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澤田 良子医学部附属病院 整形外科助教
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■ 論文- (一社)中部日本整形外科災害外科学会, 2025年11月, 中部日本整形外科災害外科学会雑誌, 68(6) (6), 844 - 845, 日本語悪性腫瘍切除後の脛骨広範骨欠損に対する新たな生物学的骨再建法:チタンメッシュプレートと自家細片化腸骨移植を用いた1例
- (一社)中部日本整形外科災害外科学会, 2025年10月, 中部日本整形外科災害外科学会雑誌, 68(秋季学会) (秋季学会), 276 - 276, 日本語下腿に多発したグロムス腫瘍の一例
- Granulocyte-colony stimulating factor (G-CSF) is commonly used to reduce neutropenia-related complications following chemotherapy. It is a glycoprotein that stimulates the production of granulocytes [white blood cells (WBCs) in the bone marrow. In the present study, the case of a 59-year-old man is presented who received chemotherapy (eribulin) for liver metastases from sacral chordoma and subsequently developed acute aortitis after the administration of G-CSF. Grade 3 neutropenia occurred on day eight of the fifth chemotherapy cycle, and pegfilgrastim was administered on day nine. A total of 3 days after pegfilgrastim administration, the patient developed a fever that persisted for 6 days. He visited our hospital on day 18 with abdominal pain and elevated WBC count and C-reactive protein levels. Febrile neutropenia was suspected, and antibiotics were administered. However, both blood and urinalysis cultures returned negative results, and antibiotics were ineffective. Contrast-enhanced computed tomography revealed a thickened wall of the brachiocephalic artery and abdominal aorta, consistent with aortitis. After discontinuing the antibiotics, the patient was monitored closely without further treatment. His condition improved within a few days; therefore, it was concluded that aortitis was induced by G-CSF.2025年10月, Biomedical reports, 23(4) (4), 161 - 161, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本整形外科学会, 2025年09月, 日本整形外科学会雑誌, 99(8) (8), S1612 - S1612, 日本語
- (公社)日本整形外科学会, 2025年09月, 日本整形外科学会雑誌, 99(8) (8), S1612 - S1612, 日本語
- Evidence regarding the effectiveness of rehabilitation treatments in patients with bone metastases remains limited. This study evaluated the implementation and effectiveness of rehabilitation in patients with bone metastases who did not undergo surgery. This retrospective study included 200 patients with nonsurgically treated bone metastases at our institution. The patients were categorized into a rehabilitation group (R group, n = 61) and a non-rehabilitation group (N group, n = 139). Over the course of one month, we compared activities of daily living (ADL), assessed using the Barthel Index (BI), quality of life (QOL), measured using the EuroQoL-5 Dimension (EQ-5D), and demographic and clinical characteristics. Propensity score matching was conducted to minimize selection bias. After matching, 31 patients in each group were included in the analysis. No statistically significant differences were observed in baseline BI and EQ-5D scores between the two groups. In the R group, BI improved significantly from 80 (interquartile range [IQR]: 60-100) to 90 (IQR: 70-100), and EQ-5D improved from 0.444 (IQR: 0.282-0.608) to 0.608 (IQR: 0.533-0.768). In contrast, no improvements were observed in either score in the N group. Chemotherapy was identified as a significant factor associated with improvements in BI (odds ratio 4.03) and EQ-5D (odds ratio 5.29). Rehabilitation may be a valuable treatment option for nonsurgically treated patients with bone metastases, warranting further validation in prospective studies.2025年08月, Journal of bone oncology, 53, 100703 - 100703, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1373 - S1373, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1409 - S1409, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1411 - S1411, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1453 - S1453, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1455 - S1455, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1462 - S1462, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1515 - S1515, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1409 - S1409, 日本語
- (公社)日本整形外科学会, 2025年06月, 日本整形外科学会雑誌, 99(6) (6), S1455 - S1455, 日本語
- Cancer stem cells (CSCs) have been implicated as critical mediators in the progression, chemoresistance and metastatic capabilities of diverse malignancies, including osteosarcoma (OS). The authors have succeeded in generating CSC‑like cells (MG‑OKS) from the OS cell line MG‑63 by transducing defined factors. A significant increase in small proline‑rich protein 1A (SPRR1A) expression, a cross‑linked envelope protein in keratinocytes, was observed in MG‑OKS cells. Therefore, SPRR1A could be involved in tumor initiation, growth and poor OS progression. However, its specific role in OS remains unclear. The present study aimed to evaluate the role of SPRR1A in OS both in vitro and in vivo using MG‑OKS cells. Three experimental groups were established: MG‑OKS cells transfected with SPRR1A small interfering (si)RNA (siMG‑OKS), untransfected MG‑OKS cells and MG‑OKS cells transfected with scrambled siRNA (scMG‑OKS) as controls. SPRR1A expression, morphological changes, cell proliferation and migration were assessed in these groups. RNA sequencing was performed to examine the genetic changes caused by SPRR1A suppression. To evaluate tumorigenicity in vivo, cells from each group were subcutaneously transplanted into the backs of nude mice. Tumor volume and Ki‑67 expression were assessed and compared among the three groups at four weeks post‑transplantation. The siMG‑OKS group exhibited altered cell morphology, reduced cell proliferation and decreased migratory abilities in vitro. RNA sequencing revealed suppression of genes involved in cell adhesion in the siMG‑OKS group. Furthermore, the in vivo tumorigenicity of siMG‑OKS was lower than that of the other two experimental groups. These findings suggest that SPRR1A is one of the key cell adhesion‑related molecules involved in OS progression, potentially serving as a therapeutic target for this refractory tumor. However, further research is needed to fully elucidate the mechanisms by which SPRR1A influences OS pathogenesis and to explore its clinical potential.2025年02月, Oncology reports, 53(2) (2), 英語, 国際誌研究論文(学術雑誌)
- (NPO)日本緩和医療学会, 2025年, Palliative Care Research, 20(Suppl._Kansai) (Suppl._Kansai), S701 - S701, 日本語がん骨転移チーム医療を学ぶ~自施設にリソースがない時の対応策~ 四肢長管骨・骨盤の骨転移への実践的アプローチ
- (一社)中部日本整形外科災害外科学会, 2024年10月, 中部日本整形外科災害外科学会雑誌, 68(秋季学会) (秋季学会), 68 - 68, 日本語がんロコモ対策の現状と課題 四肢骨転移に対する治療の現状と課題
- (一社)中部日本整形外科災害外科学会, 2024年10月, 中部日本整形外科災害外科学会雑誌, 68(秋季学会) (秋季学会), 92 - 92, 日本語整形外科における女性医師キャリア形成の現状と課題 自身のキャリア形成の現状と課題 1度手術を手放した私が再び手術を学ぶチャンスをつかむまで
- (一社)中部日本整形外科災害外科学会, 2024年10月, 中部日本整形外科災害外科学会雑誌, 68(秋季学会) (秋季学会), 269 - 269, 日本語肘部管症候群を合併した右肘滑膜軟骨腫症の一例
- (公社)日本整形外科学会, 2024年09月, 日本整形外科学会雑誌, 98(8) (8), S1964 - S1964, 日本語
- (公社)日本整形外科学会, 2024年09月, 日本整形外科学会雑誌, 98(8) (8), S1967 - S1967, 日本語
