Biomedical subjects

Junnosuke Ryu

Publications and source records attributed to Junnosuke Ryu.

12 recordsLinked to original sources

PubMed2007

Survivin expression levels as independent predictors of survival for osteosarcoma patients.

Survivin expression has been detected in various cancers and correlations have been recognized between the level of expression of this gene in tumors and prognosis. However, the aforementioned authors did not evaluate correlations between prognosis and survivin expression levels using surgically resected samples. In this study, we retrospectively investigated outcomes by examining the correlations between expression of this gene and clinicopathological parameters. Biopsy and resected specimens from which paraffin-embedded tissues could be extracted, were available from 16 patients in our hospital. We used the RT-PCR method and conducted a densitometric analysis to determine the ratio of survivin relative to h-GAPDH as an internal marker. Expression of survivin mRNA was detected in all samples. There was a significant negative correlation between survivin expression levels and duration of follow up, in months, using the Spearman's rank for the initial biopsy samples (rho=-0.775, p<0.01) and those obtained after chemotherapy (rho=-0.687, p<0.01). Moreover, Cox multivariate regression identified the survivin expression levels in both biopsy and post-chemotherapy samples as independent predictors of survival. We conclude that survivin levels in both initial biopsy and post-chemotherapy samples are useful prognostic indicators.

Adolescent↗

PubMed2006

Midterm results of Metasul metal-on-metal total hip arthroplasty.

We assessed 106 total hip arthroplasties performed with a new metal-on-metal hip system; the patients were monitored for at least 5 years. The average Harris Hip Score of the patients was 39.5 points before surgery and 87.8 points at final follow-up evaluation. Radiographically, the acetabular component was stable in 103 hips and possibly unstable in 3 hips. The femoral component was bone ingrown in 97 hips and stable and fibrous in 9. After surgery, 6 hips dislocated. The polyethylene liner dissociated in one patient. No patient exhibited clear signs of loosening, migration, or osteolysis. Distal femoral cortical hypertrophy was seen in 35.8% of the cases. Survival at the mean follow-up point (6.4 years) was 99.1%. There was no significant difference in serum chromium concentration between metal-on-metal bearings and polyethylene-on-metal bearings (control subjects). This study found that metal-on-metal total hip arthroplasty produces excellent midterm results.

Acetabulum↗

PubMed2006

Radical excision of malignant sacral tumors using a modified threadwire saw.

BACKGROUND: Surgical treatment of malignant sacral tumors is difficult, and has a high rate of recurrence. OBJECTIVES: The aim of this study was to examine the wide margin of large and small malignant sacral tumors using a threadwire saw (T-saw). MATERIALS AND METHODS: We devised a flexible silver guide probe connected to a modified threadwire saw by a suture thread to perform osteotomies. We operated on 10 patients with sacral tumors using this device. The sacral excisions were performed via a posterior approach by four surgeons (two on each side) working simultaneously. RESULTS: We obtained a wide margin in all cases and no recurrence, after a mean follow-up of 4 years 2 months (range, 1 year 8 months-7 years 8 months). In one case, one nerve root on the right side was injured. CONCLUSIONS: Our new method is easier and faster than the conventional method in cases in which bilateral sacral nerve root canals require sectioning, and it produces a wide tumor margin.

Adult↗

PubMed2006

The combined effects of anti-TNFalpha antibody and IL-1 receptor antagonist in human rheumatoid arthritis synovial membrane.

TNFalpha and IL-1 are the pivotal cytokines involved in rheumatoid arthritis (RA). More recently, the biological therapy targeting TNFalpha or IL-1 has been impressively effective for many RA patients, however, it remains insufficient in some patients. In the present study, we examined the combined effects of two agents against TNFalpha and IL-1 in human RA synovial membrane. Synovial explants (an ex vivo model) and synovial fibroblasts (an in vitro model) were prepared from 11 RA patients, and then anti-TNFalpha antibody (Anti-TNFalpha) and IL-1 receptor antagonist (IL-1Ra), either alone or in combination, were added to the synovial explants and fibroblasts. IL-6 and MMP-3 production were measured after incubation. As a result, their production significantly decreased by the combination of agents compared with the control group in both the synovial explants and fibroblasts. The efficacy of this combination was also observed for IL-6 production compared with each agent alone in the synovial explants, and for IL-6 and MMP-3 production compared with each agent alone in the synovial fibroblasts. Therefore, the combination of Anti-TNFalpha and IL-1Ra appears more beneficial in synovial membrane, particularly when compared with a single agent alone.

Adult↗

PubMed2005

Clinical significance of a wide excision policy for sacrococcygeal chordoma.

