研究者業績

阿部 幸喜

アベ こうき  (Koki Abe)

基本情報

所属
千葉大学 医学部附属病院 特任講師
学位
先端医学薬学(2018年3月 千葉大学大学院医学薬学府)

研究者番号
80409151
J-GLOBAL ID
202201013270220954
researchmap会員ID
R000042443

研究キーワード

 2

主要な論文

 286
  • Koki Abe, Kazuhide Inage, Kensuke Yoshimura, Daisuke Sato, Keishi Yamashita, Masaomi Yamashita, Toshihide Sasaki, Akiyoshi Yamaoka, Yasuhiro Shiga, Yawara Eguchi, Sumihisa Orita, Seiji Ohtori
    Journal of Orthopaedic Science 2023年11月  査読有り筆頭著者
  • Koki Abe, Hirokazu Kawase, Noriaki Yokogawa, Keishi Yamashita, Masaomi Yamashita, Toshihide Sasaki, Akiyoshi Yamaoka, Yasuhiro Shiga, Satoshi Maki, Kazuhide Inage, Yawara Eguchi, Sumihisa Orita, Seiji Ohtori
    Journal of Orthopaedic Science 2023年2月  査読有り筆頭著者
    BACKGROUND: The Japanese Orthopedic Association launched the Japanese Orthopedic Association National Registry (JOANR), Japan's first large-scale nationwide musculoskeletal disease registry, in 2020. The World Health Organization released the International Classification of Health Interventions (ICHI) Beta-3 version in the same year. This concurrence served as an impetus to examine the relationship between domestic and international classification for orthopedic interventions. Our objective was to evaluate the possibility of utilizing JOANR for international comparison and the potential usage of ICHI in the domestic medical fee reimbursement system. This study is a novel attempt at mapping a domestic orthopedic scheme to the ICHI. METHODS: We mapped 149 codes out of 581 orthopedic surgical codes, on JOANR's registration form, to the ICHI, and then classified the nature of JOANR codes' relationship, to both ICHI single stem codes and stem codes accompanied by other additional stem codes, extension codes, and International Classification of Diseases for Mortality and Morbidity Statistics (ICD) codes, into five categories: Equivalent (exact match), Narrower (compared to ICHI; can be smoothly incorporated into ICHI), Broader (compared to ICHI), Slipped (combination of both Narrower and Broader), and None (no appropriate code). Finally, debatable issues that arose during the mapping operation were noted. RESULTS: The domestic codes' relationship to ICHI single stem code by category were Equivalent: 27 (18.1%) and Narrower: 65 (43.6%), respectively. Further, the rate of Equivalent rose to 120 (80.5%) on adding other stem codes, extension codes, and ICD codes. Additionally, certain domestic titles, which were unsuitable for classification as they included diagnostic information, and arthroscopic surgeries without corresponding ICHI codes, were recoded. CONCLUSIONS: JOANR can be converted to an international comparison standard via ICHI to a certain extent, and ICHI accompanied by ICD codes has potential for deployment in the domestic medical fee reimbursement system.
  • Takuya Sakamoto, Koki Abe, Sumihisa Orita, Kazuhide Inage, Miyako Suzuki, Kazuki Fujimoto, Yasuhiro Shiga, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Masaki Norimoto, Tomotaka Umimura, Yawara Eguchi, Kazuhisa Takahashi, Seiji Ohtori
    Clinical case reports 7(1) 206-210 2019年1月  
    The incidence of spinal fusion surgery and associated adjacent segment disease (ASD) is steadily increasing. We report three cases of ASD after posterior fixation, treated by oblique lateral interbody fusion (OLIF). All cases had a good postoperative course. Altogether, OLIF surgery may be a viable option for treating ASD.
  • Koki Abe, Kazuhide Inage, Sumihisa Orita, Yoshihiro Sakuma, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Masaki Norimoto, Tomotaka Umimura, Ikuko Tajiri, Miyako Suzuki, Yawara Eguchi, Kazuhisa Takahashi, Seiji Ohtori
    Spine surgery and related research 2(4) 324-330 2018年10月26日  査読有り筆頭著者
