76 results on '"Hiroshi Iwasaki"'
Search Results
2. Spinopelvic Parameters in the Elderly: Does Inadequate Correction Portend Worse Outcomes?
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Masanari Takami, Shunji Tsutsui, Keiji Nagata, Hiroshi Iwasaki, Akihito Minamide, Yasutsugu Yukawa, Motohiro Okada, Ryo Taiji, Shizumasa Murata, Takuhei Kozaki, Hiroshi Hashizume, and Hiroshi Yamada
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elderly patients with spinal deformity ,undercorrection ,sagittal corrective goal ,pelvic incidence minus lumbar lordosis mismatch ,extensive corrective fusion ,scoliosis research society-schwab classification ,adult spinal deformity ,Surgery ,RD1-811 - Abstract
Introduction: This study aimed to compare the outcomes of corrective fusion for adult spinal deformity (ASD) in older people using two different sagittal correction goals: the conventional formula of “pelvic incidence (PI)-lumbar lordosis (LL) mismatch 20° or LL
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- 2024
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3. Comparative Evaluation of Postoperative Epidural Hematoma after Lumbar Microendoscopic Laminotomy: The Utility of Ultrasonography versus Magnetic Resonance Imaging
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Shizumasa Murata, Hiroshi Iwasaki, Hiroshi Hashizume, Yasutsugu Yukawa, Akihito Minamide, Yukihiro Nakagawa, Shunji Tsutsui, Masanari Takami, Motohiro Okada, Keiji Nagata, Yuyu Ishimoto, Masatoshi Teraguchi, Hiroki Iwahashi, Kimihide Murakami, Ryo Taiji, Takuhei Kozaki, Yoji Kitano, Munehito Yoshida, and Hiroshi Yamada
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ultrasonography ,postoperative epidural hematoma ,lumbar microendoscopic laminotomy ,comparative study ,mri evaluation ,Surgery ,RD1-811 - Abstract
Introduction: Postoperative spinal epidural hematoma (PSEH) is a severe complication of spinal surgery that necessitates accurate and timely diagnosis. This study aimed to assess the accuracy of ultrasonography as an alternative diagnostic tool for PSEH after microendoscopic laminotomy (MEL) for lumbar spinal stenosis, comparing it with magnetic resonance imaging (MRI). Methods: A total of 65 patients who underwent MEL were evaluated using both ultrasound- and MRI-based classifications for PSEH. Intra- and interrater reliabilities were analyzed. Furthermore, ethical standards were strictly followed, with spine surgeons certified by the Japanese Orthopaedic Association performing evaluations. Results: Among the 65 patients, 91 vertebral segments were assessed. The intra- and interrater agreements for PSEH classification were almost perfect for both ultrasound (κ=0.824 [95% confidence interval (CI) 0.729-0.918] and κ=0.810 [95% CI 0.712-0.909], respectively) and MRI (κ=0.839 [95% CI 0.748-0.931] and κ=0.853 [95% CI 0.764-0.942], respectively). The results showed high concordance between ultrasound- and MRI-based classifications, validating the reliability of ultrasound in postoperative PSEH evaluation. Conclusions: This study presents a significant advancement by introducing ultrasound as a precise and practical alternative to MRI for PSEH evaluation. The comparable accuracy of ultrasound to MRI, rapid bedside assessments, and radiation-free nature make it valuable for routine postoperative evaluations. Despite the limitations related to specific surgical contexts and clinical outcome assessment, the clinical potential of ultrasound is evident. It offers clinicians a faster, cost-effective, and repeatable diagnostic option, potentially enhancing patient care. This study establishes the utility of ultrasound in evaluating postoperative spinal epidural hematomas after MEL. With high concordance to MRI, ultrasound emerges as a reliable, practical, and innovative tool, promising improved diagnostic efficiency and patient outcomes. Further studies should explore its clinical impact across diverse surgical scenarios.
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- 2024
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4. Spinal Cord Herniation after Dural Defect Repaired Using Polyglycolic Acid Mesh and Fibrin Glue: A Case Report
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Takuhei Kozaki, Hiroshi Iwasaki, Keiji Nagata, Akihiro Hoshino, Kazunari Hirai, Takahiro Kozaki, and Hiroshi Yamada
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dural defect ,spinal cord herniation ,polyglycolic acid mesh ,fibrin glue ,Surgery ,RD1-811 - Published
- 2023
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5. Unique Characteristics of New Bone Formation Induced by Lateral Lumbar Interbody Fusion Procedure
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Masanari Takami, Shunji Tsutsui, Motohiro Okada, Keiji Nagata, Hiroshi Iwasaki, Akihito Minamide, Yasutsugu Yukawa, Hiroshi Hashizume, Ryo Taiji, Shizumasa Murata, Takuhei Kozaki, and Hiroshi Yamada
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lateral bridging callus outside cages ,lateral lumbar interbody fusion ,extreme lateral interbody fusion ,autogenous bone grafting ,osteophytes ,multivariate logistic regression analysis ,bone union ,Surgery ,RD1-811 - Abstract
Introduction: Despite the absence of bone grafting in the area outside the cage, lateral bridging callus outside cages (LBC) formation is often observed here following extreme lateral interbody fusion (XLIF) conversely to conventional methods of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion. The LBC, which may increase stabilization and decrease nonunion rate in treated segments, has rarely been described. This study aimed to identify the incidence and associated factors of LBC following XLIF. Methods: We enrolled 136 consecutive patients [56 males, 80 females; mean age 69.6 (42-85) years] who underwent lumbar fusion surgery using XLIF, including L4/5 level with posterior fixation at a single institution between February 2013 and February 2018. One year postoperatively, the treated L4/5 segments were divided into the LBC formation and non-formation groups. Potential influential factors, such as age, sex, body mass index, bone density, height of cages, cage material (titanium or polyetheretherketone [PEEK]), presence or absence of diffuse idiopathic skeletal hyperostosis (DISH), and radiological parameters, were evaluated. Multivariate logistic regression analysis was performed for factors significantly different from the univariate analysis. Results: The incidence of LBC formation was 58.8%. Multivariate logistic regression analysis showed that the length of osteophytes [+1 mm; odds ratio, 1.29; 95% confidence interval, 1.17-1.45; p
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- 2023
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6. Pelvic compensation accompanying spinal malalignment and back pain-related factors in a general population: the Wakayama spine study
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Shizumasa Murata, Hiroshi Hashizume, Shunji Tsutsui, Hiroyuki Oka, Masatoshi Teraguchi, Yuyu Ishomoto, Keiji Nagata, Masanari Takami, Hiroshi Iwasaki, Akihito Minamide, Yukihiro Nakagawa, Sakae Tanaka, Noriko Yoshimura, Munehito Yoshida, and Hiroshi Yamada
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Medicine ,Science - Abstract
Abstract Some older adults with spinal deformity maintain standing posture via pelvic compensation when their center of gravity moves forward. Therefore, evaluations of global alignment should include both pelvic tilt (PT) and seventh cervical vertebra-sagittal vertical axis (C7-SVA). Here, we evaluate standing postures of older adults using C7-SVA with PT and investigate factors related to postural abnormality. This cross-sectional study used an established population-based cohort in Japan wherein 1121 participants underwent sagittal whole-spine radiography in a standing position and bioelectrical impedance analysis for muscle mass measurements. Presence of low back pain (LBP), visual analog scale (VAS) of LBP, and LBP-related disability (Oswestry Disability Index [ODI]) were evaluated. Based on the PT and C7-SVA, the participants were divided into four groups: normal, compensated, non-compensated, and decompensated. We defined the latter three categories as “malalignment” and examined group characteristics and factors. There were significant differences in ODI%, VAS and prevalence of LBP, and sarcopenia among the four groups, although these were non-significant between non-compensated and decompensated groups on stratified analysis. Moreover, the decompensated group was significantly associated with sarcopenia. Individuals with pelvic compensation are at increased risk for LBP and related disorders even with the C7-SVA maintained within normal range.
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- 2023
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7. Ultrasonography is an effective tool for the evaluation of traumatic vertebral artery injuries distal to fourth cervical vertebra in the emergency room
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Yuyu Ishimoto, Hiroshi Iwasaki, Mayumi Sonekatsu, Shizumasa Murata, Takuhei Kozaki, Hiroshi Hashizume, Shunji Tsutsui, Masanari Takami, Keiji Nagata, Kazuhiro Hira, Seiya Kato, and Hiroshi Yamada
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Ultrasonography ,Vertebral artery ,Cervical spine injury ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background This study aimed to determine the feasibility of ultrasonography in the assessment of cervical vertebral artery (VA) injury as an alternative to computed tomography angiography (CTA) in the emergency room. Methods We analyzed 50 VAs from 25 consecutive patients with cervical spine injury that had been admitted to our emergency room. Ultrasonography and CTA were performed to assess the VA in patients with cervical spine injury. We examined the sensitivity and specificity of ultrasonography compared with CTA. Results Among these VAs, six were occluded on CTA. The agreement between ultrasonography and CTA was 98% (49/50) with 0.92 Cohen's Kappa index. The sensitivity, specificity, and positive and negative predictive values of ultrasonography were 100%, 97.7%, 85.7%, and 100%, respectively. In one case with hypoplastic VA, the detection of flow in the VA by ultrasonography differed from detection by CTA. Meanwhile, there were two cases in which VAs entered at C5 transverse foramen rather than at C6 level. However, ultrasonography could detect the blood flow in these VAs. Conclusions Ultrasonography had a sensitivity of 100% compared with CTA in assessment of the VA. Ultrasonography can be used as an initial screening test for VA injury in the emergency room.