PURPOSE: Surgical treatment of sacrococcygeal chordoma is very difficult and the recurrence rate is high. We investigated the outcomes of wide excision in 12 sacrococcygeal chordoma patients treated between 1983 and 2003. METHODS: The 12 patients underwent primary wide excision. The conventional procedure was wide excision employing a chisel and airtome for sacral tumours, and in 1997 a new threadwire saw procedure was introduced. All 12 patients were included in a retrospective analysis of tumour- and treatment-related variables, and outcomes. RESULTS: Six patients underwent surgery with a combined anterior-posterior approach at the cephalad sacral border. In 12 patients, 11 lesions were broadly excised, and in the 1 remaining patient the intralesional margin showed tumour contamination due to a fracture macroscopically. The latter patient received post-operative radiation therapy, but suffered a recurrence 8.0 years later. Three patients died before final follow-up: one from subsequent metastases, two elderly patients from complications. For the 10 chordoma patients, i.e. excluding the two who died due to complications, the 5, 10 and 20 years recurrence rates were 100, 66.7 and 66.7%, respectively. For the 12 patients, overall 5, 10 and 20 years survival rates were 83.3, 55.6 and 55.6%, respectively. CONCLUSIONS: Our results suggest that large chordoma should be widely excised, using a modified threadwire saw, with a combination of anterior-posterior procedures.

Adult↗

PubMed2005

A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis.

STUDY DESIGN: A semi-prospective clinical study was conducted. OBJECTIVES: To evaluate the accuracy of a revised scoring system predicting metastatic spinal tumor prognosis and the suitability of the subsequent treatment strategy. SUMMARY OF THE BACKGROUND DATA: We used a scoring system for the preoperative evaluation of the prognosis of metastatic spinal tumors and selected treatment methods for the predicted prognosis. In the previous version of our scoring system, the reliability of the predicting prognosis was 63.3% in 128 patients with metastatic spinal tumors. METHODS: The study participants were 164 patients who died after surgery and 82 who died after conservative treatment. Six parameters were used in the revised scoring system. Each parameter ranged from 0 to 5 points, and the total score was 15 points. In principle, conservative treatment or palliative procedures were indicated in patients with a total score of 8 or less (predicted survival period, less than 6 months) or those with multiple vertebral metastases, while excisional procedures were performed in patients with a total score of 12 or more (predicted survival period, 1 year or more) or those with a total score of 9 to 11 (predicted survival period, 6 months or more) and with metastasis in a single vertebra. The selection of treatment modality was followed faithfully according to the criteria of the revised scoring system after 1998. The prognosis predicted by the revised scoring system and the actual survival period after treatment were compared, and the reliability of the prognostic criteria was analyzed for the group subjected to it prospectively after 1998 (n = 118) and for all 246 patients it was applied to retrospectively. RESULTS: The total score for each patient could be correlated with the survival period. This correlation was also observed in each treatment group. The consistency rate between the predicted prognosis from the criteria of the total scores and the actual survival period was high in patients within each score range (0-8, 9-11, or 12-15), 86.4% in the 118 patients evaluated prospectively after 1998, and 82.5% in the 246 patients evaluated retrospectively. Furthermore, a similar result was also observed in both the surgical procedure group and conservative treatment group. The rate of consistency between the predicted prognosis and the actual survival period in each local extension of the lesion was 75% or more in all types, excluding Type 6 in the surgical classification of Tomita et al. CONCLUSION: The prognostic criteria using the total scores from our revised scoring system were useful for the pretreatment evaluation of metastatic spinal tumor prognosis irrespective of treatment modality or local extension of the lesion.

Adolescent↗

PubMed2005

New meniscus repair by an all-inside knot suture technique.

The indications for the all-inside knot suture technique include tears in the red-red zone or red-white zone in the meniscus, and a horizontal tear, a vertical tear, and a peripheral tear. First, find an appropriate place for a suture insertion site with a Kateran needle or a spinal needle. Make sure it exits beyond the tear in the meniscus. Once the insertion site is chosen, a suture is passed into and through the joint. The suture is slowly pulled back. You should be able to feel the tip of the suture come out of the joint capsule. If you want to make a vertical suture to suture the tear, move the suture vertically apex. Then insert the suture back into the joint through the capsule. Make sure the suture stays inside the joint. Find and grab the suture with a punch inserted from the clear cannula. Pull the suture out of the joint through the clear cannula with the punch. Tighten the knot with a knot pusher. Then confirm the stability of the sutured site with the probe. Our all-inside knot suture technique can be performed arthroscopically, allowing reliable repair of the torn meniscus.

Anterior Cruciate Ligament↗

PubMed2005

[Surgical treatment of rheumatoid arthritis based on EBM].

