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Matsuoka M, Tsukamoto S, Orihara Y, Kawamura R, Kuratani M, Haga N, Ikebuchi K, Katagiri T. Corrigendum to "Design of primers for direct sequencing of nine coding exons in the human ACVR1 gene" [Bone 138 (2020) 115469]. Bone 2024; 179:116962. [PMID: 37984130 DOI: 10.1016/j.bone.2023.116962] [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: 11/22/2023]
Affiliation(s)
- Masaru Matsuoka
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan; Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan
| | - Sho Tsukamoto
- Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan; Division of Biomedical Sciences, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yuta Orihara
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan
| | - Rieko Kawamura
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan
| | - Mai Kuratani
- Division of Biomedical Sciences, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Ikebuchi
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan; Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan.
| | - Takenobu Katagiri
- Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan; Division of Biomedical Sciences, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan.
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Sawada R, Shinoda Y, Ohki T, Ishibashi Y, Kobayashi H, Matsubayashi Y, Tanaka S, Haga N. End-of-life walking ability in cancer patients with spinal metastases. Jpn J Clin Oncol 2024; 54:81-88. [PMID: 37815145 DOI: 10.1093/jjco/hyad138] [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: 07/20/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Even terminal cancer patients desire to walk to the toilet by themselves until the very last day. This study aimed to describe the walking ability of patients with spinal metastases at the end-of-life stage and identify the factors affecting this ability. METHODS Among 527 patients who first visited our multidisciplinary team for bone metastasis between 2013 and 2016, 56 patients who had spinal metastases with a Spinal Instability Neoplastic Score ≥7 and died during follow-up were included. We collected general clinical data, performance status, Frankel classification, epidural spinal cord compression scale and Spinal Instability Neoplastic Score at the first consultation. Patients' last day of walking and date of death were also examined. Univariate analyses (chi-squared tests) were performed to identify the factors that impacted walking ability 30 and 14 days before patients' death. RESULTS A total of 56 patients were extracted, and 57.1% (32/56) and 32.7% (16/49) of patients were ambulatory 30 and 14 days before death, respectively. Their performance status (P = 0.0007), Frankel grade (P = 0.012) and epidural spinal cord compression grade (P = 0.006) at the first examination, and administration of bone modifying agents during follow-up period (P = 0.029) were significantly related to walking ability 30 days before death. Among ambulatory patients 30 days before death, those with Spinal Instability Neoplastic Score ≥10 (P = 0.005), especially with high scores of collapse (P = 0.002) and alignment (P = 0.002), were less likely to walk 14 days before death. The walking period in the last month of their life was significantly longer in patients with total Spinal Instability Neoplastic Score 7-9 (P = 0.009) and in patients without collapse (P = 0.040) by the Wilcoxon test. CONCLUSION The progression of spinal metastasis, especially neurological deficit, at the initial consultation were associated with walking ability 30 days before death, and spinal stability might be crucial for preserving walking ability during the last month. Early diagnosis and implementation of appropriate bone management might be important for the end-of-life walking ability.
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Affiliation(s)
- Ryoko Sawada
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takahiro Ohki
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuki Ishibashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshitaka Matsubayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
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Nishizaka C, Fujiwara S, Mano H, Haga N. Difference between affected and unaffected sides of forearm bone length in children with congenital terminal transverse deficiencies at the level of carpal bone. J Pediatr Orthop B 2024; 33:76-82. [PMID: 36562436 PMCID: PMC10686272 DOI: 10.1097/bpb.0000000000001044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022]
Abstract
The forearm of the affected sideis often shorter than that of the unaffected side in children with congenital terminal transverse deficiencies at the level of proximal or distal carpals. The aim of this study is to clarify the characteristics of forearm bone length in those children, especially to quantify the difference in forearm bone length between affected and unaffected sides. The subjects were children with carpal partial transverse deficiencies. The lengths of the radius and the ulna were measured in the radiographs. The lengths of affected and unaffected sides (A/U) were compared in order to quantify the discrepancy. The A/U ratio was defined as the length of the affected side divided by that of the unaffected side. The A/U ratios ranged from 77.1 to 99.0% in the radii and from 74.1 to 99.6% in the ulnae. In both the radius and ulna, the A/U ratios were significantly lower than the left/right ratios of normal adults. Additionally, the A/U ratios of the ulna were significantly lower than the A/U ratios of the radius. The forearm bones of affected side are significantly shorter than those of unaffected side. Although the cause remains unclear, it is possible that not only congenital factors but also acquired factors such as infrequent use of the affected upper limb are involved. A future longitudinal study is necessary to investigate whether length discrepancies can be reduced by using prostheses to increase the frequency of use on the affected limb.
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Affiliation(s)
- Chika Nishizaka
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo
| | - Hiroshi Mano
- Department of Rehabilitation Medicine, Shizuoka Children’s Hospital, Shizuoka
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Lindborg CM, Al Mukaddam M, Baujat G, Cho TJ, De Cunto CL, Delai PLR, Eekhoff EMW, Haga N, Hsiao EC, Morhart R, de Ruiter R, Scott C, Seemann P, Szczepanek M, Tabarkiewicz J, Pignolo RJ, Kaplan FS. Most Fractures Treated Nonoperatively in Individuals With Fibrodysplasia Ossificans Progressiva Heal With a Paucity of Flareups, Heterotopic Ossification, and Loss of Mobility. Clin Orthop Relat Res 2023; 481:2447-2458. [PMID: 37156007 PMCID: PMC10642855 DOI: 10.1097/corr.0000000000002672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/05/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Fibrodysplasia ossificans progressiva (FOP) is an ultrarare genetic disorder with episodic and progressive heterotopic ossification. Tissue trauma is a major risk factor for flareups, heterotopic ossification (HO), and loss of mobility in patients with FOP. The International Clinical Council on FOP generally recommends avoiding surgery in patients with FOP unless the situation is life-threatening, because soft tissue injury can trigger an FOP flareup. Surprisingly little is known about flareups, HO formation, and loss of mobility after fractures of the normotopic (occurring in the normal place, distinct from heterotopic) skeleton when treated nonoperatively in patients with FOP. QUESTIONS/PURPOSES (1) What proportion of fractures had radiographic evidence of union (defined as radiographic evidence of healing at 6 weeks) or nonunion (defined as the radiographic absence of a bridging callus at 3 years after the fracture)? (2) What proportion of patients had clinical symptoms of an FOP flareup because of the fracture (defined by increased pain or swelling at the fracture site within several days after closed immobilization)? (3) What proportion of patients with fractures had radiographic evidence of HO? (4) What proportion of patients lost movement after a fracture? METHODS We retrospectively identified 36 patients with FOP from five continents who sustained 48 fractures of the normotopic skeleton from January 2001 to February 2021, who were treated nonoperatively, and who were followed for a minimum of 18 months after the fracture and for as long as 20 years, depending on when they sustained their fracture during the study period. Five patients (seven fractures) were excluded from the analysis to minimize cotreatment bias because these patients were enrolled in palovarotene clinical trials (NCT02190747 and NCT03312634) at the time of their fractures. Thus, we analyzed 31 patients (13 male, 18 female, median age 22 years, range 5 to 57 years) who sustained 41 fractures of the normotopic skeleton that were treated nonoperatively. Patients were analyzed at a median follow-up of 6 years (range 18 months to 20 years), and none was lost to follow-up. Clinical records for each patient were reviewed by the referring physician-author and the following data for each fracture were recorded: biological sex, ACVR1 gene pathogenic variant, age at the time of fracture, fracture mechanism, fracture location, initial treatment modality, prednisone use at the time of the fracture as indicated in the FOP Treatment Guidelines for flare prevention (2 mg/kg once daily for 4 days), patient-reported flareups (episodic inflammatory lesions of muscle and deep soft connective tissue characterized variably by swelling, escalating pain, stiffness, and immobility) after the fracture, follow-up radiographs of the fracture if available, HO formation (yes or no) as a result of the fracture determined at a minimum of 6 weeks after the fracture, and patient-reported loss of motion at least 6 months after and as long as 20 years after the fracture. Postfracture radiographs were available in 76% (31 of 41) of fractures in 25 patients and were independently reviewed by the referring physician-author and senior author for radiographic criteria of fracture healing and HO. RESULTS Radiographic healing was noted in 97% (30 of 31) of fractures at 6 weeks after the incident fracture. Painless nonunion was noted in one patient who sustained a displaced patellar fracture and HO. In seven percent (three of 41) of fractures, patients reported increased pain or swelling at or near the fracture site within several days after fracture immobilization that likely indicated a site-specific FOP flareup. The same three patients reported a residual loss of motion 1 year after the fracture compared with their prefracture status. HO developed in 10% (three of 31) of the fractures for which follow-up radiographs were available. Patient-reported loss of motion occurred in 10% (four of 41) of fractures. Two of the four patients reported noticeable loss of motion and the other two patients reported that the joint was completely immobile (ankylosis). CONCLUSION Most fractures treated nonoperatively in individuals with FOP healed with few flareups, little or no HO, and preservation of mobility, suggesting an uncoupling of fracture repair and HO, which are two inflammation-induced processes of endochondral ossification. These findings underscore the importance of considering nonoperative treatment for fractures in individuals with FOP. Physicians who treat fractures in patients with FOP should consult with a member of the International Clinical Council listed in the FOP Treatment Guidelines ( https://www.iccfop.org ). LEVEL OF EVIDENCE Level IV, therapeutic study.
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Affiliation(s)
- Carter M. Lindborg
- Department of Orthopaedic Surgery, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
- The Center for Research in FOP and Related Disorders, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - Mona Al Mukaddam
- Department of Orthopaedic Surgery, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
- The Center for Research in FOP and Related Disorders, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - Genevieve Baujat
- Département de Genetique, Institut IMAGINE and Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Tae-Joon Cho
- Division of Pediatric Orthopaedics, Seoul National University Children’s Hospital, Seoul, Republic of Korea
| | - Carmen L. De Cunto
- Department of Pediatrics, Pediatric Rheumatology Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Patricia L. R. Delai
- Hospital Israelita Albert Einstein, Instituto de Ensino e Pesquisa, São Paulo, Brazil
| | - Elisabeth M. W. Eekhoff
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Nobuhiko Haga
- Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa City, Japan
| | - Edward C. Hsiao
- Division of Endocrinology, Diabetes, and Metabolism, the Institute for Human Genetics, the Ely and Edythe Broad Institute for Regeneration Medicine, the Program in Craniofacial Biology and the Department of Medicine, University of California, San Francisco, CA, USA
| | - Rolf Morhart
- Department of Pediatrics, Klinikum Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
| | - Ruben de Ruiter
- Department of Internal Medicine, Division of Endocrinology, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Christiaan Scott
- Department of Orthopaedic Surgery, the University of Cape Town, Cape Town, South Africa and Department of Rheumatology, Red Cross Children’s Hospital, Cape Town, South Africa
| | - Petra Seemann
- Institute for Experimental Endocrinology, Charite University Hospital, Berlin, Germany
| | - Małgorzata Szczepanek
- Department of Pediatrics, Institute of Medical Sciences, Medical College of Rzeszow University, University of Rzeszow, Rzeszow, Poland
| | - Jacek Tabarkiewicz
- Department of Human Immunology, Institute of Medical Sciences, Medical College of Rzeszow University, University of Rzeszow, Rzeszow, Poland
| | - Robert J. Pignolo
- Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Frederick S. Kaplan
- Department of Orthopaedic Surgery, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
- The Center for Research in FOP and Related Disorders, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
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Kaneoka A, Inokuchi H, Ueha R, Sato T, Goto T, Yamauchi A, Seto Y, Haga N. Longitudinal Analysis of Dysphagia and Factors Related to Postoperative Pneumonia in Patients Undergoing Esophagectomy for Esophageal Cancer. Dysphagia 2023:10.1007/s00455-023-10618-6. [PMID: 37934250 DOI: 10.1007/s00455-023-10618-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/15/2023] [Indexed: 11/08/2023]
Abstract
Few studies have quantified longitudinal changes in swallowing in patients undergoing esophagectomy for esophageal cancer. This study longitudinally analyzed the changes in the Modified Barium Swallow Study Impairment Profile (MBSImP™) scores, swallowing kinematic measurements, and swallowing-related symptoms in patients undergoing esophagectomy. We also examined the association between identified swallowing impairment and aspiration pneumonia after surgery. We included consecutive patients who underwent esophagectomy and completed laryngoscopy and videofluoroscopy before, two weeks, and three months after surgery. We analyzed physiological impairments using the MBSImP. We also assessed the swallowing kinematics on a 5 mL thickened liquid bolus at three time points. Vocal fold mobility was assessed using a laryngoscope. Repeated measures were statistically examined for longitudinal changes in swallowing function. The association between the significant changes identified after esophagectomy and aspiration pneumonia was tested. Twenty-nine patients were included in this study. Preoperative swallowing function was intact in all participants. The timing of swallowing initiation and opening of the pharyngoesophageal segment remained unchanged after surgery. Tongue base retraction and pharyngeal constriction ratio worsened two weeks after surgery but returned to baseline levels three months after surgery. Three months after surgery, hyoid displacement and vocal fold immobility did not fully recover. Aspiration pneumonia occurred in nine patients after surgery and was associated with postoperative MBSImP pharyngeal residue scores. Decreased hyoid displacement and vocal fold immobility were observed postoperatively and persisted for a long time. The postoperative pharyngeal residue was associated with pneumonia and thus should be appropriately managed after surgery.
