|
Affiliation |
Faculty of Medicine College Hospital Orthopedics department |
|
Title |
Assistant Professor |
|
External Link |
|
|
Related SDGs |
|
NAGASAWA Makoto
|
|
|
Papers 【 display / non-display 】
-
悪性腫瘍と鑑別を要した原発性結核膿瘍の1例 Reviewed
鮫島 勇汰, 大田 智美, 田島 卓也, 山口 奈美, 長澤 誠, 森田 雄大, 横江 琢示, 土屋 慧祐, 帖佐 悦男, 亀井 直輔
整形外科と災害外科 74 ( 4 ) 827 - 830 2025.9
Authorship：Lead author, Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会
【はじめに】転移性結核膿瘍の報告は散見されるが，原発病変のない結核膿瘍は稀である．悪性腫瘍と鑑別を要した原発性結核膿瘍の1例を経験したので報告する．【症例】73歳男性．誘因なく背部腫瘤を自覚し，MRIで背部皮下に8×7 cm大で中心部T2 high，T1 low，辺縁部T2 high，lowが混在し，一部胸腔内に浸潤した腫瘤を認めた．PETCTでも腫瘤に高度集積あり，悪性軟部腫瘍を疑った．切開生検術の際，多量の排膿あり，培養で<i>M. tuberculosis</i>が同定され，結核膿瘍の診断となった．INH，RFP，EB，PZAの内服を12か月継続し，現在再発は認めていない．【考察】原発巣のない結核膿瘍は非常に稀であり，炎症で見られる疼痛・発赤・熱感に乏しいことが多く，画像上も悪性腫瘍を疑ったため，排膿を確認するまで結核膿瘍を疑えなかった症例である．結核膿瘍の診断について，文献的考察を加え報告する．
-
ハムストリング近位部損傷における当科での2例の手術経験 Reviewed
土屋 慧祐, 森田 雄大, 田島 卓也, 山口 奈美, 大田 智美, 長澤 誠, 横江 琢示, 帖佐 悦男, 亀井 直輔
整形外科と災害外科 74 ( 3 ) 634 - 636 2025.9
Authorship：Lead author, Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会
【はじめに】ハムストリングの肉ばなれはスポーツ外傷において比較的頻繁に経験するが，手術に至るケースは稀である．今回，ハムストリング腱近位部損傷において手術加療を要した2例を経験したので報告する．【症例1】22歳男性，実業団柔道選手．練習中に強制開脚位となり受傷．MRIにて大腿二頭筋腱，半腱様筋腱の坐骨結節からの断裂（JISS分類：3型3度）と診断し手術を施行した．術後6か月で競技復帰し経過良好であった．【症例2】17歳男性，走高跳選手．跳躍時に踏み込んだ際に左臀部痛自覚．MRIにて大腿二頭筋腱損傷（JISS分類：2型3度）と診断し手術施行した．術後3か月で競技復帰し経過良好であった．【考察】スポーツ選手においてハムストリング腱の3型3度損傷は絶対的手術適応であるが，2型損傷においても手術加療を選択する場合がある．今回，2型，3型損傷に対して手術加療を行い，再損傷なく元のレベルに競技復帰可能であり良好な成績を得た．
-
Morita Y., Tajima T., Yamaguchi N., Yokoe T., Nagasawa M., Ota T., Ouchi K., Chosa E.
