PubMed Health⌕ Search

Biomedical subjects

Jun Nishida

Publications and source records attributed to Jun Nishida.

At least 19 recordsLinked to original sources

Clinical relevance of pathological grades of malignant peripheral nerve sheath tumor: a multi-institution TMTS study of 56 cases in Northern Japan.

BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) is a relatively rare soft tissue tumor, and its clinical relevance of pathological grades remains obscure. METHODS: Fifty-six cases of MPNST identified from the files of seven oncology centers of the Tohoku Musculoskeletal Tumor Society (TMTS) and National Cancer Center were analyzed for histologic grades, demographics, treatments, and prognostic factors. The average follow-up period was 41 months. RESULTS: Twenty-two men and 34 women with a mean age of 45 years were involved. Forty-four (78.6%) of 56 tumors were in the lower extremity or trunk. Fifty tumors (89%) were classified as high grade, and the remaining six as low grade. Twenty-one (39.6%) of 53 patients who underwent tumor excision developed local recurrences. An axial site and inadequate surgical margin were defined as risk factors for local recurrence. The overall survival rates of the 56 patients were 55.1% at 3 years and 43.3% at 5 years. Univariate analysis of the 56 patients revealed large-sized tumors, metastasis at presentation, and histologically high grade were significantly associated with poor prognosis. Multivariate analysis revealed a large tumor and metastasis at presentation to be independent prognostic factors. CONCLUSIONS: The current study involving 56 patients with MPNST showed the aggressive clinical behavior of the tumor. Large-sized tumors, metastasis at presentation, and high histological grade were related to poor prognosis on univariate analysis, but independency of histological grade was still obscure. In the treatment for a large and high-grade MPNST, an alternative strategy should be further considered.

Adolescent↗

Tuberculous bicipitoradial bursitis: a case report.

An 76-year-old man with an indolent soft tissue mass on the volar aspect of the left elbow was referred to our institution with a diagnosis of a soft tissue tumor. He had a history of lung tuberculosis since the age of 30. The mass was adjacent to the biceps brachi tendon. It demonstrated homogeneous low-signal intensity on T1-weighted magnetic resonance (MR) images and heterogeneous relatively high signal intensity with scattered low and high signal intensity areas on T2-weighted MR images. An excision was performed after needle biopsy with presumptive diagnosis of bicipitoradial bursitis. The histological specimen revealed an epithelioid cell granuloma with central necrosis. While the occurrence of tuberculous bicipitoradial bursitis has never been reported, this case demonstrates that it can be considered to be among the causes of a cystic lesion around the elbow joint.

Aged↗

Effect of hyaluronic acid on the excursion resistance of tendon graft: a biomechanical in vitro study in a modified human model.

BACKGROUND: Adhesion between the tendon and tendon sheath after flexor tendon graft inhibits restoration of excursion and strength of the grafted tendons, so post-operative finger function is occasionally unsatisfactory. Early setting rehabilitation is one important factor to prevent the adhesion, and another factor may be a lubricant. We considered the possibility of utilizing hyaluronic acid as a lubricant. The goal of this study is to investigate the in vitro effect of hyaluronic acid on tendon excursion resistance against a digital pulley in a modified human model. METHODS: The excursion resistance between grafted intrasynovial and extrasynovial tendons and A2 pulley were evaluated, and compared before and after soaking in 10 mg/ml hyaluronic acid. FINDINGS: The resistance increased after extrasynovial tendon graft, and then it decreased after soaking hyaluronic acid solution. INTERPRETATION: The evidence we collected suggests that some style of administration of the hyaluronic acid might reduce the excursion resistance in the tendon-pulley unit, facilitating post-operative rehabilitation and limiting adhesion, after tendon graft and possibly improve the clinical outcome of flexor tendon graft.

Adjuvants, Immunologic↗

Vascularized iliac bone graft for iliosacral bone defect after tumor excision.

We present the clinical outcome of five patients who had reconstruction of large osseous defects in the iliosacral region after excision of aggressive bone tumors using pedicled-or free-vascularized iliac bone grafts. Surgical margin, incidence of recurrence and metastasis, patient survival, time to bone union, and postoperative function were evaluated. Limb-salvage surgery resulted in wide excisions in two patients with giant-cell tumors of bone and chordoma, respectively, a marginal excision in one patient with a schwannoma, and intralesional excisions to preserve nerve roots in two patients with giant-cell tumors. There was no recurrence at final followup in any of the patients. Bone union required an average of 5.4 months. The postoperative functional results were excellent in all patients except for the patient with a chordoma. In one of the patients with a giant-cell tumor, the screws and rod were removed partially because of skin necrosis in the instrumentation area. This technique is considered a good alternative for reconstruction of a large osseous defect in the pelvis because graft harvest is relatively simple and rapid, especially if a pedicled iliac bone transfer is performed.