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Affiliation(s)
- Asako Kaneoka
- The University of Tokyo Hospital Rehabilitation Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan.
- The University of Tokyo Hospital Swallowing Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Haruhi Inokuchi
- The University of Tokyo Hospital Rehabilitation Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
- The University of Tokyo Hospital Swallowing Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Rumi Ueha
- The University of Tokyo Hospital Swallowing Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Taku Sato
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Takao Goto
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Akihito Yamauchi
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Nobuhiko Haga
- Rehabilitation Services Bureau, The National Rehabilitation Center for Persons With Disabilities, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan
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Mano H, Fujiwara S, Nishizaka C, Haga N. Intellectual Characteristics in Children With Congenital Unilateral Upper Limb Deficiencies. Cureus 2023; 15:e37100. [PMID: 37168211 PMCID: PMC10166379 DOI: 10.7759/cureus.37100] [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] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction Some children with motor disabilities show low cognitive levels. However, the influence of motor disabilities on children's intelligence remains to be fully elucidated. This study aimed to clarify the intellectual characteristics of children with upper limb deficiencies and the influence of upper limb impairments on intelligence. Methods The participants were 10 children from four to six years of age with congenital unilateral transradial or transcarpal limb deficiencies who received prosthetic interventions. The children's intelligence and adaptive behaviors, including motor skills, were examined using the Wechsler Preschool and Primary Scale of Intelligence and the Vineland Adaptive Behavior Scale, respectively. Results There were no significant characteristics or discrepancies in cognitive level in children with upper limb deficiencies. The Adaptive Behavior Composite Score of the Vineland Adaptive Behavior Scale was significantly positively correlated with the Full-Scale Intelligence Quotient of the Wechsler Preschool and Primary Scale of Intelligence. Conclusions The children with congenital limb deficiencies showed average cognitive levels. Expansion of adaptive behaviors, including appropriate complementation of disabilities, may promote intellectual development in children with motor disabilities.
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Pignolo RJ, Hsiao EC, Al Mukaddam M, Baujat G, Berglund SK, Brown MA, Cheung AM, De Cunto C, Delai P, Haga N, Kannu P, Keen R, Le Quan Sang KH, Mancilla EE, Marino R, Strahs A, Kaplan FS. Reduction of New Heterotopic Ossification (HO) in the Open-Label, Phase 3 MOVE Trial of Palovarotene for Fibrodysplasia Ossificans Progressiva (FOP). J Bone Miner Res 2023; 38:381-394. [PMID: 36583535 DOI: 10.1002/jbmr.4762] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 08/10/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare, severely disabling genetic disorder of progressive heterotopic ossification (HO). The single-arm, open-label, phase 3 MOVE trial (NCT03312634) assessed efficacy and safety of palovarotene, a selective retinoic acid receptor gamma agonist, in patients with FOP. Findings were compared with FOP natural history study (NHS; NCT02322255) participants untreated beyond standard of care. Patients aged ≥4 years received palovarotene once daily (chronic: 5 mg; flare-up: 20 mg for 4 weeks, then 10 mg for ≥8 weeks; weight-adjusted if skeletally immature). The primary endpoint was annualized change in new HO volume versus NHS participants (by low-dose whole-body computed tomography [WBCT]), analyzed using a Bayesian compound Poisson model (BcPM) with square-root transformation. Twelve-month interim analyses met futility criteria; dosing was paused. An independent Data Monitoring Committee recommended trial continuation. Post hoc 18-month interim analyses utilized BcPM with square-root transformation and HO data collapsed to equalize MOVE and NHS visit schedules, BcPM without transformation, and weighted linear mixed-effects (wLME) models, alongside prespecified analysis. Safety was assessed throughout. Eighteen-month interim analyses included 97 MOVE and 101 NHS individuals with post-baseline WBCT. BcPM analyses without transformation showed 99.4% probability of any reduction in new HO with palovarotene versus NHS participants (with transformation: 65.4%). Mean annualized new HO volume was 60% lower in MOVE versus the NHS. wLME results were similar (54% reduction fitted; nominal p = 0.039). All palovarotene-treated patients reported ≥1 adverse event (AE); 97.0% reported ≥1 retinoid-associated AE; 29.3% reported ≥1 serious AE, including premature physeal closure (PPC)/epiphyseal disorder in 21/57 (36.8%) patients aged <14 years. Post hoc computational analyses using WBCT showed decreased vertebral bone mineral density, content, and strength, and increased vertebral fracture risk in palovarotene-treated patients. Thus, post hoc analyses showed evidence for efficacy of palovarotene in reducing new HO in FOP, but high risk of PPC in skeletally immature patients. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | - Edward C Hsiao
- Division of Endocrinology and Metabolism, the UCSF Metabolic Bone Clinic, the Eli and Edythe Broad Institute for Regeneration Medicine, and the Institute of Human Genetics, Department of Medicine, and the UCSF Program in Craniofacial Biology, University of California-San Francisco, San Francisco, CA, USA
| | - Mona Al Mukaddam
- Departments of Orthopaedic Surgery & Medicine, The Center for Research in FOP and Related Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Geneviève Baujat
- Département de Génétique, Institut IMAGINE and Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Staffan K Berglund
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Matthew A Brown
- Faculty of Life Sciences and Medicine, King's College London, London, UK
- Genomics England Ltd, London, UK
| | - Angela M Cheung
- Department of Medicine and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Carmen De Cunto
- Pediatric Rheumatology Section, Department of Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Patricia Delai
- Centro de Pesquisa Clinica, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Peter Kannu
- Hospital for Sick Children, Toronto, ON, Canada
| | - Richard Keen
- Centre for Metabolic Bone Disease, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Kim-Hanh Le Quan Sang
- Département de Génétique, Institut IMAGINE and Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Edna E Mancilla
- Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Frederick S Kaplan
- Departments of Orthopaedic Surgery & Medicine, The Center for Research in FOP and Related Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Dube L, Haga N, Grogan D, Ogier J, Le Quan Sang KH. A Pharmacokinetic, Safety, and Tolerability Trial of Palovarotene in Healthy Japanese and Non-Japanese Participants. Eur J Drug Metab Pharmacokinet 2023; 48:141-150. [PMID: 36802022 PMCID: PMC10011291 DOI: 10.1007/s13318-023-00815-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND AND OBJECTIVE: Palovarotene is an oral, selective retinoic acid receptor gamma agonist under investigation for fibrodysplasia ossificans progressiva (FOP). Palovarotene is primarily metabolized by cytochrome P450 (CYP) 3A4. Differences in CYP-mediated metabolism of CYP substrates have been observed between Japanese and non-Japanese individuals. This phase I trial (NCT04829786) compared the pharmacokinetic profile of palovarotene in healthy Japanese and non-Japanese participants and evaluated the safety of single doses. METHODS Healthy Japanese and non-Japanese participants were matched individually (1:1) and randomized to receive a single oral dose of palovarotene 5 or 10 mg, followed by the alternate dose after a 5-day washout period. Maximum plasma drug concentration (Cmax) and area under the plasma concentration-time curve (AUC) were assessed. Estimates of the geometric mean difference between dose and Japanese and non-Japanese groups were calculated for natural log-transformed Cmax and AUC parameters. Adverse events (AEs), serious AEs, and treatment-emergent AEs were recorded. RESULTS Eight pairs of matched non-Japanese and Japanese individuals and two unmatched Japanese individuals participated. Mean plasma concentration-time profiles were similar between the two cohorts at both dose levels, demonstrating that palovarotene absorption and elimination are similar irrespective of dose level. The pharmacokinetic parameters of palovarotene were similar between groups at both dose levels. Cmax and AUC values were dose-proportional between doses in each group. Palovarotene was well tolerated; there were no deaths or AEs leading to treatment discontinuation. CONCLUSIONS Japanese and non-Japanese groups had similar pharmacokinetic profiles, indicating that palovarotene dose adjustments are not necessary for Japanese patients with FOP.
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Affiliation(s)
- Louise Dube
- Pleiades Consultation Inc, Phoenix, Arizona, USA
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | | | | | - Kim-Hanh Le Quan Sang
- Département de Génétique Clinique', Hôpital Universitaire Necker-Enfants Malades, Imagine, Université Paris Cité, Paris, France
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Kubota M, Haga N. Impact of the coronavirus pandemic on families of patients with congenital insensitivity to pain with anhidrosis. Pediatr Int 2023; 65:e15415. [PMID: 36371639 PMCID: PMC9877935 DOI: 10.1111/ped.15415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 10/11/2022] [Accepted: 11/07/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Novel coronavirus disease (COVID-19) outbreaks have dramatically changed lifestyles, with various effects on the physical and mental health of families and children with various childhood-onset neurological diseases. A questionnaire survey was conducted to identify family-specific issues and needs of patients with congenital insensitivity to pain with anhidrosis (CIPA) during major changes in their daily lives due to the COVID-19 outbreaks. METHODS An anonymous questionnaire was sent to 56 families that were members of the Association of Patients and Families of CIPA in Japan between October and November 2020, the first 2 months of the third outbreak. RESULTS Thirty-eight families (67.2% response rate) responded to the questionnaire. The current concerns of the parents were (1) difficulty in predicting the future (19 parents, 50%), (2) household and work concerns (eight parents, 21.1%), and (3) whether they would become infected (25 parents, 65.8%). Fifteen families indicated stress due to increased time together (stress + group), and 10 families had a better understanding of each other due to increased time together. New sleep disturbances and behavioral changes were observed in approximately 20% and 50% of patients with CIPA, respectively. No single factor could explain family stress. There were also free descriptions of the importance of peer support, connections with experts, and prompt responses for resolution. CONCLUSIONS Each family has its own way of coping with multiple factors that contribute to the stress of the patient and family. A long-established resilience to the disease proved effective during this pandemic.
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Affiliation(s)
- Masaya Kubota
- Department of Pediatrics, Shimada Ryoiku Medical Center for Challenged Children, Tokyo, Japan.,Division of Neurology, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Nobuhiko Haga
- Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
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10
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Inooka Y, Yamana H, Shinoda Y, Inokuchi H, Matsui H, Fushimi K, Yasunaga H, Haga N. Predictive Factors for Oral Intake Recovery After Acute Stroke: Analysis of a Japanese Nationwide Inpatient Database. Dysphagia 2022; 37:1623-1632. [PMID: 35218414 DOI: 10.1007/s00455-022-10423-7] [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: 04/17/2021] [Accepted: 02/14/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE It remains unclear which factors contribute to dysphagia recovery after an acute stroke. This study aimed to identify factors associated with complete oral intake recovery in patients with post-stroke dysphagia. METHODS Data were obtained from the Diagnosis Procedure Combination database, which is a nationwide database of administrative claims and discharge abstracts in Japan. We selected patients admitted within 3 days of stroke onset and conducted multivariable logistic regression analysis. Total oral intake within 30 days of admission was the primary outcome measure. RESULTS A total of 151,302 patients were included, and total oral intake was observed in 48% of them within 30 days of admission. Total oral intake was significantly associated with age, sex, stroke subtype, consciousness disturbance, low body mass index, multiple comorbidities, and the modified Rankin Scale before stroke onset. In addition, males had worse outcomes than females (odds ratio, 0.75; 95% confidence interval, 0.73-0.77, p < 0.001), and intracerebral and subarachnoid hemorrhagic stroke subtypes were associated with non-recovery. CONCLUSION This study identified several prognostic factors for total oral intake in patients with acute stroke. These results may be useful for predicting a patient's dysphagia prognosis at the time of admission and designing a nutritional management plan for patients with acute stroke.
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Affiliation(s)
- Yasuhiro Inooka
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
- Department of Rehabilitation, Yoyogi Hospital, 1-30-7 Sendagaya, Shibuya-ku, Tokyo, Japan
| | - Hayato Yamana
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
- Department of Rehabilitation Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-cho, Iruma-gun, Saitama, Japan.
- Department of Rehabilitation Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma-Gun, Saitama, 350-0495, Japan.
| | - Haruhi Inokuchi
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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11
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Fujihara Y, Mori Y, Saijo H, Abe T, Susami T, Haga N, Hoshi K. Long-term dental outcomes in patients with fibrodysplasia ossificans progressiva: a report of three cases of tooth extraction. Quintessence Int 2022; 53:712-720. [PMID: 35674162 DOI: 10.3290/j.qi.b3094989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is an extremely rare autosomal dominant disorder characterized by congenital skeletal malformation and progressive heterotopic ossification. In the oral and maxillofacial region, deformity of the temporomandibular joint is a common feature of FOP, as well as restricted mouth opening derived from heterotopic ossification in the masticatory muscles. Since surgical procedures are generally not recommended because of the risk of flare-ups and increased heterotopic ossification, reports of tooth extractions and their outcomes in patients with FOP are limited. The present article reports the long-term oral outcomes of three Japanese patients with FOP, in whom the teeth were deliberately extracted to avoid the risk of oral inflammation causing further heterotopic ossification. The extractions were conducted under local or general anesthesia, and healing of sockets was nonproblematic with the formation of new bone. Undesirable events, including progression of heterotopic ossification in the oral and maxillofacial region and further restriction of mouth opening, were not apparent. The extractions also alleviated the existing inflammation, contributing to maintaining their oral hygiene. These cases suggest that deliberate planning and judicious surgery could induce favorable healing after tooth extractions in patients with FOP, leading to long-term stability of their oral health status.
