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Yokogawa N, Demura S, Ohara T, Tauchi R, Takimura K, Yanagida H, Yamaguchi T, Watanabe K, Suzuki S, Uno K, Suzuki T, Watanabe K, Kotani T, Nakayama K, Oku N, Taniguchi Y, Murakami H, Yamamoto T, Kawamura I, Takeshita K, Sugawara R, Kikkawa I, Kawakami N. Instrumentation failure following pediatric spine deformity growth-sparing surgery using traditional growing rods or vertical expandable prosthetic titanium ribs. BMC Musculoskelet Disord 2024; 25:115. [PMID: 38331756 PMCID: PMC10851562 DOI: 10.1186/s12891-024-07211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Instrumentation failure (IF) is a major complication associated with growth-sparing surgery for pediatric spinal deformities; however, studies focusing on IF following each surgical procedure are lacking. We aimed to evaluate the incidence, timing, and rates of unplanned return to the operating room (UPROR) associated with IF following each surgical procedure in growth-sparing surgeries using traditional growing rods (TGRs) and vertical expandable prosthetic titanium ribs (VEPTRs). METHODS We reviewed 1,139 surgical procedures documented in a Japanese multicenter database from 2015 to 2017. Of these, 544 TGR and 455 VEPTR procedures were included for evaluation on a per-surgery basis. IF was defined as the occurrence of an implant-related complication requiring revision surgery. RESULTS The surgery-based incidences of IF requiring revision surgery in the TGR and VEPTR groups were 4.3% and 4.0%, respectively, with no significant intergroup difference. Remarkably, there was a negative correlation between IF incidence per surgical procedure and the number of lengthening surgeries in both groups. In addition, rod breakage in the TGR group and anchor-related complications in the VEPTR group tended to occur relatively early in the treatment course. The surgery-based rates of UPROR due to IF in the TGR and VEPTR groups were 2.0% and 1.5%, respectively, showing no statistically significant difference. CONCLUSIONS We found that IF, such as anchor related-complications and rod breakage, occurs more frequently earlier in the course of lengthening surgeries. This finding may help in patient counseling and highlights the importance of close postoperative follow-up to detect IF and improve outcomes.
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Affiliation(s)
- Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Ishikawa, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Ishikawa, Japan.
| | - Tetsuya Ohara
- Department of Orthopaedic Surgery, Meijo Hospital, Aichi, Japan
| | - Ryoji Tauchi
- Department of Orthopaedic Surgery, Meijo Hospital, Aichi, Japan
| | - Kosuke Takimura
- Department of Orthopaedic Surgery, Meijo Hospital, Aichi, Japan
| | - Haruhisa Yanagida
- Department of Orthopaedic and Spine Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Toru Yamaguchi
- Department of Orthopaedic and Spine Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Hyogo, Japan
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Hyogo, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University, Niigata, Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Keita Nakayama
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Norihiro Oku
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Ishikawa, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Iwate Medical University, Iwate, Japan
| | - Takuya Yamamoto
- Department of Orthopaedic Surgery, Kagoshima Red Cross Hospital, Kagoshima, Japan
| | - Ichiro Kawamura
- Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan
| | - Katsushi Takeshita
- Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Ryo Sugawara
- Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Ichiro Kikkawa
- Department of Pediatric Orthopedics, Jichi Children's Medical Center, Tochigi, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Aichi, Japan
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Yamauchi I, Nakashima H, Machino M, Ito S, Segi N, Tauchi R, Ohara T, Kawakami N, Imagama S. Rod fracture after multiple-rod technique for adult spinal deformity: a case report. Nagoya J Med Sci 2024; 86:135-141. [PMID: 38505719 PMCID: PMC10945232 DOI: 10.18999/nagjms.86.1.135] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/06/2023] [Indexed: 03/21/2024]
Abstract
Here we report the case of a 71-year-old woman who complained of lower back and left leg pain due to rod fracture following instrumented fusion using the lateral lumbar interbody fusion and multi-rod technique to treat adult spinal deformity. Radiographic images revealed bilateral rod fractures at L4-5 and pseudoarthrosis at L2-5; lower lumbar lordosis was minimal, but upper lumbar hyperlordosis was noted. The patient underwent revision surgery, which included posterior spinal instrument replacement, L3-4 and L4-5 lateral lumbar interbody fusion cage removal, and L4 vertebral body replacement via the anterior approach. This is a rare case of reoperation with the multi-rod technique. Revision surgery should be performed in consideration of the proportion of lumbar lordosis and anterior bony fusion as the posterior component is resected and bony fusion can only be achieved anteriorly.
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Affiliation(s)
- Ippei Yamauchi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Machino
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sadayuki Ito
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Segi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryoji Tauchi
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Tetsuya Ohara
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Ichinomiya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Maeda Y, Watanabe K, Kawakami N, Ohara T, Nakamura M, Matsumoto M. Surgical treatment for lumbar hyperlordosis associated with facioscapulohumeral muscular dystrophy: A case series. J Orthop Sci 2024; 29:428-433. [PMID: 35999089 DOI: 10.1016/j.jos.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/25/2022] [Accepted: 07/09/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Yoshihiro Maeda
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Noriaki Kawakami
- Department of Orthopedics & Spine Surgery, Meijo Hospital, Japan; Department of Othopedic Surgery, Ichinomiya Nishi Hospital, Japan
| | - Tetsuya Ohara
- Department of Orthopedics & Spine Surgery, Meijo Hospital, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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Nakashima H, Kawakami N, Ohara T, Saito T, Tauchi R, Imagama S. Cervical Spinal Cord Compression in Adult Scoliosis. Global Spine J 2023; 13:1576-1581. [PMID: 34494486 PMCID: PMC10448092 DOI: 10.1177/21925682211041979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES The aim was to examine cervical spinal cord compression (SCC) in adult scoliosis and clarify the prevalence of and risk factors for cervical SCC. METHODS This study included 270 adult scoliosis patients and 1211 healthy volunteers. Cervical SCC was evaluated on cervical magnetic resonance imaging (MRI). The rates of SCC for those with adult scoliosis and the healthy volunteers were compared. Logistic regression analysis was conducted to examine the factors associated with cervical SCC on MRI. RESULTS In cases with adult scoliosis, preoperative major scoliosis curve was 56.0° ± 18.8°, and cervical SCC was detected in 25 patients (9.3%). Among the healthy volunteers, 64 cases with cervical SCC were detected. Only in cases with adult scoliosis, logistic regression analysis revealed higher age (OR 1.09, 95% CI 1.04-1.14, P < .001), narrow canal diameter (OR 2.27, 95% CI 1.35-3.85, P = .002), and inferior sagittal balance (OR 2.45, 95% CI 1.02-5.89, P = .04) as significant risk factors. In the logistic regression analysis in all subjects (including adult scoliosis and healthy volunteers), higher age (OR 1.08, 95% CI 1.06-1.10, P < .001) and narrow canal diameter (OR 1.62, 95% CI 1.37-1.92, P < .001) were also found to be significant risk factors, but the presence of scoliosis was not a significant factor. CONCLUSIONS Adult scoliosis itself was not significantly associated with cervical SCC. Inferior sagittal balance in addition to scoliosis constituted a significant risk factor for cervical SCC.
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Affiliation(s)
- Hiroaki Nakashima
- Meijo Hospital, Nagoya, Japan
- Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Noriaki Kawakami
- Meijo Hospital, Nagoya, Japan
- Ichinomiyanishi Hospital, Ichinomiya, Japan
| | | | - Toshiki Saito
- Meijo Hospital, Nagoya, Japan
- Ichinomiyanishi Hospital, Ichinomiya, Japan
| | | | - Shiro Imagama
- Nagoya University Graduate School of Medicine, Nagoya, Japan
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Otomo N, Khanshour AM, Koido M, Takeda K, Momozawa Y, Kubo M, Kamatani Y, Herring JA, Ogura Y, Takahashi Y, Minami S, Uno K, Kawakami N, Ito M, Sato T, Watanabe K, Kaito T, Yanagida H, Taneichi H, Harimaya K, Taniguchi Y, Shigematsu H, Iida T, Demura S, Sugawara R, Fujita N, Yagi M, Okada E, Hosogane N, Kono K, Nakamura M, Chiba K, Kotani T, Sakuma T, Akazawa T, Suzuki T, Nishida K, Kakutani K, Tsuji T, Sudo H, Iwata A, Inami S, Wise CA, Kochi Y, Matsumoto M, Ikegawa S, Watanabe K, Terao C. Evidence of causality of low body mass index on risk of adolescent idiopathic scoliosis: a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1089414. [PMID: 37415668 PMCID: PMC10319580 DOI: 10.3389/fendo.2023.1089414] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/17/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Adolescent idiopathic scoliosis (AIS) is a disorder with a three-dimensional spinal deformity and is a common disease affecting 1-5% of adolescents. AIS is also known as a complex disease involved in environmental and genetic factors. A relation between AIS and body mass index (BMI) has been epidemiologically and genetically suggested. However, the causal relationship between AIS and BMI remains to be elucidated. Material and methods Mendelian randomization (MR) analysis was performed using summary statistics from genome-wide association studies (GWASs) of AIS (Japanese cohort, 5,327 cases, 73,884 controls; US cohort: 1,468 cases, 20,158 controls) and BMI (Biobank Japan: 173430 individual; meta-analysis of genetic investigation of anthropometric traits and UK Biobank: 806334 individuals; European Children cohort: 39620 individuals; Population Architecture using Genomics and Epidemiology: 49335 individuals). In MR analyses evaluating the effect of BMI on AIS, the association between BMI and AIS summary statistics was evaluated using the inverse-variance weighted (IVW) method, weighted median method, and Egger regression (MR-Egger) methods in Japanese. Results Significant causality of genetically decreased BMI on risk of AIS was estimated: IVW method (Estimate (beta) [SE] = -0.56 [0.16], p = 1.8 × 10-3), weighted median method (beta = -0.56 [0.18], p = 8.5 × 10-3) and MR-Egger method (beta = -1.50 [0.43], p = 4.7 × 10-3), respectively. Consistent results were also observed when using the US AIS summary statistic in three MR methods; however, no significant causality was observed when evaluating the effect of AIS on BMI. Conclusions Our Mendelian randomization analysis using large studies of AIS and GWAS for BMI summary statistics revealed that genetic variants contributing to low BMI have a causal effect on the onset of AIS. This result was consistent with those of epidemiological studies and would contribute to the early detection of AIS.
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Affiliation(s)
- Nao Otomo
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Anas M. Khanshour
- Center for Translational Research, Scottish Rite for Children, Dallas, TX, United States
| | - Masaru Koido
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Division of Molecular Pathology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kazuki Takeda
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Michiaki Kubo
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yoichiro Kamatani
- Division of Molecular Pathology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Laboratory of Complex Trait Genomics, Graduate School of Frontier Science, The University of Tokyo, Tokyo, Japan
| | - John A. Herring
- Department of Orthopaedic Surgery , Scottish Rite for Children, Dallas, TX, United States
- Department of Orthopaedic Surgery and Pediatric, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Yoji Ogura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Takahashi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shohei Minami
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Manabu Ito
- Department of Orthopaedic Surgery, National Hospital Organization, Hokkaido Medical Center, Sapporo, Japan
| | - Tatsuya Sato
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Haruhisa Yanagida
- Department of Orthopaedic and Spine Surgery, Fukuoka Children’s Hospital, Fukuoka, Japan
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Katsumi Harimaya
- Department of Orthopaedic Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideki Shigematsu
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
| | - Takahiro Iida
- Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
- Department of Orthopaedic Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery Graduated School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Ryo Sugawara
- Department of Orthopaedic Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Japan
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naobumi Hosogane
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Katsuki Kono
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Department of Orthopaedic Surgery, Kono Orthopaedic Clinic, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Chiba
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsuyoshi Sakuma
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsutomu Akazawa
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | - Kotaro Nishida
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taichi Tsuji
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akira Iwata
- Department of Preventive and Therapeutic Research for Metastatic Bone Tumor, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Inami
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Carol A. Wise
- Center for Translational Research, Scottish Rite for Children, Dallas, TX, United States
- Department of Orthopaedic Surgery and Pediatric, University of Texas Southwestern Medical Center, Dallas, TX, United States
- McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Yuta Kochi
- Department of Genomic Function and Diversity, Medical Research Institute, Tokyo Medical and Dental and University, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Clinical Research Center, Shizuoka General Hospital, Shizuoka, Japan
- Department of Applied Genetics, The School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
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Yamauchi I, Nakashima H, Machino M, Ito S, Segi N, Tauchi R, Ohara T, Kawakami N, Imagama S. Relationship between lumbosacral transitional vertebra and postoperative outcomes of patients with Lenke 5C adolescent idiopathic scoliosis: a minimum 5-year follow-up study. Eur Spine J 2023:10.1007/s00586-023-07752-y. [PMID: 37140639 DOI: 10.1007/s00586-023-07752-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE To assess the incidence of lumbosacral transitional vertebra (LSTV) in Lenke 5C adolescent idiopathic scoliosis (AIS) and evaluate the relationship between postoperative outcomes and LSTV when the lowest instrumented vertebra (LIV) is fixed at L3. METHODS The study included 61 patients with Lenke 5C AIS who underwent fusion surgery of L3 as the LIV who were followed-up for a minimum of 5 years. Patients were divided into two groups: LSTV + and LSTV-. Demographic, surgical, and radiographic data, including L4 tilt and thoracolumbar/lumbar (TL/L) Cobb angle, were obtained and analyzed. RESULTS LSTV was observed in 15 patients (24.5%). The L4 tilt was not significantly different between the two groups preoperatively (P = 0.54); however, it was significantly greater in the LSTV group postoperatively (2 weeks: LSTV + = 11.7 ± 3.1, LSTV - = 8.8 ± 3.2, P = 0.013; 2 years: LSTV + = 11.5 ± 3.5, LSTV - = 7.9 ± 4.1, P = 0.006; 5 years: LSTV + = 9.8 ± 3.1, LSTV - = 7.3 ± 4.5, P= 0.042). The postoperative TL/L curve was greater in the LSTV + group, with significant differences at 2 weeks and 2 years postoperatively (preoperative: LSTV + = 53.5 ± 11.2, LSTV - = 51.7 ± 10.3,P = 0.675; 2 weeks: LSTV + = 16.1 ± 5.0, LSTV- = 12.2 ± 6.6, P = 0.027; 2 years: LSTV + = 21.7 ± 5.9, LSTV - = 17.6 ± 5.9, P = 0.035; 5 years: LSTV + = 18.7 ± 5.8, LSTV - = 17.0 ± 6.1, P = 0.205). CONCLUSION The prevalence of LSTV in Lenke 5C AIS patients was 24.5%. Lenke 5C AIS patients with LSTV with the LIV at L3 had a significantly greater postoperative L4 tilt than those without LSTV and retained the TL/L curve.
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Affiliation(s)
- Ippei Yamauchi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
| | - Masaaki Machino
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Sadayuki Ito
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Naoki Segi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Ryoji Tauchi
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Tetsuya Ohara
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Ichinomiya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
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7
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Demura S, Ohara T, Tauchi R, Takimura K, Watanabe K, Suzuki S, Uno K, Suzuki T, Yanagida H, Yamaguchi T, Kotani T, Nakayama K, Watanabe K, Yokogawa N, Oku N, Tsuchiya H, Yamamoto T, Kawamura I, Taniguchi Y, Takeshita K, Sugawara R, Kikkawa I, Sato T, Fujiwara K, Akazawa T, Murakami H, Kawakami N. Incidence and causes of instrument-related complications after primary definitive fusion for pediatric spine deformity. J Neurosurg Spine 2023; 38:192-198. [PMID: 36461844 DOI: 10.3171/2022.8.spine22729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/19/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Various complications have been reported in the treatment of pediatric spinal deformities. Among these, instrument-related complications could be critical concerns and risks of reoperation. This study aimed to identify the incidence and causes of complications after primary definitive fusion for pediatric spine deformities. METHODS The authors retrospectively collected data from 14 institutions about patients who underwent primary definitive fusion between 2015 and 2017. There were 1490 eligible patients (1184 female and 306 male), with a mean age of 13.9 years. The incidence, causes, and reoperation rates were analyzed according to 4 etiologies of pediatric spine deformity (congenital, neuromuscular, syndromic, idiopathic). The complications were also categorized as screw-, hook-, or rod-related complications, implant loosening or backout, and junctional problems. RESULTS The incidence of overall instrument-related complications was 5.6% (84 cases). Regarding etiology, the incidence rates were 4.3% (idiopathic), 6.8% (syndromic), 7.9% (congenital), and 10.4% (neuromuscular) (p < 0.05). The most common causes were pedicle screw malposition (60.7%), followed by implant backout or loosening (15.4%), junctional problems (13.1%), rod breakage (4.8%), and other complications (6.0%). Univariate analysis showed that etiology, type of deformity (kyphosis), surgical procedure, operation time, and estimated blood loss were significant factors. Multivariate analysis revealed that etiology (neuromuscular), surgical procedure (combined approach), and operation time (> 5 hours) remained as significant risk factors. Among all patients with instrument-related complications, 45% (38/84) required revision surgery. Of these cases, > 50% were related to pedicle screw malposition. Medial breach was the most common complication regardless of location, from upper thoracic to lumbar spine. CONCLUSIONS Pedicle screw malposition was the primary cause of overall complications and subsequent reoperation. In addition to more precise screw insertion techniques, meticulous confirmation of pedicle screw placement, especially of medial breach, may reduce the overall instrument-related complications and revision rates.
