大腿四頭筋の等尺性収縮は、膝蓋上外側アプローチによる膝関節内注射の正確性を向上する

Background: Intra-articular injection is an important technique for treating rheumatoid arthritis and osteoarthritis of the knee. However, medication is often inaccurately injected outside of the joint. We devised an intra-articular injection method in which the needle is inserted into the suprapatellar bursa while the patient maintains isometric contraction of the quadriceps. This isometric contraction method is based on the concept that isometric contraction of the quadriceps induces contraction of the articularis genus muscle, thus expanding the lumen of the suprapatellar bursa. Methods: Intra-articular injections were performed on 150 osteoarthritic knees without effusion. The knees were alternately assigned to the isometric quadriceps method group (75 knees) and non-activated quadriceps method group (75 knees). Prior to joint injection, the anterior-posterior dimension of each suprapatellar bursa was measured to ascertain its expansion. The isometric quadriceps method was performed with the quadriceps and the articularis genus muscle maintained in a contracted state. The non-activated quadriceps method was performed in a relaxed state. Ultrasound guidance was not used for either method. Subsequently, an ultrasonic probe was used only to confirm whether the intra-articular injections were successful. We compared the accuracy of injections performed between the 2 groups. Results: Suprapatellar expansion was significantly larger (p < 0.001) using the isometric quadriceps method (2.1 ± 1.4 mm [range, 0 to 5 mm]) than using the non-activated quadriceps method (0.8 ± 0.7 mm [range, 0 to 2 mm]). The percentage of accurate intra-articular injections was significantly higher (p = 0.0287) using the isometric quadriceps method (93%) compared with the non-activated quadriceps method (80%). Conclusions: In comparison with the non-activated quadriceps method, the isometric quadriceps method led to a larger expansion of the suprapatellar bursa, which should lead to more accurate intra-articular injections. The isometric quadriceps method is effective in reducing inaccurate injections into the synovium or surrounding fatty tissues. Clinical relevance: Putting force on the quadriceps muscle increases the success rate of intra-articular injection of the knee. The results of this study could provide a clinically relevant injection technique for future treatment.博士（医学）・乙第1448号・令和元年12月5日Copyright © 2018 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND https://creativecommons.org/licenses/by-nc-nd/4.0/), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal

内側楔状開大式高位脛骨骨切り術後の3次元T1ρ-mappingを用いた軟骨定量評価

Purpose: To evaluate the recently developed three-dimensional (3D) T1ρ-mapping technique for the quantitative evaluation of cartilage changes after open-wedge high tibial osteotomy (OWHTO). Method: Eleven patients with medial knee osteoarthritis and spontaneous osteonecrosis of the medial femoral condyle underwent T1ρ magnetic resonance imaging. The full-thickness cartilage of the medial femoral condyle (MFC), lateral femoral condyle, medial tibial condyle, and lateral tibial condyle, and the trochlea and patella were set as regions of interest; mean T1ρ values were calculated using two-dimensional (2D) and 3D analyses. The state of cartilage injury was evaluated using the International Cartilage Repair Society grading system (ICRS grade). T1ρ values before OWHTO and after hardware removal were compared using the Wilcoxon signed-rank test. The correlation between T1ρ values and the ICRS grade was explored using the Spearman rank correlation coefficient. Results: Cartilage repair at the MFC was observed in a high proportion of patients (82%), but 2D analysis did not reveal a significant difference after surgery at any site. In contrast, 3D analysis revealed a significant decrease in T1ρ values after surgery at the MFC (before surgery: 44.1 ms; after surgery: 38.9 ms; p = 0.016), but no significant difference at any other site. In the MFC, there was a positive correlation between 3D T1ρ values and arthroscopic findings before and after surgery (rs = 0.62, p < 0.01), which was absent from the 2D T1ρ values. Conclusions: 3D T1ρ-mapping may be an effective tool for detecting changes in cartilage quality after OWHTO.博士（医学）・甲第848号・令和4年9月28日© 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/)

国際比較調査データを用いた「幸福観」の日韓比較

Open House, ISM in Tachikawa, 2018.6.15統計数理研究所オープンハウス（立川）、H30.6.15ポスター発

震災復旧と地域の「絆」――ソーシャル・キャピタルと支援行動および復旧認知の関連に着目して ―

Open House, ISM in Tachikawa, 2014.6.13統計数理研究所オープンハウス（立川）、H26.6.13ポスター発