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Biomedical subjects

Shinya Kawai

Publications and source records attributed to Shinya Kawai.

At least 37 records · Page 2Linked to original sources

Calcineurin inhibitors block dorsal-side signaling that affect late-stage development of the heart, kidney, liver, gut and somitic tissue during Xenopus embryogenesis.

Calcineurin, a calcium/calmodulin-dependent serine/threonine protein phosphatase, is a key constituent of signaling pathways involved in antigen-dependent T-cell activation and development of the mammalian heart. In addition, calcineurin constitutes a part of the Wnt/calcium-signaling pathway that regulates early stages of dorsoventral axis formation in Xenopus embryos. Although some of the Wnt family members are involved in organ formation at relatively late stages of Xenopus development, the involvement of calcineurin in the development of those organs remains unclear. In the present study, we demonstrate that calcineurin inhibitors (cyclosporine A, FK506, and FK520), but not non-calcineurin inhibitors (rapamycin and GPI1046) that bind the same intracellular receptor as that for FK506, induce edema and gut coiling disruption and exhibit teratogenesis in the kidney, heart, gut, liver, and somitic tissue during Xenopus development. The same effects were observed by injecting the calcineurin inhibitors into the dorsal side, but not ventral side, of blastomeres at the 4-cell stage, although the inhibitors did not affect dorsoventral axis formation. These results suggest that calcineurin is involved in dorsal-side signaling that leads to the formation of the heart, kidney, liver, gut and somitic tissue during Xenopus embryogenesis.

Animals↗

Dynamic contrast-enhanced magnetic resonance imaging of osteoporotic vertebral fracture.

STUDY DESIGN: This was a retrospective study of the relation between the blood perfusion of bone marrow in injured vertebrae and the degree of subsequent vertebral collapse in patients with osteoporotic vertebral fractures. OBJECTIVE: The objective was to evaluate blood perfusion of bone marrow in injured vertebrae using dynamic magnetic resonance imaging and study the possibility of predicting the progression of vertebral collapse. SUMMARY OF BACKGROUND DATA: Avascular necrosis of the vertebra is considered to be a cause of delayed vertebral collapse following osteoporotic vertebral fractures, but studies on the relation with the degree of progression of vertebral collapse by evaluation of vertebral blood perfusion have not been reported. METHODS: The subjects were 15 vertebrae in 14 patients with osteoporotic vertebral fractures, including 11 women and three men with a median age of 79 years. All patients underwent dynamic magnetic resonance imaging soon after the fracture and the area rate of the noncontrast region of the injured vertebrae in dynamic magnetic resonance imaging was measured. The correlation with the degree of progression of vertebral collapse obtained from plain radiograph imaging was studied. RESULTS: The vertebral collapse rate (percentage loss in vertebral body height) on initial examination was 17 +/- 10% (mean +/- SD) and that at the final examination was 33 +/- 19%, showing a progression of 16 +/- 11%. The noncontrast area rate in dynamic magnetic resonance imaging was 18 +/- 12%. A significant correlation was found between the degree of progression of vertebral collapse and the noncontrast area rate (Spearman r = 0.97, P < 0.001). CONCLUSIONS: The subsequent progression of vertebral collapse tended to increase the greater the noncontrast area in the injured vertebrae in dynamic magnetic resonance imaging. Dynamic magnetic resonance imaging appears to be useful in predicting the progression of collapse of fractured vertebrae.

Aged↗

Skeletal reconstruction by vascularized allogenic bone transplantation: effects of statin in rats.

BACKGROUND: Some statins have been reported to suppress the immune system and increase the expression of bone morphogenetic protein-2 gene that plays a pivotal role in bone regeneration. METHODS: The effects of cerivastatin on skeletal reconstruction by vascularized bone allograft were investigated in a rat tibia-fibula graft model. After transplantation, the recipient rats were treated with vehicle, low-dose cerivastatin, high-dose cerivastatin, or cyclosporine A. RESULTS: Transplanted bones treated with low-dose cerivastatin and vehicle failed to unite with the recipient bones. In contrast, high-dose cerivastatin induced the bone union as effectively as cyclosporine A. Histologically, high-dose cerivastatin-treated transplanted bones were nonvital, but new bone formation occurred at the outer layer of the nonvital cortex. CONCLUSION: These results indicate that statins could promote fracture healing. Because transplant recipients have the increased risks of osteoporotic fracture and hypercholesterolemia, statins may be a good choice in the treatment of these patients.