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Affiliation(s)
- Satoru Demura
- 1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa
| | - Tetsuya Ohara
- 2Department of Orthopaedic Surgery, Meijo Hospital, Nagoya
| | - Ryoji Tauchi
- 2Department of Orthopaedic Surgery, Meijo Hospital, Nagoya
| | | | - Kota Watanabe
- 3Department of Orthopaedic Surgery, Keio University, Tokyo
| | - Satoshi Suzuki
- 3Department of Orthopaedic Surgery, Keio University, Tokyo
| | - Koki Uno
- 4Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe
| | - Teppei Suzuki
- 4Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe
| | - Haruhisa Yanagida
- 5Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Fukuoka
| | - Toru Yamaguchi
- 5Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Fukuoka
| | - Toshiaki Kotani
- 6Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Chiba
| | - Keita Nakayama
- 6Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Chiba
| | - Kei Watanabe
- 7Department of Orthopedic Surgery, Niigata University, Niigata
| | - Noriaki Yokogawa
- 1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa
| | - Norihiro Oku
- 1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa
| | - Hiroyuki Tsuchiya
- 1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa
| | - Takuya Yamamoto
- 8Department of Orthopaedic Surgery, Kagoshima Red Cross Hospital, Kagoshima
| | - Ichiro Kawamura
- 9Department of Orthopaedic Surgery, Kagoshima University, Kagoshima
| | - Yuki Taniguchi
- 10Department of Orthopaedic Surgery, The University of Tokyo, Tokyo
| | | | - Ryo Sugawara
- 11Department of Orthopedic Surgery, Jichi Medical University, Tochigi
| | - Ichiro Kikkawa
- 12Department of Pediatric Orthopedics, Jichi Children's Medical Center, Tochigi
| | - Tatsuya Sato
- 13Department of Orthopaedics, Juntendo University School of Medicine, Tokyo
| | - Kenta Fujiwara
- 14Department of Orthopaedics, Osaka Medical and Pharmaceutical University, Osaka
| | - Tsutomu Akazawa
- 15Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa
| | - Hideki Murakami
- 16Department of Orthopaedic Surgery, Iwate Medical University, Iwate; and
| | - Noriaki Kawakami
- 17Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Aichi, Japan
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8
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Yonezawa Y, Guo L, Kakinuma H, Otomo N, Yoshino S, Takeda K, Nakajima M, Shiraki T, Ogura Y, Takahashi Y, Koike Y, Minami S, Uno K, Kawakami N, Ito M, Yonezawa I, Watanabe K, Kaito T, Yanagida H, Taneichi H, Harimaya K, Taniguchi Y, Shigematsu H, Iida T, Demura S, Sugawara R, Fujita N, Yagi M, Okada E, Hosogane N, Kono K, Chiba K, Kotani T, Sakuma T, Akazawa T, Suzuki T, Nishida K, Kakutani K, Tsuji T, Sudo H, Iwata A, Sato T, Inami S, Nakamura M, Matsumoto M, Terao C, Watanabe K, Okamoto H, Ikegawa S. Identification of a Functional Susceptibility Variant for Adolescent Idiopathic Scoliosis that Upregulates Early Growth Response 1 (EGR1)-Mediated UNCX Expression. J Bone Miner Res 2023; 38:144-153. [PMID: 36342191 DOI: 10.1002/jbmr.4738] [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: 07/22/2022] [Revised: 10/23/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is a serious health problem affecting 3% of live births all over the world. Many loci associated with AIS have been identified by previous genome wide association studies, but their biological implication remains mostly unclear. In this study, we evaluated the AIS-associated variants in the 7p22.3 locus by combining in silico, in vitro, and in vivo analyses. rs78148157 was located in an enhancer of UNCX, a homeobox gene and its risk allele upregulated the UNCX expression. A transcription factor, early growth response 1 (EGR1), transactivated the rs78148157-located enhancer and showed a higher binding affinity for the risk allele of rs78148157. Furthermore, zebrafish larvae with UNCX messenger RNA (mRNA) injection developed body curvature and defective neurogenesis in a dose-dependent manner. rs78148157 confers the genetic susceptibility to AIS by enhancing the EGR1-regulated UNCX expression. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Yoshiro Yonezawa
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.,Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Long Guo
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan.,Department of Laboratory Animal Science, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Hisaya Kakinuma
- Laboratory for Neural Circuit Dynamics of Decision Making, RIKEN Brain Science Institute, Saitama, Japan
| | - Nao Otomo
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Soichiro Yoshino
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.,Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuki Takeda
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Nakajima
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Toshiyuki Shiraki
- Laboratory for Neural Circuit Dynamics of Decision Making, RIKEN Brain Science Institute, Saitama, Japan
| | - Yoji Ogura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Takahashi
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshinao Koike
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.,Department of Orthopedic Surgery, Graduate School of Medical Sciences, Hokkaido University, Sapporo, Japan
| | - Shohei Minami
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Koki Uno
- Department of Orthopedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | | | - Manabu Ito
- Department of Orthopedic Surgery, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Ikuho Yonezawa
- Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan
| | - Takashi Kaito
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Haruhisa Yanagida
- Department of Orthopedic Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Hiroshi Taneichi
- Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Katsumi Harimaya
- Department of Orthopedic Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Yuki Taniguchi
- Department of Orthopedic, Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideki Shigematsu
- Department of Orthopedic Surgery, Nara Medical University, Nara, Japan
| | - Takahiro Iida
- Department of Orthopedic Surgery, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Satoru Demura
- Department of Orthopedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
| | - Ryo Sugawara
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Nobuyuki Fujita
- Department of Orthopedic Surgery, Fujita Health University, Nagoya, Japan
| | - Mitsuru Yagi
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Eijiro Okada
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naobumi Hosogane
- Department of Orthopedic Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Katsuki Kono
- Department of Orthopedic Surgery, Kono Orthopaedic Clinic, Tokyo, Japan
| | - Kazuhiro Chiba
- Department of Orthopedic Surgery, National Defense Medical College, Saitama, Japan
| | - Toshiaki Kotani
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Tsuyoshi Sakuma
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Tsutomu Akazawa
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Teppei Suzuki
- Department of Orthopedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichiro Kakutani
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taichi Tsuji
- Department of Orthopedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akira Iwata
- Department of Preventive and Therapeutic Research for Metastatic Bone Tumor, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tatsuya Sato
- Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Satoshi Inami
- Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Kota Watanabe
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hitoshi Okamoto
- Laboratory for Neural Circuit Dynamics of Decision Making, RIKEN Brain Science Institute, Saitama, Japan
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
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9
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Minatogawa M, Tsuji T, Inaba M, Kawakami N, Mizuno S, Kosho T. Atypical Sotos syndrome caused by a novel splice site variant. Hum Genome Var 2022; 9:41. [PMID: 36379925 PMCID: PMC9666520 DOI: 10.1038/s41439-022-00219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022] Open
Abstract
Sotos syndrome is usually caused by haploinsufficiency of NSD1; it is characterized by overgrowth, craniofacial features, and learning disabilities. We describe a boy with Sotos syndrome caused by a splicing variant (c.4378+5G>A). The clinical manifestations included severe connective tissue involvement, including joint hypermobility, progressive scoliosis, pectus deformity, and skin hyperextensibility; no overgrowth was observed.
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Affiliation(s)
- Mari Minatogawa
- grid.263518.b0000 0001 1507 4692Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan ,grid.412568.c0000 0004 0447 9995Center for Medical Genetics, Shinshu University Hospital, Matsumoto, Japan
| | - Taichi Tsuji
- grid.410782.80000 0004 1771 9476Department of Orthopedics, Meijo Hospital, Nagoya, Japan ,grid.452852.c0000 0004 0568 8449Department of Orthopedics, Toyota Kosei Hospital, Toyota, Japan
| | - Mie Inaba
- grid.440395.f0000 0004 1773 8175Department of Pediatrics, Central Hospital, Aichi Developmental Disability Center, Kasugai, Japan
| | - Noriaki Kawakami
- grid.410782.80000 0004 1771 9476Department of Orthopedics, Meijo Hospital, Nagoya, Japan ,Department of Orthopedics, Ichinomiyanishi Hospital, Ichinomiya, Japan
| | - Seiji Mizuno
- grid.440395.f0000 0004 1773 8175Department of Pediatrics, Central Hospital, Aichi Developmental Disability Center, Kasugai, Japan
| | - Tomoki Kosho
- grid.263518.b0000 0001 1507 4692Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan ,grid.412568.c0000 0004 0447 9995Center for Medical Genetics, Shinshu University Hospital, Matsumoto, Japan ,grid.263518.b0000 0001 1507 4692Division of Clinical Sequencing, Shinshu University School of Medicine, Matsumoto, Japan ,grid.263518.b0000 0001 1507 4692Research Center for Supports to Advanced Science, Shinshu University, Matsumoto, Nagano, Japan
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10
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Iwahashi S, Lyu J, Tokumura K, Osumi R, Hiraiwa M, Kubo T, Horie T, Demura S, Kawakami N, Saito T, Park G, Fukasawa K, Iezaki T, Suzuki A, Tomizawa A, Ochi H, Hojo H, Ohba S, Hinoi E. Cover Image, Volume 237, Number 11, November 2022. J Cell Physiol 2022. [DOI: 10.1002/jcp.30926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Sayuki Iwahashi
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Jiajun Lyu
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Kazuya Tokumura
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Ryoma Osumi
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Manami Hiraiwa
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Takuya Kubo
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Tetsuhiro Horie
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences Kanazawa University Kanazawa Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery Ichinomiya Nishi Hospital Ichinomiya Japan
| | - Taku Saito
- Sensory and Motor System Medicine, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Gyujin Park
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Kazuya Fukasawa
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Takashi Iezaki
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Akane Suzuki
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Akane Tomizawa
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
| | - Hiroki Ochi
- Department of Rehabilitation for Motor Functions, Research Institute National Rehabilitation Center for Persons with Disabilities Tokorozawa, Saitama Japan
| | - Hironori Hojo
- Center for Disease Biology and Integrative Medicine, Graduate School of Medicine The University of Tokyo Tokyo Japan
- Department of Bioengineering, Graduate School of Engineering The University of Tokyo Tokyo Japan
| | - Shinsuke Ohba
- Department of Cell Biology, Institute of Biomedical Sciences Nagasaki University Nagasaki Japan
| | - Eiichi Hinoi
- Department of Bioactive Molecules, Pharmacology Gifu Pharmaceutical University Gifu Japan
- United Graduate School of Drug Discovery and Medical Information Sciences Gifu University Gifu Japan
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11
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Iwahashi S, Lyu J, Tokumura K, Osumi R, Hiraiwa M, Kubo T, Horie T, Demura S, Kawakami N, Saito T, Park G, Fukasawa K, Iezaki T, Suzuki A, Tomizawa A, Ochi H, Hojo H, Ohba S, Hinoi E. Conditional inactivation of the L-type amino acid transporter LAT1 in chondrocytes models idiopathic scoliosis in mice. J Cell Physiol 2022; 237:4292-4302. [PMID: 36161979 DOI: 10.1002/jcp.30883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/08/2022]
Abstract
Scoliosis, usually diagnosed in childhood and early adolescence, is an abnormal lateral curvature of the spine. L-type amino acid transporter 1 (LAT1), encoded by solute carrier transporter 7a5 (Slc7a5), plays a crucial role in amino acid sensing and signaling in specific cell types. We previously demonstrated the pivotal role of LAT1 on bone homeostasis in mice, and the expression of LAT1/SLC7A5 in vertebral cartilage of pediatric scoliosis patients; however, its role in chondrocytes on spinal homeostasis and implications regarding the underlying mechanisms during the onset and progression of scoliosis, remain unknown. Here, we identified LAT1 in mouse chondrocytes as an important regulator of postnatal spinal homeostasis. Conditional inactivation of LAT1 in chondrocytes resulted in a postnatal-onset severe thoracic scoliosis at the early adolescent stage with normal embryonic spinal development. Histological analyses revealed that Slc7a5 deletion in chondrocytes led to general disorganization of chondrocytes in the vertebral growth plate, along with an increase in apoptosis and a decrease in cell proliferation. Furthermore, loss of Slc7a5 in chondrocytes activated the general amino acid control (GAAC) pathway but inactivated the mechanistic target of rapamycin complex 1 (mTORC1) pathway in the vertebrae. The spinal deformity in Slc7a5-deficient mice was corrected by genetic inactivation of the GAAC pathway, but not by genetic activation of the mTORC1 pathway. These findings suggest that the LAT1-GAAC pathway in chondrocytes plays a critical role in the maintenance of proper spinal homeostasis by modulating cell proliferation and survivability.
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Affiliation(s)
- Sayuki Iwahashi
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Jiajun Lyu
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Kazuya Tokumura
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Ryoma Osumi
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Manami Hiraiwa
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Takuya Kubo
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Tetsuhiro Horie
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Ichinomiya, Japan
| | - Taku Saito
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gyujin Park
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Kazuya Fukasawa
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Takashi Iezaki
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Akane Suzuki
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Akane Tomizawa
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Hiroki Ochi
- Department of Rehabilitation for Motor Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama, Japan
| | - Hironori Hojo
- Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Ohba
- Department of Cell Biology, Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Eiichi Hinoi
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan.,United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Gifu, Japan
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12
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Demura S, Hinoi E, Kawakami N, Handa M, Yokogawa N, Hiraiwa M, Kato S, Shinmura K, Shimizu T, Oku N, Annen R, Kobayashi M, Yamada Y, Nagatani S, Iezaki T, Taniguchi Y, Tsuchiya H. The L-type Amino Acid Transporter (LAT1) Expression in Patients with Scoliosis. Spine Surg Relat Res 2022; 6:402-407. [PMID: 36051676 PMCID: PMC9381085 DOI: 10.22603/ssrr.2021-0189] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/11/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction Amino acid transporters are transmembrane proteins that are known to mediate the transfer of amino acids. As one of the amino acid transporters, LAT1, which is encoded by Slc7a5, mediates the cellular uptake of the essential amino acids. Recently, most studies have focused on examining the relationship between LAT1 and skeletal formation in terms of development. However, little is known regarding the clinical features of LAT1 in the cartilage, which might result in the development of skeletal deformities such as scoliosis. Thus, the aim of this study was to investigate the expression of L-type amino acid transporter 1 (LAT1) and its solute carrier transporter 7a5 (Slc7a5) in patients with pediatric scoliosis and to compare with the relationship between LAT1 and Slc7a5 expression and their clinical features. Methods We have prospectively recruited 56 patients who underwent corrective spinal fusion for scoliosis. The patients comprised 40 girls and 16 boys, with a mean age of 13.1 years at the time of surgery. There were 34 idiopathic scoliosis (IS) patients, whereas 22 were congenital scoliosis (CS) patients. During the surgery, an epiphyseal part of the spinous process at apical vertebra was harvested; then, LAT1 and Slc7a5 expressions in the cartilage were evaluated. Results As per our findings, LAT1 expression was observed in the cartilage in 60.7% (34 out of 56) of the patients. LAT1 expression in IS patients was 76%, which were statistically higher compared to 36% in CS patients. When compared with LAT1 expression, no statistical difference was noted in terms of age, gender, body mass index (BMI), Cobb angle, and Risser grade. Meanwhile, the mean Slc7a5 expression in IS patients was determined to be significantly higher than that in CS patients. No significant correlation was observed between Slc7a5 expression and age, BMI, and Cobb angle. Conclusions LAT1 and Slc7a5 expression in IS and CS patients showed significant differences. These expressions were found to be not correlated with age, stature, and severity of the deformity.
