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Biomedical subjects

Yoshitaka Matsusue

Publications and source records attributed to Yoshitaka Matsusue.

At least 19 recordsLinked to original sources

The MR tracking of transplanted ATDC5 cells using fluorinated poly-L-lysine-CF3.

Magnetic resonance (MR) imaging using super-paramagnetic iron oxides (SPIOs) is a powerful tool to monitor transplanted cells in living animals. However, since SPIOs are negative contrast agents it is difficult to track transplanted cells in bone and cartilage that originally display low signals. In this study, we examined the feasibility of tracking with fluorescein isothiocyanate (FITC)-labeled poly-L-lysine-CF(3) (PLK-CF(3)) using mouse ATDC5 cells, a stem cell line of bone and cartilage cells. FITC-labeled PLK-CF(3) was easily internalized by ATDC5 cells by adding it into culture medium. No acute or long-term toxicities were seen at less than 160 microg/ml. Labeled cells transplanted into the cranial bone of mice were detected for at least 7 days by MR images. FITC-labeled PLK-CF(3) is a useful positive contrast agent for MR tracking in bone and cartilage.

Animals↗

MR tracking of transplanted glial cells using poly-L-lysine-CF3.

Magnetic resonance (MR) imaging using super-paramagnetic iron oxides (SPIOs) is a powerful tool to monitor transplanted cells in living animals. Since, however, SPIOs are negative contrast agents, positive agents have been explored. In this study, we examined the feasibility of FITC-labeled poly-L-lysine-CF3 (PLK-CF3) using glial cells. FITC-labeled PLK-CF3 was easily internalized by neuroblastoma cells and glia as adding it into culture medium. No toxicity was seen at the concentration of less than 80 microg/ml. MR images positively detected labeled cells transplanted in the brain of living mouse. The results indicate that FITC-labeled PLK-CF3 is a useful positive contrast agent for MR tracking.

Animals↗

A large-scale genetic association study of ossification of the posterior longitudinal ligament of the spine.

Research to date has identified several genes that are implicated in the etiology of ossification of the posterior longitudinal ligament of the spine (OPLL); however, their pathogenetic relevance remains obscure. The aim of this study is to identify susceptibility genes for OPLL through a large-scale case-control association study and to re-examine previously reported associations. A total of 109 single nucleotide polymorphisms (SNPs) in 35 candidate genes were genotyped for 711 sporadic OPLL patients and 896 controls. The differences in allelic and genotypic distribution between patients and controls were assessed using the chi (2) test with Bonferroni's correction. We also analyzed the association by separating patients into subgroups according to sex, age and the number of ossified vertebrae. The nominal P values fell below 0.05 for five SNPs in three genes. An intronic SNP in the TGF3 gene (P=0.00040) showed the most significant association. Previously reported associations of COL11A2, NPPS and TGFB1 with OPLL could not be reproduced. Further, no significant associations were detected in stratified analyses based on sex, age or the number of ossified vertebrae. TGFB3 warrants further investigation because it is located within a genomic region that has been positively linked with OPLL.

Adolescent↗

A 5-7 year in vivo study of high-strength hydroxyapatite/poly(L-lactide) composite rods for the internal fixation of bone fractures.

The biocompatibility and biodegradation of hydroxyapatite (HA)/poly(L-lactide) (PLLA) composite bone implant rods were studied using two types of HA particles as reinforcing fillers, uncalcined-HA (u-HA) or calcined-HA (c-HA). Composite rods of u-HA/PLLA and c-HA/PLLA were implanted into the distal femurs of 25 rabbits. Four of these rabbits lived for more than 5 years after implantation, with one living for 7 years 4 months. Samples were retrieved after the rabbits died naturally and specimens were examined by light microscopy and scanning electron microscopy (SEM). For u-HA/PLLA, the shrinkage of the rods progressed further after 4 years, and some were almost completely resorbed. We could not find traces of the rod in some sections from more than 6 years. Remodeled bone encircled the residual material, and trabecular bone bonded directly to the rod was found toward the center. For u-HA/PLLA 30%, results were similar to u-HA/PLLA 40%, and the cross-sectional area had decreased by 4.0% at over 7 years. Most of the PLLA had been released from the rods. Neither obvious osteolytic nor osteoarthritic changes were found after 4 years.

