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Suzuki H, Tsujimoto T, Ota M, Hasegawa Y, Oha F, Shimamura Y, Tanaka M, Hashimoto T, Iwasaki N, Kanayama M. Scrotal pain of a patient with ankylosing spondylitis successfully treated with TNF-alpha inhibitor: a case report. J Orthop Sci 2024; 29:402-404. [PMID: 35690543 DOI: 10.1016/j.jos.2022.05.007] [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: 01/18/2022] [Revised: 03/08/2022] [Accepted: 05/10/2022] [Indexed: 02/09/2023]
Affiliation(s)
- Hisataka Suzuki
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan.
| | - Masahiro Ota
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
| | - Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
| | - Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido 040-8585, Japan
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Tanaka M, Kanayama M, Oha F, Shimamura Y, Tsujimoto T, Hasegawa Y, Hashimoto T, Nojiri H, Ishijima M. Potential of whole-body dual-energy X-ray absorptiometry to predict muscle size of psoas major, gluteus maximus and back muscles. BMC Musculoskelet Disord 2023; 24:917. [PMID: 38012671 PMCID: PMC10680309 DOI: 10.1186/s12891-023-07051-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Measurement of trunk muscle cross-sectional area (CSA) using axial magnetic resonance imaging (MRI) is considered clinically meaningful for understanding several spinal pathologies, such as low back pain and spinal sagittal imbalance. However, it remains unclear whether trunk muscle mass (TMM) measured using dual-energy X-ray absorptiometry (DXA) can predict the trunk muscle CSA. The aim of this study is to determine if DXA-derived TMM is associated and predicts with CSA of paraspinal muscles and gluteus maximus measured using MRI in healthy volunteers. METHODS A total of 48 healthy volunteers underwent whole-body DXA and MRI of the spinopelvic region. The CSA of the psoas major, back muscles, and gluteus maximus were measured on axial MRI. Correlations and linear regressions between the TMM measured using DXA and the CSA of each musculature were investigated. RESULTS There was a weak correlation between TMM and CSA of the psoas major in men (r = 0.39, P = 0.0678), and the linear regression was y = 301.74x - 401.24 (R2 = 0.2976, P = 0.0070). A moderate correlation was found in women (r = 0.58, P = 0.0021), and the linear regression was y = 230.21x - 695.29 (R2 = 0.4445, P = 0.0003). Moderate correlations were observed between TMM and CSA of the back muscles in both men (r = 0.63, P = 0.0012) and women (r = 0.63, P = 0.0007), the linear regression was y = 468.52x + 3688.5 (R2 = 0.5505, P < 0.0001) in men and y = 477.39x + 2364.1 (R2 = 0.564, P < 0.0001) in women. There was a strong correlation between TMM and CSA of the gluteus maximus in men (r = 0.72, P < 0.0001), and the linear regression was y = 252.69x - 880.5 (R2 = 0.6906, P < 0.0001). A moderate correlation was found in women (r = 0.69, P < 0.0001), and the linear regression was y = 230.74x - 231.32 (R2 = 0.6542, P < 0.0001). CONCLUSIONS The DXA-derived TMM was able to predict the CSA of the psoas major, back muscles, and gluteus maximus, and significantly correlated with the CSA of the back muscles and gluteus maximus. It might be a safer and cheaper alternative for evaluating the size of the back muscles and gluteus maximus.
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Affiliation(s)
- Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Hidetoshi Nojiri
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
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Shimamura Y, Kanayama M, Horio M, Yamaguchi A, Oha F, Tsujimoto T, Tanaka M, Hasegawa Y, Endo T, Hashimoto T. Posterior lumbar fusion surgery doesn't change sexual activities in patients with lumbar degenerative disease: an observational study. BMC Musculoskelet Disord 2023; 24:724. [PMID: 37700275 PMCID: PMC10496199 DOI: 10.1186/s12891-023-06855-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND There are few studies about sexual function in the patient with posterior lumbar spinal fusion for degenerative lumbar disease. The aim of this study is to investigate sexual activities in patients with lumbar degenerative disease before and after lumbar fusion surgery. METHODS We recruited 35 patients who underwent lumbar spinal fusion at the age of 55 years or younger. They were 17 men and 18 women with a mean age of 47.4 years. After informed consent, the patients were asked to complete anonymous questionnaire concerning sexual desire, activity, and satisfaction before and after surgery. RESULTS In the presick period, 69% of the patients had sexual desire, and 79% achieved satisfaction during sexual activity. Lumbar degenerative disease decreased sexual desire and frequency of sexual activity in 40%, and 74% respectively. Before surgery, satisfaction in sexual activities decreased in 53%, and 55% of the patients felt discomfort during sexual activity. Adjustment in sexual position was required in 44% of man and 54% of woman. After surgery, Sexual desire, frequency of sexual activity and satisfaction did not regain after surgery in 94%, 93% and 92%, respectively. Those who did not feel discomfort after surgery was significantly lower VAS in both low back pain and leg pain than the patients felt discomfort (low back pain; p = 0.024, leg pain; p = 0.046). CONCLUSION This study demonstrated that lumbar degenerative diseases decreased sexual desire, frequency of sexual activity and satisfaction, and little of the patients regained their sexual activities after posterior lumbar fusion surgery in the middle-aged patients.
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Affiliation(s)
- Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Michiko Horio
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Ai Yamaguchi
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tsutomu Endo
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
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Tanaka M, Kanayama M, Hashimoto T, Oha F, Shimamura Y, Tsujimoto T, Hasegawa Y, Endo T, Nojiri H, Ishijima M. Characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic - a case-control study. BMC Musculoskelet Disord 2023; 24:626. [PMID: 37533001 PMCID: PMC10394852 DOI: 10.1186/s12891-023-06755-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Under the restriction of social activities during the coronavirus disease 2019 (COVID-19) pandemic, there was concern about the loss of muscle mass due to a decrease in physical activity for the elderly. The purpose of this study was to investigate the characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic in Japan. METHODS A total of 54 patients with postmenopausal osteoporosis were evaluated in this study. Whole-body dual-energy X-ray absorptiometry was performed pre- and post-COVID-19 pandemic to measure trunk and lower limb muscle mass. At the time of the post-COVID-19 pandemic, we conducted a survey to compare lifestyle before pandemic (the frequency of going out, the frequency of meeting acquaintances or families living apart, regular exercise habits, walking time, family structure), and comorbidities between the muscle mass loss (ML) group and the muscle mass maintenance (MM) group. The ML group consisted of patients with at least a 5% decrease in lower limb muscle mass or trunk muscle mass. RESULTS A significant difference was found only for the family structure (P = 0.0279); in the ML group, those living alone were the largest group, while in the MM group they were the smallest group. CONCLUSIONS The ML group was significantly more likely to live alone than the MM group. The current study showed that loss of muscle mass was more common in patients living alone.
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Affiliation(s)
- Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F Yushima, Bunkyo-Ku, Tokyo, 113-0034, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tsutomu Endo
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Hidetoshi Nojiri
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F Yushima, Bunkyo-Ku, Tokyo, 113-0034, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F Yushima, Bunkyo-Ku, Tokyo, 113-0034, Japan
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Tsujimoto T, Itoga R, Kanayama M, Oha F, Shimamura Y, Tanaka M, Hasegawa Y, Fukada S, Hashimoto T, Takahata M, Iwasaki N. Clinical outcomes of short-segment lumbar fusion in patients older than 85 years with a minimum 2-year follow-up. J Neurosurg Spine 2023; 39:40-46. [PMID: 36964728 DOI: 10.3171/2023.2.spine221356] [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: 12/08/2022] [Accepted: 02/20/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Although the number of elderly patients requiring lumbar fusion for lumbar degenerative disorders has increased over time, the postoperative outcomes of lumbar fusion in very elderly patients (> 85 years) remains unknown. This study aimed to evaluate the comprehensive outcomes of lumbar fusion in elderly patients older than 85 years with mid-term follow-up. METHODS The authors retrospectively researched patients older than 85 years who underwent single- or double-level posterior lumbar interbody fusion or transforaminal lumbar interbody fusion from 2012 to 2019. Twenty-nine patients who had at least 2 years of follow-up were included in this study. The average age was 86.4 years, and the average follow-up period was 42.2 months. Each patient was matched with 60- to 75-year-old controls. The Oswestry Disability Index (ODI) score; Roland-Morris Disability Questionnaire (RMDQ) score; Japanese Orthopaedic Association (JOA) score; JOA recovery rate; and low-back pain (LBP), leg pain, and leg numbness visual analog scale (VAS) scores were obtained. The spinopelvic parameters were measured using lateral standing radiographs of the whole spine. RESULTS Although there were no significant differences in the ODI, RMDQ, JOA recovery rate, and leg pain and leg numbness VAS scores at 2 years postoperatively between the very elderly and control groups, the VAS LBP score was significantly lower in the very elderly group than in the control group. Preoperative and postoperative sagittal vertical axes were significantly higher and sacral slopes were significantly lower in the very elderly group than in the control group. The incidences of postoperative delirium and new lumbar vertebral fracture were significantly higher in the very elderly group (17.2%) than in the control group (4.6%). CONCLUSIONS This study showed that lumbar fusion could be performed in patients older than 85 years with satisfactory postoperative outcomes at the 2-year follow-up. In contrast, progressive spinopelvic sagittal imbalance, the incidence of lumbar vertebral fracture up to the final follow-up, and postoperative delirium were greater in the very elderly group than in the control group.
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Affiliation(s)
- Takeru Tsujimoto
- 1Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido
| | - Ryo Itoga
- 1Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido
| | - Masahiro Kanayama
- 1Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido
| | - Fumihiro Oha
- 1Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido
| | | | - Masaru Tanaka
- 1Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido
| | - Yuichi Hasegawa
- 1Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido
| | - Syotaro Fukada
- 1Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido
| | | | - Masahiko Takahata
- 2Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- 2Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Endo T, Koike Y, Hisada Y, Fujita R, Suzuki R, Tanaka M, Tsujimoto T, Shimamura Y, Hasegawa Y, Kanayama M, Yamada K, Iwata A, Sudo H, Ishii M, Iwasaki N, Takahata M. Aggravation of Ossified Ligamentum Flavum Lesion Is Associated With the Degree of Obesity. Global Spine J 2023; 13:1325-1331. [PMID: 34615403 PMCID: PMC10416604 DOI: 10.1177/21925682211031514] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective cross-sectional study. OBJECTIVES There is insufficient data on the clinical features of ossification of the ligamentum flavum (OLF) of the thoracic spine and the risk of progression of ossified lesions. The link between obesity and ossification of the posterior longitudinal ligament (OPLL), which frequently coexists with OLF, has been demonstrated. However, the link between obesity and OLF has not been recognized. We aimed to determine the prevalence of obesity in thoracic OLF and whether the severity of OLF is associated with the degree of obesity. METHODS A total of 204 symptomatic Japanese subjects with thoracic OLF and 136 subjects without spinal ligament ossification as controls were included. OLF subjects were divided into 3 groups: 1) localized OLF (OLF <2-intervertebral regions); 2) multilevel OLF (OLF ≥3-intervertebral regions); and 3) OLF + OPLL. The severity of OLF was quantified using the OLF index using computed tomography imaging of the entire spine. RESULTS The proportion of severely obese subjects (BMI ≥ 30 kg/m2) was significantly higher both in the multilevel OLF group (25.5%) and the OLF + OPLL group (44.3%) than in the localized OLF group (3.6%) and the control group (1.4%) (P < 0.01). BMI, age, and coexistence of cervical OPLL and lumbar OLF were associated with thoracic OLF index in the multiple regression analysis. CONCLUSIONS Our findings demonstrated that obesity is a distinct feature of multilevel OLF in the thoracic spine and that the severity of OLF is associated with the degree of obesity.
