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Murata S, Nagata K, Iwasaki H, Hashizume H, Minamide A, Nakagawa Y, Tsutsui S, Takami M, Ishimoto Y, Teraguchi M, Iwahashi H, Murakami K, Taiji R, Kozaki T, Kitano Y, Yoshida M, Yamada H. Long-term efficacy of microendoscopic laminotomy for lumbar spinal stenosis in advanced degenerative spondylolisthesis with or without dynamic spinal instability: a propensity score-matching analysis. J Neurosurg Spine 2024:1-8. [PMID: 38669704 DOI: 10.3171/2024.2.spine231075] [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: 09/28/2023] [Accepted: 02/07/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE In this study, the authors aimed to determine the mid- to long-term outcomes of microendoscopic laminotomy (MEL) for lumbar spinal stenosis (LSS) with degenerative spondylolisthesis (DS) and identify preoperative predictors of poor mid- to long-term outcomes. METHODS The authors retrospectively reviewed the medical records of 274 patients who underwent spinal MEL for symptomatic LSS. The minimum postoperative follow-up duration was 5 years. Patients were classified into two groups according to DS: those with DS (the DS+ group) and those without DS (the DS- group). The patients were subjected to propensity score matching based on sex, age, BMI, surgical segments, and preoperative leg pain visual analog scale scores. Clinical outcomes were evaluated 1 year and > 5 years after surgery. RESULTS Surgical outcomes of MEL for LSS were not significantly different between the DS+ and DS- groups at the final follow-up (mean 7.8 years) in terms of Oswestry Disability Index (p = 0.498), satisfaction (p = 0.913), and reoperation rate (p = 0.154). In the multivariate analysis, female sex (standard β -0.260), patients with slip angle > 5° in the forward bending position (standard β -0.313), and those with dynamic progression of Meyerding grade (standard β -0.325) were at a high risk of poor long-term outcomes. CONCLUSIONS MEL may have good long-term results in patients with DS without dynamic instability. Women with dynamic instability may require additional fusion surgery in approximately 25% of cases for a period of ≥ 5 years.
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Affiliation(s)
- Shizumasa Murata
- 1Department of Orthopedic Surgery, Shingu Municipal Medical Center, Wakayama
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Keiji Nagata
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Hiroshi Iwasaki
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Hiroshi Hashizume
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Akihito Minamide
- 3Spine Center, Dokkyo Medical University Nikko Medical Center, Nikko City, Tochigi
| | - Yukihiro Nakagawa
- 4Spine Care Center, Wakayama Medical University Kihoku Hospital, Katsuragi-cho, Ito-gun, Wakayama; and
| | - Shunji Tsutsui
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Masanari Takami
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Yuyu Ishimoto
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | | | - Hiroki Iwahashi
- 1Department of Orthopedic Surgery, Shingu Municipal Medical Center, Wakayama
| | - Kimihide Murakami
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Ryo Taiji
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Takuhei Kozaki
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
| | - Yoji Kitano
- 1Department of Orthopedic Surgery, Shingu Municipal Medical Center, Wakayama
| | - Munehito Yoshida
- 5Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, Wakayama, Japan
| | - Hiroshi Yamada
- 2Department of Orthopedic Surgery, Wakayama Medical University, Wakayama
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Kubo T, Sunami K, Koyama T, Kitami M, Fujiwara Y, Kondo S, Yonemori K, Noguchi E, Morizane C, Goto Y, Maejima A, Iwasa S, Hamaguchi T, Kawai A, Namikawa K, Arakawa A, Sugiyama M, Ohno M, Yoshida T, Hiraoka N, Yoshida A, Yoshida M, Nishino T, Furukawa E, Narushima D, Nagai M, Kato M, Ichikawa H, Fujiwara Y, Kohno T, Yamamoto N. The impact of rare cancer and early-line treatments on the benefit of comprehensive genome profiling-based precision oncology. ESMO Open 2024; 9:102981. [PMID: 38613908 PMCID: PMC11033064 DOI: 10.1016/j.esmoop.2024.102981] [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: 07/11/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Comprehensive genome profiling (CGP) serves as a guide for suitable genomically matched therapies for patients with cancer. However, little is known about the impact of the timing and types of cancer on the therapeutic benefit of CGP. MATERIALS AND METHODS A single hospital-based pan-cancer prospective study (TOP-GEAR; UMIN000011141) was conducted to examine the benefit of CGP with respect to the timing and types of cancer. Patients with advanced solid tumors (>30 types) who either progressed with or without standard treatments were genotyped using a single CGP test. The subjects were followed up for a median duration of 590 days to examine therapeutic response, using progression-free survival (PFS), PFS ratio, and factors associated with therapeutic response. RESULTS Among the 507 patients, 62 (12.2%) received matched therapies with an overall response rate (ORR) of 32.3%. The PFS ratios (≥1.3) were observed in 46.3% (19/41) of the evaluated patients. The proportion of subjects receiving such therapies in the rare cancer cohort was lower than that in the non-rare cancer cohort (9.6% and 17.4%, respectively; P = 0.010). However, ORR of the rare cancer patients was higher than that in the non-rare cancer cohort (43.8% and 20.0%, respectively; P = 0.046). Moreover, ORR of matched therapies in the first or second line after receiving the CGP test was higher than that in the third or later lines (62.5% and 21.7%, respectively; P = 0.003). Rare cancer and early-line treatment were significantly and independently associated with ORR of matched therapies in multivariable analysis (P = 0.017 and 0.004, respectively). CONCLUSION Patients with rare cancer preferentially benefited from tumor mutation profiling by increasing the chances of therapeutic response to matched therapies. Early-line treatments after profiling increase the therapeutic benefit, irrespective of tumor types.
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Affiliation(s)
- T Kubo
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo
| | - K Sunami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Division of Genome Biology, National Cancer Center Research Institute, Tokyo
| | - T Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo
| | - M Kitami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - Y Fujiwara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo; Department of Thoracic Oncology, Aichi Cancer Center Hospital, Aichi
| | - S Kondo
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - K Yonemori
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - E Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - C Morizane
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - Y Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo
| | - A Maejima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo; Department of Urology, National Cancer Center Hospital, Tokyo
| | - S Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Hamaguchi
- Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama
| | - A Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo
| | - A Arakawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Sugiyama
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo
| | - T Yoshida
- Department of Genetic Services and Medicine, National Cancer Center Hospital, Tokyo
| | - N Hiraoka
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - A Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - M Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - T Nishino
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - E Furukawa
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - D Narushima
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Nagai
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Kato
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - H Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - Y Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Kohno
- Division of Genome Biology, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - N Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo.
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Kouzu K, Tsujimoto H, Ishinuki T, Shinji S, Shinkawa H, Tamura K, Uchino M, Ohge H, Shimizu J, Haji S, Mohri Y, Yamashita C, Kitagawa Y, Suzuki K, Kobayashi M, Kobayashi M, Hanai Y, Nobuhara H, Imaoka H, Yoshida M, Mizuguchi T, Mayumi T, Kitagawa Y. The effectiveness of fascial closure with antimicrobial-coated sutures in preventing incisional surgical site infections in gastrointestinal surgery: a systematic review and meta-analysis. J Hosp Infect 2024; 146:174-182. [PMID: 37734678 DOI: 10.1016/j.jhin.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis of the efficacy of fascial closure using antimicrobial-sutures specifically for the prevention of surgical site infections (SSIs) in gastrointestinal surgery, as part of the revision of the SSI prevention guidelines of the Japanese Society of Surgical Infectious Diseases (JSSI). We searched CENTRAL, PubMed and ICHUSHI-Web in May 2023, and included randomized controlled trials (RCTs) comparing antimicrobial-coated and non-coated sutures for fascial closure in gastrointestinal surgery (PROSPERO No. CRD42023430377). Three authors independently screened the RCTs. We assessed the risk of bias and the GRADE criteria for the extracted data. The primary outcome was incisional SSI and the secondary outcomes were abdominal wall dehiscence and the length of postoperative hospital stay. This study was supported partially by the JSSI. A total of 10 RCTs and 5396 patients were included. The use of antimicrobial-coated sutures significantly lowered the risk of incisional SSIs compared with non-coated suture (risk ratio: 0.79, 95% confidence intervals: 0.64-0.98). In subgroup analyses, antimicrobial-coated sutures reduced the risk of SSIs for open surgeries, and when monofilament sutures were used. Antimicrobial-coated sutures did not reduce the incidence of abdominal wall dehiscence and the length of hospital stay compared with non-coated sutures. The certainty of the evidence was rated as moderate according to the GRADE criteria, because of risk of bias. In conclusion, the use of antimicrobial-coated sutures for fascial closure in gastrointestinal surgery is associated with a significantly lower risk of SSI than non-coated sutures.
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Affiliation(s)
- K Kouzu
- Department of Surgery, National Defense Medical College, Japan
| | - H Tsujimoto
- Department of Surgery, National Defense Medical College, Japan.
| | - T Ishinuki
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - S Shinji
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Japan
| | - H Shinkawa
- Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - K Tamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - M Uchino
- Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Japan
| | - H Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Japan
| | - J Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Japan
| | - S Haji
- Department of Surgery, Soseikai General Hospital, Japan
| | - Y Mohri
- Department of Surgery, Mie Prefectural General Medical Center, Japan
| | - C Yamashita
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Japan
| | - Y Kitagawa
- Department of Infection Control, National Center for Geriatrics and Gerontology, Japan
| | - K Suzuki
- Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - M Kobayashi
- Department of Anesthesiology, Hokushinkai Megumino Hospital, Japan
| | - M Kobayashi
- Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Kitasato University, Japan
| | - Y Hanai
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Japan
| | - H Nobuhara
- Department of Dentistry, Hiroshima Prefectural Hospital, Japan
| | - H Imaoka
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Japan
| | - M Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, School of Medicine, Japan
| | - T Mizuguchi
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - T Mayumi
- Department of Intensive Care Unit, Japan Community Healthcare Organization Chukyo Hospital, Japan
| | - Y Kitagawa
- Keio University, School of Medicine, Japan
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4
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Murata S, Takami M, Iwasaki H, Hashizume H, Yukawa Y, Minamide A, Nakagawa Y, Tsutsui S, Okada M, Nagata K, Ishimoto Y, Teraguchi M, Iwahashi H, Murakami K, Taiji R, Kozaki T, Kitano Y, Yoshida M, Yamada H. Outcomes and Vertebral Osteophytes and Bulging Intervertebral Discs Occupancy as a Decision-Making Tool for Surgical Success in Patients Undergoing Microendoscopic Foraminotomy for Lumbar Foraminal Stenosis. World Neurosurg 2024; 182:e570-e578. [PMID: 38052363 DOI: 10.1016/j.wneu.2023.11.150] [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: 10/05/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE The objective of this study was to determine the long-term outcomes of microendoscopic foraminotomy in treating lumbar foraminal stenosis and identify the optimal extent of decompression that yields improved results and fewer complications. METHODS A retrospective cohort study reviewed the medical records of 95 consecutive patients who underwent microendoscopic foraminotomy for lumbar foraminal stenosis. Clinical outcomes were assessed using the Japanese Orthopaedic Association scoring system and visual analog scale for low back and leg pain. Surgical success was determined by meeting significant improvement thresholds for back and leg pain at 2 years postoperatively. Multiple regression analysis identified factors associated with improved pain scores. Receiver operating characteristic curve analysis determined the cut-off values for successful surgeries. RESULTS Significant improvements were observed in Japanese Orthopaedic Association and visual analog scale scores for back and leg pain 2 years postoperatively compared with preoperative scores (P < 0.0001) and sustained over a ≥5-year follow-up period. Reoperation rates were low and did not significantly increase over time. Multiple regression analysis identified occupancy of the vertebral osteophytes and bulging intervertebral discs (O/D complex) as surgical success predictors. A 45.0% O/D complex occupancy cutoff value was determined, displaying high sensitivity and specificity for predicting surgical success. CONCLUSIONS This study provides evidence supporting the long-term efficacy of microendoscopic foraminotomy for lumbar foraminal stenosis and predicting surgical success. The 45.0% O/D complex occupancy cut-off value can guide patient selection and outcome prediction. These insights contribute to informed surgical decision-making and underscore the importance of evaluating the O/D complex in preoperative planning and predicting outcomes.
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Affiliation(s)
- Shizumasa Murata
- Department of Orthopedic Surgery, Shingu Municipal Medical Center, Shingu, Wakayama, Japan; Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masanari Takami
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
| | - Hiroshi Iwasaki
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | | | - Akihito Minamide
- Spine Center, Dokkyo Medical University Nikko Medical Center, Nikko City, Tochigi, Japan
| | - Yukihiro Nakagawa
- Spine Care Center, Wakayama Medical University Kihoku Hospital, Katsuragi, Wakayama, Japan
| | - Shunji Tsutsui
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motohiro Okada
- Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, Wakayama, Japan
| | - Keiji Nagata
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yuyu Ishimoto
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masatoshi Teraguchi
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroki Iwahashi
- Department of Orthopedic Surgery, Shingu Municipal Medical Center, Shingu, Wakayama, Japan
| | - Kimihide Murakami
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Ryo Taiji
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takuhei Kozaki
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yoji Kitano
- Department of Orthopedic Surgery, Shingu Municipal Medical Center, Shingu, Wakayama, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
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Tomomatsu K, Taniguchi T, Hashizume H, Harada T, Iidaka T, Asai Y, Oka H, Muraki S, Akune T, Kawaguchi H, Nakamura K, Yoshida M, Tanaka S, Yoshimura N, Yamada H. Factors associated with cam deformity in Japanese local residents. Sci Rep 2024; 14:1585. [PMID: 38238438 PMCID: PMC10796762 DOI: 10.1038/s41598-024-51876-0] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
Femoroacetabular impingement has increasingly been recognized as a cause of primary hip osteoarthritis; however, its epidemiological indications remain unclear. We aimed to clarify the epidemiological indications and factors associated with cam deformity in a large-scale population-based cohort in Japan. Overall, 1480 participants (2960 hips) (491 men, 989 women; mean age, 65.3 years) analyzed in the third survey of the Research on Osteoarthritis/Osteoporosis Against Disability study were included. The α angle and spinopelvic parameters (lumbar lordosis, sacral slope, pelvic tilt, and pelvic incidence) were radiographically measured. Cam deformity was defined as α angle ≥ 60°. Overall, the cam deformity prevalence was 147/2960 (5.0%). Cam deformity prevalence tended to increase with age; in the univariate analysis, a higher percentage of men was observed in the group with cam deformity than in the group without it. No relationship was observed between cam deformity and hip pain. Factors associated with α angle were examined via multiple regression analysis for each gender; α angle was significantly associated with age and BMI in each gender. The α angle and PT were correlated in women. Thus, α angle and cam deformity prevalence increase with age in Japanese individuals. Accordingly, cam deformity can be considered a developmental disease.
