Faculty Profiles - OZAKI Toshifumi

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血管腫・血管奇形に対するinterventional radiology

三村秀文, 藤原寛康, 平木隆夫, 郷原英夫, 芝本健太郎, 木股敬裕, 尾﨑敏文, 佐々木了, 金澤右

岡山医学会雑誌 122巻 ( 1号 ) 55 - 59 2010

Radiographic measurements in the evaluation and classification of elbow joint destruction in patients with rheumatoid arthritis. International journal

Kenzo Hashizume, Keiichiro Nishida, Kazuo Fujiwara, Yasutaka Kadota, Ryuichi Nakahara, Kazuhiko Ezawa, Hajime Inoue, Toshifumi Ozaki

Clinical rheumatology 29 ( 6 ) 637 - 643 2010

Language：English

We developed two new radiographic parameters-the humeral surface height ratio and ulnar surface height ratio-to precisely detect changes in the bony structure of rheumatoid elbows. Of the 59 patients with rheumatoid arthritis, 101 elbows were classified into four types (osteoarthritis, ankylosis, erosive, and resorptive) according to the radiographic appearance. Clinically, osteoarthritis type and ankylosis type were considered to be stable form, and erosive type and resorptive type were unstable form. Patients' clinical data and yearly radiographic changes in the bony structure evaluated by the humeral surface height ratio and ulnar surface height ratio were compared among the four types and between the two forms. There were significant differences between the two forms and among the three types except for the ankylosis type in yearly radiographic changes in the bony structure evaluated by the humeral surface height ratio and ulnar surface height ratio. Stable and unstable forms were distinguished by a cut-off point of 0.65 and 2.58 in yearly radiographic changes in the bony structure evaluated by the humeral surface height ratio and the ulnar surface height ratio, respectively. These parameters might be useful for monitoring the structural changes of the elbow joint in rheumatoid arthritis.

DOI： 10.1007/s10067-010-1381-y

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2P1-G21 Tool Path Generation Method for High-speed Bone Cutting in Joint Replacement Assisting System

Bekku Akira, Nakano Taiga, Sugita Naohiko, Nakajima Yoshikazu, Kato Takeharu, Hujiwara Kazuo, Abe Nobuhito, Ozaki Toshifumi, Suzuki Masahiko, Inoue Takayuki, Kuramoto Kouiti, Nakashima Yoshio, Mitsuishi Mamoru

2010 "2P1 - G21(1)"-"2P1-G21(3)" 2010

Language：Japanese Publisher：The Japan Society of Mechanical Engineers

Multi-axis medical machine tool enables high-accuracy bone cutting in joint replacement assisting system. Short-time bone cutting is considered to be challenging problems in Joint Replacement Assisting System with multi-axis medical machine tool. The objective of this study is to propose tool path generation method for cutting down the time to form mounting surface for artificial joint and minimizing the collision of cutting tool with soft tissue. Short-time bone cutting decreases the danger of the infectious disease, and decreases the amount of blood under the operation. Software is developed for the application and the effectiveness is evaluated with a cadaveric bone.

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人工膝関節置換術に対する独自開発ナビゲーションシステムの精度評価

横山裕介, 藤原一夫, 阿部信寛, 西田圭一郎, 尾崎敏文, 鈴木昌彦, 中島義和, 斎藤季, 杉田直彦, 光石衛, 井上貴之, 藏本孝一

日本整形外科学会雑誌 84 ( 8 ) 2010

関節構成体機械特性測定プローブの開発

杉田直彦, 木崎通, 菅野大輔, 光石衛, 阿部信寛, 横山裕介, 尾崎敏文

精密工学会大会学術講演会講演論文集 2010 2010

The ACCURACY OF A ROBOT SYSTEM FOR LESS INVASIVE KNEE ARTHROPLASTY

FUJIWARA K., ABE N., NISHIDA K., OZAKI T., SUZUKI M., SAITO T., SUGITA N., NAKAJIMA Y., MITSUISHI M., INOUE T., KURAMOTO K., NAKASHIMA Y.

11 ( 3 ) 143 - 144 2009.11

Robotic Surgical System for the Minimally Invasive Knee Arthroplasty

MITSUISHI M., SUGITA N., NAKAJIMA Y., SAITO T., INOUE T., KURAMOTO K., NAKASHIMA Y., TANIMOTO K., FUJIWARA K., ABE N., OZAKI T., SUZUKI M.

