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( Shuji Nakagawa ),( Yuji Arai ),( Hiroaki Inoue ),( Hiroyuki Kan ),( Manabu Hino ),( Shohei Ichimaru ),( Kazuya Ikoma ),( Hiroyoshi Fujiwara ),( Fumimasa Amaya ),( Teiji Sawa ),( Toshikazu Kubo ) 대한슬관절학회 2016 대한슬관절학회지 Vol.28 No.3
Purpose: This study compared the analgesic effects of local infiltration analgesia (LIA) and femoral nerve block (FNB) after total knee arthroplasty (TKA) and assessed factors associated with analgesia obtained by these two methods. Materials and Methods: Study subjects included 66 patients (72 knees) who underwent TKA for osteoarthritis of the knee. Pain visual analogue scale (VAS), the amount of analgesics used, number of days to achieve 90o of flexion of the knee joint, date of initiating parallel-bar walking, range of motion of the knee joint at discharge, and adverse events were investigated. Results: The VAS scores did not differ significantly between two groups, whereas the amount of analgesics used was significantly lower in the LIA group. Preoperative flexion contracture was significantly more severe in the LIA group with high VAS compared with low VAS. No serious adverse event occurred in the LIA or FNB group. Conclusions: The lower analgesic usage in the LIA group than the FNB group indicates that the analgesic effect of LIA was greater than that of singleshot FNB after TKA. There were no serious complications in either group. The postoperative analgesic effect of LIA was smaller in patients with severe than less severe preoperative flexion contracture.
Persistent activation of Nrf2 through p62 in hepatocellular carcinoma cells
Inami, Yoshihiro,Waguri, Satoshi,Sakamoto, Ayako,Kouno, Tsuguka,Nakada, Kazuto,Hino, Okio,Watanabe, Sumio,Ando, Jin,Iwadate, Manabu,Yamamoto, Masayuki,Lee, Myung-Shik,Tanaka, Keiji,Komatsu, Masaaki The Rockefeller University Press 2011 The Journal of cell biology Vol.193 No.2
<P>Suppression of autophagy is always accompanied by marked accumulation of p62, a selective autophagy substrate. Because p62 interacts with the Nrf2-binding site on Keap1, which is a Cullin 3–based ubiquitin ligase adapter protein, autophagy deficiency causes competitive inhibition of the Nrf2–Keap1 interaction, resulting in stabilization of Nrf2 followed by transcriptional activation of Nrf2 target genes. Herein, we show that liver-specific autophagy-deficient mice harbor adenomas linked to both the formation of p62- and Keap1-positive cellular aggregates and induction of Nrf2 targets. Importantly, similar aggregates were identified in more than 25% of human hepatocellular carcinomas (HCC), and induction of Nrf2 target genes was recognized in most of these tumors. Gene targeting of <I>p62</I> in an HCC cell line markedly abrogates the anchorage-independent growth, whereas forced expression of p62, but not a Keap1 interaction-defective mutant, resulted in recovery of the growth defect. These results indicate the involvement of persistent activation of Nrf2 through the accumulation of p62 in hepatoma development.</P>
Shuji Nakagawa,Yuji Arai,Kunio Hara,Hiroaki Inoue,Manabu Hino,Toshikazu Kubo 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.4
We describe a patient who underwent arthroscopic pullout fixation for a posterior cruciate ligament (PCL) avulsion fracture. A 46-year-old female, injured in a fall while riding a motorcycle, was diagnosed with a right knee PCL tibial attachment avulsion fracture and underwent arthroscopic osteosynthesis. A Kirschner wire was drilled to a point just medial to the medial border of the anterior tibial bony bed. A suture wire was folded into a loop and introduced into the posteromedial compartment via the bone tunnel. A fixation thread was inserted from the posteromedial portal, through the medial and lateral loop wires, and into the posteromedial compartment. The lateral and medial loop wires attached to the thread were pulled to the outside, and the thread was fixed onto the tibia. Three months post-surgery, she returned to her job. This procedure represents a minimally invasive method of treating avulsion fractures of the tibial attachment of the PCL.
( Hiroyuki Kan ),( Yuji Arai ),( Masashi Kobayashi ),( Shuji Nakagawa ),( Hiroaki Inoue ),( Manabu Hino ),( Shintaro Komaki ),( Kazuya Ikoma ),( Keiichiro Ueshima ),( Hiroyoshi Fujiwara ),( Toshikazu 대한슬관절학회 2017 대한슬관절학회지 Vol.29 No.1
Purpose: The fixed flexion view (FFV) of the knee is considered useful for evaluating the joint space when assessing the severity of osteoarthritis (OA) of the knee. To clarify the usefulness of FFV for evaluation of the joint space and severity of knee OA, this study evaluated changes in the joint space on the FFV and standing extended view (SEV) in patients with knee OA. Materials and Methods: The SEV and FFV images were acquired in 567 patients (1,102 knees) who visited the hospital with a chief complaint of knee joint pain. Medial joint space width (MJSW) and Kellgren-Lawrence (K-L) classification assessed using the SEV and FFV images were compared. Results: Mean MJSW was significantly smaller when assessed on the FFV than on the SEV (3.02±1.55 mm vs. 4.31±1.30 mm; p<0.001). The K-L grade was the same or higher on the FFV than on the SEV. Conclusions: The FFV is more useful than the SEV for evaluating the joint space in OA knees. Treatment strategies in patients with knee OA should be determined based on routinely acquired FFV images.