- BACKGROUND: Few studies have compared the clinical outcomes of patients with pelvic bone sarcomas treated surgically and those treated with particle beam therapy. This is a multicenter retrospective cohort study which compared the clinical outcomes of patients with pelvic bone sarcoma who underwent surgical treatment and particle beam therapy in Japan. METHODS: A total of 116 patients with pelvic bone sarcoma treated at 19 specialized sarcoma centers in Japan were included in this study. Fifty-seven patients underwent surgery (surgery group), and 59 patients underwent particle beam therapy (particle beam group; carbon-ion radiotherapy: 55 patients, proton: four patients). RESULTS: The median age at primary tumor diagnosis was 52 years in the surgery group and 66 years in the particle beam group (P < 0.001), and the median tumor size was 9 cm in the surgery group and 8 cm in the particle beam group (P = 0.091). Overall survival (OS), local control (LC), and metastasis-free survival (MFS) rates were evaluated using the Kaplan-Meier method and compared among 116 patients with bone sarcoma (surgery group, 57 patients; particle beam group, 59 patients). After propensity score matching, the 3-year OS, LC, and MFS rates were 82.9% (95% confidence interval [CI], 60.5-93.2%), 66.0% (95% CI, 43.3-81.3%), and 78.4% (95% CI, 55.5-90.5%), respectively, in the surgery group and 64.9% (95% CI, 41.7-80.8%), 86.4% (95% CI, 63.3-95.4%), and 62.6% (95% CI, 38.5-79.4%), respectively, in the particle beam group. In chordoma patients, only surgery was significantly correlated with worse LC in the univariate analysis. CONCLUSIONS: The groups had no significant differences in the OS, LC, and MFS rates. Among the patients with chordomas, the 3-year LC rate in the particle beam group was significantly higher than in the surgery group.2024年07月, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Working while receiving cancer treatment is challenging for patients, with considerable impact on their quality of life (QOL). However, there have been no reports on the factors that prevent employment in patients with bone metastases. This study aimed to investigate the employment status and factors impacting the continued employment of patients with bone metastases. METHODS: We analyzed clinical data from new patients consulting The University of Tokyo Hospital team for bone metastasis treatment between June 2015 and September 2017. Patients who were working at the time of cancer diagnosis (n = 124) completed four QOL questionnaires. Factors associated with work sustainability were identified via univariate analysis and a chi-squared test. Multivariate logistic regression analysis was used for significant variables. Relationships between employment and QOL scales were investigated using the Wilcoxon rank-sum test, with P < .05 considered as statistically significant. RESULTS: Among the 124 patients, only 45 (36.3%) were still working when the questionnaire was administered. Multivariate analysis revealed temporary employment, lytic or mixed bone metastases, and lower limb or acetabular metastasis, as significant factors hindering work sustainability. The QOL scores were high in the continued employment group. However, the relationship between employment status and pain remains unclear. CONCLUSIONS: Lytic or mixed bone metastases and the lower limb and acetabular metastasis were significantly associated with employment resignation. Mobility difficulties may prevent patients with bone metastases from sustaining employment. Collaboration between rehabilitation professionals, oncologists, and workplaces is imperative to address this problem.2024年06月, Japanese journal of clinical oncology, 英語, 国際誌研究論文(学術雑誌)
- (公社)日本整形外科学会, 2024年06月, 日本整形外科学会雑誌, 98(6) (6), S1506 - S1506, 日本語
- (公社)日本整形外科学会, 2024年06月, 日本整形外科学会雑誌, 98(6) (6), S1599 - S1599, 日本語
- (公社)日本整形外科学会, 2024年06月, 日本整形外科学会雑誌, 98(6) (6), S1674 - S1674, 日本語
- (公社)日本整形外科学会, 2024年06月, 日本整形外科学会雑誌, 98(6) (6), S1527 - S1527, 日本語
- (公社)日本整形外科学会, 2024年06月, 日本整形外科学会雑誌, 98(6) (6), S1528 - S1528, 日本語
- Background and Objectives: Changes in activities of daily living (ADL) and quality of life (QOL) of patients with bone metastasis who underwent surgical treatment through Bone Metastasis Cancer Boards (BMCBs), a recent multidisciplinary approach for managing bone metastases, have been reported; however, no reports exist on patients who undergo conservative treatment. In this study, we aimed to evaluate these patients' ADL and QOL and examine the factors influencing changes in these parameters. Materials and Methods: We retrospectively reviewed 200 patients with bone metastases who underwent conservative therapy through BMCBs between 2013 and 2021. A reassessment was conducted within 2-8 weeks after the initial assessment. Patients' background and changes in performance status (PS), Barthel Index (BI), EuroQol five-dimension (EQ-5D) scores, and Numerical Rating Scale (NRS) scores were initially assessed. Furthermore, we categorized patients into two groups based on improvements or deteriorations in ADL and QOL and performed comparative analyses. Results: Significant improvements in EQ-5D (0.57 ± 0.02 versus [vs.] 0.64 ± 0.02), NRS max (5.21 ± 0.24 vs. 3.56 ± 0.21), and NRS average (2.98 ± 0.18 vs. 1.85 ± 0.13) scores were observed between the initial assessment and reassessment (all p < 0.001). PS (1.84 ± 0.08 vs. 1.72 ± 0.08) and BI (83.15 ± 1.68 vs. 84.42 ± 1.73) also showed improvements (p = 0.06, and 0.054, respectively). In addition, spinal cord paralysis (odds ratio [OR]: 3.69, p = 0.049; OR: 8.42, p < 0.001), chemotherapy (OR: 0.43, p = 0.02; OR: 0.25, p = 0.007), and NRS average scores (OR: 0.38, p = 0.02; OR: 0.14, p < 0.001) were independent factors associated with ADL and QOL. Conclusions: Patients with bone metastases who underwent conservative treatment through BMCBs exhibited an increase in QOL without a decline in ADL. The presence of spinal cord paralysis, absence of chemotherapy, and poor pain control were associated with a higher risk of deterioration in ADL and QOL.2024年05月, Medicina (Kaunas, Lithuania), 60(6) (6), 英語, 国際誌研究論文(学術雑誌)
- (一社)中部日本整形外科災害外科学会, 2024年04月, 中部日本整形外科災害外科学会雑誌, 67(春季学会) (春季学会), 175 - 175, 日本語小児脛骨に発症したBCG骨髄炎の1例
- (公社)日本整形外科学会, 2024年03月, 日本整形外科学会雑誌, 98(2) (2), S530 - S530, 日本語
- BACKGROUND: Even terminal cancer patients desire to walk to the toilet by themselves until the very last day. This study aimed to describe the walking ability of patients with spinal metastases at the end-of-life stage and identify the factors affecting this ability. METHODS: Among 527 patients who first visited our multidisciplinary team for bone metastasis between 2013 and 2016, 56 patients who had spinal metastases with a Spinal Instability Neoplastic Score ≥7 and died during follow-up were included. We collected general clinical data, performance status, Frankel classification, epidural spinal cord compression scale and Spinal Instability Neoplastic Score at the first consultation. Patients' last day of walking and date of death were also examined. Univariate analyses (chi-squared tests) were performed to identify the factors that impacted walking ability 30 and 14 days before patients' death. RESULTS: A total of 56 patients were extracted, and 57.1% (32/56) and 32.7% (16/49) of patients were ambulatory 30 and 14 days before death, respectively. Their performance status (P = 0.0007), Frankel grade (P = 0.012) and epidural spinal cord compression grade (P = 0.006) at the first examination, and administration of bone modifying agents during follow-up period (P = 0.029) were significantly related to walking ability 30 days before death. Among ambulatory patients 30 days before death, those with Spinal Instability Neoplastic Score ≥10 (P = 0.005), especially with high scores of collapse (P = 0.002) and alignment (P = 0.002), were less likely to walk 14 days before death. The walking period in the last month of their life was significantly longer in patients with total Spinal Instability Neoplastic Score 7-9 (P = 0.009) and in patients without collapse (P = 0.040) by the Wilcoxon test. CONCLUSION: The progression of spinal metastasis, especially neurological deficit, at the initial consultation were associated with walking ability 30 days before death, and spinal stability might be crucial for preserving walking ability during the last month. Early diagnosis and implementation of appropriate bone management might be important for the end-of-life walking ability.2024年01月, Japanese journal of clinical oncology, 54(1) (1), 81 - 88, 英語, 国際誌研究論文(学術雑誌)
- Japanese Association of Rehabilitation Medicine, 2024年, Progress in Rehabilitation Medicine, 9, n/a - n/a研究論文(学術雑誌)
- (一社)中部日本整形外科災害外科学会, 2023年10月, 中部日本整形外科災害外科学会雑誌, 66(秋季学会) (秋季学会), 318 - 318, 日本語左第2肋骨に生じた骨軟骨腫を胸腔鏡補助下に摘出した一例
- (公社)日本整形外科学会, 2023年06月, 日本整形外科学会雑誌, 97(6) (6), S1382 - S1382, 日本語
- (公社)日本整形外科学会, 2023年06月, 日本整形外科学会雑誌, 97(6) (6), S1435 - S1435, 日本語
- (公社)日本整形外科学会, 2023年06月, 日本整形外科学会雑誌, 97(6) (6), S1439 - S1439, 日本語
- (公社)日本整形外科学会, 2023年06月, 日本整形外科学会雑誌, 97(6) (6), S1440 - S1440, 日本語
