Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NAGOYA UNIV, SCH MED  

Stanniocalcin-1 (STC1) is a glycoprotein that was originally identified as a calcium-regulating hormone in bony fish, and that has been shown to also critically mediate cell growth, proliferation and differentiation, etc. in humans. Increased STC1 expression levels have been previously detected in different human cancer samples, such as those isolated from lung, breast, ovary, colon, pancreas. and liver tumors; thus, the present study evaluated STC1 expression in various soft-tissue tumors. STC1 mRNA isolated from 16 cell lines and 186 clinical soft-tissue tumor specimens were analyzed via quantitative real-time PCR, and the calculated expression levels were normalized to those exhibited by STC1-expressing MDA-MB-231 cells. The results of these analyses did not reveal any specific histological tumor types that displayed significantly increased STC1 expression; however, they did not indicate that STC1 expression was significantly higher in malignant compared to benign soft-tissue tumors. Furthermore, in adipocytic tumors, STC1 expression in dedifferentiated liposarcomas was found to be highest and lowest in lipoma tissues, respectively, suggesting that adipocytic tumors may express increasely high levels of STC1 mRNA as they become histologically more advanced. STC1 expression correlates with the malignancy grade in soft-tissue tumors.

DOI： 10.18999/nagjms.82.1.85

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Language：Japanese   Publisher：日本レックリングハウゼン病学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Patellar tendon autograft after intraoperative extracorporeal radiotherapy has been used for reconstruction of the extensor mechanism following limb-sparing wide tumor resection around the knee. The purpose of this study was to determine the clinical outcome of this reconstruction technique. METHODS: We retrospectively reviewed six consecutive patients with peripatellar tendon and proximal tibial sarcoma who underwent reconstruction of the knee extensor mechanism. The resection area was planned to be contained with the patellar tendon in order to obtain a wide margin. First, the patella was osteotomized at the midline, and the inferior half of patella, patellar tendon, and tibial tuberosity were excised en bloc. The resected segments were devitalized with intraoperative extracorporeal radiotherapy and reimplanted into the original site. A follow-up evaluation included an assessment of the range of motion, extensor lag, the International Society of Limb Salvage score, and complications. RESULTS: Six patients were followed up for 121-270 months. One patient underwent an additional reconstruction with total knee arthroplasty due to a collapse of the tibial subchondral bone. A supracondylar fracture of the femur occurred in two patients, and a delayed union of the osteosynthesis site of the tibial shaft was observed in one patient. At the latest follow up, extensor lag had a median of five degrees, and International Society of Limb Salvage scores had a median of 83%. No local recurrence or rupture of the patellar tendon was observed. CONCLUSIONS: Reconstruction of the knee extensor mechanism using a patellar tendon treated with intraoperative radiotherapy is a reliable and successful method.

DOI： 10.1016/j.knee.2019.10.008

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Language：Japanese   Publisher：(一社)日本小児血液・がん学会  

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Publishing type：Research paper (scientific journal)   Publisher：Tohoku University Medical Press  

DOI： 10.1620/tjem.248.87

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DOI： 10.1016/j.jtcvs.2019.04.015

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DOI： 10.1089/jpm.2018.0415

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The natural history of asymptomatic retroperitoneal schwannomas is poorly understood. This study aimed at investigating the natural history of incidental retroperitoneal schwannomas. The medical charts and imaging studies of 22 asymptomatic patients under observation for at least 12 months for retroperitoneal schwannomas were reviewed. The duration of follow-up ranged between 13 and 176 months (mean 48 months). In the 22 patients managed by the "wait and see" approach, the average tumor size at initial presentation was 51 mm, which increased to 57 mm at final follow-up. During the final follow-up, 2 patients required surgical treatment for tumor enlargement, while the remaining patients remained asymptomatic without surgery. The average growth rate of the tumors was 1.9 mm/year (range: -1.9 to 8.7 mm/year). The majority of asymptomatic retroperitoneal schwannomas demonstrate minimal growth and may be suitable for management with the "wait and see" approach.

DOI： 10.1371/journal.pone.0215336

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jos.2018.09.009

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The association between the immune status within the tumor microenvironment and prognosis in synovial sarcoma is not well understood. We aimed to investigate the tumor immune microenvironment and analyze its prognostic impact for patients with synovial sarcoma. A total of 36 primary patients who were treated in our institution were retrospectively evaluated. Infiltration of lymphocytes (CD4+, CD8+, and FOXP3+), CD163+ macrophages, and expression of human leukocyte antigen (HLA) class I and programmed death ligand 1 (PD-L1) were evaluated by immunohistochemistry. Moreover, we investigated PD-L1 and programmed death ligand 2 (PD-L2) mRNA expression in 19 of the 36 cases, using real-time PCR. The Kaplan-Meier method was used to estimate overall survival and progression-free survival. Infiltration of lymphocytes and macrophages varied among the patients. Furthermore, the expression of HLA class I was negative or downregulated in 11 specimens. No PD-L1 expression was observed using immunohistochemistry. Moreover, although PD-L1 mRNA expression was observed in 18 of 19 specimens, the expression level was low. A higher infiltration of CD8+ or FOXP3+ lymphocytes in patients was associated with a favorable overall survival. In addition, a higher infiltration of CD163+ macrophages indicated a significantly worse overall and progression-free survival. Infiltration of CD4+ lymphocytes, HLA class I, PD-L1, and PD-L2 expression were not associated with patient prognosis. This represents the first report investigating the tumor immune microenvironment as a prognostic factor in synovial sarcoma, indicating that CD163+ macrophages are associated with tumor progression. Our results underscore the clinical significance of the tumor immune microenvironment in synovial sarcoma.

DOI： 10.1111/cas.13769

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Language：English   Publishing type：Research paper (scientific journal)  

Bone leiomyosarcoma is a rare primary osseous malignant tumor with a high metastatic potential. Similar to other bone sarcomas, high histological grade and tumor stage are predictive of a poor outcome. We herein present our experience with treating a 64-year-old woman with bone leiomyosarcoma accompanied by multiple bone metastases. A biopsy revealed occasional osteoclast-like giant cells. In addition to radiation therapy, the osteoclastogenesis inhibitor denosumab was administered but the patient did not undergo adjuvant chemotherapy or surgery. Good clinical and short-term radiological responses to denosumab have been observed for 2 years. Therefore, denosumab may represent a viable treatment option without the need for adjuvant chemotherapy.