    INTRODUCTION: Thus far, few reports have described the time series histological variations in injured paravertebral muscle tissues for long durations, considering the type of pain. The purpose of this study is to evaluate histological changes in injured paravertebral muscles and dominant nerves considering the type of pain. METHODS: We used 59 eight-week-old male Sprague-Dawley rats. A 115-g weight was dropped from a height of 1 m on the right paravertebral muscle. Fluoro-Gold (FG), a sensory nerve tracer, was injected into this muscle. Hematoxylin and eosin (HE) staining and nerve growth factor (NGF) immunostaining of the muscle were performed for histological evaluation. L2 dorsal root ganglia (DRG) on both sides were resected, and immunohistochemical staining was performed for calcitonin gene-related peptide (CGRP, a pain-related neuropeptide) and for activating transcription factor 3 (ATF3, a neuron injury marker). Each examination was performed at 3 days, 1-3 weeks, and 6 weeks after injury. RESULTS: HE staining of the paravertebral muscle indicated infiltration of inflammatory cells and the presence of granulation tissue in the injured part on the ipsilateral side at 3 days and 1 week after the injury. Fibroblasts and adipocytes were present at 2-3 weeks. At 6 weeks, the injured tissue was almost completely repaired. NGF was detected at 2-3 weeks post injury and appeared to colocalize with fibroblasts, but was not observed at 6 weeks post injury. The percentage of cells double-labeled with FG and CGRP in FG-positive cells of the primary muscle was significantly higher in the injured side at 3 days and 1-3 weeks post injury (P < 0.05). However, at 6 weeks, no significant difference was observed. No significant expression of ATF3 was observed. CONCLUSIONS: These results suggest that sensitization of the dominant nerve in the DRG, in which NGF may play an important role, can protract pain in injured muscles.
  • Koki Abe, Kazuhide Inage, Keishi Yamashita, Masaomi Yamashita, Akiyoshi Yamamaoka, Masaki Norimoto, Yoshinori Nakata, Takeshi Mitsuka, Kaoru Suseki, Sumihisa Orita, Kazuki Fujimoto, Yasuhiro Shiga, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Tomotaka Umimura, Yawara Eguchi, Takeo Furuya, Kazuhisa Takahashi, Seiji Ohtori
    Annals of rehabilitation medicine 42(4) 569-574 2018年8月  査読有り筆頭著者
    OBJECTIVE: To validate the relationship between residual walking ability and monthly care cost as well as long-term care insurance (LTCI) certification level in elderly patients after surgical treatment for hip fractures in Japan. METHODS: Elderly patients aged >75 years who underwent surgical treatment for hip fractures in our hospital were included. The preand post-surgical (6-month) walking ability and LTCI certification and the presence or absence of dementia was determined from medical records and questionnaires. Walking ability was classified into 6 levels used in our daily medical practice. Based on these data, we correlated the relationship between walking ability and the LTCI certification level. Further, based on the official statistics pertaining to the average monthly costs per person at each LTCI certification level, we evaluated the relationship between walking ability and monthly care cost. RESULTS: A total of 105 cases (mean age, 80.2 years; 16 men; 39 patients with dementia) were included. The correlation between walking ability and average monthly cost per person as well as LTCI certification level at 6 months postoperatively (r=0.58) was demonstrated. The correlation was found in both groups with and without dementia. CONCLUSION: The ability to walk reduced the cost of care in elderly patients who experienced hip fracture, regardless of the presence of dementia.
  • Kenji Kubota, Koki Abe, Sumihisa Orita, Kazuhide Inage, Miyako Suzuki, Jun Sato, Kazuki Fujimoto, Yasuhiro Shiga, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Masaki Norimoto, Tomotaka Umimura, Kazuhisa Takahashi, Seiji Ohtori
    Clinical case reports 6(4) 669-673 2018年4月  
    In daily practice, when CT or MRI does not show a pathological lesion in a patient with persistent abnormal neurological signs, it is important to obtain imaging studies of the spine in dynamic position.
  • Koki Abe, Kazuhide Inage, Yoshihiro Sakuma, Sumihisa Orita, Kazuyo Yamauchi, Miyako Suzuki, Go Kubota, Yasuhiro Oikawa, Takeshi Sainoh, Jun Sato, Kazuki Fujimoto, Yasuhiro Shiga, Hirohito Kanamoto, Kazuhisa Takahashi, Seiji Ohtori