Scientific Reports 14 ( 1 ) 6192 2024.12
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Scientific Reports
Posterior tibial translation (PTT) after double-bundle posterior cruciate ligament (PCL) reconstruction has sometimes occurred. Purpose of this study is to identify the risk factors for postoperative PTT after double-bundle PCL reconstruction with a hamstring autograft. Comparing the results of bilateral gravity sag view (GSV) at 12 months after surgery, over 5-mm PTT was defined as ‘failure’ in this study. Of 26 isolated PCL reconstruction cases, over 5-mm PTT was seen in 7 cases (group F: 9.57 ± 1.28 mm), and 19 cases had less than 5 mm (group G: 2.84 ± 1.29 mm). Age, sex, body mass index (BMI), preoperative GSV, posterior slope angle of the tibia, anterolateral bundle (ALB) and posteromedial bundle (PMB) graft diameters, and tibial tunnel diameter were evaluated. The two groups were compared with the 2 × 2 chi-squared test, the Mann Whitney U-test, and Spearman’s rank correlation coefficient. Multivariate logistic regression analysis was also performed to determine the risk factor. Statistical significance was indicated as p < 0.01 for correlation with postoperative PTT, and as p < 0.05 for all other comparisons. Mean age (group G 31.8 ± 12.5 vs group F 34.9 ± 15.9 years), sex (male/female: 15/4 vs 3/4), BMI (25.6 ± 4.6 vs 24.9 ± 3.9 kg/m<sup>2</sup>), preoperative GSV (11.3 ± 2.2 vs 11.6 ± 2.9 mm), PMB diameter (5.37 ± 0.33 vs 5.36 ± 0.48 mm), and tibial tunnel diameter (9.32 ± 0.58 vs 9.29 ± 0.49 mm) showed no significant differences. ALB diameter was significantly greater in group G (7.0 ± 0.5 mm) than in group F (6.5 ± 0.29 mm; p = 0.022). There was also a significant difference in posterior tibial slope angle (group G 9.19 ± 1.94 vs group F 6.54 ± 1.45, p = 0.004). On Spearman rank correlation coefficient analysis, ALB diameter GSV (correlation coefficient: − 0.561, p = 0.003) and posterior tibial slope angle (correlation coefficient: − 0.533, p = 0.005) showed a significant correlation with postoperative PTT. Multivariate logistic regression analysis showed that ALB diameter (OR 19.028; 95% CI 1.082–334.6; p = 0.044) and posterior slope angle of tibia (OR 3.081; 95% CI 1.109–8.556; p = 0.031) were independently associated with postoperative PTT, respectively. In double-bundle PCL reconstruction with hamstring, smaller ALB graft diameter and lower (flatted) tibial slope angle were considered risk factors for postoperative PTT.
-
Direct repair of the chronic ochronotic Achilles tendon rupture: a case report Reviewed
Yokoe T., Nagasawa M., Tajima T., Yamaguchi N., Ota T., Morita Y., Chosa E.
BMC Musculoskeletal Disorders 25 ( 1 ) 843 2024.12
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：BMC Musculoskeletal Disorders
Background: Alkaptonuria (AKU) is a rare hereditary disease. Ochronotic arthropathy, tendinopathy, and osteopenia/osteoporosis are generally musculoskeletal manifestations in patients with AKU. Because of the ochronotic tendinopathy and osteopenia, the surgical strategy for chronic ochronotic Achilles tendon rupture may be challenging. No studies have reported the surgical treatment of chronic Achilles tendon rupture in patients with AKU. Case presentation: We report a case of AKU that required surgical treatment for chronic Achilles tendon rupture. A 60-year-old woman was referred to our department for the assessment of left hindfoot pain that persisted for more than nine months after an ankle sprain. Three years prior to the first presentation to our hospital, she was diagnosed with AKU due to pigmented hip cartilage at the time of total hip arthroplasty. The patient was diagnosed as chronic Achilles tendon rupture based on the results of physical examination and magnetic resonance imaging (MRI). The MRI showed enlarged scar tissue of the Achilles tendon with an intrasubstance high signal intensity. We performed resection of the central part of the scar tissue (total length, 24 mm) followed by direct repair using the proximal and distal stumps of the scar tissue. The MRI at 12months after surgery showed continuity of the repaired Achilles tendon. At 18 months after surgery, the Achilles Tendon Total Rupture Score improved from 22 points preoperatively to 84 points postoperatively. The foot and ankle outcome score also improved. Conclusions: We reported a case of AKU with chronic Achilles tendon rupture in which direct repair using scar tissue between the tendon stumps was effective. Careful selection of the surgical procedure for the treatment of chronic ochronotic Achilles tendon rupture is recommended because of concomitant ochronotic tendinopathy and osteopenia/osteoporosis.
