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Malnutrition Assessed Using the Geriatric Nutritional Risk Index Is Associated with Preoperative Incidence of Deep Vein Thrombosis in Japanese Patients Undergoing Total Knee Arthroplasty

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Open Journal of Orthopedics 2024年第8期14卷 355-365页

作者： Taizo Kaneko Kentaro Hayakawa tsuyoshi miyazaki Department of Orthopaedic Surgery Tokyo Metropolitan Institute for Geriatrics and Gerontology Tokyo Japan

Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.

关键词： Malnutrition Geriatric Nutritional Risk Index Controlling Nutritional Status Score Preoperative Deep Vein Thrombosis Total Knee Arthroplasty

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Malnutrition and Its Association with the Mortality of Patients with Femoral Intertrochanteric Fractures: A Retrospective Analysis of Japanese Patients

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Open Journal of Orthopedics 2024年第1期14卷 22-31页

作者： Taizo Kaneko Kyoko Matsudaira Kentaro Hayakawa Fumiaki Tokimura tsuyoshi miyazaki Department of Orthopaedic Surgery Tokyo Metropolitan Institute for Geriatrics and Gerontology Tokyo Japan

Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.

关键词： Intertrochanteric Fracture Mortality Geriatric Nutritional Risk Index Malnutrition Risk Factor

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Experimental and Modeling Investigation of Shallow Water Table Fluctuations in Relation to Reverse Wieringermeer Effect

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Open Journal of Soil Science 2011年第2期1卷 17-24页

作者： Ibrahimi Mohamed Khaled miyazaki tsuyoshi Nishikawa Kohei Nishimura Taku Imoto Hiromi 不详

Soil column experiments and modeling investigations were performed to study the behavior of shallow water table in response to various recharge events. Hence, shallow water table fluctuations inside sandy (Toyoura sand) and clayey (Chiba light clay) soil columns in response to surface and sub-surface recharge events were investigated under laboratory conditions. Experimental results showed that small application of water could raise the shallow water table level more than 100 times in depth in the case of Toyoura sand and more than 50 times in the case of Chiba LiC, reflecting a reverse Wieringermeer effect (RWE) response type of groundwater. This rise was associated with a prompt change of pressure head values which exhibited instantaneous fluctuations of centimeters due to the addition of millimeters of water. The recharge volumes leading to such disproportionate water table rise were successfully estimated using a simple analytical model based on the moisture retention curve of the soil and considering the hysteresis effect on soil water dynamics within the capillary fringe zone.

关键词： Groundwater Fluctuation Shallow Water Table Reverse Wieringermeer Effect Capillary Fringe

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SOC Turnover and Lime-CO<sub>2</sub>Evolution during Liming of an Acid Andisol and Ultisol

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Open Journal of Soil Science 2011年第2期1卷 49-53页

作者： Wilfredo A. Dumale Jr. tsuyoshi miyazaki Kenta Hirai Taku Nishimura Department of Plant Science Nueva Vizcaya State University Bayombong Nueva Vizcaya Philippines Department of Biological and Environmental Engineering University of Tokyo Tokyo Japan.

Agricultural liming contributes significantly to atmospheric CO2 emission from soils but data on magnitude of lime- contributed CO2 in a wide range of acid soils are still few. Data on lime-contributed CO2 and SOC turnover for global acid soils are needed to estimate the potential contribution of agricultural liming to atmospheric CO2. Using Ca13CO3 (13C 99%) as lime and tracer, here we separated lime-contributed and SOC-originated CO2 evolution in an acidic Kuroboku Andisol from Tanashi, Tokyo Prefecture (35°44′ N, 139°32′ E) and Kunigami Mahji Ultisol of Nakijin, Okinawa Prefecture, Japan (26°38′ N, 127°58′ E). On the average, lime-CO2 was 76.84% (Kuroboku Andisol) and 66.36% (Kunigami Mahji Ultisol) of overall CO2 emission after 36 days. There was increased SOC turnover in all limed soils, confirming priming effect (PE) of liming. The calculated PE of lime (Kuroboku Andisol, 51.97% - 114.95%;Kunigami Mahji Ultisol, 10.13% - 35.61%) was entirely 12C turnover of stable soil organic carbon (SOC) since SMBC, a labile SOC pool, was suppressed by liming in our experiment. Our results confirmed that mineralization of lime-carbonates is the major source of CO2 emission from acid soils during agricultural liming. Liming can influence the size of CO2 evolution from agricultural ecosystems considering global extent of acid soils and current volume of lime utilization. We propose the inclusion of liming in simulating carbon dynamics in agricultural ecosystems.

