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Nakatsuka K, Ono R, Murata S, Akisue T, Fukuda H. Claims-based Frailty Index in Japanese Older Adults: A Cohort Study Using LIFE Study Data. J Epidemiol 2024; 34:112-118. [PMID: 36967119 PMCID: PMC10853043 DOI: 10.2188/jea.je20220310] [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: 11/02/2022] [Accepted: 02/21/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND We aimed to assess whether the United States-developed Claims-based Frailty Index (CFI) can be implemented in Japanese older adults using claims data. METHODS We used the monthly claims data and certification of long-term care (LTC) insurance data of residents from 12 municipalities from April 2014 to March 2019. The 12 months from first recording was defined as the "baseline period," and the time thereafter as the "follow-up period". Participants aged ≥65 years were included, and those with no certified LTC insurance or who died at baseline were excluded. New certification of LTC insurance and all-cause mortality during the follow-up period were defined as outcome events. CFI categorization consisted of three steps including: 1) using 12 months deficit-accumulation approach that assigned different weights to each of the 52 items; 2) the accumulated score to derive the CFI; and 3) categorizing the CFI as "robust" (<0.15), "prefrail" (0.15-0.24), and "frail" (≥0.25). Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the association between CFI and outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. RESULTS There were 519,941 participants in total. After adjusting for covariates, the severe CFI category had a high risk of certification of LTC insurance (prefrail: HR 1.33; 95% CI, 1.27-1.39 and frail: HR 1.60; 95% CI, 1.53-1.68) and all-cause mortality (prefrail: HR 1.44; 95% CI, 1.29-1.60 and frail: HR 1.84; 95% CI, 1.66-2.05). CONCLUSION This study suggests that CFI can be implemented in Japanese claims data to predict the certification of LTC insurance and mortality.
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Affiliation(s)
- Kiyomasa Nakatsuka
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Rei Ono
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, National Institute of Health and Nutrition, Tokyo, Japan
| | - Shunsuke Murata
- Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | | | - Haruhisa Fukuda
- Kyushu University Graduate School of Medical Sciences, Department of Health Care Administration and Management, Fukuoka, Japan
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Uchida K, Sugimoto T, Tange C, Nishita Y, Shimokata H, Saji N, Kuroda Y, Matsumoto N, Kishino Y, Ono R, Akisue T, Otsuka R, Sakurai T. Association between abdominal adiposity and cognitive decline in older adults: a 10-year community-based study. J Nutr Health Aging 2024; 28:100175. [PMID: 38308924 DOI: 10.1016/j.jnha.2024.100175] [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: 10/11/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES This study aimed to investigate the association between abdominal adiposity and change in cognitive function in community-dwelling older adults. DESIGN, SETTING, AND PARTICIPANTS This longitudinal study included older adults aged ≥60 years without cognitive impairment who participated in the National Institute for Longevity Sciences - Longitudinal Study of Aging. MEASUREMENTS Cognitive function was evaluated biennially using the Mini-Mental State Examination (MMSE) over 10 years. Waist circumference (WC) was measured at the naval level, and subcutaneous fat area (SFA) and visceral fat area (VFA) were assessed using baseline computed tomography scans. WC, SFA, and VFA areas were stratified into sex-adjusted tertiles. A linear mixed model was applied separately for men and women. RESULTS This study included 873 older adults. In men, the groups with the highest levels of WC, SFA, and VFA exhibited a greater decline in MMSE score than the groups with the lowest levels (β [95% confidence interval]: WC, -0.12 [-0.23 to -0.01]; SFA, -0.13 [-0.24 to -0.02]; VFA, -0.11 [-0.22 to -0.01]). In women, the group with the highest level of WC and SFA showed a greater decline in MMSE score than the group with the lowest level (WC, -0.12 [-0.25 to -0.01]; SFA, -0.18 [-0.30 to -0.06]), but VFA was not associated with cognitive decline. CONCLUSION Higher WC, SFA, and VFA in men and higher WC and SFA in women were identified as risk factors for cognitive decline in later life, suggesting that abdominal adiposity involved in cognitive decline may differ according to sex.
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Affiliation(s)
- Kazuaki Uchida
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo 654-0142, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Chikako Tange
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Hiroshi Shimokata
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Aichi 470-0196, Japan
| | - Naoki Saji
- Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Yujiro Kuroda
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Nanae Matsumoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Yoshinobu Kishino
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Department of Cognitive and Behavioral Science, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466-855, Japan
| | - Rei Ono
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu, Osaka 566-0002, Japan; Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo 654-0142, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo 654-0142, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Department of Cognitive and Behavioral Science, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466-855, Japan; Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
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Yamada N, Nakatsuka K, Tezuka M, Murata F, Maeda M, Akisue T, Fukuda H, Ono R. Pneumococcal vaccination coverage and vaccination-related factors among older adults in Japan: LIFE Study. Vaccine 2024; 42:239-245. [PMID: 38087713 DOI: 10.1016/j.vaccine.2023.12.009] [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: 02/28/2023] [Revised: 10/31/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
PURPOSE To investigate individual and environmental vaccination-related factors among the older adults in Japan, using administrative data. METHODS We conducted a cohort study and included people who reached the relevant age (≥65 years) for routine pneumococcal vaccination of older adults between April 2015 and March 2020. Monthly data of residents in the two municipalities from April 2014 to March 2020 and vaccination records from April 2015 to March 2020 were used. We defined five cohorts according to the year in which routine vaccinations were available. Each cohort was followed for a total of two years, with the first year being the "baseline period" and second year being the "vaccine follow-up period." Pneumococcal vaccination data was extracted from vaccination records at "first dose." Age, sex, socioeconomic status, comorbidities, hospital visit history, hospitalization history, Specific Health Check-ups participation, and information on contracted hospitals for pneumococcal vaccination were used as covariates. A multivariate logistic regression model was used to investigate the relationship between pneumococcal vaccination and vaccination-related factors. Odds ratios (OR) and 95 % confidence intervals (95 % CI) were calculated. RESULTS Analysis included 17,991 patients. Vaccination coverage was 33.6 % for all subjects. Multivariate analysis found the following as significant vaccination-related factors: female (OR: 1.18, 95 % CI: 1.11-1.26), not low income (1.76, 1.17-2.76), hospital visits: ≥once/month (1.27, 1.19-1.35), and Specific Health Check-ups participation (2.10, 1.95-2.27). No significant results were found for hospitals that contracted pneumococcal vaccination. CONCLUSIONS Individual factors, such as sex and Specific Health Check-ups participation, were found to be important factors affecting pneumococcal vaccination among older adults in Japan. Environmental factors, such as the characteristics of residential areas, should be evaluated in further investigations.
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Affiliation(s)
- Naoki Yamada
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Kiyomasa Nakatsuka
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Masato Tezuka
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Fumiko Murata
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
| | - Megumi Maeda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Haruhisa Fukuda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan; Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, KENTO Innovation Park NK Bldg, 3-17, Senriokashinmachi, Settu, Osaka 566-0002, Japan.
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Miyazaki K, Kanda Y, Sakai Y, Yoshikawa R, Yurube T, Takeoka Y, Hara H, Akisue T, Kuroda R, Kakutani K. Effect of Bone Metastasis Cancer Board on Spinal Surgery Outcomes: A Retrospective Study. Medicina (Kaunas) 2023; 59:2087. [PMID: 38138190 PMCID: PMC10744340 DOI: 10.3390/medicina59122087] [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] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/18/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Bone metastasis cancer boards (BMCBs) focusing on the management of bone metastases have been gathering much attention. However, the association of BMCBs with spinal surgery in patients with spinal metastases remains unclear. In this retrospective single-center observational study, we aimed to clarify the effect of a BMCB on spinal metastasis treatment. Materials and Methods: We reviewed consecutive cases of posterior decompression and/or instrumentation surgery for metastatic spinal tumors from 2008 to 2019. The BMCB involved a team of specialists in orthopedics, rehabilitation medicine, radiation oncology, radiology, palliative supportive care, oncology, and hematology. We compared demographics, eastern cooperative oncology group performance status (ECOGPS), Barthel index (BI), number of overall versus emergency surgeries, and primary tumors between patients before (2008-2012) and after (2013-2019) BMCB establishment. Results: A total of 226 patients including 33 patients before BMCB started were enrolled; lung cancer was the most common primary tumor. After BMCB establishment, the mean patient age was 5 years older (p = 0.028), the mean operating time was 34 min shorter (p = 0.025), the mean hospital stay was 34.5 days shorter (p < 0.001), and the mean BI before surgery was 12 points higher (p = 0.049) than before. Moreover, the mean number of surgeries per year increased more than fourfold to 27.6 per year (p < 0.01) and emergency surgery rates decreased from 48.5% to 29.0% (p = 0.041). Patients with an unknown primary tumor before surgery decreased from 24.2% to 9.3% (p = 0.033). Postoperative deterioration rates from 1 to 6 months after surgery of ECOGPS and BI after BMCB started were lower than before (p = 0.045 and p = 0.027, respectively). Conclusion: The BMCB decreased the emergency surgery and unknown primary tumor rate despite an increase in the overall number of spinal surgeries. The BMCB also contributed to shorter operation times, shorter hospital stays, and lower postoperative deterioration rates of ECOGPS and BI.
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Affiliation(s)
- Kunihiko Miyazaki
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yutaro Kanda
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Ryo Yoshikawa
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Takashi Yurube
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshiki Takeoka
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hitomi Hara
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
| | - Ryosuke Kuroda
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Kenichiro Kakutani
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Nakamura J, Nakatsuka K, Uchida K, Akisue T, Maeda M, Murata F, Fukuda H, Ono R. Analysis of post-extraction bleeding in patients taking antithrombotic therapy using data from the longevity improvement and fair evidence study. Gerodontology 2023. [PMID: 37469221 DOI: 10.1111/ger.12703] [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] [Accepted: 06/21/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Several studies have investigated post-extraction bleeding in patients on antithrombotic therapy, but most included a small sample size. OBJECTIVE This study aimed to analyse post-extraction bleeding in patients on antithrombotic therapy using data from a large database. MATERIALS AND METHODS Claims data of National Health Insurance and Late-Stage Elderly Healthcare System enrollees who underwent tooth extraction between October 2014 and March 2019 (n = 107 767) in a large multiregional cohort study (Longevity Improvement and Fair Evidence study) were included. Antithrombotic therapy was determined based on the drug codes used at the time of tooth extraction (classified into six groups: no antithrombotic, single antiplatelet, dual antiplatelet, Direct Oral Anticoagulant, warfarin and combined antiplatelet and anticoagulant therapies). The outcome was defined as the presence of "post-extraction bleeding" as a receipt disease name in the same month as tooth extraction. To examine the association between antithrombotic therapy and post-extraction bleeding in detail, multiple logistic regression analysis was performed with post-extraction bleeding as the objective variable; each antithrombotic therapy as the explanatory variable; and age, sex and comorbidities as adjustment variables. RESULTS Antithrombotic therapy was administered in 14 343 patients (13.3%), and post-extraction bleeding was observed in 419 patients (0.4%). The rate of post-extraction bleeding was significantly lower in the no antithrombotic therapy and single antiplatelet groups than that in the other groups (odds ratio: 2.00-9.02). CONCLUSION The frequency of post-extraction bleeding is high in patients on anticoagulation or dual antithrombotic therapy. Therefore, careful preparation before extraction is necessary in these patients.
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Affiliation(s)
- Junya Nakamura
- Department of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Aichi, Japan
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Kiyomasa Nakatsuka
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Kazuaki Uchida
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Megumi Maeda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Fumiko Murata
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Haruhisa Fukuda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Rei Ono
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
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Kanda Y, Kakutani K, Sakai Y, Miyazaki K, Matsuo T, Yurube T, Takeoka Y, Ohnishi H, Ryu M, Kumagai N, Kuroshima K, Hiranaka Y, Kawamoto T, Hara H, Hoshino Y, Hayashi S, Akisue T, Kuroda R. Clinical Characteristics and Surgical Outcomes of Metastatic Spine Tumors in the Very Elderly: A Prospective Cohort Study in a Super-Aged Society. J Clin Med 2023; 12:4747. [PMID: 37510862 PMCID: PMC10380659 DOI: 10.3390/jcm12144747] [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: 04/21/2023] [Revised: 06/09/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The number of advanced-age patients with spinal metastases is rising. This study was performed to clarify the characteristics and surgical outcomes of spinal metastases in advanced-age patients. We prospectively analyzed 216 patients with spinal metastases from 2015 to 2020 and divided them into three age groups: <70 years (n = 119), 70-79 years (n = 73), and ≥80 years (n = 24). Although there were no significant intergroup differences in preoperative characteristics and surgery-related factors except for age, patients aged ≥80 years tended to have a worse performance status (PS), Barthel index, and EuroQol-5 dimension (EQ-5D) before and after surgery than the other two groups. Although the median PS, mean Barthel index and mean EQ-5D greatly improved postoperatively in each group, the median PS and mean Barthel index at 6 months and the mean EQ-5D at 1 month postoperatively were significantly poorer in the ≥80-year group than the 70-79-year group. The rates of postoperative complications and re-deterioration of the EQ-5D were significantly higher in the oldest group than in the other two groups. Although surgery for spinal metastases improved the PS, Barthel index, and EQ-5D regardless of age, clinicians should be aware of the poorer outcomes and higher complication rates in advanced-age patients.