DOI： 10.3892/mco.2017.1489

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Background: Reconstruction of the extensor mechanism after resection of the proximal tibia is challenging, and several surgical procedures are available. The purpose of this study was to determine the outcome of the fibular transposition technique for reconstruction of the extensor mechanism of the knee after proximal tibial resection.
Methods: We retrospectively reviewed five consecutive patients who underwent resection of the proximal tibia with prosthetic reconstruction and reconstruction of the extensor using fibular transposition between 1997 and 2011. There were two female and three male patients with a mean age of 50 years (range, 27 to 76 years). A follow-up evaluation included both passive and active range of motion, extensor lag, the MSTS score and complications.
Results: Patients were followed up for 93 months (range, 44 to 160 months). The mean extensor lag and active flexion were four degrees (range, 0 to 10 degrees) and 103 degrees (range, 85 to 110 degrees), respectively. The mean MSTS score was 80% (range, 73 to 90%). All patients were able to ambulate without crutches at the latest follow-up.
Conclusions: The utilization of the fibular transposition technique is a simple, reliable, and successful procedure for extensor reconstruction after proximal tibial resection. (C) 2016 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.knee.2016.11.005

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Background: A solitary fibrous tumour (SFT) is an unusual neoplasm typically found in soft tissues. Although SFTs can arise in the bones, they very rarely arise in the vertebral arch. Here, we describe a case of a SFT that arose in the vertebral arch of the first lumbar (L1) spinal vertebrae and mimicked osteosarcoma.
Case presentation: A 49-year-old woman presented with a 2-month history of lower back pain and a lumbar region mass. Magnetic resonance imaging demonstrated a heterogeneously enhanced mass in the L1 vertebral arch. The patient received neoadjuvant chemotherapy, followed by a surgical procedure comprising an anterior spinal fusion and en bloc resection. Histologically, our initial diagnosis was osteosarcoma. The postoperative course was uneventful, and the patient received adjuvant chemotherapy. However, the tumour metastasised to the lung 5 years after the first surgery, and a second surgery was performed for lung tumour resection. The histology of the metastatic lung tumour appeared similar to that of the malignant SFT, and the specimen from the first surgery was re-examined. Immunohistochemically, the tumour was positive for STAT6. Reverse transcription-polymerase chain reaction revealed a NAB2-STAT6 fusion gene, thus confirming our final diagnosis of malignant SFT. The patient died of disease progression 8 years after the first surgery; however, there was no evidence of local recurrence.
Conclusions: Malignant SFT in the vertebral arch is extremely rare and very difficult to distinguish histologically an osteoid from lace-like collagen. STAT6 immunostaining is useful for distinguishing malignant SFTs from other neoplasms. Although it is difficult to completely resect a SFT arising from the spine, we demonstrated the feasibility of an en bloc resection of spinal tumours arising from posterior elements, without local recurrence.

DOI： 10.1186/s12957-017-1161-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPANDIDOS PUBL LTD  

The prognosis of alveolar soft part sarcoma is poor, despite the slow growth of the tumor. A number of cases with spontaneous regression of this rare tumor have been reported. Although the mechanisms underlying spontaneous regression remain uncertain, local immune reaction may be a possible contributing factor. Immunohistochemical expression of human leukocyte antigen (HLA) class I, cluster of differentiation (CD) 3, CD4, CD8, CD20, CD45, CD56, CD68, CD138 and CD163 were assessed in a series of 10 alveolar soft part sarcomas, and the expression profiles were associated with patients' clinicopathological parameters. Expression of HLA class I was observed in almost all the tumor cells of all cases. CD8(+) cells were identified in all tumors with varying densities. Moderate infiltration of CD8(+) cells was detected in three patients; one of these patients survived with long-term tumor remission. Infiltration of CD10(+), CD20(+), CD56(+) or CD138(+) cells was not revealed in all tumors. Moderate-diffuse infiltration of CD163(+) cells was observed in all tumors. To the best of our knowledge, the present study represents the first report of intratumoral immune cells in alveolar soft part sarcoma. Frequent expression of HLA class I in tumor cells was observed. CD8(+) cells were identified at various densi-sarcoma. Moderate infiltration of CD8(+) cells in patients with a good prognosis may indicate the antitumor effects of immune cells in alveolar soft part sarcoma.

DOI： 10.3892/ol.2017.5696

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Intravertebral cleft (IVC) is a common finding in osteoporotic compression fracture. However, since the vertebral collapse attributable to cancer metastasis is rarely associated with IVC, the phenomenon is generally considered as a sign of a benign lesion. In this study, we retrospectively reviewed the radiographs, computed tomography scans, and magnetic resonance images of 111 patients with spinal metastasis. Three cases (2.7 %) had IVC in the collapsed thoracic vertebral bodies (T7, T8, and T11) attributable to cancer metastasis. IVC alone is not necessarily an indicator of a benign vertebral collapse.

DOI： 10.1007/s00256-016-2505-5

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Myoepithelial carcinoma of the breast is an extremely rare tumor composed entirely of malignant spindle cells with myoepithelial differentiation. The majority of previously reported cases have mainly described the clinicopathological features of the disease, and few have presented cytogenetic data. We herein present the case of a 48-year-old woman who was admitted with a left sided breast lump in the inner upper quadrant that was initially diagnosed as a myoepithelioma with potentially malignant disorder. At 12 months after resection, she complained about a newly developed solid mass in the subareolar region of the ipsilateral breast that was diagnosed as an invasive ductal carcinoma. In addition, 16 months after the initial admission, a re-growing remnant lesion recurred in the inner upper quadrant and was ultimately diagnosed as a myoepithelial carcinoma. Lymph node metastasis of the myoepithelial carcinoma was also observed in her left axillary region 11 months after local recurrence. A cytogenetic analysis showed recurring specific chromosomal alterations both in the locally recurrent and in the lymph-node metastatic lesion: 48, XX, t(5;18)(q13;q23),del(6)(q?),+14. + marl. To our knowledge, this is the first published report of clonal chromosomal rearrangements in myoepithelial carcinoma of the breast that presented as metachronic double cancer with invasive ductal carcinoma in the ipsilateral breast.