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- 2023
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8. Publisher Correction: Pelvic compensation accompanying spinal malalignment and back pain-related factors in a general population: the Wakayama spine study
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Shizumasa Murata, Hiroshi Hashizume, Shunji Tsutsui, Hiroyuki Oka, Masatoshi Teraguchi, Yuyu Ishomoto, Keiji Nagata, Masanari Takami, Hiroshi Iwasaki, Akihito Minamide, Yukihiro Nakagawa, Sakae Tanaka, Noriko Yoshimura, Munehito Yoshida, and Hiroshi Yamada
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Medicine ,Science - Published
- 2023
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9. Current Trends in Intraoperative Spinal Cord Monitoring: A Survey Analysis among Japanese Expert Spine Surgeons
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Hideki Shigematsu, Go Yoshida, Shinji Morito, Masahiro Funaba, Nobuaki Tadokoro, Masaaki Machino, Kazuyoshi Kobayashi, Muneharu Ando, Shigenori Kawabata, Kei Yamada, Tsukasa Kanchiku, Yasushi Fujiwara, Shinichirou Taniguchi, Hiroshi Iwasaki, Masahito Takahashi, Kanichiro Wada, Naoya Yamamoto, Akimasa Yasuda, Hiroki Ushirozako, Jun Hashimoto, Kei Ando, Yukihiro Matsuyama, and Shiro Imagama
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intraoperative neuromonitoring ,br(e)-msep ,survey ,alarm point ,complications ,multimodality ionm ,japan ,Surgery ,RD1-811 - Abstract
Introduction: Although intraoperative spinal neuromonitoring (IONM) is recommended for spine surgeries, there are no guidelines regarding its use in Japan, and its usage is mainly based on the surgeon's preferences. Therefore, this study aimed to provide an overview of the current trends in IONM usage in Japan. Methods: In this web-based survey, expert spine surgeons belonging to the Japanese Society for Spine Surgery and Related Research were asked to respond to a questionnaire regarding IONM management. The questionnaire covered various aspects of IONM usage, including the preferred modality, operation of IONM, details regarding muscle-evoked potential after electrical stimulation of the brain (Br(E)-MsEP), and need for consistent use of IONM in major spine surgeries. Results: Responses were received from 134 of 186 expert spine surgeons (response rate, 72%). Of these, 124 respondents used IONM routinely. Medical staff rarely performed IONM without a medical doctor. Br(E)-MsEP was predominantly used for IONM. One-third of the respondents reported complications, such as bite injuries caused by Br(E)-MsEP. Interestingly, two-thirds of the respondents did not plan responses to alarm points. Intramedullary spinal cord tumor, scoliosis (idiopathic, congenital, or neuromuscular in pediatric), and thoracic ossification of the posterior longitudinal ligament were representative diseases that require IONM. Conclusions: IONM has become an essential tool in Japan, and Br(E)-MsEP is a predominant modality for IONM at present. Although we investigated spine surgeries for which consistent use of IONM is supported, a cost-benefit analysis may be required.
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- 2023
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10. Human Rad51 Protein Requires Higher Concentrations of Calcium Ions for D-Loop Formation than for Oligonucleotide Strand Exchange
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Axelle Renodon-Corniere, Tsutomu Mikawa, Naoyuki Kuwabara, Kentaro Ito, Dmitri Levitsky, Hiroshi Iwasaki, and Masayuki Takahashi
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Rad51 protein ,homologous recombination ,DNA strand exchange ,calcium ion ,D-loop ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Human Rad51 protein (HsRad51)-promoted DNA strand exchange, a crucial step in homologous recombination, is regulated by proteins and calcium ions. Both the activator protein Swi5/Sfr1 and Ca2+ ions stimulate different reaction steps and induce perpendicular DNA base alignment in the presynaptic complex. To investigate the role of base orientation in the strand exchange reaction, we examined the Ca2+ concentration dependence of strand exchange activities and structural changes in the presynaptic complex. Our results show that optimal D-loop formation (strand exchange with closed circular DNA) required Ca2+ concentrations greater than 5 mM, whereas 1 mM Ca2+ was sufficient for strand exchange between two oligonucleotides. Structural changes indicated by increased fluorescence intensity of poly(dεA) (a poly(dA) analog) reached a plateau at 1 mM Ca2+. Ca2+ > 2 mM was required for saturation of linear dichroism signal intensity at 260 nm, associated with rigid perpendicular DNA base orientation, suggesting a correlation with the stimulation of D-loop formation. Therefore, Ca2+ exerts two different effects. Thermal stability measurements suggest that HsRad51 binds two Ca2+ ions with KD values of 0.2 and 2.5 mM, implying that one step is stimulated by one Ca2+ bond and the other by two Ca2+ bonds. Our results indicate parallels between the Mg2+ activation of RecA and the Ca2+ activation of HsRad51.
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- 2024
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11. Psychometric Evaluation and External Validity of the Japanese Version of Lumbar Stiffness Disability Index
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Masanari Takami, Mamoru Kawakami, Hiroshi Hashizume, Shunji Tsutsui, Hiroyuki Oka, Tomohiro Shinozaki, Hiroshi Iwasaki, and Hiroshi Yamada
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adult spinal deformity ,lumbar stiffness ,lumbar stiffness disability index ,oswestry disability index ,japanese orthopaedic association back pain evaluation questionnaire ,lumbar range of motion ,psychometric evaluation ,external validity ,Surgery ,RD1-811 - Abstract
Introduction: Long fusion surgery for adult spinal deformity may restrict activities of daily living due to lumbar stiffness. While the Lumbar Stiffness Disability Index (LSDI) can help assess lumbar stiffness, in Asia the external validity of this questionnaire has not been sufficiently examined. We performed the psychometric evaluation and external validation of the Japanese version of the LSDI (LSDI-J). Methods: Fifty consecutive patients (14 males and 36 females; mean age 70.6 years) who underwent lumbar fusion surgery at our institution a minimum of one year after surgery and who visited the outpatient clinic between April and May 2019, were surveyed using the LSDI-J. The mean number of fusion levels was 4.4. Cronbach's alpha coefficients were calculated for internal consistency, and the intraclass correlation coefficient (ICC) was calculated to evaluate reliability. External validity was assessed by comparisons with the Oswestry Disability Index (ODI), the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and the lumbar range of motion (LROM) with LSDI-J scores. Results: Cronbach's alpha coefficient was 0.652 overall, and 0.849 after excluding Question 10 due to a low response rate. The ICC was 0.824 overall and 0.851 after excluding Question 10. The correlation with the ODI was 0.684, and the correlation coefficients with each domain of the JOABPEQ ranged from −0.590 to −0.413, indicating moderate correlation. However, LROM and the LSDI-J were not correlated (r=−0.055, P=0.734). Conclusions: The LSDI-J may not be suitable in Japan because there was no correlation with LROM, the most important factor for external validity. It may be necessary to investigate why the LSDI-J did not apply to the Japanese population in terms of lower limb function. Alternatively, a unique method may be needed to assess lumbar stiffness disability that is more suitable for actual clinical practice in Japan.
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- 2022
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12. Lumbar Fusion including Sacroiliac Joint Fixation Increases the Stress and Angular Motion at the Hip Joint: A Finite Element Study
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Takuhei Kozaki, Hiroshi Hashizume, Hiroyuki Oka, Satoru Ohashi, Yoh Kumano, Ei Yamamoto, Akihito Minamide, Yasutsugu Yukawa, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Keiji Nakata, Takaya Taniguchi, Daisuke Fukui, Daisuke Nishiyama, Manabu Yamanaka, Hidenobu Tamai, Ryo Taiji, Shizumasa Murata, Akimasa Murata, and Hiroshi Yamada
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adult spinal deformity surgery ,sacroiliac joint fixation ,hip pathology ,finite element analysis ,adjacent segment disease on hip joint ,adjacent joint disease ,Surgery ,RD1-811 - Abstract
Introduction: Adult spinal fusion surgery improves lumbar alignment and patient satisfaction. Adult spinal deformity surgery improves saggital balance not only lumbar lesion, but also at hip joint coverage. It was expected that hip joint coverage rate was improved and joint stress decreased. However, it was reported that adjacent joint disease at hip joint was induced by adult spinal fusion surgery including sacroiliac joint fixation on an X-ray study. The mechanism is still unclear. We aimed to investigate the association between lumbosacral fusion including sacroiliac joint fixation and contact stress of the hip joint. Methods: A 40-year-old woman with intact lumbar vertebrae underwent computed tomography. A three-dimensional nonlinear finite element model was constructed from the L4 vertebra to the femoral bone with triangular shell elements (thickness, 2 mm; size, 3 mm) for the cortical bone's outer surface and 2-mm (lumbar spine) or 3-mm (femoral bone) tetrahedral solid elements for the remaining bone. We constructed the following four models: a non-fusion model (NF), a L4-5 fusion model (L5F), a L4-S1 fusion model (S1F), and a L4-S2 alar iliac screw fixation model (S2F). A compressive load of 400 N was applied vertically to the L4 vertebra and a 10-Nm bending moment was additionally applied to the L4 vertebra to stimulate flexion, extension, left lateral bending, and axial rotation. Each model's hip joint's von Mises stress and angular motion were analyzed. Results: The hip joint's angular motion in NF, L5F, S1F, and S2F gradually increased; the S2F model presented the greatest angular motion. Conclusions: The average and maximum contact stress of the hip joint was the highest in the S2F model. Thus, lumbosacral fusion surgery with sacroiliac joint fixation placed added stress on the hip joint. We propose that this was a consequence of adjacent joint spinopelvic fixation. Lumbar-to-pelvic fixation increases the angular motion and stress at the hip joint.
