < 5 mm; grade 2, 5 ≤ MOD < 10 mm; and grade 3, MOD ≥ 10 mm. The intra- and inter-observer reliability of the MOD grade had high reproducibility. Furthermore, the MOD and MOD grade improved significantly after joint-preserving surgeries for lesser toe deformities. Our results suggest that MOD and MOD grade might be useful tools for the evaluation of deformities of the lesser toe and the effect of surgical intervention for MTP joints in patients with RA.

DOI： 10.3390/ijerph18147520

Cement augmentation of internal fixation for trochanteric fracture: a systematic review and meta-analysis. International journal

Norio Yamamoto, Takahisa Ogawa, Masahiro Banno, Jun Watanabe, Tomoyuki Noda, Haggai Schermann, Toshifumi Ozaki

European journal of trauma and emergency surgery : official publication of the European Trauma Society 48 ( 3 ) 1699 - 1709 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: This study aimed to determine the efficacy and safety of cement augmentation for internally fixed trochanteric fractures through a systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: We searched the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov databases to identify RCTs, published until July 2020 that examined the effects of cement augmentation of internal fixation of trochanteric fractures. The primary outcomes were reoperation and Parker Mobility Score, whereas the secondary outcomes were 1-year mortality rate, EuroQol 5 Dimension, fixation failures, and adverse events. We conducted meta-analyses of the outcome measures using the random-effects models. We evaluated the certainty of evidence based on the Cochrane risk-of-bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: We included three RCTs (326 participants). No significant effect was observed in favor of cement augmentation on all these outcomes. The certainty of evidence for fixation failures was very low and that for the other outcomes was low. The overall risk of bias for each outcome was high or of some concern in all included studies. CONCLUSIONS: The effect of cement augmentation of internal fixation of trochanteric fractures was uncertain for the clinical outcomes due to the low certainty of evidence. Further RCTs with a low risk of selection bias may present convincing conclusions on the efficacy and safety of cement augmentation. LEVEL OF EVIDENCE: Level 1.

DOI： 10.1007/s00068-021-01746-5

Postoperative external tibial rotation is correlated with inferior meniscal healing following pullout repair of a medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Keisuke Kintaka, Yusuke Kamatsuki, Ximing Zhang, Haowei Xue, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: The purpose of this study was to evaluate the influence of tibial rotation on the postoperative healing status of the medial meniscus (MM) following pullout repair of the MM posterior root tear (MMPRT). METHODS: Ninety-one patients (68 women and 23 men; mean age 63.3 ± 8.8 years) who had undergone transtibial pullout repair of MMPRT were enrolled in the study. The tibial external rotation angle (ERA) in each patient was measured postoperatively using computed tomography in the extended knee position. The meniscal healing status following transtibial pullout repair was assessed by second-look arthroscopy (mean postoperative period 12 months) using a previously published scoring system (range 0-10). The association between the ERA and the meniscal healing score was investigated using univariate linear regression models. The ERA cut-off for improved meniscal healing score (≥ 7) was determined using receiver-operating characteristic analysis. RESULTS: The ERA and the meniscal healing score were significantly associated, confirming that increased ERAs were correlated with worse meniscal healing status (R = - 0.28; P < 0.001). The optimum ERA cut-off value was 0.5°, with a sensitivity of 68% and a specificity of 63%. The mean meniscal healing scores were 7.3 and 6.2 among patients with ERAs < 0.5° and those with ERAs ≥ 0.5°, respectively (P < 0.001). CONCLUSION: This study demonstrated that the ERA was significantly correlated with the postoperative meniscal healing status. Postoperative tibial rotation could be one of the factors affecting postoperative outcomes of pullout repair of MMPRT. Controlling the tibial rotation may possibly improve meniscal healing. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-021-06656-y

Spinopelvic fixation with retention of external fixation in a lateral position for unstable pelvic fracture. International journal

Norio Yamamoto, Hisanori Ikuma, Tomoyuki Noda, Tomoo Inoue, Keisuke Kawasaki, Toshifumi Ozaki

Orthopaedics & traumatology, surgery & research : OTSR 103008 - 103008 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Anterior external fixation (EF), as the primary treatment for unstable pelvic fractures, is performed with patients in the supine position. In most cases, however, definitive surgery for posterior fixation is performed first in the prone position without EF. We report the case of a patient with unilateral and vertically unstable pelvic fracture whom we had treated with minimally invasive spinopelvic fixation, with retention of the anterior EF in a lateral position. Reduction of the residual displacement was performed with percutaneous spinal instrumentation, and acceptable reduction was achieved. At the 13-month follow-up, the functional outcome, calculated using the Majeed Score, was 87 points. The plain radiograph showed good bone union, except for the right superior pubic ramus. The radiological outcome, measured using the Matta rating, was excellent. Thus, retaining the EF facilitates safe and accurate reduction without major surgical complications and may offer surgeons an additional management option for such fractures.

DOI： 10.1016/j.otsr.2021.103008

Symptomatic Venous Thromboembolism in Patients with Malignant Bone and Soft Tissue Tumors: A Prospective Multicenter Cohort Study

Shintaro Iwata, Akira Kawai, Takafumi Ueda, Takeshi Ishii, Tsukasa Yonemoto, Tsukasa Yonemoto, Hiroto Kamoda, Yoshihisa Suzuki, Kazutaka Kikuta, Jungo Imanishi, Taketo Okubo, Yasuo Yazawa, Tsukasa Sotobori, Hiroaki Murata, Toshifumi Ozaki, Toshiyuki Kunisada, Tomohiro Fujiwara, Shigeki Kakunaga, Koji Hiraoka, Tetsuya Hamada, Kotaro Matsuda, Takashi Yanagawa, Kenichi Saito, Hirofumi Namba, Motohiro Kawasaki, Shunji Nishimura, Kazuhiko Hashimoto, Takeshi Okamoto, Ukei Anazawa, Itsuo Watanabe, Michiyuki Hakozaki, Yoshinori Imura, Yoshinori Imura, Eisuke Kobayashi, Koichi Ogura, Taketoshi Yasuda, Kayo Suzuki, Toru Akiyama, Masami Hosaka, Munenori Watanuki, Kou Hayashi, Toshiharu Shirai, Ryu Terauchi, Hisaki Aiba, Hiroaki Kimura, Kunihiro Asanuma, Tomoki Nakamura, Tomohito Hagi, Satoshi Abe, Kenji Sato, Yukihiro Yoshida, Yoshiyuki Suehara, Keisuke Akaike, Hiroaki Hiraga, Tamotsu Soma, Hiroshi Kobayashi, Yusuke Shinoda, Ryoko Sawada

ANNALS OF SURGICAL ONCOLOGY 28 ( 7 ) 3919 - 3927 2021.7

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

Background A prospective cohort study was conducted to determine the incidence and risk factors of symptomatic venous thromboembolism (sVTE) during the perioperative period in patients with malignant bone and soft tissue tumors. Methods Patients with newly diagnosed primary malignant bone and soft tissue tumors for whom definitive surgery was planned were consecutively registered among 27 tertiary hospitals specializing in musculoskeletal oncology. Clinicopathological information on each patient was collected prospectively, and careful follow-up was conducted for 6 months after surgery. The study endpoint was the occurrence of sVTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Results Eleven of 929 patients developed sVTE, including 8 patients with DVT, 2 with PE, and 1 with both, making the incidence of sVTE 1.18%. The median time until the development of sVTE after tumor resection was 11 days, ranging from - 7 to 95 days. Multiple logistic regression analyses revealed that ischemic heart disease as a comorbidity, maximum tumor diameter exceeding 8 cm, and elevated preoperative platelet count were independent risk factors for sVTE. Conclusions The incidence of sVTE in this series of patients with bone and soft tissue sarcomas was 1.18%, which was relatively lower than in previous retrospective studies. We identified the risk factors for sVTE specific to patients with malignant bone and soft tissue tumors, and these included ischemic heart disease, tumor size, and elevation of the preoperative platelet count.

DOI： 10.1245/s10434-020-09308-6

Treatment for postoperative infection of pathological femoral fracture after radiotherapy: two case reports and review of the literature. International journal

Minami Matsuhashi, Taichi Saito, Tomoyuki Noda, Takenori Uehara, Yasunori Shimamura, Toshifumi Ozaki

Archives of orthopaedic and trauma surgery 141 ( 7 ) 1139 - 1148 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Radiation-induced pathological fractures show high nonunion and infection rates. Successful treatment of postoperative infections of these fractures without limb amputation is extremely rare. METHODS: We report two cases of postoperative infection of pathological femoral fracture after radiation therapy for soft tissue tumors. Considering the poor condition of the irradiated site, a two-staged operation was selected to create the optimal situation for bone union. The treatment involved the Masquelet technique, latissimus dorsi (LD) flap, and a free vascularized fibula graft (FVFG). In the first stage, we drastically resected the necrotic bone and the surrounding infected tissue and placed antibiotic polymethylmethacrylate space on the bone gap according to the Masquelet technique. Next, we used an Ilizarov external fixator as a temporizing stabilizer and performed the LD flap. Six weeks later, in the second stage, we changed the external fixation to plate fixation; packed the artificial bone (β-TCP) and autograft bone to the induced membrane; and performed FVFG on the other side of the plate. As postoperative therapy, toe touch was allowed immediately, and partial weight bearing was started 2 months after second surgery. RESULTS: Both patients achieved bone union and were able to walk without postoperative complications. At the 2-year follow-up, there was no recurrence of infection. CONCLUSION: Our treatment is effective for controlling postoperative infection of radiation-induced pathological fracture.

DOI： 10.1007/s00402-020-03493-5

Clinical prediction model for postoperative ambulatory ability outcomes in patients with trochanteric fractures. International journal

Yosuke Tomita, Norio Yamamoto, Tomoo Inoue, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Injury 52 ( 7 ) 1826 - 1832 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Regaining independent ambulatory ability is one of the primary goals of treatment in patients with trochanteric fractures. This study aimed to develop and evaluate the discriminative accuracy of a clinical prediction model for ambulatory ability outcomes 3 months after surgery for trochanteric fractures. METHODS: This retrospective cohort study included 346 patients treated with intramedullary nailing for trochanteric fractures who had independent ambulatory ability before their injury. Multiple regression models with preoperative and postoperative factors were used to predict ambulatory ability outcomes at 3 months. A clinical prediction model (CPM) was created based on a decision tree developed using a chi-square automatic interaction detector technique. RESULTS: Three months after surgery, 263 (76.0%) and 83 (24.0%) patients regained and lost independent ambulatory ability, respectively. Univariate analysis showed that the Barthel index (BI) total score at 2 weeks predicted the ambulatory ability outcome at 3 months with good discriminative accuracy (area under the receiver operating characteristic curve [AUROC]: 0.819; 95% confidence interval [CI]: [0.769, 0.868], cut-off value: 22.5; sensitivity: 69.5%; specificity: 82.3%). Multiple logistic regression analysis showed that preoperative factors (residence before injury, diagnosis of dementia, and serum albumin at admission) and postoperative factors (BI total score at 2 weeks) predicted ambulatory ability outcomes at 3 months (AUROC: 0.710; 95%CI: [0.636, 0.783]; sensitivity: 91.3%; specificity: 41.8%). The CPM with the BI total score at 2 weeks (≤10; 10<, ≤50; >50 points) and dementia status (present; absent) had a moderate discriminative accuracy (AUROC: 0.676; 95%CI: [0.600, 0.752]; sensitivity: 94.7%; specificity: 40.5%). CONCLUSIONS: We developed a CPM with moderate accuracy to predict ambulatory ability outcomes in patients 3 months after surgery for trochanteric fractures. Our results demonstrate the importance of the BI score measured soon after surgery and dementia status for the prediction of postoperative ambulation.

DOI： 10.1016/j.injury.2021.04.043

Reduction quality and nail fixation ratio as bone-implant stability factors associated with reoperation for trochanteric fractures. International journal

Norio Yamamoto, Yosuke Tomita, Tomoyuki Noda, Tomoo Inoue, Yusuke Mochizuki, Toshifumi Ozaki

Injury 52 ( 7 ) 1813 - 1818 2021.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Geriatric trochanteric fractures are a major global issue, and their incidence is steadily rising. Bone quality, fracture type, fracture reduction quality, implant selection, and implant placement affect bone-implant stability in osteoporotic fractures. Our aim in this study was to evaluate the association between bone-implant stability factors, including nail construct, and the rate of reoperation in a more extensive case series with comprehensive variables. METHODS: This was a retrospective cohort study of 390 patients with trochanteric fractures aged ≥60 years and treated with intramedullary nailing. The primary outcome was the rate of reoperation due to any cause. Univariate and multivariable logistic regression analyses were used to identify factors associated with reoperation. RESULTS: In this study, 15 patients (3.8%) required reoperation. Univariate analysis showed that the following variables were significantly different between patients who required reoperation and those who did not: T-score at the total hip and lumbar spine, cortical thickness index, fracture type, and reduction quality. Multivariable logistic regression analysis showed that the odds ratio (OR) for A3 fracture type was 2.76 (95% confidence interval [CI], 0.77-9.76; p=0.116) and that for inadequate reduction, assessed by computed tomography, was 2.94 (95% CI, 0.89-9.69; p=0.076). These were independent predictors of reoperation. There was only one case (6.7%) of reoperation among patients with a distal femoral fragment fixation ratio (FR) >0.8. Considering the intraoperative decision-making process, the combination of inadequate reduction and an FR ≤0.8 were associated with the highest reoperation at a rate of 9.3% (OR, 3.327; 95% CI, 1.091-10.142; p=0.043). CONCLUSIONS: Risk factors on bone-implant stability for reoperation were the reduction quality and fracture type. Regarding the intraoperative decision-making process, the selection of a nail length with an FR >0.8 is a better option when the intramedullary reduction has been maintained intraoperatively.

DOI： 10.1016/j.injury.2021.04.048

高齢者脛骨近位部骨折の治療成績

畑利彰, 野田知之, 島村安則, 上原健敬, 吉村将秀, 福岡史朗, 佐藤浩平, 近藤宏也, 齋藤太一, 尾崎敏文

骨折 43 ( Suppl. ) S201 - S201 2021.7

寛骨臼骨折手術における術中コンピュータ支援によるスクリュー挿入精度の向上

上原健敬, 野田知之, 福岡史朗, 佐藤浩平, 畑利彰, 近藤宏也, 齋藤太一, 島村安則, 尾崎敏文

骨折 43 ( Suppl. ) S163 - S163 2021.7

後方(Burks)アプローチによる脛骨近位部骨折(後外側骨片)の整復固定手技

野田知之, 上原健敬, 島村安則, 福岡史朗, 佐藤浩平, 畑利彰, 近藤宏也, 齋藤太一, 尾崎敏文

骨折 43 ( Suppl. ) S90 - S90 2021.7

大腿骨転子部骨折患者におけるCONUTを用いた術前栄養状態と術後歩行能力の関連性の検討

佐藤浩平, 野田知之, 福岡史朗, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 島村安則, 東原信七郎, 尾崎敏文

骨折 43 ( Suppl. ) S295 - S295 2021.7

寛骨臼骨折に対する術後臨床成績評価方法の比較 Matta scoreとJHEQの比較検討

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S283 - S283 2021.7

大腿骨骨幹部骨折の治療成績

福岡史朗, 佐藤浩平, 畑利彰, 近藤宏也, 上原健敬, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S257 - S257 2021.7

踵骨骨折に対する外側小切開による骨接合術の治療成績ロッキングプレート固定とスクリュー固定の比較

佐藤浩平, 野田知之, 福岡史朗, 近藤宏也, 畑利彰, 上原健敬, 横尾賢, 吉村将秀, 尾崎敏文

骨折 43 ( Suppl. ) S251 - S251 2021.7

踵骨骨折における3DCTを用いた後距踵関節面の評価

上原健敬, 野田知之, 福岡史朗, 佐藤浩平, 畑利彰, 近藤宏也, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

骨折 43 ( Suppl. ) S248 - S248 2021.7

関節面の整復に術中3D撮影およびナビゲーションが有用であった寛骨臼骨折の2例

畑利彰, 野田知之, 島村安則, 上原健敬, 福岡史朗, 佐藤浩平, 近藤宏也, 齋藤太一, 雑賀建多, 尾崎敏文

骨折 43 ( Suppl. ) S367 - S367 2021.7

多発外傷患者における筋断面積の推移の比較

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S371 - S371 2021.7

Subjective and Objective Outcomes of Surgery for Rheumatoid Forefoot Deformities Under the Current Treatment Paradigm. International journal

Masahiro Horita, Keiichiro Nishida, Daisuke Kaneda, Kenzo Hashizume, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Hideki Ohashi, Masahito Watanabe, Toshifumi Ozaki

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 61 ( 1 ) 53 - 59 2021.6

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

We investigated the clinical outcomes of surgical procedures for the treatment of forefoot deformities in patients with rheumatoid arthritis. Twenty feet in 16 women (mean age 62.1 years) underwent corrective osteotomy of the first metatarsal bone with shortening oblique osteotomy of the lesser metatarsophalangeal joints (joint-preservation group), while 13 feet in 12 women (mean age 67.4 years) underwent arthrodesis of the first metatarsophalangeal joint with resection arthroplasty of the lesser metatarsophalangeal joints (joint-sacrifice group); mean follow-up for each group was 25.8 and 23.8 months, respectively. The mean total Japanese Society for Surgery of the Foot (JSSF) scale improved significantly from 64.2 to 89.2 in the joint-preservation group (p < .001), and from 54.2 to 74.2 in the joint-sacrifice group (p = .003). In the joint-preservation group, the postoperative range of motion (ROM) of the joint, walking ability, and activities of daily living scores of the JSSF scale were significantly higher than those in the joint-sacrifice group (p = .001, p = .001, and p = .019, respectively). There were no differences in the subscale scores of the self-administered foot evaluation questionnaire between 2 groups either pre- or postoperatively. No differences in the postoperative complications were found between 2 groups. Although the joint-sacrificing procedure resulted in lower objective outcomes than the joint-preserving procedure regarding the ROM of the joint, the walking ability, and the level of activities of daily living, both procedures resulted in similar treatment outcomes when evaluated by the subjective measures.

DOI： 10.1053/j.jfas.2021.06.008

Transtibial pullout repair techniques using two simple stitches for medial meniscus posterior root tear can prevent the progression of medial meniscus extrusion and obtain successful outcomes. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Shinichi Miyazawa, Yuki Okazaki, Keisuke Kintaka, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2021.6

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Transtibial pullout repairs using two simple stitches (TSS) and a combination of TSS with posteromedial pullout repair (TSS + PMP) using an all-inside meniscal repair device have been reported previously for the treatment of medial meniscus (MM) posterior root tears. This study aimed to investigate the postoperative clinical outcomes of these techniques including MM extrusion (MME). METHODS: Fifty-two patients who underwent transtibial pullout repair were investigated and divided into TSS (n = 27) and TSS + PMP (n = 25) groups. The clinical outcomes were assessed using the Lysholm knee score and Knee Injury and Osteoarthritis Outcome Score 1 year postoperatively and compared between two groups. MME was measured using magnetic resonance imaging at 1 year postoperatively and compared between two groups. RESULTS: A significant improvement in each clinical score was observed in both groups, and no significant difference was seen in clinical outcomes. Moreover, no significant difference in postoperative MME was observed in both groups (TSS and TSS + PMP: 3.5 mm and 3.8 mm, respectively). Though no significant progression of MME was observed in TSS group, a significant progression of it was observed in TSS + PMP group postoperatively. CONCLUSIONS: This study demonstrated that both techniques improved clinical outcomes in the short-term postoperative period. However, MME was progressed significantly in TSS + PMP group 1 year postoperatively, which indicated that PMP might not be a useful additional procedure for reducing the postoperative MME.

DOI： 10.1007/s00590-021-03035-8

Adrenergic signaling promotes the expansion of cancer stem-like cells of malignant peripheral nerve sheath tumors. International journal

Rongsheng Huang, Atsushi Fujimura, Eiji Nakata, Shota Takihira, Hirofumi Inoue, Soichiro Yoshikawa, Takeshi Hiyama, Toshifumi Ozaki, Atsunori Kamiya

Biochemical and biophysical research communications 557 199 - 205 2021.6

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

Malignant peripheral nerve sheath tumor (MPNST), a highly malignant tumor that arises in peripheral nerve tissues, is known to be highly resistant to radiation and chemotherapy. Although there are several reports on genetic mutations and epigenetic changes that define the pathogenesis of MPNST, there is insufficient information regarding the microenvironment that contributes to the malignancy of MPNST. In the present study, we demonstrate that adrenaline increases the cancer stem cell population in MPNST. This effect is mediated by adrenaline stimulation of beta-2 adrenergic receptor (ADRB2), which activates the Hippo transducer, YAP/TAZ. Inhibition and RNAi experiments revealed that inhibition of ADRB2 attenuated the adrenaline-triggered activity of YAP/TAZ and subsequently attenuated MPNST cells stemness. Furthermore, ADRB2-YAP/TAZ axis was confirmed in the MPNST patients' specimens. The prognosis of patients with high levels of ADRB2 was found to be significantly worse. These data show that adrenaline exacerbates MPNST prognosis and may aid the development of new treatment strategies for MPNST.

DOI： 10.1016/j.bbrc.2021.03.172

Clinical outcome of patients with recurrent or refractory localized Ewing's sarcoma family of tumors: A retrospective report from the Japan Ewing Sarcoma Study Group. International journal

Katsutsugu Umeda, Takako Miyamura, Kenji Yamada, Hideki Sano, Ako Hosono, Minako Sumi, Hajime Okita, Tadashi Kumamoto, Akira Kawai, Junya Hirayama, Ryoji Jyoko, Akihisa Sawada, Hideki Nakayama, Yosuke Hosoya, Naoko Maeda, Nobuyuki Yamamoto, Chihaya Imai, Daiichiro Hasegawa, Motoaki Chin, Toshifumi Ozaki

Cancer reports (Hoboken, N.J.) 4 ( 3 ) e1329 2021.6

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Patients with Ewing's sarcoma family of tumors (ESFT) who experience relapse or progression have a poor prognosis. AIM: This study aimed to identify the prognostic and therapeutic factors affecting overall survival (OS) of patients with recurrent or refractory localized ESFT. METHODS AND RESULTS: Thirty-eight patients with localized ESFT who experienced first relapse or progression between 2000 and 2018 were retrospectively reviewed. The 5-year OS rate of the entire cohort was 48.3% (95% confidence interval, 29.9%-64.5%). Multivariate analysis of OS identified time to relapse or progression, but not stem cell transplantation (SCT), as the sole independent risk factor (hazard ratio, 35.8; P = .002). Among 31 patients who received salvage chemotherapy before local treatment, 21 received chemotherapy regimens that are not conventionally used for newly diagnosed ESFT. The objective response rate to first-line salvage chemotherapy was 55.2% in the 29 evaluable patients. Time to relapse or progression was significantly associated with response to first-line salvage chemotherapy (P = .006). CONCLUSIONS: The present study fails to demonstrate significant clinical benefit of SCT for recurrent or refractory localized ESFT. Recently established chemotherapy regimens may increase the survival rate of patients with recurrent or refractory localized ESFT while attenuating the beneficial effect of SCT.

DOI： 10.1002/cnr2.1329

骨・軟部腫瘍のgermline findingsに対する遺伝子医療部門の取り組み

二川摩周, 中田英二, 十川麗美, 加藤芙美乃, 浦川優作, 河内麻里子, 山本英喜, 国定俊之, 平沢晃, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1251 - S1251 2021.6

がんロコモの現状と課題遠隔転移のないがん患者における周術期のがんロコモの発生率とそのリスクファクター

堅山佳美, 中田英二, 明崎禎輝, 千田益生, 国定俊之, 濱田全紀, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1298 - S1298 2021.6

がんロコモの現状と課題がんロコモ発生予防のための院内システムの構築

中田英二, 堅山佳美, 明崎禎輝, 濱田全紀, 国定俊之, 藤原智洋, 千田益生, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1241 - S1241 2021.6

DDH治療後の腸腰筋断面積の検討

佐藤嘉洋, 鉄永智紀, 山田和希, 廣瀬一樹, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 1 ) 44 - 46 2021.6

Authorship：Last author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本小児整形外科学会

発育性股関節形成不全(以下、DDH)に対して、当院では観血的整復術(広範囲展開法:田邊法、以下、OR)の適応を保存的整復不成功例や歩行開始後の診断遅延例とし、ORで腸腰筋前方移行を行っている。本研究の目的は、腸腰筋の断面積をOR群とRiemenbuegel装具による保存的整復(以下、CR)群で比較し、ORにおける腸腰筋前方移行の影響を明らかにすることである。対象はDDH症例26例26股(女:男23:3)。OR群13例、CR群13例、CT axial viewで、S2椎間孔、臼蓋上縁、恥骨結合の各高位で腸腰筋断面積の健側に対する患側の割合(以下、%Area)を求め、OR群とCR群で比較した。結果、各高位の%Area(%)はOR群で有意に小さく、腸腰筋前方移行により長期的には腸腰筋のボリュームが低下していた。腸腰筋の機能として股関節屈曲、腰椎屈曲、側屈に加え姿勢制御がある。最終観察時に症状はなかったが、長期的には腰痛等生じる可能性はあり、注意深い経過観察が必要である。(著者抄録)

人工知能による骨肉腫X線像読影システム

長谷井嬢, 中原龍一, 板野拓人, 沖田駿治, 三宅孝昌, 杉本佳久, 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 95 ( 6 ) S1250 - S1250 2021.6

前腕に発生した肉腫の治療成績

畑利彰, 佐藤浩平, 近藤宏也, たき平将太, 藤原智洋, 中田英二, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1354 - S1354 2021.6

肉腫の心臓転移

板野拓人, 中田英二, 国定俊之, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1389 - S1389 2021.6

がん遺伝子パネルによる肉腫における融合遺伝子の検出

佐藤浩平, 中田英二, 近藤宏也, 畑利彰, たき平将太, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1269 - S1269 2021.6

がんゲノム中核拠点病院における肉腫のがんゲノム医療

中田英二, 国定俊之, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1252 - S1252 2021.6

肉腫における免疫療法

たき平将太, 佐藤浩平, 畑利彰, 近藤宏也, 中田英二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 95 ( 6 ) S1338 - S1338 2021.6

寛骨臼を含む骨盤発生Ewing肉腫に対する英国集約化施設における治療変遷とその成績

藤原智洋, Stevenson Jonathan, Parry Michael, 津田祐輔, 中田英二, 国定俊之, 尾崎敏文, Grimer Robert, Jeys Lee

日本整形外科学会雑誌 95 ( 6 ) S1272 - S1272 2021.6

NICE軟部肉腫ガイドラインは英国における軟部肉腫患者の診療体制や生存予後にどのような影響を与えたか

藤原智洋, Grimer Robert, Evans Scott, 津田祐輔, 中田英二, 国定俊之, 尾崎敏文, Abudu Adesegun

日本整形外科学会雑誌 95 ( 6 ) S1371 - S1371 2021.6

骨肉腫における腫瘍関連マクロファージの臨床病理学的意義

近藤宏也, 藤原智洋, 吉田晶, 佐藤浩平, 畑利彰, 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 95 ( 6 ) S1410 - S1410 2021.6

Postoperative computed tomography assessment of anteromedial cortex reduction is a predictor for reoperation after intramedullary nail fixation for pertrochanteric fractures. International journal

Norio Yamamoto, Takahiro Imaizumi, Tomoyuki Noda, Tomoo Inoue, Keisuke Kawasaki, Toshifumi Ozaki

European journal of trauma and emergency surgery : official publication of the European Trauma Society 2021.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Postoperative radiographs are routinely used to assess fracture reduction following intramedullary nail fixation for pertrochanteric fractures, even though computed tomography (CT) is a superior modality. We aimed to determine the association between reduction quality assessed by CT and rates of reoperation and to evaluate the association of reoperation and reduction quality according to the assessment modality (plain radiographs vs. CT). METHODS: A retrospective analysis of 299 consecutive patients treated with intramedullary nail fixation for pertrochanteric fractures was conducted. Fracture reduction measured by postoperative radiographs and CT was categorized as anatomical type, extramedullary type, or intramedullary type. Postoperative data for analysis included reduction status, tip-apex distance (TAD), screw position in the femoral head, sliding distance, and conditions associated with reoperation. RESULTS: Of the 299 patients included with a mean age of 83.1 ± 8.2 years, there were six patients who required reoperation (2.0%). According to the CT assessments, there were 42 intramedullary reductions (14.0%). Patients with a non-intramedullary reduction based on postoperative CT images were significantly more likely to have proper placement of the screw, a reduced TAD, a reduced sliding distance, and a lower reoperation rate than those with an intramedullary reduction (P < 0.05). The reduction quality assessed by postoperative CT was significantly associated with reoperation (95% CI, 1.45-29.31). CONCLUSIONS: Intramedullary reduction assessed by CT was associated with reoperation. The reduction quality based on CT findings was more predictive for reoperation than that from plain radiographs.

DOI： 10.1007/s00068-021-01718-9

A newly-developed guide can create tibial tunnel at an optimal position during medial meniscus posterior root repairs.

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Keisuke Kintaka, Tadashi Yamawaki, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2021.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: During transtibial pullout repair of medial meniscus (MM) posterior root tears (MMPRTs), accurate tibial tunnel creation within the anatomic MM posterior root attachment seems critical. This study aimed to evaluate the tibial tunnel position created by a newly-developed Precision guide during pullout repair of MMPRTs. METHODS: In 40 patients who underwent transtibial pullout repairs, the tibial tunnel was created using the Unicorn Meniscal Root (UMR) (n = 20) or Precision guide (n = 20). Three-dimensional computed tomography images of the tibial surface were evaluated postoperatively, using Tsukada's measurement method. The expected anatomic center of the MM posterior root attachment was defined as the center of three tangential lines corresponding to anatomic bony landmarks. The expected anatomic center (AC) and the tibial tunnel center (TC) were evaluated using the percentage-based posterolateral location on the tibial surface. The difference in the mediolateral and anteroposterior percentage distance between the AC and TC was calculated, as was the absolute distance between the AC and TC. RESULTS: The mean AC was located 77.4% posterior and 40.1% lateral. The mean TC was similar in the UMR and Precision guide groups. There was no significant difference in the mediolateral percentage distance (UMR 3.9% vs. Precision 3.6%, p = 0.405), but a significant difference was observed in the anteroposterior percentage distance (UMR 3.5% vs. Precision 2.6%, p = 0.031). The mean absolute distance between the AC and TC was 3.9 mm and 3.5 mm (UMR and Precision guide groups, respectively) (p = 0.364). CONCLUSIONS: The new Precision guide can create tibial tunnel in an optimal and stable position during pullout repair of MMPRTs.

DOI： 10.1016/j.jos.2021.04.002

A randomized phase II trial of second-line treatment for advanced soft tissue sarcoma comparing trabectedin, eribulin and pazopanib (2ND-STEP, JCOG1802).

Makoto Endo, Kazuhiro Tanaka, Yoshihiro Matsumoto, Hiroaki Hiraga, Shintaro Iwata, Satoshi Tsukushi, Munenori Watanuki, Toru Akiyama, Tsukasa Yonemoto, Robert Nakayama, Keisuke Ae, Hiroyuki Kawashima, Hiroyuki Tsuchiya, Hirohisa Katagiri, Akihito Nagano, Satoshi Takenaka, Tomoko Kataoka, Ryunosuke Machida, Haruhiko Fukuda, Toshifumi Ozaki

Journal of Clinical Oncology 39 ( 15_suppl ) TPS11580 - TPS11580 2021.5

Publishing type：Research paper (scientific journal) Publisher：American Society of Clinical Oncology (ASCO)

TPS11580

Background: Soft tissue sarcomas (STS) are a rare type of malignancy, which comprises of a variety of histologies. Chemotherapy is the standard treatment for patients with advanced STS. Doxorubicin alone or in combination with ifosfamide is widely accepted as the first-line chemotherapy for advanced STS. While a combination with gemcitabine and docetaxel is regarded as a standard regimen of the second-line chemotherapy after failure of doxorubicin-based first-line regimen, the efficacy is not sufficient. Trabectedin, eribulin, and pazopanib are the candidates of the second-line chemotherapy for advanced STS, although there is no clear evidence showing which is better among those agents. The purpose of this clinical trial conducted by Bone and Soft Tissue Tumor Study Group of Japan Clinical Oncology Group (JCOG) is to determine the most promising regimen among trabectedin, eribulin and pazopanib as the test arm regimen in the future phase III trial of the second-line treatment for patients with advanced STS. Methods: The study, JCOG1802, is a multicenter, selection design, randomized phase II trial comparing trabectedin (1.2 mg/m² IV, every 3 weeks), eribulin (1.4 mg/m² IV, days 1 and 8, every 3 weeks) and pazopanib (800 mg PO, everyday) for patients with unresectable or metastatic STS refractory to doxorubicin-based first-line chemotherapy. Eligibility criteria include 16 year-old or older, unresectable and/or metastatic STS, an exacerbation within 6 months prior to registration, histological diagnosis of STS other than Ewing sarcoma, well-differentiated liposarcoma and myxoid liposarcoma, a history of chemotherapy for STS other than doxorubicin-based regimen, ECOG (Eastern Cooperative Oncology Group) performance status 0 to 2, and sufficient organ function. Primary endpoint is progression-free survival (PFS), and secondary endpoints include overall survival, disease-control rate, response rate, and adverse events. To select the most promising regimen in median PFS (3 months in the worst regimen and 4 months in the best regimen) with a probability of at least 80%, a total of 120 patients will be enrolled from 37 institutions in Japan. After JCOG1802, a subsequent phase III trial comparing the winner of this study and a combination of gemcitabine and docetaxel will be planned. The study was activated at December 5, 2019 and 22 of planned 120 patients have been enrolled as of February 15, 2021. Clinical trial information: jRCTs031190152.

DOI： 10.1200/jco.2021.39.15_suppl.tps11580

Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors. International journal

Masato Ise, Eiji Nakata, Yoshimi Katayama, Masanori Hamada, Toshiyuki Kunisada, Tomohiro Fujiwara, Ryuichi Nakahara, Shouta Takihira, Kohei Sato, Yoshiteru Akezaki, Masuo Senda, Toshifumi Ozaki

Healthcare (Basel, Switzerland) 9 ( 5 ) 2021.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient's distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.

DOI： 10.3390/healthcare9050566

Comparison of posterior root remnant cells and horn cells of the medial meniscus. International journal

Ximing Zhang, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Haowei Xue, Keisuke Kintaka, Shinichi Miyazawa, Toshifumi Ozaki

Connective tissue research 1 - 10 2021.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Purpose/Aim of the study: Previous studies have noted distinctions between medial meniscus posterior root and horn cells. However, the characteristics of root remnant cells have not been explored in detail. The purpose of this study was to evaluate the gene expression levels, proliferation, and resistance to mechanical stress of remnant and horn cells.Materials and Methods: Medial meniscus tissue samples were obtained from patients who underwent total or uni-compartmental knee arthroplasty. Cellular morphology, sry-type HMG box 9, type II collagen, and chondromodulin-I gene expression levels were analyzed. Collagen synthesis was assessed by immunofluorescence staining. Proliferation analysis after 4 h-cyclic tensile strain was performed.Results: Horn cells displayed triangular morphology, whereas root remnant cells appeared fibroblast-like. sry-type HMG box 9 mRNA expression levels were similar in both cells, but type II collagen and chondromodulin-I mRNA expressions were observed only in horn cells. The ratio of type II collagen-positive cells in horn cells was about 10-fold higher than that in root remnant cells, whereas the ratio of sry-type HMG box 9-positive cells was similar. A significant increase in proliferation was observed in root remnant cells compared to that in horn cells. Further, under cyclic tensile strain, the survival rate was higher in root remnant cells than in horn cells.Conclusions: Medial meniscus root remnant cells showed higher proliferation and resistant properties to cyclic tensile strain than horn cells and showed no chondromodulin-I expression. Preserving the medial meniscus posterior root remnant during pullout repair surgery might maintain mechanical stress-resistant tissue and support healing.

DOI： 10.1080/03008207.2021.1920935

A retro-odontoid pseudotumor treated with fixation and tumor resection by the lateral approach: illustrative case. International journal

Yoshiaki Oda, Takamitsu Tokioka, Toshifumi Ozaki

Journal of neurosurgery. Case lessons 1 ( 19 ) CASE20160 2021.5

Language：English

BACKGROUND: A retro-odontoid pseudotumor is not a condition that requires resection. However, pathological diagnosis is required when a tumor such as a meningeal tumor or chordoma is suspected. The authors report a case of a large lesion treated with posterior fixation and tumor resection using a lateral approach. OBSERVATIONS: A 77-year-old man visited the authors' department complaining of neck pain and decreased dexterity of the upper extremities. Magnetic resonance imaging showed a large, beak-shaped lesion behind the dens and severe compression of the spinal cord. Surgery consisted of occipitocervical-C2 fixation, followed by tumor resection with a left lateral approach. The pathological diagnosis was consistent with a retro-odontoid pseudotumor. The tumor was resected to a relatively large extent and shrank over time, leading to complete disappearance. LESSONS: Pathological examination is also possible with a posterior approach if the tumor can be reached through the lateral edge of the dura. In that situation, the amount of resection is limited, and there is a risk of spinal cord compression. Intradural dissemination of tumors is a concern with the transdural approach. If tumor resection by the posterior approach is difficult, the lateral approach can facilitate tumor resection.

DOI： 10.3171/CASE20160

Risk factors of postoperative delayed wound healing in patients with rheumatoid arthritis treated with a biological agent. International journal

Shunji Okita, Hajime Ishikawa, Asami Abe, Satoshi Ito, Kiyoshi Nakazono, Akira Murasawa, Keiichiro Nishida, Toshifumi Ozaki

Modern rheumatology 31 ( 3 ) 587 - 592 2021.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: This retrospective study aimed to investigate the risk factors associated with delayed wound healing (DWH) after orthopedic surgery in rheumatoid arthritis (RA) patients treated with biological disease-modifying antirheumatic drugs (bDMARDs). METHODS: We reviewed medical records of 276 orthopedic procedures for 187 RA patients treated with bDMARDs. As a preoperative nutritional status assessment, we evaluated body mass index, prognostic nutritional index (PNI), and controlling nutritional status (CONUT). We evaluated DAS28-CRP, DAS28-ESR, face scale, global health, and HAQ-DI to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for DWH. RESULTS: In 276 procedures, DWH was identified in 24 patients (8.7%). Disease duration, foot and ankle surgery, and preoperative use of tocilizumab were significant in the univariate analyses. These variables were entered into a multivariate model, and it was revealed that preoperative use of tocilizumab and procedures in the foot and ankle were associated with an increased risk of DWH. CONCLUSION: The current retrospective study suggested that preoperative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH.

DOI： 10.1080/14397595.2020.1790138

Telomerase-specific oncolytic immunotherapy for promoting efficacy of PD-1 blockade in osteosarcoma. International journal

Yusuke Mochizuki, Hiroshi Tazawa, Koji Demiya, Miho Kure, Hiroya Kondo, Tadashi Komatsubara, Kazuhisa Sugiu, Joe Hasei, Aki Yoshida, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 70 ( 5 ) 1405 - 1417 2021.5

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

Immune checkpoint inhibitors including anti-programmed cell death 1 (PD-1) antibody have recently improved clinical outcome in certain cancer patients; however, osteosarcoma (OS) patients are refractory to PD-1 blockade. Oncolytic virotherapy has emerged as novel immunogenic therapy to augment antitumor immune response. We developed a telomerase-specific replication-competent oncolytic adenovirus OBP-502 that induces lytic cell death via binding to integrins. In this study, we assessed the combined effect of PD-1 blockade and OBP-502 in OS cells. The expression of coxsackie and adenovirus receptor (CAR), integrins αvβ3 and αvβ5, and programmed cell death ligand 1 (PD-L1) was analyzed in two murine OS cells (K7M2, NHOS). The cytopathic activity of OBP-502 in both cells was analyzed using the XTT assay. OBP-502-induced immunogenic cell death was assessed by analyzing the level of extracellular ATP and high-mobility group box protein B1 (HMGB1). Subcutaneous tumor models for K7M2 and NHOS cells were used to evaluate the antitumor effect and number of tumor-infiltrating CD8+ cells in combination therapy. K7M2 and NHOS cells showed high expression of integrins αvβ3 and αvβ5, but not CAR. OBP-502 significantly suppressed the viability of both cells, in which PD-L1 expression and the release of ATP and HMGB1 were significantly increased. Intratumoral injection of OBP-502 significantly augmented the efficacy of PD-1 blockade on subcutaneous K2M2 and NHOS tumor models via enhancement of tumor-infiltrating CD8+ T cells. Our results suggest that telomerase-specific oncolytic virotherapy is a promising antitumor strategy to promote the efficacy of PD-1 blockade in OS.

DOI： 10.1007/s00262-020-02774-7

High body mass index is a risk factor for unfavorable clinical outcomes after medial meniscus posterior root repair in well-aligned knees.

Ximing Zhang, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Yuya Kodama, Haowei Xue, Yoshiki Okazaki, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 3 ) 430 - 434 2021.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Severe chondral lesions and varus knee alignment are associated with poor outcomes following transtibial pullout repair for medial meniscus posterior root tears and meniscus tear is strongly associated with body mass index. The prognostic factors in well-aligned knees (femorotibial angle < 180°) with mild chondral lesions are unknown. Therefore, we investigated the prognostic factors in these patients. We hypothesized that high body mass index would lead to poor clinical outcomes following pullout repair of medial meniscus posterior root tears. METHODS: We retrospectively reviewed the files of 28 patients who had undergone pullout repair of medial meniscus posterior root tears between October 2016 and December 2017. We recorded the baseline characteristics (age, gender, height, weight, and body mass index) and the time between injury and surgery. We recorded the International Knee Documentation Committee scores, Knee injury and Osteoarthritis Outcome Scores, and pain visual analog scale scores. Using magnetic resonance imaging preoperatively and 1 year after surgery, we measured the medial meniscus body width and absolute and relative medial meniscus extrusion. Pearson correlation and multivariate linear regression analyses were used to assess potential associations between these factors and clinical outcomes. RESULTS: Age positively correlated (coefficient = 0.49, P < 0.01) and body mass index negatively correlated with the postoperative International Knee Documentation Committee score (coefficient = -0.64, P < 0.01). In multivariate linear regression analysis, body mass index was a significant factor leading to poor postoperative International Knee Documentation Committee score (R2 = 0.29, P < 0.05). CONCLUSIONS: Body mass index > 30 kg/m2 is a risk factor for unfavorable clinical outcomes following pullout repair of medial meniscus posterior root tears in well-aligned knees. LEVEL OF EVIDENCE: III, Comparative retrospective study.

DOI： 10.1016/j.jos.2020.04.018

脊椎転移に対する集学的治療麻痺を認めない脊椎SREに対する保存的治療の成績

中田英二, 国定俊之, 藤原智洋, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) JSY39 - 1 2021.5

中等度特発性手根管症候群患者に対する、電気生理学的検査による機能的予後予測の検討

伊勢真人, 本郷匡一, 堅山佳美, 濱田全紀, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 3 - 2 2021.5

肺癌・食道癌患者の術前におけるがんロコモ・サルコペニアの発生頻度

堅山佳美, 千田益生, 濱田全紀, 中田英二, 伊勢真人, 本郷匡一, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 9 2021.5

65歳以下の慢性疼痛患者におけるロコモティブシンドロームと体組成及び運動機能評価

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 7 2021.5

慢性疼痛患者に対するロコモティブシンドローム診断における診断時の特徴及び注意点

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 6 2021.5

周術期のリハビリテーション医療

千田益生, 濱田全紀, 堅山佳美, 伊勢真人, 本郷匡一, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) SL41 - SL41 2021.5

中等度特発性手根管症候群患者に対する、電気生理学的検査による機能的予後予測の検討

伊勢真人, 本郷匡一, 堅山佳美, 濱田全紀, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 3 - 2 2021.5

肺癌・食道癌患者の術前におけるがんロコモ・サルコペニアの発生頻度

堅山佳美, 千田益生, 濱田全紀, 中田英二, 伊勢真人, 本郷匡一, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 9 2021.5

65歳以下の慢性疼痛患者におけるロコモティブシンドロームと体組成及び運動機能評価

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 7 2021.5

慢性疼痛患者に対するロコモティブシンドローム診断における診断時の特徴及び注意点

辻寛謙, 三澤治夫, 千田益生, 西田圭一郎, 濱田全紀, 堅山佳美, 鉄永智紀, 小田孔明, 伊勢真人, 梶木裕矢, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) 2 - 6 2021.5

周術期のリハビリテーション医療

千田益生, 濱田全紀, 堅山佳美, 伊勢真人, 本郷匡一, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) SL41 - SL41 2021.5

脊椎転移に対する集学的治療麻痺を認めない脊椎SREに対する保存的治療の成績

中田英二, 国定俊之, 藤原智洋, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 58 ( 特別号 ) JSY39 - 1 2021.5

Oncolytic virotherapy promotes radiosensitivity in soft tissue sarcoma by suppressing anti-apoptotic MCL1 expression International journal

Toshinori Omori, Hiroshi Tazawa, Yasuaki Yamakawa, Shuhei Osaki, Joe Hasei, Kazuhisa Sugiu, Tadashi Komatsubara, Tomohiro Fujiwara, Aki Yoshida, Toshiyuki Kunisada, Yasuo Urata, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

PLOS ONE 16 ( 4 ) e0250643 - e0250643 2021.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Public Library of Science (PLoS)

Soft tissue sarcoma (STS) is a rare cancer that develops from soft tissues in any part of the body. Despite major advances in the treatment of STS, patients are often refractory to conventional radiotherapy, leading to poor prognosis. Enhancement of sensitivity to radiotherapy would therefore improve the clinical outcome of STS patients. We previously revealed that the tumor-specific, replication-competent oncolytic adenovirus OBP-301 kills human sarcoma cells. In this study, we investigated the radiosensitizing effect of OBP-301 in human STS cells. The in vitro antitumor effect of OBP-301 and ionizing radiation in monotherapy or combination therapy was assessed using highly radiosensitive (RD-ES and SK-ES-1) and moderately radiosensitive (HT1080 and NMS-2) STS cell lines. The expression of markers for apoptosis and DNA damage were evaluated in STS cells after treatment. The therapeutic potential of combination therapy was further analyzed using SK-ES-1 and HT1080 cells in subcutaneous xenograft tumor models. The combination of OBP-301 and ionizing radiation showed a synergistic antitumor effect in all human STS cell lines tested, including those that show different radiosensitivity. OBP-301 was found to enhance irradiation-induced apoptosis and DNA damage via suppression of anti-apoptotic myeloid cell leukemia 1 (MCL1), which was expressed at higher levels in moderately radiosensitive cell lines. The combination of OBP-301 and ionizing radiation showed a more profound antitumor effect compared to monotherapy in SK-ES-1 (highly radiosensitive) and HT1080 (moderately radiosensitive) subcutaneous xenograft tumors. OBP-301 is a promising antitumor reagent to improve the therapeutic potential of radiotherapy by increasing radiation-induced apoptosis in STS.

DOI： 10.1371/journal.pone.0250643

A posterior shiny-corner lesion of the tibia is observed in the early phase after medial meniscus posterior root tear. International journal

Yuki Okazaki, Takayuki Furumatsu, Yuya Kajiki, Takaaki Hiranaka, Keisuke Kintaka, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUNDS: Medial meniscus (MM) posterior root tear (PRT) results in joint overloading and degenerative changes in the knee, and pullout repair is recommended to prevent subsequent osteoarthritis. Diagnosing MMPRT is sometimes difficult, especially in the case of an incomplete tear. A posterior shiny-corner lesion (PSCL) is reported to be useful for diagnosis, although the association between MMPRT and PSCL is unknown. This study aimed to investigate the properties of PSCL, such as the location, volume, and duration from injury to the time of MRI (duration). We hypothesized that PSCL is observed in the early phase after the MMPRT onset. METHODS: T2-weighted fat-suppression magnetic resonance imaging (MRI) was obtained from 55 patients with MMPRT preoperatively. The prevalence of the PSCL; giraffe neck, cleft, and ghost signs; severe MM extrusion (> 3 mm); and the PSCL volume were evaluated. The PSCL lesion elliptical volume (mm3) was calculated by measuring the anteroposterior, transverse, and craniocaudal dimensions. RESULTS: PSCL was observed in 34 (62%) cases. The mean volume of the PSCL was 102.0 mm3. A significantly shorter duration was observed in the PSCL-positive group (5.6 weeks) than that in the PSCL-negative group (40.9 weeks, P < 0.01), although no significant correlation was observed between the PSCL volume and duration. The sensitivity for the MMPRT was 90.5% when the cut-off duration value was 3 weeks and 81.8% when the cut-off value was 8 weeks. CONCLUSIONS: MRI examination may detect PSCL if it is performed early following MMPRT onset. Detecting PSCL may be useful in diagnosing MMPRT with high sensitivity.

DOI： 10.1007/s00590-021-02968-4

Liquid Biopsy Targeting Monocarboxylate Transporter 1 on the Surface Membrane of Tumor-Derived Extracellular Vesicles from Synovial Sarcoma. International journal

Suguru Yokoo, Tomohiro Fujiwara, Aki Yoshida, Koji Uotani, Takuya Morita, Masahiro Kiyono, Joe Hasei, Eiji Nakata, Toshiyuki Kunisada, Shintaro Iwata, Tsukasa Yonemoto, Koji Ueda, Toshifumi Ozaki

Cancers 13 ( 8 ) 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

The lack of noninvasive biomarkers that can be used for tumor monitoring is a major problem for soft-tissue sarcomas. Here we describe a sensitive analytical technique for tumor monitoring by detecting circulating extracellular vesicles (EVs) of patients with synovial sarcoma (SS). The proteomic analysis of purified EVs from SYO-1, HS-SY-II, and YaFuSS identified 199 common proteins. DAVID GO analysis identified monocarboxylate transporter 1 (MCT1) as a surface marker of SS-derived EVs, which was also highly expressed in SS patient-derived EVs compared with healthy individuals. MCT1+CD9+ EVs were also detected from SS-bearing mice and their expression levels were significantly correlated with tumor volume (p = 0.003). Furthermore, serum levels of MCT1+CD9+ EVs reflected tumor burden in SS patients. Immunohistochemistry revealed that MCT1 was positive in 96.7% of SS specimens and its expression on the cytoplasm/plasma membrane was significantly associated with worse overall survival (p = 0.002). Silencing of MCT1 reduced the cellular viability, and migration and invasion capability of SS cells. This work describes a new liquid biopsy technique to sensitively monitor SS using circulating MCT1+CD9+ EVs and indicates the therapeutic potential of MCT1 in SS.

DOI： 10.3390/cancers13081823

Evaluation of the labrum on postoperative magnetic resonance images: a predictor of acetabular development in developmental dysplasia of the hip. International journal

Tomonori Tetsunaga, Tomoko Tetsunaga, Hirofumi Akazawa, Kazuki Yamada, Takayuki Furumatsu, Toshifumi Ozaki

Hip international : the journal of clinical and experimental research on hip pathology and therapy 11207000211004917 - 11207000211004917 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Residual acetabular dysplasia of the hip after open reduction can complicate the treatment of developmental dysplasia of the hip (DDH) due to the potential need for corrective surgery. This retrospective study aimed to determine the predictive factors for acetabular development using postoperative radiographs and magnetic resonance imaging (MRI). METHODS: We retrospectively investigated 74 hips of patients with DDH who underwent open reduction after reaching walking age and were followed up radiologically until skeletal maturity. We evaluated the cartilaginous acetabulum and labrum using a new method that measures the cartilaginous and labral landmarks on coronal and axial MR T2*-weighted images in patients aged 5 years. The mean age at the time of surgery was 22 months and that at the final survey was 20 years. Severin classification was determined at the final follow-up. Groups with good (53 hips) and poor (21 hips) outcomes were compared using the postoperative radiographic and MRI parameters recorded at 5 years of age. Factors predicting acetabular development were identified using univariate and multiple logistic analyses. RESULTS: There were no significant differences in the bony-acetabular index (AI) and centre-edge (CE) angle between the good and poor outcome groups. However, the poor outcome group had significantly larger cartilaginous- and labral-AIs but significantly smaller cartilaginous- and labral-CE angles than the good outcome group (both p < 0.05). Multiple logistic regression analysis showed that labral-AI and labral-CE angle were predictors of acetabular development after open reduction for DDH, and their optimal cut-offs were 4° (77% sensitivity, 76% specificity) and 37° (68% sensitivity, 85% specificity), respectively. DISCUSSION: Normal cartilaginous acetabulum development occurs in childhood, and evaluation using only radiographs is difficult. However, labral-AI ⩾4° and labral-CE angle <37° on MRI at 5 years of age offer useful indications for corrective surgery in patients with DDH.

DOI： 10.1177/11207000211004917

Histologic Evaluation of Tibial Attachment in 11-Year Double-Bundle ACL Reconstruction with Hamstring Tendons: A Case Report. International journal

Yuki Okazaki, Nobuhiro Abe, Kimihiko Makiyama, Takayuki Furumatsu, Shinichi Miyazawa, Toshifumi Ozaki

JBJS case connector 11 ( 2 ) 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

CASE: A 49-year-old woman injured her anterior cruciate ligament (ACL) as a high-school student. Double-bundle ACL reconstruction (DBACLR) using hamstring tendon grafts was performed because of recurrent instability. Eleven years after DBACLR, total knee arthroplasty was performed because of osteoarthritis progression. Histologic analysis was completed to observe the osteointegration of the tendon in the obtained proximal tibia. The tibial tunnel showed Sharpey-like fibers anteriorly, connecting the tendon graft and lamellar bone, whereas the intraarticular exit revealed well-aligned chondrocytes posteriorly, indicating chondral metaplasia of the tendon graft. CONCLUSION: Tendon-bone healing can regenerate both fibrous insertion and chondral metaplasia in DBACLR.

DOI： 10.2106/JBJS.CC.20.00509

Immunotherapy for sarcomas. International journal

Eiji Nakata, Tomohiro Fujiwara, Toshiyuki Kunisada, Tastuo Ito, Shota Takihira, Toshifumi Ozaki

Japanese journal of clinical oncology 51 ( 4 ) 523 - 537 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Sarcomas are a heterogeneous group of malignancies of mesenchymal origin; their molecular and genomic mechanisms differ with regard to histology. These characteristics lead to the presentation of varied immunological profiles based on the tumor microenvironment. Various immunotherapies are considered for the treatment of sarcoma. These treatments are performed either in isolation or in combination with other methods such as cytotoxic chemotherapy or the use of molecular target agents. Among these, two recently emerging immunotherapies include T-cell receptor gene therapy and immune checkpoint inhibitor therapy, which are expected to be effective for many types of sarcoma. A sarcoma with a disease-specific translocation and a limited number of mutations, such as synovial sarcoma, expresses high levels of self-antigens, like the New York esophageal squamous cell carcinoma 1, which has been targeted in T-cell receptor gene therapy. On the other hand, sarcomas with a greater number of mutations, such as undifferentiated pleomorphic sarcomas, myxofibrosarcoma and dedifferentiated liposarcomas, can be good candidates for immune checkpoint inhibitors. Among immune checkpoint inhibitor therapies, programmed cell death-1 blockade (nivolumab and pembrolizumab) and cytotoxic T-lymphocyte-associated antigen 4 blockade (ipilimumab) have been investigated most often in sarcoma. Although the sole use of immune checkpoint inhibitors provides limited efficacy, combined immunotherapy with immune checkpoint inhibitors or molecular target agents, especially antiangiogenic agents, has shown moderate results against some types of sarcoma, such as the alveolar soft part sarcoma. Several clinical trials utilizing immunotherapy, including T-cell receptor gene therapy and immune checkpoint inhibitors, in sarcomas are under progress. By clarifying the tumor microenvironment and biomarker-predictive capacity of immunotherapy in sarcomas, better clinical trials can be designed; this could lead to improved outcomes for immunotherapy in sarcoma.

DOI： 10.1093/jjco/hyab005

Placement of an anatomic tibial tunnel significantly improves the medial meniscus posterior extrusion at 90° of knee flexion following medial meniscus posterior root pullout repair. International journal

Yusuke Kamatsuki, Takayuki Furumatsu, Takaaki Hiranaka, Yoshiki Okazaki, Yuki Okazaki, Yuya Kodama, Tomohito Hino, Shin Masuda, Shinichi Miyazawa, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 4 ) 1025 - 1034 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: The purpose of this study was to evaluate the influence of tibial tunnel position in pullout repair for a medial meniscus (MM) posterior root tear (MMPRT) on postoperative MM extrusion. METHODS: Thirty patients (median age 63 years, range 35-72 years) who underwent transtibial pullout repairs for MMPRTs were included. Three-dimensional computed tomography images of the tibial surface were evaluated using a rectangular measurement grid for assessment of tibial tunnel position and MM posterior root attachment. Preoperative and postoperative MM medial extrusion (MMME) and posterior extrusion (MMPE) at 10° and 90° knee flexion were measured using open magnetic resonance imaging. RESULTS: Tibial tunnel centers were located more anteriorly and more medially than the anatomic center (median distance 5.8 mm, range 0-9.3 mm). The postoperative MMPE at 90° knee flexion was significantly reduced after pullout repair, although there was no significant reduction in MMME or MMPE at 10° knee flexion after surgery. In the correlation analysis of the displacement between the anatomic center to the tibial tunnel center and improvements in MMME, and MMPE at 10° and 90° knee flexion, there was a significant positive correlation between percentage distance and improvement of MMPE at 90° knee flexion. CONCLUSION: This study demonstrated that the nearer the tibial tunnel position to the anatomic attachment of the MM posterior root, the more effective the reduction in MMPE at 90° knee flexion. Our results emphasize that an anatomic tibial tunnel should be created in the MM posterior root to improve the postoperative MMPE and protect the articular cartilage in a knee flexion position. Placement of an anatomic tibial tunnel significantly improves the MMPE at 90° of knee flexion after MM posterior root pullout repair. LEVEL OF EVIDENCE: IV.

DOI： 10.1007/s00167-020-06070-w

Steep posterior slope of the medial tibial plateau is associated with ramp lesions of the medial meniscus and a concomitant anterior cruciate ligament injury. International journal

Yuki Okazaki, Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology 24 23 - 28 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Background: Medial meniscus (MM) tears are associated with both acute and chronic anterior cruciate ligament (ACL) insufficiency and can lead to degenerative changes in the knee. ACL reconstruction (ACLR) combined with the meniscal repair was reported to result in decreased anterior knee joint laxity with evidence of improved patient-reported outcomes in the long term. However, a subtle tear of the MM posterior segment, also known as a ramp lesion, is difficult to detect on conventional magnetic resonance imaging (MRI) and is frequently missed in ACL-deficient knees. However, there are few studies about the associations between bone geometry and ramp lesion of the MM. This study aimed to compare sagittal medial tibial slope (MTS), medial tibial plateau depth (MTPD), and coronal tibial slope (CTS) between ACL-injured knees with and without ramp lesion of the MM. We hypothesised that patients with ramp lesion of the MM and a concomitant ACL injury have a steeper MTS and shallower MTPD than those without ramp lesion of the MM. Methods: Twenty-seven patients who underwent ACLR (group A), and 15 patients with combined MM repair (group AM) were included in the study. Anterior tibial translation (ATT) was measured under general anaesthesia just before surgery using a knee arthrometer. MRI was performed in the 10°-knee-flexed position. The MTS and MTPD were measured on sagittal view, and the CTS was measured on coronal view. These parameters were compared between the groups. Differences in MRI measurements or patient demographics between the groups were evaluated using the Mann-Whitney U test. Results: No significant difference was observed in demographic data and post-operative side-to-side difference in ATT between both groups. Pre-operative ATT was significantly higher in group AM than in group A (P < 0.05), whereas post-operative ATT was similar in both groups. Further, Pre-operative ATT was significantly higher in patients with MTS ≥5.0° than in those with MTS <5.0° (P < 0.05). In groups A and AM, the MTS were 3.6° ± 1.8° and 6.2° ± 2.9°, the MTPD were 2.0 ± 0.5 mm and 2.1 ± 0.6 mm, and the CTS were 2.5° ± 1.8° and 2.4° ± 1.6°, respectively. Patients in group AM had a significantly steeper MTS compared to those in group A (P < 0.01), whereas MTPD and CTS were nearly the same in both groups. When the MTS cut-off value was set at 5.0°, the sensitivity and specificity for ACL injury with concomitant ramp lesion of the MM were 0.73 and 0.76, respectively. Conclusion: A steep posterior slope of the medial tibial plateau is a risk factor for ramp lesion of the MM associated with an ACL injury. Especially in patients with MTS ≥5.0°, an occult MM ramp lesion should be strongly suspected, and surgeons should prepare for MM repair in combination with ACLR.

DOI： 10.1016/j.asmart.2021.01.005

Knee Flexion-induced Translation of Pullout Sutures Used in the Repair of Medial Meniscus Posterior Root Tears.

Haowei Xue, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Keisuke Kintaka, Masataka Fujii, Ximing Zhang, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 147 - 152 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Medial meniscus posterior root tears (MMPRTs) have recently attracted considerable interest in orthopedics. To date, no in vivo human study has investigated suture translation changes in repaired MMPRTs with different degrees of knee flexion. This study examined suture translation at various degrees of knee flexion in 30 patients undergoing medial meniscus posterior root repair using the modified Mason-Allen suture technique between August 2016 and September 2017. Intraoperatively, sutures were provisionally fixed to an isometric positioner at the tibial site of the desired meniscal attachment, and the suture translation was measured at 0°, 30°, 60°, and 90° of knee flexion. The results showed significant increases in mean suture translation at the knee flexion positions from 0° to 30°, 30° to 60°, and 60° to 90° (p<0.01 for all). Our findings indicate that surgeons should carefully assess the degree of knee flexion at the moment when the meniscus is refixed by surgical sutures.

DOI： 10.18926/AMO/61881

Maximal Resection of Intramedullary Lipoma Using Intraoperative Ultrasonography: A Technical Note.

Haruo Misawa, Yoshiaki Oda, Kentaro Yamane, Tomoko Tetsunaga, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 239 - 242 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

One of the problems during surgery for intramedullary lipoma is the ambiguous boundary between the lipoma and the spinal cord, resulting in either incomplete resection or damage to the spinal cord. We report a case of intramedullary lipoma resection on a 61-year-old man in which the boundary between the tumor and spinal cord was repeatedly visualized with intraoperative ultrasonography. We focused on the distinctive features of fat as hyperechoic, in contrast to low-echo neural tissue. Subtotal resection of the tumor was achieved without any aggravation of neurological symptoms. Intraoperative ultrasonography may be useful for confirming tumor boundaries during intramedullary lipoma resection.

DOI： 10.18926/AMO/61907

Histological Analysis of Repaired Tissue after Pullout Repair of a Medial Meniscus Posterior Root Tear.

Haowei Xue, Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Keisuke Kintaka, Ximing Zhang, Aki Yoshida, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 225 - 230 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

A 65-year-old man presented with a left medial meniscus (MM) posterior root tear (PRT). Unicompartmental knee arthroplasty was performed 12 months after transtibial pullout repair of the MMPRT. Repaired MM posterior root tissue was subjected to histological analysis. Immunostaining and picrosirius red staining showed sufficient deposition of type I collagen, and hematoxylin-eosin staining using a polarized microscope showed well-aligned fiber orientation in the repaired tissue. The repaired posterior root (post-transtibial pullout repair) showed mature and well-aligned ligament-like tissue. Preserving the MM posterior root remnant to mimic the original posterior root tissue might be useful when performing pullout repair.

DOI： 10.18926/AMO/61905

Osteosynthesis for Geriatric Acetabular Fractures: An Epidemiological and Clinico-Radiological Study Related to Marginal or Roof Impaction.

Madoka Inoue, Tomoyuki Noda, Takenori Uehara, Tomonori Tetsunaga, Kazuki Yamada, Taichi Saito, Yasunori Shimamura, Yasuaki Yamakawa, Toshifumi Ozaki

Acta medica Okayama 75 ( 2 ) 177 - 185 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

This retrospective study sought to elucidate the incidence rates of roof impaction (RI) and marginal impaction (MI) and radiological and clinical outcomes of open reduction and internal fixation (ORIF) for RI and MI in geriatric acetabular fractures. The cases of 68 patients aged ≥ 65 years (mean 71 years) treated with ORIF were analyzed. MI was present in 12 fractures (67%) and an RI of the weight-bearing surface was present in 24 (46%) of the potential fracture types. Regarding the reduction quality, 54% of the reductions were graded as anatomical, 37% as imperfect, and 9% as poor. In the clinical evaluations of the 45 patients who had > 1-year follow-up (follow-up rate: 66.2%), 18% were graded as excellent, 53% as good, 16% as fair, and 13% as poor. An anatomic reduction was strongly associated with good or excellent clinical and radiological outcomes. CT was superior to radiographs for detecting the residual displacement postoperatively. Postoperative deep infection occurred in four patients. Three patients (6.7%) underwent a total hip arthroplasty conversion due to secondary osteoarthritis of the hip. We recommend ORIF as the preferred surgical treatment option for displaced acetabular fractures in elderly patients.

DOI： 10.18926/AMO/61895

Steep medial tibial slope and prolonged delay to surgery are associated with bilateral medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Tadashi Yamawaki, Yoshiki Okazaki, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 4 ) 1052 - 1057 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Contralateral medial meniscus posterior root tear (MMPRT) can sometimes occur after primary surgeries for MMPRT and lead to unsatisfactory outcomes. The incidence rate and risk factors for contralateral MMPRT have not been well investigated, despite their clinical importance. Therefore, the incidence and predictors of bilateral MMPRT were aimed to be evaluated. METHODS: Fourteen patients with bilateral MMPRT (group B) and 169 patients with unilateral MMPRT (group U) were enrolled in this study. Sex, age, body mass index, time between injury and surgery, and medial tibial slope angle (MTSA) were compared between the groups. MTSA was measured using lateral radiographs. RESULTS: The incidence rate of bilateral MMPRT was 6.2% among all patients with MMPRTs. Multivariate logistic regression analysis showed that a prolonged time between injury and surgery (odds ratio [OR], 1.0; 95% confidence interval [CI] 1.00-1.01; P < 0.05) and steeper MTSA (OR, 1.85; 95% CI 1.21-2.64; P < 0.01) were significantly associated with the development of bilateral MMPRT. Receiver operating characteristic curve analysis showed that MTSA > 10.0° was associated with bilateral MMPRT, with a sensitivity of 93% and specificity of 69%. CONCLUSION: A longer time between injury and surgery and steeper MTSA were risk factors for the development of bilateral MMPRT. Surgeons need to pay close attention to the contralateral knee in addition to the primary injured knees when treating knees with steep MTSA. Besides, early meniscal repair of primary MMPRT would be important to prevent the events of contralateral MMPRT. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-020-06079-1

Intraarticular lengths of double-bundle grafts can change during knee flexion: Intraoperative measurements in anatomic anterior cruciate ligament reconstructions. International journal

Takayuki Furumatsu, Takaaki Hiranaka, Yuya Kodama, Yusuke Kamatsuki, Yuki Okazaki, Tadashi Yamawaki, Hirosuke Endo, Toshifumi Ozaki

Orthopaedics & traumatology, surgery & research : OTSR 107 ( 2 ) 102816 - 102816 2021.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The lengths of the anteromedial bundle (AMB) and posterolateral bundle (PLB) change during knee motion in double-bundle anterior cruciate ligament (ACL) reconstruction. However, the actual intraarticular graft length would be affected by the bone tunnel position and tunnel creation angle during ACL reconstruction. The aim of this study was to investigate the intraarticular length change of the AMB and PLB in patients who underwent anatomic double-bundle ACL reconstruction. HYPOTHESIS: We hypothesized that the PLB would show a more dynamic length change pattern than the AMB during knee flexion at ACL reconstruction. METHODS: Thirty-two patients (16 men and 16 women) who had isolated ACL injuries with intact menisci were investigated. Anatomic double-bundle ACL reconstructions were performed using semitendinosus tendon autografts at a mean age of 30.6 years. The graft and tunnel lengths were measured intraoperatively. Intraarticular graft lengths and length changes were calculated at 0° and 90° of knee flexion during ACL reconstruction. Intraoperative data were collected prospectively, and analyses were performed retrospectively. RESULTS: The intraarticular length of the AMB at 0° of knee flexion was 28.1±5.5mm. At 90° of knee flexion, the AMB intraarticular length decreased to 25.6±4.8mm. The intraarticular length of the PLB decreased to 17.7±4.6mm at 90° of knee flexion compared to 22.0±4.2mm at 0° of knee flexion. Changes in the intraarticular graft length during knee flexion were detected more in the PLB (4.1mm) than in the AMB (2.0mm, p=0.01). DISCUSSION: This study demonstrated that the intraarticular length change of the PLB during knee motion was larger than that of the AMB in anatomic double-bundle ACL reconstructions with semitendinosus tendon autografts and suspensory femoral fixation devices. LEVEL OF EVIDENCE: IV; retrospective cohort study.

DOI： 10.1016/j.otsr.2021.102816

Correction to: Steep medial tibial slope and prolonged delay to surgery are associated with bilateral medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yuki Okazaki, Tadashi Yamawaki, Yoshiki Okazaki, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 4 ) 1058 - 1058 2021.4

当科における切断指治療の現状

松橋美波, 齋藤太一, 堀田佳史, 島村安則, 渡邊敏之, 長谷川健二郎, 尾崎敏文

日本手外科学会雑誌 38 ( 1 ) O43 - 11 2021.4

当科における切断指治療の現状

松橋美波, 齋藤太一, 堀田佳史, 島村安則, 渡邊敏之, 長谷川健二郎, 尾崎敏文

日本手外科学会雑誌 38 ( 1 ) O43 - 11 2021.4

手根管症候群患者に対する神経伝導検査の術後成績予後予測能の検討

斎藤太一, 伊勢真人, 堀田佳史, 根津智史, 松橋美波, 島村安則, 西田圭一郎, 尾崎敏文

日本手外科学会雑誌 38 ( 1 ) O23 - 34 2021.4

Medial meniscus posterior root repair reduces the extruded meniscus volume during knee flexion with favorable clinical outcome. International journal

Ximing Zhang, Takayuki Furumatsu, Yoshiki Okazaki, Yuki Okazaki, Takaaki Hiranaka, Haowei Xue, Keisuke Kintaka, Takatsugu Yamauchi, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: The volume of medial meniscus (MM) extrusion at 10° and 90° knee flexions using three-dimensional (3D) magnetic resonance imaging (MRI) and assessed relevant clinical outcomes at 1-year follow-up were evaluated. METHODS: Twenty-four patients who underwent MM posterior root repair were retrospectively reviewed. At 10° and 90° knee flexions, the meniscal extrusion distance and volume were measured using 3D meniscus models constructed by SYNAPSE VINCENT®. The correlation between Knee Injury and Osteoarthritis Outcome Score, Lysholm, International Knee Documentation Committee scores, Tegner activity, and pain visual analog scales and changes in MM extrusion were assessed. RESULTS: No significant differences in the MM medial extrusion were observed between 10° and 90° knee flexions postoperatively. MM posterior extrusion (MMPE) decreased significantly at 10° and 90° knee flexions postoperatively. At 90° knee flexion, the meniscus volume at the intra-tibial surface increased at 3 and 12 months postoperatively. The MM extrusion volume increased slightly at 10° knee flexion; however, the volume decreased significantly at 90° knee flexion postoperatively. The change in MMPE significantly correlated with clinical scores. All 12-month clinical scores were significantly improved compared to preoperative scores. CONCLUSIONS: The progression of meniscus posterior extrusion and reduction of its volume at 90° knee flexion can be suppressed by MM posterior root repair. Postoperative clinical scores correlated with reductions of the posterior extrusion. Regarding clinical relevance, the dynamic stability of the meniscus can be maintained by MM posterior root repair, which is an effective therapeutic method for improving its clinical status. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1007/s00167-021-06505-y

Role of Tumor-Associated Macrophages in Sarcomas. International journal

Tomohiro Fujiwara, John Healey, Koichi Ogura, Aki Yoshida, Hiroya Kondo, Toshiaki Hata, Miho Kure, Hiroshi Tazawa, Eiji Nakata, Toshiyuki Kunisada, Toshiyoshi Fujiwara, Toshifumi Ozaki

Cancers 13 ( 5 ) 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Sarcomas are complex tissues in which sarcoma cells maintain intricate interactions with their tumor microenvironment. Tumor-associated macrophages (TAMs) are a major component of tumor-infiltrating immune cells in the tumor microenvironment and have a dominant role as orchestrators of tumor-related inflammation. TAMs promote tumor growth and metastasis, stimulate angiogenesis, mediate immune suppression, and limit the antitumor activity of conventional chemotherapy and radiotherapy. Evidence suggests that the increased infiltration of TAMs and elevated expression of macrophage-related genes are associated with poor prognoses in most solid tumors, whereas evidence of this in sarcomas is limited. Based on these findings, TAM-targeted therapeutic strategies, such as inhibition of CSF-1/CSF-1R, CCL2/CCR2, and CD47/SIRPα, have been developed and are currently being evaluated in clinical trials. While most of the therapeutic challenges that target sarcoma cells have been unsuccessful and the prognosis of sarcomas has plateaued since the 1990s, several clinical trials of these strategies have yielded promising results and warrant further investigation to determine their translational benefit in sarcoma patients. This review summarizes the roles of TAMs in sarcomas and provides a rationale and update of TAM-targeted therapy as a novel treatment approach for sarcomas.

DOI： 10.3390/cancers13051086

Differences between the root and horn cells of the human medial meniscus from the osteoarthritic knee in cellular characteristics and responses to mechanical stress.

Yuki Okazaki, Takayuki Furumatsu, Yusuke Kamatsuki, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Taichi Saito, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 230 - 236 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Many histological, mechanical, and clinical studies have been performed on the medial meniscus posterior root attachment, as it often tears in patients with osteoarthritic knee. Medial meniscal root repair is recommended in clinical situations; however, to date, no studies have examined the differences between meniscal root and horn cells. The aim of this study was, therefore, to investigate the morphology, reaction to cyclic tensile strain, and gene expression levels of medial meniscal root and horn cells. METHODS: Meniscal samples were obtained from the medial knee compartments of 10 patients with osteoarthritis who underwent total knee arthroplasty. Root and horn cells were cultured in Dulbecco's modified Eagle's medium without enzymes. The morphology, distribution, and proliferation of medial meniscal root and horn cells, as well as the gene and protein expression levels of Sry-type HMG box 9 and type II collagen, were determined after cyclic tensile strain treatment. RESULTS: Horn cells had a triangular morphology, whereas root cells were fibroblast-like. The number of horn cells positive for Sry-type HMG box 9 and type II collagen was considerably higher than that of root cells. Although root and horn cells showed similar levels of proliferation after 48, 72, or 96 h of culture, more horn cells than root cells were lost following a 2-h treatment with 5% and 10% cyclic tensile. Sry-type HMG box 9 and α1(II) collagen mRNA expression levels were significantly enhanced in both cells after 2- and 4-h cyclic tensile strain (5%) treatment. CONCLUSIONS: Medial meniscal root and horn cells have distinct morphologies, reactions to mechanical stress, and cellular phenotypes. Our results suggest that physiological tensile strain is important to activate extracellular matrix production in horn cells.

DOI： 10.1016/j.jos.2020.02.015

Radiological findings and outcomes of anterior wall fractures in pertrochanteric fractures.

Norio Yamamoto, Ryu Tamura, Tomoo Inoue, Tomoyuki Noda, Hiroshi Nagano, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 247 - 253 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Anterior wall fractures with comminution at the anterior cortex in pertrochanteric fractures are relatively rare. We aimed to investigate the prevalence and clinical findings of anterior wall fractures in this comparative cohort study. METHODS: We reviewed 516 consecutive patients who underwent internal fixation. Anterior wall fractures were classified into three types: proximal, distal, and proximal/distal. Outcome measures included demographic data, residual anterior cortex length, fracture reduction, tip-apex distance (TAD), sliding distance, bone union, and revision surgery. We compared radiological outcomes between patients with anterior wall fractures and posterior comminuted fractures without an anterior wall fracture. The groups were matched for age and sex. RESULTS: Anterior wall fractures were noted in 44 patients (8.5%). Residual anterior cortex length was shorter for the proximal/distal type. The distal type was the most common, was the most difficult to achieve an acceptable reduction status for, and was associated with the longest sliding distance. The proportion of unacceptable reduction status was higher for anterior wall fractures. However, there were no statistically significant differences between anterior wall fractures and posterior comminuted fractures without an anterior wall fracture in terms of TAD, sliding distance, bone union, and revision rate. CONCLUSIONS: This study suggests that anterior wall fracture is not a significant predictor of over-sliding distance.

DOI： 10.1016/j.jos.2020.02.020

関節リウマチ超音波検査におけるデジタルカメラ画像とAIを用いたボディーマーク付与

中原龍一, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 555 - 555 2021.3

Prognostic and therapeutic factors influencing the clinical outcome of metastatic Ewing sarcoma family of tumors: A retrospective report from the Japan Ewing Sarcoma Study Group. International journal

Katsutsugu Umeda, Takako Miyamura, Kenji Yamada, Hideki Sano, Ako Hosono, Minako Sumi, Hajime Okita, Takuya Kamio, Naoko Maeda, Hiroyuki Fujisaki, Ryoji Jyoko, Atsuko Watanabe, Yosuke Hosoya, Daiichiro Hasegawa, Satoshi Takenaka, Shunsuke Nakagawa, Motoaki Chin, Toshifumi Ozaki

Pediatric blood & cancer 68 ( 3 ) e28844 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The prognosis of patients with metastatic Ewing sarcoma family of tumors (ESFT) remains poor. PROCEDURE: We retrospectively analyzed 57 patients diagnosed with metastatic ESFT between 2000 and 2018 to identify prognostic and therapeutic factors affecting the clinical outcome. RESULTS: The 3-year overall survival (OS) rate of the entire cohort was 46.8% (95% confidence interval [CI], 33.0-59.4%). Treatment-related death was not observed. Multivariate analysis identified stem cell transplantation (SCT), response to first-line chemotherapy, and bone metastasis as independent risk factors for OS. Objective response rate to first-line chemotherapy was 65.1% in the 43 evaluable patients. There was no significant difference in the response to different types of first-line chemotherapy. Among patients with lung metastasis alone, the 3-year OS rate was higher in 13 patients who received local treatment than in four who did not, although the difference was not significant. CONCLUSIONS: One possible reason for the high OS rates was the absence of treatment-related mortality even in patients receiving SCT, which could be attributed to advances in the management of post-SCT complications. Novel first-line chemotherapy strategies need to be established to improve the disease status prior to SCT in a higher proportion of patients.

DOI： 10.1002/pbc.28844

大腿骨頸部前捻角に左右差はあるか 3D計測による検討

佐藤浩平, 野田知之, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1125 - S1125 2021.3

不安定型骨盤輪損傷に対するCTナビゲーションガイド下スクリュー固定の治療成績

上原健敬, 野田知之, 畑利彰, 佐藤浩平, 近藤宏也, 齋藤太一, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1116 - S1116 2021.3

寛骨臼骨折におけるroof-arc angle計測の妥当性の検討単純X線写真計測と3D計測の比較と術後臨床評価との関連性

近藤宏也, 上原健敬, 佐藤浩平, 畑利彰, 根津智史, 松橋美波, 齋藤太一, 島村安則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1116 - S1116 2021.3

The trend of treatment and conveyance system for upper extremity replantation in Japan: A nationwide population-based study from the Japan trauma data bank.

Taichi Saito, Satoshi Nezu, Minami Matsuhashi, Ryuichi Nakahara, Yasunori Shimamura, Tomoyuki Noda, Tetsuya Yumoto, Atsunori Nakao, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 271 - 275 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: In Japan, microsurgical skill development and a system to transfer patients to an appropriate hospital for upper extremity amputation have been promoted; however, information about trends of replantation is limited. Therefore, the aim of this study was to clarify the trends in the treatment for upper extremity amputation using the Japan Trauma Data Bank (JTDB). METHODS: Data derived from JTDB (2004-2015) were used to quantify trends in the volume of replantation for upper extremity amputation including finger amputation. Trauma was diagnosed based on the Abbreviated Injury Scale code; a subgroup of patients who underwent replantation was delineated. We investigated patient demographics, infection rate, and characteristics of treating facilities. RESULTS: A total of 1240 patients underwent upper extremity amputation. Among these, 510 (41.1%) underwent replantation, and the rate of replantation did not change over the study period. The average age of patients who underwent or did not undergo replantation was 45.5 and 47.2 years, respectively. The proportion of the patients who were transferred to another hospital for treatment significantly decreased between 2004 (28.5%) and 2015 (16.3%) (P < 0.01). Time taken for transfer from the accident site to hospitals increased. The rate of patients who underwent replantation differed among different hospitals; however, higher-volume hospitals were more likely to perform replantation. CONCLUSION: The rate of patients transferred to another hospital decreased between 2004 and 2015; however, the rate of patients who underwent replantation remained unchanged. This suggests that the number of patients who were transported directly from the accident site to an appropriate hospital has increased, whereas the indication for care in each hospital remains unchanged. Common criteria for amputations are needed to address the differing rates of replantation among hospitals.

DOI： 10.1016/j.jos.2020.03.006

An MRI-based suspension bridge sign can predict an arthroscopically favorable meniscal healing following the medial meniscus posterior root repair.

Takayuki Furumatsu, Yuki Okazaki, Takaaki Hiranaka, Yuya Kodama, Yusuke Kamatsuki, Yoshiki Okazaki, Ximing Zhang, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 2 ) 237 - 242 2021.3

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Medial meniscus (MM) posterior root repairs show favorable clinical outcomes in patients with MM posterior root tears (MMPRTs). However, there is no useful magnetic resonance imaging (MRI) finding to determine a functionally good meniscal healing following MM posterior root repairs. We hypothesized that a characteristic postoperative MRI finding can predict a good meniscal healing following pullout repairs. The aim of this study was to investigate a clinical usefulness of several MRI findings for estimating an actual meniscal healing following MMPRT repairs. METHODS: Fifty eight patients who had a posteromedial painful popping of the injured knee and underwent an arthroscopic pullout repair for the MMPRT were included. Arthroscopic meniscal healing was assessed according to the Furumatsu scoring system at 1 year postoperatively. We evaluated postoperative MRI-based meniscal healing using signal intensity, continuity, suspension bridge-like sign of the MM posterior root, and MM medial extrusion on coronal images. Postoperative clinical outcome evaluations were performed at second-look arthroscopy. RESULTS: Twenty three patients showed good arthroscopic healing scores (≥7 points). Thirty five patients had moderate/poor arthroscopic healing scores (<7 points). At 1-year follow-up period, clinical outcome scores were significantly higher in the good healing group than in the moderate/poor healing group. A characteristic meniscal shape, termed "suspension bridge sign", was highly observed in the good meniscal healing group (83%) compared with in the moderate/poor healing group (26%, P < 0.001). High signal intensity and continuity of the MM posterior root and MM medial extrusion showed no differences between both groups. CONCLUSIONS: Our study demonstrated that the MRI-based suspension bridge sign can predict an arthroscopically favorable meniscal healing following the MM posterior root repair. The suspension bridge-like MRI finding of the MM would be a useful indicator to evaluate the actual meniscal healing in patients who underwent pullout repairs for MMPRTs.

DOI： 10.1016/j.jos.2020.03.012

生物学的製剤と手術当科におけるリウマチ外科手術1569例の患者背景

那須義久, 堀田佳史, 渡辺雅仁, 松橋美波, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 343 - 343 2021.3

慢性疼痛患者におけるロコモティブシンドローム有病率とその特徴

辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S934 - S934 2021.3

慢性疼痛患者の自己効力感は介護者の介護負担度に影響を与える

辻寛謙, 鉄永倫子, 鉄永智紀, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S919 - S919 2021.3

寛骨臼回転骨切り術前後での三次元的大腿骨頭移動はADLに影響するか

鉄永智紀, 山田和希, 佐藤嘉洋, 廣瀬一樹, 鉄永倫子, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S972 - S972 2021.3

成人脊椎変形術後の固定隣接椎体骨折に術前胸椎CTハンスフィールド値が与える影響

山根健太郎, 三澤治夫, 小田孔明, 鉄永倫子, 辻寛謙, 高尾真一郎, 梶木裕矢, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1012 - S1012 2021.3

不安定型骨盤輪損傷に対するCTナビゲーションガイド下スクリュー固定の治療成績

上原健敬, 野田知之, 畑利彰, 佐藤浩平, 近藤宏也, 齋藤太一, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1116 - S1116 2021.3

寛骨臼骨折におけるroof-arc angle計測の妥当性の検討単純X線写真計測と3D計測の比較と術後臨床評価との関連性

近藤宏也, 上原健敬, 佐藤浩平, 畑利彰, 根津智史, 松橋美波, 齋藤太一, 島村安則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1116 - S1116 2021.3

若手整形外科医が知っておくべき骨折治療法下肢骨折に対するプレート固定の適応と限界

野田知之, 上原健敬, 島村安則, 佐藤浩平, 畑利彰, 近藤宏也, 根津智史, 松橋美波, 齋藤太一, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S573 - S573 2021.3

大腿骨頸部前捻角に左右差はあるか 3D計測による検討

佐藤浩平, 野田知之, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1125 - S1125 2021.3

Growing rod挿入術の矯正率予想

小田孔明, 三澤治夫, 山根健太郎, 鉄永倫子, 辻寛謙, 高尾真一郎, 梶木裕矢, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1022 - S1022 2021.3

骨折を伴ったリウマチ肘に対するPROSNAPを用いた人工肘関節全置換術の治療成績

堀田佳史, 西田圭一郎, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 602 - 602 2021.3

関節リウマチ超音波検査におけるデジタルカメラ画像とAIを用いたボディーマーク付与

中原龍一, 西田圭一郎, 那須義久, 渡辺雅仁, 松橋美波, 堀田佳史, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 555 - 555 2021.3

生物学的製剤と手術当科におけるリウマチ外科手術1569例の患者背景

那須義久, 堀田佳史, 渡辺雅仁, 松橋美波, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 65回 343 - 343 2021.3

Medial meniscus posterior root repairs: A comparison among three surgical techniques in short-term clinical outcomes and arthroscopic meniscal healing scores.

Takayuki Furumatsu, Takaaki Hiranaka, Yuki Okazaki, Keisuke Kintaka, Yuya Kodama, Yusuke Kamatsuki, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2021.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Medial meniscus (MM) posterior root repairs lead to favorable clinical outcomes in patients with MM posterior root tears (MMPRTs). However, there are few comparative studies in evaluating the superiority among several pullout repair techniques such as modified Mason-Allen suture, simple stitch, and concomitant posteromedial pullout repair. We hypothesized that an additional pullout suture at the MM posteromedial part would have clinical advantages in transtibial pullout repairs of the MMPRTs. The aim of this study was to compare the clinical usefulness among several types of pullout repair techniques in patients with MMPRTs. METHODS: Eighty-three patients who underwent arthroscopic pullout repairs of the MMPRTs were investigated. Patients were divided into three groups using different pullout repair techniques: a modified Mason-Allen suture using FasT-Fix all-inside meniscal repair device (F-MMA, n = 28), two simple stitches (TSS, n = 30), and TSS concomitant with posteromedial pullout repair using all-inside meniscal repair device (TSS-PM, n = 25). Postoperative clinical outcomes and semi-quantitative arthroscopic meniscal healing scores (0-10 points) were evaluated at second-look arthroscopies. RESULTS: No significant differences among the three groups were observed in patient demographics and preoperative clinical scores, except for preoperative Lysholm scores. At second-look arthroscopies, there were no significant differences among the three techniques in postoperative clinical outcomes and meniscal healing scores. CONCLUSIONS: This study demonstrated that the TSS-PM pullout repair technique did not show better scores in postoperative clinical outcomes and meniscal healings compared with the F-MMA and TSS techniques. Our results suggest that the concomitant posteromedial pullout suture may have no clinical advantage in the conventional pullout repairs for the patients with MMPRTs.

DOI： 10.1016/j.jos.2020.11.013

Adjuvant and neoadjuvant chemotherapy for soft tissue sarcomas: JCOG Bone and Soft Tissue Tumor Study Group. International journal

Kazuhiro Tanaka, Toshifumi Ozaki

Japanese journal of clinical oncology 51 ( 2 ) 180 - 184 2021.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

The standard therapy for all localized soft tissue sarcomas is surgical resection of the tumor. For patients with soft tissue sarcomas who are at high risk for recurrence and/or metastasis, perioperative chemotherapy is a potential treatment option. Adriamycin plus ifosfamide is currently the most promising chemotherapy regimen for localized soft tissue sarcomas. Randomized controlled trials and meta-analyses of adjuvant postoperative chemotherapy for soft tissue sarcomas have suggested that adjuvant chemotherapy may provide an advantage, however small, compared with surgery alone. On the other hand, recent randomized trials have demonstrated the efficacy of neoadjuvant preoperative chemotherapy using full-dose anthracycline plus ifosfamide for high-risk soft tissue sarcomas and showed survival benefits in patients with large, deep-seated and high-grade soft tissue sarcomas of the trunk and extremities. In this review, adjuvant and neoadjuvant chemotherapies for soft tissue sarcomas and future perspectives are discussed.

DOI： 10.1093/jjco/hyaa231

Bipolar Hip Arthroplasty Using a Conjoined Tendon-preserving Posterior Approach in Geriatric Patients.

Tomonori Tetsunaga, Tomoko Tetsunaga, Kazuki Yamada, Tomoaki Sanki, Yoshi Kawamura, Toshifumi Ozaki

Acta medica Okayama 75 ( 1 ) 25 - 30 2021.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

In bipolar hemiarthroplasty (BHA), it is important to preserve soft tissue to reduce the risk of postoperative dislocation. A variety of surgical approaches for BHA are available, but extra care is needed with muscle- and tendon-preserving approaches in geriatric patients. We investigated the usefulness of BHA using a conjoined tendon-preserving posterior (CPP) approach, in which only the external obturator muscle is dissected, in geri-atric patients. We retrospectively analyzed the cases of 40 femoral neck fracture patients (10 men, 30 women) aged ≥ 80 years who underwent BHA using the CPP approach. The patients' average age was 85.8 years (80-94 years). We examined the operation time, bleeding, preservation of short external rotator muscles, complica-tions, and stem alignment and subsidence from postoperative radiographs. Although gemellus inferior muscle injury was detected in 4 patients (10%), the hip joint stability was very excellent in all cases. There was no intraoperative fracture or postoperative dislocation. On postoperative radiographs, all femoral stems were in a neutral position. There was no stem subsidence in all 40 patients. BHA using the CPP approach appeared to be useful even in geriatric patients.

DOI： 10.18926/AMO/61430

The Thickness of the Medial Wall of the Acetabulum Prevents Acetabular Fracture during the Insertion of a Cementless Cup in Total Hip Arthroplasty: A Biomechanical Study.

Tomoaki Sanki, Tomonori Tetsunaga, Takayuki Furumatsu, Kazuki Yamada, Yoshi Kawamura, Toshifumi Ozaki

Acta medica Okayama 75 ( 1 ) 71 - 77 2021.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Intra-operative acetabular fracture is a total hip arthroplasty complication that can occur during cementless cup insertion, especially in osteoporotic patients. We conducted this biomechanical study to investigate the impact resistance of the acetabulum with simulated bones of different density by drop-weight impact testing. Low- and high-density polyurethane foam blocks were used as osteoporotic and healthy bone models, respectively. Polyurethane blocks were used as the acetabular cancellous bone. Composite sheets were used as the acetabu-lum's medial cortex. The testing revealed that the osteoporotic bone model's impact resistance was significantly lower than that the healthy bone model'. In the healthy bone model, even thin acetabular cancellous bone with ≥ 1 mm acetabulum medial cortex was less likely to fracture. In the osteoporotic bone model, fracture was pos-sible without ≥ 1 mm medial cortex of the acetabulum and thick acetabular cancellous bone. Although impac-tion resistance differs due to bone quality, the impaction resistance in this osteoporotic bone model was equiv-alent to that healthy bone model's when a thick medial wall was present. To avoid intra-operative acetabulum fracture, surgeons should consider both the bone quality and the thicknesses of the medial cortex and acetabu-lar cancellous bone.

DOI： 10.18926/AMO/61437

Quantification of patellar tendon reflex using portable mechanomyography and electromyography devices. International journal

Hironori Tsuji, Haruo Misawa, Tomoyuki Takigawa, Tomoko Tetsunaga, Kentaro Yamane, Yoshiaki Oda, Toshifumi Ozaki

Scientific reports 11 ( 1 ) 2284 - 2284 2021.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Deep tendon reflexes are one of the main components of the clinical nervous system examinations. These assessments are inexpensive and quick. However, evaluation can be subjective and qualitative. This study aimed to objectively evaluate hyperreflexia of the patellar tendon reflex using portable mechanomyography (MMG) and electromyography (EMG) devices. This study included 10 preoperative patients (20 legs) who had a pathology that could cause bilateral patellar tendon hyperreflexia and 12 healthy volunteers (24 legs) with no prior history of neurological disorders. We attached MMG/EMG sensors onto the quadriceps and tapped the patellar tendon with maximal and constant force. Our results showed a significantly high amplitude of the root mean square (RMS) and low frequency of the mean power frequency (MPF) in the rectus femoris, vastus medialis, and vastus lateralis muscles in both EMG and MMG with both maximal and constant force. Especially in the patients with cervical and thoracic myelopathy, the receiver operating characteristic (ROC) curve for diagnosing hyperreflexia of the patellar tendon showed a moderate to very high area under the curve for all EMG-RMS, EMG-MPF, MMG-RMS, and MMG-MPF values. The use of EMG and MMG for objectively quantifying the patellar tendon reflex is simple and desirable for future clinical applications and could help diagnose neurological disorders.

DOI： 10.1038/s41598-021-81874-5

Chronic Pain Has Little Effect on Physical Condition During the COVID-19 Pandemic in Japan: A Web-based Cross-Sectional Survey

Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Hironori Tsuji, Toshifumi Ozaki, Takahiro Tabuchi

2021.1

Publisher：Research Square Platform LLC

<title>Abstract</title>
<bold><italic>Background</italic></bold> Chronic pain affects people negatively, both mentally and physically. It is unclear how chronic pain affects people during social isolation and remote work due to the COVID-19 pandemic. The aim of this study was to analyze the effect of chronic pain on life during the COVID-19 pandemic.<bold><italic>Methods</italic></bold> This retrospective study included 4,972 matched-participants with or without chronic pain (2,311 males, 2,661 females; mean age, 53.8 years). The participants were divided into a chronic pain group (<italic>n</italic>=2,486) and a control group (<italic>n</italic>=2,486). Participants with chronic pain for three months or more were classified into the chronic pain group. All participants completed self-reported questionnaires. Factors related to physical condition during the COVID-19 pandemic were identified by univariate and multivariate analyses.<bold><italic>Results</italic></bold> Significant differences were found between participants with and without chronic pain for the pain that developed during the COVID-19 pandemic, lifestyle, interpersonal relationships, psychological factors related to COVID-19, and deterioration of physical condition. Multiple logistic regression analysis identified insomnia, poor work/study/housework performance, and anxiety/depression as factors related to deterioration of physical condition. Chronic pain was not identified as factor related to deterioration of physical condition.<bold><italic>Conclusions </italic></bold>The effect of chronic pain on lifestyle and physical condition during the COVID-19 pandemic was limited. The factors related to deterioration of the physical condition were insomnia, poor work/study/housework performance, and anxiety/depression.

DOI： 10.21203/rs.3.rs-138931/v1

Other Link： https://www.researchsquare.com/article/rs-138931/v1.html

Accurate placement of a tibial tunnel significantly improves meniscal healing and clinical outcomes at 1 year after medial meniscus posterior root repair. International journal

Yusuke Kamatsuki, Takayuki Furumatsu, Takaaki Hiranaka, Yuki Okazaki, Yuya Kodama, Keisuke Kintaka, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2021.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: A medial meniscus posterior root tear results in the loss of meniscal circumferential hoop stress and causes a pathological posteromedial extrusion of the medial meniscus. Although creating a tibial tunnel in the anatomic place improves postoperative medial meniscus posterior extrusion, no studies have evaluated the relationship between tibial tunnel position and clinical outcomes. This study aimed to evaluate how tibial tunnel positioning of medial meniscus posterior root pullout repair affects meniscal healing status and clinical outcomes. METHODS: Sixty-two patients with 64 medial meniscus posterior root tears (mean age 62.8 ± 7.9 years) who had undergone pullout repairs and second-look arthroscopies were included. All 62 patients were Lachman test negative. Three-dimensional computed tomography images of the tibial surface were evaluated using a rectangular measurement grid to assess the tibial tunnel centre and medial meniscus posterior root attachment centre. Spearman's rank correlation analysis was undertaken to determine displacement distance from the medial meniscus posterior root attachment centre to the tibial tunnel centre and a meniscal healing score, as well as clinical outcomes at 1 year post-repair. RESULTS: Tibial tunnel centres were located more anteriorly and medially than the medial meniscus posterior root attachment centre (mean distance 5.0 ± 2.2 mm). The mean meniscal healing score was 6.7 ± 1.8 of 10 possible points. The 1-year postoperative clinical scores showed significant improvement compared with preoperative scores for all the items. There was a significant negative correlation in the absolute distance between the medial meniscus posterior root attachment centre and the tibial tunnel centre with the meniscal healing score (ρ = - 0.39, p = 0.002). Furthermore, there were significant positive correlations between the distance between the medial meniscus posterior root attachment centre and the tibial tunnel centre in the mediolateral direction and patient-based clinical outcomes (ρ = 0.25-0.43, p < 0.05). CONCLUSION: Accurate placement of a tibial tunnel, especially in the mediolateral direction, significantly improved meniscal healing and clinical outcomes at 1 year following medial meniscus posterior root repair. Surgeons should create a medial meniscus posterior root tibial tunnel at the anatomic attachment with particular attention to the mediolateral position. LEVEL OF EVIDENCE: Level IV.

DOI： 10.1007/s00167-020-06376-9

Phase II clinical trial of pazopanib for patients with unresectable or metastatic malignant peripheral nerve sheath tumors. International journal

Yoshihiro Nishida, Hiroshi Urakawa, Robert Nakayama, Eisuke Kobayashi, Toshifumi Ozaki, Keisuke Ae, Yoshihiro Matsumoto, Hiroyuki Tsuchiya, Takahiro Goto, Hiroaki Hiraga, Norifumi Naka, Shunji Takahashi, Yuichi Ando, Masahiko Ando, Yachiyo Kuwatsuka, Shunsuke Hamada, Takafumi Ueda, Akira Kawai

International journal of cancer 148 ( 1 ) 140 - 149 2021.1

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

Malignant peripheral nerve sheath tumor (MPNST) often does not respond well to chemotherapy and develops against a background of NF1. The purpose of our study was to examine the efficacy of pazopanib against MPNST. Our study was designed as a physician-initiated phase II clinical trial in patients with advanced MPNST. Patients were registered from 11 large hospitals. The primary endpoint was set to clarify the clinical benefit rate (CBR) at 12 weeks according to response evaluation criteria in solid tumors (RECIST). Progression-free survival (PFS), overall survival (OS) and the CBR based on modified Choi evaluation at week 12 were set as secondary endpoints along with treatment-related safety. The study enrolled 12 patients. Median age was 49 years. Seven had Grade 2 and five Grade 3 according to the FNCLCC evaluation. Median follow-up period was 10.6 months. CBR at 12 weeks was both 50.0% (RECIST and Choi). The median PFS was 5.4 months for both RECIST and Choi, and the median OS was 10.6 months. Of special interest, the median PFS was 2.9 months for patients with FNCLCC Grade 2 and 10.2 months for Grade 3 (both RECIST and Choi). Grade 4 adverse events of neutropenia and lipase elevation were noted in one patient each. The results of this pazopanib therapy were generally better than those of any of the other single molecular targeted therapies reported previously. Although accumulation of more cases remains necessary, we conclude pazopanib treatment for MPNST to be a safe and promising treatment after doxorubicin-based chemotherapy.

DOI： 10.1002/ijc.33201

Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears. International journal

Yuki Okazaki, Takayuki Furumatsu, Yuya Kodama, Yusuke Kamatsuki, Yoshiki Okazaki, Takaaki Hiranaka, Shota Takihira, Tomonori Tetsunaga, Kenta Saiga, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 29 ( 1 ) 44 - 50 2021.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Bone morphological factors are important for menisci. Their association with medial meniscus posterior root tears, however, has not yet been studied. This study aimed to compare sagittal medial tibial slope and medial tibial plateau depth between knees with and without medial meniscus posterior root tears. METHODS: Nine healthy volunteers, 24 patients who underwent anterior cruciate ligament reconstruction, and 36 patients who underwent medial meniscus posterior root pullout repair were included. Magnetic resonance imaging examinations were performed in the 10°-knee-flexed position. The medial tibial slope and medial tibial plateau depth were compared among the groups. RESULTS: In healthy volunteers, the anterior cruciate ligament reconstruction group, and the medial meniscus posterior root tear group, the medial tibial slopes were 3.5° ± 1.4°, 4.0° ± 1.9°, and 7.2° ± 1.9°, respectively, and the medial tibial plateau depths were 2.1 ± 0.7 mm, 2.2 ± 0.6 mm, and 1.2 ± 0.5 mm, respectively. Patients with medial meniscus posterior root tears had a significantly steep medial tibial slope and shallow medial tibial plateau concavity compared to those of healthy volunteers (P < 0.01) and the anterior cruciate ligament group (P < 0.01). In the multivariate logistic regression analysis, body mass index, medial tibial slope, and medial tibial plateau depth were significantly associated with medial meniscus posterior root tears. CONCLUSIONS: A steep posterior slope and a shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tear. LEVEL OF EVIDENCE: Level III: Case-control study.

DOI： 10.1007/s00167-019-05590-4

PRRX1 promotes malignant properties in human osteosarcoma. International journal

Ryoji Joko, Daisuke Yamada, Masahiro Nakamura, Aki Yoshida, Shota Takihira, Tomoka Takao, Ming Lu, Kohei Sato, Tatsuo Ito, Toshiyuki Kunisada, Eiji Nakata, Toshifumi Ozaki, Takeshi Takarada

Translational oncology 14 ( 1 ) 100960 - 100960 2021.1

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

Paired related homeobox 1 (PRRX1) is a marker of limb bud mesenchymal cells, and deficiency of p53 or Rb in Prrx1-positive cells induces osteosarcoma in several mouse models. However, the regulatory roles of PRRX1 in human osteosarcoma have not been defined. In this study, we performed PRRX1 immunostaining on 35 human osteosarcoma specimens to assess the correlation between PRRX1 level and overall survival. In patients with osteosarcoma, the expression level of PRRX1 positively correlated with poor prognosis or the ratio of lung metastasis. Additionally, we found PRRX1 expression on in 143B cells, a human osteosarcoma line with a high metastatic capacity. Downregulation of PRRX1 not only suppressed proliferation and invasion but also increased the sensitivity to cisplatin and doxorubicin. When 143B cells were subcutaneously transplanted into nude mice, PRRX1 knockdown decreased tumor sizes and rates of lung metastasis. Interestingly, forskolin, a chemical compound identified by Connectivity Map analysis using RNA expression signatures during PRRX1 knockdown, decreased tumor proliferation and cell migration to the same degree as PRRX1 knockdown. These results demonstrate that PRRX1 promotes tumor malignancy in human osteosarcoma.

DOI： 10.1016/j.tranon.2020.100960

Preoperative morphologic changes of the medial meniscus correlate with suture translations during knee flexion in pullout repair of medial meniscus posterior root tear. International journal

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

The Knee 28 346 - 353 2021.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Medial meniscus (MM) translates and extrudes posteriorly during knee flexion in MM posterior root tear (MMPRT) knees, and transtibial pullout repair of MMPRT has been performed to regulate the MM extrusion. This study aimed to calculate each suture translation during knee flexion in transtibial pullout repair of MMPRT, and to investigate the morphologic features of the MM that lead to longer suture translations during knee flexion. METHODS: Thirty patients with MMPRT who met the operative indication of pullout repair were enrolled and investigated prospectively. Pullout repair was performed by using two simple stitches (outer and inner sutures) and an all-inside suture in the posteromedial part of the MM. Each suture's translation from 0° to 90° of knee flexion was measured intraoperatively. The MM morphologic features, including MM medial extrusion (MMME) and MM posterior height (MMPH), were measured using preoperative magnetic resonance imaging, and the correlation between these values and each suture translation was evaluated. RESULTS: The average outer, inner, and all-inside suture translations were 4.8 mm, 3.9 mm, and 1.3 mm, respectively. Significant correlations were observed between the outer suture translation and MMME, and MMPH (p < 0.001 and <0.01, respectively). The thresholds for preoperative MMME and MMPH for longer outer suture translations (≥6 mm) were 2.1 mm and 5.4 mm, respectively. CONCLUSIONS: Preoperative longer MMME and higher MMPH were associated with longer meniscus translations during knee flexion during MMPRT repair.

DOI： 10.1016/j.knee.2020.12.020

RANKL expression in chondrocytes and its promotion by lymphotoxin-α in the course of cartilage destruction during rheumatoid arthritis. International journal

Ayumu Takeshita, Keiichiro Nishida, Aki Yoshida, Yoshihisa Nasu, Ryuichi Nakahara, Daisuke Kaneda, Hideki Ohashi, Toshifumi Ozaki

PloS one 16 ( 7 ) e0254268 2021

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

We investigated the expression and localization of the receptor activator nuclear factor κB ligand (RANKL) in cartilage from patients with rheumatoid arthritis (RA) of relevance to cartilage degeneration. We also examined the role of exogenous lymphotoxin (LT)-α on RANKL expression in human chondrocytes and its effect on in vitro osteoclast differentiation. Cartilage and synovial fluid samples were obtained from 45 patients undergoing total joint replacement surgery or joint puncture, including 24 patients with osteoarthritis (OA) and 21 patients with RA. RANKL expression in articular cartilage was examined by immunohistochemistry. LT-α concentrations in synovial fluid were measured using an enzyme-linked immunosorbent assay (ELISA). Normal human chondrocytes were stimulated with LT-α, and the relative mRNA levels of RANKL, osteoprotegerin (OPG), matrix metalloproteinase-9, and vascular endothelial growth factor were examined by real-time polymerase chain reaction. Soluble RANKL protein in culture media was measured using ELISA, and membrane-bound RANKL protein in cells was examined by western blotting. Co-cultures of human chondrocytes with peripheral blood mononuclear cells (PBMCs) were stimulated with macrophage-colony stimulating factor and LT-α, and osteoclast differentiation was evaluated by staining for tartrate-resistant acid phosphatase. LT-α concentrations were higher in RA synovial fluid than in OA samples. The population of RANKL-positive chondrocytes of RA cartilage was higher than that of OA cartilage, and correlated with cartilage degeneration. Stimulation of cultured human chondrocytes by LT-α increased RANKL expression, the RANKL/OPG ratio, and angiogenic factors. Membrane-bound RANKL in chondrocytes was up-regulated after stimulation of LT-α, whereas soluble RANKL in culture medium did not increase. Co-cultures of human chondrocytes and PBMCs demonstrated that LT-α stimulated human chondrocytes to produce RANKL and induced osteoclastic differentiation of PBMCs. RANKL produced by chondrocytes may contribute to cartilage destruction during RA and LT-α could promote the expression of RANKL in human chondrocytes.

DOI： 10.1371/journal.pone.0254268

BAPGAN: GAN-based Bone Age Progression of Femur and Phalange X-ray Images.

