PubMed Health⌕ Search

Biomedical subjects

Toshihiro Akisue

Publications and source records attributed to Toshihiro Akisue.

At least 19 recordsLinked to original sources

Biceps tendinitis caused by an osteochondroma in the bicipital groove: a rare cause of shoulder pain in a baseball player.

Tendinitis of the long head of the biceps brachii muscle is commonly seen in athletes who do repetitive overhead motions. Common causes of biceps tendinitis include impingement syndrome, subluxation of the biceps tendon, and attrition tendinitis, whereas biceps tendinitis secondary to a bone neoplasm is rare. A case of biceps tendinitis caused by an osteochondroma arising in the left humeral bicipital groove in a 25-year-old male baseball player is reported. The tumor was hook-shaped, originated from the inferomedial portion of the humeral lesser tubercle, and surrounded the biceps tendon. Symptoms of increasing pain and inability to throw resulted from direct irritation of the biceps tendon by the tumor. Total excision of the tumor relieved the symptoms within 3 weeks. To our knowledge, there have been no reported cases in the English-language literature of biceps tendinitis caused by an osteochondroma.

Adult↗

Establishment and characterization of a KIT-positive and stem cell factor-producing cell line, KTHOS, derived from human osteosarcoma.

Osteosarcoma is a malignant bone tumor that commonly affects adolescents and young adults. In the present study a human osteosarcoma cell line, KTHOS, was established from a primary osteosarcoma lesion in the distal femur of a 16-year-old girl. After 106 passages, the KTHOS cell line retained the biological characteristics of osteosarcoma. The KTHOS cells had spindle to pleomorphic cytoplasm with round to ovoid nuclei containing multiple prominent nucleoli, as expected based on the mesodermic origin of osteoblasts. The KTHOS cells were immunoreactive for osteocalcin, osteonectin, stem cell factor (SCF), and KIT (CD117). Reverse transcriptase-polymerase chain reaction indicated that the KTHOS cell line expressed mRNA for SCF and KIT. The KTHOS cells produced relatively high amounts of soluble SCF as determined by enzyme-linked immunosorbent assay. The results suggest that cell proliferation of the KTHOS cell line might be involved in autocrine and/or paracrine loops of the SCF/KIT signaling system. The KTHOS cell line is a novel human osteosarcoma cell line that releases SCF and expresses KIT. This cell line can be used for studies to explore the mechanisms for oncogenesis of human osteosarcomas.

Adolescent↗

Three-dimensional images of contrast-enhanced MDCT for preoperative assessment of musculoskeletal masses: comparison with MRI and plain radiographs.

PURPOSE: To evaluate the diagnostic capability of contrast-enhanced multidetector computed tomography (MDCT) for the preoperative assessment of musculoskeletal masses, in comparison with magnetic resonance imaging and plain radiographs (MRI+X-p). MATERIALS AND METHODS: Sixty-eight patients with musculoskeletal masses underwent plain radiography, MRI, and contrast-enhanced MDCT. The following five items were evaluated for all images: histological properties, vascularity, neurovascular involvement, calcification/ossification, and cortical/marrow involvement. The MDCT images with three-dimensional reconstruction were retrospectively compared with MRI+X-p. RESULTS: In 32 bone lesions, MDCT was superior/equal/inferior to MRI+X-p regarding histological properties in 4/10/18, vascularity in 0/11/21, neurovascular involvement in 0/26/6, calcification/ossification in 15/17/0, and cortical/marrow involvement in 29/3/0 cases, respectively. In 36 soft-tissue lesions, MDCT was superior/equal/inferior to MRI+X-p with histological properties in 1/18/17, vascularity in 0/12/24, neurovascular involvement in 1/24/11, calcification/ossification in 8/28/0, and cortical/marrow involvement in 7/29/0 cases, respectively. The MDCT evaluation of both calcification/ossification and cortical/marrow involvement in bone lesions was superior to that in soft-tissue lesions (p<0.05). There were no statistically significant differences between benign and malignant lesions in the evaluation of each of the five items. CONCLUSION: MDCT provided additional and more comprehensive information than MRI+X-p for the preoperative assessment of musculoskeletal masses, especially for calcification/ossification and cortical/marrow involvement. Three-dimensional contrast-enhanced MDCT images can be adopted equally to MRI for the preoperative evaluation of neurovascular involvement.

Adolescent↗

Expression of transforming growth factor beta isoforms and their receptors in malignant fibrous histiocytoma of soft tissues.