    Asian spine journal 11(1) 88-92 2017年2月  査読有り筆頭著者
    STUDY DESIGN: Animal model study. PURPOSE: The purpose of this study was to evaluate the histological variation in the injured muscle and production of calcitonin gene-related peptide in rats over time. OVERVIEW OF LITERATURE: Vertebral surgery has been reported to cause atrophy of the back muscles, which may result in pain. However, few reports have described the time series histological variation in the injured muscle and changes in the dominant nerve. METHODS: We used 30 male, 8-week-old Sprague-Dawley rats. The right and left sides of the paravertebral muscle were considered as the injured and uninjured sides, respectively. A 115 g weight was dropped from a height of 1 m on the right paravertebral muscle. Hematoxylin and eosin (H&E) staining of the muscle was performed 1-3 weeks after injury for histological evaluation. Fluoro-Gold (FG) was injected into the paravertebral muscle. The L2 dorsal root ganglia on both sides were resected 1, 2, and 3 weeks after injury, and immunohistochemical staining for calcitonin gene-related peptide was performed. RESULTS: H&E staining of the paravertebral muscle showed infiltration of inflammatory cells and the presence of granulation tissue in the injured part on the ipsilateral side 1 week after injury. Muscle atrophy occurred 3 weeks after injury, but was repaired via spontaneous replacement of muscle cells/fibers. In contrast, compared with the uninjured side, the percentage of cells double-labeled with FG and calcitonin gene-related peptide in FG-positive cells in the dorsal root ganglia of the injured side was significantly increased at each time point throughout the study period. CONCLUSIONS: These results suggest that sensitization of the dominant nerve in the dorsal root ganglia, which may be caused by cicatrix formation, can protract injured muscle pain. This information may be helpful in elucidating the underlying mechanism of persistent pain after back muscle injury.
  • Koki Abe, Sumihisa Orita, Chikato Mannoji, Hiroyuki Motegi, Masaaki Aramomi, Tetsuhiro Ishikawa, Toshiaki Kotani, Tsutomu Akazawa, Tatsuo Morinaga, Takayuki Fujiyoshi, Fumio Hasue, Masatsune Yamagata, Mitsuhiro Hashimoto, Tomonori Yamauchi, Yawara Eguchi, Munetaka Suzuki, Eiji Hanaoka, Kazuhide Inage, Jun Sato, Kazuki Fujimoto, Yasuhiro Shiga, Hirohito Kanamoto, Kazuyo Yamauchi, Junichi Nakamura, Takane Suzuki, Richard A Hynes, Yasuchika Aoki, Kazuhisa Takahashi, Seiji Ohtori
    Spine 42(1) 55-62 2017年1月1日  査読有り筆頭著者
    STUDY DESIGN: A retrospective multicenter survey. OBJECTIVE: To investigate the perioperative complications of oblique lateral interbody fusion (OLIF) surgery. SUMMARY OF BACKGROUND DATA: OLIF has been widely performed to achieve minimally invasive, rigid lumbar lateral interbody fusion. The associated perioperative complications are not yet well described. METHODS: The participants were patients who underwent OLIF surgery under the diagnosis of degenerative lumbar diseases between April 2013 and May 2015 at 11 affiliated medical institutions. The collected data were classified into intraoperative and early-stage postoperative (≤1 mo) complications. The intraoperative complications were then subcategorized into organ damage (neural, vertebral, vascular, and others) and other complications, mainly related to instrumental failure. The collected data were also divided and analyzed based on whether the surgeon was certified to perform the surgery and the incidence of complications in the early (April 2013-March 2014) and late stages (April 2014-May 2015) of OLIF introduction. RESULTS: In the 155 included patients, 75 complications were reported (incidence rate, 48.3%). The most common complication was endplate fracture/subsidence (18.7%), followed by transient psoas weakness and thigh numbness (13.5%) and segmental artery injury (2.6%). Almost all these complications were transient, except for three patients who had permanent damage: one had ureteral injury and two had neurological injury. Postoperative complications included