Adult↗

Comparative responsiveness of Japanese versions of the DASH and SF-36 questionnaires and physical measurement to clinical changes after carpal tunnel release.

The purpose of the present study was to test the responsiveness of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder and Hand questionnaire (DASH-JSSH) by evaluating effect size (ES) and standardised response mean (SRM) in patients undergoing carpal tunnel release. Subjects comprised 25 patients with carpal tunnel syndrome. All subjects completed the DASH-JSSH, medical outcomes 36-item short-form health survey (SF-36) and visual analogue scale (VAS) for pain and underwent objective assessment of grip strength, pinch strength and static two-point discrimination before and three months after surgery. DASH-JSSH displayed the highest sensitivity to changes at three months, followed by VAS. All subscales of SF-36 were much less sensitive and both grip and pinch strength were unchanged over the three-month period. DASH-JSSH demonstrated more responsiveness to changes after carpal tunnel release than SF-36, VAS and physical measurements, and displayed correlations with subscales of SF-36.

Adult↗

DPPH radical scavenging reaction of hydroxy- and methoxychalcones.

The DPPH radical scavenging activity of 2',4',6'-trihydroxy- and 2'-hydroxy-4',6'-dimethoxychalcones carrying a 2,3- and 3,4-dihydroxylated, and 3,4,5-trihydroxylated B-ring was evaluated in alcoholic and non-alcoholic solvents. All test compounds scavenged more than two equivalent of radicals by a possible conversion to the corresponding B-ring quinones and in most cases subsequently underwent cyclization to aurones and flavanones, these being identified in the reaction solutions by an in situ NMR analysis. Interestingly, the reaction between 2',3,4-trihydroxy-4',6'-dimethoxychalcone and the DPPH radical was significantly affected by the solvent used, which might be accounted for by the difference in readiness for cyclization to an aurone.

Biphenyl Compounds↗

Validation of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder, and Hand questionnaire.

BACKGROUND: The Disability of the Arm, Shoulder and Hand (DASH) questionnaire is a region-specific self-administered questionnaire that consists of a disability/symptom (DASH-DS) scale, and two optional modules, the work (DASH-W) and the sport/music (DASH-SM) modules. The DASH was cross-culturally adapted and developed by the Impairment Evaluation Committee, Japanese Society for Surgery of the Hand. The purpose of this study was to test the reliability, validity, and responsiveness of the Japanese version of DASH (DASH-JSSH). METHODS: A series of 72 patients with upper extremity disorders completed the DASH-JSSH, the medical outcomes study 36-item short-form health survey (SF-36), and the Visual Analog Scale (VAS) for pain. Thirty-eight of the patients were reassessed for test-retest reliability 1 or 2 weeks later. Reliability was investigated by reproducibility and internal consistency. To analyze the validity, a principal component analysis and correlation coefficients between the DASH-JSSH and the SF-36 were obtained. Responsiveness was examined by calculating the standardized response mean (mean change/SD) and effect size (mean change/SD of baseline value) after carpal tunnel release of the 17 patients with carpal tunnel syndrome. RESULTS: Cronbach's alpha coefficients in the DASH-DS and DASH-W were 0.962 and 0.967, respectively. The intraclass correlation coefficients for the same were 0.82 and 0.85, respectively. The unidimensionality of the DASH-DS and DASH-W were confirmed. The correlations between the DASH-DS score and the subscale of the SF-36 scale ranged from -0.29 to -0.73. The correlation coefficient between the DASH-DS and the DASH-W was 0.79. The standardized response mean/effect size of DASH-DS, DASH-W, and VAS for pain were -0.48/-0.26, -0.68/-0.41, and -0.40/-0.40, respectively. DASH-DS and DASH-W were as moderately sensitive as VAS for pain. CONCLUSION: The DASH-DS and DASH-W Japanese version have evaluation capacities equivalent to those of the original and other language versions of the DASH.