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- 2022
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13. Sacroiliac Joint Pain Should Be Suspected in Early Buttock and Groin Pain after Adult Spinal Deformity Surgery: An Observational Study
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Shizumasa Murata, Hiroshi Iwasaki, Masanari Takami, Keiji Nagata, Hiroshi Hashizume, Shunji Tsutsui, Ryo Taiji, Takuhei Kozaki, and Hiroshi Yamada
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adult spinal deformity ,sacroiliac joint pain ,s2 alar-iliac screws ,ultrasonography ,sacroiliac joint block ,ultrasound-guided sacroiliac joint block ,physical therapy ,Surgery ,RD1-811 - Abstract
Introduction: Sacroiliac joint pain (SIJP) is one of the pathological conditions of adjacent segment disorders occurring after adult spinal deformity (ASD) surgery. This study aimed to test the hypothesis that even in ASD surgery using S2 alar-iliac (S2AI) screws, SIJP can develop much earlier than reported previously and can be rescued by ultrasound-guided sacroiliac joint block. Methods: Overall, 94 patients with ASD treated with long spinal fusion using S2AI screws were prospectively investigated for SIJP postoperatively, and the effect of ultrasound-guided sacroiliac joint block was evaluated. Additionally, the relationship between the symptomatic side of the SIJP and the surgical procedure; the preoperative and postoperative whole-spine sagittal and coronal alignment, lumbar pelvis sagittal plane alignment, and pelvic incidence-lumbar lordosis were retrospectively compared between the groups with and without SIJP. Results: Eleven of 94 cases (11.7%) developed SIJP. The average onset was 12.0 (±6.2) days after surgery. The “one-finger test,”“Gaenslen test,” and “tenderness of the posterosuperior iliac spine” had high positivity rates for SIJP. Night pain occurred in 81.8% of patients and was one of the diagnostic features. There were no significant relationships between the symptomatic side of SIJP and the approach-side of lumbar interbody fusion, donor site of the iliac bone graft, or malposition of the S2AI screw. There were no significant differences in preoperative characteristics and radiological parameters between the SIJP-positive and -negative groups preoperatively, postoperatively, or in postoperative changes. Two of the 11 cases required the SIJ block four times, but all patients eventually achieved >70% pain relief with no recurrence. Conclusions: For good pain control and physical therapy, the fact that early buttock-groin pain after spinal fusion surgery has a 12% likelihood of being due to SIJP and can be relieved with the ultrasound-guided SIJ block is clinically important for diagnosis and pain management.
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- 2022
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14. Long-Term Outcomes after Selective Microendoscopic Laminotomy for Multilevel Lumbar Spinal Stenosis with and without Remaining Radiographic Stenosis: A 10-Year Follow-Up Study
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Shizumasa Murata, Keiji Nagata, Hiroshi Iwasaki, Hiroshi Hashizume, Yasutsugu Yukawa, Akihito Minamide, Yukihiro Nakagawa, Shunji Tsutsui, Masanari Takami, Ryo Taiji, Takuhei Kozaki, Andrew J. Schoenfeld, Andrew K. Simpson, Munehito Yoshida, and Hiroshi Yamada
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lumbar spinal stenosis ,microendoscopic laminotomy ,multilevel stenosis ,selective decompression ,Surgery ,RD1-811 - Abstract
Introduction: Long-term clinical outcomes of microendoscopic laminotomy (MEL) for patients with multilevel radiographic lumbar spinal canal stenosis (LSS) have not been widely explored. The clinical significance and natural progression of additional untreated levels (e.g., remaining radiographic (RR)-LSS not addressed by selective MEL) remain unknown. This retrospective study aimed to investigate the long-term clinical outcomes of selective MEL in LSS patients and compare outcomes between patients with and without remaining RR-LSS to determine the efficacy of this procedure. Methods: Forty-nine patients at a single center underwent posterior spinal microendoscopic decompression surgery for neurogenic claudication or radicular leg pain in moderate-to-severe spinal stenosis. The patients were categorized into the RR-LSS-positive and RR-LSS-negative cohorts based on unaddressed levels of stenosis. Pre-operative and 10-year follow-up evaluations, including the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) score for low back pain and leg pain, Oswestry Disability Index (ODI), and satisfaction, were compared between the groups. Additionally, the need for reoperation was determined. Results: MEL significantly improved JOA scores, lumbar VAS, and ODI over the 10-year postoperative period. Pre-operative characteristics and postoperative outcomes were not significantly different between the cohorts. Overall, 18.4% (9/49) of patients required reoperation during the follow-up period. The reoperation rate in the RR-LSS-positive (13.8%; 4/29) group was similar to that in the RR-LL-negative (15.0%; 3/20) group. Conclusions: MEL is effective for lumbar stenosis, with improved clinical outcomes up to 10 years following surgery. Selective MEL, addressing only symptomatic levels in multilevel stenosis, with residual remaining lumbar stenosis, is similarly effective without increased reoperation rates. Surgeons may consider more limited selective decompression in patients with multilevel stenosis, avoiding the risk and invasiveness of extensive procedures. Level of Evidence: Level III.
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- 2022
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15. High CRP-albumin ratio predicts poor prognosis in transplant ineligible elderly patients with newly diagnosed acute myeloid leukemia
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Hajime Senjo, Masahiro Onozawa, Daisuke Hidaka, Shota Yokoyama, Satoshi Yamamoto, Yutaka Tsutsumi, Yoshihito Haseyama, Takahiro Nagashima, Akio Mori, Shuichi Ota, Hajime Sakai, Toshimichi Ishihara, Takuto Miyagishima, Yasutaka Kakinoki, Mitsutoshi Kurosawa, Hajime Kobayashi, Hiroshi Iwasaki, Daigo Hashimoto, Takeshi Kondo, and Takanori Teshima
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Medicine ,Science - Abstract
Abstract Acute myeloid leukemia (AML) patients older than 65 years have a poor prognosis. Recently, CAR (C-reactive-protein/albumin ratio) has been actively reported as a prognostic index reflecting the nutritional and inflammatory status of elderly patients with solid tumors, but the usefulness of this index as a prognostic indicator in transplant-ineligible elderly AML patients has not been investigated. We studied genetic alterations and CARs in 188 newly diagnosed AML patients aged 65 years or older who were treated in a multicenter setting and had treated without HSCT. Both NCCN 2017 risk group, reflecting the genetic component of the tumor, and CAR, reflecting the inflammatory and nutritional status of the patient, successfully stratified the overall survival (OS) of the patients (2-year OS; CAR low vs high, 42.3% vs 17.8%, P
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- 2022
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16. A novel technique using ultrasonography in upper airway management after anterior cervical decompression and fusion
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Shizumasa Murata, Hiroshi Iwasaki, Hiroyuki Oka, Hiroshi Hashizume, Yasutsugu Yukawa, Akihito Minamide, Shunji Tsutsui, Masanari Takami, Keiji Nagata, Ryo Taiji, Takuhei Kozaki, and Hiroshi Yamada
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Anterior cervical decompression and fusion ,Ultrasonography ,Prevertebral soft tissue evaluation ,Cervical spine ,Spine surgery ,Airway complication ,Medical technology ,R855-855.5 - Abstract
Abstract Background Airway complications are the most serious complications after anterior cervical decompression and fusion (ACDF) and can have devastating consequences if their detection and intervention are delayed. Plain radiography is useful for predicting the risk of dyspnea by permitting the comparison of the prevertebral soft tissue (PST) thickness before and after surgery. However, it entails frequent radiation exposure and is inconvenient. Therefore, we aimed to overcome these problems by using ultrasonography to evaluate the PST and upper airway after ACDF and investigate the compatibility between X-ray and ultrasonography for PST evaluation. Methods We included 11 radiculopathy/myelopathy patients who underwent ACDF involving C5/6, C6/7, or both segments. The condition of the PST and upper airway was evaluated over 14 days. The Bland–Altman method was used to evaluate the degree of agreement between the PST values obtained using radiography versus ultrasonography. The Pearson correlation coefficient was used to determine the relationship between the PST measurement methods. Single-level and double-level ACDF were performed in 8 and 3 cases, respectively. Results PST and upper airway thickness peaked on postoperative day 3, with no airway complications. The Bland–Altman bias was within the prespecified clinically nonsignificant range: 0.13 ± 0.36 mm (95% confidence interval 0.04–0.22 mm). Ultrasonography effectively captured post-ACDF changes in the PST and upper airway thickness and detected airway edema. Conclusions Ultrasonography can help in the continuous assessment of the PST and the upper airway as it is simple and has no risk of radiation exposure risk. Therefore, ultrasonography is more clinically useful to evaluate the PST than radiography from the viewpoint of invasiveness and convenience.
