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Biomedical subjects

Atsumasa Uchida

Publications and source records attributed to Atsumasa Uchida.

At least 37 records · Page 2Linked to original sources
PubMed2006

Extraskeletal myxoid chondrosarcoma arising from the clavicle.

This report presents an extremely rare case of extraskeletal myxoid chondrosarcoma (EMC) arising from the clavicular periosteum. To the best of our knowledge, this may be the first detailed report of its clinicopathological findings. The patient was a 48-year-old man. Plain radiography and CT did not demonstrate any osteolytic lesion or periosteal reaction in the right clavicle. However, MRI showed an isosignal-intensity mass on T1-weighted images and a homogeneous high signal intensity lesion on T2-weighted images. The histological findings of the widely resected tumor were consistent with the diagnosis of extraskeletal myxoid chondrosarcoma. Preoperative diagnosis of extraskeletal myxoid chondrosarcoma at an unusual location, as in this case, is difficult not only with imaging examinations alone, but sometimes even after histological examination of biopsy specimens.

Bone Neoplasms↗
PubMed2005

Pre-and postoperative psychological characteristics in mothers of patients with idiopathic scoliosis.

The purpose of the present study was to clarify changes in the psychological state of mothers of patients with idiopathic scoliosis, and to clarify relationships between the psychological states of the mothers and patients. The Maudsley personality inventory (MPI) was administered to 30 patients with idiopathic scoliosis who underwent surgery and their mothers preoperatively and at about 1 year postoperatively. We investigated the relationships between preoperative MPI scores and postoperative scores in patients and their mothers, respectively, and the relationships between MPI scores for patients and mothers. The results of the present study revealed that patients became more extroverted following surgery, while mothers displayed reduced neurotic tendencies. In conclusion, the mothers of patients who undergo corrective treatment for scoliosis may have experienced a substantial psychological burden before surgery, and doctors who treat patients with scoliosis should bear this point in mind.

Adult↗
PubMed2005

Method of cell transplantation promoting the organization of intraarterial thrombus.

BACKGROUND: Endovascular aortic repairs have been developed as less invasive treatments for aortic aneurysms. Some aneurismal cavities, however, remain without organization, causing a re-expansion of the aneurysms. We studied cell transplantation into the aneurismal sac to promote the organization of thrombus for the complete healing of aneurysms. METHODS AND RESULTS: Skin fibroblasts and skeletal myoblasts were isolated from rats for cell transplantation. An intraarterial thrombus model was made by ligation of the carotid artery. Culture medium (medium group, n=11), collagen gel (gel group, n=11), fibroblasts with collagen gel (F group, n=15), myoblasts with collagen gel (M group, n=12), or mixture of fibroblasts and myoblasts with collagen gel (F+M group, n=14) were injected into the thrombus. After 28 days, histologically, the arterial lumens of the F and M groups were partly filled with fibrous tissues, whereas in the F+M group organization was almost completed and luminal sizes diminished. Immunohistochemical staining demonstrated that alpha-smooth muscle actin-positive cells were more abundantly contained in the organized area of the F+M group than in the other groups. We also analyzed cellular function in vitro with immunofluorescence; coculture of fibroblasts and myoblasts showed that the fraction of alpha-smooth muscle actin-positive fibroblasts increased. This phenomenon accounts for the rapid organization of thrombus in the F+M group in vivo. CONCLUSIONS: Cell transplantation accelerated thrombus organization. Especially, myoblasts enhanced differentiation of fibroblasts into myofibroblasts, contributing to rapid thrombus organization. Cell transplantation into unorganized spaces seems applicable to endovascular treatment of aneurysms.

Aneurysm↗
PubMed2005

Rapidly destructive coxopathy after subchondral insufficiency fracture of the femoral head.

Rapidly destructive coxopathy (RDC) is a rare disorder, and its pathophysiology is unknown. Here, we report a case of RDC evaluated by roentgenography and magnetic resonance imaging, from the onset of hip pain without changes on roentgenograms, to the terminal stage with collapse of the femoral head. Our serial radiological findings clearly illustrate the entire process of RDC, especially the initial stage. Subchondral insufficiency fracture of the femoral head seems to be an important preliminary event in the development of RDC.

Aged↗
PubMed2005

An aspartic acid repeat polymorphism in asporin inhibits chondrogenesis and increases susceptibility to osteoarthritis.