Shinji Nakazawa, Changhee Han, Joe Hasei, Ryuichi Nakahara, Toshifumi Ozaki

CoRR abs/2110.08509 2021

Radiographic and clinical assessment of unidirectional porous hydroxyapatite to treat benign bone tumors. International journal

Toshiyuki Kunisada, Joe Hasei, Tomohiro Fujiwara, Eiji Nakata, Suguru Yokoo, Koji Demiya, Toshifumi Ozaki

Scientific reports 10 ( 1 ) 21578 - 21578 2020.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Unidirectional porous hydroxyapatite (UDPHAp) was developed as an excellent scaffold with unidirectional pores oriented in the horizontal direction with interpore connections. The purpose of this study was to assess radiographic changes and clinical outcomes and complications following UDPHAp implantation to treat benign bone tumors. We retrospectively analyzed 44 patients treated with intralesional resection and UDPHAp implantation for benign bone tumors between 2010 and 2015. Clinical and radiographic findings were evaluated postoperatively at regular follow-up visits. The mean follow-up was 49 months. Radiographic changes were classified into five stages based on bone formation in the implanted UDPHAp according to Tamai's classification. All patients showed excellent bone formation inside and around implanted UDPHAp. Absorption of UDPHAp and bone marrow cavity remodeling was identified in 20 patients at a mean of 17 months postoperatively, and was significantly more common in young patients. Preoperative cortical thinning was completely regenerated in 26 of 31 patients on average 10 months after surgery. There were no cases of delayed wound healing, postoperative infection, or allergic reaction related to implanted UDPHAp. UDPHAp is a useful bone-filling substitute for treating benign bone tumor, and the use of this material has a low complication rate.

DOI： 10.1038/s41598-020-78409-9

Clinical Outcome of Patients with Recurrent/Refractory Localized Ewing's Sarcoma Family of Tumors: A Retrospective Report From the JESS Group

Katsutsugu Umeda, Takako Miyamura, Kenji Yamada, Ako Hosono, Hideki Sano, Minako Sumi, Hajime Okita, Yosuke Hosoya, Motoaki Chin, Toshifumi Ozaki

PEDIATRIC BLOOD & CANCER 67 2020.12

Clinical Outcome of Patients with Metastatic Ewing's Sarcoma Family of Tumors: A Retrospective Report From the JESS Group

Katsutsugu Umeda, Takako Miyamura, Ako Hosono, Hideki Sano, Minako Sumi, Hajime Okita, Yosuke Hosoya, Daiichiro Hasegawa, Motoaki Chin, Toshifumi Ozaki

PEDIATRIC BLOOD & CANCER 67 2020.12

Deep Learning for Osteoporosis Classification Using Hip Radiographs and Patient Clinical Covariates. International journal

Norio Yamamoto, Shintaro Sukegawa, Akira Kitamura, Ryosuke Goto, Tomoyuki Noda, Keisuke Nakano, Kiyofumi Takabatake, Hotaka Kawai, Hitoshi Nagatsuka, Keisuke Kawasaki, Yoshihiko Furuki, Toshifumi Ozaki

Biomolecules 10 ( 11 ) 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

This study considers the use of deep learning to diagnose osteoporosis from hip radiographs, and whether adding clinical data improves diagnostic performance over the image mode alone. For objective labeling, we collected a dataset containing 1131 images from patients who underwent both skeletal bone mineral density measurement and hip radiography at a single general hospital between 2014 and 2019. Osteoporosis was assessed from the hip radiographs using five convolutional neural network (CNN) models. We also investigated ensemble models with clinical covariates added to each CNN. The accuracy, precision, recall, specificity, negative predictive value (npv), F1 score, and area under the curve (AUC) score were calculated for each network. In the evaluation of the five CNN models using only hip radiographs, GoogleNet and EfficientNet b3 exhibited the best accuracy, precision, and specificity. Among the five ensemble models, EfficientNet b3 exhibited the best accuracy, recall, npv, F1 score, and AUC score when patient variables were included. The CNN models diagnosed osteoporosis from hip radiographs with high accuracy, and their performance improved further with the addition of clinical covariates from patient records.

DOI： 10.3390/biom10111534

Medial meniscus posterior root repair prevents the progression of subchondral insufficiency fracture of the knee.

Yuki Okazaki, Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Shota Takihira, Yusuke Kamatsuki, Tomonori Tetsunaga, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 6 ) 1051 - 1055 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Medial meniscus posterior root tear (MMPRT) causes medial meniscus extrusion (MME) and leads to subchondral insufficiency fracture of the knee (SIFK). However, the progression of SIFK after MMPRT pullout repair remains unknown. This study aimed to investigate the progression of SIFK and compare clinical outcomes in patients with SIFK to those without SIFK after MMPRT pullout repair. We hypothesized that the progression of SIFK would be prevented by MMPRT pullout repair, and clinical outcomes would improve in all patients. METHODS: The SIFK grade (1-4) was evaluated using T2-fat suppression magnetic resonance imaging. Thirty-eight patients without SIFK (n = 22) and with low-grade SIFK (1 and 2; n = 16) who underwent MMPRT pullout repair were included. Preoperative factors, such as the duration from injury to the time of magnetic resonance imaging/surgery (weeks), femorotibial angle (degree), MME (mm), and clinical outcomes were evaluated, as well as the progression of SIFK. RESULTS: SIFK was identified in only 9 patients (grade 1) postoperatively. Significantly improved clinical outcomes were observed in all patients. Preoperative femorotibial angle, MME, and duration from injury to the time of magnetic resonance imaging/surgery were 177.1 ± 1.5°, 3.2 ± 1.6 mm, and 6.4 ± 7.0/10.1 ± 7.5 weeks, respectively. No significant difference in preoperative factors and clinical outcomes was observed between patients with SIFK and those without SIFK. CONCLUSIONS: MMPRT pullout repair prevented the progression of low-grade SIFK and improved clinical outcomes in all patients, although bone contusions (grade 1 SIFK) were not completely healed within 1 year. MMPRT pullout repair could be a good treatment option for optimizing clinical outcomes in patients with low-grade SIFK.

DOI： 10.1016/j.jos.2020.10.008

Medial meniscus posterior root repair restores the intra-articular volume of the medial meniscus by decreasing posteromedial extrusion at knee flexion. International journal

Yoshiki Okazaki, Takayuki Furumatsu, Takatsugu Yamauchi, Yuki Okazaki, Yusuke Kamatsuki, Takaaki Hiranaka, Yuya Kajiki, Ximing Zhang, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 28 ( 11 ) 3435 - 3442 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Transtibial repair of a medial meniscus posterior root tear (MMPRT) can improve clinical outcomes, although meniscal extrusion remains. However, few studies have investigated the volume of meniscal extrusion. This study aimed to evaluate the effect of transtibial repair in reducing the volume using three-dimensional (3D) magnetic resonance imaging, at 10° and 90° knee flexion. METHODS: Twenty patients with MMPRTs and 16 volunteers with normal knees participated. The 3D models of meniscus were constructed using SYNAPSE VINCENT®. The meniscal extrusion and its volume were measured at 10° and 90° knee flexion. Differences between the pre- and postoperative examinations were assessed using the Wilcoxon signed-rank test. The postoperative parameters were compared to those in patients with normal knees. RESULTS: There were no significant pre- and postoperative differences in any parameter at 10° knee flexion. At 90° knee flexion, the posterior extrusion and its meniscal volume were decreased significantly after transtibial repair (p < 0.05), even though these parameters were larger than in the normal knees. On the other hand, intra-articular meniscal volume calculated by the extrusion volume was increased to the level of the normal knee. CONCLUSIONS: This study demonstrated that transtibial repairs improved the intra-articular/intra-tibial surface volume of the medial meniscus by reducing the posteromedial extrusion during knee flexion. This 3D analysis is clinically relevant in evaluating that, while transtibial root repair has a limited ability to reduce meniscal extrusion, it can restore the functional volume of the medial meniscus which contributes to the shock absorber postoperatively. LEVEL OF EVIDENCE: IV.

DOI： 10.1007/s00167-020-05953-2

What Are the Results of Resection of Localized Dedifferentiated Liposarcomas in the Extremities? International journal

Eiji Nakata, Toshiyuki Kunisada, Joe Hasei, Ryuichi Nakahara, Hiroyuki Yanai, Tomohiro Toji, Hirofumi Inoue Ct, Toshifumi Ozaki

Clinical orthopaedics and related research 478 ( 11 ) 2550 - 2561 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Dedifferentiated liposarcoma (DDLPS) is a rare malignancy that transitions from an atypical lipomatous tumor to a sarcoma with a variable morphologic appearance. The behavior of this tumor in the retroperitoneum is aggressive, but the behavior of DDLPS in the extremities is less well-defined because it is rare. Few reports have assessed the imaging features and clinical outcomes of primary DDLPS in the extremities. QUESTIONS/PURPOSES: In patients with primary DDLPS of the extremity, we asked the following questions: (1) How frequently do additional primary malignancies occur in patients with DDLPS? (2) What is the rate of overall survival, metastases, and local recurrence in DDLPS? (3) What factors are associated with metastasis-free survival and local recurrence in DDLPS? METHODS: We defined DDLPS as a biphasic neoplasm that transitions from an atypical lipomatous tumor (ALT) to a sarcoma of variable morphologic appearance and histologic grades. We retrospectively evaluated the medical records of patients with DDLPS of the extremities who underwent surgery in our institution between 2003 and 2017. During that time, 16 patients were treated for this diagnosis; one was excluded from this study because the patient did not have an MRI, leaving 15 patients (nine men, six women; their median [range] age was 67 years [42 to 87]) for evaluation. All had a minimum of 2 years follow-up (median [range] 54 months [25 to 136]); 14 of 15 have been seen in the last 5 years (one patient, who was doing well at the time, was lost after 9 years of follow-up). In 11 patients, MRI demonstrated two components: an ALT component with high intensity on both T1-weighed and T2-weighted sequences and a dedifferentiated component low-to-intermediate intensity on T1-weighed and heterogeneous hyperintensity on T2-weighted sequence. Nine patients were evaluated using 2-deoxy-2-18F-fluoro-D-glucose positron emission tomography (FDG-PET) combined with CT (PET/CT). PET/CT showed a biphasic pattern with a close relationship to MRI findings. The dedifferentiated component presented with high FDG uptake (median [range] maximum standardized uptake value 5.1 [1.9 to 22.6]), while the atypical lipomatous tumor component showed almost no FDG uptake. In all patients, immunohistochemical studies of p16 and cyclin-dependent kinase-4 (CDK4) were investigated. Positive staining for both p16 and CDK4 were seen in 13 of 15 patients.We retrospectively evaluated the electronic medical records of all patients in our institution for the presence of additional primary malignancies, local recurrence-free survival, metastasis-free survival, and overall survival. The survival rate was estimated using the Kaplan-Meier method. The Wilcoxon exact test was used to determine the prognostic importance of the following survival variables: age, sex, maximum tumor size, radiotherapy, and surgical margin. RESULTS: Seven additional primary malignancies developed in five of 15 patients (two lung cancers, two sarcomas, one renal cell cancer, one uterine cancer, and one non-Hodgkin lymphoma). The 3- and 5-year metastasis-free survival rates were 86% (95% CI 0.67 to 1.00) and 75% (95% CI 0.49 to 1.00), respectively. With the numbers available, we found no factors associated with metastasis-free survival. The 3- and 5-year overall survival rates were 100% (95% CI 1.00 to 1.00) and 88% (95% CI 0.65 to 1.00), respectively. Three of 15 patients had local recurrence. The 3- and 5-year local recurrence-free survival rates were 86% (95% CI 0.67 to 1.00) and 75% (95% CI 0.49 to 1.00), respectively. Large (> 15 cm) tumors were more likely to have a local recurrence (p = 0.04). CONCLUSIONS: In this small series, we found that the extremities are a favorable site for DDLPS compared with the retroperitoneum, although we did not directly compare the two sites. This rare tumor has a relatively high likelihood of being associated with other malignancies. We believe patients should be assessed and monitored carefully for this possibility. In the future, larger studies are needed to better define predictors of local recurrence, although the tumor's size may be associated with a greater propensity for local recurrence. LEVEL OF EVIDENCE: Level II, prognostic study.

DOI： 10.1097/CORR.0000000000001338

What Factors Are Associated with Treatment Outcomes of Japanese Patients with Clear Cell Chondrosarcoma? International journal

Robert Nakayama, Keiko Hayakawa, Eisuke Kobayashi, Makoto Endo, Naofumi Asano, Tsukasa Yonemoto, Hiroyuki Kawashima, Kenichiro Hamada, Itsuo Watanabe, Hiroyuki Futani, Takahiro Goto, Yoshihiro Nishida, Toshifumi Ozaki

Clinical orthopaedics and related research 478 ( 11 ) 2537 - 2547 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Clear cell chondrosarcoma is an extremely rare chondrosarcoma subtype; thus, its treatment outcomes and associated factors have not been widely studied. Knowing more about it is potentially important because clear cell chondrosarcomas are often misdiagnosed as other benign lesions and subsequently treated and followed inappropriately. QUESTIONS/PURPOSES: (1) What are the patient- and tumor-related characteristics of clear cell chondrosarcoma? (2) What proportion of patients with clear cell chondrosarcoma initially had a misdiagnosis or a misleading initial biopsy result? (3) What is the survivorship of patients with clear cell chondrosarcoma free from death, local recurrence, and distant metastasis, and what factors are associated with greater survivorship or a reduced risk of local recurrence? METHODS: Between 1985 and 2018, 12 Japanese Musculoskeletal Oncology Group (JMOG) hospitals treated 42 patients with a diagnosis of clear cell chondrosarcoma. All 42 patients had complete medical records at a minimum of 1 year or death, and were included in this multicenter, retrospective, observational study. No patients were lost to follow-up within 5 years of treatment but four were lost to follow-up greater than 5 years after treatment because their physicians thought their follow-up was sufficient. Clinical data were collected by chart review. The median (range) follow-up period was 69 months (2 to 392). In general, when a possibly malignant bone tumor was found on imaging studies, the histological diagnosis was made by biopsy before initiating treatment. Once the diagnosis had been made, the patients were treated by surgery only, complete resection if technically possible, because chondrosarcomas are known to be resistant to chemotherapy and radiotherapy. Unresectable tumors were treated with particle-beam radiation therapy. When patients with chondrosarcoma were referred after unplanned surgical procedures with inadequate surgical margins, immediate additional wide resection was considered before local recurrence developed. This diagnostic and treatment strategy is common to all JMOG hospitals and did not change during the study period. Primary wide resection was performed in 79% (33 of 42) patients, additional wide resection after initial inadequate surgery in 12% (five of 42), curettage and bone grafting in 5% (two of 42) patients, and radiotherapy was administered to 5% (two of 42). Surgical margins among the 40 patients who underwent surgery at JMOG hospitals were no residual tumor in 93% (37 of 42) of patients, microscopic residual tumor in 2% (one of 42), and macroscopic residual tumor or state after curettage or intralesional excision in 5% (two of 42). The oncological endpoints of interest were 5- and 10- year overall survival, disease-free survival, survival free of local recurrence, and survival free of distant metastases; these were calculated using the Kaplan-Meier method and compared using the log-rank test. Risk ratios with their respective 95% confidence intervals (CIs) were estimated in a Cox regression model. The Bonferroni adjustment was used for multiple testing correction. RESULTS: The sex distribution was 74% men and 26% women (31 and 11 of 42, respectively), with a mean age of 47 ± 17 years. Eighty one percent (34 of 42) of tumors occurred at the ends of long bones, and the proximal femur was the most common site accounting for 60% (25 of 42). The mean size of the primary tumors was 6.3 ± 2.7 cm. Definite pathologic fractures were present in 26% (10 of 42) and another 26% (10 of 42) had extraskeletal involvement. None had metastases at presentation. Twenty four percent (six of 25) tumors in the proximal femur were misdiagnosed as benign lesions and treated inadequately without biopsy. Twenty nine percent (10 of 35) patients had initial misdiagnoses by biopsy and core needle biopsies had a greater risk of resulting in inaccurate histological diagnoses. The study patients' 5- and 10-year overall survival rates were 89% (95% CI 74 to 96) and 89% (95% CI 74 to 96), respectively; 5- and 10- year disease-free survival rates 77% (95% CI 58 to 89) and 57% (95% CI 36 to 75), respectively; 5- and 10-year local recurrence-free survival rates 86% (95% CI 68 to 95) and 71% (95% CI 49 to 86), respectively; and 5- and 10-year distant metastasis-free survival rates 84% (95% CI 67 to 93) and 74% (95% CI 53 to 88), respectively. Notably, bone metastases (17%, seven of 42) were as common as pulmonary metastases (14%, six of 42); four patients developed both bone and pulmonary metastases. The difference between 10-year overall survival rates and 10-year disease-free survival indicated very late recurrence more than 5 years after the initial treatment. After controlling for multiple comparisons, the only factor we found that was associated with local recurrence-free survival was initial treatment (positive margin versus primary wide resection) (risk ratio 8.83 [95% CI 1.47 to 53.1]; p = 0.022 after the Bonferroni adjustment). Additional wide resection reduced the risk of local recurrence. CONCLUSIONS: The femoral head was the most common location of clear cell chondrosarcoma and had a high risk of misdiagnosis as common benign lesions that resulted in initial inadequate surgery and a consequent high risk of local recurrence. Immediate additional wide resection should be considered in patients who had initial inadequate surgery to reduce the risk of local recurrence. Because clear cell chondrosarcoma can recur locally or distantly in the bones and lungs in the long term, patients should be informed of the risk of very late recurrence and the necessity of decades-long with surveillance for local recurrence and lung and bone metastases. LEVEL OF EVIDENCE: Level IV, therapeutic study.

DOI： 10.1097/CORR.0000000000001266

Diagnostic performance of open MRI in the flexed knee position for the detection of medial meniscus ramp lesions. International journal

Yuki Okazaki, Takayuki Furumatsu, Soichiro Okamoto, Takaaki Hiranaka, Keisuke Kintaka, Shinichi Miyazawa, Toshifumi Ozaki

Skeletal radiology 49 ( 11 ) 1781 - 1788 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: To identify the diagnostic performance of magnetic resonance imaging (MRI) in the knee-flexed position for the detection of meniscal ramp lesions in patients with anterior cruciate ligament tears. MATERIALS AND METHODS: Forty-three patients (mean age 24.5 ± 9.5 years; 21 males, 22 females) with an arthroscopically proven anterior cruciate ligament tear were included in this retrospective study. The presence of the following two important features on MRI was recorded: irregularity of the medial meniscus at the posterior margin, and complete fluid filling between the posterior horn of the medial meniscus and the capsule margin. Findings obtained in arthroscopy served as the reference standard. The diagnostic sensitivity, specificity, and inter-observer agreement were calculated. RESULTS: Sixteen ramp lesions were noted on arthroscopy (37.2%). With an irregularity of the medial meniscus at the posterior margin on MRI, the sensitivity and specificity were 87.5 and 59.3% at 10° knee flexion and 93.8 and 85.2% at 90° flexion, respectively. The complete fluid filling sign on MRI showed sensitivity and specificity of 31.3 and 100% at 10° knee flexion and 87.5 and 100% at 90° flexion, respectively. The concordance between the two observers for the two MRI features was very good (k = 0.70-0.88). CONCLUSION: MRI with the knee in the flexed position improves the diagnostic performance of the detection of meniscal ramp lesions compared with MRI with the knee in the extended position.

DOI： 10.1007/s00256-020-03480-2

A histological study of the medial meniscus posterior root tibial insertion. International journal

Tomohito Hino, Takayuki Furumatsu, Shinichi Miyazawa, Masataka Fujii, Yuya Kodama, Yusuke Kamatsuki, Yoshiki Okazaki, Shin Masuda, Yuki Okazaki, Toshifumi Ozaki

Connective tissue research 61 ( 6 ) 546 - 553 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Purpose/Aim of the study: Posterior root injury of the medial meniscus often leads to articular cartilage degeneration due to altered biomechanics. To avoid dysfunction, the attachment must be repaired using the transtibial pullout technique. To guide appropriate placement of the tibial tunnel, additional details on the normal anatomy of the meniscus insertion are needed. Therefore, we performed a histological analysis of a tibial bone slice with the medial meniscus posterior insertion obtained during total knee arthroplasty surgery. Materials and methods: Horizontal slices of the proximal tibia were obtained from 7 patients with osteoarthritis who underwent total knee arthroplasty. After decalcification, the region of the posterior horn was cut out and segmented into four pieces (2.0 mm thickness; medial to lateral). Sagittal sections were evaluated by safranin O staining or immunohistochemistry with anti-type collagen antibody. Results: Safranin O staining showed that the insertion of the posterior root consisted primarily of fibrocartilaginous layers in segment 2. Anatomically, segment 2 corresponded to the sagittal plane passing through the peak of the medial intercondylar tubercle. In this section, safranin O staining and immunohistochemistry revealed that the anterior one-third of the posterior root insertion was richer in proteoglycans and type II collagen than the central and posterior one-third. Conclusions: Anatomical insertion of the posterior root of the medial meniscus was located at the sagittal plane passing through the peak of the medial intercondylar tubercle. The structure of the medial meniscus posterior insertion was mainly localized in the anterior one-third.

DOI： 10.1080/03008207.2019.1631298

Medial meniscus posterior root tear causes swelling of the medial meniscus and expansion of the extruded meniscus: a comparative analysis between 2D and 3D MRI. International journal

Yoshiki Okazaki, Takayuki Furumatsu, Takuya Yamaguchi, Yuya Kodama, Yusuke Kamatsuki, Shin Masuda, Yuki Okazaki, Takaaki Hiranaka, Ximing Zhang, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 28 ( 11 ) 3405 - 3415 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: This study aimed to clarify the advantages of three-dimensional (3D) magnetic resonance imaging (MRI) over two-dimensional (2D) MRI in measuring the size of the medial meniscus (MM) and to analyse the volumes of MM and the extruded meniscus in patients with MM posterior root tear (MMPRT), at 10° and 90° knee flexion. METHODS: This study included 17 patients with MMPRTs and 15 volunteers with uninjured knees. The MMs were manually segmented for 3D reconstruction; thereafter, the extruded part separated from the tibial edge was determined. The length, width, height, and extrusion of MM were measured by the 2D and 3D methods, and compared. The MM volume, extruded meniscus volume, and their ratio were also calculated using 3D analysis software in the two groups. RESULTS: The estimated length and posterior height of MM were larger with 3D MRI than with 2D MRI measurements. The MM volume was significantly greater in MMPRT knees than in normal knees, with increasing MM height. In MMPRT knees, the mean volume of the extruded meniscus and its ratio significantly increased by 304 mm3 (p = 0.02) and 9.1% (p < 0.01), respectively, during knee flexion. CONCLUSIONS: This study demonstrated that 3D MRI could estimate the precise MM size and that MMPRT caused swelling of the meniscus due to the increased thickness in the posteromedial part. The clinical significance of this study lies in its 3D evaluation of MM volume, which should help the surgeon understand the biomechanical failure of MM function and improve MMPRT repair technique. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-019-05580-6

Transtibial fixation for medial meniscus posterior root tear reduces posterior extrusion and physiological translation of the medial meniscus in middle-aged and elderly patients. International journal

Yuya Kodama, Takayuki Furumatsu, Shin Masuda, Yoshiki Okazaki, Yusuke Kamatsuki, Yuki Okazaki, Takaaki Hiranaka, Shinichi Miyazawa, Masaharu Yasumitsu, Toshifumi Ozaki

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 28 ( 11 ) 3416 - 3425 2020.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To investigate changes in meniscal extrusion during knee flexion before and after pullout fixation for medial meniscus posterior root tear (MMPRT) and determine whether these changes correlate with articular cartilage degeneration and short-term clinical outcomes. METHODS: Twenty-two patients (mean age 58.4 ± 8.2 years) diagnosed with type II MMPRT underwent open magnetic resonance imaging preoperatively, 3 months after transtibial fixation and at 12 months after surgery, when second-look arthroscopy was also performed. The medial meniscus medial extrusion (MMME) and the medial meniscus posterior extrusion (MMPE) were measured at knee 10° and 90° flexion at which medial meniscus (MM) posterior translation was also calculated. Articular cartilage degeneration was assessed using International Cartilage Research Society grade at primary surgery and second-look arthroscopy. Clinical evaluations included Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee subjective knee evaluation form, Lysholm score, Tegner activity level scale, and pain visual analogue scale. RESULTS: MMPE at 10° knee flexion was higher 12 months postoperatively than preoperatively (4.8 ± 1.5 vs. 3.5 ± 1.2, p = 0.01). MMPE at 90° knee flexion and MM posterior translation were smaller 12 months postoperatively than preoperatively (3.5 ± 1.1 vs. 4.6 ± 1.3, 7.2 ± 1.7 vs. 8.9 ± 2.0, p < 0.01). Articular cartilage degeneration of medial femoral condyle correlated with MMME in knee extension (r = 0.5, p = 0.04). All clinical scores significantly improved 12 months postoperatively. However, correlations of all clinical scores against decreased MMPE and increased MMME were not detected. CONCLUSIONS: MMPRT transtibial fixation suppressed the progression of MMPE and cartilage degeneration and progressed MMME minimally in knee flexion position at 1 year. However, in the knee extension position, MMME progressed and correlated with cartilage degeneration of medial femoral condyle. MMPRT transtibial fixation contributes to the dynamic stability of the MM in the knee flexion position. LEVEL OF EVIDENCE: IV.

DOI： 10.1007/s00167-019-05810-x

Letter regarding "Comparing the usefulness of a fluoroscopic navigation system in femoral trochanteric fracture for orthopaedic residents with the conventional method". International journal

Norio Yamamoto, Yosuke Tomita, Keisuke Kawasaki, Toshifumi Ozaki

Injury 51 ( 10 ) 2348 - 2348 2020.10

Cognitive factors associated with locomotive syndrome in chronic pain patients: A retrospective study.

Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Keiichiro Nishida, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 5 ) 896 - 901 2020.9

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Prevention and treatment for locomotive syndrome (LS) are important for extending healthy life expectancy. The 25-question geriatric locomotive function scale (GLFS-25) was developed to diagnose LS. The Fear-Avoidance model was proposed to explain pain chronicity. LS and chronic pain decrease activities of daily living; however, the relationships between LS and factors related to chronic pain in the Fear-Avoidance model are unknown. Objective of the current study was to assess the prevalence of LS and examine the factors of the Fear-Avoidance model and the GLFS-25 that affect the prevalence of LS in patients with chronic pain. METHODS: Participants included 281 patients (99 men, 182 women) aged over 40 years with chronic pain who visited our outpatient clinic for chronic pain. All participants completed the GLFS-25, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), and Athene insomnia scale (AIS). According to a GLFS-25 cutoff point, participants were divided into three groups (LS-2; GLFS-25 ≥ 16, LS-1; 7 ≤ GLFS-25 < 16, and non-LS; GLFS-25 < 7 points) and each parameter was compared among the groups, followed by multiple logistic regression analysis. Next, multiple linear regression analysis was performed to determine the factors associated with the GLFS-25. RESULTS: Of all 281 patients, 241 (85.8%) patients were diagnosed with LS-2. Univariate analysis revealed there were significant differences in NRS, PCS, HADS anxiety, HADS depression, and AIS among groups. Multiple logistic regression analyses showed PCS was significantly associated with LS-2 prevalence. The GLFS-25 was positively correlated with NRS, HADS depression, AIS in multiple linear regression analysis. CONCLUSIONS: We found that patients with chronic pain in our outpatient clinic had a significant rate of LS-2. The prevalence of LS-2 was significantly correlate with pain catastrophizing, and the GLFS-25 was significantly correlated with higher pain intensity, depression, and insomnia.

DOI： 10.1016/j.jos.2020.08.007

Early response of bone metastases can predict tumor response in patients with non-small-cell lung cancer with bone metastases in the treatment with nivolumab. International journal

Eiji Nakata, Shinsuke Sugihara, Yoshifumi Sugawara, Toshiyuki Kozuki, Daijiro Harada, Naoyuki Nogami, Ryuichi Nakahara, Takayuki Furumatsu, Tomonori Tetsunaga, Toshiyuki Kunisada, Toshifumi Ozaki

Oncology letters 20 ( 3 ) 2977 - 2986 2020.9

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

The effect of nivolumab and the relation between bone response and tumor control in patients with non-small-cell lung cancer (NSCLC) with bone metastases are not clear. The outcome of nivolumab monotherapy was investigated, and whether the response of bone metastases is useful as an early predictor of tumor control in patients with NSCLC with bone metastases was examined. The participants included 15 patients who received nivolumab monotherapy for NSCLC with bone metastases in our institution between 2015 and 2017. Tumor control was defined using Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST1.1). Response of bone metastases was assessed by the MD Anderson response criteria (MDA criteria). Responses according to RECIST1.1 and the MDA criteria were classified as responder (complete response or partial response) and non-responder [progressive disease (PD) or stable disease]. Progression-free survival (PFS) was investigated using the Kaplan-Meier method. With RECIST1.1, the overall response rate was 20%. Multivariate analysis showed that the MDA criteria were the only risk factor for patients with PD (RECIST1.1). Median PFS was 1.9 months, with PFS of 20% at 6 months. Univariate analysis showed that being a non-responder according to the MDA criteria was the only risk factor for PFS. In patients who were responders (MDA criteria) within 3 months, PFS was 83 and 50% at 3 and 6 months, respectively, though all non-responder (MDA criteria) patients converted to PD (RECIST1.1) within 3 months. Response according to RECIST1.1 was significantly correlated with response according to the MDA criteria (P<0.05). In patients who were both responders according to RECIST1.1 and the MDA criteria, time to response with the MDA criteria (1.4-2.0 months) was earlier than with RECIST1.1 (2.8-3.0 months) in all patients. In conclusion, application of the MDA criteria within 2 months of nivolumab monotherapy is useful for early prediction of response and prognosis in patients with NSCLC with bone metastases.

DOI： 10.3892/ol.2020.11856

Phase II trial of pazopanib in patients with metastatic or unresectable chemoresistant sarcomas: A Japanese Musculoskeletal Oncology Group study. International journal

Hiroshi Urakawa, Akira Kawai, Takahiro Goto, Hiroaki Hiraga, Toshifumi Ozaki, Hiroyuki Tsuchiya, Robert Nakayama, Norifumi Naka, Yoshihiro Matsumoto, Eisuke Kobayashi, Tomotake Okuma, Toshiyuki Kunisada, Masahiko Ando, Takafumi Ueda, Yoshihiro Nishida

Cancer science 111 ( 9 ) 3303 - 3312 2020.9

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

Alveolar soft part sarcoma (ASPS), epithelioid sarcoma (ES), and clear cell sarcoma (CCS) are known to be chemoresistant tumors. The aim of this study was to investigate the effect of pazopanib on these chemoresistant tumors. This study is designed as a single-arm, multicenter, investigator-initiated phase II trial. Patient enrollment was undertaken between July 2016 and August 2018 at 10 hospitals participating in the Japanese Musculoskeletal Oncology Group. The primary end-point is the CBR (CBR, including complete or partial response and stable disease) at 12 weeks after treatment with pazopanib according to RECIST. Eight patients were enrolled within the period. The histological subtypes were 5 ASPS, 2 ES, and 1 CCS. The median follow-up period was 22.2 (range, 4.9-24.9) months. All patients initially received pazopanib 800 mg once daily. The CBRs were 87.5% (7 of 8) and 75.0% (6 of 8) according to RECIST and Choi criteria at 12 weeks after pazopanib treatment, respectively. The CBRs at 12 weeks according to RECIST were 80.0%, 100.0%, and 100.0% in ASPS, ES, and CCS, respectively. Partial response was observed in 1 ASPS according to RECIST and 3 ASPS and 1 ES according to Choi criteria at 12 weeks after pazopanib treatment. This study documented antitumor activity of pazopanib, especially in ASPS. These results support the frontline use of pazopanib for ASPS. Prospective data collection is desired using both RECIST and Choi criteria for these rare chemoresistant tumors.

DOI： 10.1111/cas.14542

Acetabular depth, an early predictive factor of acetabular development: MRI in patients with developmental dysplasia of the hip after open reduction. International journal

Yoshi Kawamura, Tomonori Tetsunaga, Hirofumi Akazawa, Kazuki Yamada, Tomoaki Sanki, Yoshihiro Sato, Eiji Nakata, Toshifumi Ozaki

Journal of pediatric orthopedics. Part B 30 ( 6 ) 509 - 514 2020.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Early prediction of future acetabular development is important to determine an additional surgery for developmental dysplasia of the hip (DDH). The purpose of this study was to investigate the predictive factors of acetabular development using MRI. We retrospectively investigated dislocated 40 hips and 34 normal hips in 37 pediatric patients (9 males and 28 females) with DDH who underwent open reduction after walking age. We evaluated the cartilaginous acetabulum and labrum of the patients using coronal MRI T2*-weighted images at 5 years of age. The mean age at the time of surgery was 22 months, and the mean age at the final survey was 19 years. We divided patients into two groups in accordance with the Severin classification at the final follow-up. Groups with good outcomes (affected 26 hips and unaffected 27 hips) and poor outcomes (14 hips and 7 hips) were compared using the MRI parameters on each side. Predictive factors of acetabular development were identified using univariate and multiple logistic regression analyses. Using multiple logistic regression analysis, labral acetabular roof depth and labral hip center distance at 5 years of age represented predictors after open reduction (odds ratio 0.27, P = 0.035; odds ratio 3.4, P = 0.028, respectively) on the affected side, and bony hip center distance represented a predictor on the unaffected side (odds ratio 2.6, P = 0.049). Acetabular development in the unaffected side could be predicted by bony assessment, while acetabular development in the affected side had to be assessed by labrum using MRI.

DOI： 10.1097/BPB.0000000000000799

Tibial Tunnel Positioning Using the Posterolateral (PL) Divergence Guide in Anterior Cruciate Ligament Reconstruction.

Takaaki Tanaka, Takayuki Furumatsu, Takaaki Hiranaka, Yuki Okazaki, Kenji Masuda, Noritaka Seno, Toshifumi Ozaki

Acta medica Okayama 74 ( 4 ) 345 - 350 2020.8

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

The aim of this study was to evaluate tunnel coalition and inter-tunnel distance by comparing the tibial tunnel position in double-bundle anterior cruciate ligament (ACL) reconstruction performed with a conventional guide versus a posterolateral (PL) divergence (PLD) guide. Subjects were 43 patients (ACL tip aimer: 20 knees; PLD guide: 23 knees) who underwent double-bundle ACL reconstruction between September 2014 and December 2017. In all cases, the tibial tunnel position, tunnel edge distance and tunnel angles were evaluated based on CT images. Clinical outcome was evaluated using the Lachman test, pivot-shift test, and Lysholm score. Tibial tunnel positions were similar between the conventional and PLD guide groups, while tibial tunnel edge distance was significantly less in the conventional group. Tunnel coalition was observed in 5 knees in the conventional and no knees in the PLD guide group. Distance between two tibial tunnel centers was 9.1 mm for the tip aimer, and 10.5 mm for the PLD guide. Creation of the PL tunnel tended to involve insertion from a more medial aspect for the PLD guide group than the conventional guide group. No differences in clinical outcomes were noted. The PLD guide can be used to create anatomically-positioned PL tunnels, and reduce the probability of occurrence of tunnel coalition.

DOI： 10.18926/AMO/60373

Risk factors of local recurrence after surgery in extraabdominal desmoid-type fibromatosis: A multicenter study in Japan. International journal

Yoshihiro Nishida, Shunsuke Hamada, Akira Kawai, Toshiyuki Kunisada, Akira Ogose, Yoshihiro Matsumoto, Keisuke Ae, Junya Toguchida, Toshifumi Ozaki, Akihiro Hirakawa, Toru Motoi, Tomohisa Sakai, Eisuke Kobayashi, Tabu Gokita, Takeshi Okamoto, Tomoya Matsunobu, Koki Shimizu, Hiroshi Koike

Cancer science 111 ( 8 ) 2935 - 2942 2020.8

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

This study was undertaken to clarify the risk factors, including the mutation status of CTNNB1, for the local recurrence after surgery of the rare disease desmoid-type fibromatosis. It was designed as a multiinstitutional joint research project with 7 major centers in Japan participating. The committee members of 7 major medical centers specializing in bone and soft tissue tumors formed this study group to develop clinical care guidelines. Of 196 cases with specimens and medical records collected from the 7 institutions, 88 surgically treated ones were analyzed regarding clinicopathologic prognostic factors including CTNNB1 mutation status. Excluding R2 cases (n = 3), 5-year local recurrence-free survival (LRFS) was 52.9%. No case had received pre- or postoperative radiotherapy. Univariate analysis revealed that extremity location (P < .001) and larger size (8 cm or more, P = .036) were significant adverse risk factors for LRFS. Multivariate analysis indicated that extremity location (P < .001) was a significantly adverse factor in addition to recurrent tumor (P = .041), S45F mutation (P = .028), and R1 surgical margin (P = .039). Preoperative drug treatment, including nonsteroidal antiinflammatory drugs, did not reduce the incidence of local recurrence (P = .199). This is the first study to analyze the factors correlating with outcomes of surgical treatment, including CTNNB1 mutation status, in a relatively large number of cases from an Asian country. Tumor location was found to be the most influential prognostic factor for local recurrence, similar to the results from Europe and North America. The development of more sensitive method(s) for determination of CTNNB1 mutation is a priority for future study.

DOI： 10.1111/cas.14528

Cam type FAIに対する骨軟骨形成術においてcam切除量を定量化した1例

佐藤嘉洋, 鉄永智紀, 山田和希, 三喜知明, 河村涌志, 尾崎敏文

Hip Joint 46 ( 1 ) 428 - 430 2020.8

股関節の関節裂隙開大距離と関節弛緩性およびX線学的指標についての検討

山田和希, 遠藤裕介, 鉄永智紀, 三喜知明, 河村涌志, 佐藤嘉洋, 尾崎敏文

Hip Joint 46 ( 1 ) 566 - 570 2020.8

寛骨臼形成不全股における骨頭被覆とX線学的指標の比較検討

三喜知明, 鉄永智紀, 遠藤裕介, 山田和希, 河村涌志, 佐藤嘉洋, 尾崎敏文

Hip Joint 46 ( 2 ) 1031 - 1034 2020.8

Authorship：Last author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本股関節学会

当院で寛骨臼形成不全股に対し寛骨臼回転骨切り術を施行した35関節を対象に、CTによる骨頭被覆率と二次元的X線学的指標の比較検討を行った。その結果、骨頭被覆率に対してCE角とAHIは強い正の相関、AROは強い負の相関を認めた。

A repair technique using two simple stitches reduces the short-term postoperative medial meniscus extrusion after pullout repair for medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Shin Masuda, Yoshiki Okazaki, Yuki Okazaki, Yuya Kodama, Yusuke Kamatsuki, Yuya Kajiki, Ximing Zhang, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 30 ( 5 ) 901 - 908 2020.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Two types of repair techniques, FasT-Fix modified Mason-Allen (F-MMA) and two simple stitches (TSS), for the treatment of a medial meniscus posterior root tear (MMPRT) were previously reported. However, whether these techniques could prevent postoperative medial meniscus extrusion (MME) progression is unknown. This study investigated and compared postoperative MME of the two repair techniques. METHODS: Forty-seven knees that had undergone pullout repair for MMPRT were retrospectively reviewed. These knees were divided into two groups as follows: In 26 knees, MMPRT was treated using the F-MMA technique and fixed with the knee flexed at 45° and 20 N of tension [F-MMA (45°-20 N) group], and in 21 knees, MMPRT was treated using the TSS technique and fixed with the knee flexed at 20° and 30 N of tension [TSS (20°-30 N) group]. The medial meniscus body width (MMBW), absolute MME (aMME), and relative MME (rMME = absolute MME/MMBW) were measured and compared using magnetic resonance imaging 3 months postoperatively. The Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales for clinical outcomes were compared between the two groups at 6 months postoperatively. RESULTS: At 3 months postoperatively, the aMME and rMME significantly decreased in the TSS (20°-30 N) compared to the F-MMA (45°-20 N) group. The TSS (20°-30 N) group had better KOOS subscale scores than the F-MMA (45°-20 N) group at 6 months postoperatively. CONCLUSIONS: The TSS technique with appropriate tibial fixation can decrease MME soon after surgery. This may prevent osteoarthritis progression and improve clinical outcomes.

DOI： 10.1007/s00590-020-02647-w

Vacuum phenomenon in pelvic fractures. International journal

Norio Yamamoto, Tomoyuki Noda, Shintaro Sukegawa, Tomohiro Inoue, Keisuke Kawasaki, Toshifumi Ozaki

Injury 51 ( 7 ) 1618 - 1621 2020.7

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Vacuum phenomenon (VP) in closed pelvic fracture is a rare disorder. This study aimed to examine the prevalence and clinical findings of VP in closed pelvic fracture. METHODS: We retrospectively reviewed 197 patients with closed pelvic fracture who presented to our institution from January 2012 to December 2018. Pelvic fractures were diagnosed by plain radiography and computed tomography (CT). First, we investigated the prevalence and clinical findings of VP in pelvic fractures. Second, we compared the clinical findings between pelvic fracture with and without VP. Finally, VP in pelvic fracture was evaluated clinically and radiologically. RESULTS: VP in pelvic fractures was detected by CT in 9 (3.6%) of the 197 patients with pelvic fractures. Patients with VP had a significantly greater proportion of fracture progression than those without VP (42.9% vs. 11.3%, P = 0.02). Patients with VP had a greater proportion of fragility fractures of the pelvis (FFP), and a lesser proportion of bone union than those without VP, although the differences were not significant. In nine pelvic fractures with VP, all sacral fractures were classified as type 1 according to the Denis classification, and all pubic fractures were classified as type 1 according to the Nakatani classification. Two (22.2%) nonunion in nine pelvic fractures with VP occurred at the pubic fracture site alone. CONCLUSIONS: Orthopedic clinicians should be aware of the potential of CT for detecting VP in pelvic fractures, especially in the course of FFP progression.

DOI： 10.1016/j.injury.2020.03.051

Clinical relevance and functional significance of cell-free microRNA-1260b expression profiles in infiltrative myxofibrosarcoma. International journal

Takuya Morita, Tomohiro Fujiwara, Aki Yoshida, Koji Uotani, Masahiro Kiyono, Suguru Yokoo, Joe Hasei, Toshiyuki Kunisada, Toshifumi Ozaki

Scientific reports 10 ( 1 ) 9414 - 9414 2020.6

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Infiltrative tumor growth into adjacent soft tissues is a major cause of the frequent recurrence and tumor-related death of myxofibrosarcoma (MFS), but no useful biomarkers reflecting tumor burden and infiltrative growth are available. While emerging evidence suggests a diagnostic and functional role of extracellular/circulating microRNA (miRNA) in various malignant diseases, their significance in MFS patients remains unknown. Global miRNA profiling identified four upregulated miRNAs in MFS patient sera and culture media of MFS cells. Among these, serum miR-1260b level was significantly upregulated in patient serum discriminating from healthy individuals and closely correlated with clinical status and tumor dynamics in MFS-bearing mice. In addition, high miR-1260b expression in serum was correlated with radiological tail-like patterns, characteristic of the infiltrative MFS. The extracellular miR-1260b was embedded in tumor-derived extracellular vesicles (EVs) and promoted cellular invasion of MFS through the downregulation of PCDH9 in the adjacent normal fibroblasts. Collectively, circulating miR-1260b expression may represent a novel diagnostic target for tumor monitoring of this highly aggressive sarcoma. Moreover, EV-miR-1260b could act as a transfer messenger to adjacent cells and mediate the infiltrative growth of MFS, providing new insights into the mechanism of infiltrative nature via crosstalk between tumor cells and their microenvironment.

DOI： 10.1038/s41598-020-66120-8

The distance between the tibial tunnel aperture and meniscal root attachment is correlated with meniscal healing status following transtibial pullout repair for medial meniscus posterior root tear. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yusuke Kamatsuki, Shinichi Miyazawa, Yoshiki Okazaki, Shin Masuda, Yuki Okazaki, Yuya Kodama, Toshifumi Ozaki

The Knee 27 ( 3 ) 899 - 905 2020.6

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

BACKGROUND: To investigate the relationship between tibial tunnel aperture location and postoperative meniscal healing. METHODS: We enrolled 25 patients (20 women and five men, mean age: 62.5 years) who underwent transtibial pullout repair for medial meniscus (MM) posterior root repair. The expected MM posterior root attachment center (AC) and tibial tunnel center (TC) were identified using three-dimensional computed tomography, and the minimum AC-TC distance was calculated. The meniscal healing status following transtibial pullout repair was assessed by second-look arthroscopy (mean postoperative period: 15 months) using a previously reported scoring system (meniscal healing score; range: 0-10). The association between AC-TC distance and meniscal healing score was investigated using univariate linear regression models. The optimal AC-TC distance cut-off for improved MM healing score (≥7) was determined using receiver operating characteristic analysis. RESULTS: The AC-TC distance and meniscal healing score were significantly associated (y = -0.42x + 9.48, R2 = 0.342; P = 0.002), with the optimum AC-TC distance being 5.8 mm. This cut-off had a sensitivity of 100% and specificity of 53%. CONCLUSIONS: This study demonstrates that AC-TC distance is significantly correlated with postoperative meniscal healing. Anatomical repair within 5.8 mm of the AC may result in improved meniscal healing.

DOI： 10.1016/j.knee.2020.02.025

Comparison of the clinical outcomes of transtibial pull-out repair for medial meniscus posterior root tear: Two simple stitches versus modified Mason-Allen suture. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Shinichi Miyazawa, Yoshiki Okazaki, Yuki Okazaki, Shota Takihira, Yuya Kodama, Yusuke Kamatsuki, Shin Masuda, Taichi Saito, Toshifumi Ozaki

The Knee 27 ( 3 ) 701 - 708 2020.6

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Transtibial pullout repair of a medial meniscus posterior root tear (MMPRT) is a commonly used procedure, and several techniques have been reported. We hypothesised that pull-out repairs using two simple stitches (TSS) would have similar postoperative outcomes as those using the modified Mason-Allen suture with FasT-Fix (F-MMA). We aimed to investigate the clinical outcomes of these techniques, including the meniscal healing status and osteoarthritic change. METHODS: The data of 68 patients who underwent transtibial pull-out repair were retrospectively investigated. The patients were divided into two groups of 41 and 27 patients using F-MMA and TSS, respectively. The clinical outcomes were assessed preoperatively and at second-look arthroscopy (the mean period from surgery was one year) using the Knee injury and Osteoarthritis Outcome Score. The meniscal healing status, evaluated at second-look arthroscopy, was compared between the two groups. The cartilage damage was graded as per the classification of the International Cartilage Repair Society and compared at the primary surgery and second-look arthroscopy. RESULTS: Both groups showed significant improvement in each clinical score. No significant difference was seen in the clinical outcome scores and the meniscal healing status between the two groups at second-look arthroscopy. Moreover, no significant progression of cartilage damage was observed in both groups. Fourteen patients in the F-MMA group developed a complication of suture bar failures postoperatively; however, there were no complications in the TSS group. CONCLUSIONS: The TSS and F-MMA techniques showed favourable clinical outcomes and would be established as clinically useful techniques for the MMPRT treatment.

DOI： 10.1016/j.knee.2020.04.023

Effect of Lateral Gutter Osteophyte Resection on Correction of Varus Deformity in Arthroscopic Ankle Arthrodesis. International journal

Kenta Saiga, Suguru Yokoo, Hideki Ohashi, Masahiro Horita, Takayuki Furumatsu, Toshifumi Ozaki

Foot & ankle international 41 ( 6 ) 683 - 688 2020.6

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Recently, arthroscopic ankle arthrodesis has been performed for moderate-to-severe varus-deformed ankle osteoarthritis. However, the effect of osteophyte resection in the lateral gutter in arthroscopic ankle arthrodesis has not been clarified. We hypothesized that a varus-deviated ankle with lateral gutter osteophytes can be corrected by osteophyte resection. METHODS: Thirty-nine ankles of 38 patients were included. The mean age of patients was 70.0 (45-83) years. The patients were divided into the following groups: group with an osteophyte in the lateral gutter (osteophyte) and group with no osteophytes (nonosteophyte). Preoperative and postoperative tibiotalar angle, tibial plafond angle, and tibiotalar angle under valgus stress, as well as the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale, were recorded. Twelve ankles underwent lateral gutter osteophyte resection, whereas the other 27 ankles did not require osteophyte resection. RESULTS: Preoperative tibiotalar angle was higher in the osteophyte group than in the nonosteophyte group (21.8 vs 11.2 degrees, P = .01). The tibiotalar angle in the preoperative valgus stress imaging was higher in the osteophyte group (12.9 vs 5.7, P < .01). However, the postoperative tibiotalar angle was similar between the 2 groups (7.1 vs 5.4, P = .183). JSSF ankle/hindfoot scale improved in both groups. CONCLUSION: Lateral gutter osteophyte resection enabled correction of the varus malalignment in arthroscopic ankle arthrodesis. LEVEL OF EVIDENCE: Level III, retrospective comparative series.

DOI： 10.1177/1071100720910388

Short-term outcomes of mirogabalin in patients with peripheral neuropathic pain: a retrospective study. International journal

Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Haruo Misawa, Tomoyuki Takigawa, Kentaro Yamane, Hironori Tsuji, Yoshitaka Takei, Toshifumi Ozaki

Journal of orthopaedic surgery and research 15 ( 1 ) 191 - 191 2020.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the α2δ subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the α2δ-1 and α2δ-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin administration in patients with peripheral neuropathic pain who ceased treatment with pregabalin. METHODS: We retrospectively assessed peripheral neuropathic pain using the neuropathic pain screening questionnaire (NeP score) in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had switched from pregabalin to mirogabalin due to lack of efficacy or adverse events. Differences in the treatment course (i.e., numeric rating scale (NRS) scores) were compared using one-way analysis of variance with Bonferroni post hoc tests. RESULTS: The mean age of the patients was 72.3 years (range, 30-94 years), and the mean duration of disease was 37 months (range, 3-252 months). After treatment with mirogabalin for 1 week, NRS scores significantly decreased compared with baseline and continued to decrease over time. After 8 weeks, NRS scores improved by ≥ 30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin. CONCLUSIONS: The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain.

DOI： 10.1186/s13018-020-01709-3

Definitive radiation therapy in patients with unresectable desmoid tumors: a systematic review. International journal

Tomoya Matsunobu, Toshiyuki Kunisada, Toshifumi Ozaki, Yukihide Iwamoto, Masahiro Yoshida, Yoshihiro Nishida

Japanese journal of clinical oncology 50 ( 5 ) 568 - 573 2020.5

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

BACKGROUND: Desmoid tumors are rare soft tissue tumors. Wide local excision has been the standard surgical treatment for desmoid tumors. However, this procedure results in high local recurrence rates, so non-surgical treatments should be considered. The aim of this systematic review was to evaluate the effect of radiation therapy on patients with desmoid tumors, especially those with unresectable disease. METHODS: We evaluated studies published between 1 January 1990 and 31 August 2017 and cited in PubMed and Ichushi (in Japanese). All studies evaluating the effect of radiation therapy on desmoid tumors were included. Data regarding radiation dose, recurrence and adverse events were recorded. RESULTS: Among 218 identified studies, only 6 were finally included in this review. Local control was achieved in 253 of 317 patients with unresectable or unresected tumors who underwent definitive radiation therapy (the crude rate of local control was 79.8%). Toxicity was evaluated in patients who underwent definitive radiation therapy or surgery plus radiation therapy. One of the most common acute complications was skin toxicity. Frequent late complications of radiation therapy included fibrosis/contracture/joint stiffness, skin disorders, lymphedema and pain. Six patients developed secondary malignancies in the radiation field. CONCLUSIONS: In patients treated unsuccessfully with surgery, watchful waiting and pharmacotherapy, radiation therapy may be an option as salvage therapy because of the high rate of local control. Because desmoid tumors frequently develop in young individuals, children and young patients who receive radiation therapy for the treatment of desmoid tumors should be followed up on a long-term basis with periodic monitoring for late radiation toxicities.

DOI： 10.1093/jjco/hyaa007

Results of a randomized phase II/III study comparing perioperative adriamycin plus ifosfamide and gemcitabine plus docetaxel for high-grade soft tissue sarcomas: Japan Clinical Oncology Group study JCOG1306.

Kazuhiro Tanaka, Ryunosuke Machida, Akira Kawai, Robert Nakayama, Satoshi Tsukushi, Kunihiro Asanuma, Yoshihiro Matsumoto, Hiroaki Hiraga, Koji Hiraoka, Munenori Watanuki, Tsukasa Yonemoto, Satoshi Abe, Hirohisa Katagiri, Yoshihiro Nishida, Akihito Nagano, Yoshiyuki Suehara, Tomoko Kataoka, Haruhiko Fukuda, Toshifumi Ozaki, Yukihide Iwamoto

JOURNAL OF CLINICAL ONCOLOGY 38 ( 15 ) 2020.5

Transtibial pullout repair of the lateral meniscus posterior root tear combined with anterior cruciate ligament reconstruction reduces lateral meniscus extrusion: A retrospective study. International journal

Yuki Okazaki, Takayuki Furumatsu, Yusuke Kamatsuki, Yoshiki Okazaki, Shin Masuda, Takaaki Hiranaka, Yuya Kodama, Shinichi Miyazawa, Toshifumi Ozaki

Orthopaedics & traumatology, surgery & research : OTSR 106 ( 3 ) 469 - 473 2020.5

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Lateral meniscus (LM) posterior root tear (PRT) is often associated with anterior cruciate ligament (ACL) injury and can result in rotational instability, joint overloading, and degenerative changes in the knee. Improved rotational stability and kinematics have been reported after LMPRT repair. However, it is unclear what repair technique can achieve the greatest reduction in LM extrusion (LME). HYPOTHESIS: We hypothesized that transtibial pullout repair would decrease LME to a greater extent than other repair techniques. PATIENTS AND METHODS: Seventeen patients with ACL injury and complete LMPRT were evaluated. Nine underwent ACL reconstruction (ACLR) and transtibial pullout repair, and eight underwent ACLR and other repairs such as inside-out suturing. Double-bundle ACLR was performed using hamstring tendons, and LMPRT pullout repair was performed through the bone tunnel for the posterolateral bundle. Magnetic resonance imaging was performed immediately preoperatively and at>6 months postoperatively, and LME was measured from coronal images only. RESULTS: A significantly greater decrease in the value of LME from pre- to postoperative measurement was observed in the transtibial pullout repair group (-0.5±0.7mm) than in the other-repair group (1.0±0.9mm, p<0.01). Pre- and postoperative LME measurements were not significantly different between the two groups. DISCUSSION: The most important finding of this study was that transtibial pullout repair resulted in a greater decrease in LME than other repair techniques in patients with ACL injury and LMPRT. This technique might be useful for restoring hoop tension by decreasing LME. LEVEL OF EVIDENCE: III, comparative retrospective study.

DOI： 10.1016/j.otsr.2019.10.022

Multimodal treatment including standard chemotherapy with vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide for the Ewing sarcoma family of tumors in Japan: Results of the Japan Ewing Sarcoma Study 04. International journal

Motoaki Chin, Ryohei Yokoyama, Minako Sumi, Hajime Okita, Akira Kawai, Ako Hosono, Yuhki Koga, Hideki Sano, Hiroyoshi Watanabe, Toshifumi Ozaki, Hideo Mugishima

Pediatric blood & cancer 67 ( 5 ) e28194 2020.5

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

BACKGROUND: The survival rate in patients with Ewing sarcoma family of tumors (ESFT) in Japan was reported to be < 50% in the 1990s. The Japan Ewing Sarcoma Study Group was established to improve the prognosis of ESFT in Japan. The aim of this phase II trial was to determine the efficacy and safety of multimodal treatment for nonmetastatic ESFT. PROCEDURE: Patients with ESFT aged < 30 years were eligible for participation. The chemotherapy regimen consisted of vincristine, doxorubicin, and cyclophosphamide (VDC) alternating with ifosfamide and etoposide (IE) repeating every 21 days for 52 weeks. Local treatment included surgery and/or radiation therapy (0-55.8 Gy) based on the margin of resection and histologic response. The primary endpoint was progression-free survival (PFS) at three years. The study was designed to test whether the lower limit of the 90% confidence interval for PFS would exceed the threshold of 60%. The planned sample size was 53 patients, allowing for 10% of patients being ineligible. RESULTS: Of the 53 patients screened for entry, seven were deemed ineligible. Forty-six patients were considered as the per-protocol set and were used for the efficacy analysis. Three-year PFS was 71.7% (0.59-0.81). Estimated five-year PFS and overall survival were both 69.6%. Although no previously unknown adverse event was reported, three patients developed secondary malignancies (acute lymphoblastic leukemia, myelodysplastic syndrome, and osteosarcoma, one patient each). CONCLUSIONS: Multimodal treatment with standard VDC-IE chemotherapy improved the prognosis for patients with ESFT in Japan, although statistical confirmation of efficacy compared to historical control was not achieved.

DOI： 10.1002/pbc.28194

An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position. International journal

Tomonori Tetsunaga, Kazuki Yamada, Tomoko Tetsunaga, Tomoaki Sanki, Yoshi Kawamura, Toshifumi Ozaki

Journal of orthopaedic surgery and research 15 ( 1 ) 147 - 147 2020.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Inadequate acetabular component orientation is associated with postoperative impingement, dislocation, and accelerated polyethylene wear. Computed tomography (CT)-based navigation systems provide accuracy for total hip arthroplasty (THA) but are not available in all facilities. Accelerometer-based navigation systems are inexpensive, but their accuracy remains undetermined. This study compares the accuracy of cup orientation in THA using CT-based and accelerometer-based navigation systems. METHODS: This retrospective study included 35 consecutive patients (11 males, 24 females; mean age, 65 years) who underwent primary cementless THA via an anterolateral approach in the supine position. Both CT-based and accelerometer-based navigation systems were used simultaneously. The accuracy of cup orientation was compared between the two systems using postoperative CT. RESULTS: The accuracy of cup inclination was 2.7° ± 2.0° in the CT-based group and 3.3° ± 2.4° in the accelerometer-based group. The accuracy of cup anteversion was 2.8° ± 2.6° in the CT-based group and 3.4° ± 2.2° in the accelerometer-based group. No significant difference was observed in cup inclination (p = 0.29) or cup anteversion (p = 0.34) between CT-based and accelerometer-based navigation. CONCLUSIONS: The accuracy of cup positioning did not differ significantly between CT-based and accelerometer-based navigation systems.

DOI： 10.1186/s13018-020-01673-y

Acute Calcific Retropharyngeal Tendinitis with Eggshell-like Calcification: Case Report and Literature Review on Time-course Changes in Imaging Findings. International journal

Norio Yamamoto, Takashi Watari, Keisuke Kawasaki, Yuzuru Matsui, Toshifumi Ozaki

Cureus 12 ( 4 ) e7611 2020.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Acute calcific retropharyngeal tendinitis is a rare disease, and few studies have reported the radiological findings of its time-course in detail. These radiological findings vary according to the calcific stage. We report a case of acute calcific retropharyngeal tendinitis with eggshell-like calcification detected on follow-up computed tomography (CT). We also review pertinent literature on calcific retropharyngeal tendinitis, with a focus on time-course changes in imaging findings. A 54-year-old Japanese woman presented with acute severe neck pain. She also had a limited range of motion in the rotation of her neck and moderate pain and discomfort during swallowing. Plain radiographs of the cervical spine showed no apparent abnormality. CT revealed massive retropharyngeal calcification in front of the C1-C2 vertebrae. The patient was diagnosed with acute calcific retropharyngeal tendinitis and treated with a soft collar and non-steroidal anti-inflammatory drugs. Two weeks later, the neck pain and dysphagia improved. At the one-month follow-up, CT showed residual marginal calcification, which was diminishing in size, suggesting eggshell-like calcification. We believe that although the eggshell calcification appearance is extremely rare, it is important to note this atypical presentation of acute calcific retropharyngeal tendinitis.

DOI： 10.7759/cureus.7611

Letter to the editor concerning "Li P., lv Y., zhou F., et al. medial wall fragment involving large posterior cortex in Pertrochanteric femur fractures: A notable preoperative risk factor for implant failure. injury. 2020". International journal

Norio Yamamoto, Tomoyuki Noda, Toshifumi Ozaki

Injury 51 ( 4 ) 1146 - 1146 2020.4

Multidisciplinary treatment system for bone metastases for early diagnosis, treatment and prevention of malignant spinal cord compression. International journal

Eiji Nakata, Shinsuke Sugihara, Yoshifumi Sugawara, Ryuichi Nakahara, Takayuki Furumatsu, Tomonori Tetsunaga, Toshiyuki Kunisada, Kazuo Nakanishi, Yoshiteru Akezaki, Toshifumi Ozaki

Oncology letters 19 ( 4 ) 3137 - 3144 2020.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Malignant spinal cord compression (MSCC) is a serious complication of cancers. The present study aimed to establish a multidisciplinary treatment system for urgent magnetic resonance imaging (MRI) and referral to orthopedists in order to prevent neurological deficits caused by MSCC. In the present study, the extent to which this system achieved early diagnosis and treatment and prevented MSCC-caused neurological deficits was examined. The records from patients with neurological deficits caused by MSCC before (between April 2007 and March 2012; group A) and after (between April 2012 and March 2017; group B) the establishment of the multidisciplinary system at the Shikoku Cancer Center (Ehime, Japan) were retrospectively evaluated. The numbers of patients with neurological deficits were 38 and 7 in groups A and B, respectively. All patients received radiotherapy. The incidence of neurological deficits was 13.2 and 3.4% in groups A and B, respectively (P<0.001). The proportion of patients with improvement in the severity of neurological deficits was 5.3 and 28.6% in groups A and B, respectively (P<0.001). The interval between physicians' recognition of a neurological deficit and MRI and the start of treatment, the number of cases, and the severity of neurological deficits were evaluated in groups A and B. The median interval between recognition of a neurological deficit by physicians and MRI was 3 and 0 days in groups A and B, respectively (P<0.001). The median interval between physicians' recognition of a neurological deficit and the start of treatment was 3 and 0 days in groups A and B, respectively (P<0.001). By using a multidisciplinary treatment system, the incidence and severity of neurological deficits following treatment were significantly improved. Therefore, the multidisciplinary treatment system used in the present study may be useful for early diagnosis, treatment and prevention of MSCC in patients with bone metastases.

DOI： 10.3892/ol.2020.11415

Non-traumatic Atypical Peri-implant Femoral Fracture at the Distal Screw after Short Femoral Nail Fixation for a Pertrochanteric Fracture.

Norio Yamamoto, Tomoyuki Dan'ura, Tomoyuki Noda, Toshifumi Ozaki

Acta medica Okayama 74 ( 2 ) 151 - 157 2020.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

This is the second report of an atypical peri-implant femoral fracture occurring at the distal screw after intramedullary nail fixation of a pertrochanteric fracture. A 94-year-old Japanese female with a 5-year history of alendronate intake presented with prodromal pain in her right thigh after intramedullary nail fixation. Plain radiographs showed an incomplete noncomminuted transverse fracture at the distal screw, suggesting an atypical peri-implant femoral fracture. The pathogenesis of an atypical peri-implant femoral fracture could be a combined systemic bone metabolism disorder and repetitive overloading at the screw, similar to the pathogenesis of an atypical periprosthetic femoral fracture around stem implantation.

DOI： 10.18926/AMO/58274

External iliac artery thrombosis following open reduction of acetabular fracture: a case report and literature review. International journal

Norio Yamamoto, Tomoyuki Noda, Taichi Saito, Takenori Uehara, Yasunori Shimamura, Toshifumi Ozaki

Archives of orthopaedic and trauma surgery 140 ( 4 ) 481 - 485 2020.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Postoperative thrombosis of the external iliac artery (EIA) following open reduction and internal fixation for acetabular fracture is extremely rare. PURPOSE: To report a patient with EIA thrombosis following open reduction and internal fixation using the modified ilioinguinal approach for acetabular fractures. STUDY DESIGN: This is a case report of a 69-year-old male with a left acetabular fracture who was treated surgically. METHODS: A 69-year-old male presented with left hip pain after a 1.5-m fall. Radiographs revealed left acetabular anterior wall and posterior hemitransverse fractures with dome impaction. Computed tomography (CT) showed atherosclerotic changes in many arteries. Open reduction and internal fixation were performed using the modified ilioinguinal approach. Adhesion around the external iliac vessels was severe, and the external iliac vein (EIV) ruptured during exposure. After EIV repair, anatomical reduction was achieved and the fracture was fixed using a reconstruction plate. Nine hours after surgery, the left lower limb showed acute ischemic symptoms. Contrast-enhanced CT indicated complete occlusion of the left EIA. The patient was immediately taken for a thrombectomy via EIA cut-down using a Fogarty catheter. Postoperatively, he had palpable dorsalis pedis and posterior tibial pulses; however, post-reperfusion compartment syndrome developed. Fasciotomy of the left leg was performed. RESULTS: At the 2-year and 4-month follow-up, he was pain-free in his hip and leg. Although he was walking with a cane, activity was limited due to a mild foot drop. CONCLUSIONS: It is very important for surgeons to consider EIA thrombosis as a potential complication following open reduction and internal fixation. In this case, EIA thrombosis could be explained by preoperative atherosclerotic changes and intraoperative vascular handling procedures. Preoperative screening and management, and meticulous surgical procedures are necessary for patients with a high risk of thrombosis.

DOI： 10.1007/s00402-019-03288-3

Early chondral damage following meniscus repairs with anterior cruciate ligament reconstruction. International journal

Takaaki Hiranaka, Takayuki Furumatsu, Yusuke Kamatsuki, Kazuhisa Sugiu, Shinichi Miyazawa, Yoshiki Okazaki, Shin Masuda, Yuki Okazaki, Yuya Kodama, Toshifumi Ozaki

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology 20 1 - 5 2020.4

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Background: Meniscal tears are commonly observed in patients with anterior cruciate ligament (ACL) injuries. Meniscal repair has become a common procedure for the injured meniscus, and good clinical outcomes have been reported in such cases when used concurrently with ACL reconstruction. However, it is unclear whether early chondral damage progression can be prevented following meniscal repair with ACL reconstruction, as meniscal damage is a potential risk factor for the development of osteoarthritis. The purpose of this study was to evaluate the zone-specific chondral damage that occurs after arthroscopic meniscal repair with concomitant ACL reconstruction. Our hypothesis was that meniscal repair with ACL reconstruction would not decrease the rate of progression of chondral damage compared to that observed in isolated ACL reconstruction with intact menisci. Methods: This study included 40 patients who underwent anatomic double-bundle ACL reconstruction. We divided the patients into the following two groups: Group A with an intact meniscus (20 knees) and Group M requiring meniscal repair (20 knees). Chondral damage was evaluated arthroscopically in six compartments and 40 sub-compartments, and these features were graded using the International Cartilage Repair Society lesion classification. The cartilage damage in each sub-compartment and compartment was compared between the two groups both at reconstruction and at second-look arthroscopy (average 16 months postoperatively). At the latest follow-up examination (average 37 months postoperatively), the International Knee Documentation Committee (IKDC) score was compared between the two groups. Results: Group M had a significantly worse cartilage status than Group A in five sub-compartments (mainly in the medial compartment) at reconstruction and in nine sub-compartments (mainly in the bilateral compartments) at second-look arthroscopy. The mean IKDC score was better in Group A than in Group M (Group A; 90 vs. Group M; 86). The overall success rate of meniscal repairs was 92% (23 of 25 menisci) at second-look arthroscopy. Conclusion: The progression of post-traumatic chondral damage may occur at a faster rate in patients who require ACL reconstruction and meniscal repair than in patients with intact menisci.

DOI： 10.1016/j.asmart.2020.01.001

Atypical ulnar fracture with atypical femoral fracture: A case report and literature review.

Norio Yamamoto, Mika Yamauchi, Tomoyuki Noda, Yuzuru Matsui, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2020.3

Pulmonary resection in a prone position for lung cancer invading the spine. Reviewed

Shunsaku Miyauchi, Junichi Soh, Kazuhiko Shien, Masato Tanaka, Hiromasa Yamamoto, Toshifumi Ozaki, Shinichi Toyooka

General thoracic and cardiovascular surgery 68 ( 3 ) 298 - 301 2020.3

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

The prone position is usually not selected for pulmonary resection. The intraoperative body position is an important issue in surgery for non-small cell lung cancer invading the spine because the standard intraoperative body position for a vertebrectomy is a prone position, while that for a pulmonary resection is a lateral decubitus position. Intraoperative changes in body position can cause several complications. Using an O-arm with a navigation system, a partial vertebrectomy was completed with the patient in a prone position thanks to the recognition of accurate surgical margins in the vertebral body; then, without changing the patient's body position, a lobectomy with systemic lymph node dissection was performed via a posterior approach. Especially for procedures requiring a wide resection of the chest wall, a prone position can be selected for a lobectomy with systemic lymph node dissection via a posterior approach without any significant difficulties.

DOI： 10.1007/s11748-019-01113-7

腰椎変性後側彎症に対する前後合併手術後における静脈血栓塞栓症の検討

三澤治夫, 瀧川朋亨, 鉄永倫子, 山根健太郎, 村岡聡介, 辻寛謙, 高尾真一郎, 尾崎敏文

Journal of Spine Research 11 ( 3 ) 442 - 442 2020.3

頸髄症が四肢体幹筋量及び身体機能に与える影響サルコペニア、フレイルに注目した検討

辻寛謙, 三澤治夫, 瀧川朋亨, 山根健太郎, 村岡聡介, 上甲良二, 高尾真一郎, 尾崎敏文

Journal of Spine Research 11 ( 3 ) 565 - 565 2020.3

脊髄損傷患者の骨密度と海綿骨スコアについての検討

村岡聡介, 瀧川朋亨, 三澤治夫, 山根健太郎, 辻寛謙, 高尾真一郎, 尾崎敏文

Journal of Spine Research 11 ( 3 ) 594 - 594 2020.3

側彎を有する成人脊柱変形患者における腰椎CTハンスフィールド値の検討

山根健太郎, 三澤治夫, 瀧川朋亨, 鉄永倫子, 村岡聡介, 辻寛謙, 高尾真一郎, 尾崎敏文

Journal of Spine Research 11 ( 3 ) 504 - 504 2020.3

椎体CT値(Hounsfield Unit)は椎体内の高位に伴って変化する CT値による椎体骨強度の評価法を確立させるために

高尾真一郎, 三澤治夫, 瀧川朋亨, 山根健太郎, 村岡聡介, 辻寛謙, 尾崎敏文

Journal of Spine Research 11 ( 3 ) 520 - 520 2020.3

脊髄腫瘍の複数回手術症例についての検討

村岡聡介, 瀧川朋亨, 三澤治夫, 山根健太郎, 辻寛謙, 高尾真一郎, 尾崎敏文

Journal of Spine Research 11 ( 3 ) 282 - 282 2020.3

骨肉腫X線画像の読影を目指した人工知能の開発

長谷井嬢, 中田英二, 国定俊之, 尾崎敏文

日本CAOS研究会・日本最小侵襲整形外科学会プログラム・抄録集 14回・26回 135 - 135 2020.3

Bone and Soft-Tissue Sarcoma: A New Target for Telomerase-Specific Oncolytic Virotherapy. Reviewed International journal

Hiroshi Tazawa, Joe Hasei, Shuya Yano, Shunsuke Kagawa, Toshifumi Ozaki, Toshiyoshi Fujiwara

Cancers 12 ( 2 ) 2020.2

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

Adenovirus serotype 5 (Ad5) is widely and frequently used as a virus vector in cancer gene therapy and oncolytic virotherapy. Oncolytic virotherapy is a novel antitumor treatment for inducing lytic cell death in tumor cells without affecting normal cells. Based on the Ad5 genome, we have generated three types of telomerase-specific replication-competent oncolytic adenoviruses: OBP-301 (Telomelysin), green fluorescent protein (GFP)-expressing OBP-401 (TelomeScan), and tumor suppressor p53-armed OBP-702. These viruses drive the expression of the adenoviral E1A and E1B genes under the control of the hTERT (human telomerase reverse transcriptase-encoding gene) promoter, providing tumor-specific virus replication. This review focuses on the therapeutic potential of three hTERT promoter-driven oncolytic adenoviruses against bone and soft-tissue sarcoma cells with telomerase activity. OBP-301 induces the antitumor effect in monotherapy or combination therapy with chemotherapeutic drugs via induction of autophagy and apoptosis. OBP-401 enables visualization of sarcoma cells within normal tissues by serving as a tumor-specific labeling reagent for fluorescence-guided surgery via induction of GFP expression. OBP-702 exhibits a profound antitumor effect in OBP-301-resistant sarcoma cells via activation of the p53 signaling pathway. Taken together, telomerase-specific oncolytic adenoviruses are promising antitumor reagents that are expected to provide novel therapeutic options for the treatment of bone and soft-tissue sarcomas.

DOI： 10.3390/cancers12020478

Comparison of the accuracy of CT- and accelerometer-based navigation systems for cup orientation in total hip arthroplasty. International journal

Tomonori Tetsunaga, Kazuki Yamada, Tomoko Tetsunaga, Takayuki Furumatsu, Tomoaki Sanki, Yoshi Kawamura, Toshifumi Ozaki

Hip international : the journal of clinical and experimental research on hip pathology and therapy 31 ( 5 ) 1120700020904940 - 1120700020904940 2020.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The accuracies of various navigation systems in total hip arthroplasty (THA) have been described; however, the accuracy of cup orientation with an accelerometer-based navigation system has not been reported. The purpose of this study was to compare the accuracies of computed tomography (CT)- and accelerometer-based navigation systems for cup orientation in THA. METHODS: In this prospective study, 30 patients who underwent cementless THA via anterolateral approach in the lateral decubitus position were analysed. A CT-based navigation system (30 hips) and an accelerometer-based navigation system (30 hips) were used simultaneously. The accuracy of cup orientation (absolute difference between intraoperative vs. postoperative measurements) was compared between the navigation systems using postoperative CT. RESULTS: The accuracy of cup inclination was 3.2 ± 2.4° in the CT-based navigation group and 4.1 ± 3.7° in the accelerometer-based navigation group (p = 0.3035). The accuracy of cup anteversion was 3.0° ± 2.5° in the CT-based navigation group and 6.8° ± 4.8° in the accelerometer-based navigation group. Cup anteversion was significantly more accurate with the CT-based navigation system than with accelerometer-based navigation (p = 0.0009). Multiple regression analysis demonstrated that the malposition in cup anteversion was positively correlated with the change in pelvic tilt and loosening of the reference antenna. CONCLUSIONS: Although, these results are only true for this specific accelerometer system, cup positioning was significantly more accurate with the CT-based navigation system than an accelerometer-based navigation in the lateral decubitus position. This is because of considerable discrepancies in the sagittal pelvic tilt, resulting in variability in cup anteversion angle with the use of an accelerometer-based navigation system.

DOI： 10.1177/1120700020904940

Idiopathic Chondrolysis of the Hip Treated by Immunosuppressive Therapy and Arthroscopic Intervention.

Hirosuke Endo, Hirofumi Akazawa, Masato Yashiro, Kazuki Yamada, Tomoaki Sanki, Tomonori Tetsunaga, Keiichiro Nishida, Takayuki Furumatsu, Toshifumi Ozaki

Acta medica Okayama 74 ( 1 ) 77 - 81 2020.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Idiopathic chondrolysis of the hip (ICH), a very rare disorder of unknown etiology, occurs mainly in female adolescents. Characterized by pain, limp, stiffness and radiological narrowing joint space from the rapid destruction of the articular cartilage, ICH sometimes results in ankyloses. We present the case of a 10-year-old girl diagnosed with ICH based on arthroscopic inspection and synovium biopsy. The femoral deformity appeared gradually, like a cam-type femoroacetabular impingement. She was treated with intensive rehabilitation and immunosuppressive drug. We later performed an arthroscopic bumpectomy for residual symptoms. She achieved a favorable outcome as a 15-year-old at the latest follow-up.

DOI： 10.18926/AMO/57957

Ten-Year Outcomes of Total Hip Arthroplasty Using Fit-and-Fill Type Cementless Collared Straight Stem Implants: Relationship between the Initial Contact Status and Stress Shielding.

Tomoaki Sanki, Hirosuke Endo, Tomonori Tetsunaga, Takayuki Furumatsu, Kazuki Yamada, Toshifumi Ozaki

Acta medica Okayama 74 ( 1 ) 7 - 15 2020.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

We investigated the relationship between the initial contact status and stress shielding in total hip arthroplasty (THA) using fit-and-fill type straight-stem implants. In addition we evaluated the clinical and radiographic outcomes. Subjects were 100 hips of 94 patients who underwent THA and were followed-up for ≥10 years. Contact areas with the femoral cortical bone were investigated according to the zonal distribution of Gruen using postoperative CT images. Depending on the number of contact areas, the patients were classified into high contact [HC], medium contact [MC], and low contact [LC] groups. Radiographic and clinical outcomes were evaluated. In the HC group (20 hips), severe stress shielding was observed in 12 hips, which was statistically significant (p=0.008). In the LC group (29 hips), mild stress shielding was observed in 27 hips which was statistically significant (p<0.001). No significant differences were observed among the 3 groups in clinical outcomes, Harris hip score (p=0.719) or Japanese Orthopedic Association (JOA) score (p=0.301). In insertion of cementless collared fit-and-fill type straight-stem implants, severe late stress shielding of the femoral bone may occur if high contact of the femoral component is achieved. However, the degree of stress shielding does not result in adverse clinical outcomes.

DOI： 10.18926/AMO/57947

The Masquelet technique for septic arthritis of the small joint in the hands: Case reports. International journal

Taichi Saito, Tomoyuki Noda, Hiroya Kondo, Koji Demiya, Satoshi Nezu, Suguru Yokoo, Minami Matsuhashi, Takenori Uehara, Yasunori Shimamura, Masayuki Kodama, Toshifumi Ozaki

Trauma case reports 25 100268 - 100268 2020.2

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Septic arthritis in distal interphalangeal (DIP) joints sometimes occurs in association with mucous cysts or after the surgical treatment of mallet fingers. Recently, several studies have demonstrated the effectiveness of the Masquelet technique in the treatment of bone defects caused by trauma or infection. However, only few studies have reported the use of this technique for septic arthritis in small joints of the hand, and its effectiveness in treating septic arthritis in DIP joints remains unclear. We report the clinical and radiological outcomes of three patients who were treated with the Masquelet technique for septic arthritis in DIP joints. One patient had uncontrolled diabetes and another had rheumatoid arthritis treated with methotrexate and prednisolone. The first surgical stage involved thorough debridement of the infection site, including the middle and distal phalanx. We placed an external fixator from the middle to the distal phalanx and then packed the cavity of the DIP joint with antibiotic cement bead of polymethylmethacrylate (40 g) including 2 g of vancomycin and 200 mg of minocycline. At 4-6 weeks after the first surgical stage, the infection had cleared, and the second surgical stage was performed. The external fixator and cement bead were carefully removed while carefully preserving the surrounding osteo-induced membrane. The membrane was smooth and nonadherent to the cement block. In the second surgical stage, an autogenous bone graft was harvested from the iliac bone and inserted into the joint space, within the membrane. The bone graft, distal phalanx, and middle phalanx were fixed with Kirschner wires and/or a soft wire. Despite the high risk of infection, bone union was achieved in all patients without recurrence of infection. Although the Masquelet technique requires two surgeries, it can lead to favorable clinical and radiological outcomes for infected small joints of the hand.

DOI： 10.1016/j.tcr.2019.100268

肘頭疲労骨折における骨折線のマッピング

根津智史, 島村安則, 内野崇彦, 斉藤太一, 島村好信, 野田知之, 尾崎敏文

日本肘関節学会雑誌 27 ( 1 ) S26 - S26 2020.2

Bone microarchitectural analysis using ultra-high-resolution CT in tiger vertebra and human tibia. International journal

Ryota Inai, Ryuichi Nakahara, Yusuke Morimitsu, Noriaki Akagi, Youhei Marukawa, Toshi Matsushita, Takashi Tanaka, Akihiro Tada, Takao Hiraki, Yoshihisa Nasu, Keiichiro Nishida, Toshifumi Ozaki, Susumu Kanazawa

European radiology experimental 4 ( 1 ) 4 - 4 2020.1

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

BACKGROUND: To reveal trends in bone microarchitectural parameters with increasing spatial resolution on ultra-high-resolution computed tomography (UHRCT) in vivo and to compare its performance with that of conventional-resolution CT (CRCT) and micro-CT ex vivo. METHODS: We retrospectively assessed 5 tiger vertebrae ex vivo and 16 human tibiae in vivo. Seven-pattern and four-pattern resolution imaging were performed on tiger vertebra using CRCT, UHRCT, and micro-CT, and on human tibiae using UHRCT. We measured six microarchitectural parameters: volumetric bone mineral density (vBMD), trabecular bone volume fraction (bone volume/total volume, BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp), and connectivity density (ConnD). Comparisons between different imaging resolutions were performed using Tukey or Dunnett T3 test. RESULTS: The vBMD, BV/TV, Tb.N, and ConnD parameters showed an increasing trend, while Tb.Sp showed a decreasing trend both ex vivo and in vivo. Ex vivo, UHRCT at the two highest resolutions (1024- and 2048-matrix imaging with 0.25-mm slice thickness) and CRCT showed significant differences (p ≤ 0.047) in vBMD (51.4 mg/cm3 and 63.5 mg/cm3 versus 20.8 mg/cm3), BV/TV (26.5% and 29.5% versus 13.8 %), Tb.N (1.3 l/mm and 1.48 l/mm versus 0.47 l/mm), and ConnD (0.52 l/mm3 and 0.74 l/mm3 versus 0.02 l/mm3, respectively). In vivo, the 512- and 1024-matrix imaging with 0.25-mm slice thickness showed significant differences in Tb.N (0.38 l/mm versus 0.67 l/mm, respectively) and ConnD (0.06 l/mm3 versus 0.22 l/mm3, respectively). CONCLUSIONS: We observed characteristic trends in microarchitectural parameters and demonstrated the potential utility of applying UHRCT for microarchitectural analysis.

DOI： 10.1186/s41747-019-0135-0

Combining pullout suture and retrograde screw fixation for anterior cruciate ligament tibial eminence avulsion fractures: A case report

Takaaki Hiranaka, Takayuki Furumatsu, Takaaki Tanaka, Yuki Okazaki, Yuya Kodama, Yusuke Kamatsuki, Kenji Masuda, Noritaka Seno, Toshifumi Ozaki

Journal of Orthopaedic Surgery 28 ( 2 ) 2020.1

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications Ltd

This report describes a novel arthroscopic technique for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fractures. A 16-year-old boy who was diagnosed with a left ACL tibial eminence avulsion fracture was treated by arthroscopic fixation. Two bone tunnels were created from the anterior tibial cortex into the fracture bed, and a strong suture passed through the ACL just above its insertion was pulled out through them for reduction and fixation. A retrograde cannulated screw fixation was added for stronger fixation. Weight-bearing and range of motion exercises were started immediately after surgery. Radiographically, bone union was obtained 6 months postoperatively. During second-look arthroscopy (24 months postoperatively), there was no loss of reduction and no subsequent meniscal or cartilage injuries. At that point, the Lysholm score was 95, and the International Knee Documentation Committee score was 96.

DOI： 10.1177/2309499020918681

The role of chemotherapy and radiotherapy in localized extraskeletal osteosarcoma Reviewed

Marilyn Heng, Abha Gupta, Peter W. Chung, John H. Healey, Max Vaynrub, Peter S. Rose, Matthew T. Houdek, Patrick P. Lin, Andrew J. Bishop, Francis J. Hornicek, Yen Lin Chen, Santiago Lozano-Calderon, Ginger E. Holt, Ilkyu Han, David Biau, Xiaohui Niu, Nicholas M. Bernthal, Peter C. Ferguson, Jay S. Wunder, Takafumi Ueda, Shigeki Kakunaga, Akira Kawai, Hideshi Sugiura, Teruki Kidani, Toshiyuki Kunisasa, Toshifumi Ozaki, Keisuke Ae, Akihito Nagano, Takatoshi Ohno, Koji Hiraoka, Norio Yamamoto, Hiroyuki Tsuchiya, Yoshihiro Matsumoto, Takashi Yanagawa, Robart Nakayama, Hideo Morioka, Tadahiko Kubo, Shoji Simose, Yoshiki Yamagami, Tetsuji Yamamoto, Motohiro Kawasaki, Tomoaki Torigoe, Yasuo Yazawa, Toru Akiyama, Tabu Gokita, Jun Manabe, Mitsunori Kaya, Makoto Emori, Tomoki Nakamura, Akihiko Matsumine, Shinsuke Sugihara, Masahiro Yokouchi, Setsuro Komiya, Yoshiyuki Suehara, Tatsuya Takagi, Teruya Kawamoto, Junji Wasa, Tsukasa Yonemoto, Takeshi Ishii, Ichiro Baba, Manabu Hoshi, Kenichiro Hamada, Norifumi Naka, Tsukasa Sotobori, Nobuhito Araki, Tomotake Okuma, Takahiro Goto, Hiroshi Kobayashi, Hirotaka Kawano, Masami Hosaka, Hiroyuki Futani, Hiroaski Hiraga, Yoshihiro Nishida, Anthony Griffin, Albiruni R.Abdul Razak, David Benjamin Shultz, Charles Catton, Steven Robinson, Shreyaskumar R. Patel, Valerae O. Lewis, B. Ashleigh Guadagnolo, Thomas DeLaney, Haotong Wang, Kevin Raskin, Alexandra K. Callan, Robert Henshaw, Marc Isler, Sophie Mottard, Wei Ming Chen, Frank Traub, Tom Wei Wu Chen, Robert E. Turcotte, Darin Davidson, Per Ulf Tunn, Herbert Loong, Michelle Ghert, Joel Werier, Paul Clarkson, John A. Abraham

European Journal of Cancer 125 130 - 141 2020.1

Publishing type：Research paper (scientific journal)

© 2019 Elsevier Ltd Purpose: The role of chemotherapy (CT) and radiotherapy (RT) for management of extraskeletal osteosarcoma (ESOS) remains controversial. We examined disease outcomes for ESOS patients and investigated the association between CT/RT with recurrence and survival. Patients and methods: Retrospective review at 25 international sarcoma centers identified patients ≥18 years old treated for ESOS from 1971 to 2016. Patient/tumour characteristics, treatment, local/systemic recurrence, and survival data were collected. Kaplan–Meier survival and Cox proportional-hazards regression and cumulative incidence competing risks analysis were performed. Results: 370 patients with localized ESOS treated definitively with surgery presented with mainly deep tumours (n = 294, 80%). 122 patients underwent surgical resection alone, 96 (26%) also received CT, 70 (19%) RT and 82 (22%) both adjuvants. Five-year survival for patients with localized ESOS was 56% (95% CI 51%–62%). Almost half of patients (n = 173, 47%) developed recurrence: local 9% (35/370), distant 28% (102/370) or both 10% (36/370). Considering death as a competing event, there was no significant difference in cumulative incidence of local or systemic recurrence between patients who received CT, RT, both or neither (local p = 0.50, systemic p = 0.69). Multiple regression Cox analysis showed a significant association between RT and decreased local recurrence (HR 0.46 [95% CI 0.26–0.80], p = 0.01). Conclusion: Although the use of RT significantly decreased local recurrences, CT did not decrease the risk of systemic recurrence, and neither CT, nor RT nor both were associated with improved survival in patients with localized ESOS. Our results do not support the use of CT; however, adjuvant RT demonstrates benefit in patients with locally resectable ESOS.

DOI： 10.1016/j.ejca.2019.07.029

Medial meniscus posterior root repair decreases posteromedial extrusion of the medial meniscus during knee flexion. International journal

Yuki Okazaki, Takayuki Furumatsu, Yoshiki Okazaki, Shin Masuda, Takaaki Hiranaka, Yuya Kodama, Yusuke Kamatsuki, Shinichi Miyazawa, Tomonori Tetsunaga, Toshifumi Ozaki

The Knee 27 ( 1 ) 132 - 139 2020.1

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Medial meniscus (MM) medial extrusion in the coronal plane does not always improve, even after repair. This study aimed to determine the extent of posteromedial extrusion of the MM during knee flexion before and after MM pullout repair using three-dimensional magnetic resonance imaging (MRI). METHODS: Data from 14 patients (mean age, 63.4 years; 86% female) who had undergone MM pullout repair at the current institution between August 2017 and October 2018 were retrospectively reviewed. The MRIs were performed pre-operatively and ≥3 months postoperatively. Three-dimensional MRIs of the tibial surface and MM were evaluated using Tsukada's measurement method before and after pullout repair. The expected center of MM posterior root attachment (point A), the point on the extruded edge of the MM farthest away from point A (point E), and the point of intersection of a line through the posteromedial corner of the medial tibial plateau and a line connecting points A and E (point I) were identified. Subsequently, the pre-operative and postoperative AE and IE distances were calculated and compared. RESULTS: Point E was laterally shifted by the pullout repair, whereas point I showed no significant change. The postoperative IE distance (6.7 mm) was significantly shorter than the pre-operative one (9.1 mm, P < 0.01). The postoperative AE distance (29.3 mm) was significantly shorter than the pre-operative one (31.5 mm, P < 0.01). CONCLUSIONS: The AE and IE distances significantly decreased after MM posterior root repair, suggesting that transtibial pullout repair may be useful in reducing posteromedial extrusion of the MM.

DOI： 10.1016/j.knee.2019.09.005

Molecular radiosensitization of soft tissue sarcoma by oncolytic virus-mediated MCL1 ablation

Omori T, Tazawa H, Yamakawa Y, Osaki S, Hasei J, Sugiu K, Komatsubara T, Fujiwara T, Yoshida A, Kunisada T, Urata Y, Kagawa S, Ozaki T, Fujiwara T

2020.1

Relationship between oral condition and risk factors for jaw osteonecrosis in patients with hip fractures.

Norio Yamamoto, Shintaro Sukegawa, Yuka Sukegawa-Takahashi, Toru Honda, Yoshihiko Furuki, Keisuke Kawasaki, Toshifumi Ozaki

The journal of medical investigation : JMI 67 ( 3.4 ) 328 - 331 2020

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Purpose : Antiresorptive agents, such as bisphosphonates, are useful for the prevention of the recurrence of hip fractures. However, their administration has a risk of antiresorptive agent-related osteonecrosis of the jaw (ARONJ), and risk factors include poor oral hygiene. It is difficult for an orthopedic surgeon to examine a patient's oral condition thoroughly. This study evaluated the relationship between risk factors for ARONJ and intraoral findings in hip fracture patients. Materials and Methods : We evaluated 79 patients (average age of 82.2 years) with hip fracture surgery who underwent an oral assessment by dentists. The risk assessments of the intraoral findings were classified into four levels (levels 0-3), with levels 2 and 3 requiring dental treatment intervention. Data that could be extracted as risk factors of ARONJ were also examined. Results : Level 1 was found most frequently (54.4%), followed by level 0 (35.4%), level 2 (8.9%), level 3 (1.3%). The area under the receiver operating characteristic curve for the number of risk factors for the two groups (dental treatment intervention required and unnecessary) and oral findings were 0.732. When the cut-off value was set to two risk factors, the specificity and sensitivity was 53.5% and 87.5%. Conclusions : For hip fracture patients with a more than 2 risk factors, dental visits are recommended to prevent ARONJ. This is a useful evaluation method that can be used to screen for ONJ from data obtained from other risk factors, even if it is difficult to evaluate the oral condition in hospitals where dentists are absent. J. Med. Invest. 67 : 328-331, August, 2020.

DOI： 10.2152/jmi.67.328

Medial and Lateral Meniscus Posterior Root Tears with an Intact Anterior Cruciate Ligament. International journal

Yuki Okazaki, Takayuki Furumatsu, Yuya Kodama, Yoshinori Matsumoto, Motoki Takahashi, Toshifumi Ozaki

Case reports in orthopedics 2020 8842167 - 8842167 2020

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Background: Medial meniscus (MM) posterior root tear (PRT) is often caused by meniscal degeneration, whereas lateral meniscus (LM) PRT is mainly caused by trauma, especially trauma associated with anterior cruciate ligament (ACL) injuries. Although there are a few reports on PRTs of both menisci with an ACL injury, to our knowledge, there is no report on those with an intact ACL. Thus, the purpose of this study was to describe a rare case of both meniscal PRTs with an intact ACL. Case Presentation. A 67-year-old woman complained of right knee pain during weeding in a deep knee flexion position. At presentation, three days after the injury, physical examination revealed signs of meniscal injury without ACL rupture. Magnetic resonance imaging showed PRTs of both menisci and damaged cartilage, especially on the medial femoral condyle and lateral tibial plateau. MM was sutured using the FasT-Fix dependent modified Mason-Allen suture technique, and LM by a single simple stitch using the Knee Scorpion suture passer. Referring to previous cadaveric studies, transtibial pullout repair using a single tibial tunnel for MM fixation was performed. The stability of the repaired menisci was checked by probing during second-look arthroscopy at one year after the primary surgery, and no meniscal signs and symptoms were present at the last follow-up one year after the surgery. Conclusions: This rare case showed PRTs of both menisci with an intact ACL. We speculated that, in this case, both roots tore because of the degenerative menisci. A good clinical outcome was achieved after single-transtibial pullout repair. This technique may be an effective surgical approach for PRTs of both menisci.

DOI： 10.1155/2020/8842167

The factors driving self-efficacy in intractable chronic pain patients: a retrospective study. International journal

Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Haruo Misawa, Toshifumi Ozaki

Journal of orthopaedic surgery and research 14 ( 1 ) 473 - 473 2019.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The fear-avoidance model is a theoretical paradigm for explaining acute and chronic pain. In this model, pain catastrophizing plays an important role. On the other hand, self-efficacy influences whether patients view their pain optimistically, ultimately preventing the conversion of pain into intractable pain. The aim of the present study was to evaluate the factors that influence self-efficacy in patients with chronic pain. METHODS: Study participants included 147 outpatients (35 men, 112 women) with intractable chronic pain who visited our hospital between September 2014 and July 2015. Their mean age was 71.0 (range 32-92) years. Pain sites were as follows: low back, 97 patients; knee, 71 patients; shoulder, 34 patients; and hip, 15 patients. All patients were assessed using the following measures: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and Pain Self-Efficacy Questionnaire (PSEQ). All participants were further divided into two groups based on median PSEQ scores (group L: PSEQ of 35 points or less, n = 74; group H: PSEQ greater than 35 points, n = 73). The factors that influenced self-efficacy in these patients were analyzed using univariate and multiple linear regression analyses. RESULTS: Significant differences were observed in gender; pain duration; and NRS, PDAS, HADS, and PCS scores between group L and group H. Multiple linear regression analysis revealed that self-efficacy was correlated with PDAS score, HADS depression score, and pain duration. CONCLUSIONS: Patients with longer pain duration indicated greater self-efficacy and patients with higher pain disability and depression exhibited lower self-efficacy.

DOI： 10.1186/s13018-019-1535-9

Multipotent Neurotrophic Effects of Hepatocyte Growth Factor in Spinal Cord Injury. International journal

Kentaro Yamane, Haruo Misawa, Tomoyuki Takigawa, Yoshihiro Ito, Toshifumi Ozaki, Akihiro Matsukawa

International journal of molecular sciences 20 ( 23 ) 2019.12

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

Spinal cord injury (SCI) results in neural tissue loss and so far untreatable functional impairment. In addition, at the initial injury site, inflammation induces secondary damage, and glial scar formation occurs to limit inflammation-mediated tissue damage. Consequently, it obstructs neural regeneration. Many studies have been conducted in the field of SCI; however, no satisfactory treatment has been established to date. Hepatocyte growth factor (HGF) is one of the neurotrophic growth factors and has been listed as a candidate medicine for SCI treatment. The highlighted effects of HGF on neural regeneration are associated with its anti-inflammatory and anti-fibrotic activities. Moreover, HGF exerts positive effects on transplanted stem cell differentiation into neurons. This paper reviews the mechanisms underlying the therapeutic effects of HGF in SCI recovery, and introduces recent advances in the clinical applications of HGF therapy.

DOI： 10.3390/ijms20236078

Transtibial Pullout Repair Reduces Posterior Extrusion of the Medial Meniscus.

Shin Masuda, Takayuki Furumatsu, Yoshiki Okazaki, Yusuke Kamatsuki, Yuki Okazaki, Yuya Kodama, Takaaki Hiranaka, Eiji Nakata, Toshifumi Ozaki

Acta medica Okayama 73 ( 6 ) 495 - 501 2019.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Medial meniscus posterior root tear causes rapid knee cartilage degradation by inducing posteromedial displacement of the medial meniscus. We evaluated medial meniscus posterior extrusion before and after pullout repair for medial meniscus posterior root tear using magnetic resonance images. Twenty-eight patients with symptomatic medial meniscus posterior root tear were included. The inclusion criteria were: acute (< 3 months) or chronic (≥3 months) medial meniscus posterior root tear after painful popping events. The exclusion criteria were: other meniscus and anterior cruciate ligament injuries. We measured medial meniscus posterior extrusion and medial meniscus anteroposterior interval at knee flexion angles of 10° and 90° preoperatively and at 3 months postoperatively. The posterior extrusion at 90° knee flexion decreased from 4.42±1.38 mm preoperatively to 3.09±1.06 mm (p<0.001) postoperatively, while at 10° knee flexion it was -4.17±1.63 mm preoperatively and -3.77±1.72mm postoperatively, showing no significant change. The anteroposterior interval at 10° knee flexion increased from 19.74±4.27 mm preoperatively to 22.15±5.10 mm postoperatively (p<0.001); at 90° knee flexion, it increased from 16.81±4.51 mm preoperatively to 19.20±4.30 mm postoperatively (p<0.001). Medial meniscus posterior extrusion and movement decreased after pullout repair. Pullout repair for medial meniscus posterior root tear improves medial meniscus posterior extrusion, especially at 90° knee flexion.

DOI： 10.18926/AMO/57713

Intra-articular 1 g tranexamic acid administration during total knee arthroplasty is safe and effective for the reduction of blood loss and blood transfusion. International journal

Yusuke Kamatsuki, Shinichi Miyazawa, Takayuki Furumatsu, Yuya Kodama, Tomohito Hino, Yoshiki Okazaki, Shin Masuda, Yuki Okazaki, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 29 ( 8 ) 1737 - 1741 2019.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: The effect of tranexamic acid (TXA) on the incidence of venous thromboembolic events (VTEs) in total knee arthroplasty (TKA) as assessed by contrast-enhanced computed tomography (CT) is unclear. Thus, we investigated the efficacy and safety profiles of TXA administration during TKA. We hypothesised that intra-articular 1 g TXA administration would have a sufficient effect on the reduction of blood loss and transfusion rates without increasing VTE risk. MATERIALS AND METHODS: We retrospectively analysed 86 patients who underwent primary TKA from January 2014 to September 2017. The study comprised control (n = 45) and TXA (n = 41) groups. All patients underwent navigation-assisted TKA via the medial parapatellar approach. In those who received TXA, 1 g of intra-articular TXA was injected via a drain immediately following wound closure. The drain was clamped for 2 h and then reopened. Contrast-enhanced CT was performed 5-6 days after surgery to detect deep venous thrombosis (DVT) and pulmonary embolism (PE). Blood loss was calculated using the haemoglobin balance method. RESULTS: The mean postoperative volume of blood loss was 900 ± 296 mL vs 1216 ± 445 mL in the TXA vs control group (p < 0.01). Allogeneic blood transfusion was required for 0 (0%) vs 6 (13.3%) patients in the TXA vs control group (p = 0.013). There were no significant inter-group differences regarding DVT and PE incidence (p > 0.05). No case of symptomatic PE occurred. CONCLUSIONS: This study demonstrated that intra-articular 1 g TXA administration during TKA is safe and effective for reducing blood loss and blood transfusion without increasing VTE risk.

DOI： 10.1007/s00590-019-02520-5

A novel suture technique to reduce the meniscus extrusion in the pullout repair for medial meniscus posterior root tears. International journal

Yoshiki Okazaki, Takayuki Furumatsu, Shinichi Miyazawa, Shin Masuda, Yuki Okazaki, Takaaki Hiranaka, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 29 ( 8 ) 1805 - 1809 2019.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

The medial meniscus (MM) posterior root has important functions in preventing an excessive loading stress during knee motion and degeneration of the articular cartilage. Although the transtibial pullout repair has become the gold standard for MM posterior root tears (MMPRTs), MM extrusion remains. In addition, during knee extension to deep flexion, the MM posterior segment in the MMPRT knee has been shown to translate toward the posteromedial direction, causing a notable MM posterior extrusion. Thus, the reduction in the MM posteromedial extrusion is one of the important postoperative outcomes to restore the meniscal function and eventually prevent the progression of knee osteoarthritis. The present technical note describes an arthroscopic technique addition to the pullout repair, in which an all-inside suture is inserted into the posteromedial part of the MM to reduce the MM posteromedial extrusion.

DOI： 10.1007/s00590-019-02513-4

Calcaneal insufficiency fractures following total knee arthroplasty: Classification and clinical findings. International journal

Norio Yamamoto, Sachiyuki Tsukada, Jun Kawai, Daisuke Ueda, Tomoyuki Noda, Toshifumi Ozaki

Injury 50 ( 12 ) 2339 - 2345 2019.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Calcaneal insufficiency fracture (IF) following total knee arthroplasty (TKA) is a rare disorder. This study aimed to examine the prevalence and clinical findings of calcaneal IF following TKA. METHODS: We retrospectively reviewed 3,585 consecutive patients undergoing primary TKA between 2012 and 2017 in four hospitals. Calcaneal IF following TKA was diagnosed by plain radiography or magnetic resonance imaging. First, we investigated the prevalence and clinical findings of calcaneal IF following TKA. Second, we classified calcaneal IF into three types based on its location: type 1, fracture by traction force around the Achilles tendon insertion; type 2, compression fracture around the posterior subtalar joint; and type 3, fracture by ground reaction force at the bottom of the calcaneus. Finally, we compared the clinical findings between calcaneal IF with and without TKA. RESULTS: Calcaneal IF following TKA was seen in 17 (0.5%) of the 3,585 patients undergoing primary TKA. All patients were female, with a mean age of 76.5 ± 5.9 years, relatively high body mass index (BMI), and osteoporosis. All fractures achieved bone union with conservative treatment. Type 1 fractures were the most common. Calcaneal IFs following TKA were significantly shorter in height and the patients had higher BMI than those without TKA. The locations of calcaneal IF following TKA varied, while only type 1 calcaneal IFs were seen in cases without TKA. However, there were no significant differences with regard to the bone union period or malunion between the two groups. CONCLUSIONS: Calcaneal IF should be suspected in patients presenting with ipsilateral foot pain following TKA, particularly in female patients with a relatively high BMI and osteoporosis. Calcaneal IF can be classified into three types based on the fracture location. These variations in calcaneal IF may be due to differences in conditions and changes in mechanical loading of the lower extremity and bone quality following TKA.

DOI： 10.1016/j.injury.2019.10.017

Bilateral Anterior Cruciate Ligament Tear Combined with Medial Meniscus Posterior Root Tear.

Takaaki Hiranaka, Takayuki Furumatsu, Yoshiki Okazaki, Yusuke Kamatsuki, Shin Masuda, Yuki Okazaki, Shota Takihira, Shinichi Miyazawa, Eiji Nakata, Toshifumi Ozaki

Acta medica Okayama 73 ( 6 ) 523 - 528 2019.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

The case of an individual with a bilateral anterior cruciate ligament (ACL) tear combined with a medial meniscus (MM) posterior root tear is described. A 34-year-old Japanese man with bilateral ACL rupture that occurred > 10 years earlier was diagnosed with bilateral ACL tear combined with MM posterior root tear (MMPRT). We performed a transtibial pullout repair of the MMPRT with ACL reconstruction. The tibial tunnels for the MM posterior root repair and ACL reconstruction were created separately. Postoperatively, a good clinical outcome and meniscal healing were obtained. Our surgical technique may thus contribute to anatomical MM posterior root repair and ACL reconstruction.

DOI： 10.18926/AMO/57717

The Early Arthroscopic Pullout Repair of Medial Meniscus Posterior Root Tear Is More Effective for Reducing Medial Meniscus Extrusion.

Yusuke Kamatsuki, Takayuki Furumatsu, Shinichi Miyazawa, Yuya Kodama, Tomohito Hino, Yoshiki Okazaki, Shin Masuda, Yuki Okazaki, Tomoyuki Noda, Yasuaki Yamakawa, Tomoko Tetsunaga, Toshifumi Ozaki

Acta medica Okayama 73 ( 6 ) 503 - 510 2019.12

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

Clinical studies have demonstrated that transtibial pullout repair led to favorable midterm outcomes in patients with medial meniscus posterior root tears (MMPRTs) although medial meniscal extrusion (MME) continued to be present. It has been unclear whether these residual postoperative MMEs existed after the pullout repair or had progressed at the very short-term evaluation after surgery. We sought to determine which characteristics of patients with MMPRTs influence the incidence of postoperative MME. The cases of 23 patients whose date of injury was known were analyzed. All patients underwent MMPRT pullout fixation. Preoperative and 3-month postoperative magnetic resonance imaging (MRI) examinations were performed. MME was retrospectively assessed on the mid-coronal plane of MRI scans. The preoperative and postoperative MME values were 4.2±1.2 mm and 4.3±1.5 mm, respectively (p=0.559). Pullout repair surgery was performed significantly earlier after the MMPRT-specific injury in patients whose postoperative MME improved compared to the patients whose MME did not improve (p<0.001). Our findings demonstrated that an early transtibial pullout repair of an MMPRT was more effective in reducing MME than a late repair. Surgeons should not miss the optimal timing for the pullout repair of an MMPRT, considering the period from the injury and the preoperative MME.

DOI： 10.18926/AMO/57714

Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort. International journal

Masahiro Kiyono, Tomoyuki Noda, Hiroshi Nagano, Takashi Maehara, Yasuaki Yamakawa, Yusuke Mochizuki, Takahiko Uchino, Suguru Yokoo, Koji Demiya, Kenta Saiga, Yasunori Shimamura, Toshifumi Ozaki

Journal of orthopaedic surgery and research 14 ( 1 ) 384 - 384 2019.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Plate fixation is one of the standard surgical treatments for distal femoral fractures. There are few reports on the relationship between the screw position and bone union when fixing by the bridging plate (relative stability) method. METHODS: This retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Univariate analysis was performed on them. RESULTS: Of 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm. Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p = 0.06). In cases with simple fractures, one non-union case had one empty hole and one non-union case had four empty holes, whereas in cases with comminuted fractures, five non-union cases had two more empty holes. CONCLUSIONS: We concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate.

DOI： 10.1186/s13018-019-1401-9

Posttraumatic cartilage degradation progresses following anterior cruciate ligament reconstruction: A second-look arthroscopic evaluation.

Takaaki Hiranaka, Takayuki Furumatsu, Yusuke Kamatsuki, Kazuhisa Sugiu, Yoshiki Okazaki, Shin Masuda, Yuki Okazaki, Shota Takihira, Shinichi Miyazawa, Eiji Nakata, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 24 ( 6 ) 1058 - 1063 2019.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Several studies have demonstrated that posttraumatic knee osteoarthritis progresses even after anterior cruciate ligament reconstruction. Few reports described zone-specific cartilaginous damages after anterior cruciate ligament reconstruction. This study aimed to compare the status of articular cartilage at anterior cruciate ligament reconstruction with that at second-look arthroscopy. METHODS: This study included 20 patients (20 knees, 10 males and 10 females, mean age 22.4 years, Body mass index 24.4 kg/m2) that underwent arthroscopic anatomic double-bundle anterior cruciate ligament reconstruction and second-look arthroscopy. Mean periods from injury to reconstruction and from reconstruction to second-look arthroscopy were 3.4 and 15.3 months, respectively. Cartilage lesions were evaluated arthroscopically in the 6 articular surfaces and 40 articular subcompartments independently, and these features were graded with the International Cartilage Repair Society articular cartilage injury classification; comparisons were made between the grades at reconstruction and at second-look arthroscopy. Furthermore, clinical outcomes were assessed at reconstruction and at second-look arthroscopy, using the Lysholm knee score, Tegner activity scale, International Knee Documentation Committee score, Knee injury and Osteoarthritis Outcome Score, side-to-side difference of the KT-2000 arthrometer, and pivot shift test. RESULTS: Each compartment showed a deteriorated condition at second-look arthroscopy compared with the pre-reconstruction period. A significant worsening of the articular cartilage was noted in all compartments except the lateral tibial plateau and was also observed in the central region of the medial femoral condyle and trochlea after reconstruction. However, each clinical outcome was significantly improved postoperatively. CONCLUSIONS: Good cartilage conditions were restored in most subcompartments at second-look arthroscopy. Furthermore, posttraumatic osteoarthritic changes in the patellofemoral and medial compartments progressed even in the early postoperative period, although good knee stability and clinical outcomes were obtained. Care is necessary regarding the progression of osteoarthritis and the appearance of knee symptoms in patients undergoing anterior cruciate ligament reconstruction.

