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Prevalence of Non-Responders to Both Oral Bisphosphonate Monotherapy and Intravenous Ibandronate in Patients with Postmenopausal Osteoporosis

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Open Journal of Orthopedics 2020年第3期10卷 43-53页

作者： Naohisa Miyakoshi Yuji Kasukawa Michio Hongo Akira Horikawa yoichi shimada Department of Orthopedic Surgery Akita University Graduate School of Medicine Hondo Akita Japan Igarashi Memorial Hospital Tsuchizakiminato-Chuo Akita Japan

Objectives: Although bisphosphonates (BPs) are effective for the majority of patients with osteoporosis, some individuals do not adequately respond to these drugs. The objective of this study was to estimate the prevalence of true BP non-responders who showed insufficient response after both oral BPs and intravenous ibandronate. Methods: Among 146 consecutive patients with postmenopausal osteoporosis who received oral BP monotherapy for more than 12 months, insufficient responders to oral BP monotherapy were switched to intravenous ibandronate injection and followed for more than 12 months. Serum N-terminal telopeptide of type I collagen (NTX) and bone alkaline phosphatase (BAP) concentrations were measured. Patients who also showed insufficient response to intravenous ibandronate were defined as true BP non-responders. Insufficient response to BP therapy was evaluated based on the serum NTX reduction cut-off for minimum significant change. Results: Sixty-one patients (41.8%) were diagnosed as oral BP non-responders. Fourteen patients who switched to intravenous ibandronate and had complete data available were used for final analysis. After switching to intravenous ibandronate, both NTX and BAP decreased significantly (p Conclusion: These results estimated that as few as 9% - 15% (i.e., 21.4% - 35.7% of 41.8%) or as many as 24% - 27% (i.e., 57.1% - 64.3% of 41.8%) of patents might be true BP non-responders.

关键词： Bone Resorption Biphosphonates Ibandronic Acid Osteoporosis Prevalence

Learning Control of Hyper Redundant Robots Based on Linear Learning Control Scheme

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Learning Control of Hyper Redundant Robots Based on Linear L...

Differences in the Length and Thickness of the Coracoacromial Ligament between Normal Shoulders and Shoulders with Rotator Cuff Tears

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作者： Daisuke Matsuura Nobuyuki Iwatsuki yoichi shimada Kouichi Morikawa Graduate School Tokyo Institute of Technology2-12-1 OhokayamaMeguro-kuTokyo 152-8552Japan Komatsu Co. Ltd.Japan

This paper describes motion control of hyper redundant robots with learning control based on linear learning control *** the conventional linear learning control scheme for non-redundant robots,the increment of joint inputs in a celtain learning process could be calculated with an inverse Jacobian matrix and the linear combination of error *** using general solution of inverse kinematics with pseudo inverse of Jacobian matrix,the control scheme was extended so that a redundant robot can realize a motion as a sub task while generating the trajectory specified as a main *** new control scheme was applied to control a planar serial manipulator with 5 DOF,which generated continuous path trajectory while avoiding obstacles in its workspace. Several simulations and experiments revealed that the proposed control scheme was effective and useful.

关键词： Learning control Linear learning control scheme Hyper redundant robot Obstacle avoidance

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Surgical Science 2021年第1期12卷 9-16页

作者： Manabu Watanabe Hiroaki Kijima Takayuki Yoshikawa Kentaro Ohuchi Yusuke Sugimura Naohisa Miyakoshi yoichi shimada Department of Orthopedic Surgery Yuri Kumiai General Hospital Yuri-Honjo City Japan Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan Akita Sports Arthroscopy and Knee Group (ASAKG) Akita Japan

Although the relationship between the material properties of the coracoacromial ligament and rotator cuff tears has been clarified, it is difficult to evaluate these properties in the clinical setting. The purpose of this study was to clarify the relationship between rotator cuff tears and the length and thickness of the coracoacromial ligament in living shoulders, in order to assess the potential use of these parameters as clinical indicators of the possible risk or progression of rotator cuff tears. Thirty-five volunteers (46 shoulders, mean age: 52 years) were enrolled. The presence or absence of rotator cuff tears and the length and thickness of the coracoacromial ligament were evaluated by ultrasonography. Longitudinal images of the coracoacromial ligaments with the acromion and coracoid process as landmarks were obtained, and the lengths of the ligaments were measured using acoustic shadows as the index. On the same screens, the thicknesses at the center of the ligaments were measured. Ligaments in shoulders with a rotator cuff tear were significantly shorter than ligaments in shoulders without a rotator cuff tear (25.9 ± 2.5 mm vs. 28.6 ± 1.7 mm, respectively;P < 0.0001). There was no significant difference in the thicknesses of the ligaments. The length and thickness of the coracoacromial ligament of living shoulders were easily evaluated with ultrasonography in the present study, and the coracoacromial ligament was found to be significantly shorter in shoulders with a rotator cuff tear. The risk and progression of rotator cuff tears can be evaluated clinically by measuring the length of the coracoacromial ligament.