Animals↗

Ulnar variance and the role of joint levelling procedure for Kienböck's disease.

Forty patients with Kienböck's disease were reviewed to determine the relationship between ulnar variance and the development of Kienböck's disease in a Japanese cohort. The joint levelling procedures designed to correct ulnar variance were evaluated in 11 patients after a mean of 9.7 years following surgery. The mean ulnar variance was 0.50+/-1.67 in patients with Kienböck's disease and 0.56+/-1.76 in a control group. The onset of wrist symptoms in a younger age group was noticed after sports injuries, whereas older patients had no distinct history of trauma. Joint levelling procedures produced good clinical results, but carpal height ratio, Stahl's index and radioscaphoid angle were not improved, as evidenced radiographically. Our study suggests that in a Japanese cohort ulnar minus variance is not an important factor in the aetiology of Kienböck's disease. Although joint levelling procedures improved the clinical results, they did not reverse lunate collapse or carpal alignment.

Adolescent↗

Patellar tendon rupture and marked joint instability after total knee arthroplasty.

BACKGROUND: Patellar tendon rupture is a rare complication of total knee arthroplasty (TKA). Multiple repair methods have been described in the literature. METHODS: A 66-year-old woman suffered a patellar tendon re-rupture and marked joint instability within 6 months after revision TKA. She underwent re-revision TKA and extensor mechanism reconstruction with femoral quadriceps tendon and augmentation by a Leeds-Keio ligament. RESULT: It was fairly difficult to acquire a satisfactory range of motion as well as gain in knee extension capacity by eliminating the extension lag. CONCLUSION: Patellar tendon ruptures after TKA should be repaired as soon as they are recognized.

Aged↗

Down-regulation of an anionic peroxidase in transgenic aspen and its effect on lignin characteristics.

It is generally accepted that peroxidases catalyze the final step in the biosynthesis of lignin. In this study, to examine how expression of prxA3a, a gene for an anionic peroxidase, might be related to lignification in plant tissues, we produced transgenic tobacco plants that harbored a gene for beta-glucuronidase (GUS) fused to the prxA3a promoter. Histochemical staining for GUS activity indicated that the prxA3a promoter was active mainly in the lignifying cells of stem tissues. Further, to examine the effects of suppressing the expression of prxA3a, we transferred an antisense prxA3a gene construct into the original host, hybrid aspen ( Populus sieboldii x P. gradidentata), under the control of the original promoter of the prxA3a gene. Eleven transformed aspens were obtained and characterized, and the stable integration of the antisense construct was confirmed by PCR and Southern blotting analysis in all these lines. Assays of enzymatic activity showed that both total peroxidase activity and acidic peroxidase activity were lower in most transgenic lines than in the control plants. In addition, the reduction of peroxidase activity was associated with lower lignin content and modified lignin composition. Transgenic lines with the highest reduction of peroxidase activity displayed a higher syringyl/vanillin (S/V) ratio and a lower S+V yield, mainly because of a decreased amount of V units. Thus, our results indicate that prxA3a is involved in the lignification of xylem tissue and that the down-regulation of anionic peroxidase alters both lignin content and composition in hybrid aspen.

Down-Regulation↗

Carpal instability in rheumatoid wrists.

This study was conducted to identify patterns of carpal instability in the rheumatoid wrist. One hundred patients with proven rheumatoid arthritis were randomly chosen, and posteroanterior and lateral radiographs of right wrists were taken. The most common isolated pattern was volar intercalated segmental instability, apparent in 16 wrists, while nine wrists had scapholunate dissociations. Larsen grading scores revealed a correlation between disease duration, carpal height ratio, and ulnar translocation index. In the early stages of disease, the scapholunate angle was significantly increased and the lunate rotated volarly due to loosening of the intrinsic carpal ligament. In later phases, the capitolunate angle significantly increased and the capitate rotated dorsally. Patterns of carpal instability in rheumatoid wrists seem to be complicated, involving combined laxity of the intrinsic and extrinsic carpal ligaments.