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Affiliation(s)
- Satoru Demura
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Eiichi Hinoi
- Department of Bioactive Molecules, Gifu Pharmaceutical University, Gifu, Japan.,United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Gifu, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Aichi, Japan
| | - Makoto Handa
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Noriaki Yokogawa
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Manami Hiraiwa
- Department of Bioactive Molecules, Gifu Pharmaceutical University, Gifu, Japan
| | - Satoshi Kato
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Kazuya Shinmura
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Takaki Shimizu
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Norihiro Oku
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Ryohei Annen
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Motoya Kobayashi
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Yohei Yamada
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Satoshi Nagatani
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
| | - Takashi Iezaki
- Department of Bioactive Molecules, Gifu Pharmaceutical University, Gifu, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery Graduate School of Medical Sciences Kanazawa University, Kanazawa, Japan
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13
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Machino M, Kawakami N, Ohara T, Saito T, Tauchi R, Imagama S. Factors affecting postoperative pulmonary function deterioration in adolescent idiopathic scoliosis: A prospective study using 3-dimensional image reconstruction by biplanar stereoradiography. J Clin Neurosci 2022; 98:182-188. [PMID: 35189542 DOI: 10.1016/j.jocn.2022.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
This study aimed both to evaluate rib cage parameters in patients with adolescent idiopathic scoliosis (AIS) by three-dimensional (3D) image reconstruction using biplanar stereoradiography (EOS) (EOS Imaging, Paris, France) and identify factors associated with postoperative pulmonary function deterioration (PFD). A total of 67 patients with Lenke type 1 or 2 AIS (59 females and 8 males; mean age, 14.4 years) undergoing posterior corrective fusion with a rod rotation maneuver based on segmental pedicle screw fixation were recruited. 3D images and pulmonary function test results were analyzed preoperatively and at 2 years postoperatively. The following parameters were measured: maximum thickness, maximum width, thoracic index, rib hump, rib cage volume (RCV), spinal penetration index (SPI), endothoracic hump ratio (EHR), vertebra-sternum angle (VSA), rib-vertebra angle difference, vertebral lateral decentering (VLD), forced vital capacity (FVC), and percent predicted FVC (%FVC). PFD was defined as a postoperative %FVC decline of 5% or greater. Patients were divided into two groups, namely PFD and non-PFD. FVC increased from 2.62 L to 2.73 L, while %FVC decreased from 88.7% to 82.7%. The maximum width diminished postoperatively in the PFD group. Patients in the PFD group exhibited a significantly smaller increase in RCV and VLD as well as a significantly smaller decrease in SPI, EHR, and VSA than those in the non-PFD group. The rib cage parameters quantified on 3D images reconstructed using EOS are useful in identifying factors affecting PFD in patients with AIS.
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Affiliation(s)
- Masaaki Machino
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Ichinomiyanishi Hospital, Ichinomiya, Japan.
| | - Tetsuya Ohara
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Toshiki Saito
- Department of Orthopedics and Spine Surgery, Ichinomiyanishi Hospital, Ichinomiya, Japan
| | - Ryoji Tauchi
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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14
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Sato T, Yonezawa I, Matsumoto H, Otomo N, Suzuki T, Manabe N, Demura S, Watanabe K, Saito T, Nohara A, Kurakawa T, Shimizu T, Uno K, Matsumoto M, Kawakami N. Surgical Predictors for Prevention of Postoperative Shoulder Imbalance in Lenke Type 2A Adolescent Idiopathic Scoliosis. Spine (Phila Pa 1976) 2022; 47:E132-E141. [PMID: 34075011 DOI: 10.1097/brs.0000000000004135] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Multicenter, retrospective cohort study. OBJECTIVE The aim of this study was to investigate the occurrence and surgical predictors of postoperative shoulder imbalance (PSI) in Lenke type 2A adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA Although several studies have investigated the factors influencing PSI in Lenke type 2 curves, no studies have analyzed PSI-related factors considering upper instrumented vertebra (UIV) and lumbar modifier type simultaneously. METHODS Patients with Lenke Type 2A AIS treated by spinal fusion were retrospectively identified and their data were extracted from six spine centers in Japan. Inclusion criteria were age between 10 and 20 years at surgery, UIV = T2, major curve 40° to 90°, and follow-up for 24 to 30 months after surgery. We analyzed patient characteristics, surgical characteristics, and preoperative and immediate-postoperative radiographic parameters. We defined patients with lower instrumented vertebra (LIV) equal or proximal to the last touching vertebra (LTV) as selective thoracic fusion (STF-LTV) and patients with LIV distal to the LTV as non-STF-LTV. t Tests, Mann-Whitney U test, χ2 tests, Fisher exact tests, and multivariate logistic regression were used for statistical analyses. RESULTS Among the 99 consecutive patients with a mean follow-up of 25.6 months, PSI was seen in 27 (27.3%) patients immediately after and in 17 (17.2%) patients at 24 to 30 months. The univariate analysis revealed that the significant risk factors of PSI were preoperative radiographical shoulder height, non-STF-LTV, and high main thoracic curve (MTC) correction (immediate-postoperative MTC correction rate: ≥70%), with PSI incidence of 40.0%. The multivariate logistic regression analysis indicated that interaction term of non-STF-LTV and high MTC correction was an independent risk factor for PSI (non-STF-LTV and high MTC correction, odds ratio: 5.167, 95% confidence interval: 1.470-18.159, P = 0.010). CONCLUSION To prevent PSI in Lenke Type 2A AIS patients, surgeons should avoid the combination of non-STF-LTV and high MTC correction in those surgeries with UIV as T2.Level of Evidence: 4.
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Affiliation(s)
- Tatsuya Sato
- Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan
| | - Ikuho Yonezawa
- Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan
- Department of Orthopaedic Surgery, Sangubashi Spine Surgery Hospital, Tokyo, Japan
| | - Hiroko Matsumoto
- Department of Orthopaedic Surgery, Columbia University Irving Medical Center, New York, NY
| | - Nao Otomo
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, Kobe Medical Center Kobe, Japan
| | - Nodoka Manabe
- Department of Orthopaedic Surgery, Gunma Spine Center, Takasaki, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Toshiki Saito
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Ayato Nohara
- Department of Orthopedic Surgery, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Takuto Kurakawa
- Department of Orthopaedic Surgery, Kobe Medical Center Kobe, Japan
| | - Takachika Shimizu
- Department of Orthopaedic Surgery, Gunma Spine Center, Takasaki, Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, Kobe Medical Center Kobe, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
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15
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Nakashima H, Kawakami N, Ohara T, Saito T, Tauchi R, Imagama S, Redding GJ. Does pulmonary function improve after surgical correction of adult idiopathic scoliosis? Spine Deform 2021; 9:1609-1616. [PMID: 34176081 DOI: 10.1007/s43390-021-00379-3] [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] [Received: 11/01/2020] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim was to investigate pulmonary function after surgical correction of adult idiopathic scoliosis. METHODS This study included 146 adult scoliosis patients aged 20-50 years (main curve in thoracic spine). Respiratory function was assessed as predicted forced vital capacity (%FVC) and the ratio of forced expiratory volume in 1 s / FVC (%FEV1) preoperatively and 2 years postoperatively and classified as a normal function (≥ 80%), mild impairment (≥ 65% and < 80%), and moderate impairment (< 65%). RESULTS Preoperative %FVC and %FEV1 were 85.3% and 85.4%, which were 81.5% and 87.5% at 2 years post-surgery. The preoperative %FVC was mild and moderate in 39 (26.7%) and 12 patients (11.6%), respectively. The %FVC significantly improved (+ 6.2% ± 11.4%, P < 0.001) postoperatively for moderate severity but significantly decreased postoperatively (- 6.4% ± 9.4%, P < 0.001) for normal function. The preoperative %FEV1 was mild and moderate in 27 (18.5%) and 0 patients, respectively. The %FEV1 significantly improved postoperatively (6.3% ± 5.3%, P < 0.001) for mild severity but did not significantly change for normal severity. Twenty-three (15.8%) and 41 (28.1%) patients showed improved ⊿%FVC and ⊿% FEV1 > 5%. Logistic regression analysis showed that preoperative %FVC and %FEV1 severities were independent factors affecting postoperative recovery of %FVC (OR 0.95) and %FEV1 (OR 0.85). CONCLUSION Pulmonary function improved in patients with preoperative pulmonary impairment of < 65% in %FVC and < 80% in %FEV1, and the real improvement was limited to patients with severe preoperative impairment.
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Affiliation(s)
- Hiroaki Nakashima
- Meijo Hospital Orthopedics and Spine Center, 1-3-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.,Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Noriaki Kawakami
- Meijo Hospital Orthopedics and Spine Center, 1-3-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan. .,Department of Orthopedics and Spine Surgery, Ichinomiyanishi Hospital, Ichinomiya, Japan. .,Department of Orthopedics and Spine Surgery, Meijo Hospital, 1-3-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.
| | - Tetsuya Ohara
- Meijo Hospital Orthopedics and Spine Center, 1-3-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Toshiki Saito
- Meijo Hospital Orthopedics and Spine Center, 1-3-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Ryoji Tauchi
- Meijo Hospital Orthopedics and Spine Center, 1-3-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Gregory J Redding
- Pediatric Pulmonary Division, Room OC.7.721, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98145, USA
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Mo AZ, Miller PE, Pizones J, Helenius I, Ruf M, El-Hawary R, de Oliveira RG, Ovadia D, Kawakami N, Crawford H, Odent T, Yazici M, Johnson MB, Miyanji F, Hedequist DJ. The reliability of the AOSpine Thoracolumbar Spine Injury Classification System in children: an international validation study. J Child Orthop 2021; 15:472-478. [PMID: 34858534 PMCID: PMC8582611 DOI: 10.1302/1863-2548.15.200188] [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: 03/16/2021] [Accepted: 08/03/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To evaluate the AOSpine Thoracolumbar Spine Injury Classification System and if it is reliable and reproducible when applied to the paediatric population globally. METHODS A total of 12 paediatric orthopaedic surgeons were asked to review MRI and CT imaging of 25 paediatric patients with thoracolumbar spine traumatic injuries, in order to determine the classification of the lesions observed. The evaluators classified injuries into primary categories: A, B and C. Interobserver reliability was assessed for the initial reading by Fleiss's kappa coefficient (kF) along with 95% confidence intervals (CI). For A and B type injuries, sub-classification was conducted including A0-A4 and B1-B2 subtypes. Interobserver reliability across subclasses was assessed using Krippendorff's alpha (αk) along with bootstrapped 95% CIs. A second round of classification was performed one-month later. Intraobserver reproducibility was assessed for the primary classifications using Fleiss's kappa and sub-classification reproducibility was assessed by Krippendorff's alpha (αk) along with 95% CIs. RESULTS In total, 25 cases were read for a total of 300 initial and 300 repeated evaluations. Adjusted interobserver reliability was almost perfect (kF = 0.74; 95% CI 0.71 to 0.78) across all observers. Sub-classification reliability was substantial (αk= 0.67; 95% CI 0.51 to 0.81), Adjusted intraobserver reproducibility was almost perfect (kF = 0.91; 95% CI 0.83 to 0.99) for both primary classifications and for sub-classifications (αk = 0.88; 95% CI 0.83 to 0.93). CONCLUSION The inter- and intraobserver reliability for the AOSpine Thoracolumbar Spine Injury Classification System was high amongst paediatric orthopaedic surgeons. The AOSpine Thoracolumbar Spine Injury Classification System is a promising option as a uniform fracture classification in children. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Andrew Z. Mo
- Department of Orthopaedic Surgery, Georgetown University Medical Center, Washington, District of Columbia, United States
| | - Patricia E. Miller
- Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States
| | - Javier Pizones
- Spine Unit, Hospital Universitario La Paz, Madrid, Spain
| | - Ilkka Helenius
- Professor and Chairman, Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Michael Ruf
- Center for Spinal Surgery, Orthopedics, and Traumatology, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
| | | | | | - Dror Ovadia
- Dana Dwek Children’s Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Noriaki Kawakami
- Director of Spine & Scoliosis Center, Department of Orthopedic Surgery, Ichinomiyanishi Hospital, Ichinomiya, Japan
| | - Haemish Crawford
- Paediatric Orthopaedic Surgeon, Starship Children’s Hospital, Auckland, New Zealand
| | - Thierry Odent
- Service de Chirurgie Orthopédique Pédiatrique, Université François Rabelais de Tours, PRES Centre-Val de Loire Université, Hôpital Gatien-de-Clocheville, Tours, France
| | - Muharrem Yazici
- Hacettepe University, Faculty of Medicine, Orthopaedics, Ankara, Turkey
| | | | - Firoz Miyanji
- Department of Orthopedics, British Columbia Children’s Hospital, Pediatric Orthopedics and Spine Surgery, Vancouver, British Columbia, Canada
| | - Daniel J. Hedequist
- Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States,Correspondence should be sent to Daniel J. Hedequist, Department of Orthopedic Surgery, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115United States. E-mail:
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17
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Watanabe K, Yamaguchi T, Suzuki S, Suzuki T, Nakayama K, Demura S, Taniguchi Y, Yamamoto T, Sugawara R, Sato T, Fujiwara K, Murakami H, Akazawa T, Kakutani K, Hirano T, Yanagida H, Watanabe K, Matsumoto M, Uno K, Kotani T, Takeshita K, Ohara T, Kawakami N. Surgical Site Infection Following Primary Definitive Fusion for Pediatric Spinal Deformity: A Multicenter Study of Rates, Risk Factors, and Pathogens. Spine (Phila Pa 1976) 2021; 46:1097-1104. [PMID: 33496537 DOI: 10.1097/brs.0000000000003960] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective multicenter study. OBJECTIVE To determine the surgical site infection (SSI) rate, associated risk factors, and causative pathogens in pediatric patients with spinal deformity. SUMMARY OF BACKGROUND DATA There have been no extensive investigations of the risk factors for SSI in Japan. METHODS Demographic data, radiographic findings, and the incidence of SSI were retrospectively analyzed in 1449 pediatric patients who underwent primary definitive fusion surgery for spinal deformity at any of 15 institutions from 2015 to 2017. SSI was defined according to the US Centers for Disease Control and Prevention guideline. RESULTS The incidence of all SSIs was 1.4% and that of deep SSIs was 0.76%. The most common pathogenic microbes were methicillin-resistant staphylococci (n = 5) followed by gram-negative rods (n = 4), methicillin-sensitive staphylococci (n = 1), and others (n = 10). In univariate analysis, younger age, male sex, a diagnosis of kyphosis, type of scoliosis, American Society of Anesthesiologists (ASA) class ≥3, mental retardation urinary incontinence, combined anterior-posterior fusion, greater magnitude of kyphosis, three-column osteotomy, use of blood transfusion, and number of antibiotic administration were associated with the likelihood of SSI (all P < 0.05). Multivariate logistic regression analysis identified the following independent risk factors for SSI: syndromic scoliosis etiology (vs. idiopathic scoliosis; adjusted odds ratio [OR] 16.106; 95% confidence interval [CI] 2.225-116.602), neuromuscular scoliosis etiology (vs. idiopathic scoliosis; adjusted OR 11.814; 95% CI 1.109-125.805), ASA class 3 (vs. class 2; adjusted OR 15.231; 95% CI 1.201-193.178), and administration of antibiotic therapy twice daily (vs. three times daily; adjusted OR 6.121; 95% CI 1.261-29.718). CONCLUSION The overall infection rate was low. The most common causative bacteria were methicillin-resistant followed by gram-negative rods. Independent risk factors for SSI in pediatric patients undergoing spinal deformity surgery were scoliosis etiology, ASA class 3, and administration of antibiotic therapy twice daily.Level of Evidence: 3.