DOI： 10.1016/j.jos.2019.08.001

Preliminary diagnosis of medial meniscus posterior root tears using the Rosenberg radiographic view. International journal

Yuya Kodama, Takayuki Furumatsu, Yusuke Kamatsuki, Takaaki Hiranaka, Tomohiro Takahata, Masayuki Sadakane, Haruhiko Ikuta, Masaharu Yasumitsu, Toshifumi Ozaki

Knee surgery & related research 31 ( 1 ) 9 - 9 2019.9

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

PURPOSE: To verify the effectiveness of detecting medial meniscus posterior root tears (MMPRTs) using weight-bearing posterior-anterior (PA) radiographs. MATERIALS AND METHODS: Twenty-three patients were diagnosed with an MMPRT using magnetic resonance imaging (Group A), with 23 matched individuals forming the control group (Group B). The distance between medial tibial eminence and the lateral edge of the medial femoral condyle (MTE-MFC distance) and medial joint space (MJS) width were measured on weight-bearing PA radiographs, with the knee flexed at 45° (Rosenberg view). Absolute medial meniscus extrusion (MME) was measured on magnetic resonance images. RESULTS: The MTE-MFC distance was greater and the MJS width was smaller in Group A than Group B (7.7 ± 1.7 mm versus 6.0 ± 1.24 mm and 3.2 ± 0.8 mm versus 4.5 ± 0.7 mm, respectively; P < 0.05). The MTE-MFC distance and MJS width correlated with MME (r = 0.603 and 0.579, respectively; P < 0.05), and the extent of MME was greater in Group A than Group B (4.1 ± 1.1 mm versus 1.8 ± 1.5 mm, respectively; P < 0.05). CONCLUSIONS: MMPRTs increase the MTE-MFC distance and decrease the MJS width, with these measurements correlating to the MME. Therefore, measurement of the MTE-MFC distance and MJS width on the Rosenberg view could be a useful preliminary method for the diagnosis of an MMPRT. LEVEL OF EVIDENCE: IV.

DOI： 10.1186/s43019-019-0011-5

Ten-year follow-up results of perioperative chemotherapy with doxorubicin and ifosfamide for high-grade soft-tissue sarcoma of the extremities: Japan Clinical Oncology Group study JCOG0304. Reviewed

Tanaka K, Mizusawa J, Naka N, Kawai A, Katagiri H, Hiruma T, Matsumoto Y, Tsuchiya H, Nakayama R, Hatano H, Emori M, Watanuki M, Yoshida Y, Okamoto T, Abe S, Asanuma K, Yokoyama R, Hiraga H, Yonemoto T, Morii T, Ae K, Nagano A, Yoshikawa H, Fukuda H, Ozaki T, Iwamoto Y

BMC cancer 19 ( 1 ) 890 2019.9

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

Background Soft-tissue sarcomas (STS) are rare malignant tumors those are resistant to chemotherapy. We have previously reported the 3-year follow-up result on the efficacy of perioperative chemotherapy with doxorubicin (DXR) and ifosfamide (IFM) for high-risk STS of the extremities (JCOG0304). In the present study, we analyzed the 10-year follow-up results of JCOG0304. Methods Patients with operable, high-risk STS (T2bN0M0, AJCC 6th edition) of the extremities were treated with 3 courses of preoperative and 2 courses of postoperative chemotherapy, which consisted of 60 mg/m(2) of DXR plus 10 g/m(2) of IFM over a 3-week interval. The primary study endpoint was progression-free survival (PFS) estimated by Kaplan-Meier methods. Prognostic factors were evaluated by univariable and multivariable Cox proportional hazards model. Results A total of 72 patients were enrolled between March 2004 and September 2008, with 70 of these patients being eligible. The median follow-up period was 10.0 years for all eligible patients. Local recurrence and distant metastasis were observed in 5 and 19 patients, respectively. The 10-year PFS was 65.7% (95% CI: 53.4-75.5%) with no PFS events being detected during the last 5 years of follow-up. The 10-year overall survival was 78.1% (95% CI: 66.3-86.2%). Secondary malignancy was detected in 6 patients. The subgroup analysis demonstrated that there was significant difference in survival with regard to primary tumor size. Conclusions Only a few long-term results of clinical trials for perioperative chemotherapy treatment of STS have been reported. Our results demonstrate that the 10-year outcome of JCOG0304 for patients with operable, high-risk STS of the extremities was stable and remained favorable during the last 5 years of follow-up.

DOI： 10.1186/s12885-019-6114-2

The accuracy of a newly developed guide system in medial meniscus posterior root repair: a comparison between two aiming guides. International journal

Takayuki Furumatsu, Yuki Okazaki, Yuya Kodama, Yoshiki Okazaki, Yusuke Kamatsuki, Shin Masuda, Takaaki Hiranaka, Toshifumi Ozaki

Knee surgery & related research 31 ( 1 ) 7 - 7 2019.8

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

PURPOSE: Posterior root repair of the medial meniscus (MM) can prevent rapid progression of knee osteoarthritis in patients with a MM posterior root tear (MMPRT). The anatomic reattachment of the MM posterior root is considered to be critical in a transtibial pullout repair. However, tibial tunnel creation at the anatomic attachment is technically difficult. We hypothesized that a newly developed point-contact aiming guide [Unicorn Meniscal Root (UMR) guide] can create the tibial tunnel at a better position rather than a previously designed MMPRT guide. The aim of this study was to compare the position of the created tibial tunnel between the two meniscal root repair guides. MATERIALS AND METHODS: Thirty-eight patients underwent transtibial pullout repairs. Tibial tunnel creation was performed using the UMR guide (19 cases) or MMPRT guide (19 cases). Three-dimensional computed tomography images of the tibial surface were evaluated using the Tsukada's measurement method postoperatively. The expected anatomic center of the MM posterior root attachment was defined as the center of three tangential lines referring to three anatomic bony landmarks (anterior border of the posterior cruciate ligament, lateral margin of the medial tibial plateau, and retro-eminence ridge). The expected anatomic center and tibial tunnel center were evaluated using the percentage-based posterolateral location on the tibial surface. The distance between the anatomic center and tunnel center was calculated. RESULTS: The anatomic center of the MM posterior root footprint was located at a position of 79.2% posterior and 39.5% lateral. The mean of the tunnel center in the UMR guide was similar to that in the MMPRT guide (posterior direction, P = 0.096; lateral direction, P = 0.280). The mean distances between the tunnel center and the anatomic center were 4.06 and 3.99 mm in the UMR and MMPRT guide group, respectively (P = 0.455). CONCLUSIONS: The UMR guide, as well as the MMPRT guide, is a useful device to create favorable tibial tunnels at the MM posterior root attachment for pullout repairs in patients with MMPRTs. LEVEL OF EVIDENCE: IV.

DOI： 10.1186/s43019-019-0007-1

Tuberosity-overlapping Fixation of the Humeral Shaft in Humeral Head Replacement Surgery.

Takaaki Hiranaka, Keiichiro Nishida, Taizo Konishiike, Toshifumi Ozaki, Motohiko Mikasa

Acta medica Okayama 73 ( 4 ) 299 - 305 2019.8

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

The fixation technique of bony fragments is crucial for the bone union of the tuberosities after humeral head replacement (HHR) for a comminuted fracture of the proximal humerus. To increase the bone union rate, we reduce tuberosities to overlap on the humeral shaft by approx. 1 cm and fix them with cable wire. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure. Twenty-six patients who underwent cementless HHR for the treatment of comminuted fractures of the proximal humerus were investigated. The Constant-Murley score, active shoulder mobility, and bone union rate were evaluated. The mean duration of follow-up was 56.3 months (range 24-197). At the final follow-up, the average Constant-Murley score was 58 (range 40-76). Forward elevation was 126° on average (range 35°-180°). Twenty-three cases (88%) showed bone union between the tuberosities and the shaft at an average follow-up of 4.1 months (range 4-5 months) after surgery. Non-union was noted in 1 case, and bone resorption was noted in 2 cases. The bone union rate and the clinical outcome of our procedure were relatively favorable.

DOI： 10.18926/AMO/56931

Possible reparative effect of low-intensity pulsed ultrasound (LIPUS) on injured meniscus. Reviewed International journal

Kamatsuki Y, Aoyama E, Furumatsu T, Miyazawa S, Maehara A, Yamanaka N, Nishida T, Kubota S, Ozaki T, Takigawa M

Journal of cell communication and signaling 13 ( 2 ) 193 - 207 2019.6

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

Menisci are a pair of crescent-shaped fibrocartilages, particularly of which their inner region of meniscus is an avascular tissue. It has characteristics similar to those of articular cartilage, and hence is inferior in healing. We previously reported that low-intensity pulsed ultrasound (LIPUS) treatment stimulates the production of CCN2/CTGF, a protein involved in repairing articular cartilage, and the gene expression of major cartilage matrices such as type II collagen and aggrecan in cultured chondrocytes. Therefore, in this present study, we investigated whether LIPUS has also favorable effect on meniscus cells and tissues. LIPUS applied with a 60 mW/cm2 intensity for 20 min stimulated the gene expression and protein production of CCN2 via ERK and p38 signaling pathways, as well as gene expression of SOX9, aggrecan, and collagen type II in human inner meniscus cells in culture, and slightly stimulated the gene expression of CCN2 and promoted the migration in human outer meniscus cells in culture. LIPUS also induced the expression of Ccn2, Sox9, Col2a1, and Vegf in rat intact meniscus. Furthermore, histological evaluations showed that LIPUS treatment for 1 to 4 weeks promoted healing of rat injured lateral meniscus, as evidenced by better and earlier angiogenesis and extracellular matrix synthesis. The data presented indicate that LIPUS treatment might prevent meniscus from degenerative change and exert a reparative effect on injured meniscus via up-regulation of repairing factors such as CCN2 and that it might thus be useful for treatment of an injured meniscus as a non-invasive therapy.

DOI： 10.1007/s12079-018-0496-9

Post-traumatic Articular Cartilage Lesions Increase at Second-look Arthroscopy Following Primary Anterior Cruciate Ligament Reconstruction.

Kazuhisa Sugiu, Takayuki Furumatsu, Yuya Kodama, Yusuke Kamatsuki, Yoshiki Okazaki, Yuki Okazaki, Takaaki Hiranaka, Toshifumi Ozaki

Acta medica Okayama 73 ( 3 ) 223 - 228 2019.6

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

Anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL rupture improves the instability of the knee joint and decreases mechanical stress to the meniscus and articular cartilage. However, there are reports that post-traumatic osteoarthritis (PTOA) is observed over time following ACLR. In this study, we assessed changes in cartilage lesions by arthroscopic findings following anatomical double-bundle ACLR and at post-operative second-look arthroscopy about 14 months later. We retrospectively evaluated 37 knees in cases with patients <40 years of age who had undergone an anatomical double-bundle ACL reconstruction <1 year after ACL rupture injury from March 2012 to December 2016. Clinical results and arthroscopic cartilage/meniscal lesion were evaluated and compared between a cartilage lesion-detected group and intact-cartilage group. Surgery improved anteroposterior laxity and other clinical measures; however, cartilage lesions were detected at 11 sites during ACLR and at 54 sites at second-look arthroscopy. The periods from injury to second-look arthroscopy and from ACLR to second-look arthroscopy were significantly longer in the cartilage-lesion group (n=23) than in the intact-cartilage group (n=14). Conversely, 96% of meniscal damage observed during ACLR was cured at the time of second-look arthroscopy. Knee articular cartilage lesions after ACL rupture cannot be completely suppressed, even using the anatomical ACL reconstruction technique. This study suggested that articular cartilage lesions can progress to a level that can be confirmed arthroscopically at approximately 17 months after ACL injury. Therefore, in ACLR patients, the possibility of developing knee articular cartilage lesions and PTOA should be considered.

DOI： 10.18926/AMO/56864

Prevalence of and Risk Factors for the Progression of Upper Cervical Lesions in Patients with Rheumatoid Arthritis.

Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Sugimoto, Yoshihisa Nasu, Ryuichi Nakahara, Ryozo Harada, Toshifumi Ozaki

Acta medica Okayama 73 ( 3 ) 235 - 240 2019.6

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

We investigated the prevalence of and risk factors for the progression of upper cervical lesions (UCLs) in patients with rheumatoid arthritis (RA). A retrospective analysis of 49 patients with RA (4 males, 45 females) was conducted. The UCLs included atlanto-axial subluxation and vertical subluxation. We investigated the clinical factors including the Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) and the modified Health Assessment Questionnaire-Disability Index as well as radiographic changes between the baseline (at May 2010 to April 2013) and final follow-up. Forty patients (81.6%) were classified as the non-progressive group, and the other 9 patients (18.4%) comprised the progressive group. The progressive group's final CRP values, baseline or final MMP-3 levels, DAS28-CRP, and rate of pre-existing lesions at baseline were all significantly higher than those of the non-progressive group (p=0.017, p=0.043, p=0.002, p=0.008, p<0.001, and p=0.008 respectively). A multivariate logistic regression analysis demonstrated that DAS28-CRP at baseline was a risk factor for radiographic progression (p=0.018, odds ratio: 2.54, 95% confidence interval: 1.17-5.51). Our findings indicate that higher disease activity might influence the progression of UCLs in patients with RA.

DOI： 10.18926/AMO/56866

10-year follow-up results of perioperative chemotherapy with doxorubicin (DXR) and ifosfamide (IFM) for high-grade soft tissue sarcomas (STS) in the extremities: Japan Clinical Oncology Group study JCOG0304.

Kazuhiro Tanaka, Junki Mizusawa, Norifumi Naka, Akira Kawai, Hirohisa Katagiri, Toru Hiruma, Yoshihiro Matsumoto, Hiroyuki Tsuchiya, Robert Nakayama, Hiroshi Hatano, Makoto Emori, Masami Hosaka, Yukihiro Yoshida, Takeshi Okamoto, Satoshi Abe, Kunihiro Asanuma, Ryohei Yokoyama, Haruhiko Fukuda, Toshifumi Ozaki, Yukihide Iwamoto

JOURNAL OF CLINICAL ONCOLOGY 37 ( 15 ) 2019.5

Osteosarcoma in patients over 50 years of age: Multi-institutional retrospective analysis of 104 patients. Reviewed

Nagano A, Matsumoto S, Kawai A, Okuma T, Hiraga H, Matsumoto Y, Nishida Y, Yonemoto T, Hosaka M, Takahashi M, Yoshikawa H, Kunisada T, Asanuma K, Naka N, Emori M, Kubo T, Kawashima H, Kawamoto T, Yokoyama R, Tsukushi S, Sato K, Okamoto T, Hiraoka K, Morioka H, Tanaka K, Takagi T, Iwamoto Y, Ozaki T

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 25 ( 2 ) 319 - 323 2019.5

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

BACKGROUND: Primary osteosarcoma in elderly patients are rare malignant tumors. Its optimal treatment has not yet been determined. METHODS: This retrospective study included 104 patients aged >50 years with resectable, non-metastatic osteosarcoma treated by the members of the Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group. The effects of adjuvant chemotherapy were estimated by comparing outcomes in patients who received surgery plus chemotherapy with those who underwent surgery alone. RESULTS: Median age at presentation was 59 years. Neoadjuvant and adjuvant chemotherapy was administered to 83 (79.8%) patients. Patients who underwent surgery plus chemotherapy and those who underwent surgery alone had 5-year overall survival (OS) rates of 68.6% and 71.7%, respectively (p = 0.780), and 5-year relapse free survival (RFS) rates of 48.2% and 43.6%, respectively (p = 0.64). Univariate analysis showed that resection with wide margins was significantly correlated with better prognosis. CONCLUSIONS: The addition of chemotherapy to surgery did not improve OS or RFS in patients aged >50 years with resectable, non-metastatic osteosarcoma. Surgery with wide margins was only significantly prognostic of improved survival. The effect of chemotherapy in elderly osteosarcoma patients was unclear.

DOI： 10.1016/j.jos.2019.04.008

Arthroscopic scoring system of meniscal healing following medial meniscus posterior root repair. International journal

Takayuki Furumatsu, Shinichi Miyazawa, Masataka Fujii, Takaaki Tanaka, Yuya Kodama, Toshifumi Ozaki

International orthopaedics 43 ( 5 ) 1239 - 1245 2019.5

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

PURPOSE: Medial meniscus posterior root tear (MMPRT) leads to a rapid degradation of articular cartilage. In the treatment of MMPRT, transtibial pullout repair demonstrates a high clinical survival rate. However, there is no reliable method to evaluate the meniscal healing after surgery. We propose an arthroscopic scoring system for evaluating the meniscal healing status. The aim of this study was to investigate the correlations between second-look arthroscopic scores and clinical outcomes after transtibial pullout repair. METHODS: Twenty patients who had MMPRTs underwent transtibial pullout repairs. Clinical outcomes were assessed using the Japanese Knee Injury and Osteoarthritis Outcome Score (KOOS) and pain score evaluated by visual analogue scale at preoperatively and 1 year postoperatively. The healing status of repaired MM was assessed at one year post-operatively using a semi-quantitative arthroscopic scoring system (total, 10 points) composed of three evaluation criteria: (i) anteroposterior width of bridging tissues, (ii) stability of the MM posterior root, and (iii) synovial coverage of the sutures. Linear regression analysis was used to assess the correlation between second-look arthroscopic scores and clinical outcomes. RESULTS: Transtibial pullout repairs of MMPRTs significantly improved clinical evaluation scores at one year post-operatively. A median of second-look arthroscopic scores was 6.5 (5.75-8). A good correlation was observed between the arthroscopic score and KOOS quality of life (QOL) subscale. A moderate negative correlation between the arthroscopic score and pain score was observed. CONCLUSIONS: This study demonstrated that our semi-quantitative scoring system of meniscal healing correlated with the KOOS QOL subscale following MMPRT transtibial pullout repair. Our results suggest that the second-look arthroscopic score using this system may be a useful scale to determine and compare the healing status of the MM posterior root.

DOI： 10.1007/s00264-018-4071-z

Very rare solitary primary peripheral nerve onset cytotoxic molecule-positive peripheral T-cell lymphoma (PTCL)

Namiko Matsumoto, Kota Sato, Yoshiaki Takahashi, Yuko Kawahara, Taijun Yunoki, Jingwei Shang, Mami Takemoto, Nozomi Hishikawa, Yasuyuki Ohta, Toru Yamashita, Maiko Sakamoto, Eisei Kondou, Rei Shibata, Tadashi Yoshino, Toshifumi Ozaki, Koji Abe

NEUROLOGY AND CLINICAL NEUROSCIENCE 7 ( 3 ) 146 - 149 2019.5

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

Here we present the first report of solitary primary peripheral nerve onset cytotoxic molecule (CM)-positive peripheral T-cell lymphoma (PTCL) diagnosed after nerve biopsy. An 84-year-old female with rheumatoid arthritis (RA) complained of asymmetric severe tenderness in her upper limbs. The biopsy pathology revealed a direct invasion of CM-positive PTCL. When RA patients complain of numbness, tenderness, or weakness, lymphomatic peripheral nerve invasion should be considered.

DOI： 10.1111/ncn3.12280

Histological alterations to the hamstring tendon caused by cleaning during autograft preparation Reviewed International journal

Okazaki Y, Furumatsu T, Maehara A, Miyazawa S, Kamatsuki Y, Hino T, Ozaki T

Muscles, Ligaments and Tendons Journal 9 ( 2 ) 217 - 224 2019.4

Nonunion fragility fracture of the pelvis with complication from bladder rupture: A case report. Reviewed International journal

Yamakawa Y, Noda T, Saito T, Saiga K, Nakahara R, Shimamura Y, Ozaki T

Trauma case reports 20 100169 - 100169 2019.4

Language：English

The incidence rate of bladder rupture associated with pelvic ring fractures is reported to be about 5-10%, mostly occurring at the time of injury. Fragility pelvic ring fractures are reported to increase fracture displacement or become nonunion if they are treated inadequately. Few case reports on bladder rupture associated with fragility pelvic ring fracture have been published. We report a rare case of delayed bladder rupture associated with a fragility fracture of the pelvis. A 65-year-old female felt right hip pain without sustaining any trauma. She was diagnosed with a right pubic rami fracture. However, her pain deteriorated, and a sacral fracture was identified one month later. She was prescribed teriparatide, but her pain worsened and she was referred to our hospital. She was diagnosed with fragility fracture of the pelvis (Rommens classification type IVb) and was treated operatively. During the surgery, her thin bladder wall, which was compressed by a displaced pubic fragment, was torn and repaired. This is the first report describing a fragility fracture of the pelvis associated with a bladder rupture. Our treatment led to a successful result.

DOI： 10.1016/j.tcr.2019.100169

Temporary External Fixation Can Stabilize Hip Transposition Arthroplasty After Resection of Malignant Periacetabular Bone Tumors. Reviewed International journal

Kunisada T, Fujiwara T, Hasei J, Nakata E, Senda M, Ozaki T

Clinical orthopaedics and related research 477 ( 8 ) 1892 - 1901 2019.4

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

BACKGROUND: The choice of reconstructive procedure to restore limb function is challenging after internal hemipelvectomy. Hip transposition arthroplasty, also known as resection arthroplasty, removes a malignant or aggressive tumor of the pelvis and acetabulum after which the remaining femoral head is moved proximally to the lateral surface side of the sacrum or the underside of the resected ilium after internal hemipelvectomy. It may provide reasonable functional results and have some advantages such as lowering the risk of an infected implant compared with other reconstructions because no foreign implants are used. Hip transposition is generally managed with prolonged bed rest or immobilization postoperatively to stabilize the soft tissue surrounding the remaining femur. Because enabling patients to be mobile while the soft tissues heal might be advantageous, we reviewed our experience with an external fixation for this procedure. QUESTIONS/PURPOSES: (1) Does temporary external fixation facilitate postoperative physiotherapy in patients who undergo hip transposition arthroplasty? (2) What functional Musculoskeletal Tumor Society (MSTS) scores were achieved at short term in a small series of patients treated with hip transposition and temporary external fixation? (3) What were the complications of using external fixation in a small series of patients who received it for malignant tumors? METHODS: Between 2008 and 2012, we treated seven patients (three men and four women; median age, 37 years; age range, 18-53 years) with acetabular resection for malignant bone tumors; all were managed with a hip transposition, initially stabilized using external fixation. No other types of procedures were used for this indication in this period. Minimum followup in this retrospective study was 45 months, except for one patient who died at 18 months (range of followup duration, 18-90 months; median followup, 57 months), and no patients were lost to followup. The pins for external fixation were inserted into the affected side of the femur and the healthy contralateral ilium. External fixation was removed 6 weeks postoperatively and weightbearing was started at that time. Preoperative chemotherapy was administrated in four patients, but postoperative chemotherapy was delayed since it was given after external fixation removal in three patients. The postoperative rehabilitation course and functional results were assessed by chart review, functional results were determined using MSTS scores, tallied by physiotherapists who were not part of the surgical team, and complications were ascertained through chart review. Major complications were defined as complications that were treated with additional operations, such as deep infection, or ones that could cause severe postoperative dysfunction, such as nerve injury. RESULTS: With temporary external fixation, standing next to a bed was achieved in median 7 days (range, 6-9 days) postoperatively, transferring to a wheel chair in median 8 days (range, 6-28 days), and gait training using parallel bars in median 15 days (range, 7-48 days). At most recent followup, three patients could walk without a crutch or cane, three could walk with a cane, and one could walk with a crutch. The median MSTS score at most recent followup (median, 57 months) was 63%. Two patients had complications that resulted in reoperations; one had a wound dehiscence, and one had an abdominal herniation that gradually developed, and which was reconstructed using polypropylene mesh 2 years after pelvic resection. Two patients had nerve palsies that recovered by the end of the first year. All patients had pin tract infections that resolved with nonsurgical approaches. CONCLUSIONS: Hip transposition with temporary external fixation can stabilize the bone soft tissue after pelvic resection. Although we did not have a comparison group of patients, we believe that external fixation facilitates early postoperative physiotherapy and rehabilitation and provides good functional results without major surgical complications. Because it delays the resumption of chemotherapy, more patients with longer followup are needed to determine whether this will be associated with poorer oncologic results. LEVEL OF EVIDENCE: Level IV, therapeutic study.

DOI： 10.1097/CORR.0000000000000764

Involvement of ADAM12 in Chondrocyte Differentiation by Regulation of TGF-β1-Induced IGF-1 and RUNX-2 Expressions. Reviewed International journal

Horita M, Nishida K, Hasei J, Furumatsu T, Sakurai M, Onodera Y, Fukuda K, Salter DM, Ozaki T

Calcified tissue international 105 ( 1 ) 97 - 106 2019.4

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

A disintegrin and metalloproteinase 12 (ADAM12) is known to be involved in chondrocyte proliferation and maturation; however, the mechanisms are not fully understood. In this study, expression and localization of ADAM12 during chondrocyte differentiation were examined in the mouse growth plate by immunohistochemistry. Adam12 expression during ATDC5 chondrogenic differentiation was examined by real-time PCR and compared with the expression pattern of type X collagen. The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 system was used to generate Adam12-knockout (KO) ATDC5 cells. Adam12-KO and Adam12 overexpressing cells were used for analyses of ADAM12 expression with or without TGF-β1 stimulation. ADAM12 was identified predominantly in chondrocytes of the proliferative zone in mouse growth plates by immunohistochemistry. Adam12 was upregulated prior to Col10a1 during chondrogenic differentiation in wild-type ATDC5 cells. In Adam12-KO ATDC5 cells, following initiation of chondrogenic differentiation, we observed a reduction in Igf-1 expression along with an upregulation of hypertrophy-associated Runx2, Col10a1, and type X collagen protein expressions. In ATDC5 wild-type cells, stimulation with TGF-β1 upregulated the expressions of Adam12 and Igf-1 and downregulated the expression of Runx2. In contrast, in Adam12-KO ATDC5 cells, these TGF-β1-induced changes were suppressed. Adam12 overexpression resulted in an upregulation of Igf-1 and downregulation of Runx2 expression in ATDC5 cells. The findings suggest that ADAM12 has important role in the regulation of chondrocyte differentiation, potentially by regulation of TGF-β1-dependent signaling and that targeting of ADAM12 may have a role in management of abnormal chondrocyte differentiation.

DOI： 10.1007/s00223-019-00549-6

Posteromedial vertical capsulotomy selectively increases the extension gap in posterior stabilized total knee arthroplasty. Reviewed International journal

Masuda S, Miyazawa S, Yuya K, Kamatski Y, Tomohito H, Yoshiki O, Yuki O, Furumatsu T, Ozaki T

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 28 ( 5 ) 1419 - 1424 2019.4

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

PURPOSE: In total knee arthroplasty (TKA), it is important to obtain an appropriate flexion-extension gap. The extension gap is expanded by posteromedial vertical capsulotomy (PMVC). This study aimed to evaluate the increase in the extension gap by PMVC using a navigation system. METHODS: In posterior stabilized (PS)-type TKA, PMVC was performed in 37 knees. The medial extension gap at 0° and flexion gap at 90° flexion of the knee joint using the navigation system before and after PMVC were measured. RESULTS: The extension gap before the PMVC was 5.3 ± 2.9 mm. After PMVC, the extension gap had significantly increased to 8.0 ± 2.8 mm (p < 0.001). In addition, the flexion gap was 8.1 ± 2.7 mm before the PMVC, but it was 8.7 ± 2.8 mm after the PMVC, and the flexion gap was not enlarged (n.s.). CONCLUSION: In PS-type TKA, it is possible to obtain selective expansion of about 2.7 mm of the extension gap by PMVC. Therefore, gap balance can be acquired by soft-tissue treatment while preserving the bone. The PMVC was a useful method for acquiring gap balance and preserving the bone stock. LEVEL OF EVIDENCE: IV.

DOI： 10.1007/s00167-019-05511-5

Description of a surgical technique of medial meniscus root repair: a fixation technique with two simple stiches under an expected initial tension. Reviewed International journal

Okazaki Y, Furumatsu T, Kodama Y, Kamatsuki Y, Masuda S, Ozaki T

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 29 ( 3 ) 705 - 709 2019.4

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

The medial meniscus (MM) posterior root has an important role in the maintenance of knee kinematics and articular cartilage. Although transtibial pullout repair of the MM posterior root tear (MMPRT) has become the gold standard, it is associated with several suturing difficulties. The present technical note describes a simple fixation technique using two simple stiches under an expected initial tension. After the degree of knee flexion (20°) and an expected tension (30 N) are checked, tibial fixation is performed using a bioabsorbable interference screw with a spring tensioner. After that, a suture knot is made just below the screw in case the sutures are pulled toward the joint direction. Furthermore, a cancellous screw is inserted at a position 1-cm distal from the tibial tunnel for augmentation and is tightened. MMPRT usually occurs in middle-aged females who often have decreased bone quality. However, there is no risk of tibial fracture with our new technique because the bone does not need to be hit. Adopting the advances of fixation with a spring tensioner and Biosure RG instead of Double Spike Plate, we can determine an expected tension easily and safely. The present fixation technique allows reproducibility for many operators to determine an initial tension and might be a good candidate for arthroscopic repair of the MMPRT. Further follow-up studies including second-look arthroscopy and scoring will be necessary to show the clinical benefits of this technique.

DOI： 10.1007/s00590-018-2347-z

A randomized phase III trial of denosumab before curettage for giant cell tumor of bone: Japan Clinical Oncology Group Study JCOG1610. Reviewed

Urakawa H, Mizusawa J, Tanaka K, Eba J, Hiraga H, Kawai A, Nishida Y, Hosaka M, Iwamoto Y, Fukuda H, Ozaki T

Japanese journal of clinical oncology 49 ( 4 ) 379 - 382 2019.4

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS

A randomized phase III trial was planned to commence in October 2017. Resectable giant cell tumor of bone (GCTB) without possible postoperative large bone defect has been treated by curettage with local adjuvant treatment, with the local recurrence rate found to be as high as 24.6-30.8%. The aim of this study is to confirm the superiority of preoperative denosumab for patients with GCTB without possible postoperative large bone defect. A total of 106 patients will be accrued from 34 Japanese institutions over 5 years. The primary endpoint is relapse-free survival (RFS). Secondary endpoints include overall survival, joint-preserved survival, local RFS, metastasis-free survival, adverse events, serious adverse events, surgical and postoperative complications, and discontinuation of denosumab. This trial is conducted by the Bone and Soft Tissue Tumor Study Group in the Japan Clinical Oncology Group and has been registered in the UMIN Clinical Trials Registry as UMIN000029451 [http://www.umin.ac.jp/ctr/index.htm].

DOI： 10.1093/jjco/hyz004

Metformin induces CD11b+-cell-mediated growth inhibition of an osteosarcoma: implications for metabolic reprogramming of myeloid cells and anti-tumor effects. Reviewed International journal

Takenori Uehara, Shingo Eikawa, Mikako Nishida, Yuki Kunisada, Aki Yoshida, Tomohiro Fujiwara, Toshiyuki Kunisada, Toshifumi Ozaki, Heiichiro Udono

International immunology 31 ( 4 ) 187 - 198 2019.3

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

CD11b+ myeloid subpopulations, including myeloid-derived suppressor cells (MDSCs) and tumor-associated macrophages (TAMs), play crucial roles in the suppression of T-cell-mediated anti-tumor immunity. Regulation of these cell types is a primary goal for achieving efficient cancer immunotherapy. We found that metformin (Met) induces CD11b+-cell-mediated growth inhibition of a K7M2neo osteosarcoma independent of T cells, as growth inhibition of K7M2neo was still observed in wild-type (WT) mice depleted of T cells by antibodies and in SCID; this contrasted with the effect of Met on Meth A fibrosarcoma, which was entirely T-cell-dependent. Moreover, the inhibitory effect seen in SCID was abrogated by anti-CD11b antibody injection. PMN-MDSCs were significantly reduced in both spleens and tumors following Met treatment. In TAMs, production of IL-12 and TNF-α, but not IL-10, became apparent, and elevation of MHC class II with reduction of CD206 was observed, indicating a shift from an M2- to M1-like phenotype via Met administration. Metabolically, Met treatment decreased basal respiration and the oxygen consumption rate (OCR)/extracellular acidification rate (ECAR) ratio of CD11b+ cells in tumors, but not in the spleen. In addition, decreased reactive oxygen species (ROS) production and proton leakage in MDSCs and TAMs were consistently observed in tumors. Uptake of both 2-deoxy-2-d-glucose (2-NBDG) and BODIPY® decreased in MDSCs, but only BODIPY® incorporation was decreased in TAMs. Overall, our results suggest that Met redirects the metabolism of CD11b+ cells to lower oxidative phosphorylation (OXPHOS) while elevating glycolysis, thereby pushing the microenvironment to a state that inhibits the growth of certain tumors.

DOI： 10.1093/intimm/dxy079

Comparison of the postoperative analgesic efficacies of intravenous acetaminophen and fascia iliaca compartment block inhip fracture surgery: A randomised controlled trial. Reviewed International journal

Yamamoto N, Sakura S, Noda T, Nishiyama A, Dan'ura T, Matsui Y, Ozaki T

Injury 50 ( 10 ) 1689 - 1693 2019.3

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

BACKGROUND: Managing pain during movement after hip fracture surgery is important for achieving earlier hip mobilisation and for preventing postoperative complications. In the present study, we tested the hypothesis that the fascia iliaca compartment block (FICB) would improve postoperative pain on movement compared with intravenous acetaminophen. METHODS: In this prospective, randomised, controlled, parallel trial, patients were assigned to either the intravenous acetaminophen or the ultrasound-guided FICB group. Visual analog scale (VAS) pain scores were evaluated at 6, 9, 12, 18, 24 h, 2 days, and 7 days postoperatively. The primary outcome was VAS scores on movement at 24 h after surgery. The secondary outcomes were VAS scores on movement at the other time points, VAS scores at rest, the total number of rescue analgesics required and incidence of delirium during the first 24 h postoperatively, potential drug or block-related complications, and the time to first standing. RESULTS: VAS scores on movement at 24 h after surgery were significantly lower in the FICB group than in the intravenous acetaminophen group [median (the 25th to 75th percentiles), 20 (10-30) vs 40 (30-53); P < 0.01]. The VAS scores on movement at any other time point and the scores at rest at 12 h after surgery were also significantly lower in the FICB group than in the intravenous acetaminophen group. The two groups did not differ in terms of the total number of rescue analgesics required or the incidence of delirium during the first 24 h postoperatively; complications; or the time to first standing. CONCLUSIONS: FICB improved postoperative pain on movement compared with intravenous acetaminophen without increasing the complication rate. However, the total number of rescue analgesics required and the time to first standing were not significantly different between the two groups.

DOI： 10.1016/j.injury.2019.03.008

Predicting acetabular growth in developmental dysplasia of the hip following open reduction after walking age. Reviewed

Miyake T, Tetsunaga T, Endo H, Yamada K, Sanki T, Fujiwara K, Nakata E, Ozaki T

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 24 ( 2 ) 326 - 331 2019.3

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

BACKGROUND: Acetabular dysplasia of the hip following open reduction can complicate the treatment of developmental dysplasia of the hip (DDH). The purposes of this retrospective study were to investigate the long-term results of open reduction performed via an extensive anterolateral approach for DDH after walking age and to predict acetabular development using postoperative radiographs and arthrograms. METHODS: From 1973 to 2001, we performed open reduction for 131 hips in 119 pediatric patients with DDH after failed closed reduction. Of these, 85 hips of 73 patients who underwent arthrography at 5 years old were followed-up radiologically until skeletal maturity. Mean age at the time of surgery was 17 ± 4.6 months (range, 10-33 months), and mean age at final survey was 19 ± 5.7 years (range, 14-33 years). Mean follow-up time was 17.7 ± 5.8 years (range, 13-32 years). Groups with satisfactory outcomes (66 hips) and unsatisfactory outcomes (19 hips) according to the Severin classification were compared. Factors predicting acetabular development were identified using univariate and multiple logistic analyses. RESULTS: Univariate analysis showed a significant between-group difference in acetabular index (AI) at 2 months postoperatively, and in center-edge (CE) angle, cartilaginous AI (CAI), and cartilaginous CE angle at 5 years old (p < 0.05 each). In multiple logistic regression analysis, CAI at 5 years old represented a predictor of acetabular development after open reduction for DDH (odds ratio, 1.81; 95% confidence interval (CI), 1.04-3.13; p < 0.05). Area under the receiver operating characteristic curve for CAI at 5 years old was 0.93 (95%CI, 0.85-1.0), and the optimal cut-off was 10° (81.8% sensitivity, 92% specificity). CONCLUSIONS: A CAI ≥10° on hip arthrograms at 5 years old may offer a useful indicator of the need for corrective surgery following open reduction after walking age.

DOI： 10.1016/j.jos.2018.09.015

Early response assessment of re-ossification after palliative conventional radiotherapy for vertebral bone metastases. Reviewed

Nakata E, Sugihara S, Kataoka M, Yamashita N, Furumatsu T, Takigawa T, Tetsunaga T, Ozaki T

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 24 ( 2 ) 332 - 336 2019.3

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

BACKGROUND: To evaluate the therapeutic outcomes in patients with bone metastases receiving radiotherapy (RT), it is important to use objective radiological response criteria. The aim of this study was to investigate the changes in pain and re-ossification after RT for painful vertebral bone metastases without paralysis by malignant spinal cord compression. METHODS: The participants included 55 patients who received RT for painful vertebral bone metastases without paralysis in our institution between 2012 and 2016. Bone modifying agents (BMAs) were administered in all patients. Follow-up assessments were done just before the start of RT and at 1, 2, 3, 4, and 6 months after RT. Radiological responses of irradiated vertebrae by RT were assessed by computed tomography (CT) using MD Anderson response classification criteria (MDA criteria) and the pain response was assessed by Numeric Rating Scale (NRS). Response was classified as complete response (CR), partial response (PR), progressive disease (PD), and stable disease (SD). RESULTS: The rates of CR were 2%, 7%, 20%, 30%, and 56% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were 15%, 49%, 77%, 91%, and 91% at 1, 2, 3, 4, and 6 months, respectively. The rates of CR or PR were significantly higher in patients with breast cancer than in patients with lung cancer (p = 0.043). At one month, there was an association between the NRS and radiological response assessed by MDA criteria. There was a significant trend that, with a better response, there were more patients without pain (p = 0.021). CONCLUSIONS: Under BMAs administration, successful RT for vertebral bone metastases decreased pain and caused re-ossification. The MD Anderson criteria could be useful for assessment of radiological responses of irradiated vertebrae.

DOI： 10.1016/j.jos.2018.08.018

Mini-open excision of osteoid osteoma using intraoperative O-arm/Stealth navigation. Reviewed

Fujiwara T, Kunisada T, Takeda K, Hasei J, Nakata E, Mochizuki Y, Kiyono M, Yoshida A, Ozaki T

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 24 ( 2 ) 337 - 341 2019.3

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

BACKGROUND: Although osteoid osteomas have traditionally been treated by surgical excision, radiofrequency ablation (RFA) has gained favor as a less invasive procedure. However, RFA is contraindicated for osteoid osteomas close to the skin or crucial neurovascular structures, and is not covered by national health insurance in Japan. The aim of the present study was to evaluate the efficacy of surgical excision of osteoid osteomas using intraoperative navigation. METHODS: We performed a retrospective review of five patients with osteoid osteoma who underwent a mini-open excision using O-arm/Stealth navigation at our institution. The osteoid osteomas were excised using a cannulated cutter or curetted out with the assistance of navigation. RESULTS: Complete excision was achieved in all patients, which was confirmed by pathological examination. The mean skin incision was 2.1 cm (range, 1.5 to 3.0 cm) and the mean duration required for setup three-dimensional image was 15 min (range, 12 to 20 min). Although the mean visual analog scale score was 7 (range, 4 to 8) before surgery, all patients experienced relief from their characteristic pain immediately after surgery, with the mean scores of 2.2 (range, 1 to 3) and 0 at 2 days and 4 weeks after surgery, respectively. There was no intra-operative complication related to the navigation and no recurrence was observed during the mean follow-up period of 25 months (range, 13 to 33 months). CONCLUSIONS: Mini-open excision using intraoperative O-arm/Stealth navigation is a safe and accurate procedure for patients with osteoid osteoma, which could cover the limitation of RFA.

DOI： 10.1016/j.jos.2018.09.017

Time-Dependent Increase in Medial Meniscus Extrusion after Medial Meniscus Posterior Root Tear Analyzed by Using Magnetic Resonance Imaging. Reviewed International journal

Okazaki Y, Furumatsu T, Shimamura Y, Saiga K, Ohashi H, Uchino T, Kamatsuki Y, Okazaki Y, Ozaki T

Knee surgery & related research 31 ( 2 ) 120 - 125 2019.3

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

Purpose: Medial meniscus posterior root tear (MMPRT) causes progression of medial meniscus extrusion (MME). This study aims to calculate the progression rate of MME based on findings in two preoperative magnetic resonance imaging (MRI) scans and determine the associated factors. Materials and Methods: We retrospectively reviewed 33 patients (27 females and 6 males; mean age, 60 years) who underwent MRI twice, at a mean interval of 48 days. We measured the medial meniscus body width, medial joint space width (MJSW), and MME. The MME progression rate was derived from regression analysis of the increase in MME (ΔMME) between the two MRI scans. In addition, the correlations of the MME increase rate with age, body mass index, femorotibial angle, and MJSW were evaluated. Results: The mean MME increased from 3.4 mm to 4.5 mm (p<0.001). A good correlation was observed between ΔMME and the interval of MRI scans (R2=0.621), and the MME progression rate was 0.020 mm per day. A moderate correlation was observed between the MME increase rate and the MJSW (R2=0.432). Conclusions: The MME progression rate was rapid in MMPRT and narrowing of the MJSW was associated with the progression of MME. Level of Evidence: V, Cross-sectional study.

DOI： 10.5792/ksrr.18.059

Pullout repair using modified Mason-Allen suture induces better meniscal healing and superior clinical outcomes: A comparison between two surgical methods. Reviewed International journal

Furumatsu T, Okazaki Y, Kodama Y, Okazaki Y, Masuda S, Kamatsuki Y, Takihira S, Hiranaka T, Yamawaki T, Ozaki T

The Knee 26 ( 3 ) 653 - 659 2019.3

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

BACKGROUND: Pullout repairs of medial meniscus posterior root tears (MMPRTs) have many surgical options. However, there has been no reliable clinical study conducted to compare the superiority of each pullout repair technique. The current study hypothesized that pullout repairs using a modified Mason-Allen suture with FasT-Fix (F-MMA) would have several advantages in postoperative clinical outcomes and meniscal healing compared with single FasT-Fix. The aim of this study was to investigate the clinical usefulness of these two techniques in treating MMPRTs. METHODS: Thirty-eight patients who had complete MMPRTs were included. All patients underwent transtibial pullout repairs. To compare the clinical usefulness between pullout repairs using single FasT-Fix and F-MMA techniques, patients were divided into two groups. Second-look arthroscopic evaluations of meniscal healing were performed at one year postoperatively. Clinical outcomes were assessed using: Lysholm and visual analogue scale (VAS) pain scores, and Knee Injury and Osteoarthritis Outcome Score (KOOS). RESULTS: Single FasT-Fix and F-MMA pullout repairs improved clinical outcomes in patients with MMPRTs. At second-look arthroscopy, VAS pain, KOOS pain, and arthroscopic meniscal healing scores following F-MMA pullout repairs were superior to those after single FasT-Fix pullout repairs. CONCLUSIONS: This study demonstrated that F-MMA suture configuration obtained better meniscal healing and superior clinical outcomes compared with single FasT-Fix repairs in patients with MMPRTs. These results suggest that the F-MMA pullout repair may possibly reduce knee pain in arthroscopic treatments of MMPRTs.

DOI： 10.1016/j.knee.2019.02.007

Injury patterns of medial meniscus posterior root tears. Reviewed International journal

Furumatsu T, Okazaki Y, Okazaki Y, Hino T, Kamatsuki Y, Masuda S, Miyazawa S, Nakata E, Hasei J, Kunisada T, Ozaki T

Orthopaedics & traumatology, surgery & research : OTSR 105 ( 1 ) 107 - 111 2019.2

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

INTRODUCTION: Medial meniscus posterior root tear (MMPRT) can occur in middle-aged patients who have a posteromedial painful popping during light activities. MMPRTs are more common in patients with increased age, female gender, sedentary lifestyle, obesity, and varus knee alignment. However, injury mechanisms of minor traumatic MMPRTs are still unclear. We hypothesized that high flexion activities are the major cause of MMPRTs. The aim of this study was to clarify injury patterns of MMPRTs. MATERIALS AND METHODS: One hundred patients were diagnosed having MMPRTs after posteromedial painful popping episodes. Details of posteromedial painful popping episode, situation of injury, and position of injured leg were obtained from the patients by careful interviews. Injury patterns were divided into 8 groups: descending knee motion, walking, squatting, standing up action, falling down, twisting, light exercise, and minor automobile accident. RESULTS: A descending knee motion was the most common cause of MMPRTs (38%) followed by a walking injury pattern (18%) and a squatting action related to high flexion activities of the knee (13%). The other injury patterns were less than 10%. DISCUSSION: Descending knee motions associated with descending stairs, step, and downhill slope are the most common injury pattern of MMPRTs. High flexion activities of the knee are not the greatest cause of MMPRTs. Our results suggest that the descending action with a low knee flexion angle may trigger minor traumatic MMPRTs. LEVEL OF EVIDENCE: IV, retrospective cohort study.

DOI： 10.1016/j.otsr.2018.10.001

Is immunohistochemical staining for β-catenin the definitive pathological diagnostic tool for desmoid-type fibromatosis? A multi-institutional study. Reviewed International journal

Koike H, Nishida Y, Kohno K, Shimoyama Y, Motoi T, Hamada S, Kawai A, Ogose A, Ozaki T, Kunisada T, Matsumoto Y, Matsunobu T, Ae K, Gokita T, Sakai T, Shimizu K, Ishiguro N

Human pathology 84 155 - 163 2019.2

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

Immunohistochemical staining with anti-β-catenin antibody has been applied as a diagnostic tool for desmoid-type fibromatoses (DFs). In recent years, specific gene mutation (CTNNB1) analysis has also been reported to be useful for diagnosis of DF; however, the association between CTNNB1 mutation status and immunohistochemical staining pattern of β-catenin is rarely reported. The purposes of this study are to clarify the relationship of the staining pattern of β-catenin with the CTNNB1 mutation status and various clinical variables, and to investigate the significance of immunohistochemical staining of β-catenin in cases diagnosed as DF. Between 1997 and 2017, 104 cases diagnosed as DF from 6 institutions in Japan were enrolled in this study: Nagoya University, National Cancer Center Hospital, Niigata University, Okayama University, Kyushu University, and Cancer Institute Hospital. For all cases, immunohistochemical staining of β-catenin and gene mutation analysis of CTNNB1 were performed. Of 104 cases, 87 (84%) showed nuclear staining of β-catenin, and 95 (91%) showed positive staining in the cytoplasm. The proportion of cases showing strong nuclear staining of β-catenin was significantly higher in the cases with S45F than in those with T41A or wild type. The proportion of cases stained strongly in the cytoplasm rather than in the nucleus was significantly higher in the group of T41A than that of S45F or wild type. Among 17 cases in which nuclear immunostaining was absent, CTNNB1 mutation was observed in 5 cases (29.4%). There were unignorable cases of DF with negative β-catenin immunostaining despite a definitive clinical and pathological diagnosis of DF and/or positive CTNNB1 mutation.

DOI： 10.1016/j.humpath.2018.09.018

New TNM classification (AJCC eighth edition) of bone and soft tissue sarcomas: JCOG Bone and Soft Tissue Tumor Study Group. Reviewed International journal

Tanaka K, Ozaki T

Japanese journal of clinical oncology 49 ( 2 ) 103 - 107 2019.2

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

The Cancer Staging Manual of the American Joint Committee on Cancer (AJCC) has recently been revised and updated to its eighth edition. This review focuses on the new staging system of bone and soft tissue sarcomas and outlines the revision points and caveats in the latest edition. The major changes in the eighth edition of the AJCC staging for bone and soft tissue sarcomas are the following four points. (i) Tumors are described separately according to the primary sites. For bone sarcoma, three tumor locations are described: (a) appendicular skeleton, trunk, skull and facial bones; (b) spine and (c) pelvis. Meanwhile, four tumor locations are described for soft tissue sarcoma: (1) trunk and extremity; (2) retroperitoneum; (3) head and neck and (4) visceral sites. (ii) Histologic grading system in bone sarcoma is changed to three-grade classifications. (iii) For soft tissue sarcoma, AnyTN1M0 tumor in the trunk and extremity is classified as stage IV, whereas for the retroperitoneal tumor, anyTN1M0 remains as stage IIIB. (iv) For soft tissue sarcomas in the trunk, extremity and retroperitoneum, tumor size was classified into four categories: (a) ≤5 cm; (b) >5 cm and ≤10 cm; (c) >10 cm and ≤15 cm and (d) >15 cm. In addition, the notation about the depth of the tumor (superficial or deep from the superficial fascia) has been eliminated.

DOI： 10.1093/jjco/hyy157

Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position. Reviewed International journal

Okazaki Y, Furumatsu T, Miyazawa S, Kodama Y, Kamatsuki Y, Hino T, Masuda S, Ozaki T

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 27 ( 2 ) 361 - 368 2019.2

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

PURPOSE: The purpose of this study was to evaluate the shape and shift of the medial meniscus before and after meniscal repair concurrent with anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI) at 90° of knee flexion. METHODS: This study included 18 patients with ACL-deficient knees without meniscus tears (group A), 11 patients with medial meniscus tears alone (group M), and 15 patients with ACL-deficient knees complicated with medial meniscus tears (group AM). The posterior segment shape was evaluated using open MRI at 90° of knee flexion preoperatively and at 3 months postoperatively. The length, height, width, and posterior extrusion of the medial meniscus and posterior tibiofemoral distance were measured. These measurements were compared between the three groups. RESULTS: On preoperative MRI, a significant difference was observed in the posterior extrusion of the medial meniscus (group A, 1.2 ± 0.5 mm; group M, 1.7 ± 0.3 mm; group AM, 4.1 ± 1.5 mm, p < 0.001). All parameters did not differ between the three groups on postoperative MRI. In addition, the posterior width and extrusion of the medial meniscus were decreased significantly after meniscal repair concurrent with ACL reconstruction. CONCLUSIONS: This study demonstrated that the medial meniscus shifted posteriorly at 90° of knee flexion in ACL-deficient knees complicated with medial meniscus tears. Medial meniscal repair concurrent with ACL reconstruction improved the deformed morphology and posterior extrusion. MRI measurements of the posterior extrusion at the knee-flexed position may be clinically useful to assess the functional improvement of the medial meniscus following meniscal repair combined with ACL reconstruction. LEVEL OF EVIDENCE: III.

DOI： 10.1007/s00167-018-5157-2

Transtibial pullout repair of medial meniscus posterior root tear restores physiological rotation of the tibia in the knee-flexed position. Reviewed International journal

Okazaki Y, Furumatsu T, Kodama Y, Hino T, Kamatsuki Y, Okazaki Y, Masuda S, Miyazawa S, Endo H, Tetsunaga T, Yamada K, Ozaki T

Orthopaedics & traumatology, surgery & research : OTSR 105 ( 1 ) 113 - 117 2019.2

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

BACKGROUND: Medial meniscus posterior root tear (MMPRT) results in joint overloading and degenerative changes in the knee. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. To date, however, in vivo tibial rotational changes before and after root repair remain poorly understood. The purpose of this study was to investigate postoperative changes in tibial rotation following MMPRT pullout repair. HYPOTHESIS: Pathological external rotation of the tibia in the knee-flexed position is caused by MMPRT and is reduced after transtibial pullout repair. PATIENTS AND METHODS: Fifteen patients who underwent MMPRT pullout repair and 7 healthy volunteers were included. Magnetic resonance imaging examinations were performed in the 10° and 90° knee-flexed positions. The angles between the surgical epicondylar axis and a line between the medial border of the patellar tendon and the apex of the medial tibial spine were measured. Baseline was defined as a line lying at a right angle to the other, and a value was positive and negative when the tibia rotated internally and externally, respectively. RESULTS: In the volunteer's normal knees, tibial internal rotation was +1.00°±3.27° at 10° flexion and +4.14°±3.46° at 90° flexion. In the MMPRT preoperative knees, tibial internal rotation was +1.07°±3.01° at 10° flexion and +1.27°±2.96° at 90° flexion. In the postoperative knees, tibial internal rotation was +1.60°±2.85° at 10° flexion and +4.33°±2.89° at 90° flexion. DISCUSSION: This study demonstrates discontinuity of the MM posterior root may induce a pathological external rotation of the tibia during knee flexion and that MMPRT pullout repair reduces the pathological external rotation of the tibia in the knee-flexed position. LEVEL OF EVIDENCE: III, comparative retrospective study.

DOI： 10.1016/j.otsr.2018.10.005

Sub-deltoid approach for removal of large lipoma around the proximal humerus: A report of three cases. Reviewed

Hasei J, Kunisada T, Nakata E, Ozaki T

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 26 ( 6 ) 1147 - 1151 2019.2

Changes in acetabular component alignment due to screw fixation in patients with hip dysplasia. Reviewed International journal

Tetsunaga T, Fujiwara K, Endo H, Tetsunaga T, Miyake T, Yamada K, Sanki T, Ozaki T

Hip international : the journal of clinical and experimental research on hip pathology and therapy 29 ( 5 ) 1120700019828708 - 542 2019.2

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

INTRODUCTION: Adequate initial stability of the acetabular cup is essential for total hip arthroplasty (THA). However, changes in the alignment of the acetabular component caused by screw fixation are concerning in patients with inadequate bone stock. This study aimed to investigate the effects of screw fixation on the alignment of the acetabular component in THA patients with hip dysplasia. METHODS: We retrospectively examined 256 hips (range 28-87 years) that underwent THA using a navigation system. Patients were divided into 2 groups based on the presence or absence of changes in the alignment of the intraoperative acetabular cup, and univariate and multivariate analyses were performed to identify factors that were predictive of changes in acetabular component alignment after screw fixation in 2 dimensions: inclination and anteversion. RESULTS: Screw fixation led to a mean change in inclination of 1.6° (range 0-10°) and a mean change in anteversion of 1.4° (range 0-14°). The Crowe classification, the presence of bone cysts, and the use of an inferior quadrant screw were identified as factors that correlated with acetabular cup alignment changes in inclination (odds ratios, 6.01, 5.94 and 0.03, respectively). Only the Crowe classification was identified as a factor that correlated with intraoperative alignment changes in anteversion (odds ratio, 2.08). CONCLUSIONS: Screw fixation altered the acetabular cup alignment. The inclination changes were related to the extent of the dysplasia, and the risk was reduced when the inferior quadrant screw was used. Surgeons should use caution during screw fixation in THAs performed on severely dysplastic hips.

DOI： 10.1177/1120700019828708

Minimally Invasive Percutaneous Spinopelvic Fixation for Unstable Pelvic Ring Fracture Performed With the Patient in a Lateral Position. Reviewed International journal

Tsuji H, Takigawa T, Misawa H, Shiozaki Y, Yamakawa Y, Noda T, Ozaki T

Clinical spine surgery 32 ( 5 ) 191 - 197 2019.2

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

Spinopelvic fixation provides a strong fixation for unstable pelvic ring fractures. However, the technique is usually performed with the patient in the prone position, with the applied weight on the anterior superior iliac crests aggravating fracture displacement. We developed a novel approach for minimally invasive percutaneous spinopelvic fixation that is performed with the patient in a lateral (side lying) position. We describe the application of our technique for the treatment of a bilateral pelvic ring and acetabulum fracture in a 79-year-old woman injured in a traffic accident. Initial posterior fixation was performed with the patient in the left-side lying position, using bilateral pedicle screws at L3 and L4 and a left sacral-alar iliac screw and 2 right iliac screws inserted under navigation. The lateral and cranial displacement of the right pelvic ring was reduced percutaneously. One week after this initial surgery, we proceeded with an open anterior reduction and internal fixation of the left pelvic ring and acetabulum fracture. The postoperative course was uneventful and clinical outcomes were satisfactory. Reduction of a pelvic ring fracture in a lateral position, with subsequent spinopelvic fixation, is a reasonable option for the treatment of an unstable pelvic ring fracture.

DOI： 10.1097/BSD.0000000000000798

The morphology of the femur in elderly Japanese females: Analysis using 3D-CT. Reviewed

Maehara T, Kiyono M, Noda T, Sato R, Kadota H, Hori T, Koga Y, Hidaka Y, Joko R, Muraoka S, Ozaki T

Journal of orthopaedic surgery (Hong Kong) 27 ( 1 ) 2309499018816488 2019.1

Avulsion fracture of the ischial tuberosity treated with the suture bridge technique: a case report. Reviewed International journal

Tetsunaga T, Endo H, Tetsunaga T, Yamada K, Furumatsu T, Ozaki T

BMC musculoskeletal disorders 20 ( 1 ) 9 - 9 2019.1

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

BACKGROUND: In cases of avulsion fracture of the ischial tuberosity in which the bone fragments are substantially displaced, nonunion may cause pain in the ischial area. Various surgical procedures have been reported, but achieving sufficient fixation strength is difficult. CASE PRESENTATION: We treated a 12-year-old male track-and-field athlete with avulsion fracture of the ischial tuberosity by suture anchor fixation using the suture bridge technique. The boy felt pain in the left gluteal area while running. Radiography showed a left avulsion fracture of the ischial tuberosity with approximately 20-mm displacement. Union was not achieved by conservative non-weight-bearing therapy, and muscle weakness persisted; therefore, surgery was performed. A subgluteal approach was taken via a longitudinal incision in the buttocks, and the avulsed fragment was fixed with five biodegradable suture anchors using the suture bridge technique. CONCLUSIONS: Although the majority of avulsion fractures of the ischial tuberosity can be treated conservatively, patients with excessive displacement require surgical treatment. The suture bridge technique provided secure fixation and enabled an early return to sports activities.

DOI： 10.1186/s12891-018-2377-z

Clinical features and treatment outcome of desmoid-type fibromatosis: based on a bone and soft tissue tumor registry in Japan Reviewed

Nishida Y, Kawai A, Toguchida J, Ogose A, Ae K, Kunisada T, Matsumoto Y, Matsunobu T, Takahashi K, Nishida K, Ozaki T

International Journal of Clinical Oncology 24 ( 11 ) 1498 - 1505 2019

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

BACKGROUND: Treatment modality of desmoid-type fibromatosis (DF) has changed from surgery with a wide surgical margin to conservative treatment. In this study, tumor characteristics of DF, transition of the treatment modality, and clinical outcome of surgical treatment were analyzed based on data obtained from the bone and soft tissue tumor registry established in Japan. METHODS: Data were collected as registration data and follow-up data. Five hundred and thirty registered cases of DF were identified, including 223 cases with follow-up data with or without surgical treatment. RESULTS: The number of registered patients increased gradually. The frequency of surgical treatment was gradually reduced year by year. The 3-year local recurrence free survival (LRFS) was 77.7%, with tumor location and size tending to correlate with LRFS. Interestingly, there was no significant difference in LRFS between wide and marginal margin (P = 0.34). CONCLUSIONS: The treatment modality has shifted from surgical to conservative treatment, with risk factors for surgical treatment similar to those noted in previous studies. The National registry system is crucial for a rare disease such as DF, and in the future, a population based registry system should be established to better comprehend the actual status of DF.

DOI： 10.1007/s10147-019-01512-z

Regeneration of the Fibula with Unidirectional Porous Hydroxyapatite. International journal

Koji Demiya, Toshiyuki Kunisada, Eiji Nakata, Joe Hasei, Toshifumi Ozaki

Case reports in orthopedics 2019 9024643 - 9024643 2019

Language：English

A fibula graft is one of the most common orthopedic procedures for reconstruction of a bone defect, and some complications related to persistent defects of the fibula have been reported previously. We believe that regeneration of the fibula may be critical for postoperative function and prevention of complications. This report describes a 9-year-old female with Ewing sarcoma of the pelvis who was treated with the double-barrel fibula grafts for pelvic bone defect following tumor resection. The defect after fibular resection was filled with unidirectional porous hydroxyapatite (UDPHAp) implants. A plain radiograph revealed new bone formation and a callus-like structure at one month after surgery and bony union between each UDPHAp implant 5 months after surgery. Resorption of implanted UDPHAp was identified, and partial remodeling of the bone marrow cavity could be seen 1 year 2 months after surgery. A radiograph at final follow-up (5 years 10 months after surgery) demonstrated almost complete absorption of the implanted UDPHAp and clear formation of the cortex and bone marrow in the resected part of the fibula. The patient is able to walk well without any walking supports and to take part in sports activities.

DOI： 10.1155/2019/9024643

Difference between the Right and Left Phrenic Nerve Conduction Times, Latency, and Amplitude. Reviewed

Katayama Y, Senda M, Kaneda D, Ozaki T

Acta medica Okayama 72 ( 6 ) 563 - 566 2018.12

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

We studied phrenic nerve conduction times in 90 phrenic nerves of 45 normal subjects. The phrenic nerve was stimulated at the posterior border of the sternomastoid muscle in the supraclavicular fossa, just above the clavicle, with bipolar surface electrodes. For recording, positive and negative electrodes were placed on the xiphoid process and at the eighth intercostal bone-cartilage transition, respectively. We studied both the right and left sides to determine whether there was any difference between the two sides. The mean onset latency (± SD) of the right compound muscle action potentials (CMAPs) (5.99±0.39 msec) was significantly shorter than that of the left CMAPs (6.45±0.50 msec). The mean peak latency was significantly shorter in the right CMAPs (10.22±1.33 msec) than the left CMAPs (12.48±2.02 msec). The mean (± SD) amplitude was significantly lower in the left CMAPs (0.42±0.11 mV) than the right CMAPs (0.49±0.10 mV). The difference between the length of the nerve on the right and left sides might have affected the difference in latency between the two sides.

DOI： 10.18926/AMO/56373

Minimal Ablation of the Tibial Stump Using Bony Landmarks Improved Stability and Synovial Coverage Following Double-Bundle Anterior Cruciate Ligament Reconstruction. Reviewed International journal

Kodama Y, Furumatsu T, Hino T, Kamatsuki Y, Ozaki T

Knee surgery & related research 30 ( 4 ) 348 - 355 2018.12

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

Purpose: To evaluate the clinical effects of using anatomical bony landmarks (Parsons' knob and the medial intercondylar ridge) and minimal ablation of the tibial footprint to improve knee anterior instability and synovial graft coverage after double-bundle anterior cruciate ligament reconstruction. Materials and Methods: We performed a retrospective comparison of outcomes between patients who underwent reconstruction with minimal ablation of the tibial footprint, using an anatomical tibial bony landmark technique, and those who underwent reconstruction with wide ablation of the tibial footprint. Differences between the two groups were evaluated using second-look arthroscopy, radiological assessment of the tunnel position, postoperative anterior knee joint laxity, and clinical outcomes. Results: Use of the anatomical reference and minimal ablation of the tibial footprint resulted in a more anterior positioning of the tibial tunnel, with greater synovial coverage of the graft postoperatively (p=0.01), and improved anterior stability of the knee on second-look arthroscopy. Both groups had comparable clinical outcomes. Conclusions: Use of anatomical tibial bony landmarks that resulted in a more anteromedial tibial tunnel position improved anterior knee laxity, and minimal ablation improved synovial coverage of the graft; however, it did not significantly improve subjective and functional short-term outcomes.

DOI： 10.5792/ksrr.18.024

Identification of Circulating Exosomal Marker in Synovial Sarcoma

Suguru Yokoo, Tomohiro Fujiwara, Aki Yoshida, Masahiro Kiyono, Yusuke Mochizuki, Koji Demiya, Joe Hasei, Toshiyuki Kunisada, Yusuke Yoshioka, Koji Ueda, Takahiro Ochiya, Toshifumi Ozaki

CANCER SCIENCE 109 570 - 570 2018.12

【腰痛治療の最前線】腰痛の治療腰痛のリエゾン療法

鉄永倫子, 西田圭一郎, 鉄永智紀, 尾崎敏文

関節外科 37 ( 12 ) 1350 - 1356 2018.12

Intraoperative O-arm-navigated resection in musculoskeletal tumors. Reviewed

Fujiwara T, Kunisada T, Takeda K, Hasei J, Nakata E, Nakahara R, Yoshida A, Ozaki T

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 23 ( 6 ) 1045 - 1050 2018.11

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

BACKGROUND: Although emerging evidence has suggested that computer-assisted navigation allows surgeons to plan the optimal level of resection without compromising the surgical margins, the precise accuracy of the procedures has been unclear. The aim of this study was to investigate the accuracy and safety of the musculoskeletal tumor resection using O-arm/Stealth intraoperative navigation assistance. METHODS: A retrospective study of six patients with bone and soft tissue tumors who underwent surgical resection using O-arm/Stealth navigation system was performed. The histological diagnosis was osteosarcoma, metastatic bone tumor, leiomyosarcoma, undifferentiated sarcoma, and synovial sarcoma, respectively. Tumor resection was performed according to planned osteotomy planes determined on O-arm/Stealth three-dimensional intraoperative images. The resection accuracy, length of time for the procedures, surgical margins, and perioperative complications were evaluated. RESULTS: The distances between the entry and exit points for the planned and actual cuts were 1.5 ± 0.3 mm and 2.3 ± 0.3 mm, respectively, and the mean discrepancy of the osteotomy angle was 2.8 ± 1.2°. The mean length of time required for navigation was 14 min. A histological examination revealed clear margins in all patients. There were no complications related to navigation, and no patients developed local recurrence during a mean follow-up of 30.6 months. CONCLUSIONS: The O-arm/Stealth intraoperative CT navigation system provides safe and accurate osteotomy in musculoskeletal tumor resections. However, surgeons should keep in mind and be careful of minimal errors during osteotomy, which are around 2 mm from the planned line.

DOI： 10.1016/j.jos.2018.06.012

Early response assessment of palliative conventional radiotherapy for painful uncomplicated vertebral bone metastases. Reviewed

Nakata E, Sugihara S, Kataoka M, Yamashita N, Furumatsu T, Takigawa T, Tetsunaga T, Ozaki T

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 23 ( 6 ) 912 - 917 2018.11

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

BACKGROUND: Radiation therapy (RT) is the common treatment for painful vertebral bone metastases without paralysis by malignant spinal cord compression. However, no studies have focused on the time course of pain after RT. Then, we investigated the change of pain after RT for painful vertebral bone metastases without paralysis. METHODS: Participants included 101 patients who received RT for painful vertebral bone metastases without paralysis in our institution between 2012 and 2016. All patients received RT and pain response was evaluated by Numeric Rating Scale (NRS). Follow-up assessments were performed just before the start of RT and every month for six months after RT. Pain response was classified as complete response (CR), partial response (PR), pain progression (PP), and indeterminate response (IR) based on the response criteria of International Bone Metastases Consensus Working Party. Responders were classified as either CR or PR, and non-responders as either PP or IR. RESULTS: Median NRS scores for pain were 5 before RT, decreasing to 0 by one month after RT and remaining zero until last follow-up, representing a significant decrease over time (P < 0.001). The rate of responders at each month from one to six months was 93, 96, 95, 100, 98, and 96%, respectively. Multivariate analysis revealed that Spinal Instability Neoplastic Score (SINS) was the only risk factor for response to RT at one month. At one month pain disappeared in 88% of the patients with spinal stability (SINS < 7), although pain disappeared 58% of the patients with spinal instability (SINS ≥ 7), which was significant (P = 0.002). CONCLUSIONS: Pain decreased significantly over time and 93% of patients were classified as responders as early as one month after RT in patients with painful vertebral bone metastases without paralysis. Pretreatment SINS could be a predictor of pain response to RT.

DOI： 10.1016/j.jos.2018.07.007

骨形成不全症大腿骨骨折を繰り返し治療に難渋している骨形成不全症の1例

三喜知明, 遠藤裕介, 野田知之, 鉄永智紀, 尾崎敏文, 高橋欣吾, 武田健

日本整形外科学会雑誌 92 ( 11 ) 918 - 921 2018.11

Language：Japanese Publisher：(公社)日本整形外科学会

症例は13歳男児で、出生時に多発骨折(左上腕骨、左腓骨、第2〜4肋骨)を認め、骨形成不全症(Sillence分類IV型)と診断された。8歳時に転倒し、右大腿骨骨幹部骨折に対し当院でギプス加療を行った。左大腿骨は骨幹部骨折を生後3ヵ月時と6歳時に生じ、10歳時に転倒し左大腿骨顆上骨折を受傷したが、転位は軽度でギプス固定による保存的加療により骨癒合が得られていた。その後も骨折を繰り返し、13歳時に車いすで転倒しそうになった際に左股関節に違和感があり左大腿骨頸部不全骨折を生じ、LCPプレート孔より4.5mm CCSと5.0mmロッキングスクリューを挿入し、前方より6.5mm CCS1本の計3本で追加固定を施行されている。最終術後2ヵ月時の単純X線像では骨折転位は認めておらず、移動は車いすで自立している。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01133&link_issn=&doc_id=20181204100016&doc_link_id=%2Ffj2ortho%2F2018%2F009211%2F018%2F0918-0921%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffj2ortho%2F2018%2F009211%2F018%2F0918-0921%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Composition of Cell Clusters in Torn Menisci and Their Extracellular Matrix Components. Reviewed

Kodama Y, Furumatsu T, Maehara A, Ozaki T

Acta medica Okayama 72 ( 5 ) 499 - 506 2018.10

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

Cell clusters, or groups of cells sharing a single chondron-like structure, are frequently found in degenerated areas of the osteoarthritic (OA) meniscus. However, little is known about these meniscal clusters in humans. The aim of our study was to determine the composition of the extracellular matrix deposition around cell clusters in human OA menisci. Twenty-six menisci were obtained through total knee arthroplasty from patients with OA knee joints. The specimens were subjected to safranin O staining and immunostaining for Sry-type HMG box 9 (SOX9), type II collagen, and aggrecan. Their signal density after staining was assessed using ImageJ software. Five regions of interest were analyzed within each tissue sample. The SOX9, type II collagen, and aggrecan densities were considerably higher in cluster areas than in intact superficial layers of the meniscus. In addition, a substantial difference was detected between cluster areas and degenerative areas without cell clusters. We demonstrated that cell clusters localized near fissures and clefts showed remarkable uniformity in menisci exposed to a broad range of injuries. In addition, the chondrogenic proteins SOX9, type II collagen, and aggrecan were highly expressed in these tissues.

DOI： 10.18926/AMO/56248

A high incidence of extensor pollicis brevis insertion into the distal phalanx in rheumatoid arthritis patients who required the surgical reconstruction for thumb boutonnière deformity. Reviewed International journal

Okita S, Nishida K, Ohtsuka A, Ozaki T

Modern rheumatology 29 ( 6 ) 1 - 15 2018.10

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

Objectives: The aim of the current study was to investigate the pattern of extensor pollicis brevis (EPB) insertion macroscopically and histologically using cadaveric thumbs, and to compare the incidence of different insertions with that of thumb boutonnière deformity in rheumatoid arthritis (RA) patients who required surgical reconstruction.Methods: We examined 103 thumbs of 58 adult cadavers with no evidence of RA, and reviewed the surgical records of 28 thumbs of 23 RA patients who underwent surgical reconstruction for thumb boutonnière deformity. The incidence of different insertion patterns of the cadaveric thumbs and the RA thumbs were compared using the Fisher's exact test.Results: Macroscopic and histologic examination revealed that the insertion patterns of EPB could be divided into three groups: insertion into the base of the proximal phalanx (Type P1), integration of EPB into the dorsal fibrocartilage of the MCP joint (Type P2), and insertion into the distal phalanx (Type D). The incidence of Type D was significantly higher in RA patients with thumb boutonnière deformity (64%) than that in the non-RA cadavers (29%; P < .05).Conclusion: EPB is inserted into the distal phalanx more frequently in RA patients who require surgery for thumb boutonnière deformity than non-RA cadavers, suggesting an additional possible mechanism of this deformity.

DOI： 10.1080/14397595.2018.1532484

Drug dependence in patients with chronic pain: A retrospective study. Reviewed International journal

Tetsunaga T, Tetsunaga T, Nishida K, Kanzaki H, Misawa H, Takigawa T, Shiozaki Y, Ozaki T

Medicine 97 ( 40 ) e12748 2018.10

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

Drug dependence, which can exist concurrently with chronic pain, is seen as one of the major causes of rapidly increasing medical expenses. However, drug dependence in patients with chronic pain has not been evaluated. The aim of this study was to identify the risk factors for drug dependence in patients with chronic noncancer pain.This retrospective study included 151 patients with chronic noncancer pain (43 males, 108 females; mean age, 72 years). Low back pain (LBP) occurred in 96 patients, whereas 22 had shoulder pain, 8 had hip pain, and 77 had knee pain. Patients were divided into drug dependence and nondrug dependence groups based on the Severity of Dependence Scale (SDS) scores. Patients with SDS scores ≥5 and <5 were classified into drug dependence and nondrug dependence groups, respectively. All patients completed self-report questionnaires. Factors that predict drug dependence were identified by performing univariate and multivariate analyses.Sixty (40%) of the 151 patients met the SDS criteria for drug dependence. Significant differences were found between patients with and without drug dependence for the LBP, hip pain, number of medications, and for the Numerical Rating Scale, Pain Disability Assessment Scale (PDAS), Hospital Anxiety and Depression Scale, and Pain Catastrophizing Scale (PCS) scores. Multiple regression analysis identified LBP, hip pain, PCS, and PDAS scores as factors related to drug dependence in patients with chronic noncancer pain.Drug dependence tends to differ in patients based on the location of their chronic pain. Pain catastrophizing and disability indicated a greater tendency for drug dependence. Thus, PCS and PDAS scores are useful screening tools for predicting drug dependence in patients with chronic pain.

DOI： 10.1097/MD.0000000000012748

Thymol turbidity test is associated with the risk of cyclops syndrome following anterior cruciate ligament reconstruction. Reviewed International journal

Kodama Y, Furumatsu T, Hino T, Kamatsuki Y, Okazaki Y, Masuda S, Okazaki Y, Ozaki T

BMC musculoskeletal disorders 19 ( 1 ) 367 - 367 2018.10

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

BACKGROUND: Cyclops nodule formation is a serious complication after anterior cruciate ligament (ACL) reconstruction. The purpose of our study was to investigate whether an increase in thymol turbidity test (TTT) values is involved in the development of cyclops nodule formation or cyclopoid scar formation following ACL reconstruction. METHODS: Between 2011 and 2014, 120 cases underwent outside-in ACL reconstruction. Forty-seven patients who had high TTT values were individually matched for age, sex, body mass index, and meniscus injury to a low TTT value group of 47 patients. The primary outcome was the occurrence of cyclops nodule formation or cyclopoid scar formation. All 94 patients were divided into 3 groups using surgical records and intra-operative video to enable a sub-analysis. The groups were a no-cyclops group, a cyclopoid group, and a cyclops group. Blood examinations, including TTT, and knee range of motion evaluations were performed before surgery, 3 months after surgery, and 1 year after surgery. RESULTS: There were no differences in preoperative demographic data between the two groups. TTT values did not significantly influence cyclopoid scar formation (OR, 1.67; 95% CI, 0.62 to 4.66; p = 0.362). However, patients with cyclops nodule formation showed significantly higher TTT values than the control patients. (OR, 9.34; 95% CI, 1.94 to 90.3; p = 0.002). Knee extension loss was observed in the cyclopoid and cyclops groups 3 months after reconstruction. In the cyclops group, arthroscopic resection of the cyclops nodule was performed 3 months after reconstruction. Eventually, almost full range of motion was restored in all patients. CONCLUSIONS: High TTT values before ACL reconstruction were an indicator of cyclops nodule formation. Furthermore, cyclopoid scar formations may not be the result of an individual's immune reaction but that of extension loss in the early post-reconstruction phase.

DOI： 10.1186/s12891-018-2286-1

Pullout Repair of the Medial Meniscus Posterior Root Tear Reduces Proton Density-Weighted Imaging Signal Intensity of the Medial Meniscus. Reviewed

Okazaki Y, Furumatsu T, Masuda S, Miyazawa S, Kodama Y, Kamatsuki Y, Hino T, Okazaki Y, Ozaki T

Acta medica Okayama 72 ( 5 ) 493 - 498 2018.10

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

Medial meniscus (MM) posterior root tear (PRT) results in joint overloading and degenerative changes in the knee. MM root repair is recommended to prevent subsequent cartilage degeneration following MMPRT. Favorable clinical outcomes have been reported after transtibial pullout repair of MMPRT. However, it is unclear whether pullout repair can cause compositional change in the MM posterior segment. We examined this question in 14 patients who underwent MMPRT pullout repair. Magnetic resonance imaging examinations were performed preoperatively and 3 months postoperatively at 10° knee flexion. The region-of-interest was marked along the MM posterior segment edge. Intra-meniscal signal intensity (IMSI) was expressed as the signal intensity ratio of the repaired MM to the intact lateral meniscus, which was used as a control. MMPRT pullout repair reduced IMSI from 1 to 0.915±0.096 (range, 0.760-1.074) 3 months postoperatively (p=0.006, power=0.90). Meniscal degeneration causes high proton density-weighted imaging signal intensity of the meniscal body. In our study, MMPRT pullout repair reduced IMSI contrary to other tears. This technique may decrease the MM posterior segment signal intensity by restoring the hoop tension mechanism. Measuring IMSI may be useful to assess the effect of MMPRT pullout repair on meniscal healing.

DOI： 10.18926/AMO/56247

関節リウマチにおけるPDスコアの関節破壊予測能の検討

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

日本関節病学会誌 37 ( 3 ) 306 - 306 2018.10

深層学習を用いた超音波画像の関節部位推定

中原龍一, 西田圭一郎, 沖田駿治, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 那須義久, 野田知之, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 305 - 305 2018.10

RA手の障害に対する手指人工関節における角速度の術後経過

松山宜之, 中原龍一, 松岡玲衣, 藤岡晃, 鍋倉由佳, 小川加苗, 岡佳純, 那須義久, 堅山佳美, 西田圭一郎, 千田益生, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 271 - 271 2018.10

人工手関節全置換術(TWA)を受ける関節リウマチ患者の看護

小橋靖子, 西田圭一郎, 宮地亜美, 鍋倉由佳, 藤岡晃, 那須義久, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 216 - 216 2018.10

関節リウマチに対するAVANTAとAVANTA preflexによる小指MP人工指関節置換術の治療成績

松橋美波, 那須義久, 渡辺雅仁, 沖田駿治, 木曽洋平, 大橋秀基, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 216 - 216 2018.10

関節リウマチに対するMCP関節人工関節置換術中に手関節部での腱処置剥離術を要した症例の検討

木曽洋平, 那須義久, 松橋美波, 渡辺雅仁, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 37 ( 3 ) 199 - 199 2018.10

腫瘍用人工関節KLS system術後機能回復の経過

増田翔太, 岩井賢司, 築山尚司, 堅山佳美, 中田英二, 尾崎敏文, 千田益生

日本関節病学会誌 37 ( 3 ) 272 - 272 2018.10

大腿骨骨幹部開放骨折の治療成績

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

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

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

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

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

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

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

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。

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

リウマチ性疾患治療中に発症し診断に難渋した手指屈筋腱腱鞘滑膜炎の3例

沖田駿治, 那須義久, 松橋美波, 渡辺雅仁, 木曽洋平, 大橋秀基, 中原龍一, 西田圭一郎, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 41回 126 - 126 2018.7

関節リウマチ前足部手術における術式別のTUGおよびJSSF-RA scaleの検討とX線学的解析

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 大橋秀基, 木曽洋平, 沖田駿治, 松橋美波, 尾崎敏文

関節の外科 45 ( 2 ) 96 - 96 2018.7

上肢:上腕骨骨幹部骨折上腕骨骨幹部骨折における最小侵襲プレート骨接合術(MIPO)による手術治療

島村安則, 野田知之, 山川泰明, 斎藤太一, 内野崇彦, 中原龍一, 尾崎敏文

骨折 40 ( Suppl. ) S15 - S15 2018.7

Medial meniscus posterior root tear induces pathological posterior extrusion of the meniscus in the knee-flexed position: An open magnetic resonance imaging analysis Reviewed

S. Masuda, T. Furumatsu, Y. Okazaki, Y. Kodama, T. Hino, Y. Kamatsuki, S. Miyazawa, T. Ozaki

Orthopaedics and Traumatology: Surgery and Research 104 ( 4 ) 485 - 489 2018.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Masson SAS

Background: A medial meniscus posterior root tear (MMPRT) is defined as an injury to the posterior meniscal insertion on the tibia. In MMPRT, the medial meniscus (MM) hoop function is damaged, and the MM undergoes a medial extrusion into the interior from the superior articular surface of the tibia. However, the details of MM position and movement during knee joint movement are unclear in MMPRT cases. The present study aims to evaluate MM position and movement via magnetic resonance imaging (MRI) examination of the MM posterior extrusion (MMPE) at knee flexion angles of 10° and 90°. We hypothesized that, during knee flexion, the MM will shift to the posterior and the posterior extrusion will increase compared to that when the knee is extended. Materials and methods: Twenty-four patients were diagnosed with symptomatic MMPRT on open MRI examination. Preoperative MMPE, anteroposterior interval (API) of the MM, and MM medial extrusion (MMME) at knee flexion angles of 10° and 90° were measured. Results: For patients with MMPRT, the MMPE increased from −4.77 ± 1.43 mm to 3.79 ± 1.17 mm (p &lt
0.001) when the knee flexion angle increased from 10° to 90°. Further, flexing the knee from 10° to 90° decreased the API of the MM from 20.19 ± 4.22 mm to 16.41 ± 5.14 mm (p &lt
0.001). MMME showed no significant change between knee flexion angles of 10° and 90°. Discussion: This study demonstrated that, in cases of MMPRT, the MMPE clearly increases when the knee is flexed to 90° while MMME does not change. Our results suggest that open MRI examination can be used to evaluate the dynamic position of the posterior MM by scanning the knee as it flexes to 90°. Level of evidence: IV: retrospective cohort study.

DOI： 10.1016/j.otsr.2018.02.012

Medial meniscus posterior root tear induces pathological posterior extrusion of the meniscus in the knee-flexed position: An open magnetic resonance imaging analysis Reviewed

S. Masuda, T. Furumatsu, Y. Okazaki, Y. Kodama, T. Hino, Y. Kamatsuki, S. Miyazawa, T. Ozaki

Revue de Chirurgie Orthopedique et Traumatologique 104 ( 4 ) 339 2018.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Masson SAS

Background: A medial meniscus posterior root tear (MMPRT) is defined as an injury to the posterior meniscal insertion on the tibia. In MMPRT, the medial meniscus (MM) hoop function is damaged, and the MM undergoes a medial extrusion into the interior from the superior articular surface of the tibia. However, the details of MM position and movement during knee joint movement are unclear in MMPRT cases. The present study aims to evaluate MM position and movement via magnetic resonance imaging (MRI) examination of the MM posterior extrusion (MMPE) at knee flexion angles of 10° and 90°. We hypothesized that, during knee flexion, the MM will shift to the posterior and the posterior extrusion will increase compared to that when the knee is extended. Materials and methods: Twenty-four patients were diagnosed with symptomatic MMPRT on open MRI examination. Preoperative MMPE, anteroposterior interval (API) of the MM, and MM medial extrusion (MMME) at knee flexion angles of 10° and 90° were measured. Results: For patients with MMPRT, the MMPE increased from −4.77 ± 1.43 mm to 3.79 ± 1.17 mm (p &lt
0.001) when the knee flexion angle increased from 10° to 90°. Further, flexing the knee from 10° to 90° decreased the API of the MM from 20.19 ± 4.22 mm to 16.41 ± 5.14 mm (p &lt
0.001). MMME showed no significant change between knee flexion angles of 10° and 90°. Discussion: This study demonstrated that, in cases of MMPRT, the MMPE clearly increases when the knee is flexed to 90° while MMME does not change. Our results suggest that open MRI examination can be used to evaluate the dynamic position of the posterior MM by scanning the knee as it flexes to 90°. Level of evidence: IV retrospective cohort study.

DOI： 10.1016/j.rcot.2018.04.006

Les l?sions de la racine post?rieure du m?nisque m?dial induisent une extrusion m?niscale post?rieure anormale en semi-flexion Reviewed International journal

Masuda S, Furumatsu T, Okazaki Y, Kodama Y, Hino T, Kamatsuki Y, Miyazawa S, Ozaki T

Revue de Chirurgie Orthopedique et Traumatologique, Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur, Revue d'orthope?die et de chirurgie de l'appareil moteur 104 ( 4 ) 2018.6

中高齢者原発性悪性骨腫瘍に対する補助化学療法の検討 JCOG骨軟部腫瘍グループアンケート結果より

永野昭仁, 松本誠一, 川井章, 大隈知威, 平賀博明, 松本嘉寛, 西田佳弘, 米本司, 保坂正美, 高橋満, 吉川秀樹, 尾崎敏文, 淺沼邦洋, 中紀文, 江森誠人, 久保忠彦, 川島寛之, 河本旭哉, 横山良平, 筑紫聡

日本整形外科学会雑誌 92 ( 6 ) S1408 - S1408 2018.6

骨肉腫の細胞内外microRNA-25-3p発現異常の腫瘍学的意義

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 ( 6 ) S1460 - S1460 2018.6

骨転移治療に対する院内コンセンサス形成整形外科としての骨転移への関わりがん専門病院の立場から

杉原進介, 魚谷弘二, 中田英二, 尾崎敏文

日本整形外科学会雑誌 92 ( 6 ) S1509 - S1509 2018.6

Utility of Bayesian Single-Arm Design in New Drug Application for Rare Cancers in Japan: A Case Study of Phase 2 Trial for Sarcoma Reviewed

Akihiro Hirakawa, Tadaaki Nishikawa, Kan Yonemori, Taro Shibata, Kenichi Nakamura, Masashi Ando, Takafumi Ueda, Toshifumi Ozaki, Kenji Tamura, Akira Kawai, Yasuhiro Fujiwara

Therapeutic Innovation and Regulatory Science 52 ( 3 ) 334 - 338 2018.5

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications Inc.

Investigational drugs for rare cancers are often approved based solely on a single-arm phase II trial that primarily evaluates response rate in Japan. Such trials typically use a fixed sample size determined on the basis of the frequentist manner. However, since predicting the speed of patient enrollment is challenging because of the disease rarity, the time needed to complete the enrollment of the fixed number of patients is prolonged in some cases. A Bayesian design without fixing the sample size is useful for single-arm phase II trials of rare cancers. However, the arbitrariness of prior distribution specifications and the frequentist operating characteristics are regulatory issues. We recently started a Bayesian single-arm phase II trial of nivolumab in patients with sarcoma for new drug application in Japan and examined the statistical rationale and design consideration. In the Bayesian design, we specify the minimum and maximum numbers of enrolled patients during the enrollment period and the prior distributions of response rates. Considering these parameters, we obtain the minimum number of responders needed for the positive conclusion of the efficacy of nivolumab for each sample size. Simulation studies demonstrated that the operating characteristics of this design would be acceptable from the frequentist view. The Bayesian design provided an adaptive decision rule for efficacy conclusion for the drug without fixing the sample size. We hope our trial’s success will provide a new drug development option for rare cancers in Japan.

DOI： 10.1177/2168479017728989

骨粗鬆性骨折患者における骨粗鬆治療薬の骨折予防効果システマティックレビュー

斎藤太一, 島村安則, 千田益生, 尾崎敏文

運動器リハビリテーション 29 ( 2 ) 249 - 249 2018.5

Relationship between displacement of the psoas major muscle and spinal alignment in patients with adult spinal deformity Reviewed

Yoshiaki Oda, Tomoyuki Takigawa, Ryo Ugawa, Yasuyuki Shiozaki, Haruo Misawa, Yoshihisa Sugimoto, Masato Tanaka, Toshifumi Ozaki

Asian Spine Journal 12 ( 2 ) 335 - 342 2018.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Korean Society of Spine Surgery

Study Design: Cross sectional study. Purpose: To clarify the difference in position of the psoas muscle between adult spinal deformity (ASD) and lumbar spinal stenosis (LSS). Overview of Literature: Although it is known that the psoas major muscle deviates in ASD patients, no report is available regarding the difference in comparison with LSS patients. Methods: This study investigates 39 patients. For evaluating spinal alignment, pelvic tilt (PT), pelvic incidence (PI), sacral slope, lumbar lordosis (LL), PI-LL, Cobb angle, and the convex side, the lumbar curves were measured. For measuring the position of the psoas major at the L4/5 disk level, magnetic resonance imaging was used. The displacements of psoas major muscle were measured separately in the anterior-posterior and lateral directions. We examined the relationship between the radiographic parameters and anterior displacement (AD) and lateral displacement (LD) of the psoas major muscle. Results: AD was demonstrated in 15 cases with ASD and nine cases with LSS (p &gt
0.05). LD was observed in 13 cases with ASD and no cases with LSS (p &lt
0.01). The Cobb angle was significantly greater in cases with AD than in those without AD (p =0.04). PT, LL, PI- LL, and Cobb angle were significantly greater in cases with LD (p &lt
0.05). All cases with LD had AD, but no case without AD had LD (p &lt
0.001). The side of greater displacement at L4/5 and the convex side of the lumbar curve were consistent in all cases. Conclusions: Despite AD being observed in LSS as well, LD was observed only in the ASD group. Radiographic parameters were worse when LD was seen, rather than AD.

DOI： 10.4184/asj.2018.12.2.335

Clinical and Functional Significance of Intracellular and Extracellular microRNA-25-3p in Osteosarcoma. Reviewed

Yoshida A, Fujiwara T, Uotani K, Morita T, Kiyono M, Yokoo S, Hasei J, Nakata E, Kunisada T, Ozaki T

Acta medica Okayama 72 ( 2 ) 165 - 174 2018.4

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

Although there is considerable evidence indicating that the dysregulation of microRNAs (miRNAs) in malignant tumors plays a role in tumor development, the overall function of miRNAs and their clinicopathological significance are not well understood. In this retrospective analysis of 45 biopsy specimens from osteosarcoma (OS) patients, we investigated the functional and clinical significance of miR-25-3p in OS, which we previously identified as a highly expressed miRNA in OS patients' serum. We observed that miR-25-3p dysregulation in human OS tissues was negatively correlated with the clinical prognosis, whereas the expression level of its target gene, Dickkopf WNT Signaling Pathway Inhibitor 3 (DKK3), was positively correlated with the clinical prognosis. Endogenous miR-25-3p upregulation promoted tumor growth, invasion, and drug resistance, which was consistent with DKK3 silencing in OS cells. In addition, secretory miR-25-3p was embedded in tumor-derived exosomes, where it promoted capillary formation and the invasion of vascular endothelial cells. Overall, our results show that miR-25-3p has intracellular and extracellular oncogenic functions as well as clinicopathological relevance in OS, indicating its potential as a novel diagnostic and therapeutic tool for the clinical management of this disease.

DOI： 10.18926/AMO/55857

足関節脱臼骨折後遺残変形に対し腓骨延長を行った2例

雑賀建多, 大橋秀基, 堀田昌宏, 出宮光二, 横尾賢, 内野崇彦, 清野正普, 望月雄介, 小松原将, 吉村将秀, 中道亮, 山川泰明, 齋藤太一, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 30 ( 1 ) 163 - 163 2018.4

脊椎に原発した骨肉腫の5例

塩崎泰之, 瀧川朋亨, 三澤治夫, 尾崎敏文, 中田英二, 国定俊之

中国・四国整形外科学会雑誌 30 ( 1 ) 79 - 82 2018.4

Language：Japanese Publisher：中国・四国整形外科学会

当院で経験した脊椎原発の骨肉腫5例(男性2例、女性3例、診断時平均年齢52歳)について検討した。発生高位はT1が1例、L2が1例、L3が1例、L5が2例であった。初診時の症状は腰椎発生の3例では全例に腰痛が認められ、2例に下肢不全麻痺が合併していた。胸椎発生の2例では、それぞれ背部痛と上肢痛を認められた。治療は全摘出術を2例、重粒子線治療を3例に行った。また、化学療法は4例に行った。予後は、治療中の2例を除き、3例は診断後平均66ヵ月で死亡していた。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02438&link_issn=&doc_id=20180621090018&doc_link_id=%2Fcm4ortho%2F2018%2F003001%2F018%2F0079-0082%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2018%2F003001%2F018%2F0079-0082%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

【運動器画像診療の最前線】部位別・疾患別画像診療の最前線骨腫瘍の画像診療

中田英二, 国定俊之, 長谷井嬢, 藤原智洋, 尾崎敏文

関節外科 37 ( 4月増刊 ) 130 - 143 2018.4

Language：Japanese Publisher：(株)メジカルビュー社

＜画像診療のポイント＞●骨腫瘍の診療において、画像検査は鑑別診断や治療効果判定だけではなく、手術にも有用である。●鑑別診断について、初診医は一般整形外科医であることが多く、悪性を疑う所見を見逃さないことが重要である。●骨腫瘍にはそれぞれ特徴的な年齢分布や好発部位があり、年齢や既往歴などの臨床情報も踏まえ、複数の画像検査の情報を組み合わせて診断を行う。●単純X線像の読影では、腫瘍の局在と性状に注目する。●CTは、単純X線検査では評価が困難な部位の診断、微細な石灰化や骨化の有無の検出などを調べるのに適している。また、三次元的に骨病変を評価することができ、術前計画にも有用である。さらに、近年はコンピュータ支援手術により術中に短時間で高画質の2D・3D画像が取得でき、画像データをナビゲーションシステムに送信することで、より低侵襲かつ安全で確実な手術が可能となっている。●MRIは優れたコントラスト分解能をもち、腫瘍の進展や質的診断、治療効果判定などに有用である。●PET/CTは、良悪性の鑑別診断、病期診断、治療効果判定に有用である。●各画像検査には長所と短所があるため、その特徴を理解しておくことが重要である。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00282&link_issn=&doc_id=20180406150013&doc_link_id=10.18885%2FJ00282.2018192551&url=https%3A%2F%2Fdoi.org%2F10.18885%2FJ00282.2018192551&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

MiRNA-133a-5p inhibits the expression of osteoblast differentiation-associated markers by targeting the 3′ UTR of RUNX2 Reviewed

Wei Zhang, Yonggang Wu, Yasuyuki Shiozaki, Yoshihisa Sugimoto, Tomoyuki Takigawa, Masato Tanaka, Akihiro Matsukawa, Toshifumi Ozaki

DNA and Cell Biology 37 ( 3 ) 199 - 209 2018.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Mary Ann Liebert Inc.

Recent studies have recognized the involvement of microRNAs (miRNAs) in the development of osteoporosis, which regulate the balance between osteogenesis and osteoclasis. In this study, we investigated the regulation by miRNA-133a-5p on the osteoblast differentiation-associated markers in the mouse osteoblast-like MC3T3-E1 cells by RUNX2. First, we manipulated the miRNA-133a level in the MC3T3-E1 cells with 20 or 40 nM miR-133a-5p mimics, miR-133a-5p inhibitor, or scramble miRNA. Then, we quantified with real-time polymerase chain reaction (qRT-PCR) the expression of Collagen I, osteocalcin (OCN), and osteopontin (OPN) in the miR-133a-5p-manipulated MC3T3-E1 cells. And the confocal microscopy was also utilized to confirm the regulation by miR-133a-5p on the expression of the three molecules. We also investigated the extracellular matrix (ECM) mineralization and the alkaline phosphatase (ALP) activity in the miR-133a-5p-manipulated MC3T3-E1 cells. In addition, we explored the possible targeting by miR-133a-5p on RUNX2, which was a well-recognized promoter to osteoblast differentiation, with luciferase reporter, qRT-PCR, and Western blotting assay. Results demonstrated that the miRNA-133a-5p mimics markedly reduced, whereas the miRNA-133a-5p inhibitor significantly promoted the expression of Collagen I, OCN, and OPN, the ECM mineralization, and the ALP activity in MC3T3-E1 cells. The alignment analysis demonstrated a high homology between miRNA-133a-5p and the 3′ UTR of RUNX2. Moreover, the luciferase reporter assay demonstrated that miRNA-133a-5p targeted the 3′ UTR of RUNX2, and inhibited the expression of RUNX2 in both mRNA and protein levels. In conclusion, we identified the inhibition by miRNA-133a-5p to the expression of osteoblast differentiation markers, to the ECM mineralization, and to the ALP activity in MC3T3-E1 cells, by targeting the 3′ UTR of RUNX2. Our study suggests that miRNA-133a-5p might be an important target to inhibit osteoblast differentiation in osteoporosis.

DOI： 10.1089/dna.2017.3936

Outcomes of Resection and Joint-Preserving Arthroplasty for Forefoot Deformities for Rheumatoid Arthritis Reviewed

Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Takahiro Machida, Hideki Ohashi, Toshifumi Ozaki

Foot and Ankle International 39 ( 3 ) 292 - 299 2018.3

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications Inc.

Background: We investigated the clinical outcomes of resection and joint-preserving arthroplasty for forefoot deformities in patients with rheumatoid arthritis. Methods: Sixteen feet of 14 women (average age, 67.1 years
range, 53-82) underwent resection arthroplasty of the metatarsal head (resection group), and 18 feet of 15 women (average age, 61.3 years
range, 40-73) underwent a metatarsophalangeal joint-preserving procedure with shortening oblique metatarsal osteotomies of the lesser toes (joint preservation group). The mean disease duration in the resection and joint preservation groups was 23.6 and 19.1 years, and the average follow-up period was 37.3 and 33.5 months, respectively. The classification of Larsen was used to assess the severity of destruction of the metatarsophalangeal (MTP) joint. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) score and postoperative complications. Results: The number of preoperative radiographic destruction of the MTP joints (Larsen grade II, III, IV, and V) was 0, 29, 39, and 12 joints in the resection group and 13, 67, 9, and 1 joints in the joint preservation group. The mean JSSF score improved significantly from 61.3 to 83.9 points in the resection group (P &lt
.001) and from 62.2 to 90.8 points in the joint preservation group (P &lt
.001). In the resection group, recurrence of callosities and claw toe deformity was observed in 6 and 3 feet, respectively. In the joint-preserving group, recurrence of callosities and hammer toe deformity was observed in 1 foot each. Conclusion: The resection arthroplasty and joint-preserving procedure showed satisfactory clinical outcomes. However, whether both procedures can maintain the good clinical results without the recurrence of forefoot deformity will require longer follow-up. Level of Evidence: Level III, retrospective comparative series.

DOI： 10.1177/1071100717743996

関節リウマチ肘に対するLinked人工肘関節(PROSNAP)の臨床成績の検討

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 734 - 734 2018.3

関節リウマチに対するMCP関節人工関節置換術中に手関節部での腱剥離術を要した症例の検討

木曽洋平, 那須義久, 渡辺雅仁, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 729 - 729 2018.3

関節リウマチの手術4:上肢・その他関節リウマチの手術が患者のボディイメージに与える影響

小橋靖子, 西田圭一郎, 堀田昌宏, 那須義久, 橋詰謙三, 中原龍一, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 587 - 587 2018.3

関節リウマチの手術4:上肢・その他短母指伸筋腱の停止様式と母指ボタン穴変形との関連について

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 586 - 586 2018.3

新専門医制度下の専門医研修のめざすところと今後の展望 I型施設岡山大学整形外科専門研修プログラム

島村安則, 那須義久, 宮澤慎一, 野田知之, 尾崎敏文

日本整形外科学会雑誌 92 ( 2 ) S33 - S33 2018.3

関節リウマチの手術4:上肢・その他関節リウマチによる手指伸筋腱断裂症例の患者背景近年の傾向と薬物療法との関係

那須義久, 渡辺雅仁, 木曽洋平, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 586 - 586 2018.3

リウマチ性疾患の画像1:関節エコーRA 動画画像を教師画像とした深層学習を用いた関節リウマチ患者の超音波画像自動分類

中原龍一, 西田圭一郎, 木曽洋平, 沖田駿治, 大橋秀基, 兼田大輔, 竹下歩, 那須義久, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 455 - 455 2018.3

リウマチ上肢のリハビリと手術〜真の寛解を目指して〜リウマチ上肢のリハビリと手術人工肘関節置換術で社会的・精神的寛解をえられるか

西田圭一郎, 那須義久, 小橋靖子, 橋詰謙三, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 231 - 231 2018.3

関節リウマチ患者のQOL向上を目指した薬物・手術のcombined therapy 疾患活動性からみた整形外科手術が患者Body Imageに与える影響

西田圭一郎, 小橋靖子, 堀田昌宏, 那須義久, 中原龍一, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 62回 220 - 220 2018.3

単純X線足荷重位正面像における外側趾MTP関節背側脱臼の重症度スコア

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, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1169 - S1169 2018.3

関節リウマチに対する手術加療の傾向初回手術例の患者背景

那須義久, 渡辺雅仁, 沖田駿治, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1041 - S1041 2018.3

関節リウマチ前足部手術における術式別のTUGおよびJSSF-RA scaleの検討

渡辺雅仁, 西田圭一郎, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 大橋秀基, 木曽洋平, 沖田駿治, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1028 - S1028 2018.3

関節リウマチ診療における超音波多関節評価・検査時間の短縮の研究

中原龍一, 西田圭一郎, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 那須義久, 尾崎敏文

日本整形外科学会雑誌 92 ( 2 ) S313 - S313 2018.3

短母指伸筋腱の停止様式が母指ボタン穴変形発症に与える影響

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本整形外科学会雑誌 92 ( 2 ) S175 - S175 2018.3

遊離複合組織移植とMasquelet法を併用し治療した放射線照射後病的骨折術後骨髄炎の1例

松橋美波, 野田知之, 山川泰明, 斎藤太一, 島村安則, 尾崎敏文

中部日本整形外科災害外科学会雑誌 61 ( 春季学会 ) 198 - 198 2018.3

リトルリーグショルダーに対する新しい診断法抵抗下外旋テストおよび抵抗下内旋テストの有用性

内野崇彦, 島村安則, 志渡澤央和, 中道亮, 齋藤太一, 雑賀建多, 島村好信, 古松毅之, 名越充, 野田知之, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1175 - S1175 2018.3

肉腫進行例の新しい診療システムサルコーマセンター設立と腫瘍内科医との連携

国定俊之, 田端雅弘, 山根弘路, 中田英二, 長谷井嬢, 尾崎敏文

中部日本整形外科災害外科学会雑誌 61 ( 春季学会 ) 88 - 88 2018.3

特発性側彎症における胸椎横突起肋骨結合の解析

瀧川朋亨, 宇川諒, 小田孔明, 塩崎泰之, 三澤治夫, 尾崎敏文

日本整形外科学会雑誌 92 ( 2 ) S196 - S196 2018.3

重症脳性麻痺患者における側彎症治療の健康関連QOL調査

小田孔明, 瀧川朋亨, 塩崎泰之, 三澤治夫, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 92 ( 2 ) S228 - S228 2018.3

脊柱変形手術時の運動誘発電位モニタリングにおけるanesthetic fade現象の検討

宇川諒, 瀧川朋亨, 村岡聡介, 小田孔明, 塩崎泰之, 三澤治夫, 尾崎敏文, 田中雅人

日本整形外科学会雑誌 92 ( 3 ) S798 - S798 2018.3

脊椎再手術例の検討

瀧川朋亨, 宇川諒, 小田孔明, 塩崎泰之, 三澤治夫, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S813 - S813 2018.3

Patients with osteosarcoma and soft tissue sarcoma might become “cancer refugees” in some japanese regional cities Reviewed

Hiromichi Yamane, Toshiyuki Kunisada, Toshifumi Ozaki, Nobuaki Ochi, Yoshihiro Honda, Yasunari Nagasaki, Nozomu Nakagawa, Tomoko Yamagishi, Hidekazu Nakanishi, Nagio Takigawa

Cancer Management and Research 10 353 - 359 2018.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Dove Medical Press Ltd

Purpose: “Rare cancer” is defined as malignancy with a disease prevalence (age-adjusted incidence rate) of less than six per 100,000 population. Proper treatments which these patients need cannot always be performed unless they find dedicated facilities. Patients tend to be desperate, searching for advice and care. Thus, they are called “cancer refugees”. Osteosarcoma and soft tissue sarcoma (OS/STS) are representative rare cancers in Japan. We conducted a retrospective analysis of patients with OS/STS to improve the current treatment modalities in a Japanese regional city. Patients and methods: Twenty-one patients with OS/STS who were hospitalized to receive standard chemotherapy or palliative treatment were enrolled between October 2011 and January 2017. Patients with non-Hodgkin’s lymphoma (NHL) and advanced cancer who were treated in the palliative care unit (PCU) of the Kawasaki Medical School General Medical Center were recruited as the control groups. We analyzed the difference in residential area between patients with OS/STS and the control groups. Results: Approximately one-third of patients with OS/STS were referred from hospitals outside of Okayama prefecture. The ratio of patients with OS/STS referred from Okayama city and/or the same medical administration area of Okayama prefecture was lower than that of patients with NHL and advanced cancer who were treated in the PCU. Conclusion: Because the medical environment of patients with OS/STS in Japanese local cities has not been consolidated, completing medical care within the patient’s own medical administration area is difficult. Thus, some patients with OS/STS may become “cancer refugees” who are unable to receive standard therapy near their residence.

DOI： 10.2147/CMAR.S155282

Improvement in the medial meniscus posterior shift following anterior cruciate ligament reconstruction Reviewed

Hiroto Inoue, Takayuki Furumatsu, Shinichi Miyazawa, Masataka Fujii, Yuya Kodama, Toshifumi Ozaki

Knee Surgery, Sports Traumatology, Arthroscopy 26 ( 2 ) 434 - 441 2018.2

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

Purpose: Anterior cruciate ligament (ACL) reconstruction can reduce the risk of developing osteoarthritic knees. The goals of ACL reconstruction are to restore knee stability and reduce post-traumatic meniscal tears and cartilage degradation. A chronic ACL insufficiency frequently results in medial meniscus (MM) injury at the posterior segment. How ACL reconstruction can reduce the deformation of the MM posterior segment remains unclear. In this study, we evaluated the form of the MM posterior segment and anterior tibial translation before and after ACL reconstruction using open magnetic resonance imaging (MRI). Methods: Seventeen patients who underwent ACL reconstructions without MM injuries were included in this study. MM deformation was evaluated using open MRI before surgery and 3 months after surgery. We measured medial meniscal length (MML), medial meniscal height (MMH), medial meniscal posterior body width (MPBW), MM–femoral condyle contact width (M-FCW) and posterior tibiofemoral distance (PTFD) at knee flexion angles of 10° and 90°. Results: There were no significant pre- and postoperative differences during a flexion angle of 10°. At a flexion angle of 90°, MML decreased from 43.7 ± 4.5 to 41.4 ± 4.5 mm (P &lt
0.001), MMH from 7.5 ± 1.4 to 6.9 ± 1.4 mm (P = 0.006), MPBW from 13.1 ± 2.0 to 12.2 ± 1.9 mm (P &lt
0.001) and M-FCW from 10.0 ± 1.5 to 8.5 ± 1.5 mm (P &lt
0.001) after ACL reconstruction. The PTFD increased from 2.1 ± 2.8 to 2.7 ± 2.4 mm after ACL reconstruction (P = 0.015). Conclusions: ACL reconstruction affects the contact pattern between the MM posterior segment and medial femoral condyle and can reduce the deformation of the MM posterior segment in the knee-flexed position by reducing abnormal anterior tibial translation. It possibly prevents secondary injury to the MM posterior segment and cartilage that progresses to knee osteoarthritis. Level of evidence: IV.