11 ( 3 ) 157 - 159 2009.11

Open Reduction for Untreated Developmental Dislocation in the Hip for Infants Older than 3 Years

MINAGAWA Hiroshi

18 ( 2 ) 277 - 281 2009.9

Optical imaging of mouse articular cartilage using the glycosaminoglycans binding property of fluorescent-labeled octaarginine

K. Inagawa, T. Oohashi, K. Nishida, J. Minaguchi, T. Tsubakishita, K. O. Yaykasli, A. Ohtsuka, T. Ozaki, T. Moriguchi, Y. Ninomiya

OSTEOARTHRITIS AND CARTILAGE 17 ( 9 ) 1209 - 1218 2009.9

Language：English Publisher：W B SAUNDERS CO LTD

Objective: The aim of the current study was to examine the cartilage-specific binding property of polyarginine peptides (R4, 8, 12, and 16) and specifically to test octaarginine peptides for the optical imaging of articular cartilage in experimentally induced arthritis in mice.
Methods: Four rhodamine-labeled polyarginine peptides each with a different-length arginine chain (R4, 8, 12, or 16) were injected into the knee joints of C57BL/6J mice (n = 20). The joints were excised 1 h later and the fluorescent signal intensity in cartilage cryosections was compared for the four peptides. To examine the substrate of R8 in cartilage, femoral condyles obtained from another set of mice were treated with chondroitinase ABC (Ch'ase ABC), keratanase or heparitinase then immersed in R8-rhodamine. Fluorescent signals were examined by fluorescent microscopy. Next, R8-rhodamine was injected into the right knee joints of three control and three collagen antibody-induced arthritis (CAIA) mice, and fluorescent intensity in normal and degenerative cartilage was semi-quantitatively analysed on the histological sections using image software. Finally, femoral condyles from normal mice (n = 2) and CAIA mice (n = 2) were immersed in R8-rhodamine and calcein, then imaged using optical projection tomography (OPT).
Results: Fluorescent signals were specifically detected in the cartilage pericellular matrix from the surface to the tide mark but were completely absent in the calcified layer or bone marrow. The number of arginine residues significantly influenced peptide accumulation in articular cartilage, with R8 accumulating the most. The fluorescent signal in the femoral condylar cartilage diminished when it was treated with Ch'ase ABC. R8 accumulation was significantly decreased in the degenerative cartilage of CAIA mice, and this was demonstrated both histologically and in three-dimensional (3D)-reconstruction image by OPT.
Conclusion: R8 may be a useful new experimental probe for optical imaging of normal and arthritic articular cartilage. (C) 2009 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.joca.2009.03.010

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Usefulness of a navigation system in surgery for scoliosis: segmental pedicle screw fixation in the treatment

Kazuo Nakanishi, Masato Tanaka, Haruo Misawa, Yoshihisa Sugimoto, Tomoyuki Takigawa, Toshifumi Ozaki

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY 129 ( 9 ) 1211 - 1218 2009.9

Language：English Publisher：SPRINGER

Postoperative outcomes of segmental pedicle screw fixation were evaluated in posterior scoliosis surgery with the use of navigation system.
We report the usefulness of a navigation system and a segmental pedicle screw fixation in surgery for scoliosis.
Few reports on a segmental pedicle screw fixation method for scoliosis surgery using a navigation system have been published. This is the report on the usefulness of a navigation system in segmental pedicle screw fixation.
We targeted 16 cases in which segmental pedicle screw fixation had been performed using a navigation system at our hospital. We inserted 264 pedicle screws in total, and we did not perform registration for each corpus vertebrate in order to shorten the duration of the surgery. We reviewed screw deviation among the items for review using Neo classification with postoperative CT images (1.25 mm). For screw deviation in this case, grade 2 or higher in the Neo classification system was designated as total deviation. Furthermore, we evaluated the registration period per corpus vertebrae, the complications, duration of surgery, blood loss, Cobb angle, and the correction rate.
In terms of screw deviation, 11 (4.2%) of the 264 inserted screws were classified as total deviation. However, there were no neurovascular complications during or after surgery in any cases, and all cases maintained strong internal fixation. In the relationship between the use or nonuse of registration and the deviation, four screws (3.2%) in the corpus vertebrae for which registration was performed and seven screws (5.0%) in the adjacent corpus vertebrae for which registration was not performed had deviated. The duration of registration per corpus vertebrate averaged 4 min and 24 s (58-791 s), but registration also requires a learning curve, so the duration of registration per corpus vertebrae averaged 1 min and 14 s in more recent cases, thus marking a significant shortening.
Segmental pedicle screw fixation are excellent in regard to their fixing and correction force and have been clinically applied even in surgery for scoliosis, but the potential risk of neurovascular complications is unavoidable. The adoption of a navigation system in surgery for scoliosis is useful to increase the safety and certainty of the insertion of pedicle screws.