surgical site infection (1.9%) and reoperation (1.9%). Whether the primary operator was experienced did not affect the incidence of complications. Regarding the introductory stage, the incidence of complications was 50% in the early stage and 38% in the late stage. CONCLUSION: The overall incidence of perioperative complications of OLIF surgery reached 48.3%, of which only 1.9% resulted in permanent damage. Our analysis based on surgeon experience indicated that the OLIF procedure could be performed without increasing incidence of complications, under the guidance of experienced supervisors. LEVEL OF EVIDENCE: 3.
  • Shohei Ise, Koki Abe, Sumihisa Orita, Tetsuhiro Ishikawa, Kazuhide Inage, Kazuyo Yamauchi, Miyako Suzuki, Jun Sato, Kazuki Fujimoto, Yasuhiro Shiga, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Kazuhisa Takahashi, Seiji Ohtori
    BMC research notes 9 329-329 2016年6月28日  
    BACKGROUND: Far-out syndrome was reported by Wiltse et al. in 1984, which is a condition characterized by L5 spinal nerve radiculopathy due to nerve compression between the L5 transverse process and sacral alar. Although many cases of far-out syndrome have been reported, to our knowledge, the present case firstly showed far-out syndrome due to assimilated L4 hemivertebra and L5 vertebra through which abnormal nerve root passed. CASE PRESENTATION: A 71-year-old man presented with left lower back pain and intermittent claudication accompanied by severe left buttock pain. Radiological examination showed assimilation between the L4 hemivertebra and L5 vertebra, which had two pedicles on the right side, with no canal stenosis. However, computed tomography and magnetic resonance imaging of coronal sections showed extraforaminal stenosis between the L5 transverse process and sacral alar, whereby the L5 spinal nerve was pinched ("far-out lesion"), and an abnormal nerve root passage in the assimilated vertebral corpus. We performed transforaminal lumbar interbody fusion, then resected the L5 transverse process to decompress the extraforaminal stenosis, and finally installed pedicle screws, but not at the one of pedicles of the assimilated vertebra in order to prevent nerve injury. Postoperatively, the patient had no symptoms up to 1.5 years after the surgery. CONCLUSION: The current case suggests the importance of detailed preoperative examination of patients with anatomical abnormalities such as assimilated vertebrae, which may result in incorrect diagnosis and failed surgery.
  • Koki Abe, Takeshi Mitsuka, Akiyoshi Yamaoka, Keishi Yamashita, Masaomi Yamashita, Masaki Norimoto, Yasuyoshi Sakurai
    Internal medicine (Tokyo, Japan) 52(21) 2469-72 2013年  査読有り筆頭著者
    A woman with rheumatoid arthritis (RA) experienced glottic stenosis approximately two months after switching from etanercept to tocilizumab. Cricoarytenoid joint (CAJ) arthritis due to RA was diagnosed. An awake tracheostomy saved the relievable airway, and the administration of methylprednisolone and infliximab ameliorated the flare-up and glottic stenosis. A follow-up examination revealed the recovery of the patient's normal voice and good control of RA with infliximab and methotrexate. Although general physicians do not frequently encounter patients with symptomatic CAJ arthritis, this condition should be considered as it can be life-threatening. Therefore, when detected, it should be diagnosed and treated immediately.
  • Koki Abe, Takeshi Mitsuka, Shigeo Kanamori, Keishi Yamashita, Akiyoshi Yamaoka
    Modern rheumatology 17(6) 511-3 2007年  査読有り筆頭著者
    A 68-year-old man with a 3-year history of rheumatoid arthritis (RA) developed gynecomastia 3 months after beginning oral low-dose methotrexate (MTX) therapy. Four months after MTX therapy was discontinued, the gynecomastia symptoms improved. Only eight cases of gynecomastia resulting from low-dose MTX administration have been reported worldwide, and no cases have previously been reported in Japan. Although it occurs infrequently, gynecomastia resulting from low-dose MTX therapy should be considered in male patients with RA.