Even though the advancement of pharmacotherapy, the maintenance treatment to keep the function of degenerated and destructed joint on rheumatoid arthritis and the surgical treatment for joint reconstruction are very important to prevent the patients from being bedridden and to keep the quality of life. The adaptation of operation varies among disease stage and site of bone destruction. Missing the chance of operation, it becomes impossible to perform surgical treatment. So it is important to consult with specialist finding proper opportunity.

Arthritis, Rheumatoid↗

PubMed2004

Meniscus allograft transplantation using posterior peripheral suture technique: a preliminary follow-up study.

The aim of this study was to describe the indication, planning, technique, rehabilitation, and clinical results after cryopreserved allograft meniscus transplantation. Forty consecutive patients, 33 men and 7 women (mean, 37.3 years of age), were evaluated at 1-year follow-up post surgery. Symptoms, patient satisfaction, ROM (range of motion), surgical time, blood loss, and surgical history were evaluated. Thirty-eight (95%) patients had previous total or partial meniscectomy (mean, 11.4 years ago). Preoperatively, chief complaints were knee joint line pain and swelling. Mean surgical time and blood loss were 123 min and 87 g, respectively. At 12 months postsurgery, 5% and 10%, respectively, complained of pain and swelling; ROM was 0 degrees -132 degrees. Thirty-eight (95%) patients were satisfied. According to the results, meniscus transplantation can lead to significant pain relief and satisfaction in young symptomatic meniscectomized patients. However, long-term results must be obtained to prove the effectiveness of this technique in prevention of degenerative joint changes.

Adult↗

PubMed2004

Discoid lateral menisci in Japanese cadaver knees.

We undertook a descriptive, observational study to determine the prevalence of the discoid lateral menisci. The relation between the lateral meniscal shapes and the incidence of meniscal tears were studied, and the gender differences in discoid lateral menisci and the similarities of the lateral meniscal shapes in bilateral knees were examined. A total of 602 knees from 306 cadavers were macroscopically analyzed. Altogether, 577 lateral menisci were classified into the following three types: normal type (NM); incomplete discoid type (ICDM); and complete discoid type (CDM). Each lateral meniscus was examined for meniscal tears. The prevalence of a discoid lateral meniscus and gender differences in its prevalence were examined, as were the presence of a meniscal tear for the three types of lateral meniscus. In all, there were 21 (3. 6%) CDM cases and 171 ICDM cases (29.6%). The prevalence of discoid lateral meniscus, including ICDM and CDM, in the female cadavers was significantly higher than that in the male cadavers, but there was no significant gender difference in the prevalence of CDM. It was found that the shape of the lateral meniscus was similar bilaterally. The incidence of meniscal tears for ICDM was significantly higher than that for NM.

Journal Article↗

PubMed2004

Patellar dislocation: arthroscopic patellar stabilization with anchor sutures.

There are many procedures to treat recurrent patellar subluxations and dislocations. Most of these procedures are open repairs for acute conditions or open reconstructions for chronic conditions, and both surgeries need large skin incisions. Although there are many arthroscopic procedures for meniscal and ligament injuries, there are very few arthroscopic procedures described for patellofemoral instability. In this report, we describe a new arthroscopic method to stabilize the patella for acute dislocation. Our technique includes an arthroscopic lateral release and a medial structure repair. We suggest that this procedure is minimally invasive and easier than traditional open procedures. Moreover, this may prevent patients from developing chronic instability of the patellofemoral joint.

Acute Disease↗

PubMedDate not supplied

Correlation between the histological grade of chondrosarcoma and the expression of MMPs, ADAMTSs and TIMPs.

BACKGROUND: The malignant degree of human chondrosarcoma can be difficult to determine using only histological findings. We, therefore, assessed the expression of matrix metalloproteinases (MMPs), a disintegrin and metalloproteinase (ADAM) with thrombospondin motifs (ADAMTSs) and tissue inhibitor of metalloproteinases (TIMPs) in chondrosarcoma and ascertained the relationships to histological degree of malignancy and prognosis. MATERIALS AND METHODS: In 28 chondrosarcoma cases, immunostaining was performed using antibodies against MMP 2, 3, 7, 9, 13, ADAMTS 4, 5 and TIMP 1, 2, 3. RESULTS: The chondrosarcoma were classified into groups of 7, 15 and 6 cases based on histologically malignant grade I, II and III, respectively. All target proteins were expressed in chondrosarcoma. Positive correlations (p < 0.05) existed between immunostaining scores and histological grades for all proteins except MMP 9, with strong correlations (p < 0.01) for MMPs 2, 3 and 13, both ADAMTSs and all 3 TIMPs. No correlation existed between prognosis and immunostaining scores. CONCLUSION: These target proteins could, thus, indicate the degree of malignancy in human chondrosarcoma.

ADAM Proteins↗