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Affiliation(s)
- Koichi Tomomatsu
- Naga Municipal Hospital, 1282 Uchida, Kinokawa City, Wakayama, Japan
| | - Takaya Taniguchi
- Naga Municipal Hospital, 1282 Uchida, Kinokawa City, Wakayama, Japan.
| | - Hiroshi Hashizume
- School of Health and Nursing Science, Wakayama Medical University, 590 Mikazura, Wakayama City, Wakayama, Japan
| | - Teiji Harada
- Naga Municipal Hospital, 1282 Uchida, Kinokawa City, Wakayama, Japan
| | - Toshiko Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo, Japan
| | - Yoshiki Asai
- Department of Orthopaedic Surgery, Wakayama Medical University, 811‑1 Kimiidera, Wakayama City, Wakayama, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical &Research Center, Faculty of Medicine, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo, Japan
| | - Shigeyuki Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo, Japan
| | - Toru Akune
- National Rehabilitation Center for Persons With Disabilities, 4‑1 Namiki, Tokorozawa City, Saitama, Japan
| | | | - Kozo Nakamura
- Department of Orthopaedic Surgery, Towa Hospital, 4‑7‑10 Towa, Adachi‑ku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Sumiya Orthopedic Hospital, 337 Yoshida, Wakayama City, Wakayama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811‑1 Kimiidera, Wakayama City, Wakayama, Japan
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6
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Nagata K, Hashizume H, Oka H, Ishimoto Y, Muraki S, Nakamura K, Yoshida M, Tanaka S, Yamada H, Yoshimura N. Plasma pentosidine concentration is associated with ligament ossification and high-grade osteoarthritis: The ROAD study. Geriatr Gerontol Int 2024; 24:154-160. [PMID: 38031320 DOI: 10.1111/ggi.14745] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/11/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
AIM No studies have examined the association between plasma pentosidine levels and ossification diseases in large cohorts of Japanese residents. This study aimed to investigate the association between cervical ossification of the posterior longitudinal ligament (OPLL) and other ossification diseases, including diffuse idiopathic skeletal hyperostosis, lumbar spondylosis and knee osteoarthritis (OA), by examining plain radiographs of the knee, and cervical, thoracic and lumbar spine from 1690 participants, and the association between these diseases and plasma pentosidine. DESIGN We enrolled 1690 participants (596 men and 1094 women) from mountainous and coastal areas from the study population of the previous Research on Osteoarthritis/Osteoporosis Against Disability study. X-ray examination of the cervical/thoracic/lumbar spine and knee was carried out only in these individuals, and not those from urban areas. Plasma pentosidine concentrations were determined using enzyme-linked immunoassays. RESULTS Radiographic OPLL was detected in 30 (17 men, 13 women) of 1562 individuals who underwent X-ray examination of the cervical spine. OPLL, diffuse idiopathic skeletal hyperostosis, lumbar spondylosis Kellgren-Lawrence (KL) grade, and knee OA KL grade were associated with high plasma pentosidine concentrations (all P < 0.05). Furthermore, significant intragroup differences (KL grade 4 vs 3) of plasma pentosidine concentration were observed between the lumbar spondylosis and knee OA groups. The plasma pentosidine concentration was significantly associated with age, OPLL, lumbar spondylosis (KL grade 4) and knee OA (KL grade 4). CONCLUSIONS OPLL is significantly associated with other ossification diseases. The development of more severe OA might lead to the accumulation of plasma pentosidine. Plasma pentosidine levels were associated with OPLL and severe OA. Geriatr Gerontol Int 2024; 24: 154-160.
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Affiliation(s)
- Keiji Nagata
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama City, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama City, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuyu Ishimoto
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama City, Japan
| | - Shigeyuki Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Munehito Yoshida
- Department of Orthopedic Surgery, Sumiya Orthopedic Hospital, Wakayama City, Japan
| | - Sakae Tanaka
- Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama City, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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7
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Teraguchi M, Hashizume H, Oka H, Kagotani R, Nagata K, Ishimoto Y, Tanaka S, Yoshida M, Yoshimura N, Yamada H. Prevalence and distribution of Schmorl node and endplate signal change, and correlation with disc degeneration in a population-based cohort: the Wakayama Spine Study. Eur Spine J 2024; 33:103-110. [PMID: 37907767 DOI: 10.1007/s00586-023-08009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/06/2023] [Accepted: 10/15/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE Degenerative spinal conditions, including disc degeneration (DD), Schmorl nodes (SN), and endplate signal changes (ESC), are pervasive age-associated phenomena that critically affect spinal health. Despite their prevalence, a comprehensive exploration of their distribution and correlations is lacking. This study examined the prevalence, distribution, and correlation of DD, SN, and ESC across the entire spine in a population-based cohort. METHODS The Wakayama Spine Study included 975 participants (324 men, mean age 67.2 years; 651 women, mean age 66.0 years). Magnetic resonance imaging (MRI) was used to evaluate the intervertebral space from C2/3 to L5/S1. DD was classified using Pfirrmann's system, ESC was identified by diffuse high-intensity signal changes on the endplates, and SN was defined as a herniation pit with a hypointense signal. We assessed the prevalence and distribution of SN, ESC, and DD across the entire spine. The correlations among these factors were examined. RESULTS Prevalence of ≥ 1 SN over the entire spine was 71% in men and 77% in women, while prevalence of ≥ 1 ESC was 57.9% in men and 56.3% in women. The prevalence of ESC and SN in the thoracic region was the highest among the three regions in both sexes. Positive linear correlations were observed between the number of SN and DD (r = 0.41, p < 0.001) and the number of ESC and DD (r = 0.40, p < 0.001), but weak correlations were found between the number of SN and ESC (r = 0.29, p < 0.001). CONCLUSION The prevalence and distribution of SN and ESC over the entire spine were observed, and correlations between SN, ESC, and DD were established. This population-based cohort study provides a comprehensive analysis of these factors.
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Affiliation(s)
- Masatoshi Teraguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan.
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryohei Kagotani
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Yuyu Ishimoto
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan
- Department of Orthopaedic Surgery, Sumiya Orthopaedic Hospital, Wakayama, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan
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Higuchi J, Matsumoto T, Kasai T, Takeda R, Iidaka T, Horii C, Oka H, Muraki S, Hashizume H, Yamada H, Yoshida M, Nakamura K, Tanaka S, Yoshimura N. Relationship between medial partite hallux sesamoid and hallux valgus in the general population. Foot Ankle Surg 2023; 29:621-626. [PMID: 37679197 DOI: 10.1016/j.fas.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/25/2023] [Accepted: 07/24/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND An association between the medial partite hallux sesamoid (MPHS) and hallux valgus (HV) has been suggested; however, a causal relationship has not been confirmed. This study aimed to determine their causal relationship using a cross-sectional radiographic survey of a large-scale population cohort covering a wide age group. PATIENTS AND METHODS The fifth survey of the Research on Osteoarthritis/Osteoporosis against Disability study involved 1997 participants aged 21-95 years who had undergone anteroposterior radiography of bilateral feet. The presence of MPHS, its morphology, and radiographic parameters related to the HV were assessed using radiographs. Changes in the prevalence of MPHS with age were assessed using trend tests. The relationship between the MPHS and HV was assessed based on sex and age. RESULTS MPHS was found in 508 out of 3994 feet (12.7 %), with a significant difference in prevalence between men and women (10.0 % vs. 13.7 %, p < 0.001). Trend analysis demonstrated a significant decrease in MPHS occurrence with age in both sexes. HV angle was significantly higher in feet with MPHS than in those without (Men: 17.8 ± 7.0° vs. 14.0 ± 5.9°, p < 0.0001; Women: 19.6 ± 7.7° vs. 17.7 ± 7.9°, p < 0.0001). The prevalence of HV angle ≥ 20° was also significantly higher in feet with MPHS than in those without (Men: 33.3 % vs. 14.6 %, p < 0.0001; Women: 46.5 % vs. 34.6 %, p < 0.0001). This association between MPHS and HV was noticeable in younger adults and became less prominent with age. CONCLUSIONS MPHS is associated with HV. The weakening of this relationship and the decreased prevalence of MPHS with age suggest that MPHS is not caused by HV, but is one of the causes of HV, especially in younger adults.
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Affiliation(s)
- Junya Higuchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Takumi Matsumoto
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan.
| | - Taro Kasai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Ryutaro Takeda
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Toshiko Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Chiaki Horii
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Hiroyuki Oka
- Division of Musculoskeletal AI System Development, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shigeyuki Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Hiroshi Hashizume
- School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan; Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan; Sumiya Orthopaedic Hospital, Wakayama, Japan
| | | | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Kin F, Itoh K, Bando T, Shinohara K, Oyama N, Terakado A, Yoshida M, Sumida S. Impact of avalanche type of transport on internal transport barrier formation in tokamak plasmas. Sci Rep 2023; 13:19748. [PMID: 37957265 PMCID: PMC10643559 DOI: 10.1038/s41598-023-46978-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023] Open
Abstract
In magnetic fusion plasmas, a transport barrier is essential to improve the plasma confinement. The key physics behind the formation of a transport barrier is the suppression of the micro-scale turbulent transport. On the other hand, long-range transport events, such as avalanches, has been recognized to play significant roles for global profile formations. In this study, we observed the impact of the avalanche-type of transport on the formation of a transport barrier for the first time. The avalanches are found to inhibit the formation of the internal transport barrier (ITB) observed in JT-60U tokamak. We found that (1) ITBs do not form in the presence of avalanches but form under the disappearance of avalanches, (2) the surface integral of avalanche-driven heat fluxe is comparable to the time rate change of stored energy retained at the ITB onset, (3) the mean E × B flow shear is accelerated via the ion temperature gradient that is not sustained under the existence of avalanches, and (4) after the ITB formation, avalanches are damped inside the ITB, while they remain outside the ITB.
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Affiliation(s)
- F Kin
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan.
- Institute of Advanced Energy, Kyoto University, Uji, 611-0011, Japan.
| | - K Itoh
- Frontier Research Institute, Chubu University, Kasugai, 487-8501, Japan
- Research Center for Plasma Turbulence, Kyushu University, Kasuga, 816-8580, Japan
| | - T Bando
- Toyohashi University of Technology, Toyohashi, 441-8580, Japan
| | - K Shinohara
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
- The University of Tokyo, Kashiwa, 277-8561, Japan
| | - N Oyama
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
| | - A Terakado
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
| | - M Yoshida
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
| | - S Sumida
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
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Murata S, Hashizume H, Tsutsui S, Oka H, Teraguchi M, Ishomoto Y, Nagata K, Takami M, Iwasaki H, Minamide A, Nakagawa Y, Tanaka S, Yoshimura N, Yoshida M, Yamada H. Publisher Correction: Pelvic compensation accompanying spinal malalignment and back pain-related factors in a general population: the Wakayama spine study. Sci Rep 2023; 13:12791. [PMID: 37550444 PMCID: PMC10406805 DOI: 10.1038/s41598-023-39895-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Affiliation(s)
- Shizumasa Murata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan.
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroyuki Oka
- Division of Musculoskeletal AI System Development, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Masatoshi Teraguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Yuyu Ishomoto
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroshi Iwasaki
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Akihito Minamide
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
- Spine Center, Dokkyo Medical University Nikko Medical Center, 632 Takatoku, Nikko City, Tochigi, Japan
| | - Yukihiro Nakagawa
- Spine Care Center, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Ito-gun, Wakayama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
- Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, 337 Yoshida, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
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Murata S, Hashizume H, Tsutsui S, Oka H, Teraguchi M, Ishomoto Y, Nagata K, Takami M, Iwasaki H, Minamide A, Nakagawa Y, Tanaka S, Yoshimura N, Yoshida M, Yamada H. Pelvic compensation accompanying spinal malalignment and back pain-related factors in a general population: the Wakayama spine study. Sci Rep 2023; 13:11862. [PMID: 37481604 PMCID: PMC10363166 DOI: 10.1038/s41598-023-39044-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/19/2023] [Indexed: 07/24/2023] Open
Abstract
Some older adults with spinal deformity maintain standing posture via pelvic compensation when their center of gravity moves forward. Therefore, evaluations of global alignment should include both pelvic tilt (PT) and seventh cervical vertebra-sagittal vertical axis (C7-SVA). Here, we evaluate standing postures of older adults using C7-SVA with PT and investigate factors related to postural abnormality. This cross-sectional study used an established population-based cohort in Japan wherein 1121 participants underwent sagittal whole-spine radiography in a standing position and bioelectrical impedance analysis for muscle mass measurements. Presence of low back pain (LBP), visual analog scale (VAS) of LBP, and LBP-related disability (Oswestry Disability Index [ODI]) were evaluated. Based on the PT and C7-SVA, the participants were divided into four groups: normal, compensated, non-compensated, and decompensated. We defined the latter three categories as "malalignment" and examined group characteristics and factors. There were significant differences in ODI%, VAS and prevalence of LBP, and sarcopenia among the four groups, although these were non-significant between non-compensated and decompensated groups on stratified analysis. Moreover, the decompensated group was significantly associated with sarcopenia. Individuals with pelvic compensation are at increased risk for LBP and related disorders even with the C7-SVA maintained within normal range.
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Affiliation(s)
- Shizumasa Murata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan.