Adult↗

Changes in microstructure and gene expression of articular chondrocytes cultured in a tube under mechanical stress.

OBJECTIVE: The objective of this study was to clarify the effects of mechanical stress on chondrocytes cultured in a tube. Centrifugal pressure was applied to chondrocytes cultured in a tube for 28 days, and the effect of this stress was evaluated using a molecular biological method. DESIGN: Articular cartilage was harvested from a rabbit. A cell suspension was then prepared, and transferred in 1 ml aliquots to polypropylene tubes. After 48 h of incubation, centrifugal pressure (6.9 MPa) was applied every 24 h. Changes in morphology, expression of messenger RNA (mRNA) for insulin-like growth factor-I (IGF-I) and type II collagen, cell number, wet weight and protein concentration were evaluated. RESULTS: Microscopically, formation of chondrocyte clusters was seen in the cultures subjected to stress. Ultrastructurally, collagen fibers were seen to run parallel to the cytoplasmic surface of the stressed chondrocytes. The peak of IGF-I mRNA expression was seen on day 5, whereas type II collagen mRNA expression peaked on day 14. Cell number, wet weight and protein concentration were significantly increased in the stressed cultures. CONCLUSIONS: These results suggest that mechanical stress might affect the arrangement of collagen fibers and the IGF-I activity of chondrocytes cultured in a tube, thus influencing chondrocyte proliferation and increasing the volume of the extracellular matrix. Furthermore, mechanical stress may also affect the metabolism of articular cartilage in vitro.

Animals↗

Solid variant of aneurysmal bone cyst of the cervical spine.

STUDY DESIGN: A case of the solid variant of aneurysmal bone cyst affecting the posterior component of the fourth cervical vertebra is reported. Imaging studies showed an expansile destructive lesion. After curettage, autologous iliac bone grafting with posterior fusion was performed. There was no sign of local recurrence 2 years after surgery. OBJECTIVES: To emphasize the occurrence of the solid variant of aneurysmal bone cyst in the cervical spine. SUMMARY OF BACKGROUND DATA: The solid variant of aneurysmal bone cyst is rare, and only 12 cases occurring in the vertebrae, including 3 in the cervical vertebrae, have been reported. The condition is difficult to diagnose radiologically before biopsy or surgery. METHODS: A 9-year-old girl presented with pain in the nape of the neck without any neurologic deficit. She was found to have the solid variant of aneurysmal bone cyst in the posterior component of the fourth cervical vertebra, which had destroyed the lamina and spinous process. Part of the posterior aspect of the C4 vertebral body was also involved. Curettage of the lesion was performed, and the defect in the posterior component of the vertebra was reconstructed using an autologous iliac bone graft with posterior fusion using a halo vest. RESULTS: Magnetic resonance imaging disclosed a homogeneous low intensity mass at the lamina, spinous process, and vertebral body of C4 on T1-weighted images. The mass showed heterogeneous high signal intensity on Gd-enhanced images. Histologically, the resected specimen showed predominant fibroblastic proliferation, with minor foci of reactive osteoid formation and an area of osteoclast-like giant cells. Neither cellular atypia nor mitotic figures were evident. There was no sign of local recurrence 2 years after surgery. CONCLUSIONS: The solid variant of aneurysmal bone cyst should be included in the differential diagnosis of any lytic expansile lesion of the spine, even though it is a destructive lesion. Gd-enhanced magnetic resonance imaging may be helpful for distinguishing the solid variant from conventional aneurysmal bone cyst.

Bone Cysts, Aneurysmal↗

Stress fracture of the second metacarpal bone.

Stress fractures are usually encountered in athletes; however, only eight such cases involving the metacarpal bones have been reported in the English literature. We report on the rare case of a 15-year-old female tennis player with a stress fracture of the second metacarpal bone.

Adolescent↗

Rapid involution of proliferative fasciitis.

A process of evolution and involution is a characteristic feature of reactive fibrous lesions, but has not been emphasized in either the radiology or pathology literature. We report a case of proliferative fasciitis, pseudotumorous fibrous proliferation similar to nodular fasciitis, showing evolution and involution during a 1-month period. A 35-year-old Japanese woman presented with a tender soft tissue mass in the forearm that had grown over a 2-week period. MR imaging revealed a soft tissue mass of nonspecific signal intensity on the muscle fascia. Needle biopsy revealed diffuse proliferation of fibroblastic spindle cells representing proliferative fasciitis. Two weeks after biopsy the mass had rapidly decreased in size, and the pain subsided. MR imaging obtained 1 month later demonstrated only minimal residual reactive change along the fascia. Conservative treatment may be a reasonable treatment option for this condition.

