Details of a Researcher - TERAMOTO Atsushi

Papers - TERAMOTO Atsushi

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Relevance between Schmorl's Node and Lumbar Intervertebral Disc Degeneration Quantified with Magnetic Resonance Imaging T2 Mapping in Chronic Low Back Pain.

Izaya Ogon, Hiroyuki Takashima, Tomonori Morita, Tsutomu Oshigiri, Yoshinori Terashima, Mitsunori Yoshimoto, Ryunosuke Fukushi, Shutaro Fujimoto, Makoto Emori, Atsushi Teramoto, Tsuneo Takebayashi, Toshihiko Yamashita

Asian spine journal 14 ( 5 ) 621 - 628 2020.03 [Refereed] [International journal]

Study Design: Cross-sectional study. Purpose: The purpose of this study was to elucidate the relevance among Schmorl's node (SN), chronic low back pain (CLBP), and intervertebral disc degeneration (IVDD) with the use of magnetic resonance imaging T2 mapping. Overview of Literature: SN may be combined with CLBP and/or IVDD; however, their relationship has not been determined to date. Methods: A total of 105 subjects were included (48 men and 57 women; mean age, 63.2±2.7 years; range, 22-84 years). We analyzed five functional spinal unit levels (L1-S1) and evaluated the T2 values of the anterior annulus fibrosus (AF), nucleus pulposus, and posterior AF. We compared the low back pain (LBP) Visual Analog Scale (VAS) scores and the T2 values in each decade with or without SN. Results: There were no remarkable differences in SN prevalence rate regarding age decade or gender. SNs were more prevalent in the upper 2 levels (70.3%). LBP VAS scores with and without SN were 64.7±4.3 mm and 61.9±2.8 mm, respectively, with no significant differences between the groups (p =0.62). The T2 values of anterior AF with SN were significantly lower than those without SN in patients in their 50s, 60s, 70s, and 80s (p <0.01). Conclusions: SN presence is not itself a risk factor for CLBP; however, it indicates IVDD of the anterior AF in subjects with SN who are ≥50 years old.

Denosumab prevents periprosthetic bone mineral density loss in the tibial metaphysis in total knee arthroplasty.

Yasutaka Murahashi, Atsushi Teramoto, Shunsuke Jimbo, Yohei Okada, Tomoaki Kamiya, Rui Imamura, Hiroyuki Takashima, Kota Watanabe, Satoshi Nagoya, Toshihiko Yamashita

The Knee 27 ( 2 ) 580 - 586 2020.03 [Refereed] [International journal]

BACKGROUND: Periprosthetic bone quality is one of the most important factors preventing early prosthesis migration and long-term failure. Although denosumab, which binds to the receptor activator of nuclear factor kappa-B ligand (RANKL), has been linked with periprosthetic bone mineral density (BMD), the effectiveness of denosumab against bone loss remains unclear. We hypothesized that denosumab treatment after total knee arthroplasty (TKA) could prevent periprosthetic bone resorption. METHODS: In this prospective cohort study, 28 patients with primary knee osteoarthritis were divided into two groups: denosumab (denosumab and vitamin D) and control (vitamin D only) groups. All patients underwent TKA with the same implant model and received medication after surgery. We used dual-energy X-ray absorptiometry to measure periprosthetic BMD after TKA. RESULTS: In the control group, the BMD of the proximal medial tibia decreased drastically at 12 months after TKA (-19.7%). Denosumab treatment significantly preserved this BMD loss (0.7%). The linear regression analysis revealed that denosumab intervention had the highest significantly positive relationship with BMD. CONCLUSIONS: Our results indicate that denosumab treatment significantly reduces periprosthetic BMD loss, even at the early stages after TKA. This therapeutic strategy may facilitate early stable fixation of the prosthesis which, in turn, may help to prevent early implant migration and reduce the need for revision surgery.

Effect of Initial Graft Tension During Anterior Talofibular Ligament Reconstruction on Ankle Kinematics, Laxity, and In Situ Forces of the Reconstructed Graft.