PURPOSE: Transforming growth factor beta (TGF-beta) is a multifunctional growth factor that variably affects proliferation, differentiation, and extracellular matrix formation. Little information is currently available on the TGF-beta expression in malignant fibrous histiocytoma (MFH). The aims of the present study were to investigate the expression of TGF-beta isoforms and their receptors in human MFH specimens. EXPERIMENTAL DESIGN: The expression of TGF isoforms, and TGF-beta receptors (TGF-beta R1 and -beta R2) were immunohistochemically evaluated in 43 paraffin-embedded MFH specimens. Furthermore, the correlation of the TGF-beta and receptor expression with tumor proliferative activity assessed by MIB-1 indices was analyzed. RESULTS: Positive immunoreactivity for TGF-beta1, -beta2, and -beta 3 was identified in tumor cells of 42, 40, and 38 of the 43 MFHs, respectively. In each TGF-beta isoform immunostaining, the specimens were divided into two groups based on the number of positive tumor cells: those with low (<25%) and those with high (>==25%) immunoreactivity. There were no statistically significant differences in the MIB-1 indices between the two groups. Positive immunoreactivity for TGF-beta R1 and -beta R2 was identified in tumor cells of 36 and 24 of the MFHs, respectively. The specimens were divided into two groups based on their receptor expression patterns: those with both TGF-beta R1- and -beta R2-positive immunoreactivity (n = 23), and those with both or either TGF-beta R1- and -beta R2-negative immunoreactivity (n = 20). The MIB-1 indices in the both-TGF-beta R1- and -beta R2-positive group were significantly higher than those in the other group (P = 0.0102). There was no significant difference in pulmonary metastasis ratios between the two groups. CONCLUSIONS: These findings strongly suggest an association of the TGF-beta ligand/receptor system with a significantly higher MIB-1 index in human MFHs. Investigation of the TGF-beta R1 and -beta R2 coexpression might be useful in predicting tumor behavior of MFHs.

Activin Receptors, Type I↗

Apophysitis of the ischial tuberosity mimicking a neoplasm on magnetic resonance imaging.

We present multimodality imaging features of an ischial tuberosity apophysitis in a 13-year-old boy who was an active baseball pitcher. Roentgenography of the pelvis and computed tomography showed mild irregularity in the inferior margin of the left ischial tuberosity. T1-weighted MRI showed a wide area with low signal intensity in the left ischial body; T2-weighted fat-suppression images showed areas with markedly high signal intensity in the ischial apophysis and body and the surrounding periosteum; contrast-enhanced T1-weighted fat-suppression MRI showed that the ischial body, surrounding periosteum, and origin of the hamstring muscles strongly enhanced; technetium-99m scintigraphic scans showed increased isotope uptake in the entire ischial body. Histological specimens obtained from the bone showed increased osteoblastic activity, edema, and proliferation of benign spindle cells and small vessels in the bone marrow spaces. In the present case, because MR imaging demonstrated extensive signal abnormalities involving the apophysis, periosteum, and intramedullary portion of bone, a neoplasm could not be excluded, and a biopsy was undertaken.

Athletic Injuries↗

Effect of cyclic mechanical stretch and titanium particles on prostaglandin E2 production by human macrophages in vitro.

Early implant instability has been proposed as a critical factor in the onset and progression of aseptic loosening and periprosthetic osteolysis in total joint arthroplasties. Previous in vitro studies have reported that macrophages stimulated with cyclic mechanical strain release inflammatory mediators. Little is known, however, about the response of these cells to mechanical strain with particles, which is often a component of the physical environment of the cell. We therefore studied the production of prostaglandin E(2) (PGE(2)), an important mediator in aseptic loosening and periprosthetic osteolysis in total joint arthroplasties, for human macrophages treated with mechanical stretch alone, titanium particles alone, and mechanical stretch and particles combined. A combination of mechanical stretch and titanium particles resulted in a statistically synergistic elevation of levels of PGE(2) compared with the levels found with either stretch or particles alone. Exposure of human macrophages to mechanical stretch with particles upregulated the expression of cyclooxygenase (COX)-2 mRNA but not COX-1 mRNA, this expression resulting in a 97-fold increase in PGE(2) production compared to the nonstimulated cells. The current study is the first to investigate the effects of mechanical stretch with particles on cultured macrophages and include an investigation of the time course of PGE(2) production and COX-2 mRNA expression. Our results suggest that, while mechanical strain may be one of the primary factors responsible for macrophage activation and periprosthetic osteolysis, mechanical strain with particles load may contribute significantly to the osteolytic potential of macrophages in vitro. The synergistic effect observed between mechanical stretch and particles could accelerate implant loosening and implies that reduction in either cyclic mechanical strain or wear debris load would lead to a reduction of osteolysis.

