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Biomedical subjects

Hideki Yoshikawa

Publications and source records attributed to Hideki Yoshikawa.

At least 145 records · Page 8Linked to original sources
PubMed2004

Operative technique of a new decompression procedure for Kienböck disease: partial capitate shortening.

A new decompression procedure for Kienböck disease, namely "partial capitate shortening," was developed. Patients in Lichtman stages 2 and 3A, independent of the ulnar variance, are candidates for this procedure. This procedure can dramatically reduce compressive forces on the lunate almost as much as a traditional decompression procedure of the capitate (capitate shortening combined with capitate-hamate fusion) and much more than the decompression procedure of the forearm bone such as radial shortening. We surmise that our procedure will allow better lunate revascularization. Although the scaphoid progressively adopts an abnormal palmarflexed position after capitate shortening combined with capitate-hamate fusion, partial capitate shortening can maintain normal carpal alignment, resulting in better joint congruency around the scaphoid and range of motion of the wrist. Moreover, partial capitate shortening allows minimal invasion and is an easy technique without bone grafting. Both operating and immobilizing time are shortened, and there are no secondary problems in the distal radioulnar and/or ulnocarpal joint often seen after radial osteotomy procedures.

Journal Article↗
PubMed2004

Improvement of depth position in 2-D/3-D registration of knee implants using single-plane fluoroscopy.

Two-dimensional (2-D)/three-dimensional (3-D) registration techniques using single-plane fluoroscopy are highly important for analyzing 3-D kinematics in applications such as total knee arthroplasty (TKA) implants. The accuracy of single-plane fluoroscopy-based techniques in the determination of translation perpendicular to the image plane (depth position), however, is relatively poor because a change in the depth position causes only small changes in the 2-D silhouette. Accuracies achieved in depth position using conventional 2-D/3-D registration techniques are insufficient for clinical applications. Therefore, we propose a technique for improving the accuracy of depth position determination in order to develop a system for analyzing knee kinematics over the full six degrees of freedom (6 DOF) using single-plane fluoroscopy. In preliminary experiments, the behaviors of errors for each free variable were quantified as evaluation curves by examining changes in cost function with variations in the free variable. The evaluation curve for depth position was more jagged, and the curve peak less pointy, compared to the evaluation curves of the other five variables, and the curve was found to behave differently. Depth position is therefore optimized independently of the other variables, using an approximate evaluation curve of depth position prepared after initial registration. Accuracy of the proposed technique was evaluated by computer simulation and in vitro tests, with validation of absolute position and orientation performed for each knee component. In computer simulation tests, root-mean-square error (RMSE) in depth position was improved from 2.6 mm (conventional) to 0.9 mm (proposed), whereas for in vitro tests, RMSE improved from 3.2 mm to 1.4 mm. Accuracy of the estimation of the remaining two translational and three rotational variables was found to be almost the same as that obtained by conventional techniques. Results of in vivo tests are also described in which the possibility of full 6 DOF kinematic analysis of TKA implants is shown.

Algorithms↗
PubMed2004

Differentiation status dependent function of FOG-1.

The molecular interactions between transcription factors and cofactors play crucial roles in various biological processes, including haematopoiesis. FOG-1 is a cognate cofactor of GATA-1, and the FOG-1/GATA-1 complex is essential for the haematopoietic differentiation of erythroid cells and megakaryocytes. In order to elucidate the biological functions of FOG-1 in the different contexts of cell differentiation, we analysed the effects of FOG-1 expression on haematopoietic cell differentiation, using a combination of in vitro differentiation of mouse embryonic stem (ES) cells and conditional gene expression. FOG-1 suppressed the proliferation of primitive and definitive erythroid cells in all stages of differentiation. However, FOG-1 inhibited and enhanced megakaryopoiesis in the early and late differentiation stages, respectively, through different molecular mechanisms. In addition, FOG-1 inhibited the proliferation of ES cells, the molecular mechanism of which differs from those of erythroid and megakaryocytic cells. These results suggest that FOG-1 functions in a cell differentiation context-dependent manner.

