Publications by authors named "Kenichiro Kakutani"
Cancer stem cells (CSCs) have been implicated as critical mediators in the progression, chemoresistance and metastatic capabilities of diverse malignancies, including osteosarcoma (OS). The authors have succeeded in generating CSC‑like cells (MG‑OKS) from the OS cell line MG‑63 by transducing defined factors. A significant increase in small proline‑rich protein 1A (SPRR1A) expression, a cross‑linked envelope protein in keratinocytes, was observed in MG‑OKS cells.
View Article and Find Full Text PDFThe mammalian target of rapamycin (mTOR), a serine/threonine kinase, promotes cell growth and inhibits autophagy. The following two complexes contain mTOR: mTORC1 with the regulatory associated protein of mTOR (RAPTOR) and mTORC2 with the rapamycin-insensitive companion of mTOR (RICTOR). The phosphatidylinositol 3-kinase (PI3K)/Akt/mTOR signaling pathway is important in the intervertebral disk, which is the largest avascular, hypoxic, low-nutrient organ in the body.
View Article and Find Full Text PDFArticle Synopsis
- * Out of 451 patients over 65 years with cervical fractures, 69% had mid-cervical injuries while 31% had lower-cervical injuries, with lower-cervical injuries being linked to more high-energy trauma cases.
- * Although lower-cervical injuries resulted in fewer muscle weaknesses compared to mid-cervical injuries, many patients still experienced neurological deficits and similar overall complication rates after treatment, such as respiratory issues but no significant differences in mortality or mobility outcomes.
Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.
View Article and Find Full Text PDFAims: Frailty has been gathering attention as a factor to predict surgical outcomes. However, the association of frailty with postoperative complications remains controversial in spinal metastases surgery. We therefore designed a prospective study to elucidate risk factors for postoperative complications with a focus on frailty.
View Article and Find Full Text PDFArticle Synopsis
- The study examines how the preoperative Spine Instability Neoplastic Score (SINS) relates to surgical decisions and patient outcomes in spinal metastases patients.
- The research involved 317 patients and assessed various factors like surgery type, existing conditions, and postoperative health indicators over 6 months.
- Findings revealed that SINS did not correlate with life expectancy, all patient-reported outcomes improved post-surgery, and surgical approach (especially fusion vs. non-fusion) didn't significantly impact these outcomes.
Study Design: Prospective multicenter study.
Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.
Article Synopsis
- Dysphagia, a serious swallowing disorder, affects older adults post-spinal cord injury, particularly those with cervical injuries, though its risk factors are not well understood.
- A study involving 707 patients aged 65 and older identified male sex, low nutritional status (GNRI <92), dementia, fractures, complete paralysis, anterior surgery, and tracheostomy as significant risk factors for dysphagia.
- The findings suggest that a low geriatric nutritional risk index (GNRI) is a key indicator of dysphagia risk, implying that nutritional health is critical for recovery in elderly patients with cervical spinal injuries.
Background: Pediatric lumbar spondylolysis, a stress fracture of the lumbar spine, frequently affects young athletes, and nonoperative treatment is often the first choice of management. Because the union rate in lumbar spondylolysis is lower than that in general fatigue fractures, identifying risk factors for nonunion is essential for optimizing treatment.
Purpose: To determine the risk factors for nonunion after nonoperative treatment of acute pediatric lumbar spondylolysis through multivariate analysis.
Article Synopsis
- The study investigated the postoperative outcomes for patients with spinal metastases from prostate cancer, focusing on improvements in their quality of life and other patient-oriented assessments.
- Conducted across 35 centers, the research assessed 413 patients, with 41 specifically having prostate cancer, and followed them for at least a year following surgery using various evaluation methods.
- Results showed significant improvements in neurological function, quality of life, and patient motivation post-surgery, indicating that surgical intervention is beneficial for these patients.
Objective: To evaluate the preoperative and perioperative predictors of persistent leg numbness following lumbar fusion in patients aged ≥ 75 years.
Methods: This single-center retrospective study examined 304 patients aged ≥ 75 years who underwent lumbar fusion for lumbar degenerative disease (102 men, 202 women; mean age, 79.2 [75-90] years).
Objective: Spine surgeons are often at risk of radiation exposure due to intraoperative fluoroscopy, leading to health concerns such as carcinogenesis. This is due to the increasing use of percutaneous pedicle screw (PPS) in spinal surgeries, resulting from the widespread adoption of minimally invasive spine stabilization. This study aimed to elucidate the effectiveness of smart glasses (SG) in PPS insertion under fluoroscopy.