Animals↗

Extension of lumbar spine infection into osteoarthritic hip through psoas abscess.

We present a case of pyogenic lumbar discitis and septic hip arthritis, accompanied by a psoas abscess and pyogenic iliopsoas bursitis, for which the correct diagnosis was delayed. The patho-mechanism was speculated to be initial hematogenous infection in the lumbar spine that spread along the psoas muscle as a psoas abscess and then extended into the hip joint via the iliopsoas bursa. For an early correct diagnosis, clinicians should be aware that the lumbar spine and hip joint regions communicate through the psoas muscle space and iliopsoas bursa, making it possible for infection to spread.

Bursitis↗

Bony lesion recurrence after mosaicplasty for osteochondritis dissecans of the talus.

Autogenous osteochondral grafts have recently become popular for use in small, isolated, contained articular cartilage defects. We treated a 26-year-old man who had a cartilage defect measuring 10 x 20 mm in the anteromedial area of the right talus. We performed multiple osteochondral grafting of the lesion with medial malleolar osteotomy from a donor site in the ipsilateral knee joint. Two years after the operation, the patient's ankle pain recurred and the bony lesion in the talus also became osteolytic. Because we believed that only the cartilaginous portions of the osteochondral plugs grafted 2 years previously were fully fixed and viable, and that recurrence had occurred at the bony portions, at reoperation we performed curettage of the bony lesions and grafted iliac bone into the lesions with fenestration of the inferomedial ankle joint cartilage, not grafted plug cartilage. Therefore, probably because of overuse, the bony lesion in the talus had recurred 2 years after the first operation, but the grafted hyaline cartilage had survived. Autogenous osteochondral grafting into the talus, unlike the knee joint, should be done with care to ensure there is no sclerotic bone surrounding the lesion in patients with long-standing symptoms and recurrence of bony lesions.

Adult↗

The complete process of bioresorption and bone replacement using devices made of forged composites of raw hydroxyapatite particles/poly l-lactide (F-u-HA/PLLA).

Here we document the complete process of bioresorption and bone replacement of rods made of forged composites of unsintered hydroxyapatite particles/poly l-lactide (F-u-HA/PLLA) implanted in the femoral medullary cavities of rabbits. Bioresorption, osteoconductive bioactivity and bone replacement were compared in three implantation sites. In the first site, the end of the rod was located near the endosteum in the proximal medullary cavity. In the second, the rod was located at the centre of the bone marrow space without contacting the endosteum. In the third, the rod was in direct contact with cancellous bone within the distal femoral condyle. Micro-computerised tomography, scanning electron microscopy and photomicrographs of stained sections were used to document the complete process of bioresorption and bone replacement. At the first implantation site, the rod was completely resorbed and unbound u-HA particles were detected in and around the endosteum 5-6 years after implantation. At the second site, the rod showed significant shrinkage 4-5 years after implantation due to the release of almost all the PLLA, although a contracted cylindrical structure containing a few u-HA persisted even after approximately 6 years. At the third site, u-HA particles were almost completely replaced with bone after 5-6 years. Conversely, PLLA-only rods showed little bone conduction, and small amounts of degraded PLLA debris and intervening some tissue persisted even after long periods. Namely, the u-HA/PLLA composites were replaced with bone in the distal femoral condyle, where they were in direct contact with the bone and new bone formation was anatomically necessary. By contrast, composite rods were resorbed without replacement in the proximal medullary cavity, in which new bone growth was not required. We therefore conclude that the F-u-HA30/40 composites containing 30 wt%/40 wt% u-HA particles are clinically effective for use in high-strength bioactive, bioresorbable bone-fixation devices with the capacity for total bone replacement.

Absorbable Implants↗

Posttraumatic recurrent dislocation of extensor pollicis brevis tendon over the metacarpophalangeal joint.