DOI： 10.1007/s00402-008-0807-3

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Mechanical stretch stimulates integrin alpha V beta 3-mediated collagen expression in human anterior cruciate ligament cells

Tomonori Tetsunaga, Takayuki Furumatsu, Nobuhiro Abe, Keiichiro Nishida, Keiji Naruse, Toshifumi Ozaki

JOURNAL OF BIOMECHANICS 42 ( 13 ) 2097 - 2103 2009.9

Language：English Publisher：ELSEVIER SCI LTD

Biomechanical stimuli have fundamental roles in the maintenance and remodeling of ligaments including collagen gene expressions. Mechanical stretching signals are mainly transduced by cell adhesion molecules such as integrins. However. the relationships between stress-induced collagen expressions and integrin-mediated cellular behaviors are still unclear in anterior cruciate ligament cells. Here, we focused on the stretch-related responses of different cells derived from the ligament-to-bone interface and midsubstance regions of human anterior cruciate ligaments. Chondroblastic interface cells easily lost their potential to produce collagen genes in non-stretched conditions, rather than fibroblastic midsubstance cells. Uni-axial mechanical stretches increased the type I collagen gene expression of interface and midsubstance cells up to 14- and 6-fold levels of each non-stretched control, respectively. Mechanical stretches also activated the stress fiber formation by shifting the distribution of integrin alpha V beta 3 to the peripheral edges in both interface and midsubstance cells. In addition, integrin alpha V beta 3 colocalized with phosphorylated focal adhesion kinase in stretched cells. Functional blocking analyses using anti-integrin antibodies revealed that the stretch-activated collagen gene expressions on fibronectin were dependent on integrin alpha V beta 3-mediated cellular adhesions in the interface and midsubstance cells. These findings suggest that the integrin alpha V beta 3-mediated stretch signal transduction might have a key role to stimulate collagen gene expression in human anterior cruciate ligament, especially in the ligament-to-bone interface. (C) 2009 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jbiomech.2009.06.016

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Bone repair by transplantation of hTERT-immortalized human mesenchymal stem cells in mice. International journal

Hiroyuki Nakahara, Haruo Misawa, Takahiro Hayashi, Eisaku Kondo, Takeshi Yuasa, Yasuhiro Kubota, Masayuki Seita, Hironobu Kawamoto, Wael A R A Hassan, Reham A R A Hassan, Shahid M Javed, Masato Tanaka, Hirosuke Endo, Hirofumi Noguchi, Shinichi Matsumoto, Katsuyoshi Takata, Yuichi Tashiro, Shuhei Nakaji, Toshifumi Ozaki, Naoya Kobayashi

Transplantation 88 ( 3 ) 346 - 53 2009.8

Language：English

BACKGROUND: Human mesenchymal stem cells (hMSCs) are multipotent stem cells found in the adult bone marrow that have the capacity to differentiate into various mesenchymal cell types. The hMSCs may provide a potential therapy to restore damaged tissues or organs of mesenchymal origin; however, a drawback is their limited life span in vitro. METHODS: We immortalized normal hMSCs with retrovirally transmitted human telomerase reverse transcriptase cDNA. One of the immortalized clones (YKNK-12) was established, and the biological characteristics were investigated in vitro and in vivo. RESULTS: YKNK-12 cells were capable of differentiating adipocytes, osetoblasts, and chondrocytes. Osteogenically differentiated YKNK-12 cells produced significant levels of growth factors BMP4, BMP6, FGF6, FGF7, transforming growth factor-beta1, and transforming growth factor-beta3.. Microcomputer tomography T and soft X-ray assays showed an excellent calvarial bone healing in mice after transplantation of osteogenically differentiated YKNK-12 cells. These cells expressed human-specific osteocalcin and increased the gene expression of runt-related transcription factor 2, alkaline phosphatase, osteocalcin, and osterix in the bone regenerating area. YKNK-12 cell transplant corrected the bone defect without inducing any adverse effects. CONCLUSIONS: We conclude that hMSCs immortalized by transduction with human telomerase reverse transcriptase may provide an unlimited source of cells for therapeutic use in bone regeneration.