Yuzuru Sakakibara, Atsushi Teramoto, Tetsuya Takagi, Satoshi Yamakawa, Hiroaki Shoji, Yohei Okada, Takuma Kobayashi, Tomoaki Kamiya, Mineko Fujimiya, Hiromichi Fujie, Kota Watanabe, Toshihiko Yamashita

The American journal of sports medicine 48 ( 4 ) 916 - 922 2020.03 [Refereed] [International journal]

BACKGROUND: Although a variety of surgical procedures for anterior talofibular ligament (ATFL) reconstruction have been reported, the effect of initial graft tension during ATFL reconstruction remains unclear. PURPOSE/HYPOTHESIS: This study investigated the effects of initial graft tension on ATFL reconstruction. We hypothesized that a high degree of initial graft tension would cause abnormal kinematics and laxity. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve cadaveric ankles were tested with a robotic system with 6 degrees of freedom to apply passive plantarflexion and dorsiflexion motions and a multidirectional load. A repeated measures experiment was designed with the intact ATFL, transected ATFL, and reconstructed ATFL at initial tension conditions of 10, 30, 50, and 70 N. The 3-dimensional path and reconstructed graft tension were simultaneously recorded, and the in situ forces of the ATFL and reconstructed graft were calculated with the principle of superposition. RESULTS: Initial tension of 10 N was sufficient to imitate normal ankle kinematics and laxity, which were not significantly different when compared with those of the intact ankles. The in situ force on the reconstructed graft tended to increase as the initial tension increased. In situ force on the reconstructed graft >30 N was significantly greater than that of intact ankles. The in situ force on the ATFL was 19 N at 30° of plantarflexion. In situ forces of 21.9, 30.4, 38.2, and 46.8 N were observed at initial tensions of 10, 30, 50, and 70 N, respectively, at 30° of plantarflexion. CONCLUSION: Approximate ankle kinematic patterns and sufficient laxity, even with an initial tension of 10 N, could be obtained immediately after ATFL reconstruction. Moreover, excessive initial graft tension during ATFL reconstruction caused excessive in situ force on the reconstructed graft. CLINICAL RELEVANCE: This study revealed the effects of initial graft tension during ATFL reconstruction. These data suggest that excessive tension during ATFL reconstruction should be avoided to ensure restoration of normal ankle motion.

Screw Internal Fixation and Ilizarov External Fixation: A Comparison of Outcomes in Ankle Arthrodesis

Atsushi Teramoto, Koji Nozaka, Tomoaki Kamiya, Takeshi Kashiwagura, Hiroaki Shoji, Kota Watanabe, Yoichi Shimada, Toshihiko Yamashita

JOURNAL OF FOOT & ANKLE SURGERY ( ELSEVIER SCIENCE INC ) 59 ( 2 ) 343 - 346 2020.03 [Refereed]

The purpose of this study was to compare the mid-term clinical outcomes between screw internal fixation and Ilizarov external fixation in patients who underwent ankle arthrodesis and to elucidate the differences between the 2 fixation methods. This study investigated 43 ankles in 41 patients who underwent ankle arthrodesis at 1 of the 2 study institutions. There were 15 men and 26 women, and their mean age was 66.2 (range 49 to 87) years. The primary disease included osteoarthritis (OA) (79%), rheumatoid arthritis (RA) (16.3%), and Charcot joint (4.7%). Patients were divided into 2 groups depending on the surgical approach: the screw group (S) and the Ilizarov group (I). The following items were evaluated and compared between the 2 groups: patient characteristics, Tanaka-Takakura classification based on preoperative plain X-ray images, duration of surgery, blood loss, surgical complications, time to start weightbearing, and the Japanese Society of Surgery of the Foot (JSSF) standard rating system for the ankle-hind-foot. Duration of surgery was significantly shorter in the S group (162.3 versus 194.9 min), and the amount of blood loss was also significantly lower in the S group (29.2 versus 97.5 ml). Preoperative JSSF scale was significantly lower in the I group (44.8 versus 33), but postoperative JSSF scale was not significantly different between the 2 groups (82.1 versus 77.9). The S group had satisfactory clinical outcomes with a shorter duration of surgery and smaller amount of blood loss than the I group. However, severe patients in the I group achieved similar treatment outcomes. (C) 2019 by the American College of Foot and Ankle Surgeons. All rights reserved.