Adult↗

Magnetic resonance imaging diagnosis and new classification of the osteoporotic vertebral fracture.

The purpose of this study was to investigate the usefulness of magnetic resonance imaging (MRI) in the diagnosis of, and when deciding on treatment policies for, vertebral fractures in patients with osteoporosis by comparing the diagnostic success rates for such fractures using MRI and plain radiographs. We also devised a new classification of vertebral fractures in osteoporotic patients based on MRI findings. The subjects were 34 patients with a total of 316 osteoporosis-related vertebral fractures treated in our department during the past 2 years. They consisted of 30 women and 4 men with an average age of 82 years (range 61-95 years). The site diagnostic rates of plain radiographs and MRI for the vertebral fractures were compared, and changes in signal intensity of the fractured vertebrae in MRI were examined. The areas of change in signal intensity in T1-weighted sagittal images were classified into six types: total, anterior, posterior, superior, inferior, central. The site diagnostic rate for vertebral fractures was 98% for MRI, which was better than the 87% obtained with plain radiographs. Changes in signal intensity in the vertebrae showed no intraspinal protrusion in the inferior and superior types, and neurological stability was achieved; but there was a high frequency of intraspinal protrusion in the total and posterior types.

Aged↗

Unilateral drop finger due to cervical spondylosis at the C6/7 intervertebral level.

A 64-year-old man who presented right drop fingers without pyramidal signs due to cervical spondylosis is reported. Magnetic resonance imaging showed a high signal intensity change on T2-weighted scans of the spinal cord at the C6/7 intervertebral level. Evoked spinal cord potentials following ulnar nerve stimulation were attenuated at the C6/7 intervertebral level. Compound muscle action potentials (CMAPs) following right cervical nerve root stimulation were recorded from the extensor digitorum communis. CMAPs following right C8 nerve root stimulation were evoked with small amplitudes. Small polyphasic CMAPs with prolonged onset latency were recorded following right C7 nerve root stimulation. Simultaneous C7 radiculopathy and C8 segmental spinal cord lesion due to cervical spondylosis at the C6/7 intervertebral level were the causes of drop fingers in the present case. Unilateral drop finger is a clinical symptom commonly associated with posterior interosseus nerve palsy, but mention should be made about cervical lesions causing drop finger. Electromyographic abnormalities of the triceps and first dorsal interosseus muscle were the key findings for differentiating the cause from paralysis of the posterior interosseous nerve.

Cervical Vertebrae↗

Results of surgical treatment for lumbar canal stenosis due to degenerative spondylolisthesis: enlargement of the lumbar spinal canal.

The purpose of this retrospective study was to analyze clinical results and radiographic findings in patients who underwent surgical enlargement of the lumbar spinal canal combined with resection of the posterosuperior margin underneath the slipping vertebral body for the treatment of lumbar canal stenosis due to degenerative spondylolisthesis. A series of 64 patients who were observed for 3 years or more after operation were examined. The mean age at the time of operation was 64.2 years. The follow-up period was 3-17 years. The Japanese Orthopaedic Association (JOA) score increased from 14.9 points before operation to 25.4 points at the time of the study on average. The general improvement rate was 75.6%. The height and range of motion of the enlarged intervertebral disc were mildly to moderately decreased, and it was found there was a small effect on the adjacent intervertebral disc. On computed tomography, the total level of the enlarged region of the posterosuperior margin increased from 184.4 mm(2) to 339.1 mm(2) on average, but the area of the resected region was 163.3 mm(2) and accounted for 48% of the postoperative area of the spinal canal in the posterosuperior margin. This enlargement of the spinal canal was maintained along the dural canal, and physiological morphology was established. By surgically enlarging the lumbar spinal canal combined with resecting the posterosuperior margin underneath the slipping vertebral body, concomitant repositioning or spinal fixation was unnecessary.