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12
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Eekhoff EM, de Ruiter RD, Smilde BJ, Schoenmaker T, de Vries TJ, Netelenbos C, Hsiao EC, Scott C, Haga N, Grunwald Z, De Cunto CL, di Rocco M, Delai PLR, Diecidue RJ, Madhuri V, Cho TJ, Morhart R, Friedman CS, Zasloff M, Pals G, Shim JH, Gao G, Kaplan F, Pignolo RJ, Micha D. Gene Therapy for Fibrodysplasia Ossificans Progressiva: Feasibility and Obstacles. Hum Gene Ther 2022; 33:782-788. [PMID: 35502479 PMCID: PMC9419966 DOI: 10.1089/hum.2022.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/06/2022] [Indexed: 02/02/2023] Open
Abstract
Fibrodysplasia ossificans progressiva (FOP) is a rare and devastating genetic disease, in which soft connective tissue is converted into heterotopic bone through an endochondral ossification process. Patients succumb early as they gradually become trapped in a second skeleton of heterotopic bone. Although the underlying genetic defect is long known, the inherent complexity of the disease has hindered the discovery of effective preventions and treatments. New developments in the gene therapy field have motivated its consideration as an attractive therapeutic option for FOP. However, the immune system's role in FOP activation and the as-yet unknown primary causative cell, are crucial issues which must be taken into account in the therapy design. While gene therapy offers a potential therapeutic solution, more knowledge about FOP is needed to enable its optimal and safe application.
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Affiliation(s)
- Elisabeth M.W. Eekhoff
- Section Endocrinology, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Rare Bone Disease Center, Amsterdam Bone Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Ruben D. de Ruiter
- Section Endocrinology, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Rare Bone Disease Center, Amsterdam Bone Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Bernard J. Smilde
- Section Endocrinology, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Rare Bone Disease Center, Amsterdam Bone Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Ton Schoenmaker
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
| | - Teun J. de Vries
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
| | - Coen Netelenbos
- Section Endocrinology, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Rare Bone Disease Center, Amsterdam Bone Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Edward C. Hsiao
- Division of Endocrinology and Metabolism, Department of Medicine, Institute for Human Genetics, Program in Craniofacial Biology, the Institute for Regeneration Medicine, University of California, San Francisco, California, USA
| | - Christiaan Scott
- Division of Paediatric Rheumatology, Department of Paediatrics and Child Heath, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Nobuhiko Haga
- Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama, Japan
| | - Zvi Grunwald
- Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, USA
| | - Carmen L. De Cunto
- Department of Pediatrics, Section Pediatric Rheumatology, Hospital Italiano Buenos Aires, Argentina
| | - Maja di Rocco
- Department of Pediatrics, Unit of Rare Diseases, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Patricia L. R. Delai
- Teaching and Research Institute of the Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Robert J. Diecidue
- Department of Oral and Maxillofacial Surgery, Sidney Kimmel Medical College, Philadelphia, USA
| | - Vrisha Madhuri
- Department of Paediatric Orthopaedics and Center for Stem Cell Research, Christian Medical College and Hospital, Vellore, India
| | - Tae-Joon Cho
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Rolf Morhart
- Department of Pediatrics, Garmisch-Partenkichen Medical Center, Garmisch-Partenkirchen, Germany
| | - Clive S. Friedman
- Schulich School of Medicine and Dentistry, Western University, Clinical Skills Building, London, Ontario, Canada
| | - Michael Zasloff
- Surgery and Pediatrics, MedStar Georgetown Transplant Institute, Washington, District of Columbia, USA
| | - Gerard Pals
- Department of Human Genetics, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Rare Bone Disease Center, Amsterdam Bone Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jae-Hyuck Shim
- Department of Medicine/Rheumatology, Horae Gene Therapy Center, Li Weibo Institute for Rare Diseases Research, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Guangping Gao
- Department of Microbiology and Physiological Systems, Horae Gene Therapy Center, Viral Vector Core, Li Weibo Institute for Rare Diseases Research, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Frederick Kaplan
- Department of Orthopaedic Surgery and Medicine, Center for Research in FOP and Related Disorders, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Dimitra Micha
- Department of Human Genetics, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Rare Bone Disease Center, Amsterdam Bone Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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13
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Ajimi A, Matsushita M, Mishima K, Haga N, Fujiwara S, Ozono K, Kubota T, Kitaoka T, Imagama S, Kitoh H. Inconvenience and adaptation in Japanese adult achondroplasia and hypochondroplasia: A cross-sectional study. Clin Pediatr Endocrinol 2022; 31:18-24. [PMID: 35002064 PMCID: PMC8713058 DOI: 10.1297/cpe.2021-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/05/2021] [Indexed: 11/28/2022] Open
Abstract
The health-related quality of life is reduced in patients with achondroplasia (ACH) and
hypochondroplasia (HCH); however, the detailed inconveniences in the daily living and
individual adaptations have not been elucidated. This study aimed to evaluate the
inconvenience and adaptation in patients with ACH/HCH. A cross-sectional study was
conducted in patients with ACH/HCH aged 20 yr or older. Questionnaires were sent to 567
patients (described 86) with a medical history at the co-authors’ institutions or who were
registered at the patients’ association with ACH in Japan. The questionnaire included a
free description format for the inconveniences and adaptations in daily living; a content
analysis was performed. The recorded inconveniences included 148 physical, 84 mental, and
52 social problems. Patients who underwent spine surgery had significantly more recorded
physical problems than those who did not (p < 0.05). Pain and numbness were
significantly higher in patients aged ≥ 50 yr (p < 0.05). The 160 and 1 adaptations
were for physical and social problems, respectively. No patient adaptation was found for
mental health problems. Individual adaptations by ACH/HCH patients can improve only some
aspects of physical and social problems. Multilateral social support is needed to resolve
patients’ issues.
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Affiliation(s)
- Akiko Ajimi
- Department of Physical Therapy, Faculty of Health Sciences, Mejiro University, Saitama, Japan
| | - Masaki Matsushita
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenichi Mishima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Taichi Kitaoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Kitoh
- Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, Aichi, Japan.,Department of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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14
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Mano H, Fujiwara S, Yabuki S, Takikawa K, Tanaka H, Haga N. Visual attention to their own paralytic limbs in children with spina bifida: Measurement of gaze direction using eye tracking. Pediatr Int 2022; 64:e15037. [PMID: 34699660 DOI: 10.1111/ped.15037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/08/2021] [Accepted: 10/25/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patients with spina bifida experience sensory and motor paralysis and complications in the form of deformation and skin problems of the lower limbs. Enhancing their awareness of the paralysed lesions could be helpful for these patients to prevent secondary disorders. This study sought to investigate to what extent children with spina bifida are visually aware of their body parts and, in particular, to their paralysed lesions. METHODS Participants included children with spina bifida (n = 10) and typically developing control children (n = 10) between the ages of 5 and 11 years. All participants were shown still images of themselves on a monitor after which their gaze direction was measured using an eye tracker, with or without providing an instruction to direct their attention to their limbs. The gaze direction data were analyzed and compared between children with spina bifida and the control children. RESULTS Children with spina bifida paid visual attention to their bodies in a manner similar to that of control children. Prompts to direct their attention to their limbs were effective in both groups; however, the degree of efficacy in children with spina bifida was inferior to that in control children. CONCLUSIONS Promotion of visual awareness to their paralytic parts could be a reasonable and effective method for children with spina bifida to improve their understanding and recognition of their body and prevent associated skin problems.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Sayumi Yabuki
- Department of Orthopedics, Tokyo Metropolitan Kita Medical Rehabilitation Center for the Disabled, Tokyo, Japan
| | - Kazuharu Takikawa
- Department of Pediatric Orthopedics, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Hiroshi Tanaka
- Department of Orthopedics, National Rehabilitation Center for Children with Disabilities, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
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15
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Mano H, Fujiwara S, Yabuki S, Tanaka H, Takikawa K, Haga N. Body knowledge in children with spina bifida. Pediatr Int 2022; 64:e14713. [PMID: 33780073 DOI: 10.1111/ped.14713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/17/2021] [Accepted: 03/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with spina bifida suffer from motor paralysis and sensory disturbance, secondary deformation of the lower extremities, and development of decubitus ulcers. A deep understanding of one's body, such as identifying the names, functions, relationships, homology (e.g. upper and lower limbs) and relative position of body parts, may prevent secondary disorders. The awareness of the body and its characteristics in children with spina bifida has not been fully elucidated. This study aimed to investigate how children with spina bifida perceive their bodies, especially their paralyzed parts and related or homologous ones. METHODS Participants included 36 children with spina bifida and 14 control children, aged 5-11 years. They were asked to draw self-portraits, and to answer questions about the names of body parts. The number of drawn body parts in the pictures and the correct response rates to the questions were quantified and compared between children with spina bifida and control children. RESULTS Children with spina bifida drew fewer hands, legs, and feet than control children. In the verbal tests, children with spina bifida had a lower correct response rate than control children on questions concerning the upper limbs, hands, trunk, and feet. CONCLUSIONS Children with spina bifida have diminished visuospatial and lexical-semantic body knowledge of the paralyzed parts and related organs.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Bunkyo-ku, Japan.,Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Bunkyo-ku, Japan
| | - Sayumi Yabuki
- Department of Orthopedics, Tokyo Metropolitan Kita Medical Rehabilitation Center for the Disabled, Kita-ku, Japan
| | - Hiroshi Tanaka
- Department of Orthopedics, National Rehabilitation Center for Children with Disabilities, Itabashi-ku, Japan
| | - Kazuharu Takikawa
- Department of Pediatric Orthopedics, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Bunkyo-ku, Japan
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16
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Matsushita M, Mishima K, Kamiya Y, Haga N, Fujiwara S, Ozono K, Kubota T, Kitaoka T, Imagama S, Kitoh H. Health-related Quality of Life in Adult Patients with Multiple Epiphyseal Dysplasia and Spondyloepiphyseal Dysplasia. Prog Rehabil Med 2021; 6:20210048. [PMID: 34909512 PMCID: PMC8640375 DOI: 10.2490/prm.20210048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/10/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives: Multiple epiphyseal dysplasia (MED) and spondyloepiphyseal dysplasia (SED) are skeletal
dysplasias associated with premature osteoarthritis and short stature. Patients with SED
often have spinal and ocular problems. Few reports have focused on the health-related
quality of life (HRQoL) of patients with skeletal dysplasias associated with premature
osteoarthritis. The purpose of this study was to evaluate the HRQoL of adult patients
with MED and SED. Methods: Questionnaires covering demographics, medical history (cataract, retinal detachment,
and osteoarthritis), surgical history (osteotomy and arthroplasty), and the Short
Form-36 (SF-36) health survey were sent to all patients with MED and SED with medical
records at the investigators’ institutions. Among the 27 patients who completed the
questionnaire, patients aged 20 years or older were included in this cohort. Results: The subjects were 18 affected individuals. The physical component summary score (PCS)
was significantly lower in the MED and SED groups than in the normal population and
tended to deteriorate with age. Conversely, there was a positive correlation between the
mental component summary score and age. The role/social component summary score was not
correlated with age. MED patients with osteoarthritis had a low PCS. PCS was
particularly low in two SED patients with a medical history of cataract, whereas there
was no association with a history of retinal detachment or osteoarthritis. Conclusions: The physical domain of HRQoL in MED and SED patients significantly deteriorated at a
young age. Appropriate medical management of these skeletal dysplasias is required not
only for orthopedic functions but also for ocular problems.