主要なMISC

 17
  • 阿部 幸喜
    整形・災害外科 65(7) 863-868 2022年6月  招待有り筆頭著者
    <文献概要>ダイバーシティは「多様性」と訳され,整形外科領域で注目するのは労働資源(人材)や勤務体制,キャリア形成に関する部分である。千葉大学整形外科教室にはダイバーシティに富んだ土壌があり,医局員の6割以上および教官の4割以上が他大学出身である。女性医局員も歓迎され,専門医資格および学位習得へ進むキャリアパスも確立されている。この環境で育成された医局員をもって地域医療および医学研究へ貢献し,国内外との人材交流を図っている。他大学卒で中途入局の筆者も厚生労働省へ出向(人事交流)の機会を得た後,現在は千葉大学医学部附属病院次世代医療構想センターの席に就き,ダイバーシティに富む職歴を得ている。「働き方改革」が進み,労働力確保が難しくなる中,経歴や性別にとらわれない人材採用と育成が必須となり,適材適所に配置された人材が組織の外と交流することも望まれ,経歴の異なる者や数的弱者にも,これまで以上に機会が与えられる時代を迎える。
  • 阿部 幸喜, 及川 恵美子, 中山 佳保里, 森 桂
    日本リウマチ学会総会・学術集会プログラム・抄録集 63回 289-289 2019年3月  招待有り
  • 阿部 幸喜, 折田 純久, 稲毛 一秀, 大鳥 精司
    脊椎脊髄ジャーナル 30(10) 901-907 2017年10月  
  • 阿部 幸喜, 山下 桂志, 河野 好子, 神野 敬士朗, 乗本 将輝, 山下 正臣, 山岡 昭義, 沼野 徹, 杉村 昌信, 岡 靖子, 永瀬 祥子, 浪川 薫, 成田 亜希子, 末永 朋子, 山口 真紀子, 桑田 順子
    心臓 47(7) 925-929 2015年7月  
    大腿骨近位部骨折手術例における静脈血栓塞栓症(VTE)発生の実態を調査し、Dダイマー値と下肢周囲径の変化率がVTE発生の指標を成り得るか検討した。対象は、大腿骨近位部骨折症例204例(男性35例、女性169例、平均年齢80.5歳)とした。VTEは42例(20.6%)に発生した。肺塞栓症(PE)は3例(1.5%)で、いずれも呼吸困難感を伴った酸素飽和度の低下を示し、造影CT検査で肺動脈末梢に微小塞栓を認めた。下肢深部静脈塞栓(DVT)単独39例(19.1%)で、近位型1例、遠位型38例であった。手術側と非手術側に分けたところ、DVT発生は手術側肢22肢、非手術側肢29肢で、有意差は認めなかった。血栓群と非血栓群にてDダイマー値は入院時は有意差を認めなかったが、術後1、3、7日目において有意差(P<0.01)を認め、術後14、21日目についても有意差(P<0.05)を認めた。術後7日目について、ROC曲線を描いて、Dダイマー値5.5μg/mLをカットオフ値とすると、感度100%、特異度25.1%となった。下肢周囲径変化率については、血栓肢が-1.17±6.38、非血栓肢は-0.53±8.59%で、2群間に有意差は認めなかった。
  • 阿部 幸喜, 益子 邦洋, 伊藤 文夫, 鈴木 春男, 榛澤 芳雄, 安井 一彦, 大橋 秀幸
    救急医学 31(4) 481-486 2007年4月  