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Affiliation(s)
- Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University School of Medicine, Niigata City, Niigata, Japan
| | - Toru Yamaguchi
- Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Higashi-ku, Fukuoka City, Fukuoka, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center, Suma-ku, Kobe City, Hyogo, Japan
| | - Keita Nakayama
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura City, Chiba, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa City, Ishikawa, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Takuya Yamamoto
- Department of Orthopaedic Surgery, Red Cross Kagoshima Hospital, Kagoshima City, Kagoshima, Japan
| | - Ryo Sugawara
- Department of Orthopaedic Surgery, Jichi Medical University School of Medicine, Shimotsuke City, Tochigi, Japan
| | - Tatsuya Sato
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenta Fujiwara
- Department of Orthopaedic Surgery, Osaka Medical College School of Medicine, Takatsuki City, Osaka, Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Iwate Medical University School of Medicine, Morioka City, Iwate, Japan
| | - Tsutomu Akazawa
- Department of Orthopaedic Surgery, St Marianna University School of Medicine, Miyamae-ku, Kawasaki City, Kanagawa, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University School of Medicine, chuou-ku, Kobe City, Hyogo, Japan
| | - Toru Hirano
- Department of Orthopaedic Surgery, Niigata University School of Medicine, Niigata City, Niigata, Japan
| | - Haruhisa Yanagida
- Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Higashi-ku, Fukuoka City, Fukuoka, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, National Hospital Organization Kobe Medical Center, Suma-ku, Kobe City, Hyogo, Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura City, Chiba, Japan
| | - Katsushi Takeshita
- Department of Orthopaedic Surgery, Jichi Medical University School of Medicine, Shimotsuke City, Tochigi, Japan
| | - Tetsuya Ohara
- Department of Orthopaedic Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi, Japan
- Department of Orthopaedic Surgery, Ichinomiyanishi Hospital, Ichinomiya City, Aichi, Japan
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18
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Otomo N, Lu HF, Koido M, Kou I, Takeda K, Momozawa Y, Kubo M, Kamatani Y, Ogura Y, Takahashi Y, Nakajima M, Minami S, Uno K, Kawakami N, Ito M, Sato T, Watanabe K, Kaito T, Yanagida H, Taneichi H, Harimaya K, Taniguchi Y, Shigematsu H, Iida T, Demura S, Sugawara R, Fujita N, Yagi M, Okada E, Hosogane N, Kono K, Nakamura M, Chiba K, Kotani T, Sakuma T, Akazawa T, Suzuki T, Nishida K, Kakutani K, Tsuji T, Sudo H, Iwata A, Kaneko K, Inami S, Kochi Y, Chang WC, Matsumoto M, Watanabe K, Ikegawa S, Terao C. Polygenic Risk Score of Adolescent Idiopathic Scoliosis for Potential Clinical Use. J Bone Miner Res 2021; 36:1481-1491. [PMID: 34159637 DOI: 10.1002/jbmr.4324] [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] [Received: 10/04/2020] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 12/12/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is a common disease causing three-dimensional spinal deformity in as many as 3% of adolescents. Development of a method that can accurately predict the onset and progression of AIS is an immediate need for clinical practice. Because the heritability of AIS is estimated as high as 87.5% in twin studies, prediction of its onset and progression based on genetic data is a promising option. We show the usefulness of polygenic risk score (PRS) for the prediction of onset and progression of AIS. We used AIS genomewide association study (GWAS) data comprising 79,211 subjects in three cohorts and constructed a PRS based on association statistics in a discovery set including 31,999 female subjects. After calibration using a validation data set, we applied the PRS to a test data set. By integrating functional annotations showing heritability enrichment in the selection of variants, the PRS demonstrated an association with AIS susceptibility (p = 3.5 × 10-40 with area under the receiver-operating characteristic [AUROC] = 0.674, sensitivity = 0.644, and specificity = 0.622). The decile with the highest PRS showed an odds ratio of as high as 3.36 (p = 1.4 × 10-10 ) to develop AIS compared with the fifth in decile. The addition of a predictive model with only a single clinical parameter (body mass index) improved predictive ability for development of AIS (AUROC = 0.722, net reclassification improvement [NRI] 0.505 ± 0.054, p = 1.6 × 10-8 ), potentiating clinical use of the prediction model. Furthermore, we found the Cobb angle (CA), the severity measurement of AIS, to be a polygenic trait that showed a significant genetic correlation with AIS susceptibility (rg = 0.6, p = 3.0 × 10-4 ). The AIS PRS demonstrated a significant association with CA. These results indicate a shared polygenic architecture between onset and progression of AIS and the potential usefulness of PRS in clinical settings as a predictor to promote early intervention of AIS and avoid invasive surgery. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Nao Otomo
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.,Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Hsing-Fang Lu
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Clinical Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Masaru Koido
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan.,Division of Molecular Pathology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Ikuyo Kou
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Kazuki Takeda
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Michiaki Kubo
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan.,Laboratory of Complex Trait Genomics, Graduate School of Frontier Science, The University of Tokyo, Tokyo, Japan
| | - Yoji Ogura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Takahashi
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Nakajima
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Shohei Minami
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Koki Uno
- Department of Orthopedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | | | - Manabu Ito
- Department of Orthopedic Surgery, National Hospital Organization, Hokkaido Medical Center, Sapporo, Japan
| | - Tatsuya Sato
- Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan
| | - Takashi Kaito
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Haruhisa Yanagida
- Department of Orthopedic & Spine Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Hiroshi Taneichi
- Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Katsumi Harimaya
- Department of Orthopedic Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Yuki Taniguchi
- Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideki Shigematsu
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
| | - Takahiro Iida
- First Department of Orthopedic Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Satoru Demura
- Department of Orthopedic Surgery, Graduate School of Medical Science Kanazawa University, Kanazawa, Japan
| | - Ryo Sugawara
- Department of Orthopedic Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Nobuyuki Fujita
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Orthopedic Surgery, Fujita Health University, Toyoake, Japan
| | - Mitsuru Yagi
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Eijiro Okada
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naobumi Hosogane
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Katsuki Kono
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.,Kono Orthopaedic Clinic, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Chiba
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Toshiaki Kotani
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsuyoshi Sakuma
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsutomu Akazawa
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Teppei Suzuki
- Department of Orthopedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichiro Kakutani
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taichi Tsuji
- Department of Orthopedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akira Iwata
- Department of Preventive and Therapeutic Research for Metastatic Bone Tumor, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuo Kaneko
- Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Satoshi Inami
- Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Yuta Kochi
- Department of Genomic Function and Diversity, Medical Research Institute, Tokyo Medical and Dental and University, Tokyo, Japan
| | - Wei-Chiao Chang
- Department of Clinical Pharmacy, Taipei Medical University, Taipei, Taiwan.,Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Taipei Medical University-Wangfang Hospital, Taipei, Taiwan.,Center for Biomarkers and Biotech Drugs, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan.,Clinical Research Center, Shizuoka General Hospital, Shizuoka, Japan.,Department of Applied Genetics, The School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
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19
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Hidaka Y, Sasaki N, Imamura K, Tsuno K, Kuroda R, Kawakami N. Changes in fears and worries related to COVID-19 during the pandemic among current employees in Japan: a 5-month longitudinal study. Public Health 2021; 198:69-74. [PMID: 34365108 PMCID: PMC8463081 DOI: 10.1016/j.puhe.2021.06.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/01/2022]
Abstract
Objectives This study investigates and describes the time course of fears and worries about COVID-19 among current employees during this outbreak. Study design This was a longitudinal study. Methods This study was a part of the Employee Cohort Study in Japan. The study comprised 4120 individuals from February 2019. A baseline survey in March 2020, a 2-month follow-up survey in May 2020, and a 5-month follow-up survey in August 2020 were conducted. Questions surveyed respondents’ global fear and worry and six items related to COVID-19. A mixed model for repeated measures of an analysis of variance was used. Results A total of 1421 respondents completed the baseline survey. At 2- and 5-month follow-ups, 1032 and 1181 respondents completed surveys, respectively. Of those, 64 and 33 individuals who were temporarily laid off or on leave were recorded as missing values. Global fear and worry about COVID-19 significantly increased from March to August 2020. Fears of personal or family infection, limiting one's activities and national and local government policies also significantly increased with time. In contrast, fears of lack of knowledge and difficulty of obtaining hygiene products significantly decreased. Conclusion To conduct efficient risk communication during a pandemic, knowing the concerns of the populace, providing correct information and a sufficient supply of products, and setting clear guidelines are essential.
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Affiliation(s)
- Y Hidaka
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 3-7-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda, Tokyo, 102-0083, Japan.
| | - N Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 3-7-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
| | - K Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 3-7-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
| | - K Tsuno
- School of Health Innovation, Kanagawa University of Human Services, Research Gate Building TONOMACHI2, 3-25-10, Tonomachi, Kawasaki-ku, Kawasaki-shi, 210-0821, Kanagawa, Japan.
| | - R Kuroda
- Division for Environment, Health and Safety, The University of Tokyo, 3-7-1 Hongo, Bunkyo, Tokyo, 113-8654, Japan.
| | - N Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 3-7-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
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20
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Kokabu T, Kanai S, Kawakami N, Uno K, Kotani T, Suzuki T, Tachi H, Abe Y, Iwasaki N, Sudo H. An algorithm for using deep learning convolutional neural networks with three dimensional depth sensor imaging in scoliosis detection. Spine J 2021; 21:980-987. [PMID: 33540125 DOI: 10.1016/j.spinee.2021.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 08/12/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Timely intervention in growing individuals, such as brace treatment, relies on early detection of adolescent idiopathic scoliosis (AIS). To this end, several screening methods have been implemented. However, these methods have limitations in predicting the Cobb angle. PURPOSE This study aimed to evaluate the performance of a three-dimensional depth sensor imaging system with a deep learning algorithm, in predicting the Cobb angle in AIS. STUDY DESIGN Retrospective analysis of prospectively collected, consecutive, nonrandomized series of patients at five scoliosis centers in Japan. PATIENT SAMPLE One hundred and-sixty human subjects suspected to have AIS were included. OUTCOME MEASURES Patient demographics, radiographic measurements, and predicted Cobb angle derived from the deep learning algorithm were the outcome measures for this study. METHODS One hundred and sixty data files were shuffled into five datasets with 32 data files at random (dataset 1, 2, 3, 4, and 5) and five-fold cross validation was performed. The relationships between the actual and predicted Cobb angles were calculated using Pearson's correlation coefficient analyses. The prediction performances of the network models were evaluated using mean absolute error and root mean square error between the actual and predicted Cobb angles. The shuffling into five datasets and five-fold cross validation was conducted ten times. There were no study-specific biases related to conflicts of interest. RESULTS The correlation between the actual and the mean predicted Cobb angles was 0.91. The mean absolute error and root mean square error were 4.0° and 5.4°, respectively. The accuracy of the mean predicted Cobb angle was 94% for identifying a Cobb angle of ≥10° and 89% for that of ≥20°. CONCLUSIONS The three-dimensional depth sensor imaging system with its newly innovated convolutional neural network for regression is objective and has significant ability to predict the Cobb angle in children and adolescents. This system is expected to be used for screening scoliosis in clinics or physical examination at schools.
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Affiliation(s)
- Terufumi Kokabu
- Department of Orthopedic Surgery, Hokkaido University Hospital, Nishi 5 Chome Kita 14 Jo, Kita Ward, Sapporo, Hokkaido 060-8648, Japan; Department of Orthopedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido 061-1449, Japan
| | - Satoshi Kanai
- Division of Systems Science and Informatics, Hokkaido University Graduate School of Information Science and Technology, Nishi 9 Chome Kita 13 Jo, Kita Ward, Sapporo, Hokkaido 060-0813, Japan
| | - Noriaki Kawakami
- Department of Orthopedic Surgery, Ichinomiyanishi Hospital, Ichinomiya, Kaimei, Aza Hira 1, 494-0001 Aichi, Japan
| | - Koki Uno
- Department of Orthopedic Surgery, National Hospital Organization, Kobe Medical Center, 3 Chome-1-1 Nishiochiai, Suma Ward, Kobe, Hyogo 654-0155, Japan
| | - Toshiaki Kotani
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, 2 Chome-36-2 Ebaradai, Sakura, Chiba 285-8765, Japan
| | - Teppei Suzuki
- Department of Orthopedic Surgery, National Hospital Organization, Kobe Medical Center, 3 Chome-1-1 Nishiochiai, Suma Ward, Kobe, Hyogo 654-0155, Japan
| | - Hiroyuki Tachi
- Department of Orthopedic Surgery, Hokkaido University Hospital, Nishi 5 Chome Kita 14 Jo, Kita Ward, Sapporo, Hokkaido 060-8648, Japan; Department of Orthopedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido 061-1449, Japan
| | - Yuichiro Abe
- Department of Orthopedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido 061-1449, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Hospital, Nishi 5 Chome Kita 14 Jo, Kita Ward, Sapporo, Hokkaido 060-8648, Japan
| | - Hideki Sudo
- Department of Orthopedic Surgery, Hokkaido University Hospital, Nishi 5 Chome Kita 14 Jo, Kita Ward, Sapporo, Hokkaido 060-8648, Japan; Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan.
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21
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Suzuki S, Fujiwara H, Nori S, Tsuji O, Nagoshi N, Okada E, Fujita N, Yagi M, Nohara A, Kawakami N, Michikawa T, Nakamura M, Matsumoto M, Watanabe K. Residual lumbar curvature that developed during adolescence accelerates intervertebral disc degeneration in adulthood. Spine Deform 2021; 9:711-720. [PMID: 33245504 DOI: 10.1007/s43390-020-00252-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To elucidate the influence of spinal deformity in adolescent idiopathic scoliosis (AIS) on lumbar intervertebral disc (IVD) degeneration in adulthood using magnetic resonance imaging (MRI). METHODS A total of 102 patients (8 men, 94 women; mean age, 31.4 years) who had developed idiopathic scoliosis at the age of 10-18 years and underwent preoperative lumbar spine MRI at the age of ≥ 20 were included in the study. Twenty volunteers (3 men, 17 women; mean age, 33.6 years) without scoliosis were assessed as controls. We divided the adult scoliosis patients into two groups: Group A consisted of patients with lumbar modifier A, and Group BC consisted of those with modifiers B and C. IVD degeneration from L1/2 to L5/S1 was assessed by MRI. The Scoliosis Research Society-22 (SRS-22) patient questionnaire was used in the patients' clinical assessment. RESULTS There were 40 patients in the Group A and 62 in the Group BC. Compared to the control groups, significant IVD degeneration was observed at L2/3 and L3/4 in Group A, and at all levels except for L5/S1 in Group BC. The proportion of degenerated IVDs patients (Grades 1c and 2) was significantly higher in Group BC than those in Group A at L3/L4 and L4/L5. Furthermore, the severity of IVD degeneration was significantly greater in the group BC than in the group A at all levels, except for L5/S1, especially in patients aged > 30 years. The mean scores of all subdomains in the SRS-22 questionnaire were comparable between the two groups. CONCLUSION Our study showed that the residual lumbar curvature from AIS may have accelerated IVD degeneration in adulthood, especially in patients aged > 30 years. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Hirokazu Fujiwara
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Nori
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Osahiko Tsuji
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, Fujita Health University, Aichi, Japan
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Ayato Nohara
- Department of Spine Surgery, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Japan
- Department of Orthopaedic Surgery, Ichinomiyanishi Hospital, Aichi, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
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22
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Taniguchi Y, Ohara T, Suzuki S, Watanabe K, Suzuki T, Uno K, Yamaguchi T, Yanagida H, Nakayama K, Kotani T, Watanabe K, Hirano T, Yamamoto T, Kawamura I, Sugawara R, Takeshita K, Demura S, Oku N, Sato T, Fujiwara K, Akazawa T, Murakami H, Kakutani K, Matsubayashi Y, Kawakami N. Incidence and Risk Factors for Unplanned Return to the Operating Room Following Primary Definitive Fusion for Pediatric Spinal Deformity: A Multicenter Study with Minimum 2-year Follow-Up. Spine (Phila Pa 1976) 2021; 46:E498-E504. [PMID: 33186273 DOI: 10.1097/brs.0000000000003822] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective multicenter cohort study. OBJECTIVE The aim of this study was to identify the incidence and risk factors for UPROR within minimum 2-year follow-up in primary definitive fusion for pediatric spinal deformity. SUMMARY OF BACKGROUND DATA Several previous reports have elucidated the incidence of complications after pediatric scoliosis surgery; however, there has been no study that described the incidence and risk factors for unplanned return to the operating room (UPROR) with long-term follow-up in surgery for pediatric scoliosis with every etiology. METHODS We retrospectively extracted data of patients aged <19 years, from 14 institutes in Japan, who underwent primary definitive fusion surgery for spinal deformity between January 1, 2015 and December 31, 2017. The primary outcomes were the incidence of UPROR within the minimum 2-year follow-up period for any reason. Univariate and multivariate logistical analyses were conducted to identify potential risk factors associated with UPROR. RESULTS We identified 1417 eligible patients (287 males and 1130 females) with a mean age of 13.9 years. UPROR for any reason within minimum 2-year follow-up was identified in 68 patients (4.8%). The most frequent cause for UPROR was implant failure found in 29 patients, followed by surgical site infection in 14 patients, junctional problems in 10 patients, and neurological complications in six patients. The multivariate logistic regression analysis revealed that a diagnosis of kyphosis (odds ratio [OR], 2.65; 95% confidence interval [CI] 1.16-6.04), etiology of congenital or structural type (OR 2.21; 95% CI 1.08-4.53), etiology of syndromic type (OR 2.67; 95% CI 1.27-5.64), and increased operation time of ≥300 minutes (OR 1.81; 95% CI 1.07-3.07) were the risk factors for the incidence of UPROR. CONCLUSION The present multicenter study identified for the first time the incidence and risk factors for UPROR with minimum 2-year follow-up after primary definitive fusion surgery for pediatric spinal deformity with every etiology.Level of Evidence: 3.