关键词： Agricultural Liming Soil Organic Carbon SOC Turnover Andisol Ultisol

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Natural Postoperative Bone Metabolic Changes after Total Knee Arthroplasty Determined by Positron Emission Tomography Scans

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Open Journal of Orthopedics 2018年第12期8卷 443-457页

作者： Masakazu Kanetaka Soichiro Kaneko Kei Wagatsuma Kenji Ishii Kimiteru Ito Shinya Nakamura Hiroshi Hamaji Yukimasa Yamato Yorito Anamizu Fumiaki Tokimura tsuyoshi miyazaki Department of Orthopaedic Surgery Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo Japan Research Team for Neuroimaging Research Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo Japan Department of Diagnostic Radiology Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo Japan Department of Spine Surgery Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo Japan

Artificial joint replacement surgery is the orthopedic procedure of choice to relieve pain, correct joint deformities, and help patients resume everyday activities. However, the detailed mechanisms regulating peri-implant bone remodeling at the bone-prosthesis interface remain elusive. To address this gap in knowledge, we evaluated the natural postoperative course of bone metabolism by using [18F] NaF positron emission tomography (PET)/computed tomography in 57 patients (104 joints) who underwent asymptomatic total knee arthroplasty (TKA). First, we measured total tracer uptake around TKA to determine the total bone metabolism (TBM) and used the ischial tuberosity as the reference tissue for normalization of PET images. Second, we calculated the TBM ratio (TBMR) by dividing the TBM by tracer uptake in the reference tissue. A moderate increase in TBMR was observed 4 - 5 days after implantation, and its intensity reached the maximum on the seventh postoperative day. The TBMR showed no differences until 12 weeks, after which it decreased slowly and returned to the basal levels. The new parameter TBMR and the unique pattern of postoperative metabolic changes in the bone around the prosthesis may help set accurate interpretation criteria to diagnose complications such as loosening or infections.

关键词： NaF PET Bone Metabolism Total Knee Arthroplasty Ischial Tuberosity

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Acute liver failure caused by drug-induced hypersensitivity syndrome associated with hyperferritinemia

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World Journal of Gastroenterology 2011年第44期17卷 4928-4931页

作者： Masayuki miyazaki Masatake Tanaka Akihiro Ueda tsuyoshi Yoshimoto Masaki Kato Makoto Nakamuta Kazuhiro Kotoh Ryoichi Takayanagi Department of Medicine and Bioregulatory Science Graduate School of Medical ScienceKyushu University Department of Gastroenterology Kyushu Medical CenterNational Hospital Organization

Drug-induced hypersensitivity syndrome(DIHS) is a severe reaction usually characterized by fever,rash,and multiorgan failure,occurring 2-6 wk after drug *** is an immune-mediated reaction involving macrophage and T-lymphocyte activation and cytokine release.A 54-year-old woman was diagnosed with rheumatic arthritis and initiated salazosulfapyridine by *** 10 d later,she had a high fever,skin rash and liver *** was admitted to hospital and diagnosed with a drug *** was treated with oral prednisolone 30 mg/d;however,she developed high fever again and her blood tests showed acute liver failure and cytopenia associated with *** was diagnosed with acute liver failure and hemophagocytosis caused by *** was transferred to the Department of Medicine and Bioregulatory Science,Kyushu University,where she was treated with arterial steroid injection *** this treatment,her liver function improved and serum ferritin immediately *** hypothesized that an immune-mediated reaction in DIHS may have generated over-activation of macrophages and T-lymphocytes,followed by a cytokine storm that affected various *** measurement of serum ferritin might be a useful marker of the severity of DIHS.

关键词： Acute liver failure Drug-induced hypersensitivity syndrome Ferritin Human herpes virus 6 Macrophage

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Preoperative albumin-bilirubin score and liver resection percentage determine postoperative liver regeneration after partial hepatectomy

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World Journal of Gastroenterology 2024年第14期30卷 2006-2017页

作者： Kazuhiro Takahashi Masahiko Gosho Yoshihiro miyazaki Hiromitsu Nakahashi Osamu Shimomura Kinji Furuya Manami Doi Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi tsuyoshi Enomoto Shinji Hashimoto Tatsuya Oda Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery University of TsukubaTsukuba 3058-575IbarakiJapan Department of Biostatistics University of TsukubaTsukuba 3058-575IbarakiJapan

BACKGROUND The success of liver resection relies on the ability of the remnant liver to *** of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are ***,there is limited knowledge about the preoperative factors that influence postoperative *** To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver *** A total of 268 patients who received partial hepatectomy were *** were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)*** regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,*** lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months *** The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,*** RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri *** to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed ***,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.