There have been numerous reports on dislocation of the extensor tendons in the fingers. We describe an acquired dislocation of the extensor tendons of the thumb. We report a case with posttraumatic dislocation of extensor pollicis brevis (EPB) over the metacarpophalangeal (MCP) joint of the thumb. Ulnar dislocation of the EPB took place during a firm grip on a badminton racket and the patient could not extend the thumb from this position. After reconstruction of the extensor aponeurosis to centralize the EPB tendon the patient recovered normal function of thumb extensors.

Adolescent↗

Association of CYP17 with HLA-B27-negative seronegative spondyloarthropathy in Japanese males.

Susceptibility genes for seronegative spondyloarthropathy (SNSA) other than HLA-B27 remain unclarified. Sex hormones are implicated in the pathogenesis of SNSA. Cytochrome P450c17a (CYP17) is a key regulator of androgen biosynthesis, and a single nucleotide polymorphism (SNP) in the 5'-untranslated region of the CYP17 gene (CYP17), -34C > T, is associated with variety of diseases. We have investigated the association between the CYP17 SNP and SNSA in Japanese males. Genomic DNA was extracted from 149 Japanese male SNSA patients and 380 controls. The CYP17 SNP was genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis. Allelic and genotypic frequencies of the SNP were compared between SNSA patients and controls, and within SNSA patients. We also computed haplotype frequencies using an expectation-maximization algorithm, analyzed the difference between SNSA and control groups, and examined the potential association of other known SNPs in the CYP17 gene. The frequency of the -34T allele was significantly increased in HLA-B27-negative SNSA, but not in total or HLA-B27-positive SNSA when compared to controls. The T allele was more prevalent in HLA-B27-negative SNSA than in HLA-B27-positive SNSA, and the T/T genotype was over-represented in HLA-B27-negative SNSA. Haplotype analysis did not demonstrate more significant association. The CYP17 SNP is associated with SNSA in HLA-B27-negative Japanese males.

Adolescent↗

Type-selective muscular degeneration promotes infiltrative growth of intramuscular lipoma.

BACKGROUND: Intramuscular lipoma is a relatively common benign neoplasm that is occasionally described as an infiltrating lipoma. Typical benign tumors show a clear margin, however, the infiltrative growth pattern of this lipoma mimics that of a malignant tumor. Although its growth has an effect on muscle bundles and it is known to never metastasize, the mechanism of infiltrative growth is not well understood. Previously, little attention has been paid to pathogenic features of muscle fibers around an intramuscular lipoma. METHODS: In the present study, we focused on pathologic changes of the surrounding skeletal muscles especially to the degenerative features of involving muscular types, and evaluate the role of type-selective muscular degeneration for the infiltrative growth of intramuscular lipomas. Following a review of the medical records in our institute, 17 lesions containing muscle tissues in their specimens (15 infiltrating lipomas, 2 well-circumscribed lipomas) were analyzed immunohistochemically. The tumor from the most recent case was also subjected to ultrastructural analysis. Two cases of the traumatic muscle damage were also evaluated as the control experiments. RESULTS: These analyses revealed type-selective muscle involution in 11 of 17 intramuscular lipomas and in 10 of 11 of the infiltrative type, with an involving pattern that resembled that of a neurogenic or myogenic disorder. Immunoreactivity to cathepsin-D, a lysosomal catabolic enzyme, was increased in the involved muscle fibers. Subsarcolemmal vacuoles in the muscle fibers of the peripheral areas were also positive for cathepsin-D, while degenerative findings were not visually apparent in these areas. Ultrastructural analysis revealed degenerative changes in those fibers. Neither positive staining for cathepsin-D nor type-selective atrophy was detected in the sections of traumatic muscle damage. CONCLUSIONS: Our findings suggest that type-selective muscular degeneration and endomysial fatty growth as a result of atrophy may modulate the infiltrating growth characteristic of intramuscular lipoma.

Adipocytes↗

Evaluation of standard nucleotomy for lumbar disc herniation using the Love method: results of follow-up studies after more than 10 years.