Animals↗
PubMed2004

Constitutionally tall stature with morphological abnormality of the pituitary gland.

We describe two male pubertal cases of constitutionally tall stature (CTS) with an enlarged pituitary gland or pituitary microadenoma. Both patients' basal serum growth hormone (GH) levels were normal. Neither had oversecretion of any other pituitary hormones. However, their serum GH levels were paradoxically increased in response to an intravenous administration of thyrotropin-releasing hormone (TRH). A later GH response to an intravenous administration of luteinizing hormone-releasing hormone (LHRH) was also found in one patient. In addition, oral glucose loading (OGL) caused a late increase in serum GH at 180 min in both patients. Our present findings suggest that endocrinological and morphological abnormalities of the pituitary gland are found in some subjects with CTS during puberty. It is speculated that these paradoxical GH responses are associated with dysregulation of GH secretion. Finally, it is important to investigate whether tall children with morphological abnormalities of the pituitary gland such as our patients are preacromegalic, in which case, given that overproduction of GH secretion may occur in the future, further observation is necessary.

Adenoma↗
PubMed2004

Low-intensity pulsed ultrasound accelerates maturation of callus in patients treated with opening-wedge high tibial osteotomy by hemicallotasis.

BACKGROUND: Opening-wedge high tibial osteotomy by hemicallotasis for osteoarthritis in the medial compartment of the knee requires external fixation for a long time, until callus maturation is complete. The aim of this study was to determine if low-intensity pulsed ultrasound would accelerate callus maturation when applied after distraction to limbs treated with opening-wedge high tibial osteotomy by hemicallotasis. METHODS: Twenty-one patients with symmetric grades of osteoarthritis and similar degrees of varus deformity in the two knees underwent bilateral one-stage opening-wedge high tibial osteotomy by hemicallotasis. After completion of distraction, the bone mineral density of the distraction callus was measured. Then, one randomly selected limb was subjected to ultrasound treatment for twenty minutes daily until removal of the external fixator. The contralateral limb was left untreated to serve as the control. After four weeks of treatment, bone mineral density was measured again. RESULTS: During the four-week treatment period, the mean increase in callus bone mineral density was significantly greater in the ultrasound-treated tibiae (0.20 +/- 0.12 g/cm(2)) than in the control tibiae (0.13 +/- 0.10 g/cm(2)) (p = 0.02, unpaired t test). In eighteen patients the increase in the bone mineral density was greater in the ultrasound-treated limb than in the control limb, whereas in three patients the increase was greater in the control limb. CONCLUSIONS: We found that low-intensity pulsed ultrasound applied during the consolidation phase of distraction osteogenesis accelerates callus maturation after opening-wedge high tibial osteotomy by hemicallotasis in elderly patients.

Absorptiometry, Photon↗
PubMed2004

Development of a camera model and calibration procedure for oblique-viewing endoscopes.

Oblique-viewing endoscopes (oblique scopes) are widely used in medical practice. They are essential for certain procedures such as laparoscopy, arthroscopy and sinus endoscopy. In an oblique scope the viewing directions are changeable by rotating the scope cylinder. Although a camera calibration method is necessary to apply augmented reality technologies to oblique endoscopic procedures, no method for oblique scope calibration has yet been developed. In the present paper, we formulate a camera model and a calibration procedure for oblique scopes. In the calibration procedure, Tsai's calibration is performed at zero rotation of the scope cylinder, then the variation of the external camera parameters corresponding to the rotation of the scope cylinder is modeled and estimated as a function of the rotation angle. Accurate estimation of the rotational axis is included in the procedure. The accuracy of this estimation was demonstrated to have a significant effect on overall calibration accuracy in the experimental evaluation, especially with large rotation angles. The projection error in the image plane was approximately two pixels. The proposed method was shown to be clinically applicable.

Algorithms↗
PubMed2004

Laminoplasty for cervical myelopathy caused by subaxial lesions in rheumatoid arthritis.