- INTRODUCTION: The introduction of tyrosine kinase inhibitors has revolutionized treatment strategies for metastatic renal cell carcinoma (RCC) and has improved survival rates. The number of patients with bone metastases from RCC requiring surgery will increase as survival rates improve. However, there is insufficient evidence to standardize the treatment of bone metastases after the introduction of targeted therapy for metastatic RCC. We aimed to determine the outcomes of palliative surgical treatment of bone metastases in the extremities of patients with metastatic RCC. MATERIALS AND METHODS: We retrospectively reviewed 26 lesions from 17 patients who underwent surgery for extremity and acetabular bone metastases and were treated with targeted therapies for advanced RCC between 2008 and 2020. The median follow-up duration was 19 months (range, 4-76). We assessed the patients' activities of daily living, quality of life, and pain and analyzed their postoperative values relative to preoperative values. Postoperative overall survival (OS), local progression-free survival (LPFS), and the factors affecting them were evaluated using the Kaplan-Meier method and log-rank test. RESULTS: The 5-year OS and LPFS rates were 39.5% and 65.6%, respectively. The factors affecting OS were sex, Katagiri score, visceral metastases, and preoperative targeted therapy, while the factors affecting LPFS were pathologic fractures and surgical technique. CONCLUSION: In this study, the postoperative outcomes of palliative surgery for bone metastases from metastatic RCC were good. We suggest that systemic treatment should be prioritized over local control for advanced bone metastasis in RCC and surgery before pathological fracture should be performed for local control.2023年05月, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 49(5) (5), 928 - 933, 英語, 国際誌研究論文(学術雑誌)
- Ewing sarcoma (ES) is an aggressive primary malignant bone tumor that predominantly affects children and young adults. Multimodal treatment approaches have markedly improved the survival of patients with localized ES. However, local recurrence and distant metastasis following curative therapies remain a main concern for patients with ES. Recent studies have suggested that slow‑cycling cells (SCCs) are associated with tumor progression, local recurrence and distant metastasis in various types of cancers. According to the results of these studies, it was hypothesized that SCCs may play a critical role in tumor progression, chemoresistance and local/distal recurrence in patients with ES. The present study applied a label‑retaining system using carboxyfluorescein diacetate succinimidyl ester (CFSE) to identify and isolate SCCs in ES cell lines. In addition, the properties of SCCs, including sphere formation ability, cell cycle distribution and chemoresistance, in comparison with non‑SCCs were investigated. RNA sequencing also revealed several upregulated genes in SCCs as compared with non‑SCCs; the identified genes not only inhibited cell cycle progression, but also promoted the malignant properties of SCCs. On the whole, the present study successfully identified SCCs in ES cells through a label‑retaining system using CFSE. Moreover, to the best of our knowledge, the present study is the first to describe the characteristic properties of SCCs in ES. The findings of this study, if confirmed, may prove to be useful in elucidating the underlying molecular mechanisms and identifying effective therapeutic targets for ES.2022年11月, International journal of oncology, 61(5) (5), 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Eribulin is a tubulin and microtubule-targeting drug that has clinical benefit in overall survival (OS) for patients with advanced soft tissue sarcoma. Eribulin's efficacy has been confirmed in several clinical trials, although no clinically useful biomarkers have been identified. We therefore sought to clarify the predictive factor of eribulin treatment, while focusing on systemic inflammation and immune response values. METHODS: This study included 33 advanced STS patients treated with eribulin between March 2016 and September 2019. We evaluated the associations of clinical factors influencing the efficacy of eribulin treatment and systemic inflammatory and immune response, including the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR), the systemic inflammation response index (SIRI), and the prognostic nutrition index (PNI), with progression-free survival (PFS) and OS using the Kaplan-Meier method and log-rank test. RESULTS: NLR, LMR, PLR, SIRI, and PNI were unassociated with PFS. Compared with patients with SIRI <1.5, those with an SIRI ≥1.5 had a significantly shorter OS [median OS 15 months (95% confidence interval [CI] 8-not reached) vs. 7 months (95% CI 3-14), P = 0.04]. Moreover, the PFS tended to be shorter for patients with SIRI ≥1.5 who received chemotherapy after eribulin treatment than in those with SIRI >1.5 [median PFS 92.5 days (95% CI 27-204) vs. 133 days (95% CI 36-507), P = 0.08]. CONCLUSIONS: High SIRI values may predict poorer overall survival and the efficacy of subsequent drugs after eribulin treatment among patients with advanced soft tissue sarcoma.2022年01月, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 27(1) (1), 222 - 228, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Surgical procedure for symptomatic spinal metastasis is expected to improve the quality of life. Factors related to short-term perioperative mortality after surgery for spinal metastasis may be different from those related to long-term mortality, which have classically been used to determine the indication for surgery. The purposes of this study were to evaluate factors related to the 30-day mortality after surgery for spinal metastasis and create an integer risk scoring system. METHODS: Using the Diagnosis Procedure Combination database from 2010 to 2016, we extracted data of patients who underwent surgical procedure for spinal metastasis. Multivariable logistic regression analysis was performed to clarify the association between patient backgrounds and the 30-day postoperative mortality. We created a risk scoring system using regression coefficients to estimate the 30-day mortality for each patient. RESULTS: Among 3524 patients, the 30-day mortality was 2.6%. Factors associated with a higher 30-day mortality were male sex (odds ratio, 2.50 [95% confidence interval, 1.45-4.31]), emergency admission (1.80 [1.11-2.92]), rapid growth tumors (3.83 [2.49-5.90]), and non-skeletal metastasis (2.27 [1.42-3.64]). In patients with the maximum risk score of five, the 30-day mortality was 16.2%. CONCLUSIONS: Factors related to the 30-day mortality were male sex, emergency admission, rapid growth tumors, and non-skeletal metastasis. These findings provide spine surgeons and patients knowledge of the potential risk of short-term perioperative mortality and allow them to consider the risk of surgery.2021年07月, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 26(4) (4), 666 - 671, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: Soft tissue metastasis is rarer than bone metastasis. Patients with soft tissue metastasis generally have a dismal prognosis. The treatment for metastatic lesions is sometimes difficult, because the prognostic factors of patients with soft tissue metastasis remain unelucidated. Therefore, this study aimed to identify these prognostic factors. METHODS: Thirty-one patients with soft tissue metastasis were included in the study. We evaluated associations of overall survival with clinical parameters and inflammatory markers using Kaplan-Meier curves and Cox proportional hazards models. RESULTS: Twelve patients received surgery for soft tissue metastasis, while radiation therapy was performed in six cases. The median overall survival after the detection of soft tissue metastasis was 11 months. Univariate analysis revealed that detection of soft tissue metastasis after the multidisciplinary treatment (P = 0.01); solitary metastasis (P = 0.0003); and pretreatment C-reactive protein (CRP) level < 0.4 mg/dL (P < 0.0001), white blood cell count < 8500 × 103/μL (P = 0.0003), and neutrophil-to-lymphocyte ratio < 5 (P = 0.02) were significant good prognostic factors. Multivariate analysis revealed that a CRP value < 0.4 mg/dL (P = 0.07) and solitary metastasis (P = 0.09) were possible significant predictors of survival. Furthermore, in case of CRP levels <0.4 mg/dL and metastatic tumor resection, patients had a good prognosis; however, when the CRP levels increased to 0.4 mg/dL and above, patients had a poor prognosis, irrespective of tumor resection. CONCLUSIONS: CRP is potentially useful for determining the indication of radical metastasectomy in soft tissue metastasis.2021年05月, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 26(3) (3), 478 - 482, 英語, 国内誌研究論文(学術雑誌)