Osteoarthritis is the most common form of human arthritis. We investigated the potential role of asporin, an extracellular matrix component expressed abundantly in the articular cartilage of individuals with osteoarthritis, in the pathogenesis of osteoarthritis. Here we report a significant association between a polymorphism in the aspartic acid (D) repeat of the gene encoding asporin (ASPN) and osteoarthritis. In two independent populations of individuals with knee osteoarthritis, the D14 allele of ASPN is over-represented relative to the common D13 allele, and its frequency increases with disease severity. The D14 allele is also over-represented in individuals with hip osteoarthritis. Asporin suppresses TGF-beta-mediated expression of the genes aggrecan (AGC1) and type II collagen (COL2A1) and reduced proteoglycan accumulation in an in vitro model of chondrogenesis. The effect on TGF-beta activity is allele-specific, with the D14 allele resulting in greater inhibition than other alleles. In vitro binding assays showed a direct interaction between asporin and TGF-beta. Taken together, these findings provide another functional link between extracellular matrix proteins, TGF-beta activity and disease, suggesting new therapeutic strategies for osteoarthritis.

Aggrecans↗
PubMed2005

Enhanced reinnervation after neurotization with Schwann cell transplantation.

We investigated the feasibility of using Schwann cell transplantation to enhance reinnervation after direct nerve-to-muscle neurotization (NMN). The denervated anterior tibial muscle was neurotized by tibial nerve implantation, and Schwann cell suspension (transplantation group) or an equivalent volume of culture medium (control group) was injected at the implantation site. In the control group, few axons invaded the muscle, demonstrating that skeletal muscle was poorly permissive to the advancement of axons. In the transplantation group, a large number of regenerating axons grew for a longer distance throughout the muscle, and reinnervated motor endplates were significantly more abundant. Enhanced reinnervation and functional recovery of the muscle in the transplantation group was confirmed by a significant increase in the compound muscle action potential and in muscle weight. These results suggest that intramuscular Schwann cell transplantation has potential as a cell therapy to improve functional recovery after NMN.

Animals↗
PubMed2005

MMP-2 expression is associated with rapidly proliferative arteriosclerosis in the flexor tenosynovium and pain severity in carpal tunnel syndrome.

Due to the lack of correlation between symptom severity and electrophysiology or nerve function, the 'container hypothesis' has emerged as a new concept in carpal tunnel syndrome (CTS). This proposes that symptoms relate to connective tissue alteration rather than to nerve fibre pathology. This study was conducted to investigate the pathology of the flexor tenosynovium and its relationship with symptomatology. The subjects comprised 40 patients with electrophysiologically proven CTS who underwent open carpal tunnel release (age range: 31-79 years). In all patients, subjective symptom severity was assessed with a Likert scale and symptom duration was recorded preoperatively. Flexor tenosynovium biopsied during surgery was analysed for arterial and connective tissue alteration. Proliferative arteriosclerosis was graded using the modified Banff score. Gelatin zymography and immunohistochemistry were also performed to investigate the role of gelatinase in CTS. Relationships were evaluated using Spearman rank correlation coefficients. Proliferative arteriosclerosis occurred with disease progression in the flexor tenosynovium, in the absence of inflammation. This event did not correlate with patient age but correlated closely with symptom duration. Immunohistochemistry with antibodies against MMP-2 and elastic van Gieson staining revealed that arterioles express high levels of MMP-2 within 3 months of symptom onset and that intimal hyperplasia proceeded rapidly between 4 and 7 months, resulting in severe vascular narrowing. Gelatin zymography showed that MMP-2 activity correlated negatively with symptom duration and positively with pain severity.

Adult↗
PubMed2005

Enhanced repair of large osteochondral defects using a combination of artificial cartilage and basic fibroblast growth factor.