OBJECT: Although controversy exists regarding surgical treatment for rheumatoid subaxial lesions, no detailed studies have been conducted to examine the efficacy of laminoplasty in such cases. To discuss indications for laminoplasty in rheumatoid subaxial lesions, the authors retrospectively investigated clinical and radiological outcomes in patients who underwent laminoplasty for subaxial lesions. METHODS: Thirty patients (11 men and 19 women) underwent laminoplasty for rheumatoid subaxial lesions. The patients were divided into those with mutilating-type rheumatoid arthritis (RA) and those with nonmutilating-type RA according to the number of eroding joints. As of final follow-up examination laminoplasty resulted in improvement of myelopathy in 24 patients (seven with mutilating- and 17 with nonmutilating-type RA) and transient or no improvement in six (five with mutilating- and one with nonmutilating-type RA). In the group with mutilating-type RA, significantly poorer results were displayed (p < 0.05). In most patients preoperative radiographs demonstrated vertebral slippage less than or equal to 5 mm at only one or two levels. Postlaminoplasty deterioration of subaxial subluxation and unfavorable alignment change occurred significantly more often in patients with mutilating-type RA (p < 0.05). CONCLUSIONS: Patients with nonmutilating-type RA can benefit from laminoplasty for myelopathy due to subaxial lesions.

Aged↗
PubMed2004

Bone tissue engineering using novel interconnected porous hydroxyapatite ceramics combined with marrow mesenchymal cells: quantitative and three-dimensional image analysis.

We developed fully opened interconnected porous calcium hydroxyapatite ceramics having two different pore sizes. One has pores with an average size of 150 microm in diameter, an average 40-microm interconnecting pore diameter, and 75% porosity (HA150). The other has pores with an average size of 300 microm in diameter, an average 60-100-microm interconnecting pore diameter, and 75% porosity (HA300). Because of its smaller pore diameter, HA150 has greater mechanical strength than that of HA300. These ceramics were combined with rat marrow mesenchymal cells and cultured for 2 weeks in the presence of dexamethasone. The cultured ceramics were then implanted into subcutaneous sites in syngeneic rats and harvested 2-8 weeks after implantation. All the implants showed bone formation inside the pore areas as evidenced by decalcified histological sections and microcomputed tomography images, which enabled three-dimensional analysis of the newly formed bone and calculation of the bone volume in the implants. The bone volume increased over time. At 8 weeks after implantation, extensive bone volume was detected not only in the surface pore areas but also in the center pore areas of the implants. A high degree of alkaline phosphatase activity with a peak at 2 weeks and a high level of osteocalcin with a gradual increase over time were detected in the implants. The levels of these biochemical parameters were higher in HA150 than in HA300. The results indicate that a combination of HA150 and mesenchymal cells could be used as an excellent bone graft substitute because of its mechanical properties and capability of inducing bone formation.

Animals↗
PubMed2004

[Optimization of the chest exposure condition with a contrast-detail phantom: evaluation of the flat-panel versus computed radiography systems].

In this study, we evaluated the performance of a digital chest imaging system using a contrast-detail (C-D) phantom. In the initial step, 76 sample images of the C-D phantom were produced by changing the doses from 0.5, 0.75, 1.0, 1.25, 1.5, to 2.0 times the dose for a screen-film (S/F) system. The sample images were analyzed by five radiological technologists and two medical physicists, and the image quality figure (IQF) was determined. The quality of each image was examined, and appropriate doses were determined from the calculated IQF to obtain the same image quality for other digital chest imaging systems. The method of determining IQF from C-D phantom analysis was very useful for comparing image quality and determining radiographic techniques.

Phantoms, Imaging↗
PubMed2004

Prediction of response to neoadjuvant chemotherapy for osteosarcoma by gene-expression profiles.