DOI： 10.1016/j.cancergen.2016.10.005

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

The receptor-activator of nuclear kappaB ligand (RANKL) signaling pathway plays an important role in the regulation of bone growth and mediates the formation and activation of osteoclasts. Osteoclasts are involved in significant bone resorption and destruction. Denosumab is a fully human monoclonal antibody against RANKL that specifically inhibits osteoclast differentiation and bone resorption. It has been approved for use for multiple myeloma and bone metastases, as well as for giant cell tumor of bone. However, there is no previous report quantitatively, comparing RANKL expression in histologically varied bone tumors. Therefore, we analyzed the mRNA level of various bone tumors and investigated the possibility of these tumors as a new therapeutic target for denosumab. We examined RANKL mRNA expression in 135 clinical specimens of primary and metastatic bone tumors using real-time PCR. The relative quantification of mRNA expression levels was performed via normalization with RPMI8226, a human multiple myeloma cell line that is recognized to express RANKL. Of 135 cases, 64 were also evaluated for RANKL expression by using immunohistochemistry. Among all of the tumors investigated, RANKL expression and the RANKL/osteoprotegerin ratio were highest in giant cell tumor of bone. High RANKL mRNA expression was observed in cases of aneurysmal bone cyst, fibrous dysplasia, osteosarcoma, chondrosarcoma, and enchondroma, as compared to cases of multiple myeloma and bone lesions from metastatic carcinoma. RANKL-positive stromal cells were detected in six cases: five cases of GCTB and one case of fibrous dysplasia. The current study findings indicate that some primary bone tumors present new therapeutic targets for denosumab, particularly those tumors expressing RANKL and those involving bone resorption by osteoclasts.

DOI： 10.1371/journal.pone.0154680

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPANDIDOS PUBL LTD  

Musculoskeletal sarcomas (MSS) are a heterogeneous group of malignancies with relatively high mortality rates. The prognosis for patients with MSS is poor, with few drugs inducing measurable activity. Alkylating agents, namely ifosfamide and dacarbazine, which act nonspecifically on proliferating cells, are the typical therapy prescribed for advanced MSS. A novel alkylating agent, temozolomide (TMZ), has several advantages over existing alkylating agents. TMZ induces the formation of O-6-methylguanine in DNA, thereby inducing mismatches during DNA replication and the subsequent activation of apoptotic pathways. However, due to conflicting data in the literature, the mechanism of TMZ action has remained elusive. Therefore, the present study aimed to evaluate apoptosis in MSS cells treated with TMZ, and to evaluate the correlation between TMZ action and survival pathways, including the phosphoinositide 3-kinase (PI3K)/Akt and extracellular signal-regulated kinase (ERK)1/2 mitogen activated protein kinase (MAPK) pathways. Cell proliferation was evaluated by performing an XTT (sodium 3'-[1-(phenylaminocarbony1)-3,4-tetrazolium] -bis (4-methoxy-6-nitro) benzene sulfonic acid hydrate) assay. Apoptotic morphological changes, for example chromatin condensation, were evaluated by fluorescence confocal microscopy. The expression of the apoptosis-associated proteins caspase-3, poly adenosine diphosphate ribose polymerase (PARP), Akt and ERK1/2, was determined by western blotting. The results of the present study indicated that, in certain MSS cells, the IC50 value was lower than that in TMZ-sensitive U-87 MG cells. Furthermore, TMZ treatment was associated with apoptotic morphological changes and the expression levels of pro-apoptotic cleaved caspase-3 and PARP were also increased in TMZ-treated MSS cells. In addition, the result indicated that PI3K/Akt and ERK1/2 MAPK were constitutively phosphorylated in MSS cells, and phosphorylation of PI3K/Akt was suppressed in certain cells, and maintained in other cells, by TMZ. These observations emphasized the plasticity of MSS cells, and suggested that this plasticity may contribute to the variance in cell sensitivity to TMZ and TMZ-resistance in MSS.

DOI： 10.3892/ol.2015.3506

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPANDIDOS PUBL LTD  

Secondary osteosarcoma from fibrous dysplasia (FD) is very rare. The etiology of FD is linked to activating missense mutations of the guanine nucleotide-binding protein alpha-subunit (GNAS) gene, which encodes the stimulatory alpha subunit of the G protein (G(s)alpha) and is located at chromosome 20q13. These mutations are central to the pathogenesis of FD; however, it is not known whether G(s)alpha mutations are retained following malignant transformation in FD. In addition, to the best of our knowledge, no studies have been performed on chromosomal analysis of secondary osteosarcoma from FD. The present study presents a case of secondary osteosarcoma arising from polyostotic FD in a 72-year-old male. Chromosomal analysis showed 44, X, -Y, add(4)(p11), add(5)(p15), der(11)add(11)(p15) t(1;11)(q21;q23), add(12)(q11), -13, der(22)t(12;22)(q11;p12). Reverse transcription-polymerase chain reaction (RT-PCR) analysis demonstrated the presence of a G(s)alpha mutation in both the primary tumor cells and secondary osteosarcoma cells. There was no alteration in this mutation in the region of malignant transformation, which suggests that this mutation may be a useful clinical marker for distinguishing de novo osteosarcoma (primary osteosarcoma) from secondary osteosarcoma arising from FD.