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroyuki Oka
- Division of Musculoskeletal AI System Development, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Masatoshi Teraguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Yuyu Ishomoto
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Hiroshi Iwasaki
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - Akihito Minamide
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
- Spine Center, Dokkyo Medical University Nikko Medical Center, 632 Takatoku, Nikko City, Tochigi, Japan
| | - Yukihiro Nakagawa
- Spine Care Center, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Ito-gun, Wakayama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
- Department of Orthopedic Surgery, Sumiya Orthopaedic Hospital, 337 Yoshida, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
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Teraguchi M, Hashizume H, Asai Y, Oka H, Nagata K, Ishimoto Y, Iwasaki H, Tsutsui S, Takami M, Tanaka S, Yoshida M, Yoshimura N, Yamada H. Association between modic changes, disc degeneration, and pelvic incidence-lumbar lordosis mismatch in a large population based cohort: the Wakayama spine study. Eur Spine J 2023:10.1007/s00586-023-07702-8. [PMID: 37100965 DOI: 10.1007/s00586-023-07702-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE Sagittal plane alignment is crucial for treating spinal malalignment and low back pain. Pelvic incidence-lumbar lordosis (PI-LL) mismatch is commonly used to evaluate clinical outcomes in patients with sagittal malalignment. The association between PI-LL mismatch and changes surrounding the intervertebral disc is very important to understand the compensatory mechanisms involved. This study aimed to examine the association between PI-LL mismatch and magnetic resonance imaging (MRI) changes surrounding the intervertebral disc in a large population-based cohort. METHODS We evaluated participants from the second Wakayama Spine Study, recruiting the general population aged 20 years or older, irrespective of sex, who were registered residents in one region in 2014. In total, 857 individuals underwent an MRI of the whole spine; however, 43 MRI results were not included due to incomplete or inadequate quality images. PI-LL mismatch was defined as > 11°. We compared the MRI changes, such as Modic change (MC), disc degeneration (DD), and high-intensity zones (HIZ), between PI-LL mismatch and non-PI-LL mismatch groups. Multivariate logistic regression analysis was conducted to determine the association between the MRI changes and PI-LL mismatch with adjustment for age, sex, and body mass index in the lumbar region and at each level. RESULTS A total of 795 participants (243 men, 552 women, mean age 63.5 ± 13.1 years old) were evaluated; 181 were included in the PI-LL mismatch group. MC and DD in the lumbar region were significantly higher in the PI-LL mismatch group. MC in the lumbar region was significantly associated with PI-LL mismatch (odds ratio (OR); 1.81, 95% confidence interval (CI) 1.2-2.7). MC at each level was significantly associated with PI-LL mismatch (OR; 1.7-1.9, 95%CI 1.1-3.2), and DD at L1/2, L3/4, and L4/5 was associated with PI-LL mismatch (OR; 2.0- 2.4. 95%CI 1.2-3.9). CONCLUSION MC and DD were significantly associated with PI-LL mismatch. Therefore, profiling MC may be helpful in improving the targeted treatment of LBP associated with the adult spinal deformity.
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Affiliation(s)
- Masatoshi Teraguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan.
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Yoshiki Asai
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22Nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Yuyu Ishimoto
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Hiroshi Iwasaki
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Medical Research and Management for Musculoskeletal Pain, 22Nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
- Department of Orthopaedic Surgery, Sumiya Orthopaedic Hospital, Wakayama, Wakayama, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
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Yoshii Y, Jimbo K, Hashiguchi H, Shikata S, Ogawa A, Watase C, Shiino S, Murata T, Yoshida M, Takayama S, Suto A. P173 Should positive surgical margin involvement of in situ carcinoma of invasive breast cancer after breast conserving surgery be treated with additional resection? Breast 2023. [DOI: 10.1016/s0960-9776(23)00290-4] [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: 03/17/2023] Open
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Nomura K, Yoshida M, Okada M, Nakamura Y, Yawatari K, Nakayama E. Effectiveness of a Gelatin-Thrombin Matrix Sealant (Floseal®) for Reducing Blood Loss During Microendoscopic Decompression Surgery for Lumbar Spinal Canal Stenosis: A Retrospective Cohort Study. Global Spine J 2023; 13:764-770. [PMID: 33906458 DOI: 10.1177/21925682211008835] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES To investigate the effectiveness and safety of a gelatin-thrombin matrix sealant (GTMS) during microendoscopic laminectomy (MEL) for lumbar spinal canal stenosis (LSCS). METHODS This study included 158 LSCS cases on hemostasis-affecting medication who underwent MEL by a single surgeon between September 2016 and August 2020. Patients were divided into 2 groups depending on whether GTMS was used (37 cases, Group A) or not (121 cases, Group B). Perioperative data related to bleeding or postoperative spinal epidural hematoma (PSEH) was investigated. Clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score for low back pain. RESULTS The mean intraoperative blood loss per level was greater in Group A (26.0 ± 20.3 g) than in Group B (13.6 ± 9.0 g), whereas the postoperative drainage volume was smaller in Group A (79.1 ± 42.5 g) than in Group B (97.3 ± 55.6 g). No revision surgeries for PSEH were required in Group A, while 2 (1.7%) revisions were required in Group B (P = .957). The median JOA score improved significantly from the preoperative period to 1-year postoperatively in both Group A and B (total score, 16.0-23.5 and 17.0-25.0 points, respectively). CONCLUSIONS The use of GTMS during MEL for LSCS may be associated with a reduction in postoperative drainage volume. The revision rate for PSEH was not affected significantly by the use of GTMS. Clinical outcomes (represented by the JOA score) were significantly improved after the surgery, regardless of GTMS use during MEL.
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Affiliation(s)
- Kazunori Nomura
- Department of Orthopedic Surgery, 88463Sumiya Orthopaedic Hospital, Wakayama-shi, Wakayama, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, 88463Sumiya Orthopaedic Hospital, Wakayama-shi, Wakayama, Japan
| | - Motohiro Okada
- Department of Orthopedic Surgery, 88463Sumiya Orthopaedic Hospital, Wakayama-shi, Wakayama, Japan
| | - Yosuke Nakamura
- Department of Orthopedic Surgery, 88463Sumiya Orthopaedic Hospital, Wakayama-shi, Wakayama, Japan
| | - Kenichi Yawatari
- Department of Orthopedic Surgery, 88463Sumiya Orthopaedic Hospital, Wakayama-shi, Wakayama, Japan
| | - Enshi Nakayama
- Department of Orthopedic Surgery, 88463Sumiya Orthopaedic Hospital, Wakayama-shi, Wakayama, Japan
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Takami M, Yukawa Y, Noda Y, Yoshida M, Yamada H. Salvage Surgery for Symptomatic Recurrence of Retro-Odontoid Pseudotumor after a C1 Laminectomy. Acta Med Okayama 2022; 76:749-754. [PMID: 36549779 DOI: 10.18926/amo/64127] [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] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We provide the first report of successful salvage surgery for a post-C1 laminectomy symptomatic recurrence of a retro-odontoid pseudotumor (ROP) that caused myelopathy. The 72-year-old Japanese woman presented with an ROP causing symptomatic cervical myelopathy. With ultrasonography support, we performed the enucleation of the ROP via a transdural approach and fusion surgery for the recurrence of the mass. At the final observation 2-year post-surgery, MRI demonstrated the mass's regression and spinal cord decompression, and the patient's symptoms had improved. Our strategy is an effective option for a symptomatic recurrence of ROP.
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Affiliation(s)
- Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University
| | | | - Yusuke Noda
- Department of Orthopaedic Surgery, Wakayama Rosai Hospital
| | | | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University
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Tokuzawa T, Nasu T, Inagaki S, Moon C, Ido T, Idei H, Ejiri A, Imazawa R, Yoshida M, Oyama N, Tanaka K, Ida K. 3D metal powder additive manufacturing phased array antenna for multichannel Doppler reflectometer. Rev Sci Instrum 2022; 93:113535. [PMID: 36461436 DOI: 10.1063/5.0101723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/07/2022] [Indexed: 06/17/2023]
Abstract
Measuring the time variation of the wavenumber spectrum of turbulence is important for understanding the characteristics of high-temperature plasmas, and the application of a Doppler reflectometer with simultaneous multi-frequency sources is expected. To implement this diagnostic in future fusion devices, the use of a phased array antenna (PAA) that can scan microwave beams without moving antennas is recommended. Since the frequency-scanning waveguide leaky-wave antenna-type PAA has a complex structure, we have investigated its characteristics by modeling it with 3D metal powder additive manufacturing (AM). First, a single waveguide is fabricated to understand the characteristics of 3D AM techniques, and it is clear that there are differences in performance depending on the direction of manufacture and surface treatment. Then, a PAA is made, and it is confirmed that the beam can be emitted in any direction by frequency scanning. The plasma flow velocity can be measured by applying the 3D manufacturing PAA to plasma measurement.
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Affiliation(s)
- T Tokuzawa
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki 509-5292, Japan
| | - T Nasu
- The Graduate University for Advanced Studies, SOKENDAI, Toki 509-5292, Japan
| | - S Inagaki
- Institute of Advanced Energy, Kyoto University, Gokasho, Uji 611-0011, Japan
| | - C Moon
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - T Ido
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - H Idei
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - A Ejiri
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa 277-8561, Japan
| | - R Imazawa
- National Institutes for Quantum Science and Technology, 801-1 Mukoyama, Naka, Ibaraki 311-0193, Japan
| | - M Yoshida
- National Institutes for Quantum Science and Technology, 801-1 Mukoyama, Naka, Ibaraki 311-0193, Japan
| | - N Oyama
- National Institutes for Quantum Science and Technology, 801-1 Mukoyama, Naka, Ibaraki 311-0193, Japan
| | - K Tanaka
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki 509-5292, Japan
| | - K Ida
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki 509-5292, Japan
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Osaka M, Yoshida M. Citrullination of histoneH3 in neutrophil via CXCL1 enhances neutrophil adhesion to femoral artery of LDLR−/− mice fed HFD. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3079] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Vascular inflammation plays an important role in the development of atherosclerosis. Previously we have shown that a high-fat diet (HFD) increased neutrophil adhesion to the vascular intima in wild-type (wt) mice (Osaka M. Sci Rep. 2016). However, the involvement of neutrophils in atherosclerosis-related vascular inflammation is not well known.
Purpose
This study examined that neutrophil extracellular trap (NETs) or the hypercitrullination of histone H3 in neutrophils enhances neutrophil adhesion to atheroprone-arteries in LDL receptor null (LDLR−/−) mice.
Methods
We observed leukocyte adhesion in the femoral artery of LDLR−/− mice fed normal chow (NC) or HFD, and determined leukocyte subtype that adhered on vascular endothelium under neutrophil or monocyte depletion using intravital microscopy. Importantly, neutrophil adhesion was examined under the administration of TDFA which inhibits NETs and citrullination of histone H3, in LDLR−/− mice fed HFD. Furthermore, immunohistochemistry for citrullinated histone H3 in peripheral neutrophils of mice was examined. Comprehensive cytokine/chemokine analysis for a plasma of mice was performed to determine the factors citrullinating histone H3 in LDLR−/− mice. Moreover, these mice were treated with a novel specific PPARα agonist, to reduce the elevation of plasma triglyceride levels.
Results
Leukocyte adhesion in LDLR−/− mice fed HFD significantly increased compared to NC. More interestingly, it significantly enhanced compared to wt mice fed HFD. Furthermore, neutrophil depletion rather than monocyte depletion diminished leukocyte adhesion, suggesting that the leukocyte subtype that adhered in LDLR−/− mice fed HFD was neutrophil. Neutrophil adhesion in these mice significantly was reduced by the administration of TDFA, suggesting a pivotal role for histone H3 citrullination in neutrophil adhesion. Moreover, citrullination of histone H3 in neutrophils from LDLR−/− mice fed HFD but not from those without HFD was significantly enhanced. In addition, comprehensive cytokine/chemokine analysis revealed an increase of CXCL1 in plasma of LDLR−/− mice fed HFD. CXCL1 enhanced neutrophil adhesion to HUVECs, and the adhesion significantly decreased by the treatment of TDFA to neutrophil in vitro non-static adhesion assay. These results showed that CXCL1 enhanced neutrophil adhesion in LDLR−/− mice fed HFD through citrullination. Furthermore, when these mice were treated with PPARα agonist, observed histone citrullination, as well as neutrophil adhesion, was significantly reduced.
Conclusion
These results suggest that HFD induced histone citrullination in neutrophils in LDLR−/− mice and PPARα agonist plays a role during hypertriglyceridemia-mediated vascular inflammation in atherosclerosis.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research(C)
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Affiliation(s)
- M Osaka
- Tokyo Medical and Dental University , Tokyo , Japan
| | - M Yoshida
- Tokyo Medical and Dental University , Tokyo , Japan
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Kim M, Baumlin N, Mohiuddin M, Yoshida M, Dennis J, Bengtson C, Salathe M. 426 Metformin improves high mobility group box protein 1–induced mucociliary dysfunction in cystic fibrosis airway epithelial cells. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01116-x] [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: 11/07/2022]
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Yoshimura N, Iidaka T, Horii C, Mure K, Muraki S, Oka H, Kawaguchi H, Akune T, Ishibashi H, Ohe T, Hashizume H, Yamada H, Yoshida M, Nakamura K, Tanaka S. Correction to: Epidemiology of locomotive syndrome using updated clinical decision limits: 6-year follow-ups of the ROAD study. J Bone Miner Metab 2022; 40:872. [PMID: 35699791 DOI: 10.1007/s00774-022-01349-z] [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] [Indexed: 10/18/2022]
Affiliation(s)
- Noriko Yoshimura
- Department of Prevention Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Toshiko Iidaka
- Department of Prevention Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Chiaki Horii
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Kanae Mure
- Department of Public Health, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8510, Japan
| | - Shigeyuki Muraki
- Department of Prevention Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 113-8655, Japan
| | | | - Toru Akune
- National Rehabilitation Center for Persons With Disabilities, Saitama, 359-0042, Japan
| | - Hideaki Ishibashi
- Department of Orthopedic Surgery, Ina Hospital, Saitama, 362-0806, Japan
| | - Takashi Ohe
- NTT Medical Center Tokyo, Tokyo, 141-8625, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan
| | | | - Sakae Tanaka
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
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Yoshimura N, Iidaka T, Horii C, Mure K, Muraki S, Oka H, Kawaguchi H, Akune T, Ishibashi H, Ohe T, Hashizume H, Yamada H, Yoshida M, Nakamura K, Tanaka S. Epidemiology of locomotive syndrome using updated clinical decision limits: 6-year follow-ups of the ROAD study. J Bone Miner Metab 2022; 40:623-635. [PMID: 35536512 DOI: 10.1007/s00774-022-01324-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Locomotive syndrome (LOCOMO) is defined by the Japanese Orthopaedic Association (JOA) as a condition requiring nursing care due to a decline in mobility resulting from musculoskeletal disorders. In 2020, the JOA announced the new definition of LOCOMO stage 3 and revision of clinical decision limits in stages of LOCOMO. However, there are few reports on the epidemiological indices of LOCOMO. This prospective cohort study aimed to investigate the prevalence, incidence, and association of poor prognosis with LOCOMO stages. MATERIALS AND METHODS The third survey of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study was conducted during 2012-2013, examining a population-based cohort of 1575 participants (513 men and 1062 women, mean age 65.6 years). Three LOCOMO risk tests were performed, and patients were classified into LOCOMO stages 0, 1, 2, and 3. They were followed up for 6 years, and identical examination of LOCOMO was performed in 3- and 6-year follow-ups. Data on patients' prognoses, including disability and death, were collected. RESULTS The prevalence of LOCOMO stages 1, 2, and 3 was 41.3, 14.9, and 11.6%, respectively. The incidence of LOCOMO stages 1, 2, and 3 were 83.7, 23.0, and 18.6 per 1000 person-years, respectively. Compared with LOCOMO stage 0, logistic regression analysis showed that LOCOMO stage 3 significantly increased the risk of disability and mortality. In addition, each value of LOCOMO risk tests for LOCOMO stage 3 increased the risk of poor prognosis. CONCLUSION LOCOMO stage 3 is a sensitive indicator of future disability and mortality.