- Lower limb pathological fractures caused by bone metastases can severely impair activities of daily living, so recognizing fracture risk is essential. Medial cortical involvement (MCI) in the proximal femur has been demonstrated to affect bone strength in biomechanical studies, but it has not been investigated in real patients. Between 2012 and 2019, 161 bone metastases with computed tomography (CT) images were retrospectively examined. Twenty-nine fractures were observed including 14 metastases with pathological fractures at the first examination, and prophylactic surgery was performed for 50 metastases. We extracted clinicopathological data using CT images, including patient's background, MCI in the proximal femur, site, size, circumferential cortical involvement (CCI), pain, and nature of metastasis. Cox proportional hazard regression analyses were performed, and we created integer scores for predicting fractures. We revealed that MCI, CCI, lytic dominant lesion, and pain were significant factors by univariate analyses. By multivariable analysis, MCI and each 25% CCI were significant and integer score 1 was assigned based on hazard ratio. The full score was four points, with MCI in the proximal femur (one point) and ≥ 75% CCI (three points). With integer score two, sensitivity was 88.9% and specificity was 81.2% for predicting fracture within 60 days. In conclusion, MCI and CCI examined by CT images were the risk factors for pathological fracture. CCI ≥ 50% is a widely known risk factor, but in addition, it may be better to consider surgery if MCI in the proximal femur is observed in metastasis with 25-50% CCI.2020年10月, Clinical & experimental metastasis, 37(5) (5), 607 - 616, 英語, 国際誌研究論文(学術雑誌)
- OBJECTIVE: In contrast to acrometastasis, defined as bone metastasis to the hand or foot, the frequency and prognosis of bone metastasis of other limb segments remain unclear. To compare prognosis according to sites of bone metastasis, we defined two new terms in this study: 'mesometastasis' and 'rhizometastasis' as bone metastasis of 'forearm or lower leg' and 'arm or thigh', respectively. METHODS: A total of 539 patients who were registered to the bone metastasis database of The University of Tokyo Hospital from April 2012 to May 2016 were retrospectively surveyed. All patients who were diagnosed to have bone metastases in our hospital are registered to the database. Patients were categorized into four groups according to the most distal site of bone metastases: 'acrometastasis', 'mesometastasis', 'rhizometastasis' and 'body trunk metastasis'. RESULTS: The frequency of rhizometastasis (22.5%) or body trunk metastasis (73.1%) was significantly higher than that of acrometastasis (2.0%) or mesometastasis (2.4%). The median survival time after diagnosis of bone metastases for each group was as follows: 6.5 months in acrometastasis, 4.0 months in mesometastasis, 16 months in rhizometastasis, 17 months in body trunk metastasis and 16 months overall. In survival curve, there was a statistically significant difference between mesometastasis and body trunk metastasis. CONCLUSIONS: Our findings suggest that 'mesometastasis' could be another poor prognostic factor in cancer patients and that patients with mesometastasis should receive appropriate treatments according to their expected prognosis.2020年09月, Japanese journal of clinical oncology, 50(10) (10), 1226 - 1226, 英語, 国際誌研究論文(学術雑誌)
- Fibrodysplasia ossificans progressiva (FOP) is a rare genetic skeletal disorder manifesting progressive heterotopic ossification (HO) and congenital malformation of the great toes. Since 2007, we have conducted research on FOP. Here, we review the findings on FOP published to date, including the results of our research. Epidemiological studies in Japan have indicated that FOP has nearly the same prevalence in Japan as in the rest of the world. Basic research on its pathoetiology has progressed rapidly since the identification of the causal gene in 2006. Clinical and radiological findings have been thoroughly researched, including early radiological signs, and diagnostic criteria were established, designating FOP as an intractable disease in Japan. In patients with FOP, the progression of HO is associated with numerous disabilities, often manifesting in vicious cycles that can lead to early mortality. Through cross-sectional and short-term longitudinal studies, we have explored patient education, quality of life, and activities of daily living among Japanese patients. The management of FOP requires education of patients and caregivers, the use of medications to settle inflammation and flare-ups, instructions to ensure proper oral care, and other compensatory approaches that aid in rehabilitation. An avoidance of medical intervention, which may cause HO to progress, is also important. The advent of new drugs to prevent HO could have clinical benefit.2020年01月, Pediatrics international : official journal of the Japan Pediatric Society, 62(1) (1), 3 - 13, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: It is important to assess the fracture risk associated with metastasis in the proximal femur. The study aimed to clarify the effect of tumor location on the risk of pathological fracture of the proximal femur and investigate the fracture risk not only in the stance-loading configuration (SC), but also in the fall-loading configuration (FC) using a computed tomography (CT)-based finite element (FE) method based on a simulated metastatic model. METHODS: The axial CT scans of the proximal femora of non-osteoporotic healthy men (n = 4; age range, 42-48 years) and osteoporotic post-menopausal women (n = 4; age range, 69-78 years) were obtained with a calibration phantom, from which the three-dimensional FE models were constructed. A single 15-mm-diameter spherical void simulating a tumor was created at various locations from the neck to subtrochanteric level. Nonlinear FE analyses were performed. RESULTS: The mean predicted fracture loads without spherical voids in the SC were 7700 N in men and 4370 N in women. With the void at the medial femoral neck and in the region anteromedial to lesser trochanter, the mean predicted fracture load significantly reduced to 51.3% and 59.4% in men and 34.1% and 64.5% in women, respectively. The mean predicted fracture loads without a spherical void in the FC were 2500 N in men and 1862 N in women. With the void at the medial and posterior femoral neck, the predicted fracture load was significantly reduced to 65.7% and 79.7% in men and 48.3% and 65.4% in women, respectively. CONCLUSIONS: These results showed that the risk of pathologic fracture was quite high in both the SC and FC when the lytic lesion existed along the principal compressive trabecular trajectory or posterior neck. Prophylactic intervention should be considered for metastases at these locations.2019年11月, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 24(6) (6), 1074 - 1080, 英語, 国内誌研究論文(学術雑誌)