股関節屈曲・伸展運動時における長内転筋の筋スティフネスに及ぼす股関節角度の影響

加藤拓也, 谷口圭吾, 神谷智昭, 寺本篤史, 渡邉耕太, 片寄正樹, 山下敏彦

日本整形外科学会雑誌 ( (公社)日本整形外科学会 ) 94 ( 3 ) S995 - S995 2020.03

Radiographic Evaluation of Medial Opening-Wedge High Tibial Osteotomy Using a New Internal Fixator with a Wedge-Shaped Spacer Block.

Shinichiro Okimura, Atsushi Teramoto, Kota Watanabe, Satoshi Nuka, Tomoaki Kamiya, Toshihiko Yamashita

The journal of knee surgery 2020.01 [Refereed] [International journal]

We developed a new internal fixator: a rigid T: -shaped plate with locking screws and wedge-shaped spacer block for high tibial osteotomy. The purpose of the present study was to evaluate the radiographic outcome of opening-wedge high tibial osteotomy (OWHTO) using this new internal fixator. Sixty OWHTOs were performed in patients with medial compartment osteoarthritis and varus deformity (28 males and 23 females). Patients' mean age was 60.4 years. Preoperative and postoperative radiographs were obtained. The paired t-test was used to evaluate the differences over time with respect to radiographic variables. Union of the osteotomy gap was obtained in all patients, and no implant breakage was found. On anterior-posterior radiographs, a significant difference was observed (p < 0.01) between the preoperative and postoperative mean values of femorotibial angles (179.6 ± 3.2 vs. 170.6 ± 2.5 degrees), weight-bearing line ratios (23.8 ± 13.5 vs. 60.5 ± 11.5%), anatomical medial proximal tibial angles (84.8 ± 2.5 vs. 91.0 ± 2.6 degrees), and joint line coverage angles (3.6 ± 2.0 vs. 2.4 ± 1.7 degrees). On lateral radiographs, posterior tibial slopes were 11.5 ± 3.9 degrees preoperatively and 12.2 ± 4.0 degrees postoperatively (p < 0.01), and Insall-Salvati ratios were 1.04 ± 0.12 preoperatively and 1.06 ± 0.13 postoperatively (p = 0.24). Performing OWHTO using a new internal fixator with a wedge-shaped spacer achieves adequate correction of lower limb alignment without implant-related complications. This is a Level IV, case series study.

Do We Have Adequate Flexion-extension Radiographs for Evaluating Instability in Patients With Lumbar Spondylolisthesis?

Tomonori Morita, Mitsunori Yoshimoto, Yoshinori Terashima, Katsumasa Tanimoto, Noriyuki Iesato, Izaya Ogon, Tsutomu Oshigiri, Atsushi Teramoto, Makoto Emori, Hiroyuki Takashima, Ryosuke Hirota, Shutaro Fujimoto, Toshihiko Yamashita

Spine 45 ( 1 ) 48 - 54 2020.01 [Refereed] [International journal]