关键词： Coracoacromial Ligament Rotator Cuff Tear Shoulder Subacromial Impingement

Eosinophilic Granuloma Arising from the Sacrum: A Case Report

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Open Journal of Orthopedics 2011年第2期1卷 5-8页

作者： Yuji Kasukawa Naohisa Miyakoshi Michio Hongo Shigeru Ando Yoshinori Ishikawa yoichi shimada 不详

Introduction: Osseous eosinophilic granulomas commonly occur in the skull, pelvis, vertebrae, mandible, and ribs. However, the eosinophilic granuloma in the sacrum is rare. Case presentation: We present the case of a 13-year-old Japanese boy, who presented with left low-back pain, and was diagnosed with eosinophilic granuloma arising in the sacrum. Computed tomography (CT) and magnetic resonance imaging demonstrated an osteolytic lesion with interruption of the cortex, and signal intensity changes at the left sacral body and wing. Histologic examination indicated an eosinophilic granuloma. Two years after CT-guided biopsy, the tumor had spontaneously healed completely, with no residual ***: The present case was eosiophilic granuloma arising from the rare site of sacrum. The tumor was completely remodeled two years after biopsy.

关键词： Eosinophilic granuloma Sacrum Biopsy

Rheumatoid Arthritis with High Serum KL-6 Complicating Malignant Tumor: Two Case Reports

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Open Journal of Orthopedics 2015年第3期5卷 41-45页

作者： Hiroyuki Tsuchie Seiya Miyamoto yoichi Kataoka Seietsu Senma Yuichiro Narita Yuji Hatakeyama Moto Kobayashi Kana Sasaki yoichi shimada Division of Orthopedic Surgery Nakadori General Hospital Akita Japan Joto Orthopedic Clinic Akita Japan Division of Orthopedic Surgery Hiraka General Hospital Yokote Japan Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan

Interstitial pneumonia develops not only as a rheumatoid arthritis (RA) manifestation, but also due to the side effects of drugs for its treatment, leading to the necessity of regular examinations. Krebs von den Lungen-6 (KL-6) is often used to check the activity of interstitial pneumonia in RA patients. However, this marker is also produced by some malignant tumors, and a high level of serum KL-6 has been reported in cancer patients. We describe herein 2 cases of RA with the complication of a malignant tumor not involving the lung, although there is no lesion in the lung regardless of the high level of serum KL-6.

关键词： KL-6 Malignant Tumor Rheumatoid Arthritis SP-D

Evaluation with Heart Rate Variability for the Treatment Effect of Aminophylline in Patients with Bradycardia after Cervical Spinal Cord Injury: A Preliminary Study

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Open Journal of Orthopedics 2013年第1期3卷 10-13页

作者： Noriyuki Ishikawa Naohisa Miyakoshi Tetsuya Suzuki Akiko a Misaw Yuichi Takano yoichi shimada Department of Orthopedic Surgery Akita Prefectural Center on Development and Disa- bility Akita Japan Department of Orthopedic Surgery Akita Red Cross Hospital Akita Japan Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan Iwai Orthopaedic Medical Hospital Tokyo Japan

After cervical spinal cord injury (SCI), the autonomic nervous system (ANS) becomes impaired and then, bradycardia can develop. In view of this, we performed to prescribe aminophylline as pharmacotherapy for bradycardia. The study population consisted of 36 patients with cervical SCI. Bradycardia developed in 20 patients (55.6%), of these patients, 8 showed spontaneous recovery. Twelve patients had persistent bradycardia, therefore, aminophylline was administered at 0.5 mg/kg/hr by intravenous infusion. Their average heart rate increased within 24 hours after the start of infusion. In heart rate variability analysis for 7 preliminarily selected patients, the spectral waveforms of “oligowave type” indicating ANS impairment tended to appear in relatively early phase after injury (i.e., 2 days to 2 weeks after injury), whereas “normal type” was observed in the late phase (i.e., at 4 weeks). “Sympathetic block type” was observed throughout the follow-up period (2 days to 4 weeks). “Sympathetic block type” was also observed in a non-bradycardic patient on day 2. These results underscore the importance of treating ANS impairment with aminophylline while keeping in mind that bradycardia can occur even in post-SCI patients without clinical manifestations.