To establish a method for predicting the response to chemotherapy for osteosarcoma (OS), we performed expression profile analysis using cDNA microarray consisting of 23,040 genes. Hierarchical clustering based on the expression profiles of 19 biopsy samples of OS demonstrated two major clusters, one of which consisted exclusively of typical OS, i.e. conventional central OS in long bone of patients in the second decade. A set of genes was identified to characterize this subgroup, some of which have previously indicated some relation to carcinogenesis. Thirteen of the 19 patients were treated with an identical protocol of chemotherapy containing doxorubicin, cis-platinum and ifosfamide, and histological examination of resected specimens after operation classified 6 cases as responder and 7 as non-responder. A comparison of expression profiles of these two groups identified 60 genes whose expression levels were likely to be correlated with the response to chemotherapy (P<0.008). A drug response scoring (DRS) system was developed based on the expression levels of these genes, which proved to be applicable to predict the response to chemotherapy irrespective for the subclassification of OS. The reliability of the DRS system was further confirmed by testing additional 5 OS cases. These results indicated that scoring system based on gene-expression profiles might be useful to predict the response to chemotherapy for OS.

Adolescent↗
PubMed2004

[Role of BMPs and Smads during endochondral bone formation].

Biochemical research has revealed that BMP signals are mainly mediated through ligand binding to the receptors followed by activation of Smad proteins. BMP signaling is subjected to regulation at extracellular level by noggin and at intracellular level by inhibitory-Smads. Analysis of transgenic mice in which BMP signals are activated or inactivated has been clarifying a role of BMP signaling during endochondral bone formation. BMPs promote chondrocyte proliferation and hypertrophy, whereas Smad signaling regulates chondrocyte hypertrophy. Proper regulation of these signals is necessary for normal bone formation.

Animals↗
PubMed2003

C5 palsy after decompression surgery for cervical myelopathy: review of the literature.

STUDY DESIGN: A literature review was conducted to integrate and compile available reports on postoperative C5 palsy. OBJECTIVES: To review the clinical features, possible pathogenesis, and procedures for treatment and prevention of postoperative C5 palsy as a complication of surgery for cervical compression myelopathy. SUMMARY OF BACKGROUND DATA: Although postoperative C5 palsy develops in approximately 5% of patients after decompression surgery of the cervical spine, its pathogenesis and the options for prevention and treatment remain unidentified and many controversies exist. METHOD: We reviewed and analyzed papers published from 1986 to 2002 regarding C5 palsy as a postoperative complication. Statistical comparisons were made when appropriate. RESULTS: Postoperative C5 palsy is reported to occur in an average of 4.6% of patients after surgery for cervical compression myelopathy. No significant differences were noted between patients undergoing anterior decompression and fusion and laminoplasty, nor were distinctions apparent between unilateral hinge laminoplasty and French-door laminoplasty, or between cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. Two theories were put forth to account for the pathogenesis of C5 palsy: nerve root injury and segmental spinal cord disorder. Neither of these hypotheses has been consistently supported and evidence to refute each hypothesis can be found in the literature. Recently, surgeons have advocated foraminotomy combined with laminoplasty to prevent or treat C5 palsy, but further studies into the efficacy of this procedure are needed. Although patients with C5 palsy generally have a good prognosis for neurologic and functional recovery, those with severe paralysis require significantly longer recovery times when compared to more mild cases. CONCLUSION: The incidence of postoperative C5 palsy has been reported at 4.6% after surgery for cervical compression myelopathy and this value has not varied with different surgical procedures or disease etiologies. The pathogenesis of postoperative C5 palsy remains unclear at the present time. Patients with postoperative C5 palsy generally have a good prognosis for functional recovery, but the severely paralyzed cases required significantly longer recovery times than the mild cases.

Cervical Vertebrae↗
PubMed2003

Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation.

