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Watanabe S, Yoshioka H, Sakai H, Hotta K, Takenoyama M, Yamada K, Sugawara S, Takiguchi Y, Hosomi Y, Tomii K, Niho S, Nishio M, Kato T, Takahashi T, Ebi H, Aono M, Yamamoto N, Ohe Y, Nakagawa K. Association between skin toxicity and efficacy of necitumumab in squamous non-small-cell lung cancer: a pooled analysis of two randomized clinical trials-SQUIRE and JFCM. ESMO Open 2024; 9:102975. [PMID: 38520847 PMCID: PMC10980953 DOI: 10.1016/j.esmoop.2024.102975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Efficacy of necitumumab [recombinant human monoclonal antibody that blocks the ligand binding epidermal growth factor receptor (EGFR)] in patients with squamous (SQ) non-small-cell lung cancer (NSCLC) has been confirmed in two randomized clinical trials (SQUIRE and JFCM). This study evaluated the association between efficacy and initial skin toxicity with necitumumab treatment by analyzing pooled data from two clinical trials (SQUIRE and JFCM). MATERIALS AND METHODS Data of 635 patients with SQ-NSCLC (intent-to-treat population) treated with necitumumab plus gemcitabine and cisplatin (N + GC) were pooled from two clinical trials (SQUIRE and JFCM). The relationship between skin toxicities developed by the end of the second cycle and efficacy was evaluated. Efficacy endpoints included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). Univariate and multivariate analyses were carried out for these endpoints. RESULTS OS and ORR were associated with skin toxicity, whereas PFS was not. Patients with grade ≥2 or grade 1 skin toxicity had significantly longer OS compared to patients without skin toxicity (grade 0) in the N + GC group [median = 15.0 (grade ≥2); 12.7 (grade 1); 9.4 (grade 0) months; hazard ratio (HR) = 0.51 (grade ≥2 to grade 0); 95% confidence interval (CI) 0.40-0.64, P < 0.001 and HR = 0.64 (grade 1 to grade 0); 95% CI 0.52-0.80, P < 0.001]. In multivariate analysis, OS was significantly associated with skin toxicity. CONCLUSIONS A significant association was found between necitumumab-induced skin toxicity and efficacy. These results are consistent with the previously reported association between other EGFR inhibitors-induced skin toxicity and efficacy.
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Affiliation(s)
- S Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - H Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata.
| | - H Sakai
- Department of Thoracic Oncology, Ageo Central General Hospital, Ageo
| | - K Hotta
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama
| | - M Takenoyama
- Department of Thoracic Surgery, Matsuyama Red Cross Hospital, Matsuyama
| | - K Yamada
- Department of Respiratory Medicine, Shin Koga Hospital, Fukuoka
| | - S Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai
| | - Y Takiguchi
- Department of Medical Oncology, Chiba University Hospital, Chiba
| | - Y Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo
| | - K Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe
| | - S Niho
- Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University, Mibu
| | - M Nishio
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - T Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama
| | - T Takahashi
- Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi
| | - H Ebi
- Pharmaceuticals Group, Nippon Kayaku Co., Ltd, Chiyoda-ku, Tokyo
| | - M Aono
- Pharmaceuticals Group, Nippon Kayaku Co., Ltd, Chiyoda-ku, Tokyo
| | - N Yamamoto
- Internal Medicine III, Wakayama Medical University, Wakayama
| | - Y Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
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Amekura H, Chettah A, Narumi K, Chiba A, Hirano Y, Yamada K, Yamamoto S, Leino AA, Djurabekova F, Nordlund K, Ishikawa N, Okubo N, Saitoh Y. Latent ion tracks were finally observed in diamond. Nat Commun 2024; 15:1786. [PMID: 38413643 PMCID: PMC10899563 DOI: 10.1038/s41467-024-45934-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
Injecting high-energy heavy ions in the electronic stopping regime into solids can create cylindrical damage zones called latent ion tracks. Although these tracks form in many materials, none have ever been observed in diamond, even when irradiated with high-energy GeV uranium ions. Here we report the first observation of ion track formation in diamond irradiated with 2-9 MeV C60 fullerene ions. Depending on the ion energy, the mean track length (diameter) changed from 17 (3.2) nm to 52 (7.1) nm. High resolution scanning transmission electron microscopy (HR-STEM) indicated the amorphization in the tracks, in which π-bonding signal from graphite was detected by the electron energy loss spectroscopy (EELS). Since the melting transition is not induced in diamond at atmospheric pressure, conventional inelastic thermal spike calculations cannot be applied. Two-temperature molecular dynamics simulations succeeded in the reproduction of both the track formation under MeV C60 irradiations and the no-track formation under GeV monoatomic ion irradiations.
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Affiliation(s)
- H Amekura
- National Institute for Materials Science (NIMS), Tsukuba, Ibaraki, 305-0003, Japan.
| | - A Chettah
- Department of Physics, LGMM laboratory, University of 20 Août 1955-Skikda, BP 26, route d'El Hadaiek-Skikda, Skikda, 21000, Algeria
| | - K Narumi
- Takasaki Institute for Advanced Quantum Science, National Institutes for Quantum Science and Technology (QST), Takasaki, Gumma, 370-1292, Japan
| | - A Chiba
- Takasaki Institute for Advanced Quantum Science, National Institutes for Quantum Science and Technology (QST), Takasaki, Gumma, 370-1292, Japan
| | - Y Hirano
- Takasaki Institute for Advanced Quantum Science, National Institutes for Quantum Science and Technology (QST), Takasaki, Gumma, 370-1292, Japan
| | - K Yamada
- Takasaki Institute for Advanced Quantum Science, National Institutes for Quantum Science and Technology (QST), Takasaki, Gumma, 370-1292, Japan
| | - S Yamamoto
- Takasaki Institute for Advanced Quantum Science, National Institutes for Quantum Science and Technology (QST), Takasaki, Gumma, 370-1292, Japan
| | - A A Leino
- Department of Physics and Helsinki Institute of Physics, University of Helsinki, PO Box 43, FI-00014, Helsinki, Finland
| | - F Djurabekova
- Department of Physics and Helsinki Institute of Physics, University of Helsinki, PO Box 43, FI-00014, Helsinki, Finland
| | - K Nordlund
- Department of Physics and Helsinki Institute of Physics, University of Helsinki, PO Box 43, FI-00014, Helsinki, Finland
| | - N Ishikawa
- Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki, 319-1195, Japan
| | - N Okubo
- Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki, 319-1195, Japan
| | - Y Saitoh
- Takasaki Institute for Advanced Quantum Science, National Institutes for Quantum Science and Technology (QST), Takasaki, Gumma, 370-1292, Japan
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Yamada K, Bixler B, Sakurai Y, Ashton PC, Sugiyama J, Arnold K, Begin J, Corbett L, Day-Weiss S, Galitzki N, Hill CA, Johnson BR, Jost B, Kusaka A, Koopman BJ, Lashner J, Lee AT, Mangu A, Nishino H, Page LA, Randall MJ, Sasaki D, Song X, Spisak J, Tsan T, Wang Y, Williams PA. The Simons Observatory: Cryogenic half wave plate rotation mechanism for the small aperture telescopes. Rev Sci Instrum 2024; 95:024504. [PMID: 38385955 DOI: 10.1063/5.0178066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
We present the requirements, design, and evaluation of the cryogenic continuously rotating half-wave plate (CHWP) for the Simons Observatory (SO). SO is a cosmic microwave background polarization experiment at Parque Astronómico de Atacama in northern Chile that covers a wide range of angular scales using both small (⌀0.42 m) and large (⌀6 m) aperture telescopes. In particular, the small aperture telescopes (SATs) focus on large angular scales for primordial B-mode polarization. To this end, the SATs employ a CHWP to modulate the polarization of the incident light at 8 Hz, suppressing atmospheric 1/f noise and mitigating systematic uncertainties that would otherwise arise due to the differential response of detectors sensitive to orthogonal polarizations. The CHWP consists of a 505 mm diameter achromatic sapphire HWP and a cryogenic rotation mechanism, both of which are cooled down to ∼50 K to reduce detector thermal loading. Under normal operation, the HWP is suspended by a superconducting magnetic bearing and rotates with a constant 2 Hz frequency, controlled by an electromagnetic synchronous motor. We find that the number of superconductors and the number of magnets that make up the superconducting magnetic bearing are important design parameters, especially for the rotation mechanism's vibration performance. The rotation angle is detected through an angular encoder with a noise level of 0.07 μrad s. During a cooldown process, the rotor is held in place by a grip-and-release mechanism that serves as both an alignment device and a thermal path. In this paper, we provide an overview of the SO SAT CHWP: its requirements, hardware design, and laboratory performance.
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Affiliation(s)
- K Yamada
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - B Bixler
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - Y Sakurai
- Graduate School of Natural Science and Technology, Okayama University, Okayama 700-8530, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
| | - P C Ashton
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J Sugiyama
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Arnold
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - J Begin
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - L Corbett
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S Day-Weiss
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - N Galitzki
- Department of Physics, University of Texas at Austin, Austin, Texas 78722, USA
- Weinberg Institute for Theoretical Physics, Texas Center for Cosmology and Astroparticle Physics, Austin, Texas 78712, USA
| | - C A Hill
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - B R Johnson
- Department of Astronomy, University of Virginia, Charlottesville, Virginia 22904, USA
| | - B Jost
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
| | - A Kusaka
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B J Koopman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Lashner
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A T Lee
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - A Mangu
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H Nishino
- Research Center for the Early Universe, School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - L A Page
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - M J Randall
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - D Sasaki
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - X Song
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J Spisak
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - T Tsan
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - Y Wang
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - P A Williams
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
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Shimizu T, Suda K, Matsumoto Harmon S, Komatsu M, Ota M, Ushirozako H, Inomata K, Minami A, Yamada K, Endo T, Takahata M, Iwasaki N, Takahashi H, Koda M, Yamazaki M. Effect of urgent surgery within 8 hours compared to surgery between 8 and 24 hours on perioperative complications and neurological prognosis in patients older than 70 years with cervical spinal cord injury: a propensity score-matched analysis. J Neurosurg Spine 2024:1-11. [PMID: 38277664 DOI: 10.3171/2023.11.spine23810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/21/2023] [Indexed: 01/28/2024]
Abstract
OBJECTIVE This study aimed to investigate the effect of surgery within 8 hours on perioperative complications and neurological prognosis in older patients with cervical spinal cord injury by using a propensity score-matched analysis. METHODS The authors included 87 consecutive patients older than 70 years who had cervical spinal cord injury and who had undergone posterior decompression and fusion surgery within 24 hours of injury. The patients were divided into two groups based on the time from injury to surgery: surgery within 8 hours (group 8 hours) and between 8 and 24 hours (group 8-24 hours). Following the preliminary study, the authors established a 1:1 matched model using propensity scores to adjust for baseline characteristics and neurological status on admission. Perioperative complication rates and neurological outcomes at discharge were compared between the two groups. RESULTS Preliminary analysis of 87 prematched patients (39 in group 8 hours and 48 in group 8-24 hours) revealed that the motor index score (MIS) on admission was lower for lower extremities (12.3 ± 15.5 vs 20.0 ± 18.6, respectively; p = 0.048), and total extremities (26.7 ± 27.1 vs 40.2 ± 30.6, respectively; p = 0.035) in group 8 hours. In terms of perioperative complications, group 8 hours had significantly higher rates of cardiopulmonary dysfunction (46.2% vs 25.0%, respectively; p = 0.039). MIS improvement (the difference in scores between admission and discharge) was greater in group 8 hours for lower extremities (15.8 ± 12.6 vs 9.0 ± 10.5, respectively; p = 0.009) and total extremities (29.4 ± 21.7 vs 18.7 ± 17.7, respectively; p = 0.016). Using a 1:1 propensity score-matched analysis, 29 patient pairs from group 8 hours and group 8-24 hours were selected. There were no significant differences in baseline characteristics, neurological status on admission, and perioperative complications between the two groups, including cardiopulmonary dysfunction. Even after matching, MIS improvement was significantly greater in group 8 hours for upper extremities (13.0 ± 10.9 vs 7.8 ± 8.3, respectively; p = 0.045), lower extremities (14.8 ± 12.7 vs 8.3 ± 11.0, respectively; p = 0.044) and total extremities (27.8 ± 21.0 vs 16.0 ± 17.5, respectively; p = 0.026). CONCLUSIONS Results of the comparison after matching demonstrated that urgent surgery within 8 hours did not increase the perioperative complication rate and significantly improved the MIS, suggesting that surgery within 8 hours may be efficient, even in older patients.
