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Kenji Takagishi

Publications and source records attributed to Kenji Takagishi.

At least 19 recordsLinked to original sources
PubMed2006

Effects of the Second National Acute Spinal Cord Injury Study of high-dose methylprednisolone therapy on acute cervical spinal cord injury-results in spinal injuries center.

STUDY DESIGN: Retrospective single-center study. OBJECTIVE: To evaluate the recovery of motor function and the early complications in patients with acute cervical spinal cord injury after receiving a high dose of methylprednisolone sodium succinate (MPSS) within 8 hours of injury. SUMMARY OF BACKGROUND DATA: High-dose MPSS therapy has been demonstrated to improve the neurologic recovery in patients with acute spinal cord injury. However, it remains a controversial treatment. METHODS: Seventy patients were included in this study: 37 in the MPSS group who were treated with MPSS within 8 hours of their injury according to the Second National Acute Spinal Cord Injury Study protocol, and 33 in non-MPSS group who were not administered with MPSS. Improvements in the American Spinal Injury Association motor score were compared between the MPSS group and the non-MPSS group. In patients with complete motor loss at admission and follow-up periods, improvements of myotomal levels between the MPSS (n = 15) and non-MPSS groups (n = 21) were compared. Early complications within 6 weeks of high-dose MPSS therapy were compared with those of no MPSS therapy. RESULTS: Among the patients with incomplete paralysis at admission, the American Spinal Injury Association motor scores in the MPSS group were improved more significantly than those in the non-MPSS group at 6 weeks and 6 months after injury. Meanwhile, among the patients with complete paralysis at admission, the patients in the MPSS group did not show significantly more change in motor score than those in the non-MPSS group. Improvement in myotomal level had no significant difference between the MPSS and non-MPSS groups. The MPSS group had 10 patients with early complications, while the non-MPSS group had 14. The differences between the 2 groups showed no statistical significance. CONCLUSIONS: MPSS should be administered to patients with incomplete cervical spinal cord injury according to the Second National Acute Spinal Cord Injury Study protocol.

Acute Disease↗
PubMed2006

Interlaminar bony fusion after cervical laminoplasty: its characteristics and relationship with clinical results.

STUDY DESIGN: A radiographic study in 32 patients with cervical myelopathy. OBJECTIVE: To investigate postoperative interlaminar bony fusion, and its characteristics and relationship to clinical results in patients undergoing laminoplasty. SUMMARY OF BACKGROUND DATA: Laminoplasty is being increasingly performed for multi-segmental cervical myelopathy, and its superior long-term results have been reported in some articles. We often see cases that develop postoperative interlaminar bony fusion after laminoplasty. METHODS: In 32 patients, lateral cervical radiographs were obtained every year after surgery, and postoperative interlaminar bony fusion was evaluated. Range of motion (ROM) of the cervical spine at last follow-up was compared with the respective preoperative values. Furthermore, the neurologic recovery rates at last follow-up were compared to preoperative values. RESULTS: Postoperative interlaminar bony fusion was shown in 17 patients (53%, group 1), and in most, fusion appeared within 3 years after surgery. Average age at surgery in group 1 and the remaining 15 patients (group 2) was 64.6 years and 57.0 years, respectively (P < 0.04). Preoperative and postoperative ranges of motion in group 1 were 45.6 degrees and 28.1 degrees on average, respectively. However, those of group 2 were 50.3 degrees and 39.8 degrees on average, respectively. Postoperative ROM in group 2 was significantly better maintained than that in group 1(P < 0.04). In group 1, the average preoperative Japanese Orthopedic Association score was 9.56 points, which improved to 13.6 points at the final follow-up, providing a 55.6% average recovery. In group 2, it was 10.9 points, which improved to 14.1 points at the final follow-up, providing a 56.5% average recovery. There was no significant difference in the average percentage of recovery between the 2 groups (P > 0.93). CONCLUSIONS: Postoperative interlaminar bony fusion occurred in 53% of patients, with marked frequency at C2/3 after laminoplasty. It did not influence neurologic recovery, but it did reduce the postoperative sagittal ROM of the cervical spine.

Aged↗
PubMed2006

Pre- and postoperative evaluation of the metabolic activity in muscles associated with ruptured rotator cuffs by F-FDG PET imaging.

