Histological Evaluation of Lumbar Spine Changes in Rats with Collagen-induced Arthritis

【Background】 To histologically evaluate lumbar involvement in rheumatoid arthritis (RA) by investigating rats with collagen-induced arthritis (CIA) and to assess the potential effects of RA on the discovertebral joints and facet joints. 【Methods】 Seven-month-old female Sprague-Dawley rats were divided into groups with CIA and without CIA (control). All rats were sacrificed at 8 weeks after initial sensitization and the lumbar spine (L5/6) was harvested. Then the lumbar spine block specimens were stained with Villaneuva bone stain and sectioned in the midsagittal plane. The left facet joints were also sectioned in the midaxial plane. Specimens were studied under a microscope and infiltration of inflammatory cells was investigated. 【Results】 In the CIA group, lumbar lesions were observed in 13/18 rats (76%). Lymphocytes infiltrated into the anterior rim of the vertebral bodies only in 2 rats, while lymphocytes infiltrated the facet joints only in 4 rats. Both sites were involved in 7 rats. In addition, osteoclasts invaded the anterior rim of the vertebral bodies and formed cavities that also contained lymphocytes. Formation of pannus was seen in the facet joints in 11/18 rats. 【Conclusion】 In CIA rats, infiltration of inflammatory cells into the anterior rim of the vertebral bodies alone or into the facet joints alone was demonstrated in 2 rats and 4 rats, respectively, while both sites were involved in 7 rats. Therefore, lesions at the anterior rim of the vertebral body did not arise secondary to facet joint involvement, but were caused by CIA along with synovial lesions of the facet joints

Utility of CD64 on Neutrophils in Orthopedic Infection

【Background】 Musculoskeletal infections are often seen in the daily practice of orthopedics. Several markers [white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)] have been used for diagnosing these infections. However, these markers may be elevated due to surgery or trauma, and may not be infection-related. These markers also show drug-dependent dynamics during infection that differ from its usual dynamics. Such situations make diagnosis of infections difficult, and Cluster of Differentiation 64 (CD64) has been brought to attention. This study aimed to clarify the utility of CD64 on neutrophils by comparing it with conventional infection markers (CRP, PCT) in musculoskeletal infection. 【Methods】 Forty-four patients who were suspected of having musculoskeletal infection between May 2010 and November 2013 in our hospital were enrolled in this study. Patients were divided into subgroups according to their culture results, antibiotics administration, measurement timing, and if they were immunocompromised. The measurements of the infection markers were compared between each group. In addition, the positive rates of each infection marker were compared between groups. 【Results】 There was no difference in the infection marker measurements between several groups. There was no statistically significant difference between groups for the positive rates of CD64, CRP, and PCT. 【Conclusion】 We evaluated the utility of CD64 on neutrophils in musculoskeletal infection. CD64 showed the utility that was equivalent to conventional infection markers in diagnoses of various musculoskeletal infections

Analysis of heat shock proteins and cytokines expressed during early stages of osteoarthritis in a mouse model

SummaryObjective:Osteoarthritis (OA) is a debilitating disease of the joints. The joints of affected individuals are characterized by a progressive degeneration of articular cartilage leading to inflammation and pain. The expression of heat shock proteins (HSPs) is a ubiquitous self-protective mechanism of all cells under stress, furthermore, the synovium of osteoarthritic individuals contains high levels of cytokines. This study seeks to establish the role of HSPs and cytokines in OA.Methods:We have investigated the presence of HSPs and cytokines in articular cartilage during early stages of OA in a mouse that is known to develop spontaneous OA lesions (C57 black mouse). The articular cartilage from closely related mice (C57BL/6) was used as control. Messenger RNAs (mRNAs) for HSPs (HSP32, HSP47, HSP60, HSP70, HSP84 and HSP86) and cytokines [interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ)] were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results:The mRNA levels of HSP47, HSP70, HSP86, IL-6, and IFN-γ were up-regulated in the cartilage of C57 black mice, whereas, the level of expression of HSP32, HSP60, HSP84 and IL-1β remained unchanged. Furthermore, the expression of IL-1β, IL-6, TNF-α and IFN-γ mRNA was associated with expression of HSP60, HSP47, HSP70 and HSP70/HSP86 mRNA, respectively.Conclusions:The findings in this study suggest that chondrocytes are conditioned under non-physiological stress during early stages of OA, In addition, among HSPs, HSP70 was associated with two different highly expressed cytokines in C57 black mice, indicating the possible role of HSP70 as a characteristic indicator of early stage of OA

Neurogenic Dumbbell Tumor Resected by Combined Posterior and Thoracoscopic Approaches

The patient was a 51-year-old female with a chief complaint of numbness of the right thigh. A dumbbell tumor compressing the 11th thoracic spinal cord was present in the posterior mediastinum on chest computed tomography and myelography. In surgery, the tumor in the spinal canal was resected by a posterior approach, and the residual tumor was completely excised by thoracoscopic surgery. The tumor measured 78 48 mm, and histopathologically diagnosed as schwannoma. The surgical procedure for neurogenic dumbbell tumors should be decided based on Eden’s classification. For types II and III, such as this patient, excision of the tumor in the spinal canal should be performed to avoid spinal cord damage, followed by thoracoscopic complete resection. Thoracoscopic surgery was applicable even though the tumor was large

Angiosarcoma of the proximal humerus: a case report and review of the literature

Abstract Introduction Angiosarcoma of bone is an uncommon primary bone neoplasm that is composed of tumor cells that show endothelial differentiation. This is an aggressive malignancy characterized by frequent local recurrence and distant metastases. The majority of patients die within one year of diagnosis, and this shows that angiosarcoma of bone is an aggressive high-grade tumor. Case presentation We present the case of a 65-year-old Japanese woman who had primary angiosarcoma of the proximal humerus with a pathological fracture. An open biopsy confirmed a diagnosis of primary angiosarcoma of bone. Our patient was treated with neoadjuvant chemotherapy and wide resection. One month after surgery, she developed multifocal distant metastasis to her liver and spleen. Conclusions Angiosarcoma of the humerus is extremely rare. Radiographically, there is no specific finding associated with angiosarcoma of bone as opposed to other malignant bone tumors. The cornerstone of treatment is en bloc resection followed by as much adjuvant radiation therapy as possible. However, the role of chemotherapy remains undefined, and better systemic agents are clearly needed.</p