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Affiliation(s)
- Tomoaki Shimizu
- 1Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido
- 2Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and
| | - Kota Suda
- 1Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido
| | | | - Miki Komatsu
- 1Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido
| | - Masahiro Ota
- 1Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido
| | - Hiroki Ushirozako
- 1Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido
| | - Kento Inomata
- 1Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido
- 2Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and
| | - Akio Minami
- 1Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido
| | - Katsuhisa Yamada
- 3Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Tsutomu Endo
- 3Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Masahiko Takahata
- 3Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Norimasa Iwasaki
- 3Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Hiroshi Takahashi
- 2Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and
| | - Masao Koda
- 2Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and
| | - Masashi Yamazaki
- 2Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and
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Namikawa H, Imoto W, Yamada K, Tochino Y, Kaneko Y, Kakeya H, Shuto T. Predictors for onset of extended-spectrum beta-lactamase-producing Escherichia coli-induced bacteraemia: a systematic review and meta-analysis. J Hosp Infect 2023; 142:88-95. [PMID: 37802238 DOI: 10.1016/j.jhin.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/08/2023]
Abstract
Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli bacteraemia can induce unfavourable clinical outcomes due to delay in appropriate antimicrobial treatment and limited therapeutic options. Therefore, elucidating the predictors of ESBL-producing E. coli-induced bacteraemia is crucial to improve clinical outcomes. However, a literature search did not reveal any studies that incorporate a meta-analysis of the predictors of ESBL-producing E. coli-induced bacteraemia. As such, this review was undertaken to assess current evidence on the predictors of ESBL-producing E. coli-induced bacteraemia. PubMed, Web of Science and Cochrane Library databases were searched for all relevant publications from January 2000 to September 2021. This systematic review evaluated 10 observational studies, comprising a total of 2325 patients with E. coli-induced bacteraemia and 850 (36.6%) ESBL-producing strains. In the meta-analysis, previous antibiotic therapy [pooled risk ratio (RR) 2.72; P<0.001], especially with cephalosporins (pooled RR 4.66; P<0.001) and quinolones (pooled RR 5.47; P<0.001), and urinary catheter use (pooled RR 3.79; P<0.001) were predictive of ESBL-producing E. coli-induced bacteraemia. Antibiotic therapy for patients with the above-mentioned risk factors should be selected considering the possibility of ESBL-producing E. coli-induced bacteraemia compared with non-ESBL-producing E. coli-induced bacteraemia. It is important to elucidate whether appropriate modulation of the identified risk factors can potentially mitigate the risk of ESBL-producing E. coli-induced bacteraemia compared with non-ESBL-producing E. coli-induced bacteraemia.
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Affiliation(s)
- H Namikawa
- Department of Medical Education and General Practice, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan.
| | - W Imoto
- Department of Infection Control Science, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - K Yamada
- Department of Infection Control Science, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Research Centre for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Y Tochino
- Department of Medical Education and General Practice, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Y Kaneko
- Research Centre for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan; Department of Bacteriology, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - H Kakeya
- Department of Infection Control Science, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Research Centre for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - T Shuto
- Department of Medical Education and General Practice, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
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Fujita R, Endo T, Takahata M, Koike Y, Yoneoka D, Suzuki R, Tanaka M, Yamada K, Sudo H, Hasegawa T, Terkawi MA, Kadoya K, Iwasaki N. High whole-body bone mineral density in ossification of the posterior longitudinal ligament. Spine J 2023; 23:1461-1470. [PMID: 37437695 DOI: 10.1016/j.spinee.2023.06.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND CONTEXT Recent studies suggest that ossification of the posterior longitudinal ligament (OPLL) is exacerbated by systemic metabolic disturbances, including obesity. However, although an increase in bone mineral density (BMD) measured at the lumbar spine has been reported in patients with OPLL, no studies have investigated the systemic BMD of patients with OPLL in detail. PURPOSE We investigated whether patients with OPLL develop increased whole-body BMD. STUDY DESIGN Single institution cross-sectional study. PATIENT SAMPLE Data were collected from Japanese patients with symptomatic OPLL (OPLL [+]; n=99). Control data (OPLL [-]; n=226) without spinal ligament ossification were collected from patients who underwent spinal decompression, spinal fusion, or hip replacement surgery. OUTCOME MEASURES Demographic data, including age, body mass index (BMI), comorbidities, history of treatment for osteoporosis, and history of vertebral and nonvertebral fractures, was obtained from all participants. In addition, whole-body BMD, including the lumbar spine, thoracic spine, femoral neck, skull, ribs, entire upper extremity, entire lower extremity, and pelvis, were measured in all participants using whole-body dual-energy X-ray absorptiometry. METHODS Patient data were collected from 2018 to 2022. All participants were categorized based on sex, age (middle-aged [<70 years] and older adults [≥70 years]), and OPLL type (localized OPLL [OPLL only in the cervical spine], diffuse OPLL [OPLL in regions including the thoracic spine]), and OPLL [-]) and each parameter was compared. The factors associated with whole-body BMD were evaluated via multivariable linear regression analysis. RESULTS Compared with the OPLL (-) group, the OPLL (+) group of older women had significantly higher BMD in all body parts (p<.01), and the OPLL (+) group of older men had significantly higher BMD in all body parts except the ribs, forearm, and skull (p<.01). The factors associated with increased BMD of both the femoral neck (load-bearing bone) and skull (nonload-bearing bone) were age, BMI, and coexisting diffuse OPLL in women and BMI and coexisting localized OPLL in men. CONCLUSIONS Patients with OPLL have increased whole-body BMD regardless of sex, indicating that it is not simply due to load-bearing from obesity. These findings suggested that OPLL is associated with a systemic pathology.
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Affiliation(s)
- Ryo Fujita
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan; Hakodate Central General Hospital, Hakodate, Japan.
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Yoshinao Koike
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Daisuke Yoneoka
- Division of Biostatistics and Bioinformatics, Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Ryota Suzuki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | | | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Tomoka Hasegawa
- Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
| | - Mohamad Alaa Terkawi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Ken Kadoya
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan
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7
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Saito T, Shikama N, Takahashi T, Nakamura N, Aoyama H, Nakajima K, Koizumi M, Sekii S, Ebara T, Kiyohara H, Higuchi K, Yorozu A, Nishimura T, Ejima Y, Harada H, Araki N, Miwa M, Yamada K, Kawamoto T, Onishi H, Imano N. Quality of Palliative Radiation Therapy Assessed Using Quality Indicators: A Multicenter Survey. Int J Radiat Oncol Biol Phys 2023; 117:e111. [PMID: 37784649 DOI: 10.1016/j.ijrobp.2023.06.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Clinical practice is not always performed in accordance with guideline recommendations. Quality indicators (QIs) are valuable tools for evaluating the quality of healthcare systems. We sought to identify potential gaps between clinical practice and evidence using QIs previously developed using a modified Delphi method. MATERIALS/METHODS We used seven QIs (Table 1) to assess the quality of radiation therapy for bone (BoM) and brain metastases (BrM) at 29 centers; 13 (45%) were academic (12 university hospitals and 1 cancer center) and 16 (55%) were nonacademic hospitals. Compliance rate was calculated as the percentage of patients for whom recommended medical care was conducted. Random effects models were used to estimate pooled compliance rates. Mixed effects models with a Q test were used to compare compliance rates between academic and nonacademic centers. RESULTS The estimates of the compliance rates with 95% confidence intervals are presented in Table 1. For BoM-1, the compliance rate was higher in academic hospitals (100% [100-100%]) than in non-academic hospitals (96% [89-100%]) (P = 0.021). For BrM-3, the compliance rate was lower in academic hospitals (92% [81-99%]) than in nonacademic hospitals (100% [98-100%]) (P = 0.016). CONCLUSION A quality assessment based on these seven QIs is feasible. Overall, compliance rates were high; however, for BoM-3, the practice remains to be improved in some centers. Based on BoM-4 compliance rates, steroids are infrequently used concurrently with radiation therapy for malignant spinal cord compression. Extended fractionation for BoM was less frequently performed in academic than in nonacademic centers. The initiation of radiation therapy for brain metastases was more frequently delayed in academic than in nonacademic centers.
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Affiliation(s)
- T Saito
- Department of Radiation Oncology, Arao Municipal Hospital, Kumamoto, Japan
| | - N Shikama
- Division of Radiation Oncology, Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - T Takahashi
- Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - N Nakamura
- Department of Radiation Oncology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - H Aoyama
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - K Nakajima
- Asahikawa Medical College, Asahikawa, Japan
| | - M Koizumi
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - S Sekii
- Kita-Harima Medical Center, Hyogo, Japan
| | - T Ebara
- Department of Radiation Oncology, Kyorin University, Mitaka, Tokyo, Japan
| | - H Kiyohara
- Department of Radiation Oncology, Japanese Red Cross Maebashi Hospital, Gunma, Japan
| | - K Higuchi
- Department of Radiation Oncology, Isesaki Municipal Hospital, Gunma, Japan
| | - A Yorozu
- Department of Radiation Oncology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - T Nishimura
- Department of Radiology, Fukuchiyama City Hospital, Kyoto, Japan
| | - Y Ejima
- Department of Radiology, Dokkyo Medical University, Koshigaya, Japan
| | - H Harada
- Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - N Araki
- Department of Radiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Miwa
- Department of Radiation Oncology, Sendai Kousei Hospital, Sendai, Japan
| | - K Yamada
- Department of Radiation Oncology, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - T Kawamoto
- Division of Radiation Oncology, Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - H Onishi
- University of Yamanashi, Chuo, Japan
| | - N Imano
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University, Hiroshima, Japan
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Ishikawa Y, Kanai S, Ura K, Kokabu T, Yamada K, Abe Y, Tachi H, Suzuki H, Ohnishi T, Endo T, Ukeba D, Takahata M, Iwasaki N, Sudo H. Development of Notch-Free, Pre-Bent Rod Applicable for Posterior Corrective Surgery of Thoracolumbar/Lumbar Adolescent Idiopathic Scoliosis. J Clin Med 2023; 12:5750. [PMID: 37685817 PMCID: PMC10488454 DOI: 10.3390/jcm12175750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS), the most common pediatric musculoskeletal disorder, causes a three-dimensional spine deformity. Lenke type 5 AIS is defined as a structural thoracolumbar/lumbar curve with nonstructural thoracic curves. Although a rod curvature will affect clinical outcomes, intraoperative contouring of the straight rod depends on the surgeon's knowledge and experience. This study aimed to determine the optimum rod geometries to provide a pre-bent rod system for posterior spinal surgery in patients with Lenke type 5 AIS. These pre-bent rods will be beneficial for achieving proper postoperative outcomes without rod contouring based on surgeon experience. We investigated 20 rod geometries traced in posterior spinal reconstruction in patients with Lenke type 5 AIS. The differences between the center point clouds in each cluster were evaluated using the iterative closest point (ICP) method with modification. Before the evaluation using the ICP method, the point clouds were divided into four clusters based on the rod length using a hierarchical cluster analysis. Because the differences in the values derived from the ICP method were <5 mm for each length-based cluster, four representative rod shapes were generated from the length-based clusters. We identified four optimized rod shapes that will reduce operation time, leading to a decreased patient and surgeon burden.
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Affiliation(s)
- Yoko Ishikawa
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
- Department of Orthopaedic Surgery, Eniwa Hospital, 2-1-1 Kogane-Chuo, Eniwa 061-1449, Hokkaido, Japan;
| | - Satoshi Kanai
- Division of Systems Science and Informatics, Hokkaido University Graduate School of Information Science and Technology, N14W9, Sapporo 060-0814, Hokkaido, Japan
| | - Katsuro Ura
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
| | - Terufumi Kokabu
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
- Department of Orthopaedic Surgery, Eniwa Hospital, 2-1-1 Kogane-Chuo, Eniwa 061-1449, Hokkaido, Japan;
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
| | - Yuichiro Abe
- Department of Orthopaedic Surgery, Eniwa Hospital, 2-1-1 Kogane-Chuo, Eniwa 061-1449, Hokkaido, Japan;
| | - Hiroyuki Tachi
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
- Department of Orthopaedic Surgery, Eniwa Hospital, 2-1-1 Kogane-Chuo, Eniwa 061-1449, Hokkaido, Japan;
| | - Hisataka Suzuki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
- Department of Orthopaedic Surgery, Eniwa Hospital, 2-1-1 Kogane-Chuo, Eniwa 061-1449, Hokkaido, Japan;
| | - Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
| | - Daisuke Ukeba
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo 060-8638, Hokkaido, Japan; (Y.I.); (K.U.); (T.K.); (K.Y.); (H.T.); (H.S.); (T.O.); (T.E.); (D.U.); (M.T.); (N.I.)
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Hokkaido, Japan
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Endo T, Koike Y, Hisada Y, Fujita R, Suzuki R, Tanaka M, Tsujimoto T, Shimamura Y, Hasegawa Y, Kanayama M, Yamada K, Iwata A, Sudo H, Ishii M, Iwasaki N, Takahata M. Aggravation of Ossified Ligamentum Flavum Lesion Is Associated With the Degree of Obesity. Global Spine J 2023; 13:1325-1331. [PMID: 34615403 PMCID: PMC10416604 DOI: 10.1177/21925682211031514] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective cross-sectional study. OBJECTIVES There is insufficient data on the clinical features of ossification of the ligamentum flavum (OLF) of the thoracic spine and the risk of progression of ossified lesions. The link between obesity and ossification of the posterior longitudinal ligament (OPLL), which frequently coexists with OLF, has been demonstrated. However, the link between obesity and OLF has not been recognized. We aimed to determine the prevalence of obesity in thoracic OLF and whether the severity of OLF is associated with the degree of obesity. METHODS A total of 204 symptomatic Japanese subjects with thoracic OLF and 136 subjects without spinal ligament ossification as controls were included. OLF subjects were divided into 3 groups: 1) localized OLF (OLF <2-intervertebral regions); 2) multilevel OLF (OLF ≥3-intervertebral regions); and 3) OLF + OPLL. The severity of OLF was quantified using the OLF index using computed tomography imaging of the entire spine. RESULTS The proportion of severely obese subjects (BMI ≥ 30 kg/m2) was significantly higher both in the multilevel OLF group (25.5%) and the OLF + OPLL group (44.3%) than in the localized OLF group (3.6%) and the control group (1.4%) (P < 0.01). BMI, age, and coexistence of cervical OPLL and lumbar OLF were associated with thoracic OLF index in the multiple regression analysis. CONCLUSIONS Our findings demonstrated that obesity is a distinct feature of multilevel OLF in the thoracic spine and that the severity of OLF is associated with the degree of obesity.
