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Biomedical subjects

T Kokubo

Publications and source records attributed to T Kokubo.

At least 235 records · Page 13Linked to original sources

Secondary malignant lymphoma of the central nervous system with delayed high uptake on 123I-IMP single-photon emission computerized tomography. Case report.

A case of secondary central nervous system (CNS) lymphoma with high uptake in the delayed image of N-isopropyl-[123I]-p-iodoamphetamine (125I-IMP) single-photon emission computerized tomography (SPECT) is presented. Previous to this report, only six cases of brain tumor with high uptake on the delayed 123I-IMP SPECT scan have been reported, two of which were CNS malignant lymphomas. Of 19 brain tumors examined with 123I-IMP SPECT at Kameda General Hospital, this case was the only one that showed high uptake in the delayed image. These data imply that 123I-IMP SPECT, which has now become rather obsolete as a tumor-imaging method, can be useful in diagnosing CNS malignant lymphoma.

Adult↗

Magnetic resonance imaging and scintigraphy of avascular necrosis of the femoral head. Prediction of subsequent segmental collapse.

For the purpose of an effective management of patients at high risk for nontraumatic avascular necrosis of the femoral head (ANFH), it is expedient to examine the femoral heads of patients most likely to undergo subsequent segmental collapse. The purpose of this study was to evaluate the ability of magnetic resonance imaging (MRI) and radionuclide bone scanning (RS) to predict segmental collapse of the femoral head at the roentgenographically normal stage. Fifty-five hips in 37 patients at risk for ANFH and having normal roentgenograms were included in this study. Magnetic resonance imaging was performed in all hips and RS in 29 hips. The patients were observed during a period of more than two years without any invasive intervention, and nine femoral heads manifested collapse during this period. Predictive values for subsequent segmental collapse of a positive test of MRI and RS were 31% and 13%, respectively, whereas those indicative of a negative test were 100% and 76%, respectively. Magnetic resonance imaging was more useful than RS in detecting patients in need of intensive follow-up examination. In particular, a bandlike area of low intensity that traversed the femoral head in midcoronal slices on MR images seemed to be a significant indicator of subsequent collapse.

Adult↗

Enhancement of bone bonding to bioactive ceramics by demineralized bone powder.

In an attempt to enhance the bonding of bone to bioactive ceramics, allogeneic demineralized bone powder (DBP) was used in combination with bioactive ceramic implants in rabbit tibiae. Rectangular plates (10 x 15 x 2 mm) made of apatite-wollastonite-containing glass ceramics were implanted in the proximal metaphyses of the bilateral tibiae of 20 rabbits, with DBP packed into the medullary cavity. In the control group, only the plates of A-W GC were implanted in the bilateral tibiae of 20 rabbits. Four rabbits from each group were killed at two, four, eight, 12, and 25 weeks after implantation for the tensile test. Results of the tensile test and histologic examination of the undecalcified specimens by Giemsa surface stain and contact microradiography confirmed that DBP significantly accelerated the process of bone bonding to the implant and increased the strength of bone-implant bonding.

Animals↗

A heat-generating bioactive glass-ceramic for hyperthermia.

Glass plates of the chemical composition: CaO (29.0), SiO 2 (31.0), Fe 2O 3 (40.0), B 2O 3 (3.0), P 2O 5 (3.0) in weight ratio were heated to 1050 degrees C at a rate of 5 degrees C/min and then cooled to laboratory temperature. The resulting glass-ceramic containing magnetite and wollastonite crystals showed high-saturation magnetization. The bonding ability of this new glass-ceramic to bone tissue was evaluated using rabbit tibiae, and compared with glass of the same composition. This glass-ceramic formed a Ca, P-rich layer on its surface and bonded tightly with bone within 8 weeks of implantation. However, the glass did not form this Ca, P-rich layer, nor had it bonded with bone at 25 weeks. The bone-heating ability of this glass-ceramic was investigated by applying a max. 300-Oe, 100-kHz magnetic field. The granules of the glass-ceramic filled in the rabbit tibiae heated the whole surrounding bone to more than 42 degrees C and maintained this temperature for 30 min. Bioactive ceramics reinforce the mechanical strength of bone tissue. Furthermore, this heat-generating bioactive glass-ceramic can be used for hyperthermic treatment of bone tumors.

Animals↗

A new bioactive bone cement: its histological and mechanical characterization.