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Affiliation(s)
- Yutaro Kanda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Kunihiko Miyazaki
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Tomoya Matsuo
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Takashi Yurube
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshiki Takeoka
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hiroki Ohnishi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Masao Ryu
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Naotoshi Kumagai
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Kohei Kuroshima
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshiaki Hiranaka
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Shinya Hayashi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Mizuta S, Uchida K, Sawa R, Nakamura J, Encho H, Akisue T, Ono R. Context of walking and loneliness among community-dwelling older adults: a cross-sectional study. BMC Geriatr 2023; 23:326. [PMID: 37231334 DOI: 10.1186/s12877-023-04043-5] [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: 03/16/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Older adults are more likely to experience loneliness than younger people. Moreover, greater loneliness in older adults is associated with poor mental health and increased risk of cardiovascular disease and mortality. Physical activity is an effective intervention for reducing loneliness among older adults. Among physical activities, walking is suitable for older adults, because it is easy and safe to incorporate into daily life. We hypothesized that the association between walking and loneliness depends on the presence of others and the number of people present. The aim of this study is to investigate the association between the context of walking (the number of walkers) and loneliness among community-dwelling older adults. METHODS This cross-sectional study included 173 community-dwelling older adults aged 65 or older. Context of walking was classified as non-walking, walking alone (days of walking alone > days of walking with someone), and walking with someone (days of walking alone ≤ days of walking with someone). Loneliness was measured using the Japanese version of the University of California Los Angeles Loneliness Scale. A linear regression model was used to investigate the relationship between context of walking and loneliness, adjusted for age, sex, living situation, social participation, and physical activity excluding walking. RESULTS Data from 171 community-dwelling older adults (mean age = 78.0 years, 59.6% women) were analyzed. After adjustment, walking with someone was associated with lower loneliness than non-walking (adjusted β: -0.51, 95% confidence interval: -1.00, -0.01). CONCLUSIONS The study's findings suggest that walking with a companion may effectively prevent or reduce loneliness among older adults.
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Affiliation(s)
- Sachiko Mizuta
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Kazuaki Uchida
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ryuichi Sawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Junya Nakamura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Department of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Haruhi Encho
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Rei Ono
- National Institute of Health and Nutrition, Health and Nutrition, National Institutes of Biomedical Innovation, KENTO Innovation Park NK Bldg., 3-17, Senriokashinmachi, Settu, Osaka, 566-0002, Japan.
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Encho H, Uchida K, Nakamura J, Mizuta S, Akisue T, Kowa H, Ono R. Association between locomotive syndrome and anemia among community-dwelling older adults. Geriatr Gerontol Int 2023. [PMID: 37165517 DOI: 10.1111/ggi.14593] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/07/2023] [Accepted: 04/19/2023] [Indexed: 05/12/2023]
Abstract
AIM To investigate the association between locomotive syndrome and anemia among community-dwelling older adults. METHODS This cross-sectional study was conducted at specific health checkup centers in Japan between 2019 and 2020. We sent a questionnaire to older adults aged ≥65 years who participated in health checkups. A total of 2507 community-dwelling older adults were included in this study (mean age = 72.3 years, 51.4% women). Locomotive syndrome was measured using a 25-question Geriatric Locomotive Function Scale with a score range of 0-100, and was defined as ≥16 points. Anemia was defined using World Health Organization criteria, as a hemoglobin concentration of <13.0 g/dL in men and <12.0 g/dL in women. Logistic regression analyses were performed to investigate the association between locomotive syndrome and anemia, adjusted for age, sex, body mass index, depression symptoms, self-reported comorbidities (cancer, rheumatoid arthritis, knee osteoarthritis, fractures, and spinal disease), hypertension, and renal function. RESULTS Of all the participants, 11.6% had locomotive syndrome and 12.8% had anemia. Even after adjustment, a relationship between locomotive syndrome and anemia was observed (adjusted odds ratio = 1.9, 95% confidence interval = 1.3-2.7). CONCLUSIONS Community-dwelling older adults with anemia had a significantly higher prevalence of locomotive syndrome than those without. This finding suggests that older adults with anemia are at risk of locomotive syndrome, and appropriate measures should be taken for prevention. Geriatr Gerontol Int 2023; ••: ••-••.
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Affiliation(s)
- Haruhi Encho
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Kazuaki Uchida
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Junya Nakamura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
- Department of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Sachiko Mizuta
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Hisatomo Kowa
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
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Hara H, Kawamoto T, Fukase N, Sawada R, Fujiwara S, Yahiro S, Miyamoto T, Terakawa T, Mifune Y, Hoshino Y, Kakutani K, Matsumoto T, Matsushita T, Niikura T, Kuroda R, Akisue T. Outcomes of palliative surgery for bone metastasis of metastatic renal cell carcinoma in the era of targeted therapy. Eur J Surg Oncol 2023; 49:928-933. [PMID: 36463006 DOI: 10.1016/j.ejso.2022.11.094] [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: 05/25/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The introduction of tyrosine kinase inhibitors has revolutionized treatment strategies for metastatic renal cell carcinoma (RCC) and has improved survival rates. The number of patients with bone metastases from RCC requiring surgery will increase as survival rates improve. However, there is insufficient evidence to standardize the treatment of bone metastases after the introduction of targeted therapy for metastatic RCC. We aimed to determine the outcomes of palliative surgical treatment of bone metastases in the extremities of patients with metastatic RCC. MATERIALS AND METHODS We retrospectively reviewed 26 lesions from 17 patients who underwent surgery for extremity and acetabular bone metastases and were treated with targeted therapies for advanced RCC between 2008 and 2020. The median follow-up duration was 19 months (range, 4-76). We assessed the patients' activities of daily living, quality of life, and pain and analyzed their postoperative values relative to preoperative values. Postoperative overall survival (OS), local progression-free survival (LPFS), and the factors affecting them were evaluated using the Kaplan-Meier method and log-rank test. RESULTS The 5-year OS and LPFS rates were 39.5% and 65.6%, respectively. The factors affecting OS were sex, Katagiri score, visceral metastases, and preoperative targeted therapy, while the factors affecting LPFS were pathologic fractures and surgical technique. CONCLUSION In this study, the postoperative outcomes of palliative surgery for bone metastases from metastatic RCC were good. We suggest that systemic treatment should be prioritized over local control for advanced bone metastasis in RCC and surgery before pathological fracture should be performed for local control.
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Affiliation(s)
- Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Teruya Kawamoto
- Division of Orthopaedic Surgery, Kobe University Hospital International Clinical Cancer Research Center, 1-5-1 Minatojimaminami-cho, Chuo-ku, Kobe, 650-0047, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ryoko Sawada
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomohiro Miyamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoaki Terakawa
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Science, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
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10
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Kondo S, Inoue T, Saito T, Fujikawa T, Kamada M, Inoue S, Fujiwara S, Goto M, Sato N, Ono R, Akisue T, Katoh S, Takizawa H, Matsuura T. Impact of postoperative physical activity on the development of pneumonia in the subacute phase after esophagectomy in patients with esophageal cancer: A retrospective cohort study. Eur J Oncol Nurs 2023; 62:102270. [PMID: 36709719 DOI: 10.1016/j.ejon.2023.102270] [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: 11/23/2022] [Accepted: 01/22/2023] [Indexed: 01/24/2023]
Abstract
PURPOSE Physical activity is important to improve recovery following surgery. This study investigated the impact of physical activity on the development of pneumonia after radical esophagectomy in patients with thoracic esophageal cancer in the subacute phase from postoperative day 11 to hospital discharge. METHODS This retrospective cohort study included 83 patients who underwent radical esophagectomy for esophageal cancer between 2016 and 2022. Physical activity was measured using an activity tracker, and the average number of steps between postoperative days 8 and 10 was examined. The primary outcome was pneumonia (Clavien-Dindo classification 2 or higher) developing between postoperative day 11 and hospital discharge. We used the receiver operating characteristic (ROC) curve analysis to calculate the optimal cutoff value of physical activity that can predict the development of pneumonia and define low physical activity. We used logistic regression analysis to investigate the impact of low physical activity on postoperative pneumonia. RESULTS Pneumonia developed in 10 patients (12.0%) during the observation period. The optimal cutoff value of physical activity for predicting pneumonia was 1494 steps per day (sensitivity: 60.0%, specificity: 89.0%, area under the curve: 0.743). In multivariate analysis, low physical activity was an independent predictor of incident pneumonia [odds ratio: 12.10, 95% confidence interval: 2.21-65.90, p = 0.004], with adjustment for age, gastric tube reconstruction route, and postoperative recurrent nerve palsy. CONCLUSIONS Physical activity following radical esophagectomy in patients with thoracic esophageal cancer was an independent predictor of the development of pneumonia in the subacute phase after radical esophagectomy.
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Affiliation(s)
- Shin Kondo
- Division of Rehabilitation, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan; Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, Niigata, 950-3198, Japan
| | - Takashi Saito
- Division of Rehabilitation, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Takashi Fujikawa
- Department of Rehabilitation, Kobe City Medical Center West Hospital, 2-4 ichiban-cho, Nagata-ku, Kobe, 653-0013, Japan
| | - Motomu Kamada
- Division of Rehabilitation, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Seiya Inoue
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Satoshi Fujiwara
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Masakazu Goto
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Nori Sato
- Department of Rehabilitation Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Rei Ono
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan; Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Shinsuke Katoh
- Department of Rehabilitation Medicine, Red Cross Tokushima Hinomine Rehabilitation Center for People with Disabilities, 4-1 Shinbiraki, Chuden-cho, Komathushima-shi, Tokushima, 773-0014, Japan
| | - Hiromitsu Takizawa
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Tetsuya Matsuura
- Department of Rehabilitation Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan
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11
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Uchida K, Sugimoto T, Tange C, Nishita Y, Shimokata H, Saji N, Kuroda Y, Matsumoto N, Kishino Y, Ono R, Akisue T, Otsuka R, Sakurai T. Association between Reduction of Muscle Mass and Faster Declines in Global Cognition among Older People: A 4-Year Prospective Cohort Study. J Nutr Health Aging 2023; 27:932-939. [PMID: 37997712 DOI: 10.1007/s12603-023-2007-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/16/2023] [Accepted: 08/17/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES A few studies reported that both decrease and increase in body mass index (BMI) were associated with the development of dementia in later life. However, it is unclear what changes in body composition are associated with cognitive decline. This study investigated the longitudinal influences of changes in body composition on cognitive function among community-dwelling adults. DESIGN, SETTING AND PARTICIPANTS This longitudinal study included older adults aged ≥60 years without cognitive impairment who participated in National Institute for Longevity Sciences - Longitudinal Study of Aging. MEASUREMENTS Cognitive function was assessed using the MMSE. Body composition was measured by a dual-energy X-ray absorptiometry system. Then, BMI, fat mass index (FMI), fat-free mass index (FFMI), and muscle mass index (MMI) were calculated. The changes in body composition over 6 years (second wave to fifth wave) were calculated, and three groups were created: decreased group, decrease of >5%; stable group, change within 5%, and increased group, increase of >5%. In statistical analysis, a linear mixed model was applied by sex to investigate the influences of body composition changes on cognitive function over 4 years (fifth wave to seventh wave). RESULTS This study analyzed 515 participants (mean age, 67.05 years; 53.4% men). Men with decreased group in FFMI and MMI exhibited faster declines in MMSE scores than those with stable group (β [95% CI]: FFMI, -0.293 [-0.719 to -0.020]; MMI, -0.472 [-0.884 to -0.059]). In women, there was no significant association between body composition changes and cognitive functions. CONCLUSIONS Decrease in fat-free mass and muscle mass is associated with faster cognitive declines in men. These results suggest the importance of continuous monitoring of muscle mass to prevent cognitive decline in later life.
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Affiliation(s)
- K Uchida
- Takashi Sakurai, 7-430 Morioka, Obu, Aichi 474-8511, Japan, TEL: +81-562-46-2311, FAX: +81-562-46-8394, E-mail:
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12
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Yahiro S, Kawamoto T, Fujiwara S, Hara H, Fukase N, Sawada R, Takemori T, Miyamoto T, Mifune Y, Kakutani K, Hoshino Y, Hayashi S, Matsumoto T, Matsushita T, Koyanagi-Aoi M, Aoi T, Kuroda R, Akisue T. Identification and characterization of slow‑cycling cells in Ewing sarcoma. Int J Oncol 2022; 61:138. [PMID: 36148888 PMCID: PMC9529430 DOI: 10.3892/ijo.2022.5428] [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: 07/14/2022] [Accepted: 09/06/2022] [Indexed: 11/07/2022] Open
Abstract
Ewing sarcoma (ES) is an aggressive primary malignant bone tumor that predominantly affects children and young adults. Multimodal treatment approaches have markedly improved the survival of patients with localized ES. However, local recurrence and distant metastasis following curative therapies remain a main concern for patients with ES. Recent studies have suggested that slow-cycling cells (SCCs) are associated with tumor progression, local recurrence and distant metastasis in various types of cancers. According to the results of these studies, it was hypothesized that SCCs may play a critical role in tumor progression, chemoresistance and local/distal recurrence in patients with ES. The present study applied a label-retaining system using carboxyfluorescein diacetate succinimidyl ester (CFSE) to identify and isolate SCCs in ES cell lines. In addition, the properties of SCCs, including sphere formation ability, cell cycle distribution and chemoresistance, in comparison with non-SCCs were investigated. RNA sequencing also revealed several upregulated genes in SCCs as compared with non-SCCs; the identified genes not only inhibited cell cycle progression, but also promoted the malignant properties of SCCs. On the whole, the present study successfully identified SCCs in ES cells through a label-retaining system using CFSE. Moreover, to the best of our knowledge, the present study is the first to describe the characteristic properties of SCCs in ES. The findings of this study, if confirmed, may prove to be useful in elucidating the underlying molecular mechanisms and identifying effective therapeutic targets for ES.