DOI： 10.1007/s00167-017-4729-x

Extensive Bilateral Patellar Tendon Ossification in a Spinal Cord Injury Patient.

Norio Yamamoto, Takaaki Miki, Akihiro Nishiyama, Tomoyuki Dan'ura, Yuzuru Matsui, Toshifumi Ozaki

Acta medica Okayama 72 ( 1 ) 89 - 93 2018.2

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

This is the first report of extensive bilateral patellar tendon ossification occurring over a prolonged time after a unilateral knee injury. An 84-year-old Japanese man with a spinal cord injury caused by a burst fracture of the T12 vertebra presented with a bony hard prominence on the left knee, which was injured in a traffic accident when he was 77 years old. Radiography revealed extensive ossification of the bilateral patellar tendons. We review the English literature with a focus on the localization of bilateral heterotopic ossification of the knee in patients who had a central nervous system injury.

DOI： 10.18926/AMO/55670

骨折治療の最前線多発骨折・多発外傷における近年の治療戦略と変化リハビリテーション治療と関連して

山川泰明, 野田知之, 大塚貴久, 堅山佳美, 尾崎敏文, 千田益生

Journal of Clinical Rehabilitation 27 ( 2 ) 162 - 167 2018.2

Collagen-Binding Hepatocyte Growth Factor (HGF) alone or with a Gelatin- furfurylamine Hydrogel Enhances Functional Recovery in Mice after Spinal Cord Injury. Reviewed International journal

Kentaro Yamane, Tetsuro Mazaki, Yasuyuki Shiozaki, Aki Yoshida, Kensuke Shinohara, Mariko Nakamura, Yasuhiro Yoshida, Di Zhou, Takashi Kitajima, Masato Tanaka, Yoshihiro Ito, Toshifumi Ozaki, Akihiro Matsukawa

Scientific reports 8 ( 1 ) 917 - 917 2018.1

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

The treatment of spinal cord injury (SCI) is currently a significant challenge. Hepatocyte growth factor (HGF) is a multipotent neurotrophic and neuroregenerative factor that can be beneficial for the treatment of SCI. However, immobilized HGF targeted to extracellular matrix may be more effective than diffusible, unmodified HGF. In this study, we evaluated the neurorestorative effects of an engineered HGF with a collagen biding domain (CBD-HGF). CBD-HGF remained in the spinal cord for 7 days after a single administration, while unmodified HGF was barely seen at 1 day. When a gelatin-furfurylamine (FA) hydrogel was applied on damaged spinal cord as a scaffold, CBD-HGF was retained in gelatin-FA hydrogel for 7 days, whereas HGF had faded by 1 day. A single administration of CBD-HGF enhanced recovery from spinal cord compression injury compared with HGF, as determined by motor recovery, and electrophysiological and immunohistochemical analyses. CBD-HGF alone failed to improve recovery from a complete transection injury, however CBD-HGF combined with gelatin-FA hydrogel promoted endogenous repair and recovery more effectively than HGF with hydrogel. These results suggest that engineered CBD-HGF has superior therapeutic effects than naïve HGF. CBD-HGF combined with hydrogel scaffold may be promising for the treatment of serious SCI.

DOI： 10.1038/s41598-018-19316-y

Accuracy of Cup Positioning With the Computed Tomography-Based Two-dimensional to Three-Dimensional Matched Navigation System: A Prospective, Randomized Controlled Study Reviewed

Kazuki Yamada, Hirosuke Endo, Tomonori Tetsunaga, Takamasa Miyake, Tomoaki Sanki, Toshifumi Ozaki

Journal of Arthroplasty 33 ( 1 ) 136 - 143 2018.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Churchill Livingstone Inc.

Background The accuracy of various navigation systems used for total hip arthroplasty has been described, but no publications reported the accuracy of cup orientation in computed tomography (CT)-based 2D-3D (two-dimensional to three-dimensional) matched navigation. Methods In a prospective, randomized controlled study, 80 hips including 44 with developmental dysplasia of the hips were divided into a CT-based 2D-3D matched navigation group (2D-3D group) and a paired-point matched navigation group (PPM group). The accuracy of cup orientation (absolute difference between the intraoperative record and the postoperative measurement) was compared between groups. Additionally, multiple logistic regression analysis was performed to evaluate patient factors affecting the accuracy of cup orientation in each navigation. Results The accuracy of cup inclination was 2.5° ± 2.2° in the 2D-3D group and 4.6° ± 3.3° in the PPM group (P =.0016). The accuracy of cup anteversion was 2.3° ± 1.7° in the 2D-3D group and 4.4° ± 3.3° in the PPM group (P =.0009). In the PPM group, the presence of roof osteophytes decreased the accuracy of cup inclination (odds ratio 8.27, P =.0140) and the absolute value of pelvic tilt had a negative influence on the accuracy of cup anteversion (odds ratio 1.27, P =.0222). In the 2D-3D group, patient factors had no effect on the accuracy of cup orientation. Conclusion The accuracy of cup positioning in CT-based 2D-3D matched navigation was better than in paired-point matched navigation, and was not affected by patient factors. It is a useful system for even severely deformed pelvises such as developmental dysplasia of the hips.

DOI： 10.1016/j.arth.2017.08.001

Iatrogenic injury of the lateral meniscus anterior insertion following anterior cruciate ligament reconstruction: A case report Reviewed

Takayuki Furumatsu, Toshifumi Ozaki

Journal of Orthopaedic Science 23 ( 1 ) 197 - 201 2018.1

La R?paration en ?pull out? transtibial des l?sions de la racine post?rieure du m?nisque m?dial restaure la rotation physiologique du m?nisque m?dial sur un genou fl?chi Reviewed International journal

Okazaki Y, Furumatsu T, Kodama Y, Hino T, Kamatsuki Y, Masuda S, Miyazawa S, Endo H, Tetsunaga Tomonori, Yamada K, Ozaki T

Revue de Chirurgie Orthopedique et Traumatologique, Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur, Revue d'orthope?die et de chirurgie de l'appareil moteur 2018.1

The clinical course of patients with rheumatoid arthritis who underwent orthopaedic surgeries under disease control by tofacitinib. Reviewed International journal

Nishida K, Harada R, Nasu Y, Takeshita A, Nakahara R, Matsumeda M, Ozaki T

Modern rheumatology 28 ( 6 ) 1 - 8 2018.1

Molecular radiosensitization of p53-armed telomerase-dependent oncolytic adenovirus against human soft-tissue sarcoma

Tadashi Komatsubara, Hiroshi Tazawa, Yusuke Mochizuki, Kazuhisa Sugiu, Toshinori Omori, Yasuaki Yamakawa, Syuhei Osaki, Joe Hasei, Tomohiro Fujiwara, Toshiyuki Kunisada, Yasuo Urata, Toshifumi Ozaki, Toshiyoshi Fujiwara

CANCER SCIENCE 109 454 - 454 2018.1

Liquid biopsy using tumor-derived exosomes for Ewing sarcoma patients

Aki Yoshida, Tomohiro Fujiwara, Koji Uotani, Shintaro Iwata, Yusuke Yoshioka, Koji Ueda, Takuya Morita, Masahiro Kiyono, Suguru Yokoo, Joe Hasei, Toshiyuki Kunisada, Takahiro Ochiya, Toshifumi Ozaki

CANCER SCIENCE 109 312 - 312 2018.1

肺がん骨転移に対するニボルマブの治療効果

中田英二, 杉原進介, 上月稔幸, 原田大二郎, 武智宣佳, 尾崎敏文

中部日本整形外科災害外科学会雑誌 61 ( 1 ) 39 - 40 2018.1

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

抗PD-1抗体であるニボルマブの肺がん転移に対する治療効果について検討した。平成28年1月〜平成29年3月に当院でニボルマブの治療を行った非小細胞肺がん骨転移16例(男性11例、女性5例、平均年齢65歳)を対象とした。治療効果はPR 3例、SD 3例、PD 10例で、奏効率19%、病勢コントロール率38%であった。PRの全例、SDの1例で骨転移巣の骨形成や骨外腫瘤の縮小を認めたが、他の症例では不変あるいは骨破壊の進行を認めた。4例で骨転移巣に骨形成を認め、骨転移に対する治療効果はCR1例、PR3例、SD10例、PD2例であった。Second lineとしてニボルマブ投与が行われた5例の治療効果はPR2例、SD2例、PD1例で、骨転移に対する治療効果はCR1例、PR2例、SD2例であった。CRの1例は有害事象により投与開始後2ヵ月でニボルマブの投与を休止し、その後抗がん剤投与を行わなかったが、経時的に原発巣と肺転移巣の縮小と骨転移巣の骨形成を認め、最終観察時(投与中止後6ヵ月)には再増大を認めなかった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00831&link_issn=&doc_id=20180409210014&doc_link_id=10.11359%2Fchubu.2018.39&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2018.39&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

肘関節尺側側副靱帯損傷の不安定性の評価関節造影ストレス撮影とMRI画像所見との関連性

内野崇彦, 島村安則, 島村好信, 名越充, 井上博登, 山脇正, 中道亮, 齋藤太一, 野田知之, 尾崎敏文

日本肘関節学会雑誌 25 ( 1 ) S59 - S59 2018.1

Intercondylar and central regions of complete discoid lateral meniscus have different cell and matrix organizations Reviewed

Takayuki Furumatsu, Ami Maehara, Yuki Okazaki, Toshifumi Ozaki

Journal of Orthopaedic Science 23 ( 5 ) 811 - 818 2018

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

Background: A complete discoid lateral meniscus (DLM) has a high risk of horizontal tear. However, cellular phenotypes and extracellular matrix organizations in complete DLMs are still unclear. The aim of this study was to investigate histological and cellular biological characteristics in both the intercondylar and central regions of complete DLM. Materials and methods: Meniscal samples were obtained from the intercondylar and central regions of complete DLM (n = 6). Blood vessels and aggregated cell ratio were measured in each region. Depositions of type I/II collagens and safranin O-stained proteoglycans in the extracellular matrix were assessed. Experiments in gene expression, morphology, proliferation, and effect of mechanical stretch were performed using cultured cells derived from each region. Results: Blood vessel counts were significantly higher in the intercondylar region than in the central region. The ratio of aggregated cells was lower in the intercondylar region than in the central region. Deposition of type I collagen was comparable for both regions. The central region contained a larger quantity of type II collagen and safranin O staining density compared with the intercondylar region. Proliferation of the fibroblastic intercondylar cells was not affected by 5%-stretching. However, stretching treatments decreased relative proliferation of the chondrocytic central cells. Conclusions: This study demonstrated that the central region of complete DLM had different cellular properties and collagen components compared with the intercondylar region. Our results suggest that the central region of complete DLM may have a low healing potential like the inner avascular region of the meniscus.

DOI： 10.1016/j.jos.2018.05.006

A rare manifestation of extraskeletal myxoid chondrosarcoma with a huge expanding hematoma Reviewed

Toshinori Omori, Tomohiro Fujiwara, Toshiyuki Kunisada, Ken Takeda, Joe Hasei, Aki Yoshida, Hiroyuki Yanai, Toshifumi Ozaki

Journal of Orthopaedic Science 24 ( 2 ) 377 - 381 2018

Meniscal Extrusion Progresses Shortly after the Medial Meniscus Posterior Root Tear. Reviewed International journal

Furumatsu T, Kodama Y, Kamatsuki Y, Hino T, Okazaki Y, Ozaki T

Knee surgery & related research 29 ( 4 ) 295 - 301 2017.12

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

Purpose: Medial meniscus posterior root tears (MMPRT) induce medial meniscus extrusion (MME). However, the time-dependent extent of MME in patients suffering from the MMPRT remains unclear. This study evaluated the extent of MME after painful popping events that occurred at the onset of the MMPRT. Materials and Methods: Thirty-five patients who had an episode of posteromedial painful popping were investigated. All the patients were diagnosed as having an MMPRT by magnetic resonance imaging (MRI) within 12 months after painful popping. Medial meniscus body width (MMBW), absolute MME, and relative MME (100×absolute MME/MMBW) were assessed among three groups divided according to the time after painful popping events: early period (〈1 month), subacute period (1-3 months), and chronic period (4-12 months). Results: In the early period, absolute and relative MMEs were 3.0 mm and 32.7%, respectively. Absolute MME increased up to 4.2 mm and 5.8 mm during the subacute and chronic periods, respectively. Relative MME also progressed to 49.2% and 60.3% in the subacute and chronic periods, respectively. Conclusions: This study demonstrated that absolute and relative MMEs increased progressively within the short period after the onset of symptomatic MMPRT. Our results suggest that early diagnosis of an MMPRT may be important to prevent progression of MME following the MMPRT.

DOI： 10.5792/ksrr.17.027

Autonomous feedback loop of RUNX1-p53-CBFB in acute myeloid leukemia cells Reviewed

Ken Morita, Mina Noura, Chieko Tokushige, Shintaro Maeda, Hiroki Kiyose, Gengo Kashiwazaki, Junichi Taniguchi, Toshikazu Bando, Kenichi Yoshida, Toshifumi Ozaki, Hidemasa Matsuo, Seishi Ogawa, Pu Paul Liu, Tatsutoshi Nakahata, Hiroshi Sugiyama, Souichi Adachi, Yasuhiko Kamikubo

SCIENTIFIC REPORTS 7 ( 1 ) 16604 2017.11

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

Although runt-related transcription factor 1 (RUNX1) and its associating core binding factor-beta (CBFB) play pivotal roles in leukemogenesis, and inhibition of RUNX1 has now been widely recognized as a novel strategy for anti-leukemic therapies, it has been elusive how leukemic cells could acquire the serious resistance against RUNX1-inhibition therapies and also whether CBFB could participate in this process. Here, we show evidence that p53 (TP53) and CBFB are sequentially up-regulated in response to RUNX1 depletion, and their mutual interaction causes the physiological resistance against chemotherapy for acute myeloid leukemia (AML) cells. Mechanistically, p53 induced by RUNX1 gene silencing directly binds to CBFB promoter and stimulates its transcription as well as its translation, which in turn acts as a platform for the stabilization of RUNX1, thereby creating a compensative RUNX1-p53-CBFB feedback loop. Indeed, AML cells derived from relapsed cases exhibited higher CBFB expression levels compared to those from primary AML cells at diagnosis, and these CBFB expressions were positively correlated to those of p53. Our present results underscore the importance of RUNX1-p53-CBFB regulatory loop in the development and/or maintenance of AML cells, which could be targeted at any sides of this triangle in strategizing anti-leukemia therapies.

DOI： 10.1038/s41598-017-16799-z

Circulating MicroRNA-92b-3p as a Novel Biomarker for Monitoring of Synovial Sarcoma Reviewed

Koji Uotani, Tomohiro Fujiwara, Aki Yoshida, Shintaro Iwata, Takuya Morita, Masahiro Kiyono, Suguru Yokoo, Toshiyuki Kunisada, Ken Takeda, Joe Hasei, Kunihiko Numoto, Yutaka Nezu, Tsukasa Yonemoto, Takeshi Ishii, Akira Kawai, Takahiro Ochiya, Toshifumi Ozaki

SCIENTIFIC REPORTS 7 ( 1 ) 14634 2017.11

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

The lack of useful biomarkers is a crucial problem for patients with soft tissue sarcomas (STSs). Emerging evidence has suggested that circulating microRNAs (miRNAs) in body fluids have novel impact as biomarkers for patients with malignant diseases, but their significance in synovial sarcoma (SS) patients remains unknown. Initial global miRNA screening using SS patient serum and SS cell culture media identified a signature of four upregulated miRNAs. Among these candidates, miR-92b-3p secretion from SS cells was confirmed, which was embedded within tumour-derived exosomes rather than argonaute-2. Animal experiments revealed a close correlation between serum miR-92b-3p levels and tumour dynamics. Clinical relevance was validated in two independent clinical cohorts, and we subsequently identified that serum miR-92b-3p levels were significantly higher in SS patients in comparison to that in healthy individuals. Moreover, serum miR-92b-3p was robust in discriminating patients with SS from the other STS patients and reflected tumour burden in SS patients. Overall, liquid biopsy using serum miR-92b-3p expression levels may represent a novel approach for monitoring tumour dynamics of SS.

DOI： 10.1038/s41598-017-12660-5

Inhibitory effect of JAK inhibitor on mechanical stress-induced protease expression by human articular chondrocytes. International journal

Takahiro Machida, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Masatsugu Ozawa, Ryozo Harada, Masahiro Horita, Ayumu Takeshita, Daisuke Kaneda, Aki Yoshida, Toshifumi Ozaki

Inflammation research : official journal of the European Histamine Research Society ... [et al.] 66 ( 11 ) 999 - 1009 2017.11

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

OBJECTIVE: To investigate whether janus kinase (JAK) inhibitor exhibits a chondro-protective effect against mechanical stress-induced expression of a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) and matrix metalloproteinase (MMPs) in human chondrocytes. MATERIALS AND METHODS: Normal human articular chondrocytes were seeded onto stretch chambers and incubated with or without tofacitinib (1000 nM) for 12 h before mechanical stimulation or cytokine stimulation. Uni-axial cyclic tensile strain (CTS) (0.5 Hz, 10% elongation, 30 min) was applied and the gene expression levels of type II collagen α1 chain (COL2A1), aggrecan (ACAN), ADAMTS4, ADAMTS5, MMP13, and runt-related transcription factor 2 (RUNX-2) were examined by real-time polymerase chain reaction. Nuclear translocation of RUNX-2 and nuclear factor-κB (NF-κB) was examined by immunocytochemistry, and phosphorylation of mitogen-activated protein kinase (MAPK) and signaling transducer and activator of transcription (STAT) 3 was examined by western blotting. The concentration of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in the supernatant was examined by enzyme-linked immunosorbent assay. RESULTS: COL2A1 and ACAN gene expression levels were decreased by CTS, but these catabolic effects were canceled by tofacitinib. Tofacitinib significantly down-regulated CTS-induced expression of ADAMTS4, ADAMTS5, MMP13, and RUNX2, and the release of IL-6 in supernatant by chondrocytes. Tofacitinib also reduced CTS-induced nuclear translocation of RUNX-2 and NF-κB, and phosphorylation of MAPK and STAT3. CONCLUSION: Tofacitinib suppressed mechanical stress-induced expression of ADAMTS4, ADAMTS5, and MMP13 by human chondrocytes through inhibition of the JAK/STAT and MAPK cascades.

DOI： 10.1007/s00011-017-1083-x

Tibial eminence width can predict the presence of complete discoid lateral meniscus: A preliminary study.

Tomohito Hino, Takayuki Furumatsu, Masataka Fujii, Yuya Kodama, Shinichi Miyazawa, Yusuke Kamatsuki, Kazuki Yamada, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 22 ( 6 ) 1084 - 1088 2017.11

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

BACKGROUND: To compare the plain knee radiograph finding of tibial eminence width between knees with complete discoid lateral meniscus, incomplete discoid lateral meniscus, and normal lateral meniscus. MATERIALS AND METHODS: The study included 27 knees with discoid lateral meniscus, including 13 knees with complete discoid lateral meniscus and 14 knees with incomplete discoid lateral meniscus. A control group of 14 knees with normal lateral meniscus was also included. Tibial eminence width and the lateral slope angle of the medial tibial eminence were assessed using plain frontal knee radiographs. Individual differences in knee size were corrected by dividing tibial eminence width by tibial width to obtain the tibial eminence width percentage. RESULTS: Mean tibial eminence width and tibial eminence width percentage in the complete discoid lateral meniscus group was significant larger than other groups. Mean lateral slope angle in the complete discoid lateral meniscus group was significantly smaller than other groups. A tibial eminence width cut-off of 13.9 mm showed a sensitivity and specificity of 100% and 83%, respectively. A tibial eminence width percentage cut-off of 18.8% showed a sensitivity and specificity of 100% and 90%, respectively. A lateral slope angle cut-off of 27.1° showed a sensitivity and specificity of 71% and 83%, respectively. CONCLUSION: There were clear differences in tibial eminence width, tibial eminence width percentage, and lateral slope angle between the complete discoid lateral meniscus group and the other groups. The plain radiographic parameters identified by this study could be useful for complete discoid lateral meniscus screening. STUDY DESIGN: Clinical.

DOI： 10.1016/j.jos.2017.07.011

側彎症手術を行った重症脳性麻痺患者における健康関連QOL調査の試み

小田孔明, 瀧川朋亨, 杉本佳久, 田中雅人, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 6 ) 1049 - 1050 2017.11

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

肢体不自由児施設入所中の脳性麻痺(CP)患者79名(平均年齢13.3歳)を対象に、日本語に翻訳したCaregiver Priorities and Child Health Index of Life with Disabilities(CPCHILD)がQOL調査に使用可能であるか検討した。アンケート結果の内的整合性を検討し、更に、2週間の間隔を開け2回調査して再現性も検討した。また、当大学病院で側彎症手術を受けたGMFCS IVまたはVの重症CP患者6名(平均年齢13.3歳)に対してもアンケートを用いてQOL調査を行った。内的整合性をみたCronbachのα係数および再現性の結果は、いずれも0.6を上回っていた。CPCHILDのスコアをGMFCS level別に比較したところ、section 1～3とtotal scoreでGMFCSの重症度とCPCHILDスコアは相関していた。術前CPCHILDスコアはsection 1～6で19.7、19.1、76.8、91.9、72.2、56.7、術後のスコアは20.7、14.7、75.2、93.4、75.0、60.0であり、統計学的有意差は認めなかった。以上、日本語翻訳したCPCHILDは内的妥当性と再現性は良好であり、脳性麻痺の重症度もスコアに反映していたが、術後QOLの改善は認めなかった。

Other Link： https://search.jamas.or.jp/default/link?pub_year=2017&ichushi_jid=J00831&link_issn=&doc_id=20180117120028&doc_link_id=10.11359%2Fchubu.2017.1049&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2017.1049&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Arthroscopic Repair of the Medial Meniscus Radial/Oblique Tear Prevents the Progression of Meniscal Extrusion in Mildly Osteoarthritic Knees Reviewed

Takayuki Furumatsu, Yuya Kodama, Yusuke Kamatsuki, Tomohito Hino, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 71 ( 5 ) 413 - 418 2017.10

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

Extrusion of the medial meniscus (MM) is associated with knee joint pain in osteoarthritic knees. The relationships among MM radial/ oblique tears, MM extrusion (MME), and the effect of arthroscopic meniscal repair are not established. Here we evaluated the effects of arthroscopic all-inside MM repair on MME and the clinical outcomes in patients with radially oriented MM tears and mildly osteoarthritic knees. Twenty patients with a symptomatic radial or oblique tear of the MM posterior segment, MME = 2.5 mm, and mildly osteoarthritic knees were treated using FasT-Fix 360 All-inside Meniscal Suture devices. We used magnetic resonance imaging (MRI) to measure the patients' MM body width (MMBW), absolute MME, and relative MME. The Japanese Knee Injury and Osteoarthritis Outcome Score, Lysholm, Tegner, IKDC Subjective Knee Evaluation, and Visual Analogue Scale scores were obtained. Arthroscopic all-inside MM repair prevented increases of absolute and relative MME. The preoperative and 3- and 12-month MRI-based MMBW values were similar. Over a 24-month follow-up after the MM repairs, the clinical scores showed significant improvements. Our results suggest that all-inside meniscal repairs would be useful in preventing the progression of MME in patients suffering from symptomatic MM radial/ oblique tears associated with mildly osteoarthritic knees.

DOI： 10.18926/AMO/55439

Tensile strength of the pullout repair technique for the medial meniscus posterior root tear: a porcine study. International journal

Masataka Fujii, Takayuki Furumatsu, Haowei Xue, Shinichi Miyazawa, Yuya Kodama, Tomohito Hino, Yusuke Kamatsuki, Toshifumi Ozaki

International orthopaedics 41 ( 10 ) 2113 - 2118 2017.10

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

PURPOSE: The purpose of this study was to compare the load-to-failure of different common suturing techniques with a new technique for the medial meniscus posterior root tear (MMPRT). METHODS: Thirty porcine medial menisci were randomly assigned to three suturing techniques used for transtibial pullout repair of the MMPRT (n = 10 per group). Three different meniscal suture configurations were studied: the two simple suture (TSS) technique, the conventional modified Mason-Allen suture (MMA) technique, and the new MMA technique using the FasT-Fix combined with the Ultrabraid (F-MMA). The ultimate failure load was tested using a tensile testing machine. RESULTS: The MMA and F-MMA groups demonstrated significantly higher failure loads than the TSS group (P = 0.0003 and P = 0.0005, respectively). No significant differences were observed between the MMA and F-MMA groups (P = 0.734). CONCLUSIONS: The ultimate failure load was significantly greater in the F-MMA than the TSS group and similar to the conventional MMA technique.

DOI： 10.1007/s00264-017-3561-8

関節リウマチ肘に対するlinked人工肘関節(PROSNAP)の治療成績の検討

沖田駿治, 西田圭一郎, 渡辺雅仁, 木曽洋平, 大橋秀基, 兼田大輔, 竹下歩, 中原龍一, 那須義久, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 367 - 367 2017.10

深層学習を用いた関節リウマチ患者の超音波画像分類における動画データ利用

中原龍一, 西田圭一郎, 木曽洋平, 大橋秀樹, 兼田大輔, 竹下歩, 那須義久, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 366 - 366 2017.10

関節リウマチ新時代の手術療法 50歳未満のRA患者に対する人工肘関節全置換術

西田圭一郎, 沖田駿治, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 大橋秀基, 木曽洋平, 尾崎敏文, 橋詰謙三

日本関節病学会誌 36 ( 3 ) 362 - 362 2017.10

中足骨遠位斜め骨切り短縮術を行った関節リウマチ外側趾のX線学的経時変化

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, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 360 - 360 2017.10

関節リウマチ前足部手術における足長変化に関する検討

木曽洋平, 那須義久, 渡辺雅仁, 沖田瞬治, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 雑賀健多, 西田圭一郎, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 359 - 359 2017.10

関節リウマチ前足部変形における外側趾中足骨短縮骨切りが外反母趾角に与える影響

那須義久, 渡辺雅仁, 木曽洋平, 沖田駿治, 大橋基広, 兼田大輔, 竹下歩, 中原龍一, 西田圭一郎, 尾崎敏文

日本関節病学会誌 36 ( 3 ) 358 - 358 2017.10

人工肘関節置換術(TEA)後の尺骨神経障害の治療と神経伝導検査

堅山佳美, 千田益生, 兼田大輔, 日野知仁, 池田吉宏, 尾崎敏文

臨床神経生理学 45 ( 5 ) 421 - 421 2017.10

外側型肘離断性骨軟骨炎に対する膝外側壁を含む骨軟骨柱移植術

島村安則, 内野崇彦, 名越充, 島村好信, 中道亮, 野田知之, 西田圭一郎, 尾崎敏文

日本肩関節学会抄録集 44回 161 - 161 2017.10

リトルリーグショルダーに対する抵抗下外旋テストの有用性

内野崇彦, 島村安則, 島村好信, 中道亮, 名越充, 野田知之, 尾崎敏文

日本肩関節学会抄録集 44回 334 - 334 2017.10

地方都市における希少がん標準的化学療法の取り組み骨軟部腫瘍化学療法の現状

山根弘路, 越智宣昭, 本多宣裕, 山岸智子, 中川望, 長崎泰有, 国定俊之, 藤原智洋, 長谷井嬢, 尾崎敏文, 瀧川奈義夫

日本癌治療学会学術集会抄録集 55回 P42 - 4 2017.10

Role of zoledronic acid in oncolytic virotherapy: Promotion of antitumor effect and prevention of bone destruction. Reviewed

Yamakawa Y, Tazawa H, Hasei J, Osaki S, Omori T, Sugiu K, Komatsubara T, Uotani K, Fujiwara T, Yoshida A, Kunisada T, Urata Y, Kagawa S, Ozaki T, Fujiwara T

Cancer science 108 ( 9 ) 1870 - 1880 2017.9

がん免疫療法の一段の進化へむけて腫瘍浸潤免疫細胞の代謝は抗腫瘍免疫応答を制御する

鵜殿平一郎, 榮川伸吾, 國定勇希, 上原健敬, 渡邉元嗣, 木村裕司, 佐々木朗, 尾崎敏文, 豊岡伸一, 藤原俊義

日本癌学会総会記事 76回 S10 - 5 2017.9

関節リウマチ治療手術のタイミングと工夫リウマチ肘関節に対する人工関節置換術の適応とインプラント選択

那須義久, 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 60 ( 秋季学会 ) 55 - 55 2017.9

胸部食道癌術後症例の誤嚥性肺炎のリスク要因の検討

池田吉宏, 日野知仁, 兼田大輔, 堅山佳美, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 54 ( 秋季特別号 ) S274 - S274 2017.9

骨肉腫細胞内と分泌エクソソーム内におけるmicroRNA発現の相違と患者血清エクソソーム内の発現と臨床的相関性

清野正普, 藤原智洋, 吉田晶, 森田卓也, 横尾賢, 小松原将, 望月雄介, 出宮浩二, 長谷井嬢, 国定俊之, 尾崎敏文

日本癌学会総会記事 76回 P - 2045 2017.9

悪性骨腫瘍切除後の機能再建手術

尾崎敏文, 中田英二, 藤原智洋, 長谷井嬢, 国定俊之

The Japanese Journal of Rehabilitation Medicine 54 ( 秋季特別号 ) S138 - S138 2017.9

未来人が拓く整形外科医療骨盤骨腫瘍に対する切除後再建法

長谷井嬢, 国定俊之, 藤原智洋, 中田英二, 尾崎敏文

中国・四国整形外科学会雑誌 29 ( 3 ) 329 - 329 2017.9

悪性骨軟部腫瘍に対する治療の進歩術中ナビゲーションシステムを併用した悪性骨軟部腫瘍手術

国定俊之, 藤原智洋, 長谷井嬢, 瀧川朋亨, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 秋季学会 ) 48 - 48 2017.9

軟部肉腫に対するp53発現テロメラーゼ依存型腫瘍融解アデノウイルスの放射線効果増強

小松原将, 田澤大, 望月雄介, 杉生和久, 大森敏規, 山川泰明, 尾崎修平, 長谷井嬢, 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 76回 J - 2008 2017.9

Ewing肉腫におけるエクソソームを標的とした体液診断法の確立

吉田晶, 藤原智洋, 魚谷弘二, 岩田慎太郎, 吉岡祐亮, 植田幸嗣, 森田卓也, 清野正普, 横尾賢, 長谷井嬢, 国定俊之, 落谷孝広, 尾崎敏文

日本癌学会総会記事 76回 P - 1289 2017.9

粘液線維肉腫由来エクソソーム中microRNAプロファイリングの特定と機能解析

森田卓也, 藤原智洋, 吉田晶, 清野正晋, 横尾賢, 長谷井嬢, 国定俊之, 尾崎敏文

日本癌学会総会記事 76回 P - 2295 2017.9

転写因子Mohawkは椎間板線維輪の維持、再生に重要である

中道亮, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 秋季学会 ) 254 - 254 2017.9

重症脳性麻痺患者におけるgrowth spurt中の側彎症進行調査

小田孔明, 瀧川朋亨, 塩崎泰之, 三澤治夫, 赤澤啓史, 尾崎敏文

中国・四国整形外科学会雑誌 29 ( 3 ) 350 - 350 2017.9

関節リウマチ患者の環軸椎亜脱臼に対する固定術式の検討

三澤ハルオ, 瀧川朋亨, 塩崎泰之, 小田孔明, 宇川諒, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 秋季学会 ) 184 - 184 2017.9

頸椎に生じた骨軟骨腫の1例

村岡聡介, 小田孔明, 塩崎泰之, 瀧川朋亨, 三澤治夫, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 秋季学会 ) 216 - 216 2017.9

Cervical Spine Osteoradionecrosis Reviewed

Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Yoshihiro Kimata, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 71 ( 4 ) 345 - 349 2017.8

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

Osteoradionecrosis (ORN), a well-known complication of radiotherapy in the mandibular bone, is very rare in the cervical spine. The authors report the result of a 3-year follow-up of a 63-year-old female patient with ORN of the cervical spine. The patient had a history of laryngeal carcinoma and was treated with chemotherapy and radiation therapy with a total of 120 Gy. Eight years later, she developed acute, severe neck pain due to cervical spine necrosis. The authors performed vascularized fibular bone graft and posterior pedicle screw fixation to reconstruct her cervical spine. The patient was successfully treated with surgery, and cervical alignment was preserved. She had neither neurological deficits nor severe neck pain at her final follow-up 3 years later. Delaying treatment of ORN may be life threatening, so the early diagnosis of this condition is important for patients who receive radiotherapy. Otolaryngologists and spine surgeons should understand this potential complication to speed diagnosis and treatment as early as possible.

DOI： 10.18926/AMO/55312

An Analysis of the Characteristics and Improved Use of Newly Developed CT-based Navigation System in Total Hip Arthroplasty.

Yosuke Fujii, Kazuo Fujiwara, Tomonori Tetsunaga, Takamasa Miyake, Kazuki Yamada, Hirosuke Endo, Nobuhiro Abe, Naohiko Sugita, Mamoru Mitsuishi, Takayuki Inoue, Yoshio Nakashima, Toshifumi Ozaki

Acta medica Okayama 71 ( 4 ) 279 - 289 2017.8

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

We developed a surface matching-type computed tomography (CT)-based navigation system for total hip arthroplasty (the N-navi; TEIJIN NAKASHIMA MEDICAL, Okayama, Japan). In the registration step, surface matching was performed with digitizing points on the pelvic bone surface after coarse paired matching. In the present study, we made model bones from the CT data of patients whose acetabular shapes had various deformities. We measured the distances and angles after surface matching from the fiducial points and evaluated the ability to correct surface-matching registration on each pelvic form, using several areas and numbers of points. When the surface-matching points were taken on the superior area of the acetabulum, the correction was easy for the external direction, but it was difficult to correct for the anterior and proximal directions. The correction was difficult for external and proximal directions on the posterior area. Each area of surface-matching points has particular directions that are easily corrected and other directions that are difficult to correct. The shape of the pelvis also affected the correction ability. Our present findings suggest that checking the position after coarse paired matching and choosing the surface-matching area and points that are optimal to correct will improve the accuracy of total hip arthroplasty and reduce surgical times.

DOI： 10.18926/AMO/55304

Location of the tibial tunnel aperture affects extrusion of the lateral meniscus following reconstruction of the anterior cruciate ligament. International journal

Yuya Kodama, Takayuki Furumatsu, Shinichi Miyazawa, Masataka Fujii, Takaaki Tanaka, Hiroto Inoue, Toshifumi Ozaki

Journal of orthopaedic research : official publication of the Orthopaedic Research Society 35 ( 8 ) 1625 - 1633 2017.8

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

The anterior root of the lateral meniscus provides functional stability to the meniscus. In this study, we evaluated the relationship between the position of the tibial tunnel and extrusion of the lateral meniscus after anterior cruciate ligament reconstruction, where extrusion provides a proxy measure of injury to the anterior root. The relationship between extrusion and tibial tunnel location was retrospectively evaluated from computed tomography and magnetic resonance images of 26 reconstructed knees, contributed by 25 patients aged 17-31 years. A measurement grid was used to localize the position of the tibial tunnel based on anatomical landmarks identified from the three-dimensional reconstruction of axial computed tomography images of the tibial plateaus. The reference point-to-tibial tunnel distance (mm) was defined as the distance from the midpoint of the lateral edge of the grid to the posterolateral aspect of the tunnel aperture. The optimal cutoff of this distance to minimize post-operative extrusion was identified using receiver operating curve analysis. Extrusion of the lateral meniscus was positively correlated to the reference point-to-tibial tunnel distance (r 2 = 0.64; p < 0.001), with a cutoff distance of 5 mm having a sensitivity to extrusion of 83% and specificity of 93%. The mean extrusion for a distance >5 mm was 0.40 ± 0.43 mm, compared to 1.40 ± 0.51 mm for a distance ≤5 mm (p < 0.001). Therefore, a posterolateral location of the tibial tunnel aperture within the footprint of the anterior cruciate ligament decreases the reference point-to-tibial tunnel distance and increases extrusion of the lateral meniscus post-reconstruction. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1625-1633, 2017.

DOI： 10.1002/jor.23450

Residual Femoral Deformity and Femoroacetabular Impingement after Intertrochanteric Osteotomy for Slipped Capital Femoral Epiphysis.

Yosuke Fujii, Hirosuke Endo, Shigeru Mitani, Hirofumi Akazawa, Tomonori Tetsunaga, Takamasa Miyake, Kazuki Yamada, Kiyoshi Aoki, Toshifumi Ozaki

Acta medica Okayama 71 ( 4 ) 315 - 323 2017.8

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

We retrospectively reviewed 29 hips in which intertrochanteric osteotomies were performed for severe slipped capital femoral epiphyses. Mean age at surgery: 12.6 years. Mean follow-up period: 6 years. At the final follow-up evaluation, one patient had coxalgia, and six hips showed a limited range of motion. A pistol-grip deformity was observed in 13 hips, osteoarthritis in two hips, and a bump existed in 19 hips on the latest radiographs. Gradual remodeling of the bumps was observed post-operatively in 22 hips. The mean α and β angles and offset α and β improved over time. The remodeling proceeded rapidly for 1 year post-surgery. We compared hips classified as β angles of ≥ 63° to < 63° at the final follow-up evaluation, the mean β angle 1 year post-surgery, and the mean ratio of improvement of the β angle per year from 1 year post-surgery to the final follow up, which differed significantly. Nearly all of the patients who underwent intertrochanteric osteotomies had residual morphologic abnormalities, but few had clinical symptoms. The β angle 1 year post-surgery and the ratio of remodeling of the bump from 1 year post-surgery to the final follow-up can be regarded as a potential predictor of morphologic results after intertrochanteric osteotomy.

DOI： 10.18926/AMO/55308

軟骨細胞によるIL-1β誘導性蛋白分解酵素発現に対する脂肪由来抽出液の影響

大橋秀基, 那須義久, 竹下歩, 兼田大輔, 木曽洋平, 沖田駿治, 渡辺雅仁, 中原龍一, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1758 - S1758 2017.8

メカニカルストレスによる軟骨細胞におけるRANKLの発現

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 大橋秀基, 沖田駿治, 木曽洋平, 渡辺雅仁, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1617 - S1617 2017.8

軟骨分化制御による骨棘形成過程へのADAM12の関与

堀田昌宏, 西田圭一郎, 長谷井嬢, 古松毅之, 宮澤慎一, 那須義久, 中原龍一, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1597 - S1597 2017.8

深層学習を用いた自動学習に必要な教師画像数の検討関節リウマチ患者の単純X線画像の自動学習

中原龍一, 西田圭一郎, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 那須義久, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1550 - S1550 2017.8

RA軟骨におけるRANKL発現とその誘導因子の検討

竹下歩, 西田圭一郎, 那須義久, 中原龍一, 兼田大輔, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1515 - S1515 2017.8

多糖複合体を担体とした抗菌薬伝達システムの開発

渡邉典行, 吉田晶, 田中雅人, 松川昭博, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1661 - S1661 2017.8

Ewing肉腫における腫瘍由来exosomeを標的としたliquid biopsy法の確立

魚谷弘二, 藤原智洋, 吉田晶, 岩田慎太郎, 森田卓也, 清野正普, 長谷井嬢, 国定俊之, 吉岡祐亮, 植田幸嗣, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1713 - S1713 2017.8

悪性骨・軟部腫瘍転移制御への道粘液線維肉腫における分泌型microRNAは腫瘍の浸潤性と関連しているか

森田卓也, 藤原智洋, 魚谷弘二, 吉田晶, 清野正普, 杉生和久, 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 91 ( 8 ) S1709 - S1709 2017.8

骨肉腫細胞内と分泌エクソソーム内におけるmicroRNA発現プロファイリングの相違と患者循環エクソソーム内の発現評価

清野正普, 藤原智洋, 魚谷弘二, 吉田晶, 森田卓也, 杉生和久, 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 91 ( 8 ) S1525 - S1525 2017.8

腫瘍融解ウイルスの骨・軟部腫瘍組織に対する感染効率の評価

吉田晶, 魚谷弘二, 藤原智洋, 長谷井嬢, 森田卓也, 清野正普, 杉生和久, 小松原将, 望月雄介, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1823 - S1823 2017.8

p53発現腫瘍融解アデノウイルスによる軟部肉腫に対する放射線治療併用効果の検討

小松原将, 望月雄介, 杉生和久, 大森敏規, 長谷井嬢, 吉田晶, 藤原智洋, 国定俊之, 浦田泰生, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1499 - S1499 2017.8

ドキソルビシン耐性骨肉腫細胞に対するp53発現腫瘍融解アデノウイルスによるMDR1発現抑制を介した薬剤耐性克服機序の検討

杉生和久, 田澤大, 望月雄介, 小松原将, 大森敏規, 山川泰明, 吉田晶, 長谷井嬢, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1523 - S1523 2017.8

青年期の肘関節弛緩性に対して年齢が与える影響についての検討

内野崇彦, 島村安則, 島村好信, 名越充, 中道亮, 井上博登, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本整形外科スポーツ医学会雑誌 37 ( 4 ) 561 - 561 2017.8

スノーボードによる稀な陳旧性肘関節側方脱臼の一例

清水健志, 島村安則, 内野崇彦, 中道亮, 野田知之, 尾崎敏文

日本整形外科スポーツ医学会雑誌 37 ( 4 ) 447 - 447 2017.8

思春期特発性側彎症における体幹体表変形の三次元的評価

小田孔明, 瀧川朋亨, 中原龍一, 宇川諒, 塩崎泰之, 杉本佳久, 鉄永倫子, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1809 - S1809 2017.8

脊柱変形手術時の運動誘発電位モニタリングにおけるanesthetic fade現象の検討

宇川諒, 瀧川朋亨, 小田孔明, 塩崎泰之, 鉄永倫子, 杉本佳久, 三澤治夫, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 91 ( 8 ) S1733 - S1733 2017.8

A giraffe neck sign of the medial meniscus: A characteristic finding of the medial meniscus posterior root tear on magnetic resonance imaging.

Takayuki Furumatsu, Masataka Fujii, Yuya Kodama, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 22 ( 4 ) 731 - 736 2017.7

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

BACKGROUND: The posterior root ligament of the medial meniscus (MM) has a critical role in regulating the MM movement. An accurate diagnosis of the MM posterior root tear (MMPRT) using magnetic resonance imaging (MRI) is important for preventing sequential osteoarthritis following the MMPRT. However, diagnosis of the MMPRT is relatively difficult even after using several characteristic MRI findings. The aim of this study was to identify a useful meniscal body sign of the MMPRT for improving diagnostic MRI reading. METHODS: Eighty-five patients who underwent surgical treatments for the MMPRT (39 knees) and other types of MM tears (49 knees) were included. The presence of characteristic MRI findings such as cleft sign, ghost sign, radial tear sign, medial extrusion sign, and new meniscal body shape-oriented "giraffe neck sign" was evaluated in 120 MRI examinations. RESULTS: Giraffe neck signs were observed in 81.7% of the MMPRTs and in 3.3% of other MM tears. Cleft, ghost, and radial tear signs were highly positive in the MMPRTs compared with other MM tears. Medial extrusion signs were frequently observed in both groups. Coexistence rates of any 2 MRI signs, except for medial extrusion sign, were 91.7% in the MMPRT group and 5% in other MM tears. CONCLUSIONS: This study demonstrated that a new characteristic MRI finding "giraffe neck sign" was observed in 81.7% of the MMPRT. Our results suggest that the combination of giraffe neck, cleft, ghost, and radial tear signs may be important for an accurate diagnostic MRI reading of the MMPRT.

DOI： 10.1016/j.jos.2017.03.013

The distribution of vascular endothelial growth factor in human meniscus and a meniscal injury model.

Zhichao Lu, Takayuki Furumatsu, Masataka Fujii, Ami Maehara, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 22 ( 4 ) 715 - 721 2017.7

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

BACKGROUND: The meniscus plays an important role in controlling the complex biomechanics of the knee. Meniscus injury is common in the knee joint. The perimeniscal capillary plexus supplies the outer meniscus, whereas the inner meniscus is composed of avascular tissue. Angiogenesis factors, such as vascular endothelial growth factor (VEGF), have important roles in promoting vascularization of various tissues. VEGF-mediated neovascularization is beneficial to the healing of injured tissues. However, the distribution and angiogenic role of VEGF remains unclear in the meniscus and injured meniscus. We hypothesized that VEGF could affect meniscus cells and modulate the meniscus healing process. METHODS: Menisci were obtained from total knee arthroplasty patients. Meniscal injury was created ex vivo by a microsurgical blade. VEGF mRNA and protein expression were detected by the polymerase chain reaction and immunohistochemical analyses, respectively. RESULTS: In native meniscal tissue, the expression of VEGF and HIF-1α mRNAs could not be detected. However, VEGF and HIF-1α mRNAs were found in cultured meniscal cells (VEGF: outer > inner; HIF-1α: outer = inner). Injury increased mRNA levels of both VEGF and HIF-1α, with the increase being greatest in the outer area. Immunohistochemical analyses revealed that VEGF protein was detected mainly in the outer region and around injured areas of the meniscus. However, VEGF concentrations were similar between inner and outer menisci-derived media. CONCLUSIONS: This study demonstrated that both the inner and outer regions of the meniscus contained VEGF. HIF-1α expression and VEGF deposition were high in injured meniscal tissue. Our results suggest that injury stimulates the expression of HIF-1α and VEGF that may be preserved in the extracellular matrix as the healing stimulator of damaged meniscus, especially in the outer meniscus.

DOI： 10.1016/j.jos.2017.02.006

関節リウマチ患者のボディイメージに対する手術治療の影響

堀田昌宏, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 林充, 尾崎敏文

関節の外科 44 ( 2 ) 67 - 67 2017.7

足関節・足部最良の機能再建とQOL向上を目指して関節リウマチ前足部手術における足長変化に関する検討

木曽洋平, 那須義久, 渡辺雅仁, 沖田駿治, 大橋秀基, 竹下歩, 兼田大輔, 堀田昌宏, 中原龍一, 雑賀健多, 西田圭一郎, 尾崎敏文

関節の外科 44 ( 2 ) 36 - 36 2017.7

鎖骨骨幹部骨折に対する最小侵襲プレート骨接合術(MIPO) 患者適合型プレベンディング法による手術手技

島村安則, 野田知之, 山川泰明, 吉村将秀, 内野崇彦, 中道亮, 島村好信, 中原龍一, 尾崎敏文

骨折 39 ( Suppl. ) S371 - S371 2017.7

Discrimination between Malignant and Benign Vertebral Fractures Using Magnetic Resonance Imaging. International journal

Tomoyuki Takigawa, Masato Tanaka, Yoshihisa Sugimoto, Tomoko Tetsunaga, Keiichiro Nishida, Toshifumi Ozaki

Asian spine journal 11 ( 3 ) 478 - 483 2017.6

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

STUDY DESIGN: Retrospective analysis using magnetic resonance imaging (MRI). PURPOSE: To identify MRI features that could discriminate benign from malignant vertebral fractures. OVERVIEW OF LITERATURE: Discrimination between benign and malignant vertebral fractures remains challenging, particularly in patients with osteoporosis and cancer. Presently, the most sensitive means of detecting and assessing fracture etiology is MRI. However, published reports have focused on only one or a few discriminators. METHODS: Totally, 106 patients were assessed by MRI within six weeks of sustaining 114 thoracic and/or lumbar vertebral fractures (benign, n=65; malignant, n=49). The fractures were pathologically confirmed if malignant or clinically diagnosed if benign and were followed up for a minimum of six months. Seventeen features were analyzed in all fractures' magnetic resonance images. Single parameters were analyzed using the chi-square test; a logit model was established using multivariate logistic regression analysis. RESULTS: The chi-square test revealed 11 malignant and 4 benign parameters. Multivariate logistic regression analysis selected (i) posterior wall diffuse protrusion (odds ratio [OR], 48; 95% confidence interval [CI], 4.2-548; p=0.002), (ii) pedicle involvement (OR, 21; 95% CI, 2.0-229; p=0.01), (iii) posterior involvement (OR, 21; 95% CI, 1.5-21; p=0.02), and (iv) band pattern (OR, 0.047; 95% CI, 0.0005-4.7; p=0.19). The logit model was expressed as P=1/[1+exp (x)], x=-3.88×(i)-3.05×(ii)-3.02×(iii)+3.05×(iv)+5.00, where P is the probability of malignancy. The total predictive value was 97.3%. The only exception was multiple myeloma with features of a benign fracture. CONCLUSIONS: Although each MRI feature had a different meaning with a variable differentiation power, combining them led to an accurate diagnosis. This study identified the most relevant MRI features that would be helpful in discriminating benign from malignant vertebral fractures.

DOI： 10.4184/asj.2017.11.3.478

Accuracy of pedicle screw insertion in posterior scoliosis surgery: a comparison between intraoperative navigation and preoperative navigation techniques. International journal

Wei Zhang, Tomoyuki Takigawa, YongGang Wu, Yoshihisa Sugimoto, Masato Tanaka, Toshifumi Ozaki

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 26 ( 6 ) 1756 - 1764 2017.6

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

PURPOSE: This study was conducted to compare the efficacy and accuracy of intraoperative navigation (O-arm or Arcadis navigation) and preoperative CT-based navigation in adolescent idiopathic scoliosis (AIS) surgery. METHODS: Sixty-seven patients with scoliosis were grouped according to the method of navigation used in their fixation surgeries. A total of 492 pedicle screws were implanted in 27 patients using intraoperative navigation, and 626 screws were implanted in 40 patients using preoperative navigation. We analyzed the postoperative CT images for pedicle violations using the Gertzbein classification. RESULTS: There was no statistical difference in the accuracy of pedicle screw placement between two groups. However, in the apical region (the apex ± 2 vertebrae), the accuracy of safe pedicle screw placement (grades 0, 1) was significantly higher in the intraoperative navigation group than in the preoperative navigation group (94.8 vs 89.2%, respectively; P = 0.035). Intraoperative navigation significantly diminished medial perforation compared to preoperative navigation (P = 0.027), and the number of screws per vertebra that could be placed in the apical region was significantly higher in intraoperative navigation group (P < 0.001). In addition, the time required for the registration procedure and insertion of one pedicle screw was 11.3 ± 2.1 min in the preoperative group, but significantly decreased to 5.1 ± 1.1 min in the intraoperative group (P < 0.001). CONCLUSIONS: Both preoperative CT-based and intraoperative navigation systems provide sufficient accuracy and safety in pedicle screw insertion for AIS surgery. Intraoperative navigation systems facilitate pedicle screw insertion in the apical region and reduce registration time during AIS surgery which improves the efficacy and accuracy of pedicle screw insertion.

DOI： 10.1007/s00586-016-4930-5

全人工肘関節置換術(TEA)後の尺骨神経障害

堅山佳美, 千田益生, 兼田大輔, 日野知仁, 池田吉宏, 尾崎敏文

運動器リハビリテーション 28 ( 2 ) 174 - 174 2017.6

粘液線維肉腫患者における分泌型microRNAの特定

森田卓也, 藤原智洋, 魚谷弘二, 吉田晶, 清野正晋, 杉生和久, 小松原将, 望月雄介, 長谷井嬢, 国定俊之, 落合孝広, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1394 - S1394 2017.6

術中CTナビゲーションシステムの良性骨腫瘍手術における有用性

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

日本整形外科学会雑誌 91 ( 6 ) S1290 - S1290 2017.6

骨肉腫切除後のGrowing Kotz人工関節置換症例における長期フォロー成績

望月雄介, 長谷井嬢, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1252 - S1252 2017.6

Ewing肉腫患者の血中を循環する腫瘍由来exosomeの表面抗原を標的とした体液診断法の開発

吉田晶, 藤原智洋, 魚谷弘二, 森田卓也, 清野正普, 杉生和久, 小松原将, 望月雄介, 国定俊之, 長谷井嬢, 吉岡祐亮, 植田幸嗣, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1321 - S1321 2017.6

骨肉腫細胞から分泌されるエクソソームは腫瘍進展においてどのような役割を担っているか

清野正普, 藤原智洋, 魚谷弘二, 吉田晶, 森田卓也, 杉生和久, 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 91 ( 6 ) S1320 - S1320 2017.6

切除縁評価と骨・軟部肉腫手術再発悪性骨・軟部腫瘍に対する手術切除縁と治療成績

国定俊之, 藤原智洋, 長谷井嬢, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1346 - S1346 2017.6

踵骨原発骨腫瘍に対する治療成績の検討

沖田駿治, 藤原智洋, 国定俊之, 長谷井嬢, 小松原将, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1331 - S1331 2017.6

術後10年以上経過した腫瘍用人工関節の長期治療成績

長谷井嬢, 望月雄介, 吉田晶, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1382 - S1382 2017.6

滑膜肉腫における分泌型microRNAの細胞外安定性の解析

魚谷弘二, 藤原智洋, 吉田晶, 森田卓也, 清野正普, 長谷井嬢, 国定俊之, 根津悠, 岩田慎太郎, 川井章, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1355 - S1355 2017.6

軟部肉腫に対する腫瘍融解アデノウイルスによる放射線治療増感効果の検討

小松原将, 大森敏規, 望月雄介, 杉生和久, 長谷井嬢, 吉田晶, 藤原智洋, 国定俊之, 浦田泰生, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1385 - S1385 2017.6

p53発現腫瘍融解アデノウイルスの薬剤耐性骨肉腫細胞に対する抗腫瘍効果と耐性克服メカニズムの検討

杉生和久, 田澤大, 望月雄介, 小松原将, 大森敏規, 山川泰明, 吉田晶, 長谷井嬢, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 91 ( 6 ) S1385 - S1385 2017.6

Clinical significance of circulating miR-25-3p as a novel diagnostic and prognostic biomarker in osteosarcoma. International journal

Tomohiro Fujiwara, Koji Uotani, Aki Yoshida, Takuya Morita, Yutaka Nezu, Eisuke Kobayashi, Akihiko Yoshida, Takenori Uehara, Toshinori Omori, Kazuhisa Sugiu, Tadashi Komatsubara, Ken Takeda, Toshiyuki Kunisada, Machiko Kawamura, Akira Kawai, Takahiro Ochiya, Toshifumi Ozaki

Oncotarget 8 ( 20 ) 33375 - 33392 2017.5

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

BACKGROUND: Emerging evidence has suggested that circulating microRNAs (miRNAs) in body fluids have novel diagnostic and prognostic significance for patients with malignant diseases. The lack of useful biomarkers is a crucial problem of bone and soft tissue sarcomas; therefore, we investigated the circulating miRNA signature and its clinical relevance in osteosarcoma. METHODS: Global miRNA profiling was performed using patient serum collected from a discovery cohort of osteosarcoma patients and controls and cell culture media. The secretion of the detected miRNAs from osteosarcoma cells and clinical relevance of serum miRNA levels were evaluated using in vitro and in vivo models and a validation patient cohort. RESULTS: Discovery screening identified 236 serum miRNAs that were highly expressed in osteosarcoma patients compared with controls, and eight among these were also identified in the cell culture media. Upregulated expression levels of miR-17-5p and miR-25-3p were identified in osteosarcoma cells, and these were abundantly secreted into the culture media in tumor-derived exosomes. Serum miR-25-3p levels were significantly higher in osteosarcoma patients than in control individuals in the validation cohort, with favorable sensitivity and specificity compared with serum alkaline phosphatase. Furthermore, serum miR-25-3p levels at diagnosis were correlated with patient prognosis and reflected tumor burden in both in vivo models and patients; these associations were more sensitive than those of serum alkaline phosphatase. CONCLUSIONS: Serum-based circulating miR-25-3p may serve as a non-invasive blood-based biomarker for tumor monitoring and prognostic prediction in osteosarcoma patients.

DOI： 10.18632/oncotarget.16498

A new aiming guide can create the tibial tunnel at favorable position in transtibial pullout repair for the medial meniscus posterior root tear Reviewed

T. Furumatsu, Y. Kodama, M. Fujii, T. Tanaka, T. Hino, Y. Kamatsuki, K. Yamada, S. Miyazawa, T. Ozaki

Revue de Chirurgie Orthopedique et Traumatologique 103 ( 3 ) 248 2017.5

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Masson SAS

Introduction Injuries to the medial meniscus (MM) posterior root lead to accelerated cartilage degeneration of the knee. An anatomic placement of the MM posterior root attachment is considered to be critical in transtibial pullout repair of the medial meniscus posterior root tear (MMPRT). However, tibial tunnel creation at the anatomic attachment of the MM posterior root is technically difficult using a conventional aiming device. The aim of this study was to compare two aiming guides. We hypothesized that a newly-developed guide specifically designed creates the tibial tunnel at an adequate position rather than a conventional device. Materials and methods Twenty-six patients underwent transtibial pullout repairs. Tibial tunnel creation was performed using the Multi-use guide (8 cases) or the PRT guide that had a narrow twisting/curving shape (18 cases). Three-dimensional computed tomography images of the tibial surface were evaluated using the Tsukada's measurement method postoperatively. Expected anatomic center of the MM posterior root attachment and tibial tunnel center were evaluated using the percentage-based posterolateral location on the tibial surface. Percentage distance between anatomic center and tunnel center was calculated. Results Anatomic center of the MM posterior root footprint located at a position of 78.5% posterior and 39.4% lateral. Both tunnels were anteromedial but tibial tunnel center located at a more favorable position in the PRT group: percentage distance was significantly smaller in the PRT guide group (8.7%) than in the Multi-use guide group (13.1%). Discussion The PRT guide may have great advantage to achieve a more anatomic location of the tibial tunnel in MMPRT pullout repair. Level of evidence IV.

DOI： 10.1016/j.rcot.2017.02.008

Short-term outcomes of patients being treated for chronic intractable pain at a liaison clinic and exacerbating factors of prolonged pain after treatment.

Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 22 ( 3 ) 554 - 559 2017.5

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

BACKGROUND: Although a multidisciplinary approach is often recommended to treat intractable pain, this approach does not completely prevent uncontrolled pain in some patients. The aim of this retrospective study was to investigate the exacerbating factors of prolonged, intractable pain among patients being treated at a pain liaison clinic. METHODS: The participants of this study were 94 outpatients (32 men, 62 women) with chronic intractable pain who visited our hospital between April 2013 and February 2015. Demographic and clinical information was obtained from all patients at baseline. Experts in various fields, including anesthesia, orthopedic surgery, psychiatry, physical therapy, and nursing, were involved in the treatment procedures. All patients were assessed before and after a 6-month treatment period using the following measures: the Numeric Rating Scale (NRS); the Pain Catastrophizing Scale (PCS); the Hospital Anxiety and Depression Scale (HADS); the Pain Disability Assessment Scale (PDAS); and the Oswestry Disability Index (ODI). All participants were then divided into two groups based on their self-reported pain after treatment: a pain relief group (n = 70) and a prolonged pain group (n = 24). The exacerbating factors of prolonged pain after treatment in the pain liaison outpatient clinic were analyzed using univariate and multiple logistic regression analysis. RESULTS: A significant improvement in NRS scores was observed after the 6-month follow-up period. After treatment, 24 (25.5%) of the 94 patients reported having prolonged pain. Significant improvements were seen in the PCS, PDAS, and ODI scores in the pain relief group, and in the HADS depression scores in the prolonged pain group. On univariate and multiple regression analysis, HADS depression scores were identified as a factor related to prolonged pain after treatment. CONCLUSIONS: The results of the present study suggest that severe depression at the initial visit to the liaison outpatient clinic was an exacerbating factor for prolonged pain after treatment.

DOI： 10.1016/j.jos.2017.01.004

Congenital double-level cervical spondylolysis: a case report and review of the literature. International journal

Norio Yamamoto, Takaaki Miki, Yoshihisa Nasu, Akihiro Nishiyama, Tomoyuki Dan'ura, Yuzuru Matsui, Toshifumi Ozaki

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 26 ( Suppl 1 ) 181 - 185 2017.5

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

PURPOSE: We report a rare Japanese female who was affected with three genetic-linked diseases: double-level cervical bilateral spondylolysis in association with spina bifida occulta, cleft lip and monostotic fibrous dysplasia of the right proximal femur. The case was considered to be congenital in origin. We also review the pertinent literature of cervical spondylolysis, with a focus on the pathogenesis of multiple-level cervical spondylolysis. METHODS: A 40-year-old female presented with progressive clumsiness and numbness of the hands. Japanese Orthopedic Association (JOA) score for the cervical spine was 14.5. Plain radiographs of the cervical spine showed bilateral spondylolysis of the articular mass portion, with an adjacent dysplastic change and spina bifida occulta of C4 and C5. Cervical laminoplasty from C4 to C6 was performed. RESULTS: The postoperative course was uneventful, and the patient had some recovery of muscle power and sensation, with JOA score improving to 15.5. At the 8-year follow-up, the patient had no recurrence of symptoms, but did show kyphotic and degenerative changes at the C4/5 and C5/6 level with no apparent instability. CONCLUSIONS: This case is a rare presentation of bilateral cervical spondylolysis involving C4 and C5, presumably congenital, accompanied by combined dysplastic changes of the cervical spine, cleft lip, and fibrous dysplasia, possibly through an error involving an ossification center during the embryonic stage.

DOI： 10.1007/s00586-017-5005-y

股関節鏡手術に際しVAPRの破損を生じた2例

山田和希, 遠藤裕介, 尾崎敏文

JOSKAS 42 ( 4 ) 692 - 692 2017.5

側彎症手術を行った重症脳性麻痺患者における健康関連QOL調査の試み

小田孔明, 堅山佳美, 赤澤啓史, 田中雅人, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 54 ( 特別号 ) 3 - 4 2017.5

食道癌術後における反回神経麻痺の有無と術前機能評価

堅山佳美, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 54 ( 特別号 ) 1 - 4 2017.5

Scoliosis in Patients with Severe Cerebral Palsy: Three Different Courses in Adolescents.

Yoshiaki Oda, Tomoyuki Takigawa, Yoshihisa Sugimoto, Masato Tanaka, Hirofumi Akazawa, Toshifumi Ozaki

Acta medica Okayama 71 ( 2 ) 119 - 126 2017.4

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

Patients with cerebral palsy (CP) frequently present with scoliosis; however, the pattern of curve progression is difficult to predict. We aimed to clarify the natural course of the progression of scoliosis and to identify scoliosis predictors. This was a retrospective, single-center, observational study. Total of 92 CP patients from Asahikawasou Ryouiku Iryou Center in Okayama, Japan were retrospectively analyzed. Cobb angle, presence of hip dislocation and pelvic obliquity, and Gross Motor Function Classification System (GMFCS) were investigated. Severe CP was defined as GMFCS level IV or V. The mean observation period was 10.7 years. Thirtyfour severe CP patients presented with scoliosis and were divided into 3 groups based on their clinical courses: severe, moderate and mild. The mean Cobb angles at the final follow-up were 129°, 53°, and 13° in the severe, moderate, and mild groups, respectively. The average progressions from 18 to 25 years were 2.7°/year, 0.7°/year, and 0.1°/year in the severe, moderate, and mild curve groups, respectively. We observed the natural course of scoliosis and identified 3 courses based on the Cobb angle at 15 and 18 years of age. This method of classification may help clinicians predict the patients' disease progression.

DOI： 10.18926/AMO/54980

Charcot股関節に対しTHAを施行した1例

山田和希, 藤原一夫, 鉄永智紀, 藤井洋佑, 三宅孝昌, 遠藤裕介, 塩田直史, 佐藤徹, 尾崎敏文

中国・四国整形外科学会雑誌 29 ( 1 ) 145 - 145 2017.4

RAにおける手関節形成術の検討

竹下歩, 西田圭一郎, 那須義久, 中原龍一, 町田崇博, 堀田昌宏, 兼田大輔, 尾崎敏文

岡山医学会雑誌 129 ( 1 ) 65 - 65 2017.4

関節リウマチ患者の前足部変形に対する切除関節形成術と関節温存手術の治療成績の比較

堀田昌宏, 雑賀建多, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一

中国・四国整形外科学会雑誌 29 ( 1 ) 157 - 157 2017.4

鎖骨骨切りにより切除可能となった腕神経叢発生脂肪性腫瘍の治療経験

横尾賢, 国定俊之, 藤原智洋, 長谷井嬢, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 春季学会 ) 193 - 193 2017.4

上腕骨小頭離断性骨軟骨炎に対する肘関節内側障害の影響

内野崇彦, 島村安則, 中道亮, 島村好信, 名越充, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 春季学会 ) 129 - 129 2017.4

側彎症手術を行った重症脳性麻痺患者における健康関連QOL調査の試み

小田孔明, 瀧川朋亨, 杉本佳久, 赤澤啓史, 田中雅人, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 春季学会 ) 210 - 210 2017.4

脊椎に発生したpigmented villonodular synovitisの3例

魚谷弘二, 塩崎泰之, 瀧川朋亨, 杉本佳久, 田中雅人, 尾崎敏文

中部日本整形外科災害外科学会雑誌 60 ( 春季学会 ) 227 - 227 2017.4

Denosumab and alendronate treatment in patients with back pain due to fresh osteoporotic vertebral fractures.

Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Yoshitaka Takei, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 22 ( 2 ) 230 - 236 2017.3

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

INTRODUCTION: Denosumab specifically inhibits the receptor activator for nuclear factor-kappa B ligand (RANKL), and prevents osteoporotic fractures. Several reports have analyzed the effects of denosumab and alendronate alone on bone mineral density (BMD) or reduction of fracture risk. The objective of this study was to analyze the effects of antiresorptive osteoporosis pharmacotherapy on pain relief in patients with fresh vertebral fracture. METHODS: This retrospective, single-center study included 80 patients (10 males, 70 females) with fresh osteoporotic vertebral fractures treated using denosumab at a dose of 60 mg subcutaneously every 6 months (40 patients) or alendronate at a dose of 35 mg orally every week (40 patients) for 6 months in our hospital. The mean age of subjects was 77 years (range, 55-92 years). The primary outcome was duration of back pain. Secondary outcomes included changes in BMD, serum type 1 collagen cross-linked N-telopeptide (NTX), and serum N-terminal propeptide of type 1 collagen (P1NP) from baseline to 6 months. Pain catastrophizing due to back pain was assessed using the Pain Catastrophizing Scale (PCS). The incidences of further vertebral fracture and adverse events were also assessed. RESULTS: Pain relief was obtained at a mean of 3.3 weeks with denosumab and 5.4 weeks with alendronate. Pain relief was achieved significantly earlier with denosumab than with alendronate. At 6 months, change in BMD was higher with denosumab (6.1%) than with alendronate (0.8%). No significant differences in changes in NTX and P1NP were observed between groups. Scores for PCS were significantly lower for denosumab than for alendronate. The incidence of further vertebral fractures was 5% with denosumab and 10% with alendronate. Adverse event rates were similar between groups. CONCLUSIONS: Denosumab enabled earlier pain relief than alendronate and avoided catastrophizing in patients with osteoporotic vertebral fractures after 6 months of treatment.

DOI： 10.1016/j.jos.2016.11.017

Total hip arthroplasty after failed treatment of proximal femur fracture. International journal

Tomonori Tetsunaga, Kazuo Fujiwara, Hirosuke Endo, Tomoyuki Noda, Tomoko Tetsunaga, Toru Sato, Naofumi Shiota, Toshifumi Ozaki

Archives of orthopaedic and trauma surgery 137 ( 3 ) 417 - 424 2017.3

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

INTRODUCTION: Total hip arthroplasty (THA) is a good option as a salvage procedure after failed treatment of proximal femur fracture. The anatomy of the proximal femur, however, makes this surgery complicated and challenging. The purpose of this study was to evaluate the radiographic and clinical outcomes of THA after failed treatment of proximal femur fractures. MATERIALS AND METHODS: We retrospectively analysed 50 consecutive THAs (42 women, 8 men; mean age 77 years) after failed treatment of a proximal femur fracture. Mean postoperative follow-up was 58.1 months. Preoperative diagnoses were femoral neck fracture in 18 hips and trochanteric fracture in 32 hips, including three that were infected. Failure resulted from cutout in 22 cases, osteonecrosis in 12, non-union with failed fixation in nine, postoperative osteoarthritis in four, and infection in three. Factors compared included radiographic assessment, complication rate, visual analogue scale (VAS), and Harris Hip Scores (HHS). Radiographic variables included femoral neck anteversion and cup and stem alignment. RESULTS: Absolute values of the differences in femoral neck anteversion between the affected and healthy sides were 6.0° in the femoral neck fracture group and 19.2° in the trochanteric fracture group (p = 0.01). There were no significant differences in cup anteversion (p = 0.20) or stem anteversion (p = 0.08). The complication rate was significantly higher in the trochanteric fracture group than in the femoral neck fracture group (25 vs 0%, p < 0.0001). Postoperative complications in the trochanteric fracture group included three periprosthetic fractures (9.4%), two dislocations (6.3%), two surgical-site infections (6.3%), and one stem penetration (3.1%). Although no significant differences between groups were seen in the VAS or HHS at final follow-up (p = 0.32, 0.09, respectively), these measures were significantly improved at final follow-up in both groups (p < 0.0001 for both). CONCLUSIONS: Performing THA after failed treatment of trochanteric fractures requires consideration of complication risk and incorrect femoral neck anteversion.

DOI： 10.1007/s00402-017-2631-0

Anatomic alignment法における脛骨骨切り面形状の解析 Mechanical alignment法との比較

山田和希, 古松毅之, 宮澤慎一, 藤井政孝, 井上博登, 児玉有弥, 日野知仁, 釜付祐輔, 尾崎敏文, 塩田直史

日本整形外科学会雑誌 91 ( 3 ) S918 - S918 2017.3

RAの手術上肢 50歳未満の比較的若年者に行った人工肘関節全置換術の臨床成績の検討

沖田駿治, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 538 - 538 2017.3

膠原病と妊娠関節リウマチ(RA)の手術が患者のボディイメージ(BI)に与える影響

小橋靖子, 西田圭一郎, 堀田昌宏, 那須義久, 橋詰謙三, 中原龍一, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 521 - 521 2017.3

RAの手術下肢 RA前足部手術における術式選択と治療成績の検討

兼田大輔, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 原田遼三, 町田崇博, 堀田昌宏, 竹下歩, 大橋秀基, 沖田駿治, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 501 - 501 2017.3

RAの手術下肢関節リウマチ(RA)患者における足部・足関節手術と抑うつ傾向の関係性

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 兼田大輔, 小橋靖子, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 501 - 501 2017.3

関節リウマチ診療における患者立脚型評価患者立脚型評価からみたRA手術の有用性

堀田昌宏, 西田圭一郎, 小橋靖子, 橋詰謙三, 那須義久, 中原龍一, 町田崇博, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 258 - 258 2017.3

リウマチ性疾患に合併する感染症の対策と克服手術部位感染症とDMARDsの管理

那須義久, 中原龍一, 西田圭一郎, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 246 - 246 2017.3

TKAによらない膝OA治療変形性膝関節症に対する保存的治療運動療法に関するEBM

千田益生, 堅山佳美, 兼田大輔, 尾崎敏文

日本整形外科学会雑誌 91 ( 2 ) S318 - S318 2017.3

関節リウマチ中後足部変形に対する選択的固定術の短・中期成績

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 竹下歩, 兼田大輔, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S863 - S863 2017.3

SAFE-Qを用いた関節リウマチ足部手術成績の評価

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 雑賀建多, 堀田昌宏, 竹下歩, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S863 - S863 2017.3

関節リウマチ患者の前足部変形に対する切除関節形成術と関節温存手術の治療成績

堀田昌宏, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 雑賀建多, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S860 - S860 2017.3

関節リウマチ患者における足部障害の評価

吉村将秀, 雑賀建多, 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

日本整形外科学会雑誌 91 ( 3 ) S845 - S845 2017.3

関節リウマチの罹病期間・疾患活動性と関節破壊 modified Total Sharp ScoreとARASHI scoreの比較検討

那須義久, 橋詰謙三, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌弘, 中原龍一, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S712 - S712 2017.3

QOL向上を目指したRA薬物療法と手術療法の融合リウマチ患者のbody imageに対する手術治療の影響

西田圭一郎, 堀田昌宏, 那須義久, 中原龍一, 大橋秀基, 竹下歩, 兼田大輔, 沖田駿治, 尾崎敏文

日本整形外科学会雑誌 91 ( 2 ) S415 - S415 2017.3

トファシチニブ投与中に行った整形外科手術の周術期経過

竹下歩, 西田圭一郎, 那須義久, 中原龍一, 堀田昌宏, 兼田大輔, 大橋秀基, 沖田駿治, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 641 - 641 2017.3

リウマチ性疾患の画像深層学習を用いた関節リウマチ患者単純X線写真の骨びらん解析教師データの最適化

中原龍一, 西田圭一郎, 那須義久, 堀田昌宏, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本リウマチ学会総会・学術集会プログラム・抄録集 61回 579 - 579 2017.3

骨肉腫患者の組織ならびに血中におけるoncogenic miR-25-3pの臨床病理学的意義

藤原智洋, 魚谷弘二, 吉田晶, 森田卓也, 清野正普, 国定俊之, 根津悠, 小林英介, 川井章, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S707 - S707 2017.3

骨・軟部肉腫切除術における感染リスクファクターの検討

長谷井嬢, 望月雄介, 小松原将, 国定俊之, 藤原智洋, 魚谷弘二, 杉生和久, 尾崎敏文

日本整形外科学会雑誌 91 ( 2 ) S598 - S598 2017.3

肩関節周辺悪性骨腫瘍切除後の肩関節再建手術腫瘍型上腕骨人工骨頭置換術に対する軟部組織再建術

国定俊之, 藤原智洋, 長谷井嬢, 尾崎敏文

日本整形外科学会雑誌 91 ( 2 ) S400 - S400 2017.3

骨・軟部腫瘍における術中CTナビゲーション手術の正確性と臨床評価

藤原智洋, 国定俊之, 長谷井嬢, 吉田晶, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S711 - S711 2017.3

肘関節内側側副靱帯損傷に対する関節造影ストレス撮影の有用性

島村安則, 内野崇彦, 島村好信, 中道亮, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S1109 - S1109 2017.3

上腕骨小頭離断性骨軟骨炎の発生部位は内側支持機構のゆるみに影響される

内野崇彦, 島村安則, 島村好信, 中道亮, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S1106 - S1106 2017.3

Neurofibromatosis type 1に伴う脊柱側彎症の手術成績

宇川諒, 杉本佳久, 小田孔明, 塩崎泰之, 鉄永倫子, 瀧川朋亨, 田中雅人, 尾崎敏文

Journal of Spine Research 8 ( 3 ) 783 - 783 2017.3

思春期特発性側彎症患者の自己イメージ

瀧川朋亨, 小田孔明, 宇川諒, 塩崎泰之, 鉄永倫子, 杉本佳久, 田中雅人, 尾崎敏文

Journal of Spine Research 8 ( 3 ) 286 - 286 2017.3

STLを用いた特発性側彎症患者の体表変形定量化の試み

小田孔明, 瀧川朋亨, 杉本佳久, 塩崎泰之, 鉄永倫子, 渡邉典行, 宇川諒, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 91 ( 2 ) S143 - S143 2017.3

思春期特発性側彎症における3次元的体表測定の試み

小田孔明, 瀧川朋亨, 中原龍一, 宇川諒, 塩崎泰之, 鉄永倫子, 杉本佳久, 田中雅人, 尾崎敏文

Journal of Spine Research 8 ( 3 ) 285 - 285 2017.3

側方侵入腰椎椎体間固定術式の比較周術期合併症と腸腰筋の変化

塩崎泰之, 杉本佳久, 瀧川朋亨, 小田孔明, 魚谷弘二, 宇川諒, 小松原将, 森田卓也, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 91 ( 2 ) S124 - S124 2017.3

Inflammation-induced miRNA-155 inhibits self-renewal of neural stem cells via suppression of CCAAT/enhancer binding protein β (C/EBPβ) expression. International journal

Kayoko Obora, Yuta Onodera, Toshiyuki Takehara, John Frampton, Joe Hasei, Toshifumi Ozaki, Takeshi Teramura, Kanji Fukuda

Scientific reports 7 43604 - 43604 2017.2

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

Intracerebral inflammation resulting from injury or disease is implicated in disruption of neural regeneration and may lead to irreversible neuronal dysfunction. Analysis of inflammation-related microRNA profiles in various tissues, including the brain, has identified miR-155 among the most prominent miRNAs linked to inflammation. Here, we hypothesize that miR-155 mediates inflammation-induced suppression of neural stem cell (NSC) self-renewal. Using primary mouse NSCs and human NSCs derived from induced pluripotent stem (iPS) cells, we demonstrate that three important genes involved in NSC self-renewal (Msi1, Hes1 and Bmi1) are suppressed by miR-155. We also demonstrate that suppression of self-renewal genes is mediated by the common transcription factor C/EBPβ, which is a direct target of miR-155. Our study describes an axis linking inflammation and miR-155 to expression of genes related to NSC self-renewal, suggesting that regulation of miR-155 may hold potential as a novel therapeutic strategy for treating neuroinflammatory diseases.

DOI： 10.1038/srep43604

Phase 2 study of eribulin in patients with previously treated advanced or metastatic soft tissue sarcoma. International journal

Akira Kawai, Nobuhito Araki, Yoichi Naito, Toshifumi Ozaki, Hideshi Sugiura, Yasuo Yazawa, Hideo Morioka, Akihiko Matsumine, Kenichi Saito, Shun Asami, Kazuo Isu

Japanese journal of clinical oncology 47 ( 2 ) 137 - 144 2017.2

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

Objective: Eribulin, a microtubule dynamics inhibitor, is approved for the treatment of patients with breast cancer and soft tissue sarcoma. We investigated the efficacy and safety of eribulin in Japanese patients with soft tissue sarcoma. Methods: This open-label, multicenter, nonrandomized, Phase 2 study enrolled Japanese patients with measurable, advanced/metastatic soft tissue sarcoma of high/intermediate grade and ≥1 prior chemotherapy for advanced disease. Patients received eribulin mesilate 1.4 mg/m2 intravenously over 2–5 minutes on Days 1 and 8 of a 21-day cycle. The primary endpoint was progression-free rate at 12 weeks. Secondary endpoints included overall survival, progression-free survival and safety. Efficacy analyses were stratified by histology (liposarcoma or leiomyosarcoma, and other subtypes). Results: Overall, 52 patients were enrolled and 51 patients were treated. Patients with liposarcoma/leiomyosarcoma (n = 35) had similar characteristics to those with other subtypes (n = 16), except for a higher proportion of women (63% vs 38%, respectively) and patients with Eastern Cooperative Oncology Group performance status 0 (57% vs 44%). Progression-free rate at 12 weeks was 60% in liposarcoma/leiomyosarcoma patients, 31% in other subtypes and 51% overall. Median progression-free survival was 5.5 months in liposarcoma/leiomyosarcoma patients, 2.0 months in other subtypes and 4.1 months overall. Median overall survival was 17.0 months in liposarcoma/leiomyosarcoma patients, 7.6 months in other subtypes and 13.2 months overall. The most common Grade 3–4 adverse events were neutropenia (86%), leukopenia (75%), lymphopenia (33%), anemia (14%) and febrile neutropenia (8%). Conclusion: Eribulin showed clinical activity with a manageable safety profile in previously treated Japanese patients with advanced/metastatic soft tissue sarcoma.

DOI： 10.1093/jjco/hyw175

Results of Total Elbow Arthroplasty with Cementless Implantation of an Alumina Ceramic Elbow Prosthesis for Patients with Rheumatoid Arthritis.

Keiichiro Nishida, Kenzo Hashizume, Masatsugu Ozawa, Ayumu Takeshita, Daisuke Kaneda, Ryuichi Nakahara, Yoshihisa Nasu, Yasunori Shimamura, Hajime Inoue, Toshifumi Ozaki

Acta medica Okayama 71 ( 1 ) 41 - 47 2017.2

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

We investigated the long-term clinical results of total elbow arthroplasty (TEA) by cementless fixation of alumina ceramic unlinked elbow prostheses (J-alumina ceramic elbows: JACE) for the reconstruction of elbow joints with rheumatoid arthritis (RA). Seventeen elbows in 17 patients (aged 44-72 years, average 54.8) replaced by JACE TEA without bone cement were investigated. The average follow-up period was 10.7 (range, 1.0-19.3) years. Clinical conditions of each elbow before and after surgery were assessed according to the Mayo Elbow Performance Index (MEPI). Radiographic loosening was defined as a progressive radiolucent line of more than 1 mm that was completely circumferential around the intramedullary stem. The average MEPI significantly improved from 46.8 points preoperatively to 66.8 points at final follow-up (p=0.0226). However, aseptic loosening was noted in 10 of 17 elbows (58.8%) and revision surgery was required in 7 (41.2%). Most loosening was observed on the humeral side. With radiographic loosening and revision surgery defined as the end points, the likelihoods of prosthesis survival were 41.2% and 51.8%, respectively, up to 15 years by Kaplan-Meier analysis. The clinical results of JACE implantation without bone cement were disappointing, with high revision and loosening rates of the humeral component.

DOI： 10.18926/AMO/54824

Verification of Implant Surface Modification by a Novel Processing Method.

Yoshiki Okada, Nobuhiro Abe, Noriyuki Hisamori, Toshiaki Kaneeda, Shigeaki Moriyama, Hitoshi Ohmori, Masayoshi Mizutani, Hiroyuki Yanai, Yoshio Nakashima, Yusuke Yokoyama, Toshifumi Ozaki

Acta medica Okayama 71 ( 1 ) 49 - 57 2017.2

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

Metals have been used clinically as biomaterials, especially in the orthopaedic and dental fields. Metals used as implants wear at contact surfaces, producing metal particles and metal ions that may be harmful. Newly developed metal implants and methods of implant surface modification are currently under scrutiny. We evaluated the use of electrolytic in-process dressing (ELID) as a surface finishing method for metal implants. Metal implants processed using the ELID method (ELID group) or not processed (Non-ELID group) were inserted surgically into rabbit femurs. The rabbits were sacrificed postoperatively over a 24-week period. We assessed the concentrations of the cytokines, interleukin (IL)-1β, IL-6, and tumor necrosis factor-α, the resistance to implant pull-out, and histopathology at the implant site. There was no significant difference between the groups regarding the cytokine concentrations or implant pull-out resistance. Many particles indicating wear around the implant were noted in the Non-ELID group (n=10) but not the ELID group (n=13), while a fibrous membrane adhering to the every implant was noted in the ELID group. The formation of a fibrous membrane rather than metal particles in the ELID group may indicate improved biocompatibility, and it suggests that ELID may prevent corrosion in the areas of contact.

DOI： 10.18926/AMO/54825

肘関節投球障害に対する関節造影ストレス撮影の有用性

島村安則, 内野崇彦, 島村好信, 中道亮, 井上博登, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本肘関節学会雑誌 24 ( 1 ) S106 - S106 2017.1

上腕骨小頭離断性骨軟骨炎に対する内側支持機構のゆるみの影響

内野崇彦, 島村安則, 島村好信, 中道亮, 井上博登, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本肘関節学会雑誌 24 ( 1 ) S18 - S18 2017.1

Calcar femorale in patients with osteoarthritis of the hip secondary to developmental dysplasia Reviewed

Tomonori Tetsunaga, Kazuo Fujiwara, Hirosuke Endo, Tomoko Tetsunaga, Naofumi Shiota, Toru Sato, Toshifumi Ozaki

CiOS Clinics in Orthopedic Surgery 9 ( 4 ) 413 - 419 2017

Language：English Publishing type：Research paper (scientific journal) Publisher：Korean Orthopaedic Association

Background: We investigated whether the calcar femorale, a cortical septum in the region of the lesser trochanter of the femur, correlates with results of femoral stem implantation in patients with osteoarthritis of the hip secondary to developmental dysplasia using computed tomography. Methods: This retrospective study included 277 hips (41 males and 236 females
age, 37 to 92 years) of patients who had presented to Okayama Medical Center with hip pain. Of these, a total of 219 hips (31 males and 188 females) had previously undergone total hip arthroplasty. According to the Crowe classification, 147 hips were classified as Crowe grade I, 72 hips as Crowe grade II– IV, and 58 hips as normal. Results: The calcar femorale was identified in 267 hips (96.4%). The calcar femorale was significantly shorter and more ante-verted in Crowe grade II–IV hips than in Crowe grade I or normal hips. Significant differences in the shape of the calcar femorale were found according to the severity of hip deformity. Three stem designs were analyzed: single-wedge (59 hips), double-wedge metaphyseal filling (147 hips), and modular (13 hips). Single-wedge stems were inserted more parallel to the calcar femorale rather than femoral neck anteversion, while other types of stems scraped the calcar femorale. Conclusions: The angle of the calcar femorale differs according to the severity of hip deformity, and the calcar femorale might thus serve as a more useful reference for stem insertion than femoral neck anteversion in total hip arthroplasty using a single-wedge stem.

DOI： 10.4055/cios.2017.9.4.413

Neurological Recovery after Posterior Spinal Surgery in Patients with Metastatic Epidural Spinal Cord Compression Reviewed

Noriyuki Watanabe, Yoshihisa Sugimoto, Masato Tanaka, Tetsuro Mazaki, Shinya Arataki, Tomoyuki Takigawa, Masaki Kataoka, Toshiyuki Kunisada, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 70 ( 6 ) 449 - 453 2016.12

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

Metastatic epidural spinal cord compression (MESCC) is a common complication in patients with a malignant tumor, but it is difficult to decide the proper time to perform the necessary surgery. Here we analyzed the prognostic factors for postoperative walking ability. We retrospectively reviewed the cases of 112 MESCC patients treated surgically at our institute and divided them into ambulatory (n = 88) and non-ambulatory (n = 24) groups based on their American Spinal Injury Association (ASIA) Impairment Scale grades at the final follow-up. We also classified the patients preoperatively using the revised Tokuhashi score. We assessed the correlation between preoperative or intraoperative factors and postoperative walking ability in both groups. Of the 10 patients classified preoperatively as grade A or B, 2 (20) were ambulatory at the final follow-up. Of the 102 patients classified preoperatively as grade C, D or E, 86 (84) were ambulatory at the final follow-up (p < 0.001). There were no significant differences between the groups in the average total Tokuhashi score. Our analysis revealed that the severity of paralysis significantly affects neurological recovery in patients with MESCC. Patients with MESCC should receive surgery before the preoperative ASIA Impairment Scale grade falls below grade C.

DOI： 10.18926/AMO/54807

可視光硬化型ゼラチンとコラーゲン結合性肝細胞増殖因子を用いた脊髄損傷治療

山根健太郎, 吉田晶, 松川昭博, 伊藤嘉浩, 尾崎敏文

移植 51 ( 6 ) 517 - 517 2016.12

SH人工股関節システムを用いたセメント人工股関節全置換術の長期成績

藤井洋佑, 藤原一夫, 遠藤裕介, 鉄永智紀, 香川洋平, 三宅孝昌, 尾崎敏文

日本人工関節学会誌 46 217 - 218 2016.12

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

1992年5月〜1995年3月にSH人工股関節システム(MIZUHO社)を用いて初回セメント人工股関節全置換術(THA)を施行し、20年以上の経過観察を行った18例20股の長期成績を検討した。内訳は変形性股関節症15股、大腿骨頭壊死症5股であった。再置換症例の割合とその原因、ポリエチレンの線摩耗量、aseptic looseningによる再置換をend pointとしたKaplan-Meier生存率について評価した。X線学的評価としてはHodgkinson分類のType 3、Type 4をCup looseningと定義し、Harris分類のDefiniteをstem looseningの定義とした。再置換症例は13股(65%)で、カップのみの再置換2股(10%)、カップとステムの再置換11股であった。再置換の原因は、カップ側の弛み9股、ステム側の弛み1股、両側の弛み3股であった。平均線摩耗量としては全症例の平均が0.11±0.079mm/年、弛みなし症例が0.060±0.047mm/年、弛みあり症例が0.14±0.079mm/年で2群間に有意差を認めた。術後10年の累積生存率は100%であったが、15年で70%、20年で40%となっていた。

BHA後にアウターヘッドが高度に陥入した症例に対する治療経験

遠藤裕介, 香川洋平, 藤井洋佑, 鉄永智紀, 三宅孝昌, 尾崎敏文

日本人工関節学会誌 46 757 - 758 2016.12

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

症例1(80歳男性)。右大腿骨頸部骨折に対するセメントレス人工骨頭置換術(BHA)後、6年目に脚短縮と股関節痛が出現し紹介となった。症例2(63歳男性)。左大腿骨頸部骨折に対するセメントレスBHA後、6年で脚短縮と股関節痛を生じ紹介となった。症例3(56歳男性)。右大腿骨頸部骨折に対するセメントレスBHA後、22年目より股関節痛を生じ紹介となった。いずれもアウターヘッドが3cm以上寛骨臼上方へ陥入していたため、症例1と3はETOによるアプローチでステム、アウターヘッドを抜去し、同種骨骨頭1個とchip同種骨骨頭2個分を充填し、KTプレートを設置した。更ににセメントカップとセメントロングステムを挿入し、整復後にETOの骨片をネスプロンテープとリコンプレートで再接合した。症例2は中臀筋前方の偽関節包を切除し、modular stemの近位パーツを抜去するとアウターヘッドの抜去が可能であり、同種骨頭を移植しKTプレートを設置しtrialで整復可能であったため、遠位パーツはそのままで再置換を行うことができた。それぞれ術後1年、術後1年、術後11ヵ月の時点で疼痛なく、可動域制限は改善した。症例1,症例2は杖なし歩行可能で、症例3は1本杖歩行可能である。

低年齢発症ペルテス病の広範囲壊死症例の治療成績

藤井洋佑, 遠藤裕介, 三宅孝昌, 香川洋平, 鉄永智紀, 尾崎敏文

日本小児整形外科学会雑誌 25 ( 2 ) 208 - 211 2016.12

Language：Japanese Publisher：(一社)日本小児整形外科学会

5歳未満発症のペルテス病でCatterall分類Group III以上の症例の治療成績について検討した。当科でペルテス病と診断され、5歳未満発症例48例52股のうち3年以上経過観察が可能で、Catterall分類Group III以上であった15例15股を対象とした。検討項目として、治療法、Catterall分類、lateral pillar分類、Combined pillar score、初療までの期間、発症年齢、Head at risk徴候を調査した。また、Stulberg分類Class I、IIを成績良好群として治療成績に関連する因子の検討を行った。最終調査時の成績良好群は66.7%で、Combined pillar score 2点以上、初療の遅延、Head at riskが成績不良因子であった。低年齢発症でも、広範囲壊死症例では予後不良となる症例が存在し、早期発見と厳重な免荷加療が必要である。(著者抄録)

小児上腕骨顆上骨折後にVolkmann拘縮を来した1例

柏原尚子, 島村安則, 原田遼三, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

日本小児整形外科学会雑誌 25 ( 2 ) 183 - 187 2016.12

Language：Japanese Publisher：(一社)日本小児整形外科学会

小児上腕骨顆上骨折は、小児肘関節周囲骨折の中で最も高頻度に発生し、合併症が多い疾患である。上腕骨顆上骨折後にVolkmann拘縮を来した1例を経験したので報告する。7歳男児、ジャングルジムより墜落して受傷。前医で上腕骨顆上骨折と診断され、当日創外固定術を施行された。術後徐々に手指の屈曲傾向が進行し、当科紹介となった。Volkmann拘縮と診断し、装具加療や徹底したリハビリの後、屈筋腱解離術を施行した。手術所見としては、屈筋群深層筋線維に変性像を認め、正中・尺骨神経剥離術、屈筋群剥離・前進術を施行した。術後6ヵ月時、DIP関節の屈曲拘縮が残存するも全指伸展位保持可能となり、術後7年時生活に支障のない状態まで回復した。小児上腕骨顆上骨折の合併症であるVolkmann拘縮は、重篤な後遺症を残す。本骨折に対していかなる治療方法を選択しても、阻血性障害への注意が重要である。(著者抄録)

骨腫瘍切除後の骨欠損に対する配向連通気孔構造を有する人工骨移植の治療経験

清野正普, 国定俊之, 藤原智洋, 長谷井嬢, 杉生和久, 魚谷弘二, 森田卓也, 小松原将, 望月雄介, 尾崎敏文

移植 51 ( 6 ) 527 - 527 2016.12

転写因子Mohawkは椎間板線維輪の発生に重要である

中道亮, 浅原弘嗣, 尾崎敏文

移植 51 ( 6 ) 534 - 534 2016.12

Pullout repair of a medial meniscus posterior root tear using a FasT Fix® all-inside suture technique Reviewed

Y. Kodama, T. Furumatsu, M. Fujii, T. Tanaka, S. Miyazawa, T. Ozaki

Revue de Chirurgie Orthopedique et Traumatologique 102 ( 7 ) 675 2016.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier Masson SAS

A medial meniscus posterior root tear (MMPRT) may increase the tibiofemoral contact pressure by decreasing the tibiofemoral contact area. Meniscal dysfunction induced by posterior root injury may lead to the development of osteoarthritic knees. Repair of a MMPRT can restore medial meniscus function and prevent knee osteoarthritis progression. Several surgical procedures have been reported for treating a MMPRT. However, these procedures are associated with several technical difficulties. Here, we describe a technique to stabilize a torn MM posterior root using the FasT-Fix® all-inside meniscal suture device and a new aiming device. The uncut free-end of the FasT-Fix® suture can be used as a thread for transtibial pullout repair. Our procedure might help overcome the technical difficulties in arthroscopic treatment of a MMPRT.

DOI： 10.1016/j.rcot.2016.07.020

Acetabular development after open reduction to treat dislocation of the hip after walking age Reviewed

Yohei Kagawa, Hirosuke Endo, Tomonori Tetsunaga, Yosuke Fujii, Takamasa Miyake, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC SCIENCE 21 ( 6 ) 815 - 820 2016.11

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

Background: Treatment of hip dislocation diagnosed after walking age is often difficult. We report the surgical treatment of these patients by open reduction with a soft tissue surgical procedure without osteotomy.
Methods: Thirty-eight children (43 hips) diagnosed with complete dislocation of the hip after walking age were included in this study. We radiographically analysed postoperative hip joint development up to 6 years of age. To assess the predictors of acetabular development, we evaluated the radiographs, using an acetabular index of <= 35 degrees and a centre-edge angle of >5 degrees at 6 years of age as satisfactory outcomes, and evaluated the advance of acetabular development over time.
Results: AI on the affected side was improved with time after open reduction. The diameter of the capital femoral ossific nucleus on the affected side was almost equivalent to that on the unaffected side at 6-12 months after surgery, after which the centre -edge angle improved gradually from one year after surgery. We compared hips classified as satisfactory to unsatisfactory at 6 years of age, and found that the centre -edge angle at one year after open reduction was significantly associated with acetabular development (P = 0.044). The cut-off value was -2 degrees with sensitivity of 0.909 and specificity of 0.677.
Conclusions: The results of the current study suggest that initial development of the capital femoral ossific nucleus after open reduction would be followed by improved joint congruity, and that this would facilitate acetabular development. The centre -edge angle at one year after surgery could be regarded as a potential predictor of acetabular development in open reduction surgery for late -diagnosed developmental dysplasia of the hip cases. (C) 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.jos.2016.07.007

骨肉腫における腫瘍浸潤骨髄球型細胞を介したメトホルミンの抗腫瘍効果

上原健敬, 榮川伸吾, 國定勇希, 渡邉元嗣, 友信奈保子, 吉田晶, 藤原智洋, 国定俊之, 尾崎敏文, 鵜殿平一郎

日本癌学会総会記事 75回 P - 3220 2016.10

Circulating microRNAの骨肉腫における新規バイオマーカーとしての可能性

藤原智洋, 魚谷弘二, 吉田晶, 森田卓也, 清野正晋, 杉生和久, 小松原将, 長谷井嬢, 国定俊之, 根津悠, 川井章, 落谷孝広, 尾崎敏文

日本癌学会総会記事 75回 P - 3084 2016.10

軟部肉腫に対するテロメラーゼ標的型腫瘍融解アデノウイルスの放射線効果増強

小松原将, 大森敏規, 田澤大, 杉生和久, 望月雄介, 山川泰明, 尾崎修平, 長谷井嬢, 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 75回 P - 3306 2016.10

体液診断への応用を目指したEwing肉腫由来分泌エクソソーム表面マーカーの解析

吉田晶, 魚谷弘二, 藤原智洋, 森田卓也, 清野正普, 長谷井嬢, 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 75回 P - 2319 2016.10

腫瘍融解ウイルス療法による骨肉腫のABC Transporterを介した薬剤耐性の克服

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, 望月雄介, 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 75回 J - 3020 2016.10

滑膜肉腫の新規バイオマーカー開発を目指した循環型cell-free microRNAの特定と検証

魚谷弘二, 藤原智洋, 吉田晶, 森田卓也, 杉生和久, 小松原将, 清野正普, 根津悠, 国定俊之, 川井章, 岩田慎太郎, 落谷孝広, 尾崎敏文

日本癌学会総会記事 75回 P - 2327 2016.10

粘液線維肉腫におけるcirculating cell-free microRNAの特定

森田卓也, 藤原智洋, 魚谷弘二, 吉田晶, 清野正晋, 杉生和久, 小松原将, 望月雄介, 国定俊之, 落谷孝広, 尾崎敏文

日本癌学会総会記事 75回 P - 2325 2016.10

骨肉腫細胞内と細胞外分泌エクソソーム内のmicroRNA発現プロファイリングは転移能の違いによりどのように異なるか

清野正普, 藤原智洋, 魚谷弘二, 吉田晶, 杉生和久, 小松原将, 望月雄介, 長谷井嬢, 國定俊之, 尾崎敏文

日本癌学会総会記事 75回 P - 3085 2016.10

CEMOVERの使用経験

山田和希, 遠藤裕介, 藤井洋佑, 井上淳, 池田吉宏, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 3 ) 452 - 452 2016.9

ナビゲーションを利用した類骨骨腫の小侵襲切除術

国定俊之, 藤原智洋, 長谷井嬢, 小松原将, 森田卓也, 尾崎敏文

中部日本整形外科災害外科学会雑誌 59 ( 秋季学会 ) 97 - 97 2016.9

岡山大学骨軟部腫瘍グループの活動

国定俊之, 藤原智洋, 長谷井嬢, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 3 ) 372 - 372 2016.9

ヒト軟骨組織におけるTWIST1の異化反応誘導とOA発症メカニズム

長谷井嬢, 藤原智洋, 国定俊之, 福田寛二, 浅原弘嗣, 尾崎敏文

中部日本整形外科災害外科学会雑誌 59 ( 秋季学会 ) 245 - 245 2016.9

類骨骨腫に対するラジオ波焼灼術の治療成績

藤原智洋, 国定俊之, 長谷井嬢, 郷原英夫, 金澤右, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 3 ) 410 - 410 2016.9

踵骨発生原発性骨腫瘍に対する治療成績

小松原将, 藤原智洋, 国定俊之, 長谷井嬢, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 3 ) 409 - 409 2016.9

O-armによる術中ナビゲーションシステムを併用した悪性骨軟部腫瘍手術の精度

藤原智洋, 国定俊之, 長谷井嬢, 清野正晋, 望月雄介, 尾崎敏文

中部日本整形外科災害外科学会雑誌 59 ( 秋季学会 ) 148 - 148 2016.9

前後方同時固定におけるO-arm Naviを用いた側臥位PPSの有用性

魚谷弘二, 塩崎泰之, 杉本佳久, 瀧川朋亨, 渡邉典行, 小松原将, 森田卓也, 小田孔明, 宇川諒, 田中雅人, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 3 ) 408 - 408 2016.9

Neurofibromatosis type 1に伴う脊柱側彎症の手術成績

宇川りょう, 杉本佳久, 瀧川朋亨, 鉄永倫子, 塩崎泰之, 渡邉典行, 小田孔明, 田中雅人, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 3 ) 465 - 465 2016.9

解剖学的二重束前十字靱帯再建における脛骨骨孔位置と外側半月板逸脱に関する検討

山田和希, 古松毅之, 宮澤慎一, 田中孝明, 井上博登, 児玉有弥, 釜付祐輔, 日野知仁, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1786 - S1786 2016.8

解剖学的二重束前十字靱帯再建における脛骨骨孔位置と術後外側半月板逸脱に関する比較検討

山田和希, 古松毅之, 宮澤慎一, 藤井政孝, 田中孝明, 井上博登, 児玉有弥, 釜付祐輔, 日野知仁, 尾崎敏文

日本整形外科スポーツ医学会雑誌 36 ( 4 ) 509 - 509 2016.8

低侵襲人工膝関節置換術におけるsemi-active骨切除ロボット操作で要求される術者の動作評価

山田和希, 藤原一夫, 三宅孝昌, 藤井洋佑, 尾崎敏文, 阿部信寛, 江口透, 山本江, 杉田直彦, 光石衛

日本整形外科学会雑誌 90 ( 8 ) S1700 - S1700 2016.8

Metforminは腫瘍内骨髄球系細胞の代謝を制御し骨肉腫形成を抑制する

上原健敬, 榮川伸吾, 小松原将, 森田卓也, 杉生和久, 魚谷弘二, 大森敏規, 吉田晶, 藤原智洋, 武田健, 国定俊之, 鵜殿平一郎, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1555 - S1555 2016.8

骨肉腫における新規バイオマーカーおよび予後予測因子としてのcirculating microRNAの同定

藤原智洋, 魚谷弘二, 吉田晶, 森田卓也, 清野正晋, 上原健敬, 杉生和久, 小松原将, 望月雄介, 国定俊之, 根津悠, 岩田慎太郎, 小林英介, 川井章, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1553 - S1553 2016.8

網羅的解析による滑膜肉腫由来circulating cell-free microRNAの特定および検証

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

日本整形外科学会雑誌 90 ( 8 ) S1560 - S1560 2016.8

変形性関節症における骨棘形成に対するADAM12の関与

堀田昌宏, 西田圭一郎, 古松毅之, 宮澤慎一, 那須義久, 中原龍一, 藤原智洋, 町田崇博, 竹下歩, 兼田大輔, 前原亜美, 櫻井美和, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1590 - S1590 2016.8

Ewing肉腫から分泌されるexosomeの表面蛋白を利用したliquid biopsyの開発

望月雄介, 藤原智洋, 魚谷弘二, 吉田晶, 森田卓也, 清野正普, 大森敏規, 杉生和久, 小松原将, 武田健, 国定俊之, 吉岡祐亮, 植田幸嗣, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1559 - S1559 2016.8

p53発現腫瘍融解アデノウイルスはMDR-1発現を抑制することにより薬剤耐性骨肉腫細胞に対して強力な抗腫瘍効果を示す

杉生和久, 望月雄介, 小松原将, 大森敏規, 山川泰明, 吉田晶, 長谷井嬢, 藤原智洋, 国定俊之, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1554 - S1554 2016.8

放射線抵抗性を示す骨・軟部肉腫に対する腫瘍融解アデノ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, 杉生和久, 藤原智洋, 吉田晶, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1564 - S1564 2016.8

粘液線維肉腫患者血清における分泌型microRNAの特定

森田卓也, 藤原智洋, 魚谷弘二, 吉田晶, 杉生和久, 小松原将, 清野正普, 望月雄介, 根津悠, 国定俊之, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1560 - S1560 2016.8

骨肉腫細胞内と細胞外分泌エクソソーム内のmicroRNA発現プロファイリングはどのように異なるか

清野正普, 藤原智洋, 魚谷弘二, 吉田晶, 森田卓也, 杉生和久, 小松原将, 望月雄介, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1801 - S1801 2016.8

軟部肉腫に対する腫瘍融解アデノウイルスと放射線治療の併用効果の検討

小松原将, 大森敏規, 杉生和久, 森田卓也, 魚谷弘二, 吉田晶, 藤原智洋, 武田健, 国定俊之, 浦田泰生, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1565 - S1565 2016.8

臨床検体を用いた腫瘍融解アデノウイルスの骨・軟部腫瘍への適応に関する検討

吉田晶, 魚谷弘二, 藤原智洋, 長谷井嬢, 大森敏規, 杉生和久, 小松原将, 森田卓也, 清野正晋, 望月雄介, 武田健, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1627 - S1627 2016.8

思春期特発性側彎症における背部体表変形の三次元的評価の試み

小田孔明, 瀧川朋亨, 中原龍一, 杉本佳久, 荒瀧慎也, 鉄永倫子, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 90 ( 8 ) S1644 - S1644 2016.8

解剖学的2重束前十字靱帯再建術における脛骨骨孔角度と骨孔位置の検討

山田和希, 古松毅之, 宮澤慎一, 田中孝明, 井上博登, 児玉有弥, 釜付祐輔, 尾崎敏文

JOSKAS 41 ( 4 ) 164 - 164 2016.7

大腿骨骨幹部骨折髄内釘術後の回旋変形の検討

小松原将, 山川泰明, 吉村将秀, 杉生和久, 上原健敬, 野田知之, 尾崎敏文

骨折 38 ( Suppl. ) S310 - S310 2016.7

骨軟部肉腫切除における感染リスクファクター

望月雄介, 小松原将, 長谷井嬢, 国定俊之, 藤原智洋, 魚谷弘二, 杉生和久, 尾崎敏文

日本骨・関節感染症学会プログラム・抄録集 39回 90 - 90 2016.7

介護老人福祉施設入所者の大腿骨骨折と要介護度との検討

堅山佳美, 千田益生, 上原健敬, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( JARM2016 ) I36 - I36 2016.6

メトホルミンの骨肉腫に対する免疫を介した抗腫瘍効果

上原健敬, 榮川伸吾, 小松原将, 森田卓也, 杉生和久, 魚谷弘二, 吉田晶, 藤原智洋, 武田健, 国定俊之, 鵜殿平一郎, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1259 - S1259 2016.6

術中ナビゲーションが有用であった脛骨原発phosphaturic mesenchymal tumorの1例

藤原智洋, 国定俊之, 武田健, 上原健敬, 大森敏規, 魚谷弘二, 杉生和久, 森田卓也, 小松原将, 吉田晶, 西山悠紀, 稲垣謙一, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1398 - S1398 2016.6

手・足部発生の類骨骨腫の治療経験

小松原将, 武田健, 森田卓也, 杉生和久, 魚谷弘二, 大森敏規, 上原健敬, 吉田晶, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1396 - S1396 2016.6

軟部原発平滑筋肉腫の治療成績

藤原智洋, 国定俊之, 武田健, 上原健敬, 大森敏規, 魚谷弘二, 杉生和久, 森田卓也, 小松原将, 吉田晶, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1308 - S1308 2016.6

サルコペニアとリハビリテーション

千田益生, 堅山佳美, 上原健敬, 兼田大輔, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( JARM2016 ) S261 - S261 2016.6

健常者における横隔神経伝導速度の左右差の検討

上原健敬, 堅山佳美, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( JARM2016 ) I95 - I95 2016.6

創外固定を利用した悪性骨盤腫瘍に対する早期リハビリテーション

国定俊之, 藤原智洋, 野田知之, 堅山佳美, 千田益生, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine ( JARM2016 ) I438 - I438 2016.6

骨・軟部腫瘍外科における手術支援ナビゲーションシステムを用いた骨・軟部腫瘍手術

国定俊之, 武田健, 藤原智洋, 瀧川朋亨, 荒瀧慎也, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1296 - S1296 2016.6

血清中分泌型microRNAをマーカーとした軟部肉腫の鑑別

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

日本整形外科学会雑誌 90 ( 6 ) S1275 - S1275 2016.6

骨・軟部肉腫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, 杉生和久, 藤原智洋, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1260 - S1260 2016.6

脊椎に発生したpigmented villonodular synovitisの2例

魚谷弘二, 藤原智洋, 瀧川朋亨, 荒瀧慎也, 杉本佳久, 武田健, 国定俊之, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 90 ( 6 ) S1353 - S1353 2016.6

大腿骨骨幹部骨折髄内釘治療後の回旋変形

小松原将, 山川泰明, 吉村将秀, 上原健敬, 野田知之, 尾崎敏文

日本外傷学会雑誌 30 ( 2 ) 246 - 246 2016.5

Cancer stem cells of sarcoma

Tomohiro Fujiwara, Akira Kawai, Akihiko Yoshida, Toshifumi Ozaki, Takahiro Ochiya

Role of Cancer Stem Cells in Cancer Biology and Therapy 23 - 78 2016.4

上腕骨骨幹部骨折に対するMIPOによる治療成績

島村安則, 山川泰明, 吉村将秀, 原田遼三, 堀田昌宏, 竹下歩, 上原健敬, 雑賀建多, 中原龍一, 木浪陽, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 1 ) 164 - 164 2016.4

大腿骨近位部骨折を伴う大腿骨骨幹部骨折の治療経験

清野正普, 野田知之, 山川泰明, 小松原将, 吉村将秀, 杉生和久, 上原健敬, 中原龍一, 島村安則, 尾崎敏文

中国・四国整形外科学会雑誌 28 ( 1 ) 168 - 168 2016.4

RA手指変形の治療関節リウマチのボタン穴変形・スワンネック変形に対する再建術

西田圭一郎, 中原龍一, 那須義久, 島村安則, 尾崎敏文

日本手外科学会雑誌 33 ( 1 ) S19 - S19 2016.4

【転移性脊椎腫瘍の治療戦略】骨転移診療システム脊椎転移による麻痺や廃用症候群予防を目的とした取り組み

中田英二, 杉原進介, 菅原敬文, 尾崎敏文

関節外科 35 ( 4 ) 374 - 387 2016.4

骨肉腫における予後予測ノモグラムの開発と外的妥当性の検証

小倉浩一, 藤原智洋, 康永秀生, 松居宏樹, Jeon Dae-Geun, 平賀博明, 石井猛, 米本司, 鴨田博人, 尾崎敏文, 小澤英史, 西田佳弘, 森岡秀夫, 比留間徹, 角永茂樹, 上田孝文, 荒木信人, 中紀文, 津田祐輔, 河野博隆, 川井章

日本整形外科学会雑誌 90 ( 3 ) S1072 - S1072 2016.3

40歳以上の中高齢者発生骨肉腫の治療成績

藤原智洋, 国定俊之, 武田健, 魚谷弘二, 杉生和久, 森田卓也, 小松原将, 大森敏規, 上原健敬, 吉田晶, 尾崎敏文

日本整形外科学会雑誌 90 ( 3 ) S856 - S856 2016.3

メトホルミンの骨肉腫に対する免疫を介した抗腫瘍効果

上原健敬, 榮川伸吾, 杉生和久, 魚谷弘二, 吉田晶, 藤原智洋, 武田健, 国定俊之, 鵜殿平一郎, 尾崎敏文

日本整形外科学会雑誌 90 ( 2 ) S143 - S143 2016.3

岡山大学病院における難治性慢性痛に対する集学的治療の検討

鉄永倫子, 西田圭一郎, 鉄永智紀, 尾崎敏文, 西江宏行, 太田晴之, 井上真一郎, 小田幸治, 龍野耕一, 宮脇卓也, 神崎浩孝

日本整形外科学会雑誌 90 ( 2 ) S39 - S39 2016.3

胞巣状軟部肉腫の特徴的な画像所見

国定俊之, 武田健, 藤原智洋, 魚谷弘二, 杉生和久, 尾崎敏文

中部日本整形外科災害外科学会雑誌 59 ( 春季学会 ) 89 - 89 2016.3

骨・軟部肉腫切除後にプレート固定した自家処理骨移植の治療成績

武田健, 国定俊之, 森田卓也, 小松原将, 魚谷弘二, 杉生和久, 藤原智洋, 杉原進介, 尾崎敏文

日本整形外科学会雑誌 90 ( 2 ) S171 - S171 2016.3

術中ナビゲーションを用いて切除し得た脛骨原発phosphaturic mesenchymal tumorの一例

藤原智洋, 国定俊之, 武田健, 西山悠紀, 稲垣兼一, 尾崎敏文

中部日本整形外科災害外科学会雑誌 59 ( 春季学会 ) 171 - 171 2016.3

ラジオ波焼灼術(RFA)を行った類骨骨腫の治療成績

国定俊之, 武田健, 藤原智洋, 郷原英夫, 金澤右, 尾崎敏文

日本整形外科学会雑誌 90 ( 3 ) S843 - S843 2016.3

Circulating microRNAの新規バイオマーカーとしての可能性の検証骨肉腫診療における可能性

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

日本整形外科学会雑誌 90 ( 3 ) S611 - S611 2016.3

後十字靱帯断面積と大腿骨・脛骨付着部面積の関係についての検討

藤井政孝, 藤巻良昌, 佐々木祐介, 古松毅之, 宮澤慎一, 尾崎敏文, Fu Freddie

日本整形外科学会雑誌 90 ( 3 ) S775 - S775 2016.3

成人脊柱変形におけるsacral alar iliac screwのentry pointとtrajectoryの検討

渡邉典行, 瀧川朋亨, 小田孔明, 魚谷弘二, 篠原健介, 鉄永倫子, 荒瀧慎也, 杉本佳久, 田中雅人, 尾崎敏文

Journal of Spine Research 7 ( 3 ) 319 - 319 2016.3

思春期特発性側彎症Lenke5Cに対する術後肩バランスの検討

荒瀧慎也, 田中雅人, 杉本佳久, 瀧川朋亨, 鉄永倫子, 篠原健介, 渡邉典行, 魚谷弘二, 小田孔明, 小松原将, 宇川諒, 尾崎敏文

Journal of Spine Research 7 ( 3 ) 647 - 647 2016.3

成人脊柱変形における腰椎側彎と大腰筋の位置の関係

小田孔明, 瀧川朋亨, 杉本佳久, 荒瀧慎也, 鉄永倫子, 田中雅人, 尾崎敏文

Journal of Spine Research 7 ( 3 ) 312 - 312 2016.3

Chiari奇形と脊髄空洞症に伴う側彎症の検討

小松原将, 荒瀧慎也, 小田孔明, 森田卓也, 魚谷弘二, 渡邉典行, 篠原健介, 瀧川朋亨, 杉本佳久, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 90 ( 3 ) S698 - S698 2016.3

低侵襲側方進入椎体間固定術の合併症について

荒瀧慎也, 田中雅人, 杉本佳久, 瀧川朋亨, 鉄永倫子, 篠原健介, 渡邉典行, 小田孔明, 小松原将, 森田卓也, 尾崎敏文

日本整形外科学会雑誌 90 ( 3 ) S879 - S879 2016.3

腸腰筋の位置に対する腰椎アライメントの影響

小田孔明, 荒瀧慎也, 瀧川朋亨, 杉本佳久, 鉄永倫子, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 90 ( 3 ) S1074 - S1074 2016.3

思春期特発性側彎症Lenke1、2に対する選択的胸椎後方固定術後の胸腰椎/腰椎カーブおよび冠状面バランスはどのように推移するのか?