STUDY DESIGN: A retrospective cohort study of consecutive patients. OBJECTIVE: To investigate whether adequate flexion-extension was acquired in standard functional radiographs in lumbar spondylolisthesis. SUMMARY OF BACKGROUND DATA: In lumbar spondylolisthesis, flexion-extension radiographs taken in the standing position are most commonly used to evaluate spinal instability. However, these functional radiographs occasionally depend on the patient's effort and cooperation, they can provide different results. METHODS: This study included 92 consecutive patients diagnosed with L4-5 degenerative lumbar spondylolisthesis. We analyzed the flexion-extension radiographs taken with the patient being led by the hand (LH) and those taken without LH (NLH). Sagittal translation (ST), segmental angulation (SA), posterior opening (PO), and lumbar lordosis (LL) were measured on functional radiographs taken in both tests. Then, ST, SA, PO, detection rate of instability, and LL observed in LH were compared with those observed in NLH. Furthermore, the correlation of the difference was evaluated between ST, lumbar angulation, and LL. RESULTS: A relative value of ST was 9.5% ± 4.3% in LH and 5.6% ± 3.3% in NLH, which differed significantly (P < 0.001). SA and PO were also significantly greater in LH than in NLH. The detection rate of instability was 71.7% in LH and 30.4% in NLH (P < 0.001). LL measurement on flexion showed 17.6° ± 13.5° in LH and 28.2° ± 12.2° in NLH, which differed significantly (P < 0.001). However, no significant difference was found in LL on extension between LH and NLH. There was a moderate correlation between the difference of ST, SA, PO, and LL on flexion. CONCLUSION: Flexion with physical assistance was useful for the detection of abnormal lumbar mobility. Taking radiation exposure into consideration, physical assistance such as using a table in front of a patient could lead the similar evaluation of the segmental instability. LEVEL OF EVIDENCE: 2.

3D MRI evaluation of morphological characteristics of lateral ankle ligaments in injured patients and uninjured controls.

Atsushi Teramoto, Yoshihiro Akatsuka, Hiroyuki Takashima, Hiroaki Shoji, Yuzuru Sakakibara, Kota Watanabe, Toshihiko Yamashita

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 25 ( 1 ) 183 - 187 2020.01 [Refereed] [Domestic journal]

BACKGROUND: With ultrasonography or 2D magnetic resonance imaging (MRI) of the lateral ankle ligament, it is particularly difficult to show the entire calcaneofibular ligament (CFL). The purpose of this study was to evaluate the morphological characteristics of the lateral ankle ligaments in injured patients and uninjured controls using 3D MRI. METHODS: A total of 64 ankles of 59 healthy volunteers and lateral ligament injury patients (mean age of 32.4 years) were examined. The 64 ankles included a healthy group of 11 ankles, an acute injury group of 12 ankles that underwent MRI a month after injury, and a chronic injury group of 41 ankles that underwent MRI more than 3 months after injury. Using a 3.0-T MRI system, imaging was done with fast imaging employing steady-state acquisition cycled phases. Oblique sagittal images that most clearly depicted the entire anterior talofibular ligament (ATFL) and CFL were prepared manually and evaluated using a workstation. RESULTS: In the healthy group, both the ATFL and CFL were clearly and entirely visualized. The mean width in the central portion was 4.0 ± 1.0 mm in the ATFL and 4.8 ± 0.6 mm in the CFL. 3D MRI in the acute injury group showed findings of diffuse swelling with hyperintensity in the ATFL of all patients. The CFL in 7 of 12 ankles showed findings of diffuse swelling with hyperintensity. In the chronic injury group, morphological abnormalities of the ATFL were seen in 19 of 41 ankles. The ligament signal disappeared in 2 ankles, thinned in 4 ankles, and showed swelling in 13 ankles. Morphological abnormalities of the CFL were seen in 17 of 41 ankles. The ligament signal disappeared in 1 ankle, thinned in 2 ankles, and showed swelling in 14 ankles. CONCLUSION: 3D MRI may be a useful modality to visualize both the ATFL and the CFL.

Glossopharyngeal and Hypoglossal Nerve Paralysis Secondary to Prevertebral Phlegmon.