关键词： Liver regeneration Albumin-bilirubin score Liver resection percentage Partial hepatectomy Human Regeneration index

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Treatment of gastric outlet obstruction that results fromunresectable gastric cancer:Current evidence

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World Journal of Gastrointestinal Endoscopy 2016年第3期8卷 165-172页

作者： Yasuhiro miyazaki Shuji Takiguchi tsuyoshi Takahashi Yukinori Kurokawa Tomoki Makino Makoto Yamasaki,Kiyokazu Nakajima Masaki Mori Yuichiro Doki Department of Gastroenterological Surgery Osaka University Graduate School of MedicineSuita-shiOsaka 565-0871Japan

Malignant gastric outlet obstruction(GOO) is a common condition that results from locally advanced malignancies in the upper gastrointestinal tract, such as pancreatic, gastric, and other carcinomas. Two types of procedures for malignant GOO, namely, gastrojejunostomy(GJ) with laparotomy or a laparoscopic approach and endoscopic stenting(ES), are currently available. Although numerous previous reports have clarified the benefits and drawbacks of each procedure, whether GJ or ES should be used in patients with GOO that results from gastric cancer who may have a longer life expectancy than patients with other malignancies has not been determined. In this review, which focuses on gastric cancer-induced GOO, we analyzed the two systematic reviews and a meta-analysis that compared GJ and ES and outlined the current status of GOO treatment. We also provide an updated review that includes laparoscopic GJ. Various data from 13 studies in one review and 6 studies in another review were analyzed. Although the main results of the present review indicated that both GJ and ES were efficacious treatments in patients with GOO that resulted from gastric cancer, current evidence suggests that GJ may be the preferable procedure given its good performance status and improved prognosis in gastric cancer patients.

关键词： Gastric outlet obstruction Gastrojejunostomy Endoscopic stenting Gastric cancer Review

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Analysis of a Questionnaire Survey regarding Current Conditions against Exposure to Anticancer Drugs and Reports of Cancer Chemotherapy at Outpatient Departments in Japan

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Pharmacology & Pharmacy 2017年第5期8卷 140-152页

作者： tsuyoshi Shirakawa Tomoko Hara Kojiro Hata Kojiro Hata Kimitaka Suetsugu Hideki Kakimoto Kentaro Ogata Yousuke Ikari Hidenori Sasaki Makoto Takahashi Masaru Fukahori Miyuki Uoi Taito Esaki Mikako Hiraike Toshinobu Hayashi Akira Tokunaga Norio Ureshino Tsuneo Kuwamura Hitoshi Kusaba Kenji Mitsugi Eishi Baba Department of Pharmacy National Hospital Organization Kyushu Medical Center Fukuoka Japan Department of Oncology Miyazaki Prefectural Miyazaki Hospital Miyazaki Japan Department of Internal Medicine Fukuoka Wajiro Hospital Fukuoka Japan Department of Pharmacy Hamanomachi Hospital Fukuoka Japan Department of Pharmacy Kyushu University Hospital Fukuoka Japan Department of Pharmacy Fukuoka University Hospital Fukuoka Japan Department of Practical Pharmaceutical Science Faculty of Pharmaceutical Sciences Fukuoka University Fukuoka Japan Division of Medical Oncology Hematology and Infection Diseases Fukuoka University Hospital Fukuoka Japan Department of Pharmacy Kurume University Hospital Fukuoka Japan Division of Gastroenterology Kurume University Department of Medicine Fukuoka Japan Department of Pharmacy National Kyushu Cancer Center Fukuoka Japan Department of Gastrointestinal and Medical Oncology National Kyushu Cancer Center Fukuoka Japan Department of Pharmacy National Hospital Organization Kyushu Medical Center Fukuoka Japan Department of Pharmacy Saga-Ken Medical Centre Koseikan Saga Japan Department of Medical Oncology Saga-Ken Medical Centre Koseikan Saga Japan Department of Pharmacy Japan Community Healthcare Organization Kyushu Hospital Fukuoka Japan Department of Medicine and Comprehensive Biosystemic Science Kyushu University Graduate School of Medical Sciences Fukuoka Japan Department of Medical Oncology Hamanomachi Hospital Fukuoka Japan Department of Comprehensive Clinical Oncology Faculty of Medical Sciences Kyushu University Fukuoka Japan

[Background] Medical staff have many occasions to be exposed to anticancer drugs (ACDs) in the process of performing cancer chemotherapy. Although guidelines for the safe handling of ACDs have been published, actual measures against exposure to ACDs differ between hospitals, and no surveillance data regarding the conditions of each hospital in relation to performing chemotherapy in Japan are available. [Methods] To understand current measures against exposure to ACDs and problems related to cancer chemotherapy at outpatient departments, we conducted a questionnaire survey on doctors, pharmacists, and nurses in 10 leading hospitals for cancer chemotherapy in Japan. [Results] Responses were received from all 10 institutions. The hospital pharmacists prepared all ACDs for outpatients in each institution. All hospitals took basic measures against ACD exposure, such as using personal protective equipment and penetration-resistant waste containers. Conditions against exposure to ACDs generally improved between 2012 and 2015, especially in terms of conveyance of ACDs and use of a closed-system drug transfer device. However, no measures linking ACDs with administration routes or injection sites were commonly taken in any of the hospitals in 2015. [Conclusions] Conditions against ACD exposure improved between 2012 and 2015, possibly because new guidelines were issued. To improve measures for ACD exposure in Japan, preparing more appropriate manuals and offering more opportunities to medical staff for continuing education are considered important.

关键词： Exposure Anticancer Drugs Measurement Personal Protective Equipment Outpatient Service

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