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Affiliation(s)
- Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yoshinao Koike
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yuichiro Hisada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryo Fujita
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryota Suzuki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masaru Tanaka
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Takeru Tsujimoto
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yukitoshi Shimamura
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yuichi Hasegawa
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Masahiro Kanayama
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Akira Iwata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hideki Sudo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Misaki Ishii
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Tsujimoto T, Kanayama M, Oha F, Shimamura Y, Tanaka M, Hasegawa Y, Fukada S, Hashimoto T, Takahata M, Iwasaki N. Characteristics of the Patients with Poor Clinical Outcomes After Symptomatic Postoperative Lumbar Epidural Hematoma. World Neurosurg 2023; 172:e364-e371. [PMID: 36640830 DOI: 10.1016/j.wneu.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Symptomatic postoperative lumbar epidural hematoma (PLEH) may lead to poor outcomes even after evacuation. This study aimed to verify the short-term clinical outcomes after the evacuation of PLEH and to clarify the characteristics of the patients with poor postoperative outcomes. METHODS Twenty-five patients (average age; 70.4 years) underwent PLEH evacuation after lumbar spine surgery. The mean follow-up period was 12.0 (range 3-37) months. Pre and postoperative Japanese Orthopedic Association scores and visual analog scale (VAS) of low back pain (LBP), leg pain, and leg numbness were retrospectively collected. The dural sac cross-sectional area at the most compressed level was measured on magnetic resonance imaging. The patients were classified into 2 groups: poor outcome group (P group) had less than 50% of Japanese Orthopedic Associationrecovery rate and good group (G group) with 50% or more recovery rate. RESULTS The rate of delayed evacuation (over 24 hours of onset) was significantly higher in P group than in G group (P = 0.027). There was no significant difference in dural sac cross-sectional areabetween the 2 groups (P = 0.438). VAS of LBP, leg pain, and leg numbness in G group significantly improved postoperatively. Although VAS of LBP and leg pain in P group significantly improved postoperatively, there was no significant difference between the pre and postoperative VAS of leg numbness. CONCLUSIONS Delayed evacuation of PLEH can lead to poor postoperative outcomes after lumbar spine surgery. Moreover, patients with poor outcomes remained with postoperative leg numbness. Early evacuation of symptomatic PLEH is key to avoid poor outcomes and persistent leg numbness.
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Affiliation(s)
- Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | | | - Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Syotaro Fukada
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Tsujimoto T, Kanayama M, Suda K, Oha F, Komatsu M, Shimamura Y, Tanaka M, Ukeba D, Hasegawa Y, Hashimoto T, Takahata M, Iwasaki N. Perioperative Complications of Open Spine Surgery in Older Adults over 90 Years of Age. Spine Surg Relat Res 2022; 6:664-670. [PMID: 36561154 PMCID: PMC9747208 DOI: 10.22603/ssrr.2022-0036] [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: 02/12/2022] [Accepted: 04/13/2022] [Indexed: 12/25/2022] Open
Abstract
Introduction Despite perioperative risks in nonagenarian patients who undergo open spine surgery for degeneration disorder or spinal trauma being of great interest, the prevalence of complications in this group remains unclear. This study aims to examine the perioperative complications of open spine surgery in the elderly over 90 years of age. Methods Preoperative and intraoperative characteristics including the American Society of Anesthesiologists Physical Status (ASA-PS) class, type of surgery, and complications within 30 postoperative days were retrospectively collected from the medical records of nonagenarians who underwent open spine surgery between April 2004 and July 2019 at our spine centers. Results A total of 48 patients met the inclusion criteria of this study. All belong to ASA-PS class 2 (69%) or 3. Preoperative American Spinal Injury Association Impairment Scale grades in trauma group were grade A in 4 cases, B in 1 case, C in 5 cases, D in 11 cases, and E in 1 case. Major complications (deep surgical site infection, cardiac event, respiratory disorder, gastrointestinal hemorrhage, and renal failure) occurred in 13 cases, and the rate of overall perioperative complications was 45.8%. One patient who underwent cervical stabilization for cervical fracture dislocation died at postoperative 13 days due to respiratory disorder. The rates of major complications and overall perioperative complications were 3.6% and 14.3% in the degenerative group and 45.5% and 81.8% in the trauma group, respectively. Especially in the trauma group, respiratory disorder occurred in 7 cases, delirium in 11 cases, and urinary tract infection in 5 cases. Conclusions Although the perioperative complication rate reached 81.8% in spinal trauma cases, the complication rate in degenerative disorders was relatively low as 14.3%. Open spine surgery for degenerative disorders can be relatively safe even in nonagenarians, whereas the risks of perioperative complications, including respiratory disorder and delirium, were high in spinal trauma cases.
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Affiliation(s)
- Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Kota Suda
- Department of Orthopedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai, Hokkaido, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Miki Komatsu
- Department of Orthopedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai, Hokkaido, Japan
| | | | - Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Daisuke Ukeba
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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9
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Shimamura Y, Kanayama M, Oha F, Tsujimoto T, Takana M, Hasegawa Y, Endo T, Hashimoto T. Pre-existing adjacent level foraminal stenosis does not affect the outcome of a single level lumbar interbody fusion. J Orthop Sci 2022:S0949-2658(22)00072-0. [PMID: 35469740 DOI: 10.1016/j.jos.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/01/2022] [Accepted: 03/22/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND The aim of this study was to investigate whether or not pre-existing asymptomatic neuroforaminal stenosis adjacent to the fusion level develops adjacent segment disease (ASD) after single-level lumbar interbody fusion. SUMMARY AND BACKGROUND DATA Risk factors of ASD after spinal fusion have been well investigated, but there have been few studies focused on the relationship between ASD and pre-existing asymptomatic neuroforaminal stenosis. METHODS A total of 302 patients who had undergone a single-level lumbar interbody fusion were reviewed at a minimum of 2 year follow-up. They were 109 men and 193 women with a mean age of 68.8 years. Follow-up periods was averaged 53.5 months. ASD was defined as neurological deterioration related to adjacent segment pathologies which required an additional surgery. Based on the pathologies, patients were divided into three categories: ASD due to foraminal stenosis (ASD-FS), ASD due to central stenosis (ASD-CS), and ASD due to herniated disc (ASD-HD). Measured variables were age, gender, diagnosis, BMI, decompression procedures at adjacent segments, preoperative anterior/posterior slip, asymptomatic neuroforaminal stenosis, facet tropism, and postoperative spinopelvic parameters. RESULTS Thirty-eight patients (12.6%) developed ASD. There were 15 patients with ASD-FS, 18 patients with ASD-CS, and five patients with ASD-HD. Lumbar lordosis (LL) and sacral slope (SS) were significantly smaller and pelvic tilt (PT) was significantly larger in ASD-FS. Asymptomatic neuroforaminal stenosis was detected preoperatively in 33.3% of the ASD-FS group, and 18.6% of non-ASD group; the incidence was not significantly different. CONCLUSIONS Adjacent-level neuroforaminal stenosis was not a significant risk of ASD after single-level lumbar interbody fusion, and might not need to be fused if asymptomatic.
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Affiliation(s)
- Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan
| | - Masaru Takana
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan
| | - Tsutomu Endo
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, Japan
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10
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Tanaka M, Kanayama M, Hashimoto T, Oha F, Shimamura Y, Tsujimoto T, Hasegawa Y, Nojiri H, Ishijima M. Trends of Spine Surgeries during the First COVID-19 Semi-Lockdown: Survey in a Non-Epidemic Region in Japan. Spine Surg Relat Res 2022; 6:109-114. [PMID: 35478977 PMCID: PMC8995125 DOI: 10.22603/ssrr.2021-0208] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/06/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Methods Results Conclusions
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Affiliation(s)
| | | | | | | | | | | | | | - Hidetoshi Nojiri
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine
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11
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Wu Y, Kurosaka H, Wang Q, Inubushi T, Nakatsugawa K, Kikuchi M, Ohara H, Tsujimoto T, Natsuyama S, Shida Y, Sandell LL, Trainor PA, Yamashiro T. Retinoic Acid Deficiency Underlies the Etiology of Midfacial Defects. J Dent Res 2022; 101:686-694. [PMID: 35001679 DOI: 10.1177/00220345211062049] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Embryonic craniofacial development depends on the coordinated outgrowth and fusion of multiple facial primordia, which are populated with cranial neural crest cells and covered by the facial ectoderm. Any disturbance in these developmental events, their progenitor tissues, or signaling pathways can result in craniofacial deformities such as orofacial clefts, which are among the most common birth defects in humans. In the present study, we show that Rdh10 loss of function leads to a substantial reduction in retinoic acid (RA) signaling in the developing frontonasal process during early embryogenesis, which results in a variety of craniofacial anomalies, including midfacial cleft and ectopic chondrogenic nodules. Elevated apoptosis and perturbed cell proliferation in postmigratory cranial neural crest cells and a substantial reduction in Alx1 and Alx3 transcription in the developing frontonasal process were associated with midfacial cleft in Rdh10-deficient mice. More important, expanded Shh signaling in the ventral forebrain, as well as partial abrogation of midfacial defects in Rdh10 mutants via inhibition of Hh signaling, indicates that misregulation of Shh signaling underlies the pathogenesis of reduced RA signaling-associated midfacial defects. Taken together, these data illustrate the precise spatiotemporal function of Rdh10 and RA signaling during early embryogenesis and their importance in orchestrating molecular and cellular events essential for normal midfacial development.