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Affiliation(s)
- Noriko Yoshimura
- Department of Prevention Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Toshiko Iidaka
- Department of Prevention Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Chiaki Horii
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Kanae Mure
- Department of Public Health, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8510, Japan
| | - Shigeyuki Muraki
- Department of Prevention Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, 113-8655, Japan
| | | | - Toru Akune
- National Rehabilitation Center for Persons With Disabilities, Saitama, 359-0042, Japan
| | - Hideaki Ishibashi
- Department of Orthopedic Surgery, Ina Hospital, Saitama, 362-0806, Japan
| | - Takashi Ohe
- NTT Medical Center Tokyo, Tokyo, 141-8625, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan
| | | | - Sakae Tanaka
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
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Yoshida M, Zoshima T, Kawano M. AB0270 EFFECT OF METHOTREXATE USE ON JOINT AND LUNG DISEASE OUTCOMES IN PATIENTS HAVING RHEUMATOID ARTHRITIS WITH INTERSTITIAL LUNG DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundInterstitial lung disease (ILD) is a frequent complication of rheumatoid arthritis (RA). Although methotrexate (MTX) is an anchor drug for RA management, its use may worsen lung disease severity in patients with RA related ILD (RA-ILD). The safety and efficacy of MTX use in RA-ILD treatment have not been elucidated.ObjectivesWe aimed to clarify the clinical characteristics of patients with RA-ILD and the effect of MTX use on joint and lung disease outcomes.MethodsIn this retrospective study, we included patients with RA-ILD who visited our department from 2011 to 2019 and underwent chest computed tomography (CT). RA was diagnosed using the 1987 ACR criteria or the 2010 ACR/EULAR classification criteria. During the abovementioned period, we defined the baseline as the time of the first chest CT scan; moreover, the final observation was defined as the time of the final chest CT scan in patients who underwent CT more than once, or as the final visit in those without a second chest CT scan. We excluded patients whose RA-ILD status could not be fully evaluated using chest CT scans due to other causes, including respiratory infections. Severe infections were defined as infectious events requiring hospitalization.To identify the clinical characteristics of patients with RA-ILD, we compared the features of RA with versus without ILD at baseline. To clarify the effect of MTX use on RA-ILD outcomes, we compared the outcomes of patients with RA-ILD with versus without MTX use. Furthermore, we investigated factors associated with RA disease activity or ILD deterioration using multivariate analyses.ResultsIn this study, we included 452 patients (mean age, 60.2 years; females, 78.5%; mean observational period, 77.5 months), 325 (71.9%) of whom underwent chest CT more than two times.Patients with ILD (ILD; n=90, 19.9%) were older and had a higher RF positivity rate than those without ILD. Moreover, patients with ILD were treated with lower MTX use (20.2% vs. 52.9%, p<0.001; 1.46 vs. 3.53 mg/week, p<0.001) and TNF inhibitors exposure (21.1% vs. 13.1%, p<0.044) than those without ILD, albeit with similar uses of prednisolone and other bDMARDs, including tocilizumab and abatacept. DAS28-CRP was higher in patients with than in those without ILD at baseline (4.60 vs. 3.42, p=0.063) and at the final observation (2.42 vs. 2.09, p=0.025). Linear regression analysis showed that baseline age and ILD were significantly associated with DAS28-CRP at the final observation (β=0.206 and 0.173, respectively). Kaplan Meier analysis revealed that patients with ILD experienced severe infections and respiratory infections more frequently than those without ILD (log-rank test, p<0.001 and p<0.001).Seventeen patients (20.2%) with ILD were treated with MTX. At baseline, these patients had similar ages and RF/ACPA positivity rates, as well as prednisolone and tDMARDs exposures, with higher bDMARD exposure (41.2 vs. 13.4%, p=0.016) compared to that in ILD patients without MTX use. DAS28-CRP was comparable in patients with and without MTX use at baseline, but was lower at the final observation in MTX-treated patients with ILD (1.41 vs. 2.73, p<0.001). Kaplan Meier analyses revealed no differences in the frequencies of severe infections, respiratory infections, or ILD deterioration between patients with and without MTX use. Cox regression analysis demonstrated that the risk factors for ILD deterioration included baseline age (hazard ratio [HR] 1.088; 95% confidence interval [CI] 1.037-1.147), but not MTX use (HR 1.666; 95% CI 0.472-5.876).ConclusionRA-ILD were treated with lower MTX use, which resulted in higher RA disease activity. In contrast, patients with RA-ILD treated with MTX had lower RA disease activity without ILD deterioration. As RA-ILD is undertreated, appropriate MTX use may be required for effective RA-ILD treatmentReferences[1]Arthritis Rheumatol 2021;73:1108-23.Disclosure of InterestsNone declared
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Tsuge S, Fujii H, Tamai M, Mizushima I, Yoshida M, Suzuki N, Takahashi Y, Takeji A, Horita S, Fujisawa Y, Matsunaga T, Zoshima T, Nishioka R, Nuka H, Hara S, Tani Y, Suzuki Y, Ito K, Yamada K, Nakazaki S, Kawakami A, Kawano M. POS1339 FACTORS RELATED TO SERUM IgG4 ELEVATION AND DEVELOPMENT OF IgG4-RELATED DISEASE: DATA FROM RESIDENT EXAMINATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundElevated serum IgG4 levels are one of the characteristic findings in immunoglobulin G4 (IgG4)-related disease (IgG4-RD). Serum IgG4 levels have an impact to a certain extent on the diagnosis of IgG4-RD although there are some issues in their sensitivity and specificity. In the reports from Japan, China, USA, and Europe, elevated serum IgG4 levels were reported to be observed in 83-97% of patients with IgG4-RD [1-5]. In the past investigations of hospital patients, some studies reported that 10-15% of hospital patients with elevated serum IgG4 levels had IgG4-RD [6,7]. However, in general adults with no symptom, investigations of prevalence of elevated serum IgG4 levels and/or IgG4-RD have rarely been conducted.ObjectivesThis study aimed to investigate the frequency of serum IgG4 elevation in the general Japanese population and its associated factors using data from resident examinations.MethodsWe measured the serum IgG4 levels in 1,204 residents who underwent a general medical examination in Ishikawa prefecture, Japan. Logistic regression analysis was used to search for factors related to elevated serum IgG4 levels. Secondary examinations were conducted for participants in whom elevation was identified.ResultsThe mean serum IgG4 level was 44 mg/dL, and elevated serum IgG4 levels were observed in 42 patients (3.5%). Univariate logistic regression analyses showed that male sex, older age, lower estimated glomerular filtration rates based on cystatin C (eGFR-CysC), serum high-density lipoprotein cholesterol levels, and higher hemoglobin A1c (HbA1c) levels were associated with elevated serum IgG4 levels. Subgroup analyses in men showed that older age, lower eGFR-CysC levels, and higher serum HbA1c levels were associated with elevated serum IgG4 levels. In contrast, the analyses in women found no significant factors. One of the 10 residents who underwent secondary examinations was diagnosed with possible IgG4-related retroperitoneal fibrosis.ConclusionIn the general population, elevated serum IgG4 levels are more common in elderly men, which is similar to the epidemiological features of IgG4-RD.References[1]Inoue D, et al. IgG4-related disease: dataset of 235 consecutive patients. Medicine (Baltimore). 2015;94(15):e680.[2]Yamada K, et al. New clues to the nature of immunoglobulin G4-related disease: a retrospective Japanese multicenter study of baseline clinical features of 334 cases. Arthritis Res Ther. 2017;19(1):262[3]Culver EL, et al. Elevated serum IgG4 levels in diagnosis, treatment response, organ involvement, and relapse in a prospective IgG4-related disease UK cohort. Am J Gastroenterol 2016;111:733–43.[4]Lin W, et al. Clinical characteristics of immunoglobulin G4-related disease: a prospective study of 118 Chinese patients. Rheumatology (Oxford). 2015;54(11):1982–90.[5]Carruthers MN, et al. The diagnostic utility of serum IgG4 concentrations in IgG4-related disease. Ann Rheum Dis 2015;74:14-18.[6]James Yun, et al. Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease. Asia Pac Allergy. 2014 Jul;4(3):172-176.[7]Taiwo N Ngwa, et al. Sreum immunoglobulin G4 level is a poor predictor of immunoglobulin G4–related disease. Pancreas. 2014 Jul;43(5):704-7.Disclosure of InterestsNone declared
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Kato H, Nemoto K, Shimizu M, Abe A, Asai S, Ishihama N, Matsuoka S, Daimon T, Ojika M, Kawakita K, Onai K, Shirasu K, Yoshida M, Ishiura M, Takemoto D, Takano Y, Terauchi R. Recognition of pathogen-derived sphingolipids in Arabidopsis. Science 2022; 376:857-860. [PMID: 35587979 DOI: 10.1126/science.abn0650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In plants, many invading microbial pathogens are recognized by cell-surface pattern recognition receptors, which induce defense responses. Here, we show that the ceramide Phytophthora infestans-ceramide D (Pi-Cer D) from the plant pathogenic oomycete P. infestans triggers defense responses in Arabidopsis. Pi-Cer D is cleaved by an Arabidopsis apoplastic ceramidase, NEUTRAL CERAMIDASE 2 (NCER2), and the resulting 9-methyl-branched sphingoid base is recognized by a plasma membrane lectin receptor-like kinase, RESISTANT TO DFPM-INHIBITION OF ABSCISIC ACID SIGNALING 2 (RDA2). 9-Methyl-branched sphingoid base is specific to microbes and induces plant immune responses by physically interacting with RDA2. Loss of RDA2 or NCER2 function compromised Arabidopsis resistance against an oomycete pathogen. Thus, we elucidated the recognition mechanisms of pathogen-derived lipid molecules in plants.
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Affiliation(s)
- H Kato
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - K Nemoto
- Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
| | - M Shimizu
- Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
| | - A Abe
- Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
| | - S Asai
- RIKEN Center for Sustainable Resource Science, Yokohama 230-0045, Japan
| | - N Ishihama
- RIKEN Center for Sustainable Resource Science, Yokohama 230-0045, Japan
| | - S Matsuoka
- RIKEN Center for Sustainable Resource Science, Wako 351-0198, Japan
| | - T Daimon
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - M Ojika
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - K Kawakita
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - K Onai
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - K Shirasu
- RIKEN Center for Sustainable Resource Science, Yokohama 230-0045, Japan.,Graduate School of Science, The University of Tokyo, Tokyo 113-8654, Japan
| | - M Yoshida
- RIKEN Center for Sustainable Resource Science, Wako 351-0198, Japan.,Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo 113-8657, Japan
| | - M Ishiura
- Graduate School of Science, Nagoya University, Nagoya 464-8601, Japan
| | - D Takemoto
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - Y Takano
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - R Terauchi
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan.,Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
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Horii C, Iidaka T, Muraki S, Oka H, Asai Y, Tsutsui S, Hashizume H, Yamada H, Yoshida M, Kawaguchi H, Nakamura K, Akune T, Oshima Y, Tanaka S, Yoshimura N. The cumulative incidence of and risk factors for morphometric severe vertebral fractures in Japanese men and women: the ROAD study third and fourth surveys. Osteoporos Int 2022; 33:889-899. [PMID: 34797391 DOI: 10.1007/s00198-021-06143-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/30/2021] [Indexed: 10/19/2022]
Abstract
UNLABELLED This population-based cohort study with a 3-year follow-up revealed that the annual incidence rates of vertebral fracture (VF) and severe VF (sVF) were 5.9%/year and 1.7%/year, respectively. The presence of mild VF at the baseline was a significant risk factor for incident sVF in participants without prevalent sVF. INTRODUCTION This study aimed to estimate the incidence of morphometric vertebral fracture (VF) and severe VF (sVF) in men and women and clarify whether the presence of a mild VF (mVF) increases the risk of incident sVF. METHODS Data from the population-based cohort study, entitled the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study, were analyzed. In total, 1190 participants aged ≥ 40 years (mean age, 65.0 ± 11.2) years completed whole-spine lateral radiography both at the third (2012-2013, baseline) and fourth surveys performed 3 years later (2015-2016, follow-up). VF was defined using Genant's semi-quantitative (SQ) method: VF as SQ ≥ 1, mVF as SQ = 1, and sVF as SQ ≥ 2. Cumulative incidence of VF and sVF was estimated. Multivariate logistic regression analyses were performed to evaluate risk factors for incident sVF. RESULTS The baseline prevalence of mVF and sVF were 16.8% and 6.0%, respectively. The annual incidence rates of VF and sVF were 5.9%/year and 1.7%/year, respectively. The annual incidence rates of sVF in participants without prevalent VF, with prevalent mVF, and with prevalent sVF were 0.6%/year, 3.8%/year, and 11.7%/year (p < 0.001), respectively. Multivariate logistic regression analyses in participants without prevalent sVF showed that the adjusted odds ratios for incident sVF were 4.12 [95% confident interval 1.85-9.16] and 4.53 [1.49-13.77] if the number of prevalent mVF at the baseline was 1 and ≥ 2, respectively. CONCLUSIONS The annual incidence rates of VF and sVF were 5.9%/year and 1.7%/year, respectively. The presence of prevalent mVF was an independent risk factor for incident sVF.