A retrospective analysis of long-term follow-up results more than 10 years after a standard nucleotomy for lumbar disc herniation with the Love method was done to determine the effectiveness of this procedure. Nucleotomy according to Love was the standard treatment for lumbar disc herniation before the various minimally invasive alternatives were recently introduced. Without long-term follow-up analysis of Love operations, evidence-based evaluation of those new methods is impossible. We believe that the standard nucleotomy procedure should now be evaluated precisely. In this study we present a comparison of 1-year follow-up results to the results more than 10 years after lumbar nucleotomy. Seventy-six consecutive patients who had undergone lumbar nucleotomy were identified. It was possible to assess 54 (71.1%) of the cases more than 10 years after surgery. The initial and final outcomes were assessed using the MacNab classification and the Japanese Orthopaedic Association (JOA) score. With the MacNab classification a successful outcome 1 year after surgery was achieved in 87.0% of the cases. At the final follow-up, this result was reduced to 74.1%. Seven patients required a second operation and patients under 21 years of age were at risk for reoperation. Patient overall satisfaction with the results of the standard nucleotomy was high. The disc height of the operation site significantly decreased after surgery; nevertheless, this did not affect the clinical outcome. A standard lumbar nucleotomy according to Love is a safe and reliable method of treating selected patients with lumbar disc herniations.

Adult↗

Bath ankylosing spondylitis functional index (BASFI) evaluation of postoperative patients with OPLL.

Although surgical decompression of the involved spinal cord achieves a good recovery of neurological conditions, one of the most important complaints of patients with ossification of the posterior longitudinal ligament (OPLL) is disability as a result of spinal immobility. The activities of daily living (ADL) of postoperative patients with OPLL were examined. To evaluate the ADL of postoperative patients with OPLL in the cervical spine, we utilized the Bath Ankylosing Spondylitis Functional Index (BASFI), one of the most widely used functional indexes for ankylosing spondylitis. We investigated consecutive cases that underwent surgery for OPLL of the cervical spine in our department from 1978 to 1998. The latest and postoperative scores were compared to the preoperative Japanese Orthopaedic Association (JOA) scores (range, 0-17) to assess neurological recovery. We also evaluated ADL at the latest follow-up, using BASFI scores. Significant recoveries of JOA scores were confirmed; however, 77% of patients complained of disability. In BASFI, questions that seemed to reflect spinal condition received low scores in the present study. BASFI scoring was not sufficient in the present form; however, it is one of the candidate functional indexes for evaluating ADL in postoperative patients with OPLL. Establishment of an ideal functional index for such evaluation is needed.

Activities of Daily Living↗

Osteochondral grafting for cartilage defects in the patellar grooves of bilateral knee joints.

Autogenous osteochondral grafts have become popular recently for use in small, isolated, contained articular cartilage defects. We treated a 35-year-old man who had cartilage defects, which were the same shape and probably the result of overuse, in the patellar grooves of both knee joints. The left side was 30 x 25 mm, and the right side was 17 x 17 mm in his right patellar groove, and 15 x 7 mm in his right medial femoral condyle. Therefore, we performed multiple osteochondral grafting of the bilateral lesions. Thirty-two months after his right knee operation (37 months after his left one), he had no pain or symptoms in his left knee and occasional mild pain and catching in his right knee. At second-look arthroscopy, the joint surface of the articular cartilage in the bilateral patellar groove was almost completely smooth. However, the whole of the weight-bearing area around the grafted plugs in the medial femoral condyle showed cartilage degeneration. Approximately 3 years after implantation of osteochondral grafts into similarly shaped cartilage lesions in the bilateral patellar grooves, the operative results were good. However, careful follow up is needed.

Adult↗

Spontaneous rupture of the flexor digitorum profundus and superficialis of the index finger and the flexor pollicis longus without labor-associated tendon loading.