DOI： 10.3892/ol.2014.2082

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Background: Diagnosing adipocytic tumors can be challenging because it is often difficult to morphologically distinguish between benign, intermediate and malignant adipocytic tumors, and other sarcomas that are histologically similar. Recently, a number of tumor-specific chromosome translocations and associated fusion genes have been identified in adipocytic tumors and atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDL), which have a supernumerary ring and/or giant chromosome marker with amplified sequences of the MDM2 and CDK4 genes. The purpose of this study was to investigate whether quantitative real-time polymerase chain reaction (PCR) could be used to amplify MDM2 and CDK4 from total RNA samples obtained from core-needle biopsy sections for the diagnosis of ALT/WDL.
Methods: A series of lipoma (n = 124) and ALT/WDL (n = 44) cases were analyzed for cytogenetic analysis and lipoma fusion genes, as well as for MDM2 and CDK4 expression by real-time PCR. Moreover, the expression of MDM2 and CDK4 in whole tissue sections was compared with that in core-needle biopsy sections of the same tumor in order to determine whether real-time PCR could be used to distinguish ALT/WDL from lipoma at the preoperative stage.
Results: In whole tissue sections, the medians for MDM2 and CDK4 expression in ALT/WDL were higher than those in the lipomas (P < 0.05). Moreover, karyotype subdivisions with rings and/or giant chromosomes had higher MDM2 and CDK4 expression levels compared to karyotypes with 12q13-15 rearrangements, other abnormal karyotypes, and normal karyotypes (P < 0.05). On the other hand, MDM2 and CDK4 expression levels in core-needle biopsy sections were similar to those in whole-tissue sections (MDM2: P = 0.6, CDK4: P = 0.8, Wilcoxon signed-rank test).
Conclusion: Quantitative real-time PCR of total RNA can be used to evaluate the MDM2 and CDK4 expression levels in core-needle biopsies and may be useful for distinguishing ALT/WDL from adipocytic tumors. Thus, total RNA from core-needle biopsy sections may have potential as a routine diagnostic tool for other tumors where gene overexpression is a feature of the tumor.

DOI： 10.1186/1471-2407-14-468

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This study investigated the pathway underlying the antitumor activity of telomelysin, a telomerase-dependent, replication-selective oncolytic adenovirus, in soft tissue sarcoma cells. Treatment with telomelysin alone resulted in simultaneous induction of apoptosis and autophagy, whereas cotreatment with telomelysin and 3-methyladenine significantly reduced cell viability and increased apoptosis and the cellular ATP level compared to treatment with telomelysin alone, indicating that telomelysin-mediated autophagy is a death-protective but not death-promoting process. Cotreatment with Z-Val-Ala-Asp-CH2F significantly increased cellular ATP depletion compared to telomelysin-alone treatment while inhibiting telomelysin-induced apoptosis and having no significant effect on cell viability, indicating that it promotes transition from apoptotic to necrotic cell death. © 2013 Japanese Cancer Association.

DOI： 10.1111/cas.12208

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Other Link： http://search.jamas.or.jp/link/ui/2012161645

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPANDIDOS PUBL LTD  

Polyostotic fibrous dysplasia (PFD) is a high-turnover bone disease that frequently entails chronic bone pain, pathological fractures and severe deformities. Recently, bisphosphonates have shown effective antiresorptive properties in the treatment of children or adults with PFD. We report on a 79-year-old female with PR), who had severe lower limb deformity and chronic bone pain in multiple sites of her extremities for more than 55 years. The patient experienced significant decrease in bone pain and bone turnover markers following long-term (8.5 years) treatment with a low-dose oral alendronate treatment (5 mg/day). To the best of our knowledge, this is the first report of a long-term follow-up of a postmenopausal elderly patient with long-standing symptomatic PFD following continuous low-dose oral alendronate therapy. This case report indicates that long-term daily administration of low-dose alendronate alone is a potential treatment option for elderly patients with PFD, particularly those with long-standing bone pain.

DOI： 10.3892/ol.2011.369

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Language：Japanese   Publisher：(一社)日本癌治療学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

We established a dedifferentiated liposarcoma cell line (NDDLS-1) that produces interleukin-6 (IL-6) and granulocyte-colony stimulating factor (G-CSF). The parental tumor showed high leukemoid reactions. The NDDLS-1 cell line was established from a pleural effusion associated with a lung metastasis. Pleomorphic tumor cells arranged in a haphazard growth pattern were seen in xenograft tumors. Numerous inflammatory cells including neutrophils or eosinophils were present throughout the tumor cells. This finding resembled the dedifferentiated area of the parental tumor. The mice bearing NDDLS-1 showed marked leukocytosis. In addition, the NDDLS-1 cells expressed IL-6 and G-CSF at both the mRNA and protein levels, while the NDDLS-1 cells produced near normal levels of tumor necrosis factor alpha (TNF-alpha). In the cytogenetic analysis, both the parental tumor and the NDDLS-1 cells showed a ring or giant marker chromosomes. The NDDLS-1 cell line demonstrated the amplification and expression of both MDM2 and CDK4 by fluorescence in situ hybridization and immunohistochemical analysis. The NDDLS-1 cell line is consistent with the parental dedifferentiated liposarcoma, and it should therefore be useful for further investigations of human dedifferentiated liposarcomas.

DOI： 10.1111/j.1440-1827.2011.02683.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

A telomerase-specific oncolytic adenovirus, Telomelysin, can selectively kill cancer cells, and be attenuated in normal cells. We herein describe the oncolytic effect of Telomelysin on human osteosarcoma both in vitro and in vivo.
The anti-tumor effects of Telomelysin were evaluated on human osteosarcoma cell lines in vitro and in a mouse xenograft model of human osteosarcoma in vivo. The replication efficiencies of Telomelysin in human osteosarcoma cell lines and normal cell lines and in osteosarcoma xenografts were determined by the expression levels of E1 mRNA and E1A protein using real-time quantitative PCR, Western blot analysis and immunohistochemistry. The in vitro telomerase-specific replication and the viral infection rate were also confirmed by TelomeScan (Telomelysin-GFP), using fluorescent microscopy and flow cytometry, respectively. The cell viabilities were examined by XTT assay, and the tumor volumes were measured every 2 days. The induction of apoptosis was assessed by Western blot analysis, as well as by TUNEL assay.
TelomeScan and Telomelysin were efficiently replicated in human osteosarcoma cell lines and led to a dose- and time-dependent expression of GFP, E1 mRNA and E1A protein. Telomelysin infection induced marked cytolysis and apoptosis in osteosarcoma cell lines in vitro. Neither cytotoxicity nor apoptosis were induced in normal human cell lines. In the human osteosarcoma cell xenograft model, intratumoral injection of Telomelysin resulted in increased viral replication, significant tumor growth suppression and distinct apoptotic cell death.
This study indicated that virotherapy with Telomelysin may provide a promising strategy for the treatment of human osteosarcoma.