荒瀧慎也, 田中雅人, 杉本佳久, 瀧川朋亨, 鉄永倫子, 篠原健介, 渡邉典行, 魚谷弘二, 小田孔明, 森田卓也, 宇川諒, 尾崎敏文

Journal of Spine Research 7 ( 3 ) 266 - 266 2016.3

放射線被曝フリーを目指した経皮的椎弓根スクリュー挿入法の正確性と安全性

荒瀧慎也, 田中雅人, 杉本佳久, 瀧川朋亨, 鉄永倫子, 篠原健介, 渡邉典行, 魚谷弘二, 森田卓也, 小松原将, 尾崎敏文

日本整形外科学会雑誌 90 ( 3 ) S878 - S878 2016.3

【3Dモデル・3Dプリンターを利用した整形外科手術】整形外科分野への応用整形外科外傷治療における3Dモデル・3Dプリンターの応用

杉生和久, 中原龍一, 吉村将秀, 山川泰明, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

関節外科 35 ( 2 ) 180 - 189 2016.2

【3Dモデル・3Dプリンターを利用した整形外科手術】整形外科分野への応用 3D実体モデルを利用した骨・軟部腫瘍手術

武田健, 中原龍一, 原田遼三, 国定俊之, 尾崎敏文

関節外科 35 ( 2 ) 198 - 204 2016.2

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

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

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

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

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.

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。

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。

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

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

胞巣状軟部肉腫に対する広範切除術前に血管内治療による腫瘍塞栓術を施行した2例

宇川諒, 武田健, 藤原智洋, 国定俊之, 平木隆夫, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 3 ) 447 - 447 2015.9

寛骨臼骨折におけるposterior column screwの安全域 3DCTによる検討

吉村将秀, 上原健敬, 野田知之, 小松原将, 杉生和久, 山川泰明, 雑賀建多, 中原龍一, 島村安則, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1424 - S1424 2015.9

骨盤輪骨折(救命から観血的治療まで) 骨盤輪損傷の内固定法

野田知之, 上原健敬, 吉村将秀, 島村安則, 尾崎敏文, 山川泰明

中部日本整形外科災害外科学会雑誌 58 ( 秋季学会 ) 56 - 56 2015.9

骨肉腫患者における腫瘍由来分泌型miRNAの特定と非侵襲的バイオマーカーとしての実験的検討

藤原智洋, 魚谷弘二, 吉田晶, 杉生和久, 大森敏規, 上原健敬, 山川泰明, 武田健, 国定俊之, 根津悠, 川井章, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1798 - S1798 2015.9

マウス乳がん骨転移モデルに対するリン酸化プルラン・ゾレドロン酸混和物の抗腫瘍効果の検討

武田健, 魚谷弘二, 杉生和久, 大森敏規, 上原健敬, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1675 - S1675 2015.9

骨肉腫におけるmyeloid derived suppressor cell(MDSC)に対するmetforminの作用の検討

上原健敬, 榮川伸吾, 藤原智洋, 杉生和久, 魚谷弘二, 大森敏規, 吉田晶, 武田健, 国定俊之, 鵜殿平一郎, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1670 - S1670 2015.9

新規生体材料によるインプラントコーティング

香川洋平, 山根健太郎, 篠原健介, 渡邉典行, 張偉, 吉田晶, 吉田靖弘, 尾崎敏文, 松川昭博

日本整形外科学会雑誌 89 ( 8 ) S1576 - S1576 2015.9

脊髄損傷治療におけるコラーゲン結合性ドメイン連結肝細胞増殖因子の有用性

山根健太郎, 吉田晶, 篠原健介, 張偉, 香川洋平, 渡邉典行, 伊藤嘉浩, 田中雅人, 松川昭博, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1622 - S1622 2015.9

多糖複合体リン酸化プルランを用いた抗菌薬含有骨セメントの開発

渡邉典行, 山根健太郎, 香川洋平, 篠原健介, 張偉, 吉田晶, 松川昭博, 吉田靖弘, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1577 - S1577 2015.9

メカニカルストレスに対するJAK阻害薬tofacitinibの軟骨破壊抑制効果

町田崇博, 西田圭一郎, 中原龍一, 那須義久, 斎藤太一, 堀田昌宏, 竹下歩, 兼田大輔, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1718 - S1718 2015.9

腫瘍融解アデノウイルスの骨・軟部腫瘍臨床組織検体に対する感染効率および適応症例の検討

吉田晶, 藤原智洋, 魚谷弘二, 長谷井嬢, 山川泰明, 大森敏規, 杉生和久, 武田健, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1673 - S1673 2015.9

骨・軟部肉腫のゲノム解析と新治療開発の展望骨軟部腫瘍に対する手術療法の進歩

尾崎敏文, 国定俊之, 武田健, 藤原智洋

日本癌治療学会誌 50 ( 3 ) 2115 - 2115 2015.9

Liquid biopsyに応用可能なEwing肉腫細胞由来のexosome表面マーカーの同定

森田卓也, 藤原智洋, 魚谷弘二, 吉田晶, 山川泰明, 大森敏規, 杉生和久, 武田健, 国定俊之, 吉岡祐亮, 植田幸嗣, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1796 - S1796 2015.9

腫瘍特異的増殖型ウイルスによる骨・軟部肉腫circulating tumor cell(CTC)検出法の検討

小松原将, 山川泰明, 大森敏規, 杉生和久, 魚谷弘二, 吉田晶, 藤原智洋, 武田健, 国定俊之, 浦田泰生, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1795 - S1795 2015.9

骨肉腫に対する化学療法とp53発現腫瘍融解アデノウイルス治療の併用効果

杉生和久, 小松原将, 大森敏規, 山川泰明, 吉田晶, 藤原智洋, 武田健, 国定俊之, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1799 - S1799 2015.9

骨肉腫に対するテロメラーゼ依存性腫瘍融解アデノウイルスと骨周囲環境制御による新規治療戦略

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

日本整形外科学会雑誌 89 ( 8 ) S1798 - S1798 2015.9

骨軟部骨軟部腫瘍治療の新たな展開仙骨脊索腫治療後の再発切除術と重粒子線治療

国定俊之, 武田健, 藤原智洋, 鎌田正, 今井礼子, 不破信和, 尾崎敏文

日本癌治療学会誌 50 ( 3 ) 2021 - 2021 2015.9

指神経に発生した巨指症を伴わないFibrolipomatous hamartomaの1例

清野正普, 武田健, 藤原智洋, 国定俊之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 秋季学会 ) 283 - 283 2015.9

滑膜肉腫患者血清から特定した滑膜肉腫特異的分泌型miRNAに関する検討

魚谷弘二, 藤原智洋, 吉田晶, 山川泰明, 大森敏規, 杉生和久, 武田健, 国定俊之, 根津悠, 川井章, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1478 - S1478 2015.9

骨盤発生の放射線照射後肉腫の治療成績

武田健, 国定俊之, 藤原智洋, 魚谷弘二, 杉生和久, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 秋季学会 ) 286 - 286 2015.9

骨・軟部肉腫に対する腫瘍融解アデノウイルスと放射線療法の併用効果

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

日本整形外科学会雑誌 89 ( 8 ) S1673 - S1673 2015.9

後十字靱帯断面積は大腿骨付着部表面積に相関する

藤井政孝, 藤巻良昌, 佐々木祐介, 古松毅之, 尾崎敏文, Fu Freddie H.

日本整形外科学会雑誌 89 ( 8 ) S1554 - S1554 2015.9

Body line scannerを用いた立位rib humpの計測

小田孔明, 瀧川朋亨, 荒瀧慎也, 杉本佳久, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1815 - S1815 2015.9

神経線維腫症1型に合併した頸髄髄内腫瘍の1例

渡邉典行, 荒瀧慎也, 小田孔明, 魚谷弘二, 篠原健介, 鉄永倫子, 瀧川朋亨, 杉本佳久, 田中雅人, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 3 ) 446 - 446 2015.9

THA後に頻回脱臼を生じた骨盤後傾の1例

香川洋平, 遠藤裕介, 藤井洋佑, 小田孔明, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 3 ) 466 - 466 2015.9

High grade spondylolisthesisの1例

小田孔明, 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 58 ( 秋季学会 ) 249 - 249 2015.9

転写因子Mohawkは椎間板線維輪の発生・再生に重要である

中道亮, 伊藤義明, 市野瀬志津子, 酒井大輔, 舛田浩一, 尾崎敏文, 浅原弘嗣

日本整形外科学会雑誌 89 ( 8 ) S1776 - S1776 2015.9

キーンベック病に対する手術治療長期経過の1例

原田遼三, 島村安則, 井上円加, 小澤正嗣, 山川泰明, 柏原尚子, 雑賀建多, 魚谷弘二, 中原龍一, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 2 ) 379 - 379 2015.9

Scoliosis correction surgery for patients with McCune-Albright syndrome using pedicle screws: a report of two cases with different characteristics and a review of the literature Reviewed

Kentaro Yamane, Masato Tanaka, Yoshihisa Sugimoto, Haruo Misawa, Toshifumi Ozaki

EUROPEAN SPINE JOURNAL 24 ( 7 ) 1362 - 1367 2015.7

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

Scoliosis can occur secondary to McCune-Albright syndrome (MAS); it can be progressive and sometimes requires surgical treatment. It is still unclear if pedicle screw (PS) fixation in these patients with poor bone quality can be considered an effective treatment for scoliosis. The purpose of this study is to report two MAS patients with spinal fibrous dysplasia (FD) who underwent scoliosis surgeries with the PS system.
Case 1: a 12-year-old girl. Standing posteroanterior radiographs revealed a 58A degrees right curve from T7 to L2. Computed tomography (CT) showed small areas of FD throughout the spine. A posterior spinal arthrodesis from T4 to L3 using PS fixation was performed with a CT-based navigation system. Case 2: a 26-year-old woman. Radiographs in the standing position revealed a right 87A degrees curve from T8 to L2 and a 55A degrees kyphosis from T8 to T12. CT images showed multiple areas of severe spinal FD causing angular deformity and collapse of vertebral bodies. The patient underwent posterior spinal arthrodesis from T8 to her pelvis using a CT-based navigation system for PS fixation.
Superior scoliosis corrections were obtained using PS instrumentation, attaining complete bony union in both cases without major complications. However, Case 2 had some technical difficulties in treating due to the multiple large FD lesions.
PS fixation can be considered an effective treatment for correcting scoliosis and maintaining the correction at follow-up in MAS patients with poor bone quality. However, great care must be taken when performing correction and follow-up.

DOI： 10.1007/s00586-015-3813-5

Perioperative chemotherapy with ifosfamide and doxorubicin for high-grade soft tissue sarcomas in the extremities (JCOG0304). Reviewed International journal

Tanaka K, Mizusawa J, Fukuda H, Araki N, Chuman H, Takahashi M, Ozaki T, Hiruma T, Tsuchiya H, Morioka H, Hatano H, Iwamoto Y

Japanese journal of clinical oncology 45 ( 6 ) 555 - 561 2015.6

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

OBJECTIVE: The efficacy of perioperative chemotherapy for soft tissue sarcomas is controversial and only a few prospective studies of pre-operative chemotherapy for soft tissue sarcomas in the extremities have been reported. We therefore carried out Phase II study of perioperative chemotherapy for patients with soft tissue sarcomas in the extremities. METHODS: Patients with Stage III non-round cell soft tissue sarcomas in the extremities were eligible. The patients were treated with pre-operative chemotherapy consisting doxorubicin 60 mg/m(2) and ifosfamide 10 g/m(2) for three courses. After the tumor resection, two additional courses of the same regimen were carried out. RESULTS: A total of 72 patients were enrolled and 70 patients were eligible. The median age of the patients was 49 years. The major pathological subtypes were synovial sarcoma in 20 and undifferentiated pleomorphic sarcoma in 17 patients. The protocol treatments were completed in 74% of the eligible cases. The 2 and 5-year progression-free survival rates were 75.7% (95% CI, 63.9-84.1%) and 63.8% (95% CI, 51.3-73.9%), respectively. The 5-year overall survival was 82.6% (95% CI, 71.3-89.7%). There was no treatment-related death. Grade 3 or 4 hematological toxicities (leukopenia and neutropenia) were observed in most of the patients. CONCLUSIONS: Although the toxicities of the regimen were significant, pre-operative chemotherapy followed by post-operative chemotherapy using doxorubicin and high-dose ifosfamide was feasible. The outcome of the trial for the patients with high-grade soft tissue sarcomas in the extremities was favorable, and this regimen is promising for further investigation. This trial was registered at the UMIN Clinical Trials Registry (www.umin.ac.jp/ctr/) as C000000096.

DOI： 10.1093/jjco/hyv042

骨肉腫における全生存率を予測する予後予測ノモグラムの開発

小倉浩一, 藤原智洋, 松居宏樹, 康永秀生, 平賀博明, 石井猛, 米本司, 鴨田博人, 尾崎敏文, 小澤英史, 西田佳弘, 森岡秀夫, 比留間徹, 角永茂樹, 上田孝文, 荒木信人, 中紀文, 津田祐輔, 河野博隆, 川井章

日本整形外科学会雑誌 89 ( 6 ) S1329 - S1329 2015.6

大腿骨遠位骨幹部骨折偽関節に対する骨移植併用exchange nailingの治療経験

小松原将, 野田知之, 杉生和久, 堀田昌宏, 上原健敬, 山川泰明, 雑賀建多, 中原龍一, 木浪陽, 尾崎敏文

骨折 37 ( Suppl. ) S89 - S89 2015.6

脆弱性骨折に対するトータルケアーの現状と理想大腿骨近部骨折に対する外科的治療の最前線(手術手技の工夫)

野田知之, 吉村将秀, 上原健敬, 島村安則, 尾崎敏文, 山川泰明

骨折 37 ( Suppl. ) S19 - S19 2015.6

若年男性の横隔神経伝導速度の左右差についての検討

堅山佳美, 千田益生, 上原健敬, 尾崎敏文

運動器リハビリテーション 26 ( 2 ) 241 - 241 2015.6

上腕骨骨幹部骨折における最小侵襲プレート骨接合術(MIPO)による治療成績

島村安則, 野田知之, 山川泰明, 中原龍一, 木浪陽, 上原健敬, 吉村将秀, 竹下歩, 島村好信, 尾崎敏文

骨折 37 ( Suppl. ) S263 - S263 2015.6

大腿骨ステム周囲骨折に対するロッキングプレートの治療経験

児玉有弥, 野田知之, 島村安則, 木浪陽, 中原龍一, 雑賀建多, 山川泰明, 上原健敬, 杉生和久, 尾崎敏文

骨折 37 ( Suppl. ) S191 - S191 2015.6

仙骨骨巨細胞腫に対する治療戦略

藤原智洋, 国定俊之, 武田健, 山川泰明, 大森敏規, 上原健敬, 魚谷弘二, 杉生和久, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1308 - S1308 2015.6

マウス骨肉腫におけるmyeloid derived suppressor cellsとmetforminの作用

上原健敬, 榮川伸吾, 杉生和久, 魚谷弘二, 大森敏規, 山川泰明, 吉田晶, 藤原智洋, 武田健, 国定俊之, 鵜殿平一郎, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1238 - S1238 2015.6

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

武田健, 国定俊之, 小松原将, 森田卓也, 杉生和久, 魚谷弘二, 大森敏規, 上原健敬, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1209 - S1209 2015.6

足関節開放脱臼骨折に対してVAF flapを用いて治療した2例

堀田昌宏, 雑賀建多, 野田知之, 尾崎敏文, 木浪陽, 斎藤太一

骨折 37 ( 3 ) 829 - 832 2015.6

Language：Japanese Publisher：(一社)日本骨折治療学会

足関節開放脱臼骨折2例に対してvenoaccompanying artery fasciocutaneous(以下、VAF)flapを用いて治療した。症例1は49歳男性で、右足関節開放脱臼骨折(Gustilo type IIIB、AO44-B3)に対して、受傷から4時間半後に緊急で洗浄デブリドマンおよび創外固定施行、受傷後11日目に内固定し、受傷後17日目にVAF flapを施行。症例2は60歳男性で、右足関節開放脱臼骨折(Gustilo type IIIB、AO44-B3)に対して、受傷から6時間半後に緊急で洗浄デブリドマンおよび創外固定施行。受傷後11日目に内固定とVAF flapを施行。2例とも元の生活活動に復帰し経過良好であった。足関節開放骨折に対して当科では、まず洗浄・デブリドマン・創外固定を施行し、次に二期的に徹底したデブリドマンを行い、可能な限り同時に骨軟部組織再建を施行するという治療方針を立てている。今回2例とも骨接合に併用してVAF flapを用いて治療し、良好な足関節の機能を獲得することができた。足関節開放骨折Gustilo type IIIBに対し、皮弁挙上部の軟部組織損傷を認めなければVAF flapは有用であった。(著者抄録)

骨・軟部肉腫に対する腫瘍融解アデノウイルスと放射線療法の併用効果

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

日本整形外科学会雑誌 89 ( 6 ) S1244 - S1244 2015.6

前外側大腿皮弁で再建した踵骨骨肉腫の1例

小松原将, 武田健, 森田卓也, 杉生和久, 魚谷弘二, 藤原智洋, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1372 - S1372 2015.6

小児の単発性骨嚢腫に合併した大腿骨近位部骨折に対する観血的治療

杉生和久, 藤原智洋, 武田健, 国定俊之, 野田知之, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1301 - S1301 2015.6

悪性骨盤骨腫瘍術後リハビリテーション一時的創外固定法の有用性

国定俊之, 武田健, 藤原智洋, 野田知之, 堅山佳美, 千田益生, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1197 - S1197 2015.6

滑膜肉腫における患者血清由来分泌型miRNAの特定

吉田晶, 藤原智洋, 魚谷弘二, 山川泰明, 大森敏規, 杉生和久, 武田健, 国定俊之, 根津悠, 川井章, 落谷孝広, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1228 - S1228 2015.6

ナビゲーションシステムを用いた悪性骨・軟部腫瘍手術

国定俊之, 武田健, 藤原智洋, 杉本佳久, 荒瀧慎也, 瀧川朋亨, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1204 - S1204 2015.6

ゾレドロン酸とテロメラーゼ依存性腫瘍融解アデノウイルスの併用療法は骨肉腫に対する抗腫瘍効果を増強し、骨破壊を抑制する

山川泰明, 長谷井嬢, 田澤大, 杉生和久, 魚谷弘二, 尾崎修平, 吉田晶, 藤原智洋, 武田健, 国定俊之, 浦田泰生, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 89 ( 6 ) S1244 - S1244 2015.6

後十字靱帯断面積は大腿骨付着部表面積に相関する

藤井政孝, 藤巻良昌, 佐々木裕介, 古松毅之, 宮澤慎一, 尾崎敏文

JOSKAS 40 ( 4 ) 366 - 366 2015.6

レーザースキャナとロボットシステムを併用した後十字靱帯の断面積計測

藤井政孝, 藤巻良昌, 佐々木祐介, 古松毅之, 宮澤慎一, 尾崎敏文, Fu Freddie H.

JOSKAS 40 ( 3 ) 804 - 807 2015.6

Language：Japanese Publisher：(一社)日本関節鏡・膝・スポーツ整形外科学会

【目的】ヒト靱帯の断面積計測法については多くの報告があるが,膝の生理的な動きに伴うin situでの断面積を計測した報告はない.今回我々はロボットシステムを用いて再現した膝の生理的な動きの中での後十字靱帯(PCL)の断面積変化を調べた.【方法】ヒト屍体膝10体を対象とし,ロボットシステムを用いてあらかじめ記録した屈曲0,30,60,90°におけるneutral position,89N脛骨後方引出力負荷下(posterior tibial translation;PTT)の膝の動きを再現した.FAROレーザースキャナを用いて各角度,負荷下でのPCLの三次元画像を構築し,Geomagicソフトを使用し画像解析を行った.PCL実質部に適合するbest fit cylinderを作成し,それに垂直な面上での断面積を計測した.断面積計測はPCL実質部の全長を5等分した面で行い,膝屈曲30°でのneutral positionとPTTにおける断面積の変化を評価した.また,膝屈伸に伴うPCL実質部中央での断面積の変化を評価した.【結果】Neutral position,PTTにおいてPCL断面積は中央部で最小であった.全ての部位においてPTTにおける断面積がneutral positionのそれに比べ有意に小さかった.PCL中央部での断面積は膝屈曲0°で最大で90°で最小であった.全角度においてneutral positionに比べPTTにおける断面積が有意に小さかった.【考察および結論】本研究は,膝の動きに伴うin situでのPCLの断面積変化を正確に計測した初めての研究である.PCL断面積は中央部で最も小さく,どの部位においても膝屈曲とPTTにより断面積が小さくなることがわかった.(著者抄録)

寛骨臼骨折におけるPosterior Column ScrewおよびInfra Acetabular Screwの安全域 3DCTによる検討

上原健敬, 野田知之, 吉村将秀, 杉生和久, 山川泰明, 雑賀建多, 中原龍一, 島村安則, 木浪陽, 尾崎敏文

骨折 37 ( Suppl. ) S188 - S188 2015.6

The figure-of-nine leg position for anatomic anterior cruciate ligament reconstruction Reviewed

T. Furumatsu, M. Fujii, T. Tanaka, S. Miyazawa, T. Ozaki

ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH 101 ( 3 ) 391 - 393 2015.5

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

Anatomic double-bundle anterior cruciate ligament (ACL) reconstruction can restore the function and kinematics of the knee in ACL-deficient patients. Several outside-in drilling systems for accurate femoral tunnel creations have been developed. However, the femoral tunnel creation at the lower position of the intercondylar notch can be difficult in a usual leg position with the knee flexed at 90 degrees without varus stress. This technical note describes that the figure-of-nine leg position provides a better arthroscopic view to safely clean up the ACL femoral footprint located at the lower area of the lateral intercondylar wall. This position is useful to create the optimal femoral tunnels using the outside-in drilling technique, without damaging the lateral meniscus posterior root, lateral tibial eminence, and supplemental fibers that bridge the gap between the lateral meniscus and the ACL tibial insertion. (C) 2015 Elsevier Masson SAS. All rights reserved.

DOI： 10.1016/j.otsr.2014.12.015

高度肥満症例の重度四肢骨盤外傷に対する骨折治療戦略

小松原将, 木浪陽, 上原健敬, 山川泰明, 野田知之, 尾崎敏文

日本外傷学会雑誌 29 ( 2 ) 281 - 281 2015.5

骨盤輪骨折に対するナビゲーションを用いたiliosacral screwの有用性

上原健敬, 木浪陽, 吉村政秀, 杉生和久, 山川泰明, 野田知之, 尾崎敏文

日本外傷学会雑誌 29 ( 2 ) 234 - 234 2015.5

健常人の横隔神経伝導検査における左右差の検討

堅山佳美, 千田益生, 原田遼三, 上原健敬, 西田圭一郎, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 52 ( Suppl. ) S198 - S198 2015.5

Intercondylar notch size influences cyclops formation after anterior cruciate ligament reconstruction Reviewed

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

KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 23 ( 4 ) 1092 - 1099 2015.4

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

The purpose of this study was to investigate the incidence of cyclops lesions and its relationship with the cross-sectional area of the intercondylar notch.
For this study, 55 patients (24 male and 31 female) underwent follow-up arthroscopy after bi-socket anterior cruciate ligament reconstruction with hamstring tendon grafts were included. All patients underwent magnetic resonance imaging measurements of intercondylar notch dimensions. We compared the femoral intercondylar notch sizes and bone tunnel sizes between knees with cyclops lesions (cyclops group) and those without cyclops lesions (no-cyclops group). The mean percentage of the tunnel size to the cross-sectional area of the femoral intercondylar notch was also compared between the groups. The median follow-up duration was 3.8 years.
Cyclops lesions were found in 15 of the 55 knees (27.3 %) on second-look arthroscopy (cyclops group). Only 6 of the 55 knees (10.9 %) had extension loss (cyclops syndrome). The cyclops group included 3 men and 12 women. The two groups showed a statistical difference in sex variation (P = 0.04). No significant differences were found in the femoral and tibial tunnel sizes between the two groups. The cross-sectional area of the femoral intercondylar notch was significantly smaller in the cyclops group (251.7 +/- A 63.2 mm(2)) than in the no-cyclops group (335.6 +/- A 77.6 mm(2)) (P < 0.001). The percentage of the total femoral tunnel size to the cross-sectional area of the femoral intercondylar notch was significantly higher in the cyclops group (18.6 +/- A 5.3 %) than in the no-cyclops group (13.2 +/- A 3.6 %) (P = 0.02).
A smaller intercondylar notch size may be a potential risk factor for cyclops lesion formation.

DOI： 10.1007/s00167-014-2891-y

Pneumocephalus and chylothorax complicating vertebrectomy for lung cancer. Reviewed International journal

Sugimoto S, Tanaka M, Suzawa K, Nishikawa H, Toyooka S, Oto T, Ozaki T, Miyoshi S

The Annals of thoracic surgery 99 ( 4 ) 1425 - 1428 2015.4

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

Pneumocephalus is a rare, but potentially fatal complication of thoracic surgery. We describe a case of successful management of pneumocephalus complicated by persistent chylothorax developing after en bloc partial vertebrectomy performed after induction chemoradiotherapy for lung cancer invading the spine. Surgical treatment should be considered for pneumocephalus complicated by any condition requiring persistent chest drainage.

DOI： 10.1016/j.athoracsur.2014.05.098

Inhibition of KRAS codon 12 mutants using a novel DNA-alkylating pyrrole-imidazole polyamide conjugate. Reviewed International journal

Hiraoka K, Inoue T, Taylor RD, Watanabe T, Koshikawa N, Yoda H, Shinohara K, Takatori A, Sugimoto H, Maru Y, Denda T, Fujiwara K, Balmain A, Ozaki T, Bando T, Sugiyama H, Nagase H

Nature communications 6 6706 - 6706 2015.4

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

Despite extensive efforts to target mutated RAS proteins, anticancer agents capable of selectively killing tumour cells harbouring KRAS mutations have remained unavailable. Here we demonstrate the direct targeting of KRAS mutant DNA using a synthetic alkylating agent (pyrrole-imidazole polyamide indole-seco-CBI conjugate; KR12) that selectively recognizes oncogenic codon 12 KRAS mutations. KR12 alkylates adenine N3 at the target sequence, causing strand cleavage and growth suppression in human colon cancer cells with G12D or G12V mutations, thus inducing senescence and apoptosis. In xenograft models, KR12 infusions induce significant tumour growth suppression, with low host toxicity in KRAS-mutated but not wild-type tumours. This newly developed approach may be applicable to the targeting of other mutant driver oncogenes in human tumours.

DOI： 10.1038/ncomms7706

Hyaluronan suppresses mechanical stress-induced expression of catabolic enzymes by human chondrocytes via inhibition of IL-1 beta production and subsequent NF-kappa B activation Reviewed

Masatsugu Ozawa, Keiichiro Nishida, Aki Yoshida, Taichi Saito, Ryozo Harada, Takahiro Machida, Toshifumi Ozaki

INFLAMMATION RESEARCH 64 ( 3-4 ) 243 - 252 2015.4

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

To investigate the inhibitory effect of hyaluronan (HA) on mechanical stress- induced expression of a disintegrin and metalloproteinase with thrombospondin type1 motifs (ADAMTS)-4, -5 and matrix metalloproteinase (MMP)-13 by human chondrocytes.
Normal human articular chondrocytes were pre-incubated with or without 1.0 mg/mL HA (2700 kDa) for 12 h at 37 A degrees C in stretch chambers, then they were exposed to uni-axial cyclic tensile strain (CTS, 0.5 Hz, 10 % elongation). The expression of ADAMTS-4, -5, and MMP-13 were analyzed by real-time polymerase chain reaction and Immunocytochemistry. The concentration of IL-1 beta in the supernatant was measured using enzyme-linked immunosorbent assay (ELISA). The nuclear translocation of runt-related transcription factor 2 (RUNX-2) and nuclear factor-kappa B (NF-kappa B) was examined by ELISA and immunocytochemistry, and phosphorylation of NF-kappa B was examined by western blotting.
HA inhibited mRNA expression of ADAMTS-4, -5, and MMP13 after 24 h CTS via inhibition of IL-1 beta secretion and NF-kappa B activation. However, HA failed to inhibit CTS-induced RUNX-2 expression and subsequent expression of ADAMTS-5 and MMP-13 1 h after CTS.
Our results demonstrated that HA significantly suppressed mechanical stress-induced expression of catabolic proteases by inhibition of the NF-kappa B-IL-1 beta pathway, but did not suppress mechanical stress-induced RUNX-2 signaling.

DOI： 10.1007/s00011-015-0804-2

3D-navigation systemを用いたtransiliac-transsacral screw固定の経験

木浪陽, 野田知之, 上原健敬, 山川泰明, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 1 ) 182 - 182 2015.4

不安定型骨盤輪骨折に対するnavigation systemを利用したIliosacral screwの有用性

上原健敬, 野田知之, 山川泰明, 井上円加, 中原龍一, 島村安則, 尾崎敏文, 木浪陽

中国・四国整形外科学会雑誌 27 ( 1 ) 173 - 174 2015.4

小人症の大腿骨頸部骨折に対してTHAを施行した1例

遠藤裕介, 高橋欣吾, 斎藤太一, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 1 ) 199 - 199 2015.4

【骨腫瘍の診断と治療】化学療法 Ewing肉腫に対する化学療法

武田健, 藤原智洋, 国定俊之, 尾崎敏文

関節外科 34 ( 4 ) 338 - 343 2015.4

右橈骨骨腫瘍

藤原智洋, 武田健, 国定俊之, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 1 ) 224 - 224 2015.4

股関節前方より膿の排出を認めたTHA後感染の2例

小松原将, 遠藤裕介, 魚谷弘二, 藤原一夫, 香川洋平, 藤井洋佑, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 1 ) 202 - 203 2015.4

Efficacy of tramadol-acetaminophen tablets in low back pain patients with depression Reviewed

Tomoko Tetsunaga, Tomonori Tetsunaga, Masato Tanaka, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC SCIENCE 20 ( 2 ) 281 - 286 2015.3

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

Tramadol-acetaminophen tablets are currently used to treat pain, including that of degenerative lumbar disease. Although there are many reports on tramadol-acetaminophen tablets, treatment outcomes in low back pain (LBP) patients with depression remain uncertain. This study investigated the outcomes of LBP patients with depression treated with tramadol-acetaminophen tablets.
Of 95 patients with chronic LBP, 70 (26 men, 44 women; mean age 64 years) who were judged as having depression by the Self-Rating Depression Scale (SDS) were included in this study. In this trial, patients received one of two randomly assigned 8-week treatment regimes: tramadol-acetaminophen (Tramadol group, n = 35) and non-steroidal anti-inflammatory drugs (NSAIDs) (NSAID group, n = 35). In addition to completing self-report questionnaires, patients provided demographic and clinical information. All patients were assessed using a Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), Pain Disability Assessment Scale (PDAS), Hospital Anxiety and Depression Scale (HADS), SDS, and Pain Catastrophizing Scale (PCS).
After 8 weeks' treatment, the NRS and SDS scores were lower in the Tramadol group than in the NSAID group (p < 0.05). There were no significant differences in the ODI, PDAS, and PCS scores between the groups (p = 0.47, 0.09, 0.47). Although there was no difference in the anxiety component of the HADS between the groups (p = 0.36), the depression component was lower in the Tramadol group than in the NSAID group (p < 0.05). There was no significant difference between groups in the percentage of patients with treatment-associated adverse events.
This investigation found that tramadol-acetaminophen is effective for reducing LBP and provided a prophylactic antidepressant effect in chronic LBP patients with depression.

DOI： 10.1007/s00776-014-0674-4

肘関節terrible triad損傷の手術的治療

今谷潤也, 森谷史朗, 前田和茂, 桐田由季子, 林正典, 尾崎敏文, 二村昭元, 秋田恵一

日本整形外科学会雑誌 89 ( 3 ) S1108 - S1108 2015.3

前十字靱帯再建術における骨孔内での再建靱帯の偏位について大腿骨骨孔モデルを用いた検討

藤井政孝, 佐々木祐介, 荒木大輔, 古松毅之, 宮澤慎一, 尾崎敏文, Fu Freddie H.

JOSKAS 40 ( 1 ) 98 - 99 2015.3

Language：Japanese Publisher：(一社)日本関節鏡・膝・スポーツ整形外科学会

屍体膝から採取した半腱様筋腱をEndoButton CLを用いて二重折とし正確に径7mmであった8本(再建靱帯)を、大腿骨骨孔モデルとして作成したアルミニウム製立方体の径7mmの孔に通し、一端をEndoButtonで固定した。graft bending angleの変化を再現するため再建靱帯を15°、30°、45°、60°、75°の方向へ30Nで牽引し、デジタルカメラで骨孔開口部を骨孔軸の延長線上から撮影し、Image Jを用いて画像解析を行った。骨孔モデルの開口部の中心点と開口部における再建靱帯の中心点の2点間の距離を計測し、その値を再建靱帯の偏位量と定義した。再建靱帯の偏位量はgraft bending angle 15 °の時最小で0.7mm、75°の時に最大で1.1mmであった。

microRNA-133aとその標的遺伝子は骨肉腫がん幹細胞分画の悪性形質を制御し骨肉腫患者の新規予後因子として機能する

藤原智洋, 小坂展慶, 高橋陵宇, 竹下文彦, 吉田朗彦, 窪田大介, 小林英介, 落谷孝広, 川井章, 尾崎敏文

日本整形外科学会雑誌 89 ( 3 ) S861 - S861 2015.3

骨軟部腫瘍における画像評価最前線シンチグラフィを用いた骨軟部腫瘍の機能的画像診断

国定俊之, 武田健, 藤原智洋, 上原健敬, 大森敏規, 尾崎敏文

臨床整形外科 50 ( 3 ) 229 - 235 2015.3

Language：Japanese Publisher：(株)医学書院

骨軟部腫瘍の診断・治療では,骨シンチグラフィ,タリウムシンチグラフィが有用な画像診断法である.骨シンチグラフィは,骨腫瘍の活動性が評価可能であり,単発性・多発性発生の診断や悪性骨腫瘍では骨転移の診断に役立つ.タリウムシンチグラフィは腫瘍の活動性や悪性度を反映するため,術前治療の効果判定や良性・悪性の鑑別診断に有用である.術前治療が有効と判定可能であれば,縮小手術が可能となりうる.タリウムシンチグラフィとDMSAシンチグラフィを行うことで,軟骨系骨腫瘍の悪性度診断も可能とある.画像診断で良性・悪性の鑑別ができれば,外来診療での治療方針決定の一つの指標となる.(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J01554&link_issn=&doc_id=20150304050011&doc_link_id=10.11477%2Fmf.1408200144&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1408200144&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

骨温存のため液体窒素処理骨と腫瘍用人工関節術を併用した2例

上原健敬, 国定俊之, 大森敏規, 藤原智洋, 武田健, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 224 - 224 2015.3

Iliosacral screw挿入における仙骨安全域の検討

上原健敬, 野田知之, 山川泰明, 雑賀建多, 中原龍一, 木浪陽, 島村安則, 尾崎敏文

日本整形外科学会雑誌 89 ( 3 ) S805 - S805 2015.3

患肢温存術を行った15歳以下小児悪性骨腫瘍の治療成績

武田健, 国定俊之, 魚谷弘二, 杉生和久, 上原健敬, 大森敏規, 藤原智洋, 尾崎敏文

日本整形外科学会雑誌 89 ( 3 ) S687 - S687 2015.3

原発性悪性骨・軟部腫瘍に対するpolypropylene meshを用いた腫瘍用人工関節置換術の治療成績

藤原智洋, 国定俊之, 武田健, 山川泰明, 上原健敬, 大森敏規, 魚谷弘二, 杉生和久, 尾崎敏文

日本整形外科学会雑誌 89 ( 3 ) S682 - S682 2015.3

3D-navigation systemを用いたtransiliac-transsacral screw固定の経験

木浪陽, 野田知之, 上原健敬, 山川泰明, 尾崎敏文

日本整形外科学会雑誌 89 ( 3 ) S485 - S485 2015.3

脊髄損傷急性期における肝細胞増殖因子の抗炎症効果についてコラーゲン結合性改変HGFを用いた検討

山根健太郎, 篠原健介, 伊藤嘉浩, 杉本佳久, 田中雅人, 松川昭博, 尾崎敏文

Journal of Spine Research 6 ( 3 ) 585 - 585 2015.3

小人症の大腿骨頸部骨折に対してTHAを施行した1例

遠藤裕介, 高橋欣吾, 齋藤太一, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 273 - 273 2015.3

小児に生じた単発性骨嚢腫による大腿骨近位部骨折に対する観血的治療経験

杉生和久, 武田健, 藤原智洋, 国定俊之, 野田知之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 179 - 179 2015.3

四肢長管骨骨欠損に対し処理骨を用いた生物学的再建

国定俊之, 武田健, 藤原智洋, 魚谷弘二, 杉原進介, 尾崎敏文

日本整形外科学会雑誌 89 ( 3 ) S684 - S684 2015.3

骨肉腫における無転移生存率を予測する予後予測ノモグラムの開発

小倉浩一, 藤原智洋, 平賀博明, 石井猛, 米本司, 鴨田博人, 尾崎敏文, 西田佳弘, 小澤英史, 川井章

日本整形外科学会雑誌 89 ( 3 ) S509 - S509 2015.3

日本発新規microRNA阻害核酸製剤Synthetic Tough Decoyを用いた骨肉腫に対する前臨床的検討

藤原智洋, 根津悠, 吉田晶, 魚谷弘二, 武田健, 国定俊之, 伊庭英夫, 伊藤博, 尾崎敏文, 落合孝広, 川井章

日本整形外科学会雑誌 89 ( 3 ) S853 - S853 2015.3

手術治療単独で悪性転化をきたした二次性悪性骨巨細胞腫の2例

藤原智洋, 国定俊之, 武田健, 魚谷弘二, 杉生和久, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 221 - 221 2015.3

O-armによる術中CT撮影とナビゲーションシステムを用いて手術を行った類骨骨腫の1例

魚谷弘二, 武田健, 藤原智洋, 山川泰明, 国定俊之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 217 - 217 2015.3

有痛性dorsal defect of the patellaの一例

三宅孝昌, 藤原智洋, 武田健, 山川泰明, 国定俊之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 301 - 301 2015.3

【整形外科領域における集学的診療体制の構築】整形外科腫瘍領域(肉腫)における集学的治療

国定俊之, 武田健, 藤原智洋, 魚谷弘二, 杉生和久, 尾崎敏文

整形・災害外科 58 ( 3 ) 303 - 313 2015.3

骨盤腫瘍の外科的治療戦略骨盤腫瘍の治療方針

国定俊之, 武田健, 藤原智洋, 杉原進介, 尾崎敏文

日本整形外科学会雑誌 89 ( 2 ) S355 - S355 2015.3

骨肉腫患者における血中circulating miRNAの特定と臨床経過との相関

藤原智洋, 根津悠, 吉田晶, 魚谷弘二, 杉生和久, 大森敏規, 山川泰明, 武田健, 国定俊之, 川井章, 尾崎敏文

日本整形外科学会雑誌 89 ( 2 ) S139 - S139 2015.3

テロメラーゼ依存型腫瘍融解ウイルス治療とゾレドロネート併用療法の骨肉腫に対する前臨床的検討

山川泰明, 長谷井嬢, 藤原智洋, 武田健, 国定俊之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 175 - 175 2015.3

水道水による手術時手洗いは骨軟部腫瘍切除後感染に影響するか

武田健, 国定俊之, 魚谷弘二, 杉生和久, 藤原智洋, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 110 - 110 2015.3

自然退縮を認めた骨軟骨腫の2例

大森敏規, 藤原智洋, 武田健, 国定俊之, 尾崎敏文

中部日本整形外科災害外科学会雑誌 58 ( 春季学会 ) 216 - 216 2015.3

思春期特発性側彎症Lenke type 1 curveに対する装具療法の予後不良因子頂椎回矯正に着目して

山根健太郎, 田中雅人, 杉本佳久, 荒瀧慎也, 瀧川朋亨, 鉄永倫子, 篠原健介, 魚谷弘二, 渡邊典之, 尾崎敏文

Journal of Spine Research 6 ( 3 ) 617 - 617 2015.3

頸椎不安定性を有する関節リウマチ患者に対する頸椎固定術当科における過去10年間の動向

杉本佳久, 田中雅人, 荒瀧慎也, 瀧川朋亨, 鉄永倫子, 山根健太郎, 篠原健介, 魚谷弘二, 渡邉典行, 尾崎敏文

Journal of Spine Research 6 ( 3 ) 702 - 702 2015.3

軟骨無形成症による脊椎後彎症に対してVCRを併用し矯正固定術を行った3例

魚谷弘二, 瀧川朋亨, 渡邉典行, 篠原健介, 山根健太郎, 荒瀧慎介, 杉本佳久, 田中雅人, 尾崎敏文

Journal of Spine Research 6 ( 3 ) 379 - 379 2015.3

Growing rod法での金属強度の違いによるimplant折損パターンについて

篠原健介, 瀧川朋亨, 魚谷弘二, 渡邊典行, 山根健太郎, 鉄永倫子, 荒瀧慎也, 杉本佳久, 田中雅人, 皿井孝明, 廣岡孝彦, 尾崎敏文

Journal of Spine Research 6 ( 3 ) 727 - 727 2015.3

MRI of Rheumatoid Arthritis: Comparing the Outcome Measures in Rheumatology Clinical Trials (OMERACT) Scoring and Volume of Synovitis for the Assessment of Biologic Therapy Reviewed

Ryuichi Nakahara, Keiichiro Nishida, Kenzo Hashizume, Ryouzou Harada, Takahiro Machida, Masahiro Horita, Aiji Ohtsuka, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 69 ( 1 ) 29 - 35 2015.2

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

The outcome measures in rheumatology clinical trials (OMERACT) scores are the most mature quantitation system for rheumatoid arthritis (RA) on magnetic resonance imaging (MRI). Direct measuring techniques of synovial volume have been reported with good reproducibility, although few reports have demonstrated the changes of these measures in response to treatment. To assess these clinical responses, we evaluated the correlation of the changes of clinical activity score 28-joints disease activity score (DAS28-CRP) with the changes of OMERACT scores and with synovial volume measurements. Eight RA patients who were treated by biologic agents were examined with MRI of the dominant affected wrist and finger joints before and one year after the treatment. The total OMERACT score was reduced from 48.0 to 41.3, and synovial volume was reduced from 15.4 to 8.8 milliliters. Positive correlations were seen between the changes of DAS28-CRP and the changes of OMERACT synovitis score (r = 0.27), OMERACT total score (r = 0.43) and synovial volume (r = 0.30). Limited to synovium assessment, synovial volume showed a better correlation with DAS28-CRP than the OMERACT synovitis score. On the other hand, the OMERACT total score showed a higher correlation with DAS28-CRP than synovial volume, probably because the OMERACT total score includes scores for bone erosion and bone edema as well.

MicroRNAs in Bone and Soft Tissue Sarcomas and Their Value as Biomarkers Reviewed

Tomohiro Fujiwara, Yu Fujita, Yutaka Nezu, Akira Kawai, Toshifumi Ozaki, Takahiro Ochiya

Epigenetic Biomarkers and Diagnostics 613 - 642 2015.1

Language：English Publishing type：Part of collection (book) Publisher：Elsevier Inc.

Bone and soft tissue sarcomas are malignant neoplasms that are histologically and genetically heterogeneous, and various subtypes of them have been identified. Evidence of microRNA (miRNA) dysregulation in bone and soft tissue sarcomas has been recently described. miRNA dysregulation that is associated with genetic abnormalities unique to the specific subtypes of sarcomas, functionally important, or correlated with clinical prognosis has been gradually identified. Furthermore, the discovery of circulating miRNAs in patient blood has accelerated interest in their potential to transform clinical applications. Considering the lack of useful bone and soft tissue sarcoma biomarkers, the discovery of miRNA dysregulation may provide a diagnostic method that can be used at early disease stages to detect tumors, predict tumor response to chemotherapy, or identify prognoses. Such interventions would address some of the most important challenges in sarcoma management. In this review, we summarize the emerging evidence of miRNA dysregulation in bone and soft tissue sarcomas and discuss their potential as novel biomarkers and therapeutics.

DOI： 10.1016/B978-0-12-801899-6.00030-9

Stem selection of total hip arthroplasty for femoral head deformity in developmental dysplasia of the hip

KAGAWA Yohei

The Central Japan Journal of Orthopaedic Surgery & Traumatology 58 ( 6 ) 1107 - 1108 2015

The effects of prevention of VTE using oral direct FXa inhibitor after total hip arthroplasty

FUJII Yosuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 58 ( 4 ) 649 - 650 2015

Total hip arthroplasty for the DDH cases, femoral head deformity and discrepancy

ENDO Hirosuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 58 ( 4 ) 679 - 680 2015

Modification of the cell adhesion and hydrophilic characteristics of poly(ether-ether-ketone) by 172-nm Xenon excimer radiation Reviewed

Yukimasa Okada, Takayuki Furumatsu, Shinichi Miyazawa, Masataka Fujii, Hiroyuki Takahashi, Hiroomi Kimura, Toshifumi Ozaki, Nobuhiro Abe

BIO-MEDICAL MATERIALS AND ENGINEERING 25 ( 2 ) 169 - 175 2015

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

BACKGROUND: Poly-ether-ether-ketone (PEEK) has biomechanical and chemical properties that are excellent for biomedical applications; however, PEEK adhesion to bone or chondral tissue proceeds slowly due to poor hydrophilicity and other surface characteristics.
OBJECTIVE: We investigated the structural change, hydrophilicity, and cytocompatibility of a PEEK surface after 172-nm xenon excimer UV-irradiation.
METHODS: The surface characteristics before and after irradiation were evaluated by contact angle and ATR-FTIR measurements. Mouse osteoblast-like cells (MC3T3-E1) were cultured on PEEK plates and collected after 6, 12 and 24 h for cell adhesion analysis by crystal violet staining (CVS) and scanning electron microscopy (SEM).
RESULTS: UV-irradiation improved PEEK surface hydrophilicity, as indicated by a significant drop in water contact angle (p < 0.05). Irradiated PEEK showed additional peaks around 3370 cm(-1) and 1720 cm(-1), highlighting the generation of hydroxyl and carbonyl groups. CVS and SEM revealed improved adhesion to the PEEK surface after UV-irradiation.
CONCLUSION: Our results suggest that 172-nm UV-irradiated PEEK may be used in biomedical applications that require good cell adhesion.

DOI： 10.3233/BME-151267

Automatic method to determine anterior pelvic plane of pelvis Reviewed

T. Inoue, K. Fujiwara, Y. Fujii, N. Abe, T. Ozaki, Y. Nakajima, N. Sugita, M. Mitsuishi, Z. Chen

Japanese Journal of Clinical Biomechanics 36 145 - 150 2015

Kinematic analysis of total knee joint by means of navigation system Reviewed

T. Inoue, N. Abe, S. Miyazawa, K. Fujiwara, Y. Nakajima, N. Sugita, M. Mitsuishi, T. Ozaki, Z. Chen

Transactions of the JSME 81 ( 830 ) 15-00229 - 00229-15-00229 2015

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japan Society of Mechanical Engineers

For additional functionality of artificial knee joint, the kinematics of knee has been evaluated using 2D/3D image registration technique after total knee arthroplasty. To evaluate the knee kinematics of implant, it is important how to adjust the ligament balancing around knee joint during surgery. In the kinematics evaluation of image matching, it is difficult to feed back the ligament balancing of knee because the information from image matching will be available after surgery only. Therefore, we developed a CT-based navigation system with the function of measurement of knee motion during surgery, which has been normally applied to enhance the accuracy of implant setting for target bone. The kinematics of knee has been evaluated with position of implant setting and ligament balancing which were obtained by this system during surgical operation. As a result, (1) The knee kinematics showed different trends between bone and implant based coordinate system, (2) Increasing 2mm thickness of insert between femoral and tibia component of artificial knee joint, the anterior-posterior shift of implant with knee flexion was decreased by changing the ligament tension around knee joint. In conclusion, it is possible to measure the knee kinematics with consideration of ligament balancing using the developed navigation system during surgery.

DOI： 10.1299/transjsme.15-00229

Erratum. Venous Thromboembolism after Total Hip Arthroplasty Diagnosed by Enhanced Computed Tomography:Comparison of Selective Thromboprophylaxis and No Thromboprophylaxis. Reviewed

Okada Y, Endo H, Tanaka T, Mitani S, Fujiwara K, Tetsunaga T, Kagawa Y, Fujii Y, Kunisada T, Ozaki T

Acta medica Okayama 69 ( 5 ) 325 - 325 2015

Language：English

Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15%, 9.0%, 6.0%, and 6.4%, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0%), minor bleeding in 2 cases (2.0%), persistent wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0%) and progression of anemia in 1 case (1.0%). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.

DOI： 10.18926/AMO/53680

microRNAs and Soft Tissue Sarcomas. Reviewed International journal

Fujiwara T, Kunisada T, Takeda K, Ozaki T

Advances in experimental medicine and biology 889 179 - 199 2015

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

Soft tissue sarcomas are a highly heterogenous group of malignant tumors that originate from mesenchymal tissues including muscle, adipose and fibrous tissues, blood vessels, and peripheral nerves. A large variety of histological subtypes that current diagnostic approaches recognize present a diagnostic challenge because their clinical and histopathological characteristics are not always distinct. One of the important clinical problems is a lack of useful biomarkers; therefore, the discovery of biomarkers that can be used to detect tumors or predict tumor response to chemotherapy or radiotherapy could help clinicians provide more effective clinical management. Recent reports on microRNAs (miRNAs) in soft tissue sarcomas have provided clues to solve the problem. Evidence for miRNAs in tumor tissues as well as circulating miRNAs in patients' blood is accelerating the potential to transform clinical applications. In this chapter, we summarize the emerging evidence of dysregulated miRNAs in tumor tissues and patients' blood and discuss the potential of miRNAs as novel biomarkers and therapeutic targets.

DOI： 10.1007/978-3-319-23730-5_10

Immunotherapy for Bone and Soft Tissue Sarcomas. Reviewed International journal

Uehara T, Fujiwara T, Takeda K, Kunisada T, Ozaki T, Udono H

BioMed research international 2015 820813 - 820813 2015

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

Although multimodal therapies including surgery, chemotherapy, and radiotherapy have improved clinical outcomes of patients with bone and soft tissue sarcomas, the prognosis of patients has plateaued over these 20 years. Immunotherapies have shown the effectiveness for several types of advanced tumors. Immunotherapies, such as cytokine therapies, vaccinations, and adoptive cell transfers, have also been investigated for bone and soft tissue sarcomas. Cytokine therapies with interleukin-2 or interferons have limited efficacy because of their cytotoxicities. Liposomal muramyl tripeptide phosphatidylethanolamine (L-MTP-PE), an activator of the innate immune system, has been approved as adjuvant therapeutics in combination with conventional chemotherapy in Europe, which has improved the 5-year overall survival of patients. Vaccinations and transfer of T cells transduced to express chimeric antigen receptors have shown some efficacy for sarcomas. Ipilimumab and nivolumab are monoclonal antibodies designed to inhibit immune checkpoint mechanisms. These antibodies have recently been shown to be effective for patients with melanoma and also investigated for patients with sarcomas. In this review, we provide an overview of various trials of immunotherapies for bone and soft tissue sarcomas, and discuss their potential as adjuvant therapies in combination with conventional therapies.

DOI： 10.1155/2015/820813

Venous thromboembolism after total hip arthroplasty diagnosed by enhanced computed tomography:comparison of selective thromboprophylaxis and no thromboprophylaxis. Reviewed

Okada Y, Endo H, Mitani S, Fujiwara K, Tetsunaga T, Kagawa Y, Fujii Y, Kunisada T, Ozaki T

Acta medica Okayama 69 ( 4 ) 205 - 212 2015

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

Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15%, 9.0%, 6.0%, and 6.4%, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0%), minor bleeding in 2 cases (2.0%), persistent wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0%) and progression of anemia in 1 case (1.0%). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.

DOI： 10.18926/AMO/53556

Diagnostic value of Thallium-201 scintigraphy in differentiating malignant bone tumors from benign bone lesions. Reviewed

Ryota Inai, Takayoshi Shinya, Akihiro Tada, Shuhei Sato, Tomohiro Fujiwara, Ken Takeda, Toshiyuki Kunisada, Hiroyuki Yanai, Toshifumi Ozaki, Susumu Kanazawa

Annals of nuclear medicine 29 ( 8 ) 674 - 681 2015

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

OBJECTIVE: This retrospective study aims to evaluate the diagnostic capacity of thallium-201 (201Tl) scintigraphy for differentiating malignant bone tumors from benign bone lesions. METHODS: Between January 2006 and December 2012, 279 patients with bone lesions (51 malignant and 228 benign) underwent 201Tl scintigraphy before treatment. To evaluate 201Tl uptake, we investigated tumor-to-background contrast (TBC) as well as TBC washout rate (WR). The differences of TBC on early and delayed images and WR were estimated by the Mann-Whitney U test. Receiver operating characteristic (ROC) analyses were used to determine the cut-off TBC values for differentiating malignant bone tumors from benign bone lesions. RESULTS: There were statistically significant differences in median TBC between malignant tumors and benign lesions. These differences occurred for early imaging (1.57 vs. 0.09, p < 0.001) as well as for delayed imaging (0.83 vs. 0.07, p < 0.001). However, there was no statistical difference in WR between malignant tumors and benign lesions (44 vs. 43 %, NS). The chosen TBC cut-off value was 0.68 for early imaging and 0.38 for delayed imaging. Using these cut-off values, the prediction of malignancy had a 77 % sensitivity, 74 % specificity, and 75 % accuracy for early imaging and an 80 % sensitivity, 76 % specificity, and 77 % accuracy for delayed imaging. CONCLUSIONS: 201Tl scintigraphy may have the ability to distinguish malignant bone tumors from benign bone lesions.

DOI： 10.1007/s12149-015-0990-6

Both a visual and a semiquantitative analysis for differentiating benign from malignant chondrogenic bone tumors using Tc-99m (V) DMSA scintigraphy: a prospective study. Reviewed International journal

Takayoshi Shinya, Shuhei Sato, Toshiyuki Kunisada, Ryota Inai, Hiroyuki Yanai, Toshifumi Ozaki, Susumu Kanazawa

Nuclear medicine communications 36 ( 8 ) 802 - 807 2015

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

OBJECTIVE: The aims of this prospective study were to assess the relationship between tumor aggressiveness and Tc-99m (V) dimercaptosuccinic acid (DMSA) uptake in chondrogenic bone tumors and the value of Tc-99m (V) DMSA scintigraphy for differentiating benign from malignant tumors. METHODS: Twenty-four patients with chondrogenic tumors (19 benign and five malignant) underwent Tc-99m DMSA (V) scintigraphy. Radiopharmaceutical uptake was classified using a three-point scale to allow a visual-only analysis, and a tumor-to-background contrast (TBC) was computed using regions of interest to provide a semiquantitative analysis. Spearman's correlation coefficient was used to assess the correlation between tumor aggressiveness and TBC. The difference in TBC between benign and malignant tumors was analyzed with the Mann-Whitney U-test. An appropriate cutoff value of TBC was chosen for the diagnosis of malignancy of a tumor using receiver operating characteristic analysis. RESULTS: Six benign tumors showed negative uptake (uptake score 0), whereas 13 benign tumors showed positive uptake (n=10 uptake score 1; n=3 uptake score 2). All chondrosarcomas showed positive uptake (n=2 uptake score 1; n=3 uptake score 2). A significant correlation was found between tumor aggressiveness and TBC. A significant difference was seen in TBC between benign and malignant tumors. With the chosen cutoff value of TBC equal to 0.611, the sensitivity was 80.0%, specificity was 78.9%, the positive predictive value was 50.0%, and the negative predictive value was 93.8%. CONCLUSION: Tc-99m (V) DMSA scintigraphy may have the potential to improve diagnostic methods for detecting chondrosarcomas using visual and/or semiquantitative analyses.

DOI： 10.1097/MNM.0000000000000328

The figure-of-nine leg position for anatomic anterior cruciate ligament reconstruction Reviewed

T. Furumatsu, M. Fujii, T. Tanaka, S. Miyazawa, T. Ozaki

Revue de Chirurgie Orthopedique et Traumatologique 101 ( 3 ) 249 2015

Language：French Publishing type：Research paper (scientific journal) Publisher：Elsevier Masson SAS

Anatomic double-bundle anterior cruciate ligament (ACL) reconstruction can restore the function and kinematics of the knee in ACL-deficient patients. Several outside-in drilling systems for accurate femoral tunnel creations have been developed. However, the femoral tunnel creation at the lower position of the intercondylar notch can be difficult in an usual leg position with the knee flexed at 90° without varus stress. This technical note describes that the figure-of-nine leg position provides a better arthroscopic view to safely clean up the ACL femoral footprint located at the lower area of the lateral intercondylar wall. This position is useful to create the optimal femoral tunnels using the outside-in drilling technique, without damaging the lateral meniscus posterior root, lateral tibial eminence, and supplemental fibers that bridge the gap between the lateral meniscus and the ACL tibial insertion.

DOI： 10.1016/j.rcot.2014.12.013

Role of Rho Small GTPases in Meniscus Cells Reviewed

Tomoko Kanazawa, Takayuki Furumatsu, Emi Matsumoto-Ogawa, Ami Maehara, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC RESEARCH 32 ( 11 ) 1479 - 1486 2014.11

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

We previously reported that mechanical stretch regulates Sry-type HMG box (SOX) 9-dependent 1(II) collagen (COL2A1) expression in inner meniscus cells. This study examined the role of the small Rho guanosine 5' triphosphatase Rac1 and Rho-associated kinase (ROCK) in the regulation of stretch-induced SOX9 gene expression in cultured human inner meniscus cells. COL2A1 and SOX9 gene expression was assessed by real-time PCR after application of uni-axial cyclic tensile strain (CTS) in the presence or absence of ROCK and Rac1 inhibitors. The subcellular localization of SOX9 and the Rac1 effector cyclic AMP response element-binding protein (CREB), the phosphorylation state of SOX9, Rac1 activation, and the binding of CREB to the SOX9 promoter were assessed. CTS increased the expression of COL2A1 and SOX9, which was suppressed by inhibition of Rac1. ROCK inhibition enhanced COL2A1 and SOX9 gene expression in the absence of CTS. CTS stimulated the nuclear translocation and phosphorylation of SOX9, and increased Rac1 activation. CTS also increased the binding of CREB to the SOX9 promoter. The results suggest that mechanical stretch-dependent upregulation of SOX9 by CREB in inner meniscus cells depends on the antagonistic activities of ROCK and Rac1. (c) 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1479-1486, 2014.

DOI： 10.1002/jor.22703

乳がん骨転移における非定型大腿骨骨折の発生率の検討

中田英二, 杉原進介, 尾崎敏文

中部日本整形外科災害外科学会雑誌 57 ( 6 ) 1245 - 1246 2014.11

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

2004年11月〜2013年10月の間にビスフォスフォネート(BP)を24ヵ月以上静脈内投与した乳がん骨転移患者142名(全例女性、平均年齢69歳)を対象に、非定型型大腿骨骨折(AFF)の発生率について検討した。BP投与回数は24〜103回(中央値36回)、投与期間は16〜101ヵ月(中央値36ヵ月)であった。その結果、1)経過観察期間中に大腿骨病的骨折を11例に認められた。このうちAFFは2例で、1例は右側、他の1例は両側に発生していた。2)発生時のBP投与はそれぞれ41回と83回、投与期間は37・79ヵ月で、2例とも内固定術(髄内釘)が施行されたが、髄腔が硬化し髄内釘の挿入が困難なため骨折部を直視下に整復して挿入した。尚、術後合併症や遷延癒合は認められなかった。3)乳がん患者においてBPを2年以上使用した症例の非定型型大腿骨骨折の発生率は1.4%であるが、3年以上にわたり骨修飾薬を投与した症例中、大腿部痛が出現とともにX線像上で大腿骨外側部に骨皮質に肥厚を認めた場合は非定型型大腿骨骨折の可能性を考えるべきである。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J00831&link_issn=&doc_id=20150123090015&doc_link_id=10.11359%2Fchubu.2014.1245&url=https%3A%2F%2Fdoi.org%2F10.11359%2Fchubu.2014.1245&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Spinal Metaplastic Meningioma with Osseous Differentiation in the Ventral Thoracic Spinal Canal Reviewed

Kentaro Yamane, Masato Tanaka, Yoshihisa Sugimoto, Kouichi Ichimura, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 68 ( 5 ) 313 - 316 2014.10

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

Ossified meningioma is classified histologically as a phenotype of metaplastic meningioma, and it is extremely rare. There are only 12 cases involving ossified spinal meningiomas in the literature. We present the case of a 61-year-old female with a primary tumor within the ventral spinal canal at T12. Although we performed a total tumor excision using an ultrasonic bone aspirator, a temporary deterioration of motor evoked potentials (MEPs) was observed during curettage with a Kerrison rongeur. The neurologic findings worsened immediately after surgery. Histologically, the tumor was diagnosed as a metaplastic meningioma with osseous differentiation. In order to avoid spinal cord injury, great care must be taken when removing an ossified meningioma located on the ventral spinal cord.

CBTスクリュー刺入部の3次元解析

瀧川朋亨, 田中雅人, 杉本佳久, 荒瀧慎也, 鉄永倫子, 尾崎敏文

Journal of Spine Research 5 ( 10 ) 1452 - 1455 2014.10

Language：Japanese Publisher：(一社)日本脊椎脊髄病学会

本研究の目的はCBTスクリューの挿入可能な角度とスクリュー長、そのCT値を求めることである。64椎体の腰椎CTデータを用いて、4.5mm径の仮想スクリューが刺入可能な角度、スクリュー長およびスクリュー挿入部位のCT値を解析した。腰椎CBTスクリューは下位になるほどより尾外側方向で、より長いスクリューが刺入可能であった。CBTスクリュー挿入部位のCT値は椎弓根スクリューの約2倍であった。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J05510&link_issn=&doc_id=20141104100020&doc_link_id=%2Ffg7spine%2F2014%2F000510%2F021%2F1452-1455%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg7spine%2F2014%2F000510%2F021%2F1452-1455%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Dorsal defect of the patellaの1例

三宅孝昌, 藤原智洋, 武田健, 国定俊之, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 3 ) 460 - 460 2014.10

【運動器を評価する-現場で使える最新評価法活用術-】希少重要疾患の評価法軟部腫瘍の診療における評価法の活用

藤原智洋, 国定俊之, 武田健, 尾崎敏文

関節外科 33 ( 10月増刊 ) 184 - 203 2014.10

小児に生じた単発性骨嚢腫による大腿骨近位部病的骨折

杉生和久, 武田健, 藤原智洋, 国定俊之, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 3 ) 460 - 460 2014.10

Long-term follow-up of resection-replantation for sarcoma in the distal radius Reviewed

Eiji Nakada, Shinsuke Sugihara, Toshiyuki Kunisada, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC SCIENCE 19 ( 5 ) 832 - 837 2014.9

RPN2 Gene Confers Osteosarcoma Cell Malignant Phenotypes and Determines Clinical Prognosis Reviewed

Tomohiro Fujiwara, Ryou-u Takahashi, Nobuyoshi Kosaka, Yutaka Nezu, Akira Kawai, Toshifumi Ozaki, Takahiro Ochiya

MOLECULAR THERAPY-NUCLEIC ACIDS 3 e189 2014.9

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

Drug resistance and metastasis are lethal characteristics of tumors. We previously demonstrated that silencing of ribophorin II (RPN2), which is part of the N-oligosaccharyl transferase complex, efficiently induced apoptosis and reduced resistance to docetaxel in human breast cancer cells. Here, we report the clinical and functional correlations of RPN2 expression in osteosarcoma. Immunohistochemical evaluation of 35 osteosarcoma patient biopsies revealed that RPN2 was moderately to highly expressed in all specimens, and higher RPN2 mRNA expression was significantly correlated with poor prognosis. To investigate whether lethal phenotypes of osteosarcoma could be reduced by regulating the expression of RPN2, we conducted a study of RNAi-induced RPN2 knockdown in highly metastatic human osteosarcoma cells. The results indicated that RPN2 silencing reduced cell proliferation, sphere formation, cell invasion, and sensitized drug response in vitro. Mice bearing RPN2-silenced highly metastatic osteosarcoma xenografts showed reduced tumor growth and lung metastasis, and survived longer than mice bearing control tumor xenografts. Taken together, our data suggest that RPN2 silencing contributes to regulation of lethal osteosarcoma phenotypes and could be a novel target for RNAi-based therapeutics against osteosarcoma.

DOI： 10.1038/mtna.2014.35

切除縁評価法の問題点切除縁評価法の問題点悪性骨腫瘍

国定俊之, 武田健, 藤原智洋, 柳井広之, 尾崎敏文

日本整形外科学会雑誌 88 ( 9 ) 588 - 594 2014.9

Language：Japanese Publisher：(公社)日本整形外科学会

2005年〜2011年に治療した初診時遠隔転移を認めない高悪性骨腫瘍52例を対象に、最近の症例について検討し、悪性骨腫瘍の切除縁評価法に関する疑問点・問題点について検討した。組織型は骨肉腫34例、軟骨肉腫12例、Ewing肉腫3例等であった。52例の切除縁評価は2cm wide margin以上45例、1cm wide margin 4例、marginal margin以下3例であった。1cm wide marginとなった4例は血管温存目的(2例)および術前化学療法効果著効例での関節温存目的(2例)であった。marginal margin以下となった3例は骨盤発生、脊椎発生、大腿骨巨大腫瘍で、広範囲切除縁確保が困難であった。再発は4例に認め、2cm wide margin以上1例、marginal margin以下3例であった。最初の問題点は反応層の定義で、反応層をもう少し詳細に分類する必要がある。2番目の問題点は術前画像での切除縁設定の基準を決めることで、全国で統一した安全な切除縁設定の基準を決める必要があると思われた。

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01133&link_issn=&doc_id=20141006030026&doc_link_id=%2Ffj2ortho%2F2014%2Fs08809%2F005%2F0588-0594%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffj2ortho%2F2014%2Fs08809%2F005%2F0588-0594%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

仙骨発生骨巨細胞腫の治療成績

藤原智洋, 国定俊之, 武田健, 尾崎敏文

中部日本整形外科災害外科学会雑誌 57 ( 秋季学会 ) 248 - 248 2014.9

Two-Directional Arthrographic Assessment for Treating Bilateral Development Dislocation of the Hips in Children after Walking Age Reviewed

Hirosuke Endo, Hirofumi Akazawa, Shigeru Mitani, Yoshiki Okada, Kentaro Yamane, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 68 ( 4 ) 201 - 206 2014.8

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

We reviewed the treatment outcome in 14 hips of 7 patients who were diagnosed as having bilateral developmental dislocation of the hip (DDH) after walking age and could be followed up until they were at least 14 years of age. Based on the results of two-directional arthrography of the hip, closed reduction was performed in 2 hips, and open reduction was performed without osteotomy in 12 hips. The final radiographic evaluations were made according to the Kalamchi and MacEwen classification and Severin classification. The mean age at the initial visit was 1 year and 9 months (range, 1 year and 5 months to 3 years). The outcome was satisfactory for one hip in Group I and 2 hips in Group II according to the Kalamchi and MacEwen classification, and in 83% of the Severin Class I and II hips. Arthrography was useful for identifying asymmetry, demonstrating the usefulness of a treatment strategy based on arthrography of the hip.

前十字靱帯再建術における大腿骨骨孔内での再建靱帯の偏位についての検討

藤井政孝, 佐々木祐介, 荒木大輔, 古松毅之, 尾崎敏文, Fu Freddie H.

日本整形外科学会雑誌 88 ( 8 ) S1429 - S1429 2014.8

マウス骨肉腫・軟骨肉腫における免疫抑制細胞MDSCに対するmetforminの作用

上原健敬, 榮川伸吾, 大森敏規, 山川泰明, 武田健, 国定俊之, 尾崎敏文, 鵜殿平一郎

日本整形外科学会雑誌 88 ( 8 ) S1739 - S1739 2014.8

脊髄損傷急性期における肝細胞増殖因子の抗炎症効果の検討

山根健太郎, 馬崎哲朗, 吉田晶, 香川洋平, 篠原健介, 北嶋隆, 伊藤嘉浩, 松川昭博, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 88 ( 8 ) S1510 - S1510 2014.8

Ribophorin II(RPN2)は骨肉腫の化学療法感受性および浸潤能を制御する

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

日本整形外科学会雑誌 88 ( 8 ) S1362 - S1362 2014.8

骨転移におけるゾレドロン酸と腫瘍融解アデノウイルスの併用治療

山川泰明, 長谷井嬢, 杉生和久, 大森敏規, 尾崎修平, 吉田晶, 藤原智洋, 国定俊之, 浦田泰生, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 88 ( 8 ) S1684 - S1684 2014.8

腫瘍融解アデノウイルスと放射線療法を併用した骨・軟部肉腫に対する新規治療戦略

大森敏規, 長谷井嬢, 杉生和久, 山川泰明, 尾崎修平, 藤原智洋, 武田健, 吉田晶, 国定俊之, 田澤大, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 88 ( 8 ) S1362 - S1362 2014.8

レーザースキャナとロボットシステムを併用した後十字靱帯断面積の計測

藤井政孝, 藤巻良昌, 佐々木祐介, 古松毅之, 尾崎敏文, Fu Freddie H.

日本整形外科スポーツ医学会雑誌 34 ( 4 ) 374 - 374 2014.8

レーザースキャナとロボットシステムを併用した後十字靱帯断面積の計測

藤井政孝, 藤巻良昌, 佐々木祐介, 古松毅之, 尾崎敏文, Fu Freddie H.

日本整形外科学会雑誌 88 ( 8 ) S1434 - S1434 2014.8

ANTITUMOR EFFECT OF TELOMERASE-SPECIFIC ONCOLYTIC ADENOVIRUS ON HUMAN BONE AND SOFT TISSUE SARCOMA CELLS Reviewed

Hiroshi Tazawa, Tsuyoshi Sasaki, Jo Hasei, Yuuri Hashimoto, Yasuo Urata, Toshifumi Ozaki, Toshiyoshi Fujiwara

JOURNAL OF GENE MEDICINE 16 ( 7-8 ) 261 - 262 2014.7

Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction Reviewed

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

INTERNATIONAL ORTHOPAEDICS 38 ( 7 ) 1393 - 1399 2014.7

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

Meniscus repair can restore meniscal function that transfers the axial compressive force to circumferential tensile strain. However, few reports have investigated the relationship between concurrent meniscus repair with acute anterior cruciate ligament (ACL) reconstruction and postoperative meniscal position. This study aimed to evaluate medial meniscal size and clinical results in patients who underwent ACL reconstruction and concomitant all-inside medial meniscus repair.
Twenty patients underwent ACL reconstruction and concurrent medial meniscus repair of a peripheral longitudinal tear using the FasT-Fix meniscal repair device. Medial tibial plateau length (MTPL) and width (MTPW) were determined by radiographic images. We evaluated the Lysholm score, anteroposterior instability, meniscal healing and magnetic resonance imaging (MRI)-based medial meniscal length (MML) and width (MMW). Correlations between MRI-based meniscal size, radiographic measurement and height were investigated.
All patients showed complete healing of the repaired meniscus in arthroscopic evaluation. However, one patient needed a subsequent meniscus repair during the follow-up period. Lysholm score and anteroposterior instability improved significantly. A better correlation was observed between MMW and MTPW than between MML and MTPL. Concurrent all-inside medial meniscus repair with ACL reconstruction significantly increased MML percentage (%MML) (100 MML/MTPL) but did not affect MMW percentage (%MMW) (100 MMW/MTPW).
Concurrent all-inside medial meniscus repair with ACL reconstruction had satisfactory clinical results. %MML was increased by concurrent medial meniscus repair without affecting %MMW. Our results suggest that medial meniscus repair associated with ACL reconstruction may restore meniscal function by adjusting the anteroposterior length of the torn medial meniscus.

DOI： 10.1007/s00264-013-2238-1

大腿骨骨孔モデルを用いた前十字靱帯再建術における骨孔内での再建靱帯の偏位についての検討

藤井政孝, 佐々木祐介, 荒木大輔, 古松毅之, 尾崎敏文, Fu Freddie

JOSKAS 39 ( 4 ) 368 - 368 2014.7

関節リウマチ(RA)に対するSwansonとAVANTAによるMP人工指関節置換術の治療成績

原田遼三, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文, 西田圭一郎

日本関節病学会誌 33 ( 2 ) 175 - 182 2014.7

Language：Japanese Publisher：(一社)日本関節病学会

関節リウマチに対しSwansonおよびAVANTAインプラントを用いてMP人工指関節置換術を行い、半年以上経過観察し得た34例118指について治療成績を検討した。Swanson群は48指、AVANTA群は70指であった。治療成績として、MP関節可動域、握力、ピンチ力、health assessment questionnaire、Hand20、Disabilities of the Arm, Shoulder and Handを調査した。また、画像評価として、インプラント周囲の骨透亮像と硬化像を計測し、更に尺側偏位、破損等についても検討を行なった。その結果、術後の臨床成績においてAVANTA群が優れる傾向にあったが、明らかな有意差はなかった。インプラント破損をSwanson群の3指に認めたが、シリコンインプラントの耐久性として経過観察期間(Swanson群60.7±20.5ヵ月、AVANTA群21.3±9.1ヵ月)の影響が考えられた。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J05177&link_issn=&doc_id=20140813110010&doc_link_id=%2Ffd8kanse%2F2014%2F003302%2F011%2F0175-0182%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffd8kanse%2F2014%2F003302%2F011%2F0175-0182%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

レーザースキャナとロボットシステムを併用した後十字靱帯の断面積計測

藤井政孝, 藤巻良昌, 佐々木祐介, 古松毅之, 尾崎敏文, Fu Freddie

JOSKAS 39 ( 4 ) 145 - 145 2014.7

神経線維腫症1型に合併した巨大血腫に対して動脈塞栓術による止血を行った2例

武田健, 篠原健介, 長谷井嬢, 平木隆夫, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 88 ( 6 ) S1252 - S1252 2014.6

不安定型骨盤輪骨折に対するnavigation systemを利用したIliosacral screwの有用性

上原健敬, 木浪陽, 野田知之, 山川泰明, 井上円加, 中原龍一, 島村安則, 尾崎敏文

骨折 36 ( Suppl. ) S368 - S368 2014.6

上腕骨近位部発生の悪性骨腫瘍に対する患肢温存術の治療成績

武田健, 国定俊之, 大森敏規, 上原健敬, 山川泰明, 尾崎修平, 長谷井嬢, 尾崎敏文

日本整形外科学会雑誌 88 ( 6 ) S1134 - S1134 2014.6

骨・軟部腫瘍切除術時のstaple使用は創合併症に影響しない

国定俊之, 上原健敬, 武田健, 長谷井嬢, 山川泰明, 井上円加, 尾崎敏文

日本整形外科学会雑誌 88 ( 6 ) S1242 - S1242 2014.6

骨盤Ewing肉腫に対して創外固定術を併用し腓骨移植術(non-vascularized)で再建した1例

大森敏規, 武田健, 上原健敬, 山川泰明, 長谷井嬢, 吉田晶, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 88 ( 6 ) S1294 - S1294 2014.6

Ilioinguinal approach変法(Kloen変法)が有用であった寛骨臼前壁骨折の治療経験

井上円加, 野田知之, 上原健敬, 山川泰明, 木浪陽, 島村安則, 土井武, 尾崎敏文

骨折 36 ( Suppl. ) S154 - S154 2014.6

下腿骨幹部骨折の治療成績腓骨骨折高位が治療成績に影響するか?

山川泰明, 野田知之, 杉生和久, 堀田昌宏, 上原健敬, 町田崇博, 中原龍一, 木浪陽, 島村安則, 尾崎敏文

骨折 36 ( Suppl. ) S129 - S129 2014.6

トラブルから学ぶ骨折治療トラブルから学ぶ骨盤・寛骨臼骨折治療

野田知之, 上原健敬, 山川泰明, 島村安則, 尾崎敏文, 木浪陽

骨折 36 ( Suppl. ) S32 - S32 2014.6

ICU管理における小児四肢骨幹部骨折に対するelastic nailingの有用性

木浪陽, 野田知之, 杉生和久, 山川泰明, 上原健敬, 井上円加, 中原龍一, 雑賀建多, 島村安則, 尾崎敏文

骨折 36 ( Suppl. ) S467 - S467 2014.6

足関節開放脱臼骨折に対してVAF flapを用いて治療した2例

堀田昌宏, 雑賀建多, 野田知之, 井上円加, 中原龍一, 島村安則, 尾崎敏文, 木浪陽, 斎藤太一

骨折 36 ( Suppl. ) S432 - S432 2014.6

骨肉腫におけるribophorin II(RPN2)の機能解析

藤原智洋, 根津悠, 川井章, 武田健, 国定俊之, 尾崎敏文, 落谷孝広

日本整形外科学会雑誌 88 ( 6 ) S1172 - S1172 2014.6

がん治療の個別化における形成外科の役割、期待と現状骨軟部悪性腫瘍の治療診断・切除・再建

尾崎敏文, 国定俊之, 武田健, 藤原智洋, 長谷川健二郎, 木股敬裕

日本癌治療学会誌 49 ( 3 ) 678 - 678 2014.6

Phase II study of eribulin mesylate in patients (pts) with advanced soft tissue sarcoma (STS). Reviewed

Yoichi Naito, Akira Kawai, Nobuhito Araki, Toshifumi Ozaki, Hideshi Sugiura, Yasuo Yazawa, Hideo Morioka, Akihiko Matsumine, Masahide Hiraiwa, Shun Asami, Kazuo Isu

JOURNAL OF CLINICAL ONCOLOGY 32 ( 15 ) 2014.5

Prognostic factors for high-grade soft tissue sarcomas (STS) in the extremities treated by perioperative chemotherapy with ifosfamide (IFO) and doxorubicin hydrochloride (ADM): Using the data from Japan Clinical Oncology Group trial (JCOG0304). Reviewed

Kazuhiro Tanaka, Tadashi Hasegawa, Junki Mizusawa, Nobuhito Araki, Hirokazu Chuuman, Mitsuru Takahashi, Toshifumi Ozaki, Toru Hiruma, Hiroyuki Tsuchiya, Hideo Morioka, Hiroshi Hatano, Takuro Wada, Masami Hosaka, Yukihiro Yoshida, Junya Toguchida, Satoshi Abe, Akihiko Matsumine, Koichiro Yokoyama, Haruhiko Fukuda, Yukihide Iwamoto

JOURNAL OF CLINICAL ONCOLOGY 32 ( 15 ) 2014.5

人工筋肉を用いた手指痙縮に対するアプローチ

馬崎哲朗, 千田益生, 堅山佳美, 上原健敬, 尾崎敏文

The Japanese Journal of Rehabilitation Medicine 51 ( Suppl. ) S347 - S347 2014.5

家兎骨軟骨欠損モデルにおける可視光硬化ゼラチンおよび骨髄間質細胞の組織修復効果

馬崎哲朗, 塩崎泰之, 山根健太郎, 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

移植 49 ( 1 ) 178 - 178 2014.5

ROCK inhibition enhances aggrecan deposition and suppresses matrix metalloproteinase-3 production in human articular chondrocytes Reviewed

Takayuki Furumatsu, Emi Matsumoto-Ogawa, Takaaki Tanaka, Zhichao Lu, Toshifumi Ozaki

CONNECTIVE TISSUE RESEARCH 55 ( 2 ) 89 - 95 2014.4

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

Homeostasis of articular cartilage is maintained by a balance between catabolism and anabolism. Matrix metalloproteinase-3 (MMP-3) catabolism of cartilaginous extracellular matrix (ECM), including aggrecan (AGN), is an important factor in osteoarthritis progression. We previously reported that inhibition of Rho-associated coiled-coil forming kinase (ROCK), an effector of Rho family GTPases, activates the chondrogenic transcription factor SRY-type high-mobility-group box (SOX) 9 and prevents dedifferentiation of monolayer-cultured chondrocytes. We hypothesized that ROCK inhibition prevents chondrocyte dedifferentiation by altering the transcriptional balance between MMP-3 and AGN. Normal human articular chondrocytes were cultured in the presence or absence of ROCK inhibitor (ROCKi, Y-27632). Expression of MMP-3 and AGN during monolayer cultivation was assessed by quantitative real-time PCR and western blot analysis. Chondrogenic redifferentiation potential of ROCKi-treated chondrocytes was evaluated by immunohistological analysis of pellet cultures. ROCKi treatment suppressed MMP-3 expression in monolayer-and pellet-cultured chondrocytes but increased AGN expression. Chromatin immunoprecipitation revealed that the association between transcription factors E26 transformation specific (ETS)-1 and SOX9 and their target genes MMP-3 and AGN, respectively, was affected by ROCKi treatment. ROCKi decreased the association between ETS-1 and its binding sites on the MMP-3 promoter, whereas ROCKi promoted the interaction between SOX9 and the AGN promoter. Our results suggest that ROCK inhibition may have an important role in modulating the balance between degradation and synthesis of cartilaginous ECM, a finding that may facilitate development of techniques to prepare differentiated chondrocytes for cartilage regeneration therapy.

DOI： 10.3109/03008207.2013.852544

Clinical Relevance and Therapeutic Significance of MicroRNA-133a Expression Profiles and Functions in Malignant Osteosarcoma-Initiating Cells Reviewed

Tomohiro Fujiwara, Takeshi Katsuda, Keitaro Hagiwara, Nobuyoshi Kosaka, Yusuke Yoshioka, Ryou-U Takahashi, Fumitaka Takeshita, Daisuke Kubota, Tadashi Kondo, Hitoshi Ichikawa, Akihiko Yoshida, Eisuke Kobayashi, Akira Kawai, Toshifumi Ozaki, Takahiro Ochiya

STEM CELLS 32 ( 4 ) 959 - 973 2014.4

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

Novel strategies against treatment-resistant tumor cells remain a challenging but promising therapeutic approach. Despite accumulated evidence suggesting the presence of highly malignant cell populations within tumors, the unsolved issues such as in vivo targeting and clinical relevance remain. Here, we report a preclinical trial based on the identified molecular mechanisms underlying osteosarcoma-initiating cells and their clinical relevance. We identified key microRNAs (miRNAs) that were deregulated in a highly malignant CD133(high) population and found that miR-133a regulated the cell invasion that characterizes a lethal tumor phenotype. Silencing of miR-133a with locked nucleic acid (LNA) reduced cell invasion of this cell population, and systemic administration of LNA along with chemotherapy suppressed lung metastasis and prolonged the survival of osteosarcoma-bearing mice. Furthermore, in a clinical study, high expression levels of CD133 and miR-133a were significantly correlated with poor prognosis, whereas high expression levels of the four miR-133a target genes were correlated with good prognosis. Overall, silencing of miR-133a with concurrent chemotherapy would represent a novel strategy that targets multiple regulatory pathways associated with metastasis of the malignant cell population within osteosarcoma. Stem Cells 2014;32:959-973

DOI： 10.1002/stem.1618

内果骨折を合併したアキレス腱断裂(アキレス腱付着部踵骨裂離骨折)の治療経験

山川泰明, 野田知之, 上原健敬, 井上円加, 斎藤太一, 金澤智子, 長谷井嬢, 中原龍一, 島村安則, 尾崎敏文, 木浪陽, 遠藤裕介

中国・四国整形外科学会雑誌 26 ( 1 ) 162 - 163 2014.4

耕耘機による両下肢開放骨折の一例

上原健敬, 山川泰明, 井上円加, 金澤智子, 斉藤太一, 中原龍一, 島村安則, 野田知之, 尾崎敏文, 木浪陽

中国・四国整形外科学会雑誌 26 ( 1 ) 162 - 162 2014.4

大腿骨遠位骨幹部骨折偽関節(infraisthmal fracture nonunion)の治療経験

山川泰明, 野田知之, 井上円加, 金澤智子, 長谷井嬢, 斎藤太一, 中原龍一, 島村安則, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 1 ) 155 - 155 2014.4

前方小皮切slipped planting法による上腕骨骨幹部骨折の治療経験

金澤智子, 島村安則, 中原龍一, 斉藤太一, 小澤正嗣, 山川泰明, 原田遼三, 中道亮, 井上円加, 木浪陽, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 1 ) 154 - 154 2014.4

前方プレートによる手術を行った鎖骨遠位端骨折の治療経験

島村好信, 島村安則, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 井上円加, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 1 ) 150 - 150 2014.4

橈骨遠位部骨折に対するMIPO法による治療成績

島村安則, 野田知之, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 井上円加, 尾崎敏文, 西田圭一郎

中国・四国整形外科学会雑誌 26 ( 1 ) 149 - 149 2014.4

タクロリムス使用下の整形外科手術

町田崇博, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文, 那須義久

岡山医学会雑誌 126 ( 1 ) 76 - 77 2014.4

岡山大学病院における難治性慢性痛に対する新しい試み痛みリエゾン外来

鉄永倫子, 田中雅人, 尾崎敏文, 西江宏行, 石川慎一, 溝渕知司, 井上真一郎, 小田幸治, 流王雄太, 宮脇卓也, 太田晴之

中国・四国整形外科学会雑誌 26 ( 1 ) 23 - 29 2014.4

Language：Japanese Publisher：中国・四国整形外科学会

当院では平成24年4月から痛みリエゾン外来(難治性慢性痛に対する多角的集学的外来)を開設した。その概要を紹介し、これまでに診療した32例の短期成績を報告した。32例の内訳は腰痛11例、下肢痛5例、頸部痛5例、全身痛5例、足底部痛2例、前胸部痛2例、腋窩部痛1例、背部痛1例で、成績の評価指標は「Pain Disability Assessment Scale(PDAS)」「Pain Catastrophizing Scale(PCS)」「Hospital Anxiety Depression Scale(HADS)」「日本整形外科学会腰痛疾患質問票(JOABPEQ)」「日本整形外科学会頸部脊髄症評価質問票(JOACMEQ)」とした。PDASの得点は、初診時平均29.7±13.5点、1ヵ月後25.6±12.9点、3ヵ月後25.3±12.8点であり、有意な改善は認められなかった。PCSは初診時39.7±8.1点、1ヵ月後33.7±9.0点、3ヵ月後34.7±9.9点であり、有意な改善が認められた。HADSの抑うつスコアは初診時11.2±4.7点、1ヵ月後9.8±5.5点、3ヵ月後12.0±4.5点で有意な改善は認められず、不安スコアは初診時11.6±5.7点、1ヵ月後9.2±5.1点、3ヵ月後8.6±4.9点で有意な改善が認められた。JOABPEQは初診時46.3±35.1点、1ヵ月後37.5±28.5点、3ヵ月後35.5±28.5点で有意な改善が認められた。JOACMEQは全ての項目において有意な改善は認められなかった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02438&link_issn=&doc_id=20140626110004&doc_link_id=%2Fcm4ortho%2F2014%2F002601%2F004%2F0023-0029%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2014%2F002601%2F004%2F0023-0029%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

IBGによる大腿骨再建を行ったTHA再置換術の1例

遠藤裕介, 藤原一夫, 三宅由晃, 岡田芳樹, 中道亮, 尾崎敏文

中国・四国整形外科学会雑誌 26 ( 1 ) 182 - 182 2014.4

他院THA術後5年で鼠径部腫瘤を生じた1例

魚谷弘二, 岡田芳樹, 香川洋平, 尾崎敏文, 遠藤裕介, 藤原一夫

中国・四国整形外科学会雑誌 26 ( 1 ) 187 - 188 2014.4

Outcomes of pregabalin in lumbar-disease patients with depression Reviewed

Tomoko Tetsunaga, Tomonori Tetsunaga, Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC SCIENCE 19 ( 2 ) 229 - 234 2014.3

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

The anti-seizure drug pregabalin is currently used for peripheral neuropathic pain, including degenerative lumbar disease with a neuropathic component. Although there are many reports associated with pregabalin, treatment outcome in low back pain (LBP) patients with depression remains uncertain. This study investigated the outcomes of pregabalin in LBP patients with depression.
We assessed 64 patients (29 men and 35 women) using a Visual Analogue Scale, a Self-Rating Depression Scale (SDS) and the Oswestry Disability Index (ODI). Mean age was 63.3 years (range 20-81), and mean duration of disease was 69.8 months (range 3-576). The patients were divided into two groups according to SDS: normal (n = 37) and depressed group (n = 27).
Pregabalin significantly reduced both SDS and ODI in the depressed group (p < 0.05). Effect size was larger for both SDS and ODI in the depressed group than in the normal group. Pain was significantly relieved, even in the depressed group (p < 0.01). Pain reduction was achieved by the direct effect of pregabalin, as well as indirect effects attributed to change in depressive symptoms. Although both somnolence and dizziness were detected, the use of hypnotic agents was decreased in half of cases. Somnolence did not influence the analgesic effects of the drug or psychotic state.
This investigation indicated that pregabalin is safe and effective for reducing both LBP and mood disturbance in patients with depression.

DOI： 10.1007/s00776-013-0529-4

A novel, visible light-induced, rapidly cross-linkable gelatin scaffold for osteochondral tissue engineering Reviewed

Tetsuro Mazaki, Yasuyuki Shiozaki, Kentaro Yamane, Aki Yoshida, Mariko Nakamura, Yasuhiro Yoshida, Di Zhou, Takashi Kitajima, Masato Tanaka, Yoshihiro Ito, Toshifumi Ozaki, Akihiro Matsukawa

SCIENTIFIC REPORTS 4 2014.3

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

Osteochondral injuries remain difficult to repair. We developed a novel photo-cross-linkable furfurylamine-conjugated gelatin (gelatin-FA). Gelatin-FA was rapidly cross-linked by visible light with Rose Bengal, a light sensitizer, and was kept gelled for 3 weeks submerged in saline at 37 degrees C. When bone marrow-derived stromal cells (BMSCs) were suspended in gelatin-FA with 0.05% Rose Bengal, approximately 87% of the cells were viable in the hydrogel at 24 h after photo-cross-linking, and the chondrogenic differentiation of BMSCs was maintained for up to 3 weeks. BMP4 fusion protein with a collagen binding domain (CBD) was retained in the hydrogels at higher levels than unmodified BMP4. Gelatin-FA was subsequently employed as a scaffold for BMSCs and CBD-BMP4 in a rabbit osteochondral defect model. In both cases, the defect was repaired with articular cartilage-like tissue and regenerated subchondral bone. This novel, photo-cross-linkable gelatin appears to be a promising scaffold for the treatment of osteochondral injury.

DOI： 10.1038/srep04457

大腿骨骨孔モデルを用いた前十字靱帯再建術における骨孔内での再建靱帯の偏位についての検討

藤井政孝, 佐々木祐介, 荒木大輔, Monica Rosen, Patrick Smolinski, 尾崎敏文, Fu Freddie

日本整形外科学会雑誌 88 ( 2 ) S278 - S278 2014.3

Kaplan extensile lateral approachを用いた尺骨鈎状突起骨折の手術的治療

今谷潤也, 森谷史朗, 前田和茂, 桐田亜希子, 林正典, 尾崎敏文, 秋田恵一

日本整形外科学会雑誌 88 ( 3 ) S779 - S779 2014.3

骨肉腫患者治療後の長期的問題点

武田健, 国定俊之, 長谷井嬢, 上原健敬, 大森敏規, 尾崎敏文

日本整形外科学会雑誌 88 ( 2 ) S131 - S131 2014.3

脛骨・腓骨の骨折高位の違いにより下腿骨幹部骨折は治療成績に差があるか

山川泰明, 野田知之, 上原健敬, 中原龍一, 木浪陽, 島村安則, 尾崎敏文

日本整形外科学会雑誌 88 ( 3 ) S655 - S655 2014.3

不安定型骨盤輪骨折に対するnavigation systemを利用したiliosacral screwの有用性

上原健敬, 木浪陽, 野田知之, 山川泰明, 井上円加, 中原龍一, 島村安則, 尾崎敏文

日本整形外科学会雑誌 88 ( 2 ) S410 - S410 2014.3

家兎骨軟骨欠損モデルにおける可視光硬化ゼラチンおよび結合性改変成長因子CBD-BMP4による組織修復効果

馬崎哲朗, 山根健太郎, 吉田晶, 松川昭博, 伊藤嘉浩, 尾崎敏文

中部日本整形外科災害外科学会雑誌 57 ( 春季学会 ) 124 - 124 2014.3

岡山大学病院における難治性慢性痛に対する集学的治療脱落症例の検討

鉄永倫子, 田中雅人, 杉本佳久, 荒瀧慎也, 瀧川朋亨, 尾崎敏文, 西江宏行, 石川慎一, 井上真一郎, 小田幸治, 太田晴之

日本整形外科学会雑誌 88 ( 3 ) S786 - S786 2014.3

思春期特発性側彎症(Lenke type 1、2)に対する後方矯正固定術後の肩バランスの変化

荒瀧慎也, 田中雅人, 杉本佳久, 瀧川朋亨, 鉄永倫子, 馬崎哲朗, 尾崎修平, 山根健太郎, 篠原健介, 魚谷弘二, 渡邉典行, 尾崎敏文

Journal of Spine Research 5 ( 3 ) 249 - 249 2014.3

思春期特発性側彎症における後方固定術前後の矢状面バランスと骨盤パラメーターの検討

魚谷弘二, 田中雅人, 杉本佳久, 荒瀧慎也, 瀧川朋亨, 鉄永倫子, 馬崎哲朗, 尾崎修平, 山根健太郎, 篠原健介, 尾崎敏文

日本整形外科学会雑誌 88 ( 3 ) S718 - S718 2014.3

In vitro and in vivo enhanced osteogenesis by kaempferol found by a high-throughput assay using human mesenchymal stromal cells Reviewed

Tetsuro Mazaki, Takashi Kitajima, Yasuyuki Shiozaki, Miwa Sato, Megumi Mino, Aki Yoshida, Mariko Nakamura, Yasuhiro Yoshida, Masato Tanaka, Toshifumi Ozaki, Akihiro Matsukawa, Yoshihiro Ito

JOURNAL OF FUNCTIONAL FOODS 6 241 - 247 2014.1

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

High-throughput screening was performed as a phenotypic screening on clinically relevant human mesenchymal stem cells to identify small molecules that affect stem cell fate. From a library of pharmacologically active small molecules, we identified kaempferol, which is a natural flavonol, with a high osteogenic activity. Kaempferol achieved the highest levels of bone-specific markers among the chemicals tested in vitro. The osteogenic activity of kaempferol was the same as that of ipriflavone, which is a synthetic isoflavone, in ovariectomized mouse experiments. Considering that kaempferol is present in various foods such as vegetables and fruits, it will be useful as a new preventive medicine for osteoporosis. (C) 2013 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jff.2013.10.013

A 5-22-year follow-up study of stemmed alumina ceramic total elbow arthroplasties with cement fixation for patients with rheumatoid arthritis Reviewed

Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Makoto Kishimoto, Toshifumi Ozaki, Hajime Inoue

JOURNAL OF ORTHOPAEDIC SCIENCE 19 ( 1 ) 55 - 63 2014.1

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

We determined mid to long-term results of total elbow arthroplasty (TEA) by use of unlinked elbow prostheses with solid alumina ceramic trochleae, and ceramic ulnar stems (stemmed Kyocera type I; SKC-I) for patients with rheumatoid arthritis.
Fifty-four elbows of 39 patients were available for detailed clinical and radiographic review after a follow-up period of at least 5 years. The mean follow-up period was 12.6 years (range 5-22 years). Clinical condition before and after surgery was assessed by use of a modified version of the Mayo Elbow Performance Score (MEPS; 0-100 points) and a Japan Orthopaedic Association Elbow score (JOA score; 0-100 points). The radiographs were reviewed and loosening was defined as a progressive radiolucent line > 1 mm wide that was completely circumferential around the prosthesis. Clinical records of post-operative events affecting the elbows were used for survival analysis of the prostheses using the Kaplan-Meier method.
The average modified MEPS and JOA scores improved significantly from 39.7 +/- A 14.3 to 44.7 +/- A 9.4, respectively, pre-operatively, to 89.7 +/- A 15.4 and 83.1 +/- A 12.8, respectively, post-operatively (P < 0.0001). The functional assessment score also improved from 4.9 +/- A 2.8 to 8.5 +/- A 3.3 points (P < 0.0001). With loosening or implant revision defined as end points, the likelihood of survival of the prosthesis for up to 20 years was 92.6 % (95 % confidence interval (CI), 85.6-100.0) or 86.3 % (95 % CI 75.0-97.6), respectively.
Satisfactory clinical results were obtained after TEA using SKC-I prostheses, which provided excellent pain relief and functional range of motion. The results of our study reveal the high reliability over a long period of the cemented SKC-I prosthesis with an alumina ceramic component.

DOI： 10.1007/s00776-013-0492-0

3Dナビゲーションを用いたIS screw固定術の経験

木浪陽, 野田知之, 上原健敬, 井上円加, 中原龍一, 尾崎敏文

骨折 36 ( 1 ) 61 - 63 2014.1

Language：Japanese Publisher：(一社)日本骨折治療学会

当院では、仙腸関節脱臼骨折および仙骨骨折に対しiliosacral(IS)screwを挿入する場合、3Dナビゲーションを使用しており、その安全性について検討した。2011年4月〜2012年12月の期間、IS screw手技を用いた5症例(男性2例、女性3例)・7本を対象とした。平均年齢は43歳であった。全例、術後1週以内にCTでスクリュー位置を調査した。セッティング時間を除いた挿入時間は1本につき平均20分であった。全例、脊柱管・神経管への迷入や前方骨皮質穿破はなく、スクリュー位置は良好であった。通常透視下でのIS screw挿入は、神経管への迷入や前方骨皮質穿破などの危険があり、安全性には限界がある。3DナビゲーションでのIS screw挿入は、被曝量を軽減しつつ、脊柱管・神経管を確認しながらスクリュー挿入方向と深度を決定でき、正確で安全性が高く有用であった。(著者抄録)

Favorable outcome after complete resection in elderly soft tissue sarcoma patients: Japanese Musculoskeletal Oncology Group study Reviewed

Y. Yoneda, T. Kunisada, N. Naka, Y. Nishida, A. Kawai, T. Morii, K. Takeda, J. Hasei, Y. Yamakawa, T. Ozaki

EJSO 40 ( 1 ) 49 - 54 2014.1

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Background: The surgical management of soft tissue sarcoma (STS) in elderly patients has only been addressed in a few studies. The objective of the current study was to assess surgical outcomes in patients with STS aged 70 years and older and the association of older age with the survival after complete resection.
Methods: A retrospective analysis was conducted in 158 elderly patients with localized STS who visited 11 institutions participating in Japanese Musculoskeletal Oncology Group between 1995 and 2006 and were treated by surgical resection. Univariate and multivariate analyses were performed to identify prognostic factors.
Results: Median follow-up period was 38 months. Histologically high-grade tumors were detected in 71% of the patients. Wide resection with adequate margins was performed in 66% of the cases. Systemic chemotherapy was performed in only 5 patients. Univariate analysis identified histological grade and gender as statistically significant prognostic factors for sarcoma-specific survival. Multivariate analysis did not identify significant prognostic factors for sarcoma-specific survival, although high grade sarcoma emerged as a potentially significant prognostic factor (P = 0.050). Local recurrence was detected in 19% of the patients. Multivariate analysis of local recurrence-free survival showed that tumor site and surgical margins were statistically significant prognostic factors.
Conclusions: Older age was not identified as a prognostic factor for sarcoma-specific survival, which is not consistent with the findings of previous studies showing that older age was associated with decreased sarcoma-specific survival. Complete resection should be indicated and can lead to optimal treatment outcome for properly selected elderly patients. (C) 2013 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.ejso.2013.09.004

Outcome of Conservative Treatment for SRE (Skeletal Related Events) of the Spine

Nakata Eiji, Sugihara Shinsuke, Ozaki Toshifumi

The Journal of the Chugoku-Shikoku Orthopaedic Association 26 ( 2 ) 279 - 283 2014

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We evaluated the outcome of conservative treatment for SRE (skeletal related events) of the spine. Fifty-eight patients (32 men and 26 women, mean age 68 years) were treated at our institution between August 2012 and September 2013. The site of the primary tumor was the lung in 20 patients, breast in 11, prostate in 9, and other sites in 18. Instability of the spine was evaluated using the Spine Instability Neoplastic Score (SINS). Early mobilization was performed based on the stability of the spine estimated by SINS. Pain (Numerical Rating Scale (NRS)), imaging studies of the vertebral body, SINS, and ADL (Barthel Index (BI)) were evaluated at the start and at 1, 2, 3, 4, 6 months. NRS improved over time and in the imaging studies, bone formation was gradually observed in almost all cases after three months. SINS improved over time and about 90% of the patients were considered stable after three months. Although mean BI was 71 initially, it gradually improved and at the time of the last observation the mean BI was 82. Our data suggest that early mobilisation is safe and efficient for selected patients who have received conservative treatment for SRE (skeletal related events) of the spine.