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Affiliation(s)
- C Horii
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - T Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - S Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Y Asai
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - S Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - H Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - H Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - M Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - H Kawaguchi
- Department of Orthopaedic Surgery, Tokyo Neurological Center, 4-1-17, Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - K Nakamura
- Department of Orthopaedics, Towa Hospital, Towa 4-7-10, Adachi-ku, Tokyo, 120-0003, Japan
| | - T Akune
- Department of Orthopaedics, National Rehabilitation Center for Persons With Disabilities, 4-1 Namiki, Tokorozawa City, Saitama, 359-0042, Japan
| | - Y Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - S Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
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Tamai H, Teraguchi M, Hashizume H, Oka H, Cheung JPY, Samartzis D, Muraki S, Akune T, Kawaguchi H, Nakamura K, Tanaka S, Yoshida M, Yoshimura N, Yamada H. A Prospective, 3-year Longitudinal Study of Modic Changes of the Lumbar Spine in a Population-based Cohort: The Wakayama Spine Study. Spine (Phila Pa 1976) 2022; 47:490-497. [PMID: 35213525 DOI: 10.1097/brs.0000000000004301] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Large-scale, prospective, population-based, longitudinal observational study. OBJECTIVE The aim of this study was to investigate the rate of incidence, transformation, and reverse transformation of Modic changes (MCs) using T1-weighted (T1W) and T2-weighted (T2W) lumbar magnetic resonance images (MRI) over a 3-year period. SUMMARY OF BACKGROUND DATA Although MCs in populational study are considered significant, existing epidemiological evidence is based on cross-sectional studies only. METHODS Overall, 678 subjects (208 men, 470 women, mean age 62.1 ± 12.8 years in 2013) in both 2013 and 2016 surveys were included. The rate of change in Modic Type I (T1W: low-intensity, T2W: high-intensity), Type II (T1W: high, T2W: high), and Type III (T1W: low, T2W: low) at five endplates was analyzed over a 3-year period. An incidence of MC at each level and in the lumbar region was defined as no MC at baseline with signal changes at follow-up. Transformation was defined as Type I or II MC at baseline with conversion at follow-up Type II from Type I or Type III MC from Type I and II. Furthermore, reverse transformation was defined as Type I, II, or III MC at baseline, with at least one endplate showing a reversion in Modic type (no MC for baseline Type I; no MC and Type I for baseline Type II; no MC, Type I or Type II for baseline Type III) at follow-up. RESULTS Overall, 3390 endplates were included. For 3 years, the incidence, transformation, and reverse transformation of MCs were seen in 395 (11.7%), 84 (2.5%), and 11 (0.3%) endplates, respectively. The highest levels of incidence, transformation, and reverse transformation were at L2/3 (96 [14.2%] endplates), L5/S1 (32 [4.7%] endplates), and L2/3 (5 [0.7%] endplates), respectively. CONCLUSION This study revealed a high incidence of MCs at the upper lumbar levels and transformation at the lower lumbar levels. Reverse transformation of MCs occurs but are rare.Level of Evidence: 2.
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Affiliation(s)
- Hidenobu Tamai
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masatoshi Teraguchi
- Spine Care Center, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Shigeyuki Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Toru Akune
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Kawaguchi
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kozo Nakamura
- Department of Orthopedic Surgery, The University of Tokyo, Bunkyoku, Tokyo, Japan
| | - Sakae Tanaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, Sumiya Orthopedic Hospital, Wakayama City, Wakayama, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
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Odagawa S, Watari T, Yoshida M. Chinkui dermatitis: the sea bather's eruption. QJM 2022; 115:100-101. [PMID: 34791435 DOI: 10.1093/qjmed/hcab277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Odagawa
- From the General Medicine Center, Shimane University Hospital, Shimane, Japan
- Department of General Medicine, Oki Hospital, ShimaneJohoku-cho 335, Okinoshima-cho, Oki, Shimane, 685-0016, JAPANTEL 08512-2-1356
| | - T Watari
- From the General Medicine Center, Shimane University Hospital, Shimane, Japan
| | - M Yoshida
- Marine Biological Science Section, Education and Research Center for Biological Resources, Faculty of Life and Environmental Science, Shimane UniversityKamo 194, Okinoshima-cho, Oki, Shimane, 685-0024, JAPANTEL 08512-3-1007
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27
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Terakado A, Koide Y, Yoshida M, Nakano T, Homma H, Oyama N. Design of Heat-Resistant in-Vessel Components for Deuterium Beam-Aided Charge Exchange Recombination Spectroscopy in JT-60SA. Fusion Science and Technology 2022. [DOI: 10.1080/15361055.2021.1951529] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A. Terakado
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - Y. Koide
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - M. Yoshida
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - T. Nakano
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - H. Homma
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - N. Oyama
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
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Okada M, Nakagawa Y, Yoshida M, Yamada H. Anterior Decompression via a Single Posterior Approach Using the Ultrasonic Bone Scalpel for the Treatment of the Thoracic Segmental Ossification of Posterior Longitudinal Ligament: A Report of Three Cases. Spine Surg Relat Res 2022; 6:79-85. [PMID: 35224251 PMCID: PMC8842363 DOI: 10.22603/ssrr.2021-0079] [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: 04/13/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Thoracic myelopathy due to ossification of the posterior longitudinal ligament (T-OPLL) is an indication for surgical treatment because the symptom is usually progressive. The surgery for T-OPLL is technically challenging for several reasons. Various operational procedures were developed for dealing with T-OPLL. The anterior decompression through a single posterior approach is a procedure to achieve the complete decompression via the direct resection of the ossified lesion, especially for the beak-type OPLL. Previous reports showed better postoperative outcomes using this method than using other procedures. However, the difficulty and risk of complications are also reported because of the blinded resection of the lesion positioning ventrally to the dura mater. Technical Note We describe a novel method using an anterior decompression through a single posterior approach using an ultrasonic bone scalpel. The following procedure is for a case of beak-type OPLL at the T5-6 level. The posterior elements at T2-9 were exposed after a median skin incision was created above a spinous process. First, pedicle screws were inserted bilaterally at T3-5 and T7-9. After the laminectomies and dekyphosis maneuver at T3-9, the spinal cord compression by OPLL was evaluated using intraoperative ultrasonography. After the slight medial facetectomy and pediclotomy at T5-6, the ultrasonic bone scalpel was inserted through the bilateral side of the spinal cord. The tip of the handpiece was angled to reach OPLL. The resection of OPLL was performed under intraoperative spinal cord monitoring. The intraoperative ultrasonography revealed the normal pulsation of the spinal cord and the space between the vertebral body and dura mater after completing the resection of OPLL. Posterolateral fusion was completed with local bone and harvested iliac crest. Conclusions The anterior decompression through a single posterior approach using an ultrasonic bone scalpel is a safe and effective treatment of thoracic OPLL.
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Affiliation(s)
- Motohiro Okada
- Department of Orthopaedic Surgery, Sumiya Orthopaedic Hospital
| | | | | | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University
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29
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Asai Y, Tsutsui S, Yoshimura N, Hashizume H, Iidaka T, Horii C, Kawaguchi H, Nakamura K, Tanaka S, Yoshida M, Yamada H. Relationship Between Age-Related Spinopelvic Sagittal Alignment and Low Back Pain in Adults of Population-Based Cohorts: The ROAD Study. J Pain Res 2022; 15:33-38. [PMID: 35027845 PMCID: PMC8752869 DOI: 10.2147/jpr.s339712] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose The demand for surgical correction in elderly patients with adult spinal deformity (ASD) has recently increased with the growth of the aging population. Age-related changes in spinopelvic sagittal alignment have been recently reported; thus, sagittal realignment should consider age-related changes. This study aimed to investigate the relationship between age-specific sagittal spinopelvic radiographic parameters and low back pain (LBP) to support the establishment of age-specific realignment targets for patients with ASD. Materials and Methods A population-based cohort consisting of 1461 subjects (466 men and 995 women) was used. The participants were divided into five groups based on their age: (1) younger than 50 years, (2) 50–59 years, (3) 60–69 years, (4) 70–79 years, and (5) 80 years and older. Standing lateral whole-spine radiographs were assessed to measure lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and sagittal vertical axis (SVA). In addition, all participants were asked if they had LBP or not, using the following question: “Have you experienced LBP on most days during the past month and/or now?”. Results The crucial parameter associated with LBP was the mismatch between PI and LL (PI-LL). The mean values of all the radiographic parameters increased with age. PI-LL and PT reached 11.5° and 25.6°, respectively, for women without LBP in the super-aged group (age >80 years), which did not lie in the range of optimal values reported in the previous literature. Conclusion A new optimal age-related target may be needed for the management of patients with ASD.
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Affiliation(s)
- Yoshiki Asai
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shunji Tsutsui
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Toshiko Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chiaki Horii
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Kawaguchi
- Department of Orthopedic Surgery, Tokyo Neurological Center, Tokyo, Japan
| | - Kozo Nakamura
- Department of Orthopedic Surgery, Towa Hospital, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
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Murata S, Nagata K, Iwasaki H, Hashizume H, Yukawa Y, Minamide A, Nakagawa Y, Tsutsui S, Takami M, Taiji R, Kozaki T, Schoenfeld AJ, Simpson AK, Yoshida M, Yamada H. Long-Term Outcomes After Selective Microendoscopic Laminotomy For Multilevel Lumbar Spinal Stenosis With And Without Remaining Radiographic Stenosis: A 10-Year Follow-Up Study. Spine Surg Relat Res 2022; 6:488-496. [DOI: 10.22603/ssrr.2021-0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/10/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
| | - Keiji Nagata
- Department of Orthopedic Surgery, Wakayama Medical University
| | - Hiroshi Iwasaki
- Department of Orthopedic Surgery, Wakayama Medical University
| | | | | | | | | | - Shunji Tsutsui
- Department of Orthopedic Surgery, Wakayama Medical University
| | - Masanari Takami
- Department of Orthopedic Surgery, Wakayama Medical University
| | - Ryo Taiji
- Department of Orthopedic Surgery, Wakayama Medical University
| | - Takuhei Kozaki
- Department of Orthopedic Surgery, Wakayama Medical University
| | - Andrew J. Schoenfeld
- Department of Orthopaedic Surgery, Harvard Medical School Brigham and Women's Hospital
| | - Andrew K. Simpson
- Department of Orthopaedic Surgery, Harvard Medical School Brigham and Women's Hospital
| | | | - Hiroshi Yamada
- Department of Orthopedic Surgery, Wakayama Medical University
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31
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Minamide A, Yoshida M, Nakagawa Y, Okada M, Takami M, Iwasaki H, Tsutsui S, Kozaki T, Murata S, Taiji R, Murakami K, Hashizume H, Yukawa Y, Taneichi H, Yamada H, Schoenfeld AJ, Simpson AK. Long-term Clinical Outcomes of Microendoscopic Laminotomy for Cervical Spondylotic Myelopathy: A 5-Year Follow-up Study Compared With Conventional Laminoplasty. Clin Spine Surg 2021; 34:383-390. [PMID: 34121073 DOI: 10.1097/bsd.0000000000001200] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 04/14/2021] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN This was a retrospective cohort study. OBJECTIVE The objective of this study was to characterize the long-term clinical and radiographic results of articular segmental decompression surgery using endoscopy [cervical microendoscopic laminotomy (CMEL)] for cervical spondylotic myelopathy (CSM) and to compare outcomes to conventional expansive laminoplasty (ELAP). SUMMARY OF BACKGROUND DATA The spinal cord compression in CSM consists of a pincer mechanism due to bulging disk and a hypertrophied ligamentum flavum. The long-term clinical benefits of segmental decompression surgery, which removes the dorsal compressive elements of articular segment in CSM patients, have not yet been elucidated. MATERIALS AND METHODS Consecutive patients with CSM who required surgical treatment were enrolled. All enrolled patients (n=81) underwent CMEL or ELAP. All patients were followed postoperatively for >5 years. The preoperative and 5-year follow-up evaluation included neurological assessment [Japanese Orthopaedic Association (JOA) score], JOA recovery rates, axial neck pain (visual analog scale), and cervical sagittal alignment (C2-C7 subaxial cervical angle). RESULTS Sixty-four patients (CMEL group: 33, ELAP group: 31) were included for analysis. The preoperative JOA score was 10.1 points in the CMEL group and 11.1 points in the ELAP group (P=0.15). The JOA recovery rates were similar, 58.6% in the CMEL group and 55.2% in the ELAP group (P=0.55). The axial neck pain in the CMEL group was significantly lower than that in the ELAP group (P<0.01). At 5-year follow-up, cervical alignment was more favorable in the CMEL group, with an average 2.9 degrees gain in lordosis [vs. 2.3 degrees loss of lordosis in the ELAP group (P<0.05)] and lower incidence of postoperative kyphosis. CONCLUSIONS CMEL is a novel, less invasive, technique that allows for multilevel posterior cervical decompression for treatment of CSM. Our 5-year follow-up data demonstrates that patients after CMEL have similar neurological outcomes to conventional laminoplasty, with significantly less postoperative axial pain and improved subaxial cervical lordosis when compared with their traditional laminoplasty counterparts.
