- 著者
- Takashi Hirai Takuya Takahashi Tomoyuki Tanaka Takayuki Motoyoshi Yu Matsukura Masato Yuasa Hiroyuki Inose Toshitaka Yoshii Atsushi Okawa
- 出版者
- The Japanese Society for Spine Surgery and Related Research
- 雑誌
- Spine Surgery and Related Research (ISSN:2432261X)
- 巻号頁・発行日
- vol.6, no.3, pp.252-260, 2022-05-27 (Released:2022-05-27)
- 参考文献数
- 21
- 被引用文献数
- 9
Introduction: Chemonucleolysis with condoliase (chondroitin sulfate ABC endolyase) has been used to treat patients with lumbar disc herniation (LDH) in Japan since 2018. In this study, we retrospectively investigated clinical outcomes in patients who received an intradiscal condoliase injection for LDH and sought to identify significant predictors of good outcome.Methods: Indications for treatment were as follows: (1) unilateral leg pain with or without back pain, (2) nerve root compression caused by LDH confirmed on magnetic resonance imaging (MRI), and (3) leg pain resistant to at least 1 month of conservative treatment, including medication, nerve root block, or physical therapy. Patients with motor weakness or a history of severe allergy were excluded, as were those with the foraminal or sequestrated type of LDH. The injection was defined as effective if the numeric rating scale score for leg pain improved by ≥50% at 6 months post-treatment.Results: A total of 52 patients (mean age, 45.0 years) were enrolled and classified according to whether the injection was effective (E group, n=40, 76.9%) or less effective (L group, n=9, 17.3%). Three patients (5.8%) underwent herniotomy for residual pain within 6 months of the injection. There were no severe adverse events. Reduction of herniation was seen on MRI more often in the E group than in the L group. The effectiveness in patients with transligamentous LDH was similar to that in patients with subligamentous LDH. High-intensity signal change in the area of LDH on pretreatment T2-weighted MRI was a significant predictor of successful leg pain relief.Conclusions: An intradiscal condoliase injection was a safe and effective treatment for painful radiculopathy caused by LDH. Leg pain was more likely to improve in patients with high-intensity signal change in the area of LDH before treatment.
- 著者
- Osamu Matsuoka Daisuke Tsuzuki Katsuhisa Suzuki Tomoyuki Tanaka Yoshiharu Takagi Philipp Oster
- 出版者
- National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee
- 雑誌
- Japanese Journal of Infectious Diseases (ISSN:13446304)
- 巻号頁・発行日
- pp.JJID.2020.411, (Released:2020-10-30)
- 参考文献数
- 17
The quadrivalent meningococcal polysaccharide diphtheria toxoid conjugate vaccine (Men-ACWY-D) is licensed in Japan since 2014. An earlier registration study demonstrated the immunogenicity of one dose in Japanese adults. Immunogenicity against serogroup C was lowest. Determination of the potential to increase the serogroup C response with a second dose was of interest. This study (NCT02591290) evaluated the safety and immunogenicity of two doses administered eight weeks apart to 60 healthy Japanese adults aged 20–55 years. Blood samples were collected 28–35 days after each vaccination. Immunogenicity endpoints included seroprotection and seroconversion rates. Safety assessments included systemic adverse events (AEs), non-serious AEs, and serious AEs. Fifty-eight (96.7%) participants completed the study. Seroprotection rates for serogroups A, C, W, and Y before vaccination were 76.8%, 26.8%, 26.8%, and 50.0%, increasing to 100%, 83.9%, 91.1%, and 96.4% and 100%, 92.9%, 94.6%, and 94.6%, respectively, after two doses. Seroconversion rates for the four serogroups were 100%, 93.8%, 97.1%, and 94.1% after the first dose and 100%, 96.9%, 100%, and 100% after the second. Increases between doses were insignificant. There were no safety concerns. The two-dose series is well tolerated but clinical benefit of a second dose within 8 weeks seemed to be low.