Adult↗

Measuring of the compensation of a nerve root in a cervical schwannoma: a case report.

A 64-year-old woman experienced numbness and hypesthesia of the right C6 dermatome a year ago. Enhanced magnetic resonance imaging of the cervical spine revealed an enhanced tumor continuing into the foramen from the spinal cord at the C5/6 intervertebral level. It was thought to be an Eden type 2 schwannoma. Right unilateral laminectomy was performed on C5. The tumor was present in the intradural area and arose from the right C6 anterior root. Compound muscle action potentials (CMAPs) from the deltoid, biceps, and extensor carpi radial (ECR) muscles were recorded following electric cervical nerve root stimulation (0.2 ms duration, and 7 mA intensity). CMAPs of large amplitude were obtained from the deltoid, biceps, and ECR muscles following C5 root stimulation, but those following C6 root stimulation were small. As a result it was determined that the right C6 root was not associated with the nerve distribution for these muscles, so it was resected en bloc with the tumor. No apparent loss of motor function was observed. Standard needle electromyography showed no denervation potentials or decrease in motor unit potentials in either the deltoid or biceps muscles. Intraoperative investigation for compensation of nerve root is clinically useful for determining whether resection of a nerve root results in muscle weakness after surgery for a cervical schwannoma.

Action Potentials↗

Experimental study of osteoplastic laminectomy in the lumbar spine of rabbits.

Osteoplastic laminectomy has been used to treat lumbar canal stenosis and to prevent postoperative lumbar spinal instability by reconstructing the posterior element of the lumbar spine, which has been documented in many clinical studies. However, the biological sequence of repairing the posterior lumbar element, which is replaced at the time of surgery, has not yet been made clear. An in vivo rabbit study was designed to observe the biological sequence of repairing the replaced posterior element of the lumbar spine. Twenty-one adult rabbits underwent osteoplastic laminectomy at the L6. Animals were killed at 2, 4, 8, 12, 26, and 52 weeks after surgery. The samples of the L6 vertebra, which contained the replaced lamina and spinous process, were analyzed by radiography, computed tomography (CT), and a histological method. Overall, radiograms demonstrated clearly the union of interarticular osteotomized sites from 4 to 8 weeks. CT findings revealed that the union of interarticular osteotomized sites could be confirmed beginning at 12 weeks, and that postoperative narrowing of the lumbar spinal canal had not occurred in the rabbit model. The biological sequence of repairing the replaced lamina and spinous process was characterized by slowly progressive creeping substitution, with continuous remodeling.

Animals↗

Behavior of male-specific minor histocompatibility antigen in skin and limb transplantation.

BACKGROUND: Although the role of male-specific minor histocompatibility antigen H-Y has been increasingly understood in both experimental and clinical organ transplantation, little has been investigated on musculoskeletal tissue transplantation. This study was performed to describe the behavior of male-specific minor histocompatibility H-Y antigen in rat skin and whole limb transplantation. MATERIALS AND METHODS: Using three different strains of inbred rats (Lewis, F344, and Dark Agouti), 75 donor hindlimbs and eighteen skin grafts were isogenically transplanted to the sex-mismatched recipients. Recipients were observed up to 48 weeks postoperatively. Rejection was monitored by the appearance of the skin of the grafted limb and histology. Systemic microchimerism was assessed by polymerase chain reaction using Y-chromosome specific primers. RESULTS: Skin rejection didn't occur in all limb transplant recipients and histology did not show any rejection findings in all components of the limb graft through 48 weeks. Successful functional recovery was expected. Stable and high level of chimerism (>1%) was detected in the lymphoid tissues in nontreated female recipients. Male skin grafts were rejected by Lewis and F344 female recipients within 6 weeks postoperatively. All female skin grafts survived in male recipients. CONCLUSION: Our results suggest that H-Y antigen can induce graft rejection in rat skin graft but causes no rejection reaction in whole limb transplantation. Systemic chimerism may play an important role for acceptance of sex-mismatched limb graft.

Animals↗

Does cortical motor neuron excitability change in peripheral nerve injury?