DOI： 10.1007/s00432-010-0969-6

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Language：Japanese   Publisher：東北整形災害外科学会  

末梢動脈疾患による足壊疽15例15足(男13例・女2例・49〜91歳)を対象に、経皮的血管形成術(PTA)による再建術を施行した9足と非施行の6足(コントロール群)で治療成績を比較した。コントロール群の内訳は、PTA導入(2008年4月)以前に足関節以遠で切断していたのが4足、バルーン付きカテーテルが閉塞部を通過せずPTA不可能であったのが2足であった。PTA群では、PTA施行後に表層までの壊疽で自然脱落が期待できるものは保存療法を行い、深部に及ぶ壊疽には壊疽部付近での切断またはデブリドマンを行った。PTA群の創治癒率は88.8%であった。最終診察時におけるmajor amputation回避率は、PTA群100%、コントロール群50%と有意差を認めた。以上、足壊疽が足の一部に限局している症例に対しPTAを事前に行うことで、創は十分に治癒し、major amputationも回避可能となることが示唆された。

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Language：Japanese   Publisher：東北整形災害外科学会  

膝関節荷重部に発生した骨巨細胞腫26例(男13例・女13例・平均38歳)の治療成績を検討した。初回手術として腫瘍切除または掻爬後に再建術を行い、再発などに対する追加手術を含め最終手術は人工骨充填術13例、セメント充填術8例、固定術3例、腫瘍型人工関節置換術2例であった。観察期間2〜280ヵ月で、再建術後の新たなX線学的関節症性変化の出現は人工骨群1例、セメント群3例に認めた。International Society of Limb Salvage(ISOLS)患肢機能評価で平均点が他の群より低かったのは、painではセメント群4点、functionでは人工関節群3点、emotional acceptanceでは関節固定群1.3点、supportでは人工関節群4点、walkingでは人工関節群3.5点、gaitでは人工関節群3点であった。ISOLS患肢機能評価の総合平均は89%で、人工骨群97%、セメント群85%、関節固定群71%、人工関節群73%であった。人工骨群では、12例中10例が総合100%と良好であった。

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPANDIDOS PUBL LTD  

Podoplanin is a 38 kDa mucin-type transmembrane glycoprotein that was first identified in rat glomerular epithelial cells (podocytes). It is expressed in normal lymphatic endothelium, but is absent from vascular endothelial cells. D2-40 is a commercially available mouse monoclonal antibody which binds to an epitope on human podoplanin. D2-40 immunoreactivity is therefore highly sensitive and specific for lymphatic endothelium. Recent investigations have shown widespread applications of immunohistochemical staining with D2-40 in evaluating podoplanin expression as an immunohistochemical marker for diagnosis and prognosis in various tumors. To determine whether the podoplanin (D2-40) antibody may be useful for the diagnosis of soft tissue tumors, 125 cases, including 4 kinds of benign tumors, 15 kinds of malignant tumors and 3 kinds of tumor-like lesions were immunostained using the D2-40 antibody. Total RNA was extracted from frozen tumor tissue obtained from 41 corresponding soft tissue tumor patients and 12 kinds of soft tissue tumor cell lines. Quantitative real-time PCR reactions were performed. Immunohistochemical and quantitative real-time RT-PCR analyses demonstrated the expression of the podoplanin protein and mRNA in the majority of benign and malignant soft tissue tumors and tumor-like lesions examined, with the exception of alveolar soft part sarcoma, embryonal and alveolar rhabdomyosarcoma, extraskeletal Ewing's sarcoma/peripheral primitive neuro-ectodermal tumor and lipoma, which were completely negative for podoplanin. Since it is widely and highly expressed in nearly all kinds of soft tissue tumors, especially in spindle cell sarcoma, myxoid type soft tissue tumors and soft tissue tumors of the nervous system, podoplanin is considered to have little value in the differential diagnosis of soft tissue tumors.

DOI： 10.3892/or.2011.1141

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER TOKYO  

DOI： 10.1007/s00776-010-0001-7

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：INT INST ANTICANCER RESEARCH  

Background: FUS1 is a tumor suppressor gene located on human chromosome 3p21.3. Frequent loss of FUS1 protein expression is associated with lung cancer development. This study examined FUS1 expression and its possible tumor-suppressive role in bone and soft tissue sarcomas. Materials and Methods: The expressions of FUS1 mRNA and FUS1 protein were assessed in sarcoma cell lines, sarcoma tissues, benign bone and soft-tissue tumor (BST) tissues, and healthy tissues. Exogenous FUS1 gene transfection was performed on sarcoma cell lines. Results: FUS1 mRNA expression was detected in all sarcoma cell lines, all benign BSTs and healthy tissues, and almost all sarcoma tissues. In contrast, FUS1 protein expression was frequently lost in sarcoma cells and sarcoma tissues. The exogenous PUS1 gene delivery induced strong FUS1 protein expression, inhibition of cell viability and apoptosis in sarcoma cells. Conclusion: PUS1 may act as a tumor suppressor in bone and soft-tissue sarcomas.

