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- 저자 : Hidekazu Yamada (검색결과 5 건)
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Masahiro Kawanishi,Hidekazu Tanaka,Yutaka Ito,Makoto Yamada,Kunio Yokoyama,Akira Sugie,Naokado Ikeda 대한척추신경외과학회 2023 Neurospine Vol.20 No.4
The management of osteoporotic vertebral fractures (OVFs) in the elderly includes nonoperative treatment and vertebroplasty, but has not been established due to the diversity of patient backgrounds. The purpose of this study was to compare the impact of 3 treatment modalities for the management of OVF: orthotic treatment, percutaneous vertebroplasty (PVP), and balloon kyphoplasty (BKP). The method was based on an analysis of the latest RCTs, meta-analyses, and systematic reviews on these topics. No study showed a benefit of bracing with high level of evidence. Trials were found that showed comparable outcomes without orthotic treatment. Only 1 randomized controlled trial (RCT) showed an improvement in pain relief up to 6 months compared with no orthosis. Rigid and nonrigid orthoses were equally effective. Four of 5 RCTs comparing vertebroplasty and sham surgery were equally effective, and one RCT showed superior pain relief with vertebroplasty within 3 weeks of onset. In open trials comparing vertebroplasty with nonoperative management, vertebroplasty was superior. PVP and BKP were comparable in terms of pain relief, improvement in quality of life, and adjacent vertebral fractures. BKP does not affect global sagittal alignment, although BKP may restore vertebral body height. An RCT was published showing that PVP was effective in chronic cases without pain relief. Vertebroplasty improved life expectancy by 22% at 10 years. The superiority of orthotic therapy for OVF was seen only in short-term pain relief. Soft orthoses proved to be a viable alternative to rigid orthoses. Vertebroplasty within 3 weeks may be useful. There is no significant difference in clinical efficacy between PVP and BKP. Vertebroplasty improves life expectancy.
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Kunio Yokoyama,Naokado Ikeda,Hidekazu Tanaka,Yutaka Ito,Akira Sugie,Makoto Yamada,Masahiko Wanibuchi,Masahiro Kawanishi 대한척추신경외과학회 2023 Neurospine Vol.20 No.4
Objective: Whether the use of a balloon or stent in vertebroplasty for vertebral fractures, such as balloon kyphoplasty (BKP) or vertebral body stenting (VBS), actually contributes to the restoration of postoperative vertebral height is unclear. The aim of the current study was to compare the effectiveness of percutaneous vertebroplasty (PVP), BKP, and VBS in the correction of collapsed vertebrae in patients with painful vertebral fractures. Methods: The cases studied involved 34 vertebrae in 28 patients treated with PVP, 43 vertebrae in 38 patients treated with BKP, and 20 vertebrae in 20 patients treated with VBS at Izinkai Takeda General Hospital. Changes in the vertebral height and local kyphosis angle were measured based on standing lumbar radiographs before and after surgery and were compared among the treatment groups. Results: There were no differences in changes in the height of the anterior wall, middle body, or posterior wall of the treated vertebrae among the 3 treatment groups. The same was true for changes in the local kyphosis angle. The effectiveness of vertebral height restoration depended heavily upon preoperative vertebral instability in all the treatment groups. Correction loss due to balloon deflation effect or balloon sinking was noted with VBS or BKP. Conclusion: BKP and VBS have the advantage of reducing the risk of extravertebral leakage of injected bone cement, but they have a disadvantage in that they are no more effective than PVP in restoring collapsed vertebrae despite the use of a balloon or metal stent.
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Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms
Wataru Yamagami,Mikio Mikami,Satoru Nagase,Tsutomu Tabata,Yoichi Kobayashi,Masanori Kaneuchi,Hiroaki Kobayashi,Hidekazu Yamada,Kiyoshi Hasegawa,Hiroyuki Fujiwara,Hidetaka Katabuchi,Daisuke Aoki 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.1
The Fourth Edition of the Guidelines for Treatment of Uterine Body Neoplasm was published in 2018. These guidelines include 9 chapters: 1. Overview of the guidelines, 2. Initial treatment for endometrial cancer, 3. Postoperative adjuvant therapy for endometrial cancer, 4. Post-treatment surveillance for endometrial cancer, 5. Treatment for advanced or recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment of uterine carcinosarcoma and uterine sarcoma, 8. Treatment of trophoblastic disease, 9. Document collection; and nine algorithms: 1-3. Initial treatment of endometrial cancer, 4. Postoperative adjuvant treatment for endometrial cancer, 5. Treatment of recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment for uterine carcinosarcoma, 8. Treatment for uterine sarcoma, 9. Treatment for choriocarcinoma. Each chapter includes overviews and clinical questions, and recommendations, objectives, explanation, and references are provided for each clinical question. This revision has no major changes compared to the 3rd edition, but does have some differences: 1) an explanation of the recommendation decision process and conflict of interest considerations have been added in the overview, 2) nurses, pharmacists and patients participated in creation of the guidelines, in addition to physicians, 3) the approach to evidence collection is listed at the end of the guidelines, and 4) for clinical questions that lack evidence or clinical validation, the opinion of the Guidelines Committee is given as a “Recommendations for tomorrow”.
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Mutsuo Yamaya,Kazuhiro Nomura,Kazuya Arakawa,Mitsuru Sugawara,Xue Deng,Nadine Lusamba Kalonji,Hidekazu Nishimura,Mitsuhiro Yamada,Ryoichi Nagatomi,Tetsuaki Kawase 대한약학회 2020 Archives of Pharmacal Research Vol.43 No.5
Rhinoviral infection is associated with anincreased risk of asthma attacks. The macrolide clarithromycindecreases cytokine production in nasopharyngealaspirates from patients with wheezing, but the effectsof macrolides on cytokine production in nasal epithelialcells obtained from asthmatic subjects remain unclear. Here, human nasal epithelial cells were infected with type-14 rhinovirus (RV14), a major RV group. Titers and RNAof RV14 and cytokine concentrations, including IL-1b andIL-6, were higher in the supernatants of the cells obtainedfrom subjects with bronchial asthma (asthmatic group) thanin those from the non-asthmatic group. Pretreatment withclarithromycin decreased RV14 titers, viral RNA andcytokine concentrations, and susceptibility to RV14infection. Pretreatment with clarithromycin also decreasedIL-33 production, which was detected after infection. Pretreatment with clarithromycin decreased the expressionof intercellular adhesion molecule-1, the receptor forRV14, after infection, the number and fluorescence intensityof the acidic endosomes through which RV RNAenters the cytoplasm, and the activation of nuclear factorkappa-B proteins in nuclear extracts. These findings suggestedthat RV replication and cytokine production may beenhanced in nasal epithelial cells obtained from subjectswith bronchial asthma and may be modulated byclarithromycin.
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