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- 2022
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17. Lateral interbody release for fused vertebrae via transpsoas approach in adult spinal deformity surgery: a preliminary report of radiographic and clinical outcomes
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Masanari Takami, Shunji Tsutsui, Yasutsugu Yukawa, Hiroshi Hashizume, Akihito Minamide, Hiroshi Iwasaki, Keiji Nagata, Ryo Taiji, Andrew J. Schoenfeld, Andrew K. Simpson, and Hiroshi Yamada
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Lateral interbody release technique ,Lateral lumbar interbody fusion ,Fused vertebrae ,Anterior column realignment ,Adult spinal deformity ,Corrective fusion surgery ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Lateral interbody release (LIR) via a transpsoas lateral approach is a surgical strategy to address degenerative lumbar scoliosis (DLS) patients with anterior autofusion of vertebral segments. This study aimed to characterize the clinical and radiographic outcomes of this lumbar reconstruction strategy using LIR to achieve anterior column correction. Methods Data for 21 fused vertebrae in 17 consecutive patients who underwent LIR between January 2014 and March 2020 were reviewed. Demographic and intraoperative data were recorded. Radiographic parameters were assessed preoperatively and at final follow-up, including segmental lordotic angle (SLA), segmental coronal angle (SCA), bone union rate, pelvic incidence (PI), lumbar lordosis (LL), pelvic tilt, sacral slope, PI-LL mismatch, sagittal vertical axis, Cobb angle, and deviation of the C7 plumb line from the central sacral vertical line. Clinical outcomes were evaluated using Oswestry Disability Index (ODI), visual analog scale (VAS) scores for low back and leg pain, and the short form 36 health survey questionnaire (SF-36) postoperatively and at final follow-up. Complications were also assessed. Results Mean patient age was 70.3 ± 4.8 years and all patients were female. Average follow-up period was 28.4 ± 15.3 months. Average procedural time to perform LIR was 21.3 ± 9.7 min and was not significantly different from traditional lateral interbody fusion at other levels. Blood loss per single segment during LIR was 38.7 ± 53.2 mL. Fusion rate was 100.0% in this cohort. SLA improved significantly from − 7.6 ± 9.2 degrees preoperatively to 7.0 ± 8.8 degrees at final observation and SCA improved significantly from 19.1 ± 7.8 degrees preoperatively to 8.7 ± 5.9 degrees at final observation (P
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- 2022
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18. Improving effect of microendoscopic decompression surgery on low back pain in patients with lumbar spinal stenosis and predictive factors of postoperative residual low back pain: a single-center retrospective study
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Ryo Taiji, Hiroshi Iwasaki, Hiroshi Hashizume, Yasutsugu Yukawa, Akihito Minamide, Yukihiro Nakagawa, Shunji Tsutsui, Masanari Takami, Keiji Nagata, Shizumasa Murata, Takuhei Kozaki, Munehito Yoshida, and Hiroshi Yamada
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Lumbar spinal stenosis ,Decompression surgery ,Spinal endoscopy ,Low back pain ,Surgical treatment ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Although there are reports on the effectiveness of microendoscopic laminotomy using a spinal endoscope as decompression surgery for lumbar spinal stenosis, predicting the improvement of low back pain (LBP) still poses a challenge, and no clear index has been established. This study aimed to investigate whether microendoscopic laminotomy for lumbar spinal stenosis improves low back pain and determine the preoperative predictors of residual LBP. Methods In this single-center retrospective study, we examined 202 consecutive patients who underwent microendoscopic laminotomy for lumbar spinal stenosis with a preoperative visual analog scale (VAS) score for LBP of ≥40 mm. The lumbar spine Japanese Orthopaedic Association (JOA), and VAS scores for LBP, leg pain (LP), and leg numbness (LN) were examined before and at 1 year after surgery. Patients with a 1-year postoperative LBP-VAS of ≥25 mm composed the residual LBP group. The preoperative predictive factors associated with postoperative residual LBP were analyzed. Results JOA scores improved from 14.1 preoperatively to 20.2 postoperatively (p
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- 2021
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19. Relationship of sagittal spinal alignment with low back pain and physical performance in the general population
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Kazuhiro Hira, Keiji Nagata, Hiroshi Hashizume, Yoshiki Asai, Hiroyuki Oka, Shunji Tsutsui, Masanari Takami, Hiroshi Iwasaki, Shigeyuki Muraki, Toru Akune, Toshiko Iidaka, Hiroshi Kawaguchi, Kozo Nakamura, Munehito Yoshida, Sakae Tanaka, Noriko Yoshimura, and Hiroshi Yamada
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Medicine ,Science - Abstract
Abstract Studies have suggested a relationship between sagittal spinal malalignment and low back pain (LBP). The current study investigated the relationship of spinal alignment with LBP and physical performance in 1491 individuals who attended the second follow-up visit of the Wakayama Spine Study. The sagittal vertical axis at C7 (C7 SVA) was measured by a spine surgeon. The occurrence of LBP within one month, pain intensity, Oswestry Disability Index (ODI), and physical performance (grip strength, 6-m walking time, chair stand test, one-leg standing test) were also evaluated. LBP in the previous month was determined using ODI, and indicators of physical performance were measured. The mean C7 SVA was 11.0 ± 42.7 mm and was significantly greater in older participants (p
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- 2021
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20. Erratum for Lumbar Fusion including Sacroiliac Joint Fixation Increases the Stress and Angular Motion at the Hip Joint: A Finite Element Study
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Takuhei Kozaki, Hiroshi Hashizume, Hiroyuki Oka, Satoru Ohashi, Yoh Kumano, Ei Yamamoto, Akihito Minamide, Yasutsugu Yukawa, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Keiji Nakata, Takaya Taniguchi, Daisuke Fukui, Daisuke Nishiyama, Manabu Yamanaka, Hidenobu Tamai, Ryo Taiji, Shizumasa Murata, Akimasa Murata, and Hiroshi Yamada
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Surgery ,RD1-811 - Published
- 2023
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21. Is radiographic lumbar spinal stenosis associated with the quality of life?: The Wakayama Spine Study
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Satoshi Arita, Yuyu Ishimoto, Hiroshi Hashizume, Keiji Nagata, Shigeyuki Muraki, Hiroyuki Oka, Masanari Takami, Shunji Tsutsui, Hiroshi Iwasaki, Yasutsugu Yukawa, Toru Akune, Hiroshi Kawaguchi, Sakae Tanaka, Kozo Nakamura, Munehito Yoshida, Noriko Yoshimura, Hiroshi Yamada, and Consortium
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Medicine ,Science - Abstract
Objectives This prospective study aimed to determine the association between radiographic lumbar spinal stenosis (LSS) and the quality of life (QOL) in the general Japanese population. Methods The severity of radiographic LSS was qualitatively graded on axial magnetic resonance images as follows: no stenosis, mild stenosis with ≤1/3 narrowing, moderate stenosis with a narrowing between 1/3 and 2/3, and severe stenosis with > 2/3 narrowing. Patients less than 40 years of age and those who had undergone previous lumbar spine surgery were excluded from the study. The Oswestry Disability Index (ODI), which includes 10 sections, was used to assess the QOL. One-way analysis of variance was performed to determine the statistical relationship between radiographic LSS and ODI. Further, logistic regression analysis adjusted for gender, age, and body mass index was performed to detect the relationship. Results Complete data were available for 907 patients (300 men and 607 women; mean age, 67.3±12.4 years). The prevalence of severe, moderate, and non-mild/non-radiographic were 30%, 48%, and 22%, respectively. In addition, the mean values of ODI in each group were 12.9%, 13.1%, and 11.7%, respectively, and there was no statistically significant difference between the three groups in logistic analysis (P = 0.55). In addition, no significant differences in any section of the ODI were observed among the groups. However, severe radiographic LSS was associated with low back pain in the "severe" group as determined by logistic analysis adjusted for gender, age, and body mass index (odds ratio: 1.53, confidence interval: 1.13–2.07) compared with the non-severe group. Conclusion In this general population study, severe radiographic LSS was associated with low back pain (LBP), but did not affect ODI.
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- 2022
22. Long-term efficacy of microendoscopic laminotomy for lumbar spinal stenosis in advanced degenerative spondylolisthesis with or without dynamic spinal instability: a propensity score-matching analysis.
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Shizumasa Murata, Keiji Nagata, Hiroshi Iwasaki, Hiroshi Hashizume, Akihito Minamide, Yukihiro Nakagawa, Shunji Tsutsui, Masanari Takami, Yuyu Ishimoto, Masatoshi Teraguchi, Hiroki Iwahashi, Kimihide Murakami, Ryo Taiji, Takuhei Kozaki, Yoji Kitano, Munehito Yoshida, and Hiroshi Yamada
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- 2024
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23. Analysis of the indispensable RAD51 cofactor BRCA2 in Naganishia liquefaciens, a Basidiomycota yeast.
