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Function Assessment for Rheumatoid Thumb Deformity

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Open Journal of Rheumatology and Autoimmune Diseases 2015年第3期5卷 92-96页

作者： Ryo Oda Daigo Taniguchi Hiroyoshi fujiwara shogo Toyama Daisaku Tokunaga Toshikazu Kubo Department of Orthopaedics Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan

Objective: Nalebuff’s type I deformity of the rheumatoid thumb, which is the most common thumb deformity with rheumatoid arthritis, can be classified into three stages according to the range of motion of the thumb. However, a functional assessment for each stage has never been undertaken. Methods: The ranges of motion of the thumb metacarpophalangeal and interphalangeal joints were evaluated to determine Nalebuff’s clinical stage, and both the Modified Kapandji Index (MKI) and the simple test for evaluating hand function (STEF) were used to evaluate hand function in 32 rheumatoid arthritis patients with type I deformity. We assessed hand function in each stage, and examined the relationship between the three clinical stages and dysfunction of the hand. Results: The scores for both MKI and STEF were significantly reduced in parallel with advancing stage of thumb deformity. Conclusion: Nalebuff’s staging system is also useful for reflecting the level of thumb function.

关键词： Rheumatoid Arthritis Thumb Deformity Function Assessment

Significance of timing of therapeutic line on effectiveness of nivolumab for metastatic renal cell carcinoma

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Current Urology 2023年第1期17卷 52-57页

作者： Jun Teishima Daiki Murata Kazuma Yukihiro Yohei Sekino shogo Inoue Tetsutaro Hayashi Koji Mita Yasuhisa Hasegawa Masao Kato Mitsuru Kajiwara Masanobu Shigeta Satoshi Maruyama Hiroyuki Moriyama Seiji fujiwara Akio Matsubara Department of Urology Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan Department of Urology Hiroshima-City Asa Citizens HospitalHiroshimaJapan Department of Urology Fukuyama Medical CenterFukuyamaJapan Department of Urology Hiroshima General HospitalHatsukaichiJapan Department of Urology Hiroshima Prefectural HospitalHiroshimaJapan Department of Urology Kure Medical Center and Chugoku Cancer CenterKureJapan Department of Urology Miyoshi Central HospitalMiyoshiJapan Department of Urology Onomichi General HospitalOnomichiJapan Department of Urology Higashi-Hiroshima Medical Center Higashi-HiroshimaJapan

Objectives:This study aimed to clarify the significance of therapeutic timing on the effectiveness of nivolumab for treating metastatic renal cell *** and methods:Fifty-eight patients with metastatic renal cell carcinoma treated with nivolumab monotherapy were retrospectively *** who were treated with nivolumab as second-line therapy were included in the second-line group,while the others were included in the later-line *** clinicopathological characteristics,effects of nivolumab,and prognoses of these groups were ***:Twenty and thirty-eight patients were included in the second-line and later-line groups,*** were no significant differences in the distribution of International Metastatic Renal Cell Carcinoma Database Consotium risk and other clinicopathological characteristics between the 2 *** proportion of patients whose objective best response was progressive disease in the second-line group was significantly lower than that in the later-line group(15%vs.50%,p=0.0090).The 50%progression-free survival with nivolumab in the second-line group was significantly better than that in the later-line group(not reached and 5 months,p=0.0018).Multivariate analysis showed that the second-line setting was an independent predictive factor for better progression-free survival(p=0.0028,hazard ratio=0.108).The 50%overall survival after starting nivolumab in the second-line and later-line groups was not reached and 27.8 months,respectively(p=0.2652).Conclusions:The therapeutic efficacy of nivolumab as second-line therapy is expected to be better than that of later therapy.