Ryunosuke Fukushi, Izaya Ogon, Yoshinori Terashima, Hiroyuki Takashima, Tsutomu Oshigiri, Noriyuki Iesato, Mitsunori Yoshimoto, Makoto Emori, Atsushi Teramoto, Toshihiko Yamashita

Case reports in orthopedics 2020 3795035 - 3795035 2020 [Refereed] [International journal]

A 50-year-old man presented to the clinic with severe neck pain, fever, and difficulty breathing and was subsequently admitted to the local orthopedics department with possible retropharyngeal abscess and pyogenic spondylitis. Antibiotic therapy was initiated; however, due to poor oxygenation, he was referred and transferred to our department and admitted. Magnetic resonance imaging showed signal changes at the left C1/2 lateral atlantoaxial joint, posterior pharynx, longus colli muscle, carotid space, and medial deep cervical region, predominantly on the left side. In addition, despite lymph node enlargement from the posterior pharynx to the deep cervical region, there was no abscess formation. There were no signs of a space-occupying lesion or signal changes in the jugular foramen. One day postadmission, the patient's temperature had risen to 39.1°C and his SpO2 had fallen. His neck pain had also worsened, and emergency surgery was decided. Preoperatively, we suspected retropharyngeal abscess and pyogenic spondylitis. On day 13 postadmission, the patient exhibited dysphagia, deviated tongue protrusion, and the curtain sign. Glossopharyngeal and hypoglossal nerve paralysis were diagnosed. The patient's swallowing functions recovered and he was discharged on day 36. We experienced a case of glossopharyngeal and hypoglossal nerve paralysis secondary to pyogenic cervical facet joint arthritis.

Nontraumatic Chronic Subcutaneous Extensor Digitorum Longus Tendon Rupture in a Recreational Runner

Kodai Hamaoka, Kota Watanabe, Tomoaki Kamiya, Atsushi Teramoto, Toshihiko Yamashita

JBJS Case Connector 2020

A Case of Acute Intervertebral Disc Herniation into Both the Upper and Lower Vertebral Body.

Mitsunori Yoshimoto, Makoto Emori, Atsushi Teramoto, Toshihiko Yamashita

Spine surgery and related research 3 ( 2 ) 193 - 195 2019.04 [Refereed] [Domestic journal]

Kinematics and Laxity of the Ankle Joint in Anatomic and Nonanatomic Anterior Talofibular Ligament Repair: A Biomechanical Cadaveric Study.

Hiroaki Shoji, Atsushi Teramoto, Yuzuru Sakakibara, Tomoaki Kamiya, Kota Watanabe, Hiromichi Fujie, Toshihiko Yamashita

The American journal of sports medicine 47 ( 3 ) 667 - 673 2019.03 [Refereed] [International journal]

BACKGROUND: Although it is crucial to accurately identify the anterior talofibular ligament (ATFL) attachment site, it may not be feasible to fully observe the ATFL attachment site during arthroscopic surgery. As a result, the repair position might often be an unintentionally nonanatomic ATFL attachment site. HYPOTHESIS: Anatomic ATFL repair restores kinematics and laxity to the ankle joint, while nonanatomic ATFL repair does not. STUDY DESIGN: Controlled laboratory study. METHODS: Seven normal fresh-frozen human cadaveric ankles were used. The ankles were tested with a 6 degrees of freedom robotic system. The following ankle states were evaluated: intact, ATFL injured, ATFL anatomic repair, and ATFL nonanatomic repair. The ATFL nonanatomic repair position was set 8 mm proximal from the center of the ATFL attachment site of the fibula. For each state, a passive plantarflexion (PF)-dorsiflexion (DF) kinematics test and a multidirectional loading test (anterior forces, inversion moment, and internal rotation moment) were performed. RESULTS: The kinematics and laxity of the anatomic repair were not significantly different from those of the intact state. In nonanatomic repair, the inversion-eversion angle showed significant inversion (3.0°-3.4°) from 5° to 15° of DF, and the internal rotation-external rotation angle showed significant internal rotation (2.0°) at neutral PF-DF versus the intact state. In addition, internal rotation laxity was significantly increased (5.5°-5.8°) relative to the intact state in the nonanatomic repair at 30° and 15° of PF. There were no significant differences in anterior-posterior translation between the repairs. CONCLUSION: Although the anatomic ATFL repair state did not show significant differences in kinematics and laxity relative to the intact state, the nonanatomic ATFL repair state demonstrated significant inversion and internal rotation kinematics and internal rotation laxity when compared with the intact state. CLINICAL RELEVANCE: Nonanatomic repair alters kinematics and laxity from the intact condition.