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Affiliation(s)
- Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yoshinao Koike
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yuichiro Hisada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryo Fujita
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryota Suzuki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masaru Tanaka
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Takeru Tsujimoto
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yukitoshi Shimamura
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yuichi Hasegawa
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Masahiro Kanayama
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Akira Iwata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hideki Sudo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Misaki Ishii
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Hamaguchi H, Kitagawa M, Sakamoto D, Katscher U, Sudo H, Yamada K, Kudo K, Tha KK. Quantitative Assessment of Intervertebral Disc Composition by MRI: Sensitivity to Diurnal Variation. Tomography 2023; 9:1029-1040. [PMID: 37218944 DOI: 10.3390/tomography9030084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023] Open
Abstract
Whether diurnal variation exists in quantitative MRI indices such as the T1rho relaxation time (T1ρ) of the intervertebral disc (IVD) is yet to be explored. This prospective study aimed to evaluate the diurnal variation in T1ρ, apparent diffusion coefficient (ADC), and electrical conductivity (σ) of lumbar IVD and its relationship with other MRI or clinical indices. Lumbar spine MRI, including T1ρ imaging, diffusion-weighted imaging (DWI), and electric properties tomography (EPT), was conducted on 17 sedentary workers twice (morning and evening) on the same day. The T1ρ, ADC, and σ of IVD were compared between the time points. Their diurnal variation, if any, was tested for correlation with age, body mass index (BMI), IVD level, Pfirrmann grade, scan interval, and diurnal variation in IVD height index. The results showed a significant decrease in T1ρ and ADC and a significant increase in the σ of IVD in the evening. T1ρ variation had a weak correlation with age and scan interval, and ADC variation with scan interval. Diurnal variation exists for the T1ρ, ADC, and σ of lumbar IVD, which should be accounted for in image interpretation. This variation is thought to be due to diurnal variations in intradiscal water, proteoglycan, and sodium ion concentration.
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Affiliation(s)
- Hiroyuki Hamaguchi
- Laboratory for Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan
| | - Maho Kitagawa
- Laboratory for Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan
| | - Daiki Sakamoto
- Laboratory for Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan
| | - Ulrich Katscher
- Philips Research Laboratories, Roentgenstrasse 24-26, 22335 Hamburg, Germany
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14 W5, Kita-ku, Sapporo 060-8648, Japan
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14 W5, Kita-ku, Sapporo 060-8648, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Hokkaido University Hospital, N14 W5, Kita-ku, Sapporo 060-8648, Japan
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan
| | - Khin Khin Tha
- Laboratory for Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan
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Yamada K, Nagahama K, Abe Y, Hyugaji Y, Ukeba D, Endo T, Ohnishi T, Ura K, Sudo H, Iwasaki N, Takahata M. Evaluation of Surgical Indications for Full Endoscopic Discectomy at Lumbosacral Disc Levels Using Three-Dimensional Magnetic Resonance/Computed Tomography Fusion Images Created with Artificial Intelligence. Medicina (Kaunas) 2023; 59:medicina59050860. [PMID: 37241092 DOI: 10.3390/medicina59050860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Although full endoscopic lumbar discectomy with the transforaminal approach (FED-TF) is a minimally invasive spinal surgery for lumbar disc herniation, the lumbosacral levels present anatomical challenges when performing FED-TF surgery due to the presence of the iliac bone. Materials and Methods: In this study, we simulated whether FED-TF surgery could be safely performed on a total of 52 consecutive cases with L5-S1 or L5-L6 disc herniation using fused three-dimensional (3D) images of the lumbar nerve root on magnetic resonance imaging (MRI) created with artificial intelligence and of the lumbosacral spine and iliac on computed tomography (CT) images. Results: Thirteen of the fifty-two cases were deemed operable according to simulated FED-TF surgery without foraminoplasty using the 3D MRI/CT fusion images. All 13 cases underwent FED-TF surgery without neurological complications, and their clinical symptoms significantly improved. Conclusions: Three-dimensional simulation may allow for the assessment from multiple angles of the endoscope entry and path, as well as the insertion angle. FED-TF surgery simulation using 3D MRI/CT fusion images could be useful in determining the indications for full endoscopic surgery for lumbosacral disc herniation.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Ken Nagahama
- Department of Orthopaedic Surgery, Sapporo Endoscopic Spine Surgery Clinic, North-16, East-16, Higashi-ku, Sapporo 065-0016, Hokkaido, Japan
| | - Yuichiro Abe
- Department of Orthopaedic Surgery, Eniwa Hospital, Eniwa 061-1449, Hokkaido, Japan
| | - Yoshinori Hyugaji
- Department of Orthopaedic Surgery, Sapporo Endoscopic Spine Surgery Clinic, North-16, East-16, Higashi-ku, Sapporo 065-0016, Hokkaido, Japan
| | - Daisuke Ukeba
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Katsuro Ura
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
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Tsuji Y, Miura H, Hirota T, Ota Y, Yamashita M, Asai S, Fujihara A, Hongo F, Ukimura O, Yamada K. Transarterial ethiodised oil marking before CT-guided renal cryoablation: evaluation of tumour visibility in various renal cell carcinoma subtypes. Clin Radiol 2023; 78:279-285. [PMID: 36710120 DOI: 10.1016/j.crad.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/06/2022] [Accepted: 12/17/2022] [Indexed: 01/15/2023]
Abstract
AIM To evaluate ethiodised oil retention of transarterial embolisation using ethiodised oil (ethiodised oil marking) before computed tomography (CT)-guided percutaneous cryoablation (PCA) according to renal cell carcinoma (RCC) subtype. MATERIALS AND METHODS Ethiodised oil marking was performed 1-3 days before PCA in 99 patients with 99 RCCs from 2016 to 2020. Ethiodised oil retention on CT images was evaluated retrospectively and CT attenuation values in the tumour were measured. Regions of interest (ROI) were placed on the tumours to calculate: average (ROI-average), maximal (ROI-max), minimum (ROI-min), and standard deviation (ROI-SD). Qualitative scores comprising a five-point scale (5, excellent; 1, poor) were evaluated for the retention scores (RS) of ethiodised oil in the tumour (ethiodised oil-RS) and the visualisation scores (VS) of the boundary between the tumour and renal parenchyma (boundary-VS). RESULTS The histological subtypes comprised clear cell (ccRCC; n=85), papillary (pRCC; n=6), and chromophobe/oncocytoma renal cell carcinoma (chrRCC; n=8). The mean ROI-average, ROI-max, and ROI-SD were significantly higher in ccRCCs than in chrRCCs and pRCCs (p<0.05). The mean ethiodised oil-RS was significantly lower in pRCCs than in ccRCCs (p=0.039), and the mean boundary-VS was >4 in all subtypes. Even with poor intratumour ethiodised oil retention (n=6), sufficient boundary-VS was obtained due to "inverted marking." All PCA procedures were completed without additional intravenous contrast material injection at the time of PCA. CONCLUSION Regardless of the tumour subtypes, ethiodised oil marking aids in visualising the boundary between the tumour and parenchyma on non-contrast CT in PCA.
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Affiliation(s)
- Y Tsuji
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - H Miura
- Department of Radiology, Kyoto Second Red Cross Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, Japan
| | - T Hirota
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Y Ota
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - M Yamashita
- Department of Radiology, Kyoto First Red Cross Hospital, 15-749 Hon-machi, Higashiyama-ku, Kyoto, Japan
| | - S Asai
- Department of Radiology, Fukuchiyama City Hospital, 231 Atsunaka-machi, Fukuchiyama City, Kyoto, Japan
| | - A Fujihara
- Department of Urology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - F Hongo
- Department of Urology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - O Ukimura
- Department of Urology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - K Yamada
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
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Yamada K, Takata T, Anoushiravani A, Campos L, Graham T, Kotoku J, Farsad K. Abstract No. 53 Image Quality Improvement for Digital Subtraction Angiography (DSA) around High-Density Obstacles Using Deep Learning: A Bench-Top Study. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Yamada K, Takahata M, Nagahama K, Iwata A, Endo T, Fujita R, Hasebe H, Ohnishi T, Sudo H, Ito M, Iwasaki N. Posterolateral full-endoscopic debridement and irrigation is effective in treating thoraco-lumbar pyogenic spondylodiscitis, except in cases with large abscess cavities. Eur Spine J 2023; 32:859-866. [PMID: 36418783 DOI: 10.1007/s00586-022-07470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/13/2022] [Accepted: 11/13/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the efficacy and poor prognostic factors of posterolateral full-endoscopic debridement and irrigation (PEDI) surgery for thoraco-lumbar pyogenic spondylodiscitis. METHODS We included 64 patients (46 men, 18 women; average age: 63.7 years) with thoracic/lumbar pyogenic spondylodiscitis who had undergone PEDI treatment and were followed up for more than 2 years. Clinical outcomes after PEDI surgery were retrospectively investigated to analyze the incidence and risk factors for prolonged and recurrent infection. RESULTS Of 64 patients, 53 (82.8%) were cured of infection after PEDI surgery, and nine (17.2%) had prolonged or recurrent infection. Multivariate analysis demonstrated that significant risk factors for poor prognosis included a large intervertebral abscess cavity (P = 0.02) and multilevel intervertebral infections (P < 0.05). CONCLUSION PEDI treatment is an effective, minimally invasive procedure for pyogenic spondylodiscitis. However, a large intervertebral abscess space could cause instability at the infected spinal column, leading to prolonged or recurrent infection after PEDI. In cases with a large abscess cavity with or without vertebral bone destruction, endoscopic drainage alone may have a poor prognosis, and spinal fixation surgery could be considered.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan.
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Ken Nagahama
- Department of Orthopaedic Surgery, Sapporo Endoscopic Spine Surgery Clinic, North-16, East-16, Higashi-Ku, Sapporo, Hokkaido, 065-0016, Japan
| | - Akira Iwata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Ryo Fujita
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Hiroyuki Hasebe
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Manabu Ito
- Department of Spine and Spinal Cord Disorders, National Hospital Organization, Hokkaido Medical Center, Yamanote 5-7, Nishi-Ku, Sapporo, Hokkaido, 063-0005, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan
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Namikawa H, Oinuma KI, Yamada K, Kaneko Y, Kakeya H, Shuto T. Predictors of hypervirulent Klebsiella pneumoniae infections: a systematic review and meta-analysis. J Hosp Infect 2023; 134:153-160. [PMID: 36813165 DOI: 10.1016/j.jhin.2023.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Hypervirulent Klebsiella pneumoniae (hvKp) infections confer notable morbidity and mortality. Differential diagnosis to determine whether the infections are caused by either the hvKp or classical K. pneumoniae (cKp) strain is particularly important for undertaking optimal clinical care and infection control efforts. AIM To identify and assess the potential predictors of hvKp infections. METHODS PubMed, Web of Science, and Cochrane Library databases were searched for all relevant publications from January 2000 to March 2022. The search terms included a combination of the following terms: (i) Klebsiella pneumoniae or K. pneumoniae and (ii) hypervirulent or hypervirulence. A meta-analysis of factors for which risk ratio was reported in three or more studies was conducted, and at least one statistically significant association was identified. FINDINGS In this systematic review of 11 observational studies, a total of 1392 patients with K. pneumoniae infection and 596 (42.8%) with hvKp strains were evaluated. In the meta-analysis, diabetes mellitus and liver abscess (pooled risk ratio: 2.61 (95% confidence interval: 1.79-3.80) and 9.04 (2.58-31.72), respectively; all P < 0.001) were predictors of hvKp infections. CONCLUSION For patients with a history of the abovementioned predictors, prudent management, including the search for multiple sites of infection and/or metastatic spread and the enforcement of an early and appropriate source control procedure, should be initiated in consideration of the potential presence of hvKp. We believe that this research highlights the urgent need for increasing clinical awareness of the management of hvKp infections.
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Affiliation(s)
- H Namikawa
- Department of Medical Education and General Practice, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan.
| | - K-I Oinuma
- Department of Bacteriology, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Research Center for Infectious Disease Sciences, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - K Yamada
- Research Center for Infectious Disease Sciences, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Department of Infection Control Science, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Y Kaneko
- Department of Bacteriology, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Research Center for Infectious Disease Sciences, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - H Kakeya
- Research Center for Infectious Disease Sciences, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Department of Infection Control Science, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - T Shuto
- Department of Medical Education and General Practice, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
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Suzuki H, Ura K, Ukeba D, Suyama T, Iwasaki N, Watanabe M, Matsuzaki Y, Yamada K, Sudo H. Injection of Ultra-Purified Stem Cells with Sodium Alginate Reduces Discogenic Pain in a Rat Model. Cells 2023; 12:cells12030505. [PMID: 36766847 PMCID: PMC9914726 DOI: 10.3390/cells12030505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/21/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Intervertebral disc (IVD) degeneration is a major cause of low back pain. However, treatments directly approaching the etiology of IVD degeneration and discogenic pain are not yet established. We previously demonstrated that intradiscal implantation of cell-free bioresorbable ultra-purified alginate (UPAL) gel promotes tissue repair and reduces discogenic pain, and a combination of ultra-purified, Good Manufacturing Practice (GMP)-compliant, human bone marrow mesenchymal stem cells (rapidly expanding clones; RECs), and the UPAL gel increasingly enhanced IVD regeneration in animal models. This study investigated the therapeutic efficacy of injecting a mixture of REC and UPAL non-gelling solution for discogenic pain and IVD regeneration in a rat caudal nucleus pulposus punch model. REC and UPAL mixture and UPAL alone suppressed not only the expression of TNF-α, IL-6, and TrkA (p < 0.01, respectively), but also IVD degeneration and nociceptive behavior compared to punching alone (p < 0.01, respectively). Furthermore, REC and UPAL mixture suppressed these expression levels and nociceptive behavior compared to UPAL alone (p < 0.01, respectively). These results suggest that this minimally invasive treatment strategy with a single injection may be applied to treat discogenic pain and as a regenerative therapy.
