Differences in Risk Factors for Decreased Cervical Lordosis after Multiple-Segment Laminoplasty for Cervical Spondylotic Myelopathy and Ossification of the Posterior Longitudinal Ligament: A Pilot Study

Inoue Takaki,Maki Satoshi,Furuya Takeo,Okimatsu Sho,Yunde Atsushi,Miura Masataka,Shiratani Yuki,Nagashima Yuki,Maruyama Juntaro,Shiga Yasuhiro,Inage Kazuhide,Orita Sumihisa,Eguchi Yawara,Ohtori Seiji 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.4

Study Design: Retrospective study.Purpose: To compare the radiographic risk factors for decreased cervical lordosis (CL) after laminoplasty, focusing on the difference between cervical spondylotic myelopathy (CSM) and cervical ossification of the posterior longitudinal ligament (C-OPLL).Overview of Literature: A few reports compared the risk factors for decreased CL between CSM and C-OPLL although these two pathologies have their characteristics.Methods: This study included 50 patients with CSM and 39 with C-OPLL who underwent multi-segment laminoplasty. Decreased CL was defined as the difference between preoperative and 2-year postoperative neutral C2–7 Cobb angles. Radiographic parameters included preoperative neutral C2–7 Cobb angles, C2–7 sagittal vertical axis (SVA), T1 slope (T1S), dynamic extension reserve (DER), and range of motion. The radiographic risk factors were investigated for decreased CL in CSM and C-OPLL. Additionally, the Japanese Orthopedic Association (JOA) score was assessed preoperatively and 2 years postoperatively.Results: C2–7 SVA (<i>p</i> =0.018) and DER (<i>p</i> =0.002) were significantly correlated with decreased CL in CSM, while C2–7 Cobb angle (<i>p</i> =0.012) and C2–7 SVA (<i>p</i> =0.028) were correlated with decreased CL in C-OPLL. Multiple linear regression analysis revealed that greater C2–7 SVA (<i>B</i> =0.22, <i>p</i> =0.026) and small DER (<i>B</i> =−0.53, <i>p</i> =0.002) were significantly associated with decreased CL in CSM. By contrast, greater C2–7 SVA (<i>B</i> =0.36, <i>p</i> =0.031) was significantly associated with decreased CL in C-OPLL. The JOA score significantly improved in both CSM and C-OPLL (<i>p</i> <0.001).Conclusions: C2–7 SVA was associated with a postoperative decreased CL in both CSM and C-OPLL, but DER was only associated with decreased CL in CSM. Risk factors for decreased CL slightly differed depending on the etiology of the condition.

Additive effect of rikkunshito, an herbal medicine, on chemotherapy-induced nausea, vomiting, and anorexia in uterine cervical or corpus cancer patients treated with cisplatin and paclitaxel: results of a randomized phase II study (JORTC KMP-02)

Shunsuke Ohnishi,Hidemichi Watari,Maki Kanno,Yoko Ohba,Satoshi Takeuchi,Tempei Miyaji,Shunsuke Oyamada,Eiji Nomura,Hidenori Kato,Toru Sugiyama,Masahiro Asaka,Noriaki Sakuragi,Takuhiro Yamaguchi,Yasuhi 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5

Objective: Rikkunshito, an herbal medicine, is widely prescribed in Japan for the treatmentof anorexia and functional dyspepsia, and has been reported to recover reductions in foodintake caused by cisplatin. We investigated whether rikkunshito could improve chemotherapyinducednausea and vomiting (CINV) and anorexia in patients treated with cisplatin. Methods: Patients with uterine cervical or corpus cancer who were to receive cisplatin (50 mg/m2day 1) and paclitaxel (135 mg/m2day 0) as first-line chemotherapy were randomly assignedto the rikkunshito group receiving oral administration on days 0–13 with standard antiemetics,or the control group receiving antiemetics only. The primary endpoint was the rate of completecontrol (CC: no emesis, no rescue medication, and no significant nausea) in the overall phase(0–120 hours). Two-tailed p<0.20 was considered significant in the planned analysis. Results: The CC rate in the overall phase was significantly higher in the rikkunshito groupthan in the control group (57.9% vs. 35.3%, p=0.175), as were the secondary endpoints:the CC rate in the delayed phase (24–120 hours), and the complete response (CR) rates(no emesis and no rescue medication) in the overall and delayed phases (63.2% vs. 35.3%, p=0.095; 84.2% vs. 52.9%, p=0.042; 84.2% vs. 52.9%, p=0.042, respectively), and time totreatment failure (p=0.059). Appetite assessed by visual analogue scale (VAS) appeared to besuperior in the rikkunshito group from day 2 through day 6. Conclusion: Rikkunshito provided additive effect for the prevention of CINV and anorexia