-
リファンピシン使用によりステロイド作用が減弱し治療に難渋した手関節非結核性抗酸菌症の1例 Reviewed
松永 美穂, 大田 智美, 田島 卓也, 山口 奈美, 長澤 誠, 森田 雄大, 横江 琢示, 帖佐 悦男
整形外科と災害外科 73 ( 3 ) 602 - 605 2024.9
Authorship：Lead author, Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会
【はじめに】ステロイド薬は他薬との薬物相互作用が比較的少なく汎用されるが，抗結核薬のリファンピシン（以下RFP）との相互作用はあまり知られていない．ネフローゼ症候群加療中に非結核性抗酸菌症（以下NTM）を合併し，ステロイドとRFPの併用で原疾患およびNTMの治療に難渋した1例を経験した．【症例】41歳男性，21歳時にネフローゼ症候群と診断され，ステロイドを内服中に手関節掌背側の腫脹を認め，滑膜切除術後に非結核性抗酸菌性滑膜炎の診断となった．RFPを含む抗結核薬3剤を開始したところ，ネフローゼ症候群が悪化しステロイドを増量，尿蛋白は改善するも手関節腫脹が再発し，2回目の滑膜切除術施行後，高気圧酸素療法で感染は鎮静化した．【考察】NTMにはRFPが汎用されるが，ステロイドとの相互作用により治療に難渋することがある．薬物の相互作用を十分に熟知し，NTMの治療にあたる必要がある．
MISC 【 display / non-display 】
-
What do you sew a rotator cuff tear with? Reviewed
41 ( 11 ) 68 - 76 2022.10
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
-
鎖骨骨折 Invited
長澤誠
整形外科看護 23 ( 11 ) 18 - 19 2018.11
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：MCメディカ出版
-
肩関節の必須解剖知識 Invited
長澤誠
整形外科看護 23 ( 11 ) 10 - 11 2018.11
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：MCメディカ出版
-
肩関節周囲炎 Invited
長澤誠
整形外科看護 23 ( 11 ) 12 - 13 2018.11
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：MCメディカ出版
-
肩腱板断裂 Invited
長澤誠
整形外科看護 23 ( 11 ) 14 - 15 2018.11
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：MCメディカ出版
Presentations 【 display / non-display 】
-
上腕骨小頭離断性骨軟骨炎に対する骨軟骨柱移植術
長澤誠、帖佐悦男
第36回日本肘関節学会学術集会 2024.3.1
Event date： 2024.3.1 - 2024.3.2
Presentation type：Oral presentation (general)
-
遠井上腕二頭筋腱断裂の2例
大野鉄平、大田智美、長澤誠、帖佐悦男
第36回日本肘関節学会学術集会 2024.3.1
Event date： 2024.3.1 - 2024.3.2
Presentation type：Oral presentation (general)
-
徒手前方引き出しテストとストレス超音波検査による足関節回旋不安定性の関係
横江琢示、田島卓也、山口奈美、大田智美、長澤誠、森田雄大、帖佐悦男
第35回九州・山口スポーツ医・科学研究会 2023.12.9
Event date： 2023.12.9
Presentation type：Oral presentation (general)
-
大腿骨膝蓋面に生じた骨軟骨病変に対して自家骨軟骨柱と吸収ピンが骨接合に必要であった1例
肥後聖、横江琢示、田島卓也、山口奈美、大田智美、長澤誠、森田雄大、帖佐悦男
第35回九州・山口スポーツ医・科学研究会 2023.12.9
Event date： 2023.12.9
Presentation type：Oral presentation (general)
-
少年野球検診の投球障害に関する危険因子
長澤誠、田島卓也、山口奈美、大田智美、森田雄大、横江琢示、肥後聖、帖佐悦男
第35回九州・山口スポーツ医・科学研究会 2023.12.9
Event date： 2023.12.9
Presentation type：Oral presentation (general)
Other research activities 【 display / non-display 】
-
NPB12球団ジュニアトーナメント2015
2015.12
野球の大会への医師派遣
-
青島太平洋マラソン2015
2015.12
マラソン大会への医師派遣