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Affiliation(s)
- Masaki Matsushita
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenichi Mishima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasunari Kamiya
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Taichi Kitaoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Kitoh
- Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, Obu, Japan.,Department of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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17
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Kawaguchi K, Taketomi S, Mizutani Y, Uchiyama E, Ikegami Y, Tanaka S, Haga N, Nakamura Y. Sex-Based Differences in the Drop Vertical Jump as Revealed by Video Motion Capture Analysis Using Artificial Intelligence. Orthop J Sports Med 2021; 9:23259671211048188. [PMID: 34778472 PMCID: PMC8573498 DOI: 10.1177/23259671211048188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sex-based biomechanical differences during a drop vertical jump (DVJ) may explain the increased risk of anterior cruciate ligament injury in females. Video motion capture using artificial intelligence (VMocap) is a new method for accurate motion analysis. PURPOSE To use VMocap to identify sex-based differences in biomechanics during a DVJ in Asian athletes. STUDY DESIGN Controlled laboratory study. METHODS A total of 63 female and 61 male Asian soccer players volunteered for this study in 2018. Participants performed a bilateral DVJ using VMocap, and the knee valgus angle (KVA), knee flexion angle (KFA), hip flexion angle (HFA), and lower leg anterior inclination angle (LAIA) were calculated from the motion capture data. These joint angles and inclination angles were evaluated at the time of highest point of the first jump (H1), initial contact (IC), maximum knee flexion (MKF), toe-off (TO), and highest point of the second jump (H2). The unpaired t test was used to compare sex-based differences. RESULTS At H1, the KVA in females showed more valgus (-2.9° vs -5.4°) and the LAIA in females was greater (29.1° vs 25.7°) versus males (P < .01 for both). At IC, the KVA in females showed more valgus (-1.3° vs -3.0°) and females had a greater KFA (20.8° vs 14.3°) and LAIA (5.1° vs 0.0°) compared with males (P < .01 for all). At MKF, female KVA showed more valgus (6.2° vs -9.5°), and females had greater LAIA (36.6° vs 34.6°), smaller KFA (77.5° vs 87.5°), and smaller HFA (55.8° vs 82.0°) compared with males (P < .01 for all). At TO, female KVA showed more valgus (-0.7° vs -3.1°) and female KFA, HFA, and LAIA were greater (31.7° vs 19.2°; 19.9° vs 16.4°; and 18.2° vs 11.5°, respectively) than males (P < .01 for all). At H2, females had a greater KFA (18.6° vs 14.6°) and LAIA (13.3° vs 9.9°) than males (P < .04 for both). CONCLUSION Asian female soccer players showed increased KVA and LAIA, decreased KFA and HFA at MKF, and increased KFA at IC and TO compared with their male counterparts in this analysis of the DVJ. CLINICAL RELEVANCE Elucidation of kinematic differences between the sexes can aid in predicting injuries.
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Affiliation(s)
- Kohei Kawaguchi
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Taketomi
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuri Mizutani
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
| | - Emiko Uchiyama
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Yosuke Ikegami
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhiko Haga
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiko Nakamura
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
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18
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Mano H, Fujiwara S, Haga N. How Children with Congenital Limb Deficiencies Visually Attend to Their Limbs and Prostheses: Eye Tracking of Displayed Still Images and Visuospatial Body Knowledge. Dev Neurorehabil 2021; 24:547-554. [PMID: 33834932 DOI: 10.1080/17518423.2021.1901151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: This study aimed to clarify how children with congenital limb deficiencies visually attend to their bodies, particularly their limbs and prostheses.Methods: Participants included children with and without congenital limb deficiencies. They were shown photographs of themselves and their visual attention was measured using an eye tracker.Results: Six children with lower limb deficiencies (age [mean ± SD]: 8.8 ± 2.9; 2 girls and 4 boys), six children with upper limb deficiencies (age: 7.0 ± 2.3; 2 girls and 4 boys), and ten control children (age: 7.7 ± 1.9; 5 girls and 5 boys) were included. Children with congenital upper/lower limb deficiencies looked at their upper/lower limbs as often or more than the control children. Prompts to direct their visual attention to their limbs had limited efficacy.Conclusions: To improve the body knowledge of limbs, approaches other than visual recognition prompting, such as improving linguistic understanding, might be considered.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
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19
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Mano H, Noguchi S, Fujiwara S, Haga N. Relationship between degree of disability, usefulness of assistive devices, and daily use duration: an investigation in children with congenital upper limb deficiencies who use upper limb prostheses. Assist Technol 2021; 35:136-141. [PMID: 34410874 DOI: 10.1080/10400435.2021.1970652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Upper limb prostheses can help children with congenital upper limb deficiencies (ULDs) perform activities of daily living. Although the degree of disability and prosthesis usefulness may be related to becoming accustomed to wearing a prosthesis, these relationships have not been confirmed. This study was aimed at investigating the relationship between motor function, the usefulness of prostheses in everyday activities, and daily duration of prosthesis use in children with congenital ULDs. Eleven children with congenital transcarpal or transradial ULDs and their caregivers participated in this study. The caregivers were asked to complete a questionnaire concerning their children's everyday activities and the daily duration of prosthesis wearing. The adaptive behavior scale was used to measure motor function prior to intervention. Correlations analyses revealed no significant correlation between the children's adaptive behavior, including motor skills before intervention, and daily duration of prosthesis wearing, but revealed a positive correlation between the number of activities that the children performed more effectively with their prostheses and the daily use duration. To ensure that children with congenital ULDs become accustomed to wearing their prostheses, the prostheses should meet the requirements of everyday activities.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Satoko Noguchi
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
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20
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Kawaguchi K, Taketomi S, Mizutani Y, Inui H, Yamagami R, Kono K, Takagi K, Kage T, Sameshima S, Tanaka S, Haga N. Hip Abductor Muscle Strength Deficit as a Risk Factor for Inversion Ankle Sprain in Male College Soccer Players: A Prospective Cohort Study. Orthop J Sports Med 2021; 9:23259671211020287. [PMID: 34377718 PMCID: PMC8320582 DOI: 10.1177/23259671211020287] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/18/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Previous studies have attempted to determine whether certain risk factors can predict the occurrence of inversion ankle sprains in male collegiate soccer players. However, no consensus has been reached on the predictive risk factors of inversion ankle sprain in this population. Purpose: To identify risk factors for inversion ankle sprains among male collegiate soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: Included were 145 male collegiate soccer players in Japan who were assessed during a preseason medical checkup for potential risk factors of inversion ankle sprain. The preseason assessment included anthropometric measurements, joint laxity and flexibility, muscle flexibility, muscle strength, and balance ability, with a total of 33 variables. The participants were monitored during the 2019 season for inversion ankle sprains as diagnosed by physicians. Results: A total of 31 inversion ankle sprains in 31 players (21.4%) occurred during the season. Only the measured isometric hip abductor strength was significantly lower in injured players as compared with uninjured players. Logistic regression analysis revealed measured hip abductor muscle strength deficit as a significant risk factor for inversion ankle sprain (odds ratio, 0.978 [95% CI, 0.976-0.999]; P = .05). Conclusion: Hip abductor strength deficit was a risk factor for inversion ankle sprain in the study population. This finding could be useful for the prevention of inversion ankle sprains in male collegiate soccer players.
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Affiliation(s)
- Kohei Kawaguchi
- UTokyo Sports Science Initiative, Tokyo, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Taketomi
- UTokyo Sports Science Initiative, Tokyo, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Hiroshi Inui
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryota Yamagami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenichi Kono
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Takagi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomofumi Kage
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shin Sameshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhiko Haga
- UTokyo Sports Science Initiative, Tokyo, Japan.,Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
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21
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Mano H, Fujiwara S, Takamura K, Kitoh H, Takayama S, Ogata T, Haga N. Treatment approaches for congenital transverse limb deficiency: Data analysis from an epidemiological national survey in Japan. J Orthop Sci 2021; 26:650-654. [PMID: 32600906 DOI: 10.1016/j.jos.2020.05.008] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/11/2020] [Accepted: 05/20/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND Congenital limb deficiency is a rare anomaly that impairs limb function. Transverse deficiency accounts for approximately half of congenital limb deficiency cases. In Japan, there have been no detailed data of clinical features, especially treatment approaches, of this disorder. The present study aimed to investigate the status of treatment approaches of congenital transverse limb deficiency in Japan. METHODS From the national epidemiological survey of congenital limb deficiency undertaken in Japan in 2016, all the data of 200 patients with congenital transverse limb deficiencies were extracted. These data were analysed to reveal the treatment approaches of congenital transverse limb deficiency and its basic clinical features. RESULTS Surgical treatments and prosthetic or orthotic intervention had been implemented or planned for about one-quarter of patients, respectively. In the upper limb deficiencies, prosthetic or orthotic intervention was likely chosen in cases of deficiency at the metacarpal or proximal to metacarpal level. Surgical treatment was chosen only in cases of deficiency at the carpal or distal to carpal level. Although the number of patients with transverse lower limb deficiencies was small, prosthetic or orthotic intervention was likely chosen in proximal deficiencies, and surgical treatment was likely chosen in distal deficiencies. CONCLUSIONS Herein, we revealed the status of treatment approaches for congenital transverse limb deficiency in Japan. Approximately half of the patients had no history of-and no plans for-surgical, prosthetic, or orthotic interventions. Further treatment advances may enable patients with congenital limb deficiencies to increase their participation in daily activities. STUDY DESIGN Cross-sectional survey.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan; Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Kazuyuki Takamura
- Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Hiroshi Kitoh
- Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, Obu, Japan
| | - Shinichiro Takayama
- Department of Orthopaedic Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Tsutomu Ogata
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.
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22
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Sawada R, Yamana H, Shinoda Y, Tsuda Y, Matsui H, Fushimi K, Kobayashi H, Matsubayashi Y, Yasunaga H, Tanaka S, Haga N. Predictive factors of the 30-day mortality after surgery for spinal metastasis: Analysis of a nationwide database. J Orthop Sci 2021; 26:666-671. [PMID: 32828617 DOI: 10.1016/j.jos.2020.07.015] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/26/2020] [Accepted: 07/02/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Surgical procedure for symptomatic spinal metastasis is expected to improve the quality of life. Factors related to short-term perioperative mortality after surgery for spinal metastasis may be different from those related to long-term mortality, which have classically been used to determine the indication for surgery. The purposes of this study were to evaluate factors related to the 30-day mortality after surgery for spinal metastasis and create an integer risk scoring system. METHODS Using the Diagnosis Procedure Combination database from 2010 to 2016, we extracted data of patients who underwent surgical procedure for spinal metastasis. Multivariable logistic regression analysis was performed to clarify the association between patient backgrounds and the 30-day postoperative mortality. We created a risk scoring system using regression coefficients to estimate the 30-day mortality for each patient. RESULTS Among 3524 patients, the 30-day mortality was 2.6%. Factors associated with a higher 30-day mortality were male sex (odds ratio, 2.50 [95% confidence interval, 1.45-4.31]), emergency admission (1.80 [1.11-2.92]), rapid growth tumors (3.83 [2.49-5.90]), and non-skeletal metastasis (2.27 [1.42-3.64]). In patients with the maximum risk score of five, the 30-day mortality was 16.2%. CONCLUSIONS Factors related to the 30-day mortality were male sex, emergency admission, rapid growth tumors, and non-skeletal metastasis. These findings provide spine surgeons and patients knowledge of the potential risk of short-term perioperative mortality and allow them to consider the risk of surgery.
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Affiliation(s)
- Ryoko Sawada
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hayato Yamana
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Yusuke Tsuda
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate school of Medicine, Tokyo, Japan
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshitaka Matsubayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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23
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Mano H, Inakazu E, Noguchi S, Nishizaka C, Fujiwara S, Haga N. Rehabilitation Approach for a Child with Cerebral Palsy and Upper Limb Deficiency. Prog Rehabil Med 2021; 6:20210016. [PMID: 33768185 PMCID: PMC7972950 DOI: 10.2490/prm.20210016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/03/2021] [Indexed: 11/09/2022] Open
Abstract
Background Congenital limb deficiency is a rare and intractable anomaly of the limbs; however, prostheses can partially complement the motor function and appearance of the missing limbs. The first prosthesis is usually prescribed for children with upper limb deficiencies at approximately 6-8 months of age. In affected children with additional problems associated with motor function, such as limb paralysis, the age for initiating prosthetic therapy and the benefit of prostheses in promoting and expanding their motor function and activities is unknown. Case In this case presentation, we describe a 25-month-old boy with cerebral palsy and left unilateral congenital upper limb deficiency caused by congenital constriction band syndrome. The patient could stand with assistance and crawl on his hands and knees. However, he was unable to walk with assistance or to stand on his own. A forearm prosthesis with a passive hand was prescribed and issued, and rehabilitation therapy for wearing and using the prosthesis was performed. At 34 months of age, the patient was able to walk forward using a walker with the prosthesis. Without the prosthesis, he still could not walk using a walker. The upper limb prosthesis also improved other movements such as sitting, standing, and tasks performed on a desk or on the floor. Discussion The prosthesis was apparently effective in improving motor function. Prosthesis prescription should be considered at an appropriate and early age considering individual developmental stages and needs, regardless of the existence of additional problems associated with motor function.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan.,Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Emi Inakazu
- Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Satoko Noguchi
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Chika Nishizaka
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
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24
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Taketomi S, Kawaguchi K, Mizutani Y, Yamagami R, Sameshima S, Takei S, Kono K, Inui H, Tanaka S, Haga N. Anthropometric and musculoskeletal gender differences in young soccer players. J Sports Med Phys Fitness 2021; 61:1212-1218. [PMID: 33555664 DOI: 10.23736/s0022-4707.21.11617-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to clarify potential gender differences across a comprehensive set of anthropometric and musculoskeletal characteristics within a young soccer player population. METHODS This study included 227 (121 males and 106 females with mean ages of 19.0 and 17.5 years, respectively) young elite soccer players. Anthropometric measurements were obtained. In addition, general joint laxity tests assessing the wrist, elbow, shoulder, trunk, hip, knee, and ankle were performed. Muscle flexibility tests were performed on the iliopsoas, quadriceps femoris, hamstring, gastrocnemius, and soleus muscles. Moreover, isometric knee extension and flexion strength and isometric hip abduction strength were measured. Single- and double-leg balance tests were also performed. RESULTS Male soccer players were taller, heavier, and had lower fat mass and percent body fat, and greater skeletal muscle mass and body minerals than female soccer players. Female soccer players had significantly greater laxity in all tests for general joint laxity. Female soccer players demonstrated significantly better hamstring and soleus flexibility than male soccer players but worse iliopsoas flexibility. Consequently, no significant differences were noticed in the quadriceps and gastrocnemius muscles between the male and female soccer players. However, female soccer players demonstrated significantly weaker knee extension and flexion and hip abduction. The hamstring- quadriceps ratio was significantly lower in female soccer players. Although no significant difference exists in the center of pressure excursion in the double-leg balance test between male and female soccer players, female soccer players displayed a significantly lower center of pressure excursion in the single-leg balance test. CONCLUSIONS Young male and female soccer players demonstrate significantly different anthropometric and musculoskeletal profiles.