We examined uptake of 2-[(18)F]-fluoro-2-deoxy-D-glucose (FDG) using positron emission tomography (PET) into the bilateral shoulder muscles of four patients before and after unilateral rotator cuff repair. The relative ratio of the subtracted standardized uptake value on the supraspinatus with a torn supraspinatus tendon to that of the subscapularis on the ipsilateral side was significantly lower than that on the normal side (0.69 +/- 0.05 versus 1.06 +/- 0.36). The relative ratio of the infraspinatus on the rupture side was also significantly lower than that on the normal side (0.91 +/- 0.09 versus 1.41 +/- 0.35). However, by 6 months postoperative, the reduced glucose metabolism in these muscles had recovered to the same levels as those on the normal side. As indicated by FDG PET, muscle metabolism in rotator cuff tears was reduced, subsequently recovering to the level of the normal side after operative repair.

Aged↗
PubMed2005

PET evaluation of fatty tumors in the extremity: possibility of using the standardized uptake value (SUV) to differentiate benign tumors from liposarcoma.

OBJECTIVE: The relative utility of various preoperative diagnostic imaging modalities, including PET (utilizing FDG and FMT), CT, and MR imaging, for evaluation of lipoma and liposarcoma, especially well-differentiated liposarcoma, was investigated. METHODS: Imaging findings in 32 patients with histopathologically documented lipoma, including one with fibrolipoma and one with angiolipoma, and 25 patients with liposarcomas whose subtypes included 10 well-differentiated, 10 myxoid, and 5 other types were reviewed retrospectively. Pre-operative imaging included FDG-PET (n = 44), FMT-PET (n = 21), CT (n = 25), and MR imaging (n = 53). RESULTS: Statistically significant imaging features of MR images favoring a diagnosis of liposarcoma involved lesions containing less than 75% fat (p < 0.001) as well as the presence of septa (p < 0.001). As compared with well-differentiated liposarcoma, benign lesions were differentiated significantly only by the presence of septa (p < 0.001), which also provided significant differentiation on CT (p < 0.05). The mean SUVs for malignant tumors were significantly higher than those for benign lesions in both FDG- and FMT-PET analyses (p < 0.0001, p = 0.0011, respectively). By using a cut-off value for FDG- and FMT-PET set at 0.81 and 1.0 respectively, which provided the highest accuracy, benign lesions were differentiated significantly from liposarcomas (p < 0.001, and p < 0.02). Furthermore, benign tumors and the three subtypes of liposarcoma were divided significantly into four biological grades by FDG- and FMT-accumulation rates (rho = 0.793, p < 0.0001; and rho = 0.745, p = 0.0009, respectively). A cut-off value of 0.81 for FDG-PET provided significant differentiation between benign lesions and well-differentiated liposarcoma (p < 0.01). CONCLUSIONS: The presence of septa on MR images differentiated lipomas from liposarcoma, even well-differentiated type. PET analysis, especially FDG-PET, quantitatively provided not only the differentiation but also the metabolic separation among subtypes of liposarcoma. Interpretation of the visual diagnostic modalities requires extensive experience and carries a risk of ignoring a critical portion of malignancy. PET metabolic imaging may be an objective and useful modality for evaluating adipose tissue tumors preoperatively.

Adult↗
PubMed2005

Histological and biochemical changes of experimental meniscus tear in the dog knee.

BACKGROUND: When degeneration is noted in the meniscus, sutures should not be applied even for a tear of the vascularized region of the meniscus because the meniscus may rerupture after suturing. In this study, the degeneration process of bucket-handle tear of the meniscus was investigated using histological and biochemical markers. METHODS: A bucket-handle tear in the intercondylar notch was prepared in the dog knee. Eight animals each were killed at 2, 4, 12, 24, and 48 weeks; and changes in the articular cartilage were observed. The cell count and morphology in the meniscus were investigated by hematoxylin and eosin staining, and glycosaminoglycans in the matrix were investigated by toluidine blue staining. Glycosaminoglycans were also measured by high-performance liquid chromatography. RESULTS: Erosion was noted in the weight-bearing region of the articular cartilage after 12 weeks. The cell count in the meniscus was markedly decreased at 48 weeks. Regarding cell morphology, fibrochondrocytes remained in the meniscus until 12 weeks. The cell morphology varied at 24 weeks, but the number of cells was maintained. Cell proliferation, mainly fibroblasts, was noted from 2 weeks and 4 weeks after surgery in the periphery and body of the meniscus, respectively. Fibrochondrocyte-like cells proliferated from 12 weeks in the meniscal body, and metachromasia was detected by toluidine blue staining, indicating meniscal repair. A marked decrease in glycosaminoglycans was noted at 48 weeks, which was consistent with the decrease in the cell count in the meniscus. CONCLUSIONS: Early application of sutures is desirable for bucket-handle tear of the meniscus because lesions appear in the cartilage within 12 weeks, but suturing may be performed until 24 weeks because of the absence of obvious meniscal degeneration. However, disorder of the meniscus progresses after 48 weeks and may affect the outcome of the meniscal suture.

