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論文
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Miwa, Shinji ; Shirai, Toshiharu ; Yamamoto, Norio ; Hayashi, Katsuhiro ; Takeuchi, Akihiko ; Tada, Kaoru ; Kajino, Yoshitomo ; Inatani, Hiroyuki ; Higuchi, Takashi ; Abe, Kensaku ; Taniguchi, Yuta ; Tsuchiya, Hiroyuki ; 三輪, 真嗣 ; 白井, 寿治 ; 山本, 憲男 ; 林, 克洋 ; 武内, 章彦 ; 多田, 薫 ; 樋口, 貴史 ; 阿部, 健作 ; 土屋, 弘行
概要:
金沢大学医薬保健研究域医学系<br />Background: Postoperative deep infection after bone tumor surgery remains a serious complication. Al
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though there are numerous reports about risk factors for postoperative deep infection in general surgery, there is only a small number of reports about those for bone tumor surgery. This retrospective study aimed to identify risk factors for postoperative deep infection after bone tumor resection. Methods: We reviewed data of 681 patients (844 bone tumors) who underwent surgery. Associations between variables, including age, recurrent tumor, pathological fracture, surgical site (pelvis/other), chemotherapy, biological reconstruction, augmentation of artificial bone or bone cement, the use of an implant, intraoperative blood loss, operative time, additional surgery for complications, and postoperative deep infection were evaluated. Results: The rate of postoperative deep infection was 3.2% (27/844 tumors). A pelvic tumor (odds ratio [OR]: 3.4, 95% confidence interval [CI]: 1.0–11.3) and use of an implant (OR: 9.3, 95% CI: 1.9–45.5) were associated with an increased risk of deep infection. Conclusions: This retrospective study showed that pelvic tumor and use of an implant were independent risk factors for deep infection. This information will help surgeons prepare an adequate surgical plan for patients with bone tumors. © 2017 Miwa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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| 2.
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多田, 薫 ; Tada, Kaoru
概要:
取得学位：博士(工学)，学位授与番号：博乙第301号，学位授与年月日：平成18年3月22日,学位授与年：2006
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Abe, Kensaku ; Takeuchi, Akihiko ; Yamamoto, Norio ; Hayashi, Katsuhiro ; Tada, Kaoru ; Miwa, Shinji ; Inatani, Hiroyuki ; Aoki, Yu ; Higuchi, Takashi ; Tsuchiya, Hiroyuki
概要:
Postoperative neurological deficits of schwannomas are the complications that we want to avoid most. Predicting postoper
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ative neurological deficits is crucial; however, the correlation between preoperative symptoms and neurological findings with postoperative neurological complications has not yet been completely clarified. Here we analyzed the risk factors for postoperative neurological complications. The study included 131 tumors from 107 patients histologically confirmed as schwannomas, which developed in the extremities and trunk without spinal cord involvement. The correlation between clinical findings and postoperative complications were statistically analyzed. One-hundred three tumors (78.6 %) had the preoperative neurological symptoms; these symptoms were detected in 93.3 % of small tumors (<4 cm3). We defined it as follows about the anatomical location of schwannomas. One is “central type” that normal nerve bundles widely splayed over the tumor’s capsule (tumor located in the central region of the nerve). Another is “peripheral type” that easy to enucleate without neurolysis (tumor located in the peripheral region of the nerve). Static analysis showed a significant difference in the Tinel sign, numbness, and postoperative neurological deficits (p = 0.04, 0.006, p < 0.001, respectively). Twenty-one cases (16.0 %) showed new postoperative neurological symptoms, including numbness in 12 cases, dysesthesia in three cases, pain in three cases, and slight motor palsy in two cases. In statistical analysis, small tumors (<4 cm3) significantly correlated with Tinel sign (p < 0.001), and was marginally significant with postoperative neurological deficits (p = 0.05). Moreover, small tumors (<4 cm3) accompanying numbness preoperatively significantly correlated with postoperative neurological deficits (p = 0.04). Small (<4 cm3) tumors significantly correlated with the preoperative neurological symptoms. Those tumors accompanying numbness also significantly correlated with the difficulty of the enucleation and postoperative neurological deficits. These findings will help to predict the neurological complication. © 2015, Abe et al.
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| 4.
