The Development of a Novel Bone Filler, Titanium Wire Ball

In designing bone fillers, hardness has heretofore not been a major concern. Fillers are typically very hard and thus often accelerate the collapse of the adjacent bones. We developed a novel, relatively soft bone filler, whose hardness is similar to the human cancellous bone. The structure is simple: a 0.14-mm-diameter pure titanium wire was rolled and folded with both ends buried in the central portion, resulting in a ball of 4-mm diameter with 83% internal void ratio, having 300-500 μm internal gaps. The balls are chemically washed in an acidic solution at the end of the manufacturing process. We call this new filling device titanium wire balls (TWBs). We implanted TWBs into the medial condyle of the right tibiae of twelve adult Japanese white rabbits, and histologically evaluated the results. Four weeks after implantation, the spaces in the TWBs were fully calcified; the TWBs, the calcified tissues in them and the cancellous bones surrounding them were all connected with each other. In conclusion, we developed a novel bone filler that has similar hardness to the human cancellous bone and an 83% internal void ratio, with 300-500 μm internal gaps. Four weeks after implantation, the spaces in TWBs were fully calcified and connected to the surrounding cancellous bones

Soft Tissue Myoepithelioma of the Shoulder

Soft tissue myoepitheliomas are often misdiagnosed due to their rarity. Herein, we describe a case of soft tissue myoepithelioma of the shoulder. A 72-year-old woman had a suspected sarcoma on her shoulder and under-went open biopsy. She was referred to our hospital, where the tumor was widely resected and the diagnosis of myoepithelioma was histologically confirmed. No recurrence has been observed in the 3 years since the sur-gery. Careful and prompt planning is necessary for the effective treatment of myoepithelioma

Expression and intracellular localization of FKHRL1 in mammary gland neoplasms.

FKHRL1 (FOXO3a), a member of the Forkhead family of genes, has been considered to be involved in the development of breast tumors; however, the in vivo expression and activation status of FKHRL1 in breast tumors still remains unclear. We immunohistochemically demonstrated the expression and intracellular localization of FKHRL1 in human breast tumors by the novel anti-FKHRL1 antibody which is available for formalin-fixed paraffin-embedded specimens. In a total of 51 cases of benign tumors, FKHRL1 was diffusely expressed in all cases, and its intracellular localization was revealed to be cytoplasmic (inactive form) in 94% of cases of intraductal papillomas (16/17) and 91% cases of fibroadenomas (31/34), with a similar pattern to normal glandular epithelium. In invasive ductal carcinomas, 83% of the cases (93/112) diffusely expressed FKHRL1; however, unlike benign tumors, 71% of the cases (66/93) showed the nuclear-targeted, active form of FKHRL1. Moreover, activated FKHRL1 was predominantly observed in scirrhous (29/36, 81% of the cases) and papillotubular (30/38, 79% of the cases) subtypes, compared to the solid-tubular subtype (7/19, 37% of the cases). Furthermore, the cases with nuclear-targeted FKHRL1 showed a tendency to have lymph nodal metastasis with statistical significance (P < 0.0001). Thus, the activation of FKHRL1 seems to be recognized as one of the specific features of invasive ductal carcinoma of the breast.</p

Salmonella Osteomyelitis of the Distal Tibia in a Healthy Woman

Salmonella osteomyelitis is extremely rare; only a few cases have been reported in healthy adults. We describe a case of salmonella osteomyelitis in an otherwise healthy 20-year-old Japanese woman who presented with distal tibial pain. X-ray and magnetic resonance imaging showed a lesion suspected to be a bone cyst. Osteomyelitis was diagnosed when pus was observed during an open biopsy. The bacterial culture examination yielded salmonella. Surgical drainage and antibiotic treatment were performed, after which no recurrence was observed. To our best knowledge, this is the first report of salmonella osteomyelitis of the distal tibia in an otherwise healthy individual

Numerical changes in blood monocytes in bronchial asthma.

Numerical changes in peripheral blood monocytes were examined in 125 patients with bronchial asthma using a new direct method of counting blood monocytes. The number of monocytes in non-attack stages of bronchial asthma was similar to that of healthy controls. The monocyte count observed in overall cases showed a significantly higher value both in pre-attack and attack stages than in non-attack stages. Changes in the number of monocytes in an individual spontaneous asthmatic cycle tended to increase in pre-attack stages, increase more markedly during asthma attacks, then to decrease after the attack was alleviated. Monocytes in cases with a positive test for bronchial challenge to house dust extract changed in almost the same manner as for spontaneous asthma attacks. The number of monocytes did not change during bronchospasm provoked by inhalation of acetylcholine. Exercise-induced asthma patients exhibited indefinite changes of monocytes; that is, some cases showed a significant increase in the number of monocytes related to the asthma cycle, but other cases did not show any appreciable change. These findings suggest that the number of monocytes in the peripheral blood may change in close relation to asthma attacks elicited by allergic reactions.</p