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Affiliation(s)
- Y Wu
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - H Kurosaka
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Q Wang
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - T Inubushi
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - K Nakatsugawa
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - M Kikuchi
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - H Ohara
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - T Tsujimoto
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - S Natsuyama
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Y Shida
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
| | - L L Sandell
- Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, KY, USA
| | - P A Trainor
- Stowers Institute for Medical Research, Kansas City, MO, USA.,Department of Anatomy and Cell Biology, School of Medicine, University of Kansas, Kansas City, KS, USA
| | - T Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Suita, Japan
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12
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Tanaka M, Kanayama M, Hashimoto T, Oha F, Shimamura Y, Endo T, Tsujimoto T, Hara H, Hasegawa Y, Nojiri H, Ishijima M. Clinical Outcomes and Postoperative Radiographic Assessment of Osteoplastic Hemilaminectomy in the Treatment of Lumbar Foraminal Nerve Root Compression. Spine Surg Relat Res 2021; 5:352-358. [PMID: 34966860 PMCID: PMC8668207 DOI: 10.22603/ssrr.2020-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/20/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Osteoplastic hemilaminectomy for the treatment of lumbar foraminal nerve root compression is a safe technique as the exiting nerve root can be directly observed during neuroforaminal decompression without spinal fusion. Moreover, this procedure allows anatomical reconstruction of the posterior elements. However, there might be a potential risk for the progression of lumbar segmental instability after performing this procedure. This study aimed to review the radiographic and clinical outcomes of osteoplastic hemilaminectomy for the treatment of lumbar foraminal nerve root compression. Methods We retrospectively reviewed 51 patients who underwent osteoplastic hemilaminectomy with a minimum follow-up of 2 years. The clinical outcomes were evaluated using the visual analog scale (VAS) for low back pain, leg pain, and numbness and the Japanese Orthopaedic Association (JOA) score. Lumbar segmental instability was evaluated as a radiographic assessment using functional radiography. The mean follow-up period was 65 months. Results The preoperative VASs for low back pain, leg pain, and numbness were 46±31, 72±26, and 43±34, respectively, which were improved to 24±23, 19±23, and 19±23, respectively. The JOA score was also improved from 14±5 to 22±4. Three patients (5.9%) were reoperated due to recurrent disc herniation within 2 years following surgery. In addition, three patients (5.9%) developed postoperative lumbar segmental instability but did not require additional surgery. Conclusions The current study revealed that 94.1% of the patients who underwent osteoplastic hemilaminectomy achieved a significant improvement in the clinical outcomes and did not require additional surgery within 2 years following the procedure. Over a 5-year follow-up on average, 5.9% of the subjects developed postoperative lumbar segmental instability; however, they have maintained acceptable clinical conditions.
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Affiliation(s)
- Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hokkaido, Japan.,Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan
| | | | | | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hokkaido, Japan
| | | | - Tsutomu Endo
- Spine Center, Hakodate Central General Hospital, Hokkaido, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hokkaido, Japan
| | - Hiroyuki Hara
- Spine Center, Hakodate Central General Hospital, Hokkaido, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hokkaido, Japan
| | - Hidetoshi Nojiri
- Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan
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13
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Suzuki R, Koike Y, Ota M, Endo T, Hisada Y, Tsujimoto T, Kanayama M, Ito YM, Sudo H, Iwata A, Yamada K, Iwasaki N, Takahata M. Thrombocytopenia Associated with Unrecognized Non-Alcoholic Fatty Liver Disease Is an Independent Predictor of Perioperative Significant Blood Loss in Cervical Laminoplasty. World Neurosurg 2021; 155:e797-e804. [PMID: 34509679 DOI: 10.1016/j.wneu.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify risk factors for significant blood loss (SBL) in cervical laminoplasty, especially regarding thrombocytopenia and coagulopathy resulting from non-alcoholic fatty liver disease (NAFLD). METHODS We retrospectively investigated differences in patient background data, laboratory data at the time of admission, and surgery-related data of 317 patients who underwent cervical laminoplasty and were divided into SBL (estimated blood loss [EBL] + drainage [D] ≥500 g) and non-SBL (EBL + D < 500 g) groups. To evaluate liver status, we used the fibrous 4 index and considered fibrous 4 index ≥1.85 as a representative phenotype for NAFLD with liver fibrosis. In addition, the risk factor for perioperative SBL was investigated using multiple logistic regression analysis, and the cutoff value was calculated. RESULTS Incidence of perioperative SBL in cervical laminoplasty was 7.3% (23/317). Compared with the non-SBL group, the SBL group demonstrated significantly lower platelet count (PLT), lower aspartate aminotransferase, longer operation time, and greater number of opened laminae. According to multivariate analysis, lower PLT and a greater number of opened laminae were identified as significant risk factors for perioperative SBL. The cutoff value of PLT for predicting SBL was determined to be 16.7 × 104/μL using a receiver operating characteristic curve. The liver fibrosis group revealed significantly lower PLT and greater EBL + D than the non-liver fibrosis group. CONCLUSIONS Thrombocytopenia is an independent predictor of perioperative SBL in cervical laminoplasty. Thus, patients with mild thrombocytopenia that may be associated with NAFLD must be carefully monitored to avoid perioperative SBL.
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Affiliation(s)
- Ryota Suzuki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yoshinao Koike
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiro Ota
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yuichiro Hisada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Takeru Tsujimoto
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Masahiro Kanayama
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yoichi M Ito
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Hideki Sudo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Akira Iwata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
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14
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Endo T, Koike Y, Miyoshi H, Hisada Y, Fujita R, Suzuki R, Tanaka M, Tsujimoto T, Shimamura Y, Hasegawa Y, Kanayama M, Hashimoto T, Oha F, Noro N, Komano K, Ishii M, Ito YM, Iwasaki N, Takahata M. Close association between non-alcoholic fatty liver disease and ossification of the posterior longitudinal ligament of the spine. Sci Rep 2021; 11:17412. [PMID: 34465807 PMCID: PMC8408257 DOI: 10.1038/s41598-021-96714-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022] Open
Abstract
Ossification of the posterior longitudinal ligament (OPLL) of the spine is a disease of unknown etiology occurring frequently in individuals with metabolic disturbances. Obesity has been suggested as a potential risk factor for the severity of OPLL. We aimed to investigate whether non-alcoholic fatty liver disease (NAFLD) is associated with OPLL severity. We assessed the severity of NAFLD by a liver-to-spleen (L/S) ratio on computed tomography (CT) scans of 85 symptomatic OPLL patients at a single institution in Japan. We also assessed the severity of OPLL by CT reconstruction sagittal and axial images. The prevalence of NAFLD in middle-aged patients (age < 70 years, n = 50) was 80.3%, which was 2.5-8 times higher than that in the general Japanese population (9-30%). The ossification index of the spinal ligaments increased in proportion to the severity of fatty liver. The L/S ratio was revealed as a significant risk factor associated with the total ossification index (standardized β: -0.40, 95% confidence interval - 54.34 to - 4.22). This study suggests the potential contribution of NAFLD to the progression of OPLL. The close association between NAFLD and OPLL demonstrated in this study warrants further study to elucidate the causal nature of this relationship.
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Affiliation(s)
- Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Yoshinao Koike
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hideaki Miyoshi
- Division of Diabetes & Obesity, Faculty of Medicine & Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yuichiro Hisada
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Ryo Fujita
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Ryota Suzuki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Masaru Tanaka
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Takeru Tsujimoto
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Yukitoshi Shimamura
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Yuichi Hasegawa
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Masahiro Kanayama
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Tomoyuki Hashimoto
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Fumihiro Oha
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Naoki Noro
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Kiyofumi Komano
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Misaki Ishii
- Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido, 040-8585, Japan
| | - Yoichi M Ito
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Kita-14 Nishi-5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
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15
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Tsujimoto T, Endo T, Menjo Y, Kanayama M, Oda I, Suda K, Fujita R, Koike Y, Hisada Y, Iwasaki N, Takahata M. Exceptional Conditions for Favorable Neurological Recovery After Laminoplasty in Cases with Cervical Myelopathy Caused by K-line (-) Ossification of Posterior Longitudinal Ligament. Spine (Phila Pa 1976) 2021; 46:990-998. [PMID: 33428361 DOI: 10.1097/brs.0000000000003945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective observational study. OBJECTIVE To clarify the exceptional conditions for a favorable neurological recovery after laminoplasty (LMP) for cervical myelopathy caused by K-line (-) ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA The K-line-based classification of cervical OPLL was developed to predict insufficient neurological recovery after LMP. For patients with K-line (-) OPLL, LMP generally yields the least improvement because of inadequate decompression of the spinal cord; however, there are some exceptional cases wherein LMP promotes favorable neurological recoveries. METHODS We retrospectively reviewed the medical records of 106 consecutive patients who underwent LMP for cervical OPLL to determine the demographic data, radiographic findings, and neurological recoveries of the patients as assessed preoperatively and 2 years postoperatively by their Japanese Orthopedic Association (JOA) scores. The factors associated with favorable outcomes after LMP in patients with K-line (-) were then investigated. RESULTS Of 106 total patients, 31 were classified as K-line (-), of whom 21 achieved the least neurological recovery after LMP (JOA recovery rate <50%), while the remaining 10 patients achieved favorable outcomes (JOA recovery rate ≥50%). Among the K-line (-) group patients, those with ext-K-line (+), which changed to K-line (+) in the neck-extended position, and the patients with up-K-line (-), in whom the lesion responsible for myelopathy in the upper cervical spine (C3 or above), showed favorable neurological recoveries after LMP. CONCLUSION Our data shows that, even for patients with K-line (-) OPLL, a favorable neurological recovery can be expected after LMP in cases in which the OPLL is in the upper cervical spine or the K-line changes to (+) in the neck-extended position. This means that K-line-based predictions of surgical outcomes after LMP should be indicated for patients with OPLL in the middle and lower cervical spine with limited extension mobility.Level of Evidence: 4.