Modified distal tibial oblique osteotomy for osteoarthritis of the ankle: Operative procedure and preliminary results.

Kota Watanabe, Atsushi Teramoto, Takuma Kobayashi, Yuzuru Sakakibara, Hiroaki Shoji, Shinichiro Okimura, Satoshi Nuka, Toshihiko Yamashita

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 24 ( 2 ) 306 - 311 2019.03 [Refereed] [Domestic journal]

BACKGROUND: Low tibial osteotomy is an effective joint-preserving surgery for ankle arthritis. However, poor postoperative wound healing, infection, and delayed or non-union of bones remain significant concerns. We describe a modified distal tibial oblique osteotomy procedure and report preliminary results for varus ankle arthritis. METHODS: The osteotomy path consisted of an oblique doglegged line from the lateral end of the distal tibia to a proximal point about one-third from the lateral edge and continuing along an arc defined by virtual coronal-plane rotation of the doglegged line to the medial edge. After osteotomy, the distal tibial fragment was rotated distally in the coronal plane for realignment while maintaining contact with the proximal tibia and the distal tibial fragment. The resulting wedge-shaped gap was filled with artificial bone blocks and tibial bone projecting medially from rotation. A locking plate was then applied for stabilization. We evaluated 7 ankles from 6 osteoarthritis patients both clinically and radiographically following this procedure. RESULTS: Bone union was achieved within 3 months for all patients. The Japanese Society for Surgery of the Foot ankle-hindfoot scale improved from a mean of 38.4 points preoperatively to 85.7 points at the latest follow-up. No wound healing problems, infections, or nerve disturbances were observed. Multiple radiographic parameters were also improved following the operation. CONCLUSIONS: This procedure maintains close bone contact for better postoperative union, obviates the need for iliac bone harvesting, and reduces tension on medial soft tissue. We believe these modifications are potential advantages for achieving stable results in patients with ankle osteoarthritis.

Morphological evaluation of the calcaneofibular ligament in different ankle positions using a three-dimensional MRI sequence.

Yoshihiro Akatsuka, Atsushi Teramoto, Hiroyuki Takashima, Kota Watanabe, Toshihiko Yamashita

Surgical and radiologic anatomy : SRA 41 ( 3 ) 307 - 311 2019.03 [Refereed] [International journal]

PURPOSE: Evaluating images of the lateral ligament of the ankle is not easy, and evaluation of the calcaneofibular ligament (CFL) in particular is difficult. We prospectively conducted morphological measurements of the CFL in different ankle positions and obtain basic data for use in functional assessment of the CFL, diagnosis of CFL injury, and determination of treatment effects. METHODS: The subjects were ten healthy volunteers (ten ankles) with a mean age of 27.8 years and no history of ankle disease. Imaging was done using a 3-T magnetic resonance imaging (MRI) machine and fast imaging employing steady-state acquisition cycled phases (FIESTA-C), a three-dimensional (3D) sequence, with the ankle in a neutral position, maximum dorsiflexion, and maximum plantar flexion. 3D images of the CFL, peroneal muscle tendons, fibula, and calcaneus were prepared at a workstation, and morphological measurements of the CFL were made. RESULTS: In all positions, the CFL showed a gently curving course with the peroneal muscle tendons as a fulcrum. The tortuosity angle was significantly smaller in plantar flexion (30.0° ± 7.4°) than in the neutral position (41.7° ± 8.3°). CONCLUSIONS: 3D MRI sequences showed that, in all positions, the CFL curved due to the influence of the peroneal muscle tendons. With maximum plantar flexion, the CFL tortuosity angle was small, which was thought to have been due to the tension in the CFL.