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Affiliation(s)
- Akihito Minamide
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
- Department of Orthopaedic Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Yukihiro Nakagawa
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Motohiro Okada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Hiroshi Iwasaki
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Takuhei Kozaki
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Shizumasa Murata
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Ryo Taiji
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Kimihide Murakami
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Yasutsugu Yukawa
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama
| | - Andrew J Schoenfeld
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Andrew K Simpson
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Teraguchi M, Hashizume H, Oka H, Cheung JPY, Samartzis D, Tamai H, Muraki S, Akune T, Tanaka S, Yoshida M, Yoshimura N, Yamada H. Detailed Subphenotyping of Lumbar Modic Changes and Their Association with Low Back Pain in a Large Population-Based Study: The Wakayama Spine Study. Pain Ther 2021; 11:57-71. [PMID: 34782999 PMCID: PMC8861214 DOI: 10.1007/s40122-021-00337-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 08/25/2021] [Accepted: 10/22/2021] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION To examine the association between the five types of Modic changes and low back pain (LBP) in a large population-based cohort. METHODS Of the 952 participants in the second Wakayama Spine Study, 814 (men, 246; women, 568; mean age, 63.6 years) were included in this study. Endplate changes on magnetic resonance imaging were classified according to the Modic classification system. Low back pain (LBP) was defined as continuous back pain for at least 48 h in the past month that is currently present. The prevalence of Modic changes in the lumbar region was assessed. Multivariate logistic regression analysis was conducted to determine the association between detailed subphenotype of Modic change and LBP comparing no Modic change in the lumbar spine and each level, respectively. RESULTS Modic changes throughout the lumbar spine were noted in 63.5% (n = 516) of all participants, with types I, I/II, II, II/III, and III observed in 7.8% (n = 63), 10.8% (n = 88), 40.0% (n = 326), 2.1% (n = 17), and 2.7% (n = 22), respectively. Modic types I/II were associated with LBP [odds ratio (OR): 3.26; 95% confidence interval (CI) 1.9, 5.5]. Furthermore, Modic type I/II changes at L2/3 and L4/5 were significantly associated with LBP (odds ratio: 2.77; 95% CI 1.04, 7.39 at L2/3; odds ratio: 2.86; 95% CI 1.39, 5.90 at L4/5). CONCLUSIONS Type I/II Modic changes in the lumbar region are significantly associated with LBP. To the best of our knowledge, this is the first large population-based study on the association between various Modic changes and LBP.
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Affiliation(s)
- Masatoshi Teraguchi
- Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi Town, Ito, Wakayama, Japan.
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, Faculty of Medicine, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Dino Samartzis
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Hidenobu Tamai
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shigeyuki Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Toru Akune
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
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Bengtson C, Yoshida M, Baumlin N, Dennis J, Kim M, Salathe M. 363: Losartan increases the efficacy of CFTR modulators to reverse inflammation-related mucociliary dysfunction. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01787-2] [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: 11/30/2022]
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Miyoshi T, Nakamura K, Amioka N, Yonezawa T, Kondo M, Saito Y, Yoshida M, Akagi S, Ito H. Sacubitril/valsartan ameliorates doxorubicin-induced cardiomyocyte toxicity through inhibiting oxidative stress in rats. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3295] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Doxorubicin (DOX)-based chemotherapy induces cardiotoxicity, which is considered the main limitation of its clinical application.
Purpose
The present study investigated the potential protective effect of sacubitril/valsartan, an angiotensin receptor–neprilysin inhibitor, against DOX-induced cardiotoxicity in rats and H9c2 cells, and whether the underlying mechanism for any such protection involves its antioxidant activity.
Methods
Male Sprague-Dawley rats were randomly divided into four groups: DOX (1.5 mg/kg/day intraperitoneally for 10 days), DOX+valsartan (31 mg/kg/day by gavage from day 1 to day 18), DOX+sacubitril/valsartan (68 mg/kg/day by gavage from day 1 to day 18), and control (saline intraperitoneally for 10 days). There were 15 rats in each group. At the end of the treatment period, samples were collected and analysed. Cardiac function, tissue morphology, and reactive oxygen species (ROS) were evaluated in rats. Serum levels of Malondialdehyde (MDA) and cardiac troponin T were also measured. Mitochondrial ROS production and cell viability were evaluated in H9c2 cells.
Results
DOX-induced cardiac dysfunction was not prevented by valsartan and sacubitril/valsartan in this model. However, the serum level of cardiac troponin T on day 18 was increased in the DOX group (0.046±0.006 ng/mL, p<0.01 vs. control) and significantly reduced in the DOX+sacubitril/valsartan group (0.039±0.007 ng/mL, p=0.03 vs. DOX), but not in the DOX+valsartan group (0.046±0.005 ng/mL, p=1.00 vs. DOX). Regarding the effect of sacubitril/valsartan on fibrosis in rat myocardium, Masson's trichrome staining showed increased intestinal fibrosis in the DOX group compared to that in the control group (1.35±0.07% and 0.49±0.04%, p<0.01) and significantly decreased intestinal fibrosis in the DOX+sacubitril/valsartan group (1.08±0.08%), but not in the DOX+ valsartan group (1.15±0.05%) compared to that in the DOX group (p=0.01 and p=0.15, respectively). The fluorescence intensity of dihydroethidium as a measure of ROD production in left ventricle, which was increased in the DOX group (1.56±0.07), was significantly reduced in the DOX+sacubitril/valsartan group (1.44±0.05, p=0.03), but not in the DOX+valsartan group (1.29±0.06, p=1.00). On day 11, the serum MDA level, which was increased in the DOX group, was significantly reduced in the DOX+ sacubitril/valsartan group (p=0.02), but not in the DOX+ valsartan group (p=0.75). In H9c2 cells, sacubitril/valsartan reduced DOX-induced mitochondrial ROS generation by 25%, which was more marked than valsartan-induced ROS generation (p<0.01 and p=0.01, respectively). Sacubitril/valsartan improved cell viability more markedly than valsartan. Thus, DOX-induced cytotoxicity in H9c2 cells was improved by sacubitril/valsartan, but not valsartan.
Conclusions
Sacubitril/valsartan protected rat hearts from DOX-induced cardiotoxicity in vivo and in vitro by decreasing oxidative stress.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This work was supported by Novartis Pharma K.K.
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Affiliation(s)
| | | | - N Amioka
- Okayama University, Okayama, Japan
| | | | - M Kondo
- Okayama University, Okayama, Japan
| | - Y Saito
- Okayama University, Okayama, Japan
| | | | - S Akagi
- Okayama University, Okayama, Japan
| | - H Ito
- Okayama University, Okayama, Japan
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Yoshida M, Saito M. Neutrophil-Reduced Platelet Rich Plasma with Optimal Platelets Concentrations for Epicondylitis of the Elbow. Muscles Ligaments Tendons J 2021. [DOI: 10.32098/mltj.03.2021.10] [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: 11/05/2022]
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36
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Yazaki S, Shimoi T, Yoshida M, Okuma H, Kita S, Yamamoto K, Kojima Y, Nishikawa T, Tanioka M, Sudo K, Noguchi E, Murata T, Takayama S, Suto A, Yonemori K. 171P Combining tumor-infiltrating lymphocytes and PD-L1 expression can stratify prognosis in early-stage triple-negative breast cancer patients who did not receive adjuvant chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.452] [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: 11/16/2022] Open
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37
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Inoue G, Kaito T, Matsuyama Y, Yamashita T, Kawakami M, Takahashi K, Yoshida M, Imagama S, Ohtori S, Taguchi T, Haro H, Taneichi H, Yamazaki M, Nishida K, Yamada H, Kabata D, Shintani A, Iwasaki M, Ito M, Miyakoshi N, Murakami H, Yonenobu K, Takura T, Mochida J. Comparison of the Effectiveness of Pharmacological Treatments for Patients with Chronic Low Back Pain: A Nationwide, Multicenter Study in Japan. Spine Surg Relat Res 2021; 5:252-263. [PMID: 34435149 PMCID: PMC8356229 DOI: 10.22603/ssrr.2020-0083] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/27/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction Chronic low back pain (CLBP) is a leading cause of disability, yet there is limited high-quality evidence to identify the most suitable pharmacological therapy. The purpose of this Japanese nationwide, multicenter, prospective study was to compare the effectiveness of four representative drug therapies-acetaminophen, celecoxib, loxoprofen, and a tramadol and acetaminophen (T+A) combination drug-to establish evidence for a drug of choice for CLBP. Methods Patients with CLBP (N=471) received one of the four treatments and were evaluated, prospectively and comprehensively, once every month for six months using a visual analog scale (VAS) for LBP, the Japanese Orthopedic Association (JOA) score, the JOA Back Pain Evaluation Questionnaire (JOABPEQ), the Roland-Morris Disability Questionnaire (RDQ), the EuroQol five-dimensions three-levels (EQ-5D-3L), and the Short Form-8 item health survey (SF-8). We conducted multivariable linear regression analyses of the four drugs at 1 and 6 months after drug allocation. Differences with P<0.05 were considered statistically significant. Results Patients who received acetaminophen showed a significant improvement from baseline in the mental health subscale of the JOABPEQ at one month (P=0.02) and the JOA score at six months (P<0.01). None of the other outcome measures among the four drugs differed significantly. Across groups, all outcome measures, except the mental component summary (MCS) score of the SF-8, improved equivalently, although most measurements showed no obvious cumulative effect over six months. The MCS score of the SF-8 decreased gradually over six months in all groups. Conclusions Most of the outcome measures among the treated groups were not significantly different, indicating similar treatment effects of the four drugs for CLBP. Our study indicated the limit of each outcome measure for evaluating the patient status, suggesting that a single outcome measure is insufficient to reflect treatment effectiveness.
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Affiliation(s)
- Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Yukihiro Matsuyama
- Division of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Toshihiko Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Mamoru Kawakami
- Department of Orthopaedic Surgery, Saiseikai Wakayama Hospital, Wakayama, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Kazuhisa Takahashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Munehito Yoshida
- Sumiya Orthopaedic Hospital, Wakayama, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Shiro Imagama
- Department of Orthopaedics/Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Toshihiko Taguchi
- Department of Orthopaedic Surgery, Yamaguchi Rosai Hospital, Sanyoonoda, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Hirotaka Haro
- Department of Orthopaedic Surgery, University of Yamanashi, Chuo, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University, Mibumachi, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Kotaro Nishida
- Department of Orthopaedic Surgery, University of the Ryukyus, Faculty of Medicine, Nishihara, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Daijiro Kabata
- Department of Medical Statistics, Osaka City University Graduate School of Medicine and Faculty of Medicine, Osaka, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Ayumi Shintani
- Department of Medical Statistics, Osaka City University Graduate School of Medicine and Faculty of Medicine, Osaka, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Motoki Iwasaki
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Manabu Ito
- Department of Orthopaedic Surgery, National Hospital Organization, Hokkaido Medical Center, Sapporo, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Kazuo Yonenobu
- Osaka Yukioka College of Health Science, Osaka, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
| | - Joji Mochida
- Department of Orthopaedic Surgery, Japan Medical Alliance, Ebina General Hospital, Ebina, Japan.,The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR)
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Nakajima N, Kawano H, Kai Y, Takai A, Abe M, Iimura Y, Cheng M, Yoshida M, Yamashita N. P–248 Statistical estimation for incidence of blastocyst trophectoderm vesicles (TVs) and efficacy of assisted hatching (AH). Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.247] [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: 11/13/2022] Open
Abstract
Abstract
Study question
The aim of this study is to analyse the association between blastocyst diameter and TVs development, and to examine the efficacy of AH.
Summary answer
Blastocysts with a diameter of more than 170 μm leads to high incidence of TVs and AH applied from the incidence should be effective.
What is known already
TVs are protrusion of trophectoderm cells often observed in expanding blastocyst stages. TVs can be observed in expanding blastocysts regardless of Intracytoplasmic sperm injection (ICSI) and Conventional-IVF (C-IVF), when the internal pressure of blastocysts increase. The rate of TVs incidence in blastocysts inseminated by ICSI is higher than that by C-IVF, due to penetration of the needle into the zona pellucida. Moreover, it has been reported that TVs may inhibit blastocyst hatching. However, the developmental timing of TVs is still unclear, and there is no study that has analysed the association between blastocyst diameter and the incidence of TVs.
Study design, size, duration
1) Diameters and TVs incidence of blastocysts by ICSI and C-IVF were measured, and the cut-off value and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were calculated to estimate the timing of TV incidence. 2) We analysed the clinical pregnancy rates of blastocysts with TVs treated by AH compared to those of blastocysts by C-IVF not subjected to AH.
Participants/materials, setting, methods
This study included 821 transferred frozen blastocysts ranging from March 2018 to November 2019. The embryos were cultured in a dry incubator after insemination by ICSI or C-IVF. Blastocyst freezing conditions were set at day5 to day7 with a diameter of more than 150 μm in inner diameter of zona pellucida, and this was measured before freezing. The ROC curve was performed using EZR statistical analysis software.
Main results and the role of chance
1) The incidence of TVs in blastocysts by ICSI and C-IVF was 27.5% (117/424) and 14.6% (58/397) respectively. The rate of the incidence of TVs in blastocysts inseminated by ICSI and C-IVF; 8.6% (12/140) and 0.95% (1/105) in 150–159 μm, 12.7% (14/110) and 8.2% (6/73) in 160–169 μm, 40.6% (28/69) and 10.5% (6/57) in 170–179 μm, 55.6% (30/54) and 25.5% (13/51) in 180–189 μm, 66.7% (20/30) and 35.7% (10/28) in 190–199 μm, and 68.4% (13/19) and 26.8% (22/82) in the diameter of more than 200 μm. The cut-off value of the ROC curve was respectively 170 μm (sensitivity 78.6% and specificity 73.0%) and 176 μm (sensitivity 84.5% and specificity 59.6%) in the diameter; the AUC was 0.8 [95%CI:0.752–0.848] and 0.74 [95%CI:0.687–0.793] respectively. 2) The clinical pregnancy rate of TVs blastocyst vs C-IVF blastocyst was 52.7% (88/167) vs 57.8% (37/64) respectively. There is no significant difference between the two clinical pregnancy rates (P = 0.556).
Limitations, reasons for caution
The findings of this study have to be seen in light of some limitations. Since this study aimed to analyse the incidence of TVs based on blastocyst size, we did not take into account the grade according to the Gardner classification and the number of trophectoderm cells.
Wider implications of the findings: Blastocysts inseminated by ICSI and C-IVF were highly likely to have TVs above 170 μm and 176 μm respectively. The clinical pregnancy rates of the blastocyst with TV treated by AH was similar to those of the C-IVF blastocyst.