    発生から24時間以内に死亡した平成16年1月1日〜12月31日の千葉県下の交通事故症例を調査した。期間中、千葉県内発生の全交通事故死亡者数は332例で、現場心停止(心停止群)は195例(58.7%)、現場生存(生存群)は137例(41.3%)であった。救急隊の現場到着から現場出発までの活動時間は13.9±8.2分であった。生存群は、心停止群よりも覚知〜救急隊現場到着の時間が有意に短く、救急隊現場到着時の生理学的重症度が有意に高値であった。また、病院到着時の予測生存率が高いほど、救急隊現場到着〜病院収容の時間は短かった。三次救急医療機関に搬送されたのは48.2%(160/332例)で、生存群においても59.5%(82/137例)に過ぎなかった。救急現場では、適切な時間内に、生理学的重症度に解剖学的重症度を加味して決定的治療の可能な病院へ搬送することが重要であり、Japan Prehospital Trauma Evaluation and Careの普及と徹底が急務であると思われた。
  • 阿部 幸喜, 益子 邦洋
    外科 67(6) 691-695 2005年6月  
  • 阿部 幸喜, 豊田 泉, 岡田 眞人, 早野 大輔, 森川 健太郎, 淺井 精一, 山口 孝治, 杉本 勝彦
    日本臨床救急医学会雑誌 7(4) 328-333 2004年8月  
    静岡県西部地区ドクターヘリの交通事故現場出動状況を調査した.ドクターヘリ体制始動4年間の出動は1533件,内訳は消防機関要請の緊急出動1155件(75.4%),病院間転送132件(8.6%),出動後キャンセル246件(16.0%)であった.交通事故出動は274件(17.4%)で,全外傷事故545件の50.2%であった.現場直近出動事例は53件で,事故覚知後ヘリ要請まで平均7分24秒,ヘリ要請から現場到着まで平均12分54秒であった.現場活動内容は全身診察71人,酸素投与46人,気道確保8人,前脊柱固定32人,胸腔穿刺・胸腔ドレナージ4人,創傷処置3人,静脈ルート確保48人,鎮静3人,複数傷病者トリアージ16件であった.53件71人の傷病者のうち現場心停止で蘇生処置による搬送中の心拍再開が2人,搬送中心停止が1人,現場での死亡確認による非搬送が2人であった
  • 阿部 幸喜, 淺井 精一, 吉田 勲, 成田 克浩, 早川 達也, 岡田 眞人
    日本航空医療学会雑誌 3(1) 37-40 2002年5月  
    筆者らの施設では2001年10月からドクターヘリの本格運行を行っており,救急現場直近への医師,看護師の出動が急増している.今回,多数傷病者が発生した交通事故2事例に対してドクターヘリで出動し,救急隊との協力のもと,トリアージ,初期治療,患者搬送を行ったが,医師の現場出動によりより正確なトリアージと初期治療が可能となった.事例1は軽トラックと軽乗用車の衝突事故で傷病者4名が発生し,1名が軽トラック車内に挟まれ救出困難となった為ドクターヘリが要請された.事例2は列車と軽ワゴンの踏切事故で4名の重傷者と1名の軽症者が発生し,ドクターヘリにて現場上空視察により大規模事故であることが早期に把握されたため医師2名同乗のドクターカーが現場に急行した事例であった.以上よりドクターヘリは患者搬送に機動力を発揮するだけでなく,事故の全体像を把握する際にも有効であることが確認された
  • 阿部 幸喜, 堀内 郁雄, 石丸 剛, 平田 建郎, 渡辺 謙介, 浅井 精一, 中村 義博
    聖隷三方原病院雑誌 4(1) 78-79 2000年7月  
    31歳男.草むらで作業中,左足底をマムシに咬まれ,来院した.約3時間の外来経過観察中に左大腿部まで疼痛が及んだため入院した.受傷第1病日,複視を訴え,第6病日Hess chart上で単眼では眼球運動異常を示さない外斜視を確認した.その後,眼症状は自然軽快し,第13病日左下肢の疼痛を残すものの全身状態良好にして退院となった

主要な講演・口頭発表等

 4

所属学協会

 3

共同研究・競争的資金等の研究課題

 4