We have developed a bioactive bone cement using CaO-SiO 2-P 2O 5-CaF 2 glass powders and ammonium phosphate solution, and investigated its histological and mechanical characteristics in vivo. A bone defect was drilled in proximal metaphysis of the rat tibia and filled with the bioactive bone cement in paste form or polymethylmethacrylate (PMMA) bone cement in the dough state. The cements were allowed to harden in situ. Histological examination demonstrated direct bonding between the new cement and bone by 4 weeks. The bioactive bone cement did not degrade up to 24 weeks postimplantation. The inflammatory reaction to the bioactive bone cement was less intense than the reaction induced by PMMA. Changes in the mechanical properties of the cement in vivo were studied by implanting hardened cylindrical specimens of both types of cement into the hindlimb muscles of rats for 12 weeks. The compressive strength of the bioactive cement increased significantly after implantation, and reached 68 MPa in 1 week and 73 MPa in 4 weeks. These values were comparable to those of PMMA, and were maintained up to 12 weeks after implantation. This bioactive bone cement hardens in situ within a few minutes with negligible rise of temperature and can be easily handled as a paste for filling bone cavities of different shapes. In addition, this cement has good osteoconductive and bone bonding potential and fairly high mechanical strength. Therefore, this new cement could be used both as a bioactive bone cement and bone defect filler.

Animals↗

Bone-bonding ability of P2O5-free CaO.SiO2 glasses.

An apatite- and wollastonite-containing glass-ceramic (A.W-GC) has been reported to form a tight bond with living bone through an apatite layer formed on its surface. This layer is considered to be formed by dissolution of Ca2+ and HSiO3- ions from the glass-ceramic into the surrounding body fluids. In order to confirm this proposed mechanism for the surface reaction of A.W-GC, three kinds of glass in the systems CaO-SiO2, CaO-SiO2-CaF2, and CaO-SiO2-P2O5 were implanted into the tibiae of rabbits for 3 or 8 weeks. Contact microradiography and SEM-EPMA showed that all three kinds of glass formed a Ca,P-rich layer in combination with a Si-rich layer on their surfaces within 3 weeks and formed a direct bond with bone via these layers. The detaching test, performed 8 weeks after implantation, showed that the loads required to detach the implants from the bone were almost equal for the phosphorus-free and the phosphorus-containing glasses. It was concluded that even P2O5-free CaO.SiO2 glass formed a Ca,P-rich layer on its surface and bonded tightly with living bone. If glasses and glass-ceramics release at least Ca2+ and HSiO3- ions, this would be sufficient for them to form the Ca,P-rich layer on their surfaces in vivo, enabling them to bond directly with bone.

Animals↗

The bonding behavior of calcite to bone.

Plates of calcite (CaCO3) were implanted in rabbit tibiae, and their biocompatibility and bonding ability to bone were studied. The plates were also implanted subfascially in rabbit muscle for 8 weeks, and changes on their surfaces in the body were examined. Contact microradiography and Giemsa surface stain demonstrated direct bonding between calcite and bone without interpositions. The average failure load of the interface between calcite and bone was 4.11 kg, indicating an adequate strength of bonding. However, a Ca-P-rich layer, which formed on the surfaces of other bioactive ceramics in vivo, was not detected by a scanning electron microscope-electron probe x-ray microanalyzer. Scanning electron micrographs of the surface of calcite implanted subfascially for 8 weeks showed marked degradation and a rough surface. However, the surface apatite layer was not detected by thin-film x-ray diffraction analysis and Fourier transform infrared reflection spectroscopy. Calcite is a biodegradable material that bonds to bone without a surface apatite layer. The mechanical bonding provided by the anchoring effect of the newly formed bone into the surface roughness of calcite is considered to be a major factor in calcite-bone bonding.

Animals↗

Bone bonding mechanism of beta-tricalcium phosphate.

It has been proposed that the formation of a surface apatite layer in vivo on surface active ceramics is an essential condition for chemical bonding between ceramics and bone tissue. To clarify the difference in bone-bonding mechanisms between surface active ceramics and bioresorbable ceramics, two experiments were performed using plates of dense beta-tricalcium phosphate (beta-TCP). First, plates of beta-TCP were implanted subcutaneously in rats for 8 weeks. Surface change due to bioresorption was observed with scanning electron microscopy. Formation of the apatite layer on the surface was investigated using thin-film x-ray diffraction and Fourier transform infrared reflection spectroscopy. Second, plates of beta-TCP were implanted in tibiae of rabbits for 8 and 25 weeks and subjected to the detaching test to measure bone-bonding strength. beta-TCP bonded strongly to bone. Undecalcified sections of the interface of bone and beta-TCP were examined with SEM-EPMA. However, by physicochemical methods, no formation of surface apatite layer was observed. These results suggest that beta-TCP bonds to bone through microanchoring between bone and rough surface of resorbed beta-TCP.