Trial registration number
Not applicable
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Affiliation(s)
- N Nakajima
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - H Kawano
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - Y Kai
- Reproductive research center in Yamashita Shonan Yume Clinic, Researcher, Fujisawa city, Japan
| | - A Takai
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - M Abe
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - Y Iimura
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - M Cheng
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - M Yoshida
- Yamashita Shonan Yume Clinic, Physician, Fujisawa city- Kanagawa, Japan
| | - N Yamashita
- Yamashita Shonan Yume Clinic, Physician, Fujisawa city- Kanagawa, Japan
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Okada M, Yoshida M, Minamide A, Nomura K, Maio K, Yamada H. Microendoscope-Assisted Decompression Surgery With Resection of Bony Fragment for Treating a Separation of Lumbar Posterior Ring Apophysis in Young Athletes. Global Spine J 2021; 11:889-895. [PMID: 32677511 PMCID: PMC8258831 DOI: 10.1177/2192568220929290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
STUDY DESIGN Case series. OBJECTIVES To report the clinical outcomes of the decompression procedure using the microendoscopic discectomy system for the treatment of a separation of lumbar posterior ring apophysis in young active athletes. METHODS We retrospectively reviewed 17 cases that underwent the microendoscopic surgery to treat a symptomatic separated lumbar ring apophysis between 2001 and 2014 at our institute or our associated hospital. The cases consisted of 15 males and 2 females, with their ages ranging from 12 to 19 years. The surgeries were performed at total of 18 lumbar levels, including 15 L4/5 and 3 L5/S1 levels. All patients were young athletes. We evaluated the following: (1) the Japanese Orthopaedic Association (JOA) score for low back pain, (2) recovery rates using Hirabayashi's method, (3) operating time, (4) intraoperative blood loss, (5) perioperative complications, (6) the status of comeback to sports, and (7) the period taken to return to sports. RESULTS The JOA score was improved after the surgery in all cases. Recovery rate was 92.0% ± 8.1%. The mean operating time per level was 89.2 ± 33.3 minutes. The mean intraoperative blood loss per level was 95.3 ± 93.1 mL. A pinhole size dural tear occurred in one case as a perioperative complication. All cases returned to sports. The mean period taken to return to sports was 10.9 ± 3.5 weeks. CONCLUSION Microendoscopic decompression surgery is useful for treating a separation of lumbar posterior ring apophysis.
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Affiliation(s)
- Motohiro Okada
- Wakayama Medical University, Wakayama, Japan,Motohiro Okada, Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8510, Japan.
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Sanders M, Ida K, Yoshinuma M, Suzuki C, Yoshimura Y, Seki R, Emoto M, Yoshida M, Kobayashi T. Analysis of the Motional Stark Effect (MSE) diagnostic to measure the rotational transform and current profile in the Large Helical Device. Rev Sci Instrum 2021; 92:053503. [PMID: 34243309 DOI: 10.1063/5.0018859] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 04/07/2021] [Indexed: 06/13/2023]
Abstract
The analysis method of the Motional Stark Effect (MSE) diagnostic to measure the rotational transform and current profiles in the Large Helical Device has been improved. This was done by using the Variational Moments Equilibrium Code to calculate an equilibrium database for various pressure profiles and current profiles. This method looks for the radial profile of the rotational transform in the equilibrium database that gives the best fit to the polarization angle profiles measured with the MSE diagnostic. This analysis improves the measurements of rotational transform, especially near the magnetic axis, where the sensitivity of the polarization angle measurements becomes low and the uncertainty due to error in the estimation of the Pfirsch-Schlüter current becomes large. The radial profiles of the rotational transform and current profiles for Electron Cyclotron Current Drive and Neutral Beam Current Drive are obtained in the new analysis method with a sufficiently high accuracy to discuss the discrepancy of the current density profiles between the measurements and the calculations.
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Affiliation(s)
- M Sanders
- Department of Applied Physics, Eindhoven University of Technology, Eindhoven 5600 MB, The Netherlands
| | - K Ida
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - M Yoshinuma
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - C Suzuki
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - Y Yoshimura
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - R Seki
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - M Emoto
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - M Yoshida
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - T Kobayashi
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
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Taylor DP, Yoshida M, Fuller K, Giannobile WV, Sfeir CS, Wagner WR, Kohn DH. Translating Dental, Oral, and Craniofacial Regenerative Medicine Innovations to the Clinic through Interdisciplinary Commercial Translation Architecture. J Dent Res 2021; 100:1039-1046. [PMID: 33906502 DOI: 10.1177/00220345211009502] [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] [Indexed: 11/15/2022] Open
Abstract
Few university-based regenerative medicine innovations in the dental, oral, and craniofacial (DOC) space have been commercialized and affected clinical practice in the United States. An analysis of the commercial translation literature and National Institute for Dental and Craniofacial Research's (NIDCR's) portfolio identified barriers to commercial translation of university-based DOC innovations. To overcome these barriers, the NIDCR established the Dental Oral Craniofacial Tissue Regeneration Consortium. We provide generalized strategies to inform readers how to bridge the "valley of death" and more effectively translate DOC technologies from the research laboratory or early stage company environment to clinical trials and bring needed innovations to the clinic. Three valleys of death are covered: 1) from basic science to translational development, 2) from translational technology validation to new company formation (or licensing to an existing company), and 3) from new company formation to scaling toward commercialization. An adapted phase-gate model is presented to inform DOC regenerative medicine teams how to involve regulatory, manufacturability, intellectual property, competitive assessments, business models, and commercially oriented funding mechanisms earlier in the translational development process. An Industrial Partners Program describes how to conduct market assessments, industry maps, business development processes, and industry relationship management methods to sustain commercial translation through the later-stage valley of death. Paramount to successfully implementing these methods is the coordination and collaboration of interdisciplinary teams around specific commercial translation goals and objectives. We also provide several case studies for translational projects with an emphasis on how they addressed DOC biomaterials for tissue regeneration within a rigorous commercial translation development environment. These generalized strategies and methods support innovations within a university-based and early stage company-based translational development process, traversing the many funding gaps in dental, oral, and craniofacial regenerative medicine innovations. Although the focus is on shepherding technologies through the US Food and Drug Administration, the approaches are applicable worldwide.
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Affiliation(s)
- D P Taylor
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,sciVelo, University of Pittsburgh Health Sciences, Pittsburgh, PA, USA
| | - M Yoshida
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - K Fuller
- Medical Device Regulatory Solutions LLC, Ann Arbor, MI, USA
| | | | - C S Sfeir
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - W R Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - D H Kohn
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Maseki H, Jimbo K, Nakadaira U, Watase C, Murata T, Shiino S, Takayama S, Yamamoto N, Yoshida M, Suto A. Evaluation of incidental implantation of tumor cells after diagnostic needle biopsy in breast cancer patients. Breast 2021. [DOI: 10.1016/s0960-9776(21)00198-3] [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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Taniguchi T, Harada T, Iidaka T, Hashizume H, Taniguchi W, Oka H, Asai Y, Muraki S, Akune T, Nakamura K, Kawaguchi H, Yoshida M, Tanaka S, Yamada H, Yoshimura N. Prevalence and associated factors of pistol grip deformity in Japanese local residents. Sci Rep 2021; 11:6025. [PMID: 33727622 PMCID: PMC7966377 DOI: 10.1038/s41598-021-85521-x] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/02/2021] [Indexed: 11/26/2022] Open
Abstract
Pistol grip deformity (PGD) may be the main factor in femoroacetabular impingement development. This study aimed to clarify the epidemiological indices and factors related to PGD in Japanese people. This population-based cohort study included 1575 local Japanese residents. PGD, center edge angle, and joint space width were measured radiographically. We investigated the relationship between PGD and spino-pelvic parameters. Factors associated with PGD were examined using multiple logistic regression analysis, with the presence/absence of PGD as an objective variable, and sex, age, body mass index (BMI), and the presence/absence of hip pain or spino-pelvic parameters as explanatory variables. In the entire cohort, 4.9% (10.6% men, 2.1% women) had PGD on at least one side. A trend was observed between PGD and increasing age in both men and women (men: p < 0.0001, women: p = 0.0004). No relationship was observed between PGD and hip pain (risk ratio 1.0 [95% confidence interval 0.97–1.03]). Factors significantly associated with PGD were age, sex, and BMI in the multivariate model. Acquired factors may be related to PGD in Japanese people as the PGD prevalence increased with age and PGD was not significantly associated with hip pain. This study provides new insights into the etiology and clinical significance of PGD.
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Affiliation(s)
- Takaya Taniguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan.
| | - Teiji Harada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Toshiko Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Wataru Taniguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yoshiki Asai
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Shigeyuki Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Toru Akune
- Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa, Saitama, Japan
| | - Kozo Nakamura
- Department of Orthopaedic Surgery, Towa Hospital, Towa, Adachi-ku, Tokyo, Japan
| | - Hiroshi Kawaguchi
- Department of Orthopaedics and Spine, Tokyo Neurological Center, 4-1-17 Toranomon, Minato-ku, Tokyo, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
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Takami M, Yoshida M, Minamide A, Hashizume H, Yukawa Y, Nakagawa Y, Iwasaki H, Tsutsui S, Nagata K, Taiji R, Nishi H, Schoenfeld AJ, Simpson AK, Yamada H. Does prophylactic use of topical gelatin-thrombin matrix sealant affect postoperative drainage volume and hematoma formation following microendoscopic spine surgery? A randomized controlled trial. Spine J 2021; 21:446-454. [PMID: 33189909 DOI: 10.1016/j.spinee.2020.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Microendoscopic spinal surgery has demonstrated efficacy and is increasingly utilized as a minimally invasive approach to neural decompression, but there is a theoretical concern that bleeding and postoperative epidural hematoma (PEH) may occur with increased frequency in a contained small surgical field. Hemostatic agents, such as topical gelatin-thrombin matrix sealant (TGTMS), are routinely used in spine surgery procedures, yet there has been no data on whether PEH is suppressed by these agents when administered in microendoscopic spine surgery. PURPOSE The purpose of this study was to investigate the effect of TGTMS on bleeding and PEH formation in lumbar micoroendoscopic surgery. STUDY DESIGN This is a randomized controlled trial (RCT) with additional prospective observational cohort. PATIENT SAMPLE Patients were registered from July 2017 to September 2018 and a hundred and three patients undergoing microendoscopic laminectomy for lumbar spinal stenosis at a single institution were enrolled in this study. OUTCOME MEASURES The primary outcome was the drainage volume within 48 hours after surgery. Secondary outcomes were the numerical rating scale (NRS) of leg pain on the second (NRS2) and seventh day (NRS7) after surgery and the hematoma area ratio (HAR) in horizontal images on magnetic resonance image (MRI). METHODS In the RCT, 41 cases that received TGTMS (F group) were compared with 41 control group cases (C group) that did not receive TGTMS at the end of the procedure. Drainage volume, NRS2, NRS7, and HAR on MRI were evaluated. Nineteen cases were excluded from the RCT (I group) due to difficulty of hemostasis during surgery and the intentional use of TGTMS for hemostasis. I group was compared with C group in the drainage volume and NRS of leg pain as a prospective observational study. RESULTS The RCT demonstrated no statistically significant difference in drainage volume between those receiving TGTMS (117.0±71.7; mean±standard deviation) and controls (125.0±127.0; p=.345). The NRS2 and NRS7 was 3.5±2.6 and 2.8±2.5 in the F group, respectively, and 3.1±2.6 and 2.1±2.3 in the C group, respectively. The HAR on MRI was 0.19±0.19 in the F group and 0.17±0.13 in the C group. There was no significant difference in postoperative leg pain and HAR (p=.644 for NRS2, p=.129 for NRS7, and p=.705 for HAR). In the secondary observational cohort, the drainage volume in the I group was 118.3±151.4, and NRS2 and NRS7 was 3.5±2.0 and 2.6±2.6, respectively. There were no statistically significant differences in drainage volume (p=.386) or postoperative NRS of leg pain between these two groups (p=.981 and .477 for NRS2 and NRS7, respectively). CONCLUSIONS The prophylactic use of TGTMS in patients undergoing microendoscopic laminotomy for lumbar spinal stenosis did not demonstrate any difference in postoperative bleeding or PEH. Nonetheless, for patients that had active bleeding that required the use of TGTMS, there was no evidence of difference in postoperative clinical outcomes relative to controls.
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Affiliation(s)
- Masanari Takami
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan.
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Akihito Minamide
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Yasutsugu Yukawa
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Yukihiro Nakagawa
- Spine Care Center, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Wakayama 649-7113, Japan
| | - Hiroshi Iwasaki
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Ryo Taiji
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Hideto Nishi
- Department of Orthopaedic Surgery, Hidaka Hospital, 116-2 Sono, Gobo-city, Wakayama 644-0002, Japan
| | - Andrew J Schoenfeld
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Andrew K Simpson
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
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Imagama S, Murakami H, Kaito T, Matsuyama Y, Yamashita T, Kawakami M, Takahashi K, Yoshida M, Ohtori S, Taguchi T, Haro H, Taneichi H, Yamazaki M, Inoue G, Nishida K, Yamada H, Kabata D, Shintani A, Iwasaki M, Ito M, Miyakoshi N, Yonenobu K, Takura T, Mochida J. Impact of background factors on outcomes of pharmacological therapy for chronic low back pain: A nationwide multicenter prospective study. J Orthop Sci 2021; 26:92-102. [PMID: 32122744 DOI: 10.1016/j.jos.2020.02.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/09/2020] [Accepted: 02/04/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chronic low back pain (CLBP) is a major cause of chronic pain with nociceptive, neuropathic or both pain components, and a leading cause of disability. The objectives of this study were to determine the impact of background factors including previous use of drugs on outcomes of pharmacological therapy for CLBP in a nationwide multicenter prospective study. METHODS The subjects were 474 patients (male: 41.9%, median age: 73.0) with CLBP. Background factors that could influence outcomes after pharmacological treatment for 6 months were examined: age, gender, body mass index (BMI), duration of CLBP, osteoporosis, history of spinal surgery, history of malignant tumor, smoking habit, employment status (yes or no), exercise habit (frequency), number of live-in family members, having something to do for pleasure, Center for Epidemiologic Studies depression scale (CES-D) score, and medication at baseline. Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) for LBP, JOA Back Pain Evaluation Questionnaire (JOABPEQ), Roland-Morris Disability Questionnaire (RDQ), Short-form 8-item health survey (SF-8), and EQ-5D were used for evaluation at baseline and after 6 months. Multivariate linear regression models were used in statistical analysis. RESULTS Drugs for neuropathic pain at baseline (p < 0.001), Tramacet® at baseline (p < 0.05), weak opioids at baseline (p < 0.05), older age (p < 0.001), long disease duration (p < 0.005), history of spinal surgery (p < 0.001), and smoking habit (p < 0.001) had significant negative effects on outcomes. Employment (p < 0.05), exercise habit (p < 0.05), and CED-D at baseline (p < 0.001) had positive effects on outcomes. CONCLUSIONS This is the first study to identify significant prognostic factors for outcomes of pharmacological treatment of CLBP. The neuropathic pain component of CLBP at baseline is a major significant negative factor for most outcomes involving improved pain, activities of daily life, and quality of life. Treatment strategies developed with consideration of these factors may be advantageous for recovery from CLBP.