DOI： 10.1097/TP.0b013e3181ae5ba2

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Radiological and Clinical Results of Rotational Acetabular Osteotomy Combined with Femoral Intertrochanteric Osteotomy for Avascular Necrosis Following Treatment for Developmental Dysplasia of the Hip

Hiroshi Minagawa, Ayako Aiga, Hirosuke Endo, Shigeru Mitani, Tomonori Tetsunaga, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 63 ( 4 ) 169 - 175 2009.8

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

This retrospective study assessed the radiographic results of 16 patients with avascular necrosis following treatment for developmental dislocation of the hip (DDH) who were subsequently treated between 1991 and 2005 by rotation acetabular osteotomy (RAO) combined with femoral intertrochanteric osteotomy (FIO). Initial treatment was by Pavlik harness, cast fixation, or overhead traction. The parameters that showed consistent improvement were the index of centralization, the index of acetabular coverage, adequate reduction of the greater trochanter, and abductor sufficiency. The combined procedure appears to be effective in cases in which preoperative planning shows a reasonable expectation of congruency and osteoarthritis is limited to the early stages.

DOI： 10.18926/AMO/31814

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マウス抗II型コラーゲン抗体関節炎におけるTh1/2反応とSOCS3・SOCS5による制御

高畑智宏, 松川昭博, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 83 ( 8 ) S1120 - S1120 2009.8

Radiographic Prediction of the Results of Long-term Treatment with the Pavlik Harness for Developmental Dislocation of the Hip

Takao Ohmori, Hirosuke Endo, Shigeru Mitani, Hiroshi Minagawa, Tomonori Tetsunaga, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 63 ( 3 ) 123 - 128 2009.6

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

In 1957, Pavlik introduced the Pavlik harness as a useful treatment for developmental dislocation of the hip (DDH), and subsequent studies have documented favorable outcomes among patients treated with this device. However, there are only a few articles reporting how early radiographic measurements can be used to determine the prognosis after treatment with the Pavlik harness. In this study, 217 hips from 192 patients whose DDH treatment with the Pavlik harness was initiated before they were 6 months old and whose follow-up lasted at least 14 years (rate, 63.8%) were analyzed using measurements from radiographs taken immediately before and after harness treatment, and at 1, 2, and 3 years of age. Severin's classification at the final follow-up was I or II in 71.9% and III or IV in 28.1% of the hips, respectively. Avascular necrosis of the femoral head (AVN) was seen in 10% of the hips. Stepwise multiple regression analysis was performed to retrospectively determine whether any radiographic factors were related to the final classification as Severin I/II or III/IV. Receiver operating characteristic (ROC) curves were drawn for these factors, and a Wiberg OE angle (Point 0 was the middle point of the proximal metaphyseal border of the femur) of 2 degrees on the 3-year radiographs was found to be the most useful screening value for judging the acetabular development of DDH cases after treatment with a Pavlik harness, with a sensitivity of 71% a specificity of 93%, and a likelihood ratio of 10.1.

DOI： 10.18926/AMO/31850

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Surgical Treatment of Metastatic Vertebral Tumors

Masato Tanaka, Shinnosuke Nakahara, Yasuo Ito, Toshiyuki Kunisada, Haruo Misawa, Koichiro Koshimune, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 63 ( 3 ) 145 - 150 2009.6

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

Surgical treatment of metastatic spinal cord compression is controversial. The purpose of this study was to investigate the effectiveness of our current surgical treatments and the use of spinal instrumentation. In this retrospective study covering the years between 1990 and 2006, 100 patients with spinal metastases which were secondary to various cancers underwent posterior and/or anterior decompression with spinal stabilization for the purposes of reduction of pain, and/or to help correct or improve neurological deficits. The group was made up of 60 men and 40 women whose ages ranged from 16 to 83 years (average of 60 years), and the average follow-up period was 14 months. The effect of treatment upon pain relief and neural deficits was assessed, and the cumulative survival rate was calculated by the Kaplan-Meier method. The average surgical time was 185 min. This was calculated based on the following times, listed here with the surgery type: 178 min for posterior surgery; 245 min for anterior surgery; 465 min for combined surgery; and 475 min for total en bloc spondylectomy. Average blood loss during surgery was 1,630 ml for posterior surgery, 1,760 ml for anterior surgery, 1,930 ml for combined surgery, and 3,640 ml for total en bloc spondylectomy. Preoperative pain and paralysis were improved by 88% and 53%, respectively. In regards to surgical complications, postoperative epidural hematoma was observed in 2 patients, and instrumentation-related infection was observed in 1. Only 2 patients died within 2 months of surgery. In conclusion, posterior and/or anterior decompression with spinal stabilization is a safe and effective treatment for patients with spinal metastases, and can improve their quality of life.