View Article and Find Full Text PDF: Changes in activities of daily living (ADL) and quality of life (QOL) of patients with bone metastasis who underwent surgical treatment through Bone Metastasis Cancer Boards (BMCBs), a recent multidisciplinary approach for managing bone metastases, have been reported; however, no reports exist on patients who undergo conservative treatment. In this study, we aimed to evaluate these patients' ADL and QOL and examine the factors influencing changes in these parameters. : We retrospectively reviewed 200 patients with bone metastases who underwent conservative therapy through BMCBs between 2013 and 2021.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to determine minimal clinically important differences (MCIDs) for patients undergoing surgery for spinal metastases to improve patient care by linking quality of life assessments with clinical outcomes.
- A total of 171 patients were evaluated pre- and post-surgery using various scales, leading to the identification of specific MCID values for different quality of life aspects based on their treatment outcomes.
- The study successfully established both anchor-based and distribution-based MCIDs for surgical interventions, which can help in assessing patient progress and overall treatment effectiveness.
Article Synopsis
- - Sacral fatigue fractures, although rare, should be considered in young adults experiencing low back and buttock pain, with most existing reports focusing mainly on long-distance runners.
- - A study analyzed 34 young athletes (aged 11-19, mean age 15) diagnosed with these fractures, revealing that a majority were active in sports such as long-distance running, baseball, basketball, and soccer.
- - Most patients returned to their sports after a median of 48 days with physical therapy, but 2 cases of recurrence were noted, indicating the need for careful management of such injuries.
Article Synopsis
- This study examined how malnutrition affects older patients (65+) with cervical spinal cord injuries and their outcomes after treatment.
- Among 789 patients, 6% had major nutritional risks at the start, which impacted their survival and recovery.
- Results showed that those with major nutritional risks had a significantly higher death rate, shorter lifespan, less neurological improvement, and greater difficulty with daily activities a year after their injury compared to matched controls.
Study Design: Retrospective cohort study.
Objectives: To define the prognosis and predictive factors for neurological improvement in older patients with incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale grade C (AIS-C).
Settings: Multi-institutions in Japan.
Objective: To elucidate the patient characteristics and outcomes of emergency surgery for spinal metastases and identify risk factors for emergency surgery.
Methods: We prospectively analyzed 216 patients with spinal metastases who underwent palliative surgery from 2015 to 2020. The Eastern Cooperative Oncology Group performance status, Barthel index, EuroQol-5 dimension (EQ5D), and neurological function were assessed at surgery and at 1, 3, and 6 months postoperatively.
Study Design: Multicenter case-control study.
Objective: To identify imaging characteristics of the cervical spine in patients with retro-odontoid pseudotumor (ROP) without rheumatoid arthritis (RA) and determine the pathogenesis of ROP.
Background: ROP results from proliferative changes in the soft tissue of the atlantoaxial junction surrounding the region of the transverse ligament, and is commonly seen in RA patients.
Study Design: Retrospective multicenter study.
Objectives: The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear.
: Bone metastasis cancer boards (BMCBs) focusing on the management of bone metastases have been gathering much attention. However, the association of BMCBs with spinal surgery in patients with spinal metastases remains unclear. In this retrospective single-center observational study, we aimed to clarify the effect of a BMCB on spinal metastasis treatment.
View Article and Find Full Text PDFStudy Design: Retrospective case series.
Objective: To report the detailed bone fusion rates and duration of treatment in unilateral and bilateral cases of pediatric lumbar spondylolysis (LS).
Summary Of Background Data: Early diagnosis and optimal conservative management for LS are crucial for achieving bony healing without surgery.
We investigated the effects of the cytokine inhibitors IL-1 receptor antagonist (IL-1Ra) and soluble tumor necrosis factor receptor-1 (sTNFR1) on the extracellular matrix metabolism of human intervertebral discs (IVDs) and the roles of IL-1β and TNF in the homeostasis of IVD cells. The 1.2% alginate beads and the explants obtained from 35 human lumbar discs were treated with cytokine inhibitors.
View Article and Find Full Text PDFThe number of advanced-age patients with spinal metastases is rising. This study was performed to clarify the characteristics and surgical outcomes of spinal metastases in advanced-age patients. We prospectively analyzed 216 patients with spinal metastases from 2015 to 2020 and divided them into three age groups: <70 years ( = 119), 70-79 years ( = 73), and ≥80 years ( = 24).
View Article and Find Full Text PDF