DOI： 10.11360/jcsoa.26.279

Total Hip Arthroplasty Without Blood Transfusion in a Jehovah's Witness : A Case Report

Tanaka Takaaki, Okada Yoshiki, Ozaki Toshifumi, Fujiwara Kazuo, Endo Hirosuke, Nishida Keiichiro

The Journal of the Chugoku-Shikoku Orthopaedic Association 26 ( 2 ) 255 - 259 2014

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Jehovah's Witnesses refuse blood transfusions on the basis of their religious belief. We report our experience with total hip arthroplasty without blood transfusion in a Jehovah's Witness.<br>The patient was a 70-year-old woman who had been receiving treatment for rheumatoid arthritis for 34 year and had been taking anti-platelet agents for atrial fibrillation and hypertension. Plain radiographs revealed severe erosions (Larsen Grade 4) in the right hip. We used a cemented femoral component and reamed the acetabulum gently to minimize any bleeding, while performing intraoperative blood-salvaging autotransfusion.<br>We carried out hybrid total hip arthroplasty with a cementless acetabular component and a cemented femoral component. The operation time was 62 minutes, intraoperative blood loss was 50ml, and postoperative blood loss was 90ml. The preoperative hemoglobin level was 9.9g/dl, and the lowest hemoglobin level was 6.8g/dl after surgery. At the final follow-up, the patient was able to walk with a T-shaped walking stick, and her Japanese Orthopaedics Association score (right/left) was 80 points/81 points on.<br>We considered that the use of a cemented femoral component and gentle reaming of the acetabulum were factors that reduced bleeding during total hip arthroplasty.

DOI： 10.11360/jcsoa.26.255

Clinical Results of Total Shoulder Arthroplasty for Osteoarthritis and Rheumatoid Arthritis

KANAZAWA Tomoko

Japanese Journal of Joint Diseases 33 ( 4 ) 479 - 485 2014

Language：English Publisher：Japanese Society for Joint Diseases

Objective: To investigate the clinical and radiographic results of total shoulder arthroplasty (TSA) for damaged shoulder joints with osteoarthritis (OA) and rheumatoid arthritis (RA).Patients and Methods: From 1999 to 2012 inclusive, we performed 19 total shoulder arthroplasties in 17 patients. A total of sixteen shoulders, five with OA and 11 with RA, from 15 patients were followed up for more than six months. All patients were female, with an average age of 71 years, and an average follow-up period of three years. Preoperative magnetic resonance imaging showed that the supraspinatus tendon was intact in five shoulders (intact group), and torn or thin in 11 shoulders (damaged group), respectively. Clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score, Disabilities of the Arm, Shoulder and Hand (DASH) score and range of motion (ROM). Radiographic loosening of the humeral stem and glenoid component was evaluated according to the criteria described by Stewart.Results: The average JOA score improved from 39.9 points preoperatively to 80.3 points at the final follow-up. The average DASH score improved from 70.1 points to 56.0 points. The range of active flexion, abduction and external rotation significantly improved postoperatively. Radiolucent line evaluation around the glenoid component was observed in two shoulders. There was no significant difference in the improvement of the JOA score between the intact group and the damaged group. In both groups, pain relief was experienced postoperatively, but the improvement in ROM consisting of flexion, abduction and external rotation, was significantly greater in the intact group than in the damaged group. The postoperative JOA score showed a strong inverse correlation with the preoperative DASH score.Conclusion: The results of the current study showed satisfactory clinical outcomes of TSA for OA and RA, particularly with the treatment effect of good postoperative pain relief. Clinical outcome may depend on the preoperative status of the rotator cuff and the function of the upper extremity.

DOI： 10.11551/jsjd.33.479

Other Link： https://jlc.jst.go.jp/DN/JLC/20002300823?from=CiNii

MicroRNAs in Soft Tissue Sarcomas: Overview of the Accumulating Evidence and Importance as Novel Biomarkers Reviewed

Tomohiro Fujiwara, Toshiyuki Kunisada, Ken Takeda, Koji Uotani, Aki Yoshida, Takahiro Ochiya, Toshifumi Ozaki

BIOMED RESEARCH INTERNATIONAL 2014 592868 2014

Language：English Publisher：HINDAWI PUBLISHING CORPORATION

Sarcomas are distinctly heterogeneous tumors and a variety of subtypes have been described. Although several diagnostic explorations in the past three decades, such as identification of chromosomal translocation, have greatly improved the diagnosis of soft tissue sarcomas, the unsolved issues, including the limited useful biomarkers, remain. Emerging reports on miRNAs in soft tissue sarcomas have provided clues to solving these problems. Evidence of circulating miRNAs in patients with soft tissue sarcomas and healthy individuals has been accumulated and is accelerating their potential to develop into clinical applications. Moreover, miRNAs that function as novel prognostic factors have been identified, thereby facilitating their use in miRNA-targeted therapy. In this review, we provide an overview of the current knowledge on miRNA deregulation in soft tissue sarcomas, and discuss their potential as novel biomarkers and therapeutics.

DOI： 10.1155/2014/592868

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

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

Acta Medica Okayama 68 ( 5 ) 303 - 306 2014

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

Strategy of the comminuted fracture of distal end of humerus (AO type C)

IMATANI Junya

The Central Japan Journal of Orthopaedic Surgery & Traumatology 57 ( 5 ) 1177 - 1178 2014

A case report of traumatic atlantooccipital dislocation with internal fixation

WATANABE Noriyuki

The Central Japan Journal of Orthopaedic Surgery & Traumatology 57 ( 5 ) 1013 - 1014 2014

Can we use a 4.0-mm arthroscope for arthroscopic ankle arthrodesis?:—Evaluation by a pre-operative stress X-ray—

SAIGA Kenta

The Central Japan Journal of Orthopaedic Surgery & Traumatology 57 ( 2 ) 419 - 420 2014

Pes equinus secondary to intramascular hemangioma: A case report

ENDO Hirosuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 57 ( 6 ) 1295 - 1296 2014

Elastic Nailing for a Femoral Shaft Fracture in a Preschool Child with Head Injury : A Case Report

Sugiu Kazuhisa, Noda Tomoyuki, Ozaki Toshifumi, Kinami You, Oonishi Manabu, Tsukahara Kouhei, Ujike Yoshihito

The Journal of the Chugoku-Shikoku Orthopaedic Association 26 ( 2 ) 329 - 333 2014

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

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

Chiari Type I Malformation Caused by Craniometaphyseal Dysplasia Reviewed

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

ACTA MEDICA OKAYAMA 67 ( 6 ) 385 - 389 2013.12

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

Factors Predicting Clinical Impairment after Surgery for Cervical Spinal Schwannoma Reviewed

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

ACTA MEDICA OKAYAMA 67 ( 6 ) 343 - 349 2013.12

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

Analysis of MicroRNAs Expressions in Chondrosarcoma Reviewed

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

JOURNAL OF ORTHOPAEDIC RESEARCH 31 ( 12 ) 1992 - 1998 2013.12

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

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 2013.12

Language：Japanese Publisher：(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)

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 Reviewed

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

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 133 ( 10 ) 1401 - 1405 2013.10

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

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

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

ACTA MEDICA OKAYAMA 67 ( 5 ) 311 - 317 2013.10

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

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 2013.10

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 2013.10

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 2013.9

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 2013.9

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 2013.9

Language：Japanese Publisher：(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)

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 2013.9

Transcription factor Mohawk and the pathogenesis of human anterior cruciate ligament degradation. International journal

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 2013.8

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

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

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 2013.8

可視光硬化型ゼラチンとコラーゲン結合性ドメイン連結成長因子を用いた脊髄損傷治療

篠原健介, 馬崎哲朗, 塩崎泰之, 吉田晶, 松川昭博, 尾崎敏文

日本整形外科学会雑誌 87 ( 8 ) S1440 - S1440 2013.8

家兎骨軟骨欠損モデルにおける可視光硬化ゼラチンおよび骨髄間質細胞の組織修復効果

香川洋平, 馬崎哲朗, 塩崎泰之, 山根健太郎, 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 ) S1405 - S1405 2013.8

ケンフェロールが骨粗鬆症モデルマウスの骨吸収と骨組織に与える影響

吉田晶, 塩崎泰之, 馬場哲朗, 山根健太郎, 松川昭博, 北嶋隆, 伊藤嘉浩, 美野愛, 佐藤美和, 尾崎敏文

日本整形外科学会雑誌 87 ( 8 ) S1380 - S1380 2013.8

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, 斉藤太一, 金澤智子, 原田遼三, 町田崇博, 尾崎敏文

日本整形外科学会雑誌 87 ( 8 ) S1321 - S1321 2013.8

PROSNAP人工肘関節置換術の短期成績

那須義久, 西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

岡山医学会雑誌 125 ( 2 ) 183 - 184 2013.8

腫瘍由来エクソソームは骨肉腫の進展においてどのような役割を担うか

藤原智洋, 勝田毅, 小坂展慶, 川井章, 尾崎敏文, 落谷孝広

日本整形外科学会雑誌 87 ( 8 ) S1461 - S1461 2013.8

医学生の臨床実習充実化のために研修医が果たす役割岡山大学病院初期研修医の学生教育に対する意識調査

三好智子, 片岡仁美, 小比賀美香子, 渡辺文恵, 別府治恵, 森祐子, 山根正修, 松川昭博, 尾崎敏文, 谷本光音

医学教育 44 ( Suppl. ) 112 - 112 2013.7

第64回西日本医科学生総合体育大会の安全対策とその結果

森俊太, 高橋政史, 宮澤慎一, 阿部信寛, 古松毅之, 尾崎敏文

日本整形外科スポーツ医学会雑誌 33 ( 3 ) 308 - 315 2013.7

Language：Japanese Publisher：(一社)日本整形外科スポーツ医学会

西日本医科学生総合体育大会は参加者が1万人を超える大きな体育大会である。過去、脊椎損傷や外傷性くも膜下出血といった重度の外傷や夏場の大会であるため熱中症が多く発生している。今大会では過去の事故等を踏まえ、例年行なわれてきた競技会場の近隣の病院や救急隊への協力要請、会場への医師の派遣に加え、緊急連絡網の確立、安全対策講習会の実施、硬式テニスの競技ルールの変更などの安全対策を導入し大会に臨んだ。病院受診が必要なスポーツ外傷や硬式テニスの熱中症件数は減少した。今後も同様に安全対策を続ける必要はあるが、次回大会以降も熱中症や外傷発生数を収集・考察することで、より安全な大会へとしていくべきである。(著者抄録)

モジュラー型硬性胸腰仙椎装具の試作

堅山佳美, 千田益生, 馬崎哲朗, 上原健敬, 尾崎敏文

運動器リハビリテーション 24 ( 2 ) 149 - 149 2013.6

上腕三頭筋切除を要した軟部肉腫の術後患肢機能

武田健, 国定俊之, 長谷井嬢, 井上円加, 大森敏規, 上原健敬, 山川泰明, 尾崎修平, 吉田晶, 尾崎敏文

日本整形外科学会雑誌 87 ( 6 ) S1190 - S1190 2013.6

長期生存が得られた胸椎原発Ewing肉腫の2例

上原健敬, 国定俊之, 武田健, 長谷井嬢, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 87 ( 6 ) S1170 - S1170 2013.6

脛骨骨幹部骨折に合併した腓骨骨折固定の重要性

山川泰明, 野田知之, 上原健敬, 井上円加, 金澤智子, 中原龍一, 木浪陽, 島村安則, 国定俊之, 尾崎敏文

骨折 35 ( Suppl. ) S350 - S350 2013.6

術中3Dナビゲーションを用いたISスクリュー固定術の経験

木浪陽, 野田知之, 山川泰明, 井上円加, 金澤智子, 斉藤太一, 中原龍一, 島村安則, 尾崎敏文

骨折 35 ( Suppl. ) S202 - S202 2013.6

上腕骨近位端骨折に骨幹部骨折を合併した症例にMIPO法によるdouble plate固定を施行した一例

原田遼三, 島村安則, 野田知之, 木浪陽, 中原龍一, 斉藤太一, 金澤智子, 井上円加, 山川泰明, 尾崎敏文

骨折 35 ( Suppl. ) S192 - S192 2013.6

骨肉腫がん幹細胞様性質に対するRNA干渉を応用した前臨床試験とその臨床的意義

藤原智洋, 小坂展慶, 高橋陵宇, 窪田大介, 近藤格, 川井章, 尾崎敏文, 落谷孝広

日本整形外科学会雑誌 87 ( 6 ) S1098 - S1098 2013.6

Tensile strain increases expression of CCN2 and COL2A1 by activating TGF-beta-Smad2/3 pathway in chondrocytic cells Reviewed

Takayuki Furumatsu, Emi Matsumoto, Tomoko Kanazawa, Masataka Fujii, Zhichao Lu, Ryotaro Kajiki, Toshifumi Ozaki

JOURNAL OF BIOMECHANICS 46 ( 9 ) 1508 - 1515 2013.5

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Physiologic mechanical stress stimulates expression of chondrogenic genes, such as multifunctional growth factor CYR61/CTGF/NOV (CCN) 2 and alpha 1(II) collagen (COL2A1), and maintains cartilage home-ostasis. In our previous studies, cyclic tensile strain (CTS) induces nuclear translocation of transforming growth factor (TGF)-beta receptor-regulated Smad2/3 and the master chondrogenic transcription factor Srytype HMG box (SOX) 9. However, the precise mechanism of stretch-mediated Smad activation remains unclear in transcriptional regulation of CCN2 and COL2A1. Here we hypothesized that CTS may induce TGF-beta 1 release and stimulate Smad-dependent chondrogenic gene expression in human chondrocytic SW1353 cells. Uni-axial CTS (0.5 Hz, 5% strain) stimulated gene expression of CCN2 and COL2A1 in SW1353 cells, and induced TGF-beta 1 secretion. CCN2 synthesis and nuclear translocalization of Smad2/3 and SOX9 were stimulated by CTS. In addition, CTS increased the complex formation between phosphorylated Smad2/3 and SOX9. The CCN2 promoter activity was cooperatively enhanced by CIS and Smad3 in luciferase reporter assay. Chromatin immunoprecipitation revealed that CTS increased Smad2/3 interaction with the CCN2 promoter and the COL2A1 enhancer. Our results suggest that CTS epigenetically stimulates CCN2 transcription via TGF-beta 1 release associated with Smad2/3 activation and enhances COL2A1 expression through the complex formation between SOX9 and Smad2/3. (C) 2013 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jbiomech.2013.03.028

Efficacy of low-intensity pulsed ultrasound treatment for surgically managed fresh diaphyseal fractures of the lower extremity: multi-center retrospective cohort study.

Yo Kinami, Tomoyuki Noda, Toshifumi Ozaki

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 18 ( 3 ) 410 - 8 2013.5

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

BACKGROUND: There are no evidence on the effects of low-intensity pulsed ultrasound (LIPUS) on surgically managed fresh fractures. We therefore performed a multicenter retrospective cohort study to investigate the effects of LIPUS on surgically managed fresh fractures. METHODS: This study included patients surgically treated for diaphyseal fractures of the femur or tibia between August 2009 and July 2010 at 14 institutions. Outcome was the union period. We performed an overall comparison of the LIPUS group (78 cases) with the control group (63 cases), as well as subgroup analyses comparing outcomes for fracture sites, fracture types, soft tissue conditions, and fixation methods between the groups. RESULTS: There was no significant difference between the groups in terms of distribution of cases by fracture site, fracture type, soft tissue condition, fixation method. Analyses comparing subgroups, however, showed significant differences between the two groups, particularly in relation to type C fractures, regardless of whether all cases or only closed-fracture cases were analyzed: there was an approximately 30 % reduction in the union period for type C fractures in the LIPUS group. There were also cases requiring reoperation due to lack of stability, even among the type C fractures. CONCLUSIONS: LIPUS is effective for surgically managed, fresh, type C comminuted diaphyseal fractures of the lower limbs when there is appropriate stability at the fracture site.

DOI： 10.1007/s00776-013-0358-5

開放性骨盤骨折の治療経験

斎藤太一, 野田知之, 島村安則, 尾崎敏文, 木浪陽, 皆川寛

骨折 35 ( 2 ) 319 - 323 2013.5

Language：Japanese Publisher：(一社)日本骨折治療学会

開放性骨盤骨折は重症度、死亡率とも極めて高く、治療に難渋する損傷である。今回4症例の治療経験につき検討した。症例は7〜47歳でいずれも男性、骨盤骨折:3例、寛骨臼骨折:1例であり全症例において会陰部周囲に開放創を伴っていた。ISSは平均48点で、骨盤骨折に対しては3症例で初期治療の段階で創外固定を使用、広範囲開放創に対しては3症例でVACを使用した。1症例は一時的に大動脈閉鎖カテーテルを使用し、1症例は選択的動脈塞栓術を行った。直腸損傷は3症例で見られ、最終的にはMiles手術を行った。尿道損傷は1例で見られ、膀胱瘻を初期治療の段階で造設した。治療においては急性期の出血コントロールに加えて感染に起因する敗血症、多臓器不全に対する対策が重要となる。そのため骨盤骨折に対する治療だけでなく、止血法の選択、膀胱瘻や人工肛門造設と肛側腸管内の洗浄など、複数科にわたる集学的医療が不可欠である。(著者抄録)

Chondromodulin-I derived from the inner meniscus prevents endothelial cell proliferation Reviewed

Masataka Fujii, Takayuki Furumatsu, Yusuke Yokoyama, Tomoko Kanazawa, Yuya Kajiki, Nobuhiro Abe, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC RESEARCH 31 ( 4 ) 538 - 543 2013.4

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

The meniscus is a fibrocartilaginous tissue that plays an important role in controlling complex biomechanics of the knee. A perimeniscal capillary plexus supplies the outer meniscus, whereas the inner meniscus is composed of avascular tissue. Anti-angiogenic molecules, such as chondromodulin-I (ChM-I) and endostatin, have pivotal roles in preserving the avascularity of cartilage. However, the anti-angiogenic role of ChM-I is unclear in the meniscus. We hypothesized that the inner meniscus might maintain its avascular feature by expressing ChM-I. Immunohistochemical analyses revealed that ChM-I was mainly detected in the inner and superficial zones of the meniscus. On the other hand, endostatin distribution was similar between the inner and outer meniscus. In Western blot, ChM-I was detected only in the inner meniscus, whereas endostatin was equally observed in both inner and outer menisci. In addition, ChM-I concentration of the inner meniscus-derived conditioned medium was higher than that of the outer meniscus-derived medium. ChM-I removal from the inner meniscus-derived medium and functional blocking of ChM-I significantly increased endothelial cell proliferation. In this study, we demonstrated that the inner meniscus contained larger amounts of ChM-I, and that the inner meniscus-derived ChM-I inhibited endothelial cell proliferation. Our results suggest that ChM-I may be a key anti-angiogenic factor for maintaining the avascularity of the inner meniscus. (c) 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 538543, 2013

DOI： 10.1002/jor.22257

股関節固定術後にTHAを施行した一例

上原健敬, 岡田芳樹, 尾崎敏文, 遠藤裕介, 藤原一夫

中国・四国整形外科学会雑誌 25 ( 1 ) 229 - 229 2013.4

骨盤骨腫瘍

武田健, 上原健敬, 大森敏規, 原田遼三, 長谷井嬢, 吉田晶, 尾崎敏文, 国定俊之

中国・四国整形外科学会雑誌 25 ( 1 ) 239 - 239 2013.4

再発した手関節尺側部痛の1例

金澤智子, 島村安則, 大森敏規, 篠原健介, 原田遼三, 山川泰明, 小澤正嗣, 井上円加, 斉藤太一, 中原龍一, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 25 ( 1 ) 245 - 245 2013.4

Dupuytren拘縮の術後成績

斎藤太一, 島村安則, 井上円加, 小澤正嗣, 尾崎敏文

日本手外科学会雑誌 30 ( 1 ) 2 - 25 2013.4

橈骨遠位端骨折に対するMIPO法による治療成績

島村安則, 野田知之, 斉藤太一, 中原龍一, 尾崎敏文

日本手外科学会雑誌 30 ( 1 ) 1 - 6 2013.4

Dual Programmed Cell Death Pathways Induced by p53 Transactivation Overcome Resistance to Oncolytic Adenovirus in Human Osteosarcoma Cells Reviewed

Joe Hasei, Tsuyoshi Sasaki, Hiroshi Tazawa, Shuhei Osaki, Yasuaki Yamakawa, Toshiyuki Kunisada, Aki Yoshida, Yuuri Hashimoto, Teppei Onishi, Futoshi Uno, Shunsuke Kagawa, Yasuo Urata, Toshifumi Ozaki, Toshiyoshi Fujiwara

MOLECULAR CANCER THERAPEUTICS 12 ( 3 ) 314 - 325 2013.3

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER ASSOC CANCER RESEARCH

Tumor suppressor p53 is a multifunctional transcription factor that regulates diverse cell fates, including apoptosis and autophagy in tumor biology. p53 overexpression enhances the antitumor activity of oncolytic adenoviruses; however, the molecular mechanism of this occurrence remains unclear. We previously developed a tumor-specific replication-competent oncolytic adenovirus, OBP-301, that kills human osteosarcoma cells, but some human osteosarcoma cells were OBP-301-resistant. In this study, we investigated the antitumor activity of a p53-expressing oncolytic adenovirus, OBP-702, and the molecular mechanism of the p53-mediated cell death pathway in OBP-301-resistant human osteosarcoma cells. The cytopathic activity of OBP-702 was examined in OBP-301-sensitive (U2OS and HOS) and OBP-301-resistant (SaOS-2 and MNNG/HOS) human osteosarcoma cells. The molecular mechanism in the OBP-702-mediated induction of two cell death pathways, apoptosis and autophagy, was investigated in OBP-301-resistant osteosarcoma cells. The antitumor effect of OBP-702 was further assessed using an orthotopic OBP-301-resistant MNNG/HOS osteosarcoma xenograft tumor model. OBP-702 suppressed the viability of OBP-301-sensitive and -resistant osteosarcoma cells more efficiently than OBP-301 or a replication-deficient p53-expressing adenovirus (Ad-p53). OBP-702 induced more profound apoptosis and autophagy when compared with OBP-301 or Ad-p53. E1A-mediated miR-93/106b upregulation induced p21 suppression, leading to p53-mediated apoptosis and autophagy in OBP-702-infected cells. p53 overexpression enhanced adenovirus-mediated autophagy through activation of damage-regulated autophagy modulator (DRAM). Moreover, OBP-702 suppressed tumor growth in an orthotopic OBP-301-resistant MNNG/HOS xenograft tumor model. These results suggest that OBP-702-mediated p53 transactivation is a promising antitumor strategy to induce dual apoptotic and autophagic cell death pathways via regulation of miRNA and DRAM in human osteosarcoma cells. Mol Cancer Ther; 12(3); 314-25. (C)2012 AACR.

DOI： 10.1158/1535-7163.MCT-12-0869

[A case of synovial sarcoma with brain metastasis treated with surgical resection and stereotactic radiosurgery]. Reviewed

Otani Y, Ichikawa T, Kurozumi K, Yanai H, Kunisada T, Ozaki T, Date I

No shinkei geka. Neurological surgery 41 ( 3 ) 255 - 262 2013.3

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

Synovial sarcomas compromise between 5 to 10% of all soft tissue sarcomas in adults. Synovial sarcoma commonly occurs in the vicinity of the large joints and cranial metastasis is rare. Here, we describe a case with intracranial metastases of a synovial sarcoma. A 41-year-old woman was admitted to our department with sensory aphasia. She had a history of a left inguinal synovial sarcoma and underwent surgery and chemotherapy for primary and metastatic lesions. Head MRI revealed three gadolinium-enhancing lesions in the left frontal, parietal and parietotemporal lobe. Gross total resection was achieved in the left parietotemporal lesion and pathological diagnosis was synovial sarcoma. Two weeks after surgery, she received cyber-knife radiosurgery and her neurological deficit was almost completely resolved. Intracranial metastatic synovial sarcoma is rare. Surgical resection and stereotaxic radiosurgery was very effective in the present case.

[Update on microRNAs research in sarcoma: review the literature and proposal of the clinical application].

Tomohiro Fujiwara, Akira Kawai, N Kosaka, Toshifumi Ozaki, Takahiro Ochiya

Gan to kagaku ryoho. Cancer & chemotherapy 40 ( 3 ) 305 - 13 2013.3

硬組織接着性多糖誘導体リン酸化プルランの骨再生能の検討

山根健太郎, 塩崎泰之, 馬崎哲朗, 杉本佳久, 瀧川朋亨, 田中雅人, 松川昭博, 尾崎敏文

Journal of Spine Research 4 ( 3 ) 575 - 575 2013.3

RAに対するBio製剤使用中の整形外科手術 Bio使用中患者の整形外科手術の適応

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 町田崇博, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 57回・22回 204 - 204 2013.3

臨床研究支援のためのスコア入力・自動統計システムの開発

中原龍一, 西田圭一郎, 橋詰謙三, 小澤正嗣, 齋藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 3 ) S910 - S910 2013.3

JACE型人工肘関節置換術の中期成績

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 那須義久, 齋藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 3 ) S818 - S818 2013.3

関節リウマチ肘に対するPROSNAP型人工肘関節の術後成績

齋藤太一, 西田圭一郎, 橋詰謙三, 中原龍一, 小澤正嗣, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 3 ) S733 - S733 2013.3

三次元テンプレートを使用した脛骨近位端外側用プレート設置の検討

山川泰明, 中原龍一, 野田知之, 井上円加, 小澤正嗣, 金澤智子, 齋藤太一, 島村安則, 木浪陽, 尾崎敏文

日本整形外科学会雑誌 87 ( 2 ) S300 - S300 2013.3

関節リウマチにおける生物学的製剤と各関節に対する手術の役割 Bio使用中関節リウマチ患者に対する肘関節手術の有用性

西田圭一郎, 金澤智子, 中原龍一, 橋詰謙三, 齋藤太一, 小澤正嗣, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 87 ( 2 ) S251 - S251 2013.3

RAに対するSwansonとAVANTAによるMP人工指関節置換術の治療成績

原田遼三, 西田圭一郎, 橋詰謙三, 中原龍一, 齋藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本整形外科学会雑誌 87 ( 2 ) S83 - S83 2013.3

関節リウマチの手術上肢 RAにおけるNalebuff type I(ボタン穴変形)の治療成績

原田遼三, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 57回・22回 403 - 403 2013.3

骨・軟骨・滑膜細胞伸展装置を用いたメカニカルストレスに対するヒアルロン酸のヒト軟骨破壊抑制効果

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 57回・22回 317 - 317 2013.3

岡山大学病院における難治性慢性痛に対する新しい試み痛みリエゾン外来

鉄永倫子, 田中雅人, 杉本佳久, 瀧川朋亨, 尾崎敏文, 太田晴之, 千田益夫, 西江宏行, 石川慎一, 溝渕知司, 井上真一郎

日本整形外科学会雑誌 87 ( 2 ) S504 - S504 2013.3

骨・軟部腫瘍骨軟部腫瘍におけるmicroRNAの最新の知見と臨床応用への挑戦

藤原智洋, 川井章, 小坂展慶, 尾崎敏文, 落谷孝広

癌と化学療法 40 ( 3 ) 305 - 313 2013.3

寛骨臼骨折に対する観血的整復内固定術後合併症についての検討

土井武, 竹下歩, 小田孔明, 野田知之, 尾崎敏文

日本整形外科学会雑誌 87 ( 3 ) S626 - S626 2013.3

Multiple Regression Analysis for Grading and Prognosis of Cubital Tunnel Syndrome: Assessment of Akahori's Classification Reviewed

Masutaka Watanabe, Seizaburo Arita, Hiroyuki Hashizume, Mitsugi Honda, Keiichiro Nishida, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 67 ( 1 ) 35 - 44 2013.2

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

The purpose of this study was to quantitatively evaluate Akahori's preoperative classification of cubital tunnel syndrome. We analyzed the results for 57 elbows that were treated by a simple decompression procedure from 1997 to 2004. The relationship between each item of Akahori's preoperative classification and clinical stage was investigated based on the parameter distribution. We evaluated Akahori's classification system using multiple regression analysis, and investigated the association between the stage and treatment results. The usefulness of the regression equation was evaluated by analysis of variance of the expected and observed scores. In the parameter distribution, each item of Akahori's classification was mostly associated with the stage, but it was difficult to judge the severity of palsy. In the mathematical evaluation, the most effective item in determining the stage was sensory conduction velocity. It was demonstrated that the established regression equation was highly reliable (R = 0.922). Akahori's preoperative classification can also be used in postoperative classification, and this classification was correlated with postoperative prognosis. Our results indicate that Akahori's preoperative classification is a suitable system. It is reliable, reproducible and well-correlated with the postoperative prognosis. In addition, the established prediction formula is useful to reduce the diagnostic complexity of Akahori's classification.

Comparison between normal and loose fragment chondrocytes in proliferation and redifferentiation potential Reviewed

Kenichiro Sakata, Takayuki Furumatsu, Shinichi Miyazawa, Yukimasa Okada, Masataka Fujii, Toshifumi Ozaki

INTERNATIONAL ORTHOPAEDICS 37 ( 1 ) 159 - 165 2013.1

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

Loose fragments in osteochondritis dissecans (OCD) of the knee require internal fixation. On the other hand, loose fragments derived from spontaneous osteonecrosis of the knee (SONK) are usually removed. However, the difference in healing potential between OCD- and SONK-related loose fragments has not been elucidated. In this study, we investigated proliferative activity and redifferentiation potential of normal cartilage-derived and loose fragment-derived chondrocytes.
Cells were prepared from normal articular cartilages and loose fragment cartilages derived from knee OCD and SONK. Cellular proliferation was compared. Redifferentiation ability of pellet-cultured chondrocytes was assessed by real-time PCR analyses. Mesenchymal differentiation potential was investigated by histological analyses. Positive ratio of a stem cell marker CD166 was evaluated in each cartilaginous tissue.
Normal and OCD chondrocytes showed a higher proliferative activity than SONK chondrocytes. Chondrogenic pellets derived from normal and OCD chondrocytes produced a larger amount of safranin O-stained proteoglycans compared with SONK-derived pellets. Expression of chondrogenic marker genes was inferior in SONK pellets. The CD166-positive ratio was higher in normal cartilages and OCD loose fragments than in SONK loose fragments.
The OCD chondrocytes maintained higher proliferative activity and redifferentiation potential compared with SONK chondrocytes. Our results suggest that chondrogenic properties of loose fragment-derived cells and the amount of CD166-positive cells may affect the repair process of osteochondral defects.

DOI： 10.1007/s00264-012-1728-x

Histone deacetylase inhibitors suppress mechanical stress-induced expression of RUNX-2 and ADAMTS-5 through the inhibition of the MAPK signaling pathway in cultured human chondrocytes

Saito T., Nishida K., Furumatsu T., Yoshida A., Ozawa M., Ozaki T.

Osteoarthritis and Cartilage 21 ( 1 ) 165 - 174 2013.1

Total Hip Arthroplasty for Hip Ankylosis due to Juvenile Idiopathic Arthritis : A Case Report

Harada Ryozo, Fujiwara Kazuo, Misawa Haruo, Miyake Yoshiaki, Okada Yoshiki, Ozaki Toshifumi, Endo Hirosuke

The Journal of the Chugoku-Shikoku Orthopaedic Association 25 ( 1 ) 13 - 17 2013

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

In patients with variable changes in pelvic inclination, total hip arthroplasty (THA) is required for accurate cup installation to prevent dislocation. Here we reported the use of THA for hip ankylosis due to juvenile idiopathic arthritis (JIA) and variable pelvic inclination with changes in posture. The patient was a 55-year-old woman, who had received medical treatment for JIA until the age of 14 year. She had been examined two years previously for bilateral leg pain and gait disturbance. Clinically, the lumbar spine had degenerative changes and the left hip joint was ankylosed at a 50-degree -flexed position, causing severe lordosis of the pelvis and lumbar spine and more severe lordosis during changes in posture. We treated the lumbar spine by laminectomy, and then THA was performed under a navigation system. Postoperatively, the patient was relieved of her symptoms and her ambulatory ability was improved. Anteversion of the pelvis with changes in posture remains, but the large femoral head has ensured that no dislocation has occurred up to the present.<br>In cases of variable pelvic inclination due to changes in posture, use of a navigation system is useful intraoperatively for accurate cup installation, and a large femoral head matches any postoperative changes in pelvic inclination.

DOI： 10.11360/jcsoa.25.13

Other Link： http://search.jamas.or.jp/link/ui/2013299772

Comparative Analysis of Tunnel Position Between Transtibial and Outside-In Double-Bundle Anterior Cruciate Ligament Reconstruction

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

The Journal of the Chugoku-Shikoku Orthopaedic Association 25 ( 1 ) 73 - 77 2013

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

The present study was conducted to evaluate the femoral and tibial tunnel positions created by the transtibial and outside-in techniques, and to assess the difference in clinical outcome between the two techniques after anterior cruciate ligament (ACL) reconstruction.<br>The study included 45 patients who underwent ACL reconstruction using either the transtibial (n=15) or outside-in (n=30) technique. Computed tomography scans of the treated knees were performed two weeks after surgery, and three-dimensional surface models were then produced. The positions of the femoral tunnels were measured by the quadrant method. Tibial tunnel aperture centers were measured in the anterior-to-posterior and medial-to-lateral directions on the tibial plateau.<br>The clinical outcomes were measured in terms of range of motion, the Lachman test, pivot shift test, KT-2000 arthrometry, and Lysholm score at 6 months after surgery.<br>On the femoral side, outside-in technique can create tunnels more accurately at the anatomic ACL footprint center than the transtibial technique.<br>On the tibial side, the bone tunnel positions for the transtibial and outside-in techniques were both significantly closer to the tunnel position that was indicated by data from previous studies.<br>There were no significant differences between the two groups in any of the physical parameters determined, or the Lysholm score.<br>The outside-in technique showed more accurate positioning of the femoral tunnels than the transtibial technique. It was difficult to create two femoral tunnels using the transtibial technique because the positions of the femoral tunnels are defined by the direction of the tibial tunnel. The present findings suggest that the outside-in technique is useful because it can create accurate positioning of the femoral tunnels independently.

DOI： 10.11360/jcsoa.25.73

Other Link： http://search.jamas.or.jp/link/ui/2013299783

A new navigation system for minimally invasive total knee arthroplasty. Reviewed

Yokoyama Y, Abe N, Fujiwara K, Suzuki M, Nakajima Y, Sugita N, Mitsuishi M, Nakashima Y, Ozaki T

Acta medica Okayama 67 ( 6 ) 351 - 358 2013

Publishing type：Research paper (scientific journal)

A computer-assisted navigation system to be used for total knee arthroplasties (TKAs) was reported to improve the accuracy of bone resection and result in precise implant placement, but the concomitant surgical invasion and time consumption are clinical problems. We developed a computed tomography (CT)-based navigation system (NNS) to be used for minimally invasive TKA. It requires only the reference points from a small limited area of the medial femoral condyle and proximal tibia through a skin incision to obtain optical images. Here we evaluated the usefulness and accuracy of the NNS in comparison with the commercially available BrainLAB image-free navigation system (BLS). In a clinical experiment, the registration times obtained with the NNS tended to be shorter than those obtained with the BLS, but not significantly so. The NNS group tended to be in the extended position in the sagittal plane of the distal femur within 3 degrees, and the BLS group showed rather flexed deviation in the sagittal plane of the anterior femur.

Other Link： http://orcid.org/0000-0002-1369-0747

Management of lumbar artery injury related to pedicle screw insertion. Reviewed

Sugimoto Y, Tanaka M, Gobara H, Misawa H, Kunisada T, Ozaki T

Acta medica Okayama 67 ( 2 ) 113 - 116 2013

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

We report on 2 patients who experienced injury to one of their lumbar arteries related to pedicle screw misplacement. In this report, the lumbar pedicle screw holes were made laterally with resultant injury to the lumbar artery. During surgery, arterial bleeding was controlled with pressure and gauze; however, the patients experienced vital shock after surgery. Vital shock ensued and they were rescued by catheter embolization. If patients receiving lumbar instrumentation surgery experience severe anemia or vital shock postoperatively, the surgeon should assume lumbar artery injury as a differential diagnosis.

DOI： 10.18926/AMO/49670

外科的摘出および定位放射線治療が有用であった転移性滑膜肉腫の1例

大谷理浩, 市川智継, 黒住和彦, 柳井広之, 国定俊之, 尾崎敏文, 伊達勲

Neurological Surgery 41 ( 3 ) 255 - 262 2013

Enhanced in vivo osteogenesis by nanocarrier-fused bone morphogenetic protein-4. Reviewed International journal

Yasuyuki Shiozaki, Takashi Kitajima, Tetsuro Mazaki, Aki Yoshida, Masato Tanaka, Akihiro Umezawa, Mariko Nakamura, Yasuhiro Yoshida, Yoshihiro Ito, Toshifumi Ozaki, Akihiro Matsukawa

International journal of nanomedicine 8 1349 - 60 2013

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

PURPOSE: Bone defects and nonunions are major clinical skeletal problems. Growth factors are commonly used to promote bone regeneration; however, the clinical impact is limited because the factors do not last long at a given site. The introduction of tissue engineering aimed to deter the diffusion of these factors is a promising therapeutic strategy. The purpose of the present study was to evaluate the in vivo osteogenic capability of an engineered bone morphogenetic protein-4 (BMP4) fusion protein. METHODS: BMP4 was fused with a nanosized carrier, collagen-binding domain (CBD), derived from fibronectin. The stability of the CBD-BMP4 fusion protein was examined in vitro and in vivo. Osteogenic effects of CBD-BMP4 were evaluated by computer tomography after intramedullary injection without a collagen-sponge scaffold. Recombinant BMP-4, CBD, or vehicle were used as controls. Expressions of bone-related genes and growth factors were compared among the groups. Osteogenesis induced by CBD-BMP4, BMP4, and CBD was also assessed in a bone-defect model. RESULTS: In vitro, CBD-BMP4 was retained in a collagen gel for at least 7 days while BMP4 alone was released within 3 hours. In vivo, CBD-BMP4 remained at the given site for at least 2 weeks, both with or without a collagen-sponge scaffold, while BMP4 disappeared from the site within 3 days after injection. CBD-BMP4 induced better bone formation than BMP4 did alone, CBD alone, and vehicle after the intramedullary injection into the mouse femur. Bone-related genes and growth factors were expressed at higher levels in CBD-BMP4-treated mice than in all other groups, including BMP4-treated mice. Finally, CBD-BMP4 potentiated more bone formation than did controls, including BMP4 alone, when applied to cranial bone defects without a collagen scaffold. CONCLUSION: Altogether, nanocarrier-CBD enhanced the retention of BMP4 in the bone, thereby promoting augmented osteogenic responses in the absence of a scaffold. These results suggest that CBD-BMP4 may be clinically useful in facilitating bone formation.

DOI： 10.2147/IJN.S44124

The clinical manifestations of lumbar disease are correlated with self-rating depression scale scores Reviewed

Tomoko Tetsunaga, Haruo Misawa, Masato Tanaka, Yoshihisa Sugimoto, Tomonori Tetsunaga, Tomoyuki Takigawa, Toshifumi Ozaki

Journal of Orthopaedic Science 18 ( 3 ) 374 - 379 2013

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

Background: Depression can exacerbate symptoms of chronic pain and worsen disability. The symptoms of lumbar disease may be particularly sensitive to psychological state, but statistical associations between low back pain (LBP) severity and mental health status have not been established. Methods: Of the 151 patients with LBP, 122 completed questionnaires probing depressive symptoms, LBP severity, and degree of disability. In addition to completing self-report questionnaires, patients provided demographic and clinical information. A self-rating depression scale (SDS) was used to screen for depression. Pain and disability were assessed by the visual analog scale (VAS) and the Roland-Morris disability questionnaire (RDQ), respectively. Overall clinical severity was assessed using the Japanese Orthopaedic Association (JOA) score. Kendall's tau correlation coefficients were calculated to examine the relationships among these variables. Results: Ninety-four patients (77 %) were in a depressive state as indicated by SDS score ≥40, including mild depression group (47 patients, SDS score from 40 to 49) and depression group (47 patients, SDS score ≥50). There were only 28 patients in the no depression group (SDS score ≤39). There was no significant difference in both age and pain duration among the three groups. The mean VAS score in the depression group (70 ± 19 mm) was higher than both no depression (41 ± 24 mm) and mild depression groups (52 ± 21 mm). The mean JOA score in the no depression group (14 ± 5.0 points) was higher than both mild depression (12 ± 4.0 points) and depression groups (10 ± 6.0 points). The mean RDQ in the depression group (15.1 ± 6.0 points) was higher than both no depression (6.4 ± 5.0 points) and mild depression groups (10.9 ± 5.4 points). Factors significantly correlated with SDS score included VAS, JOA score, and RDQ score. In contrast, SDS did not correlate with patient age or pain duration. Conclusions: The majority of chronic LBP patients examined were in a depressed state and the severity of depression correlated with pain severity, degree of self-rated disability, and clinical severity. © 2013 The Japanese Orthopaedic Association.

DOI： 10.1007/s00776-013-0363-8

Histological analysis of failed cartilage repair after marrow stimulation for the treatment of large cartilage defect in medial compartmental osteoarthritis of the knee Reviewed

Kenichiro Sakata, Takayuki Furumatsu, Nobuhiro Abe, Shinichi Miyazawa, Yoshimasa Sakoma, Toshifumi Ozaki

Acta Medica Okayama 67 ( 1 ) 65 - 74 2013

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

Bone marrow-stimulating techniques such as microfracture and subchondral drilling are valuable treatments for full-thickness cartilage defects. However, marrow stimulation-derived reparative tissues are not histologically well-documented in human osteoarthritis. We retrospectively investigated cartilage repairs after marrow stimulation for the treatment of large cartilage defects in osteoar-thritic knees. Tissues were obtained from patients who underwent total knee arthroplasty (TKA) after arthroscopic marrow stimulation in medial compartmental osteoarthritis. Clinical findings and cartilage repair were assessed. Sections of medial femoral condyles were histologically investigated by safranin 0 staining and anti-type II collagen antibody. Marrow stimulation decreased the knee pain in the short term. However, varus leg alignment gradually progressed, and TKA conversions were required. The grade of cartilage repair was not improved. Marrow stimulations resulted in insufficient cartilage regeneration on medial femoral condyles. Safranin O-stained proteoglycans and type II collagen were observed in the deep zone of marrow-stimulated holes. This study demonstrated that marrow stimulation resulted in failed cartilage repair for the treatment of large cartilage defects in osteoarthritic knees. Our results suggest that arthroscopic marrow stimulation might not improve clinical symptoms for the long term in patients suffering large osteoarthritic cartilage defects. © 2013 by Okayama University Medical School.

Development of dysphagia and trismus developed after c1-2 posterior fusion in extended position Reviewed

Haruo Misawa, Masato Tanaka, Yoshihisa Sugimoto, Kouichiro Koshimune, Toshifumi Ozaki

Acta Medica Okayama 67 ( 3 ) 185 - 190 2013

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

Cervical misalignment after upper cervical fusion including the occipital bone may cause trismus or dysphagia, because the occipito-atlanto joint is associated with most of the flex and extended motion of the cervical spine. There are no reports of dysphagia and trismus after Cl-2 fusion. The purpose of this paper is to demonstrate the potential risk of dysphagia and trismus even after upper cervical short fusion without the occipital bone. The patient was a 69-year-old man with myelopathy caused by os odontoideum and Klippel-Feil syndrome, who developed dysphagia and trismus immediately after Cl-2 fusion and C3-6 laminoplasty. Radiographs and CT revealed that his neck posture was extended, but his symptoms still existed a week after surgery. The fixation angle was hyperextended 12 days after the first surgery. His symptoms disappeared immediately after revision surgery. The fixation in the neck-flexed position is thought to be the main cause of the patient's post-operative dysphagia and tris-mus. Dysphagia and trismus may occur even after short upper cervical fusion without the occipital bone or cervical fusion in the neck-extended position. The pre-operative cervical alignment and range of motion of each segment should be thoroughly evaluated.

Novel chondrogenic and chondroprotective effects of the natural compound harmine Reviewed

Hara, Emilio Satoshi, Ono, Mitsuaki, Kubota, Satoshi, Sonoyama, Wataru, Oida, Yasutaka, Hattori, Takako, Nishida, Takashi, Furumatsu, Takayuki, Ozaki, Toshifumi, Takigawa, Masaharu, Kuboki, Takuo

Biochimie 95 ( 2 ) 374 - 381 2013

The management of total hip arthroplasty for dislocated hip

ENDO Hirosuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 56 ( 1 ) 25 - 26 2013

Recovery of Motor Function in Patients with Subaxial Cervical Spine Injury Relevant to the Fracture Pattern Reviewed

Yasuyuki Shiozaki, Yasuo Ito, Yoshihisa Sugimoto, Masao Tomioka, Tetsuya Shimokawa, Tetsuro Mazaki, Koichiro Koshimune, Masato Tanaka, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 66 ( 6 ) 469 - 473 2012.12

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

In this study, we studied the relationship between fracture patterns and motor function recovery in 70 consecutive patients with cervical spinal cord injury. Fractures were categorized into 6 fracture types and subdivided into stages according to the Allen-Ferguson classification system: compressive flexion (CF), distractive flexion (DF), compressive extension (CE), distractive extension (DE), vertical compression (VC) and lateral flexion (LF). Paralysis was evaluated using the American Spinal Injury Association (ASIA) impairment scale at the time of injury and 3 months afterwards. The residual rate of complete motor palsy (ASIA grade A or B) at the final examination was higher in those patients with DE fractures than those with CF, DF or CE. The final outcomes were as follows. Of the 14 patients who were classified with CF fractures, residual palsy was frequently seen in patients who had stage 5 injury. Of the 27 patients with DF fractures, residual palsy occurred in about half of the patients who had stage 4 or 5 injury. Of the 18 patients with CE fractures, residual palsy occurred in half of the patients with stage 3 injury or higher. Finally, of the 7 patients with DE fractures, the rate of residual palsy was high even for the stage 1 and 2 cases; indeed, all DE patients who had complete motor palsy at the first examination had residual palsy at the final examination. Accordingly, we conclude that motor recovery may be related to fracture pattern.

Surgical Treatment for Congenital Kyphosis Correction Using Both Spinal Navigation and a 3-dimensional Model Reviewed

Yoshihisa Sugimoto, Masato Tanaka, Ryuichi Nakahara, Haruo Misawa, Toshiyuki Kunisada, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 66 ( 6 ) 499 - 502 2012.12

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

An 11 year-old girl had 66 degrees of kyphosis in the thoracolumbar junction. For the purpose of planning for kyphosis correction, we created a 3-D, full-scale model of the spine and consulted spinal navigation. Three-dimensional models are generally used as tactile guides to verify the surgical approach and portray the anatomic relations specific to a given patient. We performed posterior fusion from Th10 to L3, and vertebral column resection of Th12 and L1. Screw entry points, directions, lengths and diameters were determined by reference to navigation. Both tools were useful in the bone resection. We could easily detect the posterior element to be resected using the 3D model. During the anterior bony resection, navigation helped us to check the disc level and anterior wall of the vertebrae, which were otherwise difficult to detect due to their depth in the surgical field. Thus, the combination of navigation and 3D models helped us to safely perform surgery for a patient with complex spinal deformity.

DOI： 10.18926/AMO/49047

メカニカルストレスによる軟骨基質分解酵素発現に対するヒストン脱アセチル化酵素阻害剤の抑制効果

斎藤太一, 西田圭一郎, 古松毅之, 小澤正嗣, 金澤智子, 原田遼三, 尾崎敏文

移植 47 ( 6 ) 499 - 499 2012.12

クラウドを利用した遠隔カスタムメイドインプラント作成システム

井上円加, 中原龍一, 島村安則, 野田知之, 国定俊之, 尾崎敏文

骨折 34 ( 4 ) 959 - 963 2012.12

Language：Japanese Publisher：(一社)日本骨折治療学会

【目的】当科では鎖骨骨幹部骨折に対し、CT画像を元にプレベンディングしたプレートを用いたMIPO法を行い、良好な結果を得ている。遠隔地の小規模施設でも同様の手術を行うため、クラウドサーバー経由でのCTの編集画像を転送し、作成したプレートを当該施設に輸送して手術を行うシステムを構築した。【方法】健側鎖骨のCT画像からプレベンディング用の画像データを作成する。手術を行う施設で画像処理を行い、クラウドサーバーに匿名化した編集画像を転送する。データを元に当院でプレートをプレベンディングし、当該施設に輸送し、手術を行った。【結果】当該施設でのデータ編集は30分で可能であった。編集後の画像データ量は大幅に削減でき、ネットワーク上での転送に支障はなかった。【結論】当科と手術を行う病院でクラウドサーバーを構築し、低コストでカスタムメイドインプラント作成ネットワークを作り、大学病院の手術方法を他院で実現できた。(著者抄録)

THA再置換遠位横止め式セメントレスロングステムによる人工股関節再置換術の1例

中道亮, 藤原一夫, 遠藤裕介, 三宅由晃, 岡田芳樹, 尾崎敏文

日本人工関節学会誌 42 579 - 580 2012.12

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

66歳男。16年前に人工股関節全置換術(THA)を施行したが、術後3年で感染が生じたためインプラントを抜去して、抗菌剤含有セメントスペーサーを設置した。感染が沈静化した1年後に、セメントロングステムでの再度THAを施行した。その後状態は安定していたが、術後15年頃から左大腿部痛が出現した。X線でステム周囲の広範な空洞化を認め、ステム遠位から大腿骨は内反、前彎変形していた。CTでは、再置換術を行った際のステム遠位端の開窓部と一致して前方皮質の欠損を確認し、AAOS分類でtype IVと診断した。感染の可能性は否定的であった。大腿骨の広範な骨欠損に加え、ステム遠位での大腿骨の角状変形を有していたことから、ステムに前彎をつけた遠位横止め式セメントレスロングステムを用いて再置換術を施行した。術後9ヵ月の現在、1本杖歩行が可能な状態となり、左股関節のJOAスコアは術前31点から71点に改善した。

Mechanical stretch increases Smad3-dependent CCN2 expression in inner meniscus cells Reviewed

Takayuki Furumatsu, Tomoko Kanazawa, Yoshiaki Miyake, Satoshi Kubota, Masaharu Takigawa, Toshifumi Ozaki

JOURNAL OF ORTHOPAEDIC RESEARCH 30 ( 11 ) 1738 - 1745 2012.11

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

The intrinsic zone-specific properties of the menisci are determined by biomechanical environments. In this study, we examined mechanical stretch-dependent expression of multifunctional growth factor CYR61/CTGF/NOV (CCN) 2, and investigated the role of CCN2 in meniscus cells. Uni-axial cyclic tensile strain (CTS) was applied using a STB-140 system. CTS-induced expression of CCN2 and a1(I) collagen (COL1A1) was assessed by quantitative real-time PCR analysis. The distribution of CCN2 and Smad2/3 in stretched cells was investigated by immunohistochemical analysis. Smad2/3-dependent CCN2 transactivation was measured by luciferase reporter assay. The relationship between Smad2/3 and CTS-induced CCN2 transcription was investigated by chromatin immunoprecipitation. CTS stimulated gene expression of CCN2 and COL1A1 in inner meniscus cells, but not in outer meniscus cells. Recombinant CCN2 increased COL1A1 expression only in inner meniscus cells. CCN2 synthesis and nuclear translocalization of phosphorylated Smad2/3 in inner meniscus cells were stimulated by CTS. The CCN2 promoter activity was synergistically enhanced by overexpressed Smad3 in stretched inner meniscus cells, but was not by Smad2. Chromatin immunoprecipitation revealed that CTS increased the association between Smad3 and the Smad-binding element on the CCN2 proximal promoter in inner meniscus cells. Our results suggest that stretch-induced CCN2 may have a crucial role in regulating COL1A1 expression in the inner meniscus. (c) 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:17381745, 2012

DOI： 10.1002/jor.22142

MIS手術におけるロッキングプレートの応用上肢骨折における最小侵襲プレート骨接合術(MIPO)による治療成績

島村安則, 中原龍一, 井上円加, 斉藤太一, 金澤智子, 小澤正嗣, 中道亮, 山川泰明, 野田知之, 尾崎敏文, 橋詰博行, 島村好信

日本最小侵襲整形外科学会誌 12 ( 1 ) 84 - 84 2012.11

Dual Energy CTを用いた骨抽出性能の向上

中原龍一, 西田圭一郎, 金澤智子, 原田遼三, 小澤正嗣, 斎藤太一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 243 - 243 2012.10

当科における人工肩関節置換術(TSA)の治療成績の検討

金澤智子, 西田圭一郎, 橋詰謙三, 島村安則, 中原龍一, 斉藤太一, 小澤正嗣, 那須義久, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 317 - 317 2012.10

岡山大学病院における難治性慢性疼痛に対する新しい試み痛み・リエゾン外来

鉄永倫子, 田中雅人, 尾崎敏文, 西江宏行, 石川慎一, 溝渕知司, 井上真一郎, 宮脇卓也, 太田晴之, 千田益夫

中国・四国整形外科学会雑誌 24 ( 3 ) 486 - 486 2012.10

RAにおけるSwansonとAvantaによるMP人工指関節置換術の治療成績

原田遼三, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 317 - 317 2012.10

人工関節再置換術原因と成否のポイント<パート1.肘 TEA> 岡山大式人工肘関節再置換術例の検討

西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 314 - 314 2012.10

大腿骨遠位骨幹部骨折偽関節の治療経験

山川泰明, 野田知之, 井上円加, 金澤智子, 長谷井嬢, 斎藤太一, 中原龍一, 島村安則, 尾崎敏文, 木浪陽, 皆川寛, 高城康師, 川上和秀

中国・四国整形外科学会雑誌 24 ( 3 ) 503 - 503 2012.10

関節リウマチの足関節、中後足部変形に対する治療成績

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 原田遼三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 371 - 371 2012.10

バイオ製剤使用のストラテジー並びにバイオ製剤無効例への対応と展望 Bio製剤効果不十分例に対する整形外科手術の有効性

西田圭一郎, 金澤智子, 中原龍一, 橋詰謙三, 斎藤太一, 小澤正嗣, 原田遼三, 尾崎敏文

日本関節病学会誌 31 ( 3 ) 259 - 259 2012.10

Tc-99m DMSA (V) scintigraphy for evaluation in patients with cartilaginous bone tumor

T. Shinya, S. Sato, A. Alafate, H. Gobara, K. Kato, T. Kunisada, T. Ozaki, S. Kanazawa

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 39 S473 - S474 2012.10

MicroRNA-21 correlates with tumorigenesis in malignant peripheral nerve sheath tumor (MPNST) via programmed cell death protein 4 (PDCD4) Reviewed

Satoru Itani, Toshiyuki Kunisada, Yuki Morimoto, Aki Yoshida, Tsuyoshi Sasaki, Sachio Ito, Mamoru Ouchida, Shinsuke Sugihara, Kenji Shimizu, Toshifumi Ozaki

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 138 ( 9 ) 1501 - 1509 2012.9

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

We investigated the miRNA profile in peripheral nerve tumors and clarified the involvement of miRNA in the development and progression of MPNST in comparison with neurofibroma (NF). In addition, we attempted to seek associations between the miRNA and their potential targets in MPNST.
Global miRNA expression profiling was investigated for clinical samples of 6 MPNSTs and 6 NFs. As detected by profiling analysis, the expressions of miR-21 in clinical samples of 12 MPNSTs, 11 NFs, and 5 normal nerves, and 3 MPNST cell lines were compared using quantitative real-time reverse transcription PCR. MPNST cell line (YST-1) was transfected with miR-21 inhibitor to study its effects on cell proliferation, caspase activity, and the expression of miR-21 targets.
Analysis of miRNA expression profiles in MPNST and NF revealed significantly altered expression levels of nine miRNAs, one of those, miR-21, and its putative target, programmed cell death protein 4 (PDCD4), were selected for further studies. miR-21 expression level in MPNST was significantly higher than that in NF (P < 0.05). In MPNST cells, transfection of miR-21 inhibitor significantly increased caspase activity (P < 0.01), significantly suppressed cell growth (P < 0.05), and upregulated protein level of PDCD4, indicating that miR-21 inhibitor could induce cell apoptosis of MPNST cells.
These results suggest that miR-21 plays an important role in MPNST tumorigenesis and progression through its target, PDCD4. MiR-21 and PDCD4 may be candidate novel therapeutic targets against the development or progression of MPNSTs.

DOI： 10.1007/s00432-012-1223-1

Resection of the entire first rib for fibrous dysplasia using a combined posterior-transmanubrial approach. Reviewed

Furukawa M, Soh J, Toyooka S, Ozaki T, Miyoshi S

General thoracic and cardiovascular surgery 60 ( 9 ) 584 - 586 2012.9

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

A 27-year-old woman presented with pain of the left anterior chest of 2-year duration. Chest X-ray revealed a mass in the upper-left lung field and chest computed tomography (CT) a 6-cm first-rib tumor. CT-guided biopsy was performed and the tumor diagnosed as fibrous dysplasia. Because of continued pain, surgery was deemed necessary. Surgery began with the use of the posterior approach in the prone position to expose the first thoracic vertebra and detach the first rib at the costotransverse joint. After transitioning to the spine position, the transmanubrial approach was used to resect the tumor en bloc with the left first rib. Histological examination revealed the tumor to be fibrous dysplasia. Postoperative recovery was uneventful. The outcomes of this case suggest that the combined posterior-transmanubrial approach described here is a safe, successful approach for first-rib resection of a space-occupying tumor that yields good cosmetic results.

DOI： 10.1007/s11748-012-0044-0

下腿骨幹部骨折術後非感染性偽関節の治療戦略

藤原智洋, 野田知之, 中原龍一, 島村安則, 尾崎敏文, 寺田忠司

骨折 34 ( 3 ) 702 - 706 2012.9

Language：Japanese Publisher：(一社)日本骨折治療学会

下腿骨幹部骨折術後非感染性偽関節の治療にはインプラント選択を含めた再内固定方法、骨欠損および変形への対処法など様々な問題点が存在する。当科で経験した5例を検討した。全例男性、手術時平均年齢は46歳、偽関節タイプおよび前回手術法は肥厚型3例(プレート固定1例、血管柄付き骨移植2例)、萎縮型2例(創外固定1例、髄内釘固定1例)。偽関節手術法は、髄内釘固定および髄内釘入れ替えを2例、ロッキングプレート固定を3例に実施し、偽関節部新鮮化・骨移植を4例、部分腓骨切除を併用した変形矯正を3例に行った。全例に骨癒合が得られ、矯正位は良好であった。本偽関節に対しては、適切な手術手技による髄内釘入れ替えを第一選択とし、血管柄付き骨移植後などの髄腔狭小・閉鎖例にはロッキングプレート固定を第二選択として適応し、変形や骨欠損に対する部分腓骨切除や自家骨移植などの併用により治療成績の向上が期待できる。(著者抄録)

Radiographic remodeling of the shoulder joint in a patient with rheumatoid arthritis after 4 years of treatment with etanercept Reviewed

Toshifumi Ozaki, Kenzo Hashizume, Ryuichi Nakahara, Keiichiro Nishida

MODERN RHEUMATOLOGY 22 ( 4 ) 635 - 637 2012.8

Segmental Pedicle Screw Fixation for a Scoliosis Patient with Post-laminectomy and Post-irradiation Thoracic Kyphoscoliosis of Spinal Astrocytoma Reviewed

Masato Tanaka, Yoshihiro Sugimoto, Haruo Misawa, Tomoyuki Takigawa, Toshiyuki Kunisada, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 66 ( 4 ) 363 - 368 2012.8

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

Spinal deformity is an important clinical manifestation after surgery for spinal cord tumors. One-third of patients who receive laminectomies and irradiation of the spinal column develop scoliosis, kyphosis, or kyphoscoliosis. Recent reports indicate good results after scoliosis surgery using segmental pedicle screws and a navigation system, but these reported studies have not included surgery for post-laminectomy kyphosis. Hooks and wires are ineffective in such patients who undergo laminectomy, and there are also high perioperative risks with insertion of pedicle screws because landmarks have been lost. Here, we report on the 5-year follow-up of a 13-year-old male patient with post-laminectomy and post-irradiation thoracic kyphoscoliosis after surgical treatment of spinal astrocytoma. Posterior segmental pedicle screw fixation was performed safely using a computer-assisted technique. The authors present the first case report for treatment of this condition using a navigation system.

DOI： 10.18926/AMO/48692

An anatomical study of the watershed line on the volar, distal aspect of the radius: Implications for plate placement and avoidance of tendon ruptures Reviewed

Junya Imatani, Keiichi Akita, Kumiko Yamaguchi, Hirotaka Shimizu, Hidenori Kondou, Toshifumi Ozaki

Journal of Hand Surgery 37 ( 8 ) 1550 - 1554 2012.8

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

Purpose: The watershed line is a useful surgical landmark for positioning a volar locking plate. Implants placed on or distal to it can impinge on flexor tendons and cause injury. However, the details of the anatomy of this line are unclear. We studied macroscopically and histologically the structures of the volar aspect of the distal radius. Methods: We studied 20 distal forearm regions of 10 cadavers (5 males and 5 females
mean age, 79 y [range, 56-88 y]) to clarify the details of the watershed line. In 16 specimens, we investigated the macroscopic appearance of the volar aspect of the radius and the relationships among the bone, the volarradiocarpal ligaments, and the pronator quadratus. Histological analyses were performed in 4 specimens of 2 cadavers to examine the morphology of the margin of the bony structures. Results: In the medial half of the distal volar radius, 2 lines were identified by direct macroscopic visualization
one was the proximal line that corresponded to the distal ridge of the pronator fossa, and the other was the distal line, which was more prominent. A medial bony prominence was situated on the distal line. In the lateral half, the distal and proximal lines of the medial half merged to form a single line. A lateral prominence was situated on this line. Conclusions: The watershed line might not be a distinct line, and it corresponds to the distal margin of the pronator fossa in the lateral half of the volar radius and to a hypothetical line between the distal and proximal lines in the medial half. The medial and lateral bony prominences on the volar radius should be key structures for accurate plate placement to avoid flexor tendon injury. Clinical relevance: The present study suggests bony landmarks for positioning a volar locking plate. © 2012 American Society for Surgery of the Hand.

DOI： 10.1016/j.jhsa.2012.05.011

FAI治療に対する3Dボーンモデルの有用性

遠藤裕介, 岡田芳樹, 中原龍一, 藤原一夫, 三宅由晃, 尾崎敏文, 三谷茂

Hip Joint 38 110 - 113 2012.8

Language：Japanese Publisher：日本股関節学会

観血的治療を施行したfemoroacetabular impingement患者2例(症例1:34歳男、症例2:22歳男)において、術前のCTデータより3Dボーンモデルを作成し、それを参考にして臼蓋側と大腿骨側のトリミングを行った。術前のボーンモデルにおける関節可動域は外転0°回旋0°における最大屈曲角度が症例1で77°、症例2が73°であり、外転0°屈曲60°における最大内旋角度はそれぞれ20°、10°であった。術後に作成したボーンモデルによる関節可動域は最大屈曲角度が症例1で80°、症例2が76°、最大内旋角度はそれぞれ28°、14°であった。術後の両症例平均角度は屈曲で3°、内旋で5°改善した。X線評価ではCE角が術前平均37°から27°、α角は69°から43°となった。両症例とも術後6週時には可動域は術前と同程度に回復しており、安静時痛は消失してインピンジメントテストは陰性であった。術後3ヵ月からの負担の軽いスポーツ活動を許可している。

メカニカルストレスによる軟骨基質分解酵素発現に対するヒストン脱アセチル化酵素阻害薬の抑制効果

斎藤太一, 西田圭一郎, 古松毅之, 小澤正嗣, 金澤智子, 原田遼三, 尾崎敏文

日本整形外科学会雑誌 86 ( 8 ) S1219 - S1219 2012.8

新規microRNA阻害剤による骨肉腫に対する前臨床試験

藤原智洋, 小坂展慶, 吉岡祐亮, 萩原啓太郎, 竹下文隆, 窪田大介, 川井章, 尾崎敏文, 落谷孝広

日本整形外科学会雑誌 86 ( 8 ) S1313 - S1313 2012.8

microRNA機能阻害によるがん幹細胞制御を目的とした骨肉腫に対する新規治療戦略(A Novel Therapeutic Strategy against Tumor-initiating Cells of Osteosarcoma: microRNA Inhibition with Current Treatment)

藤原智洋, 小坂展慶, 高橋陵宇, 吉岡祐亮, 萩原啓太郎, 竹下文隆, 窪田大介, 近藤格, 川井章, 尾崎敏文, 落合孝広

日本癌学会総会記事 71回 273 - 273 2012.8

RNA干渉による原発性および転移性骨腫瘍の制御

藤原智洋, 竹下文隆, 川井章, 尾崎敏文, 落谷孝広

日本骨代謝学会学術集会プログラム抄録集 30回 146 - 146 2012.7

岡山大学病院における、初期研修医アンケートの結果

小比賀美香子, 片岡仁美, 渡辺文恵, 三好智子, 金澤右, 尾崎敏文

医学教育 43 ( Suppl. ) 171 - 171 2012.7

Early Rehabilitation with Weight-bearing Standing-shaking-board Exercise in Combination with Electrical Muscle Stimulation after Anterior Cruciate Ligament Reconstruction Reviewed

Kingo Takahashi, Masamichi Hayashi, Toshihiro Fujii, Kenji Kawamura, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 66 ( 3 ) 231 - 237 2012.6

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

The objective of early rehabilitation after anterior cruciate ligament (ACL) reconstruction is to increase the muscle strength of the lower extremities. Closed kinetic chain (CRC) exercise induces co-contraction of the agonist and antagonist muscles. The purpose of this study was to compare the postoperative muscle strength/mass of subjects who performed our new CKC exercise (new rehabilitation group: group N) from week 4, and subjects who received traditional rehabilitation alone (traditional rehabilitation group: group T). The subjects stood on the device and maintained balance. Then, low-frequency stimulation waves were applied to 2 points each in the anterior and posterior region of the injured thigh 3 times a week for 3 months. Measurement of muscle strength was performed 4 times (before the start, and then once a month). Muscle mass was evaluated in CT images of the extensor and flexor muscles of 10 knees (10 subjects) in each group. The injured legs of group N showed significant improvement after one month compared to group T. The cross-sectional area of the extensor muscles of the injured legs tended to a show a greater increase at 3 months in group N. This rehabilitation method makes it possible to contract fast-twitch muscles, which may be a useful for improving extensor muscle strength after ACL reconstruction.

Statistical Analysis of Prognostic Factors for Survival in Patients with Spinal Metastasis Reviewed

Masaki Kataoka, Toshiyuki Kunisada, Masato Tanaka, Ken Takeda, Satoru Itani, Yoshihisa Sugimoto, Haruo Misawa, Masuo Senda, Shinnosuke Nakahara, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 66 ( 3 ) 213 - 219 2012.6

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

There are a variety of treatment options for patients with spinal metastasis, and predicting prognosis is essential for selecting the proper treatment. The purpose of the present study was to identify the significant prognostic factors for the survival of patients with spinal metastasis. We retrospectively reviewed 143 patients with spinal metastasis. The median age was 61 years. Eleven factors reported previously were analyzed using the Cox proportional hazards model: gender, age, performance status, neurological deficits, pain, type of primary tumor, metastasis to major organs, previous chemotherapy, disease-free interval before spinal metastasis, multiple spinal metastases, and extra-spinal bone metastasis. The average survival of study patients after the first visit to our clinic was 22 months. Multivariate survival analysis demonstrated that type of primary tumor (hazard ratio [HR] = 6.80, p < 0.001), metastasis to major organs (HR = 2.01, p = 0.005), disease-free interval before spinal metastasis (HR = 1.77, p = 0.028), and extra-spinal bone metastasis (HR = 1.75, p = 0.017) were significant prognostic factors. Type of primary tumor was the most powerful prognostic factor. Other prognostic factors may differ among the types of primary tumor and may also be closely associated with primary disease activity. Further analysis of factors predicting prognosis should be conducted with respect to each type of primary tumor to help accurately predict prognosis.

DOI： 10.18926/AMO/48560

Modified posterolateral approachによる脛骨近位部関節内骨折の治療経験

金澤智子, 野田知之, 島村安則, 木浪陽, 中原龍一, 斉藤太一, 井上円加, 小澤正嗣, 山川泰明, 皆川寛, 尾崎敏文

骨折 34 ( Suppl. ) S293 - S293 2012.6

鎖骨骨幹部骨折に対するMIPO法による治療成績(第2報)

島村安則, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 井上円加, 山川泰明, 原田遼三, 中道亮, 島村好信, 国定俊之, 野田知之, 尾崎敏文

骨折 34 ( Suppl. ) S120 - S120 2012.6

開放性骨盤骨折の治療経験

斎藤太一, 野田知之, 島村安則, 木浪陽, 皆川寛, 中原龍一, 小澤正嗣, 井上円加, 金澤智子, 山川泰明, 尾崎敏文

骨折 34 ( Suppl. ) S106 - S106 2012.6

同側骨幹部骨折を伴った脛骨高原陥没骨折に対する外側MIPO法の治療経験

木浪陽, 野田知之, 島村安則, 中原龍一, 斎藤太一, 金澤智子, 井上円加, 山川泰明, 山名圭哉, 臼井正明, 尾崎敏文

骨折 34 ( Suppl. ) S144 - S144 2012.6

CTを使用した脛骨近位端の外側プレート設置に関する三次元的解剖

山川泰明, 中原龍一, 井上円加, 小澤正嗣, 金澤智子, 斎藤太一, 木浪陽, 島村安則, 野田知之, 尾崎敏文

骨折 34 ( Suppl. ) S143 - S143 2012.6

後内側剪断骨片を有する脛骨近位部関節内骨折に対する固定方法の検討

小澤正嗣, 野田知之, 山川泰明, 金澤智子, 長谷井嬢, 齋藤太一, 中原龍一, 木浪陽, 島村安則, 国定俊之, 尾崎敏文

骨折 34 ( Suppl. ) S170 - S170 2012.6

関節内骨折の克服治療成績の向上を目指して関節内骨折の克服治療成績の向上を目指して足関節内骨折

野田知之, 島村安則, 中原龍一, 齋藤太一, 金澤智子, 長谷井嬢, 井上円加, 山川泰明, 国定俊之, 尾崎敏文, 木浪陽

骨折 34 ( Suppl. ) S9 - S9 2012.6

RNA干渉による骨肉腫の幹細胞性の制御

藤原智洋, 小坂展慶, 吉岡祐亮, 高橋陵宇, 竹下文隆, 窪田大介, 川井章, 尾崎敏文, 落谷孝広

日本整形外科学会雑誌 86 ( 6 ) S837 - S837 2012.6

鎖骨骨折後に遅発性腕神経叢麻痺を合併した一例

中道亮, 木浪陽, 杉生和久, 野田知之, 山名圭哉, 臼井正明, 尾崎敏文

骨折 34 ( Suppl. ) S146 - S146 2012.6

A multidisciplinary treatment comprising standard chemotherapy with vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide for Ewing sarcoma family of tumor (ESFT) in Japan: Results of the first Japan Ewing Sarcoma Study (JESS) 04.

Atsushi Makimoto, Motoaki Chin, Minako Sumi, Ryohei Yokoyama, Tsuyoshi Ishida, Hajime Okita, Akinobu Matsuzaki, Atsushi Kikuta, Hiroyoshi Watanabe, Toshifumi Ozaki, Kazuo Isu, Michihiro Yano, Masahito Hatori, Masahito Tsurusawa, Hideaki Ohta, Yoshifumi Kawano, Takeshi Ishii, Hiroshi Kawamoto, Satoshi Morita, Hideo Mugishima

JOURNAL OF CLINICAL ONCOLOGY 30 ( 15 ) 2012.5

多発外傷に伴うfloating shoulderの1例

金澤智子, 島村安則, 野田知之, 西山武, 斎藤太一, 尾崎敏文

骨折 34 ( 2 ) 272 - 274 2012.5

Language：Japanese Publisher：(一社)日本骨折治療学会

【目的】両側floating shoulderは極めて稀であるが、その治療経験を報告する。【症例】49歳、男性。バイク走行中に転倒し、受傷。初療時の単純X線写真、CTで両鎖骨骨折、肩甲骨骨折(右:頸部骨折、左:関節窩骨折、肩峰骨折)を合併したfloating shoulderと診断された。他に第7頸椎椎弓骨折、胸椎破裂骨折、右橈骨尺骨骨幹部開放骨折、右脛骨近位端骨折を合併していた。【手術】全身麻酔下に両側鎖骨に対しプレート固定を行った後に左肩甲骨はスクリューとワイヤーで固定。右側は保存加療とした。【考察】Floating shoulderは高エネルギー外傷によるものが多く、保存療法を選択せざるを得ない症例も多数存在し、良好な治療成績が得にくい。しかし特に今回の症例のように関節窩の転位を伴うような骨折の場合は、患者の状態の許す限り積極的な観血的治療を行い、より良好な機能回復を目指すべきであると考える。(著者抄録)

RA生物学的製剤治療の最前線寛解を目指して生物製剤の登場による手術療法の動向と適応の変化について

西田圭一郎, 中原龍一, 橋詰謙三, 斎藤太一, 金澤智子, 小澤正嗣, 那須義久, 尾崎敏文

日本整形外科学会雑誌 86 ( 5 ) 394 - 400 2012.5

3D-CADシステムを用いた鎖骨の三次元形状比較

中原龍一, 野田知之, 島村安則, 橋詰謙三, 西田圭一郎, 尾崎敏文

骨折 34 ( 2 ) 265 - 268 2012.5

Language：Japanese Publisher：(一社)日本骨折治療学会

【目的】当院では骨折症例に対してCT画像をもとに健側鏡像の立体模型か実寸大の左右反転図を作成し、プレベンディングを行っている。この方法は骨の左右差が少ないことを前提としているが、どの程度骨の左右差があるかは不明であった。そこでCADソフトを用いてCT画像を三次元的に比較するシステムを構築し、プレベンディング法を最も利用している鎖骨を対象に左右差を検討した。【方法と対象】解剖実習で摘出した屍体の左右の鎖骨16対をCTで撮影し、CADソフトを用いて三次元的な左右差を検討した。【結果】骨幹部のカーブ形状に左右差は少なかったが、径の左右差は認められた。【考察】径の左右差はあるがカーブ形状に左右差はなかったため、鎖骨に関してプレベンディングは有用であると考えられた。(著者抄録)

CTを併用した脛骨遠位部関節内骨折の転位様式に関するX線学的検討

岡田芳樹, 野田知之, 金澤智子, 齋藤太一, 中原龍一, 島村安則, 尾崎敏文, 寺田忠司

骨折 34 ( 2 ) 367 - 370 2012.5

Language：Japanese Publisher：(一社)日本骨折治療学会

脛骨遠位部骨折、とりわけpilon骨折は関節内骨折の中でも治療に難渋し未解決の多い骨折である。今回我々が経験したpilon骨折を単純X線とCTにて評価し、その特徴につき検討した。症例は66例で、17〜89歳(平均55歳)である。AO分類でB1が6例、B2が5例、B3が9例、C1が8例、C2が10例、C3が21例であった。腓骨骨折の形態分類が内反変形22例、外反変形25例、intact 12例であった。腓骨骨折が外反変形・intactでは、内反変形よりCTによる評価でcoronal family fracturesのY-type、V-typeに分類されるものが多くみられた。本研究により、単純X線写真と関節面の骨折型、および腓骨骨折の有無が骨折の重傷度を評価する一助となり、今後の手術治療アプローチ選択、固定法選択に有用である可能性が示唆された。(著者抄録)

ROCK inhibitor prevents the dedifferentiation of human articular chondrocytes Reviewed

Emi Matsumoto, Takayuki Furumatsu, Tomoko Kanazawa, Masanori Tamura, Toshifumi Ozaki

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 420 ( 1 ) 124 - 129 2012.3

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Chondrocytes lose their chondrocytic phenotypes in vitro. The Rho family GTPase ROCK, involved in organizing the actin cytoskeleton, modulates the differentiation status of chondrocytic cells. However, the optimum method to prepare a large number of un-dedifferentiated chondrocytes is still unclear. In this study, we investigated the effect of ROCK inhibitor (ROCKi) on the chondrogenic property of monolayer-cultured articular chondrocytes. Human articular chondrocytes were subcultured in the presence or absence of ROCKi (Y-27632). The expression of chondrocytic marker genes such as SOX9 and COL2A1 was assessed by quantitative real-time PCR analysis. Cellular morphology and viability were evaluated. Chondrogenic redifferentiation potential was examined by a pellet culture procedure. The expression level of SOX9 and COL2A1 was higher in ROCKi-treated chondrocytes than in untreated cells. Chondrocyte morphology varied from a spreading form to a round shape in a ROCKi-dependent manner. In addition, ROCKi treatment stimulated the proliferation of chondrocytes. The deposition of safranin O-stained proteoglycans and type II collagen was highly detected in chondrogenic pellets derived from ROCKi-pretreated chondrocytes. Our results suggest that ROCKi prevents the dedifferentiation of monolayer-cultured chondrocytes, and may be a useful reagent to maintain chondrocytic phenotypes in vitro for chondrocyte-based regeneration therapy. (C) 2012 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2012.02.127

Mechanical stretch enhances COL2A1 expression on chromatin by inducing SOX9 nuclear translocalization in inner meniscus cells. Reviewed International journal

Tomoko Kanazawa, Takayuki Furumatsu, Motomi Hachioji, Toshitaka Oohashi, Yoshifumi Ninomiya, Toshifumi Ozaki

Journal of orthopaedic research : official publication of the Orthopaedic Research Society 30 ( 3 ) 468 - 74 2012.3

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

The meniscus plays an important role in controlling the biomechanics of the knee. However, the mechanical stress-related response in meniscus cells remains unclear. We investigated mechanical stretch-regulated gene expression in human meniscus cells. Human inner and outer meniscus cells were prepared from the inner and outer halves of the lateral meniscus. The gene expressions of Sry-type HMG box (SOX) 9 and α1(II) collagen (COL2A1) were assessed by real-time PCR analyses after cyclic tensile strain (CTS) treatment (0.5 Hz, 5% stretch). The localization and phosphorylation of SOX9 were evaluated by immunohistochemical and Western blot (WB) analyses. Chromatin immunoprecipitation (IP) analysis was performed to assess the stretch-related protein-DNA complex formation between SOX9 and the COL2A1 enhancer on chromatin. Type II collagen deposition and SOX9 production were detected only in inner menisci. CTS treatments increased expression of the COL2A1 and SOX9 genes in inner meniscus cells, but not in outer meniscus cells. In addition, CTS treatments stimulated nuclear translocalization and phosphorylation of SOX9 in inner meniscus cells. Chromatin IP analyses revealed that CTS increased the association between SOX9 and its DNA-binding site, included in the COL2A1 enhancer, on chromatin. Our results indicate that inner and outer meniscus cells have different properties in mechanical stretch-induced COL2A1 expression. In inner meniscus cells, mechanical stretch may have an essential role in the epigenetic regulation of COL2A1 expression.

DOI： 10.1002/jor.21528

MTXの有効性と安全性画像的にみたMTXの有効性と限界への対応

西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 168 - 168 2012.3

関節リウマチ手術の長期成績関節リウマチ手術の長期成績人工肘関節置換術 linked vs.unlinked

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 214 - 214 2012.3

リウマチ性疾患の画像(1) 関節リウマチにおける大関節破壊の新たな画像評価基準(ARASHI status score)に関する検討

那須義久, 西田圭一郎, 高杉幸司, 山下美鈴, 棗田将光, 江澤香代, 江澤和彦, 金澤智子, 斉藤太一, 小澤正嗣, 中原龍一, 橋詰謙三, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 292 - 292 2012.3

リウマチ性疾患の画像(1) T2マッピング解析法複数シークエンス画像を用いた軟骨半自動抽出法

中原龍一, 西田圭一郎, 橋詰謙三, 小澤正嗣, 斉藤太一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 292 - 292 2012.3

関節リウマチの手術下肢(1) 関節リウマチの足関節、中後足部変形に対する治療成績

小澤正嗣, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 393 - 393 2012.3

関節リウマチの手術下肢(1) 関節リウマチ(RA)患者の外反母趾に対する切除関節形成術の治療成績

金澤智子, 西田圭一郎, 橋詰謙三, 中原龍一, 斉藤太一, 小澤正嗣, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 56回・21回 393 - 393 2012.3

関節リウマチの手関節に対する部分固定術の術後成績

斎藤太一, 西田圭一郎, 橋詰謙三, 島村安則, 尾崎敏文

日本手外科学会雑誌 29 ( 1 ) S134 - S134 2012.3

前方単独アプローチ(modified Stoppa+lateral window)による寛骨臼複合骨折の治療成績

野田知之, 島村安則, 中原龍一, 尾崎敏文, 木浪陽, 上田泰久, 戸田一潔, 高城康師, 小川健一, 依光正則

骨折 34 ( 1 ) 66 - 69 2012.2

Language：Japanese Publisher：(一社)日本骨折治療学会

寛骨臼複合骨折に対してmodified Stoppa approachにlateral windowを併用した前方単独進入(以下、MS+LW)による整復固定術の治療成績につき検討した。対象は24例で、骨折型は両柱:19例、前柱+半横:3例、T型:2型であった。全例MS+LWにて進入したが3例にmiddle windowの追加が必要であった。Quadrilateral surfaceのbuttress plate固定を20骨折、lag screw固定を4骨折に施行した。平均術中出血量は1593mlで、平均手術時間は4時間24分であった。術後X線評価は平均step offは0.9mm、平均gapは1.4mmで、anatomical:14例、imperfect:9例、poor:1例であった。6ヵ月以上経過観察しえた症例のJOA hip scoreは平均88点であった。術中合併症は外腸骨静脈損傷1例、閉鎖動脈損傷1例であった。術後合併症は閉鎖神経不全麻痺:4例、外腸骨動脈血栓形成1例、坐骨神経麻痺:1例、関節内スクリュー誤挿入1例、術後再転移1例などであった。本アプローチの利用は前方単独進入では従来整復困難であった転位の大きい後柱成分の整復固定が直視下に施行可能で有用である。(著者抄録)

下肢長管骨関節近傍骨折に対する一時的創外固定の有用性

野田知之, 島村安則, 西山武, 中原龍一, 雑賀建多, 斉藤太一, 金澤智子, 長谷井嬢, 尾崎敏文

日本創外固定・骨延長学会雑誌 23 207 - 207 2012.1

当院における人工肘関節再置換術の術後成績

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 原田遼三, 尾崎敏文

日本肘関節学会雑誌 19 ( 1 ) S24 - S24 2012.1

A Portable Arthroscopic Diagnostic Probe to Measure the Viscoelasticity of Articular Cartilage. Reviewed

Naohiko Sugita, Toru Kizaki, Daisuke Kanno, Nobuhiro Abe, Yusuke Yokoyama, Toshifumi Ozaki, Mamoru Mitsuishi

JRM 24 ( 5 ) 782 - 790 2012

Publishing type：Research paper (scientific journal)

Tissue engineering has been increasingly applied to treat diseases of the joints that adversely affect components such as cartilage and ligaments. These components do not contain blood vessels and nerves; the risk of rejection during tissue transplantation is therefore less than that for other organs. Treatment of cartilage and ligaments requires highly skilled surgeons, however, and it is necessary to establish a quantitative evaluation method. It is difficult to measure the mechanical properties of cartilage because of its viscoelasticity. Sensing technology that enables uniform qualitative evaluation is therefore desired. In this study, a portable diagnostic probe was developed and the viscoelasticity of cartilage was measured quantitatively over a short period of time. The probe was designed based on the Voigt model and comprises a piezoelectric actuator, a force sensor, and a contact probe. Stiffness and viscosity coefficients of various samples such as silicone rubber and the bovine meniscus were measured, and the accuracy of the developed probe was evaluated. Finally, the mechanical properties of human articular cartilage were measured using the diagnostic probe.

DOI： 10.20965/jrm.2012.p0782

Transplantation of Osteogenically Differentiated Mouse iPS Cells for Bone Repair Reviewed

Takahiro Hayashi, Haruo Misawa, Hiroyuki Nakahara, Hirofumi Noguchi, Aki Yoshida, Naoya Kobayashi, Masato Tanaka, Toshifumi Ozaki

CELL TRANSPLANTATION 21 ( 2-3 ) 591 - 600 2012

Language：English Publishing type：Research paper (scientific journal) Publisher：COGNIZANT COMMUNICATION CORP

Induced pluripotent stem (iPS) cells are a type of undifferentiated cell that can be obtained from differentiated cells and have the pluripotent potential to differentiate into the musculoskeletal system, the myocardium, vascular endothelial cells, neurons, and hepatocytes. We therefore cultured mouse iPS cells in a DMEM containing 15% FBS, 10(-7) M dexamethasone, 10 mM beta-glycerophosphate, and 50 mu g/ml ascorbic acid for 3 weeks, in order to induce bone differentiation, and studied the expression of the bone differentiation markers Runx2 and osteocalcin using RT-PCR in a time-dependent manner. Osteocalcin, a bone differentiation marker in bone formation, exhibited the highest expression in the third week. In addition, the deposition of calcium nodules was observed using Alizarin red S staining. iPS cells cultured for bone differentiation were transplanted into severe combined immunodeficiency (SCID) mice, and the osteogenic potential exhibited after 4 weeks was studied. When bone differentiation-induced iPS cells were transplanted into SCID mice, bone formation was confirmed in soft X-ray images and tissue specimens. However, teratoma formation was confirmed in 20% of the transplanted models. When mouse iPS cells were treated with irradiation of 2 Gray (Gy) prior to transplantation, teratoma formation was inhibited. When mouse iPS cells treated in a likewise manner were xenotransplanted into rats, bone formation was confirmed but teratoma formation was not observed. It is believed that irradiation before transplantation is an effective way to inhibit teratoma formation.

DOI： 10.3727/096368911X605529

Treatment of Histiocytic Sarcoma in the Right Lower Leg : A Case Report

Morimoto Yuki, Itani Satoru, Ozaki Toshifumi, Kunisada Toshiyuki

The Journal of the Chugoku-Shikoku Orthopaedic Association 24 ( 1 ) 5 - 9 2012

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Histiocytic sarcoma is a rare hematopoietic malignancy with a poor prognosis. We report a 31-year-old woman who developed histiocytic sarcoma in the lower extremity. An open biopsy was required because a definitive diagnosis could not be made on the basis of a core-needle biopsy specimen. The diagnosis of histiocytic sarcoma was established using immunohistochemistry. No metastatic lesion was detected by PET-CT, and wide resection based on the procedure for a malignant soft tissue tumor was performed without neo-adjuvant chemotherapy. However, adjuvant radiotherapy was performed because there are few reports of histiocytic sarcoma being treated using surgery alone. During 35 months of follow-up, neither local recurrence nor distant metastasis has been observed. Our experience suggests that if a solitary lesion of histiocytic sarcoma can be resected with a sufficient margin, chemotherapy may be unnecessary.

DOI： 10.11360/jcsoa.24.5

Ossified labrum in a case of femoroacetabular impingement

ENDO Hirosuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 55 ( 2 ) 415 - 416 2012

A case report of psoriatic arthritis of hip operated by THA

YAMAKAWA Yasuaki

The Central Japan Journal of Orthopaedic Surgery & Traumatology 55 ( 6 ) 1373 - 1374 2012

Treatment of Bone Metastases in the Extremities Associated with Pathological Fracture

Nakata Eiji, Sugihara Shinsuke, Ozaki Toshifumi

The Journal of the Chugoku-Shikoku Orthopaedic Association 24 ( 2 ) 259 - 263 2012

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We evaluated the clinical results of treatment for bone metastases in the extremities associated with pathological fracture.<br>Thirty-four patients (11 men and 23 women, mean age 62 years) were treated at our institution between August 2006 and July 2011. The site of the primary tumor was the kidney in 4 patients, lung in 5 patients, breast in 14 patients, and other sites in 11 patients. Pathological fractures were found in the humerus in 5 patients, femur in 23 patients, and tibia in 2 patients. Surgical treatment was performed in 28 cases.<br>Pathological fracture of the femur was treated by resection and prosthetic replacement in 12 cases. The remaining fractures of the femur were stabilized using locking nails (n=6) or plates (n=5). Humeral lesions were stabilized using locking nails (n=3) or plates (n=2). Pathological fractures of the tibia were stabilized using plates (n=2). Postoperative performance status (PS) of the patients with pathological fractures recovered to that before the trauma in almost all patients. Postoperative complications occurred in 6 cases, including temporary palsy of the radial nerve in 2 patients, deep infection in 1 patient, plate breakage in 1 patient, and periprosthetic femoral fractures in 2 patients.<br>The average survival after fracture was 10.5 months for patients who underwent surgery and 3.5 months for patients who were treated conservatively. These figures suggest that patient selection for treatment should be based on prognosis.

DOI： 10.11360/jcsoa.24.259

Other Link： http://search.jamas.or.jp/link/ui/2013107549

Surgical Treatment of Pedal Osteomyelitis : Report of Five Cases

Okada Yoshiki, Noda Tomoyuki, Nishiyama Takeshi, Nakahara Ryuichi, Shimamura Yasunori, Ozaki Toshifumi

The Journal of the Chugoku-Shikoku Orthopaedic Association 24 ( 2 ) 209 - 214 2012

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Osteomyelitis after trauma or surgery can be problematic, especially pedal osteomyelitis including calcaneal osteomyelitis. Here we report the results and problems associated with surgery for pedal osteomyelitis in five patients (four men and one woman). The mean age of the patients was 37 years (range 12-51 years). Four developed infection after surgery and one after contusion. Treatment involved thorough debridement of the infected area and filling of the dead space with artificial bone or cement beads incorporating a DDS (Drug Delivery System). Until the infection had subsided, we repeated this operation every 3 to 4 weeks. Finally, we performed a subtalar arthrodesis in one patient, a desis of the cuneiform bone in one, and auto-bone graft in three. The bacteria detected were MSSA in two patients, MRSA in three patients (including one case of MRSA combined with fungus). All of the infections subsided within a mean period of 9.6 months (range 5-21 months). The mean operation time was 3.2 hours (range 1-5 hours). We used mainly a DDS that released antibiotics from cement or artificial bone. There was no complication associated with this treatment. Since the calcaneus has poor vascularization and a large proportion of cancellous bone, pedal osteomyelitis, especially in the calcaneus, is challenging to treat. Filling the dead space using a DDS is effective for control of infection.

DOI： 10.11360/jcsoa.24.209

Other Link： http://search.jamas.or.jp/link/ui/2013107539

Efficacy of Pregabalin for Patients with Neuropathic Pain and Degenerative Lumbar Disease

Tetsunaga Tomoko, Tanaka Masato, Sugimoto Yoshihisa, Misawa Haruo, Takigawa Tomoyuki, Shiozaki Yasuyuki, Osaki Syuhei, Mazaki Tetsuro, Yamane Kentarou, Ozaki Toshifumi

The Journal of the Chugoku-Shikoku Orthopaedic Association 24 ( 2 ) 325 - 329 2012

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

The anti-seizure drug, pregabalin, is used for treatment of neuropathic pain and degenerative lumbar disease. The objective of this study was to evaluate the effect of pregabalin (150-300 mg/day) in patients with chronic lower back/leg pain. We assessed 47 patients (17 men and 30 women) with an average age of 65 years (range 20 to 81 years), and an average disease duration of 87 months (range 3 to 480 months). All patients were assessed using a visual analogue scale (VAS, 0-100 mm), the Self-Rating Depression Scale (SDS, 20-80 points), and the Oswestry Disability Index (ODI, 0-100%). After 8 weeks, pregabalin improved lower back pain, leg pain, SDS and ODI significantly (P<0.01). Pain was improved significantly in the depression group as well as the normal group (P<0.01). Accepted sleepiness (51%), dizziness (19%), weight gain (16%) and rash (5%) were detected after medication. The use of the hypnotic agent was decreased in half of the cases after medication. Pregabalin is safe and effective for decreasing lower back pain and leg pain in patients with depression.

DOI： 10.11360/jcsoa.24.325

Other Link： http://search.jamas.or.jp/link/ui/2013107559

Treatment for Atypical Basicervical Fracture of the Femur with a Coronal Shearing Fracture Line

Yamakawa Yasuaki, Noda Tomoyuki, Ozaki Toshifumi, Kinami Yo, Endo Hirosuke

The Journal of the Chugoku-Shikoku Orthopaedic Association 24 ( 2 ) 295 - 299 2012

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We describe our experience with atypical cases of basicervical fracture of the femur. The fracture line lay between the anterior aspect of the subcapital portion and the posterior aspect of the neck base, running through the neck with a shearing fracture line as viewed in the coronal plane. We treated ten cases : seven by hemiarthroplasty and three by osteosynthesis. Bone union was obtained within six months, and there was no implant failure or complication. For diagnosis of this fracture, careful radiological assessment is important, and for effective treatment the special characteristics of this fracture should be considered. Cases of this type present difficulty with reduction and acquisition of stable fixation because of the cortical defect of the calcar or shortness of the anterior portion of the proximal fragment.

DOI： 10.11360/jcsoa.24.295

Other Link： http://search.jamas.or.jp/link/ui/2013107554

Outcome of Treatment for Metastatic Spine Tumors with High-grade Malignancy

Mazaki Tetsuro, Tanaka Masato, Sugimoto Yoshihisa, Takigawa Tomoyuki, Tetsunaga Tomoko, Shiozaki Yasuyuki, Osaki Shuhei, Ozaki Toshifumi, Kunisada Toshiyuki, Misawa Haruo, Kataoka Masaki

The Journal of the Chugoku-Shikoku Orthopaedic Association 24 ( 2 ) 273 - 277 2012

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We report the outcome of patients with metastatic spine tumors showing high-grade malignancy using the Tokuhashi scoring system. A retrospectively compared 21 patients with such tumors (group H) and 29 patients with spinal metastases showing low-grade malignancy (group L). There were 18 men and 3 women in group H, and 16 men and 13 women in group L, and the average patient ages were 55 years and 65 years, respectively. All of the patients were scored with the Tokuhashi scoring system and evaluated for neurological symptoms with the ASIA Impairment Scale (AIS).<br>Results : The rates of improvement in the AIS score and gait ability were almost the same in both groups. Among patients who we were able to follow postoperatively for 6 months or more, 7 in group H and 4 in group L died within 6 months. The mean survival period was 12 months in group H and 17 months in group L.<br>Conclusions : The outcome after treatment in group H was almost the same as that in group L. This may have been due to progress in the treatment of malignancy. Further studies to determine the indications for surgery in such patients are warranted.

DOI： 10.11360/jcsoa.24.273

Other Link： http://search.jamas.or.jp/link/ui/2013107551

Cyclops Lesion after Reconstruction of the Anterior Cruciate Ligament

Fujii Masataka, Furumatsu Takayuki, Miyazawa Shinichi, Takata Naoki, Yokoyama Yusuke, Okada Yukimasa, Ozaki Toshifumi, Abe Nobuhiro

The Journal of the Chugoku-Shikoku Orthopaedic Association 24 ( 2 ) 375 - 379 2012

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Cyclops lesions are nodular structures that form anteriorly along anterior cruciate ligament (ACL) grafts after ACL reconstruction. The purpose of this study was to investigate the occurrence rate and pathogenesis of cyclops lesions after reconstruction of the ACL. We evaluated 40 patients by follow-up arthroscopy after anatomical bi-socket ACL reconstruction with hamstring tendons. Ten patients (25%) showed cyclops lesions, and 4 of these (10%) had extension loss.<br>We investigated the pathogenesis of cyclops lesion based on the impingement theory. All patients underwent measurement of intercondylar notch dimensions and graft size by MRI. We found that a narrower notch and larger graft size were associated with the formation of cyclops lesion.

DOI： 10.11360/jcsoa.24.375

Other Link： http://search.jamas.or.jp/link/ui/2013107567

Gene Expression and Localization of High-mobility Group Box Chromosomal Protein-1 (HMGB-1) in Human Osteoarthritic Cartilage Reviewed

Chuji Terada, Aki Yoshida, Yoshihisa Nasu, Shuji Mori, Yasuko Tomono, Masato Tanaka, Hideo K. Takahashi, Masahiro Nishibori, Toshifumi Ozaki, Keiichiro Nishida

ACTA MEDICA OKAYAMA 65 ( 6 ) 369 - 377 2011.12

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

We investigated the expression and localization of high-mobility group box chromosomal protein-1 (HMGB-1) in human osteoarthritic (OA) cartilage in relation to the histopathological grade of cartilage destruction, and examined the role of HMGB-1 in the regulation of proinflammatory cytokine expression in chondrocytes. An immunohistochemical study demonstrated that total HMGB-1-positive cell ratios increase as the Osteoarthritis Research Society International (OARSI) histological grade increased. The population of cytoplasmic HMGB-1-positive chondrocytes was especially increased in the deep layers of higher-grade cartilage. The ratios and localization of receptors for advanced glycation end products (RAGE) expression by chondrocytes in Grade 2, 3, and 4 were significantly higher than those in Grade 1. In vitro stimulation with IL-1 beta, but not TNF alpha, significantly upregulated the expression of HMGB-1 mRNA by human OA chondrocytes. Both IL-1 beta and TNFa promoted the translocation of HMGB-1 from nuclei to cytoplasm. IL-1 beta and TNF alpha secretions were stimulated at higher levels of HMGB-1. The results of our study suggest the involvement of HMGB-1 in the pathogenesis of cartilage destruction in OA.

DOI： 10.18926/AMO/47262

Japanese guidelines for the diagnosis and management of soft tissue tumor

123 ( 3 ) 231 - 235 2011.12

臼蓋再置換術THA後に早期破綻した1例

遠藤裕介, 鉄永智紀, 藤原智洋, 藤原一夫, 三宅由晃, 尾崎敏文

日本人工関節学会誌 41 700 - 701 2011.12

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

61歳女性。52歳時に他院で左変形性股関節症に対してセメントカップとセメントレスステムによる初回全人工股関節置換術(THA)が施行された。しかし、術後9年で左股関節痛を生じ、著明な跛行が認められた。また、単純X線像とCT像にてカップのゆるみとmigrationによる巨大骨欠損を認め、AAOS分類はtype III、術前のJOAスコアは56点であった。以後、再置換術として後方アプローチにてステムを抜去せずに行われたが、内側臼底部は骨性組織は消失しており、荷重部および骨欠損部にハイドロキシアパタイト(HA)顆粒をインパクションし充填した後、KTプレートを設置しカップをセメント固定した。術後3ヵ月時より杖無しで生活していたが、経過観察中に荷重部移植骨の厚みが減少し、術後8ヵ月目に膝をつき込んで転倒、急激な左股関節痛が出現した。X線上、KTプレートのmigrationとフック部の破損が認められ、再々置換術が行われた。手術は後方アプローチにて行われ、プレートはセメントカップごと容易に抜去し、HA顆粒も容易に除去された。そして同種骨大腿骨頭6個を使用し、block boneを移植した後にKTプレートを設置しカップをセメント固定した。その結果、術後は合併症として無症候性のPEが認められたが、術後2ヵ月時には自由歩行可能となり、JOAスコアは86点へと改善した。

Thallium-201 Scintigraphy Is an Effective Diagnostic Modality to Distinguish Malignant From Benign Soft-Tissue Tumors Reviewed

Naoaki Kawakami, Toshiyuki Kunisada, Shuhei Sato, Yuki Morimoto, Masato Tanaka, Tsuyoshi Sasaki, Shinsuke Sugihara, Hiroyuki Yanai, Susumu Kanazawa, Toshifumi Ozaki

CLINICAL NUCLEAR MEDICINE 36 ( 11 ) 982 - 986 2011.11

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background: The aim of this study is to evaluate whether thallium-201 (201-Tl) scintigraphy can differentiate malignant from benign soft-tissue tumors.
Methods: Between April 1995 and December 2005, 192 patients with soft-tissue tumors (85 malignant and 107 benign) underwent 201-Tl scintigraphy before treatment. Isotope uptake was used as a proxy for tumor-to-background ratio (TBR). The accuracy of TBR on early and delayed imaging was evaluated using the Mann-Whitney U and chi(2) tests.
Results: There was a statistically significant difference in mean TBR on early and delayed imaging of malignant and benign soft-tissue tumors (124% +/- 109% vs. 22% +/- 42%, and 82% +/- 83% vs. 12% +/- 25%, P < 0.0001). A TBR cutoff of 20% indicated the probability of malignancy on early and delayed imaging (82% sensitivity and 77% specificity; 82% sensitivity and 84% specificity, P < 0.0001). Well-differentiated liposarcomas showed low isotope accumulation, while pigmented villonodular synovitis and giant cell tumors of the tendon sheath showed high isotope accumulation.
Conclusions: Thallium-201 scintigraphy can distinguish malignant from benign tumors with relatively high accuracy. With the exception of low grade liposarcomas and locally aggressive benign tumors, 201-Tl scintigraphy may be an effective diagnostic modality to differentiate malignant from benign soft-tissue tumors.

DOI： 10.1097/RLU.0b013e3182177407

関節リウマチにおける大関節破壊の新たな画像評価(ARASHI status score)に関する検討

那須義久, 西田圭一郎, 金澤智子, 斎藤太一, 中原龍一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 372 - 372 2011.10

関節リウマチ(RA)患者の外反母趾に対する切除関節形成術の治療成績

金澤智子, 橋詰謙三, 西田圭一郎, 中原龍一, 斉藤太一, 小澤正嗣, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 264 - 264 2011.10

前額断剪断骨折線を示す大腿骨頸基部骨折の治療経験

山川泰明, 木浪陽, 井上円加, 金澤智子, 斎藤太一, 中原龍一, 遠藤裕介, 島村安則, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 3 ) 490 - 490 2011.10

タクロリムス使用下に術後感染症を生じた関節リウマチの3例

橋詰謙三, 西田圭一郎, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 374 - 374 2011.10

整形外科CT画像の三次元ディスプレー表示システムの有用性

中原龍一, 西田圭一郎, 金澤智子, 小澤正嗣, 斎藤太一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 368 - 368 2011.10

生物学的製剤導入とRAの手術 RA上肢の手術

西田圭一郎, 橋詰謙三, 中原龍一, 金澤智子, 斎藤太一, 小澤正嗣, 尾崎敏文

日本関節病学会誌 30 ( 3 ) 250 - 250 2011.10

NCB Distal Femur PlateによるTKA周辺大腿骨遠位部骨折の治療経験

山根健太郎, 木浪陽, 野田知之, 島村安則, 齋藤太一, 尾崎敏文

中部日本整形外科災害外科学会雑誌 55 ( 秋季学会 ) 108 - 108 2011.10

関節鏡視下切除を行った股関節色素性絨毛結節性滑膜炎の1例

武田健, 国定俊之, 遠藤裕介, 中道亮, 井谷智, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 3 ) 440 - 440 2011.10

骨折治療への三次元実体模型の応用

中原龍一, 野田知之, 島村安則, 西山武, 西田圭一郎, 尾崎敏文

骨折 33 ( 3 ) 738 - 742 2011.9

Language：Japanese Publisher：(一社)日本骨折治療学会

【目的】CT画像から作製された三次元実体模型が手術に利用されるようになった。しかし、発注が煩雑で作製時間が長いことが問題であった。当院では作製過程に医師が加わることで作業効率を改善し、骨折などの緊急症例に対応可能な院内発注システムを構築したので報告する。【方法】当院には三次元プリンターが設置されており、歯科技工士が実体模型を作製していた。医師がCTデータから領域抽出を行いDICOMデータとして保存したものを、作製期限を設けてデータを蓄積し、作製期限に間に合うように一度にまとめて作製するシステムを構築した。【結果】作業効率が改善され緊急作製に対応可能となった。2009年度は緊急作製を必要とした骨折症例7例で48時間以内にプレベンディング用の健側骨の左右反転模型を作製した。【結語】領域抽出と作製を分離することで作製効率が向上し、緊急症例に対応可能となった。(著者抄録)

Roof impactionを伴う寛骨臼骨折の治療経験

藤原智洋, 野田知之, 中原龍一, 雑賀建多, 島村安則, 尾崎敏文

骨折 33 ( 3 ) 637 - 642 2011.9

Language：Japanese Publisher：(一社)日本骨折治療学会

Roof impactionを伴う寛骨臼骨折3例の手術治療について検討した。本所見に伴う骨折型は前壁骨折1例、前柱骨折2例であった。前壁骨折に伴う1例に対してはilioinguinal approachの2nd windowから前壁骨片を翻転し陥没骨片を直視下に整復した。前柱骨折に伴う2例に対してはmodified Stoppa approachにlateral windowを併用し、1例は陥没骨片直上の骨折部から整復を、1例は骨片直上を開窓し整復した。いずれも内固定および人工骨充填によるsubchondral supportを行った。全例整復位・臨床評価ともに概ね良好な成績を得たが、うち1例はアプローチ選択に課題が残った。Roof impactionの存在は成績不良因子とされるが、個々の症例における術前の詳細な評価、アプローチ選択および整復固定法の工夫により治療成績の改善が期待できる。(著者抄録)

臼蓋形成不全股のX線学的評価とCross-over signの検討

鉄永智紀, 遠藤裕介, 三谷茂, 藤原一夫, 三宅由晃, 尾崎敏文

Hip Joint 37 840 - 843 2011.9

Language：Japanese Publisher：日本股関節学会

2004〜2010年に寛骨臼回転骨切り術を施行した臼蓋形成不全51例について、術前後に撮影した両股関節正面X線から恥骨結合近位と仙尾骨関節の距離を計測し、Siebenrockらの報告に基づいて「骨盤前傾群」「後傾群」「正常群」の3群に分け、cross-over sign(COS)の頻度を群間比較した。結果、術前X線像からは前傾群に分類されたものが15例、後傾群が17例、正常群が18例であり、各群においてCOSを認めた症例の割合は前傾群40.0%、後傾群5.9%、正常群5.6%であった。術後X線像からは前傾群が8例、後傾群16例、正常群27例であり、COSを認めた割合は前傾群87.5%、後傾群43.8%、正常群29.6%であった。COSを評価する上で正確に撮像できていない症例が半数程度存在し、前傾群ではCOS陽性となる症例が高率に存在した。COSを正しく評価するためには骨盤傾斜が正常かつ左右対称な両股関節正面X線像が必須であると考えられた。

三次元実体石膏模型を用いて、術前プレートベンディングを行った寛骨臼骨折の2例

西山武, 野田知之, 島村安則, 雑賀建多, 中原龍一, 尾崎敏文

骨折 33 ( 3 ) 643 - 647 2011.9

Language：Japanese Publisher：(一社)日本骨折治療学会

CT画像を基に作成した三次元実体石膏模型を用いて、寛骨臼骨折の術前計画を行った。使用するプレートの設定位置を決定し、術前にベンディングした。2例の寛骨臼骨折(37歳男性、左寛骨臼骨折AO分類:62-A3。53歳男性、左骨盤輪骨折および右寛骨臼骨折AO分類:61-C1+62-B2)に対し、術前にベンディングしたプレートを使用し、良好な結果を得た。三次元実体石膏模型は、術前計画において画像からの把握(視覚的情報)のみならず、立体像の把握(触覚的情報)を得ることができる。手術に有用な情報が得られ術者を助けるばかりでなく、術前にチーム間で骨盤立体構造をディスカッションすることで、立体解剖の認識が高まり、教育の面でも有用である。(著者抄録)

液体窒素処理骨による再建を行った肩甲骨Ewing肉腫の1例

金澤智子, 国定俊之, 島村安則, 野田知之, 斉藤太一, 尾崎敏文

肩関節 36 ( 1 ) 167 - 167 2011.9

骨肉腫のがん幹細胞様性質を司る分子機構の探索(Molecular mechanisms regulating the phenotype of Tumor Initiating Cells of Osteosarcoma)

藤原智洋, 高橋陵宇, 小坂展慶, 吉岡祐亮, 竹下文隆, 川井章, 尾崎敏文, 落合孝広

日本癌学会総会記事 70回 427 - 427 2011.9

MRI画像表示法カラー表示を用いて異なるシークエンス画像を同時に表示させる方法

中原龍一, 金澤智子, 齋藤太一, 橋詰謙三, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 85 ( 8 ) S1226 - S1226 2011.8

ガイドライン整形外科シリーズ上腕骨外側上顆炎の診療ガイドライン

島村安則, 井上円加, 小澤正嗣, 金澤智子, 斎藤太一, 中原龍一, 野田知之, 西田圭一郎, 尾崎敏文

岡山医学会雑誌 123 ( 2 ) 141 - 144 2011.8

リウマチ手変形に対する治療関節リウマチ手指MP関節に対する人工指関節置換術の成績

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

関節の外科 38 ( 2 ) 47 - 47 2011.8

メカニカルストレス下におけるヒストン脱アセチル化酵素阻害薬による軟骨破壊抑制効果

齋藤太一, 西田圭一郎, 小澤正嗣, 古松毅之, 鉄永智紀, 尾崎敏文

日本整形外科学会雑誌 85 ( 8 ) S1158 - S1158 2011.8

リウマチ外科治療up-to-date(新評議員報告) PROSNAP人工肘関節の短期臨床成績

西田圭一郎, 橋詰謙三, 中原龍一, 斎藤太一, 金澤智子, 那須義久, 尾崎敏文

関節の外科 38 ( 2 ) 58 - 58 2011.8

上腕骨通顆骨折に対する内固定法の力学的比較 ONI plate対従来固定法

島村安則, 今谷潤也, 野田知之, 中原龍一, 齋藤太一, 金澤智子, 井上円加, 小澤正嗣, 古松毅之, 国定俊之, 西田圭一郎, 橋詰博行, 尾崎敏文

日本整形外科学会雑誌 85 ( 8 ) S1338 - S1338 2011.8

骨肉腫のがん幹細胞様性質を制御する分子機構の探索

藤原智洋, 高橋陵宇, 小坂展慶, 竹下文隆, 川井章, 尾崎敏文, 落谷孝広

日本整形外科学会雑誌 85 ( 8 ) S1100 - S1100 2011.8

硬組織接着性多糖誘導体リン酸化プルランによる薬剤徐放能の解析

馬崎哲朗, 塩崎泰之, 高畑智宏, 吉田靖弘, 杉本佳久, 三澤治夫, 尾崎修平, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 85 ( 8 ) S1303 - S1303 2011.8

脛骨近位部関節内骨折の関節面骨折形態のCTによる評価

小澤正嗣, 野田知之, 金澤智子, 長谷井嬢, 齋藤太一, 中原龍一, 島村安則, 国定俊之, 尾崎敏文

骨折 33 ( Suppl. ) S212 - S212 2011.7

鎖骨骨幹部骨折に対するMIPO法による治療成績

島村安則, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 井上円加, 国定俊之, 野田知之, 尾崎敏文, 島村好信

骨折 33 ( Suppl. ) S239 - S239 2011.7

上腕骨近位端骨折に対する最少侵襲プレート骨接合術(MIPO)による手術成績

島村安則, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 井上円加, 国定俊之, 野田知之, 尾崎敏文, 島村好信

骨折 33 ( Suppl. ) S80 - S80 2011.7

前方プレートにより手術を行った鎖骨遠位端骨折の治療経験

島村好信, 島村安則, 中原龍一, 斉藤太一, 金澤智子, 小澤正嗣, 井上円加, 野田知之, 尾崎敏文

骨折 33 ( Suppl. ) S243 - S243 2011.7

3D-CADシステムを用いた鎖骨の三次元形状比較

中原龍一, 野田知之, 金澤智子, 斉藤太一, 雑賀建多, 島村安則, 尾崎敏文

骨折 33 ( Suppl. ) S286 - S286 2011.7

「多発外傷」に伴う両側floating shoulderの1例

金澤智子, 島村安則, 野田知之, 西山武, 中原龍一, 斉藤太一, 尾崎敏文

骨折 33 ( Suppl. ) S284 - S284 2011.7

CTに併用した脛骨遠位部関節内骨折の転位様式に関するX線学的検討

岡田芳樹, 野田知之, 金澤智子, 齋藤太一, 中原龍一, 島村安則, 尾崎敏文

骨折 33 ( Suppl. ) S88 - S88 2011.7

寛骨臼骨折に対する観血的固定術後に外腸骨動脈急性閉塞を発症した1例

斎藤太一, 野田知之, 金澤智子, 中原龍一, 西山武, 島村安則, 尾崎敏文

骨折 33 ( Suppl. ) S314 - S314 2011.7

下腿骨幹部骨折術後非感染性偽関節の治療経験

藤原智洋, 野田知之, 金澤智子, 長谷井嬢, 中原龍一, 島村安則, 国定俊之, 尾崎敏文, 寺田忠司

骨折 33 ( Suppl. ) S245 - S245 2011.7

A Case of Surgery for Kyphosis of the Thoracolumbar Spine in an Elderly Patient with Dysphagia Reviewed

Kazuo Nakanishi, Kentarou Yamane, Masato Tanaka, Haruo Misawa, Kenta Saiga, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 65 ( 3 ) 211 - 214 2011.6

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

Here we report a case of surgery for kyphosis of the thoracolumbar spine in an elderly patient, in whom surgery was performed because the patient had developed intractable digestive symptoms. The case was that of a 76-year-old female with complaints of back pain and dysphagia. When videofluoroscopic examination (VF) of swallowing was performed in the cardia of the stomach, images that indicated stagnation and the reflux of food were observed. It was easier for the patient to swallow food in the extension position. We performed corrective fusion of the posterior spine. After the surgery, the kyphosis angle was improved to 27 degrees, the patient's back pain was alleviated, and it became easier for the patient to swallow food. VF also showed that the patient's difficulties with the passage of food had improved. We believe that surgery is a good treatment option for cases of kyphosis with digestive symptoms and deteriorating activities of daily living (ADL), even in the absence of pain and paralysis. VF is also useful for performing evaluations before and after surgery.

