LCC利用客の增加に伴う沖繩縣觀光客受入體制の整備について

( Hirano Norio ),( Kakutani Naohisa ) 동북아관광학회 2015 동북아관광연구 Vol.11 No.1

航空自由化により日本にも本格的なLCCが登場し、従来航空機を利用することのなかった顧客層の新たな需要を創出している。沖縄県においてもLCC旅客数及び旅客数シェアは年々増加し、平成25(2013)年度のLCC旅客数は55万人、LCC旅客数シェアは入域観光客数の8.4%に達したと推計される。国内LCCによる那覇空港拠点化や海外LCCの新規乗り入れにより、今後も益々LCC旅客数及び旅客数シェアが高まり、平成33(2021)年には沖縄入域観光客の約4分の1にあたる250万人にまで伸長することも予測される。行動バターンが従来と異なるLCC旅客の増加は、沖縄観光に大きな変革をもたらす可能性がある。こうしたLCCがもたらす変化に対応するため、新しい着地型のビジネスプランの構築、長期滞在型施設の充実、二次交通の改善といった課題に取り組むことが必要である。 Accompanying the appearance of professional LCCs in Japan as a part of aviation liberalization, new demands have been created by customer segments that conventionally did not travel by air. The number of LCC passengers and the share of LCC passengers grow larger year by year also in Okinawa, and it is estimated that the number of LCC passengers of 2013 has reached 550,000 while the share of LCC passengers has reached 8.4% of visitors to Okinawa. It is expected that the number of LCC passengers and the share of LCC passengers continue growing being boosted by domestic LCCs increasing using Naha Airport as a hub and by new entry of overseas LCCs and that the number increases to 2,500,000 which corresponds to approximate one fourth of all travelers to Okinawa by 2021. The increase of LCC passengers whose behavior patterns differ from conventional ones might possibly cause large changes in tourism in Okinawa. To cope with such changes caused by the growth of LCCs, it is necessary to work on tasks such as establishment of new business plans of landing type, provision of facilities of long-stay type and improvements in intermodal passenger transportation.

Complications of Posterior Fusion for Atlantoaxial Instability in Children With Down Syndrome

Yoshiki Takeoka,Kenichiro Kakutani,Hiroshi Miyamoto,Teppei Suzuki,Takashi Yurube,Izumi Komoto,Masao Ryu,Shinichi Satsuma,Koki Uno 대한척추신경외과학회 2021 Neurospine Vol.18 No.4

Objective: To clarify the complications of posterior fusion for atlantoaxial instability (AAI) in children with Down syndrome and to discuss the significance of surgical intervention. Methods: Twenty pediatric patients with Down syndrome underwent posterior fusion for AAI between February 2000 and September 2018 (age, 6.1±1.9 years). C1–2 or C1–3 fusion and occipitocervical fusion were performed in 14 and 6 patients, respectively. The past medical history, operation time, estimated blood loss (EBL), duration of Halo vest immobilization, postoperative follow-up period, and intra- and perioperative complications were examined. Results: The operation time was 257.9±55.6 minutes, and the EBL was 101.6±77.9 mL. Complications related to the operation occurred in 6 patients (30.0%). They included 1 major complication (5.0%): hydrocephalus at 3 months postoperatively, possibly related to an intraoperative dural tear. Other surgery-related complications included 3 cases of superficial infections, 1 case of bone graft donor site deep infection, 1 case of C2 pedicle fracture, 1 case of Halo ring dislocation, 1 case of pseudoarthrosis that required revision surgery, and 1 case of temporary neurological deficit after Halo removal at 2 months postoperatively. Complications unrelated to the operation included 2 cases of respiratory infections and 1 case of implant loosening due to a fall at 9 months postoperatively. Conclusion: The complication rate of upper cervical fusion in patients with Down syndrome remained high; however, major complications decreased substantially. Improved intra- and perioperative management facilitates successful surgical intervention for upper cervical instability in pediatric patients with Down syndrome.