- Treatment for bone metastases aims to preserve patients' quality of life (QOL). Therefore, assessment of patients' reported QOL is important, especially in this field. This cross-sectional study sought to investigate the clinical factors of QOL in patients with bone metastasis in different cancer settings, at any treatment status, and examined the effect of these factors on systemic symptoms and psychological disorders. This study was conducted by a multidisciplinary team for bone metastases at a university hospital in Japan. One-hundred seventy-four patients who could complete the self-report questionnaires were selected. The questionnaire included the EQ-5D, EORTC QLQ-C15-PAL, BM22, and K6 distress scale. We obtained clinical data on tumor progression, bone metastasis, pain, and ECOG-PS. The mean (SD) EQ-5D score was 0.58 (0.24), which was lower than that of the general Japanese and US population (0.85). Skeletal-related events (SREs), pain, and ECOG-PS were significantly related to lower EQ-5D scores in the multivariable analysis (p < 0.01), whereas primary lesion or expected prognosis at the first examination was not. These three factors were also related to systemic symptoms and emotional functioning. Radiologically lytic bone metastasis and lower limb/acetabular metastases were related to SREs and ECOG-PS, respectively. In conclusion, for improving the QOL of patients with bone metastases, we should focus on SRE prevention, treatment for pain, and modifying ADL, and a multidisciplinary team might be useful.2019年10月, Clinical & experimental metastasis, 36(5) (5), 441 - 448, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: With the improvement in survival of hepatocellular carcinoma patients, extrahepatic metastases have become a more frequent complication. Although pathological fractures or paralysis due to bone metastases deteriorate the quality of life of patients, no treatment guideline for bone metastases has been established. This study aimed to clarify the risk factors for these events and the clinical course of patients with bone metastases. METHODS: Out of 783 hepatocellular carcinoma patients treated in our institution between 2009 and 2016, 76 patients with bone metastases were enrolled. They were divided into two groups by the trigger of bone metastases detection. One was those diagnosed by surveillance (surveillance group), and the other was those based on symptom presentation (non-surveillance group). We investigated the clinical features, risk factors for fractures or paralysis and prognostic factors for survival after bone metastases. RESULTS: Baseline characteristics and survival were not significantly different between two groups. Fractures or paralysis occurred in 10 patients (13.2%), and the frequency was significantly higher in the non-surveillance group (20.9%) than the surveillance group (3.0%) in univariate analysis (p = 0.036). The median survival after diagnosis of bone metastases was 11.7 months. Age over 75 years (p = 0.002), hepatitis C-virus etiology (p = 0.007) and Child-Pugh class B/C (p < 0.001) were significantly associated with a shorter survival in multivariate analysis, but fractures or paralysis did not affect the survival. CONCLUSIONS: Early diagnosis through surveillance for hepatocellular carcinoma bone metastases may prevent fractures or paralysis and lead to a better quality of life for these patients.2019年06月, Japanese journal of clinical oncology, 49(6) (6), 529 - 536, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Schwannomas are well-encapsulated, benign neoplasms, and enucleation is a standard operation procedure. The incidence of neurological complications after surgical treatment for schwannomas of the extremities varies, and there is no consensus concerning predictive factors for complications. The aim of this study was to elucidate predictive factors for complications after surgical treatment of schwannomas that develop in the major nerves of the extremities. METHODS: A total of 139 patients with 141 schwannomas arising in major nerves were retrospectively analyzed. Data regarding preoperative clinical features, the postoperative neurological complications, and clinical course of complications, with a median follow-up period of 2 months (range, 0.5-96), were obtained. Predictive factors for complications were statistically analyzed. RESULTS: Postoperative complications occurred in 49 lesions (34.8%), including 42 with sensory disturbance and 8 with motor weakness. In univariate analysis, older age, tumors originating from the upper extremity, and major motor nerve involvement were associated with a higher complication rate (p = 0.03, p = 0.003, and p = 0.001, respectively). In multivariate analysis, major motor nerve involvement was an independent predictive factor for postoperative complications (p = 0.03). Almost all complications gradually improved, but 6 out of 8 patients with motor weakness did not show full recovery at the final follow-up. CONCLUSIONS: Schwannomas originating from major motor nerves can lead to a higher risk for postoperative complications.2019年04月, BMC musculoskeletal disorders, 20(1) (1), 166 - 166, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Despite the clinical benefits of eribulin on overall survival of advanced soft tissue sarcoma (STS) patients, treatment-related toxicity reduces their QOL. Body composition metrics (BCMs) are associated with poor outcome and drug toxicities in several cancers. This study investigated whether BCMs could predict drug toxicity occurrence in advanced STS patients treated with eribulin. METHODS: This study included 23 advanced STS patients treated with eribulin between March 2016 and April 2018. BCMs were evaluated using a CT scan obtained within 1 month before or after treatment initiation. The relationship of BCMs and other clinical factors was evaluated and CART analysis used to develop classification models for risk groups of drug toxicity. RESULTS: Sixteen patients (69.6%) experienced any grade 3/4 toxicity. Eleven patients (47.8%) developed G4 hematologic toxicity, which was significantly higher in those with low skeletal muscle gauge (SMG) (P = 0.02) and low pretreatment neutrophil count (P = 0.0002). Six patients (26.1%) had grade 3/4 non-hematologic toxicity, and was higher in those with low SMG (P = 0.004), and low serum albumin level (P = 0.02). Five patients with high BMI (P = 0.03) experienced febrile neutropenia (FN) and low pretreatment neutrophil count (P = 0.02). CART analysis classified three risk groups, and area under the receiver operating characteristic curve (AUROCC) was 0.92, 0.88, 0.92 in G4 hematologic AE, G3/4 non-hematologic AE, FN, respectively. CONCLUSIONS: SMG is a significant predictive factor of eribulin drug toxicity in advanced STS patients. Risk classification of drug toxicity through combining predictive factors, could improve the therapeutic strategy used in chemotherapy.2019年04月, International journal of clinical oncology, 24(4) (4), 437 - 444, 英語, 国内誌研究論文(学術雑誌)
- According to lung cancer guidelines, positron emission tomography scan is recommended for initial evaluation of bone metastasis. However, guidelines differ in their recommendations for when it should be used. We investigated the appropriate use of bone imaging in nonsmall cell lung cancer (NSCLC) patients. One hundred seventy-seven consecutive NSCLC patients who had distant metastases at presentation and were admitted between January 2012 and April 2016 were retrospectively reviewed. Among patients with bone metastases, we explored bone pain, number of bone metastases, location of bone metastases, and clinical tumor (T) and lymph node (N) classification. Sixty-three patients had bone metastases. There was a trend toward an increase in prevalence of bone metastases as lymph node stage increased. The prevalence of bone pain significantly decreased as N stage increased (p = 0.017). N0 and N2-3 patients were more likely to have multiple bone metastases (p = 0.038). Compared with patients who had a single bone metastasis, patients with multiple metastases had a significantly higher probability of having at least 1 bone metastasis located in the thorax or upper abdomen. All N0 patients have at least 1 bone metastasis in the thorax or upper abdomen. Clinical N0 NSCLC patients with bone metastasis are likely to have bone pain and have multiple bone metastases. N2-3 patients are more likely to have bone metastases but less likely to have bone pain. If NSCLC patients do not have bone pain, and CT of the chest and upper abdomen does not reveal any lymph node or bone metastasis, further survey for bone metastases may be omitted; bone imaging should be performed in N2 and N3 patients regardless of symptoms.2019年02月, Current problems in cancer, 43(1) (1), 86 - 91, 英語, 国際誌研究論文(学術雑誌)