Antinociceptive effects of hyaluronic acid on monoiodoacetate-induced ankle osteoarthritis in rats.

Shunsuke Jimbo, Yoshinori Terashima, Atsushi Teramoto, Tsuneo Takebayashi, Izaya Ogon, Kota Watanabe, Tatsuya Sato, Nobutoshi Ichise, Noritsugu Tohse, Toshihiko Yamashita

Journal of pain research 12 191 - 200 2019 [Refereed] [International journal]

Purpose: Ankle osteoarthritis (OA) causes significant pain and debilitation; yet, its underlying mechanisms remain unclear. Clinically, hyaluronic acid (HA) is widely used to treat OA. The present study aimed to investigate the roles of HA in pain-related behavior, joint function, swelling, and pathological changes in cartilage in a rat model of monoiodoacetate (MIA)-induced ankle OA. Materials and methods: Male Sprague Dawley rats were assigned to three experimental groups as follows: 1) MIA rats injected with 1 mg MIA in the right tibiotarsal joint for two consecutive days; 2) sham rats injected with saline instead of MIA; and 3) MIA-HA rats injected with HA in the tibiotarsal joint at 7, 14, and 21 days after MIA injection. Joint swelling, range of motion (ROM), and pain-related behavior were evaluated 1 day before and on the 7th, 14th, 21st, and 28th day after MIA or saline injection. Pathological changes in the ankle joint were assessed 28 days after MIA or saline injection. Results: No significant difference in the degree of ankle swelling or ROM reduction was observed between MIA rats and MIA-HA rats. However, compared with those in MIA rats, mechanical and thermal hypersensitivity was significantly reduced and stride length significantly improved in MIA-HA rats. Histologic analysis revealed that cartilage degeneration was significantly suppressed in MIA-HA rats compared with that in MIA rats, reflecting the chondroprotective effects of HA. Conclusion: HA improved pain-related behavior and stride length and suppressed MIA-induced cartilage degeneration. HA may thus inhibit OA progression and suppress peripheral and/or central sensitization.

A Case of Ankylosing Spinal Hyperostosis with Massive Hemothorax Due to Thoracic Vertebral Fracture Caused by Minor Trauma.

Ryosuke Hirota, Hideto Irifune, Nobuyuki Takahashi, Makoto Emori, Atsushi Teramoto, Mitsunori Yoshimoto, Masahiro Miyajima, Atsushi Watanabe, Toshihiko Yamashita

Spine surgery and related research 3 ( 3 ) 274 - 276 2019 [Refereed] [Domestic journal]

Phosphorylated Platelet-Derived Growth Factor Receptor-Positive Cells With Anti-apoptotic Properties Accumulate in the Synovium of Patients With Rheumatoid Arthritis.

Takashi Matsumura, Yuki Saito, Tomoyuki Suzuki, Atsushi Teramoto, Yasuhiro Ozasa, Toshihiko Yamashita, Mineko Fujimiya, Takako Saito-Chikenji

Frontiers in immunology ( Frontiers Media {SA} ) 10 ( FEB ) 241 - 241 2019 [Refereed] [International journal]