关键词： Spinal Cord Injury Aminophylline Heart Rate Variability Autonomic Nervous System Bradycardia

The Serum 25(OH)D Level in Patients with Atypical Femoral Fracture

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Open Journal of Orthopedics 2018年第9期8卷 331-336页

作者： Hiroyuki Tsuchie Naohisa Miyakoshi Yuji Kasukawa Toshiaki Aizawa Hidekazu Abe Toyohito Segawa yoichi shimada Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan Department of Orthopedic Surgery Northern Akita Municipal Hospital Kitaakita Japan Ugo Municipal Hospital Ugo Japan

Objective: Excessive curvature of the femur has been considered to be one of the factors associated with atypical femoral fracture (AFF). Although we clarified that femoral curvature was markedly influenced by a low vitamin D level, very few studies have been conducted on the direct relationship between AFF and a serum low level of vitamin D. Therefore, we compared the serum vitamin D level between AFF and osteoporosis patients. Methods: A total of 48 consecutive AFFs in 36 Japanese patients were retrospectively reviewed using the medical records, and 12 consecutive AFFs in 9 patients (AFF group) whose 25-hydroxyvitamin D (25(OH)D) levels were examined were included in this study. As a non-AFF control group, 45 consecutive age-matched female patients with osteoporosis (Osteoporosis group) were enrolled. We compared some laboratory examination items, the bone mineral density, and curvature of the femur. Results: When univariate logistic regression analysis was performed to compare the 2 groups, Ca levels and lateral and anterior curvatures in the AFF group were significantly greater than in the Osteoporosis group (P < 0.05, P < 0.01, and P < 0.01, respectively), and the 25(OH)D level in the AFF group was significantly lower than in the Osteoporosis group (P < 0.01). We used discriminant analysis of these extracted items to exclude the mutual influence of factors and identify factors closely associated with AFF, and 25(OH)D, Ca and anterior curvature were identified as significant items to differentiate these diseases (P < 0.05, P < 0.01, and P < 0.01, respectively). Conclusion: AFF patients showed low vitamin D levels and marked femoral curvatures.

关键词： Fracture 25(OH)D Curvature Femur

Spinal Epidural Myeloid Sarcoma with Paraplegia in Acute Myeloid Leukemia Treated with Radiation and Chemotherapy: A Case Report

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Open Journal of Orthopedics 2019年第6期9卷 131-136页

作者： Chiaki Sato Naohisa Miyakoshi Michio Hongo Yuji Kasukawa Yoshinori Ishikawa Daisuke Kudo yoichi shimada Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan

Myeloid sarcoma occurs in 1% - 9% of patients with myelogenous leukemia. Spinal epidural myeloid sarcoma is particularly rare, and its treatment has not been established. A 27-year-old woman complained of pain on her left chest, back around the scapula, and neck. Magnetic resonance imaging (MRI) showed a thoracic epidural tumor. One week after her visit, she developed motor weakness of her lower extremities and dysuria, and she was diagnosed with acute myelogenous leukemia (AML) on peripheral blood analysis. The epidural tumor was strongly suspected to be myeloid sarcoma. The paralysis of the lower extremities and bladder dysfunction were not progressive, and chemotherapy and local radiation therapy to the spine were performed. Improvement of paralysis and complete reduction of tumor volume were achieved by the combination of local low-dose radiation therapy and chemotherapy.

关键词： Myeloid Sarcoma Acute Myeloid Leukemia Spinal Cord Compression

Anterior Compartment Syndrome after an Achilles Tendon Repair: A Case Report

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Open Journal of Orthopedics 2016年第3期6卷 47-51页

作者： Kobayashi Moto Miyamoto Seiya Kashiwagura Takeshi Nozaka Koji Chida Shuichi Miyakoshi Naohisa shimada yoichi Department of Orthopedic Surgery Hiraka General Hospital Yokote Japan Department of Orthopedic Surgery Nakadori General Hospital Akita Japan Department of Rehabilitation Akita City Hospital Akita Japan Department of Orthopedic Surgery Akita University Akita Japan

Compartment syndrome may cause irreversible dysfunction if not treated correctly. The occurrence of compartment syndrome is not recognized as a potential complication after Achilles tendon rupture, and only a small number of such cases have been reported. We report the case of a 16-year-old girl with rupture of the right Achilles tendon. On postoperative day 4, she experienced severe anterior ankle pain. A blood test revealed a creatine kinase level of 7976 IU/L;the pressure in the distal anterior compartment was 90 mmHg and proximal compartment was 40 mmHg (needle manometer method). Magnetic resonance imaging (MRI) revealed a signal change in the anterior compartment. Anterior compartment syndrome was diagnosed on the basis of clinical findings, pressure measurements, and MRI findings. Emergency surgery was performed, and the anterior fascia was released. However, the dysfunction in the form of limited range of ankle motion remained. The cause of the compartment syndrome after Achilles tendon rupture was unclear. The patient’s involvement in basketball and positioning of the ankle in plantar flexion with a cast might have been contributing factors in our case. We need to consider the possibility that compartment syndrome may occur after Achilles tendon rupture.

关键词： Achilles Tendon Rupture Compartment Syndrome Complication