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Affiliation(s)
- Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Ryoko Sawada
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Tomohiro Miyamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Shinya Hayashi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Michiyo Koyanagi-Aoi
- Division of Stem Cell Medicine, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Takashi Aoi
- Division of Stem Cell Medicine, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan
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13
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Nikaido Y, Urakami H, Okada Y, Kajimoto Y, Ishida N, Kawami Y, Akisue T, Saura R. Dynamic gait stability in patients with idiopathic normal pressure hydrocephalus with high and low fall-risk. Clin Biomech (Bristol, Avon) 2022; 99:105757. [PMID: 36113194 DOI: 10.1016/j.clinbiomech.2022.105757] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/17/2022] [Accepted: 08/30/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to investigate whether dynamic gait stability differs between idiopathic normal-pressure hydrocephalus with high- and low-fall-risk. METHODS Participants comprised 40 idiopathic normal-pressure hydrocephalus patients and 23 healthy-controls. Idiopathic normal-pressure hydrocephalus patients were divided into those with high-fall-risk (n = 20) and low-fall-risk (n = 20) groups using the cut-off score of ≤14/30 for fall-risk on the Functional Gait Assessment. Dynamic stability during gait was assessed by three-dimensional motion analysis. Dynamic stability was defined as the ability to maintain an extrapolated center of mass within the base of support at heel contact, with the distance between the two defined as the margin of stability. Conscious motor control was assessed by the Movement-Specific Reinvestment Scale. FINDINGS Anteroposterior and mediolateral margin of stabilities were significantly larger in both idiopathic normal-pressure hydrocephalus groups than in healthy-controls. The mediolateral margin of stability was significantly higher in the high-fall-risk group than in the low-fall-risk group; whereas, the anteroposterior margin of stability did not differ between idiopathic normal-pressure hydrocephalus groups. The Movement-Specific Reinvestment Scale was significantly higher in the high-fall-risk group than in the low-fall-risk group. INTERPRETATION Idiopathic normal-pressure hydrocephalus patients with have high forward and lateral dynamic stability during gait regardless of their fall-risk. In particular, idiopathic normal-pressure hydrocephalus patients with high-fall-risk may consciously maintain lateral dynamic stability to a greater extent than those with low-fall-risk. These findings highlight a conscious motor control component in the pathological gait of idiopathic normal-pressure hydrocephalus, and provide clues for rehabilitation and fall prevention strategies in idiopathic normal-pressure hydrocephalus patients.
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Affiliation(s)
- Yasutaka Nikaido
- Clinical Department of Rehabilitation, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan.
| | - Hideyuki Urakami
- Clinical Department of Rehabilitation, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
| | - Yohei Okada
- Graduate School of Health Sciences, Kio University, Nara, Japan; Neurorehabilitation Research Center of Kio University, Nara, Japan
| | - Yoshinaga Kajimoto
- Department of Neurosurgery, Division of Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Naoya Ishida
- Clinical Department of Rehabilitation, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
| | - Yuki Kawami
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan; Department of Physical Therapy, Faculty of Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Hyogo, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Ryuichi Saura
- Department of Physical and Rehabilitation Medicine, Division of Comprehensive Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
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Hiraga H, Machida R, Kawai A, Matsumoto Y, Yonemoto T, Nishida Y, Nagano A, Ae K, Yoshida S, Asanuma K, Toguchida J, Huruta D, Nakayama R, Akisue T, Hiruma T, Morii T, Tanaka K, Kataoka T, Fukuda H, Ozaki T. 1482O A phase III study comparing methotrexate (M), adriamycin (A) and cisplatin (P) with MAP + ifosfamide (MAP + IF) for the treatment of osteosarcoma: JCOG0905. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1585] [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: 11/29/2022] Open
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15
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Takemori T, Kawamoto T, Hara H, Fukase N, Fujiwara S, Fujita I, Fujimoto T, Morishita M, Kitayama K, Yahiro S, Miyamoto T, Saito M, Sugaya J, Hayashi K, Kawashima H, Torigoe T, Nakamura T, Kondo H, Wakamatsu T, Watanuki M, Kito M, Tsukushi S, Nagano A, Outani H, Toki S, Nishimura S, Kobayashi H, Watanabe I, Demizu Y, Sasaki R, Fukumoto T, Niikura T, Kuroda R, Akisue T. Clinical Outcome of Patients with Pelvic and Retroperitoneal Bone and Soft Tissue Sarcoma: A Retrospective Multicenter Study in Japan. Cancers (Basel) 2022; 14:cancers14123023. [PMID: 35740688 PMCID: PMC9221521 DOI: 10.3390/cancers14123023] [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: 05/23/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 01/25/2023] Open
Abstract
Simple Summary We aimed to clarify the clinical outcomes of patients with pelvic and retroperitoneal bone and soft tissue sarcoma. The 3-year overall survival (OS), local control (LC) rate, and progression-free survival (PFS) were 71.7%, 79.1%, and 48.6%, respectively. The most influential poor prognostic factor for OS was distant metastasis, and for PFS, this was higher age (≥60 years). Larger primary tumor size (≥10 cm) was the only poor prognostic factor for LC. In the histological analysis, osteosarcoma showed significantly worse OS and PFS than other sarcomas in the pelvis and retroperitoneum. Abstract This study aimed to retrospectively analyze the clinical outcomes of patients with pelvic and retroperitoneal bone and soft tissue sarcoma (BSTS). Overall, 187 patients with BSTS in the pelvis and retroperitoneal region treated at 19 specialized sarcoma centers in Japan were included. The prognostic factors related to overall survival (OS), local control (LC), and progression-free survival (PFS) were evaluated. The 3-year OS and LC rates in the 187 patients were 71.7% and 79.1%, respectively. The 3-year PFS in 166 patients without any distant metastases at the time of primary tumor diagnosis was 48.6%. Osteosarcoma showed significantly worse OS and PFS than other sarcomas of the pelvis and retroperitoneum. In the univariate analyses, larger primary tumor size, soft tissue tumor, distant metastasis at the time of primary tumor diagnosis, P2 location, chemotherapy, and osteosarcoma were poor prognostic factors correlated with OS. Larger primary tumor size, higher age, soft tissue tumor, chemotherapy, and osteosarcoma were poor prognostic factors correlated with PFS in patients without any metastasis at the initial presentation. Larger primary tumor size was the only poor prognostic factor correlation with LC. This study has clarified the epidemiology and prognosis of patients with pelvic and retroperitoneal BSTS in Japan.
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Affiliation(s)
- Toshiyuki Takemori
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-8558, Japan; (I.F.); (T.F.); (M.M.)
| | - Teruya Kawamoto
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
- Division of Orthopaedic Surgery, Kobe University Hospital, International Clinical Cancer Research Center, Kobe 650-0047, Japan
- Correspondence: ; Tel.: +81-783825985
| | - Hitomi Hara
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Naomasa Fukase
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Shuichi Fujiwara
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Ikuo Fujita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-8558, Japan; (I.F.); (T.F.); (M.M.)
| | - Takuya Fujimoto
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-8558, Japan; (I.F.); (T.F.); (M.M.)
| | - Masayuki Morishita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-8558, Japan; (I.F.); (T.F.); (M.M.)
| | - Kazumichi Kitayama
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Shunsuke Yahiro
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Tomohiro Miyamoto
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Masanori Saito
- Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan;
| | - Jun Sugaya
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan;
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8641, Japan;
| | - Hiroyuki Kawashima
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan;
| | - Tomoaki Torigoe
- Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka 350-1298, Japan;
| | - Tomoki Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan;
| | - Hiroya Kondo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama University, Okayama 700-8558, Japan;
| | - Toru Wakamatsu
- Department of Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka 541-8567, Japan;
| | - Munenori Watanuki
- Department of Orthopaedic Surgery, School of Medicine, Tohoku University, Sendai 980-8574, Japan;
| | - Munehisa Kito
- Department of Orthopaedic Surgery, School of Medicine, Shinshu University, Matsumoto 390-8621, Japan;
| | - Satoshi Tsukushi
- Department of Orthopaedic Surgery, Aichi Cancer Center Hospital, Nagoya 464-0021, Japan;
| | - Akihito Nagano
- Department of Orthopaedic Surgery, Gifu University, Gifu 501-1194, Japan;
| | - Hidetatsu Outani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan;
| | - Shunichi Toki
- Department of Orthopaedics, Institute of Biomedical Sciences, Graduate School, Tokushima University, Tokushima 770-8503, Japan;
| | - Shunji Nishimura
- Department of Orthopaedic Surgery, Kindai University Hospital, Osaka-Sayama 589-8511, Japan;
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan;
| | - Itsuo Watanabe
- Department of Orthopaedic Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa 272-8513, Japan;
| | - Yusuke Demizu
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe 650-0047, Japan;
| | - Ryohei Sasaki
- Division of Radiation Oncology, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan;
| | - Takumi Fukumoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan;
| | - Takahiro Niikura
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Ryosuke Kuroda
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
| | - Toshihiro Akisue
- Department of Orthoapedic Surgery, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan; (T.T.); (H.H.); (N.F.); (S.F.); (K.K.); (S.Y.); (T.M.); (T.N.); (R.K.); (T.A.)
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
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16
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Takemori T, Kawamoto T, Hara H, Fukase N, Fujiwara S, Kitayama K, Yahiro S, Miyamoto T, Mifune Y, Hoshino Y, Kakutani K, Matsumoto T, Matsushita T, Niikura T, Kuroda R, Akisue T. Clinical Outcomes and Prognostic Factors in Soft Tissue Sarcoma Patients After Unplanned Excision. Cancer Manag Res 2022; 14:1815-1824. [PMID: 35642242 PMCID: PMC9148585 DOI: 10.2147/cmar.s364912] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Soft tissue sarcomas (STSs) constitute a group of rare, heterogeneous tumors representing approximately 1% of all cancers. Owing to the rarity and pathological diversity of the disease, unplanned excision (UE) has often been performed for STS, resulting in an unfavorable prognosis. This study aimed to clarify clinical outcomes and prognostic factors in STS patients who underwent UE. Patients and Methods In a retrospective review of the medical records of patients with STS who underwent surgery at our institution between 1999 and 2015, patients were enrolled to either a UE group or a planned excision (PE) group. An analysis was then conducted to identify factors associated with prognosis after UE. Results Of 134 patients undergoing surgery for STS, 110 were enrolled to the PE group and 24 to the UE group. The median size of the primary tumor was significantly smaller, and more lesions were located in the superficial layer in the UE group than in the PE group. In addition, plastic reconstruction after additional radical resection was required significantly more often in the UE group than in the PE group. No significant difference in overall survival, local recurrence-free survival, or disease-free survival (DFS) between the UE and PE groups was observed; however, metastasis-free survival was significantly better in the UE group. In the UE group, poorer DFS was associated with older age (≥61 years) and a larger primary tumor (≥2.9 cm). Conclusion A prognosis similar to that in patients undergoing PE could be achieved by appropriate additional surgeries in patients initially undergoing UE. However, UE for STS should be avoided, especially in older patients and those with a larger primary tumor.
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Affiliation(s)
- Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Orthopaedic Surgery, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
- Correspondence: Teruya Kawamoto, Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan, Tel +81-783825985, Fax +81-783516944, Email
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazumichi Kitayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohiro Miyamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
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17
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Urakawa H, Nagano A, Machida R, Tanaka K, Kataoka T, Sekino Y, Nishida Y, Takahashi M, Kunisada T, Kawano M, Yoshida Y, Takagi T, Sato K, Hiruma T, Hatano H, Tsukushi S, Sakamoto A, Akisue T, Hiraoka K, Ozaki T. A randomized phase III trial of denosumab before curettage for giant cell tumor of bone. JCOG1610. Jpn J Clin Oncol 2022; 52:1021-1028. [PMID: 35472141 DOI: 10.1093/jjco/hyac071] [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: 01/12/2022] [Accepted: 04/09/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of JCOG1610 (randomized controlled phase III trial) was to confirm the superiority of preoperative denosumab to curettage with adjuvant local therapy for patients with giant cell tumor of bone without possible post-operative large bone defect. METHODS The primary endpoint was relapse-free survival and the total sample size was set at 106 patients. Patient accrual began in October 2017. However, the accrual was terminated in December 2020 due to a recommendation from the Data and Safety Monitoring Committee because of poor patient accrual. Now, we report the descriptive results obtained in this study. RESULTS A total of 18 patients had been registered from 13 Japanese institutions at the time of termination on December 2020. Eleven patients were assigned to Arm A (curettage and adjuvant local therapy) and 7 to Arm B (preoperative denosumab, curettage and adjuvant local therapy). Median follow-up period was 1.6 (range: 0.5-2.8) years. Protocol treatment was completed in all but one patient in Arm A who had a pathological fracture before surgery. All patients in Arm B were treated with five courses of preoperative denosumab. Relapse-free survival proportions in Arm A and B were 90.0% (95% confidence interval: 47.3-98.5) and 100% (100-100) at 1 year, and 60.0% (19.0-85.5) and 62.5% (14.2-89.3) at 2 years, respectively [hazard ratio (95% confidence interval): 1.51 (0.24-9.41)]. CONCLUSION In terms of relapse-free survival, the superiority of preoperative denosumab was not observed in patients with giant cell tumor of bone without possible post-operative large bone defect.
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Affiliation(s)
- Hiroshi Urakawa
- Department of Orthopaedic Surgery, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Akihito Nagano
- Department of Orthopaedic Surgery, Gifu University School of Medicine, Gifu, Japan
| | - Ryunosuke Machida
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhiro Tanaka
- Department of Orthopaedic Surgery, Oita University, Yufu, Japan
| | - Tomoko Kataoka
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yuta Sekino
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Mitsuru Takahashi
- Department of Orthopaedic Surgery, Shizuoka Cancer Center, Sunto-Gun, Japan
| | - Toshiyuki Kunisada
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Masanori Kawano
- Department of Orthopaedic Surgery, Oita University, Yufu, Japan
| | - Yukihiro Yoshida
- Department of Orthopedic Surgery, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Tatsuya Takagi
- Department of Orthopedic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Kenji Sato
- Department of Orthopedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Toru Hiruma
- Department of Musculoskeletal Tumor Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroshi Hatano
- Department of Orthopedic Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Satoshi Tsukushi
- Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Akio Sakamoto
- Department of Orthopedic Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Koji Hiraoka
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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18
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Nikaido Y, Okada Y, Urakami H, Ishida N, Akisue T, Kawami Y, Kuroda K, Kajimoto Y, Saura R. Dynamic stability during gait in idiopathic normal pressure hydrocephalus and Parkinson's disease. Acta Neurol Scand 2022; 145:215-222. [PMID: 34633069 DOI: 10.1111/ane.13537] [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: 04/05/2021] [Revised: 07/14/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To clarify a characteristic of dynamic stability during gait in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD), and to explore the association between dynamic stability and disease severity in each disease. MATERIALS AND METHODS The 5-m gait of 36 iNPH (precerebrospinal fluid drainage), 20 PD (medicated state), and 25 healthy controls (HC) were evaluated using three-dimensional motion analysis. Ambulatory dynamic stability was defined as the ability to maintain the extrapolated center of mass within the base of support at heel contact, with the distance between the two referred to as the margin of stability (MOS). RESULTS Anteroposterior direction (AP) MOS was significantly larger in the iNPH and PD groups than in the HC group; no significant difference was found between the iNPH and PD groups. Mediolateral direction (ML) MOS was significantly larger in the iNPH and PD groups than in the HC group and significantly larger in the iNPH group than in the PD group. In the iNPH group, the disease severity was positively correlated with only ML MOS. In the PD group, the disease severity was positively correlated with the AP MOS and ML MOS. CONCLUSIONS Dynamic stability in iNPH increases in AP and ML, and it may be associated with not only iNPH-associated gait disturbance but also with a voluntarily cautious gait strategy. Dynamic stability in PD only increased in AP, and this may be associated with PD symptoms. These findings will help physicians understand the difference in pathological gait including dynamic stability between patients with iNPH and PD.
