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Biomedical subjects

T Koshino

Publications and source records attributed to T Koshino.

At least 37 records · Page 2Linked to original sources

Reliability of the transepicondylar line as a parameter of femoral axial alignment.

The purpose of this research was to determine the significance of the transepicondylar line as a parameter of femoral axial alignment. Standing full-length X-ray films of 124 knees of 91 patients (63 women, 28 men) with osteoarthritis, rheumatoid arthritis, or osteonecrosis were used in this study, in which the lateral angles formed by the femoral anatomical axis intersecting with the transepicondylar line (angle a'), horizontal line (angle b'), and femoral condylar line (angle r') were measured. The mean value of angle b' in knees with neutral alignment was significantly smaller than that in knees with varus alignment, and significantly larger than that in knees with valgus alignment; no significant difference was found in angle a'. Also, there was no significant difference in angle a' among the patients with osteoarthritis, rheumatoid arthritis, and osteonecrosis. These findings suggest that the transepicondylar line, which is a stable reference of femoral rotation, is also a very reliable parameter of axial alignment of the femur. In the future design of extramedullary guiding for total knee arthroplasty, the transepicondylar line may play an important role as a parameter for proper and accurate implant setting.

Adult↗

New bone formation around porous hydroxyapatite wedge implanted in opening wedge high tibial osteotomy in patients with osteoarthritis.

A porous hydroxyapatite (highly purified synthetic Ca10(PO4)6(OH)2) wedge was inserted into the tibia in 10 knees of 7 patients with osteoarthritis of the knee who underwent high tibial osteotomy. The interface of this HA wedge with bone was histologically examined in undecalcified specimens obtained at the time of hardware removal in all 10 knees, and total incorporation of the HA into bone was observed, with no inflammatory reaction. The proportion of pores that were filled with regenerated bone within 300 microm from the interface was 71.8 +/- 10.1% (mean +/- S.D.), and it was positively correlated with the time from implantation to biopsy. Radiodensity of the HA wedge was measured during the follow-up period, and it did not change significantly within 36 months after osteotomy. Our study concluded that bone ingrowth into the HA block slowly progressed and was correlated with the passage of time.

Aged↗

Effects of collagen gel mixed with hydroxyapatite powder on interface between newly formed bone and grafted achilles tendon in rabbit femoral bone tunnel.

The Achilles tendon was implanted into a bone tunnel made in the femoral condyle of 20 rabbits. In the left femur, collagen gel mixed with hydroxyapatite powder (C-HAp) was injected between the graft and the bone tunnel. On the other hand, as a control, simple saline was injected in the right femur. Five rabbits were sacrificed at 4, 8, 12, and 16 weeks after surgery. Histological findings showed that in the C-HAp group, the grafted tendon came in direct contact with new bone, and Sharpey-like collagen fibers arising from the grafted tendon were observed to penetrate new bone by 4 weeks after surgery. In the control group, however, fibrous tissue was observed between new bone and the grafted tendon, but no penetrating fibers from the grafted tendon into the new bone were observed until 16 weeks. The area of new bone in the C-HAp group was significantly greater than that in the control group 4, 8, and 12 weeks after surgery (p < 0.0001, p < 0.0007, p < 0.0013, respectively).

Achilles Tendon↗

Activation of HIV-1-specific immune responses to an HIV-1 vaccine constructed from a replication-defective adenovirus vector using various combinations of immunization protocols.

We constructed a recombinant replication defective adenovirus vector containing the env gene (Ad-Bal) derived from macrophage-trophic HIV-1 (HIV-1 Bal). We then immunized mice with this vector using several administration routes and protocols, and examined the immune response. When the Ad-Bal viral vector (over 1 x 10(7) pfu) was injected subcutaneously, both humoral and cell-mediated immunities were induced. However, immune response induced by the Ad-Bal vector alone was weaker than that induced by the recombinant vaccinia viral vector. We then employed the following three immunization protocols: (l) DNA vaccination followed by immunization with the Ad-Bal; (2) vaccination using the Ad-Bal vector followed by DNA vaccination; and (3) DNA vaccination followed by Ad-Bal infection and passive transfer of dendritic cells (DCs) infected with the Ad-Bal. Among the three protocols, the last gave the strongest humoral and cell-mediated immunity. These results suggest that the combination of DNA vaccination, Ad-Bal vector infection and passive transfer of Ad-Bal-infected DCs can induce strong immunity against HIV-1 Bal.

AIDS Vaccines↗

Zymosan enhances the immune response to DNA vaccine for human immunodeficiency virus type-1 through the activation of complement system.