Rheumatoid arthritis (RA) is an autoimmune disease caused by inflammation of the synovium and characterized by chronic polyarthritis that destroys bone and cartilage. Fibroblast-like synoviocytes (FLSs) in the synovium of patients with RA can promote cartilage and bone destruction by producing proteins such as matrix metalloproteinases and receptor activator of NF-κB ligand, thereby representing an important therapeutic target for RA. FLSs have several phenotypes depending on which cell surface proteins and adhesion factors are expressed. Identifying the cellular functions associated with different phenotypes and methods of controlling them are considered essential for developing therapeutic strategies for RA. In this study, synovial tissue was collected from patients with RA and control subjects who required surgery due to ligament injury or fracture. Immunohistological analysis was used to investigate the rates of positivity for phosphorylated platelet-derived growth factor receptor-αβ (pPDGFRαβ) and cadherin-11 (CDH11) expression, and apoptosis-related markers were assessed for each cell phenotype. Next, FLSs were isolated in vitro and stimulated with tumor necrosis factor-α (TNF-α) in addition to a combination of PDGF and transforming growth factor (2GF) to investigate pPDGFRαβ and CDH11 expression and the effects of the inhibition of TNF and cyclin-dependent kinase (CDK) 4/6 on FLSs. Immunohistological analysis showed a large percentage of pPDGFRαβ+CDH11- cells in the sub-lining layer (SL) of patients with RA. These cells exhibited increased B-cell lymphoma-2 expression, reduced TNF receptor-1 expression, resistance to cell death, and abnormal proliferation, suggesting a tendency to accumulate in the synovium. Further, in vitro 2GF stimulation of FLSs lowered, whereas 2GF + TNF stimulation increased the pPDGFRαβ/CDH11 ratio. Hypothesizing that FLSs stimulated with 2GF + TNF would accumulate in vivo in RA, we determined the therapeutic effects of TNF and CDK4/6 inhibitors. The TNF inhibitor lowered the pPDGFRαβ/CDH11 ratio, whereas the CDK4/6 inhibitor suppressed cell proliferation. However, a synergistic effect was not observed by combining both the drugs. We observed an increase in pPDGFRαβ+CDH11- cells in the SL of the RA synovium and accumulation of these cells in the synovium. We found that the TNF inhibitor suppressed FLS activity and the CDK4/6 inhibitor reduced cell proliferation.

Mid-term Clinical Results of Microendoscopic Decompression for Lumbar Foraminal Stenosis.

Mitsunori Yoshimoto, Noriyuki Iesato, Yoshinori Terashima, Katsumasa Tanimoto, Tsutomu Oshigiri, Makoto Emori, Atsushi Teramoto, Toshihiko Yamashita

Spine surgery and related research 3 ( 3 ) 229 - 235 2019 [Refereed] [Domestic journal]

Introduction: There have been several reports on surgical techniques involving microendoscopy or percutaneous endoscopy for treating lumbar foraminal stenosis (LFS). However, no studies have assessed the mid-term clinical results of endoscopic techniques in spite of their relatively long history. In this study, we report 20 consecutive cases of LFS treated by our microendoscopic technique focusing on clinical results with a follow-up of at least two years. Methods: Twenty consecutive cases of LFS treated with microendoscopic decompression were followed up at 1, 2, 6, and 12 months postoperatively and annually thereafter. The patients were 14 males and 6 females, and the mean age at the time of surgery was 64.7 years. The Japanese Orthopaedic Association (JOA) score was used as the clinical outcome index. Results: Of the 20 patients, 16 were monitored successfully for more than 2 years. The follow-up rate was 80.0%, and the mean follow-up period was 66.3 months. The JOA score improved from 13.8 points before surgery to 24.6 points at final follow-up. Revision fusion surgeries were performed in two cases for LFS recurrence. Conclusions: The microendoscopic technique effectively treats LFS.

関節リウマチの滑膜リン酸化PDGFR陽性細胞に対するEtanerceptおよびPalbociclibの効果 in vitroにおける検討

松村崇史, 小笹泰宏, 寺本篤史, 山下敏彦, 齋藤悠城, 千見寺貴子, 藤宮峯子, 鈴木智之

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 61 ( 136th suppl ) 28 - 28 2019

TNF阻害薬とCDK4/6阻害薬の併用が関節リウマチの滑膜リン酸化PDGFR陽性細胞に与える影響 in vitroにおける検討

松村崇史, 小笹泰宏, 鈴木智之, 寺本篤史, 山下敏彦, 千見寺貴子, 齋藤悠城, 藤宮峯子

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 61 ( 137th suppl ) 13 - 13 2019

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