OBJECTIVE: To characterize the radiological and clinicopathologic features of cystic synovial sarcoma. DESIGN AND PATIENTS: Seven patients with primary cystic synovial sarcoma were evaluated. Computed tomography (CT) and magnetic resonance (MR) imaging were undertaken at the first presentation. The diagnosis of synovial sarcoma was made on the basis of histological examinations followed by molecular analysis. Radiological and clinicopathologic findings were reviewed. RESULTS: CT showed well-defined soft tissue mass without cortical bone erosion and invasion. Calcification was seen at the periphery of the mass in three cases. T2-weighted MR images showed multilocular inhomogeneous intensity mass in all cases, five of which showed fluid-fluid levels. On gross appearance, old and/or fresh hematomas were detected in six cases. In the one remaining case, microscopic hemorrhage in the cystic lumen was proven. Four cases had poorly differentiated areas. In five cases prominent hemangiopericytomatous vasculature was observed. Histologic grade was intermediate in one tumor and high in six. One case had a history of misdiagnosis for tarsal tunnel syndrome, one for lymphadenopathy, two for sciatica and two for hematoma. CONCLUSION: All cystic synovial sarcomas demonstrated multilocularity with well-circumscribed walls and internal septae. Synovial sarcoma should be taken into consideration in patients with deeply situated multicystic mass with triple signal intensity on T2-weighted MR imaging.

Adolescent↗
PubMed2003

High-resolution and high-intensity powder diffractometer at BL15XU in SPring-8.

A new ultra-high-resolution powder diffractometer for synchrotron radiation has been constructed at beamline BL15XU, SPring-8. The two-axis diffractometer is optimized for high-flux and high-coherent X-ray beams, which are provided by combining a planar undulator and a large offset rotated-inclined Si(111) double-crystal monochromator. The optics design of the diffractometer is based on transmission geometry, which employs a capillary specimen and reflection geometries using a flat-plate specimen. The intensity data are collected using a 2theta step-scan technique in both geometries. The diffractometer can be arranged in a variety of optical configurations, e.g. simple receiving slits, flat crystal analyzer of Ge(111) or Si(111), and in-vacuum-type long horizontal parallel slits. A minimum full width at half-maximum against 2theta was 0.00572 degrees at lambda = 0.63582 A for the (200) reflections from Si powder in the transmission geometry employing the Ge(111) crystal analyzer. A wide temperature range (32-900 K), which is controlled by a He/N(2) gas stream system, is available. 288 structure parameters of a zeolite ZSM-5 sample have been demonstrated to successfully refine with a R(wp) value of 6.96% by a Rietveld analysis of the high-resolution powder diffraction data from a 1 mm-diameter capillary specimen.

Crystallization↗
PubMed2003

Total ankle replacement in rheumatoid arthritis.

We reviewed 21 patients with rheumatoid arthritis who had a total ankle replacement between 1984 and 2000. The average follow-up was 72 (15-169) months. Clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score. At the latest review, three ankles had been revised. Two ankles were excellent, seven good, three fair, and 12 poor. Eleven patients with 13 ankles had residual pain, with radiographs showing a high incidence of radiolucent lines. Migration of the tibial component was seen in 13 ankles and collapse of talus in nine. Although clinical results were poor, patient satisfaction was not.

Adult↗
PubMed2003

Recombinant expression and characterization of a novel fibronectin isoform expressed in cartilaginous tissues.

A novel fibronectin (FN) isoform lacking the segment from IIICS (type III connecting segment) through the I-10 module is expressed predominantly in normal cartilaginous tissues. We expressed and purified recombinant cartilage-type FN using a mammalian expression system and characterized its molecular and biological properties. Although FNs have been shown to be secreted as disulfide-bonded dimers, cartilage-type FN was secreted mainly as a monomer. It was less potent than plasma-type FN in promoting cell adhesion and binding to integrin alpha5beta1, although it was more active than plasma-type FN in binding to chondroitin sulfate E. When added exogenously, cartilage-type FN was poorly assembled into the fibrillar FN matrix, mostly because of its monomeric structure. Given that cartilage is characterized by its non-fibrillar matrix with abundant chondroitin sulfate-containing proteoglycans, it is likely that cartilage-type FN has evolved to adapt itself to the non-fibrillar structure of the cartilage matrix through acquisition of a novel mechanism of alternative pre-mRNA splicing.

Animals↗