The purpose of this study was to examine the efficacy of a combination of artificial cartilage and basic fibroblast growth factor (bFGF) for the repair of large osteochondral defects. The artificial cartilage was a three-dimensional fabric (3-DF) composed of an ultra-high molecular weight polyethylene fiber with a triaxial three-dimensional structure. We implanted 3-DF impregnated with type I collagen gel containing 500 ng of bFGF (bFGF-treated group) or 3-DF impregnated with type I collagen gel alone (non-treated group) into a large full-thickness osteochondral defect (6 x 6 x 3 mm) of the patellar groove of rabbits. The defect area was examined grossly, histologically and biomechanically 4-48 weeks after surgery. Bone ingrowth into and around the 3-DF was evaluated with micro-computed tomography (micro-CT). Addition of bFGF to the 3-DF greatly accelerated cartilage formation on the articular surface and subchondral bone formation into and around the 3-DF, and improved biomechanical properties. These findings suggest that a combination of artificial cartilage and bFGF is clinically useful in cases involving large osteochondral defects.

Animals↗
PubMed2005

Cytological properties of stromal cells derived from giant cell tumor of bone (GCTSC) which can induce osteoclast formation of human blood monocytes without cell to cell contact.

When human blood monocytes were cocultured with stromal cells derived from human giant cell tumor of bone (GCTSC) and a Millipore filter (0.4 microm) was interposed between monocytes and GCTSC, multinucleated giant cell formation of monocytes was induced. The multinucleated giant cells have characters as osteoclast-like cells, indicating that a soluble osteoclast-inducing factor(s) is secreted from GCTSC expressing RANK, RANKL/ODF/OPGL and TACE mRNA. Furthermore, OCIF/OPG inhibited GCTSC-induced osteoclastogenesis, showing that the RANK-RANKL system is involved in GCTSC-induced osteoclastogenesis and that soluble form of ODF/RANKL induces osteoclasts from monocytes. GCTSC expressed the cytokine mRNAs such as M-CSF, GM-CSF, IL-3, IL-4, IL-6, and IFN-gamma mRNAs. None of IL-1ralpha, IL-1alpha, IL-1beta, IL-2, IL-4, IL-10, IL-18, TNF-alpha, G-CSF and IFN-gamma could be detected in all culture media. A significant amount of IL-6 could be detected in the culture media of all GCTSC. IL-8 was found in the culture media of two GCTSC and two osteosarcoma-derived cells. M-CSF was detected in all culture media. GCTSC express CaSR, and stimulation of GCTSC with either extracellular Ca(2+) or neomycin, agonist of CaSR, augmented the expression of RANKL. Some lines of GCTSC expressed alkaline phosphatase, osteocalcin and Cbfa1, suggesting that GCTSC are intimately related to osteoblastic lineage.

Alkaline Phosphatase↗
PubMed2005

A case of idiopathic spinal cord herniation with duplicated dura mater.

The patient was a 48-year-old man in whom a slow progression in walking difficulty occurred over a year. Magnetic resonance imaging (MRI) and computed tomography myelography (CTM) revealed duplicated dura mater from T1 to T12 and spinal cord herniation in the inner layer of the dura at the T4-T5 level. Idiopathic spinal cord herniation with duplicated dura mater was diagnosed, and surgery was performed. Intraoperative findings were of an elliptical defect of about 1 cm in the inner layer of the dura at the T4-T5 level, into which the spinal cord was herniated. A 1.5-cm cephalocaudal incision was created in the inner layer of the dura, and the incarcerated spinal cord was released, resulting in resolution of gait disturbance and an excellent postoperative clinical course. We reviewed the reports of 11 cases of idiopathic spinal cord herniation with duplicated dura mater and summarized the clinical and imaging characteristics as follows: 1) A hernial orifice was found at the T4-T6 level, 2) cross-sectional MRI or CTM showed a "snowman-like" deformation of the spinal cord, and 3) symptoms were often improved by widening the hernia orifice.

Dura Mater↗
PubMed2005

Phosphoglyceride crystal deposition disease in the spine: a case report.

The authors report phosphoglyceride crystal deposition disease in the spine after a lumbar anesthetic given at the time of appendectomy. A 76-year-old Japanese woman with increasing lumbar pain was transported to our hospital in an ambulance. She had tumor-like lesions that had repeatedly appeared in injured soft tissues for >20 years. Osteolytic changes were detected by x-ray in the 12th thoracic vertebra and the 4th lumbar vertebra. Compression of the left L4 nerve root was detected by myelography, and a tumor corresponding to the left L3-L4 intervertebral foramen was determined by computed tomography. An operation to achieve posterior decompression and fusion was performed. The histopathologic tests on this coarse matter revealed a radial deposition of needle crystals and a strong foreign matter reaction in the periphery. Based on the above analyses, the deposited crystals were regarded as phosphoglyceride. Phosphoglyceride crystal deposition disease is characterized by the deposition of crystals of the phospholipid called phosphoglyceride in sites especially susceptible to invasion, such as surgical sites. To our best knowledge, only three cases of phosphoglyceride crystal deposition disease, including this one, have been reported.