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Language：Japanese   Publisher：(公社)日本整形外科学会  

表在性の軟部腫瘍や骨外性病変が触知できる骨腫瘍では触診しながら腫瘍または骨外病変を直接穿刺し、通常の骨腫瘍はX線透視下に穿刺を行った。深部の骨・軟部腫瘍に対してはCTガイド下に穿刺を行った。骨腫瘍および軟部腫瘍に対して行われた針生検983例のうち、最終的に切除材料または開放生検で確認ができた穿刺吸引細胞診(FNAC)359例(骨腫瘍90例、軟部腫瘍269例)、針組織生検(CNB)127例(骨腫瘍40例、軟部腫瘍87例)を対象とした。FNACでは、誤診はすべて偽陰性で3例に認めた。感度、特異度、偽陽性率、偽陰性率はそれぞれび94.3%、100%、0%、5%で、正診率は96.7%であった。CNBでは、臨床所見より判定が正しいものと判断された。誤診例はなかった。感度、特異度、偽陽性率、偽陰性率はそれぞれ100%、100%、0%、0%であり、正診率は100%であった。

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

We report here, our experience of seven patients with epithelioid sarcomas and their serum CA 125 levels, as well as the results of an in vitro and in vivo study of CA 125 expression in epithelioid sarcoma cells and xenografts using three epithelioid sarcoma cell lines.
In the clinical study, the serum CA 125 levels of seven epithelioid sarcoma patients were examined at multiple time points. Expression of the MUC16 gene that encodes the CA 125 sequence was examined using RT-PCR methods in three epithelioid sarcoma cell lines, FU-EPS-1, SFT-8606 and NEPS, and the CA 125 protein in each cell lysate was examined by Western blot using anti-CA 125 clone OC125 antibody. The concentration of CA 125 in the conditioned medium of each cell line was also measured.
In five of the seven epithelioid sarcoma patients, CA 125 levels reflected regression and progression of their disease. The CA 125 concentrations in the conditioned medium of FU-EPS-1, SFT-8606 and NEPS cells were 259, 252, and 6 U/ml, respectively. Strong expression of MUC16 mRNA was shown in FU-EPS-1 and SFT-8606 cells: correspondingly, a thick band was observed by Western blot analysis in only FU-EPS-1 and SFT-8606 cells.
We concluded that epithelioid sarcoma cells produce and secrete CA 125 into the blood serum and that the elevation of serum CA 125 correlates with disease progression. Therefore, measuring the serum CA 125 level should provide an useful index for diagnosing and monitoring the course of epithelioid sarcoma.

DOI： 10.1007/s00432-009-0678-1

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

Podoplanin is known as a lymphatic marker because its expression is detected in lymphatic but not vascular endothelium. Podoplanin is also expressed in several normal tissues including osteocytes or osteoblasts. A systematic examination of the podoplanin expression was conducted in normal skeletal tissues and some bone tumor cell lines, and the diagnostic value determined in primary bone tumors. Podoplanin mRNA was expressed at a high level in bone marrow tissue and cartilage, and was upregulated with differentiation to osteoblasts in bone marrow cells. Strong podoplanin expression was seen in osteocytes, chondrocytes, and osteoblasts on immunohistochemistry. Podoplanin mRNA was expressed at a high level in several osteosarcoma and chondrosarcoma cell lines, whereas podoplanin was expressed at a low level in a Ewing's/primitive neuroectodermal tumor cell line. In the clinical samples, osteosarcomas (22/26) expressed podoplanin at various levels. In small cell osteosarcomas (2/2), podoplanin was expressed strongly, although the tissue samples included few diagnostic osteoids. Chondrosarcomas (10/10) expressed podoplanin strongly, and chondroblastomas (5/5) expressed podoplanin moderately, while podoplanin was absent or expressed at low levels in Ewing's sarcomas (0/5), chordomas (0/6) and giant cell tumors of bone (1/7). Therefore, podoplanin may be a sensitive immunohistochemical marker of osteogenic and chondrogenic bone tumors.

DOI： 10.1111/j.1440-1827.2009.02510.x

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Language：Japanese   Publisher：整形外科バイオマテリアル研究会  

下肢骨端の良性腫瘍に対する掻爬とβ-リン酸三カルシウム(β-TCP)移植の効果を後ろ向きに調べた。患者10名(男7名、女3名、手術時平均29歳)を対象とした。組織型は骨巨細胞腫が7名、軟骨芽細胞腫が3名であった。まず病巣に大きな開窓を施し、病巣を掻爬後、アルゴンビームレーザーと電気メスで掻爬壁を焼灼した。その後骨髄液を添加したβ-TCPを移植した。大腿骨頭例には血管付腸骨移植を、骨皮質の欠損した膝関節症例には遊離腸骨移植を実施した。手術後に再発を認めず、いずれも術後平均3ヵ月目には移植β-TCPと周囲正常骨の境界が不明瞭となり、移植β-TCPは自家骨へと置換されていた。関節可動域は健側と同程度に回復し、両側変形性膝関節症の既往を有する1名以外は疼痛もなく日常生活を送っている。以上より、下肢関節周辺に発生した骨腫瘍に対するβ-TCP移植は長期に安定した成績を期待できる治療法である。

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Pleomorphic rhabdomyosarcoma (PRMS) is a rare variant of rhabdomyosarcoma that occurs mostly in adults. A few cytogenetic studies of PRMS have been reported, but no consistent specific chromosome aberrations were detected. We herein report a cytogenetic study of three cases of pleomorphic rhabdomyosarcoma using a conventional G-banded karyotyping analysis. The three cases appeared to exhibit an extremely complex karyotype with numeric and structural rearrangements. Although the three cases displayed several common aberrations, including -2, -4, -9, -13, -14, -15, -19, -2 1, add(X)(p11), add(1)(q11), add(7)(p11), and add(13)(p11), no recurrent characteristic chromosomal aberrations could be detected. In addition, among these cases and seven other cases of previously reported PRMS, the most frequent chromosomal alterations were -2, -13, -14, -15, -16, and -19. No obviously consistent structural alterations can be found in these 10 PRMS cases, however, thereby suggesting that it is difficult to confirm whether these complex karyotypes correlated with the diagnosis or clinical outcome in PRMS. In this study, we detected MyoDt and myogenin gene transcripts at the mRNA level in four cases of PRMS together with other soft-tissue sarcomas, including seven cases of malignant fibrous hitiocytoma, five cases of liposacroma, and three cases of leiomyosacroma using a real-time quantitative reverse-transcriptase polymerase chain reaction (RT-PCR) analysis. High-level expressions of MyoD1 and myogenin gene transcripts were determined in all cases of PRMS. In contrast, the other non-PRMS sarcomas showed either no expression or extremely weak expressions for both genes. Our findings suggest that the detections of MyoD1 and myogenin transcripts using real-time quantitative RT-PCR, combined with immunohistochemical stains, are extremely sensitive and useful for the diagnosis of PRMS. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.cancergencyto.2009.02.011