Animals↗
PubMed2005

Clinical results after cervical laminoplasty: differences due to the duration of wearing a cervical collar.

OBJECTIVE: This investigation assessed the relationship between the duration of wearing a cervical collar and clinical results in patients undergoing laminoplasty. METHODS: Twenty-five patients with cervical myelopathy who underwent laminoplasty and wore a cervical collar for 8 weeks postoperatively were followed for an average of 27.3 months. A second group of 26 patients who underwent laminoplasty and wore a cervical collar for 4 weeks was followed for an average of 32.8 months. RESULTS: In both groups, neurologic recovery rate and range of motion on lateral cervical radiographs were longitudinally compared with those obtained preoperatively. There was no significant difference in neurologic recovery between the two groups. In patients who wore the cervical collar for 4 weeks, the total range of the cervical spine was better maintained, especially the extension range of the cervical spine, compared with that in the patients who wore the cervical collar for 8 weeks. CONCLUSIONS: It is speculated that early removal of the cervical collar prevents contracture of the facet joint and postoperative atrophy and dysfunction of the extensor musculature of the cervical spine.

Adult↗
PubMed2004

Multivariate analysis of biochemical markers in synovial fluid from the shoulder joint for diagnosis of rotator cuff tears.

Multivariate discriminant analysis allowed definition of cytokine, matrix metalloproteinases (MMP), and tissue inhibitors of metalloproteinases (TIMP) levels in synovial fluid (SF) of patients with rotator cuff tears and other shoulder lesions. We analyzed SF aspirated from the glenohumeral joints of 17 patients with rotator cuff tears; SF from nine patients with other shoulder lesions was used to characterize a non-rotator-cuff-tear (NRCT) group. Discriminant analysis demonstrated statistically significant differences in (1) the determination of whether rotator cuff tear patients are separable from the NRCT group using the influential functions, the most influential of which were interleukin 1-beta, MMP-2, and MMP-13, and (2) the assessment of whether full-thickness rotator cuff tears are distinguishable from partial tears using identical influential functions. The most influential function in the latter analysis was MMP-13. Both interleukin 1-beta and MMP-13 might be biochemical markers of impending rotator cuff tears.

Adolescent↗
PubMed2004

Proprioception and performance after anterior cruciate ligament rupture.

The aim of this study was to investigate the characteristics of proprioception in patients with an anaterior-cruciate-ligament (ACL)-injured knee and to determine whether there is a correlation between proprioception and performance. We studied 32 patients with unilateral isolated ACL ruptures. Proprioception of the knee was evaluated by examining the joint position sense. Functional performance was evaluated with the one-leg hop (OLH) and one-leg vertical jump (OLV) tests. The mean error angle of the joint position sense was 3.6+/-1.5 degrees on the intact side and 5.2+/-1.9 degrees on the injured side. The joint position sense was thus clearly reduced on the injured side (p<0.05). The distance of jumping in the OLH test and the height of jumping in the OLV test was also clearly reduced on the injured side compared with that on the intact side (p<0.01) both with and without visual control. Moreover, we found a significant correlation between proprioception and performance in the ACL-injured knees, and this correlation was more distinct with visual deprivation. In conclusion, decreased proprioception in patients with ACL deficiency reduced their functional ability.

Adolescent↗
PubMed2004

A novel treatment of hypermobile lateral meniscus with monopolar radiofrequency energy.