Cyclooxygenase 2↗

Periosteal osteoblastoma of the distal femur.

Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors.

Adolescent↗

Coexpression of hepatocyte growth factor and its receptor c-Met correlates with high MIB-1 proliferative index in malignant fibrous histiocytoma.

Hepatocyte growth factor (HGF) is a multifunctional cytokine that variably affects cell motility, proliferation, and morphogenesis. Little information is currently available on the HGF and its receptor c-Met expression in malignant fibrous histiocytoma (MFH). We immunohistochemically investigated the HGF and c-Met expression in 43 MFH tissue specimens. Furthermore, the correlation of the HGF and c-Met expression with tumor proliferative activity assessed by MIB-1 indices was analyzed. Our results showed that positive cytoplasmic immunoreactivity for HGF and c-Met was identified in tumor cells in 36 (84%) and 20 (47%) of the 43 MFH cases analyzed, respectively. Coexpression of HGF and c-Met was observed in 20 (47%) of the 43 MFHs, and was correlated with high MIB-1 proliferative indices (p = 0.0446). These findings strongly indicate that the HGF/c-Met signaling system plays an important role in promoting cell proliferation of human MFHs via an autocrine loop.

Adolescent↗

Phalangeal microgeodic syndrome resulting in rapid digital shortening.

Microgeodic phalangeal syndrome is a rare condition affecting the fingers in children. Radiographically, the affected phalanges show sclerosis with multiple small areas of osteolysis. The pathogenesis of microgeodic phalangeal syndrome is considered to be a transient disturbance of the peripheral circulation caused by cold temperatures. In most cases, the symptoms and the radiographic changes return to normal within several months without any treatment. We present a rare case of microgeodic phalangeal syndrome in the middle phalanx of the right index finger in an 8-year-old girl, in whom the affected phalanx shortened within 6 weeks of the initial presentation. It was speculated that minor trauma to the finger might have contributed to the collapse and shortening of the phalanx. The current case indicates that the use of a splint for the affected finger in the early period after onset of symptoms might be recommended to avoid digital shortening.

Bone Diseases↗

Neurilemmoma in the foot as a cause of heel pain: a report of two cases.

Two cases of deep-seated neurilemmoma that arose from plantar branches of the posterior tibial nerve and caused chronic heel pain are described. At the initial examination, one case was misdiagnosed as tarsal tunnel syndrome and the other was overlooked as plantar fasciitis; both cases were treated for long periods prior to operation. Deep-seated neurilemmomas in the foot can easily be overlooked and misdiagnosed as tarsal tunnel syndrome or plantar fasciitis because of the rarity, absence of palpable mass, and similarity of symptoms to those of other frequently encountered foot disorders. Magnetic resonance imaging provides the best modality for differential diagnosis. In the present cases, surgical excision of the tumors resulted in immediate and complete relief of chronic heel pain. Surgeons should consider neurilemmoma as a cause of persistent chronic heel pain despite the rarity of the disease.

Aged↗

Multimodality imaging features of primary xanthoma of the calcaneus.

Secondary xanthomatous features are histologically observed in various bone lesions, but primary xanthoma of bone is rare. We present a primary xanthoma of the right calcaneus in a 51-year-old woman who had no aberrant lipid metabolism. Roentgenograms showed a small osteolytic lesion in the calcaneal triangle, partially surrounded by bone sclerosis. Computed tomographic scans of the calcaneus showed multiple osteolytic areas, with an irregular trabecular pattern in the surrounding sclerotic bone. T1-weighted magnetic resonance images showed a lesion with central low signal intensity, surrounded by a peripheral ring with high signal intensity. The entire lesion showed high signal intensity on T2-weighted images, partially surrounded by areas with low signal intensity, concordant with reactive bone sclerosis. Histologically, the lesion consisted of numerous lipid-laden histiocytes arranged in sheets, scattered multinucleated giant cells and lymphocytes, and granulation tissues. There was no evidence of pre-existing lesions. Total excision of the tumor was curative.

Bone Diseases↗

Fine-needle aspiration biopsy of solid aneurysmal bone cyst in the humerus.