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Palihati, Maierdan, Hiroshi Iwasaki, and Hideo Tsubouchi
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- 2024
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24. Risk factors of postoperative coronal malalignment following long-segment spinal fusion surgery in which multilevel lateral lumbar interbody fusion was used for degenerative lumbar kyphoscoliosis.
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Masanari Takami, Shunji Tsutsui, Keiji Nagata, Ryo Taiji, Hiroshi Iwasaki, Motohiro Okada, Akihito Minamide, Yasutsugu Yukawa, Hiroshi Hashizume, and Hiroshi Yamada
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- 2024
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25. Fission yeast Swi2 designates cell-type specific donor and stimulates Rad51-driven strand exchange for mating-type switching
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Takahisa Maki, Geneviève Thon, and Hiroshi Iwasaki
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EXPRESSION ,HOMOLOG ,SCHIZOSACCHAROMYCES-POMBE ,SWI5-SFR1 COMPLEX ,PROTEINS ,DNA-REPLICATION ,Genetics ,RECOMBINATION ,DIRECTIONALITY ,IMPRINT ,CENP-B - Abstract
A haploid of the fission yeast Schizosaccharomyces pombe expresses either the P or M mating-type, determined by the active, euchromatic, mat1 cassette. Mating-type is switched by Rad51-driven gene conversion of mat1 using a heterochromatic donor cassette, mat2-P or mat3-M. The Swi2-Swi5 complex, a mating-type switching factor, is central to this process by designating a preferred donor in a cell-type-specific manner. Swi2-Swi5 selectively enables one of two cis-acting recombination enhancers, SRE2 adjacent to mat2-P or SRE3 adjacent to mat3-M. Here, we identified two functionally important motifs in Swi2, a Swi6 (HP1 homolog)-binding site and two DNA-binding AT-hooks. Genetic analysis demonstrated that the AT-hooks were required for Swi2 localization at SRE3 to select the mat3-M donor in P cells, while the Swi6-binding site was required for Swi2 localization at SRE2 to select mat2-P in M cells. In addition, the Swi2-Swi5 complex promoted Rad51-driven strand exchange in vitro. Taken together, our results show how the Swi2-Swi5 complex would localize to recombination enhancers through a cell-type specific binding mechanism and stimulate Rad51-driven gene conversion at the localization site. A haploid of the fission yeast Schizosaccharomyces pombe expresses either the P or M mating-type, determined by the active, euchromatic, mat1 cassette. Mating-type is switched by Rad51-driven gene conversion of mat1 using a heterochromatic donor cassette, mat2-P or mat3-M. The Swi2-Swi5 complex, a mating-type switching factor, is central to this process by designating a preferred donor in a cell-type-specific manner. Swi2-Swi5 selectively enables one of two cis-acting recombination enhancers, SRE2 adjacent to mat2-P or SRE3 adjacent to mat3-M. Here, we identified two functionally important motifs in Swi2, a Swi6 (HP1 homolog)-binding site and two DNA-binding AT-hooks. Genetic analysis demonstrated that the AT-hooks were required for Swi2 localization at SRE3 to select the mat3-M donor in P cells, while the Swi6-binding site was required for Swi2 localization at SRE2 to select mat2-P in M cells. In addition, the Swi2-Swi5 complex promoted Rad51-driven strand exchange in vitro. Taken together, our results show how the Swi2-Swi5 complex would localize to recombination enhancers through a cell-type specific binding mechanism and stimulate Rad51-driven gene conversion at the localization site.
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- 2023
26. Development of Pipetteless Paper-Based Analytical Devices with a Volume Gauge
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Kaewta Danchana, Hiroshi Iwasaki, Yada Thayawutthikun, Phoonthawee Saetear, and Takashi Kaneta
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General Chemical Engineering ,General Chemistry - Abstract
In this work, we propose a new design for paper based analytical devices (PADs) that eliminate the need to use a micropipette for sample introduction. With this design, a PAD is equipped with a distance-based detection channel that is connected to a storage channel that indicates the volume of a sample introduced into the PAD. The analyte in the sample solution reacts with a colorimetric reagent deposited into the distance-based detection channel as the sample solution flows into the storage channel where the volume is measured. The ratio of the lengths of the detection channel and that of the storage channel (D/S ratio) are constant for a sample containing a certain concentration, which is independent of the introduced volume. Therefore, the PADs permit volume-independent quantification using a dropper instead of a micropipette because the length of the storage channel plays the role of a volume gauge to estimate the introduced sample volume. In this study, the D/S ratios obtained with a dropper were comparable to those obtained with a micropipette, which confirmed that precise volume control is unnecessary for this PAD system. The proposed PADs were applied to the determinations of iron and bovine serum albumin using bathophenanthroline and tetrabromophenol blue as colorimetric reagents, respectively. The calibration curves showed good linear relationships with coefficients of 0.989 for iron and 0.994 for bovine serum albumin, respectively.
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- 2023
27. Using Electrical Stimulation of the Ulnar Nerve Trunk to Predict Postoperative Improvement in Hand Clumsiness in Patients With Cervical Spondylotic Myelopathy
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Shizumasa Murata, Masanari Takami, Toru Endo, Hiroshi Hashizume, Hiroshi Iwasaki, Shunji Tsutsui, Keiji Nagata, Kimihide Murakami, Ryo Taiji, Takuhei Kozaki, John G. Heller, and Hiroshi Yamada
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Orthopedics and Sports Medicine ,Neurology (clinical) - Published
- 2022
28. Importance of physiological age in determining indications for adult spinal deformity surgery in patients over 75 years of age: a propensity score matching analysis
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Shizumasa, Murata, Shunji, Tsutsui, Hiroshi, Hashizume, Akihito, Minamide, Yukihiro, Nakagawa, Hiroshi, Iwasaki, Masanari, Takami, Keiji, Nagata, Kimihide, Murakami, Ryo, Taiji, Takuhei, Kozaki, and Hiroshi, Yamada
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Adult ,Spinal Fusion ,Treatment Outcome ,Frailty ,Quality of Life ,Lordosis ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Propensity Score ,Aged ,Retrospective Studies - Abstract
Physiologically, people age at different rates, which leads to a discrepancy between physiological and chronological age. Physiological age should be a priority when considering the indications for adult spinal deformity (ASD) surgery. The primary objective of this study was to determine the characteristics of the postoperative course, surgical outcomes, and complication rates to extend the healthy life expectancy of older ASD patients (≥ 75 years). The secondary objective was to clarify the importance of physiological age in the surgical treatment of older ASD patients, considering frailty.A retrospective review of 109 consecutive patients aged ≥ 65 years with symptomatic ASD who underwent a corrective long fusion with lateral interbody fusion from the lower thoracic spine to the pelvis from 2015 to 2019 was conducted. Patients were classified into two groups according to age (group Y [65-74 years], group O [≥ 75 years]) and further divided into four groups according to the ASD-frailty index score (Y-F, Y-NF, O-F, and O-NF groups). To account for potential risk factors for perioperative course characteristics, complication rates, and surgical outcomes, patients from the database were subjected to propensity score matching based on sex, BMI, and preoperative sagittal spinal alignment (C7 sagittal vertical axis, pelvic incidence-lumbar lordosis, and pelvic tilt). Clinical outcomes were evaluated 2 years postoperatively, using three patient-reported outcome measures of health-related quality of life: the Oswestry Disability Index, Scoliosis Research Society questionnaire (SRS-22), and Short Form 36 (SF-36). Additionally, the postoperative time-to-first ambulation, as well as minor, major, and mechanical complications, were evaluated.In the comparison between Y and O groups, patients in group O were at a higher risk of minor complications (delirium and urinary tract infection). In contrast, other surgical outcomes of group O were comparable to those of group Y, except for SRS-22 (satisfaction) and time to ambulation after surgery, with better outcomes in Group O. Patients in the O-NF group had better postoperative outcomes (time to ambulation after surgery, SRS-22 (function, self-image, satisfaction), SF-36 [PCS]) than those in the Y-F group.Older age warrants monitoring of minor complications in the postoperative management of patients. However, the outcomes of ASD surgery depended more on frailty than on chronological age. Older ASD patients without frailty might tolerate corrective surgery and have satisfactory outcomes when minimally invasive techniques are used. Physiological age is more important than chronological age when determining the indications for surgery in older patients with ASD.