关键词： Immune checkpoint inhibitor Metastatic renal cell carcinoma Nivolumab Prognostic factor Second-line treatment

Establishing a Calculation Method for Estimating the Normal Circumference of the Proximal Interphalangeal Finger Joints

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Open Journal of Rheumatology and Autoimmune Diseases 2017年第4期7卷 186-195页

作者： Satoru Nakamura Daisaku Tokunaga Ryo Oda Daigo Taniguchi shogo Toyama Maki Asada Hiroyoshi fujiwara Yutaka Kawahito Takahiro Seno Toshikazu Kubo Department of Orthopaedics Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan Department of Inflammation and Immunology Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan

Objective: To estimate the normal circumference of the interphalangeal (IP) thumb joint and the proximal IP (PIP) joints from the index finger to the little finger using individual physical parameters such as body height and body weight. Methods: The maximum size on the ring gauge was recorded which caused resistance when the IP joint of the thumb or PIP joints of the index to small fingers were passed through the gauge. RG was defined as the ring gauge number with the same diameter as the circumference of the IP thumb joint and PIP finger joints from the index finger to the little finger. There were 300 healthy subjects and 600 hands. Univariate and multivariate analyses were used to analyze the relationships between RG and the parameters of age, sex, height, weight, and dominant hand, and regression equations were derived. Results: Age, sex and body weight were all statistically significant predictive factors of RG in all fingers. R2, the coefficient of determination in the regression equation, was almost 0.7 for all fingers, indicating that a moderate or strong correlation was observed between RG and the regression equation. Conclusions: The circumference of the IP thumb joint and PIP finger joints from the index finger to the little finger can be estimated in healthy individuals using a calculation formula that takes age, sex, body height and body weight into account.

关键词： PIP Joint Circumference Ring Gauge

Efficacy of MRP8/14 as a Marker of Disease Activity in Rheumatoid Arthritis

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Open Journal of Rheumatology and Autoimmune Diseases 2016年第2期6卷 34-39页

作者： Tetsuro Yamasaki Ryo Oda Kan Imai Daigo Taniguchi shogo Toyama Takahiro Seno Yuji Arai Kazuya Ikoma Hiroyoshi fujiwara Daisaku Tokunaga Yutaka Kawahito Toshikazu Kubo Department of Orthopaedics Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan Department of Inflammation and Immunology Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan

Objective: Early and accurate evaluation of the presence and activity of synovitis is extremely important in the diagnosis and treatment of rheumatoid arthritis. Myeloid related protein 8/14 (MRP8/14), also known as calprotectin or S100A8/A9 is considered as a sensitive marker for local inflammatory activity in rheumatoid arthritis. The aim of this study is to demonstrate the efficacy of MRP8/14 as a marker of disease activity in RA. Methods: Thirty-one patients with diagnosis of RA who received treatment without biological drugs at our institution were included in this study. Serum MRP8/14, CRP and MMP-3 were tested in all patients. Disease activity was evaluated using DAS28-CRP and SDAI. Ultrasonography was performed on the wrists and MCP joints of both hands using semi-quantitative scale of power Doppler signal. The sum of scales in joints was calculated as the PD score. The correlation of MRP8/14 with serum biomarkers, disease activity and ultrasonography examination was investigated. Result: Serum MRP8/14 was strongly correlated with CRP (r = 0.63) and MMP-3 (r = 0.69). A correlation was observed between serum MRP8/14 and DAS28-CRP (r = 0.53) and SDAI (r = 0.66). No significant correlation was found between PD scores and MRP8/14. Conclusion: This study demonstrated that MRP8/14 is correlated with evaluated disease activity and markers of serum inflammatory response in patients not using biological drugs. MRP8/14 is considered an effective new method for objective evaluation of synovitis in RA.

关键词： Rheumatoid Arthritis Myeloid Related Protein 8/14 (MRP8/14) Calprotectin Disease Activity

Standardized technique for single-incision laparoscopicassisted stoma creation

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World Journal of Gastrointestinal Endoscopy 2016年第15期8卷 541-545页

作者： Norikatsu Miyoshi Shiki Fujino Masayuki Ohue Masayoshi Yasui Shingo Noura Yuma Wada Ryuichiro Kimura Keijiro Sugimura Akira Tomokuni Hirofumi Akita shogo Kobayashi Hidenori Takahashi Takeshi Omori Yoshiyuki fujiwara Masahiko Yano Department of Surgery Osaka Medical Center for Cancer and Cardiovascular Diseases Department of Surgery Osaka Rosai Hospital

To describe the procedure, efficacy, and utility of singleincision laparoscopic-assisted stoma creation(SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade Ⅱ(the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infectionswere cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

关键词： Laparoscopic surgery Colostomy Stoma Postoperative complications Cosmetic outcomes