Orthopedic treatment with radiofrequency energy (RFE) was first used in shoulder surgery, and its effectiveness has been reported. The purpose of RFE treatment of soft tissue is to induce qualitative changes in collagen and obtain stability. Hypermobile lateral meniscus (HLM) is characterized by abnormal mobility resulting from rupture or defects of the popliteomeniscal fasciculi, but no satisfactory treatment has been reported. We followed up patients with HLM who underwent monopolar RFE treatment and confirmed its short-term effects by magnetic resonance imaging and second-look arthroscopy.

Adolescent↗
PubMed2004

Evaluation of muscle metabolic activity in the lower limb of a transfemoral amputee using a prosthesis by using (18)F-FDG PET imaging--an application of PET imaging to rehabilitation.

This study used FDG PET to evaluate the lower limb muscles metabolic activities of transfemoral amputees during walking with prostheses. As a preliminary study, FDG PET was applied for two normal adult volunteers to evaluate muscle activity in the lower extremities after gait exercise. This same method was applied for two amputee volunteers with prostheses. We found that FDG accumulated more in both gluteus medius muscles after gait exercise compared to other muscles in normal adult volunteers. In the skilled amputee volunteer, FDG uptake increased in the adductor and gluteus medius in the amputated side, while in the unskilled the adductor, gluteus maximus, and gluteus medius showed increased FDG uptake only in the normal side. This result suggests that basic metabolic changes such as an increase in oxidative metabolism and less reliance on glycolytic activity would occur as a result of skeletal muscle training in amputees.

Adult↗
PubMed2004

Overexpression of autocrine motility factor in metastatic tumor cells: possible association with augmented expression of KIF3A and GDI-beta.

Autocrine motility factor (AMF), which is identical to phosphohexose isomerase (PHI)/glucose-6-phosphate isomerase (GPI), a ubiquitous enzyme essential for glycolysis, neuroleukin (NLK), a neurotrophic growth factor, and maturation factor (MF) mediating the differentiation of human myeloid cells, enhances the motility and metastatic ability of tumor cells. AMF/PHI activity is elevated in the serum or urine in patients with malignant tumors. Here, we constructed an amf/phi/nlk/mf gene using adenovirus vector and transfected into two tumor cell lines. Overexpression of AMF/PHI/NLK/MF enhanced AMF secretion into the culture media in both tumor cell lines. However, upregulation of motility and metastatic ability was found only in metastatic fibrosarcoma cells expressing an AMF receptor, gp78, and was not found in gp78-undetectable osteosarcoma cells. Thus, not only serum AMF activity but also gp78-expression in tumor cells may be required for metastasis-related motility induction. With the use of microarray analyses, we detected two augmented genes, rho GDP dissociation inhibitor beta and kinesin motor 3A, as well as AMF itself. The RNA message and protein expression of these two molecules was confirmed to be upregulated, suggesting a possible association with AMF-induced signaling for cell motility and metastasis.

Adenoviridae↗
PubMed2004

Eight- to 14-year followup of arthroscopic meniscal repair.

The current study aims to elucidate the midterm to long-term progression of arthroscopic meniscal repair which had been confirmed through a second-look arthroscopy at an average of 10 months after repair. Twenty-eight menisci of 28 patients were investigated at 8 to 14 years (mean, 10.2 +/- 1.8 years), eight after isolated meniscal repair (Isolated group) and 20 after concomitant anterior cruciate reconstruction (Anterior cruciate ligament group). All were rated excellent except four that rated good in the anterior cruciate ligament group as indicated by Lysholm's score at followup. None of the Isolated group, but 12 of the Anterior cruciate ligament group, had osteoarthritic changes seen on radiographs. Four and 19, respectively, had increased signal intensity on magnetic resonance imaging scans, 10 in the Anterior cruciate ligament group had changes of Grade 3 severity. However, no meniscal signs or symptoms were present and no significant relationship between findings of radiographs and magnetic resonance imaging scans was apparent. Anterior cruciate reconstructed knees that were changed to Grade 3 severity as seen on magnetic resonance imaging scans had higher sagittal instability seen on stress radiography than knees with Grade 2 or less severe changes. The anterior laxity of the knees influenced the severity of meniscal signal changes on the magnetic resonance imaging scans.

Adolescent↗
PubMed2003

Reconstruction with autologous pasteurized whole knee joint I: experimental study in a rabbit model.