Animals↗

Apatite formation on the surface of Ceravital-type glass-ceramic in the body.

Previous studies on surface structural changes in vitro as well as in vivo of bioactive A-W-type glass-ceramics and Bio-glass-type glasses showed that the essential condition for glasses and glass-ceramics to bond to living bone is formation of a bonelike apatite layer on their surfaces in the body. Gross et al., however, had explained the bone-bonding mechanism of Ceravital-type apatite-containing glass-ceramic without mentioning formation of the surface apatite layer. In the present study, apatite formation on the surface of one of Ceravital-type glass-ceramics was investigated in vitro as well as in vivo. An apatite-containing glass-ceramic of the composition Na2O 5, CaO 33, SiO2 46, Ca(PO3)2 16 wt%, which was named KGS by Gross et al., was soaked in an acellular simulated body fluid which had ion concentrations almost equal to those of the human blood plasma. The same kind of glass-ceramic was implanted into a rabbit tibia. Thin-film x-ray diffraction, Fourier transform infrared reflection spectroscopy, and scanning electron microscopic observation of the surfaces of the specimens soaked in the simulated body fluid showed that Ceravital-type glass-ceramic also forms a layer of carbonate-containing hydroxyapatite of small crystallites and/or a defective structure on its surface in the fluid. Electron probe x-ray microanalysis of the interface between the glass-ceramic and the surrounding bone showed that a thin layer rich in Ca and P is present at the interface. These findings indicated that Ceravital-type glass-ceramics also form the bonelike apatite layer on its surface in the body and bond to living bone through the apatite layer.

Animals↗

Bioactive glass ceramics: properties and applications.

Heat treatment of an MgO-CaO-SiO2-P2O5 glass gave a glass ceramic containing crystalline apatite (Ca10(PO4)6O,F2] and beta-wollastonite (CaO,SiO2) in an MgO-CaO-SiO2 glassy matrix. It showed bioactivity and a fairly high mechanical strength which decreased only slowly, even under load-bearing conditions in the body. It is used clinically as artificial vertebrae, iliac bones, etc. The bioactivity of this glass ceramic was attributed to apatite formation on its surface in the body. Dissolution of calcium and silicate ions from the glass ceramic was considered to play an important role in forming the surface apatite layer. It was shown that some new kinds of bioactive materials can be developed from CaO,SiO2-based glasses. Ceramics, metals and organic polymers coated with bone-like apatite were obtained when such materials were placed in the vicinity of a CaO,SiO2-based glass in a simulated body fluid. A bioactive bone cement which was hardened within 4 min and bonded to living bone, forming an apatite, was obtained by mixing a CaO,SiO2-based glass powder with a neutral ammonium phosphate solution. Its compressive strength reached 80 MPa comparable to that of poly(methyl methacrylate) within 3 d. A bioactive and ferromagnetic glass ceramic containing crystalline magnetite (Fe3O4) in a matrix of CaO,SiO2-based glassy and crystalline phases was obtained by a heat treatment of a Fe2O3-CaO.SiO2-B2O3-P2O5 glass. This glass ceramic was shown to be useful as thermoseeds for hyperthermia treatment of cancer.

Animals↗

MR differentiation of hepatic haemangioma and hepatocellular carcinoma: value of delayed-phase Gd-DTPA enhanced images.

The efficacy of three different approaches (precontrast and delayed-phase postcontrast T1-weighted (T1-W) images, measurement of T2 value, and dynamic FLASH imaging) for differentiation between hepatic haemangiomas and hepatocellular carcinomas, was compared. Most haemangiomas (89%) showed iso- or hypointensity on precontrast T1-W images and hyperintensity on delayed-phase postcontrast T1-W images. By using both pre/postcontrast T1-W images and T2 measurement, 30 out of 32 lesions (94%) were correctly differentiated. The dynamic FLASH imaging did not significantly improve the overall accuracy although it played a critical role in a few problematic cases. It is concluded that the combination of pre/postcontrast T1-W images is a promising approach for differentiation of small hepatic tumours, and plays a complementary role with T2 measurement.

Adult↗

Prolyl endopeptidase from Flavobacterium meningosepticum: cloning and sequencing of the enzyme gene.