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Affiliation(s)
- Hisataka Suzuki
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Japan
| | - Katsuro Ura
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Japan
| | - Daisuke Ukeba
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Japan
| | - Takashi Suyama
- PuREC/Bio-Venture, Shimane University, Izumo 693-8501, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Japan
| | - Masatoki Watanabe
- Japan Tissue Engineering Co., Ltd. (J-TEC), Gamagori 443-0022, Japan
| | - Yumi Matsuzaki
- PuREC/Bio-Venture, Shimane University, Izumo 693-8501, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Japan
- Correspondence: (K.Y.); (H.S.)
| | - Hideki Sudo
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Japan
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo 060-8638, Japan
- Correspondence: (K.Y.); (H.S.)
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Yamada K, Iwata K, Yoshimura Y, Ota H, Oki Y, Mitani Y, Oki Y, Yamada Y, Yamamoto A, Ono K, Honda A, Kitai T, Tachikawa R, Kohara N, Tomii K, Ishikawa A. Predicting the Readmission and Mortality in Older Patients Hospitalized with Pneumonia with Preadmission Frailty. J Frailty Aging 2023; 12:208-213. [PMID: 37493381 DOI: 10.14283/jfa.2022.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
BACKGROUND In older people, frailty has been recognized as an important prognostic factor. However, only a few studies have focused on multidimensional frailty as a predictor of mortality and readmission among inpatients with pneumonia. OBJECTIVE The present study aimed to assess the association between preadmission frailty and clinical outcomes after the hospitalization of older patients with pneumonia. DESIGN Single-center, retrospective case-control study. SETTING Acute phase hospital at Kobe, Japan. PARTICIPANTS The present study included 654 consecutive older inpatients with pneumonia. MEASUREMENTS Frailty status before admission was assessed using total Kihon Checklist (KCL) score, which has been used as a self-administered questionnaire to assess comprehensive frailty, including physical, social, and cognitive status. The primary outcome was a composited 6-month mortality and readmission after discharge. RESULTS In total, 330 patients were analyzed (median age: 79 years, male: 70.4%, median total KCL score: 10 points), of which 68 were readmitted and 10 died within 6 months. After multivariate analysis, total KCL score was associated with a composited 6-month mortality and readmission (adjusted hazard ratio, 1.07; 95% confidence interval, 1.02-1.12; p = 0.006). The cutoff value for total KCL score determined by receiver operating characteristic curve analysis was 15 points (area under the curve = 0.610). The group with a total KCL score ≥ 15 points had significantly higher readmission or mortality rates than the groups with a total KCL score < 15 points (p < 0.001). CONCLUSIONS Preadmission frailty status in older patients with pneumonia was an independent risk factor for readmission and survival after hospitalization.
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Affiliation(s)
- K Yamada
- Kentaro Iwata, PT, MSc, Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminami, Chuo, Kobe 650-0047 Hyogo, Japan. Tel.: +81 78 302,
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18
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Endo T, Takahata M, Fujita R, Koike Y, Suzuki R, Hasegawa Y, Murakami T, Ishii M, Yamada K, Sudo H, Iwasaki N. Strong relationship between dyslipidemia and the ectopic ossification of the spinal ligaments. Sci Rep 2022; 12:22617. [PMID: 36585473 PMCID: PMC9803662 DOI: 10.1038/s41598-022-27136-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Obesity and metabolic disturbances are prevalent in ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF); however, the involvement of dyslipidemia (DL) in OPLL/OLF remains uncertain. We investigated the association between dyslipidemia and OPLL/OLF using a dataset of 458 individuals receiving health screening tests, including computed tomography. Subjects were grouped according to the presence or location of OPLL/OLF: controls (no OPLL/OLF, n = 230), OLF (n = 167), cervical OPLL (n = 28), and thoracic OPLL (n = 33). They were also grouped according to the presence of dyslipidemia (DL[+], n = 215; DL[-], n = 243). The proportion of dyslipidemia in the OLF and OPLL groups was 1.6-2.2 times higher than that in the control group. The proportion of OLF and OPLL in the DL(+) group was significantly higher than that in the DL(-) group (OLF, 43% vs. 29%; cervical OPLL, 14.4% vs. 3.2%; thoracic OPLL, 11.1% vs. 3.7%). Multivariate logistic regression analysis showed an association between all ossification types and dyslipidemia. This study demonstrated an association of dyslipidemia with OPLL/OLF; further investigation on the causal relationship between dyslipidemia and ectopic spinal ligament ossification is warranted to develop a therapeutic intervention for OPLL/OLF.
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Affiliation(s)
- Tsutomu Endo
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan ,grid.413530.00000 0004 0640 759XDepartment of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido 040-8585 Japan
| | - Masahiko Takahata
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
| | - Ryo Fujita
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
| | - Yoshinao Koike
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
| | - Ryota Suzuki
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
| | - Yuichi Hasegawa
- grid.413530.00000 0004 0640 759XDepartment of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido 040-8585 Japan
| | - Toshifumi Murakami
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
| | - Misaki Ishii
- grid.413530.00000 0004 0640 759XDepartment of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido 040-8585 Japan
| | - Katsuhisa Yamada
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
| | - Hideki Sudo
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
| | - Norimasa Iwasaki
- grid.39158.360000 0001 2173 7691Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638 Japan
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Osuka S, Sudo H, Yamada K, Tachi H, Watanabe K, Sentoku F, Chiba T, Iwasaki N, Mukaino M, Tohyama H. Effects of Posterior Spinal Correction and Fusion on Postural Stability in Patients with Adolescent Idiopathic Scoliosis. J Clin Med 2022; 12:jcm12010270. [PMID: 36615069 PMCID: PMC9821153 DOI: 10.3390/jcm12010270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
The present study aimed to assess the effects of posterior spinal correction and fusion on postural stability in patients with adolescent idiopathic scoliosis (AIS). The study included 41 female patients with AIS at our institution. All patients performed three 10 s single-leg standing trials on a force plate. The center of pressure (COP) was measured preoperatively, and at 1 week and 6 months postoperatively. The postural stability parameters were absolute minimum time-to-boundary (TTB), mean of the minimum TTB, mean COP velocity, standard deviation, range, and 95% confidence ellipse area. One-way repeated analysis of variance or Friedman test was applied to the postural stability parameters. Multiple comparisons were performed using the Bonferroni correction. The absolute minimum TTB and the mean minimum TTB showed a significant increase 6 months post-operation as compared to preoperatively and 1 week postoperatively. The COP velocity significantly decreased at 6 months post-operation compared to preoperatively and 1 week postoperatively. These changes in postural stability indicate that spinal correction and fusion can be considered to improve postural stability during single-leg standing tests in the postoperative period.
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Affiliation(s)
- Satoshi Osuka
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Hokkaido, Japan
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
- Correspondence:
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Hiroyuki Tachi
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
- Department of Orthopaedic Surgery, Eniwa Hospital, Eniwa 061-1449, Hokkaido, Japan
| | - Kentaro Watanabe
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Fuma Sentoku
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Takeshi Chiba
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
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Kawamoto T, Saito T, Kosugi T, Nakamura N, Wada H, Tonari A, Ogawa H, Mitsuhashi N, Yamada K, Takahashi T, Ito K, Sekii S, Araki N, Nozaki M, Heianna J, Murotani K, Hirano Y, Satoh A, Onoe T, Shikama N. Temporal Profiles of Symptom Scores After Palliative Radiotherapy for Bleeding Gastric Cancer With Adjustment for the Palliative Prognostic Index: An Exploratory Analysis of a Multicentre Prospective Observational Study (JROSG 17-3). Clin Oncol (R Coll Radiol) 2022; 34:e505-e514. [PMID: 35654667 DOI: 10.1016/j.clon.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/12/2022] [Accepted: 05/12/2022] [Indexed: 01/31/2023]
Abstract
AIMS Although palliative radiotherapy for gastric cancer may improve some symptoms, it may also have a negative impact due to its toxicity. We investigated whether symptoms improved after radiotherapy with adjustment for the Palliative Prognostic Index (PPI) considering that patients with limited survival tend to experience deterioration of symptoms. MATERIALS AND METHODS This study was an exploratory analysis of the Japanese Radiation Oncology Study Group study (JROSG 17-3). We assessed six symptom scores (nausea, anorexia, fatigue, shortness of breath, pain at the irradiated area and distress) at registration and 2, 4 and 8 weeks thereafter. We tested whether symptoms linearly improved after adjusting for the baseline PPI. Shared parameter models were used to adjust for potential bias in missing data. RESULTS The present study analysed all 55 patients enrolled in JROSG 17-3. With time from registration as the only explanatory variable in the model, a significant linear decrease was observed in shortness of breath, pain and distress (slopes, -0.26, -0.22 and -0.19, respectively). Given that the interaction terms (i.e. PPI × time) were not significantly associated with symptom scores in any of the six symptoms, only PPI was included as the main effect in the final multivariable models. After adjusting for the PPI, shortness of breath, pain and distress significantly improved (slope, -0.25, -0.19 and -0.17; P < 0.001, 0.002 and 0.047, respectively). An improvement in fatigue and distress was observed only in patients treated with a biologically effective dose ≤14.4 Gy. CONCLUSION Shortness of breath, pain and distress improved after radiotherapy. Moreover, a higher PPI was significantly associated with higher symptom scores at all time points, including baseline. In contrast, PPI did not seem to influence the improvement of these symptoms. Regardless of the expected survival, patients receiving radiotherapy for gastric cancer can expect an improvement in shortness of breath, pain and distress over 8 weeks. Multiple-fraction radiotherapy might hamper the improvement in fatigue and distress by its toxicity or treatment burden.
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Affiliation(s)
- T Kawamoto
- Division of Radiation Oncology, Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.
| | - T Saito
- Department of Radiation Oncology, Arao Municipal Hospital, Kumamoto, Japan
| | - T Kosugi
- Department of Radiation Oncology, Fujieda Municipal General Hospital, Shizuoka, Japan
| | - N Nakamura
- Department of Radiology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - H Wada
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Fukushima, Japan
| | - A Tonari
- Department of Radiation Oncology, Kyorin University Hospital, Tokyo, Japan
| | - H Ogawa
- Division of Radiation Therapy, Shizuoka Cancer Center, Shizuoka, Japan
| | - N Mitsuhashi
- Radiation Therapy Center, Hitachi Ltd, Hitachinaka General Hospital, Ibaraki, Japan
| | - K Yamada
- Department of Radiation Oncology, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - T Takahashi
- Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - K Ito
- Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - S Sekii
- Department of Radiation Oncology, Kita-Harima Medical Center, Hyogo, Japan
| | - N Araki
- Department of Radiation Oncology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Nozaki
- Department of Radiology, Saitama Medical Center, Dokkyo Medical University, Saitama, Japan
| | - J Heianna
- Department of Radiology, Nanbu Tokushukai Hospital, Okinawa, Japan
| | - K Murotani
- Biostatistics Center, Kurume University, Fukuoka, Japan
| | - Y Hirano
- Department of Radiology, Saitama Medical Center, Dokkyo Medical University, Saitama, Japan
| | - A Satoh
- Department of Surgery, Southern Tohoku General Hospital, Fukushima, Japan
| | - T Onoe
- Division of Radiation Therapy, Shizuoka Cancer Center, Shizuoka, Japan
| | - N Shikama
- Division of Radiation Oncology, Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
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21
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Kawamoto T, Saito T, Kosugi T, Nakamura N, Wada H, Tonari A, Ogawa H, Mitsuhashi N, Yamada K, Takahashi T, Ito K, Sekii S, Araki N, Nozaki M, Heianna J, Murotani K, Hirano Y, Satoh A, Onoe T, Shikama N. Temporal Profiles of Symptom Scores after Palliative Radiotherapy for Bleeding Gastric Cancer with the Adjustment for the Palliative Prognostic Index: An Exploratory Analysis of a Multicenter Prospective Observational Study (JROSG 17-3). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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22
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Takahata M, Endo T, Koike Y, Abumi K, Suda K, Fujita R, Murakami T, Sudo H, Yamada K, Ohnishi T, Ura K, Ukeba D, Iwasaki N. Long-Term Clinical Course of Patients After Decompression and Posterior Instrumented Fusion Surgery for Thoracic Ossification of the Posterior Longitudinal Ligament: An Average Follow-Up of 18 years. Global Spine J 2022:21925682221135548. [PMID: 36250487 DOI: 10.1177/21925682221135548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective observational study. OBJECTIVES To evaluate the long-term recurrence rates and functional status of patients with thoracic ossification of the posterior longitudinal ligament (OPLL) after decompression and posterior fusion surgery. METHODS Thirty-seven consecutive patients who underwent posterior thoracic spine surgery at a single institution were retrospectively reviewed. The long-term neurological and functional outcomes of 25 patients who were followed up for ≥10 years after surgery were assessed. Factors associated with the recurrence of myelopathy were also analyzed. RESULTS The mean preoperative Japanese Orthopaedic Association score was 3.7, which improved to 6.5 at postoperative year 2 and declined to 6.0 at a mean follow-up of 18 years. No patient experienced a relapse of myelopathy due to OPLL within the instrumented spinal segments. However, 15 (60%) patients experienced late neurological deterioration, 10 of whom had a relapse of myelopathy due to OPLL or ossification of the ligamentum flavum (OLF) in the region outside the primary operative lesion, while 4 developed myelopathy due to traumatic vertebral fracture of the ankylosed spine. Young age, a high body mass index, and lumbar OPLL are likely associated with late neurological deterioration. CONCLUSIONS Decompression and posterior instrumented fusion surgery is a reliable surgical procedure with stable long-term clinical outcomes for thoracic OPLL. However, as OPLL may progress through the spine, attention should be paid to the recurrence of paralysis due to OPLL or OLF in regions other than the primary operative lesion and vertebral fractures of the ankylosed spine after surgery for thoracic OPLL.