OBJECTIVE: To investigate changes in cortical motor neuron excitability after peripheral nerve injury, evoked spinal cord potentials (ESCPs) following hemispheric transcranial magnetic stimulation (TMS) were recorded in awake patients with unilateral brachial plexus injury. METHODS: ESCPs following hemispheric TMS were recorded in 6 patients with unilateral complete type brachial plexus injury. Studies were performed within 6 months from the time of injury. ESCPs were recorded from posterior epidural space using catheter electrodes. Hemispheric TMS was applied on the motor cortex using a figure-of-8 coil. The threshold of ESCPs following hemispheric TMS was measured. The number, latency, and amplitude of ESCPs following high stimulus hemispheric TMS were measured and compared. RESULTS: No significant change was observed in the threshold of ESCPs following TMS contra-lateral to the injured upper limb compared to that following TMS contra-lateral to the intact upper limb. Several ESCP components were recorded following high stimulus hemispheric TMS. No significant changes were observed in comparison with number, latency and amplitude of ESCPs following high stimulus TMS contra-lateral to the injured upper limb and those following TMS contra-lateral to the intact upper limb. CONCLUSIONS: From a study of ESCPs following single TMS, no evidence was obtained that cortical motor neuron excitability changes in patients with traumatic unilateral brachial plexus injury at relatively early stages. We investigated the changes of cortical motor neuron excitability in patients with brachial plexus injury from the ESCPs following TMS. In single TMS, our data gave no evidence for cortical excitability changes at relatively early stages.

Adolescent↗

Detachment analysis of the translocated W chromosome shows that the female-specific randomly amplified polymorphic DNA (RAPD) marker, female-218, is derived from the second chromosome fragment region of the translocated W chromosome of the sex-limited p(B) silkworm (Bombyx mori ) strain.

The sex chromosomes of the silkworm, Bombyx mori, are designated ZW for the female and ZZ for the male. We previously characterized a female-specific randomly amplified polymorphic DNA (RAPD) marker, designated Female-218, from the translocation-bearing W chromosomes. These W chromosomes contain a region of the second chromosome, which carries visible larval markers of the p loci. We used strain TWPB in which female larvae have black skin due to the p(B) gene (T(W;2)p(B), +p/+p) while male larvae have whitish skin (+p/+p). To determine whether the Female-218 RAPD marker is derived from the "W region" or a "second chromosome fragment", we induced a detachment of the translocated W chromosome, T(W;2)p(B), by treating the eggs with hot water at an early developmental stage. After hot water treatment, we obtained 27 white female larvae out of 4850 female larvae. The Female-218 RAPD marker was not amplified in 26 out of 27 white female larvae, and was amplified from one white female larva. Moreover, we obtained 11 black male larvae out of 5377 male larvae. Eight out of 11 black male larvae became adult moths, and the Female-218 RAPD marker was amplified from all eight male moths. Examination of the genetic relationship between the Female-218 RAPD marker and the second chromosome fragment of the translocated W chromosome strongly indicates that the Female-218 RAPD marker is amplified from the region of second chromosome fragment of the T(W;2)p(B) chromosome.

Animals↗

Meniscal ossification.

Meniscal ossicles are rare in the human knee. We present one case. A 57-year-old taxi driver complained of right knee pain and swelling with radiographic findings of a meniscal ossicle. Arthroscopic inspection showed a degenerative and horizontal tear and calcium deposit at the middle and posterior thirds of lateral discoid meniscus. His lateral discoid meniscus, containing the ossicle, was removed. He was asymptomatic at a 3-year follow-up.

Arthralgia↗

Snapping knee caused by intra-articular tumors.

Locking of the knee can present with no history of antecedent injury. We identified impingement of intra-articular tumors in 2 cases. Intra-articular tumors are relatively rare. Mechanical symptoms were present in both cases. On physical examination, there was a palpable mass at the medial region of the patellofemoral joint. The interior had been replaced mainly by amorphous necrotic tissue. The definite diagnosis of a soft-tissue mass of the knee could not be made on histologic examination.

Adipose Tissue↗