The prolyl endopeptidase [EC 3.4.21.26] gene of Flavobacterium meningosepticum was cloned in Escherichia coli with the aid of an oligonucleotide probe which was prepared based on the amino acid sequence. The hybrid plasmid, pFPEP1, with a 3.5 kbp insert at the HincII site of pUC19 containing the enzyme gene, was subcloned into pUC19 to construct plasmid pFPEP3. The whole nucleotide sequence of an inserted HincII-BamHI fragment of plasmid pFPEP3 was determined by the dideoxy chain-terminating method. The purified prolyl endopeptidase was labeled with tritium DFP, and the sequence surrounding the reactive serine residue was found to be Ala (551)-Leu-Ser-Gly-Arg-*Ser-Asn(557). Ser-556 was identified as a reactive serine residue. The enzyme consists of 705 amino acid residues as deduced from the nucleotide sequence and has a molecular weight of 78,705, which coincides well with the value estimated by ultra centrifugal analysis. The amino acid sequence was 38.2% homologous to that of the porcine brain prolyl endopeptidase [Rennex et al. (1991) Biochemistry 30, 2195-2203] and 24.5% homologous to E. coli protease II, which has substrate specificity for basic amino acids [Kanatani et al. (1991) J. Biochem. 110, 315-320].

Amino Acid Sequence↗

Malignancy associated with chronic empyema: radiologic assessment.

Radiologic findings of six cases of malignancy associated with chronic empyema 5-39 years in duration were reviewed. Pathologic examination confirmed three B-cell non-Hodgkin lymphomas, one round-cell sarcoma, one mesothelioma, and one adenocarcinoma. Retrospective findings on plain chest radiographs suggested the occurrence of malignancy: increased radiopacity in the thoracic cavity, soft-tissue bulgings and/or unsharpness of fat planes in the chest walls, destruction of bone near the empyema, and extensive medial deviation of the calcified pleurae. Computed tomography delineated masses with soft-tissue attenuation more clearly than radiography in all cases. Magnetic resonance images of three cases were informative because empyema cavities were surrounded by low-intensity rims, and two of them showed a signal intensity different from that of necrotic tumors. Scintigraphy revealed increased uptake of gallium in all cases. Ultrasonography was useful for biopsy guidance. Every radiologist should know this entity in observation of chest radiographs obtained in patients with chronic empyema, and further radiologic assessment and aggressive biopsy are recommended if malignancy is suspected.

Adenocarcinoma↗

Transient osteoporosis of the hip. Magnetic resonance imaging.

Magnetic resonance (MR) images of seven hips were reviewed in six patients with transient osteoporosis of the hip. The MR images of the affected joint showed increased joint fluid and diffuse signal abnormalities in the marrow of the femoral head, corresponding to a decreased signal intensity on T1-weighted images and an increased signal intensity on T2-weighted images. The MR images at the time of clinical improvement showed regression of the abnormalities. These MR abnormalities reflect the pathophysiology of this condition.

Acute Disease↗

[Correlation between the findings of magnetic resonance imaging and prognosis of patients with predisposing factors of aseptic necrosis of the femoral head].

Eighteen patients with the predisposing factors for aseptic necrosis of the femoral head were followed up for more than two years after the initial magnetic resonance (MR) imaging. At the time of the initial examination, 24 femoral heads showed abnormal low-intensity areas on MR images without abnormal findings on plain radiographs. Among them, six femoral heads collapsed in the follow-up period. The initial mid-coronal T1-weighted MR images of these femoral heads had shown characteristic findings, that is, band-shaped low-intensity areas with the lateral end not covered by the acetabulum. Subchondral fracture of the femoral head occurred in the vicinity of the lateral end of the band. The findings of initial MR imaging seem to predict subsequent collapse of the femoral head.

Adult↗

[Avascular necrosis of the femoral head: chronological change of MR images].

Tl-weighted MR images of thirty-six hips in 25 patients with avascular necrosis of the femoral head were obtained two to five times during the course of 2 to 26 months. We investigated these MR images in the light of the chronological change and compared them with plain radiographs. MR images change in 16 femoral heads; in general, the abnormal low intensity area in the femoral head reduced in extent and the internal high intensity area became smaller of disappeared. Thirteen femoral heads among them became more flattened on plain radiographs in the same period. It is noted that four different zones are defined in the femoral head after bone necrosis takes place: the dead bone marrow, the dead marrow which still contains fat, the reactive interface and the hyperemic bone marrow. In Tl-weighted MR images, the dead bone marrow, the reactive interface and the hyperemic bone marrow are demonstrated as low intensity area, while the dead marrow containing fat may remain high in intensity. On the basis of this knowledge of histopathology and MR images of this disease, we suggest that reduction of the abnormal low intensity area and disappearance of the internal high intensity area on MR images can be regarded as diminution of hyperemia in the living bone marrow and loss of fat in the dead bone marrow, respectively.

Adult↗