In the present study, the adjuvant effect of zymosan on human immunodeficiency virus type-1 (HIV-1)-specific DNA vaccine and the mechanism of this enhancement were studied in a murine model. We coinoculated zymosan with our candidate HIV-1 specific DNA vaccine (pCMV160IIIB) into skeletal muscles of BALB/c mice. Higher levels of both humoral immune response and HIV-specific delayed-type hypersensitivity (DTH) response were observed when zymosan was coinoculated with pCMV160IIIB compared with that obtained using pCMV160IIIB alone. HIV-specific cytotoxic T lymphocyte (CTL) activity was also enhanced. This enhancing activity was suppressed when coinoculated to the fifth complement (C5)-deficient DDD and AKR mice. The enhanced activity was also suppressed when anti-C3 antibody was inoculated to mice intramuscularly. There was significant induction of immunoglobulin G2a (IgG2a) and interferon-gamma (IFN-gamma) in pCMV160IIIB vaccine with zymosan. These results suggest that zymosan-mediated DNA vaccination enhances helper T cell (Th) 1-mediated immunity. The effect is suggested to be based on the consequences of its recruitment and activation of macrophages, dendritic cells or antigen-presenting cells (APC) through complement activation, especially through the alternative pathway. Taken together, these results suggest that zymosan can be an effective immunological adjuvant in DNA vaccination against HIV-1.

AIDS Vaccines↗

Neuropathy of motor branch of median or ulnar nerve induced by midpalm ganglion.

Two cases of neuropathy of a motor branch caused by a midpalmal ganglion are presented. In the first case the ganglion originated from the midcarpal joint, protruded into the thenar muscle, and compressed the motor branch of the median nerve. In the second case the ganglion, distal to the fibrous arch of the hypothenar muscles, originated from the third carpometacarpal joint and compressed the motor branch of the ulnar nerve. In both cases muscle weakness and finger deformity recovered well after resection of the ganglion. This clinical condition is rare compared with carpal tunnel syndrome and Guyon's tunnel syndrome, which are caused by a ganglion in the wrist.

Adult↗

Treatment of the unstable distal radius fracture with external fixation and a hydroxyapatite spacer.

A prospective study was performed on 25 patients (15 women, 10 men) with unstable fractures of the distal radius selectively treated with a dynamic type of external fixation combined with a hydroxyapatite spacer. The fractures ranged from type VI to type VIII according to Frykman's classification. The patients' mean age at surgery was 49 years (range, 19-75 years). The mean follow-up period was 2.5 years, and overall outcome was assessed using Gartland and Werley's demerit point system as modified by Sarmiento. Radial inclination was 26 degrees +/- 4 degrees at the time of reduction and 26 degrees +/- 5 degrees at follow-up, palmar tilt was 9 degrees +/- 2 degrees at reduction and 8 degrees +/- 3 degrees at follow-up, and ulnar variance was 1.4 +/- 0.6 mm at reduction and 2.1 +/- 0.9 mm at follow-up. The mean range of motion at follow-up was 80 degrees +/- 10 degrees in flexion, 80 degrees +/- 10 degrees in extension, 85 degrees +/- 10 degrees in supination, and 80 degrees +/- 5 degrees in pronation. The outcome in 24 of 25 patients was evaluated as excellent. In the surgical treatment of unstable fractures of the distal radius using external fixator, the fracture reduction should be supported with bone graft or a bone substitute, and a hydroxyapatite spacer was considered to be a useful substitute for a bone graft.

Adult↗

Developmental changes in tolerance to transient intrauterine ischemia in rat cerebral mitochondria.

OBJECTIVE: Mitochondfial respiratory activities were measured in neonatal rat brain to compare the influence of transient intrauterine ischemia in the preterm fetus with that in the term fetus and to evaluate the effect of alpha-phenyl-N -tert-butyl-nitrone treatment. STUDY DESIGN: Intrauterine ischemia was induced by a 30-minute occlusion of the right uterine artery. The control group consisted of term fetuses (20 days old) exposed to normoxia (n = 8) and ischemia (n = 8). For the investigation into maturity effect, preterm fetuses (14 days old) were exposed to normoxia (n = 8) or ischemia (n = 8), and for the alpha-phenyl-N -tert-butyl-nitrone treatment investigation, term fetuses were exposed to ischemia with alpha-phenyl-N -tert-butyl-nitrone (n = 8). All subjects underwent cesarean delivery at 21 days of gestation, and the mitochondrial respiration was measured polarographically 1 hour after delivery. RESULTS: In the control group the neonatal cortical tissue exposed to ischemia showed a significant decrease in mitochondrial activities compared with those in normoxic control animals. In the preterm group the mitochondrial activities of ischemic fetuses were maintained close to normoxic levels. The neonatal mitochondrial deterioration caused by term ischemia was prevented by alpha-phenyl-N -tert-butyl-nitrone. CONCLUSION: The results indicate that preterm fetuses are more capable than term fetuses of maintaining mitochondrial function under conditions of transient intrauterine ischemia and suggest that oxygen derived free radicals may play a crucial role in the development of neonatal neurologic deficit.