Mechanical stretch increases CCN2/CTGF expression in anterior cruciate ligament-derived cells Reviewed

Yoshiaki Miyake, Takayuki Furumatsu, Satoshi Kubota, Kazumi Kawata, Toshifumi Ozaki, Masaharu Takigawa

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 409 ( 2 ) 247 - 252 2011.6

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Anterior cruciate ligament (ACL)-to-bone interface serves to minimize the stress concentrations that would arise between two different tissues. Mechanical stretch plays an important role in maintaining cell-specific features by inducing CCN family 2/connective tissue growth factor (CCN2/CTGF). We previously reported that cyclic tensile strain (CTS) stimulates alpha 1(I) collagen (COL1A1) expression in human ACL-derived cells. However, the biological function and stress-related response of CCN2/CTGF were still unclear in ACL fibroblasts. In the present study, CCN2/CTGF was observed in ACL-to-bone interface, but was not in the midsubstance region by immunohistochemical analyses. CTS treatments induced higher increase of CCN2/CTGF expression and secretion in interface cells compared with midsubstance cells. COL1A1 expression was not influenced by CCN2/CTGF treatment in interface cells despite CCN2/CTGF stimulated COL1A1 expression in midsubstance cells. However, CCN2/CTGF stimulated the proliferation of interface cells. Our results suggest that distinct biological function of stretch-induced CCN2/CTGF might regulate region-specific phenotypes of ACL-derived cells. (C) 2011 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2011.04.138

生物学的製剤と外科治療生物学的製剤使用患者の手術のタイミング

西田圭一郎, 金澤智子, 中原龍一, 橋詰謙三, 那須義久, 斎藤太一, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 147 - 147 2011.6

関節リウマチの手術上肢関節リウマチ手指MP関節に対する人工指関節置換術の成績

橋詰謙三, 西田圭一郎, 那須義久, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 310 - 310 2011.6

関節リウマチの手術上肢関節リウマチ(RA)に対するSauve-Kapandji法の治療成績

金澤智子, 橋詰謙三, 西田圭一郎, 中原龍一, 斉藤太一, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 383 - 383 2011.6

関節リウマチの手術上肢 RA手関節に対する部分固定術の術後成績

斉藤太一, 西田圭一郎, 橋詰謙三, 中原龍一, 金澤智子, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 55回・20回 312 - 312 2011.6

幹細胞研究の骨・軟部腫瘍学への応用骨肉腫のがん幹細胞様性質を司る分子機構の解明

藤原智洋, 高橋陵宇, 小坂展慶, 竹下文隆, 川井章, 尾崎敏文, 落谷孝広

日本整形外科学会雑誌 85 ( 6 ) S823 - S823 2011.6

【患者さんといっしょに読める整形外科病態生理32 はじめてマニュアル】肩〜手指鎖骨骨折

島村安則, 野田知之, 中原龍一, 尾崎敏文

整形外科看護 ( 2011春季増刊 ) 10 - 17 2011.5

Increased level of heme oxygenase-1 in rheumatoid arthritis synovial fluid Reviewed

Ai Kitamura, Keiichiro Nishida, Takamitsu Komiyama, Hideyuki Doi, Yasutaka Kadota, Aki Yoshida, Toshifumi Ozaki

MODERN RHEUMATOLOGY 21 ( 2 ) 150 - 157 2011.4

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

We investigated the expression and localization of heme oxygenase-1 (HO-1) in synovial fluid and synovial tissue, and examined the stimulation of HO-1 production in rheumatoid synovial fibroblasts (RASFs). Synovial fluid samples were obtained from knee joints of 20 rheumatoid arthritis (RA) and 20 osteoarthritis (OA) patients, and concentration of HO-1 and matrix metalloproteinase-3 (MMP-3) were measured by enzyme-linked immunosorbent assay (ELISA). Synovial tissues obtained from RA or OA patients during total knee arthroplasty (TKA) were used for immunohistochemical analysis of HO-1. HO-1 production by RASFs in response to various cytokines was examined by ELISA. HO-1 levels in synovial fluid were higher in the RA group than in the OA group with significant difference (P < 0.001), and correlated with serum C-reactive protein (CRP) level (r = 0.80, P < 0.01) in the RA group. Higher levels of HO-1 were seen in the RA-L group (Larsen grade III-V) than in the RA-E (Larsen grade 0-II) group (P < 0.001). There was weak correlation between the levels of HO-1 protein and MMP-3 in synovial fluid in the RA group (r = 0.31, P < 0.01), while no positive correlation was observed in OA. Positive immunoreaction for HO-1 was observed in cells of synovial tissue including synovial fibroblasts and cells in synovial pannus. HO-1 protein levels in cultured media of RASFs were increased by stimulation by interleukin-1 beta at 6 h and tumor necrosis factor-alpha at 12 h, but suppressed by interferon-gamma at 12 and 24 h. These results indicated that HO-1 expression in synovial tissue might be stimulated by inflammatory cytokines. The correlation of HO-1 concentration in synovial fluid with serum CRP and MMP-3 in joint fluid indicated that HO-1 might be useful as a marker of joint inflammation in RA patients.

DOI： 10.1007/s10165-010-0372-9

掌側プレート固定を行った橈骨遠位端骨折における抜釘術の重要性

島村安則, 井上円加, 小澤正嗣, 斎藤太一, 金澤智子, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 1 ) 258 - 258 2011.4

ハンドル外傷による舟状骨骨折の1例

金澤智子, 島村安則, 西田圭一郎, 斎藤太一, 中原龍一, 雑賀建多, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 1 ) 253 - 253 2011.4

大腿骨基部骨折を合併した大腿骨頭すべり症の一例

尾崎修平, 遠藤裕介, 三宅由晃, 藤原一夫, 野田知之, 尾崎敏文

岡山医学会雑誌 123 ( 1 ) 73 2011.4

RA手関節に対する部分固定術の術後成績

斎藤太一, 西田圭一郎, 橋詰謙三, 島村安則, 尾崎敏文

日本手外科学会雑誌 28 ( 1 ) S138 - S138 2011.3

硬組織接着性多糖誘導体リン酸化プルランの開発

高畑智宏, 塩崎泰之, 吉田靖弘, 三澤治夫, 杉本佳久, 田中雅人, 尾崎敏文

Journal of Spine Research 2 ( 3 ) 647 - 647 2011.3

Anterior transposition of the ulnar nerve with endoscopic assistance Reviewed

T. Konishiike, K. Nishida, M. Ozawa, T. Ozaki

Journal of Hand Surgery: European Volume 36 ( 2 ) 126 - 129 2011.2

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

We treated 20 patients with cubital tunnel syndrome by anterior transposition of the ulnar nerve with endoscopic assistance. Five elbows were classified preoperatively as McGowan's stage 1, 11 as stage 2 and four as stage 3. Excellent outcomes were obtained in nine and good in eight patients. Three patients had fair results. Improvement of symptoms occurred in all patients. There were no serious complications. All ulnar nerves remained anteriorly transposed.

DOI： 10.1177/1753193410381675

Anatomical and functional segments of the deltoid muscle Reviewed

Yoshimasa Sakoma, Hirotaka Sano, Nobuhisa Shinozaki, Yoshiaki Itoigawa, Nobuyuki Yamamoto, Toshifumi Ozaki, Eiji Itoi

Journal of Anatomy 218 ( 2 ) 185 - 190 2011.2

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

Previous studies showed that the insertion of the intramuscular tendons of the deltoid muscle formed three discrete lines. The purpose of the present study was to establish a new dividing method of the deltoid muscle into various anatomical segments based on the distribution of the intramuscular tendons with their insertions (anatomical study). We further hoped to clarify the relationship between the anatomical segments and their activity pattern assessed by positron emission tomography with [18F]-2-fluoro-deoxyglucose (FDG-PET
PET study). Sixty cadaveric shoulders were investigated in the anatomical study. Three tendinous insertions of the deltoid muscle to the humerus were identified. Then, the intramuscular tendons were traced from their humeral insertions to the proximal muscular origins. The extent of each anatomical segment of the muscle including its origin and insertion was determined through careful dissection. Six healthy volunteers were examined using FDG-PET for the PET study. PET images were obtained after exercise of elevation in the scapular plane. On the PET images, margins of each anatomical segment of the deltoid muscle were determined using magnetic resonance images. Then, the standardized uptake value in each segment was calculated to quantify its activity. The anatomical study demonstrated that the deltoid muscle was divided into seven segments based on the distribution of its intramuscular tendons. The PET study revealed that the intake of FDG was not uniform in the deltoid muscle. The area with high FDG intake corresponded well to the individual muscular segments separated by the intramuscular tendons. We conclude that the deltoid muscle has seven anatomical segments, which seem to represent the functional units of this muscle. © 2010 The Authors. Journal of Anatomy © 2010 Anatomical Society of Great Britain and Ireland.

DOI： 10.1111/j.1469-7580.2010.01325.x

軟部腫瘍の良悪性鑑別におけるTI-201腫瘍シンチグラフィの有用性

佐藤修平, 稲井良太, 原田聡介, 新家崇義, 郷原英夫, 奥村能啓, 国定俊之, 尾崎敏文, 金澤右

日本医学放射線学会学術集会抄録集 70回 S365 - S366 2011.2

骨髄炎に対する抗菌薬含有セメント髄内釘による治療成績の検討

金澤智子, 野田知之, 島村安則, 西山武, 雑賀建多, 中原龍一, 尾崎敏文

日本骨・関節感染症学会雑誌 24 43 - 46 2011.2

Language：Japanese Publisher：(一社)日本骨・関節感染症学会

骨折治療後に生じた長管骨骨髄炎に対して抗菌薬含有セメント髄内釘または抗菌薬含有セメントロッドによる治療を行った7例の成績を報告した。男性6例、女性1例、年齢16〜81歳、罹患部位は大腿骨5例、脛骨2例、起因菌はMRSAが6例、不明1例であった。治療成績は6例(86%)で感染の沈静化が得られ、治療開始時に骨癒合していなかった5例中3例(60%)で骨癒合が得られた。代表例1例を提示した。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J04867&link_issn=&doc_id=20110214090009&doc_link_id=%2Fey4kotsu%2F2010%2F002400%2F009%2F0043-0046%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fey4kotsu%2F2010%2F002400%2F009%2F0043-0046%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

骨端線障害後の下肢遺残変形に対して矯正術を行った2例

斎藤太一, 尾崎敏文, 遠藤裕介, 三谷茂

日本創外固定・骨延長学会雑誌 22 13 - 16 2011.2

Language：Japanese Publisher：日本創外固定・骨延長学会

骨端線障害後の下肢遺残変形に対し、Ilizarov創外固定器による複数回の矯正術を行った2症例について検討した。症例1(10歳男児)は1歳時の化膿性膝関節炎、症例2(14歳男児)は6歳時の交通事故により骨端線障害が生じていた。6歳時と9歳時に、Ilizarov創外固定器を用いて矯正骨切りと脚延長を行った。しかし変形は再発し、2度目の手術を9歳時と13歳時に行った。2例とも、Ilizarov創外固定器を用いて良好なアライメントと脚長差の補正が得られたが、若年での骨端線障害における遺残変形に対する骨端線閉鎖術、もしくは解除術なしでの変形矯正術は、複数回の手術を要すると思われた。

硬組織接着性多糖誘導体リン酸化プルランによる薬剤徐放能の検討

塩崎泰之, 高畑智宏, 吉田靖弘, 杉本佳久, 三澤治夫, 吉田晶, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 85 ( 2 ) S109 - S109 2011.2

硬組織接着性多糖誘導体リン酸化プルランの開発

高畑智宏, 塩崎泰之, 吉田靖弘, 杉本佳久, 三澤治夫, 吉田晶, 田中雅人, 尾崎敏文

日本整形外科学会雑誌 85 ( 2 ) S108 - S108 2011.2

Toolpath generator for multi-axis medical machine tool to optimize cutting tool posture and position before skin incision Reviewed

Nawata W, Sugita N, Nakajima Y, Kato T, Fujiwara K, Abe N, Ozaki T, Suzuki M, Mitsuishi M

Proceedings of the 6th International Conference on Leading Edge Manufacturing in 21st Century, LEM 2011 2011

Publishing type：Research paper (international conference proceedings)

A robotic system has been developed for Minimally Invasive Surgery (MIS) in Total Knee Arthroplasty (TKA). In MIS TKA, it is imperative to achieve high accuracy of bone cutting and short skin incision. However, MIS TKA has a challenging issue as to the tool insertion into the small incision area. Moreover, an inappropriate incision causes inability of bone cutting or interference between tool and skin. Therefore, tool path generation method was developed based on the optimized incision placement. The experiments with model and swine legs showed that we could successfully implement the operation within 80 mm incision in clinical use.

Other Link： http://orcid.org/0000-0002-1369-0747

Toolpath strategy based on geometric model for multi-axis medical machine tool Reviewed

Sugita N, Nakano T, Abe N, Fujiwara K, Ozaki T, Suzuki M, Mitsuishi M

CIRP Annals - Manufacturing Technology 60 ( 1 ) 419 - 424 2011

Publishing type：Research paper (scientific journal)

Toolpath generation for a multi-axis medical machine tool is a challenging task. In surgical procedures, it is difficult to apply industrial CAM technology owing to the requirement for quick toolpath generation and the likelihood of tool interference with complex structures of the target area. The objectives of this study are to optimize the initial position and posture of the cutting tool for performing the ideal skin incision and to minimize contact between the cutting tool and the surrounding area. We propose a novel toolpath strategy based on geometric models. It can be potentially applied to general machine-assisted surgeries. © 2011 CIRP.

DOI： 10.1016/j.cirp.2011.03.030

Other Link： http://orcid.org/0000-0002-1369-0747

Regulation of mechanical stress-induced MMP-13 and ADAMTS-5 expression by RUNX-2 transcriptional factor in SW1353 chondrocyte-like cells. Reviewed

Tetsunaga T, Nishida K, Furumatsu T, Naruse K, Hirohata S, Yoshida A, Saito T, Ozaki T

Osteoarthritis Cartilage 19 ( 2 ) 222 - 232 2011

Publishing type：Research paper (scientific journal)

Objective: To investigate the mechanism of mechanical stress-induced expression and regulation of aggrecanases and examine the role of runt-related transcription factor 2 (RUNX-2) in chondrocyte-like cells. Methods: SW1353 cells were seeded onto stretch chambers at a concentration of 5×104cells/chamber, and a uni-axial cyclic tensile strain (CTS) (0.5Hz, 10% stretch) was applied for 30min. Total RNA was extracted, reverse transcribed, and analyzed by polymerase chain reaction (PCR) and real-time PCR. RUNX-2 overexpression and small interfering RNA (siRNA) targeting RUNX-2 were used to investigate the role of RUNX-2 in CTS-induced gene expression. The involvement of diverse mitogen-activated protein kinase (MAPK) pathways in the activation of RUNX-2, MMP-13 and ADAMTS-5 during CTS was examined by Western blotting. Results: CTS induced expression of RUNX-2, MMP-13, ADAMTS-4, -5, and -9. Overexpression of RUNX-2 up-regulated expression of MMP-13 and ADAMTS-5, whereas RUNX-2 siRNA resulted in significant down-regulation of mechanically-induced MMP-13 and ADAMTS-5 expression. CTS induced activation of p38 MAPK, and CTS induction of RUNX-2, MMP-13 and ADAMTS-5 mRNA was down-regulated by the selective p38 MAPK inhibitor SB203580 but not by the p44/42 MAPK inhibitor U0126, or the JNK MAPK inhibitor JNK inhibitor II. Conclusions: RUNX-2 might have a role as a key downstream mediator of p38's ability to regulate mechanical stress-induced MMP-13 and ADAMTS-5 expression. © 2010 Osteoarthritis Research Society International.

DOI： 10.1016/j.joca.2010.11.004

Comparison between loose fragment chondrocytes and condyle fibrochondrocytes in cellular proliferation and redifferentiation. Reviewed

Takata N, Furumatsu T, Abe N, Naruse K, Ozaki T

J Orthop Sci 16 ( 5 ) 589 - 597 2011

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

BACKGROUND: Loose fragments in spontaneous osteonecrosis of the knee (SONK) are usually removed by surgical treatment. However, the healing potential of osteonecrotic loose fragments and their clinical availability, for example as a cell source for cartilage repair and tissue engineering, have not been investigated. The objective of this study was to evaluate the cellular proliferation and redifferentiation ability of loose fragment chondrocytes for the treatment of SONK. METHODS: Cells were obtained from the remaining cartilage of chondral loose fragments or fibrocartilaginous tissue under the affected femoral condyle in SONK. The proliferation activity of loose fragment-derived chondrocytes and condyle-derived fibrochondrocytes was evaluated. In-vitro differentiation ability was assessed by PCR and histological analysis. RESULTS: The deposition of proteoglycans and type II collagen were maintained in loose fragments. However, loose fragment-derived chondrocytes had lower proliferating activity than condyle-derived fibrochondrocytes. Chondrogenic redifferentiation ability was lower in loose fragment chondrocytes than in condyle fibrochondrocytes. Differentiation towards adipogenic and osteogenic lineages was not observed in loose fragment chondrocytes. On the other hand, lipid vacuoles were detected in fibrochondrocytes after adipogenic treatment. CONCLUSIONS: This study demonstrated that loose fragment-derived chondrocytes in SONK had lower potential than fibrochondrocytes in cellular proliferation and redifferentiation. Our experimental results suggest that osteonecrotic loose fragments might have restricted cellular properties in the healing of SONK-related osteochondral defects.

DOI： 10.1007/s00776-011-0128-1

Treatment of Torn Lateral Discoid Meniscus:— Comparison of Meniscal Repair Group and Subtotal Meniscectomy Group —

Takata Naoki, Furumatsu Takayuki, Miyazawa Shinichi, Yokoyama Yusuke, Okada Yukimasa, Ozaki Toshifumi, Abe Nobuhiro

The Journal of the Chugoku-Shikoku Orthopaedic Association 23 ( 2 ) 261 - 265 2011

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Arthroscopic treatment has been widely performed for tears of the lateral discoid meniscus. However, this frequently results in total meniscectomy in cases of degenerative peripheral tear. We performed meniscal suturing of residual peripheral tears after subtotal meniscectomy to preserve the function of the meniscus.<br>Methods : We treated 15 knees of 15 patients (4 males and 11 females) with symptomatic lateral discoid meniscus tears. The mean age of the patients at surgery was 18.7 years (range, 7 to 37 years), and the mean follow-up period was 2.7 years (range, 12 to 65 months). We retrospectively compared the clinical results and the incidence rate of osteochondritis dissecans (OCD) in the peripheral repair group with those in the subtotal meniscectoy group. Clinical results were assessed on the basis of the Japanese Orthopaedic Association (JOA) score.<br>Results : Eight patients underwent arthroscopic partial meniscectomy alone. In the remaining 7 patients with degenerative peripheral tears, meniscal repair was performed after subtotal meniscectomy to avoid total meniscectomy. All of the patients had excellent JOA scores at the final follow-up point. None of them required additional surgery for re-tear. The incidence of OCD was 14% in the partial meniscectomy group, whereas OCD was not found in the peripheral repair group.<br>Conclusion : Our results demonstrate the short-term efficacy of arthroscopic partial meniscectomy in conjunction with peripheral repair in cases of degenerative peripheral tear of lateral discoid meniscus.

DOI： 10.11360/jcsoa.23.261

Comparison between Fondaparinux and Enoxaparin in Early Administration after Total Knee Arthroplasty

Okada Yukimasa, Furumatsu Takayuki, Itani Satoru, Saiga Kenta, Takata Naoki, Yokoyama Yusuke, Ozaki Toshifumi, Abe Nobuhiro

The Journal of the Chugoku-Shikoku Orthopaedic Association 23 ( 2 ) 399 - 403 2011

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Background: The validity of fondaparinux and enoxaparin has been reported in the prevention of deep vein thronbosis and pulmonary embolism (DVT/PE) after total knee arthroplasty (TKA). We compared the effectiveness of early administration of these two drugs after TKA.<br>Methods: We studied 32 patients who underwent TKA in the period between May 2009 and May 2010. The operations were performed under general anesthesia and femoral nerve block, using an air tourniquet, and using cements for implant fixation. The patients were divided in two groups, use of 2.5mg fondaparinux once daily (Fa group), and use of 2000IU of enoxaparin twice daily (Ex group). The initial dose was administered between 12 and 21 hours after surgery and continued for 14 days. We compared the incidence of DVT/PE, bleeding complications, D dimer level, and hemoglobin (Hb) loss.<br>Results: DVT/PE occurred in 6 patients (38%) in the Fa group, and 3 (19%) in the Ex group. Bleeding complications occurred in none of the Fa group and 4 (25%) in the Ex group. There were no significant differences in D dimer level and Hb loss.<br>Conclusion: Our results indicate that enoxaparin decreases the incidence of DVT/PE compared with fondaparinux, but increases the bleeding complications.

DOI： 10.11360/jcsoa.23.399

Deep venous thrombosis and pulmonary embolism after pelvic and acetabular fracture

MAZAKI Tetsuro

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 3 ) 469 - 470 2011

Corrective osteotomy for severe kyophosis in ankylosing spondylitis: One case report

MAZAKI Tetsuro

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 6 ) 1231 - 1232 2011

The long term results over 25 years follow-up of Charnley total hip arthroplasty

TETSUNAGA Tomonori

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 5 ) 1017 - 1018 2011

A case report of atypical femoral shaft farcture: the medullary cavity was obstructed at the fracture site

OSAKI Shuhei

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 5 ) 951 - 952 2011

Total hip arthroplasty with femoral shortening osteotomy for a patient treated by Schanz osteotomy

INOUE Madoka

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 5 ) 1009 - 1010 2011

Well leg compartment syndrome following radical cystectomy: A case report

OKADA Yoshiki

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 4 ) 869 - 870 2011

Radiological outcome after medial patellofemoral ligament reconstruction using Endobutton fixation

YOKOYAMA Yusuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 4 ) 731 - 732 2011

The functional outcome after subtotal scaplectomy for chondrosarcoma: two case reports

OKADA Yoshiki

The Central Japan Journal of Orthopaedic Surgery & Traumatology 54 ( 1 ) 41 - 42 2011

Minimally invasive plate osteosynthesis for osteofibrous dysplasia of the tibia: a case report. Reviewed International journal

Nakahara H, Kunisada T, Noda T, Ozaki T

Journal of orthopaedic surgery (Hong Kong) 18 ( 3 ) 374 - 377 2010.12

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

Osteofibrous dysplasia occurs most frequently in the tibia and may result in deformity and pathological fracture. We report one such case in a 6-year-old girl who underwent minimally invasive plate osteosynthesis using a locking compression plate. The varus deformity of the tibia was manually corrected, and the plate was inserted without extensive surgical exposure. At 20-week follow-up, the fracture had healed completely, and she had returned to normal daily living. At 3-year follow-up, radiographs showed no progression of the varus deformity. Minimally invasive plate osteosynthesis is useful for treatment of pathological fractures caused by osteofibrous dysplasia. It preserves blood flow at the fracture site, leading to good bone healing and stability to prevent further deformity and an early return to daily activity.

DOI： 10.1177/230949901001800325

Centpillar stemで著明なゆるみを生じた1例

長谷井嬢, 遠藤裕介, 鉄永智紀, 藤原一夫, 三谷茂, 尾崎敏文

日本人工関節学会誌 40 724 - 725 2010.12

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

54歳女。変形性股関節症で、10年前に右股関節に対しセメントTHAを施行し、今回、左股関節に対しTHAを施行した。Cup挿入にはnavigationを使用し、Stemは術前CTプランニングと同サイズをnavigation非使用で術中骨折等の合併症なく挿入した。術後2日で荷重歩行を開始し、術後1週のCTで骨折などは認めず経過良好であったが、術後2週で2mmのsubsidenceを認めた。荷重制限は行わず、術後3週でT字杖一本歩行で自宅退院し経過観察していたところ、徐々に骨萎縮が進行し、術後1年では著明な跛行およびX線上約4mmのsubsidenceと大腿骨の膨化を認めた。再置換術は希望されず、更に術後2年では約2cmのsubsidenceが生じ、術後2年6ヵ月にはステム遠位部での骨形成がみられた。術後2年以降、subsidenceの進行は認めていない。

長橈側手根伸筋(ECRL)腱を用いて母指手根中手骨(CM)関節形成術を行った1例

井上円加, 西田圭一郎, 橋詰謙三, 島村安則, 中原龍一, 斉藤太一, 金澤智子, 尾崎敏文

岡山医学会雑誌 122 ( 3 ) 279 - 279 2010.12

パルス洗浄が人工股関節全置換術術後成績に与える影響についての検討

鉄永智紀, 三谷茂, 藤原一夫, 遠藤裕介, 三宅由晃, 尾崎敏文

日本人工関節学会誌 40 234 - 235 2010.12

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

セメントレスTHAの術中にパルス洗浄を行った群(25例)と行わなかった群(25例)とで手術成績を比較検討した。評価項目は「手術時間」「術中出血量」「術後合併症」「術後の血液検査所見」「JOAスコア」とした。検討の結果、いずれの項目にも有意な群間差は認められなかった。

ケルブールプレートと人工骨を併用した臼蓋再置換術THAの短期成績の検討

遠藤裕介, 三谷茂, 藤原一夫, 三宅由晃, 鉄永智紀, 国定俊之, 尾崎敏文

日本人工関節学会誌 40 102 - 103 2010.12

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

2000年〜2007年に人工骨とケルブールプレート併用の臼蓋側再置換術(THA)を施行した骨欠損症37例中2年以上経過観察できた30例30関節(男性5例、女性25例、44〜78歳・平均66歳)を対象に、短期成績について検討した。前回手術は人工骨頭置換術(BHA)2例、人工股関節置換術(THA)28例で前回手術からの経過観察期間は平均15年(2〜26年)、再置換の理由は無菌性のゆるみ27例、感染2例、脱臼1例、平均追跡期間は4年6ヵ月(2〜9年)であった。術前のAAOS分類はIが5股、IIが2股、IIIが20股、IVが3股であった。術直後のX線像におけるケルブールプレートのフックの設置位置は14股(46%)に外側設置を認め、荷重部の移植骨の厚みは平均15mm(0〜27mm)であった。最終調査時迄に遅発性感染を2例に認め、スクリューのゆるみ・破損を6股(20%)に認めた。カップの内方への移動を7股(23%)に認め移動距離は平均7.2mm(1〜20mm)であった。JOAスコアは術前平均50点から最終観察時平均77点と改善した。感染例2例を除く28股においてカップの移動を生じた5股と問題のなかった23股を比較検討したが両群に術前の平均年齢、BMIに差はなく成績不良群には術前AAOS分類でタイプIVが2股存在した。成績不良群は全例荷重部にブロックを使用せずに人工骨顆粒のみを使用していた。荷重部の移植骨の厚みには有意差は認めず、プレートの設置状態が良好であった15股中2股に成績不良を認めた。

大腿骨頸部外骨腫にともなう変形性股関節症の1例

金澤智子, 藤原一夫, 遠藤裕介, 鉄永智紀, 尾崎敏文, 三谷茂

日本人工関節学会誌 40 726 - 727 2010.12

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

47歳男。44歳時より誘因なく右股関節痛が出現し、前医でのX線で右大腿骨頭の変形を指摘されたが、臼蓋側の変形は軽度で、関節裂隙の狭小化も僅かであった。MRIでは正常骨皮質と連続した有茎性の腫瘤を認め、周囲組織の信号変化はなかった。大腿骨頸部に発生した外骨腫の診断で保存加療を受けたが、右股関節痛が増悪し、腫瘍増大も疑われたため当科紹介受診した。受診時には歩行時痛、著明な可動域制限を認め、X線で関節裂隙は狭小化し、臼蓋側にも骨硬化と骨嚢胞を認めた。CT・MRIでは大腿骨頸部前外側に有茎性の骨性隆起を認め、周囲組織との信号変化は認めなかった。タリウムシンチグラムでは、early phase、delayed phase共に集積の亢進は認めなかった。以上より変形性股関節症と診断し、人工股関節置換術を施行した。組織学的所見では大腿骨頸部に認めた骨性隆起に軟骨様の組織を認め、軟骨帽の一部であったと考えられた。術後経過は良好で、術後4ヵ月時でJOA scoreは34点から83点に改善しており、ROMも著明改善し、1時間程度の独歩が可能であった。

Combined use of bFGF and GDF-5 enhances the healing of medial collateral ligament injury Reviewed

Kenta Saiga, Takayuki Furumatsu, Aki Yoshida, Shin Masuda, Shota Takihira, Nobuhiro Abe, Toshifumi Ozaki

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 402 ( 2 ) 329 - 334 2010.11

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Basic fibroblast growth factor (bFGF) and growth and differentiation factor (GDF)-5 stimulate the healing of medial collateral ligament (MCL) injury. However, the effect of isolated and combined use of bFGF/GDF-5 remains still unclear. We investigated cellular proliferation and migration responding to bFGF/GDF-5 using rabbit MCL fibroblasts. Rabbit MCL injury was treated by bFGF and/or GDF-5 with peptide hydrogels. Gene expression and deposition of collagens in healing tissues were evaluated. bFGF/GDF-5 treatment additively enhanced cell proliferation and migration. bFGF/GDF-5 hydrogels stimulated Col1a1 expression without increasing Col3a1 expression. Combined use of bFGF/GDF-5 stimulated type I collagen deposition and the reorganization of fiber alignment, and induced better morphology of fibroblasts in healing MCLs. Our study indicates that combined use of bFGF/GDF-5 might enhance MCL healing by increasing proliferation and migration of MCL fibroblasts, and by regulating collagen synthesis and connective fiber alignment. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2010.10.026

Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture Reviewed

Keiya Yamana, Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Toshifumi Ozaki, Hitoshi Konishi

EUROPEAN SPINE JOURNAL 19 ( 10 ) 1643 - 1650 2010.10

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

The instrumentation of the osteoporotic spine may sometimes result in failure due to the loosening or pullout of the conventional pedicle screw. Moreover, augmentation of screws with polymethylmethacrylate (PMMA) has risks of complications. We developed a new and original pedicle nail system with PMMA for osteoporotic vertebral fractures. A clinical evaluation of this novel pedicle nail system utilized in patients with an osteoporotic vertebral collapse was performed to determine the effectiveness and safety of this technique. Thirty-four elderly patients who suffered from osteoporotic compression fractures were treated by posterolateral fusion using the pedicle nail system. The mean follow-up period was 37 months. Of the 25 patients with neurological symptoms, two patients improved two stages at the Frankel level. Fifteen patients improved one stage at the Frankel level, and eight other patients improved, however, their improvement did not exceed a Frankel level. Nine cases with neuralgia symptoms improved from 4.4 to 2.2 points on average on the Denis pain scale (p < 0.01). The fusion rate was 94% as determined by X-rays of flexion and extension, and the correction of the compression fracture site was maintained well. A pedicle nail system stabilizes the spinal column with osteoporosis and reduces the instrumentation failure. The technique for the insertion of the pedicle nail reduces complication from cement augmentation. The authors speculate that the strategy using the pedicle nail system for osteoporotic spine may be effective and safe when the surgery is performed through a posterior approach.

DOI： 10.1007/s00586-010-1402-1

RA上肢変形の治療関節リウマチ(RA)に対するSauve-Kapandji(S-K)法の治療成績

金澤智子, 橋詰謙三, 西田圭一郎, 中原龍一, 斎藤太一, 尾崎敏文

日本関節病学会誌 29 ( 3 ) 398 - 398 2010.10

周術期の管理エタネルセプト使用症例の周術期感染頻度の検討

中原龍一, 西田圭一郎, 金澤智子, 斎藤太一, 橋詰謙三, 尾崎敏文

日本関節病学会誌 29 ( 3 ) 340 - 340 2010.10

【肩関節・肩甲帯部疾患病態・診断・治療の現状】治療保存的治療と手術的治療の現状骨折と脱臼鎖骨骨折鎖骨骨幹部骨折に対するプレート固定法前下方プレート法、minimally invasive plate osteosynthesis法

島村安則, 野田知之, 中原龍一, 雑賀建多, 西山武, 尾崎敏文

別冊整形外科 ( 58 ) 71 - 75 2010.10

Language：Japanese Publisher：(株)南江堂

2007年より鎖骨骨幹部骨折に対してプレート固定による手術的治療を行った症例は42例であった。そのうち、初期の32例に対してはanteroinferior plating法(AP法)を、2009年からの10例は、AP法を応用したminimally invasive plate osteosynthesis法(MIPO法)を施行した。AP法、MIPO法ともに全例において骨癒合が得られ、JOAスコア、DASHスコアともに良好な改善が得られた。MIPO法はAP法に比較して、早期に疼痛の軽減が得られている印象であった。AP法は従来の手術法に比べて早期に社会復帰が可能となる有用な方法であるが、さらにMIPO法はAP法のメリットに加えて整容面や骨折部の血流温存といった面でも有利であり、手術・保存的治療双方のメリットを併せ持つ優れた治療法であると考えられた。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J04037&link_issn=&doc_id=20101104480015&doc_link_id=10.15106%2FJ04037.2011097692&url=https%3A%2F%2Fdoi.org%2F10.15106%2FJ04037.2011097692&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

関節病に対する上肢人工関節置換術関節リウマチ肘関節破壊に対するJACE型人工肘関節置換術の中期成績

橋詰謙三, 西田圭一郎, 中原龍一, 斎藤太一, 金澤智子, 尾崎敏文

日本関節病学会誌 29 ( 3 ) 409 - 409 2010.10

Multicenter Phase II trial assessing effectiveness of imatinib mesylate on relapsed or refractory KIT-positive or PDGFR-positive sarcoma Reviewed

Hideshi Sugiura, Yasuhiro Fujiwara, Masashi Ando, Akira Kawai, Akira Ogose, Toshifumi Ozaki, Ryohei Yokoyama, Toru Hiruma, Takeshi Ishii, Hideo Morioka, Hideo Mugishima

JOURNAL OF ORTHOPAEDIC SCIENCE 15 ( 5 ) 654 - 660 2010.9

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

Imatinib myselate is a molecularly targeted drug that inhibits Abl tyrosine kinase, as well as type III tyrosine kinase receptors such as platelet-derived growth factor receptor (PDGFR), KIT, colony-stimulating factor 1 receptor (CSF-1R), and discoidin domain receptor (DDR). Ph1 chromosome-positive chronic myeloid leukemias (CMLs), KIT-positive gastrointestinal stromal tumors (GISTs), and PDGFR-positive dermatofibrosarcoma protuberans (DFSP) have been reported to be responsive to imatinib treatment. We conducted a multicenter Phase II trial of imatinib in patients with relapsed or refractory KIT-positive (excluding GISTs) or PDGFR-positive sarcomas.
Patient ages ranged from 12 and 75 years. Eligibility criteria included (1) metastatic sarcomas with a definitive diagnosis based on histopathology or that were completely unresectable and locally advanced; (2) relapsed or refractory cases that had completed standard treatment; and (3) a tumor confirmed by immunohistochemical staining to be KIT- or PDGFR-positive. A 600-mg dose of imatinib was administered to patients once a day, with each patient receiving six courses of the drug and each course lasting 4 weeks. In cases categorized as stable or progressive, the imatinib dose was increased to 800 mg/day administered twice daily.
A total of 25 patients who met the eligibility criteria were enrolled in the trial; 22 were evaluated for response. The response rate with a 600 mg/day dose of imatinib was 4.5% (0 complete response, 1 partial response). There were no other objective responses after increasing imatinib to 800 mg/day (0/10). We estimated 50% progression-free survival to be 61.0 days for an imatinib dose of 600 mg/day based on the Kaplan-Meier method. Side effects of imatinib were generally similar to those observed in previous clinical trials.
Our results did not indicate effectiveness of imatinib monotherapy at a dose of 600 or 800 mg/day in patients with relapsed or refractory KIT-positive (excluding GISTs) or PDGFR-positive sarcomas. Our findings suggest the need to evaluate the synergistic effect of combination therapy with other anticancer drugs.

DOI： 10.1007/s00776-010-1506-9

橈骨遠位端骨折に対する掌側プレートによる長母指屈筋腱断裂の3例

金澤智子, 島村安則, 野田知之, 西山武, 斎藤太一, 尾崎敏文

中部日本整形外科災害外科学会雑誌 53 ( 秋季学会 ) 177 - 177 2010.9

鎖骨骨幹部粉砕骨折に対するMIPOによる治療経験

島村安則, 野田知之, 西山武, 中原龍一, 雑賀建多, 斉藤太一, 門田康孝, 尾崎敏文

中国・四国整形外科学会雑誌 22 ( 2 ) 494 - 495 2010.9

三次元実体石膏模型を利用して治療した反復性肩関節脱臼の1例

井上円加, 中原龍一, 斎藤太一, 金澤智子, 島村安則, 小澤正嗣, 阿部信寛, 野田知之, 西田圭一郎, 尾崎敏文

肩関節 35 ( 1 ) 176 - 176 2010.9

鎖骨骨幹部骨折に対する前下方プレート法による治療成績

島村安則, 野田知之, 中原龍一, 金澤智子, 井上円加, 斎藤太一, 小澤正嗣, 雑賀建多, 西田圭一郎, 尾崎敏文

肩関節 35 ( 1 ) 75 - 75 2010.9

肩鎖関節脱臼に合併した外傷性肩関節前方不安定症の1例

島村安則, 阿部信寛, 野田知之, 雑賀建多, 斎藤太一, 金澤智子, 井上円加, 小澤正嗣, 中原龍一, 尾崎敏文

肩関節 35 ( 1 ) 189 - 189 2010.9

より安全な掌側ロッキングプレート固定術の実施をめざした橈骨遠位端掌側部の解剖学的・組織学的研究

今谷潤也, 清水弘毅, 近藤秀則, 林正典, 秋田恵一, 尾崎敏文

日本整形外科学会雑誌 84 ( 8 ) S1339 - S1339 2010.8

良性嚢胞性骨腫瘍の画像診断 FEGNO-MASHICは正しいか

郷原英夫, 稲井良太, 加藤勝也, 佐藤修平, 新家崇義, 国定俊之, 尾崎敏文, 金澤右

日本医学放射線学会秋季臨床大会抄録集 46回 S539 - S540 2010.8

The 2009 Okayama Medical Association Awards: TGF-β-Smad3 pathway activates Sox9-dependent chondrogenesis

Journal of Okayama Medical Association 122 ( 2 ) 95 - 99 2010.8

Guidelines: Orthopaedic surgery: Japanese guidelines for coxarthrosis

Journal of Okayama Medical Association 122 ( 2 ) 159 - 162 2010.8

ヒト軟骨細胞様細胞においてADAMTS-5はRUNX-2を介してメカノセンシティブに機能するアグリカナーゼである

鉄永智紀, 西田圭一郎, 古松毅之, 斎藤太一, 成瀬恵治, 尾崎敏文

日本整形外科学会雑誌 84 ( 8 ) S1230 - S1230 2010.8

NCB Distal Femurプレートによる大腿骨遠位部骨折の治療経験

斎藤太一, 野田知之, 島村安則, 中原龍一, 雑賀健多, 尾崎敏文

岡山医学会雑誌 122 ( 2 ) 178 - 178 2010.8

THA cup再置換術後に早期破綻した1例に対する治療経験

藤原智洋, 遠藤裕介, 三谷茂, 尾崎敏文, 藤原一夫

岡山医学会雑誌 122 ( 2 ) 177 - 177 2010.8

骨肉腫におけるがん幹細胞の同定と解析(Identification and characterization of tumor-initiating cells in osteosarcoma)

藤原智洋, 高橋陵宇, 竹下文隆, 尾崎敏文, 川井章, 落谷孝広

日本癌学会総会記事 69回 488 - 488 2010.8

Computed tomography fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures Reviewed

Toshihiro Iguchi, Ken-Ichi Ogawa, Takeshi Doi, Koji Miyasho, Kazuo Munetomo, Takao Hiraki, Toshifumi Ozaki, Susumu Kanazawa

SKELETAL RADIOLOGY 39 ( 7 ) 701 - 705 2010.7

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

The purpose of this study was to evaluate retrospectively the safety and effectiveness of the computed tomography (CT) fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures.
Six patients (four women and two men; mean age 55.8 years; range 35-77 years) with unstable posterior pelvic fractures underwent iliosacral screw placement under CT fluoroscopy guidance between November 2007 and August 2008. Unstable pelvic ring injury (AO types B and C) was the indication for this procedure.
In all the six patients except one, CT fluoroscopy-guided placement had been technically successful. In one patient, a second screw had been inserted, with a tilt to the caudal site, and slightly advanced into the extrasacral body; afterward, it could be exchanged safely for a shorter screw. Five patients and one patient underwent placement of two screws and one screw, respectively. The mean duration of the procedure was 15.0 min (range 9-30 min) per screw; the duration was 12.3 min and 18.2 min for the first and second screws, respectively. No complications requiring treatment occurred during or after the procedure. The mean clinical and radiologic follow-up period was 14 months (range 6-21 months). All pelvic injuries had healed satisfactorily, without complication, and all patients are now doing well clinically and can walk.
CT fluoroscopy-guided placement of iliosacral screws is a safe and effective treatment in patients with unstable posterior pelvic fractures.

DOI： 10.1007/s00256-009-0826-3

鎖骨骨幹部骨折に対するMIPOによる治療経験

島村安則, 野田知之, 中原龍一, 斎藤太一, 金澤智子, 長谷井嬢, 雑賀建多, 井上円加, 尾崎敏文

骨折 32 ( Suppl. ) S82 - S82 2010.7

ロッキングプレートによるTKA周囲大腿骨骨折の治療経験

斎藤太一, 野田知之, 島村安則, 寺田忠司, 西山武, 中原龍一, 雑賀健多, 尾崎敏文

骨折 32 ( Suppl. ) S129 - S129 2010.7

"Gull Sign"を示す寛骨臼骨折の治療経験

藤原智洋, 野田知之, 中原龍一, 雑賀建多, 西山武, 島村安則, 尾崎敏文

骨折 32 ( Suppl. ) S87 - S87 2010.7

Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images Reviewed

Mitsugi Honda, Seizaburo Arita, Shigeru Mitani, Yoshihiro Takeda, Toshifumi Ozaki, Keiji Inamura, Susumu Kanazawa

ACTA MEDICA OKAYAMA 64 ( 3 ) 189 - 196 2010.6

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

Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH). The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on the measurement of 4 items in X-ray images: the outward displacement rate, upward displacement rate, OE angle, and a angle. This system was then applied to the data from Group 2, and the results were compared between the 2 groups to verify the reliability of the system. We obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%.

当科における滑膜肉腫の治療成績

藤原智洋, 森本裕樹, 井谷智, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 84 ( 6 ) S998 - S998 2010.6

Operative treatment for pincer type femoroacetabular impingement:a case report. Reviewed

Endo H, Noda T, Mitani S, Nakahara R, Tetsunaga T, Kunisada T, Ozaki T

Acta medica Okayama 64 ( 2 ) 149 - 154 2010.4

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

Femoroacetabular impingement (FAI) is a condition characterized by the impingement of the femur and acetabulum. In Japan, this disorder has become recognized gradually. Here we report a rare case of surgically treated FAI, associated with an osseous protrusion on the acetabulum of a 30-year-old female. Plain computed tomography (CT) and reconstructive 3D-CT images clearly demonstrated an anterolateral bony protrusion. Hip arthroscopy showed no degeneration of the cartilage on either the femoral or acetabular side, but degeneration at the edge of labrum was observed in the region of the bony protrusion. The complete removal of the bony protrusion under hip arthroscopy was thus considered impracticable, and a small skin incision was therefore made anteriorly to approach the acetabulum. The Short-Form 36-Item Health Survey (SF-36) revealed improvement in all scores.

DOI： 10.18926/AMO/32853

The effect of service dogs on the improvement of health-related quality of life Reviewed

Mai Shintani, Masuo Senda, Tomoko Takayanagi, Yoshimi Katayama, Kazunari Furusawa, Tamami Okutani, Masaki Kataokani, Toshifumi Ozaki

Acta Medica Okayama 64 ( 2 ) 109 - 113 2010.4

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

To assess the effects of service dogs on health-related quality of life (HRQOL), we conducted a survey of 10 service dog owners using SF-36v2 (Medical Outcomes Study 36 Item Short-Form Health Survey Version 2.0) and compared it with a matched control group of people with physical disabilities who did not have service dogs but were eligible for one. The scores for mental health and role emotional of service dog owners were relatively high, and their mental component summary was higher than the general population norm. These results indicate that service dogs affect the mentality of their owners. The comparison with the control group indicated that service dogs alleviate the mental burden of daily activities, and subjectively improved the physical functioning of their owners. This study showed that service dogs have positive functional and mental effects on their disabled owners. © 2010 by Okayama University Medical School.

化膿性膝関節炎後の膝蓋骨脱臼を伴った大腿骨変形に対する矯正術を行った1例

斎藤太一, 遠藤裕介, 三谷茂, 鉄永智紀, 尾崎敏文

岡山医学会雑誌 122 ( 1 ) 86 - 86 2010.4

掌側ロッキングプレートを用いて加療した橈骨遠位部骨折における抜釘術の検討

島村安則, 斎藤太一, 金澤智子, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 22 ( 1 ) 199 - 199 2010.4

生物学的製剤使用下の手術治療について生物学的製剤の限界

西田圭一郎, 橋詰謙三, 門田康孝, 中原龍一, 斎藤太一, 尾崎敏文

日本整形外科学会雑誌 84 ( 3 ) S228 - S228 2010.3

掌側ロッキングプレートを用いて加療した橈骨遠位部骨折における抜釘術の検討

島村安則, 斎藤太一, 野田知之, 西田圭一郎, 尾崎敏文

日本手の外科学会雑誌 27 ( 1 ) S138 - S138 2010.3

生物学的製剤時代における手術の変遷画像診断と外科的治療画像からみた手術の適応とタイミングどの時期に手術が必要か

西田圭一郎, 橋詰謙三, 中原龍一, 門田康孝, 那須義久, 斎藤太一, 尾崎敏文

日本リウマチ学会総会・学術集会・国際リウマチシンポジウムプログラム・抄録集 54回・19回 219 - 219 2010.3

関節リウマチに対する手術療法の進歩と今後関節リウマチに対する上肢手術の進歩と今後

西田圭一郎, 橋詰謙三, 門田康孝, 中原龍一, 斎藤太一, 尾崎敏文

日本整形外科学会雑誌 84 ( 3 ) S231 - S231 2010.3

Anterior cruciate ligament-derived cells have high chondrogenic potential Reviewed

Takayuki Furumatsu, Motomi Hachioji, Kenta Saiga, Naoki Takata, Yusuke Yokoyama, Toshifumi Ozaki

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 391 ( 1 ) 1142 - 1147 2010.1

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Anterior cruciate ligament (ACL)-derived cells have a character different from medial collateral ligament (MCL)-derived cells. However, the critical difference between ACL and MCL is still unclear in their healing Potential and cellular response. The objective of this study was to investigate the mesenchymal differentiation property of each ligament-derived cell. Both ligament-derived cells differentiated into adipogenic, osteogenic, and chondrogenic lineages. In chondrogenesis, ACL-derived cells had the higher chondrogenic property than MCL-derived cells. The chondrogenic marker genes, Sox9 and alpha 1(II) collagen (Col2a1), were induced faster in ACL-derived pellets than in MCL-derived pellets. Sox9 expression preceded the increase of Col2a1 in both pellet-cultured cells. However, the expression level of Sox9 and a ligament/tendon transcription factor Scleraxis did not parallel the increase of Col2a1 expression along with chondrogenic induction. The present Study demonstrates that the balance between Sox9 and Scleraxis have an important role in the chondrogenic differentiation of ligament-derived cells. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2009.12.044

Scleraxis and E47 cooperatively regulate the Sox9-dependent transcription Reviewed

Takayuki Furumatsu, Chisa Shukunami, Michiyo Amemiya-Kudo, Hitoshi Shimano, Toshifumi Ozaki

International Journal of Biochemistry and Cell Biology 42 ( 1 ) 148 - 156 2010.1

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

During musculoskeletal development, Sry-type HMG box 9 (Sox9) has a crucial role in mesenchymal condensation and chondrogenesis. On the other hand, a tissue-specific basic helix-loop-helix (bHLH) transcription factor Scleraxis (Scx) regulates the differentiation of tendon and ligament progenitors. Whereas these two transcription factors cooperatively participate in the determination of cellular lineages, the precise interaction between Sox9 and Scx remains unclear. We have previously demonstrated that the Sox9-dependent transcription is synergistically activated by several Sox9-associating molecules, such as p300 and Smad3, on chromatin. In this study, we investigated the function of Scx in the Sox9-dependent transcription. The expression of α1(II) collagen (Col2a1) gene was stimulated by an appropriate transduction of Sox9 and Scx. Scx and its partner E47, which dimerizes with other bHLH proteins, cooperatively enhanced the Sox9-dependent transcription in luciferase reporter assays. Coactivator p300 synergistically increased the activity of Sox9-regulated reporter gene, which contains promoter and enhancer regions of Col2a1, in the presence of Scx and E47. Immunoprecipitation analyses revealed that Scx and E47 formed a transcriptional complex with Sox9 and p300. Scx/E47 heterodimer also associated with a conserved E-box sequence (CAGGTG) in the Col2a1 promoter on chromatin. These findings suggest that Scx and E47 might modulate the primary chondrogenesis by associating with the Sox9-related transcriptional complex, and by binding to the conserved E-box on Col2a1 promoter. © 2009 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.biocel.2009.10.003

Bone Repair Using a Hybrid Scaffold of Self-Assembling Peptide PuraMatrix and Polyetheretherketone Cage in Rats Reviewed

Hiroyuki Nakahara, Haruo Misawa, Aid Yoshida, Takayuki Hayashi, Masato Tanaka, Takayuki Furumatsu, Noriaki Tanaka, Naoya Kobayashi, Toshifumi Ozaki

CELL TRANSPLANTATION 19 ( 6-7 ) 791 - 797 2010

Language：English Publishing type：Research paper (scientific journal) Publisher：COGNIZANT COMMUNICATION CORP

Self-assembling peptide scaffold (SAPS) is well known to have very good bone conduction properties. However, the intensity of SAPS is too weak to actually use it for a clinical bone regeneration. Therefore, we have produced a hybrid scaffold system that involves fabricating a cage from polyetheretherketone (PEEK) that has high intensity, filling the interior of this cage with SAPS, and then transplanted this hybrid scaffold to bone defects in rat femurs. After 28 days, soft X-ray radiographs and histological assessment revealed that good new bone formation was clearly observed in the defects transplanted the PEEK cage with SAPS, but not in the PEEK cage only. The PEEK cage maintained a form and osteoconduction ability of internal SAPS, and SAPS promoted bone formation inside the PEEK; therefore, each was in charge of intensity and bone regeneration separately. The present study suggests that hybrid scaffolds made from PEEK cages and SAPS can be useful tools for the regeneration of load-bearing bones, based on the idea that it should be possible to develop ideal bone filler materials by combining the strength of artificial bone with the bone regeneration and bone conduction properties of SAPS.

DOI： 10.3727/096368910X508906

Interference free surgical tool-path generation in multi-axis bone milling robot Reviewed

Sugita N, Nakano T, Nakajima Y, Fujiwara K, Abe N, Ozaki T, Suzuki M, Mitsuishi M

2010 3rd IEEE RAS and EMBS International Conference on Biomedical Robotics and Biomechatronics, BioRob 2010 790 - 795 2010

Publishing type：Research paper (international conference proceedings)

Tool interference causes serious damage to surrounding soft tissue in minimally invasive orthopedic surgery with a milling robot. The objective of this study is to avoid the collision of cutting tool with complicated shapes, and a novel approach of interference-free toolpath generation in a short intraoperative time is proposed. In order to resolve this issue, we propose the following two methods: intraoperative modeling of soft tissues as an interference area and interference-free toolpath generation based on the model. A model is constructed to represent the opening area and the internal tissues by using a 3-dimensional optical position sensor to measure them. Based on the constructed model, interference-free toolpath is immediately determined by the preliminary definition of evacuating direction. The effectiveness of the proposed method is evaluated with artificial models on the system that the authors have developed so far. A tool contact force against the model was measured by a force sensor mounted on the cutting tool. The result revealed that the tool interference was greatly reduced by implementing the proposed method. © 2010 IEEE.

DOI： 10.1109/BIOROB.2010.5627008

Other Link： http://orcid.org/0000-0002-1369-0747

Optimal control of cutting feed rate in the robotic milling for total knee arthroplasty Reviewed

Inoue T, Sugita N, Mitsuishi M, Saito T, Nakajima Y, Yokoyama Y, Fujiwara K, Abe N, Ozaki T, Suzuki M, Kuramoto K, Nakashima Y, Tanimoto K

2010 3rd IEEE RAS and EMBS International Conference on Biomedical Robotics and Biomechatronics, BioRob 2010 215 - 220 2010

Publishing type：Research paper (international conference proceedings)

For the total knee arthroplasty, we developed the robotic system, such as the cutting feed rate is controlled depending on the hardness of the bone tissue predicted on the basis of the medical image. Since the cutting force is reduced by this system, the displacement of the bone is minimized during the bone cutting process. Therefore it makes a possibility to fix the target bone using "safer" and "less-invasive fixation technique. © 2010 IEEE.

DOI： 10.1109/BIOROB.2010.5626940

Other Link： http://orcid.org/0000-0002-1369-0747

Short-term Results of CentPillar Total Hip Arthroplasty

Tetsunaga Tomonori, Mitani Shigeru, Fujiwara Kazuo, Ozaki Toshifumi, Endo Hirosuke

The Journal of the Chugoku-Shikoku Orthopaedic Association 22 ( 2 ) 449 - 453 2010

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

The present study examined the short-term results of CentPillar cementless total hip arthroplasty (THA) using the GB HA and TMZF HA stems. We treated 31 patients during the period between January 2005 and June 2009. The average age of the patients at the time of surgery was 54 years, and the average postoperative follow-up period was 13 months. Early stem subsidence after surgery was significantly less frequent for the TMZF HA stem than for the GB HA stem. In particular, early stem subsidence was detected in cases of varus or valgus stem alignment. The change in stem alignment after surgery using the TMZF HA stem was smaller than that for the GB HA stem. There was no significant difference in the stem-occupation rate in the canal between the two stem types. The average Japanese Orthopaedic Association hip score improved significantly after surgery with both types of stem. The CentPillar TMZF HA stem achieved initial stability of the proximal femur as a result of smaller stem subsidence by coating the PureFix HA with plasma spray.

DOI： 10.11360/jcsoa.22.449

Two Cases of Old Femoral Neck Fracture

Tamura Ryu, Kano Takeshi, Fujiwara Kazuo, Endo Hirosuke, Ozaki Toshifumi

The Journal of the Chugoku-Shikoku Orthopaedic Association 22 ( 2 ) 285 - 288 2010

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We report two cases with old femoral neck fracture. One patient was an 80-year-old woman who had fallen down 6 months previously. The other patient was an 88-year-old man who had fallen down 4 months previously. Both patients had severe flexion contracture in their hip joints, and X-rays examinations showed severe old femoral neck fractures. Surgery was performed using bipolar hemiarthroplasty. This procedure was chosen in consideration of the patients' age and the presence of several risk factors related to their general condition. As the contracture was severe in the first case, we performed release of the soft tissues, especially in the area of the rectus femoris. After surgery, both patients regained full extension of their hip joints, and were able to start standing and walking exercise one week after the operation. Their ADL scores were obviously improved in comparison with those before surgery. We think that the release of soft tissue is useful in order to improve the contracture of the hip joint with old femoral neck fracture.

DOI： 10.11360/jcsoa.22.285

Posterior Dislocation of the Hip while Sprinting : A Case Report

Miyake Yoshiaki, Mitani Shigeru, Endo Hirosuke, Ozaki Toshifumi, Fujiwara Kazuo

The Journal of the Chugoku-Shikoku Orthopaedic Association 22 ( 2 ) 363 - 367 2010

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Hip dislocation is mostly caused by high-energy injury, and only rarely by athletic injury. Here we report a 17-year-old boy who suffered hip dislocation while sprinting. When he suddenly stopped after the sprint burst, posterior dislocation of the hip and anterior wall fracture of the acetabulum occurred. The hip is generally displaced posteriorly with the hip flexed, adducted, and internally rotated. Posterior wall fracture of the acetabulum sometimes occurs when the hip is less flexed. Although some authors have reported posterior dislocation with posterior wall fracture, there has been no previous report of posterior dislocation with anterior wall fracture. In the present case, the femoral neck might have impinged against the anterior acetabulum wall with the hip flexed, adducted, and internally rotated. In this position, an axial load would have been added to the hip joint, resulting in posterior dislocation and anterior wall fracture. We examined the hip joint by MRI in 5 months after the injury, and no osteonecrosis of the femoral head was evident. Careful follow-up will be necessary because hip dislocation often results in osteonecrosis even in cases of low-energy injury.

DOI： 10.11360/jcsoa.22.363

Giant Cell Tumor of the Sacrum Treated with Selective Intra-Arterial Embolization : A Case Report

Sasaki Tsuyoshi, Morimoto Yuki, Ozaki Toshifumi, Kunisada Toshiyuki, Gobara Hideo

The Journal of the Chugoku-Shikoku Orthopaedic Association 22 ( 2 ) 267 - 272 2010

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Giant cell tumor (GCT) of the sacrum is rare and difficult to treat, although several treatment modalities have been reported. Here we report a patient with sacral GCT who underwent selective intra-arterial embolization.<br>The patient, a 23-year-old woman, had been treated with curettage alone at a local hospital. However, 4 months after surgery, MRI showed recurrence of the tumor, and the patient was referred to our hospital for further treatment.<br>After discussion with her and her family, they accepted intra-arterial embolization of the tumor vessels. Embolization using a temporary embolic agent reduced the size of the tumor and the level of serum acid phosphatase (ACP). However, both the tumor size and the level of ACP increased a few months after the procedure. Therefore, embolization was performed using an embolic agent consisting of spherical particles. MRI showed a marked reduction of tumor size 1 month after the last embolization, and the level of serum ACP also fell to less than the standard value.<br>Embolization using a spherical-particulate embolic agent can be an effective treatment for sacral GCT.

DOI： 10.11360/jcsoa.22.267

Aseptic Non-union of Long Bone Fractures in the Lower Limb : Clinical Outcomes of Treatment with a Locking Plate

Fujiwara Tomohiro, Noda Tomoyuki, Nishiyama Takeshi, Nakahara Ryuichi, Saiga Kenta, Shimamura Yasunori, Ozaki Toshifumi, Kahara Naoaki, Miyazawa Shinichi, Takagi Yasushi

The Journal of the Chugoku-Shikoku Orthopaedic Association 22 ( 2 ) 355 - 361 2010

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

The development of the locking plate has allowed considerable progress in the treatment of fractures, but few studies have evaluated its usefulness for the treatment of aseptic non-union. We have treated 15 cases of aseptic non-union of long bones in the lower limb (femur : 5, tibia : 10, including 3 periprosthetic non-unions) using locking plates. The initial treatments were external fixation in 1 case, intramedullary nailing in 2, conventional plating in 5, locking plating in 4, and use of a cast only in 3. Nine cases were hypertrophic non-unions and 5 were atrophic non-unions. Union was achieved in all cases, although one case showed correction loss and 5 showed delayed union. These results were quite good, and allowed us to conclude that the locking plate is useful for the treatment of aseptic non-union of bones in the lower limb. Because the degree of bone defect and deformity differs in individual cases, detailed preoperative planning and choice of an appropriate operative technique are needed to achieve good results.

DOI： 10.11360/jcsoa.22.355

Treatment for fractures of the distal femur using with polyaxial locking plate

SAITO Taichi

The Central Japan Journal of Orthopaedic Surgery & Traumatology 53 ( 4 ) 821 - 822 2010

Continuous femoral nerve block for total knee arthroplasty

YOKOYAMA Yusuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 53 ( 4 ) 881 - 882 2010

A Case of Valgus Knee Deformity with Patellar Dislocation Caused by Infantile Septic Arthritis

Saito Taichi, Mitani Shigeru, Miyake Yoshiaki, Tetsunaga Tomonori, Ozaki Toshifumi, Endo Hirosuke

The Journal of the Chugoku-Shikoku Orthopaedic Association 22 ( 2 ) 343 - 348 2010

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We report a case of valgus knee deformity with patellar dislocation caused by infantile septic arthritis. The patient, a boy, had a congenital heart malformation. He had developed infantile septic arthritis of the knee joint at 1 month of age, and the distal lateral epiphysis of the femur had been affected. At 6 years of age, valgus deformity appeared, and therefore we performed deformity correction and leg lengthening with an Ilizarov fixator. However, the deformity recurred and the patella became dislocated laterally 3 years after initial surgery. In a second operation, we performed osteotomy at two sites of the femur. Distally, we corrected the valgus deformity and reduced the patella by changing the rotation of the femur and overlapping the medial soft tissue. Proximally, we corrected the retroversion and performed lengthening on a gradual basis. In the left leg, the preoperative mLDFA was 110° and the postoperative mLDFA was improved to 90°. As the deformity will likely relapse because of the patientｾs age, we plan to achieve realignment again by corrective surgery.

DOI： 10.11360/jcsoa.22.343

Case Report : Treatment for Retro-odontoid Pseudotumor with Posterior Fusion

Shiozaki Yasuyuki, Sugimoto Yoshihisa, Misawa Haruo, Tanaka Masato, Ozaki Toshifumi

The Journal of the Chugoku-Shikoku Orthopaedic Association 22 ( 2 ) 317 - 321 2010

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Retro-odontoid pseudotumor is an inflammatory mass most frequently associated with rheumatoid arthritis and dialysis. Recently, some case reports of retro-odontoid pseudotumor without instability have been published. Here we describe a 63-year-old man who was admitted to our hospital with numbness of the left upper extremity and walking disturbance. MRI showed a large retro-odontoid pseudotumor and severe compression of the spinal cord at the C1 level. The patient underwent C1 laminectomy, posterior occipital-C2 fusion and tumor resection via a transdural approach. Postoperative MRI showed that the retro-odontoid pseudotumor had been partially removed, but this was enough to obtain sufficient decompression of the spinal cord. Neurological symptoms were markedly improved after surgery.

DOI： 10.11360/jcsoa.22.317

Short-term follow-up of hip transposition using external fixator after resection of pelvic tumor

FUJIWARA Tomohiro

The Central Japan Journal of Orthopaedic Surgery & Traumatology 53 ( 4 ) 937 - 938 2010

10P-D-1 Supporting System for Diagnosis of Child Hip Joint by X-ray images

HONDA Mitsugi, ARITA Seizaburo, MITANI Shigeru, TAKEDA Yoshihiro, OZAKI Toshifumi, INOUE Tatsuya, INAMURA Keiji, KANAZAWA Susumu

Proceedings of the Annual Conference of Biomedical Fuzzy Systems Association 23 225 - 226 2010

Language：Japanese Publisher：Biomedical Fuzzy Systems Association

It is important to diagnose developmental dislocation of the hip (DDH) by X-ray images. The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The Min-Max method of nonlinear analysis was applied to construct the diagnostic support system based on the measurement of four items in X-ray images : the outward displacement rate, upward displacement rate, OE angle, and a angle. This system was then applied to the data, we obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%.

DOI： 10.24466/pacbfsa.23.0_225

Short-term result of congenital club foot treated with achillotectomy

KANAZAWA Tomoko

The Central Japan Journal of Orthopaedic Surgery & Traumatology 53 ( 6 ) 1249 - 1250 2010

The short term results of Chiari pelvic osteotomy combined with femoral varus osoteotomy for the advanced coxaosteoarthritis

ENDO Hirosuke

The Central Japan Journal of Orthopaedic Surgery & Traumatology 53 ( 4 ) 943 - 944 2010

A Pilot Study of the Physical Characteristics and Thermal Effects of Mud compared with Bentonite

WATANABE Masutaka, MITSUNOBU Fumihiro, OZAKI Toshifumi, SENDA Masuo, MORISHITA Tsugutake, TAKAGI Toru

The Japanese Journal of Rehabilitation Medicine 47 ( 9 ) 620 - 625 2010

Language：Japanese Publisher：The Japanese Association of Rehabilitation Medicine

Design : A pilot, comparative study was conducted. Background : Heat wraps using bentonite (HWb) are commonly used in thermotherapy. In the Okayama University Misasa Medical Center, heat wraps using mud (HWm) produced by mixing soil with boiling water have also been used. The subjective thermal effects of HWm on patients with osteoarthritis of the knee have been reported. However, the objective thermal effects of HWm have not been examined. As such, the physicochemical thermal effects of HWm were analyzed and compared with those of HMb. Methods : The thermal effects of HWm and HWb were investigated regarding heat radiation, conduction, capacity and moisture content. Heat radiation and conduction were measured by changes in temperature of the heat wraps, in addition heat conduction was also assessed by blood flow in body surfaces (N=7). Heat capacity and moisture content were measured with a Differential Scanning Calorimeter. Results: Heat radiation and heat conduction of HWm were significantly greater than those of HWb (p<0.001). The specific heat capacity of HWm was 2.0 J/g/°C, and was 1.7 J/g/°C for HWb. Moisture content of HWm and HWb were 0.6 mg/g and 0.3 mg/g, respectively. Conclusion : Heat radiation, conduction and capacity of HWm are superior to those of HWb. Moreover, the moisture content in HWm is greater than that of HWb. These results indicate that the thermal effects of HWm would have more be physicochemical usefulness.

DOI： 10.2490/jjrmc.47.620

Other Link： https://jlc.jst.go.jp/DN/JALC/00356689331?from=CiNii

Min-max methods of attribute probabilities for the child hip joint diagnosis based on X-ray images

ARITA Seizaburo, HONDA Mitsugi, MITANI Shigeru, AZUMA Yoshiharu, TAKEDA Yoshihiro, OZAKI Toshifumi, INOUE Tatsuya, INAMURA Keiji, KANAZAWA Susumu

Journal of Biomedical Fuzzy Systems Association 12 ( 1 ) 1 - 8 2010

Language：Japanese Publisher：Biomedical Fuzzy Systems Association

A diagnostic logic which outputs multiple items from multiple input items was constructed using nonlinear multivariate analysis, and applied for the diagnosis of child hip joints on X-ray images. Regarding the outward displacement rates, upward displacement rates, OE angles, and α angles as input and the diagnoses of dislocation of the hip, acetabular dysplasia, and normal hip joint as output, the attribute probability functions were introduced into the system, and diagnoses were made based on the synergism of 2 items and the Min-Max assessment. X-ray imaging data of 110 child hip joints were investigated. The data were divided into 2 groups: data for system construction and verification, and the diagnostic accuracy of the system was investigated. On applying the system to the verification data, diagnostic accuracy rate was 92.9%. The developed diagnostic system may be useful for the diagnosis of child hip joints.

DOI： 10.24466/jbfsa.12.1_1

Other Link： http://search.jamas.or.jp/link/ui/2011109479

CTベースナビゲーションシステムを用いたセメントレスTHAの術前計画精度とインプラント選択

藤原一夫, 三谷茂, 遠藤裕介, 鉄永智紀, 皆川寛, 尾崎敏文

日本人工関節学会誌 39 90 - 91 2009.12

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

CTベースナビゲーションシステムを用いたセメントレス人工股関節全置換術の術前計画精度とインプラント選択について検討した。セメントレスTHAのうち、JMM社製AMS HAカップおよびPerFix910ステムを使用した88例90股を対象とした。変形性股関節症78例80股、関節リウマチ7例7股、大腿骨頸部骨折3例3股であった。実際に使用されたカップは術前計画と比べ+2mm、-2mm、-4mmの症例がそれぞれ、1股、5股、1股で、83股(92.2%)が計画通りであった。術後CTにてマイナスサイズの症例では偏心設置であり、計画通りのインプラント設置が可能なスペースが残存し、合計89股(98.9%)で正確な術前計画となった。ステム側は術前計画より+2サイズ、+1サイズ、-1サイズの症例がそれぞれ2股、21股、9股で、58股(64.4%)が計画通りであった。

転子部骨折後の人工骨頭置換術施行後早期に高度の臼蓋欠損をきたした1例

三宅由晃, 遠藤裕介, 三谷茂, 鉄永智紀, 皆川寛, 藤原一夫, 尾崎敏文

日本人工関節学会誌 39 514 - 515 2009.12

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

83歳女。81歳時に転倒して左大腿骨転子部骨折を負い、近医で髄内釘による骨接合術を施行されたが、術後6週で髄内釘のラグスクリューがカットアウトし、他院で人工骨頭置換術を施行された。術後2年経過時に臼蓋の高度欠損と破壊をきたし、亜脱臼となったため当科に紹介され、人工股関節全置換術を行った。臼蓋欠損の原因として、カットアウトしたラグスクリューにより臼蓋後上方の軟骨下骨が損傷を受けたことが考えられた。

人工股関節再置換術における自己血貯血量に関する検討

鉄永智紀, 三谷茂, 遠藤裕介, 藤原一夫, 皆川寛, 尾崎敏文

日本人工関節学会誌 39 222 - 223 2009.12

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

当科では股関節手術に際し可能な限り自己血輸血を行っている。今回、人工股関節再置換術施行例の周術期出血量を調査することで、同手術における適正な自己血貯血量について検討した。対象は、2002〜2008年に同手術を行った症例のうち感染例と透析患者を除く52例とし、臼蓋側・大腿骨側とも再置換した群(22例;以下T群)、臼蓋側のみ再置換した群(24例;以下C群)、人工骨頭置換術後の再置換群(6例;以下B群)の3群に分けて検討した。その結果、周術期出血量から求めた手術血液準備量(SBOE)をもとに算出した適正自己血貯血量は、術後Hbを10g/dlと設定するとT群7.2単位、C群0.8単位、B群5.7単位であり、術後Hbを8g/dlと設定するとT群4.6単位、C群0単位、B群3.4単位であった。C群においては貯血前Hb値とSBOEとの間に弱い相関が認められ、貯血前Hb値が自己血貯血量の一指標となる可能性が示唆された。

Neurofibromatosis type Iに合併した脊柱側彎症に対して後方固定術を施行した1例

齋藤太一, 杉本佳久, 田中雅人, 三澤治夫, 高畑智宏, 林隆宏, 尾崎敏文

岡山医学会雑誌 121 ( 3 ) 233 - 233 2009.12

自然退縮を認めた骨軟骨腫の2例

藤原智洋, 国定俊之, 井谷智, 森本裕樹, 尾崎敏文

岡山医学会雑誌 121 ( 3 ) 233 - 233 2009.12

Cervical Cord Injury in Patients With Ankylosed Spines Progressive Paraplegia in Two Patients After Posterior Fusion Without Decompression Reviewed

Yoshihisa Sugimoto, Yasuo Ito, Masato Tanaka, Masao Tomioka, Yasuhiro Hasegawa, Kie Nakago, Yukihisa Yagata, Toshifumi Ozaki

SPINE 34 ( 23 ) E861 - E863 2009.11

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Study Design. Case report and clinical discussion.
Objective. To describe technical pitfall to treat 2 cervical cord injuries, including dislocations in patients with ankylosed spine due to diffuse idiopathic skeletal hyperostosis (DISH) or ossification of the posterior longitudinal ligament (OPLL).
Summary of Background Data. DISH and OPLL are disease processes similar in pathology, which can lead to unexpected fractures due to low-energy trauma. In reported cases of fracture of the ankylosed spine in patients with DISH or OPLL, increasing lever arm and a grossly unstable fracture occurred. However, the actual surgical intervention for these fractures and spinal cord injuries was not discussed.
Methods. We report 2 cervical cord injuries, including dislocations in patients with ankylosed spine due to DISH or OPLL.
Results. Two patients underwent posterior fusion without decompression; however, postoperative progressive paraplegia still occurred. There were 3 points in common: these patients had ankylosed spines due to DISH or OPLL; they were elderly and had spinal canal stenosis; and after undergoing posterior fusion without decompression, their bilateral, lower extremity palsies worsened after surgery. Cervical alignment was slightly different after posterior fusion, and this change concentrated in one segment because adjacent vertebral bodies were ankylosed, and thus, immoveable. Additionally, this stress caused infolding of the ligamentum flavum with resultant spinal cord compression.
Conclusion. In these cases, we recommend posterior fusion and decompression such as laminoplasty to avoid worsening palsy.

DOI： 10.1097/BRS.0b013e3181bb89fc

化膿性膝関節炎後の膝蓋骨脱臼を伴った大腿骨変形に対する矯正術を行った1例

斎藤太一, 遠藤裕介, 三谷茂, 鉄永智紀, 尾崎敏文

中国・四国整形外科学会雑誌 21 ( 3 ) 477 - 477 2009.10

ロッキングプレートによる下肢長幹骨非感染性偽関節の治療成績

藤原智洋, 野田知之, 島村安則, 中原龍一, 雑賀建多, 門田康孝, 尾崎敏文

中国・四国整形外科学会雑誌 21 ( 3 ) 479 - 479 2009.10

Arginine methyltransferase CARM1/PRMT4 regulates endochondral ossification. Reviewed International journal

Ito T, Yadav N, Lee J, Furumatsu T, Yamashita S, Yoshida K, Taniguchi N, Hashimoto M, Tsuchiya M, Ozaki T, Lotz M, Bedford MT, Asahara H

BMC developmental biology 9 47 - 47 2009.9

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

BACKGROUND: Chondrogenesis and subsequent endochondral ossification are processes tightly regulated by the transcription factor Sox9 (SRY-related high mobility group-Box gene 9), but molecular mechanisms underlying this activity remain unclear. Here we report that coactivator-associated arginine methyltransferase 1 (CARM1) regulates chondrocyte proliferation via arginine methylation of Sox9. RESULTS: CARM1-null mice display delayed endochondral ossification and decreased chondrocyte proliferation. Conversely, cartilage development of CARM1 transgenic mice was accelerated. CARM1 specifically methylates Sox9 at its HMG domain in vivo and in vitro. Arg-methylation of Sox9 by CARM1 disrupts interaction of Sox9 with beta-catenin, regulating Cyclin D1 expression and cell cycle progression of chondrocytes. CONCLUSION: These results establish a role for CARM1 as an important regulator of chondrocyte proliferation during embryogenesis.

DOI： 10.1186/1471-213X-9-47

Neurofibromatosis type Iに合併した脊柱側彎症に対する後方固定術の治療成績

齋藤太一, 杉本佳久, 田中雅人, 三澤治夫, 高畑智宏, 尾崎敏文

中部日本整形外科災害外科学会雑誌 52 ( 秋季学会 ) 99 - 99 2009.9

血管病変と診断され血管置換術が行われた滑膜肉腫の2例

藤原智洋, 国定俊之, 佐々木剛, 井谷智, 森本裕樹, 尾崎敏文

中部日本整形外科災害外科学会雑誌 52 ( 秋季学会 ) 214 - 214 2009.9

末梢神経系腫瘍microRNA発現プロファイリングの検討

井谷智, 森本裕樹, 伊藤佐智夫, 大内田守, 吉田晶, 上甲良二, 米田泰史, 佐々木剛, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 83 ( 8 ) S1151 - S1151 2009.8

感染パスツール処理骨に対する再建の経験

森定淳, 長谷川健二郎, 佐藤卓士, 渡邊敏之, 難波祐三郎, 木股敬裕, 尾崎敏文, 國定俊之

日本マイクロサージャリー学会会誌 22 ( 2 ) 136 - 136 2009.6

血管柄付広背筋皮弁の有用であった左下腿腫瘍の1例

植村享裕, 妹尾貴矢, 目谷雅恵, 森定淳, 佐藤卓士, 渡邊敏之, 徳山英二郎, 杉山成史, 長谷川健二郎, 難波祐三郎, 木股敬裕, 尾崎敏文, 国定俊之, 森本裕樹

岡山医学会雑誌 121 ( 1 ) 62 - 62 2009.4

治療後14年で肺転移をきたしたEwing肉腫の1例

米田泰史, 国定俊之, 田端雅弘, 二宮崇, 森本裕樹, 尾崎敏文

中部日本整形外科災害外科学会雑誌 52 ( 春季学会 ) 205 - 205 2009.3

Safety of atlantoaxial fusion using laminar and transarticular screws combined with an atlas hook in a patient with unilateral vertebral artery occlusion (case report) Reviewed

Yoshihisa Sugimoto, Masato Tanaka, Kazuo Nakanishi, Haruo Misawa, Tomoyuki Takigawa, Yasuo Ito, Toshifumi Ozaki

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 129 ( 1 ) 25 - 27 2009.1

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

A disadvantage of transarticular and C2 pedicle screws is vertebral artery (VA) injury as a result of screw misplacement. If unilateral occlusion of the VA is present, VA injury of the dominant side will cause fatal complications as a result of collateral flow insufficiency. Several authors have recently reported the usefulness of C2 laminar screws because of their safety on VA injury. We used transarticular and C2 laminar screws combined with the atlas hook in a patient with C1-2 instability and unilateral VA occlusion, in order to reduce the risk of further VA injury.
A 64-year-old woman with rheumatoid atlantoaxial subluxation complained of cervical myelopathy and neck pain. Preoperative MR angiography showed a left side VA occlusion.
The patient underwent atlantoaxial, posterior fusion using a transarticular screw on the side of the occlusion and a C2 laminar screw on the dominant side combined with a bilateral atlas hook. The transarticular screw was inserted using a navigation system and image intensifier, and the laminar screw was inserted free hand. Bone grafting from the iliac crest was performed.
Transarticular and C2 laminar screws fixation combined with the atlas hook in a patient with unilateral VA occlusion is a useful technique, in order to reduce the risk of further VA injury.

DOI： 10.1007/s00402-007-0510-9

Posterior spinal fusion using a pedicle nail system with polymethylmethacrylate in a paraplegic patient after vertebral collapse caused by osteoporosis Reviewed

Yoshihisa Sugimoto, Masato Tanaka, Hitoshi Konishi, Tomoyuki Takigawa, Kazuo Nakanishi, Haruo Misawa, Yasuo Ito, Toshifumi Ozaki

Spine Journal 9 ( 1 ) -e8 2009.1

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

Background context: Because posterior decompression and fusion for vertebral collapse in an osteoporotic spine sometimes results in a pullout of the pedicle screw. Several authors reported that fixation of pedicle screws in severely osteoporotic bone could be improved by inserting polymethylmethacrylate (PMMA) into the hole before inserting the screw. However, pedicle screws were not designed to be used with PMMA. Purpose: To report a patient with vertebral collapse who were treated using a novel-concept, pedicle nail using with PMMA. Study design: Case report. Methods: The patient was a 74-year-old female who experienced back pain after some heavy lifting 3 months before. She was laid up for 2 months because of the back pain and weakness of her lower legs. Radiographs and magnetic resonance imaging showed vertebral collapse and neural severe compression from the posterior wall of vertebra T12. The pedicle nail consists of an outer sheath with evenly spaced holes and an internal, removable, threaded component. The outer sheath and the internal component were connected before insertion. The pedicle nail attaches to and is bound by the PMMA through the holes of the outer sheath. We performed a T11-L1 posterior fusion and laminectomy using the pedicle nail, and we used a hydroxyapatite block to perform a transpedicular vertebroplasty of T12. Results: Bone union was observed on a lateral radiograph without pedicle nail loosening. Conclusions: The authors speculate that posterior spinal fusion and vertebroplasty using the pedicle nail will be a reasonable choice for delayed paraplegia after osteoporotic vertebral fracture. © 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.spinee.2007.10.036

Cutting Tool Protects for Soft Tissues in Bone-Milling Machining. Reviewed

Naohiko Sugita, Taiga Nakano, Takayuki Osa, Yoshikazu Nakajima, Kazuo Fujiwara, Nobuhiro Abe, Toshifumi Ozaki, Masahiko Suzuki, Mamoru Mitsuishi

IJAT 3 ( 2 ) 185 - 192 2009

Publishing type：Research paper (scientific journal) Publisher：Fuji Technology Press Ltd.

Minimally invasive orthopedic surgery using a milling machine presents challenges. The milling machine we developed has a redundant axis to minimize cutting-tool contact with surrounding soft tissue. Important components are modeled based on physical requirements, and model-based geometric optimization improves performance. Here we discuss the protective mechanism, hardware, and software we developed to cover the nonworking cutting-edge portion and to protect against soft-tissue damage. We evaluated the effectiveness of this approach using cadaveric bone.

DOI： 10.20965/ijat.2009.p0185

Interference Free Tool Path Generation in Multi-Axis Milling Machine for Orthopedic Surgery. Reviewed

Taiga Nakano, Naohiko Sugita, Takeharu Kato, Kazuo Fujiwara, Nobuhiro Abe, Toshifumi Ozaki, Masahiko Suzuki, Mamoru Mitsuishi

IJAT 3 ( 5 ) 514 - 522 2009

Publishing type：Research paper (scientific journal) Publisher：Fuji Technology Press Ltd.

Tool interference causes serious damage to surrounding soft tissue in minimally invasive orthopedic surgery with a milling robot. The objective of this study is to avoid the collision of cutting tool with complicated shapes, and a novel approach of interference-free toolpath generation in a short intraoperative time is proposed. In order to resolve this issue, we propose the following two methods: intraoperative modeling of soft tissues as an interference area and interference-free toolpath generation based on the model. A model is constructed to represent the opening area and the internal tissues by using a 3-dimensional optical position sensor to measure them. Based on the constructed model, interference-free toolpath is immediately determined by the preliminary definition of evacuating direction. The effectiveness of the proposed method is evaluated with artificial models on the system that the authors have developed so far. A tool contact force against the model was measured by a force sensor mounted on the cutting tool. The result revealed that the tool interference was greatly reduced by implementing the proposed method.

DOI： 10.20965/ijat.2009.p0514

Tool path generation to protect soft tissue with multi-axis milling machine Reviewed

Nakano T, Sugita N, Nakajima Y, Kato T, Fujiwara K, Abe N, Ozaki T, Suzuki M, Mitsuishi M

Proceedings of the 5th International Conference on Leading Edge Manufacturing in 21st Century, LEM 2009 2009

Publishing type：Research paper (international conference proceedings)

Tool interference causes damage to surrounding soft tissue in minimally invasive orthopedic surgery with a milling robot. The objective of this study is to avoid the collision of cutting tool with complicated shapes, and a novel approach of interference-free tool path generation is proposed: intraoperative modeling of tissues and interference-free tool path generation. A model is constructed by using a 3-dimensional optical position sensor. Based on the model, interference-free tool path is immediately determined by preliminary definition of evacuating direction. The effectiveness of the proposed method is evaluated with artificial models on the system that we have developed so far.

Other Link： http://orcid.org/0000-0002-1369-0747

Dynamic controlled milling process for bone machining Reviewed

Sugita N, Nakano T, Nakajima Y, Fujiwara K, Abe N, Ozaki T, Suzuki M, Mitsuishi M

Journal of Materials Processing Technology 209 ( 17 ) 5777 - 5784 2009

Publishing type：Research paper (scientific journal)

Optimal control of the machining process in orthopedic surgery can not only increase productivity but also ensure safety during tool usage. The authors have developed a technology for a force control system. The system has two modes of operation: the "air-cutting mode" and the "force control mode." In the air-cutting mode, tool feed is scheduled by predicting the air and bone-cutting zones from the CAD/CAM system. In the force control mode, the software monitors the cutting force and the cutting temperature, and it controls the feed override according to the difference between the real and the desired cutting force. The software is installed on a robot controller, and its effectiveness is evaluated with a urethane bone. © 2009 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.jmatprotec.2009.06.008

Other Link： http://orcid.org/0000-0002-1369-0747

A Case of Stem Fracture Following Bipolar Head Prosthesis

Minagawa Hiroshi, Mitani Shigeru, Endo Hirosuke, Tetsunaga Tomonori, Ozaki Toshifumi, Fujiwara Kazuo

The Journal of the Chugoku-Shikoku Orthopaedic Association 21 ( 1 ) 83 - 88 2009

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Cases of a fracture of the hydroxyapatite (HA)-coated stem in patients who underwent total hip arthroplasty have occasionally been reported. This article describes a case of stem fracture seen in a 61-year-old female patient more than 11 years after cementless bipolar head prostheses performed at this hospital. The patient had idiopathic avascular necrosis of the right femoral head, and at the age of 48, she underwent cementless bipolar head prosthesis using a titanium, HA-coated MCF stem (Kyocera Corporation, Kyoto, Japan). The stem was successfully implanted, and the postoperative clinical progress was uneventful. Eleven years and 10 months after operation, the patient had acute weakness of the right hip when she stood up, resulting in gait disturbance. Hip radiography revealed a fracture of the basal portion of the stem neck, and a revision hip arthroplasty was performed. Analysis showed that the fracture developed from the site of a rectangular notch serving as a gripper made at the stem neck. Therefore, the fracture might be caused by stress concentration at the rectangular part and the resultant metal fatigue. Implants with such design may be associated with breakage even a long time after bipolar head prostheseis.

DOI： 10.11360/jcsoa.21.83

Growth suppression and apoptosis induction in synovial sarcoma cell lines by a novel NF-κB inhibitor, dehydroxymethylepoxyquinomicin (DHMEQ) Reviewed

Keisuke Horiuchi, Hideo Morioka, Kazumasa Nishimoto, Yoshihisa Suzuki, Michiro Susa, Robert Nakayama, Akira Kawai, Hiroshi Sonobe, Hironari Takaishi, Toshifumi Ozaki, Hiroo Yabe, Kazuo Umezawa, Yoshiaki Toyama

Cancer Letters 272 ( 2 ) 336 - 344 2008.12

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

Synovial sarcoma is a relatively common soft tissue sarcoma with an aggressive clinical course. Although surgery is currently the first treatment modality, improvement of adjuvant chemotherapy is deemed essential to improve the clinical outcome. Nuclear factor-κB (NF-κB) is constitutively activated in various cancer cells and has emerged as a potential therapeutic molecular target
however, the possible involvement of NF-κB in the pathology of sarcomas remains to be clarified. Herein we examined the effects of a novel NF-κB inhibitor, dehydroxymethylepoxyquinomicin (DHMEQ) on two synovial sarcoma-derived cell lines, HS-SY-II and SYO-1. The growth of both cell lines was completely inhibited by DHMEQ and apoptosis was induced at 10 μg/ml. Additionally, we found that DHMEQ showed additive effects when used in combination with other cytotoxic agents. These observations indicate that inhibition of NF-κB activity may serve as a potential therapeutic target for synovial sarcoma. © 2008 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.canlet.2008.07.021

Isolation of a mRNA Preferentially Expressed in Synoviocytes from Rheumatoid Arthritis That is Identical with Lumican, which Encodes a Collagen Binding, Extracellular Matrix Protein Reviewed

Hiroki Mori, Keiichiro Nishida, Toshifumi Ozaki, Hajime Inoue, Tohru Nakanishi

JOURNAL OF HARD TISSUE BIOLOGY 17 ( 3 ) 125 - 130 2008.12

Language：English Publishing type：Research paper (scientific journal) Publisher：JOURNAL HARD TISSUE BIOLOGY

Rheumatoid arthritis (RA) is a complex disease including autoimmune disorder and resulting in inflammation. It also shows progressive proliferation of synoviocytes, and these synoviocytes destroys articular structure. In order to understand the mechanism of this abnormal proliferation of RA-originated synoviocytes in molecular level, we analyzed the gene expression profiles by using DNA chips that contain more than 10,000 genes. Comparing the expression profiles of normal and RA-originated synoviocytes, we found several genes that are highly expressed in RA-originated synoviocytes than normal synoviocytes. Among these genes, we focused on one hypothetical protein, cDNA of which contains one reading frame in its DNA fragment, indicating that this fragment is a part of large mRNA structure. The expression of this gene in RA-originated synoviocytes is about three times higher than that in normal synoviocytes by DNA chip analysis. After cDNA cloning of this mRNA, we found that the gene is identical with lumican, which encodes a collagen binding, extracellular matrix protein. This mRNA was widely distributed in many tissues but its alternatively spliced forms are differently expressed in various tissues.

CentPillar GB HA stemの短期成績

鉄永智紀, 三谷茂, 藤原一夫, 遠藤裕介, 皆川寛, 尾崎敏文

日本人工関節学会誌 38 522 - 523 2008.12

下肢人工関節置換術後の静脈血栓症の予防に対するアリクストラ(Fondaparinux Sodium)の使用経験

皆川寛, 三谷茂, 阿部信寛, 遠藤裕介, 鉄永智紀, 藤原一夫, 尾崎敏文

日本人工関節学会誌 38 652 - 653 2008.12

SAPHO syndrome associated spondylitis Reviewed

Tomoyuki Takigawa, Masato Tanaka, Kazuo Nakanishi, Haruo Misawa, Yoshihisa Sugimoto, Tomohiro Takahata, Hiroyuki Nakahara, Shinnosuke Nakahara, Toshifumi Ozaki

EUROPEAN SPINE JOURNAL 17 ( 10 ) 1391 - 1397 2008.10

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

The concept of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome has been well clarified, after Chamot et al. suggested this peculiar disorder in 1987. The most commonly affected site in SAPHO syndrome is the anterior chest, followed by the spine. However, the clinical course and taxonomic concept of SAPHO spinal lesions are poorly understood. This study was performed to analyze: (1) the detailed clinical course of spinal lesions in SAPHO syndrome, and (2) the relationship between SAPHO syndrome with spinal lesions and seronegative spondyloarthropathy. Thirteen patients with spondylitis in SAPHO syndrome were analyzed. The features of spinal lesions were a chronic onset with a slight inflammatory reaction, and slowly progressing non-marginal syndesmophytes at multi spinal levels, besides the coexistence of specific skin lesions. SAPHO syndrome, especially spinal lesions related to palmoplantar pustulosis, can be recognized as a subtype of seronegative spondyloarthropathy.

DOI： 10.1007/s00586-008-0722-x

SAPHO syndrome with rapidly progressing destructive spondylitis: two cases treated surgically Reviewed

Tomoyuki Takigawa, Masato Tanaka, Shinnosuke Nakahara, Yoshihisa Sugimoto, Toshifumi Ozaki

EUROPEAN SPINE JOURNAL 17 S331 - S337 2008.9

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

The authors present two cases of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome with rapidly progressing destructive spondylitis treated surgically. The spinal lesions in SAPHO syndrome generally have a good prognosis and rarely cause the structural destruction or neurological deterioration. Case 1: a 63-year-old female had palmoplantar pustulosis for 2 years. At first, she only felt a pain in the nape with no inducing factor. Two months later, she had incomplete quadriplegia (ASIA scale C). Magnetic resonance imaging showed destruction of C4-C7, kyphotic deformity, and severe compression of the spinal cord. Decompression and reconstruction surgery using anterior and posterior approach improved her paralysis. Case 2: a 69-year-old female complained of persistent back pain. Magnetic resonance imaging revealed spondylitis of T7-T9. Although there were no typical skin lesions, we diagnosed SAPHO syndrome by hyperostosis of the stemocostoclavicular joint and sacral joint. Destruction with kyphotic deformity of the spine progressed gradually for 3 months. Curettage and reconstruction surgery using thoracic endoscope relieved her pain and prevented the destruction of the spine. The histopathology of the specimen obtained surgically showed non-specific inflammation in both cases. Spondylitis in SAPHO syndrome may cause severe destruction and kyphotic deformity followed by paralysis.

DOI： 10.1007/s00586-008-0663-4

The expression of microRNA424 in rheumatoid arthritis

Yoshitaka, Teruhito, Nakasa, Tomoyuki, Inoue, Atsushi, Okubo, Atsuko, Takemoto, Fuko, Miyaki, Shigeru, Nishida, Keiichiro, Ochi, MitStio, Ozaki, Toshifumi, Sumida, Takayuki, Asahara, Hiroshi

ARTHRITIS AND RHEUMATISM 58 ( 9::Suppl. S ) 0 - 0 2008.9

ScleraxisとSox9による軟骨細胞分化調節

古松毅之, 迫間巧将, 吉田晶, 伊達宏和, 鉄永智紀, 雑賀建多, 阿部信寛, 宿南知佐, 雨宮三千代, 島野仁, 尾崎敏文

日本整形外科学会雑誌 82 ( 8 ) S1098 - S1098 2008.8

滑膜肉腫関連蛋白の細胞内局在に影響を与える薬剤および蛋白に関する検討

米田泰史, 大内田守, 神崎浩孝, 吉田晶, 佐々木剛, 森本裕樹, 国定俊之, 清水憲二, 尾崎敏文

日本整形外科学会雑誌 82 ( 8 ) S1023 - S1023 2008.8

ヒストン脱アセチル化酵素阻害剤とDNA脱メチル化剤の併用による滑膜肉腫細胞株に対する抗腫瘍効果の検討

佐藤千明, 吉田晶, 森本裕樹, 米田泰史, 佐々木剛, 国定俊之, 大内田守, 尾崎敏文

日本整形外科学会雑誌 82 ( 8 ) S1228 - S1228 2008.8

骨肉腫患者における葉酸代謝関連遺伝子の一塩基多型の検討

森本裕樹, 吉田晶, 大内田守, 米田泰史, 国定俊之, 尾崎敏文

日本整形外科学会雑誌 82 ( 8 ) S926 - S926 2008.8

Validation of radiographic response evaluation criteria of preoperative chemotherapy for bone and soft tissue sarcomas: Japanese Orthopaedic Association Committee on Musculoskeletal Tumors Cooperative Study. Reviewed

Ueda T, Naka N, Araki N, Ishii T, Tsuchiya H, Yoshikawa H, Mochizuki K, Tsuboyama T, Toguchida J, Ozaki T, Murata H, Kudawara I, Tanaka K, Iwamoto Y, Yazawa Y, Kushida K, Otsuka T, Sato K

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 13 ( 4 ) 304 - 312 2008.7

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

BACKGROUND: The radiographic evaluation of the response to preoperative chemotherapy for bone and soft tissue sarcomas is based mostly on the change in primary tumor size before and after chemotherapy, as is done for many solid cancers. Its prognostic correlation, however, has hardly been validated. METHODS: We conducted a retrospective validation study of the Japanese Orthopaedic Association (JOA) radiographic response evaluation criteria of preoperative chemotherapy for bone and soft tissue sarcomas as a JOA Committee on Musculoskeletal Tumors cooperative study. A total of 125 consecutive patients with high-grade bone (n = 77) and soft tissue (n = 48) sarcomas treated with neoadjuvant chemotherapy and definitive surgery in 25 tertiary referral hospitals were selected for the study. We investigated the correlation between the tumor size-based radiographic response evaluation criteria of preoperative chemotherapy for bone and soft tissue sarcomas provided by the JOA Committee on Musculoskeletal Tumors (hereafter called the JOA criteria) and the patients' overall survival using the Kaplan-Meier method and the log-rank test. RESULTS: The JOA criteria correlated relatively well with survival for malignant bone tumors (mostly comprising osteosarcoma and Ewing's sarcoma) but not for soft tissue sarcomas, suggesting that the tumor size-based radiographic evaluation criteria for the response to preoperative chemotherapy in patients with soft tissue sarcomas is invalid. CONCLUSIONS: The JOA criteria, based on the change in primary tumor size, is valid for malignant bone tumors but invalid for soft tissue sarcomas. Other new evaluation modalities of the response to preoperative chemotherapy using innovative functional imaging techniques are needed for soft tissue sarcomas.

DOI： 10.1007/s00776-008-1235-5

Single nucleotide polymorphism in reuced folate carrier-1 gene and methyleneterathydrofolate reductase gene in patients with osteosarcoma

Y. Morimoto, A. Yoshida, M. Ouchida, T. Kunisada, K. Shimizu, T. Ozaki

EJC SUPPLEMENTS 6 ( 9 ) 117 - 118 2008.7

橋本病を合併したMazabraud syndromeの1例

大畑範英, 森本裕樹, 吉田晶, 佐々木剛, 米田泰史, 国定俊之, 大内田守, 尾崎敏文

日本整形外科学会雑誌 82 ( 6 ) S853 - S853 2008.6

Interleukin-4 downregulates the cyclic tensile stress-induced matrix metalloproteinases-13 and cathepsin B expression by rat normal chondrocytes Reviewed

Hideyuki Doi, Keiichiro Nishida, Masanori Yorimitsu, Takamitsu Komiyama, Yasutaka Kadota, Tomonori Tetsunaga, Aki Yoshida, Satoshi Kubota, Masaharu Takigawa, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 62 ( 2 ) 119 - 126 2008.4

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

Mechanical stress plays a key role in the pathogenesis of cartilage destruction seen in osteoarthritis (OA). We investigated the effect of cyclic tensile stress (CTS) on the anabolic and catabolic gene expression of rat cultured normal chondrocytes using the Flexercell strain unit. The effects of interleukin (IL)-4, a chondroprotective cytokine, on the changes in gene expression induced by CTS were also investigated. CTS (7% elongation at 0.5 Hz) for 24 h did not affect the expression of aggrecan and type 11 collagen, whereas CTS significantly upregulated matrix metalloproteinase (MMP)-13 and cathepsin B mRNA expression by chondrocytes. IL-1 beta expression was also significantly upregulated by CTS up to 12 h. The upregulation of MMP-13 was observed at 3 h, which was earlier than that of IL-1 beta. Furthermore, pre-treatment with IL-4 (10 ng/ml) suppressed both MMP-13 and cathepsin B induction by mechanical stress, as well as CTS-induced IL-1 beta expression. Our results suggest that IL-4 might have a therapeutic value in the treatment of OA by downregulation of mechanical stress-induced MMP-13 and cathepsin B expression by chondrocytes.

DOI： 10.18926/AMO/30956

骨肉腫における6q16-23の高頻度染色体欠失の研究(High frequent allelic loss of chromosome 6q16-23 in osteosarcoma: Involvement of cyclin C in osteosarcoma)

大畑範英, 吉田晶, 伊藤佐智夫, 国定俊之, 森本裕樹, 神崎浩孝, 尾崎敏文, 清水憲二, 大内田守

日本癌学会総会記事 66回 345 - 345 2007.8

滑膜肉腫特異的転座型融合蛋白SS18-SSXおよびSS18、SSX蛋白の細胞内局在の解析

米田泰史, 大内田守, 神崎浩孝, 国定俊之, 清水憲二, 尾崎敏文

日本整形外科学会雑誌 81 ( 8 ) S1119 - S1119 2007.8

運動器リハビリテーションと健康寿命健康寿命の阻害因子としての運動器不安定症

千田益生, 堅山佳美, 濱田全紀, 迫間巧将, 那須巧, 尾崎敏文

日本整形外科学会雑誌 81 ( 4 ) S511 - S511 2007.4

Desmoid-type fibromatosisに対するTI-201シンチグラフィの検討

新家崇義, 赤木史郎, 佐藤修平, 尾形毅, 岡村淳, 郷原英夫, 加藤勝也, 清哲朗, 金澤右, 尾崎敏文

日本医学放射線学会学術集会抄録集 66回 S312 - S312 2007.2

4333 Estimation of registration error distribution from bone surfaces

SAITO Toki, NAKAJIMA Yoshikazu, SUGITA Naohiko, FUJIWARA Kazuo, ABE Nobuhiro, OZAKI Toshifumi, SUZUKI Masahiko, MORIYA Hideshige, INOUE Takayuki, KURAMOTO Koichi, NAKASHIMA Yoshio, MITSUISHI Mamoru

The proceedings of the JSME annual meeting 2007 519 - 520 2007

Language：Japanese Publisher：The Japan Society of Mechanical Engineers

Registration is a technique for corresponding between a pre-operative planning space and an intra-operative surgical space. It is often used in computer-integrated surgical systems, such as surgical navigation systems and surgical robots. One of most foundational registration methods is point-pair registration. We propose a method for estimation of most appropriate sampling-point set based on bone-surface shape analysis. The method consists of two steps; the first step is an estimation of point sampling error distribution from the bone surface, and the next one is an optimization of sampling-point set by using a computer simulation of point-pair registration. The result shows the effectiveness of this method.

DOI： 10.1299/jsmemecjo.2007.5.0_519

Bone cutting robot with soft tissue collision avoidance capability by a redundant axis for minimally invasive orthopedic surgery Reviewed

Sugita N, Genma F, Nakajima Y, Mitsuishi M, Fujiwara K, Abe N, Ozaki T, Suzuki M, Moriya H, Inoue T, Kuramoto K, Nakashima Y, Tanimoto K

2007 IEEE/ICME International Conference on Complex Medical Engineering, CME 2007 48 - 51 2007

Publishing type：Research paper (international conference proceedings)

Many of the robots developed so far, including our multi-axis bone cutting robot, use an end mill as the cutting tool, and some problems should be solved to apply them to the minimally invasive orthopedic surgery. Minimally invasive surgery makes the incisions smaller, reduces pain and trauma to the body, and enables faster recovery. The smaller incision means a small and narrow opening area. This means the robot attitude for the bone resection is restricted, and it can result in the collision of the tool with the surrounding tissue, the existence of an untouched area and the degradation of the joint position accuracy. This paper proposes a robot mechanism and a toolpath generation technique specialized for bone cutting is expected to resolve these issues. © 2007 IEEE.

DOI： 10.1109/ICCME.2007.4381690

Other Link： http://orcid.org/0000-0002-1369-0747

Assessment of head wear more than ten years after total hip arthroplasty: 22-mm zirconia vs. metal heads.

Atsushi Inoue, Koji Asaumi, Hirosuke Endo, Kazuo Fujiwara, Shigeru Mitani, Toshifumi Ozaki

Acta medica Okayama 60 ( 6 ) 311 - 8 2006.12

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

The present retrospective study assessed radiographs to determine socket wear in total hip arthroplasty (THA) with 22-mm zirconia or COP (Cobalt-Chrome alloy rich in Cobalt and Phosphorous) heads, and in cemented stems at more than 10 years after operation. Sockets of ultra high molecular weight polyethylene were used in each of two THA groups (13 hips each) in a clinical trial in our hospital between 1989 and 1990. Three observers carried out masked assessments of the radiographs. Upon final examination, there was no remarkable loosening in the zirconia or COP group, and no case had required revision surgery as of 2005. There was a statistically significant difference between the 2 groups in average annual linear wear, at 0.093 mm/year and 0.046 mm/year in the zirconia and COP groups, respectively. Volume wear and average annual volume wear were also significantly greater in the zirconia group despite its superior mechanical strength and toughness in vitro. Our present findings do not confirm early expectations of lower wear in long-term results of 22-mm zirconia femoral heads used in THA.