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Affiliation(s)
- Yuki Taniguchi
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Tetsuya Ohara
- Department of Orthopedics and Spine Surgery, Meijo Hospital , Nagoya, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Satoshi Suzuki
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Kota Watanabe
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Toru Yamaguchi
- Department of Orthopaedic and Spine Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Haruhisa Yanagida
- Department of Orthopaedic and Spine Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Keita Nakayama
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, School of Medicine, Niigata University, Niigata, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Toru Hirano
- Department of Orthopaedic Surgery, School of Medicine, Niigata University, Niigata, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Takuya Yamamoto
- Department of Orthopaedic Surgery, Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Ichiro Kawamura
- Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Ryo Sugawara
- Department of Orthopedic Surgery, Jichi Medical University, Shimotsuke, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Katsushi Takeshita
- Department of Orthopedic Surgery, Jichi Medical University, Shimotsuke, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Norihiro Oku
- Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Tatsuya Sato
- Department of Orthopedic Surgery, School of Medicine, Juntendo University, Tokyo, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Kenta Fujiwara
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Tsutomu Akazawa
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, School of Medicine, Iwate Medical University, Morioka, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Yoshitaka Matsubayashi
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
| | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Meijo Hospital , Nagoya, Japan
- Devision of Spine Surgery, Department of Orthopedic Surgery, Ichinomiya Nishi Hospital, Ichinomiya, Japan
- Japan Spinal Deformity Institute (JSDI), Japan
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23
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Machino M, Kawakami N, Ohara T, Saito T, Tauchi R, Imagama S. Three-dimensional reconstruction image by biplanar stereoradiography reflects pulmonary functional states inadolescent idiopathic scoliosis. J Clin Neurosci 2021; 88:178-184. [PMID: 33992181 DOI: 10.1016/j.jocn.2021.03.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 11/17/2022]
Abstract
This study investigated whether the rib cage parameters estimated based on reconstructed three-dimensional (3D) images with biplanar stereoradiography reflect pulmonary functional states in adolescent idiopathic scoliosis (AIS) patients. A total of 67 Lenke type 1 or 2 AIS patients (59 females and 8 males, mean age 14.4 years) were enrolled. All patients underwent preoperative pulmonary functional tests (PFT) and biplanar stereoradiography. Vital capacity (VC) and forced vital capacity (FVC) pulmonary functional data were collected. Rib-cage parameters (maximum thickness, maximum width, thoracic index (TI), rib hump (RH), rib-cage volume (RCV), spinal penetration index (SPI), endothoracic hump ratio (EHR), vertebra-sternum angle (VSA), rib vertebral angle difference (RVAD), and vertebral lateral decentering (VLD)) were quantified from 3D images. Patients were divided into two groups: restrictive lung disorder (RLD) (%FVC < 80%) and non-RLD (%FVC ≥ 80%). The maximum width and RCV were significantly correlated with VC (p < 0.0001), and FVC (p < 0.0001). RH, EHR, and VSA were negatively correlated with %FVC (p < 0.01). TI, SPI, and RVAD were not correlated with any pulmonary parameters. The maximum widths of RLD patients were significantly shorter than those of the non-RLD patients (218.3 mm vs. 229.7 mm, p < 0.01). The RCV of RLD patients was significantly smaller than that of the non-RLD patients (3.94 L vs. 4.49 L, p < 0.0001). The maximum width and RCV measured by 3D images with biplanar stereoradiography reflected pulmonary functional variables in patients with AIS.
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Affiliation(s)
- Masaaki Machino
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Ichinomiyanishi Hospital, Ichinomiya, Japan; Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan.
| | - Tetsuya Ohara
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Toshiki Saito
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Ryoji Tauchi
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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24
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Kawakami N, Ito M, Matsumoto H, Saito T, Kawakami K, Suzuki T, Uno K. Clinical and health-related quality-of-life outcomes after early and late spinal fusion in pediatric patients with congenital scoliosis at 10-year follow-up. Spine Deform 2021; 9:529-538. [PMID: 33230670 DOI: 10.1007/s43390-020-00245-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022]
Abstract
STUDY DESIGN A retrospective comparative study. OBJECTIVE This study compares the effect of age at the time of surgery on clinical and health-related quality-of-life (HRQoL) outcomes at 10-year follow-up in pediatric patients with congenital scoliosis (CS). Several studies have evaluated the outcomes of surgical treatments of CS during the growth period; however, age at surgery and its long-term effects have been assessed in only a few case reports. METHODS We enrolled patients with CS who underwent spinal fusion at the age of 18 years or younger in our study. We evaluated 97 patients (38 males, 59 females; average age 16.5 years) who met our inclusion criteria, including the availability of outcome data for a minimum of 10-year post-surgery. We divided patients into two groups in terms of the age at surgery: early fusion (EF) and late fusion (LF) groups. Clinical outcomes included re-operations, major curve corrections immediately and at 10-year follow-up, Scoliosis Research Society (SRS)-22 questionnaire, and percentage forced vital capacity (%FVC). RESULTS The EF group (33 patients) and the LF group (64 patients) did not differ significantly in terms of demographics. In all domains, the EF group had better HRQoL than the LF group. More patients (52%) in the EF group required re-operation than in the LF group (23%). In addition, patients with short fusion (< 7 segments, p = 0.0011) and greater T1-T12 height (≥ 22 cm, p = 0.0088) had better %FVC than their counterparts. CONCLUSIONS Age at surgery might have some non-negligible impacts on patients' HRQoL and clinical outcomes. Our study highlighted the important factors in surgical considerations of choosing the appropriate timing for spinal fusion, performing shorter fusions, and achieving an acceptable curve correction without allowing further curve progression that required re-operations. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Noriaki Kawakami
- Department of Orthopedic Surgery, Ichinomiya Nishi Hospital, 1 Kaimei-hira, Ichinomiya, Aichi, 494-0001, Japan. .,Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan.
| | - Masaaki Ito
- Department of Orthopedic Surgery, National Kobe Medical Center, Kobe, Japan
| | - Hiroko Matsumoto
- Department of Pediatric Orthopedic Surgery, Colombia University, New York, USA
| | - Toshiki Saito
- Department of Orthopedic Surgery, Ichinomiya Nishi Hospital, 1 Kaimei-hira, Ichinomiya, Aichi, 494-0001, Japan.,Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Kazuki Kawakami
- St. Vincent's Private Hospital Sydney, Darlinghurst, NSW, Australia
| | - Teppei Suzuki
- Department of Orthopedic Surgery, National Kobe Medical Center, Kobe, Japan
| | - Koki Uno
- Department of Orthopedic Surgery, National Kobe Medical Center, Kobe, Japan
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25
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Kanbara S, Nohara A, Ohara T, Saito T, Tauchi R, Imagama S, Kawakami N. Impact of Rigid Fixation of the Pubic Symphysis for Spinopelvic Fixation in Two Cases of Lumbosacral Agenesis. Spine Surg Relat Res 2020; 4:341-346. [PMID: 33195859 PMCID: PMC7661020 DOI: 10.22603/ssrr.2020-0015] [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: 01/24/2020] [Accepted: 02/19/2020] [Indexed: 11/08/2022] Open
Abstract
Introduction In patients with lumbosacral agenesis (SA), Renshaw type III or IV, lumbosacral instability is the primary cause of major clinical complications. Although they are usually treated with spinopelvic fusion, nonunion at the spinopelvic junction is a major complication due to the congenital sacropelvic abnormalities. The purpose of this study was to evaluate whether a combination of lumbosacral fixation and rigid fixation at the pubic symphysis could lead to postoperative bone union in patients with SA (Renshaw type III). Methods Retrospective case series study. We present the cases of two patients with SA, Renshaw type III, who were surgically treated by lumbosacral fusion using a posterior approach, and they exhibited nonunion at the lumbosacral junction. Results Case 1. A 10-year-old male underwent T8-S posterior fixation followed by multiple augmentations using allografts at the lumbosacral junction for delayed union. All additional procedures with bone graft using a posterior approach failed to achieve bone union; however, additional rigid fixation at the pubic symphysis resulted in a successful lumbosacral bone union. Case 2. A 6-year-old male underwent vertical expandable prosthetic titanium rib (VEPTR) surgery with multiple rod extension procedures. Subsequently, at the age of 10 years, a combined two-stage anterior (L1-3) and posterior (T8-iliac) fixation with T9 hemivertebrectomy was performed. As a result of subsequent nonunion with screw loosening, additional rigid fixation at the pubic symphysis was performed 1 month after posterior fixation. Bone union was finally achieved 1 year after all the surgical interventions. Conclusions Rigid fixation at the pubic symphysis may play a significant role in achieving rigid bone union for unstable lumbopelvic connection, such as SA, Renshaw type III or IV.
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Affiliation(s)
- Shunsuke Kanbara
- Department of Orthopedic Surgery, Nagoya University, Graduate School of Medicine, Nagoya, Japan.,Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Ayato Nohara
- Department of Orthopedic Surgery, JCHO Tokyo Shinjuku medical Hospital, Tokyo, Japan
| | - Tetsuya Ohara
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Toshiki Saito
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan.,Department of Orthopaedic Surgery & Spine Center, Ichinomiya West Hospital, Aichi, Japan
| | - Ryoji Tauchi
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan.,Department of Orthopaedic Surgery & Spine Center, Ichinomiya West Hospital, Aichi, Japan
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LaValva SM, MacAlpine EM, Kawakami N, Gandhi JS, Morishita K, Sturm PF, Garg S, Glotzbecker MP, Anari JB, Flynn JM, Cahill PJ. Awake serial body casting for the management of infantile idiopathic scoliosis: is general anesthesia necessary? Spine Deform 2020; 8:1109-1115. [PMID: 32383143 DOI: 10.1007/s43390-020-00123-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/13/2020] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN It is a retrospective cohort study. OBJECTIVES To compare the radiographic and clinical outcomes of serial body casting for infantile idiopathic scoliosis (IIS) with versus without the use of general anesthesia (GA). Serial body casting for IIS has traditionally been performed under GA. However, reports of neurotoxic effects of anesthetics in young children have prompted physicians to consider instead performing these procedures while patients are awake and distracted by electronic devices. METHODS Patients from a multicenter registry who underwent serial casting for IIS were included. The patients were divided into asleep (GA) and awake (no GA) cohorts. Comparisons were made between pre-casting, first in-cast, and post-casting radiographic measures in each cohort. The rates of successful casting (≥ 10° major CA improvement), curve progression, and incidence of casting abandonment for surgical intervention were also compared. RESULTS One-hundred and twenty-one patients who underwent serial casting for IIS were included. Ninety-two (76%) patients were asleep during casting procedures, while 29 (24%) were awake. Patients in the awake cohort were older (p < 0.01), had a lower BMI (p = 0.03), and more severe curve magnitudes (p < 0.01) at baseline. Patients in the awake cohort experienced greater first-in-cast correction of the major curve (p = 0.01) and improvement in thoracic spine height (p < 0.01). The rate of casting success was higher in the awake cohort (72%) as compared to the asleep cohort (48%) (p = 0.02), although the rate of curve progression (worsening) was similar (p = 0.880). Lastly, there was a lower rate of conversion to surgery at 2 years post-initiation of casting, although this was not statistically significant (0% vs. 8%; p = 0.126). CONCLUSIONS Patients who underwent awake serial casting had similar radiographic outcomes as compared to those who were under general anesthesia during the procedures. Thus, awake casting may provide a safe and effective alternative to the use of general anesthesia in patients with idiopathic infantile scoliosis. LEVEL OF EVIDENCE III.
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Affiliation(s)
| | | | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Jigar S Gandhi
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kazuaki Morishita
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | | | - Sumeet Garg
- Children's Hospital Colorado, Aurora, CO, USA
| | | | | | - John M Flynn
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Okada E, Suzuki T, Demura S, Saito T, Nohara A, Tsuji T, Uno K, Kawakami N, Matsumoto M, Watanabe K. Excessive correction impacts postoperative shoulder imbalance in lenke type 5C adolescent idiopathic scoliosis. J Orthop Sci 2020; 25:757-762. [PMID: 31668913 DOI: 10.1016/j.jos.2019.10.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/19/2019] [Accepted: 10/01/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Postoperative shoulder imbalance (PSI) has a negative impact on the surgical outcomes of patients with adolescent idiopathic scoliosis. This study aimed to evaluate the risk factors of PSI in patients with Lenke type 5C curves. METHODS This study included 100 patients who underwent posterior correction surgery using pedicle screw constructs for Lenke type 5C curves. The mean age of the patients at surgery was 15.5 ± 2.3 years, and the mean follow-up period was 36.6 ± 15.0 months. The subjects were classified into the following two groups: PSI and non-PSI. Radiographic parameters, including the preoperative and 2-year postoperative coronal and sagittal profiles, were compared between the two groups. RESULT PSI was found in eight patients (8.0%). The preoperative Cobb angles were 47.3° ± 8.7° and 48.0° ± 3.9° in the non-PSI and PSI groups, respectively. The correction rate in the PSI group was significantly higher than that in the non-PSI group (81.0% ± 17.7% vs. 67.7% ± 14.7%; p = 0.018). The preoperative T1 tilt angle in the PSI group was significantly larger than that in the non-PSI group (6.1° ± 3.3° vs. 3.1° ± 2.8°; p = 0.005). Receiver operating characteristic (ROC) analysis showed that the area under the ROC curve was 0.769 (p = 0.012, 95% confidence interval [CI], 0.556-0.982) and 0.763 (p = 0.014, 95% CI, 0.598-0.928) for the correction rate and preoperative T1 tilt, respectively. The cut-off value was 73% and 4° for the correction rate and preoperative T1, respectively. CONCLUSION PSI was found in 8.0% of Lenke type 5C curves. Excessive correction of the lumbar curve of >73% and preoperative T1 tilt of >4° can be risk factors for PSI in patients with Lenke type 5C curve.
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Affiliation(s)
- Eijiro Okada
- Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Teppei Suzuki
- Kobe Medical Center, Department of Orthopaedic Surgery, Kobe, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Satoru Demura
- Kanazawa University, Department of Orthopaedic Surgery, Kanazawa, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Toshiki Saito
- Meijo Hospital, Department of Orthopaedic Surgery, Nagoya, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Ayato Nohara
- Tokyo Shinjuku Medical Center, Department of Spine Surgery, Tokyo, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Taichi Tsuji
- Toyota Kosei Hospital, Department of Orthopaedic Surgery, Toyota, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Koki Uno
- Kobe Medical Center, Department of Orthopaedic Surgery, Kobe, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Noriaki Kawakami
- Meijo Hospital, Department of Orthopaedic Surgery, Nagoya, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Morio Matsumoto
- Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan; Japan Spinal Deformity Institute, Nagoya, Japan
| | - Kota Watanabe
- Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan; Japan Spinal Deformity Institute, Nagoya, Japan.
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Kawakami N, Iwata K, Shiotari A, Sugimoto Y. Intrinsic reconstruction of ice-I surfaces. Sci Adv 2020; 6:6/37/eabb7986. [PMID: 32917710 PMCID: PMC7486089 DOI: 10.1126/sciadv.abb7986] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
Understanding the precise atomic structure of ice surfaces is critical for revealing the mechanisms of physical and chemical phenomena at the surfaces, such as ice growth, melting, and chemical reactions. Nevertheless, no conclusive structure has been established. In this study, noncontact atomic force microscopy was used to address the characterization of the atomic structures of ice Ih(0001) and Ic(111) surfaces. The topmost hydrogen atoms are arranged with a short-range (2 × 2) order, independent of the ice thickness and growth substrates used. The electrostatic repulsion between non-hydrogen-bonded water molecules at the surface causes a reduction in the number of the topmost hydrogen atoms together with a distortion of the ideal honeycomb arrangement of water molecules, leading to a short-range-ordered surface reconstruction.
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Affiliation(s)
- N Kawakami
- Department of Advanced Materials Science, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8561, Japan
| | - K Iwata
- Department of Advanced Materials Science, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8561, Japan
| | - A Shiotari
- Department of Advanced Materials Science, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8561, Japan
| | - Y Sugimoto
- Department of Advanced Materials Science, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8561, Japan.