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Affiliation(s)
- Shuji Taketomi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan - .,UTokyo Sports Science Initiative, The University of Tokyo, Bunkyo-ku, Tokyo, Japan -
| | - Kohei Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,UTokyo Sports Science Initiative, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuri Mizutani
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,UTokyo Sports Science Initiative, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryota Yamagami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shin Sameshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Seira Takei
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kenichi Kono
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Inui
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Nobuhiko Haga
- UTokyo Sports Science Initiative, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Rehabilitaion Medicine, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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25
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Umezaki S, Shinoda Y, Mukasa A, Tanaka S, Takayanagi S, Oka H, Tagawa H, Haga N, Yoshino M. Factors associated with health-related quality of life in patients with glioma: impact of symptoms and implications for rehabilitation. Jpn J Clin Oncol 2020; 50:990-998. [PMID: 32484212 DOI: 10.1093/jjco/hyaa068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 04/29/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The factors associated with health-related quality of life in patients with glioma remain unclear; particularly, the impact of symptoms on quality of life has not been studied comprehensively. This study aims to document the quality of life of patients with glioma and clarify the impact of symptoms. METHODS In this cross-sectional study, participants were recruited from patients at The University of Tokyo Hospital and from patients who were registered at the Japan Brain Tumor Alliance. We included adult patients with World Health Organization grade II-IV glioma and excluded those with disturbances of consciousness or aphasia. We used the European Organization for Research and Treatment of Cancer QLQ-C30 and BN20 to evaluate quality of life and the symptoms. Multiple regression analyses were performed to investigate the impact of symptoms on European Organization for Research and Treatment of Cancer global health status and QLQ-C30 social functioning. In addition, we performed univariate subgroup analyses classified by World Health Organization grade and history of chemotherapy. RESULTS This study included 76 patients. Seven symptoms occurred in more than 50% of the patients: fatigue, future uncertainty, drowsiness, communication deficit, financial difficulties, motor dysfunction and weakness of legs. Multiple regression analyses showed that insomnia affected their global health status, and appetite loss, financial difficulties and motor dysfunction were significantly related to their social functioning. In subgroup analysis, the number of symptom subscales that were significantly related to global health status and social functioning was larger in World Health Organization grade II patients compared with grade III/IV patients. CONCLUSIONS In addition to neurological deficits, symptoms were associated with poor quality of life in patients with glioma. This study provided the basis on further investigation of usefulness of symptom evaluation on quality of life improvement.
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Affiliation(s)
- Shigeko Umezaki
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan.,Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shota Tanaka
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | | | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Mariko Yoshino
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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26
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Shinoda Y, Sawada R, Ishibashi Y, Akiyama T, Zhang L, Hirai T, Oka H, Ohki T, Ikegami M, Okajima K, Okuma T, Kobayashi H, Goto T, Haga N, Tanaka S. Prediction of pathological fracture in patients with lower limb bone metastasis using computed tomography imaging. Clin Exp Metastasis 2020; 37:607-616. [PMID: 32737738 DOI: 10.1007/s10585-020-10053-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
Lower limb pathological fractures caused by bone metastases can severely impair activities of daily living, so recognizing fracture risk is essential. Medial cortical involvement (MCI) in the proximal femur has been demonstrated to affect bone strength in biomechanical studies, but it has not been investigated in real patients. Between 2012 and 2019, 161 bone metastases with computed tomography (CT) images were retrospectively examined. Twenty-nine fractures were observed including 14 metastases with pathological fractures at the first examination, and prophylactic surgery was performed for 50 metastases. We extracted clinicopathological data using CT images, including patient's background, MCI in the proximal femur, site, size, circumferential cortical involvement (CCI), pain, and nature of metastasis. Cox proportional hazard regression analyses were performed, and we created integer scores for predicting fractures. We revealed that MCI, CCI, lytic dominant lesion, and pain were significant factors by univariate analyses. By multivariable analysis, MCI and each 25% CCI were significant and integer score 1 was assigned based on hazard ratio. The full score was four points, with MCI in the proximal femur (one point) and ≥ 75% CCI (three points). With integer score two, sensitivity was 88.9% and specificity was 81.2% for predicting fracture within 60 days. In conclusion, MCI and CCI examined by CT images were the risk factors for pathological fracture. CCI ≥ 50% is a widely known risk factor, but in addition, it may be better to consider surgery if MCI in the proximal femur is observed in metastasis with 25-50% CCI.
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Affiliation(s)
- Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Ryoko Sawada
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuki Ishibashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Toru Akiyama
- Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Liuzhe Zhang
- Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Toshihide Hirai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Takahiro Ohki
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masachika Ikegami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Okajima
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Tomotake Okuma
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Goto
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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27
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Matsuoka M, Tsukamoto S, Orihara Y, Kawamura R, Kuratani M, Haga N, Ikebuchi K, Katagiri T. Design of primers for direct sequencing of nine coding exons in the human ACVR1 gene. Bone 2020; 138:115469. [PMID: 32512165 DOI: 10.1016/j.bone.2020.115469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 01/13/2023]
Abstract
The human ACVR1 gene encodes a transmembrane protein consisting of 509 amino acids called activin A receptor, type I (ACVR1) or activin receptor-like kinase 2 (ALK2) and has nine coding exons. The ALK2 protein functions as a signaling receptor for ligands of the transforming growth factor-β family. In the human ACVR1 gene, approximately 20 types of heterozygotic mutations in the coding exons have been associated with congenital disorders and somatic cancer, such as fibrodysplasia ossificans progressiva (FOP), diffuse intrinsic pontine glioma, diffuse idiopathic skeletal hyperostosis and some congenital heart disorders. In the present study, we designed primers for direct sequencing of the nine coding exons in the human ACVR1 gene. The reliability of the primers was examined by PCR and DNA sequencing using genomic DNA prepared from peripheral blood or swab samples of three patients with FOP who had different mutations in the ACVR1 gene. A single nucleotide heterozygotic mutation was identified in each genomic sample without additional mutations in other regions. Therefore, the primers designed for the nine coding exons of the ACVR1 gene could be useful for the genetic diagnosis of patients who may have disorders associated with mutations in the ACVR1 gene.
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Affiliation(s)
- Masaru Matsuoka
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan; Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan
| | - Sho Tsukamoto
- Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan; Division of Biomedical Sciences, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yuta Orihara
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan
| | - Rieko Kawamura
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan
| | - Mai Kuratani
- Division of Biomedical Sciences, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Ikebuchi
- Department of Clinical Laboratory, Saitama Medical University, Saitama, Japan; Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan.
| | - Takenobu Katagiri
- Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan; Division of Biomedical Sciences, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan.
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Mano H, Fujiwara S, Haga N. Effect of prostheses on children with congenital upper limb deficiencies. Pediatr Int 2020; 62:1039-1043. [PMID: 32329154 DOI: 10.1111/ped.14265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 03/18/2020] [Accepted: 04/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individual weaknesses in motor skills are a characteristic of children with congenital upper limb deficiencies. These weaknesses increase with age. In Japan, however, prosthetic prescription and subsequent rehabilitation approaches for children with upper limb deficiencies are insufficient and often delayed. This study aimed to elucidate whether rehabilitation approaches, including prostheses prescription and occupational therapy, improve these children's adaptive behaviors, especially their motor skills. METHODS The study included nine children, aged 0-6 years, with unilateral transradial or transcarpal upper limb deficiencies. We measured their adaptive behaviors and motor skills at the beginning of prosthetic therapy and after 1.5 years, using the Vineland Adaptive Behavior Scales - Second Edition. RESULTS The score for the motor skills domain was significantly lower than the median score of the domains at the beginning of prosthetic therapy. The motor skill weaknesses significantly improved after 1.5 years of prosthetic therapy. CONCLUSIONS Although children with congenital upper limb deficiencies have individual weaknesses in their motor skill behavior, it was shown that these weaknesses can be improved through rehabilitation approaches, including occupational and prosthetic therapies. Issuing the appropriate prostheses and implementing the appropriate training to use the prostheses for congenital upper limb deficiencies are reasonable and meaningful interventions to improve quality of life.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
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29
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Taya M, Amiya E, Hatano M, Saito A, Nitta D, Maki H, Hosoya Y, Minatsuki S, Tsuji M, Sato T, Murakami H, Narita K, Konishi Y, Watanabe S, Yokota K, Haga N, Komuro I. Clinical importance of respiratory muscle fatigue in patients with cardiovascular disease. Medicine (Baltimore) 2020; 99:e21794. [PMID: 32846812 PMCID: PMC7447364 DOI: 10.1097/md.0000000000021794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Patients with cardiovascular diseases frequently experience exertional dyspnea. However, the relationship between respiratory muscle strength including its fatigue and cardiovascular dysfunctions remains to be clarified.The maximal inspiratory pressure/maximal expiratory pressure (MIP/MEP) before and after cardiopulmonary exercise testing (CPX) in 44 patients with heart failure and ischemic heart disease were measured. Respiratory muscle fatigue was evaluated by calculating MIP (MIPpost/MIPpre) and MEP (MEPpost/MEPpre) changes.The mean MIPpre and MEPpre values were 67.5 ± 29.0 and 61.6 ± 23.8 cm H2O, respectively. After CPX, MIP decreased in 25 patients, and MEP decreased in 22 patients. We evaluated the correlation relationship between respiratory muscle function including respiratory muscle fatigue and exercise capacity evaluated by CPX such as peak VO2 and VE/VCO2 slope. Among MIP, MEP, change in MIP, and change in MEP, only the value of change in MIP had an association with the value of VE/VCO2 slope (R = -0.36, P = .017). In addition, multivariate analysis for determining factor of change in MIP revealed that the association between the change in MIP and eGFR was independent from other confounding parameters (beta, 0.40, P = .017). The patients were divided into 2 groups, with (MIP change < 0.9) and without respiratory muscle fatigue (MIP change > 0.9), and a significant difference in peak VO2 (14.2 ± 3.4 [with fatigue] vs 17.4 ± 4.7 [without fatigue] mL/kg/min; P = .020) was observed between the groups.Respiratory muscle fatigue demonstrated by the change of MIP before and after CPX significantly correlated with exercise capacity and renal function in patients with cardiovascular disease.
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Affiliation(s)
- Masanobu Taya
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
- Department of Rehabilitation Medicine, the University of Tokyo Hospital
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, Tokyo
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, Tokyo
| | - Akihito Saito
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Hisataka Maki
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Yumiko Hosoya
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
- Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, Tokyo
| | - Shun Minatsuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Masaki Tsuji
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Tatsuyuki Sato
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Haruka Murakami
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Koichi Narita
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
| | - Yuto Konishi
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
- Department of Rehabilitation Medicine, the University of Tokyo Hospital
| | - Shogo Watanabe
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, Okayama Prefecture, Japan
| | - Kazuhiko Yokota
- Department of Rehabilitation Medicine, the University of Tokyo Hospital
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, the University of Tokyo Hospital
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo
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30
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Kojima T, Ishikawa H, Tanaka S, Haga N, Nishida K, Yukioka M, Hashimoto J, Miyahara H, Niki Y, Kimura T, Oda H, Asai S, Funahashi K, Kojima M, Ishiguro N. Relationship between the physician-based clinical scale for foot and ankle surgery and patient-reported outcomes in patients with long-standing rheumatoid arthritis: Results from a multicenter prospective observational cohort study. Mod Rheumatol 2020; 31:607-613. [PMID: 32643484 DOI: 10.1080/14397595.2020.1794101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To validate and establish targets for the physician-based clinical scale for foot surgery in rheumatoid arthritis (RA) patients based on patient-reported outcomes from a multicenter prospective cohort. METHODS We collected data on demographics, values from the RA foot and ankle scale by the Japanese Society for Surgery of the Foot (JSSF-RA), and patient-reported outcomes (PROs) including the Health Assessment Questionnaire Disability Index (HAQ-DI) before (baseline) and 6 and 12 months after joint surgery. Target values for JSSF-RA were determined according to the lower limit of the 95% CI of JSSF-RA in patients with HAQ-DI ≤0.5 after adjusting for age and sex. We used multiple linear regression analysis to examine potential predictors of JSSF-RA target achievement at baseline. RESULTS Cross-sectional analysis was conducted on data from 417 cases. The JSSF-RA target for foot and ankle surgery was set at 74 according to the JSSF-RA value corresponding to HAQ-DI ≤0.5 (mean 77.6, 95% CI: 74.3-80.9). Longitudinal analysis of patients who underwent foot surgery (N = 59) determined target cut-off values of 1.188 and 65 for HAQ-DI and JSSF-RA at baseline, respectively, as being predictive for achieving JSSF-RA ≥74 after surgery. CONCLUSIONS A JSSF-RA value of 74 represents an important target for patients with RA who have undergone foot surgery. In order to achieve this target, the timing of the surgery should be considered in the treatment of established RA patients.