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Affiliation(s)
- Yasutaka Nikaido
- Clinical Department of Rehabilitation Osaka Medical and Pharmaceutical University Hospital Osaka Japan
| | - Yohei Okada
- Graduate School of Health Sciences Kio University Nara Japan
- Neurorehabilitation Research Center of Kio University Nara Japan
| | - Hideyuki Urakami
- Clinical Department of Rehabilitation Osaka Medical and Pharmaceutical University Hospital Osaka Japan
| | - Naoya Ishida
- Clinical Department of Rehabilitation Osaka Medical and Pharmaceutical University Hospital Osaka Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Sciences, Graduate School of Health Sciences Kobe University Kobe Japan
| | - Yuki Kawami
- Department of Rehabilitation Sciences, Graduate School of Health Sciences Kobe University Kobe Japan
- Department of Physical Therapy, Faculty of Rehabilitation Hyogo Prefectural Rehabilitation Hospital at Nishi‐Harima Hyogo Japan
| | - Kenji Kuroda
- Clinical Department of Rehabilitation Osaka Medical and Pharmaceutical University Hospital Osaka Japan
| | - Yoshinaga Kajimoto
- Department of Neurosurgery, Division of Surgery Osaka Medical and Pharmaceutical University Osaka Japan
| | - Ryuichi Saura
- Department of Physical and Rehabilitation Medicine, Division of Comprehensive Medicine Osaka Medical and Pharmaceutical University Osaka Japan
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19
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Yahiro S, Fujimoto T, Fujita I, Takai T, Sakuma T, Sudo T, Morishita M, Takigami S, Kawamoto T, Hara H, Akisue T, Kuroda R, Hirose T. Proximal-type epithelioid sarcoma in pubic region expressing L-type amino acid transporter 1: A case report. SAGE Open Med Case Rep 2022; 10:2050313X211067917. [PMID: 35024147 PMCID: PMC8743976 DOI: 10.1177/2050313x211067917] [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: 08/07/2021] [Accepted: 12/02/2021] [Indexed: 11/15/2022] Open
Abstract
Proximal-type epithelioid sarcoma is an aggressive malignant soft-tissue neoplasm, a “proximal” variant of epithelioid sarcoma, resistant to multimodal therapy and involved in early tumor-related death. Pertinent treatments are, therefore, continually being explored. A 24-year-old woman with nonmetastatic proximal-type epithelioid sarcoma, originating subcutaneously on the right side of the vulva, underwent surgical resection; the lesion recurred, however, leading to death 3 months after the second surgery. Here described is a case of proximal-type epithelioid sarcoma expressing L-type amino acid transporter 1 (LAT1) that transports essential amino acids and p-borono-L-phenylalanine (BPA)—the chemical compound used in boron neutron capture therapy (BNCT)—and is highly expressed in many malignant tumors. Recently, LAT1 has drawn attention, and relevant treatments have been studied—LAT1 inhibitor and BNCT. LAT1 expression in proximal-type epithelioid sarcoma may lead to cogent treatments for the disease.
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Affiliation(s)
- Shunsuke Yahiro
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Japan.,Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takuya Fujimoto
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Japan.,Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ikuo Fujita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Toshihiro Takai
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
| | - Toshiko Sakuma
- Department of Pathology, Hyogo Cancer Center, Akashi, Japan
| | - Tamotsu Sudo
- Section of Translational Research, Hyogo Cancer Center, Akashi, Japan
| | | | - Shunsaku Takigami
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Orthopaedic Surgery, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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20
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Kawami Y, Nikaido Y, Nose S, Unekawa M, Marumoto K, Kawami M, Matsugashita S, Kozuki T, Akisue T. Mediolateral Postural Control during Gait in Parkinson’s Disease. Prog Rehabil Med 2022; 7:20220048. [PMID: 36160027 PMCID: PMC9470496 DOI: 10.2490/prm.20220048] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: Balance in the mediolateral direction is usually maintained in patients with
early-stage Parkinson’s disease (PD), but not in moderate-stage PD as revealed by the
Tandem Gait Test. Although mediolateral postural control in PD patients remains
controversial, previous studies have shown that the Tandem Gait Test may predict the
risk of future falls in patients with PD. This study aimed to clarify postural control
differences among PD patients with and without mediolateral balance impairments (MLBI:
mediolateral balance impairments, nMLBI: non-mediolateral balance impairments,
respectively) and healthy controls (HCs). Methods: We recruited 40 PD patients and 20 HCs. According to the Tandem Gait Test score, PD
patients were divided into MLBI and nMLBI groups. Primary outcome measures were the
ambulatory movement trajectory amplitude of the center of mass and its coefficient of
variation (CV) during gait. Results: Mediolateral movement trajectory amplitudes and CV were not significantly different
between the nMLBI group and HCs, whereas the mediolateral movement trajectory amplitude
in the MLBI group was significantly higher than that in the nMLBI group. Moreover, the
CV of the mediolateral movement trajectory amplitude in the MLBI group was significantly
lower than that in the nMLBI group. The mediolateral movement trajectory amplitude was
significantly correlated with the fall score. Conclusions: The current results suggest that PD patients with mediolateral balance impairments
showed mediolateral postural sway during gait compared with PD patients without
mediolateral balance impairments. It is necessary to focus on the instabilities in the
mediolateral direction to avoid falls in PD patients.
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Affiliation(s)
- Yuki Kawami
- Department of Physical Therapy, Faculty of Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Tatsuno, Japan
| | - Yasutaka Nikaido
- Clinical Department of Rehabilitation, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
| | - Shoma Nose
- Department of Physical Therapy, Faculty of Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Tatsuno, Japan
| | - Maya Unekawa
- Department of Physical Therapy, Faculty of Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Tatsuno, Japan
| | - Kohei Marumoto
- Department of Physical Medicine and Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Tatsuno, Japan
| | - Mika Kawami
- Department of Occupational Therapy, Faculty of Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Tatsuno, Japan
| | - So Matsugashita
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Tsuyoshi Kozuki
- Department of Physical Therapy, Faculty of Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Tatsuno, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
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21
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Kitayama K, Kawamoto T, Kawakami Y, Hara H, Takemori T, Fujiwara S, Yahiro S, Miyamoto T, Mifune Y, Hoshino Y, Kakutani K, Matsumoto T, Matsushita T, Niikura T, Kuroda R, Akisue T. Regulatory roles of miRNAs 16, 133a, and 223 on osteoclastic bone destruction caused by breast cancer metastasis. Int J Oncol 2021; 59:97. [PMID: 34713296 PMCID: PMC8562387 DOI: 10.3892/ijo.2021.5277] [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: 07/13/2021] [Accepted: 10/04/2021] [Indexed: 12/11/2022] Open
Abstract
Osteolytic bone metastasis leads to skeletal-related events, resulting in a decline in the patient activities and survival; therefore, it is important to understand the mechanism underlying bone metastasis. Recent studies have suggested that microRNAs (miRNAs or miRs) are involved in osteoclast differentiation and/or osteolytic bone metastasis; however, the roles of miRNAs have not been elucidated. In the present study, the roles of miRNAs in bone destruction caused by breast cancer metastasis were investigated in vitro and in vivo. miR-16, miR-133a and miR-223 were transfected into a human breast cancer cell line, MDA-MB-231. The expression of osteolytic factors in conditioned medium (miR-CM) collected from the culture of transfected cells was assessed. To evaluate the effects of miRNAs on osteoclast differentiation and activities, tartrate-resistant acid phosphatase (TRAP) staining and bone resorptive assays were performed in osteoclasts following miR-CM treatment. To create in vivo bone metastasis models for histological and morphometric evaluation, miRNA-transfected MDA-MB-231 cells were transplanted into the proximal tibia of nude mice. Expression of osteolytic factors, including receptor activator for nuclear factor-κB ligand (RANKL), interleukin (IL)-1β, IL-6, parathyroid hormone-related protein (PTHrP), and tumor necrosis factor (TNF), was increased in miR-16-CM, whereas it was decreased in both miR-133a-CM and miR-223-CM. TRAP staining and bone resorptive assays revealed that osteoclast function and activities were promoted by miR-16-CM treatment, whereas they were suppressed by miR-133a-CM and miR-223-CM. Consistent with in vitro findings, in vivo experiments revealed that the overexpression of miR-16 increased osteoclast activities and bone destruction in MDA-MB-231 cells, whereas the opposite results were observed in both miR-133a- and miR-223-transfected MDA-MB-231 cells. Our results indicated that miR-16 promoted osteoclast activities and bone destruction caused by breast cancer metastasis in the bone microenvironment, whereas miR-133a and miR-223 suppressed them. These miRNAs could be potential biomarkers and therapeutic targets for breast cancer bone metastasis.
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Affiliation(s)
- Kazumichi Kitayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Tomohiro Miyamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan
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22
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Inoue S, Hatakeyama J, Aoki H, Kuroki H, Niikura T, Oe K, Fukui T, Kuroda R, Akisue T, Moriyama H. Correction to: Utilization of Mechanical Stress to Treat Osteoporosis: The Effects of Electrical Stimulation, Radial Extracorporeal Shock Wave, and Ultrasound on Experimental Osteoporosis in Ovariectomized Rats. Calcif Tissue Int 2021; 109:230. [PMID: 34032863 DOI: 10.1007/s00223-021-00867-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Shota Inoue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Junpei Hatakeyama
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Hitoshi Aoki
- OG Wellness Technologies Co., Ltd, Okayama, Japan
| | - Hiroshi Kuroki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoaki Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Tomogaoka 7-10-2, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Hideki Moriyama
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Tomogaoka 7-10-2, Suma-ku, Kobe, Hyogo, 654-0142, Japan.
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Inoue S, Hatakeyama J, Aoki H, Kuroki H, Niikura T, Oe K, Fukui T, Kuroda R, Akisue T, Moriyama H. Utilization of Mechanical Stress to Treat Osteoporosis: The Effects of Electrical Stimulation, Radial Extracorporeal Shock Wave, and Ultrasound on Experimental Osteoporosis in Ovariectomized Rats. Calcif Tissue Int 2021; 109:215-229. [PMID: 33751141 DOI: 10.1007/s00223-021-00831-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
Current treatment options for osteoporosis primarily involve pharmacotherapies, but they are often accompanied by undesirable side effects. Utilization of mechanical stress which can noninvasively induce bone formation has been suggested as an alternative to conventional treatments. Here, we examined the efficacy of mechanical stress induced by electrical stimulation, radial extracorporeal shock waves, and ultrasound for estrogen-deficient osteoporosis. Female Wistar rats were divided into following five groups: sham-operated group, untreated after ovariectomy, and treated with electrical stimulation, radial extracorporeal shock wave, or ultrasound starting at 8 weeks after ovariectomy for 4 weeks. Trabecular bone architecture of the femur was assessed by micro-CT and its biomechanical properties were obtained by mechanical testing. The femurs were further evaluated by histochemical, immunohistochemical, and real-time PCR analyses. Radial extracorporeal shock wave and ultrasound treatment improved trabecular bone microarchitecture and bone strength in osteoporotic rats, but not electrical stimulation. The shock wave decreased osteoclast activity and RANKL expression. The exposure of ultrasound increased osteoblast activity and β-catenin-positive cells, and they decreased sclerostin-positive osteocytes. These findings suggest that mechanical stress induced by radial extracorporeal shock wave and ultrasound can improve estrogen-deficient bone loss and bone fragility through promoted bone formation or attenuated bone resorption.
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Affiliation(s)
- Shota Inoue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Junpei Hatakeyama
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Hitoshi Aoki
- OG Wellness Technologies Co., Ltd, Okayama, Japan
| | - Hiroshi Kuroki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoaki Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Tomogaoka 7-10-2, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Hideki Moriyama
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Tomogaoka 7-10-2, Suma-ku, Kobe, Hyogo, 654-0142, Japan.