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- 2022
29. Rapid and sensitive SARS-CoV-2 detection using a homogeneous fluorescent immunosensor Quenchbody with crowding agents
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Bo Zhu, Nobuyuki Nosaka, Shuji Kanamaru, Jinhua Dong, Yancen Dai, Akihito Inoue, Yinghui Yang, Kaori Kobayashi, Tetsuya Kitaguchi, Hiroshi Iwasaki, Ryuji Koike, Kenji Wakabayashi, and Hiroshi Ueda
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Immunoassay ,SARS-CoV-2 ,Electrochemistry ,Humans ,COVID-19 ,Environmental Chemistry ,Biosensing Techniques ,Nucleocapsid Proteins ,Pandemics ,Biochemistry ,Spectroscopy ,Analytical Chemistry - Abstract
Antigen tests for SARS-CoV-2 are widely used by the public during the ongoing COVID-19 pandemic, which demonstrates the societal impact of homogeneous immunosensor-related technologies. In this study, we used the PM Q-probe and Quenchbody technologies to develop a SARS-CoV-2 nucleocapsid protein (N protein) homogeneous immunosensor based on a human anti-N protein antibody. For the first time, we uncovered the crowding agent's role in improving the performance of the double-labeled Quenchbody, and the possible mechanisms behind this improvement are discussed. The 5% polyethylene glycol 6000 significantly improved both the response speed and sensitivity of SARS-CoV-2 Quenchbodies. The calculated limit of detection for recombinant N protein was 191 pM (9 ng mL
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- 2022
30. The Utility of Transcranial Stimulated Motor-Evoked Potential Alerts in Cervical Spine Surgery Varies Based on Preoperative Motor Status
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Masahiro, Funaba, Tsukasa, Kanchiku, Kazuyoshi, Kobayashi, Go, Yoshida, Masaaki, Machino, Kei, Yamada, Hideki, Shigematsu, Nobuaki, Tadokoro, Hiroki, Ushirozako, Masahito, Takahashi, Naoya, Yamamoto, Shinji, Morito, Shigenori, Kawabata, Yasushi, Fujiwara, Muneharu, Ando, Shinichirou, Taniguchi, Hiroshi, Iwasaki, Kanichiro, Wada, Akimasa, Yasuda, Jun, Hashimoto, Tsunenori, Takatani, Kei, Ando, Yukihiro, Matsuyama, and Shiro, Imagama
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Intraoperative Neurophysiological Monitoring ,Cervical Vertebrae ,Humans ,Paralysis ,Spinal Diseases ,Orthopedics and Sports Medicine ,Prospective Studies ,Neurology (clinical) ,Evoked Potentials, Motor ,Retrospective Studies - Abstract
A prospective multicenter observational study.The aim was to investigate the validity of transcranial motor-evoked potentials (Tc-MEP) in cervical spine surgery and identify factors associated with positive predictive value when Tc-MEP alerts are occurred.The sensitivity and specificity of Tc-MEP for detecting motor paralysis are high; however, false-positives sometimes occur.The authors examined Tc-MEP in 2476 cases of cervical spine surgeries and compared patient backgrounds, type of spinal disorders, preoperative motor status, surgical factors, and the types of Tc-MEP alerts. Tc-MEP alerts were defined as an amplitude reduction of more than 70% from the control waveform. Tc-MEP results were classified into two groups: false-positive and true-positive, and items that showed significant differences were extracted by univariate analysis and detected by multivariate analysis.Overall sensitivity was 66% (segmental paralysis: 33% and lower limb paralysis: 95.8%) and specificity was 91.5%. Tc-MEP outcomes were 33 true-positives and 233 false-positives. Positive predictive value of general spine surgery was significantly higher in cases with a severe motor status than in a nonsevere motor status (19.5% vs . 6.7%, P =0.02), but not different in high-risk spine surgery (20.8% vs . 19.4%). However, rescue rates did not significantly differ regardless of motor status (48% vs . 50%). In a multivariate logistic analysis, a preoperative severe motor status [ P =0.041, odds ratio (OR): 2.46, 95% confidence interval (95% CI): 1.03-5.86] and Tc-MEP alerts during intradural tumor resection ( P0.001, OR: 7.44, 95% CI: 2.64-20.96) associated with true-positives, while Tc-MEP alerts that could not be identified with surgical maneuvers ( P =0.011, OR: 0.23, 95% CI: 0.073-0.71) were associated with false-positives.The utility of Tc-MEP in patients with a preoperative severe motor status was enhanced, even in those without high-risk spine surgery. Regardless of the motor status, appropriate interventions following Tc-MEP alerts may prevent postoperative paralysis.
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- 2022
31. Transcranial Motor-evoked Potentials for Intraoperative Nerve Root Monitoring During Adult Spinal Deformity Surgery: A Prospective Multicenter Study
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Go, Yoshida, Hiroki, Ushirozako, Masaaki, Machino, Hideki, Shigematsu, Shigenori, Kawabata, Kei, Yamada, Tsukasa, Kanchiku, Yasushi, Fujiwara, Hiroshi, Iwasaki, Muneharu, Ando, Shinichirou, Taniguchi, Tsunenori, Takatani, Nobuaki, Tadokoro, Masahito, Takahashi, Kanichiro, Wada, Naoya, Yamamoto, Masahiro, Funaba, Akimasa, Yasuda, Jun, Hashimoto, Shinji, Morito, Kenta, Kurosu, Kazuyoshi, Kobayashi, Kei, Ando, Katsushi, Takeshita, Yukihiro, Matsuyama, and Shiro, Imagama
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Adult ,Male ,Intraoperative Neurophysiological Monitoring ,Evoked Potentials, Motor ,Neurosurgical Procedures ,Osteotomy ,Peripheral Nerve Injuries ,Humans ,Female ,Orthopedics and Sports Medicine ,Prospective Studies ,Neurology (clinical) ,Connective Tissue Diseases ,Aged ,Retrospective Studies - Abstract
A prospective, multicenter study.This study clarified the uses and limitations of transcranial motor-evoked potentials (Tc-MEPs) for nerve root monitoring during adult spinal deformity (ASD) surgeries.Whether Tc-MEPs can detect nerve root injuries (NRIs) in ASD surgeries remains controversial.We prospectively analyzed neuromonitoring data from 14 institutions between 2017 and 2020. The subjects were ASD patients surgically treated with posterior corrective fusion using multichannel Tc-MEPs. An alert was defined as a decrease of ≥70% in the Tc-MEP's waveform amplitude from baseline, and NRI was considered as meeting the focal Tc-MEP alerts shortly following surgical procedures with postoperative nerve root symptoms in the selected muscles.A total of 311 patients with ASD (262 women and 49 men) and a mean age of 65.5 years were analyzed. Tc-MEP results revealed 47 cases (15.1%) of alerts, including 25 alerts after 10 deformity corrections, six three-column osteotomies, four interbody fusions, three pedicle screw placements or two decompressions, and 22 alerts regardless of surgical maneuvers. Postoperatively, 14 patients (4.5%) had neurological deterioration considered to be all NRI, 11 true positives, and three false negatives (FN). Two FN did not reach a 70% loss of baseline (46% and 65% loss of baseline) and one was not monitored at target muscles. Multivariate logistic regression analysis revealed that risk factors of NRI were preexisting motor weakness ( P0.001, odds ratio=10.41) and three-column osteotomies ( P =0.008, odds ratio=7.397).Nerve root injuries in our ASD cohort were partially predictable using multichannel Tc-MEPs with a 70% decrease in amplitude as an alarm threshold. We propose that future research should evaluate the efficacy of an idealized warning threshold (e.g., 50%) and a more detailed evoked muscle selection, in reducing false negatives.
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- 2022
32. Role of Transcranial Motor Evoked Potential Monitoring During Traumatic Spinal Injury Surgery: A Prospective Multicenter Study of the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research.
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Hiroki Ushirozako, Go Yoshida, Shiro Imagama, Masaaki Machino, Muneharu Ando, Shigenori Kawabata, Kei Yamada, Tsukasa Kanchiku, Yasushi Fujiwara, Shinichirou Taniguchi, Hiroshi Iwasaki, Hideki Shigematsu, Nobuaki Tadokoro, Masahito Takahashi, Kanichiro Wada, Naoya Yamamoto, Masahiro Funaba, Akimasa Yasuda, Jun Hashimoto, and Shinji Morito
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- 2023
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33. Association between modic changes, disc degeneration, and pelvic incidence–lumbar lordosis mismatch in a large population based cohort: the Wakayama spine study
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Masatoshi Teraguchi, Hiroshi Hashizume, Yoshiki Asai, Hiroyuki Oka, Keiji Nagata, Yuyu Ishimoto, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Sakae Tanaka, Munehito Yoshida, Noriko Yoshimura, and Hiroshi Yamada
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Orthopedics and Sports Medicine ,Surgery - Published
- 2023
34. Euchromatin factors HULC and Set1C affect heterochromatin organization and mating-type switching in fission yeast Schizosaccharomyces pombe
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Alfredo Esquivel-Chávez, Takahisa Maki, Hideo Tsubouchi, Testuya Handa, Hiroshi Kimura, James E. Haber, Geneviève Thon, and Hiroshi Iwasaki
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Genetics ,General Medicine ,Molecular Biology - Published
- 2022
35. Supplementary Table 1 from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
- Abstract
XLSX file - 9K, A comparison of p-Akt, p-mTOR, p-S6RP, p-p70S6K and p-4E-BP1 expression results in all specimens
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- 2023
36. Data from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
- Abstract
Purpose: Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma with poor prognosis. MPNSTs occur frequently in patients with neurofibromatosis type 1 (NF1), in which NF1 gene deficiency leads to Ras hyperactivation. Ras activation causes the subsequent activation of the AKT/mTOR and Raf/MEK/ERK pathways and regulates cellular functions. However, the activation profiles of the AKT/mTOR and MAPK pathways in MPNSTs are poorly understood. The purposes of this study are to examine the correlation between the activation of these pathways and clinicopathologic or prognostic factors and to identify candidate target molecules in MPNST. Moreover, we assessed the antitumor effects of the inhibitor of candidate target.Experimental Design: Immunohistochemistry was conducted to evaluate the activation profiles of AKT/mTOR and MAPK pathways using 135 tumor specimens. Immunohistochemical expressions were confirmed by Western blotting. Then, an in vitro study was conducted to examine the antitumor effect of the mTOR inhibitor on MPNST cell lines.Results: Phosphorylated-AKT (p-AKT), p-mTOR, p-S6RP, p-p70S6K, p-4E-BP1, p-MEK1/2, and p-ERK1/2 expressions were positive in 58.2%, 47.3%, 53.8%, 57.1%, 62.6%, 93.4%, and 81.3% of primary MPNSTs, respectively. Positivity for each factor showed no difference between NF1-related and sporadic MPNSTs. Univariate prognostic analysis revealed that p-AKT, p-mTOR, and p-S6RP expressions were associated with poor prognosis. Furthermore, activation of each p-mTOR and p-S6RP was an independent poor prognostic factor by multivariate analysis. mTOR inhibition by Everolimus showed antitumor activity on MPNST cell lines in vitro.Conclusion: mTOR inhibition is a potential treatment option for both NF1-related and sporadic MPNSTs. Clin Cancer Res; 19(2); 450–61. ©2012 AACR.