Evaluation of Target Specificity of Antibacterial Agents Using Staphylococcus aureus ddlA Mutants and d-Cycloserine in a Silkworm Infection Model

Kurokawa, Kenji,Hamamoto, Hiroshi,Matsuo, Miki,Nishida, Satoshi,Yamane, Noriko,Lee, Bok Luel,Murakami, Kazuhisa,Maki, Hideki,Sekimizu, Kazuhisa American Society for Microbiology 2009 Antimicrobial Agents and Chemotherapy Vol.53 No.9

<B>ABSTRACT</B><P>The availability of a silkworm larva infection model to evaluate the therapeutic effectiveness of antibiotics was examined. The 50% effective doses (ED50) of d-cycloserine against the <I>Staphylococcus aureus ddlA</I> mutant-mediated killing of larvae were remarkably lower than those against the parental strain-mediated killing of larvae. Changes in MICs and ED50 of other antibiotics were negligible, suggesting that these alterations are d-cycloserine selective. Therefore, this model is useful for selecting desired compounds based on their therapeutic effectiveness during antibiotic development.</P>

Association between Osteoporosis and Skeletal Muscle Mass in Men

Mizutani Masaya,Eguchi Yawara,Toyoguchi Toru,Orita Sumihisa,Inage Kazuhide,Shiga Yasuhiro,Maki Satoshi,Nakamura Junichi,Hagiwara Shigeo,Aoki Yasuchika,Inoue Masahiro,Koda Masao,Takahashi Hiroshi,Akaza 대한척추외과학회 2024 Asian Spine Journal Vol.18 No.1

Study Design: Cross-sectional study.Purpose: This cross-sectional study aimed to investigate the risk factors for osteoporosis in men by assessing bone mineral density (BMD), skeletal muscle mass, body fat mass, grip strength, and advanced glycation end products (AGEs).Overview of Literature: Fewer studies have reported the correlation between BMD and skeletal muscle mass in women. Moreover, a few studies have examined the relationship between osteoporosis and skeletal muscle mass.Methods: This study included 99 men (mean age, 74.9 years; range, 28–93 years) who visited Qiball Clinic for BMD and body composition examinations. The osteoporosis group consisted of 24 patients (mean age, 72.5 years; range, 44–92 years), and the control group consisted of 75 individuals (mean age, 74.9 years; range, 28–93 years). Whole-body skeletal muscle mass was measured using a bioelectrical impedance analyzer. BMD was measured by dual X-ray absorptiometry. Skin autofluorescence (SAF), a marker of dermal AGE accumulation, was measured using a spectroscope. Osteoporosis was defined as a bone density T score of –2.5 or less. Physical findings, skeletal muscle mass, BMD, grip strength, and SAF were compared between the osteoporosis and control groups.Results: The osteoporosis group had significantly lower trunk muscle mass (23.1 kg vs. 24.9 kg), lower leg muscle mass (14.4 kg vs. 13.0 kg), and skeletal mass index (7.1 kg/m² vs. 6.7 kg/m²) than the control group (all <i>p</i><0.05). Lower limb muscle mass was identified as a risk factor for osteoporosis in men (odds ratio, 0.64; <i>p</i>=0.03).Conclusions: Conservative treatment of osteoporosis in men will require an effective approach that facilitates the maintenance or strengthening of skeletal muscle mass, including exercise therapy with a focus on lower extremities and nutritional supplementation.

Postoperative Increase in Occiput–C2 Angle Negatively Impacts Subaxial Lordosis after Occipito–Upper Cervical Posterior Fusion Surgery

Taigo Inada,Takeo Furuya,Koshiro Kamiya,Mitsutoshi Ota,Satoshi Maki,Takane Suzuki,Kazuhisa Takahashi,Masashi Yamazaki,Masaaki Aramomi,Chikato Mannoji,Masao Koda 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.4