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Affiliation(s)
- Toshihisa Kojima
- Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan
| | - Hajime Ishikawa
- Department of Rheumatology, Niigata Rheumatic Center, Niigata, Japan
| | - Sakae Tanaka
- Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Keiichiro Nishida
- Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masao Yukioka
- Department of Orthopedic Surgery, Yukioka Hospital, Osaka, Japan
| | - Jun Hashimoto
- Department of Rheumatology, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Japan
| | - Hisaaki Miyahara
- Department of Orthopedic Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasuo Niki
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoatsu Kimura
- Department of Orthopedic Surgery, University of Toyama, Faculty of Medicine, Toyama, Japan.,Shijonawate Gakuen University, Osaka, Japan
| | - Hiromi Oda
- Department of Orthopedic Surgery, Saitama Medical University, Morohongo Moroyama, Japan
| | - Shuji Asai
- Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan
| | - Koji Funahashi
- Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan.,Department of Orthopedic Surgery, Kariya-Toyota General Hospital, Kariya, Japan
| | - Masayo Kojima
- Department of Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Naoki Ishiguro
- Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan
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31
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Takeda JI, Nanatsue K, Yamagishi R, Ito M, Haga N, Hirata H, Ogi T, Ohno K. InMeRF: prediction of pathogenicity of missense variants by individual modeling for each amino acid substitution. NAR Genom Bioinform 2020; 2:lqaa038. [PMID: 33543123 PMCID: PMC7671370 DOI: 10.1093/nargab/lqaa038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 08/14/2019] [Revised: 03/03/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022] Open
Abstract
In predicting the pathogenicity of a nonsynonymous single-nucleotide variant (nsSNV), a radical change in amino acid properties is prone to be classified as being pathogenic. However, not all such nsSNVs are associated with human diseases. We generated random forest (RF) models individually for each amino acid substitution to differentiate pathogenic nsSNVs in the Human Gene Mutation Database and common nsSNVs in dbSNP. We named a set of our models ‘Individual Meta RF’ (InMeRF). Ten-fold cross-validation of InMeRF showed that the areas under the curves (AUCs) of receiver operating characteristic (ROC) and precision–recall curves were on average 0.941 and 0.957, respectively. To compare InMeRF with seven other tools, the eight tools were generated using the same training dataset, and were compared using the same three testing datasets. ROC-AUCs of InMeRF were ranked first in the eight tools. We applied InMeRF to 155 pathogenic and 125 common nsSNVs in seven major genes causing congenital myasthenic syndromes, as well as in VANGL1 causing spina bifida, and found that the sensitivity and specificity of InMeRF were 0.942 and 0.848, respectively. We made the InMeRF web service, and also made genome-wide InMeRF scores available online (https://www.med.nagoya-u.ac.jp/neurogenetics/InMeRF/).
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Affiliation(s)
- Jun-Ichi Takeda
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan
| | - Kentaro Nanatsue
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan
| | - Ryosuke Yamagishi
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan
| | - Mikako Ito
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hiromi Hirata
- Department of Chemistry and Biological Science, College of Science and Engineering, Aoyama Gakuin University, 5-10-1 Fuchinobe, Chuo-ku, Sagamihara 252-5258, Japan
| | - Tomoo Ogi
- Department of Genetics, Research Institute of Environmental Medicine (RIeM), Nagoya University, Furo, Chikusa-ku, Nagoya 464-8601, Japan
| | - Kinji Ohno
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan
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32
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Pignolo RJ, Cheung K, Kile S, Fitzpatrick MA, De Cunto C, Al Mukaddam M, Hsiao EC, Baujat G, Delai P, Eekhoff EMW, Di Rocco M, Grunwald Z, Haga N, Keen R, Levi B, Morhart R, Scott C, Sherman A, Zhang K, Kaplan FS. Self-reported baseline phenotypes from the International Fibrodysplasia Ossificans Progressiva (FOP) Association Global Registry. Bone 2020; 134:115274. [PMID: 32062004 DOI: 10.1016/j.bone.2020.115274] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 11/21/2022]
Abstract
A global, patient-reported registry has been established to characterize the course of disease and track clinical outcomes in patients with fibrodysplasia ossificans progressiva (FOP), an ultra-rare genetic condition of progressive heterotopic ossification (HO) that results in ankylosis of joints and renders most affected individuals immobile by the second decade of life. Here, we present baseline phenotypes on 299 patients (median age 21 years; range 0.1 to 78 years) from 54 countries based on aggregate data from the International FOP Association (IFOPA) Global Registry (the "FOP Registry"). The mean current age of the patients is 23.7 years (range, 0.1 to 78 years). Baseline characteristics are presented for FOP diagnosis, HO, flare-ups and precedent events, system-based prevalent symptomatology, encounters with medical and dental care providers, Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale scores, physical function, as well as the use of aids, assistive devices, and adaptations. Correlations of PROMIS Global Health scores with HO burden and physical function are calculated. Associations of joint mobility with PROMIS Global Health scores, physical function, and use of aids, assistive devices, and adaptations are summarized. Overall, the FOP Registry database contains a broad sample of the global FOP patient population, providing a useful tool for expanding knowledge of FOP, designing clinical trials and facilitating evidence-based decisions about the optimal monitoring and management of affected individuals.
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Affiliation(s)
- Robert J Pignolo
- Department of Medicine, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN, United States.
| | - Kin Cheung
- BioSAS Consulting, Inc., Wellesley, MA, United States
| | - Sammi Kile
- International FOP Association, 1520 Clay St, Suite H2, North Kansas City, MO, United States.
| | - Mary Anne Fitzpatrick
- International FOP Association, 1520 Clay St, Suite H2, North Kansas City, MO, United States.
| | - Carmen De Cunto
- Pediatric Rheumatology Section, Department of Pediatrics, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Mona Al Mukaddam
- Departments of Medicine and Orthopaedic Surgery, The Center for Research in FOP and Related Disorders, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, United States.
| | - Edward C Hsiao
- Division of Endocrinology and Metabolism, The UCSF Metabolic Bone Clinic, The Institute of Human Genetics, the UCSF Program in Craniofacial Biology, Department of Medicine, University of California-San Francisco, San Francisco, CA, United States.
| | - Genevieve Baujat
- Departement de Genetique, Institut IMAGINE, Hôpital Necker-Enfants Malades, Paris, France.
| | - Patricia Delai
- Hospital Israelita Albert Einstein, Instituto de Ensino e Pesquisa, São Paulo, SP, Brazil.
| | - Elisabeth M W Eekhoff
- VU Medical Center Amsterdam, Department of Internal Medicine/Section Endocrinology, Amsterdam, the Netherlands.
| | - Maja Di Rocco
- Unit of Rare Diseases, Department of Pediatrics, Giannina Gaslini Institute, Genoa, Italy.
| | - Zvi Grunwald
- Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA, United States.
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Richard Keen
- Centre for Metabolic Bone Disease, Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom.
| | - Benjamin Levi
- Department of Surgery, University of Michigan, Ann Arbor, MI, United States.
| | - Rolf Morhart
- Department of Pediatrics, Klinikum Garmisch-Partenkirchen GmbH, Garmisch-Partenkirchen, Germany.
| | - Christiaan Scott
- Department of Paediatric Rheumatology, Red Cross Children's Hospital, Cape Town, South Africa.
| | - Adam Sherman
- International FOP Association, 1520 Clay St, Suite H2, North Kansas City, MO, United States.
| | - Keqin Zhang
- Tongji Hospital, Shanghai Tongji University, Shanghai, PR China
| | - Fredrick S Kaplan
- Departments of Orthopaedic Surgery and Medicine, The Center for Research in FOP & Related Disorders, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, United States.
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Abstract
BACKGROUND It is advantageous to effectively develop motor functions and a deep understanding of one's body (for example, relative positions, relationships, names, and functions of body parts). It has been reported that lexical-semantic knowledge of the defective body part is diminished in children with congenital lower limb deficiencies, and the features of body knowledge in children with congenital upper limb deficiencies (ULDs) have not been clarified. This study aimed to explore how children with ULDs perceive their bodies. METHODS Participants included six children with congenital ULDs and 14 control children, aged 5-11 years. They drew self-portraits and answered questions about the names of body parts. RESULTS Children with ULDs were significantly more likely to omit hands in their self-portraits than the control children. In the verbal tests, children with ULDs had a lower rate of correct responses concerning upper limbs, arms, hands, legs, and feet than the control children. CONCLUSION Children with ULDs have diminished visuospatial body knowledge of the hands, as well as diminished lexical-semantic body knowledge of both the upper and lower limbs.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital
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34
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Matsushita M, Mishima K, Yamashita S, Haga N, Fujiwara S, Ozono K, Kubota T, Kitaoka T, Ishiguro N, Kitoh H. Impact of fracture characteristics and disease-specific complications on health-related quality of life in osteogenesis imperfecta. J Bone Miner Metab 2020; 38:109-116. [PMID: 31463628 DOI: 10.1007/s00774-019-01033-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/03/2019] [Accepted: 07/13/2019] [Indexed: 02/06/2023]
Abstract
Osteogenesis imperfecta (OI) is a connective tissue disease with bone fragility. Several studies have indicated that physical function in adult OI was correlated to the disease severity, but there have been no reports delineating the impact of the fracture characteristics and disease-specific complications on health-related quality of life (HRQoL). The purpose of this study is to clarify the factors impacted on HRQoL in adult OI patients. We conducted a cross-sectional study between July 2016 and March 2018 and sent a questionnaire regarding HRQoL using Short Form-36 (SF-36) to the OI patients at the age of 20 years or older who had a medical history of the investigators' institutions. The 40 patients completely answered the SF-36. Mental component summary and role/social component summary were unremarkable. Physical component summary (PCS) was significantly associated with z-score for height, teeth abnormality, and cardiopulmonary insufficiency (partial regression coefficient, 3.04, - 9.70, and - 11.35; p, < 0.001, 0.047, and 0.025, respectively). PCS was also significantly lower in the patients who had an initial fracture before the age of 2 years than those without occurrence of fractures until 2 years old (25.80 ± 17.15 versus 44.20 ± 16.54; p = 0.002), or those who had lower extremity fractures more than five times as compared with normal populations. Physical function was decreased in OI patients who had fractures before 2 years old, especially in lower extremity. Appropriate medical managements for cardiopulmonary insufficiency are required not only to maintain physical function but also to decrease mortality.
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Affiliation(s)
- Masaki Matsushita
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan.
| | - Kenichi Mishima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan
| | | | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Taichi Kitaoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroshi Kitoh
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan
- Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, Obu, Japan
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35
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Haga N, Nakashima Y, Kitoh H, Kamizono J, Katagiri T, Saijo H, Tsukamoto S, Shinoda Y, Sawada R, Nakahara Y. Fibrodysplasia ossificans progressiva: Review and research activities in Japan. Pediatr Int 2020; 62:3-13. [PMID: 31774601 DOI: 10.1111/ped.14065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/06/2018] [Revised: 04/11/2019] [Accepted: 05/15/2019] [Indexed: 01/08/2023]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is a rare genetic skeletal disorder manifesting progressive heterotopic ossification (HO) and congenital malformation of the great toes. Since 2007, we have conducted research on FOP. Here, we review the findings on FOP published to date, including the results of our research. Epidemiological studies in Japan have indicated that FOP has nearly the same prevalence in Japan as in the rest of the world. Basic research on its pathoetiology has progressed rapidly since the identification of the causal gene in 2006. Clinical and radiological findings have been thoroughly researched, including early radiological signs, and diagnostic criteria were established, designating FOP as an intractable disease in Japan. In patients with FOP, the progression of HO is associated with numerous disabilities, often manifesting in vicious cycles that can lead to early mortality. Through cross-sectional and short-term longitudinal studies, we have explored patient education, quality of life, and activities of daily living among Japanese patients. The management of FOP requires education of patients and caregivers, the use of medications to settle inflammation and flare-ups, instructions to ensure proper oral care, and other compensatory approaches that aid in rehabilitation. An avoidance of medical intervention, which may cause HO to progress, is also important. The advent of new drugs to prevent HO could have clinical benefit.