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- 2023
37. Supplementary Figure Legend from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
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PDF file - 72K
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- 2023
38. Supplementary Table 2 from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
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XLSX file - 9K, Multiivariate analysis for overall survival with p-AKT expression
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- 2023
39. Supplementary Figure 5 from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
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PDF file - 3331K, Representative examples of Everolimus-induced change in the activation of the AKT/mTOR and MAPK pathways assessed by immunocytochemistry. Decreased p-S6RP and p-p70S6K expressions by Everolimus (30 nM, a dose achievable in humans by oral administration) are detected in the FU-SFT8611 and HS-Sch-2 cell lines. p-AKT, p-mTOR, p-MEK, and p-ERK1/2 expressions show no obvious effect of Everolimus administration. Note that Everolimus treatment decreases the number of viable cells.
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- 2023
40. Supplementary Figure 3 from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
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PDF file - 182K, The Kaplan-Meier curves for overall survival according to p-p70S6K, p-4E-BP1, p-MEK1/2, and p-ERK1/2 expressions. Immunoreactivity for p-p70S6K, p-4E-BP1, p-MEK1/2, and p-ERK1/2 fails to show a significant difference in overall survival. p values are shown at the top right of each figure.
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- 2023
41. Supplementary Figure 1 from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
- Abstract
PDF file - 328K, A case of MPNST (left) arising from neurofibroma (right) in patients with neurofibromatosis type 1. Most MPNST cells are positive for p-AKT, p-mTOR, p-S6RP, p-p70S6K, and p-4E-BP1. Meanwhile, most tumor cells in the neurofibroma area are negative for them. NF: neurofibroma.
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- 2023
42. Supplementary Figure 2 from Prognostic Significance of AKT/mTOR and MAPK Pathways and Antitumor Effect of mTOR Inhibitor in NF1-Related and Sporadic Malignant Peripheral Nerve Sheath Tumors
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Yoshinao Oda, Yukihide Iwamoto, Kenichi Nishiyama, Yoh Dobashi, Hiroshi Iwasaki, Mikiko Aoki, Michiyuki Hakozaki, Yoshihiro Matsumoto, Kei-ichiro Iida, Takeaki Ishii, Yusuke Takahashi, Kenichi Kohashi, Nokitaka Setsu, Hidetaka Yamamoto, and Makoto Endo
- Abstract
PDF file - 268K, Western blotting (WB) for p-AKT, (total) AKT, p-mTOR, (total) mTOR, p-S6RP, p-p70S6K, p-MEK1/2, and p-ERK1/2 using frozen tumor samples and corresponding normal tissue. Positive or negative staining (P: positive; N: negative) on immunohistochemistry (IHC) is shown above each band to be compared with the WB results. The expression levels in WB correspond closely to those in IHC. p-AKT, p-mTOR, and p-p70S6K show stronger expression in tumor samples than in normal tissue in both NF1-related (Case 1, 2 and 3) and sporadic (Case 4 and 5) MPNSTs, while this tendency was not apparent for p-MEK1/2 and p-ERK1/2.
- Published
- 2023
43. Development of novel artifact-less imaging-guidance marker for MRI, CT, and Ultrasound imaging-modalities aiming for organ-preserving therapies of prostate cancer
- Author
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Koji Okihara, Takashi Ueda, Atsuko Fujihara, Takumi Shiraishi, Hiroshi Iwasaki, Takeshi Nomoto, Koji Masui, Toshiko Ito-Ihara, Eri Hara, Ryusuke Nakai, Takeshi Shiina, and Osamu Ukimura
- Abstract
Introduction: We have developed a fiducial imaging-guidance marker for prostate with less imaging-artifacts than the currently commercially available markers. The aim of this study was to evaluate the imaging-artifact and potential usefulness and safety of the novel fiducial imaging-marker under the preclinical experiments. Materials and Methods: We selected the specific metal materials and shape that can minimize artifacts, under having obtained a license for a metal with a gold-platinum (Au-Pt) alloy composition that maximized artifact-free MRI images. The both phantom test and dog-prostate test were conducted in order to evaluate the imaging-artifacts for three imaging modalities of MRI, CT, and ultrasound, and also the risk of migration of the markers from inserted site to other as well as their crushing. Results: Newly developed Au-Pt material is less imaging-artifact for all of MRI, CT, and ultrasound imaging modalities in comparison to currently commercially available fiducial markers made by gold material only, and the Au-Pt markers had sufficient strength and durability, and is considered as potential clinically useful and safe marker. Conclusion: The developed Au-Pt marker can be an indispensable device for accurate lesion-targeted organ-preserving therapy such as lesion-targeted focal therapy and active surveillance, than the conventional whole-gland surgical or radiation therapy.
- Published
- 2023
44. The development of a self-evaluation sheet based on the teacher training index for graduate students of the teaching profession: An examination of teacher training in the region
- Author
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Norihisa, SAKAKIBARA, Hiroshi, Iwasaki, Chizuko, Matsui, and Takako, Sato
- Subjects
自己評価票 ,教員育成指標 ,教員養成 ,教職大学院 ,理論と実践の融合 - Published
- 2022
45. Formulation of Japanese Orthopaedic Association (JOA) clinical practice guideline for the management of low back pain- the revised 2019 edition
- Author
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Osamu Shirado, Yoshiyasu Arai, Tetsuhiro Iguchi, Shiro Imagama, Mamoru Kawakami, Takuya Nikaido, Tadanori Ogata, Sumihisa Orita, Daisuke Sakai, Kimiaki Sato, Masahiko Takahata, Katsushi Takeshita, Takashi Tsuji, Kei Ando, Teruaki Endo, Hironari Fukuda, Masafumi Goto, Hiroshi Hashidume, Masayuki Hino, Yohei Ide, Hirokazu Inoue, Taro Inoue, Yuyu Ishimoto, Kenyu Ito, Sadayuki Ito, Masumi Iwabuchi, Shoji Iwahashi, Hiroshi Iwasaki, Ryohei Kagotani, Shunsuke Kanbara, Kinshi Kato, Atsushi Kimura, Tomoko Kitagawa, Hiroshi Kobayashi, Kazuyoshi Kobayashi, Jun Komatsu, Hiroyuki Koshimizu, Masaaki Machino, Tsunemasa Matsubara, Yu Matsukura, Akihito Minamide, Masakazu Minetama, Kenji Mizokami, Tadao Morino, Masayoshi Morozumi, Keiji Nagata, Ichiro Nakae, Masafumi Nakagawa, Yukihiro Nakagawa, Kyotaro Ota, Kenichiro Sakai, Rikiya Saruwatari, Shinichi Sasaki, Takahiro Shimazaki, Yasuyuki Shiraishi, Masanari Takami, Satoshi Tanaka, Masatoshi Teraguchi, Ryoji Tominaga, Masaki Tomori, Ichiro Torigoe, Mikito Tsushima, Shunji Tsutsui, Kazuyuki Watanabe, Hiroshi Yamada, Kei Yamada, Hidetoshi Yamaguchi, Kimiaki Yokosuka, Takanori Yoshida, Tatsuhiro Yoshida, Masato Yuasa, and Yasutsugu Yugawa
- Subjects
medicine.medical_specialty ,Evidence-Based Medicine ,business.industry ,MEDLINE ,Medical information ,Guideline ,Low back pain ,Clinical Practice ,Orthopedics ,Japan ,Clinical question ,Family medicine ,Practice Guidelines as Topic ,medicine ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Guideline development ,medicine.symptom ,business ,Low Back Pain ,Societies, Medical - Abstract
Background The latest clinical guidelines are mandatory for physicians to follow when practicing evidence-based medicine in the treatment of low back pain. Those guidelines should target not only Japanese board-certified orthopaedic surgeons, but also primary physicians, and they should be prepared based entirely on evidence-based medicine. The Japanese Orthopaedic Association Low Back Pain guideline committee decided to update the guideline and launched the formulation committee. The purpose of this study was to describe the formulation we implemented for the revision of the guideline with the latest data of evidence-based medicine. Methods The Japanese Orthopaedic Association Low Back Pain guideline formulation committee revised the previous guideline based on a method for preparing clinical guidelines in Japan proposed by Medical Information Network Distribution Service Handbook for Clinical Practice Guideline Development 2014. Two key phrases, "body of evidence" and "benefit and harm balance" were focused on in the revised version. Background and clinical questions were determined, followed by literature search related to each question. Appropriate articles were selected from all the searched literature. Structured abstracts were prepared, and then meta-analyses were performed. The strength of both the body of evidence and the recommendation was decided by the committee members. Results Nine background and nine clinical qvuestions were determined. For each clinical question, outcomes from the literature were collected and meta-analysis was performed. Answers and explanations were described for each clinical question, and the strength of the recommendation was decided. For background questions, the recommendations were described based on previous literature. Conclusions The 2019 clinical practice guideline for the management of low back pain was completed according to the latest evidence-based medicine. We strongly hope that this guideline serves as a benchmark for all physicians, as well as patients, in the management of low back pain.