Highly frequent allelic loss of chromosome 6q16-23 in osteosarcoma: involvement of cyclin C in osteosarcoma. International journal

Norihide Ohata, Sachio Ito, Aki Yoshida, Toshiyuki Kunisada, Kunihiko Numoto, Yoshimi Jitsumori, Hirotaka Kanzaki, Toshifumi Ozaki, Kenji Shimizu, Mamoru Ouchida

International journal of molecular medicine 18 ( 6 ) 1153 - 8 2006.12

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

The molecular pathogenesis of osteosarcoma is very complicated and associated with chaotic abnormalities on many chromosomal arms. We analyzed 12 cases of osteosarcomas with comparative genomic hybridization (CGH) to identify chromosomal imbalances, and detected highly frequent chromosomal alterations in chromosome 6q, 8p, 10p and 10q. To define the narrow rearranged region on chromosome 6 with higher resolution, loss of heterozygosity (LOH) analysis was performed with 21 microsatellite markers. Out of 31 cases, 23 cases (74%) showed allelic loss at least with one marker on chromosome 6q. We identified two distinct commonly deleted regions on chromosome 6 using markers D6S1565 located at 6q16 and 6q23MS1 at 6q23. The expression analysis of genes located at the deleted region was performed, and the decreased mRNA expression of the CCNC gene, one of the regulators of cell cycle, was detected. Growth of osteosarcoma cell line was significantly suppressed after the CCNC cDNA transfection. Fine mapping of the deleted region containing a possible tumor suppressor gene and the transfection assay suggest that the CCNC is a candidate tumor suppressor gene.

Expression of WISP-1 (ccn4), WISP-2 (ccn5) and WISP-3 (ccn6) in Rheumatoid Arthritic Synovium Evaluated by DNA Microarrays

Mori Hiroki, Nishida Keiichiro, Ozaki Toshifumi, Inoue Hajime, Setsu Kojun, Tsujigiwa Hidetsugu, Nagatsuka Hitoshi, Gunduz Mehmet, Nakanishi Tohru

Journal of hard tissue biology 15 ( 3 ) 89 - 95 2006.12

Language：English Publisher：The Society of Hard Tissue Biology

Rheumatoid disease (RA) is one of the complex diseases that showed multiple progression stages. At first inflammatory response is occurred by self antibodies, and then the proliferation of synoviocytes is abnormally promoted. These synoviocytes invade into articular structures and finally articular cartilage is destroyed. In order to analyze growth-promoting factors in synovial cells from articular tissues of RA, we performed DNA microarray analysis and compared the expression patterns of their mRNA to that of synoviocytes from osteoarthritis (OA). The results showed that the expression of many genes was up-regulated in RA synoviocytes comparing with OA synoviocytes. Among these genes, RT-PCR analysis revealed that Wnt-1-induced secreted protein 2 (WISP-2, CCN5) and protein 3 (WISP-3, CCN6) which are belong to the novel gene family, CCN, were highly up-regulated in RA synoviocytes. In addition, one truncated isoform of WISP-3 which may be related to the ongoing of some type of RA, was detected in RA synoviocytes. Furthermore, immunohistochemical analysis showed that the products of both CCN genes were highly distributed in active synoviocytes of articular tissues of RA. These results indicate that both CCN genes and their products play some roles in the progression of RA.

DOI： 10.2485/jhtb.15.89

Other Link： http://search.jamas.or.jp/link/ui/2007191489

軟部腫瘍のTlシンチグラフィ疑陽性例の検討

赤木史郎, 新家崇義, 郷原英夫, 佐藤修平, 黒田昌宏, 金澤右, 井谷智, 国定俊之, 尾崎敏文

核医学 43 ( 4 ) 354 - 354 2006.11

Expression of neurotrophins and their receptors tropomyosin-related kinases (Trk) under tension-stress during distraction osteogenesis.

Ayako Aiga, Koji Asaumi, You-Jin Lee, Hiroaki Kadota, Shigeru Mitani, Toshifumi Ozaki, Masaharu Takigawa

Acta medica Okayama 60 ( 5 ) 267 - 77 2006.10

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

The localization and expression of neurotrophins and their receptors during distraction osteogenesis was investigated in 72 male rat femurs (11 weeks old) to further clarify the concurrence of cellular and molecular events of new bone formation. After osteotomy, a 7-day lag phase was followed by distraction at the rate of 0.25 mm/12 h for 21 days (distraction phase), and a 7-day consolidation phase. The localization of neurotrophins (NGF, BDNF and NT-3) and their receptors tropomyosinrelated kinases (TRKA, TRKB and TRKC) by immunostaining showed positive staining in bone forming cells in each stage, although the presence and staining intensity varied by cell type and phase. The expressions of NGF, BDNF and NT-3 by real-time polymerase chain reaction (real-time PCR) showed that the peak of the mRNA expression of NGF occurred 10 days after distraction. NT-3 increased during bone extension, but decreased when distraction stopped. In contrast, BDNF continued to increase gradually throughout the distraction and consolidation phases. These findings suggest that neurotrophins and their receptors may play different roles in endochondral and intramembranous ossification in distraction osteogenesis. The tension stress caused by distraction may stimulate the expression of neurotrophins and their receptors, and promote osteogenesis.

骨形成不全症の骨折に対する治療戦略

皆川寛, 三谷茂, 遠藤裕介, 鉄永智紀, 黒田崇之, 尾崎敏文

日本整形外科学会雑誌 80 ( 10 ) 710 - 710 2006.10

Accurate diagnosis of musculoskeletal lesions by core needle biopsy. International journal

Goro Mitsuyoshi, Noriko Naito, Akira Kawai, Toshiyuki Kunisada, Aki Yoshida, Hiyoruki Yanai, Shuichi Dendo, Tadashi Yoshino, Susumu Kanazawa, Toshifumi Ozaki

Journal of surgical oncology 94 ( 1 ) 21 - 7 2006.7

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

BACKGROUND: Percutaneous needle biopsy has many advantages over open biopsy in the treatment of neoplasms. However, the accuracy of needle biopsy in the diagnosis of musculoskeletal lesions has not yet been established. Here, we evaluate the accuracy and limitations of the procedure for musculoskeletal lesions. METHODS: The diagnoses of 163 needle biopsies (bone, 91; soft tissue, 72) performed on 157 consecutive patients using a Jamshidi needle or an Ostycut needle for bone lesions, or a Tru-cut needle for soft tissue lesions were compared with the final diagnoses made by open biopsy and/or a definitive operation. RESULTS: One hundred forty-three specimens (88%) were determined to be adequate for histological examination. Obtaining undamaged cores from very hard bony lesions or sclerotic cyst walls proved difficult. A pathologist with experience in musculoskeletal lesions was able to differentiate malignant tumors from benign lesions in 97% of the cases (bone, 100%; soft tissue, 94%) and arrive at a specific diagnosis in 88% (bone, 96%; soft tissue, 78%) when adequate cores were obtained. Differentiating a well-differentiated liposarcoma from a benign lipoma and inflammatory lesions from benign tumorous conditions, was difficult. The overall accuracy was 77% (bone, 85%; soft tissue, 68%). There was no morbidity related to the procedure. CONCLUSION: The results indicate that needle biopsy is safe and accurate for diagnosing musculoskeletal lesions.

Chromosomal and genetic imbalances in synovial sarcoma detected by conventional and microarray comparative genomic hybridization. Reviewed International journal

Nakagawa Y, Numoto K, Yoshida A, Kunisada T, Ohata H, Takeda K, Wai D, Poremba C, Ozaki T

Journal of cancer research and clinical oncology 132 ( 7 ) 444 - 450 2006.7

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

PURPOSE: To analyze the relationship between chromosomal instabilities and clinicopathological factors in synovial sarcoma (SS). METHODS: Twenty-two fresh-frozen SS were analyzed by metaphase comparative genomic hybridization (CGH). Additional microarray CGH was performed in 13 cases. RESULTS: Fourteen patients with SYT-SSX1 rearrangements and nine patients with biphasic tumor subtypes had better prognosis than the eight patients with SYT-SSX2 rearrangements and 13 patients with monophasic subtypes, respectively. Gains (average 3.0) were more frequent than losses (average 1.0). Frequent gains were identified on chromosomal regions 2, 6q, 7, 8q, 12, 17q, 18q, and 21q, whereas frequent losses were over-lapped on chromosomes 1p31-p35, 3p, 6q, 16, and 17p. High-level gains were observed on chromosomes 1q21-q31, 7, 8, 12, 17q, 18q, and 21q. Thirteen monophasic and nine biphasic tumors had an average of 5.1 and 2.8 aberrations, respectively. Patients with tumors harboring numerous aberrations (>or=3) had a worse clinical course. Microarray CGH more specifically detected genetic imbalances including gains in MDM2, MSH2, KCNK12, DCC, CDK2, ERBB3, SAS, and CDK4 and losses in HRAS, RASSF1, and CCND1. Gain of SAS was an important prognostic factor of SS. CONCLUSION: We have identified several factors influencing the prognosis of SS patients by metaphase and microarray CGH.

DOI： 10.1007/s00432-006-0089-5

Decreased levels of insulin-like growth factor-1 and vascular endothelial growth factor relevant to the ossification disturbance in femoral heads spontaneous hypertensive rats.

Takamitsu Komiyama, Keiichiro Nishida, Masanori Yorimitsu, Hideyuki Doi, Shinichi Miyazawa, Ai Kitamura, Aki Yoshida, Yoshihisa Nasu, Nobuhiro Abe, Toshifumi Ozaki

Acta medica Okayama 60 ( 3 ) 141 - 8 2006.6

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

Ossification disturbance in femoral head reportedly is seen in the Spontaneously Hypertensive rats (SHR) between ages of 10 and 20 weeks. We investigated serum and tissue levels of insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) in SHR relevant to the ossification disturbance and osteonecrosis of the femoral head. Serum levels of IGF-1 and VEGF were significantly lower in SHR than in Wistar Kyoto rats (WKY) at weeks 5, 10, 15 and 20 (p<0.005). The incidence of histological ossification disturbance of the femoral head was higher in SHR (59%) than in WKY (40%) at week 20. Lower serum and local levels of VEGF in SHR appeared to be related to the incomplete ossification of the femoral heads. Immunohistochemical study showed significantly lower numbers of IGF-1 and VEGF positive chondrocytes in the femoral epiphyseal cartilage of SHR than in those of WKY at weeks 10, 15 and 20. Our results suggest that local and/or systemic levels of IGF-1 and VEGF between ages of 5 and 20 weeks might play roles in the pathogenesis of ossifi cation disturbance of the femoral head in SHR.

局所汗中乳酸測定の試み

片岡昌樹, 千田益生, 濱田全紀, 那須巧, 堅山佳美, 尾崎敏文

リハビリテーション医学 43 ( Suppl. ) S186 - S186 2006.5

Magnetic resonance angiography without contrast enhancement medium in bone and soft tissue tumors. International journal

Hideyuki Doi, Atsushi Ono, Akira Kawai, Yuki Morimoto, Toshiyuki Kunisada, Eiji Nakata, Toshifumi Ozaki

Oncology reports 15 ( 3 ) 681 - 5 2006.3

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

The aim of this study was to assess the ability of a new magnetic resonance (MR) angiography technique that does not use contrast enhancement medium to depict the vascularity of musculoskeletal neoplasms, and evaluate its clinical utility. We performed 3D fresh blood imaging (FBI) MR angiography in 57 patients with bone or soft tissue tumors, and the detection of vessels in and around the tumor was evaluated. Moreover, differences in vascularity between benign and malignant tumors were analyzed. In the lower leg, large arteries such as femoral or popliteal arteries were visible. In the trunk or arm, large vessels such as subclavian or iliac arteries were visible. Discrimination between benign and malignant tumors was impossible in bone tumors; however, the mean value of vascularity differed between benign and malignant tumors in the soft tissue tumors. This is the first trial of the FBI method for bone and soft tissue tumors. The still developing method of MRA without contrast materials could clearly depict major arteries in the trunk and the extremities, this method may replace conventional MRA of bone and soft tissue tumors because it produces vivid images while being non-invasive.

Lateral and posterior pillar grade changes during the treatment of Perthes disease in older patients using skin traction and range of motion exercises. International journal

Yoshihisa Sugimoto, Hirofumi Akazawa, Shigeru Mitani, Masato Tanaka, Tadashi Nakagomi, Koji Asaumi, Toshifumi Ozaki

Archives of orthopaedic and trauma surgery 126 ( 2 ) 101 - 4 2006.3

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

INTRODUCTION: The lateral pillar (LP) grade changes detected during treatment periods have received a lot of attention recently. Lappin et al. reported LP collapses in 92 of 275 (33%) patients during the treatment, but did not provide information for comparing treatment methods and age of onset of the disease. The purpose of this study was to review radiological changes in LP grade in older patients with Perthes disease during 20 months of treatment with skin traction and ROM exercises. We have also reported any grade changes in the posterior pillar (PP) classification. MATERIAL AND METHODS: Twenty-one patients with unilateral disease who were 9 years or older at the onset of symptoms had been followed until skeletal maturity. RESULTS: Out of 21 older patients with Perthes disease, our study had two (9.5%) who experienced LP collapse and two (9.5%) who experienced PP collapse during the first 20 months of treatment. The average time from onset to hospitalization in hips, initially classified as LP group C and PP group C, was significantly longer than in LP and PP groups A and B. The LP collapse in two hips and PP collapse in two hips occurred during months 4-8 of treatment. On the other hand, of the patients allowed to ambulate with the Pogo stick orthosis from months 8 to 12 and without a brace from months 10 to 15, none had a collapse of their LPs or PPs during these periods. CONCLUSION: Lappin et al. reported that 92 of 275 patients (33%) who were managed conservatively in several hospitals experienced LP collapse during their treatment periods. Our results suggest that older patients with this disease treated with skin traction and ROM exercises rarely suffer a LP collapse, as compared with the Lappin et al. report.

Diagnosis of deep vein thrombosis after operation for fracture of the proximal femur: comparative study of ultrasonography and venography.

Motonobu Terao, Toshifumi Ozaki, Toru Sato

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 11 ( 2 ) 146 - 53 2006.3

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

BACKGROUND: We compared investigative methods to study the diagnostic capability of ultrasonography. Subjects were 75 patients with proximal femur fractures who underwent surgery from March 2002 to December 2003. METHODS: Biochemical assays were carried out on days 3 and 7, and D-dimer levels were investigated as a time series. Ascending lower limb venography and ultrasonography were carried out nearly simultaneously in all cases on day 7. RESULTS: The incidence of deep vein thrombosis (DVT)-positive findings on venography was 61.3% (46/75). Venography results demonstrated a diagnostic sensitivity of 95.5% and specificity of 91.4% using a D-dimer cutoff of 1microg/ml on postoperative day 7. By ultrasonography, diagnostic sensitivity for DVT was 78.3%, and specificity was 96.5%. Among all proximal area cases, there were 18 limbs with DVT seen on venography among which were 17 limbs in cases demonstrating DVT at the same site on ultrasonography, a correct diagnosis rate of 94.4%. CONCLUSIONS: For the diagnosis of a thrombus more proximal than the popliteal area, a location at high risk for occurrence of pulmonary embolism, ultrasonography provided results nearly on par with those obtained by venography. Thus, we believe that ultrasonography allowed a more noninvasive, accurate diagnosis and more rapid treatment in cases where D-dimer values were 1 microg/ml or more on postoperative day 7.

Chromosomal imbalances in malignant peripheral nerve sheath tumor detected by metaphase and microarray comparative genomic hybridization. International journal

Yasuko Nakagawa, Aki Yoshida, Kunihiko Numoto, Toshiyuki Kunisada, Daniel Wai, Norihide Ohata, Ken Takeda, Akira Kawai, Toshifumi Ozaki

Oncology reports 15 ( 2 ) 297 - 303 2006.2

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

Malignant peripheral nerve sheath tumors (MPNSTs) are highly malignant tumors affecting adolescents and adults. There have been a few reports on chromosomal aberrations of MPNSTs; however, the tumor-specific alteration remains unknown. We characterized the genomic alterations in 8 MPNSTs and 8 schwannomas by metaphase comparative genomic hybridization (CGH). In 5 of 8 MPNSTs, microarray CGH was added for more detailed analyses. Frequent gains were identified on 3q13-26, 5p13-14, and 12q11-23 and frequent losses were at 1p31, 10p, 11q24-qter, 16, and 17. Microarray CGH revealed frequent gains of EGFR, DAB2, MSH2, KCNK12, DDX15, CDK6, and LAMA3, and losses of CDH1, GLTSCR2, EGR1, CTSB, GATA3, and SULT2A1. These genes seem to be responsible for developing MPNSTs. The concordance rate between metaphase CGH and microarray CGH was 66%. Metaphase CGH was useful for identifying chromosomal alterations before applying microarray CGH.

Surgical results of sacral perineural (Tarlov) cysts.

Masato Tanaka, Shinnosuke Nakahara, Yasuo Ito, Kazuo Nakanishi, Yoshihisa Sugimoto, Hisanori Ikuma, Toshifumi Ozaki

Acta medica Okayama 60 ( 1 ) 65 - 70 2006.2

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

The purpose of this study was to investigate the surgical outcomes and to determine indicators of the necessity of surgical intervention. Twelve consecutive patients harboring symptomatic sacral perineural cysts were treated between 1995 and 2003. All patients were assessed for neurological deficits and pain by neurological examination. Magnetic resonance of imaging, computerized tomography, and myelography were performed to detect signs of delayed filling of the cysts. We performed a release of the valve and imbrication of the sacral cysts with laminectomies in 8 cases or recapping laminectomies in 4 cases. After surgery, symptoms improved in 10 (83%) of 12 patients, with an average follow-up of 27 months. Ten patients had sacral perineural cysts with signs of positive filling defect. Two (17%) of 12 patients experienced no significant improvement. In one of these patients, the filling defect was negative. In conclusion, a positive filling defect may become an indicator of good treatment outcomes.

Blood loss and transfusion associated with musculoskeletal tumor surgery. International journal

Akira Kawai, Hiroaki Kadota, Umio Yamaguchi, Yuki Morimoto, Toshifumi Ozaki, Yasuo Beppu

Journal of surgical oncology 92 ( 1 ) 52 - 8 2005.10

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

BACKGROUND AND OBJECTIVES: No organized data regarding the blood losses associated with musculoskeletal tumor surgery has been existed. The present study aimed to examine the extent of blood loss and the transfusion requirement associated with various kinds of musculoskeletal tumor surgeries in a large, well-defined sample. METHODS: The records of 1,047 consecutive operations for musculoskeletal tumors were reviewed. RESULTS: The total blood loss ranged from 0 to 26,050 ml (median: 95 ml). The operative time ranged from 5 to 1,140 min (median: 105 min). There was a significant correlation between the total blood loss and the operative time. The median blood loss was 10 ml in biopsies, 100 ml in curettages, 190 ml in amputations or disarticulations, 30 ml in marginal resections (bone tumors, 50 ml; soft tissue tumors, 25 ml), and 380 ml in wide resections (bone tumors, 2,155 ml; soft tissue tumors, 180 ml). Wide resections for malignant tumors were associated with significantly more blood loss than marginal resections for benign ones. Resections of bone tumors were accompanied by significantly more blood loss than those of soft tissue tumors. Overall, blood transfusions were required after 210 (20.1%) operations. CONCLUSIONS: Our results provide the first exhaustive data about blood loss and the subsequent need for transfusion associated with various kinds of musculoskeletal tumor surgeries that may be helpful for establishing a guideline for perioperative patient management.

Significant growth suppression of synovial sarcomas by the histone deacetylase inhibitor FK228 in vitro and in vivo. International journal

Tatsuo Ito, Mamoru Ouchida, Yuki Morimoto, Aki Yoshida, Yoshimi Jitsumori, Toshifumi Ozaki, Hiroshi Sonobe, Hajime Inoue, Kenji Shimizu

Cancer letters 224 ( 2 ) 311 - 9 2005.6

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

About 97% of synovial sarcomas harbor the SYT-SSX fusion gene by chromosomal translocation. We found that the histone deacetylase (HDAC) inhibitor FK228 significantly suppressed the growth of synovial sarcoma cells as compared with that of osteosarcoma. The 50% growth inhibition IC50 value we obtained for FK228 was 0.02-0.2 nM, and it indicates that its suppression effect on synovial sarcoma cells is the highest of any of the HDAC inhibitors yet reported. It was not likely that the growth suppression of FK228 depends on the doubling time of these cells. Introduction of SYT-SSX cDNA into HEK293 cells enhanced the sensitivity of the cells for FK228. Immunostaining of the FK228-treated cells using an anti-acetyl-histone H3 antibody showed that FK228 inhibits deacetylation of histone. In a mice assay, the growth of synovial sarcoma cells was markedly inhibited by FK228 treatment, and the invasion of tumors into surrounding tissues was suppressed. These results suggest that FK228 may be useful in developing therapeutic strategies to treat synovial sarcoma.

Alternating sequential chemotherapy with high-dose ifosfamide and doxorubicin/cyclophosphamide for adult non-small round cell soft tissue sarcomas.

Akira Kawai, Toru Umeda, Takuro Wada, Koichiro Ihara, Kazuo Isu, Satoshi Abe, Takeshi Ishii, Hideshi Sugiura, Nobuhito Araki, Toshifumi Ozaki, Hiroo Yabe, Tadashi Hasegawa, Shoichiro Tsugane, Yasuo Beppu

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 10 ( 3 ) 258 - 63 2005.5

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

Doxorubicin and ifosfamide are the two most active agents used to treat soft tissue sarcomas. However, because of their overlapping side effects, concurrent administration to achieve optimal doses of each agent is difficult. We therefore conducted a Phase II trial to investigate the efficacy and feasibility of a novel alternating sequential chemotherapy regimen consisting of high dose ifosfamide and doxorubicin/cyclophosphamide in advanced adult non-small round cell soft tissue sarcomas. Adult patients with non-small round cell soft tissue sarcomas were enrolled. The treatment consisted of four sequential courses of chemotherapy that was planned for every 3 weeks. Cycles 1 and 3 consisted of ifosfamide (14 g/m(2)), and cycles 2 and 4 consisted of doxorubicin (60 mg/m(2)) and cyclophosphamide (1200 mg/m(2)). Forty-two patients (median age 47 years) were enrolled. Of the 36 assessable patients, 1 complete response and 16 partial responses were observed, for a response rate of 47.2%. Responses were observed in 57% of patients who had received no previous chemotherapy and 13% of those who had previously undergone chemotherapy. Grade 3-4 neutropenia was observed during 70% of all cycles. Sequential administration of high-dose ifosfamide and doxorubicin/cyclophosphamide has promising activity with manageable side effects in patients with advanced adult non-small round cell soft tissue sarcomas.

Calpain inhibitors prevent neuronal cell death and ameliorate motor disturbances after compression-induced spinal cord injury in rats. International journal

Shinya Arataki, Kazuhito Tomizawa, Akiyoshi Moriwaki, Keiichirou Nishida, Masayuki Matsushita, Toshifumi Ozaki, Toshiyuki Kunisada, Aki Yoshida, Hajime Inoue, Hideki Matsui

Journal of neurotrauma 22 ( 3 ) 398 - 406 2005.3

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

Traumatic spinal cord injury (SCI) results in widespread neuronal cell death. Recent studies have suggested that activated calpain mediates neuronal cell death in the central nervous system. We conducted a study to determine whether calpain mediates neuronal cell death in the motor neurons of the spinal cord after SCI, and whether postinjury administration of the calpain inhibitors N-acetyl- Leu-Leu-Met-CHO (ALLM) and calpain inhibitor III (CI III) (MDL28170) reduces the motor disturbances in rats with a model of SCI. Adult male Wistar rats were subjected to SCI by application of a 20-g weight impactor probe to the spinal cord at T12 for 20 min. The rats were divided into three groups according to whether they were injected intravenously with 0.05-2.5 mg/kg ALLM, 10 mg/kg CI III, or 0.1% DMSO as a control every 24 h for 1 week after SCI. Calpain was activated in the spinal cord at 8 h, 24 h, and 5 days after SCI, and administration of ALLM inhibited its activation. ALLM, as compared to the DMSO vehicle alone, also significantly reduced the number of motor neurons in spinal-cord lesions that were positively labeled at 24 h after SCI with the terminal deoxynucleotidyl transferase-uridine nucleotide end-labeling (TUNEL) technique. Additionally, both the inclined plane test and footprint analysis showed markedly better motor activity after 4 weeks in rats injected with ALLM or CI III than in rats given vehicle only. These results suggest that activation of calpain plays a critical role in the neuronal cell death that follows SCI, and that calpain inhibitors may have benefit in treating the motor disturbances that follow SCI.

Hoechst 33342は関節軟骨修復の長期研究において細胞標識物質として有用である

川崎啓介, 杉原進介, 大塚愛二, 西田圭一郎, 尾崎敏文, 吉田晶, 井上一

移植 40 ( 1 ) 78 - 79 2005.2

Treatment result of distal lower leg malignant soft tissue tumors

NAKATA Eiji

The Central Japan Journal of Orthopaedic Surgery & Traumatology 48 ( 1 ) 109 - 110 2005

Treatment result of synovial osteochondromatosis

NAKATA Eiji

The Central Japan Journal of Orthopaedic Surgery & Traumatology 48 ( 6 ) 989 - 990 2005

Treatment result of giant cell tumor of tendon sheath

ITANI Satoru

The Central Japan Journal of Orthopaedic Surgery & Traumatology 48 ( 6 ) 981 - 982 2005

SYT, a partner of SYT-SSX oncoprotein in synovial sarcomas, interacts with mSin3A, a component of histone deacetylase complex. International journal

Tatsuo Ito, Mamoru Ouchida, Sachio Ito, Yoshimi Jitsumori, Yuki Morimoto, Toshifumi Ozaki, Akira Kawai, Hajime Inoue, Kenji Shimizu

Laboratory investigation; a journal of technical methods and pathology 84 ( 11 ) 1484 - 90 2004.11

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

Synovial sarcomas are soft-tissue tumors predominantly affecting children and young adults. They are molecular-genetically characterized by the SYT-SSX fusion gene generated from chromosomal translocation t(X; 18) (p11.2; q11.2). When we screened new gene products that interact with SYT or SSX proteins by yeast two-hybrid assay, we found that mSin3A, a component of the histone deacetylase complex, interacts with SYT but not with SSX. These results were confirmed by mammalian two-hybrid and pull-down assays. Analyses with sequential truncated proteins revealed a main mSin3A-interaction region on the SYT amino-terminal 93 amino acids, and another one on the region between 187th amino acid and break point. In luciferase assay, mSin3A repressed the transcriptional activity of reporter promoter mediated by SYT and hBRM/BRG1. Our results suggest that the histone deacetylase complex containing mSin3A may regulate the transcriptional activation mediated by SYT.

滑膜肉腫におけるSYT-SSX蛋白結合因子の解析

大内田守, 伊藤達男, 尾崎敏文, 伊藤佐智夫, 大畑範英, 吉田晶, 清水憲二

日本癌学会総会記事 63回 370 - 370 2004.9

Crisscross CTL induction by SYT-SSX junction peptide and its HLA-A*2402 anchor substitute. International journal

Kazunori Ida, Satoshi Kawaguchi, Yuriko Sato, Tomohide Tsukahara, Yuki Nabeta, Hiroeki Sahara, Hideyuki Ikeda, Toshihiko Torigoe, Shingo Ichimiya, Kenjiro Kamiguchi, Takuro Wada, Satoshi Nagoya, Hiroaki Hiraga, Akira Kawai, Takeshi Ishii, Nobuhito Araki, Akira Myoui, Seiichi Matsumoto, Toshifumi Ozaki, Hideki Yoshikawa, Toshihiko Yamashita, Noriyuki Sato

Journal of immunology (Baltimore, Md. : 1950) 173 ( 2 ) 1436 - 43 2004.7

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

To investigate the effects of anchor substitutions in SYT-SSX junction peptide, an HLA-A24 anchor residue (position 9) of the SYT-SSX B peptide (GYDQIMPKK) was substituted to more favorable residues according to the HLA-A24-binding motif. Among four substitutes constructed, a substitute with isoleucine (termed K9I peptide) most apparently enhanced the affinity for HLA-A24 molecule. Subsequent in vitro CTL induction analysis using PBMCs of 15 HLA-A24(+) synovial sarcoma patients revealed that the original B peptide allowed to induce synovial sarcoma-specific CTLs from 7 patients (47%), whereas such CTLs were inducible from 12 patients (80%) with K9I peptide. Moreover, the extent of cytotoxicity against HLA-A24(+) synovial sarcoma cell lines was higher in K9I peptide-induced CTLs than B peptide-induced CTLs. Influence of anchor substitution on peptide/TCR interaction was evaluated by cytotoxicity assays against autologous cells and tetramer analysis. CTLs induced from a synovial sarcoma patient using K9I peptide did not lyse autologous PHA blasts or EBV-infected B cells. In vitro stimulations of PBMCs from 5 HLA-A24(+) synovial sarcoma patients with K9I peptide increased the frequency of T cells reacting with both HLA-A24/K9I peptide tetramer and HLA-A24/B peptide tetramer. In contrast, the frequency of T cells reacting with HLA/HIV-derived peptide tetramer remained low. These findings support the validity in design of anchor residue substitution in SYT-SSX fusion gene-derived peptide, and provide a potential clue to the current stagnation in vaccination trials of fusion gene-derived natural junction peptides.

Influence of telomerase activity on bone and soft tissue tumors. International journal

Norifumi Umehara, Toshifumi Ozaki, Shinsuke Sugihara, Toshiyuki Kunisada, Yuki Morimoto, Akira Kawai, Keiichiro Nishida, Aki Yoshida, Takuro Murakami, Hajime Inoue

Journal of cancer research and clinical oncology 130 ( 7 ) 411 - 6 2004.7

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

PURPOSE: Telomeres consisting of a repeating nucleotide sequence (TTAGGG)n are shortened in normal somatic cells. Telomerase is an enzyme that elongates the telomere sequence and is detected in most human cancers and usually not in normal somatic cells. Little is known about telomerase activity in bone and soft tissue tumors. The aim of this study was to investigate the relationship between telomerase activity and clinical factors in bone and soft tissue tumors. METHODS: Telomerase activity was measured using the modified telomeric repeat amplification protocol (TRAP) assay in 115 bone and soft tissue tumors obtained through open biopsy or resection. RESULTS: Telomerase activity was detected in 10% of benign tumors and 44% of malignant tumors (p < 0.001). A higher incidence of telomerase activity was detected in high-grade tumors than in low-grade tumors (p = 0.002). The cumulative metastasis-free and overall survival in telomerase-positive patients was significantly worse than in telomerase-negative patients (p = 0.045 and p = 0.048). CONCLUSION: Our study suggests that telomerase activity is associated with tumor aggressiveness and may be a useful parameter to predict the prognosis of patients with malignant bone and soft tissue tumors.

Extended total sacrectomy and reconstruction for sacral tumor. International journal

Norihide Ohata, Toshifumi Ozaki, Toshiyuki Kunisada, Yuki Morimoto, Masato Tanaka, Hajime Inoue

Spine 29 ( 6 ) E123-6 2004.3

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

STUDY DESIGN: This case report includes the results of long-term follow-up after extended total sacrectomy in a 13-year-old boy with a sarcoma originating in the sacrum with an extraskeletal extension and infiltration into the left ilium. OBJECTIVE: To report and discuss a case of sacral tumor treated by extended sacrectomy. SUMMARY OF BACKGROUND DATA: Sacral tumors are often at an advanced stage with a large volume at diagnosis. Although total or extended sacrectomy is the only radical means to treat the massive sacral tumor, unavoidable complications in total sacrectomy are serious in the treatment selection. METHODS: Initial histologic findings indicated a synovial sarcoma. Additional genetic analysis redesignated the tumor as an unclassified sarcoma. Preoperative neoadjuvant chemotherapy and radiotherapy were completed. The response to the preoperative treatment appeared as a reduction in tumor size (approximately 50%) on radiographs. After extended sacrectomy, the L5 vertebral body was fixed between the ilia, and the pelvic ring was compressed by the Zielke system. The ISOLA instrumentation system connected the lumbar spine and both ilia. All sacral nerve roots and the L5 root on the left side were cut. RESULTS: At the 5-year follow-up examination, the patient was disease-free, could walk with crutches, and could climb stairs using the handrail and one crutch. CONCLUSIONS: The patient's excellent response to preoperative antitumor treatment was considered crucial to the long-term outcome. But the decision between a radical resection with reconstruction and a less extensive procedure with combined therapy remains controversial.

Hoechst 33342 is a useful cell tracer for a long-term investigation of articular cartilage repair.

Keisuke Kawasaki, Shinsuke Sugihara, Keiichiro Nishida, Toshifumi Ozaki, Aki Yoshida, Aiji Ohtsuka, Hajime Inoue

Archives of histology and cytology 67 ( 1 ) 13 - 9 2004.3

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

The repair process of a full-thickness osteochondral defect was observed in a rat model using Hoechst 33342 as a cell tracer. The osteochondral defect was created at the medial femoral condyle of the right knee joints of twelve 11 week old male rats. Three weeks after the surgery, Hoechst 33342 was injected into the same knee joints. Calcein, a marker of the mineralization front, was then injected subcutaneousely twice at seven days and one day before harvesting of the tissue. At six, ten, and fourteen weeks and one year after the surgery, femoral condyles were obtained from the operated knee joints, fixed by alcohol, and embedded in polymethylmethacrylate. The sections were examined by fluorescent and then light microscopy. In the lateral femoral condyle cartilage, Hoechst 33342 labeling of chondrocyte nuclei was observed in all layers of the intact cartilage, and the dye never infiltrated beneath the subchondral bone plate. At 6 weeks after the surgery, Hoechst 33342-positive cells were observed not only in the regenerated fibrous cartilage, but also in the newly formed mineralized tissue in the medial femoral condyle. Interestingly, Hoechst 33342 labeling remained undiminished even one year after the intra-articular injection. The findings of the present study suggest that intra-articular injection of Hoechst 33342 is a useful tracer for long-term investigations of chondrocyte differentiation in vivo.

Reconstruction with ipsilateral fibula transfer with pasteurized bone after excision of bone sarcoma of the tibia. International journal

Toshifumi Ozaki, Kazuo Fujiwara, Toshiyuki Kunisada, Tatsuo Ito, Akira Kawai, Hajime Inoue

Sarcoma 8 ( 2-3 ) 97 - 102 2004

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

We report a technique of implantation of the ipsilateral vascularized fibula with pasteurized recycled bone after excision of tibia sarcoma in two cases. Plate and screws were used for osteosynthesis of the tibia or talus, vascularized fibula, and pasteurized bone. Microsurgery is not necessary for this reconstruction technique. Two patients who underwent this technique have obtained good functional results without tumor relapse 5 and 6 years after operation. The technique produced excellent results with regard to tibial reconstruction in these cases. We found it to be simple, speedy, safe, and a low cost technique by use of recycled bone.

DOI： 10.1080/13577140400017794

Amplification of MYCL in atypical ewing tumor. analysis of metaphase and microarray comparative genomic hybridization

Toshifumi Ozaki, Yasuko Nakagawa, Aki Yoshida, Kunihiko Numoto, Shinnsuke Sugihara, Toshiyuki Kunisada, Shuji Hamazaki, Hajime Inoue

Cancer Genomics and Proteomics 1 ( 4 ) 275 - 282 2004

Language：English Publishing type：Research paper (scientific journal) Publisher：International Institute of Anticancer Research

A 20-year-old man developed a soft tissue mass in his right upper arm and, 3 months later, was referred to our hospital. The tumor cells showed brisk mitotic activity and a large amount of cytoplasmic glycogen was demonstrated with periodic acid Schiff stain. A diagnosis of atypical Ewing sarcoma was made. Chemotherapy according to the VACA protocol, comprising vincristine, actinomycin D, cyclophosphamide and doxorubicin was started. The chemotherapy was effective and a limb salvage procedure was performed by implantation of an autoclaved bone after wide tumor excision. During the postoperative chemotherapy, a local recurrence and multiple metastases developed, and the patient died due to disease progression. Fourteen years later, this tumor sample, preserved in a deepfreeze, was analyzed by reverse-transcriptase polymerase chain reaction (RT-PCR) to detect the fusion gene. This tumor had an EWS exon 7 to FLI1 exon 6 fusion transcript. Moreover, metaphase and microarray comparative genomic hybridization (CGH) was done to detect chromosomal instabilities. Many gains and losses were noted on metaphase CGH, and MYCL amplification was identified on microarray CGH.

Single nucleotide polymorphism in fibroblast growth factor receptor 4 at codon 388 is associated with prognosis in high-grade soft tissue sarcoma. International journal

Yuki Morimoto, Toshifumi Ozaki, Mamoru Ouchida, Norifumi Umehara, Norihide Ohata, Aki Yoshida, Kenji Shimizu, Hajime Inoue

Cancer 98 ( 10 ) 2245 - 50 2003.11

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

BACKGROUND: A recent study revealed that single nucleotide polymorphism (SNP) at codon 388 (Gly or Arg) of fibroblast growth factor receptor 4 (FGFR4) was associated with prognosis in patients with carcinoma of the breast and colorectal carcinoma. The purpose of the current study was to investigate the correlation between codon 388 SNP and clinical prognosis in patients with sarcoma of the bone and soft tissues. METHODS: Tumor samples were obtained from 143 patients with high-grade bone and soft tissue sarcomas at Okayama University Hospital between 1986-2002, and from 102 healthy volunteers. SNP of codon 388 was detected by sequencing and fragment length of polymerase chain reaction products digested by restriction enzyme. The chi-square test was used to compare genotype distribution and the Kaplan-Meier method was used for survival analysis. RESULTS: With regard to FGFR4 genotypes in the 143 patients studied, 54 (37.8%) were Gly/Gly, 72 (50.3%) were Gly/Arg, and 17 (11.9%) were Arg/Arg, findings that were not significantly different from those of controls (P = 0.97). With regard to cumulative overall and metastasis-free survival, patients with the Gly/Gly genotype were found to have a better prognosis (P = 0.085 and P = 0.27, respectively). FGFR4 SNP was found to be correlated significantly with overall and metastasis-free survival in patients with soft tissue sarcomas (P = 0.029 and P = 0.045, respectively), but not in those patients with bone sarcomas (P = 0.88 and P = 0.75, respectively). CONCLUSIONS: In the current study, the authors found a significant correlation between FGFR4 SNP and prognosis in patients with soft tissue sarcoma, although the samples were comprised of various histologic types. This SNP might be used to improve the prediction of clinical prognosis and lead to new treatment strategies in patients with soft tissue sarcomas.

Correction of leg-length discrepancy after hip transposition. International journal

Robert Rödl, Georg Gosheger, Benedikt Leidinger, Norbert Lindner, Winfried Winkelmann, Toshifumi Ozaki

Clinical orthopaedics and related research ( 416 ) 271 - 7 2003.11

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

Four patients were treated with limb lengthening to correct a leg-length discrepancy that developed after a hip transposition after pelvic resection for sacroma of the pelvis. Three patients had Ewing's sacroma and one patient had osteosarcoma. All patients received chemotherapy; radiotherapy also was administered to the three patients with Ewing's sacroma. Femur lengthening was started at an average of 5.7 years (range, 4.4-6.8 years) after tumor surgery. At the start of elongation, the average age of the patients was 17.3 years (range, 10.3-20.8 years). The average leg-length discrepancy was 10.3 cm (range, 6-12 cm). The average of achieved lengthening was 6.4 cm (range 6-7.5 cm). The average healing index was 32 days (range, 27-40 days) per 1-cm elongation. According to the classification of Paley, two problems and two minor complications were treated by additional interventions. At the final followup, the average functional score was 22 (73%) according to the system of the Musculoskeletal Tumor Society. Leg-length discrepancy after hip transposition can be corrected with distraction osteogenesis. All patients who wore a stiff ankle-foot orthosis before lengthening wore an ordinary shoe lift after lengthening. The problems of the lengthening procedure are similar to the general complication rate of bone lengthening. Because the 5-year survival after resection of a pelvic sarcoma is only 20% to 30%, leg lengthening after hip transposition should be offered only to long-term survivors with at least 5 years event-free survival.

Splicing isoform of SYT-SSX fusion protein accelerates transcriptional activity and cell proliferation. International journal

Yuki Morimoto, Mamoru Ouchida, Toshifumi Ozaki, Akira Kawai, Tatsuo Ito, Aki Yoshida, Hajime Inoue, Kenji Shimizu

Cancer letters 199 ( 1 ) 35 - 43 2003.9

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

The human SYT-SSX gene has two splicing isoforms (type N and I), the latter of which contains an additional insertion of 93 bases. In the present study, we found increased transcriptional activity of the SYT-SSX type I protein in luciferase assay. When the SYT-SSX cDNAs were transfected to NIH3T3 cells, the type I transformant grew faster than the type N transformant. Furthermore, we evaluated the isoform ratio of the SYT or SYT-SSX transcripts in various tissues. Our results suggest that the SYT-SSX type I protein plays a critical role in the tumorigenesis of synovial sarcomas through increased transcriptional activity.

孤立性骨嚢腫の治療成績

中川寧子, 尾崎敏文, 国定俊之, 伊藤達男, 井上一

中部日本整形外科災害外科学会雑誌 46 ( 秋季学会 ) 46 - 46 2003.9

SYT蛋白とSSX蛋白のyeast two hybrid assayを用いた機能解析

伊藤達男, 大内田守, 尾崎敏文, 国定俊之, 森本裕樹, 大畑範英, 中川寧子, 吉田晶, 伊藤佐智夫, 清水憲二

日本癌学会総会記事 62回 536 - 536 2003.8

ある種の分子標的薬はSYT-SSX発現細胞株に特異的な抗腫瘍効果を発揮する

沼本邦彦, 伊藤達男, 尾崎敏文, 大内田守, 国定俊之, 伊藤佐智夫, 森本裕樹, 大畑範英, 中川寧子, 清水憲二, 井上一

日本整形外科学会雑誌 77 ( 8 ) S1086 - S1086 2003.8

cDNA Microarrayを用いたSYT-SSX Fusion Type間の遺伝子発現解析

森本裕樹, 川井章, 尾崎敏文, 伊藤達男, 中田英二, 井上一

日本整形外科学会雑誌 77 ( 8 ) S1086 - S1086 2003.8

滑膜肉腫に認められる転座遺伝子SYT-SSXのtwo hybrid assayを用いた機能解析

伊藤達男, 尾崎敏文, 大内田守, 国定俊之, 森本裕樹, 大畑範英, 中川寧子, 武田健, 沼本邦彦, 吉田晶, 伊藤佐智夫, 清水憲二, 井上一

日本整形外科学会雑誌 77 ( 6 ) S823 - S823 2003.6

AI及びBIIIa rotationplasty後の術後リハビリテーション

尾崎敏文, 濱田全紀, 千田益生, 井上一, HillmannAxel

日本整形外科学会雑誌 77 ( 6 ) S834 - S834 2003.6

Blood loss in patients for total knee arthroplasty. International journal

Hiroshi Fujimoto, Toshifumi Ozaki, Kohji Asaumi, Hisayoshi Kato, Keichiro Nishida, Yasuhiro Takahara, Nobuhiro Abe, Hajime Inoue

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 11 ( 3 ) 149 - 54 2003.5

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

Ninety-four patients with osteoarthritis (OA) and 180 with rheumatoid arthritis (RA) undergoing unilateral total knee arthroplasty (TKA) were analyzed to clarify the necessity for preoperative autogenous blood deposition or homologous blood transfusion. Two hundred and twenty-four and 50 patients underwent TKA with cement and without cement, respectively. The difference in average blood loss in patients between with (372 ml) and without cementation (449 ml) was significant. In the OA group the average blood loss significantly decreased after cementation but not in the RA group. Although the rate of avoiding transfusion in the OA group did not significantly decrease with the use of cement (92.4% vs. 93.3%), that in the RA group did (80% to 57.1%). Eight of 159 patients with hemoglobin level (Hb) of 11.0 g/dl or higher received homologous blood transfusion. Of these eight patients five had associated disorders. Only one patient with Hb of 12.0 g/dl or higher underwent homologous blood transfusion. Patients with Hb of 12.0 g/dl or higher are not indicated for preoperative autologous blood deposition. In patients with Hb between 11.0 and 12.0 g/dl preoperative blood deposition may be planned after consideration of general condition and complication. Patients with Hb lower than 11.0 g/dl should undergo preoperative blood deposition.

Sacral infiltration in pelvic sarcomas: joint infiltration analysis II. International journal

Toshifumi Ozaki, Robert Rödl, Georg Gosheger, Christiane Hoffmann, Christopher Poremba, Winfried Winkelmann, Norbert Lindner

Clinical orthopaedics and related research ( 407 ) 152 - 8 2003.2

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

The incidence and characteristics of sacral infiltration in pelvic sarcomas were analyzed. Fifty-one patients with a pelvic sarcoma (chondrosarcoma, 15 patients; Ewing's sarcoma, 23 patients; and osteosarcoma, 13 patients) abutting the sacroiliac joint had surgical treatment. Tumor infiltration into the sacrum was suspected based on preoperative images in 18 patients; 15 of 18 patients had histologic tumor invasion. There was a significant difference of median volume of sarcomas with and without infiltration. One of 23 Ewing's sarcomas, seven of 15 chondrosarcomas, and seven of 13 osteosarcomas penetrated the sacroiliac joint into the sacrum. Logistic regression test showed that diagnosis was the most important factor influencing sacral infiltration. Twelve tumors infiltrated through the posterior part of the joint, two tumors infiltrated through the anterior part, and one large tumor infiltrated through an unknown route. To obtain wide surgical margins, patients at risk (elderly, large tumor, or diagnosis of osteosarcoma or chondrosarcoma) for sacral involvement may require extended internal hemipelvectomy with the medial margin extending into the sacrum. High quality imaging studies should be used to assess the need for transarticular resection.

Osteosarcoma of the pelvis: experience of the Cooperative Osteosarcoma Study Group. International journal

Toshifumi Ozaki, Silke Flege, Matthias Kevric, Norbert Lindner, Rainer Maas, Günter Delling, Rudolf Schwarz, Arthur R von Hochstetter, Mechthild Salzer-Kuntschik, Wolfgang E Berdel, Heribert Jürgens, G Ulrich Exner, Peter Reichardt, Regine Mayer-Steinacker, Volker Ewerbeck, Rainer Kotz, Winfried Winkelmann, Stefan S Bielack

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 21 ( 2 ) 334 - 41 2003.1

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

PURPOSE: To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed. PATIENTS AND METHODS: Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy. RESULTS: Local failure occurred in 47 of all 67 patients (70%) and in 31 of 50 patients (62%) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27% and 19%, respectively. Large tumor size (P =.0137), primary metastases (P =.0001), and no or intralesional surgery (P <.0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P =.0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456; P =.0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P <.0001), and no radiotherapy (RR = 4.196; P =.0059) were independent poor prognostic factors. CONCLUSION: An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis.

Chromosomal alterations in osteosarcoma cell lines revealed by comparative genomic hybridization and multicolor karyotyping. International journal

Toshifumi Ozaki, Thomas Neumann, Daniel Wai, Karl-Ludwig Schäfer, Franz van Valen, Norbert Lindner, Christina Scheel, Wermer Böcker, Winfried Winkelmann, Barbara Dockhorn-Dworniczak, Jürgen Horst, Christopher Poremba

Cancer genetics and cytogenetics 140 ( 2 ) 145 - 52 2003.1

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

We characterized the chromosomal alterations in eight osteosarcoma cell lines (OST, HOS, U-2 OS, ZK-58, MG-63, SJSA-1, Saos-2, and MNNG) by comparative genomic hybridization (CGH); gains and losses of DNA sequences were defined as chromosomal regions with a fluorescence ratio, wherein all of the 95% confidence interval was above 1.25 and below 0.75, respectively. In four of 8 cell lines, multicolor karyotyping (MK) was added. CGH revealed the average number of aberrations per cell line was 20.8 (range: 10-31); the average numbers of gains and losses were 11.1 and 9.6, respectively. The frequent gains were identified on 1p21 approximately q24, 1q25-q31, 7p21, 7q31, 8q23 approximately q24, and 14q21; frequent losses were at 18q21 approximately q22, 18q12, 19p, and 3p12 approximately p14. High-level gains were observed on 8q23 approximately q24, 5p, and 1p21 approximately p22. MK revealed the most common translocations in the four cell lines were t(8;9), t(1;3), t(3;5), t(1;13), t(2;6), t(3; 17), t(1;15), t(10;20), and t(6;20). Chromosomes 1, 3, 8, 9, and 20 were most frequently involved in translocation events. The concordance rate of aberrations in CGH and translocations in MK was 76%. MK was useful to identify the chromosomal alterations and as a supplement to the CGH results in three of four chromosomes.

Genetic imbalances revealed by comparative genomic hybridization in osteosarcomas. International journal

Toshifumi Ozaki, Karl-Ludwig Schaefer, Daniel Wai, Horst Buerger, Silke Flege, Norbert Lindner, Matthias Kevric, Raihanatou Diallo, Agnes Bankfalvi, Christian Brinkschmidt, Heribert Juergens, Winfried Winkelmann, Barbara Dockhorn-Dworniczak, Stefan S Bielack, Christopher Poremba

International journal of cancer 102 ( 4 ) 355 - 65 2002.12

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

Osteosarcomas are the most frequent bone sarcomas. The molecular chromosomal aberrations in osteosarcomas were analyzed by comparative genomic hybridization (CGH). We studied 47 frozen tumors (41 primary samples, 6 relapses) in osteosarcoma patients registered in the Cooperative Osteosarcoma Study (COSS) protocol. Genomic imbalances were detected in 40 of 41 primary tumors and 6 of 6 relapsed tumors. Gains were more frequent than losses (ratio of 1.3:1). The median number of changes was 16 and 12 in primary and relapsed osteosarcomas, respectively. The median number of aberrations in primary high-grade osteosarcomas (17.0) was significantly higher than in low- or intermediate-grade osteosarcoma subtypes (3.0) (p = 0.038). The most frequent gains included 8q, 1p21-p31 and 1q21-q24, and the most frequent losses were 10q, 5q and 13q. High-level gains were observed on 8q23-q24, 17p13 and 1q21-q24. A gain of 19p (p < 0.001) or loss of 9p (p = 0.027) was more frequent in poor responders than in good responders. Univariate analysis revealed that patients with primary metastases (p = 0.002), poor histologic responses (p = 0.005), high-level gains of 19p (p = 0.012) or losses of 13q14 (p = 0.042) had significantly lower event-free survival (EFS), whereas patients with a loss of 5q (p = 0.007) or a loss of 10q21-22 (p = 0.017) had significantly higher EFS than patients without these aberrations. Multivariate analysis demonstrated that primary metastasis, loss of 13q14 and loss of 5q were independent prognostic factors. The findings of our study seem to be useful for evaluating the prognosis of patients and may finally lead to treatment strategies based on genetic background of osteosarcoma.

骨軟部腫瘍におけるレセプターチロシンキナーゼ(c-kit)の発現

吉田晶, 川井章, 内藤訓子, 森本裕樹, 伊藤達男, 大畑範英, 国定俊之, 尾崎敏文, 別府保男

日本癌学会総会記事 61回 397 - 397 2002.10

高悪性軟部腫瘍に対する化学療法の多施設共同研究

川井章, 梅田透, 鬼頭正士, 津金昌一郎, 長谷川匡, 和田卓郎, 伊原公一郎, 平賀博明, 高橋満, 荒木信人, 石井猛, 阿部哲士, 川野壽, 上田孝文, 馬場一郎, 尾崎敏文

日本癌治療学会誌 37 ( 2 ) 219 - 219 2002.9

Giant cell tumor of the spine. International journal

Toshifumi Ozaki, Ulf Liljenqvist, Henry Halm, Axel Hillmann, Georg Gosheger, Winfried Winkelmann

Clinical orthopaedics and related research ( 401 ) 194 - 201 2002.8

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

Six patients with giant cell tumor of the spine had surgery between 1981 and 1995. Three lesions were located in the scrum, two lesions were in the thoracic spine, and one lesion was in the lumbar spine. Preoperatively, all patients had local pain and neurologic symptoms. Two patients had cement implanted after curettage or intralesional excision of the sacral tumor; one patient had a local relapse. After the second curettage and cement implantation, the tumor was controlled. One patient with a sacral lesion had marginal excision and spondylodesis; no relapse developed. Two patients with thoracic lesions had planned marginal excision and spondylodesis; the margins finally became intralesional, but no relapse developed. One patient with a lumbar lesion had incomplete removal of the tumor and received postoperative irradiation. At the final followup (median, 69 months), five of six patients were disease-free and one patient died of disease progression. Two of the five surviving patients had pain after standing or neurologic problems. Although some contamination occurred, planning a marginal excision of the lesion seems beneficial for vertebral lesions above the sacrum. Total sacrectomy of a sacral lesion seems to be too invasive when cement implantation can control the lesion.

骨肉腫の治療成績過去36年間の症例

伊藤達男, 川井章, 尾崎敏文, 杉原進介, 森本裕樹, 中田英二, 大畑範英, 井上一

日本整形外科学会雑誌 76 ( 6 ) S767 - S767 2002.6

Characterization of the malignant melanoma of soft-parts cell line GG-62 by expression analysis using DNA microarrays. International journal

Karl-Ludwig Schaefer, Daniel H Wai, Christopher Poremba, Eberhard Korsching, Frans van Valen, Toshifumi Ozaki, Werner Boecker, Barbara Dockhorn-Dworniczak

Virchows Archiv : an international journal of pathology 440 ( 5 ) 476 - 84 2002.5

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

GG-62 is a cell line previously thought to be derived from an atypical Ewing tumor (ET). Reverse-transcriptase polymerase chain reaction revealed an in-frame fusion between the Ewing sarcoma gene ( EWS) codon 325 and the activating transcription factor 1 gene ( ATF1) codon 65 which permits the production of chimeric EWS-ATF1 oncoproteins. We also identified the genomic breakpoint resulting from a reciprocal t(12;22)(q13;q12), which is the hallmark of malignant melanoma of soft parts (MMSP). We applied Affymetrix human cancer G110 arrays to compare the gene expression patterns of GG-62 and other cell lines derived from small blue round cell tumors of childhood. Hierarchical clustering of 463 differentially expressed genes distinguished GG-62 from the ETs, as well as the neuroblastomas, and revealed a cluster of 36 upregulated genes. Several of these genes are involved in signal transduction pathways that may be critical for maintaining cell transformation; some examples are avian erythroblastic leukemia viral oncogene homolog 3 ( ERBB3), neuregulin 1 ( NRG1), fibroblast growth factor 9 ( FGF9), and fibroblast growth factor receptor-1 ( FGFR1). Furthermore, genes near the chromosome-12q13 breakpoint exhibited increased expression of GG-62 including ERBB3, NR4A1 (nuclear receptor subfamily 4, group A, member 1), cyclin-dependent kinase 2 ( CDK2), and alpha 5 integrin ( ITGA5). Altogether our findings demonstrate the MMSP derivation of GG-62 and may shed light on the mechanisms of tumorigenesis in this rare disease.

Infiltration of sarcomas into the hip joint: comparison of CT, MRI and histologic findings in 67 cases. International journal

Toshifumi Ozaki, Marc Putzke, Horst Bürger, Georg Gosheger, Winfried Winkelmann, Norbert Lindner

Acta orthopaedica Scandinavica 73 ( 2 ) 220 - 6 2002.4

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

We analyzed the incidence, route, and characteristics of hip joint infiltration in pelvic or proximal femoral sarcomas. 67 patients with a sarcoma that originated around the hip joint (50 pelvic and 17 femoral) were included in this study. Preoperative CT and MRI were matched with the histological findings in tumor specimens. Tumor infiltration into the hip joint was suspected on the basis of preoperative imaging in 29 patients due to articular cartilage disruption, diffuse signal changes in the acetabulum or femoral neck, signs of a tumor in the joint, or markedjoint effusion. Of these 29 patients, 15 showed tumor invasion on histological examination. 12 of 31 chondrosarcomas, none of 12 Ewing's sarcomas, and 3 of 24 osteosarcomas infiltrated into the hip joint (p = 0.008). 10 of 26 low-grade sarcomas and 5 of 41 high-grade sarcomas infiltrated into the hip joint (p = 0.02). The joint infiltration rate of the chondrosarcomas was related to their size. Of 10 tumors originating in the acetabulum, 9 penetrated through or around the osseous-ligamentous junction and one through the acetabular cartilage. In 5 proximal femur lesions, all infiltrated the joint through the femoral neck, 3 of them also through the ligamentum teres.

Osteoid osteoma and osteoblastoma of the spine: experiences with 22 patients. International journal

Toshifumi Ozaki, Ulf Liljenqvist, Axel Hillmann, Henry Halm, Norbert Lindner, Georg Gosheger, Winfried Winkelmann

Clinical orthopaedics and related research ( 397 ) 394 - 402 2002.4

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

Osteoblastomas and osteoid osteomas of the spine are relatively rare bone-forming tumors. Between 1980 and 1999, nine patients with osteoid osteoma and 13 patients with osteoblastoma had surgery for their tumors. Four tumors were in the cervical spine, six tumors were in thoracic spine, 10 tumors were in the lumbar spine, and two tumors were in the sacrum. The average duration between onset of pain and surgery was 16.6 months in 12 patients treated in the 1980s and 8.6 months in 10 patients treated in the 1990s. Seventeen patients had scoliosis. In nine of 10 patients with magnetic resonance imaging scans, high signal intensity areas in the muscles and bone around the lesion were seen. Two of nine patients with osteoid osteoma and nine of 13 patients with osteoblastoma had neurologic disorders before treatment. All patients had open resection of the lesions. Two patients with osteoid osteoma had relapse because of incomplete resection, necessitating a second excision. In 16 of 17 patients with preoperative spinal deformity, the deformity improved during followup. With development of modern imaging techniques, exact surgical planning may become possible; however, in some cases, intraoperative complete resection of the lesion still is difficult.

Implantation of hemipelvic prosthesis after resection of sarcoma. International journal

Toshifumi Ozaki, Christiane Hoffmann, Axel Hillmann, Georg Gosheger, Norbert Lindner, Winfried Winkelmann

Clinical orthopaedics and related research ( 396 ) 197 - 205 2002.3

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

Twelve adult patients with pelvic sarcoma had implantation of a hemipelvic prosthesis. Eight patients had hemipelvic resection, and four patients had acetabulopubic resection. The implanted prosthesis was a special Vitallium prosthesis, which was specially designed for each patient with the aid of a computer. At a median followup of 57 months, eight patients were free of disease. In four patients with local relapse, two had additional resection, one had hindquarter amputation, and one was observed. In three patients with deep infection, the prosthesis was removed; however, one patient had hindquarter amputation. One patient had dislocation of the hip and prosthesis loosening. Overall survival of patients was 70%, and the survival of prostheses was 42%. In eight patients, the functional evaluation showed that the average functional score with the prosthesis was 11.6 (39%) and without the prosthesis the functional score was 7.0 (23%). Implantation of a megaprosthesis seems to indicate a high complication rate and a poor functional result after hemipelvic resection.

Expression analysis of pediatric solid tumor cell lines using oligonucleotide microarrays. International journal

Daniel H Wai, Karl-Ludwig Schaefer, Alexander Schramm, Eberhard Korsching, Frans Van Valen, Toshifumi Ozaki, Werner Boecker, Lothar Schweigerer, Barbara Dockhorn-Dworniczak, Christopher Poremba

International journal of oncology 20 ( 3 ) 441 - 51 2002.3

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

We identified patterns of differentially-expressed genes in cell lines derived from several pediatric solid tumors. Affymetrix Human Cancer G110 Arrays, carrying 1,700 cancer-associated genes, were applied to a panel of 11 cell lines originating from Ewing tumors (ETs), neuroblastomas, and malignant melanoma of soft parts. Hierarchical clustering clearly differentiated these 3 entities and revealed groups of 75, 102, and 36 gene probe-sets exhibiting tumor-type specific up-regulation in these cell lines, respectively. Whereas ET lines demonstrated increased expression of microtubule-associated protein tau (MAPT), protein phosphatase 1 regulatory subunit 1A (PPP1R1A), NIMA (never in mitosis gene a)-related kinase 2 (NEK2), and cyclin D1 (CCND1), neuroblastoma samples exhibited high expression of wingless-type mouse mammary tumor virus integration site family member 11 (WNT11), Drosophila frizzled homolog 2 (FZD2), and adenomatous polyposis coli (APC) which are involved in regulating free beta-catenin levels. These genes likely maintain tumor-specific characteristics and participate in key downstream regulatory mechanisms. We also correlated the expression levels of up-regulated genes in ETs with their chromosomal localization and compared these data to the comparative genomic hybridization profiles of the cell lines. We demonstrate that gains of genetic material contribute essentially to differential gene expression.

Osteosarcoma of the spine: experience of the Cooperative Osteosarcoma Study Group. International journal

Toshifumi Ozaki, Silke Flege, Ulf Liljenqvist, Axel Hillmann, Günter Delling, Mechthild Salzer-Kuntschik, Heribert Jürgens, Rainer Kotz, Winfried Winkelmann, Stefan S Bielack

Cancer 94 ( 4 ) 1069 - 77 2002.2

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

BACKGROUND: Due to the low incidence rate, the optimal strategy for the treatment of patients with spinal osteosarcoma is unknown. METHODS: Twenty-two patients with osteosarcoma of the spine (15 with tumors of the sacrum and 7 with tumors at other sites) who received chemotherapy according to the Cooperative Osteosarcoma Study Group protocol were analyzed. Six patients presented with metastasis, and 16 patients had no evidence of metastasis at the time of entry into the protocol. Of 12 patients who underwent excision of their tumors, 2 patients underwent wide excision, 3 patients underwent marginal excision, and 7 patients underwent intralesional excision. Eight patients received irradiation: Six patients received conventional radiotherapy only, one patient received neutron beam therapy, and one patient received samarium-153-ethylene diamine tetramethylene phosphonate therapy. Follow-up ranged between 24 months and 105 months (median, 47 months). RESULTS: The median survival was 23 months, and three patients have survived without disease for > 6 years. Patients with primary metastases (P = 0.004), large tumors (P = 0.010), and sacral tumors (P = 0.048) had lower overall survival compared with patients who had no metastasis, small tumors, and nonsacral tumors, respectively. There was a significant difference in overall survival between 5 patients who underwent either wide or marginal surgery and 17 patients who underwent either intralesional surgery or no surgery (P = 0.033). Among 17 patients who underwent no surgery or intralesional surgery, overall survival tended to be better in 7 patients who received irradiation compared with the overall survival in 10 patients who did not receive irradiation (P = 0.059). CONCLUSIONS: Patients with metastases, a large tumors, and sacral tumors had a poor prognosis in the current study with small numbers of patients. Wide or marginal excision of the tumor improved survival. Patients with osteosarcoma of the spine should be treated with a combination of chemotherapy and at least marginal excision for those with surgically accessible tumors. Postoperative radiotherapy may be beneficial.

Incidence and mechanisms of infiltration of sarcomas in the shoulder. International journal

Toshifumi Ozaki, Marc Putzke, Robert Rödl, Winfried Winkelmann, Norbert Lindner

Clinical orthopaedics and related research ( 395 ) 209 - 15 2002.2

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

The intraarticular infiltration of sarcomas around the shoulder was analyzed. Of 58 sarcomas located around the shoulder, which were treated between 1993 and 1998, 15 osteosarcomas, 12 chondrosarcomas, and one Ewing's sarcoma that abutted the shoulder were selected. Radiologic images of 28 tumors were analyzed and compared with pathologic examinations. In 17 of 28 sarcomas (15 in the proximal humerus and two in the scapula), joint infiltration was suspected radiologically because of the existence of a tumor mass probably inside the joint or disruption of the joint surface and protrusion of the tumor. Seven of 17 tumors with radiologically positive and zero of 11 tumors with radiologically negative findings showed histologically positive findings for tumor inside the joint. Four of 11 osteosarcomas and three of four chondrosarcomas of the proximal humerus showed histologic findings of joint infiltration. Pericapsular extension was seen in two patients, direct articular spread with a pathologic fracture was seen in two patients, direct articular spread was seen in one patient, direct articular spread with pericapsular extension was seen in one patient, and pericapsular extension with a pathologic fracture was seen in one patient. The current study showed that pericapsular or direct articular infiltration into the glenohumeral joint is a phenomenon in sarcoma around the shoulder. Exact assessment of tumor existence inside the joint can be difficult in osteosarcoma and chondrosarcoma, so abnormal radiologic findings should be regarded as proof of existence of tumor, and extraarticular wide resection should be planned.

Treatment results of patients with pediatric osteosarcoma

OHATA Norihide

The Central Japan Journal of Orthopaedic Surgery & Traumatology 45 ( 6 ) 969 - 970 2002

Clinical result of prosthetic replacement for bone metastasis in the proximal humerus

MORIMOTO Yuki

The Central Japan Journal of Orthopaedic Surgery & Traumatology 45 ( 6 ) 961 - 962 2002

Reconstruction of the proximal humerus with the clavicle after tumor resection: A case report

T. Ozaki, H. Hashizume, T. Kunisada, A. Kawai, K. Nishida, S. Sugihara, H. Inoue

Clinical Orthopaedics and Related Research 385 170 - 175 2001

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

Reconstruction of the proximal humerus after resection for tumor and modification of the clavicular transposition procedure is described in which the blood supply of the clavicle is preserved and the clavicle is used to bridge the defect. An 11-year-old boy presented with shoulder pain, and the diagnosis was osteosarcoma of the right proximal humerus. After resection of the sarcomatous proximal humerus, the clavicle was released with its periosteum remaining intact, and the clavicle was rotated downward around the acromioclavicular joint. A vascularized fibula supplemented the reconstruction in trying to gain length of the arm. The acromioclavicular joint and the vascular supply of the clavicle were preserved. Internal fixation from the clavicle and the fibula to the distal humerus was made with an AO plate and screws. Muscles around the proximal humerus were reattached to the clavicle. Range of motion of the shoulder was 80° flexion, 85° abduction, 30° external rotation, and 90° internal rotation. Although the postoperative followup is relatively short, only 2 years, the functional advantages of this operation over other forms of reconstruction can be observed.

DOI： 10.1097/00003086-200104000-00026

A reverse transcriptase-polymerase chain reaction assay in the diagnosis of soft tissue sarcomas

N Naito, A Kawai, M Ouchida, T Dan'ura, Y Morimoto, T Ozaki, K Shimizu, H Inoue

CANCER 89 ( 9 ) 1992 - 1998 2000.11

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

BACKGROUND. Many types of sarcomas are characterized by specific chromosomal translocations that result in the production of novel chimeric genes. Detection of these fusion genes could be a sensitive molecular diagnostic assay. However, to the authors' knowledge there have been few systemic comparisons between the current histopathologic diagnosis and the presence or absence of particular fusion genes in patients with adult soft tissue sarcomas (STSs).
METHODS. Total RNA was extracted from 75 cases of STS and analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR) assay for the detection of a variety of fusion transcripts. The results of the molecular assay were compared with standard histopathologic diagnoses.
RESULTS. Of the 18 tumors diagnosed as synovial sarcoma, 17 (94%) expressed SYT-SSX chimeric transcripts. AU nine myxoid liposarcomas were positive for FUS-CHOP fusion transcripts. Of the four cases of Ewing sarcoma, two had an EWS-FLI1 fusion transcript and one had an EWS-ERG fusion transcript. A clear cell sarcoma had a EWS-ATF1 fusion transcript. None of 19 cases of malignant fibrous histiocytoma nor 3 leiomposarcomas contained a fusion transcript. Three cases with an initial diagnosis other than synovial sarcoma expressed a SYT-SSX fusion transcript. A review of the slides and additional examination showed that a diagnosis of synovial sarcoma was appropriate for these cases. There was a trend for biphasic synovial sarcoma to contain the SYT-SSX1 fusion.
CONCLUSIONS, The authors believe RT-PCR assay for the detection of a specific fusion gene provides a useful tool for confirmation of the diagnosis of adult STS in diagnostically difficult cases and in retrospective studies. (C) 2000 American Cancer Society.

DOI： 10.1002/1097-0142(20001101)89:9<1992::AID-CNCR16>3.0.CO;2-R

Expression of connective tissue growth factor in cartilaginous tumors Reviewed

Toshihiko Shakunaga, Toshifumi Ozaki, Nobuya Ohara, Koji Asaumi, Takeshi Doi, Keiichiro Nishida, Akira Kawai, Tohru Nakanishi, Masaharu Takigawa, Hajime Inoue

Cancer 89 ( 7 ) 1466 - 1473 2000.10

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

BACKGROUND. Connective tissue growth factor (CTGF) predominantly is expressed in hypertrophic chondrocytes and its specific receptors are demonstrated on chondrocytic cells. Therefore, CTGF may be involved in the proliferation and/or differentiation of cartilage cells. In the current study, CTGF expression was examined both in chondrosarcoma and enchondroma to clarify the relation between the expression of CTGF and the grade of malignancy. METHODS. The expression of CTGF and proliferating cell nuclear antigen (PCNA) were analyzed immunohistochemically in 34 cartilaginous tumor specimens. Eighteen tumors were determined to be chondrosarcoma including 8 Grade 1 tumors, 6 Grade 2 tumors, and 4 Grade 3 tumors. The percentage of CTGF positive and PCNA positive cells was quantified using at least 500 cells. RESULTS. CTGF was expressed in 70.1% of enchondroma cells, 84.0% of Grade 1 chondrosarcoma cells, 53.7% of Grade 2 tumor cells, and 26.8% of Grade 3 tumor cells (ρ = -0.501
P = 0.0053). In chondrosarcoma cases, CTGF expression was correlated closely with tumor grade (ρ = -0.920
P = 0.0001). There was a strong correlation between PCNA expression and tumor grade (ρ = 0.907
P &lt
0.0001) and a strong negative correlation between CTGF and PCNA expression (ρ = -0.493
P = 0.0061). In chondrosarcoma cases, patients with high expression of CTGF (≥ 30%) showed higher overall survival compared with those with low expression (&lt
30%) (P = 0.004). CONCLUSIONS. The current study revealed a correlation between the histologic grade of chondrosarcoma and prognosis, and the concomitant association between CTGF immunostaining and tumor grade and prognosis. Therefore, immunohistochemical staining with CTGF is a useful procedure for assessing the tumor grade anti clinical course in patients with chondrosarcoma. (C) 2000 American Cancer Society.

DOI： 10.1002/1097-0142(20001001)89:7<1466::AID-CNCR8>3.0.CO;2-G

Synovial sarcoma with a large hematoma in the inguinal region Reviewed

N Naito, T Ozaki, T Kunisada, A Kawai, T Dan'ura, Y Morimoto, H Inoue

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 120 ( 9 ) 533 - 534 2000.8

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

We report the case of a patient with synovial sarcoma and a large hematoma of the inguinal region. The patient underwent tumor resection of the lower 2/3 of the acetabulum after preoperative chemotherapy. Twenty-four months after surgery, she is alive without any relapse and can walk without support.

CD44 expression in soft tissue sarcomas

N Kahara, T Ozaki, T Doi, K Nishida, A Kawai, M Shibahara, H Inoue

VIRCHOWS ARCHIV-AN INTERNATIONAL JOURNAL OF PATHOLOGY 436 ( 6 ) 574 - 578 2000.6

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

Recent studies have shown that expression of alternatively splicing variants of CD44 is correlated with prognosis for several kinds of malignant tumors. However, little is known about the expression of CD44 standard and variant isoforms in soft tissue sarcomas. In this study 47 cases of soft tissue sarcoma [18 malignant fibrous histiocytomas (MFHs), 13 synovial sarcomas (SSs), 7 malignant schwannomas (MSs), and 9 liposarcomas (LSs)] were examined immunohistochemically. The monoclonal antibodies to the standard form of CD44 (CD44H) and variant exons of CD44v3, 4, 5, 6, 7, 9, and v10 were used. We analyzed the membranous expression pattern of CD44H and CD44 variant exons and assessed the relation between expression of CD44s and metastasis-free survival rates (MFSR) of patients with soft tissue sarcoma. A few sarcomas expressed CD44v3 (2/47) and v7 (2/47), but none of the sarcomas expressed CD44v10. CD44v4 (5/47), v5 (4/47), v6 (10/47), and v9 (9/47) are relatively common types of variant isoforms in soft tissue sarcomas. Expression of CD44v6 is more frequently detected in high-grade than in low-grade tumors. CD44v6 or CD44v9 expression was correlated with metastasis-free survival of patients with soft tissue sarcomas.

Giant schwannoma of the back Reviewed

Eiichi Takada, Toshifumi Ozaki, Toshiyuki Kunisada, Yoshiaki Harada, Hajime Inoue

Archives of Orthopaedic and Trauma Surgery 120 ( 7-8 ) 467 - 469 2000

Operative Treatment by Kotz Prosthesis of Bone Tumors around Knee Joint.

ENDO Hirosuke, KAWAI Akira, OZAKI Toshifumi, NAITO Noriko, SUGIHARA Shinsuke, INOUE Hajime

The Journal of the Chugoku-Shikoku Orthopaedic Association 12 ( 2 ) 399 - 402 2000

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

This report was based on our clinical results of 7 patients who were treated with Kotz knee arthoplasty from 1990 to 1998. Primary bone tumors were 5 osteosarcomas, 1 malignant fibrous histiocytoma, and 1 giant cell tumor. The average age at the time of operation was 22 years (11∼47) and the average duration of follow-up was 43 months. The clinical results were estimated by ISOLS system. Rizolli X-ray method was applied to evaluate the condition of the stem. At the latest review, the average of ISOLS score was 24 (80%). On X-rays, 4 cases were classified as stage A. The other 3 cases were calssified as stage B, C, and D respectively. The X-ray of the case scored as stage D was taken only 6 months after the operation. All patients were able to walk without any assistance. These results were satisfactory.

DOI： 10.11360/jcsoa1989.12.399

Imaging assessment of the responses of osteosarcoma patients to preoperative chemotherapy: Angiography compared with thallium-201 scintigraphy Reviewed

Toshiyuki Kunisada, Toshifumi Ozaki, Akira Kawai, Shinsuke Sugihara, Kohji Taguchi, Hajime Inoue

Cancer 86 ( 6 ) 949 - 956 1999.9

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

BACKGROUND. Assessment of the responses of osteosarcoma patients to preoperative chemotherapy is of clinical importance. The purpose of this study was to estimate the accuracy of angiography and thallium-201 scintigraphy, compared with histology, in assessing the responses of patients with osteosarcoma to preoperative chemotherapy. METHODS. Nineteen patients with osteosarcoma who were diagnosed between 1992 and 1997 were studied. The findings of angiography and thallium-201 scintigraphy before and after preoperative chemotherapy were compared with the percentage of necrosis of tumor cells and the response grade as determined histologically. Quantitative analysis of the isotopic uptake by thallium-201 scintigraphy before and after chemotherapy, defined as the alteration ratio, was correlated with the percentage of tumor necrosis. RESULTS. Angiography yielded a sensitivity of 88%, a specificity of 73%, and a predictive accuracy of positive test of 70%, whereas thallium-201 scintigraphy achieved 88%, 100%, and 100%, respectively. Both angiographic and scintigraphic assessment showed a significant correlation with response grade as determined histologically (P &lt
0.05 and P &lt
0.0003, respectively). The alteration ratio of thallium-201 scintigraphy showed a strong, highly significant correlation with the percentage of tumor necrosis (P &lt
0.0001). CONCLUSIONS. A change in the tumor uptake of thallium- 201 scintigraphy after preoperative chemotherapy can predict the tumor necrosis in osteosarcoma precisely. Thallium scintigraphy is a noninvasive technique and seems to be more useful than angiography in assessing the response of osteosarcoma to preoperative chemotherapy.

DOI： 10.1002/(SICI)1097-0142(19990915)86:6<949::AID-CNCR9>3.0.CO;2-H

Reconstruction of the hip abductors after resection of the proximal femur Reviewed

T Ozaki, S Kaneko, T Kunisada, A Kawai, T Dan'ura, N Naito, H Inoue

INTERNATIONAL ORTHOPAEDICS 23 ( 3 ) 182 - 183 1999.8

Angiography for assessment of preoperative chemotherapy in musculoskeletal sarcomas Reviewed

J Fujii, T Ozaki, A Kawai, T Kunisada, S Sugihara, H Inoue

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH ( 360 ) 197 - 206 1999.3

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Eleven abnormal findings of digital subtraction angiography were analyzed in 25 patients with bone sarcoma and in 23 patients with soft tissue sarcoma. The relation between digital subtraction angiographic findings and the histologic effect of chemotherapy was evaluated. Digital subtraction angiography was performed with the patient under local anesthesia with the Seldinger technique, using an ADVANT X unit. Contrast medium was injected at a rate of 4 to 6 mi per second, with the usual single bolus dose of approximately 6 to 8 mi. Eleven abnormal findings included tumor stain, hypervascularity, arterial distortion, vascular stretch, arterial dilatation, arteriovenous shunt, arterial encasement, occlusion, blood pool, caliber with irregular wall, and dilatation of draining vein. Each finding after preoperative chemotherapy was compared with that before chemotherapy and divided into three grades; Grade I, not effective; Grade 2, effective; and Grade 3, very effective. Angiographic Grades 2 and 3 were defined as responders. The histologic effect was examined and scored according to the modified classification proposed by Huvos. Histologic Grades 1 and 2 were classified as nonresponders and Grades 3 and 4 as good responders. In bone sarcomas, hypervascularity and tumor stain were seen in all patients. In soft tissue sarcomas, tumor stain was shown in all 23 patients and hypervascularity was seen in 21 patients. Tumor stain, hypervascularity, vascular stretch, and arterial encasement were correlated closely with histologic findings and showed an accuracy equal to or greater than 70%. When these four findings changed to angiographic Grade 3 after preoperative chemotherapy, 90% of patients had good histologic outcome.

Effect of dose intensity of methotrexate, doxorubicin, and ifosfamide on the prognosis of patients with osteosarcoma Reviewed

Yoichiro Uchida, Toshifumi Ozaki, Akira Kawai, Toshiyuki Kunisada, Tomoyuki Dan'ura, Noriko Naito, Hajime Inoue

International Journal of Clinical Oncology 4 ( 1 ) 36 - 40 1999.2

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

Background. The prognosis of patients with osteosarcoma has improved due to the introduction of systemic chemotherapy. The current study tried to identify the effect of each anti-tumor drug on the prognosis of patients with osteosarcoma. Methods. The records of 29 patients with osteosarcoma who received systemic chemotherapy were retrospectively analyzed. All tumors were classified as stage IIB (Enneking's surgical stage) and were located around the knee joint or more distal areas. The histologic response to preoperative chemotherapy was determined in 20 patients: 9 patients had grade 1, 4 grade 2, 5 grade 3, and 2 grade 4. The mean follow-up period was 102 months. Results. The 5-year overall survival and relapse-free survival (RFS) in the 29 patients was 47.7% and 41.4%, respectively. The 5-year RFS for the 7 good responders (grade 3 and 4) was 85.7%, and that for the 13 poor responders (grade 1 and 2) was 23.1% (P = 0.008). The mean preoperative dose intensity (DI) of methotrexate (MTX) for good responders was significantly higher than that for poor responders (P = 0.028). In 23 patients who received MTX and doxorubicin (ADR) but not ifosfamide (IFOS), the DI of MTX significantly influenced the RFS (P = 0.0128). In the 13 poor responders, 6 of whom received IFOS, the DI of IFOS and ADR significantly influenced RFS (P = 0.0112, 0.0395). Conclusion. The preoperative DI of MTX was related to the histologic response rate. The DI of MTX was significantly associated with the patients' RFS. In poor responders, the DI of IFOS and ADR influenced the patients' RFS.

DOI： 10.1007/s101470050021

Insertion of the patella tendon after prosthetic replacement of the proximal tibia Reviewed

Toshifumi Ozaki, Toshiyuki Kunisada, Akira Kawai, Yasuyuki Takahara, Hajime Inoue

Acta Orthopaedica Scandinavica 70 ( 5 ) 527 - 529 1999

Implantation of antibiotic impregnated PMMA beads for infection after implantation of endoprosthesis.

TAKADA Itsuro

The Central Japan Journal of Orthopaedic Surgery & Traumatology 42 ( 5 ) 1183 - 1184 1999

Limb-salvage for soft tissue sarcomas which involve the sciatic nerve.

KATOH Hisayoshi

The Central Japan Journal of Orthopaedic Surgery & Traumatology 42 ( 4 ) 833 - 834 1999

Prognostic factors for patients with osteosarcoma of the extremities.

KAWAI Akira

The Central Japan Journal of Orthopaedic Surgery & Traumatology 42 ( 4 ) 797 - 798 1999

悪性軟部腫ように対するＭＡＩＤ療法の検討

内藤訓子, 川井章, 尾崎敏文, 檀浦智幸, 井上一

中部日本整形外科災害外科学会雑誌 42 ( 6 ) 1415 - 1416 1999

Treatment of congenital kyphosis

OZAKI Toshifumi

The Central Japan Journal of Orthopaedic Surgery & Traumatology 42 ( 6 ) 1367 - 1368 1999

Results of hydroxyapatite grafting for treatment of benign bone tumors

NAITO Noriko

The Central Japan Journal of Orthopaedic Surgery & Traumatology 42 ( 3 ) 543 - 544 1999

Treatment of Extra-abdominal Desmoid Tumor.

SHIOTA Naofumi, OZAKI Tosifumi, DAN-URA Tomoyuki, NAITOH Noriko, INOUE Hajime

The Journal of the Chugoku-Shikoku Orthopaedic Association 11 ( 2 ) 305 - 309 1999

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Extra-abdominal desmoid tumors are benign lesions but difficult to cure because of their infiltrative nature and tendency to recur. Fifteen patients were treated at our department between 1966 and 1998. Six of them were men, and 9 women. Eleven underwent their first operation at-our department and 4 had recurrent tumors after surgery at other hospitals. Local recurrence was observed in one patient with intralesional resection (100%), and one of 8 with wide resection (12.5%). However, 2 patients with marginal resection did not have a second operation. Resection with inadequate margin at that first operation led to poor clinical results.

DOI： 10.11360/jcsoa1989.11.305

Expression of CD44 variants in osteosarcoma

M. Kuryu, T. Ozaki, K. Nishida, M. Shibahara, A. Kawai, H. Inoue

Journal of Cancer Research and Clinical Oncology 125 ( 11 ) 646 - 652 1999

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

The standard form of CD44 (CD44H) is a transmembranous glycoprotein, widely distributed on a variety of human lymphoid cells, epithelial cells and tumours. CD44 has many variant forms, which are generated by alternative splicing. In recent years, CD44 has been reported to be related to the degree of tumour differentiation, tumour cell invasion, and metastasis. We investigated 44 tumour specimens in 39 patients with osteosarcoma immunochemically to analyze the expression of CD44 standard (CD44H) and variant exon-encoded gene products (CD44v3, v4, v5, v6, v7, v9, and v10). Furthermore, the relationship between CD44 expression and the clinical outcome of patients with osteosarcoma was analyzed. Membrane accentuation and exclusive cytoplasmic reactivity were analyzed as separate staining patterns. Tumour cells and some multinucleated giant cells were markedly stained. CD44H, v3, v4, v5, v6, v7, v9, and v10 were expressed in 85%, 49%, 54%, 59%, 46%, 5%, 28%, and 10% of the specimens respectively. The cumulative 5-year metastasis-free survival was 58% in CD44v6-negative cases and 24% in CD44v6-positive cases (P = 0.046). However, the cumulative 5-year metastasis-free survival was not significantly different between cases positive and negative for other variants of CD44. Multivariate analysis (Cox proportional-hazard model) with CD44v6 expression (positive or negative), chemotherapy (intensive or non-intensive), tumour site (proximal or distal), and age (at least 30 years or less than 30 years) showed that expression of CD44v6 and chemotherapy were important prognostic factors in patients with osteosarcoma. Overexpression of CD44 isoforms containing variant v6 is correlated with poor prognosis in patients with osteosarcoma.

DOI： 10.1007/s004320050329

High complication rate of reconstruction using Ilizarov bone transport method in patients with bone sarcomas Reviewed

T Ozaki, Y Nakatsuka, T Kunisada, A Kawai, T Dan'ura, N Naito, H Inoue

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 118 ( 3 ) 136 - 139 1998.12

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

We performed five reconstructions by bone transport in patients with bone sarcoma: three osteosarcomas, one Ewing's sarcoma and one chondrosarcoma. Four sacromas were in the distal femur and one in the shaft of the tibia. Four patients received multidrug chemotherapy. The average length of the skeletal defect after tumour resection was 17 (range 10-25) cm. All patients underwent double elongation from both proximal and distal sites: of the bone defect. The average follow-up period was 48 (range 40-66) months, and the average duration of external fixation was 32 months (range 579-1340 days). In one case, bone formation was satisfactory, but in the other cases, it was poor and slow. The average treatment index was 95 (range 53-191) days per 1 cm of elongation. In one case, the bone fragment disappeared during the bone transport. In one case, the end of the bone protruded from the skin, and osteomyelitis set in. This patient underwent above-knee amputation due to failure of infection control. Three patients suffered talipes equinus. One patient died of pulmonary metastasis. Two patients had fair and three had poor function. This method is not recommended for patients with bone sarcoma who may have a poor prognosis, as it has an unacceptably high complication rate.

Treatment outcome of osteofibrous dysplasia

T. Ozaki, M. Hamada, S. Sugihara, T. Kunisada, S. Mitani, H. Inoue

Journal of Pediatric Orthopaedics Part B 7 ( 3 ) 199 - 202 1998.7

Publishing type：Research paper (scientific journal)

The disease course of six tibial lesions in five patients with osteofibrous dysplasia who were followed longer than 10 years (average: 16.8 years) was analyzed retrospectively. Three patients had a lesion of the unilateral tibia; one patient had lesions of the unilateral tibia and fibula; and one patient had lesions of the bilateral tibiae and ulnae. Curettage and autogeneic bone graft were performed on two lesions, which then healed. Of four lesions on which curettage and xenogeneic bone grafts were performed, three lesions healed, and one developed local recurrence. Curettage and xenogeneic bone graft were performed on the recurrent lesion, which finally healed and the deformity stopped. Three lesions healed without surgical treatment. During the long-term follow-up, this disease showed a clear tendency of healing. Surgical treatment should be considered in patients with disease uncontrollable by conservative treatment or those who have a high possibility of impending fracture and progressing deformity.

DOI： 10.1097/01202412-199807000-00004

Hyperparathyroid Crisis in a Patient with a Giant Brown Tumor of the Iliac Bone: A Case Report

Satoshi Ishikawa, Toshifumi Ozaki, Akira Kawai, Hajime Inoue, Hiroyoshi Doihara

Hiroshima Journal of Medical Sciences 47 ( 1 ) 27 - 30 1998.3

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

We observed a patient with a giant brown tumor of the iliac bone due to hyperparathyroidism. There was a risk of pathologic fracture due to huge cysts produced by bone absorption. In hyperparathyroid crisis, control of severe hypercalcemia is difficult without resection of the parathyroid gland.

Reconstruction of bone defect using the bone transport technique for a case of osteosarcoma of the femur Reviewed

T Ozaki, Y Nakatsuka, A Kawai, H Akazawa, T Kunisada, H Inoue

ACTA MEDICA OKAYAMA 52 ( 1 ) 67 - 70 1998.2

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

There are few reports on skeletal reconstruction using the bone transport technique to repair bone defects caused by resections of tumors associated with osteosarcoma. We attempted to reconstruct a 23 cm bone defect after resection of an osteosarcoma of the left femur, and succeeded in gaining 17 cm by bone transport. Five years after surgery, this patient remains alive without metastasis or local recurrence.

Value of thallium-201 scintigraphy in bone and soft tissue tumors Reviewed

Osamu Sato, Akira Kawai, Toshifumi Ozaki, Toshiyuki Kunisada, Tomoyuki Danura, Hajime Inoue

Journal of Orthopaedic Science 3 ( 6 ) 297 - 303 1998

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

The potential role of thallium-201 (201Tl) scintigraphy in the imaging of various musculoskeletal tumors was investigated in 80 patients. Uptake of 201Tl was observed in 17 (100%) malignant bone tumors, 6 (100%) giant cell tumors, and 2 of 8 (25%) benign bone tumors. Nineteen of 30 malignant soft tissue tumors (63%) were positive for 201Tl scintigraphy, while 2 of 14 benign soft tissue tumors (14%) yielded positive results. None of 6 liposarcomas were visualized by 201Tl scintigraphy. There was no 201Tl uptake in the tissues of 5 non-tumorous conditions. Ten patients with osteosarcoma were evaluated by 201Tl scintigraphy both pre- and post- chemotherapy. There was a significant correlation between changes in tumor- to-normal count ratio and percent necrosis of the resected tumor. The mean decrease in tumor-to-normal count ratio was 71% for patients with ≥90% tumor necrosis and 26% for those with &lt
90% tumor necrosis. Serial 201Tl scintigraphy, with quantitative analysis of alterations in 201Tl uptake, may provide a quantitative and objective measure of the effect of preoperative chemotherapy in patients with malignant bone tumors.

DOI： 10.1007/s007760050056

Vancomycin-impregnated polymethylmethacrylate beads for methicillin- resistant Staphylococcus aureus (MRSA) infection: Report of two cases Reviewed

Toshifumi Ozaki, Teruhito Yoshitaka, Toshiyuki Kunisada, Tomoyuki Dan'ura, Noriko Naito, Hajime Inoue

Journal of Orthopaedic Science 3 ( 3 ) 163 - 168 1998

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

Two patients with methicillin-resistant Staphylococcus aureus (MRSA) infection were treated with vancomycin (VCM)-impregnated polymethylmethacrylate (PMMA) beads. One patient, who had a history of polycystic kidney and diabetes mellitus, who was receiving hemodialysis due because of non-functional kidney, underwent resection of an intermediate grade chondrosarcoma in the pelvis. MRSA infection developed and curettage of the lesion was performed, but MRSA infection recurred. During the second revision surgery, VCM-impregnated PMMA beads were implanted. MRSA infection has not recurred for 16 months since the implantation of the VCM beads. The second patient had a history of total hip arthroplasty (THA) performed because of coxarthrosis. After the initial surgery, MRSA infection developed, recurring after the second revision surgery for THA. After curettage following removal of the prosthesis, VCM beads were implanted with a spacer composed of VCM-PMMA and a Luque rod. Infection did not recur and THA revision was performed 3 months after the VCM beads implantation. Fifteen months after the last revision surgery, infection has not recurred.

DOI： 10.1007/s007760050037

Chronic Inflammation of Hip Joint Resembling Bone Tumor. A Report of Two Cases.

HIROOKA Hirokimi, OZAKI Toshifumi, KAWAI Akira, INOUE Hajime

The Journal of the Chugoku-Shikoku Orthopaedic Association 10 ( 1 ) 117 - 122 1998

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We observed 2 patients with an inflammatory disease that occurred in the femoral neck. An evident inflammatory sign was not observed. Osteomyelitis or bone tumors such as osteoid osteoma was suspected by the radiological findings. These patients underwent curettage and resection of the lesion. Histological findings showed a diagnosis of chronic osteomyelitis in both patients.

DOI： 10.11360/jcsoa1989.10.117

Surgical Treatment of Metastatic Bone Tumor Affecting Lower Extremity.

KUNISADA Toshiyuki, OZAKI Toshifumi, DOI Takeshi, DAN'URA Tomoyuki, INOUE Hajime

The Journal of the Chugoku-Shikoku Orthopaedic Association 10 ( 2 ) 285 - 288 1998

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

We evaluated the results of surgical treatment of 15 metastatic lesions affecting long bones in 14 patients. Pathological fractures occured in 7 patients preoperatively. Pain due to bone metastasis subsided after the operation in 12 of 14 lesions with pain preoperatively. Since after surgery pain subsided in patients who had not suffered a pathological fracture preoperatively, we considered that prophylactic surgical treatment would be effective to control pain due to bone metastasis in a long bone. In this series, the results of surgical treatment were excellent in 4 patients, good in 6, and fair in 2. Intramedullary fixation would be a useful treatment on bone metastasis affecting long bones. Wide resection should be attempted in patients who may have a good prognosis.

DOI： 10.11360/jcsoa1989.10.285

Massive osteolysis in the pelvis - A case report

Tomoyuki Dan'ura, Toshifumi Ozaki, Shinsuke Sugihara, Kohji Taguchi, Hajime Inoue

Acta Orthopaedica Scandinavica 69 ( 2 ) 197 - 198 1998

Treatment of Tumors of the Spine

Toshifumi Ozaki, Henry Halm, Ulrich Liljenqvist, Winfried Winkelmann

Hiroshima Journal of Medical Sciences 46 ( 4 ) 125 - 131 1997.12

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

Thirty-one patients with spinal tumors underwent reconstructive surgery with our spinal instrumentation system (MPDS and MADS), with or without our new vertebral tumor prosthesis. The characteristics of the spinal tumors were analysed statistically and the treatment outcome was evaluated. There were 4 benign tumors, 6 malignant tumors, and 21 metastatic tumors. The malignant tumors involved the sacrum more frequently than the benign tumors (p=0.0098). Metastatic tumors involved the thoracic spine more frequently than benign or malignant tumors (p=0.0161). The average number of affected vertebrae was 1.2 in the benign tumors, 1.8 in the malignant tumors, and 2.4 in the metastatic tumors. The metastatic tumors had a tendency to involve the anterior or middle part of the spine more frequently than the benign or malignant tumors (statistically not significant). After surgery, neurological improvement was noted in 8 patients, nochange in 19 patients, and impairment due to resection of the nerve roots in sacral tumors in 4 patients.

Preoperative Multidisciplinary Treatment with Hyperthermia for Soft Tissue Sarcoma Reviewed

Eiichi Makihata, Masahiro Kuroda, Akira Kawai, Toshifumi Ozaki, Shinsuke Sugihara, Hajime Inoue, Ikuo Joja, Junichi Asaumi, Shoji Kawasaki, Yoshio Hiraki

Acta Medica Okayama 51 ( 2 ) 93 - 99 1997.4

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

We report the results of phase I/II studies of preoperative multidisciplinary treatment of 14 patients with soft tissue sarcoma using hyperthermia from November 1990 to April 1995. The preoperative treatment was conducted with thermo-radio-chemotherapy in 11 cases of stage III, and with thermo-radiotherapy as well as thermo-chemotherapy in three cases of stages I and II. Hyperthermia was carried out twice a week with totals ranging from 4 to 14 times (average: 8.4 times)
each session lasted 60min. Radiotherapy was administered four or five times per week, and the dose was 1.8 2Gy/fraction, with a total of 30-40Gy in a four week period. Chemotherapy was mainly in the form of MAID regimen (2-mercaptoethanesulphonic acid (mesna), adriamycin, ifosfamide and dacarbazine). The tumors were surgically resected in all patients after completing the preoperative treatment. The efficacy rate, as expressed by the percentage of either tumors in which reduction rate was 50% or more, or tumors for which post-treatment contrast enhanced CT image revealed low density volumes occupying 50% or more of the total mass, was 71 % (ten of the 14 tumors). The mean tumor necrosis rate in the resected specimens was 78%. The tumor necrosis rate was significantly high (P &lt
0.05) in patients whose Time ≥ 42°C was of long duration. Postoperative complications were observed in six patients
among these, two patients developed wound infection that required surgical treatment as a complication of surgery performed in the early stage following the preoperative treatment. After a mean postoperative follow-up of 27 months, distant metastasis occurred in four patients resulting in three fatalities. The three-year cumulative survival rate was 64.3%. No local recurrence was observed in any patient during the follow-up, thus confirming our hypothesis that preoperative multidisciplinary treatment has an excellent local efficacy. We think that it would be valuable to conduct, at many facilities, phase III studies on the treatment of soft tissue sarcoma by a combination of surgery and preoperative multidisciplinary treatment using hyperthermia, paying close attention to the interval between these two modalities.

A Clinical Analysis of Malignant Schwannoma Reviewed

Toshiyuki Kunisada, Akira Kawai, Toshifumi Ozaki, Shinsuke Sugihara, Kohji Taguchi, Hajime Inoue

Acta Medica Okayama 51 ( 2 ) 87 - 92 1997.4

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

In this study, we reviewed the clinical features of 11 patients with malignant schwannoma who were treated in our institute. Five patients had coexistent von Recklinghausen's disease and one of them showed multifocal occurrence. Patients with the centrally located tumors had a poorer prognosis than those with the others. The overall 3-year survival rate was 36%
40% in patients with von Recklinghausen's disease and 33% in the others. At the time of the last follow-up, 9 patients had died of the tumor, one continued to be tumor free, and one was alive with tumor. Postoperative local recurrence developed in 5 patients (45%)
4 out of 6 patients (67%) who underwent a marginal excision and one out of 3 (33%) who underwent primary amputation. There was no local recurrence in patients after a wide excision with at least 3cm of normal tissue removed surrounding the tumor in all directions. Nine patients (82%) developed pulmonary metastasis. The effect of adjuvant chemotherapy was not clear in this study. The high risk of pulmonary metastasis in this disease indicates the necessity of more effective adjuvant chemotherapy.

Magnetic resonance chemical shift imaging in bone and soft tissue tumours

T. Ozaki, S. Sugihara, M. Hamada, M. Akiyama, H. Inoue

International Orthopaedics 21 ( 1 ) 9 - 13 1997

Publishing type：Research paper (scientific journal)

A study was carried out in 14 patients to assess the location and differential diagnosis of bone and soft tissue tumours with a 0.5 Tesla scanner using water and fat images obtained by the three-point Dixon technique. We compared the magnetic resonance imaging findings obtained with this technique with conventional MRI, T1-T2-weighted images, and gadalinium-diethylenetriamine penta-acetic acid enhanced T1-weighted images. Localisation was better with the three-point Dixon technique than with conventional magnetic resonance imaging. Differentiation between the fat and water component around the tumour was possible. The gadalinium-diethylenetriamine penta-acetic acid enhanced water images were very sensitive to enhancement of the tissue. The three-point Dixon technique is useful when the tumour area is difficult to detect by conventional magnetic resonance imaging and information about its components is needed; these images can be made at the low magnet field.

DOI： 10.1007/s002640050109

Cementation of primary aneurysmal bone cysts

Toshifumi Ozaki, Axel Hillmann, Norbert Lindner, Winfried Winkelmann

Clinical Orthopaedics and Related Research 337 240 - 248 1997

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media, LLC

The effects of polymethylmethacrylate (bone cement) on the local control of primary aneurysmal bone cysts excluding spinal lesions were analyzed. After intensive curettage of the lesions, 30 patients underwent a bone graft, and 35 patients had the defect packed with bone cement. After cementation (median time lapse, 4.5 months), 30 of 35 patients underwent a cancellous bone graft after removal of the packed bone cement. The followup period ranged between 24 and 161 months (median, 59.5 months). The local recurrence rate after curettage and cementation was 17% and after curettage and bone graft was 37%. The difference of the cumulative 10-year relapse free survival between patients of both groups was significant. The median time between surgery and local recurrence was 17 months (range, 2-90 months).

DOI： 10.1097/00003086-199704000-00026

Chondrosarcoma of the pelvis

Toshifumi Ozaki, Axel Hillmann, Norbert Lindner, Sebastian Blasius, Winfried Winkelmann

Clinical Orthopaedics and Related Research 337 226 - 239 1997

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media, LLC

Thirty-one patients with chondrosarcoma of the pelvis were reviewed. The median followup period of the surviving patients was 66 months. Thirteen of 23 tumors after surgery with inadequate margins (57%) and 1 of 8 after surgery with adequate margins (13%) relapsed locally. Four of 10 patients had local recurrence, 2 of 2 patients had metastasis, and 4 of 4 patients who had local recurrence and metastasis died. A cumulative 10-year overall survival of patients with pelvic chondrosarcoma was 54%. Patients who had primary or high grade chondrosarcoma had a poor prognosis. Multivariate analysis (Cox proportional hazard model) showed that tumor type was the most important prognostic factor. Eight patients underwent hindquarter amputation, 6 patients had resection alone, and 17 patients had resection and reconstruction as follows: 3 interpubic arthrodeses, 2 iliosacral arthrodeses, 3 ischiofemoral arthrodeses, 8 hip prostheses 13 prostheses alone and 5 prostheses with allograft), and 1 hip transposition. Failure of reconstruction was attributed to infection in 5 patients, local recurrence of tumor in 5, and local recurrence and fracture of implant in 1 patient.

DOI： 10.1097/00003086-199704000-00025

Dedifferentiated chondrosarcoma in Albright syndrome. A case report and review of the literature

Toshifumi Ozaki, Norbert Lindner, Sebastian Blasius

Journal of Bone and Joint Surgery - Series A 79 ( 10 ) 1545 - 1551 1997

Salvage chemotherapy for recurrent Ewing's sarcomas

T. Ozaki, S. Sugihara, M. Hamada, Y. Nakagawa, H. Inoue

Neoplasma 42 ( 1 ) 39 - 42 1995

Publishing type：Research paper (scientific journal)

Metastatic disease tends to recur after remission of Ewing's sarcoma. The effectiveness of ifosfamide in patients with recurrent Ewing's sarcoma was reported in recent years. We administered IFOS combined with etoposide, pirarubicin, and cyclophosphamide to 4 Ewing's sarcoma patients with metastatic disease, and succeeded in inducing second remissions in all cases.

A Case Report of Extraskeletal Ewing's Sarcoma.

ISHIHAMA Takuo, TSUJI Hidenori, MOHRI Takahiro, KANBARA Atsushi, OZAKI Toshifumi

The Journal of the Chugoku-Shikoku Orthopaedic Association 6 ( 2 ) 317 - 322 1994

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Extraskeletal Ewing's sarcoma is a rare soft tissue tumor composed of small round cells. We report a case of extraskeletal Ewing's sarcoma in the left thigh.<br>Chemotherapy, radiation therapy and hyperthermic therapy were performed preoperatively. On MRI taken after preoperative treatment, the tumor was decreased in size and was not enhanced by Gd-DTPA. These findings suggest that the tumor was necrosed by the preoperative treatments. MRI was very useful for showing the tumor area and for assessing the preoperative therapeutic effects.

DOI： 10.11360/jcsoa1989.6.317

骨軟部腫瘍の化学療法における副作用対策

杉原進介, 尾崎敏文, 浜田全紀

中部日本整形外科災害外科学会雑誌 36 ( 6 ) 1631 - 1632 1993.11

骨軟部腫瘍における化学シフトを利用したMRI Threepoint Dixon technique

尾崎敏文, 浜田全紀, 杉原進介

中部日本整形外科災害外科学会雑誌 36 ( 6 ) 1597 - 1598 1993.11

Second malignant neoplasms after treatment for osteosarcoma: a report of three cases.

Ozaki Toshifumi, Sugihara Shinsuke, Inoue Hajime

Acta Medica Okayama 47 ( 2 ) 129 - 133 1993.4

Five Cases of Paget's Disease.

NAKAGO Kie, OZAKI Toshifumi, SUGIHARA Shinsuke, OTSUKA Kazutoshi, INOUE Hajime

The Journal of the Chugoku-Shikoku Orthopaedic Association 5 ( 2 ) 479 - 482 1993

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Five cases of Paget's disease were anaylyzed clinically and histopathologically in this study.<br>Plain X-rays revealed signs of a combined phase in all cases. Bone scintigraphy, performed in 3 cases, disclosed abnormal accumulation in the affected bone. A histopathological examinations, which was performed in all cases revealed a specific mosaic pattern for diagnosis of Paget's disease. However, a typical combined phase was observed in only one case. Two cases were treated by calcitonin and one case by calcitonin and EHDP. Although ALP rose again during long-term drug therapy or after discontinuation of drugs, pain could be controlled well by these drugs. Therefore, these drugs seem to provide an effective means for controlling pain associated with Paget's disease.

DOI： 10.11360/jcsoa1989.5.479

Ewing's sarcoma: Evaluation of chemotherapy in 17 cases

T. Ozaki, H. Inoue, S. Sugihara, M. Hamada, Y. Nakagawa, K. Taguchi

Hiroshima Journal of Medical Sciences 42 ( 2 ) 89 - 96 1993

Gadolinium-DTPA enhanced magnetic resonance imaging of bone and soft tissue sarcomas in comparison with pathological findings.

Ozaki Toshifumi, Inoue Hajime, Taguchi Kohji, Sugihara Shinsuke

Acta Medica Okayama 46 ( 6 ) 471 - 477 1992.12

骨軟部悪性腫瘍のsecond line chemotherapy

尾崎敏文, 杉原進介, 住居広士

中部日本整形外科災害外科学会雑誌 35 ( 5 ) 1479 - 1480 1992.9

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

骨軟部腫瘍の遠隔転移症例に対して,IFOSを中心とした化学療法を行った。1)多剤耐性が生じた症例(特にEwing肉腫)で,明らかな抗腫瘍効果が認められた。2)骨肉腫での有効率はEwing肉腫より低かった。3)IFOSをVP-16と使用すると,凡血球減少の如き厳重な副作用が問題となった。IFOS(+VP-16)は,メスナが市販されしだいEwing肉腫の第一選択で使用してよい薬剤である

多発性悪性線維性組織球腫の1例

尾崎敏文, 杉原進介, 住居広士

骨転移: 病態・診断・治療 8 ( 1 ) 81 - 84 1992.9

Clinical study of malignant tumors originating in the pelvic region.

Ozaki Toshifumi, Inoue Hajime, Sugihara Shinsuke

Acta Medica Okayama 46 ( 4 ) 265 - 271 1992.8

骨肉腫肺転移の治療とその問題点

尾崎敏文, 杉原進介, 住居広士

中部日本整形外科災害外科学会雑誌 35 ( 3 ) 753 - 754 1992.5

Language：Japanese Publisher：(一社)中部日本整形外科災害外科学会

37症例中肺癌転移は化学療法施行群で28例中19例(68%),未施行群では9例中7例(77%)であった.肺癌転移例は化学療法を施行して開胸術にて病巣切除可能なら,Kaplan-Miere法にて50%程度の生存率が得られた.ADM, MTX, CDDPのうち使用していない残りの化学療法が行われてきたが,近年IFOSの投与が行われている.組織学的には効果の認められるものがX線で効果が現われることが多い.また組織学的に著効を奏した例でも腫瘍細胞は残存するので開胸術は不可欠である.治療を中止した生命予後は非常に不良である

Radiological long-term follow-up of grafted xenogeneic bone in patients with bone tumors.

T Ozaki, H Inoue, S Sugihara, H Sumii

Acta medica Okayama 46 ( 2 ) 87 - 92 1992.4

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

Radiological findings on the fate of grafted Kiel bone implants for the treatment of bone tumors were evaluated in 25 lesions. The mean follow-up period was 14.8 years, ranging from 5 to 21.8 years. We classified the radiological findings into 4 grades; Excellent (4 lesions), Good (14 lesions), Fair (2 lesions), and Poor (5 lesions). All cases of the Poor grade were polyostotic fibrous dysplasia. The younger the patient at the time of the operation, the more rapidly Kiel bone grafts tended to be incorporated. The grafted bone can become enmeshed in the structure of the recipient bed (Good or Excellent grades) within 10 years in most cases, except in polyostotic fibrous dysplasia.

骨軟部腫瘍のMRI像と切除標本の比較検討

尾崎敏文, 山根孝志, 住居広士

中部日本整形外科災害外科学会雑誌 34 ( 2 ) 577 - 579 1991.3

A case report of malignant fibrous histiocytoma of the metacarpal bone.

KINOSHITA Atsushi

The Journal of the Chugoku-Shikoku Orthopaedic Association 2 ( 2 ) 465 - 468 1990

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Malignant fibrous histiocytoma (MFH) of bones in the hand has rarely been reported. A case of MFH involving a metacarpal bone is reported. This case was a 46-year-old female with a firm lump of her right hand. The tumor originated in the second metacarpal bone widely invaded to the surrounding soft tissue. The extent of the tumor involvement, especially in the soft tissue was clearly defined with magnetic resonance imaging (MRI). Radical resection was performed with a below-elbow amputation according to the Enneking surgical staging system (SSS). One and a half years later she has no evidence of local recurrence or metastasis. Although the SSS is useful in deciding the operative method for malignant bone tumors, further local concept should be added to maintain function of the hand.

DOI： 10.11360/jcsoa1989.2.465

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