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Affiliation(s)
- Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Yoshinao Koike
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Kuniyoshi Abumi
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Kota Suda
- Department of Orthopedic Surgery, Hokkaido Spinal Cord Injury Center, Japan
| | - Ryo Fujita
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Toshifumi Murakami
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Katsuro Ura
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Daisuke Ukeba
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Japan
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Fujita R, Endo T, Takahata M, Haraya K, Suzuki H, Oda I, Kanayama M, Asano T, Shigenobu K, Iwata A, Yamada K, Takeuchi H, Ohura H, Yoneoka D, Iwasaki N. Real-world persistence of twice-weekly teriparatide and factors associated with the discontinuation in patients with osteoporosis. J Bone Miner Metab 2022; 40:782-789. [PMID: 35759143 PMCID: PMC9244578 DOI: 10.1007/s00774-022-01347-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION A 28.2 μg twice-weekly formulation of teriparatide (2/W-TPD) was developed to provide comparably high efficacy for osteoporosis to a 56.5 μg once-weekly formulation while improving the safety and persistence rate. In the current study, we aimed to elucidate the real-world persistence of 2/W-TPD and to identify the factors associated with the discontinuation of 2/W-TPD in patients with severe osteoporosis. MATERIALS AND METHODS This retrospective study included 90 patients who were treated with 2/W-TPD at three hospitals in Japan. Patient information was collected, including age, sex, distance to the hospital, family structure, comorbidities, previous treatment for osteoporosis, timing of the injection, side effects and duration of 2/W-TPD treatment, barthel index (BI), and bone mineral density (BMD) of the lumbar spine and femoral neck. We examined the factors influencing 2/W-TPD discontinuation using the Cox proportional hazards model. RESULTS The 12 month completion rate of 2/W-TPD therapy was 47.5%. The Cox hazard analysis identified side effects [Hazard Ratio (HR) = 14.59, P < 0.001], low BMD of the femoral neck (HR = 0.04, P = 0.002), and morning injection (HR = 3.29, P = 0.006) as risk factors influencing the discontinuation of 2/W-TPD. Other variables, including age, did not contribute to the continuation of 2/W-TPD. CONCLUSION One year continuation rate of 2/W-TPD was higher than the previously reported value of the once-weekly formulation in real-world setting, probably due to the lower incidence of side effects. Introducing injection of 2/W-TPD may further improve the persistence of TPD therapy for osteoporosis.
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Affiliation(s)
- Ryo Fujita
- Hokkaido Orthopedic Memorial Hospital, Sapporo, Hokkaido, Japan
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan
| | - Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan.
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan
| | | | - Hisataka Suzuki
- Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Itaru Oda
- Hokkaido Orthopedic Memorial Hospital, Sapporo, Hokkaido, Japan
| | | | | | | | - Akira Iwata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan
| | | | - Hisanori Ohura
- Hokkaido Orthopedic Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Daisuke Yoneoka
- Division of Biostatistics and Bioinformatics, Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan
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Imoto W, Yamada K, Kakeya H. Long COVID with intracranial microangiopathy. QJM 2022; 115:539. [PMID: 35703982 DOI: 10.1093/qjmed/hcac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - H Kakeya
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, Osaka 545-8586, Japan
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, Osaka 545-8586, Japan
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Ishihama Y, Fukumoto K, Watanabe R, Nakatani S, Tsuda A, Otoshi T, Yamada K, Yamada S, Negoro N, Emoto M, Hashimoto M. Retroperitoneal fibrosis requiring prompt nephrostomy in a case with immunoglobulin A vasculitis. Scand J Rheumatol 2022; 51:419-421. [PMID: 35658823 DOI: 10.1080/03009742.2022.2047312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Y Ishihama
- Department of Clinical Immunology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Fukumoto
- Department of Clinical Immunology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - R Watanabe
- Department of Clinical Immunology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Nakatani
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Tsuda
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Otoshi
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Yamada
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Yamada
- Department of Clinical Immunology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - N Negoro
- Department of Clinical Immunology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Emoto
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Hashimoto
- Department of Clinical Immunology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Tsuge S, Fujii H, Tamai M, Mizushima I, Yoshida M, Suzuki N, Takahashi Y, Takeji A, Horita S, Fujisawa Y, Matsunaga T, Zoshima T, Nishioka R, Nuka H, Hara S, Tani Y, Suzuki Y, Ito K, Yamada K, Nakazaki S, Kawakami A, Kawano M. POS1339 FACTORS RELATED TO SERUM IgG4 ELEVATION AND DEVELOPMENT OF IgG4-RELATED DISEASE: DATA FROM RESIDENT EXAMINATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundElevated serum IgG4 levels are one of the characteristic findings in immunoglobulin G4 (IgG4)-related disease (IgG4-RD). Serum IgG4 levels have an impact to a certain extent on the diagnosis of IgG4-RD although there are some issues in their sensitivity and specificity. In the reports from Japan, China, USA, and Europe, elevated serum IgG4 levels were reported to be observed in 83-97% of patients with IgG4-RD [1-5]. In the past investigations of hospital patients, some studies reported that 10-15% of hospital patients with elevated serum IgG4 levels had IgG4-RD [6,7]. However, in general adults with no symptom, investigations of prevalence of elevated serum IgG4 levels and/or IgG4-RD have rarely been conducted.ObjectivesThis study aimed to investigate the frequency of serum IgG4 elevation in the general Japanese population and its associated factors using data from resident examinations.MethodsWe measured the serum IgG4 levels in 1,204 residents who underwent a general medical examination in Ishikawa prefecture, Japan. Logistic regression analysis was used to search for factors related to elevated serum IgG4 levels. Secondary examinations were conducted for participants in whom elevation was identified.ResultsThe mean serum IgG4 level was 44 mg/dL, and elevated serum IgG4 levels were observed in 42 patients (3.5%). Univariate logistic regression analyses showed that male sex, older age, lower estimated glomerular filtration rates based on cystatin C (eGFR-CysC), serum high-density lipoprotein cholesterol levels, and higher hemoglobin A1c (HbA1c) levels were associated with elevated serum IgG4 levels. Subgroup analyses in men showed that older age, lower eGFR-CysC levels, and higher serum HbA1c levels were associated with elevated serum IgG4 levels. In contrast, the analyses in women found no significant factors. One of the 10 residents who underwent secondary examinations was diagnosed with possible IgG4-related retroperitoneal fibrosis.ConclusionIn the general population, elevated serum IgG4 levels are more common in elderly men, which is similar to the epidemiological features of IgG4-RD.References[1]Inoue D, et al. IgG4-related disease: dataset of 235 consecutive patients. Medicine (Baltimore). 2015;94(15):e680.[2]Yamada K, et al. New clues to the nature of immunoglobulin G4-related disease: a retrospective Japanese multicenter study of baseline clinical features of 334 cases. Arthritis Res Ther. 2017;19(1):262[3]Culver EL, et al. Elevated serum IgG4 levels in diagnosis, treatment response, organ involvement, and relapse in a prospective IgG4-related disease UK cohort. Am J Gastroenterol 2016;111:733–43.[4]Lin W, et al. Clinical characteristics of immunoglobulin G4-related disease: a prospective study of 118 Chinese patients. Rheumatology (Oxford). 2015;54(11):1982–90.[5]Carruthers MN, et al. The diagnostic utility of serum IgG4 concentrations in IgG4-related disease. Ann Rheum Dis 2015;74:14-18.[6]James Yun, et al. Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease. Asia Pac Allergy. 2014 Jul;4(3):172-176.[7]Taiwo N Ngwa, et al. Sreum immunoglobulin G4 level is a poor predictor of immunoglobulin G4–related disease. Pancreas. 2014 Jul;43(5):704-7.Disclosure of InterestsNone declared
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Yamada K, Sakai T, Mizushima I, Hoshiba R, Suzuki F, Mizutomi K, Kawano M, Masaki Y. POS0615 CLINICAL DEMOGRAPHICS AND FACTORS AFFECTING DRYNESS IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSjogren’s syndrome (SS) is known to coexist with rheumatoid arthritis (RA). However, the prevalence of RA with SS varies widely, from 2.4% to 30%, and some patients with RA without SS also show dryness. The prevalence and clinical demographics of dryness in patients with RA are not well recognized.ObjectivesThe aim of this study was to clarify the prevalence, clinical demographics, and related factors of dryness in patients with RA who have not been diagnosed with (SS).MethodsWe enrolled 166 patients with RA (129 females, 37 males; mean age 65.8±14.3 years; disease duration 14.1±10.9 years; DAS28-CRP 2.30±0.92) who were not diagnosed with SS. We analyzed CRP, the estimated glomerular filtration rate (eGFR), RF, anti-CCP antibody, antinuclear antibody, anti-SS-A antibody (SSA), and disease activity score (DAS) 28-CRP, and identified treatments for RA. We used each question item of the EULAR SS Patient Reported Index (ESSPRI) to clarify dryness, somatic and mental fatigue, and pain. History of smoking, comorbidities, such as interstitial pneumonia, fibromyalgia, and psychiatric disorders, and narcotic and/or psychotropic medication use were determined from the medical records. We defined patients with dryness as greater than or equal to one point, and those with severe dryness as greater than or equal to five points, of the visual analog scale (VAS).ResultsDryness was observed in 93/166 (56.0%) patients and severe dryness was identified in 57/166 (34.4%) patients, and SSA was positive in 23/139 patients(13.9%). We divided our patients into dryness and non-dryness groups and compared their clinical demographics. The dryness group was relatively younger (64.0±14.5 vs. 68.1±13.8 years, p=0.052), had a female predominance (89.2% vs. 63.0%, p<0.001), had severe fatigue (4.06±2.59 vs 2.60±2.78, p<0.001), and had severe pain (3.52±2.41 vs. 2.73±2.32, p=0.020). However, the prevalence of SSA did not significantly differ in this cohort, compared with the non-dryness group (19.3% vs. 11.8%, p=0.248). Next, we analyzed the clinical characteristics of the patients with severe dryness. The severe dryness group was younger (61.9±15.5 vs. 67.9±13.2 years, p=0.022), had higher eGFR (76.1±15.5 vs. 68.9±22.7, p=0.020), had more severe fatigue (4.89±2.42 vs. 2.85±2.63), p<0.001), and had more severe pain (4.16±2.51 vs. 2.65±2.18, p<0.001), compared with non-severe dryness group. The prevalence of SSA was also significantly higher in the severe dryness group (91.2% vs. 70.6%, p=0.002). We then performed a multifactorial analysis using logistic regression analysis with a stepwise method. Female sex (OR 3.739, 1.247-11.207) and VAS of fatigue (OR 1.269, 1.054-1.526) were found to independently relate to dryness.ConclusionMore than half of the patients with RA had dryness, although only 13.9% of patients were SSA positive. Dryness was related to female predominance and fatigue. Simon et al. reported that SS was found in 2.42% of patients with RA (1). On the other hand, Harrold et al. reported that SS was found in 30% of patients with RA, and the prevalence of SS increased with duration of RA (2). Our data indicate that patients with fatigue, regardless of pain, tend to have dryness, which may be a key factor in diagnosing SS in patients with RA.References[1]Simon TA, Kawabata H, Ray N, et.al. Prevalence of Co-existing Autoimmune Disease in Rheumatoid Arthritis: A Cross-Sectional Study. Adv Ther. 2017 Nov;34(11):2481-2490.[2]Harrold LR, Shan Y, Rebello S, et al. Prevalence of Sjögren’s syndrome associated with rheumatoid arthritis in the USA: an observational study from the Corrona registry. Clin Rheumatol. 2020 Jun;39(6):1899-1905.Disclosure of InterestsNone declared
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Li N, Ferracane J, Lewis S, Andeen N, Woltjer R, Farsad K, Kaufman J, Rugonyi S, Jahangiri Y, Uchida B, Gabr A, Li J, Yamada K, Al-Hakim R. Abstract No. 299 Impact of post-thrombotic vein wall biomechanics on luminal flow during venous angioplasty and stent placement: computational modeling results. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hisada Y, Endo T, Koike Y, Kanayama M, Suzuki R, Fujita R, Yamada K, Iwata A, Hasebe H, Sudo H, Iwasaki N, Takahata M. Distinct progression pattern of ossification of the posterior longitudinal ligament of the thoracic spine versus the cervical spine: a longitudinal whole-spine CT study. J Neurosurg Spine 2022; 37:1-8. [PMID: 35245901 DOI: 10.3171/2022.1.spine211010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/13/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Data regarding risk factors for the progression of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine are scarce. Therefore, in this study, the authors aimed to elucidate the difference in the radiographic progression pattern of OPLL and its risk factors between cervical and thoracic OPLL using longitudinally acquired whole-spine CT scans. METHODS Overall, 123 patients with symptomatic OPLL who underwent repeated whole-spine CT examinations, with an average interval of 49 months (at least 3 years) between scans, were retrospectively reviewed. Progression of OPLL was assessed to compare the distribution of OPLL over the entire spine on the initial and final CT scans. Patients were divided into a cervical OPLL (C-OPLL) group and a thoracic OPLL (T-OPLL) group according to the location of the main lesion. The progression pattern of OPLL and its risk factors were compared between the two groups using the Student t-test or Mann-Whitney U-test. RESULTS In the C-OPLL group, 15 (22.1%) of 68 patients had OPLL progression, of whom 12 patients (80.0%) had progression only in the cervical spine and 3 patients (20.0%) had progression in multiple regions (cervical and thoracic/lumbar). In the T-OPLL group, 16 (29.1%) of 55 patients had OPLL progression, of which 3 patients (18.8%) had progression only in the thoracic spine and 8 patients (50.0%) had progression in multiple regions. Young age was a common risk factor for OPLL progression regardless of the location of OPLL, and this trend was more pronounced in the T-OPLL group than in the C-OPLL group. High BMI, male sex, and multilevel, severe T-OPLL were identified as independent risk factors for progression of T-OPLL (OR 1.19, 95% CI 1.03-1.37; OR 10.5, 95% CI 1.39-81.94; and OR 1.24, 95% CI 1.16-1.45, respectively). CONCLUSIONS Patients with T-OPLL are predisposed to diffuse progression of OPLL over the entire spine, whereas patients with C-OPLL are likely to have progression in only the cervical spine. Young age and high BMI are significant risk factors for OPLL progression, especially in patients with T-OPLL. Our study highlights the need for continued follow-up in patients with T-OPLL, especially in young patients and those with obesity, for early detection of spinal cord and cauda equina symptoms due to the progression of OPLL throughout the spine.
