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Biomedical subjects

M Kurosaka

Publications and source records attributed to M Kurosaka.

At least 37 records · Page 2Linked to original sources
PubMed2001

Phalangeal microgeodic syndrome: MR appearance.

The authors describe the MR features of a case of microgeodic phalangeal syndrome in a 9-year-old boy. Roentgenograms showed multiple small areas of osteolysis in the middle phalanx of the right index finger. T1-weighted MR images showed lesions with diffuse low signal intensity not only in this phalanx but also in other phalanges. These lesions exhibited high signal intensity on T2-weighted images. Contrast-enhanced T1-weighted images showed a wide non-enhancing area in the middle phalanx of the index finger.

Child↗
PubMed2001

Contrast-enhanced three-dimensional helical CT for soft tissue tumors in the extremities.

OBJECTIVE: To evaluate the ability of contrast-enhanced three-dimensional (3D) helical computed tomography (CT) to image soft tissue tumors in the extremities. DESIGN AND PATIENTS: Forty-five consecutive patients with soft tissue tumors in the extremities were examined (mean age 46.2 years; 24 females, 21 males). Twenty-five patients had benign lesions and 20 had malignant lesions. All the patients underwent contrast-enhanced 3DCT scanning and magnetic resonance (MR) imaging preoperatively. All patients were surgically treated. Spiral CT scanning was performed with intravenous contrast enhancement. 3D reconstruction images were produced after thresholding, using Active-Windows (version 2.0, General Electric, Milwaukee, WI) software. 3DCT findings were compared in a masked fashion with the MR imaging and surgical findings regarding bone and major vessel invasion by the tumors. RESULTS: Forty-four of 45 tumors were satisfactorily imaged for the interpretation of their size, location and relationship to the skeleton and major vessels. One malignant tumor was judged on 3DCT to invade the major vessel, but the vessel proved to be normal at surgery. CONCLUSIONS: Contrast-enhanced 3D helical CT can be used for the evaluation of soft tissue tumors in the extremities, for preoperative surgical planning.

Adolescent↗
PubMed2001

Establishment and characterization of cell line TNMY1 derived from human malignant fibrous histiocytoma.

Although malignant fibrous histiocytoma (MFH) is one of the most common soft tissue sarcomas, its pathogenesis remains unclear. In this study, a cell line derived from human MFH, TNMY1, was established from a metastatic chest-wall lesion of a 60-year-old woman with MFH. The TNMY1 cell line was passaged 95 times, and it still retained the biological characteristics of the original tumor. TNMY1 consists of spindle-shaped cells and pleomorphic cells associated with multinucleated giant cells. Immunohistochemical studies showed that the spindle-shaped and pleomorphic cells were positive for vimentin, CD68 and alpha-smooth muscle actin, but negative for epithelial membrane antigen, desmin, muscle actin, alpha-sarcomeric actin, myoglobin, lysozyme and S-100 protein. The cells expressed collagen types I, III and V. These results indicate that MFH may originate from mesenchymal stem cells with the potential to differentiate into either fibroblasts or histiocytes. An elevated level of collagen type V mRNA expression is considered to support a diagnosis of MFH.

Animals↗
PubMed2001

Histologic analysis of the implanted cartilage in an exact-fit osteochondral transplantation model.

PURPOSE: Osteochondral transplantation is one of the useful treatments for articular cartilage defect. However, the histologic change of the implanted cartilage has not been reported in detail. We investigated the histology of exact-fit osteochondral transplants used to repair articular cartilage defects in an animal model. TYPE OF STUDY: This was a nonrandomized control study using an animal model. METHODS: Sixteen skeletally mature female Japanese white rabbits were used in the study. The region of the femoral groove was selected as the site for the osteochondral defect. A full-thickness cylindrical defect (7 mm in diameter and 7 mm in depth) through the articular cartilage and into the subchondral bone was made using the Osteochondral Autograft Transfer System (Arthrex, Naples, FL). The entire osteochondral fragment was removed and then returned to its original site in the femoral condyle precisely. Thus, the defect was repaired with an autogenous osteochondral transplantation of exactly the same size and configuration as the defect. Specimens were obtained 2, 4, 12, and 24 weeks postoperatively and were analyzed both macroscopically and histologically. RESULTS: Macroscopically, there was smooth continuity of the articular surface and the integration of the graft to the normal host cartilage. However, histologic examination showed that the layer of the grafted cartilage was thicker than that of the normal host cartilage and the extracellular matrix of the implanted cartilage exhibited a stronger staining pattern with safranin-O fast green than the normal cartilage. Cell density was higher in the grafted cartilage, particularly in the middle and the deep zones. Round and polygonal hypertrophic clusters of chondrocytes were observed in the middle and deep zones of the grafted cartilage. CONCLUSIONS: The histologic properties of the exact-fit implanted cartilage were different from that of normal articular cartilage. Further investigation of mechanical and structural properties of grafted cartilage is necessary to verify the long-term effects of osteochondral transplantation.