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Affiliation(s)
- Takeru Tsujimoto
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Tsutomu Endo
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yusuke Menjo
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Itaru Oda
- Department of Spine Surgery, Hokkaido Orthopedic Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Kota Suda
- Department of Orthopedic Surgery, Hokkaido Spinal Cord Injury Center, Bibai, Hokkaido, Japan
| | - Ryo Fujita
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yoshinao Koike
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yuichiro Hisada
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Ukeba D, Yamada K, Tsujimoto T, Ura K, Nonoyama T, Iwasaki N, Sudo H. Bone Marrow Aspirate Concentrate Combined with in Situ Forming Bioresorbable Gel Enhances Intervertebral Disc Regeneration in Rabbits. J Bone Joint Surg Am 2021; 103:e31. [PMID: 33481466 DOI: 10.2106/jbjs.20.00606] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The current surgical procedure of choice for intervertebral disc (IVD) herniation is discectomy, which induces postoperative IVD degeneration. Thus, cell-based therapies, as a 1-step simple procedure, are desired because of the poor capacity of IVDs for self-repair. The aim of this study was to investigate the repair efficacy of ultra-purified alginate (UPAL) gels containing bone marrow aspirate concentrate (BMAC) for the treatment of discectomy-associated IVD degeneration in rabbits. METHODS The mechanical properties of 3 types of gels-UPAL, UPAL containing bone marrow-derived mesenchymal stem cells (BMSCs), and UPAL containing BMAC-were evaluated. Forty rabbits were assigned to 5 groups: intact control, discectomy (to make the cavity), UPAL (implantation of the UPAL gel after discectomy), BMSCs-UPAL (implantation of a combination of autogenic BMSCs and UPAL gel after discectomy), and BMAC-UPAL (implantation of a combination of BMAC and UPAL gel after discectomy). The gels were implanted at 4 weeks after induction of IVD degeneration. At 4 and 12 weeks, magnetic resonance imaging (MRI) as well as histological and immunohistochemical analyses were performed to analyze IVD degeneration qualitatively and the viability of the implanted cells. RESULTS There was no significant difference among the 3 types of gels in terms of the results of unconfined compression tests. The implanted cells survived for 12 weeks. The histological grades of the BMSCs-UPAL (mean and standard deviation, 2.50 ± 0.53; p < 0.001) and BMAC-UPAL (2.75 ± 0.64, p = 0.001) showed them to be more effective in preventing degeneration than UPAL gel alone (3.63 ± 0.52). The effectiveness of BMAC-UPAL was not significantly different from that of BMSCs-UPAL, except with respect to type-II collagen synthesis. CONCLUSIONS BMAC-UPAL significantly enhanced the repair of IVD defects created by discectomy. This approach could be an effective therapeutic strategy owing to its simplicity and cost-effectiveness compared with cell therapy using culture-expanded BMSCs. CLINICAL RELEVANCE Local administration of the BMAC combined with UPAL gel could be an effective therapeutic strategy to enhance IVD repair after discectomy.
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Affiliation(s)
- Daisuke Ukeba
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Katsuhisa Yamada
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takeru Tsujimoto
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Katsuro Ura
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takayuki Nonoyama
- Global Station for Soft Matter, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, Japan
| | - Norimasa Iwasaki
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideki Sudo
- Departments of Orthopedic Surgery (D.U., K.Y., T.T., K.U., N.I., and H.S.) and Advanced Medicine for Spine and Spinal Cord Disorders (H.S.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Faculty of Advanced Life Science, Hokkaido University, Sapporo, Japan
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Ura K, Yamada K, Tsujimoto T, Ukeba D, Iwasaki N, Sudo H. Ultra-purified alginate gel implantation decreases inflammatory cytokine levels, prevents intervertebral disc degeneration, and reduces acute pain after discectomy. Sci Rep 2021; 11:638. [PMID: 33436742 PMCID: PMC7804289 DOI: 10.1038/s41598-020-79958-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
Lumbar intervertebral disc (IVD) herniation causes severe low back pain (LBP), which results in substantial financial and emotional strains. Despite the effectiveness of discectomy, there is no existing treatment for post-operative LBP induced by progressive IVD degeneration. Two key factors of LBP are intradiscal inflammation, indicated by tumour necrosis factor alpha (TNF-α) and interleukin-6 (IL-6), and sensory nerve ingrowth into the inner layer of the annulus fibrosus, triggered by nerve growth factor/high-affinity tyrosine kinase A (TrkA) signalling. In an animal models of discectomy, the bioresorbable ultra-purified alginate (UPAL) gel with an extremely low-toxicity has been effective in acellular tissue repair. We aimed to investigate whether UPAL gel can alleviate LBP using a rat nucleus pulposus (NP) punch model and a rabbit NP aspirate model. In both models, we assessed TNF-α and IL-6 production and TrkA expression within the IVD by immunohistochemistry. Further, histological analysis and behavioural nociception assay were conducted in the rat model. UPAL gel implantation suppressed TNF-α and IL-6 production, downregulated TrkA expression, inhibited IVD degeneration, and reduced nociceptive behaviour. Our results suggest the potential of UPAL gel implantation as an innovative treatment for IVD herniation by reducing LBP and preventing IVD degeneration after discectomy.
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Affiliation(s)
- Katsuro Ura
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Katsuhisa Yamada
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan.
| | - Takeru Tsujimoto
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Daisuke Ukeba
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido, 060-8638, Japan.
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Ukeba D, Sudo H, Tsujimoto T, Ura K, Yamada K, Iwasaki N. Bone marrow mesenchymal stem cells combined with ultra-purified alginate gel as a regenerative therapeutic strategy after discectomy for degenerated intervertebral discs. EBioMedicine 2020; 53:102698. [PMID: 32143180 PMCID: PMC7057222 DOI: 10.1016/j.ebiom.2020.102698] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 02/07/2020] [Accepted: 02/18/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Because the regenerative ability of intervertebral discs (IVDs) is restricted, defects caused by discectomy may induce insufficient tissue repair leading to further IVD degeneration. An acellular bioresorbable biomaterial based on ultra-purified alginate (UPAL) gel was developed to fill the IVD cavity and prevent IVD degeneration. However, an acellular matrix-based strategy may have limitations, particularly in the elderly population, who exhibit low self-repair capability. Therefore, further translational studies involving product combinations, such as UPAL gel plus bone marrow-derived mesenchymal stem cells (BMSCs), are required to evaluate the regenerative effects of BMSCs embedded in UPAL gel on degenerated IVDs. METHODS Rabbit BMSCs and nucleus pulposus cells (NPCs) were co-cultured in a three-dimensional (3D) system in UPAL gel. In addition, rabbit or human BMSCs combined with UPAL gel were implanted into IVDs following partial discectomy in rabbits with degenerated IVDs. FINDINGS Gene expression of NPC markers, growth factors, and extracellular matrix was significantly increased in the NPC and BMSC 3D co-culture compared to that in each 3D mono-culture. In vivo, whereas UPAL gel alone suppressed IVD degeneration as compared to discectomy, the combination of BMSCs and UPAL gel exerted a more potent effect to induce IVD regeneration. Similar IVD regeneration was observed using human BMSCs. INTERPRETATION These findings demonstrate the therapeutic potential of BMSCs combined with UPAL gel as a regenerative strategy following discectomy for degenerated IVDs. FUNDING Ministry of Education, Culture, Sports, Science, and Technology of Japan, Japan Agency for Medical Research and Development, and the Mochida Pharmaceutical Co., Ltd.
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Affiliation(s)
- Daisuke Ukeba
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hideki Sudo
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, Sapporo, Hokkaido, Japan; Faculty of Medicine and Graduate of Medicine, Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University, Sapporo, Hokkaido, Japan.
| | - Takeru Tsujimoto
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Katsuro Ura
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Katsuhisa Yamada
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, Sapporo, Hokkaido, Japan; Faculty of Medicine and Graduate of Medicine, Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, Sapporo, Hokkaido, Japan
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Shimodan S, Sato D, Takahashi K, Nakamura Y, Hyakkan R, Watanabe T, Hishimura R, Ota M, Shimizu H, Hojo Y, Hasegawa Y, Chubachi T, Yasui K, Tsujimoto T, Tsukuda Y, Asano T, Takahashi D, Takahata M, Iwasaki N, Shimizu T. Ten years change in post-fracture care for hip fracture patients. J Bone Miner Metab 2020; 38:222-229. [PMID: 31583538 DOI: 10.1007/s00774-019-01047-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/03/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This multicenter, retrospective study aimed to clarify the changes in postoperative care provided by orthopaedic surgeons after hip fractures and clarify the incidence of secondary fractures requiring surgery. MATERIALS AND METHODS Subjects were patients with hip fracture treated surgically in seven hospitals during the 10-year period from January 2008 to December 2017. Data on patient demographics, comorbidities, preoperative and postoperative osteoporosis treatments, and secondary fractures were collected from the medical records. RESULTS In total, 4764 new hip fractures in 982 men and 3782 women (mean age: 81.3 ± 10.0 years) were identified. Approximately 10% of patients had a history of osteoporosis drug treatment and 35% of patients received postoperative drug treatment. The proportion of patients receiving postoperative drug therapy increased by approximately 10% between 2009 and 2010, 10% between 2010 and 2011, and 10% between 2011 and 2013. Although the rate of secondary fractures during the entire period and within 3 years decreased from 2011, the rate of secondary fracture within 1 year remained at around 2% every year. CONCLUSIONS The approval of new osteoporosis drugs and the establishment of osteoporosis liaison services have had a positive effect on the use of postoperative drug therapy in the orthopedic field. Our finding that the rate of secondary fracture within 1 year of the initial fracture remained around 2% every year, despite improvements in postoperative drug therapy, suggests that both rehabilitation for preventing falls and early postoperative drug therapy are essential to prevent secondary fractures.
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Affiliation(s)
- Shun Shimodan
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Kushiro City General Hospital, Kushiro, Hokkaido, Japan
| | - Dai Sato
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Iwamizawa City Hospital, Iwamizawa, Hokkaido, Japan
| | - Kaname Takahashi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Hakodate General Central Hospital, Hakodate, Hokkaido, Japan
| | - Yumejiro Nakamura
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Hakodate General Central Hospital, Hakodate, Hokkaido, Japan
| | - Ryota Hyakkan
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Hakodate General Central Hospital, Hakodate, Hokkaido, Japan
| | - Takamasa Watanabe
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Hakodate General Central Hospital, Hakodate, Hokkaido, Japan
| | - Ryosuke Hishimura
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Ebetsu City Hospital, Ebetsu, Hokkaido, Japan
| | - Masahiro Ota
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Hokushokai Hospital, Iwamizawa, Hokkaido, Japan
| | - Hirokazu Shimizu
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Hokkaido, Japan
| | - Yoshihiro Hojo
- Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Hokkaido, Japan
| | - Yuichi Hasegawa
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Obihiro Kosei Hospital, Obihiro, Hokkaido, Japan
| | - Toshiya Chubachi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Obihiro Kosei Hospital, Obihiro, Hokkaido, Japan
| | - Keigo Yasui
- Department of Orthopaedic Surgery, Obihiro Kosei Hospital, Obihiro, Hokkaido, Japan
| | - Takeru Tsujimoto
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Otaru City Hospital, Otaru, Hokkaido, Japan
| | - Yukinori Tsukuda
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
- Department of Orthopaedic Surgery, Otaru City Hospital, Otaru, Hokkaido, Japan
| | - Tsuyoshi Asano
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Daisuke Takahashi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Tomohiro Shimizu
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
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Ura K, Sudo H, Iwasaki K, Tsujimoto T, Ukeba D, Iwasaki N. Effects of Intradiscal Injection of Local Anesthetics on Intervertebral Disc Degeneration in Rabbit Degenerated Intervertebral Disc. J Orthop Res 2019; 37:1963-1971. [PMID: 31106893 DOI: 10.1002/jor.24347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 05/14/2019] [Indexed: 02/04/2023]
Abstract
Analgesic discoblock is widely used for the diagnosis or treatment of discogenic low back pain by injecting local anesthetics. The purpose of this study was to investigate the deleterious effects of local anesthetics on degenerated rabbit intervertebral disks (IVDs) using an organotypic culture model and in vivo long-term follow-up model. To induce IVD degeneration, a rabbit annular puncture model was used. For the organotypic culture model, degenerated IVDs were harvested 1 month after the initial annular puncture and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine and 0.5% bupivacaine). To perform in vivo analysis, local anesthetics were injected into degenerated IVDs, and IVDs were prepared for histological analysis after 6 or 12 months. In the organotypic model, terminal deoxynucleotidyl transferase dUTP nick end labeling-positive nucleus pulposus (NP) cells were significantly increased in the bupivacaine group compared with the other groups. In the in vivo study, the number of NP cells was significantly decreased in the saline and local anesthetics groups compared with the untreated control and puncture-only groups. However, there was no significant difference among the saline, lidocaine, and bupivacaine groups. In addition, histological analysis showed no significant difference of IVD degeneration among the puncture-only, saline, lidocaine, and bupivacaine groups. Although bupivacaine induced apoptotic NP cell death in the organotypic culture model, in vivo observations did not show any definitive proof to suggest that local anesthetics were capable of promoting degeneration in the degenerated IVD, except for pressurized injection-induced damage. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1963-1971, 2019.