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29
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Matsumoto H, Kawakami N, Saito T, Uno K, Suzuki T, Watanabe K, Matsumoto M, Yamaguchi T, Yanagida H, Kotani T, Demura S, Takeshita K, Taniguchi Y. Short fusion with vertebrectomy during growth in congenital spinal deformity: is early surgical intervention recommended? Spine Deform 2020; 8:733-742. [PMID: 32109312 DOI: 10.1007/s43390-020-00082-9] [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] [Received: 06/27/2019] [Accepted: 01/05/2020] [Indexed: 11/28/2022]
Abstract
STUDY DESIGN This was a multi-center retrospective cohort study included consecutive pediatric patients who were admitted to 8 institutions for the treatment of congenital spinal deformity from 1991 to 2012. OBJECTIVE The purpose of this study was to compare curve corrections and balances, reoperations, and complications at 2-year follow-up between those treated early vs. late. Although early intervention has been recommended, no empirical study has examined the optimal timing of short fusion among patients with congenital spinal deformity. METHODS Patients with congenital spinal deformity with formation failure undergoing vertebrectomy with short fusion (≤ 6 fusion segments) were categorized as early (surgery at ≤ 6 years) and late (7-18 years) fusion. Outcomes included coronal and sagittal curve corrections at immediate and 2-year evaluations; loss of curve correction from immediate to 2-year follow-up; coronal and sagittal balance at 2 years; and inter-operative, major and minor short-term postoperative, and long-term postoperative complications and reoperations. RESULTS Early fusion (N = 79) compared to late fusion (N = 96) was associated with greater percent curve correction at immediate (71% vs. 60%, p = 0.0046) and 2-year (63% vs. 52%, p = 0.0153) evaluations adjusting for surgeon experience and preoperative coronal balance. These associations were significant for males and those with 3-level fusions but not 4 to 6-level fusions. Early fusion compared with late fusion had more intraoperative (6% vs. 1%) and postoperative long-term complications (27% vs. 18%), as well as unplanned reoperations (13% vs. 9%). Early vs. late fusion had fewer short-term complications, both major (6% vs. 15%) and minor (6% vs. 15%). CONCLUSIONS Patients who underwent early treatment achieved larger major curve correction by 10% compared to patients with late treatment when assessed at 2-year postoperative evaluation. However, early fusion should be considered with careful attention to possible increased risk of reoperations. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Hiroko Matsumoto
- Division of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Columbia University Medical Center, Department of Epidemiology, Mailman School of Public Health, Columbia University, 3959 Broadway, Suite 800 North, New York, NY, 10032, USA
| | - Noriaki Kawakami
- Department of Orthopaedic and Spine Surgery, Meijyo Hospital, Sannomaru, 1-3-1, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
| | - Toshiyuki Saito
- Department of Orthopaedic and Spine Surgery, Meijyo Hospital, Sannomaru, 1-3-1, Naka-ku, Nagoya, Aichi, 460-0001, Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, Kobe Medical Center, 3-1-1 Nishiochiai Suma-ku, Kobe, Hyogo, 654-0155, Japan
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, Kobe Medical Center, 3-1-1 Nishiochiai Suma-ku, Kobe, Hyogo, 654-0155, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-0016, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-0016, Japan
| | - Toru Yamaguchi
- Department of Orthopaedic Surgery, Fukuoka Children's Hospital, 5-1-1 Kashiiteriha, Higishi-ku, Fukuoka, Fukuoka, 813-0017, Japan
| | - Haruhisa Yanagida
- Department of Orthopaedic Surgery, Fukuoka Children's Hospital, 5-1-1 Kashiiteriha, Higishi-ku, Fukuoka, Fukuoka, 813-0017, Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura City Hospital, 2-36-2 Ebaradai, Sakura, Chiba, 285-0825, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Katsushi Takeshita
- Department of Orthopaedic Surgery, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8654, Japan
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30
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Demura S, Watanabe K, Suzuki T, Saito T, Yamamoto T, Kotani T, Nohara A, Tsuji T, Ogura Y, Tsuchiya H, Uno K, Matsumoto M, Kawakami N. Comparison of Pulmonary Function After Selective Anterior Versus Posterior Fusion for the Correction of Thoracolumbar and Lumbar Adolescent Idiopathic Scoliosis. Global Spine J 2020; 10:433-437. [PMID: 32435563 PMCID: PMC7222688 DOI: 10.1177/2192568219859573] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective multicenter study. OBJECTIVES To compare the selective anterior spinal fusion (ASF) versus posterior spinal fusion (PSF) on postoperative pulmonary function testing (PFT) whether thoracotomy with separation of the diaphragm by anterior approach influences the PFT in thoracolumbar and lumbar adolescent idiopathic scoliosis (AIS). METHODS A multicenter series of AIS patients who underwent selective spinal fusion were retrospectively reviewed. Seventy-nine female patients were included (mean 15.8 years). There were 35 patients in the ASF group and 44 patients in the PSF group. Patient demographics, radiographic measurements, and PFT data from preoperative to 2-year follow-up were analyzed. RESULTS Preoperatively, there were no significant differences in PFTs between the groups. The ASF group patients were more likely to undergo shorter fusions (4.5 instrumented vertebral levels) than those in the PSF group (5.2 levels). At 2-year follow-up, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in ASF group were statistically lower than those in PSF group. When comparing preoperative and 2-year changes on each procedure, only %FVC showed significant difference in ASF while FVC, FEV1, and %FEV1 did not. Meanwhile, the ASF group showed a significant decrease in FVC at 6 and 12 months compared to preoperative values. In PSF group, there was a decrease at 6 months, returned to preoperative value at 1-year follow-up. CONCLUSIONS Pulmonary function after ASF and PSF was similar at 2 years; however, anterior group did not return to the baseline at 6 months and 1 year suggesting anterior approach may affect early postoperative pulmonary function.
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Affiliation(s)
- Satoru Demura
- Kanazawa University, Kanazawa, Japan,Satoru Demura, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
| | | | - Teppei Suzuki
- National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | | | | | | | | | | | | | | | - Koki Uno
- National Hospital Organization, Kobe Medical Center, Kobe, Japan
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Machino M, Kawakami N, Ohara T, Saito T, Tauchi R, Imagama S. Accuracy of rib cage parameters from 3-Dimensional reconstruction images obtained using simultaneous biplanar radiographic scanning technique in adolescent idiopathic scoliosis: Comparison with conventional computed tomography. J Clin Neurosci 2020; 75:94-98. [DOI: 10.1016/j.jocn.2020.03.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
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32
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Matsuda M, Yamanaka Y, Uemura M, Osawa M, Saito MK, Nagahashi A, Nishio M, Guo L, Ikegawa S, Sakurai S, Kihara S, Maurissen TL, Nakamura M, Matsumoto T, Yoshitomi H, Ikeya M, Kawakami N, Yamamoto T, Woltjen K, Ebisuya M, Toguchida J, Alev C. Recapitulating the human segmentation clock with pluripotent stem cells. Nature 2020; 580:124-129. [PMID: 32238941 DOI: 10.1038/s41586-020-2144-9] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 02/20/2020] [Indexed: 12/29/2022]
Abstract
Pluripotent stem cells are increasingly used to model different aspects of embryogenesis and organ formation1. Despite recent advances in in vitro induction of major mesodermal lineages and cell types2,3, experimental model systems that can recapitulate more complex features of human mesoderm development and patterning are largely missing. Here we used induced pluripotent stem cells for the stepwise in vitro induction of presomitic mesoderm and its derivatives to model distinct aspects of human somitogenesis. We focused initially on modelling the human segmentation clock, a major biological concept believed to underlie the rhythmic and controlled emergence of somites, which give rise to the segmental pattern of the vertebrate axial skeleton. We observed oscillatory expression of core segmentation clock genes, including HES7 and DKK1, determined the period of the human segmentation clock to be around five hours, and demonstrated the presence of dynamic travelling-wave-like gene expression in in vitro-induced human presomitic mesoderm. Furthermore, we identified and compared oscillatory genes in human and mouse presomitic mesoderm derived from pluripotent stem cells, which revealed species-specific and shared molecular components and pathways associated with the putative mouse and human segmentation clocks. Using CRISPR-Cas9-based genome editing technology, we then targeted genes for which mutations in patients with segmentation defects of the vertebrae, such as spondylocostal dysostosis, have been reported (HES7, LFNG, DLL3 and MESP2). Subsequent analysis of patient-like and patient-derived induced pluripotent stem cells revealed gene-specific alterations in oscillation, synchronization or differentiation properties. Our findings provide insights into the human segmentation clock as well as diseases associated with human axial skeletogenesis.
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Affiliation(s)
- Mitsuhiro Matsuda
- Laboratory for Reconstitutive Developmental Biology, RIKEN Center for Biosystems Dynamics Research (RIKEN BDR), Kobe, Japan.,European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| | - Yoshihiro Yamanaka
- Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan.,Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
| | - Maya Uemura
- Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan.,Department of Regeneration Science and Engineering, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Mitsujiro Osawa
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Megumu K Saito
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Ayako Nagahashi
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Megumi Nishio
- Department of Regeneration Science and Engineering, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Long Guo
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences (RIKEN IMS), Tokyo, Japan
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences (RIKEN IMS), Tokyo, Japan
| | - Satoko Sakurai
- Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Shunsuke Kihara
- Department of Fundamental Cell Technology, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Thomas L Maurissen
- Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Michiko Nakamura
- Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Tomoko Matsumoto
- Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Hiroyuki Yoshitomi
- Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan.,Department of Regeneration Science and Engineering, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Makoto Ikeya
- Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Takuya Yamamoto
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.,Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan.,AMED-CREST, AMED 1-7-1 Otemachi, Chiyodaku, Tokyo, Japan.,Medical-Risk Avoidance Based on iPS Cells Team, RIKEN Center for Advanced Intelligence Project (AIP), Kyoto, Japan
| | - Knut Woltjen
- Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Miki Ebisuya
- Laboratory for Reconstitutive Developmental Biology, RIKEN Center for Biosystems Dynamics Research (RIKEN BDR), Kobe, Japan. .,European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain.
| | - Junya Toguchida
- Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan.,Department of Regeneration Science and Engineering, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Cantas Alev
- Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan. .,Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.
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Tauchi R, Kawakami N, Castro MA, Ohara T, Saito T, Morishita K, Yamauchi I. Long-term Surgical Outcomes After Early Definitive Spinal Fusion for Early-onset Scoliosis With Neurofibromatosis Type 1 at Mean Follow-up of 14 Years. J Pediatr Orthop 2020; 40:42-47. [PMID: 31815861 DOI: 10.1097/bpo.0000000000001090] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several authors mentioned surgical outcome for scoliosis associated with neurofibromatosis type 1 (NF-1). However, no studies have summarized long-term surgical outcomes after surgical treatment of early-onset scoliosis (EOS) with NF-1. The purpose of this study is to evaluate the long-term surgical outcome after early definitive spinal fusion for EOS in NF-1 patients. METHODS We performed a retrospective review on a cohort of 11 patients diagnosed with EOS associated with NF-1 between 1990 and 2009 in our hospital. The study included 7 male and 4 female NF-1 patients with a mean age at fusion surgery of 8 years 4 months who underwent early definitive spinal fusion for EOS. We reviewed radiographs, computed tomography and magnetic resonance images for each patient. The data collected included type of NF-1, Cobb angles, kyphotic angle, spinal length (T1-S1), and pulmonary function. We also evaluated progression of the dystrophic change through radiographs and computed tomography during the follow-up period. RESULTS The mean follow-up duration was 14 years (5 y 10 mo to 25 y). All patients underwent anterior and posterior fusion surgeries in either 1 or 2 stages. Seven cases had subtotal tumor resection from the concave side followed by rib strut grafting. The mean preoperative Cobb angle of the primary curve was corrected from 71.2 to 24.1 degrees and was maintained at the final follow-up at 23.5 degrees. Mean values for preoperative and final follow-up T1-S1 heights were 30.7 and 36.2 cm, respectively. Mean values for preoperative and final follow-up % forced vital capacity (the present/the predicted) were 75.0% and 74.4%, respectively. The dystrophic change progressed in all cases during the long-term follow-up. CONCLUSIONS Our goals for NF-1 scoliosis are to obtain deformity correction, to achieve stable instrumentation by using longer fusion levels and to attain a solid fusion mass that can tolerate continual erosion during the long-term follow-up. We achieve this by using a circumferential approach for EOS associated with NF-1. LEVEL OF EVIDENCE Level IV-case series.
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Affiliation(s)
- Ryoji Tauchi
- Department of Orthopaedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
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Kokabu T, Kawakami N, Uno K, Kotani T, Suzuki T, Abe Y, Maeda K, Inage F, Ito YM, Iwasaki N, Sudo H. Three-dimensional depth sensor imaging to identify adolescent idiopathic scoliosis: a prospective multicenter cohort study. Sci Rep 2019; 9:9678. [PMID: 31273291 PMCID: PMC6609683 DOI: 10.1038/s41598-019-46246-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022] Open
Abstract
Adolescent idiopathic scoliosis is the most ordinary pediatric spinal disease that causes a three-dimensional deformity. Early detection of this potentially progressive deformity is considered crucial. The purpose of the present study was to report the potential for accurately diagnosis of adolescent idiopathic scoliosis using a newly developed, automated, noninvasive asymmetry-recognition system for the surface of the human back using a three-dimensional depth sensor. We included 170 subjects with suspected adolescent idiopathic scoliosis in this study. Outcomes measured included patient demographics, Cobbe angles from radiographic measurements, and asymmetry indexes. The coefficient of correlation between the asymmetry index and the Cobb angle was 0.85. For the prediction of scoliosis >10°, the area under the curve was 0.98, sensitivity was 0.97, specificity was 0.93, positive predictive value was 0.99, negative predictive value was 0.72, accuracy was 0.97, positive likelihood ratio was 13.55, and negative likelihood ratio was 0.04. The posterior test probability for the positive screen >10° was 98.9% if the asymmetry index was >1.268, three times in a row. This novel system automatically evaluated the back asymmetry. Therefore, this study demonstrates the outstanding discriminative ability of this newly developed system for deciding whether an examinee should undergo additional radiography to define scoliosis. This system can be used as an alternative to the forward bend test and scoliometer measurement in clinics. Future studies should seek to confirm these findings in a larger group and involve mass school scoliosis screening programs within the context of a multicenter trial.
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Affiliation(s)
- Terufumi Kokabu
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14W5, Sapporo, Hokkaido, 060-8648, Japan.,Department of Orthopaedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido, 061-1449, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Sannomal 1-3-1, Nagoya, Aichi, 460-0001, Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Nishiochiai 3-1-1, Kobe, Hyogo, 654-0155, Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Eharadai 2-36-2, Sakura, Chiba, 285-8765, Japan
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Nishiochiai 3-1-1, Kobe, Hyogo, 654-0155, Japan
| | - Yuichiro Abe
- Department of Orthopaedic Surgery, Eniwa Hospital, Koganechuo 2-1-1, Eniwa, Hokkaido, 061-1449, Japan
| | - Kenichiro Maeda
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Hokkaido, 060-8648, Japan
| | - Fujio Inage
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, N14W5, Sapporo, Hokkaido, 060-8648, Japan
| | - Yoichi M Ito
- Department of Biostatistics, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14W5, Sapporo, Hokkaido, 060-8648, Japan
| | - Hideki Sudo
- Department of Orthopaedic Surgery, Hokkaido University Hospital, N14W5, Sapporo, Hokkaido, 060-8648, Japan. .,Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan.
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Otomo N, Takeda K, Kawai S, Kou I, Guo L, Osawa M, Alev C, Kawakami N, Miyake N, Matsumoto N, Yasuhiko Y, Kotani T, Suzuki T, Uno K, Sudo H, Inami S, Taneichi H, Shigematsu H, Watanabe K, Yonezawa I, Sugawara R, Taniguchi Y, Minami S, Kaneko K, Nakamura M, Matsumoto M, Toguchida J, Watanabe K, Ikegawa S. Bi-allelic loss of function variants of TBX6 causes a spectrum of malformation of spine and rib including congenital scoliosis and spondylocostal dysostosis. J Med Genet 2019; 56:622-628. [DOI: 10.1136/jmedgenet-2018-105920] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/22/2019] [Accepted: 03/24/2019] [Indexed: 12/21/2022]
Abstract
BackgroundCongenital scoliosis (CS) is a common vertebral malformation. Spondylocostal dysostosis (SCD) is a rare skeletal dysplasia characterised by multiple vertebral malformations and rib anomalies. In a previous study, a compound heterozygosity for a null mutation and a risk haplotype composed by three single-nucleotide polymorphisms in TBX6 have been reported as a disease-causing model of CS. Another study identified bi-allelic missense variants in a SCD patient. The purpose of our study is to identify TBX6 variants in CS and SCD and examine their pathogenicity.MethodsWe recruited 200 patients with CS or SCD and investigated TBX6 variants. We evaluated the pathogenicity of the variants by in silico prediction and in vitro experiments.ResultsWe identified five 16p11.2 deletions, one splice-site variant and five missense variants in 10 patients. In vitro functional assays for missense variants identified in the previous and present studies demonstrated that most of the variants caused abnormal localisation of TBX6 proteins. We confirmed mislocalisation of TBX6 proteins in presomitic mesoderm cells induced from SCD patient-derived iPS cells. In induced cells, we found decreased mRNA expressions of TBX6 and its downstream genes were involved in somite formation. All CS patients with missense variants had the risk haplotype in the opposite allele, while a SCD patient with bi-allelic missense variants did not have the haplotype.ConclusionsOur study suggests that bi-allelic loss of function variants of TBX6 cause a spectrum of phenotypes including CS and SCD, depending on the severity of the loss of TBX6 function.