Senile brain atrophy and hydrocephalus -A case of treatable dementia, idiopathic normal pressure hydrocephalus-

A 76y male suffering from progressive dementia (Hasegawa\u27s dementia scale = 6), urinary incontinence, and gate disturbance received CSF shunting. The clinical findings of MRI, CT-cisternography, and a CSF-tap test were not typical for idiopathic normal pressure hydrocephalus (iNPH); rather, the MRI showed brain atrophy. The decision to perform shunting surgery was made due to the clinical manifestation of progressive dementia, and fortunately, it was successful. Senile brain atrophy does not rule out hydrocephalus. The indication of CSF shunting for senile iNPH is outlined

Long-Term Outcome of Proton Therapy and Carbon-Ion Therapy for Large (T2a–T2bN0M0) Non–Small-Cell Lung Cancer

IntroductionAlthough many reports have shown the safety and efficacy of stereotactic body radiotherapy (SBRT) for T1N0M0 non–small-cell lung cancer (NSCLC), it is rather difficult to treat T2N0M0 NSCLC, especially T2b (>5 cm) tumor, with SBRT. Our hypothesis was that particle therapy might be superior to SBRT in T2 patients. We evaluated the clinical outcome of particle therapy for T2a/bN0M0 NSCLC staged according to the 7th edition of the International Union Against Cancer (UICC) tumor, node, metastasis classification.MethodsFrom April 2003 to December 2009, 70 histologically confirmed patients were treated with proton (n = 43) or carbon-ion (n = 27) therapy according to institutional protocols. Forty-seven patients had a T2a tumor and 23 had a T2b tumor. The total dose and fraction (fr) number were 60 (Gray equivalent) GyE/10 fr in 20 patients, 52.8 GyE/4 fr in 16, 66 GyE/10 fr in 16, 80 GyE/20 fr in 14, and other in four patients, respectively. Toxicities were scored according to the Common Terminology Criteria for Adverse Events, Version 4.0.ResultsThe median follow-up period for living patients was 51 months (range, 24–103). For all 70 patients, the 4-year overall survival, local control, and progression-free survival rates were 58% (T2a, 53%; T2b, 67%), 75% (T2a, 70%; T2b, 84%), and 46% (T2a, 43%; T2b, 52%), respectively, with no significant differences between the two groups. The 4-year regional recurrence rate was 17%. Grade 3 pulmonary toxicity was observed in only two patients.ConclusionParticle therapy is well tolerated and effective for T2a/bN0M0 NSCLC. To further improve treatment outcome, adjuvant chemotherapy seems a reasonable option, whenever possible

Reference values for the locomotive syndrome risk test quantifying mobility of 8681 adults aged 20–89 years: A cross-sectional nationwide study in Japan

Background The locomotive syndrome risk test was developed to quantify the decrease in mobility among adults, which could eventually lead to disability. The purpose of this study was to establish reference values for the locomotive syndrome risk test for adults and investigate the influence of age and sex. Methods We analyzed 8681 independent community dwellers (3607 men, 5074 women). Data pertaining to locomotive syndrome risk test (the two-step test, the stand-up test, and the 25-question geriatric locomotive function scale [GLFS-25]) scores were collected from seven administrative areas of Japan. Results The reference values of the three test scores were generated and all three test scores gradually decreased among young-to-middle-aged individuals and rapidly decreased in individuals aged over 60 years. The stand-up test score began decreasing significantly from the age of 30 years. The trajectories of decrease in the two-step test score with age was slightly different between men and women especially among the middle-aged individuals. The two physical test scores were more sensitive to aging than the self-reported test score. Conclusion The reference values generated in this study could be employed to determine whether an individual has mobility comparable to independent community dwellers of the same age and sex

Chondrocyte senescence and osteoarthritis : role of oxidized LDL-induced oxidative stress

Although epidemiologic studies have shown that age is the chief risk factor for osteoarthritis (OA), the relationship between aging and the development of OA has not been completely understood yet. However, accumulating evidences in vivo and vitro have shown that the development of OA is, at least in part, attributable to the age-related chondrocyte senescence. This review focuses on how chondrocyte senescence affects the articular cartilage degeneration and how oxidative stress affects the chondrocyte senescence. Further, I would like to introduce our hypothesis that oxidized low-density lipoprotein, which is the most important molecule causing atherosclerosis, is involved in the pathogenesis of OA by playing a role as an oxidative stressor. It is interesting that even though mitotically inactive, senescent cells are far from being biologically inert. Many genes in senescent cells display higher expression levels that do not merely correlate with cell cycle arrest. Chondrocyte senescence is associated with an increased production of inflammatory mediators and matrix degrading enzymes characteristic of the senescent secretory phenotype. Age-related oxidative stress and damage may play a central role in cartilage aging through modulation of cell signaling pathways that regulate anabolic and catabolic activity