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Affiliation(s)
- Katsuro Ura
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North-15, West-7, Sapporo, 060-8638, Japan
| | - Koji Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takeru Tsujimoto
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Daisuke Ukeba
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Tsujimoto T, Wasa M, Inohara H, Ito T. MON-PO404: L-Glutamine Does not Influence the Survival Outcomes in Patients with Locally Advanced Head and Neck Cancer Receiving Chemoradiotherapy. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tsujimoto T, Sudo H, Todoh M, Yamada K, Iwasaki K, Ohnishi T, Hirohama N, Nonoyama T, Ukeba D, Ura K, Ito YM, Iwasaki N. An acellular bioresorbable ultra-purified alginate gel promotes intervertebral disc repair: A preclinical proof-of-concept study. EBioMedicine 2018; 37:521-534. [PMID: 30389504 PMCID: PMC6286260 DOI: 10.1016/j.ebiom.2018.10.055] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 09/18/2018] [Revised: 10/14/2018] [Accepted: 10/23/2018] [Indexed: 12/11/2022] Open
Abstract
Background The current surgical procedure of choice for lumbar intervertebral disc (IVD) herniation is discectomy. However, defects within IVD produced upon discectomy may impair tissue healing and predispose patients to subsequent IVD degeneration. This study aimed to investigate whether the use of an acellular bioresorbable ultra-purified alginate (UPAL) gel implantation system is safe and effective as a reparative therapeutic strategy after lumbar discectomy. Methods Human IVD cells were cultured in a three-dimensional system in UPAL gel. In addition, lumbar spines of sheep were used for mechanical analysis. Finally, the gel was implanted into IVD after discectomy in rabbits and sheep in vivo. Findings The UPAL gel was biocompatible with human IVD cells and promoted extracellular matrix production after discectomy, demonstrating sufficient biomechanical characteristics without material protrusion. Interpretation The present results indicate the safety and efficacy of UPAL gels in a large animal model and suggest that these gels represent a novel therapeutic strategy after discectomy in cases of lumbar IVD herniation. Fund Grant-in-Aid for the Ministry of Education, Culture, Sports, Science, and Technology of Japan, Japan Agency for Medical Research and Development, and the Mochida Pharmaceutical Co., Ltd.
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Affiliation(s)
- Takeru Tsujimoto
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
| | - Hideki Sudo
- Faculty of Medicine and Graduate of Medicine, Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University, N15W7, Sapporo 060-8638, Hokkaido, Japan.
| | - Masahiro Todoh
- Faculty of Engineering, Division of Human Mechanical Systems and Design, Hokkaido University, N13W8, Sapporo, Hokkaido 060-8628, Japan
| | - Katsuhisa Yamada
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
| | - Koji Iwasaki
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
| | - Takashi Ohnishi
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
| | - Naoki Hirohama
- Faculty of Engineering, Division of Human Mechanical Systems and Design, Hokkaido University, N13W8, Sapporo, Hokkaido 060-8628, Japan
| | - Takayuki Nonoyama
- Faculty of Advanced Life Science, Division of Advanced Transdisciplinary Sciences, Hokkaido University, N21W11, Sapporo, Hokkaido 001-0021, Japan
| | - Daisuke Ukeba
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
| | - Katsuro Ura
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
| | - Yoichi M Ito
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
| | - Norimasa Iwasaki
- Faculty of Medicine and Graduate of Medicine, Department of Orthopedic Surgery, Hokkaido University, N15W7, Sapporo, Hokkaido 060-8638, Japan
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Okumatsu K, Tsujimoto T, Wakaba K, Seki A, Kotake R, Yamauchi T, Hirayama S, Kobayashi H, Yamauchi H, Tanaka K. Effects of a combined exercise plus diet program on cardiorespiratory fitness of breast cancer patients. Breast Cancer 2018; 26:65-71. [PMID: 29992486 PMCID: PMC6315012 DOI: 10.1007/s12282-018-0889-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 07/01/2018] [Indexed: 01/16/2023]
Abstract
Background Decreases in cardiorespiratory fitness among breast cancer patients have often been reported in previous studies, affecting patients’ health and survival. Peak oxygen uptake (\documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak) is the gold standard for assessing cardiorespiratory fitness and is inversely correlated with cardiovascular disease among women with breast cancer. Some previous studies have reported that aerobic exercise and proper diet positively influence \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak. However, almost all studies have been conducted in the Western countries, and few studies are investigating on Asian women who have lower BMI compared with Western ones. Purpose Investigating the effects of a combined exercise and diet program among Japanese cancer patients undergoing therapy on \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak. Methods Thirty-two Japanese women with breast cancer undergoing endocrine therapy (age; 50 ± 6 years, body weight; 59 ± 10 kg) were voluntarily assigned to either intervention group (n = 21) or control group (n = 11). The intervention group completed a 12-week combined exercise plus diet program, consisting of weekly aerobic exercise and maintaining a nutritionally well-balanced 1200 kcal/day diet. The control group was instructed to continue with their usual activities. Anthropometric indices and \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak were measured at baseline and after the 12-week program. Results All 21 women completed the 12-week program. The \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}\text{O}}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak significantly increased from 26.7 to 30.4 mL/kg/min (1.57–1.62 L/min) in the intervention group, while it remained unchanged (26.9–26.9 mL/kg/min) in the control group. Mean reduction of body mass index was − 2.1 in the intervention group (P < .001) and + 0.1 in the control group. Conclusions Our combined exercise plus diet program may contribute to improvement in cardiorespiratory fitness and body weight compared with control group.
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Affiliation(s)
- K Okumatsu
- Graduate School of Comprehensive Human Sciences, Faculty of Health and Sports Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.
| | - T Tsujimoto
- Faculty of Human Sciences, Shimane University, 1060 Nishikawatsucho, Matsue, Shimane, 690-8504, Japan
| | - K Wakaba
- Graduate School of Comprehensive Human Sciences, Faculty of Health and Sports Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - A Seki
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashicho, Chou-ku, Tokyo, 104-8560, Japan
| | - R Kotake
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashicho, Chou-ku, Tokyo, 104-8560, Japan
| | - T Yamauchi
- Division of Medical Oncology, Department of Internal Medicine, St. Luke's International Hospital, 9-1 Akashicho, Chou-ku, Tokyo, 104-8560, Japan
| | - S Hirayama
- Department of Management and Planning, Central Sports Co., Ltd, 1-21-2 Shinkawa, Chuo-ku, Tokyo, 104-8255, Japan
| | - H Kobayashi
- Department of General Medicine, Mito Medical Center, Tsukuba University Hospital, 3-2-7 Miyamachi, Mito, Ibaraki, 310-0015, Japan
| | - H Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashicho, Chou-ku, Tokyo, 104-8560, Japan
| | - K Tanaka
- Faculty of Health and Sports Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
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Okumatsu K, Tsujimoto T, Seki A, Kotake R, Yamauchi T, Yamauchi H, Tanaka K. Abstract P6-11-04: Effects of a combined exercise plus diet intervention on cardiorespiratory fitness among Japanese women with breast cancer: A feasibility study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-11-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Remarkable deterioration of physical fitness is a well-established adverse event associated with endocrine therapy among breast cancer patients. Especially, impairment in cardiorespiratory fitness has been often reported in previous studies, affecting patients' health and survival. Peak oxygen uptake (VO2peak) is the gold standard for assessing cardiorespiratory fitness and is inversely correlated with cardiovascular disease among women with breast cancer as well as ordinal people. A number of previous studies have reported that aerobic exercise improves the risk of cardiovascular disease. Moreover, a proper diet program positively influences VO2peak. However, almost all studies have been conducted in the Western community and there are few studies forcing on Asian women who have lower BMI compared with Western ones. Therefore, we investigated the feasibility of a combined exercise and diet program among Japanese cancer patients undergoing endocrine therapy and the effect on VO2peak.
Methods
Thirty-Two Japanese women with breast cancer undergoing endocrine therapy (age; 50±6 years, body weight; 126±22 lbs) were voluntarily assigned to either intervention group (n = 21) or control group (n = 11). The intervention group completed a 12-week combined exercise plus diet program, consisting of weekly aerobic training and maintaining a nutritionally well-balanced 1,200 kcal/d diet. The control group were instructed to continue with their usual activities. Anthropometric indices, VO2peak and QoL were measured at baseline and after the 12-week program. VO2peak was assessed using an Okura protocol (Okura. 1999).
Results
All of the 21 women completed the 12-week program. The VO2peak increased from 26.7 to 30.4 mL/kg/min (1.57 to 1.62 L/min) in the intervention group, while it remained unchanged (26.6 to 26.7 mL/kg/min) in the control group. Significant improvements were observed in VO2peak, and QoL in the intervention group (P <. 001), while they remained essentially unchanged among the control group. Mean weight loss was 8.7% of the initial weight in the intervention group (P <. 001) and 0.1% in the control group. No adverse events were reported in the intervention group.
Conclusions
Our combined exercise plus diet program may contribute to improvement in cardiorespiratory fitness, QoL, and body weight compared with control group. Importantly, cardiorespiratory fitness has been improved by as much as 15 % after three months. Further studies are needed to consider that what kind of aerobic exercise is best to improve cardiorespiratory fitness among Asian breast cancer patients.
Citation Format: Okumatsu K, Tsujimoto T, Seki A, Kotake R, Yamauchi T, Yamauchi H, Tanaka K. Effects of a combined exercise plus diet intervention on cardiorespiratory fitness among Japanese women with breast cancer: A feasibility study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-11-04.