Aged↗
PubMed2005

Enhancement of perineurial repair and inhibition of nerve adhesion by viscous injectable pure alginate sol.

BACKGROUND: Clinical treatment of recurrent symptoms following peripheral nerve decompression is problematic. Removal of scar tissue can produce an inappropriately pronounced healing response and thereby lead to more serious tethering or compression of the nerve. The goal of the present study was to test the ability of viscous injectable pure alginate sol to prevent perineurial adhesion using a rat neurolysis model. METHODS: The antiadhesive effect of viscous injectable pure alginate sol after neurolysis was evaluated histologically and biomechanically. A total of 40 rats were used in this study. The viscous injectable pure alginate sol was applied topically on the right side after external (six rats) or extensive internal (six rats) neurolysis, whereas the left side received no treatment. The nerves were harvested over 6 weeks, and histologic analysis was performed with hematoxylin and eosin staining and Masson trichrome staining. Functional analysis of the blood and perineurial barriers was also evaluated with Evans blue albumin (four rats). Sixteen rats were used for biomechanical analysis, and eight rats were used as a control group. The results were analyzed statistically using a post hoc test. RESULTS: Histologic examination showed that the use of viscous injectable pure alginate sol was associated with excellent biocompatibility and strong inhibition of perineurial granulation. Viscous injectable pure alginate sol was absorbed completely within 6 weeks without inducing inflammation. In addition, viscous injectable pure alginate sol enhanced repair of the perineurium associated with regeneration of epithelial-like cell layers, a key structure necessary for barrier function of the inner layer of the perineurium. Functional analysis with Evans blue albumin clearly demonstrated that, although blood nerve barrier function recovered by 6 weeks postoperatively in all nerves, the perineurial barrier function recovered only in the sol-treated nerves. Biomechanical study showed a significant antiadhesive effect of viscous injectable pure alginate sol. CONCLUSIONS: Viscous injectable pure alginate sol inhibited adhesion formation around nerves and enhanced regeneration of the perineurium with barrier function. Because excessive perineurial fibrosis and tethering at the neurolysis or neurorrhaphy site is a common postoperative problem in peripheral nerve surgery, viscous injectable pure alginate sol appears to have potentially broad clinical applications.

Alginates↗
PubMed2005

Effect of viscous injectable pure alginate sol on cultured fibroblasts.

BACKGROUND: Alginates have a wide variety of potential clinical applications, including use in cell encapsulation, drug delivery, and tissue engineering. Although the compounds are typically used in the form of a calcium hydrogel, alginates in this form possess several disadvantages, including low biodegradability, induction of foreign body reactions, and cytotoxicity secondary to Ca2+ efflux and contamination with bioincompatible substances. Thus, the goal of the present study was to develop a new method of obtaining sterilized, pure, highly viscous alginate sol from seaweed alginates and to determine its utility as an injectable antiadhesion drug. METHODS: Viscous injectable pure alginate sol was produced from a commercially available sodium alginate, and its molecular and physical characteristics were analyzed. The biological properties of the viscous injectable pure alginate sol were analyzed using cultured fibroblasts prepared from the dorsal skin of neonatal rats to determine its biocompatibility and its effects on cell proliferation, cell migration, and collagen lattice contraction. RESULTS: The mannuronic acid-to-glucuronic acid ratio of viscous injectable pure alginate sol, as determined by nuclear magnetic resonance studies, was 1.2, and its viscosity at 5 percent was 17,800 mPa. Purification used to produce viscous injectable pure alginate sol decreased contamination by insoluble particles by 20 percent and decreased polyphenol concentration by 17 percent. In vitro analyses with cultured fibroblasts demonstrated that viscous injectable pure alginate sol had excellent biodegradability and biocompatibility and that viscous injectable pure alginate sol inhibited fibroblast proliferation and migration. Furthermore, assessment of collagen contraction with floating fibroblast-loaded collagen lattices indicated that viscous injectable pure alginate sol enhanced wound healing in surrounding connective tissues. CONCLUSIONS: The authors conclude that viscous injectable pure alginate sol can inhibit scar formation by presenting a physical barrier to invading fibroblasts and by enhancing wound healing of surrounding tissues.