Closed ruptures of the flexor tendon have been described in association with distinct underlying pathologies. The spontaneous rupture of the flexor tendon secondary to axial tendon loading alone is infrequent. The previously reported cases with spontaneous rupture were mostly men aged 30 to 60 years. In addition, rupture occurred during manual labor with the fingers engaged in forceful or resisted flexion. Labor-associated forceful usage, in addition to gender and age, has been implicated in the pathogenesis of the stressful rupture of the flexor tendon. Here we report a case with spontaneous rupture of the flexor digitorum profundus (FDP) and superficialis of the index finger as well as the flexor pollicis longus (FPL). Unlike the previously reported cases the present patient was an elderly woman engaged in no apparent occupational activities. In the present case, however, the patient had a particular predisposing condition. The patient used only the right hand during her whole lifetime because of a perinatal brachial plexus injury on the contralateral arm. The present case may show that the tendons of an elderly patient could yield to the axial loading of normal levels of activities of daily living when the usage is as incessant as in the present patient.

Aged↗

Expression of macrophage inflammatory protein-1alpha in Schwann cell tumors.

It is well known that tumors originating from Schwann cells often demonstrate degeneration, such as myxoid areas in Schwannoma (Antoni B) and granular cell tumors. However, the mechanism has never been understood in detail. Recruitment of circulating macrophages plays a role in degeneration, however, the factors leading to that process are not well known. Macrophage inflammatory protein-1alpha (MIP-1alpha), which belongs to the C-C family of chemokines, is thought to be involved in the recruitment of inflammatory cells and might play a role in the degenerative change of Schwann cell tumors. To elucidate the role of MIP-1alpha in such conditions, we employed immunohistochemistry and in situ hybridization analyses. Strongly positive staining of MIP-1alpha was revealed in the myxoid areas of tested tumors and in situ hybridization detected the existence of MIP-1alpha mRNA in some of the tumor cells. These results suggest that MIP-1alpha produced from tumorigenic cells plays a role in the auto-degenerative process of Schwann cell tumors. Furthermore, various levels of MIP-1alpha expression in these tumors were implicated to be correlated with histological variations.

Adult↗

Long-term study of high-strength hydroxyapatite/poly(L-lactide) composite rods for the internal fixation of bone fractures: a 2-4-year follow-up study in rabbits.

Biodegradation of hydroxyapatite (HA)/poly(L-lactide)(PLLA) composite bone implant rods was studied with the use of two types of HA particles as reinforcing fillers: uncalcined HA (u-HA) or calcined HA (c-HA). Composite rods of u-HA/PLLA and c-HA/PLLA containing 30 or 40% (w/w) HA were implanted in the distal femur of 21 rabbits, and specimens were examined by light microscopy, scanning-electron microscopy (SEM), and transmission-electron microscopy (TEM) 2-4 years later. For u-HA/PLLA, trabecular bone bonding directly onto the rod was maintained for up to 2 years. By 3 years, surface collapse had begun, and the implants were shrinking. By 4 years, they had shrunk further, with complete bone encapsulation. The u-HA particles were small and needle shaped in the peripheries, and TEM confirmed their resorption. The cross-sectional area after 4 years decreased by 23.3+/-8.4%. The mean ratio of bony ingrowth to the initial cross-sectional area around the shrunken rods was 6.7+/-1.3 %. The viscosity molecular weight of PLLA reduced from 2 x 10(5) to less than 1 x 10(3). Thus, most of the PLLA had released from the rods. The c-HA/PLLA implants also showed good osteoconductivity, but shrinkage and infiltration of histiocytes were less. No osteolytic or osteoarthritic changes were found.

Absorbable Implants↗

Hip dysplasia in Charcot-Marie-Tooth disease: report of a family.

Charcot-Marie-Tooth disease is classified into hereditary motor and sensory neuropathy (HMSN) types I and II, and affected patients present with progressive peripheral neuropathy. Some previous orthopedic studies have revealed the association of hip dysplasia with HMSN, in addition to pes cavovarus, scoliosis, and recurrent dislocation of the patella. We describe three patients from the same family who were each diagnosed as having HMSN type I with associated bilateral severe hip dysplasia, borderline abnormalities of both acetabula, and dysplastic osteoarthritis. Based on our experience with these patients and a review of previous reports, we concluded that routine screening of hip joints, especially for those with a family history of HMSN, is necessary for early diagnosis.

Adult↗