- BACKGROUND: Pazopanib is a multi-tyrosine kinase inhibitor that is used to treat advanced soft-tissue sarcoma, and its efficacy has been confirmed in several clinical trials, although no clinically useful biomarkers have been identified. In other cancers, the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the lymphocyte-to-monocyte ratio (LMR) are associated with chemotherapy response and prognosis. Therefore, we aimed to evaluate the associations of pazopanib response with NLR, PLR, and LMR among patients with advanced soft-tissue sarcoma. METHODS: Data regarding NLR, PLR, and LMR were obtained for 25 patients who received pazopanib for soft-tissue sarcoma. The patients were categorized according to their values for NLR (≥3.8 vs. <3.8), PLR (≥230 vs. <230), and LMR (≥2.4 vs. <2.4), and we evaluated the associations of these markers with progression-free survival and overall survival using Kaplan-Meier curves and Cox proportional models. RESULTS: No significant differences in progression-free survival or overall survival were observed based on the pre-treatment NLR, PLR, and LMR values. However, decreased NLR values after treatment using pazopanib were independently associated with significantly prolonged progression-free survival (hazard ratio: 0.07, p = 0.001) and overall survival (hazard ratio: 0.17, p = 0.0006). CONCLUSIONS: Decreased NLR values after treatment using pazopanib may predict high efficacy and favorable outcomes among patients with advanced soft-tissue sarcoma.2018年04月, International journal of clinical oncology, 23(2) (2), 368 - 374, 英語, 国内誌研究論文(学術雑誌)
- BACKGROUND: The aim of the present study was to elucidate the details of bone metastasis (BM) and the resulting skeletal-related events (SREs), and survival and prognostic factors, in urothelial cancer (UC) patients with BM. METHODS: A total of 48 UC patients with BM who were treated at our institution between 1994 and 2013 were enrolled. Details of BM and SREs were investigated. The Kaplan-Meier method was used to estimate survival duration. Relationships between several clinical features and survival were analyzed using the log-rank test and the Cox hazard model. RESULTS: Of the 48 patients, 39 (81.3%) were male, with a median age at diagnosis of BM of 68 years [interquartile range (IQR), 61-75 years]. Frequent metastatic sites included the pelvis (31 patients, 64.6%) and spine (28, 58.3%). SREs occurred in 31 patients (64.6%) at a median duration of 0.9 months (IQR, 0.3-5.4 months) after diagnosis of BM, including radiation therapy (n = 23; 74.2%), spinal cord compression (n = 4; 12.9%), pathological fracture (n = 3; 9.7%) and hypercalcemia (n = 1; 3.2%). Median overall survival periods after diagnosis of BM and SREs were 6.2 and 5.6 months, respectively. On multivariate analysis, factors significantly associated with survival after BM were performance status [hazard ratio (HR) for ≥2 vs. 0-1, 4.94; P = 0.0003], liver metastasis (HR, 4.08; P = 0.0018), chemotherapy after BM (HR, 0.31; P = 0.0018), and use of bone-modifying agents (HR, 0.36; P = 0.0147). CONCLUSIONS: We revealed clinicopathological factors that are predictive of prognosis of UC patients with BM. Although the prognosis is poor, chemotherapy and bone-modifying agents may confer survival benefits.2017年06月, International journal of clinical oncology, 22(3) (3), 548 - 553, 英語, 国内誌研究論文(学術雑誌)
- Metastasis may occur in any bone but more commonly occurs in the spine, pelvis, or other axial bones. Metastasis in peripheral bones located distal to the elbow or knee, so-called acrometastasis, is rare. Although the mechanism of acrometastasis development is not completely understood, it is thought to be the result of a massive dissemination of cancer cells; thus the prognosis of patients with acrometastasis is relatively poor. Here, we report the case of renal pelvic cancer with multiple acrometastases in both the upper and lower extremities without axial bone metastasis in a 68-year-old man. After two regimens of chemotherapy, he suffered from pain on his wrist and ankle and swelling and hemorrhage of his toe. He had no axial bone metastasis by CT but was diagnosed with multiple acrometastases by plain radiographs. Radiation therapy and disarticulation of the left big toe at the metacarpal-phalangeal joint were performed and his pain and hemorrhage were successfully controlled. Although acrometastasis from renal pelvic cancer is very rare, we should recognize that acrometastasis might occur which exists outside of the CT scanning field.2017年, Case reports in urology, 2017, 7830207 - 7830207, 英語, 国際誌
- A 64-year-old man with 6-year history of hepatocellular carcinoma (HCC) was referred to us regarding bone metastasis to the right proximal femur. Although he underwent radiotherapy for pain palliation and local tumor control, the pain persisted and the tumor relapsed 3 months after the radiotherapy and he was thought to be at high risk of pathologic fracture. Given hypervascularity and large tumor size, a prophylactic internal fixation combined with adjuvant radiofrequency ablation (RFA) was proposed to reduce blood loss and prevent viable tumor cells being disseminated. His postoperative course was uneventful without requiring blood transfusion and preoperative symptoms immediately disappeared after surgery. He became capable of weight-bearing walk with a single cane and was almost asymptomatic without local progression on the plain radiographs when he died 14 months after surgery. Combination therapy of RFA and internal fixation using intramedullary nailing for metastases of the long bones from HCC seems to be a very promising technique both for sufficient pain relief and for local control of the tumor. Adjuvant RFA may become a potential option for patients with metastases of the long bones for the purpose of prevention of tumor dissemination and reduction of intraoperative blood loss.2012年08月, International journal of clinical oncology, 17(4) (4), 417 - 21, 英語, 国内誌研究論文(学術雑誌)
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- (公社)日本リハビリテーション医学会, 2020年07月, The Japanese Journal of Rehabilitation Medicine, 57(特別号) (特別号), S481 - S481, 日本語がん患者の運動器障害とリハビリテーション治療 がん患者の運動器障害 総論
- (公社)日本リハビリテーション医学会, 2020年07月, The Japanese Journal of Rehabilitation Medicine, 57(特別号) (特別号), 3 - 4, 日本語終末期脊椎転移患者におけるトイレ歩行の実態調査
- (公社)日本整形外科学会, 2020年03月, 日本整形外科学会雑誌, 94(3) (3), S1098 - S1098, 日本語脊椎転移の手術後の自宅退院に影響する因子 DPCデータベースを用いた検討
- (公社)日本整形外科学会, 2020年03月, 日本整形外科学会雑誌, 94(3) (3), S776 - S776, 日本語
- (公社)日本整形外科学会, 2020年03月, 日本整形外科学会雑誌, 94(3) (3), S1098 - S1098, 日本語
- (一社)日本骨代謝学会, 2019年09月, 日本骨代謝学会学術集会プログラム抄録集, 37回, 195 - 195, 日本語
- 関東整形災害外科学会, 2019年08月, 関東整形災害外科学会雑誌, 50(4) (4), 233 - 233, 日本語骨転移キャンサーボードNOW 骨転移患者のQOLに影響する因子
- 東日本整形災害外科学会, 2019年08月, 東日本整形災害外科学会雑誌, 31(3) (3), 245 - 245, 日本語
- 関東整形災害外科学会, 2019年08月, 関東整形災害外科学会雑誌, 50(4) (4), 233 - 233, 日本語骨転移キャンサーボードNOW 骨転移患者のQOLに影響する因子
- 関東整形災害外科学会, 2019年08月, 関東整形災害外科学会雑誌, 50(4) (4), 236 - 236, 日本語転移性骨腫瘍と就労
- 日本運動器科学会, 2019年06月, 運動器リハビリテーション, 30(2) (2), 131 - 131, 日本語
- (公社)日本整形外科学会, 2019年06月, 日本整形外科学会雑誌, 93(6) (6), S1378 - S1378, 日本語
- (公社)日本整形外科学会, 2019年06月, 日本整形外科学会雑誌, 93(6) (6), S1392 - S1392, 日本語
- (公社)日本整形外科学会, 2019年06月, 日本整形外科学会雑誌, 93(6) (6), S1554 - S1554, 日本語