Hyperthermia-treated bone has been used for skeletal reconstruction after resection of malignant bone tumors, and more favorable results have been seen after pasteurization than after autoclaving or boiling. Pasteurization destroys malignant cells while preserving the bone-inducing property. All previous experimental models have studied replantation of bone segments, but reconstruction of joints is more important clinically. We studied the effects of extracorporeal hyperthermia on the reintegration of autologous whole knee joint grafts over a period of 16 weeks in a rabbit model. The whole knee joint was resected from 32 animals, heat-treated at 65 degrees C for 30 min, and replanted. In the control group, resection and replantation were performed without heat treatment. Reintegration was assessed by macroscopic analysis, histology, histochemistry, and radiography. Reintegration of the pasteurized group showed excellent remodeling during the 16 weeks, similar to the control groups. Responses to the pasteurization and the subsequent reintegration of cartilage, menisci, and ligaments were similar at 4, 8, 12, and 16 weeks with no significant difference between the two groups, although cartilage degradation seemed to occur earlier in the study group than in the control group. These results suggest that pasteurization may be superior to other cell-lethal treatments for autotransplantation of the whole joint currently available.

Animals↗
PubMed2003

Reconstruction with autologous pasteurized whole knee joint II: application for osteosarcoma of the proximal tibia.

Reconstruction of the knee joint for osteosarcoma of the proximal tibia is a formidable challenge. Here we present two patients whose knees were reconstructed with autologous grafts of whole-knee joint treated by extracorporeal pasteurization. Incorporation at the junction between host and pasteurized bone was evident. On the other hand, direct reattachment of the patellar tendon to the pasteurized tibia was not successful in case 1. In case 2, in contrast, the patella was divided followed by successful reconstruction at the osseous site. Avoiding reattachment of pasteurized ligamentous structure is recommended. The operation protocol is not ideal but so far may be superior to other reconstruction procedures because there are many fundamental complications such as low long-term survival of a massive prosthesis and the lethal risk of transfection (e.g. human immunodeficiency virus); moreover, immunological responses of the allograft can be avoided.

Adolescent↗
PubMed2003

FDG-PET for evaluating musculoskeletal tumors: a review.

Positron-emission tomography (PET) can provide an in vivo method for evaluating metabolism and physiology in normal and diseased tissues. Clinical trials with [(18)F]2-deoxy-2-fluoro- d-glucose (FDG), the most commonly used radiolabeled tracer for PET imaging, have demonstrated increased accumulation of FDG in several cancer tissues. In this article, we introduce the basic principles of FDG-PET and review current knowledge about FDG-PET for evaluating musculoskeletal tumors. Recent reports and our own experience suggest that FDG-PET cannot be a screening method for differential diagnosis between benign and malignant musculoskeletal lesions, including many neoplasms originating from different tissues altogether. FDG-PET might not accurately reflect the malignant potential of musculoskeletal tumors, but rather might implicate cellular components included in the lesions. A high accumulation of FDG can be observed in histiocytic, fibroblastic, and some neurogenic lesions, regardless of whether they are benign or malignant. More specific uses of FDG-PET, such as grading, staging, and monitoring of musculoskeletal sarcomas, should be considered for each tumor of a different histologic subtype.

Bone Neoplasms↗
PubMed2003

Human leukocyte antigen and aseptic loosening in Charnley total hip arthroplasty.

Human leukocyte antigen phenotypes and radiographic course were studied in 70 Japanese patients (90 hips) who had Charnley low friction arthroplasty. Of the 28 hips diagnosed as radiographically loose less than 15 years after surgery, seven hips (25.0%) were in patients who had a positive human leukocyte antigen A31(19). Of the 62 hips that were radiographically stable more than 15 years, two hips (3.2%) were in patients who had a positive human leukocyte antigen A31(19). Of the nine hips in patients who were positive to human leukocyte antigen A31(19), seven hips were diagnosed as radiographically loose (loosening rate was 77.8%) 15 years after surgery. On the other hand, of the 81 hips in the patients who were negative to human leukocyte antigen A31(19), only 21 hips were diagnosed as radiographically loose (loosening rate was 25.9%) 15 years after surgery. These data suggest that individual immune response to implant materials, linked to human leukocyte antigen, may participate in the process of aseptic loosening in Charnley low friction arthroplasty.

Adult↗
PubMed2003

[Osteoarthritis].

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Arthroplasty↗