Adenosine Diphosphate↗

Up-regulation of CD44 in rheumatoid chondrocytes.

The adhesion molecule CD44 is thought to play an important role in the inflammatory process. To identify the expression of CD44 in articular chondrocytes in rheumatoid arthritis (RA), monoclonal anti-CD44 antibodies were immunohistochemically used to react with articular cartilage specimens of 15 patients with RA, 9 with osteoarthritis (OA), and 6 with femoral neck fracture (FF). The proportion of CD44-positive chondrocytes in RA was 93 +/- 2% (N=16), which was significantly higher than that in OA (59 +/- 7%, N=9, p<0.001) and FF (46 +/- 5%, N=6, p<0.001). Among CD44 isoforms examined, the hemopoietic form was dominant in chondrocytes in RA. Therefore, up-regulation of CD44 on chondrocytes may play a significant role in cartilage degeneration in RA.

Arthritis, Rheumatoid↗

Hip adductor muscle strength in patients with varus deformed knee.

The isometric muscle strength of the muscles around 49 medial compartmental osteoarthritic knees of 32 women was measured quantitatively using a Musculater GT-50 (osteoarthritis group). The patients pushed up a pad containing an electrical sensor and values were compared with those obtained from the nonaffected knees of subjects (control group). The mean age of the patients in the osteoarthritis group was 62.3 years (range, 43-78 years). The control group consisted of 13 women (13 knees) with a mean age of 60.5 years (range, 49-73 years). In the osteoarthritis group, the medial joint space was preserved in 17 knees (Grade A), 23 knees had narrowing of the joint space (Grade 2), and nine knees showed joint space obliteration (Grade 3). Quadriceps strength was significantly weaker in Grade 2 knees than in Grade 0 knees; however, there was no significant difference in quadriceps to hamstrings ratio between each grade. The hip adductors to hamstrings ratio was significantly greater in Grade 2 knees than in Grade 0 knees, and was greater in Grade 3 knees than in Grade 0, Grade 1, and Grade 2 knees. The findings suggested that in patients with medial compartmental osteoarthritis of the knee, the hip adductor muscles may become strengthened to decrease varus decrease varus deformity of the limb.

Adult↗

Effect of acetabular cup position and orientation in cemented total hip arthroplasty.

Long-term clinical results of total hip arthroplasty for patients with developmental acetabular dysplasia of the hip have been reported, but placement of the femoral head center or cup orientation remains controversial, especially with a severe anterolateral shallow acetabulum or dislocated femoral head. Results of 41 Müller and 34 Harris Design 2 cemented total hip arthroplasties were evaluated for developmental dysplasia of the hip. The femoral head center and acetabular cup inclination angle were measured from the interteardrop line. Linear wear and wear direction were measured using the Livermore technique. The best position of the femoral head center was less than 35 mm vertically from the interteardrop line and 25 mm laterally from the teardrop. Femoral head center analysis showed that hips with the cup in a lateral and superior cup position all were revised, but a superior and medial position combined with a cup inclination angle less than 40 degrees did not require revision. Hips with a cup inclination angle more than 45 degrees had superior and lateral penetration patterns of the polyethylene. However, hips with an inclination angle less than 35 degrees and medial placement had medial head penetration patterns. With these all-polyethylene monolithic cemented cups, regardless of the femoral head diameter or cup thickness, better long-term results occurred with a cup inclination angle of 40 degrees or less and medial position of the cup.

Acetabulum↗

Arthroscopic synovectomy for rheumatoid arthritis using a holmium:YAG laser.