- (公社)日本整形外科学会, 2019年06月, 日本整形外科学会雑誌, 93(6) (6), S1556 - S1556, 日本語
- (株)医学書院, 2019年05月, 臨床整形外科, 54(5) (5), 465 - 468, 日本語
- 日本外科系連合学会, 2019年05月, 日本外科系連合学会誌, 44(3) (3), 533 - 533, 日本語骨転移癌の治療選択-キャンサーボードの運用について- 骨転移キャンサーボードの役割とリハビリテーションの実際
- (公社)日本リハビリテーション医学会, 2019年05月, The Japanese Journal of Rehabilitation Medicine, 56(特別号) (特別号), 1 - 3, 日本語対麻痺・膀胱直腸障害で発症した骨原発悪性リンパ腫の1例
- 関東整形災害外科学会, 2019年03月, 関東整形災害外科学会雑誌, 50(臨増号外) (臨増号外), 59 - 59, 日本語転移性骨腫瘍と就労
- 関東整形災害外科学会, 2019年03月, 関東整形災害外科学会雑誌, 50(臨増号外) (臨増号外), 84 - 84, 日本語骨転移キャンサーボードNOW 骨転移患者のQOLに影響する因子
- (公社)日本整形外科学会, 2019年03月, 日本整形外科学会雑誌, 93(3) (3), S1057 - S1057, 日本語
- (公社)日本リハビリテーション医学会, 2018年10月, The Japanese Journal of Rehabilitation Medicine, 55(秋季特別号) (秋季特別号), S214 - S214, 日本語がん骨転移のリハビリテーション:機能予後と生命予後 骨転移のリハビリテーション チーム医療の重要性
- (一社)日本骨折治療学会, 2018年07月, 骨折, 40(Suppl.) (Suppl.), S37 - S37, 日本語
- (NPO)日本緩和医療学会, 2018年06月, Palliative Care Research, 13(Suppl.) (Suppl.), S151 - S151, 日本語緩和ケアとがんロコモ~がん治療における運動器診療との連携~ 緩和ケアにおける骨転移キャンサーボードの役割
- (公社)日本整形外科学会, 2018年06月, 日本整形外科学会雑誌, 92(6) (6), S1386 - S1386, 日本語
- (公社)日本整形外科学会, 2018年06月, 日本整形外科学会雑誌, 92(6) (6), S1522 - S1522, 日本語
- (公社)日本リハビリテーション医学会, 2018年05月, The Japanese Journal of Rehabilitation Medicine, 55(特別号) (特別号), 3 - 2, 日本語有限要素法を用いた転倒条件における大腿骨近位部骨折のリスク評価
- (公社)日本整形外科学会, 2018年03月, 日本整形外科学会雑誌, 92(2) (2), S100 - S100, 日本語
- (公社)日本整形外科学会, 2018年03月, 日本整形外科学会雑誌, 92(2) (2), S484 - S484, 日本語
- (公社)日本整形外科学会, 2018年03月, 日本整形外科学会雑誌, 92(3) (3), S904 - S904, 日本語
- 抗RANKL抗体が奏効した骨巨細胞腫に対しH3F3A遺伝子変異解析と組織学的評価を行った1例42歳女性。妊娠24週時に左膝痛を主訴に前医を受診、左脛骨腫瘍を指摘され、当科へ紹介となった。血液検査ではTRACP-5bの高値を認め、単純X線およびCTでは左脛骨に加え、左腸骨にも溶骨性病変がみられた。以上より、本症例は脛骨と腸骨に生じた骨巨細胞腫と診断され、胎児に対する安全性を優先して分娩まで治療を待機した。妊娠34週6日目で自然分娩し、出産2日後より抗RANKL抗体であるDenosumabの投与を開始したところ、病変の増大が停止し、骨強度が回復したため、開始後3ヵ月目にナビゲーションガイド下で左脛骨腫瘍の掻爬術を行った。病理組織学的に骨巨細胞腫として典型的な所見を呈する多核巨細胞は消失していたが、H3F3A遺伝子変異解析ではDenosumab投与前・投与後ともに骨巨細胞腫に特異的であるG34W変異がみられた。手術から3ヵ月後、腸骨腫瘍の掻爬術を追加した結果、骨膜下の骨硬化部には浮腫状の間質を伴う正常な骨形成が確認された。現在、局所再発や遠隔転移はなく、左膝関節の可動域は正常で、全荷重歩行が可能である。関東整形災害外科学会, 2018年02月, 関東整形災害外科学会雑誌, 49(1) (1), 55 - 60, 日本語
- 関東整形災害外科学会, 2017年08月, 関東整形災害外科学会雑誌, 48(4) (4), 199 - 199, 日本語抗RANKL抗体が奏功した骨巨細胞腫に対し、H3F3A遺伝子変異解析と組織学的評価を行った1例
- 急速に進行し病的骨折をきたした肺癌骨皮質内転移の1例57歳男性。肺癌に対する胸腔鏡下右肺上葉切除術+縦隔リンパ郭清術を施行後6ヵ月より発熱、左膝痛が出現した。単純X線、CT、骨シンチ、生検の結果、肺癌の骨皮質内転移と診断され、歩行器を利用し患肢完全免荷とした。生検1週間後には放射線治療を行い、照射終了後は自宅退院となった。だが、退院1ヵ月後にベッド移動時に左下肢をひねって、左大腿骨の病的骨折をきたし、再度緊急入院となった。放射線照射後、わずか1ヵ月で骨幹部に広範な骨破壊が生じていたが、全身状態は不良であり、外固定と鎮静剤による疼痛コントロールを行った。約2週間後に自宅近くの緩和病棟へ転院し、転院1ヵ月後に死亡となった。関東整形災害外科学会, 2017年08月, 関東整形災害外科学会雑誌, 48(4) (4), 193 - 196, 日本語
- (一社)日本骨折治療学会, 2017年07月, 骨折, 39(Suppl.) (Suppl.), S239 - S239, 日本語
- (NPO)日本緩和医療学会, 2017年06月, Palliative Care Research, 12(Suppl.) (Suppl.), S174 - S174, 日本語骨転移患者の集学的ケア 骨転移診療におけるリハビリテーションの役割
- (公社)日本整形外科学会, 2017年06月, 日本整形外科学会雑誌, 91(6) (6), S1374 - S1374, 日本語
- (公社)日本整形外科学会, 2017年06月, 日本整形外科学会雑誌, 91(6) (6), S1404 - S1404, 日本語
- (公社)日本整形外科学会, 2017年06月, 日本整形外科学会雑誌, 91(6) (6), S1404 - S1404, 日本語
- (公社)日本整形外科学会, 2017年06月, 日本整形外科学会雑誌, 91(6) (6), S1410 - S1410, 日本語
- (公社)日本整形外科学会, 2017年06月, 日本整形外科学会雑誌, 91(6) (6), S1444 - S1444, 日本語
- 【はじめに,目的】 多発性骨髄腫は溶骨性変化による易骨折性を呈するため,日常生活動作(ADL)の際に病的骨折や麻痺などの発生に注意する必要がある。また,化学療法・放射線療法など治療期間が長期に及ぶため,廃用症候群予防のために早期から運動療法を開始することが望ましい。今回,多発性骨髄腫に対し化学療法と自家末梢血幹細胞移植を行い,生着後に自宅退院となった症例を約1年間に渡り担当した。長期の治療に伴う有害事象を最小限に抑えるために,化学療法開始前より理学療法士(PT)を含む多職種で連携し,診療を行った症例について報告する。 【方法】 症例は65歳女性で,四肢・脊椎の溶骨性変化による骨痛により体動困難となり当院に入院し,入院後精査により多発性骨髄腫と診断された。初回入院時の理学療法評価では,上下肢MMT3レベル,Barthel Index(BI)35点であり,車椅子移乗困難であった。四肢・脊椎に多発骨病変があり,易骨折性と疼痛のため荷重制限と疼痛コントロールが必要であったため,骨転移キャンサーボード,緩和ケアチームが介入した。治療経過と理学療法評価から,多職種で包括的な目標設定を行い,理学療法プログラムを立案・実施した。 【結果】 化学療法実施前は,車椅子移乗までという活動度制限の中で筋力トレーニング,有酸素運動,動作練習を中心に行い,身体機能の改善,車椅子移乗自立を獲得した。化学療法実施中は,治療経過に応じて,骨転移キャンサーボード,緩和ケアチーム,病棟スタッフの多職種でカンファレンスを行い,理学療法目標を設定し,荷重制限を両上下肢均等荷重→両下肢2/3部分荷重→全荷重へと変更し,活動度を車椅子→両松葉杖歩行→両T字杖歩行獲得へと拡大した。化学療法,自家末梢血幹細胞移植に伴い骨髄抑制,嘔気,食欲不振などの副作用が見られたが,PTの介入だけではなく病棟スタッフの促しで自主トレーニングを継続し,身体機能の維持をはかった。多職種で連携したことで病的骨折や麻痺を予防しつつADLを拡大し,身体機能を維持・向上することができた。治療終了後は,在宅調整のための転院を挟み自宅退院となった。当院退院時の理学療法評価は上下肢MMT5レベル,両T字杖歩行自立を獲得しBIは100点であった。 【結論】 溶骨性変化を呈する多発性骨髄腫の患者に対する理学療法では,病的骨折や麻痺を予防する必要がある。また長期に渡る治療経過,治療に伴う有害事象の程度を把握し,廃用症候群の予防,QOLやADLの拡大を目的とした理学療法が重要となる。多職種での包括的なアプローチにより,より具体的な目標設定が可能となり,充実した理学療法プログラムの実施につながると考えられた。(一社)日本理学療法学会連合, 2017年04月, 理学療法学, 44(Suppl.2) (Suppl.2), P - 1, 日本語
- 関東整形災害外科学会, 2017年03月, 関東整形災害外科学会雑誌, 48(臨増号外) (臨増号外), 50 - 50, 日本語抗RANKL抗体が著効した骨巨細胞腫に対しH3F3A遺伝子変異解析と組織学的評価を行った1例
- 関東整形災害外科学会, 2017年03月, 関東整形災害外科学会雑誌, 48(臨増号外) (臨増号外), 132 - 132, 日本語転移性脊椎腫瘍に対する治療 院内ボードのすゝめ
- (公社)日本整形外科学会, 2017年03月, 日本整形外科学会雑誌, 91(3) (3), S1059 - S1059, 日本語
- (NPO)日本肺癌学会, 2016年11月, 肺癌, 56(6) (6), 780 - 780, 日本語
- 東日本整形災害外科学会, 2016年08月, 東日本整形災害外科学会雑誌, 28(3) (3), 212 - 212, 日本語
- 東日本整形災害外科学会, 2016年08月, 東日本整形災害外科学会雑誌, 28(3) (3), 268 - 268, 日本語
- (公社)日本整形外科学会, 2016年06月, 日本整形外科学会雑誌, 90(6) (6), S1208 - S1208, 日本語
- (公社)日本整形外科学会, 2016年06月, 日本整形外科学会雑誌, 90(6) (6), S1247 - S1247, 日本語
- (公社)日本整形外科学会, 2016年06月, 日本整形外科学会雑誌, 90(6) (6), S1290 - S1290, 日本語
- (公社)日本整形外科学会, 2016年06月, 日本整形外科学会雑誌, 90(6) (6), S1292 - S1292, 日本語
- (公社)日本整形外科学会, 2016年06月, 日本整形外科学会雑誌, 90(6) (6), S1295 - S1295, 日本語
- (公社)日本整形外科学会, 2016年06月, 日本整形外科学会雑誌, 90(6) (6), S1356 - S1356, 日本語
- (公社)日本整形外科学会, 2016年06月, 日本整形外科学会雑誌, 90(6) (6), S1386 - S1386, 日本語
- (NPO)日本緩和医療学会, 2016年06月, Palliative Care Research, 11(Suppl.) (Suppl.), S375 - S375, 日本語がん脊椎転移の前後方向部位局在と下肢麻痺症状のMRI画像解析
- (公社)日本リハビリテーション医学会, 2016年06月, The Japanese Journal of Rehabilitation Medicine, (JARM2016) (JARM2016), I453 - I453, 日本語骨転移患者のQOL評価
- (公社)日本リハビリテーション医学会, 2016年06月, The Japanese Journal of Rehabilitation Medicine, (JARM2016) (JARM2016), I454 - I454, 日本語骨盤骨転移症例のリハビリテーション
- 関東整形災害外科学会, 2016年04月, 関東整形災害外科学会雑誌, 47(2) (2), 99 - 100, 日本語抗RANKL抗体が著効した骨巨細胞腫に対しH3F3A遺伝子変異解析を行った1例
- (公社)日本整形外科学会, 2016年03月, 日本整形外科学会雑誌, 90(3) (3), S857 - S857, 日本語
- 関東整形災害外科学会, 2015年10月, 関東整形災害外科学会雑誌, 46(5) (5), 272 - 273, 日本語6年の経過で緩徐に尺骨神経麻痺をきたしたlocalized hypertrophic neuropathyの1例
- (公社)日本整形外科学会, 2015年10月, 日本整形外科学会雑誌, 89(10) (10), 763 - 767, 日本語, 国際共著していない骨転移治療戦略とがんのリハビリテーション 診療科横断的なキャンサーボード(CB)診療体制による運動器マネージメントは骨転移患者のQOL維持に有用である
- 骨転移治療戦略とがんのリハビリテーション 骨転移による大腿骨病的骨折患者の在院死亡率 DPCデータベースによる検討厚生労働省科学研究班DPCデータベースに含まれる2007年~2012年の間に大腿骨病的骨折が原因で入院した骨転移患者1765例(男性853例、女性912例)を対象に、在院30日以内死亡率とそのリスク要因について検討した。その結果、1)原発巣の内訳は肺癌、乳癌、前立腺癌の順で多く、年齢は59歳以下が318例、60~69歳が403例、70~79歳が569例、80歳以上が475例であった。2)手術は1104例で行われ、非手術群は661例であった。手術の内訳は内固定が800例、切除+大腿骨近位部置換が283例、切除+膝関節置換が21例で、心血管系疾患の既往が最も多い術前併存症であった。3)全体の30日以内の死亡率は6.2%(105/1765例)であった。単変量解析では手術の有無と臓器転移の有無が在院30日以内死亡と関連しており、多変量解析でも同様に手術の有無と臓器転移の有無が在院30日以内死亡と有意に関連していた。(公社)日本整形外科学会, 2015年10月, 日本整形外科学会雑誌, 89(10) (10), 775 - 778, 日本語, 国際共著していない
- (公社)日本整形外科学会, 2015年09月, 日本整形外科学会雑誌, 89(8) (8), S1796 - S1796, 日本語
- (一社)日本癌治療学会, 2015年09月, 日本癌治療学会誌, 50(3) (3), 1447 - 1447, 日本語骨軟部 骨軟部腫瘍の診断・バイオマーカー 骨転移キャンサーボード介入がSRE発生に及ぼす効果
- (一社)日本乳癌学会, 2015年07月, 日本乳癌学会総会プログラム抄録集, 23回, 406 - 406, 日本語乳癌骨転移の骨転移Cancer Boardの介入 多診療科による骨転移マネージメントの実際
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1205 - S1205, 日本語
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1217 - S1217, 日本語
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1231 - S1231, 日本語結節性筋膜炎の臨床像およびMR画像所見の検討
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1231 - S1231, 日本語紡錘形細胞脂肪腫のMR画像所見と腫瘍体積倍加時間
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1292 - S1292, 日本語
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1292 - S1292, 日本語
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1322 - S1322, 日本語
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1350 - S1350, 日本語
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1356 - S1356, 日本語
- (公社)日本整形外科学会, 2015年06月, 日本整形外科学会雑誌, 89(6) (6), S1373 - S1373, 日本語
- (NPO)日本緩和医療学会, 2015年06月, 日本緩和医療学会学術大会プログラム・抄録集, 20回, 371 - 371, 日本語骨転移キャンサーボード設立後の手術症例24例の検討 整形外科医を中心とした当院の取り組みについて
- (NPO)日本緩和医療学会, 2015年06月, 日本緩和医療学会学術大会プログラム・抄録集, 20回, 455 - 455, 日本語骨転移患者に対する骨転移キャンサーボード早期介入の意義
- (公社)日本リハビリテーション医学会, 2015年05月, The Japanese Journal of Rehabilitation Medicine, 52(Suppl.) (Suppl.), S303 - S303, 日本語骨転移キャンサーボード早期介入により骨関連事象の発生は抑制されるか?