- Published
- 2022
46. Red–green–blue–yellow (RGBY) magnetic circularly polarized electroluminescence from iridium(III)-magnetic circularly polarized organic light-emitting diodes
- Author
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Maho Kitahara, Kengo Hara, Seika Suzuki, Hiroshi Iwasaki, Shigeyuki Yagi, and Yoshitane Imai
- Subjects
Biomaterials ,Materials Chemistry ,General Chemistry ,Electrical and Electronic Engineering ,Condensed Matter Physics ,Electronic, Optical and Magnetic Materials - Published
- 2023
47. Homology length dictates the requirement for Rad51 and Rad52 in gene targeting in the Basidiomycota yeast Naganishia liquefaciens
- Author
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Hiroshi Iwasaki, Rei Kajitani, Bilge Argunhan, Omirgul Bakenova, Yasuto Murayama, Maierdan Palihati, Yong-Woon Han, Hideo Tsubouchi, and Takehiko Itoh
- Subjects
Genetics ,Ku70 ,biology ,DNA repair ,RAD52 ,RAD51 ,Gene targeting ,General Medicine ,biology.organism_classification ,Homology (biology) ,enzymes and coenzymes (carbohydrates) ,Schizosaccharomyces pombe ,Homologous recombination - Abstract
Here, we report the development of methodologies that enable genetic modification of a Basidiomycota yeast, Naganishia liquifaciens. The gene targeting method employs electroporation with PCR products flanked by an 80 bp sequence homologous to the target. The method, combined with a newly devised CRISPR-Cas9 system, routinely achieves 80% gene targeting efficiency. We further explored the genetic requirement for this homologous recombination (HR)-mediated gene targeting. The absence of Ku70, a major component of the non-homologous end joining (NHEJ) pathway of DNA double-strand break repair, almost completely eliminated inaccurate integration of the marker. Gene targeting with short homology (80 bp) was almost exclusively dependent on Rad52, an essential component of HR in the Ascomycota yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe. By contrast, the RecA homolog Rad51, which performs homology search and strand exchange in HR, plays a relatively minor role in gene targeting, regardless of the homology length (80 bp or 1 kb). The absence of both Rad51 and Rad52, however, completely eliminated gene targeting. Unlike Ascomycota yeasts, the absence of Rad52 in N. liquefaciens conferred only mild sensitivity to ionizing radiation. These traits associated with the absence of Rad52 are reminiscent of findings in mice.
- Published
- 2021
48. Biochemical properties of fission yeast homologous recombination enzymes
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Hiroshi Iwasaki, Bilge Argunhan, and Hideo Tsubouchi
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chemistry.chemical_classification ,biology ,ved/biology ,ved/biology.organism_classification_rank.species ,Saccharomyces cerevisiae ,biology.organism_classification ,Yeast ,Eukaryotic Cells ,Enzyme ,chemistry ,Biochemistry ,Schizosaccharomyces ,Schizosaccharomyces pombe ,Genetics ,Humans ,Schizosaccharomyces pombe Proteins ,Homologous Recombination ,Model organism ,Homologous recombination ,Developmental Biology - Abstract
Homologous recombination (HR) is a universal phenomenon conserved from viruses to humans. The mechanisms of HR are essentially the same in humans and simple unicellular eukaryotes like yeast. Two highly diverged yeast species, Saccharomyces cerevisiae and Schizosaccharomyces pombe, have proven exceptionally useful in understanding the fundamental mechanisms of eukaryotic HR by serving as a source for unique biological insights and also complementing each other. Here, we will review the features of S. pombe HR mechanisms in comparison to S. cerevisiae and other model organisms. Particular emphasis will be put on the biochemical characterization of HR mechanisms uncovered using S. pombe proteins.
- Published
- 2021
49. Transcranial Motor-evoked Potential Alert After Supine-to-Prone Position Change During Thoracic Ossification in Posterior Longitudinal Ligament Surgery
- Author
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Akimasa Yasuda, Shinichirou Taniguchi, Nobuaki Tadokoro, Go Yoshida, Kei Yamada, Naoya Yamamoto, Tsunenori Takatani, Yukihiro Matsuyama, Jun Hashimoto, Shiro Imagama, Shinji Morito, Toshikazu Tani, Kazuyoshi Kobayashi, Tsukasa Kanchiku, Kei Ando, Hiroshi Iwasaki, Yasushi Fujiwara, Kanichiro Wada, Hiroki Ushirozako, Masahito Takahashi, Muneharu Ando, Masahiro Funaba, Shigenori Kawabata, and Hideki Shigematsu
- Subjects
medicine.medical_specialty ,Supine position ,Ossification of Posterior Longitudinal Ligament ,Thoracic Vertebrae ,Japan ,Osteogenesis ,Prone Position ,medicine ,Humans ,Posterior longitudinal ligament ,Orthopedics and Sports Medicine ,Prospective Studies ,Evoked potential ,Spinal cord injury ,Spinal Cord Injuries ,Fixation (histology) ,Ossification ,business.industry ,Decompression, Surgical ,Evoked Potentials, Motor ,medicine.disease ,Longitudinal Ligaments ,Surgery ,Prone position ,Position (obstetrics) ,Spinal Fusion ,Female ,Neurology (clinical) ,medicine.symptom ,business - Abstract
Study design A prospective, multicenter study. Objective To evaluate the usefulness of transcranial motor-evoked potentials (Tc-MEPs) during supine-to-prone position change for thoracic ossification of the posterior longitudinal ligament (T-OPLL). Summary of background data Supine-to-prone position change might be a risk of spinal cord injury in posterior decompression and fusion surgeries for T-OPLL. Methods The subjects were 145 patients with T-OPLL surgically treated with posterior decompression and fusion using Tc-MEPs in 14 institutes. Tc-MEPs were monitored before surgery from supine-to-prone position and intraoperatively in 7 institutes and only intraoperatively in the other 7 institutes because of disapproval of the anesthesia department. In cases of Tc-MEP alert after position change, we adjusted the cervicothoracic posture. When the MEP did not recover, we reverted the position to supine and monitored the Tc-MEPs in supine position. Results There were 83 and 62 patients with/without Tc-MEP before position change to prone (group A and B). The true-positive rate was lower in group A than group B, but without statistical significance (8.4% vs 16.1%, p = 0.12). In group A, 5 patients who had Tc-MEP alert during supine-to-prone position change were all female and had larger body mass index values and upper thoracic lesions. Among the patients, 3 underwent surgeries after cervicothoracic alignment adjustment, and 2 had postponed operations to 1 week later with halo-vest fixation because of repeated Tc-MEP alerts during position change to prone. The Tc-MEP alert at exposure was statistically more frequent in group B than in group A (p = 0.033). Conclusion Tc-MEP alert during position change is an important sign of spinal cord injury due to alignment change at the upper thoracic spine. Tc-MEP monitoring before supine-to-prone position change was necessary to prevent spinal cord injury in surgeries for T-OPLL.Level of Evidence: 4.
- Published
- 2021
50. Fission yeast Swi2 designates cell-type specific donor and stimulates Rad51-driven strand exchange
- Author
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Takahisa Maki, Geneviève Thon, and Hiroshi Iwasaki
- Abstract
A haploid of the fission yeastSchizosaccharomyces pombeexpresses either the P or M matingtype, determined by the active, euchromatic,mat1cassette. Mating-type is switched by Rad51-driven gene conversion ofmat1using a heterochromatic donor cassette,mat2-Pormat3-M. The Swi2-Swi5 complex, a mating-type switching factor, is central to this process by designating a preferred donor in a cell-type-specific manner. Swi2-Swi5 selectively enables one of twocisacting recombination enhancers,SRE2adjacent tomat2-PorSRE3adjacent tomat3-M. Here, we identified two functionally important motifs in Swi2, a Swi6 (HP1 homolog)-binding site and two DNA-binding AT-hooks. Genetic analysis demonstrated that the AT-hooks were required for Swi2 localization atSRE3to select themat3-Mdonor in P cells, while the Swi6-binding site was required for Swi2 localization atSRE2to selectmat2-Pin M cells. In addition, the Swi2-Swi5 complex promoted Rad51-driven strand exchangein vitro. Taken together, our results show how the Swi2-Swi5 complex would localize to recombination enhancers through a cell-type specific binding mechanism and stimulate Rad51-driven gene conversion at the localization site.
- Published
- 2022
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