Alginates↗
PubMed2005

Assessment of gait and balance in patients with spinal diseases using the leg reposition test.

We devised a new leg reposition test, to assess gait and balance in patients with spinal diseases. This study included 344 patients who were scheduled to undergo spine surgery; 14 (4.1%) patients showed positive results. These 14 patients had worse gait status than leg reposition test-negative patients both preoperatively and postoperatively. The leg reposition test is a simple procedure, and requires no specialized equipment. This study showed that the leg reposition test has a strong relation with gait status, and therefore a high clinical significance regarding the assessment of preoperative gait and balance and prediction of postoperative gait status.

Adolescent↗
PubMed2005

Periosteal Ewing's sarcoma treated by photodynamic therapy with acridine orange.

We recently encountered a very rare case of periosteal Ewing's sarcoma (PES), which was treated by surgery followed by photodynamic therapy using acridine orange with radiodynamic therapy. No more than 15 cases of PES have been reported previously in literature. In our case, MRI revealed the tumor to be localized on the cortical surface of the proximal humerus. Histopathological examination of biopsy specimens revealed a small round cell sarcoma suggestive of Ewing's sarcoma or PNET, and immunohistochemistry showed positive staining for MIC2. Although fusion genes EWS-FLI1 and EWS-ERG were undetectable, PES was still considered to be the most likely diagnosis. Therefore, we administered preoperative chemotherapy, as a result of which the tumor shrank to 48% of its original volume. With a view to preserve excellent shoulder and upper limb function, we attempted intralesional tumor resection supported by photodynamic therapy using acridine orange with radiodynamic therapy. After surgery followed by postoperative chemotherapy, the patient has, until the time of writing, had no local tumor recurrence and no evidence of metastatic disease, and can move his shoulder fully and throw a ball well. Since it has been reported that PES has a better prognosis and responsiveness to chemotherapy than intramedullary Ewing's sarcoma, we believe that such reduction surgery with photodynamic therapy might be the strategy of choice to obtain satisfactory limb function in cases of PES.

Acridine Orange↗
PubMed2005

Metastasis of malignant peripheral nerve sheath tumor to free vascularized myocutaneous flap.

The vascularized free myocutaneous flap graft, a recent advance in microsurgery, is a very useful reconstruction technique for covering massive soft tissue defects or muscular dysfunction caused by wide resection for malignant soft tissue tumors. We have used this technique to treat many patients after resection for malignant soft tissue tumors. Recently we encountered a case in which a malignant peripheral nerve sheath tumor (MPNST) metastasized to a vascularized free myocutaneous flap used for limb reconstruction surgery after wide resection of a primary lesion. To our knowledge, there have been no previous reports of metastasis of a malignant soft tissue tumor (or any other cancer) to a grafted cutaneous or myocutaneous flap.

Aged↗
PubMed2004

High release of antibiotic from a novel hydroxyapatite with bimodal pore size distribution.

We developed a novel hydroxyapatite (HA) cylinder (HA-A) and compared the slow release of antibiotic in vitro as well as osteoconduction of the material in vivo to a commercially produced porous hydroxyapatite cylinder (HA-B). HA-A (4 x 4 mm) was synthesized by mixing HA powder, gelatin, and vegetable oil. The material had a bimodal pore size distribution, with intragranular (10 nm to 10 microm) and intergranular (100 microm) pores, and porosity of 40 vol %, while HA-B had pore sizes ranging from 50 to 300 microm and identical porosity. In vitro drug release was tested using antibiotics (isepamicin sulfate, vancomycin hydrochloride, and flomoxef sodium) soaked on the HA cylinders using a vacuum system. The mean adsorption efficiency was higher for HA-A (46%) than for HA-B (26%) and higher levels of antibiotic were released from HA-A. Of the antibiotics, ISP showed the longest release duration. Bone ingrowth into the pores was observed for both materials. Because the novel HA showed both the slower release of antibiotic (nanosize pores) and supported excellent osteoconduction (microsize pores), it could be useful for the treatment of osteomyelitis.

Adsorption↗