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：INT INST ANTICANCER RESEARCH  

Background: A giant cell tumor (GCT) of bone is a locally aggressive tumor with a propensity for local recurrence. A characteristic pattern of peripheral bone formation has been described in GCT recurrence in soft tissue, and in some pulmonary metastases from benign GCT. Although the bone formation in GCT in supposedly due to bone morphogenetic proteins (BMPs), the expression pattern of BMPs in GCT has not been well investigated. Materials and Methods: The expression of BMPs in GCT tissues, cultured stromal cells from GCT and osteoclast-like giant cells harvested by laser microdissection (LM), as well as from control osteosarcoma (NOS-1) cells was analyzed using reverse transcriptional-semiquantitative PCR. Results: BMP 2, 3, 4, 5 and 6 were expressed in the GCT tissue. The cultured GCT cells expressed BMP 2, 4, 5 and 6. The osteoclast-like giant cells expressed BMP 2, 3, 5 and 6 and BMP 5 was expressed at the highest level. Conclusion: Both stromal cells and osteoclast-like cells in GCT expressed several kinds of BMPs.

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DOI： 10.1186/1756-9966-28-44

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Language：Japanese   Publisher：(公社)日本整形外科学会  

切除不能な再発あるいは転移を有する骨・軟部腫瘍症例で、同意が得られた8症例に対しシクロスファミド(CPM)100mgの内服を中心とした外来化学療法を施行しており、その短期成績を報告した。症例により、ドキソルビジン(DOX)の静注を月一回施行した。DOX投与後2、3日は食欲不振を来たすことがあり、吐き気や不快感がある場合は、QOLの維持に主眼を置くためDOX静注は早めに中止した。高齢者の1例、長期の入院抗癌剤治療後の2例は好中球減少が生じてCPMを減量したが、血液毒性は軽度であり、連日投与が可能であった。薬剤投与に関しては外来で十分管理可能であった。投与2ヵ月後では部分奏功1例、安定5例、進行2例であった。部分奏功例では施行後1年間は腫瘍の十分な抑制効果がみられたが、DOXが極量となり、CPM内服単独となって再増悪した。腫瘍進行までの期間は1〜11ヵ月で、最終追跡時3例が有病生存で内服を継続中であり、5例が腫瘍死した。

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Language：English   Publishing type：Research paper (scientific journal)  

Background. Multinucleated cells are frequently seen in association with a malignant neoplasm. Some of these multinucleated cells are considered to be neoplastic. The mechanism of neoplastic multinucleation remains unknown, but is considered to be induced by either cell-cell fusion or acytokinetic cell division. Myxofibrosarcoma consists of spindled and pleomorphic tumor cells and bizarre multinucleated giant cells. Some of these multinucleated cells are considered to be neoplastic. Methods. We studied the mitotic activity of the multinucleated cells by Ki-67 immunohistochemistry, and the dynamics and differentiation by live-cell video microscopy in the two myxofibrosarcoma cell lines to determine whether the mechanism of multinucleation is cell-cell fusion or acytokinetic cell division. Results. A Ki-67 immunohistochemical analysis revealed a high positive rate of multinucleated cells, as well as mononuclear cells, and mitotic ability was shown in the multinucleated cells. In live-cell video microscopy, most of the multinucleated cells were induced via the process of acytokinetic cell division. Conclusion. The current study indicates that a vulnerability of the cytoskeleton components, such as the contractile ring, causes multinucleation to occur from the telophase to the cytokinesis of the cell cycle.

DOI： 10.1186/1756-9966-28-44

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

We report a case of cystic teratoma of the diaphragm that was considered to be a soft tissue lipoma by the preoperative examination. A magnetic resonance imaging revealed an 8x8 cm well-demarcated, homogeneous mass. On T1- and T2-weighted imaging, the mass was isointense to fat. On the fat-suppressed imaging, the signal from the mass was reduced to the same degree as subcutaneous fat. We performed marginal excision. The tumor contained a large number of hairs and oily liquid; and it was connected to the diaphragm.

DOI： 10.1007/s00256-007-0318-2

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：東日本整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(NPO)日本緩和医療学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：新潟整形外科研究会  

症例は6歳男児で、2歳時に多発性軟骨性外骨腫症と診断され、自覚症状なく経過観察した。3ヵ月前に家族が歩行時の躓きと右下垂足に気づいた。X線検査にて右腓骨頭部に骨軟骨腫増大を認めた。単純X線で右腓骨頭に骨髄腔と連続した腫瘤を認め、初診時と比較し増大していた。右脛腓骨遠位にも腫瘤を認めたが、足関節の内外反変形は認めなかった。単純CTで右腓骨頭前方外側に隆起性病変を認め、MRI造影T1強調脂肪抑制像およびT2強調脂肪抑制像で同部位に骨と同信号の腫瘤を認め、T2強調脂肪抑制像で腫瘤辺縁に軟骨帽と思われる約2mmの高信号域を認めた。右下垂足の原因として腓骨神経領域に一致した筋力低下と右腓骨頭部の骨軟骨腫増大を認めたことより、腓骨頭骨軟骨腫による腓骨神経圧迫を疑い、手術を施行した。腫瘍上に神経が多数分枝し、腫瘍の一塊での摘出は囲難と考え、断片的に腫瘤を摘出して神経の圧迫を解除した。腫瘤の病理診断は、骨軟骨腫であった。術後2ヵ月