DOI： 10.18926/AMO/31849

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大腿骨転移性骨腫瘍の手術療法の検討

中田英二, 大森貴男, 黒住健人, 尾崎敏文

日本整形外科学会雑誌 83 ( 6 ) S948 - S948 2009.6

2A1-K08 Toolpath generation to protect soft tissue for minimally invasive orthopedic surgery

NAKANO Taiga, TORIGOE Yusuke, SUGITA Naohiko, NAKAJIMA Yoshikazu, KATO Takeharu, FUJIWARA Kazuo, ABE Nobuhiro, OZAKI Toshifumi, SUZUKI Masahiko, MITSUISHI Mamoru

2009 "2A1 - K08(1)"-"2A1-K08(3)" 2009.5

Language：Japanese Publisher：The Japan Society of Mechanical Engineers

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 soft tissue, and a novel approach of interference-free toolpath generation in a short processing time is proposed. The unknown shape of soft tissue is intraoperatively modeled as interference area, and interference-free tool posture is immediately determined by the preliminary definition of evacuating direction based on the model. The effectiveness of the proposed method is evaluated with artificial models on the system that the authors have developed so far.

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Smad3 activates the Sox9-dependent transcription on chromatin

Takayuki Furumatsu, Toshifumi Ozaki, Hiroshi Asahara

INTERNATIONAL JOURNAL OF BIOCHEMISTRY & CELL BIOLOGY 41 ( 5 ) 1198 - 1204 2009.5

Language：English Publisher：PERGAMON-ELSEVIER SCIENCE LTD

Transforming growth factor (TGF)-beta has an essential role for the Sry-type high-mobility-group box (Sox)-regulated chondrogenesis. Chondrogenic differentiation is also controlled by chromatin-mediated transcription. We have previously reported that TGF-beta-regulated Smad3 induces chondrogenesis through the activation of Sox9-dependent transcription. However, the cross-talk between TGF-beta signal and Sox9 on chromatin-mediated transcription has not been elucidated. In the present study, we investigated the activity of Smad3, Sox9, and coactivator p300 using an in vitro chromatin assembly model. Luciferase reporter assays revealed that Smad3 stimulated the Sox9-mediated transcription in a TGF-beta-dependent manner. Recombinant Sox9 associated with phosphorylated Smad3/4 and recognized the enhancer region of type 11 collagen gene. In vitro transcription and S1 nuclease assays showed that Smad3 and p300 cooperatively activated the Sox9-dependent transcription on chromatin template. The combination treatment of phosphorylated Smad3, Sox9, and p300 were necessary for the activation of chromatin-mediated transcription. These findings suggest that TGF-beta signal Smad3 plays a key role for chromatin remodeling to induce chondrogenesis via its association with Sox9. (C) 2008 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.biocel.2008.10.032

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Changes in the lateral pillar classification in Perthes' disease

Takayuki Kuroda, Shigeru Mitani, Yoshihisa Sugimoto, Koji Asaumi, Hirosuke Endo, Hirofumi Akazawa, Tadashi Nakagomi, Toshifumi Ozaki

JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B 18 ( 3 ) 116 - 119 2009.5

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

The purpose of this study was to examine the correlation between the changes in the lateral pillar grades and the factors influencing such changes. We reviewed 102 patients with Perthes' disease. Changes were observed in 32 (31%) hips. The percentage of the changes in each treatment group showed significant differences. Patients with extensive involvement showed significantly more changes. There was no difference in the age at the onset. We recommend that treatment methods be used that more effectively relieve the mechanical force on the capital femoral epiphysis for patients with extensive involvement regardless of the age at the onset. J Pediatr Orthop B 18:116-119 (c) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

DOI： 10.1097/BPB.0b013e32832b07b1

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