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Affiliation(s)
- K Okumatsu
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Human Science, University of Shimane, Matsue, Shimane, Japan; St. Luke's International Hospital, Chuoku, Tokyo, Japan
| | - T Tsujimoto
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Human Science, University of Shimane, Matsue, Shimane, Japan; St. Luke's International Hospital, Chuoku, Tokyo, Japan
| | - A Seki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Human Science, University of Shimane, Matsue, Shimane, Japan; St. Luke's International Hospital, Chuoku, Tokyo, Japan
| | - R Kotake
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Human Science, University of Shimane, Matsue, Shimane, Japan; St. Luke's International Hospital, Chuoku, Tokyo, Japan
| | - T Yamauchi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Human Science, University of Shimane, Matsue, Shimane, Japan; St. Luke's International Hospital, Chuoku, Tokyo, Japan
| | - H Yamauchi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Human Science, University of Shimane, Matsue, Shimane, Japan; St. Luke's International Hospital, Chuoku, Tokyo, Japan
| | - K Tanaka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Human Science, University of Shimane, Matsue, Shimane, Japan; St. Luke's International Hospital, Chuoku, Tokyo, Japan
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Abstract
The pathogenesis of intervertebral disc degeneration is unclear, but it is a major cause of several spinal diseases. Animal models have historically provided an appropriate benchmark for understanding the human spine. However, there is little information about when intervertebral disc degeneration begins in the mouse or regarding the relationship between magnetic resonance imaging and histological findings. The aim for this study was to obtain information about age-related spontaneous intervertebral disc degeneration in the mouse lumbar spine using magnetic resonance imaging and a histological score regarding when the intervertebral disc degeneration started and how rapidly it progressed, as well as how our histological score detected the degeneration. The magnetic resonance imaging index yielded a moderate correlation with our Age-related model score. The Pfirrmann grade and magnetic resonance imaging index had moderate correlations with age. However, our Age-related model score had a high correlation with age. Intervertebral disc level was not a significant variable for the severity of disc degeneration. Both Pfirrmann grade and the Age-related model score were higher in the ≥14-month-old group than in the 6-month-old group. The present results indicated that mild but significant intervertebral disc degeneration occurred in 14-month-old mice, and the degree of degeneration progressed slowly, reaching a moderate to severe condition for 22-month-old mice. At least a 14-month follow-up is mandatory for evaluating spontaneous age-related mouse intervertebral disc degeneration. The histological classification score can precisely detect the gradual progression of age-related spontaneous intervertebral disc degeneration in the mouse lumbar spine, and is appropriate for evaluating it. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:224-232, 2018.
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Affiliation(s)
- Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, North-15, West-7, Sapporo, Hokkaido 060-8638, Japan
| | - Takeru Tsujimoto
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Iwasaki K, Sudo H, Kasahara Y, Yamada K, Ohnishi T, Tsujimoto T, Iwasaki N. Effects of Multiple Intra-articular Injections of 0.5% Bupivacaine on Normal and Osteoarthritic Joints in Rats. Arthroscopy 2016; 32:2026-2036. [PMID: 27132778 DOI: 10.1016/j.arthro.2016.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/30/2016] [Accepted: 02/01/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the in vivo effects of multiple local anesthetic injections of 0.5% bupivacaine on normal and osteoarthritic articular cartilage. METHODS Rats with normal knee joints received an intra-articular injection of 0.9% saline solution or 0.5% bupivacaine in their right knees joint once a week for 5 consecutive weeks, starting 4 weeks after the beginning of the experiment. Rats were humanely killed at 8, 16, and 24 weeks. In a parallel experiment, rats underwent anterior cruciate ligament transection to induce osteoarthritic changes. These rats were subjected to the same protocol as those with normal knee joints, starting 4 weeks after the procedure. Static weight-bearing tests were performed on both hind limbs to evaluate changes in weight-bearing ability throughout the experiments. Rats were humanely killed at 8 and 16 weeks. Cell viability was assessed with confocal microscopy, using samples from the distal femur. Histologic assessment of osteoarthritis was performed using samples from the tibial plateau based on the Osteoarthritis Research Society International (OARSI) cartilage histopathology assessment system (i.e., OARSI score). RESULTS Static weight-bearing tests showed no significant changes after intra-articular injection of saline solution or bupivacaine, and bupivacaine injection did not increase weight bearing compared with saline solution injection, regardless of whether there were osteoarthritic changes. There were also no significant differences in cell viability, cell density, or OARSI scores between the saline solution and bupivacaine groups at each time point, regardless of whether osteoarthritic changes were induced. CONCLUSIONS This study suggested that single or intermittent intra-articular bupivacaine injections might not have deleterious effects on either osteoarthritic or normal joints. CLINICAL RELEVANCE There is no strong evidence that intra-articular bupivacaine injection induces degenerative changes in articular cartilage. Therefore, these results may apply to normal and osteoarthritic joints.
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Affiliation(s)
- Koji Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
| | - Yasuhiko Kasahara
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takeru Tsujimoto
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Tsujimoto T, Takahata M, Kokabu T, Matsuhashi M, Iwasaki N. Pyogenic spondylodiscitis following anti-interleukin-6 therapy in a patient with rheumatoid arthritis (implication of hematogenous infection risk in degenerative intervertebral discs): A case report and review of the literature. J Orthop Sci 2016; 21:694-7. [PMID: 26740426 DOI: 10.1016/j.jos.2015.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/24/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Takeru Tsujimoto
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Terufumi Kokabu
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Megumi Matsuhashi
- Hokkaido Medical Center for Rheumatic Diseases, Sapporo, 063-0811, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
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Ohnishi T, Sudo H, Iwasaki K, Tsujimoto T, Ito YM, Iwasaki N. In Vivo Mouse Intervertebral Disc Degeneration Model Based on a New Histological Classification. PLoS One 2016; 11:e0160486. [PMID: 27482708 PMCID: PMC4970753 DOI: 10.1371/journal.pone.0160486] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/19/2016] [Indexed: 01/28/2023] Open
Abstract
Although human intervertebral disc degeneration can lead to several spinal diseases, its pathogenesis remains unclear. This study aimed to create a new histological classification applicable to an in vivo mouse intervertebral disc degeneration model induced by needle puncture. One hundred six mice were operated and the L4/5 intervertebral disc was punctured with a 35- or 33-gauge needle. Micro-computed tomography scanning was performed, and the punctured region was confirmed. Evaluation was performed by using magnetic resonance imaging and histology by employing our classification scoring system. Our histological classification scores correlated well with the findings of magnetic resonance imaging and could detect degenerative progression, irrespective of the punctured region. However, the magnetic resonance imaging analysis revealed that there was no significant degenerative intervertebral disc change between the ventrally punctured and non-punctured control groups. To induce significant degeneration in the lumbar intervertebral discs, the central or dorsal region should be punctured instead of the ventral region.
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Affiliation(s)
- Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
- * E-mail:
| | - Koji Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Takeru Tsujimoto
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yoichi M. Ito
- Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Iwasaki K, Sudo H, Yamada K, Higashi H, Ohnishi T, Tsujimoto T, Iwasaki N. Effects of single injection of local anesthetic agents on intervertebral disc degeneration: ex vivo and long-term in vivo experimental study. PLoS One 2014; 9:e109851. [PMID: 25286407 PMCID: PMC4186881 DOI: 10.1371/journal.pone.0109851] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Analgesic discography (discoblock) can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD) cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model. METHODS For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine). Nucleus pulposus (NP) cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI) and histological analysis. RESULTS In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline- and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups. CONCLUSIONS/SIGNIFICANCE In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents on degenerated IVDs.
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Affiliation(s)
- Koji Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- * E-mail:
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hideaki Higashi
- Division of Infection and Immunity, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Takashi Ohnishi
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takeru Tsujimoto
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Kakimoto N, Shimamoto H, Chindasombatjaroen J, Tsujimoto T, Tomita S, Hasegawa Y, Murakami S, Furukawa S. Comparison of the T2 relaxation time of the temporomandibular joint articular disk between patients with temporomandibular disorders and asymptomatic volunteers. AJNR Am J Neuroradiol 2014; 35:1412-7. [PMID: 24742804 DOI: 10.3174/ajnr.a3880] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE T2 relaxation time is a quantitative MR imaging parameter used to detect degenerated cartilage in the knee and lumbar intervertebral disks. We measured the T2 relaxation time of the articular disk of the temporomandibular joint in patients with temporomandibular disorders and asymptomatic volunteers to demonstrate an association between T2 relaxation time and temporomandibular disorder MR imaging findings. MATERIALS AND METHODS One hundred forty-four patients with temporomandibular disorders and 17 volunteers were enrolled in this study. An 8-echo spin-echo sequence for measuring the T2 relaxation times was performed in the closed mouth position, and the T2 relaxation time of the entire articular disk was measured. Patients were classified according to the articular disk location and function, articular disk configuration, presence of joint effusion, osteoarthritis, and bone marrow abnormalities. RESULTS The T2 relaxation time of the entire articular disk was 29.3 ± 3.8 ms in the volunteer group and 30.7 ± 5.1 ms in the patient group (P = .177). When subgroups were analyzed, however, the T2 relaxation times of the entire articular disk in the anterior disk displacement without reduction group, the marked or extensive joint effusion group, the osteoarthritis-positive group, and the bone marrow abnormality-positive group were significantly longer than those in the volunteer group (P < .05). CONCLUSIONS The T2 relaxation times of the articular disk of the temporomandibular joint in patients with progressive temporomandibular disorders were longer than those of healthy volunteers.
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Affiliation(s)
- N Kakimoto
- From the Department of Oral and Maxillofacial Radiology (N.K., H.S., T.T., S.T., S.M., S.F.), Osaka University Graduate School of Dentistry, Osaka, Japan
| | - H Shimamoto
- From the Department of Oral and Maxillofacial Radiology (N.K., H.S., T.T., S.T., S.M., S.F.), Osaka University Graduate School of Dentistry, Osaka, Japan
| | - J Chindasombatjaroen
- Department of Oral and Maxillofacial Radiology (J.C.), Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - T Tsujimoto
- From the Department of Oral and Maxillofacial Radiology (N.K., H.S., T.T., S.T., S.M., S.F.), Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Tomita
- From the Department of Oral and Maxillofacial Radiology (N.K., H.S., T.T., S.T., S.M., S.F.), Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Hasegawa
- Department of Dentistry and Oral Surgery (Y.H.), Hyogo College of Medicine, Hyogo, Japan
| | - S Murakami
- From the Department of Oral and Maxillofacial Radiology (N.K., H.S., T.T., S.T., S.M., S.F.), Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Furukawa
- From the Department of Oral and Maxillofacial Radiology (N.K., H.S., T.T., S.T., S.M., S.F.), Osaka University Graduate School of Dentistry, Osaka, Japan
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So R, Sasai H, Matsuo T, Tsujimoto T, Eto M, Saotome K, Tanaka K. Multiple-slice magnetic resonance imaging can detect visceral adipose tissue reduction more accurately than single-slice imaging. Eur J Clin Nutr 2012; 66:1351-5. [DOI: 10.1038/ejcn.2012.147] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Abstract
ABSTRACTStructures and mechanical properties of TiAl-base alloys have been studied, in which Zr, Nb, V or Mn is added as the third element and the Al content is changed. Behavior of the third element in the TiAl-base alloys and effects of various factors on ductility have been discussed. It has been concluded that the Ti-48.4 at% Al-1.0 at% Mn alloy is the optimum composition for obtaining good room temperature ductility.