We report the fine-needle aspiration biopsy (FNAB) cytology findings of a solid aneurysmal bone cyst in the left humerus of a 69-yr-old woman. Radiographically, the lesion showed an extensive, relatively well-defined osteolysis in the diaphysis, with a pathologic fracture. FNAB smears of the lesion consisted of benign, mononuclear cells and numerous osteoclast-like multinucleated giant cells. Some clusters of the mononuclear cells were closely associated with dense, homogeneous, extracellular, matrix material. To our knowledge, the FNAB features of solid ABC of the long bones have not been described previously in the English-language literature. The cytologic features are indistinguishable from those of giant cell tumors of bone and brown tumors of hyperparathyroidism.

Aged↗

Extraabdominal desmoid tumor in a surgical scar of a patient with Sprengel's deformity.

Patients with an extraabdominal desmoid tumor have multiple minor bone abnormalities. The authors describe a rare case of an extraabdominal desmoid tumor that developed in a scar 2 years after surgery for Sprengel's deformity of the right shoulder in an 8-year-old girl. The association between the tumor and Sprengel's deformity has never been reported previously. Antecedent surgical trauma might play a role in the development of this tumor.

Back↗

"Backside" polyethylene deformation in total knee arthroplasty.

The clinical importance of polyethylene deformation between the tibial insert and base plate ("backside") is unclear. We used a semiquantitative scoring system to compare clinical and radiographic factors with articular and backside deformation of 106 retrieved polyethylene tibial inserts. Backside deformation was associated with polyethylene thickness and type of locking mechanism. Deformation of the articular surface correlated with femoral osteolysis (P=.05). The mean backside deformation score was 33% greater for implants from patients with osteolysis than for implants from patients without osteolysis (P=.07). Our study may be biased based on the types of implants available for study, but for this group of implants, we cannot conclude with 95% certainty that backside polyethylene deformation was clinically important as a cause of periprosthetic osteolysis or implant loosening.

Adult↗

Isolated suprapatellar bursitis: Computed tomographic and arthroscopic findings.

A rare case of compartmentalized suprapatellar bursitis in the left knee of an 80-year-old man is presented. Computed tomographic (CT) scans following intravenous administration of contrast media showed a cystic mass between the quadriceps tendon and the anterior surface of the femur. Multiplanar reconstruction CT scans showed a mass superior to the patella, the wall of which was enhanced. Arthroscopic examination of the knee revealed a complete suprapatellar septum that separated the suprapatellar bursa from the knee joint cavity. Surgical excision of the bursa was curative. To our knowledge, multiplanar reconstruction CT and arthroscopic features of the isolated suprapatellar bursitis have not been illustrated previously.

Aged↗

Ischiogluteal bursitis: multimodality imaging findings.

Ischiogluteal bursitis is a rare, infrequently recognized condition. Two cases of ischiogluteal bursitis in an 80-year-old man and a 75-year-old woman are presented. Both patients presented with a painful buttock mass. Contrast-enhanced multiplanar reconstruction computed tomography scans revealed a lesion with peripheral enhancement inferior to the ischial tuberosity. Magnetic resonance imaging revealed a lesion with low or intermediate signal intensity on T1-weighted images. T2-weighted images revealed a lesion with high signal intensity. Postcontrast magnetic resonance imaging scans revealed peripheral enhancement of the lesion. The multimodality imaging findings of ischiogluteal bursitis have not been described previously. Ischiogluteal bursitis should be considered in the differential diagnosis of a buttock mass.

Aged↗

Bone marrow edema syndrome associated with uterine myoma: a case report.

A patient with bone marrow edema syndrome of the hip associated with a uterine myoma is presented. A 51-year-old woman could not walk because of severe pain in both hips and had been referred to the authors' institute. Magnetic resonance imaging scans showed abnormal intensity on T1- and T2-weighted images in both femoral heads and a large mass arising from the uterus which was diagnosed as a uterine myoma. A 99mTc-methylene diphosphonate scintigraph showed diffuse uptake in both femoral heads. The pain in both hips decreased shortly after a hysterectomy and the patient could walk without crutches within 2 weeks after the gynecologic surgery. Magnetic resonance imaging scans taken 8 months after surgery showed high signal intensity on T1- and T2-weighted images, indicating normal bone marrow in the femoral heads. To the authors' knowledge, this is the first case report showing a bone marrow edema syndrome of the hip associated with uterine myoma. The pathophysiologic mechanisms for bone marrow edema syndrome of the hip in the current patient and in pregnancy may be identical. More specifically, a large intrapelvic mass may cause an increase of intrapelvic pressure and subsequent blood stasis in both conditions. The current case suggests the possible factors of bone marrow edema syndrome of the hip which need to be investigated.

Bone Marrow Diseases↗