Histological examination of frozen autograft treated by liquid nitrogen removed 6 years after implantation

金沢大学附属病

Hyaluronan in the cerebrospinal fluid of patients with spinal tumor

金沢大学大学院医学系研究科機能再生学The clinical significance of hyaluronan (HA) levels in the cerebrospinal fluid (CSF) of patients with spinal tumor (ST) was evaluated in order to clarify whether HA concentrations in the CSF of patients with ST differ according to such factors as the tumor site and histopathological diagnosis. CSF samples were obtained from 40 patients with ST who had undergone myelography and CSF examinations retrospectively. The HA levels were determined using a sandwich-binding protein assay. The total protein (TP) levels were also determined. The HA and TP concentrations in CSF were significantly higher in patients with extramedullary tumor than in patients with intramedullary tumor. There was a significant correlation between HA and TP concentrations in CSF patients with ST. A HA assay for CSF is therefore considered to be potentially useful for estimating the localization of ST. © 2006 World Scientific Publishing Company

The prognostic factors of recurrent GCT: A cooperative study by the Eastern Asian Musculoskeletal Oncology Group

Background Giant-cell tumor (GCT) of bone is a common primary benign tumor with high local recurrence and potential distant metastasis or malignant transformation. We haveinvestigated the clinical behavior of recurrent GCT of bone in the extremities. Methods We retrospectively reviewed 110 patients with recurrent GCTs of bone in the extremities treated by the Eastern Asian Musculoskeletal Oncology Group. The factors that affected the number of recurrences and distant metastasis were analyzed. Results The median interval between initial surgery and the first recurrence of GCTwas 16 months (2-180 months). All patients received additional surgery for first recurrence. Twenty-five patients had a second recurrence and 6 patients had a third recurrence. The mean interval between theinitial surgery and the first recurrence correlated withthe eventual number of recurrences-14.1 months for the repeated recurrence groups (two and three recurrences) and 28.3 months for the single recurrence group (p = 0.016). Campanacci grade did not correlate with repeated recurrence (p = 0. 446). The venue of the initial surgery did not correlate with recurrence but did affect preservation of the adjacent joint (chi-squared test; p =0.046). Campanacci grade II and III also correlated withsacrifice of the adjacent joint (p = 0.020). The incidence of lung metastasis and malignant transformation were 7.5% (8 out of 107 patients) and 2.7% (3 out of 110 patients), respectively. Repeat recurrence was associated with lung metastasis (p = 0.018). © The Japanese Orthopaedic Association 2011

Effect of troglitazone on tumor growth and pulmonary metastasis development of the mouse osteosarcoma cell line LM8

<p>Abstract</p> <p>Background</p> <p>Osteosarcoma often develops micrometastases in the lung prior to diagnosis, causing a fatal outcome. Therefore, the prevention of pulmonary metastases is critical for the improvement of the prognosis of patients with osteosarcoma. The purpose of this study was to investigate whether troglitazone (TGZ) is considered as possible therapeutics in the treatment of growth and metastasis of osteosarcoma.</p> <p>Methods</p> <p>LM8 cells were treated for 3 days with various concentrations of TGZ. The effect of TGZ on cell proliferation was determined by DNA measurement in the cultures and 5-bromo-2'-deoxyuridine incorporation study. The assay of cell invasion and motility was performed using either the Matrigel-coated cell culture inserts or the uncoated cell culture inserts in the invasion chambers. The effect of TGZ on Akt signaling was assessed by Western blot analysis of Akt and p-Akt. The effects of oral administration of either TGZ (TGZ group) or ethanol (control group) on the growth of primary tumor and the development of pulmonary metastasis were examined in nude mice implanted with LM8 cells on their backs. The expression and activity of matrix metalloproteinase 2 (MMP-2) within the tumor were determined by immunohistochemistry and zymography. The microvessel density (MVD) within the tumor was determined by immunohistochemistry for CD34.</p> <p>Results</p> <p>TGZ dose-dependently inhibits cell proliferation. TGZ-treated cells were less invasive and less motile than untreated cells. The activity of MMP-2 secreted by TGZ-treated cells was lower than that secreted by untreated cells. TGZ decreased the level of p-Akt. The primary tumor mass was smaller in the TGZ group than in the control group. The TGZ group had less metastatic tumors in the lung compared with the control group. The expression and activity of MMP-2 within the tumor of the TGZ group were lower than those of the control group. The MVD within the tumor of the TGZ group was lower than that of the control group.</p> <p>Conclusions</p> <p>Inhibition of Akt signaling by TGZ may decrease the secretion of MMP-2, resulting in the decrease of invasiveness and motility in LM8 cells. Treatment of tumor-bearing mice with TGZ decreases the expression and activity of MMP-2 within the tumor, and inhibits primary tumor growth and pulmonary metastasis development. TGZ may offer a new approach in chemotherapy for osteosarcoma.</p

<症例>経皮的自家骨髄注入による大腿骨偽関節の治療

Percutaneous bone marrow injections were performed on 7 nonunions of the femur. There were 6 hypervascular nonunions and one avascular nonunion. Two nonunions presented with active infections. One other patient had a history of infection which had subsided. One nonunion received the injection twice. After the site of nonunion was curetted and the bone surface was scored, 150 ml of bone marrow aspirated from the iliac bone was injected. Complete union occurred in 4 patients within 9 months; all of them were uninfected hypervascular nonunions following intramedullary nail fixation. One nonunion with a bone defect united partially leaving a 1×1 cm defect. The two infected femoral nonunions failed to unite . The results show that percutaneous autologous bone marrow injection for femoral nonunions can be considered for uninfected hypervascular nonunions following intramedullary nail fixation. In these cases, stimulation of healing processes of fracture leading to consolidation can be expected from bone marrow injection. However, femoral nonunion with an active infection and loss of fixation is considered to be a contraindication for this technique.7例の大腿骨偽関節症例に対して経皮的自家骨髄移植を施行した. Weber の分類法で, 7例中6例は hypervascular nonunion, 1例は avascular nonunion であった. 2例は感染を合併しており, 他の2例は感染の既往があった. 方法として, 経皮的に偽関節部の一部を掻爬し, 腸骨から吸引した骨髄 150 ml を直ちに注入した. 1例には2回の自家骨髄注入を行った. 髄内釘手術後の, 感染を合併していなかった4例に9ヵ月以内に骨癒合が得られたが, 感染のあった2例では癒合が得られなかった. この結果から, 髄内釘施行後の感染の徴候を示さない大腿骨偽関節例に対して, 経皮的自家骨髄移植は, より侵襲の少ない有用な治療方法と考えられた