Clinical Characteristics, Surgical Outcomes, and Risk Factors for Emergency Surgery in Patients With Spinal Metastases: A Prospective Cohort Study

Yutaro Kanda,Kenichiro Kakutani,Yoshitada Sakai,Takashi Yurube,Yoshiki Takeoka,Kunihiko Miyazaki,Hiroki Ohnishi,Tomoya Matsuo,Masao Ryu,Naotoshi Kumagai,Kohei Kuroshima,Yoshiaki Hiranaka,Ryosuke Kurod 대한척추신경외과학회 2024 Neurospine Vol.21 No.1

Objective: To elucidate the patient characteristics and outcomes of emergency surgery for spinal metastases and identify risk factors for emergency surgery. Methods: We prospectively analyzed 216 patients with spinal metastases who underwent palliative surgery from 2015 to 2020. The Eastern Cooperative Oncology Group performance status, Barthel index, EuroQol-5 dimension (EQ5D), and neurological function were assessed at surgery and at 1, 3, and 6 months postoperatively. Multivariate analysis was performed to identify risk factors for emergency surgery. Results: In total, 146 patients underwent nonemergency surgery and 70 patients underwent emergency surgery within 48 hours of diagnosis of a surgical indication. After propensity score matching, we compared 61 patients each who underwent nonemergency and emergency surgery. Regardless of matching, the median performance status and the mean Barthel index and EQ5D score showed a tendency toward worse outcomes in the emergency than nonemergency group both preoperatively and 1 month postoperatively, although the surgery greatly improved these values in both groups. The median survival time tended to be shorter in the emergency than nonemergency group. The multivariate analysis showed that lesions located at T3–10 (p = 0.002; odds ratio [OR], 2.92; 95% confidence interval [CI], 1.48–5.75) and Frankel grades A–C (p < 0.001; OR, 4.91; 95% CI, 2.45–9.86) were independent risk factors for emergency surgery. Conclusion: Among patients with spinal metastases, preoperative and postoperative subjective health values and postoperative survival are poorer in emergency than nonemergency surgery. Close attention to patients with T3–10 metastases is required to avoid poor outcomes after emergency surgery.

Risk Factors for Clinical Metastasis in Men Undergoing Radical Prostatectomy and Immediate Adjuvant Androgen Deprivation Therapy

Taguchi, Satoru,Fukuhara, Hiroshi,Kakutani, Shigenori,Takeshima, Yuta,Miyazaki, Hideyo,Suzuki, Motofumi,Fujimura, Tetsuya,Nakagawa, Tohru,Igawa, Yasuhiko,Kume, Haruki,Homma, Yukio Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.24

Background: Adjuvant androgen deprivation therapy (ADT) is a treatment option for prostate cancer (PC) patients after radical prostatectomy (RP). Although it can achieve a good progression-free survival rate, some patients still develop clinical metastasis. We here investigated risk factors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Materials and Methods: We identified 197 patients with non-metastatic PC who underwent RP at our institution between 2000 and 2012, followed by adjuvant ADT. The associations of various clinicopathologic factors with clinical metastasis (primary endpoint) and cancer-specific survival (secondary endpoint) were assessed. Multivariate analysis was conducted using a Cox proportional hazards model. Median follow-up was 87 months after RP. Results: Nine (4.6%) patients developed clinical metastasis and six (3.0%) died from PC. Eight of nine metastatic patients had a pathologic Gleason score (GS) 9 and developed bone metastasis, while the remaining one had pathologic GS 7 and developed metastasis only to para-aortic lymph nodes. On multivariate analyses, pathologic GS ${\geq}9$ and regional lymph node metastasis (pN1) were independent predictors of clinical metastasis and pathologic GS ${\geq}9$ was an independent predictor of cancer-specific death. Conclusions: Pathologic GS ${\geq}9$ and pN1 were independent predictors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Furthermore, pathologic GS ${\geq}9$ was an indispensable condition for bone metastasis, which may imply that patients with GS ${\leq}8$ on adjuvant ADT are unlikely to develop bone metastasis.

Analysis of the Internal Transcribed Spacer-l Sequences of Ribosomal DNA in Cylas formicarius

K. Kawamura,T. Sugimoto,K. Kakutani,Y. Matsuda,H. Toyoda 한국응용곤충학회 2005 한국응용곤충학회 학술대회논문집 Vol.2005 No.05

Running exercise and food restriction affect bone chemical properties in young female rats

Yuki Aikawa,Yuich Noma,Umon Agata,Yuya Kakutani,Satoshi Hattori,Hitomi Ogata,Ken Kiyono,Naomi Omi 한국운동영양학회 2023 Physical Activity and Nutrition (Phys Act Nutr) Vol.27 No.2