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Yasaka Y, Goto K, Taniguchi A, Tsujimoto T, Takeno H, Nakashima Y. Plasma Direct Energy Converter for Thermal Ions Using a Slanted Cusp Magnetic Field and Two-Stage Deceleration. Fusion Science and Technology 2009. [DOI: 10.13182/fst09-a6974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y. Yasaka
- Department of Electrical and Electronic Engineering, Kobe University, Kobe 657-8501, Japan
| | - K. Goto
- Department of Electrical and Electronic Engineering, Kobe University, Kobe 657-8501, Japan
| | - A. Taniguchi
- Department of Electrical and Electronic Engineering, Kobe University, Kobe 657-8501, Japan
| | - T. Tsujimoto
- Department of Electrical and Electronic Engineering, Kobe University, Kobe 657-8501, Japan
| | - H. Takeno
- Department of Electrical and Electronic Engineering, Kobe University, Kobe 657-8501, Japan
| | - Y. Nakashima
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8573, Japan
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Mizuno K, Matsukawa M, Otani T, Takada M, Mano I, Tsujimoto T. Effects of structural anisotropy of cancellous bone on speed of ultrasonic fast waves in the bovine femur. IEEE Trans Ultrason Ferroelectr Freq Control 2008; 55:1480-7. [PMID: 18986937 DOI: 10.1109/tuffc.2008.823] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Ultrasonic waves in cancellous bone change dramatically depending on its structural complexity. One good example is the separation of an ultrasonic longitudinal wave into fast and slow waves during propagation. In this study, we examined fast wave propagation in cancellous bone obtained from the head of the bovine femur, taking the bone structure into consideration. We investigated the wave propagation perpendicular to the bone axis and found the two-wave phenomenon. By rotating the cylindrical cancellous bone specimen, changes in the fast wave speed due to the rotation angle then were observed. In addition to the ultrasonic evaluation, the structural anisotropy of each specimen was measured by X-ray micro-computed tomography (CT). From the CT images, we obtained the mean intercept length (MIL), degree of anisotropy (DA), and angle of insonification relative to the trabecular orientation. The ultrasonic and CT results showed that the fast wave speed was dependent on the structural anisotropy, especially on the trabecular orientation and length. The fast wave speeds always were higher for propagation parallel to the trabecular orientation. In addition, there was a strong correlation between the DA and the ratio between maximum and minimum speeds (V(max)/V(min)) (R(2) = 0.63).
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Affiliation(s)
- K Mizuno
- Fac. of Eng., Doshisha Univ., Kyotanabe, Kyoto, Japan
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Kurumatani Y, Tsujimoto T, Yasaka Y, Takeno H. Research on Characteristics of Particle Discrimination and Direct Energy Conversion for Cusp Direct Energy Converter. Fusion Science and Technology 2007. [DOI: 10.13182/fst07-a1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y. Kurumatani
- Department of Electrical and Electronics Engineering, Kobe University: 1-1, Rokkodai-cho, Nada-ku, Kobe, 657-8501, Japan
| | - T. Tsujimoto
- Department of Electrical and Electronics Engineering, Kobe University: 1-1, Rokkodai-cho, Nada-ku, Kobe, 657-8501, Japan
| | - Y. Yasaka
- Department of Electrical and Electronics Engineering, Kobe University: 1-1, Rokkodai-cho, Nada-ku, Kobe, 657-8501, Japan
| | - H. Takeno
- Department of Electrical and Electronics Engineering, Kobe University: 1-1, Rokkodai-cho, Nada-ku, Kobe, 657-8501, Japan
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37
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Iskandar D, Iida T, Yamazawa H, Moriizumi J, Koarashi J, Yamasoto K, Yamasaki K, Shimo M, Tsujimoto T, Ishikawa S, Fukuda M, Kojima H. The transport mechanisms of 222Rn in soil at Tateishi as an anomaly spot in Japan. Appl Radiat Isot 2005; 63:401-8. [PMID: 15950479 DOI: 10.1016/j.apradiso.2005.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2004] [Revised: 02/17/2005] [Accepted: 03/29/2005] [Indexed: 10/25/2022]
Abstract
The (222)Rn concentration profiles in soil have been measured at an anomaly spot in Tateishi, Japan. In winter, the concentrations were low and showed a negative gradient with depth, but in other seasons, the concentration had both positive and negative gradients with depth, and dramatically changed by time. On the assumption that there was ventilation in deep layers and with driving forces of wind and temperatures, these phenomena were successfully explained. This finding would contribute to a numerical model for (222)Rn transport in soil.
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Affiliation(s)
- D Iskandar
- Graduate School of Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8603, Japan.
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38
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Namisaki T, Yoshiji H, Fujimoto M, Kojima H, Yanase K, Kitade M, Ikenaka Y, Toyohara M, Yamao J, Tsujimoto T, Tsuruzono T, Kitano H, Matsumura K, Matsumura Y, Fukui H. Two cases of colonic tuberculosis presenting with massive melena. Int J Clin Pract 2004; 58:1162-4. [PMID: 15646415 DOI: 10.1111/j.1742-1241.2004.00361.x] [Citation(s) in RCA: 10] [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: 11/30/2022] Open
Abstract
The clinical symptoms of colonic tuberculosis are variable, among which massive melena is extremely rare. Herein, we report two cases of colonic tuberculosis representing with massive melena, both of whom never had active pulmonary tuberculosis. The first case was a 55-year-old woman. Although her emergency colonoscopic setting suggested colonic tuberculosis, no evidence of tuberculosis could be found at that time. We performed a therapeutic trial and observed a drastic regression of the initial changes with 4-week treatment using antituberculous agents. The second case was a 37-year-old man. His emergency colonoscopy showed lesions mimicking colon carcinoma. However, the histological examinations did not indicate malignancy. The polymerase chain reaction of colonic biopsy specimen was positive for Mycobacterium tuberculosis. Similar to the first case, a significant improvement of the initial lesions was observed after 4-week treatment using antituberculous agents. Collectively, although the massive melena is a rare manifestation, tuberculosis of the colon should be suspected in the patients with such symptom.
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Affiliation(s)
- T Namisaki
- Third Department of Internal Medicine, Nara Medical University, Nara, Japan
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39
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Tominaga K, Kuriyama S, Yoshiji H, Deguchi A, Kita Y, Funakoshi F, Masaki T, Kurokohchi K, Uchida N, Tsujimoto T, Fukui H. Repeated adenoviral administration into the biliary tract can induce repeated expression of the original gene construct in rat livers without immunosuppressive strategies. Gut 2004; 53:1167-73. [PMID: 15247187 PMCID: PMC1774146 DOI: 10.1136/gut.2003.013748] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Systemic adenoviral readministration appears to be limited by immunogenicity. AIMS We examined the feasibility of repeated adenovirus mediated gene transfer into the liver via the biliary tract. METHODS Recombinant adenoviruses carrying a reporter lacZ gene were infused retrogradely into the common bile duct of rats. Transduction efficiency of the lacZ gene was estimated histochemically and quantitatively. RESULTS Retrograde administration of recombinant adenoviruses into the common bile duct of rats resulted in efficient transgene expression in the liver, specifically in hepatocytes, but not in biliary epithelia. Transduction efficiency induced by intrabiliary adenoviral administration was not substantially different from that induced by intraportal adenoviral infusion. Transgene expression in the liver was however transient, and development of neutralising antibodies against adenovirus was observed in serum but not in bile. When adenoviruses were readministered into the common bile duct, successful re-expression of the transgene in the liver was achieved despite the existence of neutralising antibodies in serum. Interestingly, although proliferation of adenovirus specific T cells in response to adenoviral readministration was suppressed significantly by immunosuppressive FK506 treatment, levels of transgene expression in the liver achieved by intrabiliary adenoviral readministration were not significantly different between animals treated with and without FK506. Furthermore, third adenoviral administration into the common bile duct also induced successful transgene expression in the liver. CONCLUSIONS These results suggest that adenovirus mediated gene transfer into the liver may be repeatable without immunosuppressive strategies in clinical settings by means of endoscopic retrograde cholangiography.
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Affiliation(s)
- K Tominaga
- Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
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40
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Tsujimoto T. Prefrontal theta oscillations associated with hand movements triggered by warning and imperative stimuli in the monkey. Neurosci Lett 2003. [DOI: 10.1016/s0304-3940(03)00948-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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41
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Abstract
Enzymatic synthesis of a new class of cross-linkable polyesters has been achieved. Polymerization of divinyl sebacate and glycerol using Candida antarctica lipase as catalyst in the presence of unsaturated higher fatty acids produced the polyesters having an unsaturated group in the side chain. The polyester was subjected to hardening by cobalt naphthenate catalyst or thermal treatment, yielding cross-linked transparent film.
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Affiliation(s)
- T Tsujimoto
- Department of Materials Chemistry, Graduate School of Engineering, Kyoto University, Kyoto 606-8501, Japan
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42
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Noda M, Takeuchi Y, Tsujimoto T, Takimoto Y, Okita H. [Pneumatosis intestinalis after allogeneic bone marrow transplantation for acute lymphocytic leukemia]. Rinsho Ketsueki 2001; 42:696-700. [PMID: 11680981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
A 45-year-old man was diagnosed as having acute lymphocytic leukemia (ALL) in February 1997. Complete remission was achieved by chemotherapy, and allogeneic BMT from his HLA-identical sister was performed on November 13, 1997. He developed acute GVHD (grade II), but quickly recovered after methyl-PSL pulse therapy. On June 5, 1998--day 202 after BMT--abdominal pain developed. X-ray and CT examinations showed pneumatosis intestinalis, pneumoperitoneum, pneumomediastinum and abdominal free air. We performed oxygen administration and methyl-PSL pulse therapy, and this quickly improved the symptoms. Corticosteroid and chronic GVHD were thought to be the causative factors of pneumatosis intestinalis in this case. Although pneumatosis intestinalis is relatively rare, it is one of the important potential complications that can occur after allogeneic BMT.