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Affiliation(s)
- Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Hiroshi Kitoh
- Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, Obu, Japan
| | - Junji Kamizono
- Emergency Care Services, Children's Medical Center, Kitakyushu City YAHATA Hospital, Kitakyushu, Japan
| | - Takenobu Katagiri
- Division of Pathophysiology, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan.,Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan
| | - Hideto Saijo
- Department of Oral and Maxillofacial Surgery, The University of Tokyo, Tokyo, Japan
| | - Sho Tsukamoto
- Division of Pathophysiology, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan.,Project of Clinical and Basic Research for FOP, Saitama Medical University, Saitama, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryoko Sawada
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuo Nakahara
- Department of Rehabilitation, Teikyo University, Tokyo, Japan
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36
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Shinoda Y, Kobayashi H, Kaneko M, Ohashi S, Bessho M, Hayashi N, Oka H, Imanishi J, Sawada R, Ogura K, Tanaka S, Haga N, Kawano H. Prediction of the pathological fracture risk during stance and fall-loading configurations for metastases in the proximal femur, using a computed tomography-based finite element method. J Orthop Sci 2019; 24:1074-1080. [PMID: 31521453 DOI: 10.1016/j.jos.2019.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/20/2019] [Accepted: 08/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND It is important to assess the fracture risk associated with metastasis in the proximal femur. The study aimed to clarify the effect of tumor location on the risk of pathological fracture of the proximal femur and investigate the fracture risk not only in the stance-loading configuration (SC), but also in the fall-loading configuration (FC) using a computed tomography (CT)-based finite element (FE) method based on a simulated metastatic model. METHODS The axial CT scans of the proximal femora of non-osteoporotic healthy men (n = 4; age range, 42-48 years) and osteoporotic post-menopausal women (n = 4; age range, 69-78 years) were obtained with a calibration phantom, from which the three-dimensional FE models were constructed. A single 15-mm-diameter spherical void simulating a tumor was created at various locations from the neck to subtrochanteric level. Nonlinear FE analyses were performed. RESULTS The mean predicted fracture loads without spherical voids in the SC were 7700 N in men and 4370 N in women. With the void at the medial femoral neck and in the region anteromedial to lesser trochanter, the mean predicted fracture load significantly reduced to 51.3% and 59.4% in men and 34.1% and 64.5% in women, respectively. The mean predicted fracture loads without a spherical void in the FC were 2500 N in men and 1862 N in women. With the void at the medial and posterior femoral neck, the predicted fracture load was significantly reduced to 65.7% and 79.7% in men and 48.3% and 65.4% in women, respectively. CONCLUSIONS These results showed that the risk of pathologic fracture was quite high in both the SC and FC when the lytic lesion existed along the principal compressive trabecular trajectory or posterior neck. Prophylactic intervention should be considered for metastases at these locations.
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Affiliation(s)
- Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan; Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
| | - Masako Kaneko
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Satoru Ohashi
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Masahiko Bessho
- Department of Orthopaedic Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Naoto Hayashi
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jungo Imanishi
- Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Ryoko Sawada
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Koichi Ogura
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
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Yamoto K, Saitsu H, Nishimura G, Kosaki R, Takayama S, Haga N, Tonoki H, Okumura A, Horii E, Okamoto N, Suzumura H, Ikegawa S, Kato F, Fujisawa Y, Nagata E, Takada S, Fukami M, Ogata T. Comprehensive clinical and molecular studies in split-hand/foot malformation: identification of two plausible candidate genes (LRP6 and UBA2). Eur J Hum Genet 2019; 27:1845-1857. [PMID: 31332306 DOI: 10.1038/s41431-019-0473-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/27/2019] [Accepted: 07/02/2019] [Indexed: 12/18/2022] Open
Abstract
Split-hand/foot malformation (SHFM) is a clinically and genetically heterogeneous condition. We sequentially performed screening of the previously identified Japanese founder 17p13.3 duplication/triplication involving BHLHA9, array comparative genomic hybridization, and whole exome sequencing (WES) in newly recruited 41 Japanese families with non-syndromic and syndromic SHFM. We also carried out WES in seven families with nonsyndromic and syndromic SHFM in which underlying genetic causes including pathogenic copy-number variants (CNVs) remained undetected in our previous studies of 56 families. Consequently, we identified not only known pathogenic CNVs (17p13.3 duplications/triplications [n = 21], 2q31 deletion [n = 1], and 10q24 duplications [n = 3]) and rare variants in known causative genes (TP63 [n = 3], DLX5 [n = 1], IGF2 [n = 1], WNT10B [n = 3], WNT10B/PORCN [n = 1], and PORCN [n = 1]), but also a de novo 19q13.11 deletion disrupting UBA2 (n = 1) and variants that probably affect function in LRP6 (n = 1) and UBA2 (n = 1). Thus, together with our previous data based on testing of 56 families, molecular studies for a total of 97 families with SHFM revealed underlying genetic causes in 75 families, and clinical studies for the 75 families indicated a certain degree of correlation between genetic causes and phenotypes. The results imply that SHFM primarily occurs as a genetic disorder with genotype-phenotype correlations. Furthermore, the results together with previous data such as the development of SHFM in Lrp6 knockout mice, the presence of SHFM in two subjects with 19q13 deletions involving UBA2, and strong mouse Uba2 expression in the developing limb buds, imply that LRP6 and UBA2 represent plausible candidate genes for SHFM.
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Affiliation(s)
- Kaori Yamoto
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hirotomo Saitsu
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Gen Nishimura
- Center for Intractable Diseases, Saitama Medical University Hospital, Iruma, Japan
| | - Rika Kosaki
- Division of Medical Genetics, National Center for Child Health and Development, Tokyo, Japan
| | - Shinichiro Takayama
- Division of Orthopedic Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Hidefumi Tonoki
- Department of Pediatrics, Sapporo Tenshi Hospital, Sapporo, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Nagakute, Japan
| | - Emiko Horii
- Department of Orthopedic Surgery, Nagoya First Red Cross Hospital, Nagoya, Japan
| | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Hiroshi Suzumura
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Shiro Ikegawa
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Fumiko Kato
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasuko Fujisawa
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Eiko Nagata
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shuji Takada
- Department of Systems BioMedicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Maki Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Tsutomu Ogata
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan. .,Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan.
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38
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Shinoda Y, Sawada R, Yoshikawa F, Oki T, Hirai T, Kobayashi H, Matsudaira K, Oka H, Tanaka S, Kawano H, Haga N. Factors related to the quality of life in patients with bone metastases. Clin Exp Metastasis 2019; 36:441-448. [DOI: 10.1007/s10585-019-09983-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/05/2019] [Indexed: 10/26/2022]
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39
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Goto M, Haga N, Takedani H. Physical activity and its related factors in Japanese people with haemophilia. Haemophilia 2019; 25:e267-e273. [PMID: 31132810 DOI: 10.1111/hae.13773] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 04/11/2019] [Accepted: 04/22/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In the general population, benefits of physical activity (PA) include improvement of physical function, prevention of lifestyle diseases and improvement of bone mineral content and quality of life. PA is recommended for patients with haemophilia (PwH), especially for those receiving advanced haemostatic treatment. We hypothesised many PwH engage in insufficient PA. AIM This study aimed to clarify PA levels and the associated factors in Japanese PwH. METHODS Physical activity was assessed using the International Physical Activity Questionnaire short version, and basic data, activities of daily living (ADLs) and self-efficacy were also collected. RESULTS A total of 106 questionnaires were completed. The average age of participant was 40.8 years. The median PA was 693.0 metabolic equivalent-min/wk. More than half of the participants (59.4%) were classified into the low activity group. PA showed a significant inverse correlation with age (P = 0.022) and a positive correlation with self-efficacy (P = 0.018). However, PA did not show a significant relationship with haemophilic severity, prophylactic treatment, annual intra-articular bleeding frequency, body mass index and ADL. In PwH receiving guidance in sports, such as activities that are safe to participate in or performing prophylaxis prior to a physical activity, self-efficacy was significantly higher (P = 0.033), ADL was better (P < 0.001), and mean age was younger (P = 0.01) than in those not receiving guidance in sports. CONCLUSION As for PA level, 60% of the subjects showed low activity. To promote PA in PwH, improvement of self-efficacy and appropriate guidance may be necessary.
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Affiliation(s)
- Miwa Goto
- Rehabilitation Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideyuki Takedani
- Department of Joint Surgery, Hospital of the Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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40
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Hirai T, Shinoda Y, Tateishi R, Asaoka Y, Uchino K, Wake T, Kobayashi H, Ikegami M, Sawada R, Haga N, Koike K, Tanaka S. Early detection of bone metastases of hepatocellular carcinoma reduces bone fracture and paralysis. Jpn J Clin Oncol 2019; 49:529-536. [DOI: 10.1093/jjco/hyz028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/03/2019] [Accepted: 02/12/2019] [Indexed: 02/07/2023] Open
Affiliation(s)
- Toshihide Hirai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Yoshinari Asaoka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Koji Uchino
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Taijiro Wake
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo
| | - Masachika Ikegami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo
| | - Ryoko Sawada
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo
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41
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Matsushita M, Kitoh H, Mishima K, Yamashita S, Haga N, Fujiwara S, Ozono K, Kubota T, Kitaoka T, Ishiguro N. Physical, Mental, and Social Problems of Adolescent and Adult Patients with Achondroplasia. Calcif Tissue Int 2019; 104:364-372. [PMID: 30706088 DOI: 10.1007/s00223-019-00518-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 01/03/2019] [Indexed: 12/26/2022]
Abstract
Patients with achondroplasia (ACH) require various medical interventions throughout the lifetime. Survey of health-related quality of life (HRQoL) in adult ACH patients is essential for the evaluation of treatment outcomes performed during childhood such as growth hormone administration and limb lengthening surgeries, but no study focused on the treatment strategy by analyzing HRQoL of ACH patients. The purpose of this study was to assess whether final height impacted on HRQoL and to evaluate what kinds of medical interventions were positively or negatively associated with HRQoL. We included 184 ACH patients (10-67 years old) who were registered in the patients' associations or who had a medical history of the investigators' institutions, and analyzed HRQoL by using Short Form-36 and patient demographics. Physical component summary (PCS) was significantly lower than the standard values in each age, especially in elderly populations, while mental component summary (MCS) was similar to the standard values. Role/social component summary was deteriorated only in elderly populations. The PCS was improved in the patients who had a height of 140 cm or taller (p < 0.001). The PCS and MCS were strongly associated with the past medical history of spine surgeries (p < 0.001 and p = 0.028, respectively). A treatment strategy would be planned to gain a final height of 140 cm or taller during childhood in combination with growth hormone administration and limb lengthening surgeries. Appropriate medical management for neurological complications of adult ACH patients is required to maintain physical and mental function.
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Affiliation(s)
- Masaki Matsushita
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan.
| | - Hiroshi Kitoh
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan
| | - Kenichi Mishima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan
| | | | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Taichi Kitaoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan
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42
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Mano H, Fujiwara S, Haga N. Body knowledge in children with congenital lower limb deficiency. Pediatr Int 2019; 61:158-165. [PMID: 30565809 DOI: 10.1111/ped.13757] [Citation(s) in RCA: 5] [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: 07/04/2018] [Revised: 08/27/2018] [Accepted: 10/26/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND In order to effectively improve motor function, a sound understanding of one's body - for example, relative spatial position, relationships, names and functions of body parts - is essential. The aim of this study was to explore how children with congenital lower limb deficiency (LLD) perceive their bodies, particularly their legs. METHODS Six children with congenital LLD and 14 controls, aged 5-12 years, were recruited for this study. They drew self-portraits and answered questions about names of body parts. These body part-related questions consisted of a production test, in which an examiner pointed to body parts on each child and asked the child to name them, and a comprehension test, in which the examiner mentioned body parts and asked the child to point to them on their own body. RESULTS No differences were found between the self-portraits of children with LLD and those of the control children. In the verbal tests, children with LLD responded correctly at lower rates to questions on body trunk, upper limbs, arms, hands and feet than the control children. CONCLUSION Children with LLD have diminished lexical-semantic body knowledge of the upper limbs and feet compared with children without LLD.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, University of Tokyo Hospital, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, University of Tokyo Hospital, Tokyo, Japan.,Department of Rehabilitation Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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43
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DeLisa J, Berbrayer D, Guzman J, Imamura M, Ceravolo M, Barotsis N, Michail X, Haga N, Li J, Wang TG, Huang AK, Chung S. 4.2 The education of the specialist of physical and rehabilitation medicine: Graduate medical education in residency training. J Int Soc Phys Rehabil Med 2019. [DOI: 10.4103/jisprm.jisprm_15_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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44
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kazuharu Takikawa
- Department of Pediatric Orthopedics, Shizuoka Children’s Hospital, 860 Urushiyama, Shizuoka 420-8860, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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45
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Hsiao EC, Di Rocco M, Cali A, Zasloff M, Al Mukaddam M, Pignolo RJ, Grunwald Z, Netelenbos C, Keen R, Baujat G, Brown MA, Cho TJ, De Cunto C, Delai P, Haga N, Morhart R, Scott C, Zhang K, Diecidue RJ, Friedman CS, Kaplan FS, Eekhoff EMW. Special considerations for clinical trials in fibrodysplasia ossificans progressiva (FOP). Br J Clin Pharmacol 2018; 85:1199-1207. [PMID: 30281842 PMCID: PMC6533500 DOI: 10.1111/bcp.13777] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/23/2018] [Accepted: 09/24/2018] [Indexed: 12/23/2022] Open
Abstract
Clinical trials for orphan diseases are critical for developing effective therapies. One such condition, fibrodysplasia ossificans progressiva (FOP; MIM#135100), is characterized by progressive heterotopic ossification (HO) that leads to severe disability. Individuals with FOP are extremely sensitive to even minor traumatic events. There has been substantial recent interest in clinical trials for novel and urgently‐needed treatments for FOP. The International Clinical Council on FOP (ICC) was established in 2016 to provide consolidated and coordinated advice on the best practices for clinical care and clinical research for individuals who suffer from FOP. The Clinical Trials Committee of the ICC developed a focused list of key considerations that encompass the specific and unique needs of the FOP community – considerations that are endorsed by the entire ICC. These considerations complement established protocols for developing and executing robust clinical trials by providing a foundation for helping to ensure the safety of subjects with FOP in clinical research trials.