Adult↗

Bone scintigraphic and CT evaluation of chondrosarcoma of the rib: correlation with histological grade in 6 cases.

OBJECTIVE: The objective of this study is to assess the value of CT and bone scintigraphic findings for grading of rib chondrosarcoma. METHODS: Included in this study were six cases of histologically proven chondrosarcoma of the rib, in which bone scintigraphy and/or CT was performed. Correlation of histologic grade (I-III), tumor size on CT, CT grading (modified Brown's system), the pattern (nodular or peripheral, presence or absence of extended uptake pattern) and the intensity (Simon and Kirchner's grade, 0-4) of scintigraphic uptake were assessed. RESULTS: CT grade was III, except for one case of dedifferentiated chondrosarcoma. Scintigraphic grade was 3 or 4 in all the cases. CONCLUSION: The patterns of CT and bone scintigraphic findings more likely reflect the size of the mass and ossification, and are not well correlated with the histological grading.

Adult↗

Skeletal muscle metastases of carcinoma: a clinicopathological study of 12 cases.

OBJECTIVE: To clarify the clinical and magnetic resonance (MR) imaging features of a rare condition of metastasis of carcinoma to skeletal muscle. METHOD: Clinicopathological findings for 12 patients (10 male, two female, age range 48-89 years, mean age 68 years) with skeletal muscle metastases of carcinomas were reviewed retrospectively. RESULTS: In nine of the 12 patients the skeletal muscle metastasis was presented as "painful mass". The lung was found to be the most common primary source, accounting for 33% of the cases, and the lower extremity was the most common metastatic site, accounting for 67% of the current series. Diagnosis was made by biopsy in all cases. Overall, MR images were not specific, but on the gadolinium-DTPA enhanced MR images, extensive peritumoral enhancement associated with central necrosis was found in 11 of the 12 patients (92%). Seven patients died within 2-19 months (average: 9 months) after the detection of the skeletal muscle metastasis, among whom only one patient was continuously disease free for 92 months after wide excision of the metastatic lesion. CONCLUSION: Skeletal muscle metastasis is often presented as a painful mass in patients with known primary carcinoma. For diagnosis, needle biopsy is mandatory. However, a painful mass with an extensive peritumoral enhancement should be highly suspected to represent carcinoma metastasis to skeletal muscles. In selected patients, wide excision with combined chemotherapy could yield unexpectedly good results.

Aged↗

Osteosarcomas after the age of 50: a clinicopathologic study of 64 cases--an experience in northern Japan.

BACKGROUND: The clinicopathologic profile and prognostic factors of osteosarcomas after the age of 50 years have been obscure. METHODS: Clinicopathologic features were analyzed in 645 patients with osteosarcoma who were registered at the Tohoku Musculoskeletal Tumor Society and National Cancer Center in Tokyo between 1972 and 2002. RESULTS: Sixty-four patients (9.9%; 34 men and 30 women) were more than 50 years old. The most common location was the distal femur (n = 13), followed by the pelvis (n = 10), proximal femur (n = 9), and proximal fibula (n = 6). Seven (11%) patients had lung metastasis at initial presentation. On radiographs, an osteolytic appearance without periosteal reactions was a common and characteristic feature. Forty-eight tumors (75%) were classified as conventional osteosarcomas. Fourteen cases (22%) were secondary; postradiation osteosarcoma was most common in these patients, but there was no Paget's sarcoma. At the initial presentation, misdiagnoses without biopsy were made in 15 (23%) of the 64 cases. Preoperative chemotherapy was given to 22 patients, but the effect was poor in 18 cases (82%). Fifty-four patients underwent surgery, whereas the other 10 patients were treated without surgery because of systemic or inoperable local conditions. The overall survival rate at 5 years was 55.5%. Multivariate analysis showed initial pulmonary metastasis, axial tumor location, and larger tumors as significant prognostic factors. CONCLUSIONS: In northern Japan, most patients with osteosarcoma after the age of 50 had primary osteosarcoma. Careful radiological examination and biopsy are mandatory for correct diagnosis. Current systemic chemotherapy is not effective for this age group. Alternative treatment strategies should be considered.