Animals↗
PubMed2001

Hemangiomatosis presenting as meralgia paresthetica.

The authors present a 15-year-boy with meralgia paresthetica caused by the recurrence of a diffuse congenital hemangiomatosis in the pelvic region. Relief of the patient's symptoms was achieved by neurolysis of the lateral femoral cutaneous nerve in the thigh and partial excision of the tumor. To our knowledge, hemangiomatosis has never been suggested as a cause of meralgia paresthetica.

Adolescent↗
PubMed2001

Paratibial cyst associated with wear debris after total knee arthroplasty.

We present a case in which a synovial cyst arose from the proximal tibia and expanded in the calf of a patient after total knee arthroplasty. A cystogram showed a direct communication between the joint cavity and the cyst, apparently associated with a screw that penetrated the tibial cortex. Histologic examination of the cyst showed an inflammatory reaction, including macrophages, foreign body giant cells, and metal and polyethylene particles. To our knowledge, this is the first case report illustrating a paraosseous cyst that developed after total knee arthroplasty. Wear debris from the total knee prosthesis may have been responsible for this unusual cyst.

Arthroplasty, Replacement, Knee↗
PubMed2001

Ulnar bursa distention following volar subluxation of the distal radioulnar joint after distal radial fracture: a rare cause of carpal tunnel syndrome.

This report describes an eighty-four-year-old woman with persistent carpal tunnel syndrome attributable to an ulnar bursa distention associated with the subluxation of the distal radioulnar joint after distal radial fracture. During surgery, when the forearm was placed in supination, the ulna head with a sharp osteophyte was found to be displaced into the carpal tunnel through a defect of the ruptured capsule of the wrist joint. This volar subluxation of the ulnar head had caused distention of the ulnar bursa, causing compression of the median nerve, which resulted in carpal tunnel syndrome. In addition to reduce displaced fractured segment to obtain anatomic articular surface, original radial length and tilt, the anatomic restoration of the distal radioulnar joint is essential to maintain better long-term function after fracture of the distal radius.

Accidental Falls↗
PubMed2001

Meralgia paresthetica occurring 40 years after iliac bone graft harvesting: case report.

OBJECTIVE AND IMPORTANCE: Meralgia paresthetica is an entrapment neuropathy involving the lateral femoral cutaneous nerve. We describe an unusual case in which meralgia paresthetica occurred many years after iliac bone graft harvesting. CLINICAL PRESENTATION: An 81-year-old man presented with a 1-year history of pain, dysesthesia, and hypesthesia in the anterolateral aspect of the right thigh. This patient had undergone iliac bone grafting when he sustained a calcaneal fracture 40 years previously. Radiographs and computed tomographic scans of the pelvis revealed a bony excrescence in the anterosuperior iliac spine. INTERVENTION: The patient underwent neurolysis of the lateral femoral cutaneous nerve and excision of the bony excrescence. At surgery, the nerve was densely adherent to the bony excrescence. CONCLUSION: The etiology of meralgia paresthetica in this patient is considered to be heterotopic ossification on the anterosuperior iliac spine and pubic symphysis degeneration. A significant relationship between pubic symphysis degeneration with increasing age and meralgia paresthetica has been reported. One should be aware of meralgia paresthetica as a late complication of iliac bone graft harvesting.

Aged↗
PubMed2001

Angiosarcoma arising from skeletal haemangiomatosis in an atomic bomb survivor.

The authors report a unique case in which an angiosarcoma arose from skeletal haemangiomatosis in a 72 year old man. This patient had a history of atomic bomb irradiation more than 50 years ago. Radiographically, the patient had multiple sclerotic foci of benign haemangiomas in the pelvis, the sacrum, and the left femur. The patient developed a high grade angiosarcoma in the left pubic bone. It is thought that atomic bomb irradiation played an important role in the development of the malignant lesion.

Aged↗
PubMed2001

Elastofibroma in shoulder osteoarthritis: a theoretical concept of the etiology.

A case of unilateral, subscapular elastofibroma dorsi secondary to degenerative osteoarthritis in the ipsilateral glenohumeral joint is presented. A 69-year-old woman had experienced symptoms of osteoarthritis in the right shoulder since contracting septic arthritis when she was 7 years old. The patient noticed a soft tissue mass in the right subscapular region when she was 65 years old. The range of motion of the glenohumeral joint was severely restricted. Histopathologic examination of the excised mass revealed elastofibroma. The authors think the excessive scapulothoracic motion was important in formation of the lesion. This case indicates that elastofibroma is not a true neoplasm but a reactive lesion formed by repetitive minor trauma.