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Nikaido Y, Urakami H, Akisue T, Okada Y, Kawami Y, Ishida N, Kuroda K, Ohno H, Kajimoto Y, Saura R. Perceived and actual changes in gait balance after CSF shunting in idiopathic normal pressure hydrocephalus. Acta Neurol Scand 2021; 144:21-28. [PMID: 33754339 DOI: 10.1111/ane.13421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/12/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We evaluated the perceived and actual changes in gait and balance function immediately after cerebrospinal fluid (CSF) shunting in patients with idiopathic normal pressure hydrocephalus (iNPH), including those with mild cases. MATERIALS AND METHODS Ninety-nine iNPH patients were assessed using the timed Up and Go (TUG) and Functional Gait Assessment (FGA) before and 1-week after CSF shunting and their perceived changes were assessed on a Global Rate of Change (GRC) scale. Minimal clinically important differences (MCIDs) were calculated using a receiver operating characteristic (ROC) curve method using GRC scores. RESULTS In all patients (n = 99), the TUG value postoperatively was significantly faster than the preoperative value (difference; 3.1 ± 4.6 s, p < 0.001), and the postoperative FGA score was significantly better than the preoperative score (difference; 3.8 ± 3.3 points, p < 0.001). In the TUG <15 s group (n = 51), the postoperative FGA score was significantly improved (difference; 3.3 ± 2.9 points, p < 0.001), whereas the TUG value was only slightly improved (difference; 0.6 ± 1.6 s, p = 0.008). The ROC curve MCIDs of GRC ≥2 points, which is the recommended level of improvement, were 1.7 s (16.5%) for the TUG and 4 points (20.0%) for the FGA in all patients (n = 99) and the TUG <15 s group (n = 51). CONCLUSIONS FGA can be used to confirm treatment effects, including perceived and actual changes after CSF shunting, in patients with mild iNPH. Our results can help clinicians to determine the clinical significance of improvements in gait and balance function immediately after CSF shunting in individual patients with iNPH.
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Affiliation(s)
- Yasutaka Nikaido
- Clinical Department of Rehabilitation Osaka Medical College Hospital Osaka Japan
| | - Hideyuki Urakami
- Clinical Department of Rehabilitation Osaka Medical College Hospital Osaka Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science Graduate School of Health Sciences Kobe University Kobe Japan
| | - Yohei Okada
- Graduate School of Health Sciences Kio University Nara Japan
- Neurorehabilitation Research Center of Kio University Nara Japan
| | - Yuki Kawami
- Department of Rehabilitation Science Graduate School of Health Sciences Kobe University Kobe Japan
- Department of Physical Therapy Faculty of Rehabilitation Hyogo Prefectural Rehabilitation Hospital at Nishi‐Harima Hyogo Japan
| | - Naoya Ishida
- Clinical Department of Rehabilitation Osaka Medical College Hospital Osaka Japan
| | - Kenji Kuroda
- Clinical Department of Rehabilitation Osaka Medical College Hospital Osaka Japan
| | - Hiroshi Ohno
- Clinical Department of Rehabilitation Osaka Medical College Hospital Osaka Japan
| | - Yoshinaga Kajimoto
- Department of Neurosurgery Division of Surgery Osaka Medical College Osaka Japan
| | - Ryuichi Saura
- Department of Physical and Rehabilitation Medicine Division of Comprehensive Medicine Osaka Medical College Osaka Japan
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25
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Inoue S, Hatakeyama J, Aoki H, Kuroki H, Niikura T, Oe K, Fukui T, Kuroda R, Akisue T, Moriyama H. Effects of ultrasound, radial extracorporeal shock waves, and electrical stimulation on rat bone defect healing. Ann N Y Acad Sci 2021; 1497:3-14. [PMID: 33619772 DOI: 10.1111/nyas.14581] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 11/27/2022]
Abstract
Fractures associated with osteoporosis are a major public health concern. Current treatments for fractures are limited to surgery or fixation, leading to long-term bedrest, which is linked to increased mortality. Alternatively, utilization of physical agents has been suggested as a promising therapeutic approach for fractures. Here, we examined the effects of ultrasound, radial extracorporeal shock waves, and electrical stimulation on normal or osteoporotic fracture healing. Femoral bone defects were created in normal or ovariectomized rats. Rats were divided into four groups: untreated, and treated with ultrasound, shock waves, or electrical stimulation after surgery. Samples were collected at 2 or 4 weeks after surgery, and the healing process was evaluated with micro-CT, histological, and immunohistochemical analyses. Ultrasound at intensities of 0.5 and 1.0 W/cm2 , but not 0.05 W/cm2 , accelerated new bone formation. Shock wave exposure also increased newly formed bone, but formed abnormal periosteal callus around the defect site. Conversely, electrical stimulation did not affect the healing process. Ultrasound exposure increased osteoblast activity and cell proliferation and decreased sclerostin-positive osteocytes. We demonstrated that higher-intensity ultrasound and radial extracorporeal shock waves accelerate fracture healing, but shock wave treatment may increase the risk of periosteal callus formation.
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Affiliation(s)
- Shota Inoue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Junpei Hatakeyama
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Hitoshi Aoki
- OG Wellness Technologies Co., Ltd., Okayama, Japan
| | - Hiroshi Kuroki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoaki Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Kobe, Japan
| | - Hideki Moriyama
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Kobe, Japan
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26
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Hara H, Sakai Y, Kawamoto T, Fukase N, Kawakami Y, Takemori T, Fujiwara S, Kitayama K, Yahiro S, Miyamoto T, Kakutani K, Niikura T, Miyawaki D, Okada T, Sakashita A, Imamura Y, Sasaki R, Kizawa Y, Minami H, Matsumoto T, Matsushita T, Kuroda R, Akisue T. Surgical outcomes of metastatic bone tumors in the extremities (Surgical outcomes of bone metastases). J Bone Oncol 2021; 27:100352. [PMID: 33850700 PMCID: PMC8039818 DOI: 10.1016/j.jbo.2021.100352] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 10/14/2020] [Revised: 01/01/2021] [Accepted: 01/20/2021] [Indexed: 11/24/2022] Open
Abstract
Prognostic factors: primary tumor, visceral metastases, and surgical procedure. PS, BI, EQ-5D, and NRS improved at 3 months after surgery. The improvements of PS, BI, EQ-5D, and NRS were maintained for 6 M after surgery. The management of bone metastases must be decided by a multidisciplinary team. The proper management of bone metastasis will reduce postoperative complications.
Background Skeletal related events due to metastatic bone tumors markedly affect the activities of daily living (ADL) and quality of life (QOL) in cancer patients. We focused on multidisciplinary therapy for metastatic bone tumors. This study aimed to evaluate the outcomes of surgical treatment for metastatic bone tumors in the extremities. Methods We retrospectively reviewed 114 patients who underwent surgical treatment for metastatic bone tumors of the extremities between 2008 and 2019 and 69 patients were reassessed for more than 6 months after surgery. The most common primary tumor was renal, followed by lung, thyroid, and breast cancers. We assessed 69 patients’ performance status (PS), Barthel Index (BI) for ADL, EuroQol 5 Dimensions (EQ-5D) for QOL, and numerical rating scale (NRS) for pain and analyzed these postoperative values relative to preoperative values using Friedman’s test. The postoperative overall survival and the prognostic factors were evaluated using the Kaplan-Meier method, the log-rank test and Cox proportional hazards analysis. Results The 1-year overall survival rate was 59%, and the median survival time after surgery was 20 months. Primary tumor, visceral metastasis, and surgical procedure were risk factors correlated with overall survival. PS, BI, EQ-5D, and NRS improved at 3 months after surgery and these improvements were maintained for 6 months after surgery regardless of the surgical procedure. Conclusions The significant factors affecting survival after surgical treatment for bone metastases included the primary tumor, presence of visceral metastases, and internal fixation without tumor resection or curettage. Surgical treatment for metastatic bone tumors effectively reduced pain and improved PS, ADL, and QOL postoperatively after 3 months.
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Affiliation(s)
- Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Kazumichi Kitayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Tomohiro Miyamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Daisuke Miyawaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Takuya Okada
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Akihiro Sakashita
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yoshinori Imamura
- Department of Medical Oncology/Hematology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Hironobu Minami
- Department of Medical Oncology/Hematology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan
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27
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Takemori T, Kawamoto T, Morishita M, Hara H, Fukase N, Kawakami Y, Fujiwara S, Kitayama K, Yahiro S, Miyamoto T, Fujimoto T, Fujita I, Mifune Y, Hoshino Y, Kakutani K, Matsumoto T, Matsushita T, Niikura T, Kuroda R, Akisue T. Clinical Outcome of the Patients With Brain Metastasis from Soft Tissue Sarcomas. Anticancer Res 2021; 41:1027-1034. [PMID: 33517311 DOI: 10.21873/anticanres.14858] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to evaluate the association of clinical characteristics with treatment outcomes to ascertain the appropriate treatment options for soft tissue sarcomas (STS) patients with brain metastasis (BM). PATIENTS AND METHODS Medical records of STS patients with BM who were treated in our institutions were retrospectively reviewed, and analyzed to identify the factors associated with post-BM survival. RESULTS Among the 509 STS patients, BM occurred in five patients (0.98%). The median survival after BM was 1.5 months. Histological subtypes of the primary lesions in the five BM patients were: two synovial sarcomas, one myxoid liposarcoma, one alveolar soft part sarcoma, and one rhabdomyosarcoma. Among the five BM patients, the post-BM survival of two patients, who underwent surgery and postoperative radiotherapy, was longer than that of the other patients (p<0.01). CONCLUSION Combined surgery and postoperative radiotherapy effectively managed symptoms and prolonged survival in STS patients with BM.
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Affiliation(s)
- Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; .,Division of Orthopaedic Surgery, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | | | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazumichi Kitayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohiro Miyamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takuya Fujimoto
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Ikuo Fujita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
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28
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Inoue S, Moriyama H, Wakimoto Y, Li C, Hatakeyama J, Wakigawa T, Sakai Y, Akisue T. Transcutaneous application of carbon dioxide improves contractures after immobilization of rat knee joint. Phys Ther Res 2021; 23:113-122. [PMID: 33489648 DOI: 10.1298/ptr.e10023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/15/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Joint contractures are a major complication following joint immobilization. However, no fully effective treatment has yet been found. Recently, carbon dioxide (CO2) therapy was developed and verified this therapeutic application in various disorders. We aimed to verify the efficacy of transcutaneous CO2 therapy for immobilization-induced joint contracture. METHOD Twenty-two Wistar rats were randomly assigned to three groups: caged control, those untreated after joint immobilization, and those treated after joint immobilization. The rats were treated with CO2 for 20 min once a daily either during immobilization, (prevention) or during remobilization after immobilization (treatment). Knee extension motion was measured with a goniometer, and the muscular and articular factors responsible for contractures were calculated. We evaluated muscle fibrosis, fibrosis-related genes (collagen Type 1α1 and TGF-β1) in muscles, synovial intima's length, and fibrosis-related proteins (Type I collagen and TGF-β1) in the joint capsules. RESULTS CO2 therapy for prevention and treatment improved the knee extension motion. Muscular and articular factors decreased in rats of the treatment group. The muscular fibrosis of treated rats decreased in the treatment group. Although CO2 therapy did not repress the increased expression of collagen Type 1α1, the therapy decreased the expression of TGF-β1 in the treatment group. CO2 therapy for treatment improved the shortening of the synovial membrane after immobilization and decreased the immunolabeling of TGF-β1 in the joint capsules. CONCLUSIONS CO2 therapy may prevent and treat contractures after joint immobilization, and appears to be more effective as a treatment strategy for the deterioration of contractures during remobilization.
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Affiliation(s)
- Shota Inoue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University
| | - Hideki Moriyama
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University
| | - Yoshio Wakimoto
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University
| | - Changxin Li
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University
| | - Junpei Hatakeyama
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University
| | - Taisei Wakigawa
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine
| | - Toshihiro Akisue
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University
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Oda T, Niikura T, Fukui T, Oe K, Kuroiwa Y, Kumabe Y, Sawauchi K, Yoshikawa R, Mifune Y, Hayashi S, Matsumoto T, Matsushita T, Kawamoto T, Sakai Y, Akisue T, Kuroda R. Transcutaneous CO 2 application accelerates fracture repair in streptozotocin-induced type I diabetic rats. BMJ Open Diabetes Res Care 2020; 8:8/2/e001129. [PMID: 33323458 PMCID: PMC7745327 DOI: 10.1136/bmjdrc-2019-001129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 10/29/2020] [Accepted: 11/11/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) negatively affects fracture repair by inhibiting endochondral ossification, chondrogenesis, callus formation, and angiogenesis. We previously reported that transcutaneous CO2 application accelerates fracture repair by promoting endochondral ossification and angiogenesis. The present study aimed to determine whether CO2 treatment would promote fracture repair in cases with type I DM. RESEARCH DESIGN AND METHODS A closed femoral shaft fracture was induced in female rats with streptozotocin-induced type I DM. CO2 treatment was performed five times a week for the CO2 group. Sham treatment, where CO2 was replaced with air, was performed for the control group. Radiographic, histologic, genetic, and biomechanical measurements were taken at several time points. RESULTS Radiographic assessment demonstrated that fracture repair was induced in the CO2 group. Histologically, accelerated endochondral ossification and capillary formation were observed in the CO2 group. Immunohistochemical assessment indicated that early postfracture proliferation of chondrocytes in callus was enhanced in the CO2 group. Genetic assessment results suggested that cartilage and bone formation, angiogenesis, and vasodilation were upregulated in the CO2 group. Biomechanical assessment revealed enhanced mechanical strength in the CO2 group. CONCLUSIONS Our findings suggest that CO2 treatment accelerates fracture repair in type I DM rats. CO2 treatment could be an effective strategy for delayed fracture repair due to DM.