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Affiliation(s)
- Yuichiro Hisada
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Tsutomu Endo
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Yoshinao Koike
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Masahiro Kanayama
- 2Department of Orthopedics, Hakodate Central General Hospital, Hokkaido, Japan
| | - Ryota Suzuki
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Ryo Fujita
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Katsuhisa Yamada
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Akira Iwata
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Hiroyuki Hasebe
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Hideki Sudo
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Norimasa Iwasaki
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
| | - Masahiko Takahata
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido; and
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Endo T, Takahata M, Koike Y, Fujita R, Suzuki R, Hisada Y, Hasegawa Y, Suzuki H, Yamada K, Iwata A, Sudo H, Yoneoka D, Iwasaki N. Association between obesity and ossification of spinal ligaments in 622 asymptomatic subjects: a cross-sectional study. J Bone Miner Metab 2022; 40:337-347. [PMID: 35034211 DOI: 10.1007/s00774-021-01292-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Previous studies on patients with symptoms of spinal ligament ossification, including ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF), have not clarified whether obesity is a cause or consequence of these diseases and were limited by selection bias. Thus, we investigated the association between obesity and the prevalence of spinal ligament ossification in randomly selected asymptomatic subjects. MATERIALS AND METHODS Between April 2020 and March 2021, 622 asymptomatic Japanese subjects who underwent computed tomography of neck to pelvis for medical check-up purposes were included. All subjects were divided into the following three groups: normal weight (body mass index [BMI] < 25 kg/m2), obese I (25 ≤ BMI < 30 kg/m2), and obese II (BMI ≥ 30 kg/m2). The relationship between factors affecting the presence of each spinal ligament ossification was evaluated using multivariate logistic regression analysis. RESULTS The proportion of subjects with thoracic OPLL was significantly higher in the obese II group than in the other two groups (vs. normal weight, P < 0.001; vs. obese I, P < 0.001). BMI was associated with the prevalence of OLF, cervical OPLL, thoracic OPLL, and ossification of the anterior longitudinal ligament (OALL). BMI was most significantly associated with the prevalence of thoracic OPLL (β, 0.28; 95% confidence interval, 0.17-0.39). CONCLUSION BMI was associated with the prevalence of OALL, cervical OPLL, thoracic OPLL, and OLF in asymptomatic subjects, suggesting that obesity is associated with the development of heterotopic ossification of the spinal ligaments.
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Affiliation(s)
- Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan.
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yoshinao Koike
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Ryo Fujita
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Ryota Suzuki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yuichiro Hisada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yuichi Hasegawa
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Hisataka Suzuki
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Akira Iwata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hideki Sudo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Daisuke Yoneoka
- Division of Biostatistics and Bioinformatics, Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
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Suzuki T, Kawano Y, Matsumoto A, Kondo M, Funayama K, Tanemura S, Miyashiro M, Nishi A, Yamada K, Tsuda M, Sato A, Morokuma K, Yamamoto Y. Melanogenic effect of dersimelagon (MT-7117), a novel oral melanocortin 1 receptor agonist. Skin Health Dis 2022; 2:e78. [PMID: 35665216 PMCID: PMC9060023 DOI: 10.1002/ski2.78] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 12/12/2022]
Abstract
Background The activation of melanocortin 1 receptor (MC1R) on melanocytes stimulates the production of eumelanin. A tridecapeptide α melanocyte‐stimulating hormone (αMSH) is known to induce skin pigmentation. Objectives We characterised the properties of a novel oral MC1R agonist dersimelagon (MT‐7117) with respect to its specific binding to MC1R, downstream signalling and eumelanin production in experimental models. Methods The competitive binding and production of intracellular cyclic adenosine 3′, 5′‐monophosphate in cells expressing recombinant melanocortin receptors were examined. A mouse melanoma cell line B16F1 was used for the evaluation of in vitro melanin production. The in vitro activity of MT‐7117 was determined with αMSH and [Nle4, D‐Phe7]‐αMSH (NDP‐αMSH) as reference comparators. The change of coat colour and skin pigmentation were evaluated after repeat administration of MT‐7117 by oral gavage to C57BL/6J‐Ay/+ mice and cynomolgus monkeys, respectively. Results MT‐7117 showed the highest affinity for human MC1R compared to the other melanocortin receptors evaluated and agonistic activity for human, cynomolgus monkey and mouse MC1R, with EC50 values in the nanomolar range. In B16F1 cells, MT‐7117 increased melanin production in a concentration‐dependent manner. In vivo, MT‐7117 (≥0.3 mg/kg/day p.o.) significantly induced coat colour darkening in mice. MT‐7117 (≥1 mg/kg/day p.o.) induced significant skin pigmentation in monkeys and complete reversibility was observed after cessation of its administration. Conclusions MT‐7117 is a novel oral MC1R agonist that induces melanogenesis in vitro and in vivo, suggesting its potential application for the prevention of phototoxic reactions in patients with photodermatoses, such as erythropoietic protoporphyria and X‐linked protoporphyria.
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Affiliation(s)
- T Suzuki
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - Y Kawano
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - A Matsumoto
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - M Kondo
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - K Funayama
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - S Tanemura
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - M Miyashiro
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - A Nishi
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - K Yamada
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - M Tsuda
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - A Sato
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - K Morokuma
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
| | - Y Yamamoto
- Sohyaku Innovative Research Division Mitsubishi Tanabe Pharma Corporation Yokohama Japan
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Yamada K, Iwasaki N, Sudo H. Biomaterials and Cell-Based Regenerative Therapies for Intervertebral Disc Degeneration with a Focus on Biological and Biomechanical Functional Repair: Targeting Treatments for Disc Herniation. Cells 2022; 11:cells11040602. [PMID: 35203253 PMCID: PMC8870062 DOI: 10.3390/cells11040602] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/22/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
Intervertebral disc (IVD) degeneration is a common cause of low back pain and most spinal disorders. As IVD degeneration is a major obstacle to the healthy life of so many individuals, it is a major issue that needs to be overcome. Currently, there is no clinical treatment for the regeneration of degenerated IVDs. However, recent advances in regenerative medicine and tissue engineering suggest the potential of cell-based and/or biomaterial-based IVD regeneration therapies. These treatments may be indicated for patients with IVDs in the intermediate degenerative stage, a point where the number of viable cells decreases, and the structural integrity of the disc begins to collapse. However, there are many biological, biomechanical, and clinical challenges that must be overcome before the clinical application of these IVD regeneration therapies can be realized. This review summarizes the basic research and clinical trials literature on cell-based and biomaterial-based IVD regenerative therapies and outlines the important role of these strategies in regenerative treatment for IVD degenerative diseases, especially disc herniation.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
- Correspondence:
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Diao X, Yamada K, Shibata Y, Imada C. Metabolites Produced by a New Lactiplantibacillus plantarum Strain BF1-13 Isolated from Deep Seawater of Izu-Akazawa Protect the Intestinal Epithelial Barrier from the Dysfunction Induced by Hydrogen Peroxide. Mar Drugs 2022; 20:md20020087. [PMID: 35200617 PMCID: PMC8878880 DOI: 10.3390/md20020087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the protective effect of the metabolites produced by a new Lactiplantibacillus plantarum strain BF1-13, isolated from deep seawater (DSW), on the intestinal epithelial barrier against the dysfunction induced by hydrogen peroxide (H2O2) and to elucidate the mechanism underlying the effect. Protective effect of the metabolites by strain BF1-13 on the barrier function of the intestinal epithelial model treated with H2O2 was investigated by the transepithelial electrical resistance (TEER). The metabolites enhanced the Claudin-4 (CLDN-4) expression, including at the transcription level, indicated by immunofluorescence staining and quantitative RT-PCR. The metabolites also showed a suppression of aquaporin3 (AQP3) expression. Lactic acid (LA) produced by this strain of homofermentative lactic acid bacteria (LAB) had a similar enhancement on CLDN-4 expression. The metabolites of L. plantarum strain BF1-13 alleviated the dysfunction of intestinal epithelial barrier owing to its enhancement on the tight junctions (TJs) by LA, along with its suppression on AQP3-facilitating H2O2 intracellular invasion into Caco-2 cells. This is the first report on the enhancement of TJs by LA produced by LAB.
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Affiliation(s)
- Xiaozhen Diao
- Applied Microbiology Lab, Course of Applied Marine Biosciences, Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, Tokyo 108-8477, Japan; (K.Y.); (C.I.)
- Correspondence:
| | - Katsuhisa Yamada
- Applied Microbiology Lab, Course of Applied Marine Biosciences, Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, Tokyo 108-8477, Japan; (K.Y.); (C.I.)
- DSW Laboratory of DHC Co., Ltd., Tokyo 106-0047, Japan;
| | - Yuji Shibata
- DSW Laboratory of DHC Co., Ltd., Tokyo 106-0047, Japan;
| | - Chiaki Imada
- Applied Microbiology Lab, Course of Applied Marine Biosciences, Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, Tokyo 108-8477, Japan; (K.Y.); (C.I.)
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Yamada K, Takahata M, Ito M, Nagahama K, Iwata A, Endo T, Sudo H, Ishiguro N, Iwasaki N. Risk factors of multidrug-resistant pyogenic spondylitis in thoraco-lumbar spine: A retrospective study of 122 cases. J Orthop Sci 2022; 27:95-100. [PMID: 33419628 DOI: 10.1016/j.jos.2020.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/13/2020] [Accepted: 11/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The number of spinal infections has been increasing in developed countries due to the increase of aged or immunosuppressed patients. Spondylitis caused by multidrug-resistant (MDR) bacterial infection often become intractable and require long-term antibiotic therapy and multiple surgeries. Therefore, it is of great importance to understand risk factors for MDR spinal infections. The aim of this study was to elucidate the risk factors for MDR bacterial spondylitis. METHODS A total of 122 patients (82 men, 40 women; average age: 63.8 y) with thoracic/lumbar spondylitis who underwent posterolateral full-endoscopic debridement and irrigation were included. The organisms detected by this endoscopic procedure were investigated, and the incidence and risk factors for MDR bacterial infection were retrospectively analyzed. RESULTS Cultures of specimens obtained by endoscopic procedures were positive in 78 patients (63.9%). Among 68 isolated bacteria, MDR bacteria accounted for 47.1%. Multivariate analysis showed that significant risk factors for MDR bacterial infection included autoimmune connective tissue disease (P = 0.03) and central venous catheter (P = 0.02). The incidence of MDR bacteria in patients who were administered a broad-spectrum antibiotic for more than 1 month preoperatively was 64.0%, which was significantly higher than in patients who were administered a broad-spectrum antibiotic for less than 1 month and patients who were administered a narrow-spectrum antibiotic (P < 0.01, P < 0.01, respectively). CONCLUSIONS The significant risk factors for MDR bacterial spondylitis included immunosuppressed conditions, such as autoimmune connective tissue disease, presence of central venous catheter, and longer administration periods of a broad-spectrum antibiotic. In patients with pyogenic spondylitis who could not be controlled with previous antibiotics and whose result of culture was negative, administration of anti-MRSA antibiotics would be considered when they have the risk factors identified in this study.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan.