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Akazawa T, Watanabe K, Matsumoto M, Tsuji T, Kawakami N, Kotani T, Sakuma T, Yamamoto T, Demura S, Orita S, Fujimoto K, Shiga Y, Niki H. Modic changes and disc degeneration in adolescent idiopathic scoliosis patients who reach middle age without surgery: Can residual deformity cause lumbar spine degeneration? J Orthop Sci 2018; 23:884-888. [PMID: 30064890 DOI: 10.1016/j.jos.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/27/2018] [Accepted: 07/08/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND We have yet to determine what types of lumbar degenerative changes can be observed on MRI in middle-aged adolescent idiopathic scoliosis (AIS) patients without undergoing surgery. The aims of this study were to investigate AIS patients who have reached middle age without undergoing surgery and to clarify if residual spinal deformities may have affected health-related quality of life (HRQOL) and lumbar spine degeneration. METHODS Subjects comprised AIS patients who reached middle age without surgery and who underwent whole-spine X-rays, lumbar MRI, and SRS-22 surveys. Of the 60 cases collected from five scoliosis centers, 25 patients who met the inclusion criteria were enrolled into the residual deformity (RD) group and analyzed. Controls (CTR) group comprised 25 individuals matched for age, sex, and BMI with the patient group. RESULTS MRI revealed no significant differences in the percentage of individuals with Pfirrmann grade 4 or 5 disc degeneration in 1 or more segments (RD group: 84%, CTR group: 60%, p = 0.059). Significantly more patients with Modic changes in 1 or more segments were observed in the RD group (RD group: 56%, CTR group: 8%, p < 0.001). All SRS-22 scores were significantly lower in the RD group. The lumbar curve cutoff point based on whether or not Modic change could be observed using ROC analysis was 39.5°. CONCLUSIONS Compared to healthy individuals, AIS patients with residual deformity who have never had surgery showed similar prevalence of disc degeneration, but they had more Modic changes and poor HRQOL. The cutoff point for lumbar curves of patients with and without Modic changes in middle age was 39.5°.
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Affiliation(s)
- Tsutomu Akazawa
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan; Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
| | - Kota Watanabe
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taichi Tsuji
- Department of Orthopedic Surgery, Toyota Kosei Hospital, Toyota, Japan; Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya, Japan
| | - Toshiaki Kotani
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsuyoshi Sakuma
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Takuya Yamamoto
- Department of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuki Fujimoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hisateru Niki
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
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Watanabe K, Sakuraya A, Kawakami N, Imamura K, Ando E, Asai Y, Eguchi H, Kobayashi Y, Nishida N, Arima H, Shimazu A, Tsutsumi A. Work-related psychosocial factors and metabolic syndrome onset among workers: a systematic review and meta-analysis. Obes Rev 2018; 19:1557-1568. [PMID: 30047228 DOI: 10.1111/obr.12725] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [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] [Received: 03/05/2018] [Revised: 05/14/2018] [Accepted: 05/31/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Work-related psychosocial factors have been associated with metabolic syndrome. However, no systematic reviews or meta-analyses have evaluated this association. METHODS A systematic literature search was conducted, using PubMed, Embase, PsycINFO, PsycARTICLES and the Japan Medical Abstracts Society. Eligible studies included those that examined the previously mentioned association; had a longitudinal or prospective cohort design; were conducted among workers; provided sufficient data for calculating odds ratios, relative risks or hazard ratios with 95% confidence intervals; were original articles in English or Japanese; and were published no later than 2016. Study characteristics, exposure and outcome variables and association measures of studies were extracted by the investigators independently. RESULTS Among 4,664 identified studies, 8 were eligible for review and meta-analysis. The pooled risk of adverse work-related stress on metabolic syndrome onset was significant and positive (RR = 1.47; 95% CI, 1.22-1.78). Sensitivity analyses limiting only the effects of job strain and shift work also indicated a significant positive relationship (RR = 1.75; 95% CI, 1.09-2.79; and RR = 1.59; 95% CI, 1.00-2.54, P = 0.049 respectively). CONCLUSION This study reveals a strong positive association between work-related psychosocial factors and an elevated risk of metabolic syndrome onset. The effects of job strain and shift work on metabolic syndrome appear to be significant.
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Affiliation(s)
- K Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Sakuraya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - N Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - E Ando
- Department of Social and Environmental Health, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Y Asai
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Eguchi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
| | | | - N Nishida
- Kyoto Industrial Health Association, Kyoto, Japan
| | - H Arima
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Shimazu
- Center for Human and Social Sciences, Kitasato University College of Liberal Arts and Sciences, Sagamihara-shi, Kanagawa, Japan
| | - A Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
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38
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Takeda K, Kou I, Mizumoto S, Yamada S, Kawakami N, Nakajima M, Otomo N, Ogura Y, Miyake N, Matsumoto N, Kotani T, Sudo H, Yonezawa I, Uno K, Taneichi H, Watanabe K, Shigematsu H, Sugawara R, Taniguchi Y, Minami S, Nakamura M, Matsumoto M, Watanabe K, Ikegawa S. Screening of known disease genes in congenital scoliosis. Mol Genet Genomic Med 2018; 6:966-974. [PMID: 30196550 PMCID: PMC6305645 DOI: 10.1002/mgg3.466] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/18/2018] [Accepted: 08/09/2018] [Indexed: 01/29/2023] Open
Abstract
Background Congenital scoliosis (CS) is defined as a lateral curvature of the spine due to the vertebral malformations and has an incidence of 0.5–1/1,000 births. We previously examined TBX6 in Japanese CS patients and revealed that approximately 10% of CS was caused by TBX6 mutations. However, the genetic cause of remaining CS is unknown. Methods We recruited 78 CS patients without TBX6 mutations and major comorbidities, and investigated the genes previously reported to be associated with CS and congenital vertebral malformations by whole‐exome sequencing. Results We identified the compound heterozygous missense variants in LFNG in one patient. No likely disease‐causing variants were identified in other patients, however. LFNG encodes a GlcNAc‐transferase. The LFNG variants showed loss of their enzyme function. Conclusions A LFNG mutation is reported in a case of spondylocostal dysostosis (SCD), a skeletal dysplasia with severe malformations of vertebra and rib. The CS patient with LFNG mutations had multiple vertebral malformations including hemivertebrae, butterfly vertebrae, and block vertebrae, and rib malformations. LFNG mutations may cause a spectrum of phenotypes including CS and SCD. The current list of known disease genes could explain only a small fraction of genetic cause of CS.
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Affiliation(s)
- Kazuki Takeda
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ikuyo Kou
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Shuji Mizumoto
- Department of Pathobiochemistry, Faculty of Pharmacy, Meijo University, Nagoya, Japan.,Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Shuhei Yamada
- Department of Pathobiochemistry, Faculty of Pharmacy, Meijo University, Nagoya, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Masahiro Nakajima
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Nao Otomo
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoji Ogura
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ikuho Yonezawa
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Koki Uno
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe, Japan
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Hospital, Niigata, Japan
| | - Hideki Shigematsu
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
| | - Ryo Sugawara
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shohei Minami
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shiro Ikegawa
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
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Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Benjet C, Bruffaerts R, Chiu W, Florescu S, de Girolamo G, Gureje O, Haro JM, He Y, Hu C, Karam EG, Kawakami N, Lee S, Lund C, Kovess-Masfety V, Levinson D, Navarro-Mateu F, Pennell BE, Sampson N, Scott K, Tachimori H, ten Have M, Viana MC, Williams DR, Wojtyniak BJ, Zarkov Z, Kessler RC, Chatterji S, Thornicroft G. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med 2018; 48:1560-1571. [PMID: 29173244 PMCID: PMC6878971 DOI: 10.1017/s0033291717003336] [Citation(s) in RCA: 218] [Impact Index Per Article: 36.3] [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] [Indexed: 02/05/2023]
Abstract
BACKGROUND The treatment gap between the number of people with mental disorders and the number treated represents a major public health challenge. We examine this gap by socio-economic status (SES; indicated by family income and respondent education) and service sector in a cross-national analysis of community epidemiological survey data. METHODS Data come from 16 753 respondents with 12-month DSM-IV disorders from community surveys in 25 countries in the WHO World Mental Health Survey Initiative. DSM-IV anxiety, mood, or substance disorders and treatment of these disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI). RESULTS Only 13.7% of 12-month DSM-IV/CIDI cases in lower-middle-income countries, 22.0% in upper-middle-income countries, and 36.8% in high-income countries received treatment. Highest-SES respondents were somewhat more likely to receive treatment, but this was true mostly for specialty mental health treatment, where the association was positive with education (highest treatment among respondents with the highest education and a weak association of education with treatment among other respondents) but non-monotonic with income (somewhat lower treatment rates among middle-income respondents and equivalent among those with high and low incomes). CONCLUSIONS The modest, but nonetheless stronger, an association of education than income with treatment raises questions about a financial barriers interpretation of the inverse association of SES with treatment, although future within-country analyses that consider contextual factors might document other important specifications. While beyond the scope of this report, such an expanded analysis could have important implications for designing interventions aimed at increasing mental disorder treatment among socio-economically disadvantaged people.
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Affiliation(s)
- S. Evans-Lacko
- Kings College London, Institute of Psychiatry, Psychology
& Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom
- PSSRU, London School of Economics and Political Science,
Houghton Street, London WC2A 2AE, United Kingdom
| | - S. Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health
System, Sacramento, California, USA
| | - A. Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya
governorate, Iraq
| | - J. Alonso
- Health Services Research Unit, IMIM-Hospital del Mar
Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF),
Barcelona, Spain; and CIBER en Epidemiología y Salud Pública
(CIBERESP), Barcelona, Spain
| | - C. Benjet
- Department of Epidemiologic and Psychosocial Research,
National Institute of Psychiatry Ramón de la Fuente Muniz, Mexico City,
Mexico
| | - R. Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke
Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - W.T. Chiu
- Department of Health Care Policy, Harvard Medical School,
Boston, Massachusetts, USA
| | - S. Florescu
- National School of Public Health, Management and
Development, Bucharest, Romania
| | - G. de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry,
Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical
Research Centre, Via Pilastroni 4, Brescia, Italy
| | - O. Gureje
- Department of Psychiatry, University College Hospital,
Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM,
Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Y. He
- Shanghai Mental Health Center, Shanghai Jiao Tong
University, School of Medicine, Shanghai, China
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen
Kangning Hospital, Shenzhen, China
| | - E. G. Karam
- Department of Psychiatry and Clinical Psychology, St
George Hospital University Medical Center, Balamand University, Faculty of Medicine,
Beirut, Lebanon; Institute for Development, Research, Advocacy and Applied Care
(IDRAAC), Beirut, Lebanon
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The
University of Tokyo, Tokyo, Japan
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong
Kong, Tai Po, Hong Kong
| | - C. Lund
- Kings College London, Institute of Psychiatry, Psychology
& Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom
- Alan J Flisher Centre for Public Mental Health,
Department of Psychiatry and Mental Health, University of Cape Town, South
Africa
| | - V. Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP),
EA 4057, Paris Descartes University, Paris, France
| | - D. Levinson
- Mental Health Services, Ministry of Health, Jerusalem,
Israel
| | - F. Navarro-Mateu
- UDIF-SM, Subdirección General de
Planificación, Innovación y Cronicidad, Servicio Murciano de Salud.
IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - B. E. Pennell
- Survey Research Center, Institute for Social Research,
University of Michigan, Ann Arbor, Michigan, USA
| | - N.A. Sampson
- Department of Health Care Policy, Harvard Medical School,
Boston, Massachusetts, USA
| | - K.M. Scott
- Department of Psychological Medicine, University of
Otago, Dunedin, Otago, New Zealand
| | - H. Tachimori
- National Institute of Mental Health, National Center for
Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - M. ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health
and Addiction, Utrecht, Netherlands
| | - M. C. Viana
- Department of Social Medicine, Federal University of
Espírito Santo, Vitoria, Brazil
| | - D. R. Williams
- Department of Society, Human Development, and Health,
Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - B. J. Wojtyniak
- Centre of Monitoring and Analyses of Population Health,
National Institute of Public Health-National Institute of Hygiene, Warsaw,
Poland
| | - Z. Zarkov
- Directorate of Mental Health, National Center of Public
Health and Analyses, Sofia, Bulgaria
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School,
Boston, Massachusetts, USA
| | - S. Chatterji
- Department of Information, Evidence and Research, World
Health Organization, Geneva, Switzerland
| | - G. Thornicroft
- Kings College London, Institute of Psychiatry, Psychology
& Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom
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40
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Kovess-Masfety V, Saha S, Lim C, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Borges G, de Girolamo G, de Jonge P, Demyttenaere K, Florescu S, Haro J, Hu C, Karam E, Kawakami N, Lee S, Lepine J, Navarro-Mateu F, Stagnaro J, ten Have M, Viana M, Kessler R, McGrath J. Psychotic experiences and religiosity: data from the WHO World Mental Health Surveys. Acta Psychiatr Scand 2018; 137:306-315. [PMID: 29453789 PMCID: PMC6839106 DOI: 10.1111/acps.12859] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Accepted: 01/23/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Religiosity is often associated with better health outcomes. The aim of the study was to examine associations between psychotic experiences (PEs) and religiosity in a large, cross-national sample. METHODS A total of 25 542 adult respondents across 18 countries from the WHO World Mental Health Surveys were assessed for PEs, religious affiliation and indices of religiosity, DSM-IV mental disorders and general medical conditions. Logistic regression models were used to estimate the association between PEs and religiosity with various adjustments. RESULTS Of 25 542 included respondents, 85.6% (SE = 0.3) (n = 21 860) respondents reported having a religious affiliation. Overall, there was no association between religious affiliation status and PEs. Within the subgroup having a religious affiliation, four of five indices of religiosity were significantly associated with increased odds of PEs (odds ratios ranged from 1.3 to 1.9). The findings persisted after adjustments for mental disorders and/or general medical conditions, as well as religious denomination type. There was a significant association between increased religiosity and reporting more types of PEs. CONCLUSIONS Among individuals with religious affiliations, those who reported more religiosity on four of five indices had increased odds of PEs. Focussed and more qualitative research will be required to unravel the interrelationship between religiosity and PEs.
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Affiliation(s)
- V. Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - S. Saha
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia
| | - C.C.W. Lim
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia
| | - S. Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - A. Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
| | - J. Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - G. Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - G. de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Via Pilastroni 4, Brescia, Italy
| | - P. de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, NL; Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, NL
| | - K. Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - S. Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - J.M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
| | - E.G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - J.P. Lepine
- Hôpital Lariboisière- Fernand Widal, Assistance Publique Hôpitaux de Paris; Universités Paris Descartes-Paris Diderot;INSERM UMR-S 1144, Paris, France
| | - F. Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - J.C. Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - M. ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - M.C. Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - R.C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - J.J. McGrath
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia; and National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
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41
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Kawakami N, Imamura K, Asai Y, Watanabe K, Tsutsumi A, Shimazu A, Inoue A, Hiro H, Odagiri Y, Yoshikawa T, Yoshikawa E. 1211 The stress check program: an evaluation of the first-year implementation of the new national workplace mental health program in japan. Health Serv Res 2018. [DOI: 10.1136/oemed-2018-icohabstracts.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Rosellini AJ, Liu H, Petukhova MV, Sampson NA, Aguilar-Gaxiola S, Alonso J, Borges G, Bruffaerts R, Bromet EJ, de Girolamo G, de Jonge P, Fayyad J, Florescu S, Gureje O, Haro JM, Hinkov H, Karam EG, Kawakami N, Koenen KC, Lee S, Lépine JP, Levinson D, Navarro-Mateu F, Oladeji BD, O’Neill S, Pennell BE, Piazza M, Posada-Villa J, Scott KM, Stein DJ, Torres Y, Viana MC, Zaslavsky AM, Kessler RC. Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Psychol Med 2018; 48:437-450. [PMID: 28720167 PMCID: PMC5758426 DOI: 10.1017/s0033291717001817] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Indexed: 01/01/2023]
Abstract
BACKGROUND Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors. METHODS The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD. RESULTS 20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2-0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66-55% v. 43%) and later-recovery (75-68% v. 39%). CONCLUSIONS We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.
