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Biomedical subjects

Toshio Fujii

Publications and source records attributed to Toshio Fujii.

10 recordsLinked to original sources

Partial physeal growth arrest treated by bridge resection and artificial dura substitute interposition.

We treated four cases of partial physeal growth arrest by resecting the bone bridge and interposing an expanded polytetrafluoroethylene membrane, which has minimal tissue response. We evaluated three cases with sufficiently long follow-up. No apparent recurrence of the bone bridge and no limb length discrepancy occurred in any of the cases. No remodeling after the operation occurred. In one case, which underwent this operation and corrective osteotomy of the proximal tibia, slight recurrence of the varus deformity occurred which was detected only by radiographs, and did not compromise the alignment of the leg. There were no complications.

Bone Diseases, Developmental↗

Musculoskeletal conditions of acute leukemia and malignant lymphoma in children.

We retrospectively reviewed 16 patients who presented to hospitals with orthopaedic complaints. Twelve patients experienced initial symptoms in the extremities and four patients had back pain. The leukocyte count was elevated in one patient, decreased in two patients, and normal in 13 patients. On radiographic examination, osteopenia was observed in 10 patients, osteolytic lesions were observed in five, and pathologic fractures were observed in five. Because the initial presentation of patients with leukemia often involves the musculoskeletal system, orthopaedists need to recognize the symptoms of this disease to avoid misdiagnosis and to expedite the initiation of appropriate potentially lifesaving treatment.

Bone Diseases, Metabolic↗

An agr-like two-component regulatory system in Lactobacillus plantarum is involved in production of a novel cyclic peptide and regulation of adherence.

We have analyzed a locus on the annotated Lactobacillus plantarum WCFS1 genome that showed homology to the staphylococcal agr quorum-sensing system and designated it lam for Lactobacillus agr-like module. Production of the lamBDCA transcript was shown to be growth phase dependent. Analysis of a response regulator-defective mutant (Delta)lamA) in an adherence assay showed that lam regulates adherence of L. plantarum to a glass surface. Global transcription analysis of the wild-type and (Delta)lamA strains in early, mid-, and late log phase of growth was performed using a clone-based microarray. Remarkably, only a small set of genes showed significant differences in transcription profiles between the wild-type and lamA mutant strains. The microarray analysis confirmed that lamBDCA is autoregulatory and showed that lamA is involved in regulation of expression of genes encoding surface polysaccharides, cell membrane proteins, and sugar utilization proteins. The lamBD genes encoding the putative autoinducing peptide precursor (LamD) and its processing protein (LamB) were overexpressed using the nisin-controlled expression system, and culture supernatants were analyzed by liquid chromatography/mass spectrometry (LC/MS) to identify overproduced LamD-derived peptides. In this way, a cyclic thiolactone pentapeptide that possesses a ring structure similar to those of autoinducing peptides of the staphylococcal agr system was identified. The peptide was designated LamD558, and its sequence (CVGIW) matched the annotated precursor peptide sequence. Time course analysis of wild-type culture supernatants by LC/MS indicated that LamD558 production was increased markedly from mid-log to late log growth phase. This is the first example of an agr-like system in nonpathogenic bacteria that encodes a cyclic thiolactone autoinducing peptide and is involved in regulation of adherence.

Amino Acid Sequence↗

The anti-allergic effects of lactic acid bacteria are strain dependent and mediated by effects on both Th1/Th2 cytokine expression and balance.

BACKGROUND: There is growing interest in the immune-stimulating effect and in particular, the anti-allergic effect, of lactic acid bacteria (LAB). However, no comprehensive studies have been done that compare the immune-stimulating potential of LAB strains. METHODS: The in vitro immune-stimulating effects on Th1/Th2 balance of more than 100 LAB strains were compared in splenocytes from ovalbumin-sensitized Th2-polarized mice. The in vivo anti-allergic ability of strain KW3110 was studied in the Th2-polarized model by detecting serum IgE concentration, Th1/Th2 cytokine secretion from splenocytes, and the expression of co-stimulatory molecules on macrophages. RESULTS: In vitro studies from Th2-polarized splenocytes, using IL-12 as a Th1 parameter and IL-4 secretion as a Th2 parameter revealed a wide variety of IL-12-inducing and IL-4-repressing activities, depending on the strain of LAB, not depending on the species. However, evaluation of individual strains in vivo revealed that after exposure to Lactobacillus paracasei KW3110 strain, the serum IgE elevation elicited by repeated OVA injection of mice was strongly inhibited. Cytokine secretion from splenocytes 20 weeks after KW3110 administration showed increased IL-12 and decreased IL-4 expression. Both CD40 and B7-1 expression on macrophages was upregulated by administration of KW3110. CONCLUSIONS: Improving the consequences of the Th1/Th2 imbalance by administration of LAB was dependent upon the LAB strain rather than the LAB species. Oral KW3110 administration in the mouse allergy model directed the Th1/Th2 balance toward Th1 through the maturation of APCs and inhibition of serum IgE elevation.