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
| | - Manabu Ito
- Department of Spine and Spinal Cord Disorders, National Hospital Organization, Hokkaido Medical Center, Yamanote 5-7, Sapporo, Hokkaido 063-0005, Japan
| | - Ken Nagahama
- Department of Orthopaedic Surgery, Sapporo Hospital, North-24, East-1, Sapporo, Hokkaido 065-0024, Japan
| | - Akira Iwata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
| | - Nobuhisa Ishiguro
- Infection Control Team, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
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Yamada K, Nagahama K, Abe Y, Murota E, Hiratsuka S, Takahata M, Iwasaki N. Unintentional Fusion in Preserved Facet Joints without Bone Grafting after Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion. Spine Surg Relat Res 2021; 5:390-396. [PMID: 34966865 PMCID: PMC8668217 DOI: 10.22603/ssrr.2020-0232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/03/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction A percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) procedure has been previously developed. During postoperative follow-up, in some patients, bone fusion occurred between opened facet joints, despite not having bone grafting in the facet joints. Here, we investigated facet fusion's frequency and tendencies following PETLIF. Methods A retrospective analysis was conducted on a prospectively collected, nonrandomized series of patients. Forty-two patients (6 males and 36 females, average age: 69.9 years) who underwent single-level PETLIF at our hospital from February 2016 to March 2019 were included in this study. Patients were assessed with lumbar X-ray images and computed tomography (CT) prior to, immediately after, and 1 year after surgery. Results Pseudarthrosis was not observed in any patients, and facet fusion was observed in 26 of 42 post-PETLIF patients (61.9%) by CT 1 year postoperatively. The average interfacet distance increased from 1.3 mm preoperatively to 4.5 mm postoperatively, and facet fusion was observed under the opened conditions of 3.8 mm at 1 year. Segmental lordotic angle of the fusion segment in the lumbar X-ray images was significantly larger in the facet fusion subgroup prior to surgery, immediately following surgery, and 1 year after surgery compared to the facet non-fusion group (p=0.02, p<0.01, p=0.01, respectively). There were no significant differences in patient background, correction loss of segmental lordosis, interfacet distance, or clinical score between the facet fusion and facet non-fusion subgroups. Conclusions Facet fusion was achieved over time within the facet joints that were opened through indirect decompression after PETLIF. We hypothesized that the preserved facet joints potentially became the base bed for spontaneous bone fusion due to the preserved facet joint capsule and surrounding soft tissue, which maintained cranio-caudal facet traffic and blood circulation in the facet joints. The complete preservation of the facet joints was a key advantage of minimally invasive lumbar interbody fusion procedures. Level of evidence Level III
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Ken Nagahama
- Department of Orthopaedic Surgery, Wajokai Sapporo Hospital, Sapporo, Japan
| | - Yuichiro Abe
- Department of Orthopaedic Surgery, Wajokai Eniwa Hospital, Eniwa, Japan
| | - Eihiro Murota
- Department of Orthopaedic Surgery, Wajokai Sapporo Hospital, Sapporo, Japan
| | - Shigeto Hiratsuka
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan
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Saito T, Kosugi T, Nakamura N, Wada H, Tonari A, Ogawa H, Mitsuhashi N, Yamada K, Takahashi T, Sekii S, Karasawa K, Araki N, Nozaki M, Heianna J, Murotani K, Hirano Y, Satoh A, Onoe T, Watakabe T, Shikama N. Assessment of Treatment Response and Re-Bleeding After Palliative Radiation Therapy for Bleeding Gastric Cancer: A Longitudinal Multicenter Prospective Observational Study. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Tachi H, Kato K, Abe Y, Kokabu T, Yamada K, Iwasaki N, Sudo H. Surgical Outcome Prediction Using a Four-Dimensional Planning Simulation System With Finite Element Analysis Incorporating Pre-bent Rods in Adolescent Idiopathic Scoliosis: Simulation for Spatiotemporal Anatomical Correction Technique. Front Bioeng Biotechnol 2021; 9:746902. [PMID: 34712654 PMCID: PMC8546212 DOI: 10.3389/fbioe.2021.746902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/09/2021] [Indexed: 01/15/2023] Open
Abstract
An optimal surgical strategy for adolescent idiopathic scoliosis (AIS) is to provide maximal deformity correction while preserving spinal mobile segments as much as possible and obtaining a balanced posture. From a spatiotemporal deformity correction standpoint, we recently showed that anatomical four-dimensional (4D) spinal correction could be accomplished by curving the rod. In the surgical procedure, two rods are bent identically to confirm spinal anatomical alignment without referring to the intraoperative alignment of the deformity. Therefore, anatomically designed rods have been developed as notch-free, pre-bent rods for easier anatomical reconstruction. In addition to providing the best spinal instrumentation configurations as pre-bent rods, prediction of surgical outcome along with its biomechanical impact can be obtained by simulation of the surgical procedures with computer modeling. However, an objective model that can simulate the surgical outcome in patients with AIS has not been completely elucidated. The present study aimed to compare simulated deformity corrections based on our newly developed spatiotemporal morphological 4D planning simulation system incorporating pre-bent rods and actual deformity corrections in patients with AIS. A consecutive series of 47 patients who underwent anatomical posterior correction for AIS curves were prospectively evaluated. After multilevel facetectomy, except for the lowest instrumented segment, 11 types of pre-bent rods were used. Patient demographic data, radiographic measurements, and sagittal rod angles were analyzed within 1 week of surgery. Our simulation system incorporating pre-bent rods showed a significant correlation with the actual postoperative spinal alignment. The present study demonstrated the feasibility of our simulation system and the ability to simulate the surgical procedure using the pre-bent rods. The simulation system can be used to minimize the differences between the optimal and possible outcomes related to the instrumentation levels and rod shapes. Preoperative assumption of rod shape and length can contribute to a reduction in operative time which decreases blood loss and risk of infection. The results of the finite element analysis in the simulation system measured for each individual patient would also provide a more realistic representation of the surgical procedures.
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Affiliation(s)
- Hiroyuki Tachi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Department of Orthopaedic Surgery, Eniwa Hospital, Eniwa, Japan
| | - Koji Kato
- Department of Systems Information Science, Future University Hakodate, Hakodate, Japan
| | - Yuichiro Abe
- Department of Orthopaedic Surgery, Eniwa Hospital, Eniwa, Japan
| | - Terufumi Kokabu
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Suzuki R, Koike Y, Ota M, Endo T, Hisada Y, Tsujimoto T, Kanayama M, Ito YM, Sudo H, Iwata A, Yamada K, Iwasaki N, Takahata M. Thrombocytopenia Associated with Unrecognized Non-Alcoholic Fatty Liver Disease Is an Independent Predictor of Perioperative Significant Blood Loss in Cervical Laminoplasty. World Neurosurg 2021; 155:e797-e804. [PMID: 34509679 DOI: 10.1016/j.wneu.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify risk factors for significant blood loss (SBL) in cervical laminoplasty, especially regarding thrombocytopenia and coagulopathy resulting from non-alcoholic fatty liver disease (NAFLD). METHODS We retrospectively investigated differences in patient background data, laboratory data at the time of admission, and surgery-related data of 317 patients who underwent cervical laminoplasty and were divided into SBL (estimated blood loss [EBL] + drainage [D] ≥500 g) and non-SBL (EBL + D < 500 g) groups. To evaluate liver status, we used the fibrous 4 index and considered fibrous 4 index ≥1.85 as a representative phenotype for NAFLD with liver fibrosis. In addition, the risk factor for perioperative SBL was investigated using multiple logistic regression analysis, and the cutoff value was calculated. RESULTS Incidence of perioperative SBL in cervical laminoplasty was 7.3% (23/317). Compared with the non-SBL group, the SBL group demonstrated significantly lower platelet count (PLT), lower aspartate aminotransferase, longer operation time, and greater number of opened laminae. According to multivariate analysis, lower PLT and a greater number of opened laminae were identified as significant risk factors for perioperative SBL. The cutoff value of PLT for predicting SBL was determined to be 16.7 × 104/μL using a receiver operating characteristic curve. The liver fibrosis group revealed significantly lower PLT and greater EBL + D than the non-liver fibrosis group. CONCLUSIONS Thrombocytopenia is an independent predictor of perioperative SBL in cervical laminoplasty. Thus, patients with mild thrombocytopenia that may be associated with NAFLD must be carefully monitored to avoid perioperative SBL.
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Affiliation(s)
- Ryota Suzuki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yoshinao Koike
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiro Ota
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yuichiro Hisada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Takeru Tsujimoto
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Masahiro Kanayama
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yoichi M Ito
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Hideki Sudo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Akira Iwata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
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Zhang Z, Zhou T, Yang T, Fukaya K, Harunari E, Saito S, Yamada K, Imada C, Urabe D, Igarashi Y. Nomimicins B-D, new tetronate-class polyketides from a marine-derived actinomycete of the genus Actinomadura. Beilstein J Org Chem 2021; 17:2194-2202. [PMID: 34497672 PMCID: PMC8404215 DOI: 10.3762/bjoc.17.141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/11/2021] [Indexed: 01/18/2023] Open
Abstract
Three new tetronate-class polyketides, nomimicins B, C, and D, along with nomimicin, hereafter named nomimicin A, were isolated from the culture extract of Actinomadura sp. AKA43 collected from floating particles in the deep-sea water of Sagami Bay, Japan. The structures of nomimicins B, C, and D were elucidated through the interpretation of NMR and MS analytical data, and the absolute configuration was determined by combination of NOESY/ROESY and ECD analyses. Nomimicins B, C, and D showed antimicrobial activity against Gram-positive bacteria, Kocuria rhizophila and Bacillus subtilis, with MIC values in the range of 6.5 to 12.5 μg/mL. Nomimicins B and C also displayed cytotoxicity against P388 murine leukemia cells with IC50 values of 33 and 89 μM, respectively.
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Affiliation(s)
- Zhiwei Zhang
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Tao Zhou
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Taehui Yang
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7, Konan, Minato-ku, Tokyo 108-8477, Japan
| | - Keisuke Fukaya
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Enjuro Harunari
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Shun Saito
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Katsuhisa Yamada
- DHC Corporation, 2-7-1 Minami-Azabu, Minato-ku, Tokyo 106-8571, Japan
| | - Chiaki Imada
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7, Konan, Minato-ku, Tokyo 108-8477, Japan
| | - Daisuke Urabe
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Yasuhiro Igarashi
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
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Turri M, Pavanello C, Ossoli A, Strazzella A, Simonelli S, Laurenzi T, Kono K, Yamada K, Kiyosawa N, Eberini I, Calabresi L. Activation of naturally occurring lecithin:Cholesterol acyltransferase mutants by a novel activator compound. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hara N, Isobe A, Yamada K, Kosugi Y, Oshima M, Kawamoto T, Shikama N, Sasai K. Unusual visual and olfactory perceptions during radiotherapy sessions: an investigation of the organs responsible. J Radiat Res 2021; 62:718-725. [PMID: 33912958 PMCID: PMC8273799 DOI: 10.1093/jrr/rrab033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/12/2021] [Indexed: 06/05/2023]
Abstract
During radiotherapy sessions to treat brain tumors or head-and-neck cancers, some patients experience unusual visual and/or olfactory perceptions. This prospective study sought to answer two questions: (i) what proportion of patients experience these unpleasant sensations?, and (ii) which organs are responsible? Eligible patients had brain or near-orbital tumors treated by helical tomotherapy. All were aged 10 years or older, able to communicate, and interviewed by a radiation oncologist at least once weekly during radiation therapy. If they had experienced such sensations, they were encouraged to join the second phase of the study. The patients were asked to indicate, using a button, when a sensation commenced and ended. The recorded data were collated with the treatment log. Thirty-eight consecutive patients were eligible. Twenty-six experienced visual and 13 olfactory sensations. The radiation doses to the organs related to the visual or olfactory sensations did not differ between patients who reported sensations and those who did not. Seventeen patients were enrolled in the second phase of the study. All 14 with visual sensations reported that the sensations occurred when the X-rays passed at eye level. Olfactory sensations were reported by eight out of nine patients when the X-rays passed through the olfactory epithelium and/or ethmoid sinus level. In conclusion, 68% of patients experienced visual sensations caused by X-rays passing through the level of the eyes, and 34% complained of olfactory sensations. With the exception of one patient, olfactory sensations occurred when the X-rays passed through the levels of the olfactory epithelium and/or ethmoid sinus.
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Affiliation(s)
- N Hara
- Department of Radiology, Juntendo University Hospital, Tokyo 113–8431, Japan
| | - A Isobe
- Department of Radiology, Juntendo University Hospital, Tokyo 113–8431, Japan
| | - K Yamada
- Department of Radiation Oncology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Y Kosugi
- Department of Radiation Oncology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - M Oshima
- Department of Radiation Oncology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - T Kawamoto
- Department of Radiation Oncology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - N Shikama
- Department of Radiation Oncology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - K Sasai
- Department of Radiation Oncology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
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Yamada K, Kenichiro M, Ito YM, Inage F, Isoe T, Yokota N, Sugita O, Sato N, Tha KK, Iwasaki N, Arato T, Sudo H. Exploratory clinical trial on the safety and capability of dMD-001 in lumbar disc herniation: Study protocol for a first-in-human pilot study. Contemp Clin Trials Commun 2021; 23:100805. [PMID: 34278043 PMCID: PMC8261539 DOI: 10.1016/j.conctc.2021.100805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 01/08/2023] Open
Abstract
Herniated nucleus pulposus (NP), one of the most common diseases of the spine, is surgically treated by removing the sequestered NP. However, intervertebral disc (IVD) defects may remain after discectomy, leading to inadequate tissue healing and predisposing patients to IVD degeneration. An acellular, bioresorbable, ultra-purified alginate (UPAL) gel (dMD-001) implantation system can be used to fill any IVD defects in order to prevent IVD degeneration after discectomy. This first-in-human pilot study aims to determine the feasibility, safety, and perceived patient response to a combined treatment involving discectomy and UPAL gel implantation for herniated NP. We designed a one-arm, double-centre, open-label, pilot trial. The study started in November 2018 and will run until a sample of 40 suitable participants is established. Patients aged 20-49 years, diagnosed with isolated lumbar IVD herniation and scheduled for discectomy represent suitable candidates. All eligible participants who provide informed consent undergo standard discectomy followed by UPAL gel implantation. The primary outcomes of the trial will be the feasibility and safety of the procedure. Secondary outcomes will include self-assessed clinical scores and magnetic resonance imaging-based measures of morphological and compositional quality of the IVD tissue. Initial outcomes will be published at 24 weeks. Analysis of feasibility and safety will be performed using descriptive statistics. Both intention-to-treat and per-protocol analyses of treatment trends of effectiveness will be conducted.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14W5, Sapporo, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Maeda Kenichiro
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Japan
| | - Yoichi M Ito
- Department of Biostatistics, Hokkaido University Graduate School of Medicine, N14W5, Sapporo, Hokkaido, Japan
| | - Fujio Inage
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Japan
| | - Toshiyuki Isoe
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Japan
| | - Nozomi Yokota
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Japan
| | - Osamu Sugita
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Japan
| | - Norihiro Sato
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Japan
| | - Khin Khin Tha
- Department of Diagnostic Imaging, Hokkaido University Hospital, N14W5, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14W5, Sapporo, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Teruyo Arato
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14W5, Sapporo, Japan.,Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
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Sudo H, Tachi H, Kokabu T, Yamada K, Iwata A, Endo T, Takahata M, Abe Y, Iwasaki N. In vivo deformation of anatomically pre-bent rods in thoracic adolescent idiopathic scoliosis. Sci Rep 2021; 11:12622. [PMID: 34135445 PMCID: PMC8209019 DOI: 10.1038/s41598-021-92187-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/07/2021] [Indexed: 11/18/2022] Open
Abstract
Some surgical strategies can maintain or restore thoracic kyphosis (TK); however, next-generation surgical schemes for adolescent idiopathic scoliosis (AIS) should consider anatomical corrections. A four-dimensional correction could be actively achieved by curving the rod. Thus, anatomically designed rods have been developed as notch-free, pre-bent rods for easier anatomical reconstruction. This study aimed to compare the initial curve corrections obtained using notch-free rods and manually bent, notched rods for the anatomical reconstruction of thoracic AIS. Two consecutive series of 60 patients who underwent anatomical posterior correction for main thoracic AIS curves were prospectively followed up. After multilevel facetectomy, except for the lowest instrumented segment, either notch-free or notched rods were used. Patient demographic data, radiographic measurements, and sagittal rod angles were analyzed within 1 week after surgery. Patients with notch-free rods had significantly higher postoperative TK than patients with notched rods (P < .001), but both groups achieved three-dimensional spinal corrections and significantly increased postoperative rates of patients with T6–T8 TK apex (P = .006 for notch-free rods and P = .008 for notched rods). The rod deformation angle at the concave side was significantly lower in the notch-free rods than in the notched rods (P < .001). The notch-free, pre-bent rod can maintain its curvature, leading to better correction or maintenance of TK after anatomical spinal correction surgery than the conventional notched rod. These results suggest the potential benefits of anatomically designed notch-free, pre-bent rods over conventional, manually bent rods.