[Purpose] To investigate the effects of a combination of running and food restriction on the chemical properties of the bone in young female rats using Raman spectroscopy. Furthermore, we investigated whether the chemical property parameters correlated with the bone-breaking strength. [Methods] Female Sprague–Dawley rats (7 weeks old) were randomly divided into four groups: sedentary and ad libitum feeding (SED, n = 8), voluntary running exercise and ad libitum feeding (EX, n = 8), sedentary and 30% food-restricted (SED-FR, n = 8), and voluntary running exercise and 30% food-restricted (EX- FR, n = 8). The experiment was conducted for a period of 12 weeks. Four parameters measured by Raman spectroscopy were used to evaluate the bone chemical quality. [Results] Exercise and restriction had significant interactions on the mineral to matrix ratio. The mineral-to-matrix ratio in the SED-FR group was significantly higher than that in the SED group and significantly lower in the EX-FR group than that in the SED-FR group. Running exercise had significant effects on increasing the crystallinity and carbonate-to-phosphate ratio. In the ad libitum intake condition, there were significant positive correlations between breaking energy and crystallinity (r = 0.593) and between breaking energy and carbonate-to-phosphate ratio (r = 0.854). [Conclusion] Our findings show that running exercise and food restriction, alone or in combination, affect the chemical properties of bone. Furthermore, under ad libitum intake conditions, positive correlations were found between the breaking energy and crystallinity, or carbonate-to-phosphate ratio.

Upper Cervical Compression Myelopathy Caused by the Retro-Odontoid Pseudotumor With Degenerative Osteoarthritis and Calcium Pyrophosphate Dihydrate Disease: A Case Report and Literature Review

Takashi Yurube,Tetsuhiro Iguchi,Keisuke Kinoshita,Takashi Sadamitsu,Kenichiro Kakutani 대한척추신경외과학회 2021 Neurospine Vol.18 No.4

The retro-odontoid pseudotumor is often concurrent with atlantoaxial subluxation (AAS). Therefore, the pseudotumor is relatively common in rheumatoid arthritis (RA) but rare in primary osteoarthritis (OA). This is a case report of an elderly male patient suffering from neck pain and compression myelopathy caused by the craniocervical pseudotumor with OA but without atlantoaxial instability. He had long-lasting peripheral and spinal pain treated by nonsteroidal anti-inflammatory drugs. Imaging found upper cervical spondylosis without AAS or dynamic instability but with periodontoid calcifications and ossifications, suggesting calcium pyrophosphate dihydrate (CPPD) crystal deposition. Based on a comprehensive literature search and review, CPPD disease around the atlantodental joint is a possible contributor to secondary OA development and retro-odontoid pannus formation through chronic inflammation, which can be enough severe to induce compression myelopathy in non-RA patients without AAS. The global increase in the aged population advises caution regarding more prevalent upper cervical spine disorders associated with OA and CPPD.

Preoperative Low Back Pain Affects Postoperative Patient Satisfaction Following Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery

Hiranaka Yoshiaki,Miyazaki Shingo,Inoue Shinichi,Ryu Masao,Yurube Takashi,Kakutani Kenichiro,Tadokoro Ko 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.4

Study Design: A single-center retrospective study.Purpose: To research the predictive factors associated with postoperative patient satisfaction 1 year after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), a minimally invasive procedure for lumbar degenerative disease.Overview of Literature: There have been reports of numerous variables influencing patient satisfaction with lumbar surgery; however, there have been few investigations on MIS are limited.Methods: This study included 229 patients (107 men and 122 women; mean age, 68.9 years) who received one or two levels of MISTLIF, and the patient’s age, gender, disease, paralysis, preoperative physical functions, duration of symptom(s), and surgery-associated factors (waiting for surgery, number of surgical levels, surgical time, and intraoperative blood loss) were studied. Radiographic characteristics and clinical outcomes such as Oswestry Disability Index (ODI) scores and Visual Analog Scale (VAS; 0–100) ODI scores for low back pain, leg pain, and numbness were studied. One year following surgery, patient satisfaction (defined as satisfaction for surgery and for present condition; 0–100) was assessed using VAS and its relationships with investigation factors were examined.Results: The mean VAS scores of satisfaction for surgery and for present condition were 88.6 and 84.2, respectively. The results of multiple regression analysis showed that preoperative adverse factors of satisfaction for surgery were being elderly (<i>β </i>=-0.17, <i>p</i> =0.023), high preoperative low back pain VAS scores (<i>β</i> =-0.15, <i>p</i> =0.020), and postoperative adverse factors were high postoperative ODI scores (<i>β </i> =-0.43, <i>p</i> <0.001). In addition, the preoperative adverse factor of satisfaction for present condition was high preoperative low back pain VAS scores (<i>β </i> =-0.21, <i>p</i> =0.002), and postoperative adverse factors were high postoperative ODI scores (<i>β </i> =-0.45, <i>p</i> <0.001) and high postoperative low back pain VAS scores (β =-0.26, p =0.001).Conclusions: According to this study, significant preoperative low back pain and high postoperative ODI score after surgery are linked to patient unhappiness.