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Affiliation(s)
- Takahiro Oda
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Takahiro Niikura
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Tomoaki Fukui
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Keisuke Oe
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Yu Kuroiwa
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Yohei Kumabe
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Kenichi Sawauchi
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Ryo Yoshikawa
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Yutaka Mifune
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Shinya Hayashi
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Tomoyuki Matsumoto
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Takehiko Matsushita
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Teruya Kawamoto
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Faculty of Health Sciences and Graduate School of Medicine Faculty of Health Sciences, Kobe, Hyogo, Japan
| | - Ryosuke Kuroda
- Orthopaedic Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Hyogo, Japan
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30
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Mitani K, Kawamoto T, Hara H, Fukase N, Kawakami Y, Morishita M, Takemori T, Fujiwara S, Kitayama K, Yahiro S, Miyamoto T, Komatsu M, Jimbo N, Kuroda R, Akisue T. Chondrolipoma of the finger in a child: A case study. Mol Clin Oncol 2020; 14:2. [PMID: 33235730 PMCID: PMC7678633 DOI: 10.3892/mco.2020.2164] [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: 06/12/2020] [Accepted: 09/19/2020] [Indexed: 11/05/2022] Open
Abstract
Chondrolipoma is, based on the limited case reports available, an extremely rare histological variant of lipoma with the proliferation of mature adipocytes containing an area of true hyaline cartilage. Chondrolipoma is characterized by adult onset and is often identified in the breast, pharynx and tongue. The current study presents a case of chondrolipoma of the finger in an 11 year-old girl. Physical examination indicated a well-defined elastic soft mass, measuring 2.5x2 cm, on the dorsal aspect of the proximal phalanx of the left middle finger. Magnetic resonance imaging (MRI) revealed a well-circumscribed lesion with heterogeneous signal intensity. On T1- and T2-weighted images, the lesion indicated a predominantly marked hyperintense signal containing linear hypointense regions, and on fat-suppressed short-tau inversion recovery sequences, the lesion indicated a predominant hypointensity, with linear regions displaying hyperintensity. Marginal excision of the tumor was performed. Histologically, the major component of the tumor was mature adipose tissue containing a limited area of mature hyaline cartilage matrix, without lipoblasts or malignancy. The postoperative course of the patient was excellent, with no local recurrence three years after surgery. To the best of our knowledge, the current study outlines the first pediatric case of chondrolipoma arising in the finger.
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Affiliation(s)
- Kazuyoshi Mitani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.,Division of Orthopaedic Surgery, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Hyogo 650-0047, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Masayuki Morishita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-0021, Japan
| | - Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kazumichi Kitayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Tomohiro Miyamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Masato Komatsu
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.,Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Hyogo 654-0142, Japan
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Fujiwara S, Kawamoto T, Kawakami Y, Koterazawa Y, Hara H, Takemori T, Kitayama K, Yahiro S, Kakutani K, Matsumoto T, Matsushita T, Niikura T, Koyanagi-Aoi M, Aoi T, Kuroda R, Akisue T. Acquisition of cancer stem cell properties in osteosarcoma cells by defined factors. Stem Cell Res Ther 2020; 11:429. [PMID: 33008481 PMCID: PMC7532109 DOI: 10.1186/s13287-020-01944-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 05/09/2020] [Accepted: 09/20/2020] [Indexed: 12/18/2022] Open
Abstract
Background Cancer stem cells (CSCs) are considered to be responsible for tumor initiation, formation, and poor prognosis of cancer patients. However, the rarity of CSCs in clinical samples makes it difficult to elucidate characteristics of CSCs, especially in osteosarcoma (OS). The aim of this study is to verify whether it is possible to generate CSC-like cells by transducing defined factors into an OS cell line. Methods We retrovirally transduced the Octamer-binding transcription factor 3/4 (OCT3/4), Kruppel-like factor 4 (KLF4), and SRY-box transcription factor 2 (SOX2) genes into the MG-63 human OS cell line (MG-OKS). Parental and GFP-transduced MG-63 cells were used as negative control. We assessed the properties of the generated cells in vitro and in vivo. Multiple comparisons among groups were made using a one-way analysis of variance (ANOVA) followed by post hoc testing with Tukey’s procedure. Results MG-OKS cells in vitro exhibited the significantly increased mRNA expression levels of CSC markers (CD24, CD26, and CD133), decreased cell growth, increased chemoresistance and cell migration, and enhanced sphere formation. Notably, MG-OKS cells cultured under osteogenic differentiation conditions showed strongly positive staining for both Alizarin Red S and alkaline phosphatase, indicating osteogenesis of the cells. Gene ontology analysis of microarray data revealed significant upregulation of epidermal-related genes. Tumors derived from MG-OKS cells in vivo were significantly larger than those from other cells in μCT analysis, and immunohistochemical staining showed that Ki-67, osteocalcin, and HIF-1α-positive cells were more frequently detected in the MG-OKS-derived tumors. Conclusions In this study, we successfully generated OS CSC-like cells with significantly enhanced CSC properties following transduction of defined factors.
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Affiliation(s)
- Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. .,Division of Orthopaedic Surgery, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan.
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yasufumi Koterazawa
- Department of iPS Cell Applications, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Advanced Medical Science, Graduate School of Science, Technology and Innovation, Kobe University, Kobe, Japan.,Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kazumichi Kitayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shunsuke Yahiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Michiyo Koyanagi-Aoi
- Department of iPS Cell Applications, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Advanced Medical Science, Graduate School of Science, Technology and Innovation, Kobe University, Kobe, Japan.,Center for Human Resource development for Regenerative Medicine, Kobe University Hospital, Kobe, Japan
| | - Takashi Aoi
- Department of iPS Cell Applications, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Advanced Medical Science, Graduate School of Science, Technology and Innovation, Kobe University, Kobe, Japan.,Center for Human Resource development for Regenerative Medicine, Kobe University Hospital, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.,Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Oda T, Iwakura T, Fukui T, Oe K, Mifune Y, Hayashi S, Matsumoto T, Matsushita T, Kawamoto T, Sakai Y, Akisue T, Kuroda R, Niikura T. Effects of the duration of transcutaneous CO 2 application on the facilitatory effect in rat fracture repair. J Orthop Sci 2020; 25:886-891. [PMID: 31635930 DOI: 10.1016/j.jos.2019.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/27/2019] [Revised: 08/22/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Carbon dioxide therapy has been reported to be effective in treating certain cardiac diseases and skin problems. Although a previous study suggested that transcutaneous carbon dioxide application accelerated fracture repair in association with promotion of angiogenesis, blood flow, and endochondral ossification, the influence of the duration of carbon dioxide application on fracture repair is unknown. The aim of this study was to investigate the effect of the duration of transcutaneous carbon dioxide application on rat fracture repair. METHODS A closed femoral shaft fracture was created in each rat. Animals were randomly divided into four groups: the control group; 1w-CO2 group, postoperative carbon dioxide treatment for 1 week; 2w-CO2 group, postoperative carbon dioxide treatment for 2 weeks; 3w-CO2 group, postoperative carbon dioxide treatment for 3 weeks. Transcutaneous carbon dioxide application was performed five times a week in the carbon dioxide groups. Sham treatment, where the carbon dioxide was replaced with air, was performed for the control group. Radiographic, histological, and biomechanical assessments were performed at 3 weeks after fracture. RESULTS The fracture union rate was significantly higher in the 3w-CO2 group than in the control group (p < 0.05). Histological assessment revealed promotion of endochondral ossification in the 3w-CO2 group than in the control group. In the biomechanical assessment, all evaluation items related to bone strength were significantly higher in the 3w-CO2 group than in the control group (p < 0.05). CONCLUSIONS The present study, conducted using an animal model, demonstrated that continuous carbon dioxide application throughout the process of fracture repair was effective in enhancing fracture healing.
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Affiliation(s)
- Takahiro Oda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takashi Iwakura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoaki Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Keisuke Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shinya Hayashi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
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Fujimoto T, Suzuki M, Sudo T, Fujita I, Sakuma T, Sakurai Y, Hirose T, Morishita M, Takata T, Tamari Y, Tanaka H, Andoh T, Kawamoto T, Hara H, Fukase N, Kawakami Y, Shigemoto R, Matsumoto T, Ichikawa H, Ono K, Kuroda R, Akisue T. Boron neutron capture therapy for clear cell sarcoma. Appl Radiat Isot 2020; 166:109324. [PMID: 32861973 DOI: 10.1016/j.apradiso.2020.109324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/19/2019] [Revised: 10/05/2019] [Accepted: 07/03/2020] [Indexed: 11/26/2022]
Abstract
Clear cell sarcoma of tendons and aponeuroses (CCS) is a rare, malignant tumor arising in lower extremities with no effective treatment other than wide surgical resection. Here described is a case of primary CCS in the peroneal tendon of the right foot of a 54-year-old woman enrolled to undergo BNCT. The tumor mass post-BNCT disappeared totally without damage to other normal tissue, demonstrating, for the first time, the potential efficacy of BNCT in complete local control of CCS.
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Affiliation(s)
- Takuya Fujimoto
- Department of Orthopaedic Surgery, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan; Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Minoru Suzuki
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-cho, Sennan-gun, 590-0494, Japan
| | - Tamotsu Sudo
- Section of Translational Research, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan
| | - Ikuo Fujita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan
| | - Toshiko Sakuma
- Department of Diagnostic Pathology, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan
| | - Yoshinori Sakurai
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-cho, Sennan-gun, 590-0494, Japan
| | - Takanori Hirose
- Department of Diagnostic Pathology, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan
| | - Masayuki Morishita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan
| | - Takushi Takata
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-cho, Sennan-gun, 590-0494, Japan
| | - Yuki Tamari
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-cho, Sennan-gun, 590-0494, Japan
| | - Hiroki Tanaka
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, 2 Asashiro-Nishi, Kumatori-cho, Sennan-gun, 590-0494, Japan
| | - Tooru Andoh
- Faculty of Pharmaceutical Sciences, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, 650-8586, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Division of Orthopaedic Surgery, Kobe University International Clinical Cancer Research Center, 1-5-1 Minatojimaminami-cho, Chuo-ku, Kobe, 650-0047, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Rika Shigemoto
- Department of Orthopaedic Surgery, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hideki Ichikawa
- Faculty of Pharmaceutical Sciences, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, 650-8586, Japan
| | - Koji Ono
- Kansai BNCT Medical Center, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10- 2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
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Kawakami Y, Hara H, Kawamoto T, Niikura T, Kuroda R, Akisue T. Extraskeletal Para-articular Osteochondroma of the Ankle Joint in a Child: A Case Report. JBJS Case Connect 2020; 10:e0274. [PMID: 32649094 DOI: 10.2106/jbjs.cc.19.00274] [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: 11/14/2022]
Abstract
CASE We present a rare case of extraskeletal para-articular osteochondroma (ESPAOC) in the ankle of a 9-year-old boy, which was causing pain and limiting the range of motion of the ankle joint. The lesion might have also contributed to the deformity of the medial aspect of the talus. Total resection resolved all of the symptoms, with no recurrence at 1-year postoperatively. CONCLUSION Operative excision should be considered when ESPAOC directly restricts ankle motion because it can lead to chronic pain and joint degeneration if left untreated.
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Affiliation(s)
- Yohei Kawakami
- 1Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan 2Division of Orthopaedic Surgery, Kobe University International Clinical Cancer Research Center, Kobe, Japan 3Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Ikuta K, Kawamoto T, Hara H, Fukase N, Morishita M, Kuroda R, Akisue T. Solitary pancreatic lesion as the initial metastasis from osteosarcoma: Report of a rare case. J Orthop Sci 2020; 25:724-728. [PMID: 28993057 DOI: 10.1016/j.jos.2017.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 09/17/2017] [Accepted: 09/20/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Kemmei Ikuta
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masayuki Morishita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Komatsu M, Yamamoto N, Kawamoto T, Kawakami Y, Hara H, Uemura S, Nishimura N, Akisue T, Kuroda R, Iijima K, Jimbo N, Kanzawa M, Kajimoto K, Itoh T, Hirose T. Soft tissue tumor with novel NR1D1-MAML1 fusion in a pediatric case. Virchows Arch 2020; 477:891-895. [PMID: 32474730 DOI: 10.1007/s00428-020-02838-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/08/2019] [Revised: 04/26/2020] [Accepted: 05/03/2020] [Indexed: 01/12/2023]
Abstract
We herein describe soft tissue tumor arising in the lower extremity of a pediatric patient. The tumor displayed a unique and wide range of histological features, sheet-like and cohesive growth pattern consisting of enlarged round to epithelioid atypical cells with a large alveolar and pseudopapillary histological architecture, focally mimicking alveolar soft part sarcoma and MiT family translocation renal cell carcinoma. Tumor cells were focally immunoreactive for cytokeratin, S-100, and EMA. RNA sequencing identified a novel in-frame NR1D1 (exon 5)-MAML1 (exon 2) gene rearrangement resulting in the formation of a putative chimeric protein containing the N-terminal C4-type zing finger domains of NR1D1 and the C-terminal MAML1 protein, which was confirmed by subsequent RT-PCR, Sanger sequencing, and FISH assay. To the best of our knowledge, NR1D1-MAML1 fusion has not yet been described in any neoplasms, suggesting the emergence of a novel tumor entity.
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Affiliation(s)
- Masato Komatsu
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, -5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan.
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Teruya Kawamoto
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan.,Division of Orthopedic Surgery, Kobe University International Clinical Cancer Research Center, 1-5-1 Minatojimaminami-machi, Chuo-ku, Kobe, Hyogo Prefecture, 650-0047, Japan
| | - Yohei Kawakami
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Hitomi Hara
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Suguru Uemura
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Noriyuki Nishimura
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo Prefecture, 654-0142, Japan
| | - Ryosuke Kuroda
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, -5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Maki Kanzawa
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, -5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Kazuyoshi Kajimoto
- Department of Diagnostic Pathology, Hyogo Cancer Center, 13-70 Kitaooji-cho, Akashi, Hyogo Prefecture, 673-0021, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, -5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
| | - Takanori Hirose
- Department of Diagnostic Pathology, Hyogo Cancer Center, 13-70 Kitaooji-cho, Akashi, Hyogo Prefecture, 673-0021, Japan.,Division of Pathology for Regional Communication, Kobe University School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo Prefecture, 650-0017, Japan
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Uemura S, Mori T, Ishiko S, Takafuji S, Nino N, Yamamoto N, Hayakawa A, Nishimura N, Hara H, Kawamoto T, Akisue T, Iijima K. Retrospective analysis of high-dose chemotherapy followed by autologous stem cell transplantation for high-risk pediatric osteosarcoma. Pediatr Hematol Oncol 2020; 37:337-343. [PMID: 32151185 DOI: 10.1080/08880018.2020.1729906] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The outcomes of osteosarcoma with poor prognostic factors, such as poor responders, metastatic disease at diagnosis, and relapsed or refractory disease, are poor. We reviewed the clinical records of the patients diagnosed with osteosarcoma at our institute between 2004 and 2018 who received high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) in our institute. Ten patients of osteosarcoma with poor responder, refractory status, and metastatic disease at diagnosis received high-dose chemotherapy followed by ASCT. Four patients underwent high-dose chemotherapy followed by ASCT with the conditioning regimen consisted of thiotepa and melphalan (MEL). Five patients underwent high-dose chemotherapy followed by ASCT with the conditioning regimen consisted of intravenous busulfan (BU) and MEL. One patient underwent tandem high-dose chemotherapy followed by ASCT with BU and MEL followed by carboplatin and etoposide. None of the ten patients died of regimen related toxicities. None of the five patients with poor responders who underwent high-dose chemotherapy followed by ASCT as part of consolidation therapy died of disease after ASCT. High-dose chemotherapy followed by ASCT might be effective for poor responders in osteosarcoma.