Aged↗
PubMed2000

Minimum 10-year outcome of decompressive laminectomy for degenerative lumbar spinal stenosis.

STUDY DESIGN: A retrospective follow-up study was conducted in patients who underwent decompressive laminectomy for degenerative lumbar spinal stenosis. OBJECTIVES: To describe the long-term outcome of decompressive laminectomy performed for degenerative lumbar spinal stenosis, and to investigate preoperative factors that influenced outcomes, especially risk factors predisposing patients to poor results. SUMMARY OF BACKGROUND DATA: The success rate of surgical treatment of decompressive laminectomy for lumbar spinal stenosis varies. Long-term follow-up investigations have indicated deterioration of outcome; however, the causes of deterioration have not been fully investigated, and there have been no reports with a minimum 10-year follow-up. METHODS: Of 151 patients who underwent decompressive laminectomy from 1980 through 1989, 37 were followed up for a minimum of 10 years. The mean age at surgery was 60.9 +/- 8. 2 years (range, 43-76), and the average follow-up period was 13.1 +/- 2.1 years (range, 10.1-17.4). The results were evaluated by the criteria of the Japanese Orthopedic Association Lumbar Score, and the outcome was classified as excellent at more than 75% improved score; good, 50-75%; fair, 25-49%; and poor, 0-24% or less. Information about impairment of activities of daily living was also obtained at follow-up. Associations between preoperative clinical and radiographic variables and clinical outcome were evaluated statistically. RESULTS: In all patients, the average score improvement of 55.2 +/- 31.6% was regarded as acceptable. The postoperative score and percentage of improvement of low back pain were lower than those of leg pain and walking ability. No impairment in activities of daily living was found in 62.2% of the patients. Rate of improvement was evaluated as excellent in 13 (35.1%), good in 8 (21.6%), fair in 8, and poor in 8 patients. Three patients required additional surgery because of disc herniation at the laminectomied segments. The patients with multiple laminectomy (P = 0.034) and more than 10 degrees preoperative sagittal rotation angle (P = 0.018) showed a significantly poorer outcome than the remainder of the patients. CONCLUSIONS: Long-term follow-up showed that even without spinal fusion, more than half the patients were evaluated as excellent or good. Patients with more than a 10 degrees sagittalrotation angle who need multiple laminectomy, should be given information about the possibility of earlier deterioration of the outcome, and alternative or additional treatment such as concomitant spinal fusion with decompression may be considered.

Activities of Daily Living↗
PubMed2000

Localization of growth factors in the reconstructed anterior cruciate ligament: immunohistological study in dogs.

This study was designed to examine localization of the growth factors in the autogenous patellar tendon graft used to reconstruct the anterior cruciate ligament (ACL) in the canine model. Among the various growth factors, basic fibroblast growth factor, transforming growth factor-beta1, and platelet-derived growth factor were selected for analysis as potential factors that regulate graft remodeling processes. In the control patellar tendon and the ACL only basic fibroblast growth factor was positively stained. In the reconstructed graft increased levels of staining for all the three factors were observed in the early postoperative period, reaching the greatest expression 3 weeks after implantation. Thereafter immunoreactivity of these growth factors decreased and returned to the preoperative levels, which were similar to that of the control ACL 12 weeks postoperatively. This rapid reduction in the level of their localization indicates that once the extrinsic cells are infiltrated to the graft and revascularization completed, these growth factors may have less significance for subsequent remodeling.

Animals↗
PubMed2000

Juxta-articular hemangioma of long bone.

We report on a rare case of an intraosseous hemangioma involving the proximal tibia in a 70-year-old man. Radiographically, the lesion was a well-defined osteolytic lesion with marginal sclerosis. The CT images demonstrated a well-defined osteolytic lesion with partial cortical breakthrough. T1-weighted MR images showed a hypointense lesion, while T2-weighted images revealed hyperintense areas, with internal, hypointense septa. Gadolinium-enhanced T1-weighted images showed lattice-like enhancement of the lesion.

Aged↗
PubMed2000

Protection and performance effects of ankle bracing.

We investigated the protection afforded to ankle ligaments by ankle supports and the extent to which these were associated with a diminution of motor performance. Eleven volunteers were subjected to a 10 degrees tilt in four directions (inversion, eversion, plantar flexion and dorsiflexion) on a rocking platform. Three-dimensional videography was used to record complex ankle kinematics. The prophylactic ankle supports used were a semi-rigid brace, a lace-up cloth brace, and taping. The ankle supports provided similar initial protection against acute ligamentous inversion sprains. The semi-rigid ankle brace produced a smaller restriction of plantar flexion-dorsiflexion movement than either the lace-up cloth brace or taping.

Adult↗