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Affiliation(s)
- M Noda
- Department of Internal Medicine, National Otake Hospital
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43
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Tanaka T, Kawashima H, Tsujimoto T, Fujino M. [Drug design in the 21st century (discussion)]. Nihon Yakurigaku Zasshi 2001; 117:229-42. [PMID: 11455934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Aoki N, Sawada S, Rogers MA, Schweizer J, Shimomura Y, Tsujimoto T, Ito K, Ito M. A novel type II cytokeratin, mK6irs, is expressed in the Huxley and Henle layers of the mouse inner root sheath. J Invest Dermatol 2001; 116:359-65. [PMID: 11231308 DOI: 10.1046/j.1523-1747.2001.01226.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hair follicle differentiation involves the expression of both epithelial-type keratins or cytokeratins and hair keratins as well as hair keratin-associated proteins. In this study, a cDNA clone encoding a cytokeratin family member was isolated using RNA differential display techniques. The predicted amino acid sequence derived from this clone, revealed a homology with a number of cytokeratins, not only in the central alpha-helical regions but also in the conserved portions of the amino and carboxy terminal domains, indicating that this protein represents a new member of the mouse type II cytokeratin family. Northern blot analysis showed expression in mouse skin, but not in other tissues, including tongue, esophagus, and forestomach. One- and two-dimensional western blot analysis showed that this new cytokeratin was 57 kDa in size and ran slightly below the area of cytokeratin 5, which corresponded to that of the cytokeratin 6 family members. Both RNA in situ hybridization and immunohistochemical studies of mouse anagen hair follicles demonstrated expression of this cytokeratin in the inner root sheath hair cone during anagen III and in the Henle and Huxley layers of the inner root sheath during anagen VI. The expression of the new cytokeratin began in the hair bulb and progressed up to the height of the keratogenous zone. Taken together the sum of the data analyzed, we have termed this novel cytokeratin mK6irs (mouse gene nomenclature k2-6g) to indicate both its similar mobility with K6 in two-dimensional gels and its specific expression in the inner root sheath of the hair follicle.
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Affiliation(s)
- N Aoki
- Department of Dermatology, Niigata University School of Medicine, Asahimachi-dori, Niigata, Japan.
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45
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Tsujinoue H, Kuriyama S, Tominaga K, Okuda H, Nakatani T, Yoshiji H, Tsujimoto T, Akahane T, Asada K, Fukui H. Intravenous readministration of an adenoviral vector performed long after the initial administration failed to induce re-expression of the original transgene in rats. Int J Oncol 2001; 18:575-80. [PMID: 11179489 DOI: 10.3892/ijo.18.3.575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although most humans have been exposed to wild-type adenoviruses in their childhood, titers of neutralizing antibodies against viruses decrease with the passage of time. In the present study, we infused adenoviruses carrying the lacZ gene into the tail vein of rats, and re-infused the same adenoviruses long after the initial administration. However, development of neutralizing antibodies against adenovirus and proliferation of adenovirus-specific T cells were elicited profoundly by adenoviral readministration, and transgene expression was not induced in rats. Our results may have important implications for efficacy considerations when adenoviral vectors are employed in clinical settings for the treatment of cancer.
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Affiliation(s)
- H Tsujinoue
- Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara 634-8522, Japan
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Kuriyama S, Tsujinoue H, Toyokawa Y, Mitoro A, Nakatani T, Yoshiji H, Tsujimoto T, Fukui H. A potential approach for electrochemotherapy against colorectal carcinoma using a clinically available alternating current system with bipolar snare in a mouse model. Scand J Gastroenterol 2001; 36:297-302. [PMID: 11305518 DOI: 10.1080/003655201750074636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 02/04/2023]
Abstract
BACKGROUND Although electrochemotherapy appears promising for the treatment of superficial tumors, its usefulness against internal tumors, such as colorectal carcinoma (CRC), has not been well examined. Furthermore, since direct current electric pulses have been used for electropermeabilization of tumors in all in vivo electrochemotherapy studies, including clinical trials, the usefulness of alternating current systems has not been examined at all. In a mouse model it was examined whether the alternating current system with a bipolar snare, which has been employed already as a clinical endoscopic treatment modality, was useful for electrochemotherapy against CRC. METHODS Murine CRC colon 26 cells were implanted subcutaneously into syngeneic BALB/c mice and electrochemotherapy with bleomycin (BLM) using the alternating current system was performed against established CRC tumors. RESULTS Electrochemotherapy significantly suppressed the growth of established CRC tumors, resulting in significantly prolonged survival of animals with CRC. Histological examination revealed that electrochemotherapy caused massive necrosis of CRC tumors. Subsequent analysis revealed that the delivery of alternating current electric pulses to CRC tumors profoundly increased intratumoral amounts of BLM. CONCLUSIONS Because the alternating current system using a bipolar snare has been used widely as an endoscopic treatment modality in clinical settings, these results indicate that electrochemotherapy using the alternating current system may be a promising approach for the treatment of CRC.
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Affiliation(s)
- S Kuriyama
- Third Dept. of Internal Medicine, Nara Medical University, Kashihara, Japan
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47
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Nakatani Y, Fukui H, Kitano H, Nagamoto I, Tsujimoto T, Kuriyama S, Kikuchi E, Hoppou K, Tsujii T. Endotoxin clearance and its relation to hepatic and renal disturbances in rats with liver cirrhosis. Liver 2001; 21:64-70. [PMID: 11169075 DOI: 10.1034/j.1600-0676.2001.210110.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND/AIMS Little is known about endotoxin clearance and secretion of cytokines from macrophages in liver cirrhosis. The aims of this study were to investigate the relationship of endotoxin clearance and release of tumor necrosis factor alpha by various macrophages to hepatic and renal disturbances in liver cirrhosis. METHODS Male Sprague-Dawley rats were given 0.04% thioacetamide orally for 6 or 12 months. The organ distribution of infused [3H]-endotoxin (10 microg/kg b.w.) was analyzed at 30 min or at 24 h. Uptake of [3H]-endotoxin and secretion of tumor necrosis factor alpha by Kupffer cells, splenic macrophages and peripheral blood monocytes (1 x 10(4) cells/ml) from cirrhotic and control rats were determined. RESULTS In cirrhotic rats, more endotoxin was left in the body and more endotoxin accumulated in the spleen and kidney, and thus was related to elevation of serum total bilirubin, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine and tumor necrosis factor alpha. Endotoxin uptake and tumor necrosis factor alpha release by the Kupffer cells were decreased and those by the splenic macrophages and peripheral blood monocytes were increased in cirrhotic rats. CONCLUSIONS In liver cirrhosis, impaired clearance of endotoxin together with increased secretion of tumor necrosis factor alpha by extrahepatic macrophages may play an important role in the progression of hepatic and renal disturbances.
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Affiliation(s)
- Y Nakatani
- Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
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Tsujimoto T, Kuriyama S, Yamazaki M, Nakatani Y, Okuda H, Yoshiji H, Fukui H. Augmented hepatocellular carcinoma progression and depressed Kupffer cell activity in rat cirrhotic livers. Int J Oncol 2001; 18:41-7. [PMID: 11115537 DOI: 10.3892/ijo.18.1.41] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
To examine the property of hepatocellular carcinoma (HCC), rat HCC cells were implanted into normal and cirrhotic rat livers. Implanted HCC grew much more progressively in cirrhotic livers than in normal livers. Kupffer cells were decreased profoundly in cirrhotic livers, resulting in markedly impaired phagocytic activity. Furthermore, production of Kupffer cell-related cytokines, such as interleukin-1 beta and tumor necrosis factor-alpha, was decreased profoundly in cirrhotic livers. Our results indicate that liver cirrhosis is a prominent promoting factor in HCC progression, and that markedly depressed Kupffer cell activity may play a role in augmented HCC progression in cirrhotic livers.
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Affiliation(s)
- T Tsujimoto
- Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara 634-8522, Japan
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Yoshikawa M, Fukui K, Kuriyama S, Tsujimoto T, Nakatani Y, Toyokawa Y, Kurematsu Y, Awata J, Shiroi A, Fukui H, Tsutsumi M. Hepatic adenomas treated with percutaneous ethanol injection in a patient with glycogen storage disease type Ia. J Gastroenterol 2001; 36:52-61. [PMID: 11211213 DOI: 10.1007/s005350170155] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 02/04/2023]
Abstract
We report a 20-year-old man with glycogen storage disease type Ia (GSD Ia) who presented multiple hepatocellular adenomas (HCAs) in 1993 and in whom percutaneous ethanol injection (PEI) was conducted as treatment for some enlarging tumors beneath the liver surface. In a 6-year follow-up period, we observed gradual enlargement of some of the HCAs, and the rapid growth of a newly developed tumor. In August 1996, one slow-growth HCA was 52 mm in diameter and was located beneath the surface of the liver. We conducted PEI therapy to prevent its spontaneous rupture. During the following year, another tumor developed beneath the liver surface, but showed extremely rapid growth, reaching 51 mm in diameter, from being undetectable, within 12 months. PEI therapy was again conducted for this newly developed tumor. Although additional PEI therapy was required for each tumor, because of suspected recurrence, no findings of discrete recurrence have been detected by computed tomography and magnetic resonance imaging for more than 2 years, up to the time of this study. We consider PEI to be a useful and effective therapeutic modality for individual HCAs in patients with GSD Ia.
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Affiliation(s)
- M Yoshikawa
- Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan
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50
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Nakatani T, Kuriyama S, Tominaga K, Tsujimoto T, Mitoro A, Yamazaki M, Tsujinoue H, Yoshiji H, Nagao S, Fukui H. Assessment of efficiency and safety of adenovirus mediated gene transfer into normal and damaged murine livers. Gut 2000; 47:563-70. [PMID: 10986218 PMCID: PMC1728072 DOI: 10.1136/gut.47.4.563] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [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: 12/26/2022]
Abstract
BACKGROUND When recombinant adenoviruses are infused directly into the circulation, transgene expression is almost completely restricted to the liver. AIMS Efficiency and safety of adenovirus mediated gene transfer into damaged livers were examined in mice with liver cirrhosis or fulminant hepatitis. METHODS Liver cirrhosis and fulminant hepatitis were induced by intraperitoneal administration of thioacetamide and D-galactosamine followed by lipopolysaccharide, respectively. Mice were infused with adenoviruses carrying the Escherichia coli beta-galactosidase gene, lacZ gene, into the tail vein. Transduction efficiency of the lacZ gene was estimated histochemically by X-gal staining and quantitatively using a chemiluminescent assay. Activation of adenovirus specific T cells and development of neutralising antibodies against adenovirus were also examined. RESULTS Histochemical evaluation revealed that approximately 40%, 80%, and 40% of cells in normal, cirrhotic, and fulminant hepatitis livers, respectively, were stained blue using X-gal staining. Quantitative analyses revealed that levels of lacZ expression in cirrhotic livers were approximately 2.5-fold and sixfold greater than those in normal and fulminant hepatitis livers, respectively. Although transgene expression in fulminant hepatitis livers was significantly lower than that in normal livers, marked levels of transgene expression were achieved even in fulminant hepatitis livers. Significant adverse effects of adenoviruses were not observed in damaged livers. There were no significant differences in cellular or humoral immune responses to adenoviruses among animals with normal, cirrhotic, and fulminant hepatitis livers. CONCLUSIONS Our results suggest that gene therapy with adenoviruses may be used efficiently and safely, even in patients with severe liver disease.
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Affiliation(s)
- T Nakatani
- Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
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