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Affiliation(s)
- A. J. Rosellini
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - H. Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - M. V. Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - S. Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA
| | - J. Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - G. Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - R. Bruffaerts
- Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - G. de Girolamo
- IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - P. de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - J. Fayyad
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
| | - S. Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - H. Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - E. G. Karam
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, St George Hospital University Medical Center, Balamand University, Beirut, Lebanon
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - K. C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - J. P. Lépine
- Hôpital Lariboisière-Fernand Widal, Assistance Publique Hôpitaux de Paris, Universités Paris Descartes-Paris Diderot, INSERM UMR-S 1144, Paris, France
| | - D. Levinson
- Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - F. Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
| | - B. D. Oladeji
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - S. O’Neill
- School of Psychology, Ulster University, Londonderry, UK
| | - B.-E. Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - M. Piazza
- Universidad Cayetano Heredia, National Institute of Health, Lima, Peru
| | | | - K. M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - D. J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa
| | - Y. Torres
- Center for Excellence on Research in Mental Health, CES University, Medellín, Colombia
| | - M. C. Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - A. M. Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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43
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Tauchi R, Suzuki Y, Tsuji T, Ohara T, Saito T, Nohara A, Morishita K, Yamauchi I, Kawakami N. Clinical Characteristics and Thoracic factors in patients with Idiopathic and Syndromic Scoliosis Associated with Pectus Excavatum. Spine Surg Relat Res 2018; 2:37-41. [PMID: 31440644 PMCID: PMC6698549 DOI: 10.22603/ssrr.2017-0027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/23/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction The purpose of this study is to demonstrate the clinical characteristics and thoracic factors such as sternal tilt angle and Haller index in patients with idiopathic or syndromic scoliosis associated with pectus excavatum. Methods We performed a retrospective review on a cohort of 70 patients (37 males and 33 females) diagnosed with idiopathic and syndromic scoliosis associated with pectus excavatum between 1985 and 2014. We investigated age, location and Cobb angle of the main curve, and thoracic factors including sternal deviation and tilting angle and Haller index using radiographs and computed tomography of the chest. Results Patients' mean age at the first visit to our hospital was 10.3 years (1-18 years old). There were 41 patients with idiopathic scoliosis and 29 with syndromic scoliosis. Main curve locations were thoracic in 52 patients, thoracolumbar in 10, and lumbar in 8. The mean Cobb angle of the main curve was 45.0 degrees (11-109 degrees). The sternum was displaced on the left side in 72% of patients, central in 23%, and right in 5%. Mean sternal tilt angle was 12.4 degrees (2.3-34 degrees), and mean Haller index score was 4.9 (2.9-9.2). There was no significant correlation between Cobb angle and sternal tilt angle/Haller index. However, a significant difference was found between sternal tilt angle and Haller index. Conclusion Most patients with both scoliosis and pectus excavatum have left side deviated sternum and a higher Haller index score; therefore this can negatively impact cardiac function. Prone positioning and the corrective force applied during scoliosis surgery as well as thoracic compression during cast or brace treatment may have a negative effect on cardiac function in these patients.
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Affiliation(s)
- Ryoji Tauchi
- Department of Orthopedic Surgery, Meijo Hospital, Aichi, Japan
| | - Yoshitaka Suzuki
- Department of Orthopedic Surgery, Nagoya Daini Red Cross Hospital, Aichi, Japan
| | - Taichi Tsuji
- Department of Orthopedic Surgery, Meijo Hospital, Aichi, Japan
| | - Tetsuya Ohara
- Department of Orthopedic Surgery, Meijo Hospital, Aichi, Japan
| | - Toshiki Saito
- Department of Orthopedic Surgery, Meijo Hospital, Aichi, Japan
| | - Ayato Nohara
- Department of Orthopedic Surgery, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan
| | | | - Ippei Yamauchi
- Department of Orthopedic Surgery, Meijo Hospital, Aichi, Japan
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44
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Ito K, Kawakami N, Tsuji T, Ohara T, Saito T, Tauchi R, Morishita K. Corrective surgery for kyphosis in a case of Gaucher's disease without history of vertebral compression fractures. Spine Surg Relat Res 2017; 1:222-224. [PMID: 31440638 PMCID: PMC6698570 DOI: 10.22603/ssrr.1.2017-0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 07/15/2017] [Indexed: 01/18/2023] Open
Abstract
Introduction Gaucher's disease is a congenital metabolic disorder characterized by the accumulation of glucocerebroside in the reticuloendothelial system. Its clinical manifestations include splenomegaly, osteopenia, and pathological fractures. Cases of patients with kyphotic deformities caused by pathological vertebral compression fractures associated with Gaucher's disease are well reported. However, there has been no report regarding surgical treatment of kyphotic deformity caused by Gaucher's disease without compression fractures. In the present report, we describe surgical treatment for kyphotic deformity caused by Gaucher's disease without a past history of vertebral compression fractures. Case Report The patient was diagnosed with Gaucher's disease at the age of 15 months. The patient was a 10-year-old girl with progressive kyphosis (84° between T6 and L3, with T12 as the apical vertebra) without compression fractures. Although the patient had been treated using a brace since the age of 3 years, the kyphosis progressed to the point where corrective surgery was required. We initially performed T3-L3 posterior spinal fusion, followed by anterior fusion 3 months later, which corrected the kyphosis to 35°. Postoperatively, the patient suffered fractures of the upper and lower extremities but did not have spinal fractures. Conclusions Two-stage anterior/posterior combined correction and fusion was performed in a patient with kyphotic deformity caused by Gaucher's disease without compression fractures. Because of bone fragility in Gaucher's disease, careful selection of the fusion range and postoperative therapy was necessary.
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Affiliation(s)
- Kenyu Ito
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Aichi, Japan.,Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Aichi, Japan
| | - Taichi Tsuji
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Aichi, Japan
| | - Tetsuya Ohara
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Aichi, Japan
| | - Toshiki Saito
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Aichi, Japan
| | - Ryoji Tauchi
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Aichi, Japan
| | - Kazuaki Morishita
- Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Aichi, Japan
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45
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Kawakami N, Matsumoto H, Saito T, Tauchi R, Ohara T, Redding G. Paper #5: Pre-operative Six Minute Walk Performance in Children with Congenital Scoliosis. Spine Deform 2017; 5:442. [PMID: 31997205 DOI: 10.1016/j.jspd.2017.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The 6 minute walk (6MW) correlates with age and inversely with the Cobb angle for patients with congenital scoliosis prior to spine surgical intervention. All had low 6MW values compared to age-matched norms. 6MW is useful as a serial measure of functional status for each patient over time.
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46
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Takeda K, Kou I, Kawakami N, Yasuhiko Y, Ogura Y, Imagawa E, Miyake N, Matsumoto N, Sudo H, Kotani T, Nakamura M, Matsumoto M, Watanabe K, Ikegawa S. Response to Lefebvre et al. Clin Genet 2017; 92:563-564. [PMID: 28990171 DOI: 10.1111/cge.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/23/2017] [Accepted: 03/06/2017] [Indexed: 11/28/2022]
Abstract
Congenital scoliosis (CS) is a common vertebral malformation with incidence of up to 1 of 1000 births worldwide. Recently, TBX6 has been reported as the first disease gene for CS: about 10% of CS patients are compound heterozygotes of rare null mutations and a common haplotype composed by 3 SNPs in TBX6. Lefebvre et al in this journal reported that 2 patients with spondylocostal dysostosis (SCD), a rare skeletal dysplasia affecting spine and ribs also have TBX6 mutations: 1 carried the microdeletion and a rare missense variant, and another 2 rare missense variants. We investigated the pathogenicity of the 3 missense variants in SCD by a luciferase assay. The results were negative for the proposal of Lefebvre et al. We consider these 2 SCD patients are more probably compound heterozygotes of null mutations and a common risk haplotype just as CS patients with TBX6 mutations.
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Affiliation(s)
- K Takeda
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - I Kou
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - N Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan
| | - Y Yasuhiko
- Division of Cellular and Molecular Toxicology, National Institute of Health Sciences, Tokyo, Japan
| | - Y Ogura
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - E Imagawa
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - N Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - N Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - H Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - T Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | | | - M Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - M Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - K Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - S Ikegawa
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
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47
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Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ, Stein DJ, Karam EG, Ruscio AM, Benjet C, Scott K, Atwoli L, Petukhova M, Lim CC, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Bunting B, Ciutan M, de Girolamo G, Degenhardt L, Gureje O, Haro JM, Huang Y, Kawakami N, Lee S, Navarro-Mateu F, Pennell BE, Piazza M, Sampson N, ten Have M, Torres Y, Viana MC, Williams D, Xavier M, Kessler RC. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol Med 2017; 47:2260-2274. [PMID: 28385165 PMCID: PMC6034513 DOI: 10.1017/s0033291717000708] [Citation(s) in RCA: 540] [Impact Index Per Article: 77.1] [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] [Indexed: 12/20/2022]
Abstract
BACKGROUND Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. METHODS Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. RESULTS The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. CONCLUSIONS PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.
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Affiliation(s)
- K. C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - A. Ratanatharathorn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - L. Ng
- Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - K. A. McLaughlin
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA
| | - D. J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa
| | - E. G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - A. Meron Ruscio
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - C. Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - K. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - L. Atwoli
- Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
| | - M. Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - C. C.W. Lim
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
- Queensland Brain Institute, University of Queensland, St Lucia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - S. Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - A. Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwania governorate, Iraq
| | - J. Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Pompeu Fabra University (UPF); CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - B. Bunting
- School of Psychology, Ulster University, Londonderry, UK
| | - M. Ciutan
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - G. de Girolamo
- IRCCS St John of God Clinical Research Centre//IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - L. Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - O. Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Y. Huang
- Institute of Mental Health, Peking University, Beijing, China
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - F. Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud IMIB-Arrixaca; CIBERESP-Murcia, Murcia, Spain
| | - B.-E. Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - M. Piazza
- Universidad Cayetano Heredia, Lima, Peru
- National Institute of Health, Lima, Peru
| | - N. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - M. ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Y. Torres
- Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
| | - M. C. Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - D. Williams
- Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massaschusetts, USA
| | - M. Xavier
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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48
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Ogura Y, Kou I, Takahashi Y, Takeda K, Minami S, Kawakami N, Uno K, Ito M, Yonezawa I, Kaito T, Yanagida H, Watanabe K, Taneichi H, Harimaya K, Taniguchi Y, Kotani T, Tsuji T, Suzuki T, Sudo H, Fujita N, Yagi M, Chiba K, Kubo M, Kamatani Y, Nakamura M, Matsumoto M, Watanabe K, Ikegawa S, Tsuyoshi S, Katsuki K, Tsutomu A, Kotaro N, Kenichiro K, Hideki S, Takahiro I, Satoru D, Naobumi H, Eijiro O. A functional variant in MIR4300HG, the host gene of microRNA MIR4300 is associated with progression of adolescent idiopathic scoliosis. Hum Mol Genet 2017; 26:4086-4092. [DOI: 10.1093/hmg/ddx291] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 07/17/2017] [Indexed: 12/19/2022] Open
Affiliation(s)
- Yoji Ogura
- Laboratory of Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan,
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Ikuyo Kou
- Laboratory of Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan,
| | - Yohei Takahashi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Kazuki Takeda
- Laboratory of Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan,
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Shohei Minami
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura 285-8765, Japan,
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya 460-0001, Japan,
| | - Koki Uno
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe 654-0155 Japan,
| | - Manabu Ito
- Department of Orthopaedic Surgery, National Hospital Organization, Hokkaido Medical Center, Hokkaido 063-0005 Japan,
| | - Ikuho Yonezawa
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo 113-8431, Japan,
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan,
| | - Haruhisa Yanagida
- Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Fukuoka 810-0063, Japan,
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Hospital, Niigata 951-8520, Japan,
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Mibu 321-0293, Japan,
| | - Katsumi Harimaya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan,
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-0033, Japan,
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura 285-8765, Japan,
| | - Taichi Tsuji
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya 460-0001, Japan,
| | - Teppei Suzuki
- Department of Orthopaedic Surgery, National Hospital Organization, Kobe Medical Center, Kobe 654-0155 Japan,
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo 060-8648, Japan,
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Kazuhiro Chiba
- Department of Orthopaedic Surgery, National Defense Medical College, Saitama 359-8513, Japan,
| | - Michiaki Kubo
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan,
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan,
| | - Shiro Ikegawa
- Laboratory of Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan,
| | - Sakuma Tsuyoshi
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura 285-8765, Japan
| | - Kono Katsuki
- Department of Orthopaedic Surgery, Kono Othopaedic Clinic, Tokyo 156-0053, Japan
| | - Akazawa Tsutomu
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Nishida Kotaro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Kakutani Kenichiro
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Shigematsu Hideki
- Department of Orthopaedic Surgery, Nara Medical University, Nara 634-8521, Japan
| | - Iida Takahiro
- Department of Orthopaedic Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya 343-8555, Japan,
| | - Demura Satoru
- Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa 920-8641, Japan
| | - Hosogane Naobumi
- Department of Orthopaedic Surgery, National Defense Medical College, Saitama 359-8513, Japan,
| | - Okada Eijiro
- Department of Orthopaedic Surgery, Saiseikai Central Hospital, Tokyo 108-0073, Japan
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Takeda K, Kou I, Kawakami N, Iida A, Nakajima M, Ogura Y, Imagawa E, Miyake N, Matsumoto N, Yasuhiko Y, Sudo H, Kotani T, Nakamura M, Matsumoto M, Watanabe K, Ikegawa S. Cover Image, Volume 38, Issue 3. Hum Mutat 2017. [DOI: 10.1002/humu.23194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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50
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Takeda K, Kou I, Kawakami N, Iida A, Nakajima M, Ogura Y, Imagawa E, Miyake N, Matsumoto N, Yasuhiko Y, Sudo H, Kotani T, Nakamura M, Matsumoto M, Watanabe K, Ikegawa S. Compound Heterozygosity for Null Mutations and a Common Hypomorphic Risk Haplotype in TBX6 Causes Congenital Scoliosis. Hum Mutat 2017; 38:317-323. [PMID: 28054739 DOI: 10.1002/humu.23168] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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: 09/30/2016] [Accepted: 12/26/2016] [Indexed: 12/17/2022]
Abstract
Congenital scoliosis (CS) occurs as a result of vertebral malformations and has an incidence of 0.5-1/1,000 births. Recently, TBX6 on chromosome 16p11.2 was reported as a disease gene for CS; about 10% of Chinese CS patients were compound heterozygotes for rare null mutations and a common haplotype defined by three SNPs in TBX6. All patients had hemivertebrae. We recruited 94 Japanese CS patients, investigated the TBX6 locus for both mutations and the risk haplotype, examined transcriptional activities of mutant TBX6 in vitro, and evaluated clinical and radiographic features. We identified TBX6 null mutations in nine patients, including a missense mutation that had a loss of function in vitro. All had the risk haplotype in the opposite allele. One of the mutations showed dominant negative effect. Although all Chinese patients had one or more hemivertebrae, two Japanese patients did not have hemivertebra. The compound heterozygosity of null mutations and the common risk haplotype in TBX6 also causes CS in Japanese patients with similar incidence. Hemivertebra was not a specific type of spinal malformation in TBX6-associated CS (TACS). A heterozygous TBX6 loss-of-function mutation has been reported in a family with autosomal-dominant spondylocostal dysostosis, but it may represent a spectrum of the same disease with TACS.
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Affiliation(s)
- Kazuki Takeda
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 108-8639, Japan
| | - Ikuyo Kou
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, 160-8582, Japan
| | - Noriaki Kawakami
- Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, 460-0001, Japan
| | - Aritoshi Iida
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, 160-8582, Japan
| | - Masahiro Nakajima
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, 160-8582, Japan
| | - Yoji Ogura
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 108-8639, Japan
| | - Eri Imagawa
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan
| | - Yukuto Yasuhiko
- Division of Cellular and Molecular Toxicology, National Institute of Health Sciences, Tokyo, 158-8501, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, 060-8648, Japan
| | - Toshiaki Kotani
- Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, 285-0825, Japan
| | | | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 108-8639, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 108-8639, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 108-8639, Japan
| | - Shiro Ikegawa
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, 160-8582, Japan
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