Study Design: Retrospective case series. Purpose: To elucidate the impact of postoperative occiput–C2 (O–C2) angle change on subaxial cervical alignment. Overview of Literature: In the case of occipito–upper cervical fixation surgery, it is recommended that the O–C2 angle should be set larger than the preoperative value postoperatively. Methods: The present study included 17 patients who underwent occipito–upper cervical spine (above C4) posterior fixation surgery for atlantoaxial subluxation of various etiologies. Plain lateral cervical radiographs in a neutral position at standing were obtained and the O–C2 angle and subaxial lordosis angle (the angle between the endplates of the lowest instrumented vertebra (LIV) and C7 vertebrae) were measured preoperatively and postoperatively soon after surgery and ambulation and at the final follow-up visit. Results: There was a significant negative correlation between the average postoperative alteration of O–C2 angle (DO–C2) and the average postoperative alteration of subaxial lordosis angle (Dsubaxial lordosis angle) (r =–0.47, p =0.03). Conclusions: There was a negative correlation between DO–C2 and Dsubaxial lordosis angles. This suggests that decrease of midto lower-cervical lordosis acts as a compensatory mechanism for lordotic correction between the occiput and C2. In occipito-cervical fusion surgery, care must be taken to avoid excessive O–C2 angle correction because it might induce mid-to-lower cervical compensatory decrease of lordosis.

Diffusion Tensor Imaging of the Spinal Canal in Quantitative Assessment of Patients with Lumbar Spinal Canal Stenosis

Norimoto Masaki,Eguchi Yawara,Kanamoto Hirohito,Oikawa Yasuhiro,Matsumoto Koji,Masuda Yoshitada,Furuya Takeo,Orita Sumihisa,Inage Kazuhide,Maki Satoshi,Shiga Yasuhiro,Kinoshita Hideyuki,Abe Koki,Inoue 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.2

Study Design: Retrospective observational study. Purpose: Lumbar spinal stenosis (LSS) has traditionally been evaluated morphologically, there is a paucity of literature on quantitative assessment of LSS. The purpose of this study was to investigate whether intraspinal diffusion tensor imaging (DTI) parameters such as apparent diffusion coefficient (ADC) and fractional anisotropy (FA) are useful for assessing LSS. Overview of Literature: Quantitative assessment of LSS is challenging. Methods: Study participants comprised five healthy volunteers (mean age, 27.2 years) and 27 patients with LSS (mean age, 58.4 years) who were individually assessed using 3.0 Tesla magnetic resonance imaging. Intraspinal ADC and FA values of 10 intervertebral discs from healthy volunteers and 52 intervertebral discs from LSS patients were measured. Also, intraspinal canal area, Schizas classification (A: normal, B: mild stenosis, C: severe stenosis) and correlations with symptoms were investigated. Clinical symptoms were checked for the presence of low back pain (LBP), intermittent claudication (IMC), and bladder and bowel dysfunction (BBD). Results: Compared to healthy individuals, LSS patients had significantly lower ADC (p <0.05) and significantly higher FA values (p <0.01). In Schizas classification, stenosis worsened from A to C. ADC values decreased significantly while FA values increased significantly in that order (p <0.05). A positive correlation was found between intraspinal canal area and ADC values (r =0.63, p <0.01) and a negative correlation between intraspinal canal area and FA values (p =−0.61, p <0.01). No correlations were noted between LBP and ADC or FA values. On the other hand, ADC values were significantly lower (p <0.05) and FA values were significantly higher (p <0.05) in patients with IMC or BBD. Conclusions: Intraspinal DTI parameters such as ADC and FA values were associated with the Schizas classification, intraspinal canal area, and clinical symptoms, suggesting that ADC and FA may be useful for quantitative assessment of LSS.

Beneficial effects of tonsillectomy plus steroid pulse therapy on inflammatory and tubular markers in patients with IgA nephropathy

( Shuntaro Maruyama ),( Tomohito Gohda ),( Yusuke Suzuki ),( Hitoshi Suzuki ),( Yuji Sonoda ),( Saki Ichikawa ),( Zi Li ),( Maki Murakoshi ),( Satoshi Horikoshi ),( Yasuhiko Tomino ) 대한신장학회 2016 Kidney Research and Clinical Practice Vol.35 No.4