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Affiliation(s)
- Shiro Imagama
- Department of Orthopaedics / Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Nagoya City University Medical School, Nagoya, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yukihiro Matsuyama
- Division of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Toshihiko Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mamoru Kawakami
- Spine Care Center, Wakayama Medical University Kihoku Hospital, Katsuragi-cho, Japan
| | - Kazuhisa Takahashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshihiko Taguchi
- Department of Orthopaedic Surgery, Yamaguchi Rosai Hospital, Sanyoonoda, Japan
| | - Hirotaka Haro
- Department of Orthopaedic Surgery, University of Yamanashi, Chuo, Japan
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University, Mibumachi, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kotaro Nishida
- Department of Orthopaedic Surgery, University of the Ryukyus, Faculty of Medicine, Nishihara, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Daijiro Kabata
- Department of Medical Statistics, Osaka City University Graduate School of Medicine and Faculty of Medicine, Osaka, Japan
| | - Ayumi Shintani
- Department of Medical Statistics, Osaka City University Graduate School of Medicine and Faculty of Medicine, Osaka, Japan
| | - Motoki Iwasaki
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Manabu Ito
- Department of Orthopaedic Surgery, National Hospital Organization, Hokkaido Medical Center, Sapporo, Japan
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | | | - Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Joji Mochida
- Department of Orthopaedic Surgery, Japan Medical Alliance, Ebina General Hospital, Ebina, Japan
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Yoshida M, Funasaki H. Optimal Platelet Concentration for The Therapeutic Effect of Autologous Neutrophil-Reduced Platelet Rich Plasma in A Rat Model of Achilles Tendinopathy. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.04.2020.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- M. Yoshida
- Department of Orthopaedic Surgery,The Jikei University School of Medicine
| | - H. Funasaki
- Department of Orthopaedic Surgery,The Jikei University School of Medicine
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47
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Miki T, Miyoshi T, Suruga K, Ichikawa K, Otsuka H, Toda H, Yoshida M, Nakamura K, Morita H, Ito H. Triglyceride to HDL-cholesterol ratio is a predictor of future coronary events: a possible role of high-risk coronary plaques detected by coronary CT angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2930] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
For the prevention of future cardiovascular events, control of residual risks such as triglyceride rich lipoproteins and HDL-cholesterol is an emerging problem beyond LDL-cholesterol. Triglyceride to HDL-cholesterol ratio (TG/HDL ratio) has been reported to be useful for risk classification of cardiovascular diseases. Meanwhile, several studies showed that high-risk plaque characteristics evaluated with coronary CT angiography (cCTA) was associated with the incidence of acute coronary syndrome. However, the relationship of TG/HDL ratio with coronary plaque characteristics and its impact of this association on future coronary events have not been fully elucidated.
Purpose
The aim of this study was to evaluate the association between TG/HDL ratio and high-risk plaque detected by cCTA and its impact on future coronary events.
Methods
A total of 944 patients suspected stable coronary artery disease who underwent cCTA at our institution were analyzed (mean 64-year-old, 55% male). Patients were divided into two groups by the median value of TG/HDL ratio (higher TG/HDL: TG/HDL ratio ≥2.0, lower TG/HDL: TG/HDL ratio <2.0). Coronary high-risk plaques were defined as a plaque with all three components; low attenuation plaque (<50H.U.), positive remodeling (remodeling index >1.1) and spotty calcification. Cardiovascular event was defined as cardiovascular death, acute coronary syndrome, and late coronary revascularization after 30 days of CT acquisition.
Results
The higher TG/HDL ratio was significantly associated with male gender (63% vs. 48%, P<0.001), body mass index (24.8±3.8 vs. 22.9±4.0, p<0.001), the prevalence of hypertension (65% vs. 54%, P<0.001), dyslipidemia (60% vs. 42%, P<0.001), diabetes mellitus (38% vs. 27%, P=0.001) and current smoking (26% vs. 10%, p<0.001). Regarding cCTA findings, the prevalence of significant stenosis, calcified plaque, non-calcified plaque, coronary plaques with low attenuation plaque, positive remodeling and spotty calcification in the higher TG/HDL group were greater than those in the lower group (Figure 1A). Of note, the difference in high-risk plaque between two groups was significant. (18% vs. 11%, p=0.004). Multivariate logistic analysis revealed that the TG/HDL ratio was an independent risk factor for high-risk plaque even after adjustment (OR, 1.35; 95% CI, 1.01–1.81; p=0.049). Regarding coronary events (median follow-up duration; 48 months), Kaplan-Meier curve showed poor event-free rate in the higher TG/HDL group (Figure 1B). At Cox proportional hazard analysis, higher TG/HDL ratio (HR, 1.94; 95% CI, 1.01–3.70; p=0.046) and CT-verified high-risk plaque (HR, 2.36; 95% CI, 1.27–4.38; p=0.006) were independent predictive factors for coronary events even after adjustment.
Conclusion
TG/HDL ratio is involved in the vulnerability of CT-verified coronary plaque characteristics. This association may play an important role in the prognostic impact of TG/HDL ratio on future cardiovascular events.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Miki
- Okayama University Hospital, Okayama, Japan
| | - T Miyoshi
- Okayama University Hospital, Okayama, Japan
| | - K Suruga
- Okayama University Hospital, Okayama, Japan
| | - K Ichikawa
- Okayama University Hospital, Okayama, Japan
| | - H Otsuka
- Okayama University Hospital, Okayama, Japan
| | - H Toda
- Okayama University Hospital, Okayama, Japan
| | - M Yoshida
- Okayama University Hospital, Okayama, Japan
| | - K Nakamura
- Okayama University Hospital, Okayama, Japan
| | - H Morita
- Okayama University Hospital, Okayama, Japan
| | - H Ito
- Okayama University Hospital, Okayama, Japan
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Nakano Y, Okumura N, Imai R, Yoshida M, Shimokata S, Adachi S, Murohara T, Kondo T. Impact of higher detection rate of residual pulmonary thromboemboli one-year after acute pulmonary embolism: modified CT scan imaging method with modified CT obstruction index. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2242] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently, post pulmonary embolism (PE) syndrome or chronic thromboembolic disease after acute PE, has been recognized as important long-term complications. Furthermore, patients may develop with chronic thromboembolic pulmonary hypertension.
Purpose
We aimed to evaluate the frequency of residual pulmonary thromboemboli after acute PE by using our “higher”-resolution CT scan imaging method to detect residual thromboemboli down to sub-segmental pulmonary arteries.
Methods
This study was a prospective multi-center observational study. We enrolled consecutive 34 patients with acute symptomatic PE whose informed consent was obtained, and followed up for one year. One year after the onset of acute PE, patients were referred to our hospital and multiple examination including CT scan, 6-minute walk test (6MWT), questionnaire of SF-36, echocardiography and laboratory testing were performed. Additionally, we have modified the CT obstruction index (CTOI) to quantitatively evaluate the thromboemboli down to sub-segmental pulmonary arteries.
Results
Mean age was 60.5±15.8 years, and 56% were male. No patient was categorized as low recurrent VTE risk which was caused by transient factors, one patient was associated with active cancer, and 12% had known thrombophilia. In 85% of the patients, this onset was the first obvious episode of PE. At diagnosis, elevated B-type natriuretic peptide (BNP) (≥100 pg/ml) or N-terminal (NT)-proBNP (≥500 pg/ml) was observed in 45% of the patients. Median tricuspid regurgitation peak gradient (TRPG) by echocardiography was 30.9 (19.3–50.1) mmHg. Among all, 35% of the patients received single-drug approach with DOACs. At discharge, all of the patients except two were treated with DOACs.
One year after the onset, 21% of the patient were in NYHA II and others were in NYHA I. It was notable that pulmonary thromboemboli was detected by our CT scan in 76% of the patients. Modified CTOI was median 11.9 (1.8–24.4) % as shown in the figure.
In multiple regression analysis, TRPG at diagnosis and BNP at one month were significantly associated with mCTOI (β=0.536, p=0.002 and β=−0.482, p=0.003, respectively). Additionally, lowest SpO2 during 6MWT after one year from the onset, tended to inversely associate with mCTOI (β=−0.341, p=0.052).
Conclusions
Using our modified CT scan imaging method and modified CTOI, residual pulmonary thromboemboli was able to be detected more frequently than the previous studies. Residual pulmonary thromboemboli could be one of the cause of the post PE syndrome and lead to exercise-induced desaturation.
Figures
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Nakano
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
| | - N Okumura
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - R Imai
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - M Yoshida
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Shimokata
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Adachi
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
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Nakano Y, Imai R, Yoshida M, Shimokata S, Adachi S, Murohara T, Kondo T. Clinical course of pulmonary embolism patients treated with DOACs: comparing prognosis, recurrent thromboembolism, and major bleeding between patients with and without cancer. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2279] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Venous thromboembolism (VTE) is the third frequent acute cardiovascular syndrome in the Europe and Japan. Since direct oral anticoagulants (DOACs) are widely used now, the morbidity and mortality of pulmonary embolism (PE) patients especially associated with cancer needs to be re-evaluated.
Purpose
We evaluated the clinical course of patients with PE mainly treated with DOACs.
Methods
This retrospective observational study was conducted in a single center. The data were collected from the medical record of consecutive patients who received inpatient treatment of PE. In this study, we have compared PE patients with cancer (cancer PE) to those without cancer (non-cancer PE) and evaluated the mortality, recurrent of VTE and major bleedings.
Results
In total, 140 patients were enrolled: 94 patients were cancer-related, and 46 patients were without cancer (Table). The type of the tumor in cancer PE patients were as follows: gastric 8 (9%), esophageal 5 (5%), pancreatic 12 (13%), lung 14 (15%), lymphoma 2 (2%), gynecologic 17 (18%), renal 2 (2%), bile duct 8 (9%), colon 12 (13%), and others 17 (18%).
Kaplan-Meier curve showed that the cumulative all-cause mortality was significantly higher in the cancer PE group (35/94 (37%) vs. 2/46 (4%), P<0.001 (log rank), HR 10.3 [95% CI:2.5–43.3]). The cumulative incidence of recurrent VTE was significantly higher in the cancer PE group (7/94 (7%) vs. 0/46, P=0.03 (log rank)). There was no significant difference in the cumulative incidence of major bleeding between the cancer PE group and the non-cancer PE group (8/94 (9%) vs. 5/46 (11%)).
Conclusions
The risk of recurrent VTE was still higher in cancer PE patients compared to non-cancer PE patients, although DOACs were used. Meanwhile the incidence of major bleeding was comparable in both groups, the risk of bleeding might be acceptable with using DOACs especially in cancer PE patients.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Nakano
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
| | - R Imai
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - M Yoshida
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Shimokata
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Adachi
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
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50
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Amioka N, Miyoshi T, Akagi S, Yoshida M, Nakamura K, Morita H, Ito H. Pemafibrate protects the rupture of experimental aortic aneurysm in mice through anti-oxidative stress with induced catalase. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3789] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Abdominal aortic aneurysm (AAA) is a life-threatening disease, while effective and preventive medical treatments remain unestablished.
Purpose
The aim of this study was to evaluate the effect of selective peroxi- some proliferator-activated receptor alpha (PPARα) modulator pemafibrate on AAA formation in mice.
Methods
AAA was induced by subcutaneous infusion of angiotensin II (AngII) in apolipoprotein E-deficient mice for 4 weeks. Treatment by pemafibrate or vehicle was started one week before AngII infusion. Oxidative stress was evaluated by dihydroethidium (DHE) staining.
Results
Prognosis after AngII infusion in pemafibrate-treated mice was significantly better than that in vehicle-treated mice (log-rang test, p=0.035) by reducing the occurrence of fatal AAA rupture. Meanwhile pemafibrate did not significantly reduce maximal diameter of the aorta. Histological findings demonstrated that the expression of collagen in adventitia in pemafibrate-treated mice was significantly greater than that in vehicle-treated mice (p<0.05). Oxidative stress in aorta of pemafibrate-treated mice was significantly reduced comparing to vehicle-treated mice, accompanying by the reduction of mRNA expression of matrix metalloproteinase 2, tumor necrosis factor-α, and interleukin-6 (all p<0.05). Catalase expression in abdominal aortic tissue was increased 1.5-fold in mice treated with pemafibrate than in mice treated with vehicle (p=0.032). In human vascular smooth muscle cells (hVSMC), pemafibrate attenuated AngII-induced oxidative stress (p<0.001), which was canceled by administrating small interfering RNA (siRNA) of PPARα (p<0.001). Furthermore, in hVSMC, pemafibrate increased catalase expression significantly (p<0.001), while this increase was significantly suppressed by knockdown of PPAR-α with siRNA. (p<0.001).
Conclusion
Pemafibrate reduced the rupture of AAA in this murine model, which is associated with anti-oxidative stress via catalase induction.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Amioka
- Okayama University Hospital, Okayama, Japan
| | - T Miyoshi
- Okayama University Hospital, Okayama, Japan
| | - S Akagi
- Okayama University Hospital, Okayama, Japan
| | - M Yoshida
- Okayama University Hospital, Okayama, Japan
| | - K Nakamura
- Okayama University Hospital, Okayama, Japan
| | - H Morita
- Okayama University Hospital, Okayama, Japan
| | - H Ito
- Okayama University Hospital, Okayama, Japan
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