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Affiliation(s)
- Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan. .,Department of Orthopaedic Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan.
| | - Hiroyuki Tachi
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan.,Department of Orthopaedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido, 061-1449, Japan
| | - Terufumi Kokabu
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan.,Department of Orthopaedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido, 061-1449, Japan
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Akira Iwata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Yuichiro Abe
- Department of Orthopaedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido, 061-1449, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N15W7, Sapporo, Hokkaido, 060-8638, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
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Igarashi Y, Matsuyuki Y, Yamada M, Fujihara N, Harunari E, Oku N, Karim MRU, Yang T, Yamada K, Imada C, Fukaya K, Urabe D. Structure Determination, Biosynthetic Origin, and Total Synthesis of Akazaoxime, an Enteromycin-Class Metabolite from a Marine-Derived Actinomycete of the Genus Micromonospora. J Org Chem 2021; 86:6528-6537. [PMID: 33885295 DOI: 10.1021/acs.joc.1c00358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A new enteromycin-class antibiotic, akazaoxime (1), possessing an aldoxime functionality in place of O-methyl nitronic acid, was isolated from the cultured extract of a marine-derived actinomycete of the genus Micromonospora, along with known A-76356 (2). The structure of 1, including the absolute stereochemistry of three chiral centers, was established by comprehensive analysis of nuclear magnetic resonance (NMR) and mass spectrometry data coupled with magnetic anisotropy analysis of its phenylglycine methyl ester derivatives. The stereochemistry of 2, not determined previously, was proven to be the same as that of 1 on the basis of the similarity of their NMR and specific rotation data. Precursor feeding experiments using 13C-labeled compounds elucidated that the carbon skeletons of 1 and 2 are constructed from propionate (methylmalonate), leucine, and glycine. Establishment of the concise and flexible synthetic route to 1 enabled us to implement biological evaluation of 1 and its unnatural analogues, demonstrating weak to moderate antimicrobial activities of 1 against Gram-positive Kocuria rhizophila [minimum inhibitory concentration (MIC) of 50 μg/mL] and those of synthetic analogues against a plant pathogen Glomerella cingulata (MIC of 50 μg/mL) and a human pathogen Trichophyton rubrum (MIC of 25-50 μg/mL).
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Affiliation(s)
- Yasuhiro Igarashi
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Yoe Matsuyuki
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Masayuki Yamada
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Nodoka Fujihara
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Enjuro Harunari
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Naoya Oku
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Md Rokon Ul Karim
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Taehui Yang
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7, Konan, Minato-ku, Tokyo 108-8477, Japan
| | - Katsuhisa Yamada
- DHC Corporation, 2-7-1 minami-Azabu, Minato-ku, Tokyo 106-8571, Japan
| | - Chiaki Imada
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7, Konan, Minato-ku, Tokyo 108-8477, Japan
| | - Keisuke Fukaya
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Daisuke Urabe
- Biotechnology Research Center and Department of Biotechnology, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
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Li N, Ferracane J, Lewis S, Andeen N, Woltjer R, Farsad K, Kaufman J, Rugonyi S, Jahangiri Y, Uchida B, Gabr A, Li J, Yamada K, Al-Hakim R. Abstract No. 225 Venous large animal model for stenosis, thrombosis, and chronic occlusion: short-term results, with biomechanical analysis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ukeba D, Yamada K, Tsujimoto T, Ura K, Nonoyama T, Iwasaki N, Sudo H. Bone Marrow Aspirate Concentrate Combined with in Situ Forming Bioresorbable Gel Enhances Intervertebral Disc Regeneration in Rabbits. J Bone Joint Surg Am 2021; 103:e31. [PMID: 33481466 DOI: 10.2106/jbjs.20.00606] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The current surgical procedure of choice for intervertebral disc (IVD) herniation is discectomy, which induces postoperative IVD degeneration. Thus, cell-based therapies, as a 1-step simple procedure, are desired because of the poor capacity of IVDs for self-repair. The aim of this study was to investigate the repair efficacy of ultra-purified alginate (UPAL) gels containing bone marrow aspirate concentrate (BMAC) for the treatment of discectomy-associated IVD degeneration in rabbits. METHODS The mechanical properties of 3 types of gels-UPAL, UPAL containing bone marrow-derived mesenchymal stem cells (BMSCs), and UPAL containing BMAC-were evaluated. Forty rabbits were assigned to 5 groups: intact control, discectomy (to make the cavity), UPAL (implantation of the UPAL gel after discectomy), BMSCs-UPAL (implantation of a combination of autogenic BMSCs and UPAL gel after discectomy), and BMAC-UPAL (implantation of a combination of BMAC and UPAL gel after discectomy). The gels were implanted at 4 weeks after induction of IVD degeneration. At 4 and 12 weeks, magnetic resonance imaging (MRI) as well as histological and immunohistochemical analyses were performed to analyze IVD degeneration qualitatively and the viability of the implanted cells. RESULTS There was no significant difference among the 3 types of gels in terms of the results of unconfined compression tests. The implanted cells survived for 12 weeks. The histological grades of the BMSCs-UPAL (mean and standard deviation, 2.50 ± 0.53; p < 0.001) and BMAC-UPAL (2.75 ± 0.64, p = 0.001) showed them to be more effective in preventing degeneration than UPAL gel alone (3.63 ± 0.52). The effectiveness of BMAC-UPAL was not significantly different from that of BMSCs-UPAL, except with respect to type-II collagen synthesis. CONCLUSIONS BMAC-UPAL significantly enhanced the repair of IVD defects created by discectomy. This approach could be an effective therapeutic strategy owing to its simplicity and cost-effectiveness compared with cell therapy using culture-expanded BMSCs. CLINICAL RELEVANCE Local administration of the BMAC combined with UPAL gel could be an effective therapeutic strategy to enhance IVD repair after discectomy.
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Affiliation(s)
- Daisuke Ukeba
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Katsuhisa Yamada
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takeru Tsujimoto
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Katsuro Ura
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takayuki Nonoyama
- Global Station for Soft Matter, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, Japan
| | - Norimasa Iwasaki
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideki Sudo
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Faculty of Advanced Life Science, Hokkaido University, Sapporo, Japan
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Igawa S, Ono T, Kasajima M, Yamada K, Oguri A, Kameda A, Yamamoto H, Kakegawa M, Hiyoshi Y, Kusuhara S, Ozawa T, Otani S, Fukui T, Mitsufuji H, Masaru K, Yokoba M, Kubota M, Sasaki J, Naoki K. P76.55 Real-world Experience of the Utility in Afatinib Therapy for Patients with EGFR-Mutant Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ono T, Igawa S, Yamada K, Kameda A, Oguri A, Yamamoto H, Manabe H, Ozawa T, Kusuhara S, Kasajima M, Kakegawa M, Otani S, Fukui T, Sasaki J, Naoki K. P76.53 Impact of Neutrophil-to-Lymphocyte Ratio in Patients with EGFR-Mutant NSCLC Treated with Tyrosine Kinase Inhibitors. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ura K, Yamada K, Tsujimoto T, Ukeba D, Iwasaki N, Sudo H. Ultra-purified alginate gel implantation decreases inflammatory cytokine levels, prevents intervertebral disc degeneration, and reduces acute pain after discectomy. Sci Rep 2021; 11:638. [PMID: 33436742 PMCID: PMC7804289 DOI: 10.1038/s41598-020-79958-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
Lumbar intervertebral disc (IVD) herniation causes severe low back pain (LBP), which results in substantial financial and emotional strains. Despite the effectiveness of discectomy, there is no existing treatment for post-operative LBP induced by progressive IVD degeneration. Two key factors of LBP are intradiscal inflammation, indicated by tumour necrosis factor alpha (TNF-α) and interleukin-6 (IL-6), and sensory nerve ingrowth into the inner layer of the annulus fibrosus, triggered by nerve growth factor/high-affinity tyrosine kinase A (TrkA) signalling. In an animal models of discectomy, the bioresorbable ultra-purified alginate (UPAL) gel with an extremely low-toxicity has been effective in acellular tissue repair. We aimed to investigate whether UPAL gel can alleviate LBP using a rat nucleus pulposus (NP) punch model and a rabbit NP aspirate model. In both models, we assessed TNF-α and IL-6 production and TrkA expression within the IVD by immunohistochemistry. Further, histological analysis and behavioural nociception assay were conducted in the rat model. UPAL gel implantation suppressed TNF-α and IL-6 production, downregulated TrkA expression, inhibited IVD degeneration, and reduced nociceptive behaviour. Our results suggest the potential of UPAL gel implantation as an innovative treatment for IVD herniation by reducing LBP and preventing IVD degeneration after discectomy.
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Affiliation(s)
- Katsuro Ura
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan.
| | - Takeru Tsujimoto
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Daisuke Ukeba
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan.
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50
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Amekura H, Toulemonde M, Narumi K, Li R, Chiba A, Hirano Y, Yamada K, Yamamoto S, Ishikawa N, Okubo N, Saitoh Y. Ion tracks in silicon formed by much lower energy deposition than the track formation threshold. Sci Rep 2021; 11:185. [PMID: 33420182 PMCID: PMC7794553 DOI: 10.1038/s41598-020-80360-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 12/15/2020] [Indexed: 11/09/2022] Open
Abstract
Damaged regions of cylindrical shapes called ion tracks, typically in nano-meters wide and tens micro-meters long, are formed along the ion trajectories in many insulators, when high energy ions in the electronic stopping regime are injected. In most cases, the ion tracks were assumed as consequences of dense electronic energy deposition from the high energy ions, except some cases where the synergy effect with the nuclear energy deposition plays an important role. In crystalline Si (c-Si), no tracks have been observed with any monomer ions up to GeV. Tracks are formed in c-Si under 40 MeV fullerene (C60) cluster ion irradiation, which provides much higher energy deposition than monomer ions. The track diameter decreases with decreasing the ion energy until they disappear at an extrapolated value of ~ 17 MeV. However, here we report the track formation of 10 nm in diameter under C60 ion irradiation of 6 MeV, i.e., much lower than the extrapolated threshold. The diameters of 10 nm were comparable to those under 40 MeV C60 irradiation. Furthermore, the tracks formed by 6 MeV C60 irradiation consisted of damaged crystalline, while those formed by 40 MeV C60 irradiation were amorphous. The track formation was observed down to 1 MeV and probably lower with decreasing the track diameters. The track lengths were much shorter than those expected from the drop of Se below the threshold. These track formations at such low energies cannot be explained by the conventional purely electronic energy deposition mechanism, indicating another origin, e.g., the synergy effect between the electronic and nuclear energy depositions, or dual transitions of transient melting and boiling.
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Affiliation(s)
- H Amekura
- National Institute for Materials Science (NIMS), Tsukuba, Japan.
| | | | - K Narumi
- National Institutes for Quantum and Radiological Science and Technology (QST), Takasaki, Japan
| | - R Li
- National Institute for Materials Science (NIMS), Tsukuba, Japan.,Shandong University, Jinan, China
| | - A Chiba
- National Institutes for Quantum and Radiological Science and Technology (QST), Takasaki, Japan
| | - Y Hirano
- National Institutes for Quantum and Radiological Science and Technology (QST), Takasaki, Japan
| | - K Yamada
- National Institutes for Quantum and Radiological Science and Technology (QST), Takasaki, Japan
| | - S Yamamoto
- National Institutes for Quantum and Radiological Science and Technology (QST), Takasaki, Japan
| | - N Ishikawa
- Japan Atomic Energy Agency, Tokai, Japan
| | - N Okubo
- Japan Atomic Energy Agency, Tokai, Japan
| | - Y Saitoh
- National Institutes for Quantum and Radiological Science and Technology (QST), Takasaki, Japan
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