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Suganuma, Seigo ; Tada, Kaoru ; Hayashi, Hiroyuki ; Segawa, Takeshi ; Tsuchiya, Hiroyuki
概要:
Ulnar nerve palsy is a rare complication of closed midshaft forearm fractures; only 8 cases have been reported. This article describes a case of ulnar nerve palsy associated with a midshaft forearm fracture. A 12-year-old girl sustained
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a right midshaft forearm fracture. Whether she had a peripheral nerve injury was unknown due to strong pain. She underwent emergency manual reduction and intramedullary pinning. However, ulnar nerve palsy was remarkable postoperatively and gradually worsened. Therefore, neurolysis was performed 9 weeks later. The nerve had adhered to surrounding scar tissue. Six months after a second surgery, she had no motor dysfunction. The pathogenesis of ulnar nerve palsy complicated with midshaft forearm fractures varies and may be the result of direct contusion, direct damage by a bony spike, bony entrapment after closed reduction, and entrapment by a scar. In the current case, the patient was uncooperative at initial examination. Therefore, it is unknown whether she presented with immediate ulnar nerve palsy after the fracture. However, the ulnar nerve was not entrapped at the fracture site, and the surrounding muscle was intact but adhered to the surrounding scar tissue. The etiology of this case was considered to be entrapment by scar formation. According to a literature search, the authors recommend exploring the nerve approximately 8 to 10 weeks after primary surgery, after which neurological symptoms do not tend to improve.
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多田, 薫 ; Tada, Kaoru
概要:
金沢大学医薬保健研究域医学系<br />手関節を牽引しながら他動的に掌背屈させる手関節の可動域訓練の効果について報告してきた。今回、牽引力及び牽引方向を定量化可能な実験装置を使用して、他動掌背屈運動時の橈骨手根関節及び手根中央関節の挙動につ
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いて、健常男性10例を対象としてMRIで評価した。その結果、手関節の牽引により中間位及び背屈位において月状骨が背屈方向に回転し、RL関節角度変化量が増加することが判明した。この効果は橈骨手根関節の可動域回復を目的としたリハビリテーションに有効であると考えられる。牽引によりRL関節及びCL関節の骨間距離は中間位、背屈位で開大していたが、このことが牽引の効果に関連していると考えられる。<br />Traction was applied to 10 hands from 10 healthy adults using an experimental device that allowed distraction in a constant direction with a constant traction force, to compare changes in the angles and joint spaces of the radiolunate joint and capitolunate joints using MRI.A significant increase was noted in the angle of the radiolunate joint in the neutral and extended positions, with a significant widening of the joint space in the capitolunate joint. Results suggest this device would be effective in rehabilitation aimed at recovering range of motion.<br />研究課題/領域番号:15K21018, 研究期間(年度):2015-04-01 - 2017-03-31
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論文
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多田, 薫 ; Tada, Kaoru
概要:
金沢大学医薬保健研究域医学系<br />生体吸収性チューブ内に脂肪幹細胞の細胞シートを封入するモデル、同種処理神経に脂肪幹細胞の細胞シートを付加するモデルについて検討しました。その結果、細胞シートを封入、付加した群はしない群に比べ有意に機能
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的な回復が得られることが判明しました。またその機序として、再生組織内のシュワン細胞数の増加やVEGFやNeuregulin-1等の遺伝子発現の増加が関与していることを確認しました。細胞シートの神経再生促進効果について今後も研究を継続する計画です。<br />We examined a model in which a cell sheet of adipose derived stem cells was enclosed in a bioabsorbable tube, and a model in which a cell sheet of adipose derived stem cells was added to decellularized allogeneic nerve. As a result, it was revealed that the group with the cell sheet had significantly higher functional recovery than the group without the cell sheet. In addition, we confirmed that the mechanism involved was an increase in the number of Schwann cells and an increase in gene expression of VEGF and Neurogulin-1 in the regenerated tissue. We plan to continue research on the neural regeneration promoting effect of cell sheet of adipose derived stem cells.<br />研究課題/領域番号:17K09030, 研究期間(年度):2017-04-01 - 2020-03-31<br />出典：「脂肪由来幹細胞の細胞シートによる末梢神経の再生に関する研究」研究成果報告書 課題番号17K09030（KAKEN：科学研究費助成事業データベース（国立情報学研究所））（https://kaken.nii.ac.jp/report/KAKENHI-PROJECT-17K09030/17K09030seika/)を加工して作成
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