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Affiliation(s)
- Suguru Uemura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Mori
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Ishiko
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoru Takafuji
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nanako Nino
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akira Hayakawa
- Department of Palliative Medicine, Yodogawa Christian Hospital, Osaka, Japan
| | - Noriyuki Nishimura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
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Mifune Y, Inui A, Nishimoto H, Kataoka T, Kurosawa T, Yamaura K, Mukohara S, Niikura T, Kokubu T, Akisue T, Kuroda R. Assessment of posterior shoulder muscle stiffness related to posterior shoulder tightness in college baseball players using shear wave elastography. J Shoulder Elbow Surg 2020; 29:571-577. [PMID: 31495703 DOI: 10.1016/j.jse.2019.05.028] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Limitations of shoulder range of motion (ROM) have been reported to be at high risk for shoulder disorders in baseball players. In this study, we assessed posterior shoulder muscle stiffness using shear wave elastography in baseball players with and without posterior shoulder tightness. MATERIALS AND METHODS In total, 21 college baseball players volunteered to participate in this study. Passive ROMs for shoulder abduction and horizontal adduction were measured using a goniometer. Subsequently, we divided all participants into 2 groups based on the differences between bilateral shoulder ROMs: STIFF+ and STIFF- groups. Thickness and elasticity of the posterior and inferior shoulder muscles were assessed using ultrasound. RESULTS Shoulder abduction ROM on the throwing side was 114.5° ± 5.3° and 131.3° ± 5.7° in the STIFF+ and STIFF- groups, respectively, which was significantly different between the 2 groups (P = .023). Horizontal adduction ROM on the throwing side was 96.6° ± 4.9° and 110.9° ± 4.8° in the STIFF+ and STIFF- groups, respectively, which was also significantly different between the 2 groups (P = .014). The elasticity of infraspinatus and lower trapezius in the STIFF+ group was significantly greater than that in the STIFF- group (P = .018 and .033, respectively). DISCUSSION In this study, we found that the elasticity of infraspinatus and lower trapezius in stiff shoulders was significantly greater than that in nonstiff shoulders, which indicated that the infraspinatus and lower trapezius could be the key muscles in posterior shoulder tightness.
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Affiliation(s)
- Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Atsuyuki Inui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hanako Nishimoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Kataoka
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takashi Kurosawa
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kohei Yamaura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shintaro Mukohara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Kokubu
- Department of Orthopaedic Surgery, Shin-Suma General Hospital, Kobe, Japan
| | | | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Niikura T, Iwakura T, Omori T, Lee SY, Sakai Y, Akisue T, Oe K, Fukui T, Matsushita T, Matsumoto T, Kuroda R. Topical cutaneous application of carbon dioxide via a hydrogel for improved fracture repair: results of phase I clinical safety trial. BMC Musculoskelet Disord 2019; 20:563. [PMID: 31766994 PMCID: PMC6878668 DOI: 10.1186/s12891-019-2911-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 10/23/2019] [Indexed: 11/25/2022] Open
Abstract
Background Clinicians have very limited options to improve fracture repair. Therefore, it is critical to develop a new clinically available therapeutic option to assist fracture repair biologically. We previously reported that the topical cutaneous application of carbon dioxide (CO2) via a CO2 absorption-enhancing hydrogel accelerates fracture repair in rats by increasing blood flow and angiogenesis and promoting endochondral ossification. The aim of this study was to assess the safety and efficacy of CO2 therapy in patients with fractures. Methods Patients with fractures of the femur and tibia were prospectively enrolled into this study with ethical approval and informed consent. The CO2 absorption-enhancing hydrogel was applied to the fractured lower limbs of patients, and then 100% CO2 was administered daily into a sealed space for 20 min over 4 weeks postoperatively. Safety was assessed based on vital signs, blood parameters, adverse events, and arterial and expired gas analyses. As the efficacy outcome, blood flow at the level of the fracture site and at a site 5 cm from the fracture in the affected limb was measured using a laser Doppler blood flow meter. Results Nineteen patients were subjected to complete analysis. No adverse events were observed. Arterial and expired gas analyses revealed no adverse systemic effects including hypercapnia. The mean ratio of blood flow 20 min after CO2 therapy compared with the pre-treatment level increased by approximately 2-fold in a time-dependent manner. Conclusions The findings of the present study revealed that CO2 therapy is safe to apply to human patients and that it can enhance blood flow in the fractured limbs. Trial registration This study has been registered in the UMIN Clinical Trials Registry (Registration number: UMIN000013641, Date of registration: July 1, 2014).
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Komatsu M, Kawamoto T, Kanzawa M, Kawakami Y, Hara H, Akisue T, Kuroda R, Nakamura H, Hokka D, Jimbo N, Itoh T, Hirose T. A novel
EWSR1
‐
VGLL1
gene fusion in a soft tissue malignant myoepithelial tumor. Genes Chromosomes Cancer 2019; 59:249-254. [DOI: 10.1002/gcc.22823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 01/06/2023] Open
Affiliation(s)
- Masato Komatsu
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Teruya Kawamoto
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
- Division of Orthopedic Surgery Kobe University International Clinical Cancer Research Center Kobe Hyogo Prefecture Japan
| | - Maki Kanzawa
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Yohei Kawakami
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Hitomi Hara
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science Kobe University Graduate School of Health Sciences Kobe Hyogo Prefecture Japan
| | - Ryosuke Kuroda
- Department of Orthopedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Hayate Nakamura
- Division of Thoracic Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Naoe Jimbo
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology Kobe University Graduate School of Medicine Kobe Hyogo Prefecture Japan
| | - Takanori Hirose
- Department of Diagnostic Pathology Hyogo Cancer Center Akashi Hyogo Prefecture Japan
- Division of Pathology for Regional Communication Kobe University School of Medicine Kobe Hyogo Prefecture Japan
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Matsumoto T, Tanaka M, Nakanish R, Takuwa M, Hirabayashi T, Ono K, Ikeji T, Maeshige N, Sakai Y, Akisue T, Kondo H, Ishihara A, Fujino H. Transcutaneous carbon dioxide attenuates impaired oxidative capacity in skeletal muscle in hyperglycemia model. Gen Physiol Biophys 2019; 38:237-244. [PMID: 31184310 DOI: 10.4149/gpb_2018048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hyperglycemia impairs oxidative capacity in skeletal muscle. Muscle oxidative capacity is regulated by peroxisome proliferator-activated receptor-γ co-activator-1α (PGC-1α). Transcutaneous carbon dioxide (CO2) enhances PGC-1α expression in skeletal muscle. Therefore, the aim of this study was to clarify the effects of CO2 therapy on muscle oxidative capacity impaired by streptozotocin (STZ)-induced hyperglycemia. Eight-week-old male Wistar rats were randomly divided into 4 groups: control, CO2 treatment, STZ-induced hyperglycemia, and STZ-induced hyperglycemia treated with CO2. STZ-induced hyperglycemia resulted in a decrease of muscle oxidative capacity and decreased PGC-1α and cytochrome c oxidase subunit 4 (COX-4) expression levels; while, application of transcutaneous CO2 attenuated this effect, and enhanced the expression levels of endothelial nitric oxide synthesis (eNOS). These results indicate that transcutaneous CO2 improves impaired muscle oxidative capacity via enhancement of eNOS and PGC-1α-related signaling in the skeletal muscle of rats with hyperglycemia.
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Affiliation(s)
- Tomohiro Matsumoto
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Suma-ku, Kobe-shi, Hyogo, Japan.
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Nikaido Y, Kajimoto Y, Akisue T, Urakami H, Kawami Y, Kuroda K, Ohno H, Saura R. Dynamic Balance Measurements Can Differentiate Patients Who Fall From Patients Who Do Not Fall in Patients With Idiopathic Normal Pressure Hydrocephalus. Arch Phys Med Rehabil 2019; 100:1458-1466. [DOI: 10.1016/j.apmr.2019.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 01/14/2019] [Accepted: 01/18/2019] [Indexed: 11/28/2022]
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Hara H, Kawamoto T, Fukase N, Kawakami Y, Takemori T, Fujiwara S, Kitayama K, Nishida K, Kuroda R, Akisue T. Gemcitabine and docetaxel combination chemotherapy for advanced bone and soft tissue sarcomas: protocol for an open-label, non-randomised, Phase 2 study. BMC Cancer 2019; 19:725. [PMID: 31337342 PMCID: PMC6651911 DOI: 10.1186/s12885-019-5923-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/30/2018] [Accepted: 07/11/2019] [Indexed: 01/14/2023] Open
Abstract
Background The prognosis of patients with metastatic or advanced sarcomas is poor and there are few options for treatment. Several studies have shown that gemcitabine and docetaxel (GD) combination chemotherapy has antitumor activity against various subtypes of sarcoma. Recently, some studies have shown a favourable outcome for GD combination chemotherapy for relapsed high-grade osteosarcoma and spindle cell sarcoma of bone. If the effectiveness of GD is proven, this will result in new treatment options for advanced bone and soft tissue sarcomas (STS). The aim of this prospective Phase 2 study is to evaluate the efficacy and toxicity of the GD combination in patients with advanced bone sarcomas and STS. Methods This is a Phase 2, single-arm, open-label study to investigate the efficacy and safety of combination chemotherapy with GD for advanced bone sarcomas and STS and will enrol 20 patients. The patients will receive gemcitabine 900 mg/m2 on Days 1 and 8, and docetaxel 70 mg/m2 on Day 8 in 3-week cycles until disease progression or other evidence of treatment failure. The primary aim of this study is to analyse GD’s effect on progression-free survival (PFS). The secondary objectives are to analyse treatment efficacy and safety in terms of response rate, tumour control rate, overall survival, and adverse event rate. The length of follow-up will be 5 years. Discussion This study will evaluate the efficacy and safety of combination therapy with gemcitabine and docetaxel for bone sarcomas and STS. If this combination proves to be acceptable, it could be used for as second, third, or later line therapy for patients with sarcomas (especially bone sarcomas). In the future, the role of various treatments, including GD therapy, will be clarified for specific subtypes of sarcoma. Trial registration This study was registered as UMIN000031004 (University Hospital Medical Information Network-Clinical Trial Registry: UMIN-CTR) on 1 March 1 2018 and with the Japan Registry of Clinical Trials (jRCT) as jRCTs051180042 on 30 January 2019. The posted information will be updated as needed to reflect protocol amendments and study progress. Electronic supplementary material The online version of this article (10.1186/s12885-019-5923-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.,Division of Orthopaedic Surgery, Kobe University International Clinical Cancer Research Centre, 1-5-1 Minatojimaminami-cho, Chuo-ku, Kobe, 650-0047, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kazumichi Kitayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kotaro Nishida
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.,Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
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Moriyama H, Ozawa J, Yakuwa T, Inoue S, Wakigawa T, Kito N, Sakai Y, Akisue T. Effects of hypertonia on contracture development in rat spinal cord injury. Spinal Cord 2019; 57:850-857. [PMID: 31201373 DOI: 10.1038/s41393-019-0312-2] [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] [Received: 02/17/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Experimental animal study. OBJECTIVES Spastic hypertonia is originally believed to cause contractures from clinical observations. Botulinum toxin is effective for the treatment of spasticity and is widely used in patients who have joints with contractures. Using an established rat model with knee contractures after spinal cord injuries, we aimed to verify whether hypertonia contributes to contracture development, and the botulinum toxin improves structural changes in muscles and joint components responsible for contractures. SETTING University laboratory in Japan. METHODS To evaluate the effect of hypertonia on contracture development, the rats received botulinum toxin injections after spinal cord injuries. Knee extension motion was measured with a goniometer applying a standardized torque under anesthesia, and the contribution by muscle or non-muscle structures to contractures were calculated by measuring joint motion before and after the myotomies. We quantitatively measured the muscle atrophy, muscle fibrosis, and synovial intima length. RESULTS Botulinum toxin injections significantly improved contractures, whereas did not completely prevent contracture development. Botulinum toxin was effective in improving the muscular factor, but little difference in the articular factor. Spinal cord injuries induced muscle atrophy, and botulinum toxin significantly accelerated muscle atrophy and fibrosis. The synovial intima length decreased significantly after spinal cord injuries, and botulinum toxin did not improve this shortening. CONCLUSIONS This animal study provides new evidence that hypertonia is not the sole cause rather is the partial contributor of contractures after spinal cord injuries. Furthermore, botulinum toxin has adverse effects in the muscle.