- 関東整形災害外科学会, 2015年03月, 関東整形災害外科学会雑誌, 46(臨増号外) (臨増号外), 88 - 88, 日本語6年の経過で緩徐に尺骨神経麻痺をきたした神経内神経周膜腫の1例
- (公社)日本整形外科学会, 2015年03月, 日本整形外科学会雑誌, 89(2) (2), S151 - S151, 日本語高齢者包括的機能評価を利用した高齢軟部肉腫患者の予後因子解析
- (公社)日本整形外科学会, 2015年03月, 日本整形外科学会雑誌, 89(3) (3), S681 - S681, 日本語
- (公社)日本整形外科学会, 2015年03月, 日本整形外科学会雑誌, 89(3) (3), S850 - S850, 日本語
- 関東整形災害外科学会, 2014年10月, 関東整形災害外科学会雑誌, 45(5) (5), 374 - 374, 日本語治療終了後から17年経過して心転移をきたしたmyxoid liposarcomaの1例
- 関東整形災害外科学会, 2014年06月, 関東整形災害外科学会雑誌, 45(3) (3), 193 - 193, 日本語自然経過で縮小傾向を示した尺骨腫瘍の1例
- (NPO)日本緩和医療学会, 2014年06月, 日本緩和医療学会学術大会プログラム・抄録集, 19回, 394 - 394, 日本語骨転移キャンサーボード(CB)による骨転移の運動器マネージメント 整形外科の役割と潜在的要対応骨転移症例の存在
- (NPO)日本緩和医療学会, 2014年06月, 日本緩和医療学会学術大会プログラム・抄録集, 19回, 394 - 394, 日本語骨転移手術における骨転移キャンサーボード介入の効果
- (公社)日本整形外科学会, 2014年06月, 日本整形外科学会雑誌, 88(6) (6), S1101 - S1101, 日本語
- (公社)日本整形外科学会, 2014年06月, 日本整形外科学会雑誌, 88(6) (6), S1102 - S1102, 日本語
- (公社)日本整形外科学会, 2014年06月, 日本整形外科学会雑誌, 88(6) (6), S1146 - S1146, 日本語
- (公社)日本整形外科学会, 2014年06月, 日本整形外科学会雑誌, 88(6) (6), S1210 - S1210, 日本語
- (公社)日本整形外科学会, 2014年06月, 日本整形外科学会雑誌, 88(6) (6), S1240 - S1240, 日本語
- (公社)日本整形外科学会, 2014年06月, 日本整形外科学会雑誌, 88(6) (6), S1246 - S1246, 日本語
- (公社)日本整形外科学会, 2014年06月, 日本整形外科学会雑誌, 88(6) (6), S1262 - S1262, 日本語
- (一社)日本癌治療学会, 2014年06月, 日本癌治療学会誌, 49(3) (3), 880 - 880, 日本語尿路上皮癌における骨転移と骨関連事象
- (一社)日本癌治療学会, 2014年06月, 日本癌治療学会誌, 49(3) (3), 886 - 886, 日本語骨転移キャンサーボードの介入により骨転移患者のQOLが改善する
- (公社)日本リハビリテーション医学会, 2014年05月, The Japanese Journal of Rehabilitation Medicine, 51(Suppl.) (Suppl.), S258 - S258, 日本語
- (公社)日本リハビリテーション医学会, 2014年05月, The Japanese Journal of Rehabilitation Medicine, 51(Suppl.) (Suppl.), S258 - S258, 日本語
- (公社)日本整形外科学会, 2014年03月, 日本整形外科学会雑誌, 88(2) (2), S311 - S311, 日本語
- (公社)日本整形外科学会, 2014年03月, 日本整形外科学会雑誌, 88(3) (3), S665 - S665, 日本語
- (公社)日本整形外科学会, 2014年03月, 日本整形外科学会雑誌, 88(3) (3), S666 - S666, 日本語
- (一社)日本癌治療学会, 2013年09月, 日本癌治療学会誌, 48(3) (3), 603 - 603, 日本語骨転移診療における緩和医療とリハビリテーション医療の融合 運動器マネージメントがもたらす新しい緩和ケアの世界
- 東日本整形災害外科学会, 2013年08月, 東日本整形災害外科学会雑誌, 25(3) (3), 347 - 347, 日本語
- 東日本整形災害外科学会, 2013年08月, 東日本整形災害外科学会雑誌, 25(3) (3), 386 - 386, 日本語
- 関東整形災害外科学会, 2013年06月, 関東整形災害外科学会雑誌, 44(3) (3), 112 - 112, 日本語足根骨に発生したchondroblastomaの2例
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1143 - S1143, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1151 - S1151, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1161 - S1161, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1180 - S1180, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1201 - S1201, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1201 - S1201, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1210 - S1210, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1221 - S1221, 日本語
- (公社)日本整形外科学会, 2013年06月, 日本整形外科学会雑誌, 87(6) (6), S1227 - S1227, 日本語
- (公社)日本整形外科学会, 2013年03月, 日本整形外科学会雑誌, 87(2) (2), S108 - S108, 日本語
- (公社)日本整形外科学会, 2013年03月, 日本整形外科学会雑誌, 87(3) (3), S725 - S725, 日本語
- 関東整形災害外科学会, 2012年10月, 関東整形災害外科学会雑誌, 43(5) (5), 422 - 423, 日本語小児大腿皮下に発生したangiomatoid fibrous histiocytomaの1例
- 東日本整形災害外科学会, 2012年08月, 東日本整形災害外科学会雑誌, 24(3) (3), 434 - 434, 日本語
- 関東整形災害外科学会, 2012年06月, 関東整形災害外科学会雑誌, 43(3) (3), 225 - 225, 日本語超高齢者骨折に対するイリザロフ創外固定の1例
- 関東整形災害外科学会, 2012年06月, 関東整形災害外科学会雑誌, 43(3) (3), 227 - 227, 日本語大腿骨遠位骨端線損傷後の成長障害に対し鏡視下Langenskioeld法を行った1例
- 関東整形災害外科学会, 2012年02月, 関東整形災害外科学会雑誌, 43(1) (1), 77 - 77, 日本語脊柱管内腫瘍と鑑別が困難であった脱出椎間板ヘルニアの3例
- 関東整形災害外科学会, 2011年09月, 関東整形災害外科学会雑誌, 42(臨増号外) (臨増号外), 178 - 178, 日本語脊柱管内腫瘍と鑑別が困難であった脱出椎間板ヘルニアの3例
- 東日本整形災害外科学会, 2011年08月, 東日本整形災害外科学会雑誌, 23(3) (3), 446 - 446, 日本語
- 関東整形災害外科学会, 2010年08月, 関東整形災害外科学会雑誌, 41(4) (4), 238 - 238, 日本語肝細胞癌大腿骨転移に対する観血的内固定術にラジオ波焼灼術を補助療法として用いた1例
- 東日本整形災害外科学会, 2010年08月, 東日本整形災害外科学会雑誌, 22(3) (3), 515 - 515, 日本語
- 関東整形災害外科学会, 2010年03月, 関東整形災害外科学会雑誌, 41(臨増号外) (臨増号外), 90 - 90, 日本語肝細胞癌大腿骨転移に対する観血的内固定術にラジオ波焼灼術を補助療法として用いた1例
- (一社)茨城県医師会, 2009年03月, 茨城県臨床医学雑誌, (44) (44), 44 - 44, 日本語混合型IPMNの1切除例
- 日本臨床外科学会, 2009年02月, 日本臨床外科学会雑誌, 70(2) (2), 630 - 630, 日本語消化管出血をきたしたBlue Rubber Bleb Nevus症候群の一例
- 日本内科学会-関東地方会, 2008年10月, 日本内科学会関東地方会, 557回, 34 - 34, 日本語再発・遷延性の経過を呈したFisher症候群の1例
- 日本臨床外科学会, 2008年03月, 日本臨床外科学会雑誌, 69(3) (3), 722 - 722, 日本語混合型IPMNの1切除例
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2024年04月01日 - 2027年03月31日小児骨肉腫における悪液質に伴う筋萎縮に対する抗酸化フラボノイドの効果
- 日本学術振興会, 科学研究費助成事業, 若手研究, 神戸大学, 2023年04月01日 - 2026年03月31日骨転移患者の就労阻害因子の同定と至適支援方法の確立
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2022年04月01日 - 2025年03月31日サルコペニアの骨格筋に対する経皮的炭酸ガス投与法の効果についてサルコペニアの成因や病態については明らかにされていない部分も多く、基礎研究が進行中であるが、臨床的には診断ガイドラインも作成されており、予防や治療法の確立が望まる。現在のところ、有効な治療法としてエビデンスが示されているのは運動療法だけであり、薬物治療や栄養療法についてのエビデンスは不十分である。サルコペニアはロコモティブシンドローム、フレイルと並んで高齢者の運動機能、身体機能の低下として問題となるが、高齢者では、運動器の慢性変性疾患による疼痛やしびれなどの自覚症状を有することが多く、さらに基礎疾患による運動制限や認知機能や気力の低下もあるため、運動療法を習慣化させることが困難である。経皮的炭酸ガス療法は運動能力が低下した状態においても施術が可能で低侵襲な新規治療法として、我々は既に骨折や悪性軟部腫瘍に対する臨床研究を行っている。有酸素運動と同様の効果が得られる本治療法が、サルコペニアに対して有効であることが示されれば、臨床応用ができ、高齢社会において大きく貢献することが可能であると考える。 そのためにはまず、自然発症高血圧ラット(SHR)に高脂肪高炭水化物食を負荷したモデル(サルコペニアラット)を使用し、経皮的炭酸ガス療法を行う。経皮的炭酸ガス治療群とコントロール群で体組成の評価を行い、摘出した骨格筋組織で病理組織学的、分子生物学的に筋量や筋サテライト細胞数の評価、筋タンパクの合成と分解に関連する因子についての評価を行う予定である。
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2021年04月01日 - 2024年03月31日人工骨肉腫幹細胞を用いた骨肉腫新規治療の開発本研究の目的は,我々が初めて作製に成功した人工骨肉腫幹細胞を用いて,骨肉腫の腫瘍発生・増生,再発・転移,治療抵抗性に関わる因子を解明することである.さらに,得られた結果を用いて臨床的に応用可能な治療標的を同定し,新規治療開発を行うことを目指す. これまでに,ヒト骨肉腫由来細胞株MG63にレトロウイルスベクターを用いてOCT3/4,KLF4,SOX2の3遺伝子を導入して作製した人工骨肉腫幹細胞MG-OKSと,同様の方法でGFPを導入して作製したコントロール細胞MG-GFPを用いて,各細胞における幹細胞関連マーカー,細胞増殖能,細胞遊走能,スフェア形成能等幹細胞特性の検討を行ったところ,MG-OKSでは幹細胞関連マーカーの発現上昇,細胞増殖能低下,細胞遊走能上昇,スフェア形成能上昇がみられ,幹細胞特性を有していることを明らかとした.さらに人工骨肉腫細胞MG-OKS,コントロール細胞MG-GFPおよび親細胞株MG-63の網羅的遺伝子解析をMicroarrayで行ったところ,MG-OKSにおいてMG-GFPおよびMG-63よりも10倍以上発現上昇をみとめた遺伝子が200個以上検出された.同遺伝子群の機能解析をGene ontologyを用いて行ったところ,悪性腫瘍との関連が報告されている遺伝子群の発現上昇が確認された.これら遺伝子群からSPRR1A遺伝子に着目し,治療標的あるいは腫瘍マーカーとして応用可能かについて現在様々な検討を行っている.
