小林 秀 (コバヤシ シュウ)

Kobayashi, Shu

写真a

所属(所属キャンパス)

医学部 整形外科学教室 (信濃町)

職名

専任講師(有期)

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  • 関節リウマチにおけるAhR(aryl hydrocarbon receptor)の役割について, 慶應義塾大学, 2009年02月

    The role of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and aryl hydrocarbone receptor (AhR) in rheumatoid arthritis 

 

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  • Stat3 as a potential therapeutic target for rheumatoid arthritis

    Oike, T., Sato, Y., Kobayashi, T., Miyamoto, K., Nakamura, S., Kaneko, Y., Kobayashi, S., Harato, K., Saya, H., Matsumoto, M., Nakamura, M., Niki, Y. and Miyamoto, T.

    Sci Rep 7 ( 1 ) 10965 2017年09月

    ISSN  2045-2322

     概要を見る

    Rheumatoid arthritis (RA) is a multi-factorial disease characterized by chronic inflammation and destruction of multiple joints. To date, various biologic treatments for RA such as anti-tumor necrosis factor alpha antibodies have been developed; however, mechanisms underlying RA development remain unclear and targeted therapy for this condition has not been established. Here, we provide evidence that signal transducer and activator of transcription 3 (Stat3) promotes inflammation and joint erosion in a mouse model of arthritis. Stat3 global KO mice show early embryonic lethality; thus, we generated viable Stat3 conditional knockout adult mice and found that they were significantly resistant to collagen-induced arthritis (CIA), the most common RA model, compared with controls. We then used an in vitro culture system to screen ninety-six existing drugs to select Stat3 inhibitors and selected five candidate inhibitors. Among them, three significantly inhibited development of arthritis and joint erosion in CIA wild-type mice. These findings suggest that Stat3 inhibitors may serve as promising drugs for RA therapy.

  • Local infiltration of analgesia and sciatic nerve block provide similar pain relief after total knee arthroplasty

    Tanikawa, H., Harato, K., Ogawa, R., Sato, T., Kobayashi, S., Nomoto, S., Niki, Y. and Okuma, K.

    J Orthop Surg Res 12 ( 1 ) 109 2017年07月

    ISSN  1749-799

     概要を見る

    BACKGROUND: Although femoral nerve block provides satisfactory analgesia after total knee arthroplasty (TKA), residual posterior knee pain may decrease patient satisfaction. We conducted a randomized controlled trial to clarify the efficacy of the sciatic nerve block (SNB) and local infiltration of analgesia with steroid (LIA) regarding postoperative analgesia after TKA, when administrated in addition to femoral nerve block (FNB). METHODS: Seventy-eight patients were randomly allocated to the two groups: concomitant administration of FNB and SNB or FNB and LIA. The outcome measures included post-operative pain, passive knee motion, C-reactive protein level, time to achieve rehabilitation goals, the Knee Society Score at the time of discharge, patient satisfaction level with anesthesia, length of hospital stay, surgical time, and complications related to local anesthesia. RESULTS: The patients in group SNB showed less pain than group LIA only on postoperative hours 0 and 3. Satisfactory postoperative analgesia after TKA was also achieved with LIA combined with FNB, while averting the risks associated with SNB. The influence on progress of rehabilitation and length of hospital stay was similar for both anesthesia techniques. CONCLUSIONS: The LIA offers a potentially safer alternative to SNB as an adjunct to FNB, particularly for patients who have risk factors for sciatic nerve injury.

  • Mechanically aligned total knee arthroplasty carries a risk of bony gap changes and flexion-extension axis displacement

    Niki, Y., Sassa, T., Nagai, K., Harato, K., Kobayashi, S. and Yamashita, T.

    Knee Surg Sports Traumatol Arthrosc 2017年02月

    ISSN  0942-2056

     概要を見る

    PURPOSE: The flexion-extension axis (FEA) of the femur is substantially changed after mechanically aligned total knee arthroplasty (TKA) due to a discrepancy in bone cut thickness between the posterior and distal femoral regions. This study assessed the bony gap changes and FEA displacement caused by this problem in osteoarthritis patients. METHODS: The study enrolled 60 knees from 60 patients for whom primary TKA was planned due to medial knee osteoarthritis. All patients underwent computed tomography, and 3-dimensional (3D) bone models were reconstructed on 3D-planning software. Bone cuts of the distal femur and proximal tibia were simulated to be perpendicular to each mechanical axis. Bony gap change was computed as the difference in bone cut thickness between medial and lateral compartments. Each femoral condyle was assessed for potential FEA displacement, as the difference in bone cut thickness between posterior and distal femoral regions. RESULTS: The mean magnitude of bony gap discrepancy necessary for mediolateral balancing was 1.6 +/- 3.3 mm (range -7 to 8.2 mm) at 0 degrees extension and -0.2 +/- 2.6 mm (range -6.4 to 4.3 mm) at 90 degrees flexion. At least 2 mm of bony gap discrepancy at 0 degrees extension and 90 degrees flexion was found in 40 patients (67%) and 26 patients (43%), respectively. In terms of femoral bone cut, posterior bone cut thickness was significantly larger than distal bone cut thickness in the medial compartment (p < 0.001). Bony gap discrepancy between distal and posterior regions of the femoral condyle was >/=2 mm in 28 patients (47%). CONCLUSIONS: This study focused on two flaws of mechanically aligned TKA in OA patients. Substantial numbers of patients inevitably required >2 mm of medial collateral ligament release at 0 degrees extension and showed a bone cut discrepancy between distal and posterior regions, carrying a risk of FEA displacement and subsequent unnatural knee motions during knee extension and flexion. Level of evidence IV.

  • Factors affecting one-leg standing time in patients with end-stage knee osteoarthritis and the age-related recovery process following total knee arthroplasty

    Harato, K., Kobayashi, S., Kojima, I., Sakurai, A., Tanikawa, H. and Niki, Y.

    J Orthop Surg Res 12 ( 1 ) 21 2017年02月

    ISSN  1749-799

     概要を見る

    BACKGROUND: The aims of the present study were to investigate the factors affecting one-leg standing (OLS) time in patients with end-stage knee osteoarthritis (OA) and to clarify the age-related recovery process following total knee arthroplasty (TKA) in the early postoperative period. METHODS: A total of 80 knees of 40 patients with knee OA were enrolled. They were asked to perform relaxed standing on one leg for as long as possible. First, OLS time was measured. Second, age, body mass index, knee flexion angle during (KFA) OLS, femorotibial angle (FTA) during OLS, and a visual analogue scale (VAS) for pain were evaluated. Multiple regression analysis was done to identify the factors affecting OLS time. In addition, the recovery process was compared between older and younger patients after TKA. RESULTS: A larger KFA during OLS, older age, and larger FTA were significantly associated with shorter OLS time. After TKA, postoperative OLS time in older patients did not improve significantly by postoperative day 20, while the time in younger patients improved significantly from postoperative day 19. CONCLUSIONS: Even if subjective knee pain and KFA during OLS improved, longer rehabilitation was required to improve OLS time in older patients in the early postoperative period.

  • A case of isolated gouty tophus in a patient without a previous history of gouty arthritis

    Kobayashi, S., Taniguchi, A., Okamoto, H., Momohara, S. and Tomatsu, T.

    J Clin Rheumatol 15 ( 7 ) 373 2009年10月

    ISSN  1076-1608

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