Background: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Tonsillectomy plus steroid pulse therapy has been able to induce clinical remission in early-stage IgAN. However, its possible effect on systemic and local cytokines and tubular markers has not been fully investigated. Methods: We obtained serum and urine samples from 38 patients just before renal biopsy and third steroid pulse therapy. Markers of tubular damage such as N-acetyl-β- D-glucosaminidase, and kidney injury molecule-1 and inflammation such as interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule (VCAM)-1 were measured by immunoassay. Results: Before renal biopsy, only urinary inflammatory markers, except MCP-1, were associated with glomerular (proteinuria) and/or tubular damage markers. Proteinuria, hematuria, and estimated glomerular filtration rate dramatically improved after therapy. In addition, levels of serum IL-6 and ICAM-1 and all urinary markers declined significantly; however, serum MCP-1 and VCAM-1 levels did not. None of the urinary markers correlated with the serum inflammatory markers. Conclusion: Tonsillectomy plus steroid pulse therapy for patients with IgAN might be useful for improving not only glomerular damage marker but also tubular damage markers through the improvement of local renal inflammation. Copyright ⓒ 2016. The Korean Society of Nephrology. Published by Elsevier. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Time-Course Changes in Bone Metabolism Markers and Density in Patients with Osteoporosis Treated with Romosozumab: A Multicenter Retrospective Study

Kazuhide Inage,Sumihisa Orita,Yawara Eguchi,Yasuhiro Shiga,Masao Koda,Yasuchika Aoki,Toshiaki Kotani,Tsutomu Akazawa,Takeo Furuya,Junichi Nakamura,Hiroshi Takahashi,Miyako Suzuki-Narita,Satoshi Maki,S 연세대학교의과대학 2021 Yonsei medical journal Vol.62 No.9

Purpose: In this multicenter retrospective observational study, we examined the early effects of romosozumab in patients with severeosteoporosis in terms of time-course changes in bone metabolism marker, improvement in bone density, and adverse effects. Materials and Methods: Patients with severe osteoporosis were included. We investigated the progress of TRACP 5b and P1NPbefore and 1–2 months after the administration of romosozumab. We also investigated the bone density of lumbar spine, femoralneck, and the entire femur, measured by the DXA method, before and 5–7 months after the administration of romosozumab. Results: A total of 70 patients (7 males and 63 females, age 75.0±3.6 years) participated in this study. Significant improvements inTRACP 5b and P1NP levels were observed before and 1–2 months after romosozumab administration. The average bone densityof lumbar spine, femoral neck, and the entire femur were measured before and 5–7 months after romosozumab administration;and a significant increase only observed in the lumbar spine. Conclusion: Consistent with the findings of previous clinical studies, romosozumab has both bone formation-enhancing andbone resorption effects (dual effect). In addition, romosozumab also demonstrated improvement in bone density from the earlyphase after the administration, though the result was only seen in the lumbar spine.

Baastrup’s Disease Is Associated with Recurrent of Sciatica after Posterior Lumbar Spinal Decompressions Utilizing Floating Spinous Process Procedures

Masao Koda,Chikato Mannoji,Masazumi Murakami,Tomoaki Kinoshita,Jiro Hirayama,Tomohiro Miyashita,Yawara Eguchi,Masashi Yamazaki,Takane Suzuki,Masaaki Aramomi,Mitsutoshi Ota,Satoshi Maki,Kazuhisa Takaha 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.6

Study Design: Retrospective case-control study. Purpose: To determine whether kissing spine is a risk factor for recurrence of sciatica after lumbar posterior decompression using a spinous process floating approach. Overview of Literature: Kissing spine is defined by apposition and sclerotic change of the facing spinous processes as shown in X-ray images, and is often accompanied by marked disc degeneration and decrement of disc height. If kissing spine significantly contributes to weight bearing and the stability of the lumbar spine, trauma to the spinous process might induce a breakdown of lumbar spine stability after posterior decompression surgery in cases of kissing spine. Methods: The present study included 161 patients who had undergone posterior decompression surgery for lumbar canal stenosis using a spinous process floating approaches. We defined recurrence of sciatica as that resolved after initial surgery and then recurred. Kissing spine was defined as sclerotic change and the apposition of the spinous process in a plain radiogram. Preoperative foraminal stenosis was determined by the decrease of perineural fat intensity detected by parasagittal T1-weighted magnetic resonance imaging. Preoperative percentage slip, segmental range of motion, and segmental scoliosis were analyzed in preoperative radiographs. Univariate analysis followed by stepwise logistic regression analysis determined factors independently associated with recurrence of sciatica. Results: Stepwise logistic regression revealed kissing spine (p =0.024; odds ratio, 3.80) and foraminal stenosis (p <0.01; odds ratio, 17.89) as independent risk factors for the recurrence of sciatica after posterior lumbar spinal decompression with spinous process floating procedures for lumbar spinal canal stenosis. Conclusions: When a patient shows kissing spine and concomitant subclinical foraminal stenosis at the affected level, we should sufficiently discuss the selection of an appropriate surgical procedure.