Animals↗

Metatarsal lengthening by callus distraction for brachymetatarsia.

Twelve metatarsal lengthening procedures by callus distraction were performed in seven patients with brachymetatarsia. The mean age at the time of the surgery was 12.0 years (range, 11.1-14.5 years). The mean duration of follow-up was 5.2 years (range, 1.2-13.5 years). The bones were lengthened at a rate of 0.7 mm/day by a mean of 20 mm (range, 15-30 mm), which was 45% of their original length (range, 37-61%). The mean healing index was 73 days/cm (range, 41-98 days/cm). Corrective shortening osteotomy was performed in one case in which the metatarsophalangeal joint was dislocated due to excessive lengthening. In 10 of the remaining 11 cases, joint stiffness, narrowing of the joint space and some degree of plantar subluxation of the metatarsophalangeal joint were observed during distraction, but these were gradually resolved without either elongation of the tendon or metatarsophalangeal joint fixation with Kirschner wire.

Adolescent↗

Correlation between center-edge angle and acetabulum-head index in developmental dysplasia of the hip with avascular necrosis of the femoral head.

In order to clarify the relationship between the center-edge angle and the acetabulum-head index, we reviewed 97 hips in 86 patients suffering from developmental dysplasia of the hip. We measured the center edge angle and the acetabulum-head index, and evaluated avascular necrosis of the femoral head according to Kalamchi classification. The center-edge angle correlated highly with the acetabulum-head index in non-avascular necrosis, and in Kalamchi groups I and II, but not in Kalamchi groups III and IV. Because of difficulties in measurement, it is possible that the center-edge angle does not precisely indicate acetabular coverage of developmental dysplasia of the hip with avascular necrosis.

Acetabulum↗

Limb salvage treatment for congenital deficiency of the tibia.

Nine limb salvage treatments were performed in 7 patients with congenital deficiency of the tibia. All feet showed equinovarus deformity and were centralized in a slightly equinus position by placing the distal end of the fibula into the posterior facet of the calcaneus. Tibiofibular fusion was performed in 4 patients with partial deficiency, and fibular transfer (fibular centralization; Brown procedure) in 5 with complete deficiency of the tibia. Callus distraction lengthening was performed repeatedly for leg-length discrepancy on either the femur or the centralized fibula. Satisfactory functional and cosmetic results were obtained in all limbs with partial deficiency, whereas in limbs with completely deficiency, none of the 5 knees treated by fibular transfer achieved a satisfactory functional result because of insufficient quadriceps strength, progressive knee flexion contracture, and persistent ligamentous instability. Nevertheless, in these 5 cases, all patients were ultimately able to withstand weight-bearing.

Adolescent↗

Sternal segment dislocation in children.

Three cases of sternal segment dislocation in children are described. The primary mechanisms were direct blow in a 4-year-old boy, indirect forces in a 3-year-old boy, and osteomyelitis in a 10-year-old boy. The two former cases were dislocated at the junction of the manubrium with the sternal body, and the latter case was at the junction of the first and second sternal segments. The dislocated segments were gradually rotated for approximately 2 weeks and were finally stabilized after rotation. While in the dislocated state, the patients were observed conservatively, although all the dislocated segments were remodeled. Surgical treatment of sternal segment dislocation is not inevitable.

Bone Remodeling↗

Pemberton osteotomy for developmental dysplasia of the hip in older children.

The authors reviewed the results of the Pemberton osteotomy as treatment of developmental dysplasia of the hip in 17 hips treated after 7 years of age. Twelve hips required one or more concomitant surgical procedures. The average age at the time of the osteotomy was 9.3 years, and the average follow-up was 9.4 years. Using modified McKay's clinical criteria, 14 hips were classified as excellent or good. Using Severin's radiographic classification, 13 hips met class I-II criteria. Two patients who preoperatively showed Kalamchi and MacEwen's group IV severe avascular necrosis, plus two patients whose necessary acetabular coverage was not achieved by the Pemberton osteotomy without femoral varus osteotomy, were found to meet Severin's class III-IV criteria. Pemberton osteotomy can be an effective procedure for older children in whom progressive acetabular development is not expected, although this osteotomy may have to be combined with other operative procedures.

Child↗