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Affiliation(s)
- Hideki Moriyama
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Kobe, Japan.
| | - Junya Ozawa
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Takumi Yakuwa
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Shota Inoue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Taisei Wakigawa
- Faculty of Health Sciences, School of Medicine, Kobe University, Kobe, Japan
| | - Nobuhiro Kito
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshihiro Akisue
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Kobe, Japan
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Nikaido Y, Urakami H, Akisue T, Okada Y, Katsuta N, Kawami Y, Ikeji T, Kuroda K, Hinoshita T, Ohno H, Kajimoto Y, Saura R. Associations among falls, gait variability, and balance function in idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg 2019; 183:105385. [PMID: 31207457 DOI: 10.1016/j.clineuro.2019.105385] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 05/25/2019] [Revised: 06/06/2019] [Accepted: 06/10/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The factors influencing falls in idiopathic normal pressure hydrocephalus (iNPH) remain unclear, although iNPH-associated gait and balance disturbances can lead to an increased risk of falls. This study aimed to investigate the associations among fall status, gait variability, balance function in iNPH, and to identify fall-related factors in iNPH. PATIENTS AND METHODS Sixty-three patients with iNPH with a positive cerebrospinal fluid tap test result according to the iNPH diagnosis criteria participated in this prospective cross-sectional study. Patients were assessed using the 10-meter walk test (10MWT), the Functional Gait Assessment (FGA), the Berg Balance Scale (BBS), and the isometric quadriceps strength (QS). We also investigated each patient's history of falls in the past 6 months. Gait variability was measured using a triaxial accelerometer attached to the patient's torso at the L3 vertebra level during the 10MWT. RESULTS Fall status correlated significantly with gait variability (measured as the coefficient of variation; CV) in step time and movement trajectory amplitude (i.e., center of mass movement) in the medial/lateral (ML) and vertical (VT) directions, with balance function as assessed by FGA and BBS scores. In contrast, QS was not correlated with fall status. The independent variables associated with the risk of falling were step time CV, FGA score, and age. CONCLUSION The factors associated with the risk of falling in iNPH were aging and gait-balance instability, particularly temporal gait variability and dynamic balance dysfunction. Our results may enable physicians to identify the patients with iNPH who are at risk of falling and implement suitable prevention strategies.
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Affiliation(s)
- Yasutaka Nikaido
- Clinical Department of Rehabilitation, Osaka Medical College Hospital, Osaka, Japan.
| | - Hideyuki Urakami
- Clinical Department of Rehabilitation, Osaka Medical College Hospital, Osaka, Japan; Graduate School of Health Science, Kio University, Nara, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Yohei Okada
- Graduate School of Health Science, Kio University, Nara, Japan; Neurorehabilitation Research Center of Kio University, Nara, Japan
| | - Naoya Katsuta
- Clinical Department of Rehabilitation, Osaka Medical College Hospital, Osaka, Japan
| | - Yuki Kawami
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan; Department of Physical Therapy, Faculty of Rehabilitation, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Hyogo, Japan
| | - Takuya Ikeji
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Kenji Kuroda
- Clinical Department of Rehabilitation, Osaka Medical College Hospital, Osaka, Japan
| | - Tetsuya Hinoshita
- Clinical Department of Rehabilitation, Osaka Medical College Hospital, Osaka, Japan
| | - Hiroshi Ohno
- Clinical Department of Rehabilitation, Osaka Medical College Hospital, Osaka, Japan
| | - Yoshinaga Kajimoto
- Department of Neurosurgery, Division of Surgery, Osaka Medical College, Osaka, Japan
| | - Ryuichi Saura
- Department of Physical and Rehabilitation Medicine, Division of Comprehensive Medicine, Osaka Medical College, Osaka, Japan
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Kuroiwa Y, Fukui T, Takahara S, Lee SY, Oe K, Arakura M, Kumabe Y, Oda T, Matsumoto T, Matsushita T, Akisue T, Sakai Y, Kuroda R, Niikura T. Topical cutaneous application of CO 2 accelerates bone healing in a rat femoral defect model. BMC Musculoskelet Disord 2019; 20:237. [PMID: 31113412 PMCID: PMC6530028 DOI: 10.1186/s12891-019-2601-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/30/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Bone defects may occur because of severe trauma, nonunion, infection, or tumor resection. However, treatments for bone defects are often difficult and have not been fully established yet. We previously designed an efficient system of topical cutaneous application of carbon dioxide (CO2) using a novel hydrogel, which facilitates CO2 absorption through the skin into the deep area within a limb. In this study, the effect of topical cutaneous application of CO2 on bone healing was investigated using a rat femoral defect model. METHODS In this basic research study, an in vivo bone defect model, fixed with an external fixator, was created using a rat femur. The affected limb was shaved, and CO2 was applied for 20 min/day, 5 days/week. In the control animals, CO2 gas was replaced with air. Radiographic, histological, biomechanical, and genetic assessments were performed to evaluate bone healing. RESULTS Radiographically, bone healing rate was significantly higher in the CO2 group than in the control group at 4 weeks (18.2% vs. 72.7%). The degree of bone healing scored using the histopathological Allen grading system was significantly higher in the CO2 group than in the control group at 2 weeks (1.389 ± 0.334 vs. 1.944 ± 0.375). The ultimate stress, extrinsic stiffness, and failure energy were significantly greater in the CO2 group than in the control group at 4 weeks (3.2 ± 0.8% vs. 38.1 ± 4.8%, 0.6 ± 0.3% vs. 41.5 ± 12.2%, 2.6 ± 0.8% vs. 24.7 ± 5.9%, respectively.). The volumetric bone mineral density of the callus in micro-computed tomography analysis was significantly higher in the CO2 group than in the control group at 4 weeks (180.9 ± 43.0 mg/cm3 vs. 247.9 ± 49.9 mg/cm3). Gene expression of vascular endothelial growth factor in the CO2 group was significantly greater than that in the control group at 3 weeks (0.617 ± 0.240 vs. 2.213 ± 0.387). CONCLUSIONS Topical cutaneous application of CO2 accelerated bone healing in a rat femoral defect model. CO2 application can be a novel and useful therapy for accelerating bone healing in bone defects; further research on its efficacy in humans is warranted.
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Affiliation(s)
- Yu Kuroiwa
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoaki Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shunsuke Takahara
- Department of Orthopaedic Surgery, Hyogo Prefectural Kakogawa Medical Center, 203 Kanno, Kanno-cho, Kakogawa, 675-8555, Japan
| | - Sang Yang Lee
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Keisuke Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Michio Arakura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yohei Kumabe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takahiro Oda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
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Matsumoto T, Tanaka M, Ikeji T, Maeshige N, Sakai Y, Akisue T, Kondo H, Ishihara A, Fujino H. Application of transcutaneous carbon dioxide improves capillary regression of skeletal muscle in hyperglycemia. J Physiol Sci 2019; 69:317-326. [PMID: 30478742 PMCID: PMC10717691 DOI: 10.1007/s12576-018-0648-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/14/2018] [Indexed: 12/17/2022]
Abstract
The purpose of the present study was to determine the effects of transcutaneous CO2 application on the blood flow and capillary architecture of the soleus muscle in rats with streptozotocin (STZ)-induced hyperglycemia. Wistar rats were randomly divided into four groups: control, control + CO2-treated, STZ-induced hyperglycemia, and STZ-induced hyperglycemia + CO2-treated groups. Blood flow in soleus muscle increased during the transcutaneous CO2 exposure, and continued to increase for 30 min after the treatment. In addition, the transcutaneous CO2 attenuated a decrease in capillary and the expression level of eNOS and VEGF protein, and an increase in the expression level of MDM-2 and TSP-1 protein of soleus muscle due to STZ-induced hyperglycemia. These results indicate that the application of transcutaneous CO2 could improve capillary regression via the change of pro- and anti-angiogenesis factors, which might be induced by an increase in blood flow.
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Affiliation(s)
- Tomohiro Matsumoto
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Masayuki Tanaka
- Department of Physical Therapy, Faculty of Human Sciences, Osaka University of Human Sciences, 1-4-1 Shojaku, Settsu, Osaka, 566-8501, Japan
| | - Takuya Ikeji
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Noriaki Maeshige
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Hiroyo Kondo
- Department of Food Science and Nutrition, Nagoya Women's University, 4-21 Shioji-cho, Mizuho-ku, Nagoya, Aichi, 467-8611, Japan
| | - Akihiko Ishihara
- Laboratory of Cell Biology and Life Science, Graduate School of Human and Environmental Studies, Kyoto University, Yoshida-nihonmatsu-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8501, Japan
| | - Hidemi Fujino
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.
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Kawami Y, Marumoto K, Shiomi Y, Okinishi M, Kozuki T, Oyabu H, Yokoyama K, Nikaido Y, Akisue T. The effect of comprehensive physiotherapy-based rehabilitation on stooped posture in Parkinson's disease. J Phys Ther Sci 2018; 30:1440-1445. [PMID: 30568331 PMCID: PMC6279693 DOI: 10.1589/jpts.30.1440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 09/12/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The effect of physiotherapy on stooped posture in Parkinson's disease patients remains to be clarified. Therefore, the purpose of this study was to investigate whether comprehensive physiotherapy-based rehabilitation can improve stooped posture in Parkinson's disease patients. [Participants and Methods] The participants were Parkinson's disease patients with stooped posture. Outpatients were assigned to the control group and inpatients to the postural rehabilitation group. The outcomes measured were trunk bending angle, lumbar lordosis, and thoracic kyphosis. Each group was assessed at baseline and 1 month later. [Results] Of 22 participants identified, 20 were included, with 10 participants in the postural rehabilitation group and 10 in the control group. The age in the postural rehabilitation group was significantly greater than that in the control group, while other parameters were comparable in both groups. After the month-long intervention, the trunk bending angle and lumbar lordosis were significantly improved in the postural rehabilitation group compared to the control group. [Conclusion] The results showed improvement in stooped posture in the postural rehabilitation group as compared to the control group. Furthermore, improvement of lumbar lordosis accompanied improvement of stooped posture. These findings suggest that comprehensive physiotherapy-based rehabilitation may improve stooped posture in Parkinson's disease patients.
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Affiliation(s)
- Yuki Kawami
- Department of Physical Therapy, Faculty of Rehabilitation,
Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima: 1-7-1 Kouto, Shingu-cho,
Tatsuno, Hyogo 679-5165, Japan
- Department of Rehabilitation Science, Kobe University
Graduate School of Health Sciences, Japan
| | - Kohei Marumoto
- Department of Physical Medicine and Rehabilitation, Hyogo
Prefectural Rehabilitation Hospital at Nishi-Harima, Japan
| | - Yukina Shiomi
- Department of Physical Therapy, Faculty of Rehabilitation,
Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima: 1-7-1 Kouto, Shingu-cho,
Tatsuno, Hyogo 679-5165, Japan
| | - Masakado Okinishi
- Department of Physical Therapy, Faculty of Rehabilitation,
Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima: 1-7-1 Kouto, Shingu-cho,
Tatsuno, Hyogo 679-5165, Japan
| | - Tsuyoshi Kozuki
- Department of Physical Therapy, Faculty of Rehabilitation,
Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima: 1-7-1 Kouto, Shingu-cho,
Tatsuno, Hyogo 679-5165, Japan
| | - Hiroko Oyabu
- Department of Physical Therapy, Faculty of Rehabilitation,
Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima: 1-7-1 Kouto, Shingu-cho,
Tatsuno, Hyogo 679-5165, Japan
| | - Kazumasa Yokoyama
- Department of Neurology, Hyogo Prefectural Rehabilitation
Hospital at Nishi-Harima, Japan
| | - Yasutaka Nikaido
- Department of Rehabilitation Science, Kobe University
Graduate School of Health Sciences, Japan
- Clinical Department of Rehabilitation, Osaka Medical
College Hospital, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University
Graduate School of Health Sciences, Japan
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Nakamura N, Sakai Y, Matsubara N, Kakutani K, Akisue T, Kiyota N, Minami H. Patterns of practice for bone metastases in Japan: Use of questionnaires to promote a multidisciplinary approach. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy440.002] [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: 11/13/2022] Open
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50
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Morishita M, Hara H, Katayama E, Kawamoto T, Fukase N, Takemori T, Fujiwara S, Nishida K, Kuroda R, Akisue T. Huge chronic expanding hematoma of the iliac bone following multiple hip surgeries: a case report. J Med Case Rep 2018; 12:265. [PMID: 30176925 PMCID: PMC6122718 DOI: 10.1186/s13256-018-1783-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/22/2017] [Accepted: 07/24/2018] [Indexed: 11/30/2022] Open
Abstract
Background Chronic expanding hematoma is a rare entity resulting from trauma or surgery. This condition usually occurs in soft tissue, such as the trunk or extremities, while chronic expanding hematoma arising from bone has not been reported previously. We describe an unusual case of a huge intraosseous chronic expanding hematoma arising from the ilium, which had grown over a 40-year period following hip surgeries. Case presentation A 57-year-old Japanese woman presented with a 1.5-year history of right hip pain. She had a history of bilateral developmental dysplasia of the hip and had undergone bilateral arthroplasties in childhood. A physical examination revealed a large, firm, immobile mass at her right ilium. Based on radiographic findings, a type of slow-growing bone tumor was suspected, and an incisional biopsy was performed. A histopathologic examination revealed large amounts of old clotted blood within the lesion, and the capsule of the lesion was composed of dense, fibrous, connective tissue. There was no evidence of neoplasia, and chronic expanding hematoma was suspected. The lesion was resistant to conservative treatment, and so we performed an internal hemipelvectomy (including the capsule of the mass) and a reconstruction by hip transposition 2.5 years after the incisional biopsy. There was no recurrence of chronic expanding hematoma at the most recent follow-up of 1 year and 8 months postoperatively. Conclusions A chronic expanding hematoma is characterized by its persistence and increasing size more than 1 month after the trauma or surgical event suspected of causing hemorrhage. To the best of our knowledge, this is the first report of chronic expanding hematoma arising from bone. We performed internal hemipelvectomy and hip transposition, and there has so far been no recurrence. This disease may be considered a differential diagnosis for bone tumor when the patient has a history of surgery or trauma, regardless of how many years have passed since the index event.
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Affiliation(s)
- Masayuki Morishita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hitomi Hara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Etsuko Katayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.,Division of Orthopaedic Surgery, Kobe University International Clinical Cancer Research Center, 1-5-1 Minatojimaminami-cho, Chuo-ku, Kobe, 650-0047, Japan
| | - Naomasa Fukase
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshiyuki Takemori
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shuichi Fujiwara
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kotaro Nishida
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Toshihiro Akisue
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.,Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10- 2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
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