OBJECTIVE: To determine the usefulness of the holmium:YAG laser system in arthroscopic synovectomy (ASSX) for treating rheumatoid arthritis (RA). METHODS: ASSX was performed on 15 knees (one Larsen Grade 1, 7 Grade 2, 7 Grade 3) and 8 ankles (6 Grade 2, 2 Grade 3) of 17 female patients with RA. The average age at ASSX was 50.6 years (25-70). The average followup period was 24.4 months (10-47). RESULTS: Seven out of 8 knees with grade 1 or 2 had reduced pain and swelling, as well as decreased average serum levels of C-reactive protein (CRP) (from 3.6+/-1.1 to 1.4+/-0.3 mg/dl). However, 4 out of 7 knees with grade 3 showed recurrence of pain and swelling along with persistent average serum level of CRP (from 4.3+/-1.0 to 3.8+/-1.0 mg/dl). All 8 ankles with Grade 2 or Grade 3 experienced reduced pain and swelling, while the average serum CRP levels did not change (from 3.2+/-0.9 to 2.9+/-1.0 mg/dl). CONCLUSION: The Holmium:YAG laser was useful in ASSX for treating RA knees and ankles.

Adult↗

[Effective use of electrolized soft acid aqueous solution for treatment of mediastinitis following cardiac surgery].

Mediastinitis following cardiac surgery occurs infrequently, but features both high mortality and morbidity, especially in patients with an artificial graft. A 24-year-old man was admitted with a diagnosis of Williams'syndrome with supraaortic stenosis. After ascending aorta and hemiarch reconstruction, mediastinitis developed, which was treated successfully with mediastinal irrigation using electrolized soft acid aqueous solution at one liter per day for 3 days. This procedure appears to be an effective method for treatment of mediastinitis following cardiac surgery.

Adult↗

[Destructed knee in patient with systemic lupus erythematosus treated with total knee arthroplasty: a case report].

We reported a case of a 61-year-old female with arthritis of right knee associated with systemic lupus erythematosus (SLE). She suffered from SLE at age 31 and felt pain around her right knee at age 60. It gradually increased despite intraarticular injections of steroid and arthroscopic synovectomy. On admission, the range of motion of her right knee was 20 to 135 degrees and remarkable gait disturbance were noted due to the pain. Radiographs of the right knee showed joint space narrowing and bone erosion. YMCK total knee arthroplasty was performed. Operation findings showed smooth and thick synovium and cartilage defect. Histological examination revealed fibrin on surface, proliferad connective tissue and newly development of vasculature. Synovium eroded both cartilage and bone. In SLE, soft tissue contructure was reported to be a main cause of joint dislocation, but there were only a few report of progressive joint destruction due to SLE. In this case, the main cause of joint destruction may be invasion synovium into cartilage and bone.

Arthritis↗

Expression of CD44 in synovium of rabbits with chronic arthritis induced by immunization with Escherichia coli.

OBJECTIVE: To investigate the expression of CD44 and its role in experimental chronic arthritis in rabbits. METHODS: Rabbits were immunized with Escherichia coli 0:14 for short (4 mo) and long (8-10 mo) periods. Immunohistochemical staining was performed on knees, using anti-CD44 antibodies. RESULTS: Lymphocyte infiltration in the synovium was found in 30.0% of rabbits after short term immunization, and the rate increased to 58.3% after longterm immunization. CD44 was present in synovial lining cells in 30.0% of rabbits after short term immunization, and it increased significantly (p < 0.05) after longterm immunization (66.7%). CD44 was also observed in lymphocytes in knee synovium after longterm immunization (25.0%). CONCLUSION: CD44 in lining cells might play a role in promoting chronic arthritis in rabbits immunized with E. coli.

Animals↗

Predictive value of serum immunosuppressive acidic protein for lung metastasis after amputation of murine osteosarcoma of the lower limb.

A spontaneously occurring murine osteosarcoma cell line (POS-1) was inoculated into the footpads of 88 mice. In 59 mice, the tumor-bearing leg was amputated at 1, 3, 5, or 7 weeks after inoculation and the mice sacrificed at 9 weeks. Lung metastasis was observed in 82.6-100% of the mice undergoing leg amputation at 5 or 7 weeks after inoculation. There were no lung metastasis in the mice amputated at 1 or 3 weeks. The serum immunosuppressive acidic protein (IAP) concentration showed a significant increase at 5 or 7 weeks after inoculation (P<0.005 and P<0.0005, respectively). When amputation was done 5 weeks after inoculation, the serum IAP concentration increased further to 5.9 times the pre-amputation level 1 week after the amputation. The IAP concentration increased only 1.3-fold in the control group without inoculation. Thus, a high serum IAP concentration before amputation and a further increase after amputation were indicators of lung metastasis in this mouse model of osteosarcoma.

Amputation, Surgical↗