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Affiliation(s)
- Edward C Hsiao
- Division of Endocrinology and Metabolism, and the Institute for Human Genetics, Department of Medicine, University of California, San Francisco, CA, USA
| | - Maja Di Rocco
- Unit of Rare Diseases, Department of Pediatrics, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Amanda Cali
- Radiant Hope Foundation and the Ian Cali FOP Research Fund, PENN Medicine, Center for Research in FOP & Related Disorders
| | - Michael Zasloff
- Departments of Orthopaedic Surgery and Genetics, The Center for Research in FOP & Related Disorders, University of Pennsylvania School of Medicine; and MedStar Georgetown Transplant Institute Georgetown University School of Medicine, Washington, DC, USA
| | - Mona Al Mukaddam
- Division of Endocrinology, Diabetes and Metabolism, Departments of Medicine and Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | | | - Zvi Grunwald
- Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Coen Netelenbos
- Department of Internal Medicine section Endocrinology, Amsterdam Bone Center, Amsterdam University Medical Centers location VUmc, Amsterdam, the Netherlands
| | - Richard Keen
- Royal National Orthopaedic Hospital, Stanmore, UK
| | - Genevieve Baujat
- Centre de Référence Maladies Osseuses Constitutionnelles, Departement de Génétique, Hôpital Necker-Enfants Malades, Institut Imagine, Paris, France
| | - Matthew A Brown
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Translational Research Institute, Woolloongabba, QLD, Australia
| | - Tae-Joon Cho
- Division of Pediatric Orthopaedics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Carmen De Cunto
- Pediatric Rheumatology Section, Department of Pediatrics, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Patricia Delai
- Hospital Israelita Albert Einstein, Instituto de Ensino e Pesquisa, São Paulo-SP, Brazil
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Rolf Morhart
- Department of Pediatrics, Klinikum Garmisch-Partenkirchen GmbH, Garmisch-Partenkirchen, Germany
| | - Christiaan Scott
- Paediatric Rheumatology, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Keqin Zhang
- Department of Endocrinology, Tongji Hospital, Shanghai Tongji University, Shanghai, China
| | - Robert J Diecidue
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Clive S Friedman
- Schulich School of Medicine and Dentistry, Pediatric Oral Health and Dentistry, London, ON, Canada
| | - Fredrick S Kaplan
- Departments of Medicine & Orthopaedic Surgery, Center for Research in FOP & Related Disorders, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elisabeth M W Eekhoff
- Department of Internal Medicine section Endocrinology, Amsterdam Bone Center, Amsterdam University Medical Centers location VUmc, Amsterdam, the Netherlands
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Yoshida M, Matsunaga A, Igawa Y, Fujimura T, Shinoda Y, Aizawa N, Sato Y, Kume H, Homma Y, Haga N, Sanada H. May perioperative ultrasound-guided pelvic floor muscle training promote early recovery of urinary continence after robot-assisted radical prostatectomy? Neurourol Urodyn 2018; 38:158-164. [PMID: 30375062 DOI: 10.1002/nau.23811] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/02/2018] [Indexed: 11/11/2022]
Abstract
AIMS The efficacy of perioperative pelvic floor muscle training (PFMT) for continence recovery after robot-assisted radical prostatectomy (RARP) remains unclear. Visualization of the bladder neck and urethra using transperineal ultrasound (US) may promote self-recognition of urethral closure during PFM contraction. This study aimed to examine whether transperineal US-guided PFMT promotes early recovery of post-RARP incontinence. METHODS This prospective cohort study included 116 men undergoing RARP. All men were offered to undergo transperineal US-guided PFMT, and 36 men agreed. The protocol consisted of biofeedback PFMT using transperineal US before RARP and 1-month after RARP with verbal instruction of PFMT immediately after urethral catheter removal. The remaining 80 patients received verbal instruction for PFMT alone. Continence recovery was defined as the number of days requiring a small pad (20 g) per day by self-report. RESULTS No differences were observed in demographic or peri-operative parameters between the two groups except the longer operative time in the US-guided PFMT group. The mean time until continence recovery was significantly shorter in the US-guided PFMT group (75.6 ± 100.0 days) than in the verbal-PFMT group (121.8 ± 132.0 days, P = 0.037). Continence recovery rates within 30 days were 52.8% (19/36) and 35.4% (28/80) in the US-guided PFMT and verbal-PFMT groups, respectively (P = 0.081). US-guided PFMT was associated with better postoperative continence status (adjusted hazard ratio [95% confidence interval]: 0.550 [0.336-0.900], P = 0.017). CONCLUSIONS The results showed that transperineal US-guided PFMT perioperatively was associated with early recovery of urinary continence after RARP.
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Affiliation(s)
- Mikako Yoshida
- Department of Imaging Nursing Science, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Global Nursing Research Center, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Akiko Matsunaga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yasuhiko Igawa
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoki Aizawa
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Sato
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Haruki Kume
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yukio Homma
- Japanese Red Cross Medical Center, Tokyo, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Gerongtological Nursing, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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47
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Kojima T, Ishikawa H, Tanaka S, Haga N, Nishida K, Yukioka M, Hashimoto J, Miyahara H, Niki Y, Kimura T, Oda H, Asai S, Funahashi K, Kojima M, Ishiguro N. Target setting for lower limb joint surgery using the Timed Up and Go test in patients with rheumatoid arthritis: A prospective cohort study. Int J Rheum Dis 2018; 21:1801-1808. [DOI: 10.1111/1756-185x.13394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/11/2018] [Accepted: 08/26/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Toshihisa Kojima
- Department of Orthopaedic Surgery; Nagoya University Hospital; Nagoya Japan
| | - Hajime Ishikawa
- Department of Rheumatology; Niigata Rheumatic Center; Niigata Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery; Faculty of Medicine; The University of Tokyo; Tokyo Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine; The University of Tokyo Hospital; Tokyo Japan
| | - Keiichiro Nishida
- Department of Orthopaedic Surgery; Dentistry and Pharmaceutical Sciences; Okayama University Graduate School of Medicine; Okayama Japan
| | - Masao Yukioka
- Department of Orthopaedic Surgery; Yukioka Hospital; Osaka Japan
| | - Jun Hashimoto
- Department of Rheumatology; National Hospital Organisation Osaka Minami Medical Center; Kawachinagano Japan
| | - Hisaaki Miyahara
- Department of Orthopaedic Surgery; National Hospital Organisation Kyushu Medical Center; Fukuoka Japan
| | - Yasuo Niki
- Department of Orthopaedic Surgery; Keio University School of Medicine; Tokyo Japan
| | - Tomoatsu Kimura
- Department of Orthopaedic Surgery; Faculty of Medicine; University of Toyama; Toyama Japan
| | - Hiromi Oda
- Department of Orthopaedic Surgery; Saitama Medical University; Morohongo Moroyama Japan
| | - Shuji Asai
- Department of Orthopaedic Surgery; Nagoya University Hospital; Nagoya Japan
| | - Koji Funahashi
- Department of Orthopaedic Surgery; Kariya-Toyota General Hospital; Kariya Japan
| | - Masayo Kojima
- Department of Medical Education; Nagoya City University Graduate School of Medical Sciences; Nagoya Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery; Nagoya University Hospital; Nagoya Japan
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Kaneoka A, Yang S, Inokuchi H, Ueha R, Yamashita H, Nito T, Seto Y, Haga N. Presentation of oropharyngeal dysphagia and rehabilitative intervention following esophagectomy: a systematic review. Dis Esophagus 2018; 31:5000038. [PMID: 29788321 PMCID: PMC6127108 DOI: 10.1093/dote/doy050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
No study has systematically reviewed the evidence on presentation of oropharyngeal dysphagia and swallowing rehabilitation following esophagectomy. The purposes of this systematic review are to 1) qualitatively synthesize the current findings on oropharyngeal swallowing abnormalities identified by instrumental swallowing evaluations, 2) describe the reported health-related outcomes in relation to swallowing abnormality following esophagectomy, and 3) examine the efficacy of reported rehabilitative interventions for oropharyngeal dysphagia in patients who underwent esophagectomy. Publications were searched using five electronic databases. No language or publication date restrictions were imposed. Two authors performed a blind review for published or unpublished studies that reported swallowing biomechanics and dysphagic symptoms using instrumental evaluation of swallowing, specifically the videofluoroscopic swallowing study and fiberoptic endoscopic evaluation of swallowing, and/or health-related outcomes in relation to swallowing abnormalities, and/or therapeutic interventions for oropharyngeal dysphagia following esophagectomy. Twelve studies out of 2,193 studies including 458 patients met the inclusion criteria. Reported abnormal swallowing biomechanics included vocal fold immobility, delayed onset of swallowing, reduced hyolaryngeal elevation, and reduced opening of the upper esophageal sphincter. Aspiration (0-81%) and pharyngeal residue (22-100%) were prevalent. Those abnormal swallowing biomechanics and swallowing symptoms were commonly reported following both transhiatal and transthoracic esophagectomy. Pneumonia presented in 5-25% of the study patients. One quasi-experimental study examined the effectiveness of swallowing exercises for postoperative oropharyngeal dysphagia; three case series reported a benefit of the chin-tuck maneuver in reducing aspiration and residue. This review revealed distinct swallowing impairments and increased pneumonia risks following esophagectomy. This review also found that evidence on the efficacy of therapeutic interventions was limited. Future studies are warranted to develop effective rehabilitative interventions for postesophagectomy patients with oropharyngeal dysphagia.
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Affiliation(s)
- A Kaneoka
- Rehabilitation Center, The University of Tokyo Hospital
| | - S Yang
- Department of Otolaryngology Head and Neck Surgery, The University of California, San Francisco, California, USA
| | - H Inokuchi
- Rehabilitation Center, The University of Tokyo Hospital
| | - R Ueha
- Department of Otorhinolaryngology and Head and Neck Surgery
| | - H Yamashita
- Department of Gastrointestinal Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - T Nito
- Department of Otorhinolaryngology and Head and Neck Surgery
| | - Y Seto
- Department of Gastrointestinal Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - N Haga
- Rehabilitation Center, The University of Tokyo Hospital
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Mano H, Fujiwara S, Takamura K, Kitoh H, Takayama S, Ogata T, Hashimoto S, Haga N. Congenital limb deficiency in Japan: a cross-sectional nationwide survey on its epidemiology. BMC Musculoskelet Disord 2018; 19:262. [PMID: 30053842 PMCID: PMC6064073 DOI: 10.1186/s12891-018-2195-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 07/16/2018] [Indexed: 12/30/2022] Open
Abstract
Background Congenital limb deficiency is a rare and intractable disease, which impairs both function and appearance of the limbs. To establish adequate medical care, it is necessary to reveal the actual conditions and problems associated with this disease. However, there have been no extensive epidemiological surveys in Japan addressing this disease. This is the first nationwide epidemiological survey of congenital limb deficiency in this country. Methods With the cooperation of epidemiology experts, we performed a two-stage nationwide survey to estimate the number of patients with congenital limb deficiency and reveal basic patient features. We targeted orthopaedic surgery, paediatric, and plastic surgery departments. Hospitals were categorized according to the institution type and the number of hospital beds; hospitals were randomly selected from these categories. We selected 2283 departments from a total 7825 departments throughout Japan. In this study, we defined congenital limb deficiency as partial or total absence of the limbs, proximal to the proximal interphalangeal joint of the fingers/lesser toes or interphalangeal joint of the thumb/great toe. We distributed the first survey querying the number of initial patient visits from January 2014 to December 2015. Targets of the second survey were departments that reported one or more initial patient visits in the first survey. Results In the first survey, 1767 departments responded (response rate: 77.4%). Among them, 161 departments reported one or more initial patient visits. We conducted the second survey among these 161 departments, of which 96 departments responded (response rate: 59.6%). The estimated number of initial visits by patients with congenital limb deficiency was 417 (95% confidence interval: 339–495) per year in 2014 and 2015. The estimated prevalence of congenital limb deficiency in Japan was 4.15 (95% confidence interval: 3.37–4.93) per 10,000 live births. The sex ratio was 1.40. Upper limbs were more affected than lower limbs. Conclusions We revealed the estimated number of initial patient visits per year and birth prevalence of congenital limb deficiency in Japan. Our results will contribute to establishing the disease concept and grades of severity of congenital limb deficiency. Electronic supplementary material The online version of this article (10.1186/s12891-018-2195-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hiroshi Mano
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Kazuyuki Takamura
- Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Hiroshi Kitoh
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichiro Takayama
- Department of Orthopaedic Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Tsutomu Ogata
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shuji Hashimoto
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan. .,Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Shinoda Y, Sawada R, Fujiwara S, Inokuchi H, Karasawa Y, Haga N. Prediction of the pathological fracture risk during stance and fall-loading configurations for metastases in the proximal femur, using a computed tomography-based finite element method. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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