Age of Onset↗

Tetraparesis caused by chondroblastoma of the cervical spine: a case report.

STUDY DESIGN: A chondroblastoma of the posterior component of the seventh cervical vertebra with tetraparesis was reported. Imaging studies showed an expansile destructive lesion with mineralization. OBJECTIVES: To emphasize the occurrence of tetraparesis caused by chondroblastoma in the cervical spine. SUMMARY OF BACKGROUND DATA: Chondroblastoma is a rare benign neoplasm of the bone. Only eight cases of chondroblastoma occurring in the vertebra are reported in the literature, including five in the cervical vertebrae. However, there was no reported case of tetraparesis in the literature. METHODS: A 19-year-old man had a tetraparesis caused by chondroblastoma of the posterior component of the seventh cervical vertebra, which invaded the vertebral body with an extraosseous involvement. Imaging studies showed an expansile destructive lesion with mineralization. Curettage of the lesion was performed from both anterior and posterior approaches. The defect of the vertebral body was reconstructed by autologous iliac bone graft with posterior fusion using the Luque instrumentation system. RESULTS: Histologically, the tumor cells were forming cartilage with round or oval nuclei, which often were indented or had a longitudinal groove. There was no sign of local recurrence, and the neurologic deficit had fully recovered 2 years and 3 months after surgery. CONCLUSIONS: Chondroblastoma should be included in the differential diagnosis of lytic expansile destructive lesion of the spine, although there is an extraosseous involvement. Prompt adequate surgery should be performed as soon as possible after establishment of the correct histologic diagnosis to restore the neurologic deficit.

Adult↗

Dendritic cell and effector cell infiltration in soft tissue sarcomas with reactive lymphoid hyperplasia.

The lymph node is the site of antigen presentation, and dendritic cells are sentinels for anti-tumor immunity. However, little is known about the histological features of lymph nodes and dendritic cells in soft tissue sarcomas. The reactive lymph node and infiltration of dendritic cells or effector cells were studied histologically in 10 soft tissue sarcomas with reactive lymphoid hyperplasia. The cases included four malignant fibrous histiocytomas, two malignant peripheral nerve sheath tumors, one synovial sarcoma, one epithelioid sarcoma, one malignant granular cell tumor, and one liposarcoma. The proportions of the T zone, lymphoid follicle, and lymphoid sinus (which was occupied by cells immunopositive for antibodies against CD3, CD20, or CD68) were 33.4% +/- 11.0%, 6.1% +/- 4.9%, and 13.5% +/- 6.5%, respectively. T zone hyperplasia was observed in all cases, and sinus histiocytosis was found in four. The proportion of the T zone in regional lymph nodes of soft tissue sarcoma patients was significantly higher than that in adult autopsy cases without a cancer history. CD8-, TIA-1-, or granzyme B-positive effector cells were found in each sarcoma tissue. Whereas CD1a-positive dendritic cells were not detected, S-100 protein-positive or CD83-positive dendritic cells were observed in five sarcoma tissues. The coefficient correlation between the numbers of effector cells and dendritic cells positive for CD83 or S-100 protein were demonstrated. Although this is a preliminary report, the present study demonstrated that some soft tissue sarcoma patients showed reactive lymphoid hyperplasia. Furthermore, the association between the infiltration of dendritic cells and that of effector cells was observed in patients with soft tissue sarcomas.

Adolescent↗

Congenital pseudoarthrosis of the tibia treated with low-intensity pulsed ultrasound stimulation (LIPUS).

A 16-year-old Japanese boy was admitted to our institution in September 2000 because no apparent callus had appeared around a fracture after 6 weeks of cast fixation. Physical examination revealed a tenderness of the right lower leg, and multiple small subcutaneous tumors and café-au-lait spots in extremities and trunk. Radiographs showed the fracture of the right lower tibia with bony sclerosis and a localized fusiform osteolytic lesion at the fracture site. The affected tibia bowed anteriorly and the medullary space in the lower tibia was narrow. A diagnosis of Boyd type IV congenital pseudoarthrosis of the tibia was made. Treatment with low-intensity pulsed ultrasound (US) stimulation (LIPUS) was administered for 20 min/day, and a nonweight-bearing gait was continued with a cast or brace fixation. At 6 months after the treatment, a small amount of bridging callus was seen. We continued the treatment for 1 year until the solid fusion was observed on radiographs and the patient started full-weight-bearing.

Adolescent↗