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

2005〜2015年までに、無治療のまま1ヵ月以上の間隔で複数回の画像評価を行った骨・軟部肉腫症例20例(男性14例、女性6例、年齢14〜85歳)を対象に、CTあるいはMRIのDICOMで腫瘍倍加時間を測定した。その結果、組織診断は未分化多型肉腫4例、高分化型脂肪肉腫、悪性末梢神経鞘腫瘍、平滑筋肉腫が各2例、その他10例で、骨腫瘍3例、軟部腫瘍17例であった。倍加時間は23〜858日、推定腫瘍発生時期は2.4〜84.7年前、推定腫瘍発生年齢は-8〜79歳であった。4例は先天性発生と推定され(生下時3例、-8歳1例)、そのうち2例は高齢者であった。最終転帰は腫瘍死9例、有病生存4例、無病生存7例で、腫瘍倍加時間が100日以内の6例は腫瘍死5例、多発転移1例で予後不良であった。

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Language：Japanese   Publisher：(NPO)日本緩和医療学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

小児骨肉腫治療を行った51例(男児24例、女児27例、初診時平均年齢12.1歳)を対象に、二次がん(SMN)発生状況とその特徴について検討した。平均観察期間13.2年の結果、SMNの発生率は7.8%(4例)であった。SMN発生例は全て女児であり、女児はリスク因子と考えられた。また、全例で疾患特異的な融合遺伝子や染色体転座を認め、化学療法の影響が示唆された。

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

1988年〜2014年の間に施行された腫瘍用下肢人工関節151例中、20年以上にわたり経過観察が可能であった12例を対象に治療成績について検討した。その結果、12例中、7例(58.3%)で平均1.4回の再置換があった。様々な合併症により再置換の必要な場合があったが、歩行機能をはじめとする患肢機能は良好で、患者の満足度も高かった。就業調査では軽作業への配置転換や定年退職があったものの、失業中の症例はなく、社会復帰は順調であった。

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Language：Japanese   Publisher：東日本整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(NPO)日本緩和医療学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(株)医学書院  

1999年から2012年までにβ-リン酸3カルシウム(β-TCP)を使用した整形外科手術714例に対し,合併症を含め後ろ向きに調査した.骨腫瘍(263例)に対して使用した症例では術後早期の骨折が3例にみられたが,遅発性の骨折や変形,術後深部感染は生じず良好な成績が得られていた.β-TCP移植を行った脊椎手術(350例)では3例に術後感染が生じ,5例に再固定手術が施行された.関節疾患,骨折に対して移植を行った101例では深部感染は生じなかった.画像判断の可能な例ではいずれも移植β-TCPと周囲骨とは連続性がみられ,症例によっては継時的にほぼすべてが吸収され新生骨に置き換わっていた.β-TCPは吸収されつつ自家骨形成が生じる優れた骨補填材料であり,整形外科手術に用いた場合,感染率の上昇などの危険性は少ないと考えられた.(著者抄録)

DOI： 10.11477/mf.1408200344

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Language：Japanese   Publisher：新潟医学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

症例1(64歳男性)。左上腕痛を主訴に受診、精査により腎癌上腕骨転移と診断された。切迫骨折状態となり、転移部が上腕骨骨幹部に近かったため髄内釘固定術が行われたが、ガイドピン刺入部から大量出血を認め、2単位の輸血を必要とした。術後1年の時点での左上肢機能はMSTAの術後評価で50%であった。症例2(56歳男性)。右上腕痛を主訴に受診、精査により腎癌上腕骨転移と診断された。上腕頸部に病的骨折と骨外腫瘤を認めたため、骨腫瘍を一塊切除してKLS補填型人工骨頭置換術が施行された。術後5ヵ月の時点で、右肩の挙上制限がみられ、MSTSの上肢機能評価は50%であった。症例3(50歳男性)。左肩痛を主訴に受診、精査にて腎癌上腕骨転移と診断され、左肩血管造影兼塞栓術を行った後、骨腫瘍を一塊切除し、KLS補填型人工骨頭置換術を施行した。その結果、出血量は少なかったものの、術後9ヵ月の時点でMSTSの上肢機能評価は33%で、その約1ヵ月後、患者は死亡の転帰となった。

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(一社)日本形成外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：新潟整形外科研究会  

2006年〜2012年に骨腫瘍の疑いで受診し、最終診断が骨髄炎であった6例(男児3例、女児3例、9〜17歳)を対象に、骨腫瘍と骨髄炎の鑑別について検討した。骨髄炎は高熱や局所の腫脹疼痛、血液検査でのWBC、CRP上昇といった強い炎症反応を伴うものから、これらがほとんどみられないものまで臨床症状は多彩である。炎症反応を伴わないあるいは軽微な場合に骨腫瘍との鑑別にしばしば苦労する。鑑別点は好発部位は骨髄炎は長管骨骨幹端、骨腫瘍は症例により多彩、MRIで骨髄炎は周囲のT2高信号、変化が強い、骨腫瘍は骨内外に腫瘤性病変を形成しやすい等である。いずれも迅速な診断が必須で、開放生検、細菌培養を速やかに施行することが重要である。

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：日本レックリングハウゼン病学会  

神経線維腫症1型(NF1)に発症した悪性末梢神経鞘腫瘍MPNSTは予後不良の疾患でしばしば全身性に転移を生じ、抗がん剤抵抗性であるといわれている。我々の施設において治療を行ったNF1に合併したMPNSTの23症例に対して診療録を利用した後ろ向き調査を行った。症例は男13例、女10例、治療開始年齢は15から81歳(平均38歳)、腫瘍径は2-25cm(平均13cm)、症状発生から治療開始までは1-144ヵ月(平均30ヵ月)であった。初回外科治療として広範切除がなされた10例には局所再発がなく、辺縁切除となった(前医を含む)9例のうち8例に局所再発がみられた。抗がん剤治療は13例に対して施行され、効果判定可能であった11例では最高効果時の評価で、部分寛解3例、不変1例、進行7例であった。不変以上の効果が得られたものはいずれも大量イホマイドを主体とするレジメンであったが、いずれも再増悪が生じた。最終転帰は腫瘍死14、持続的無病生存6、有病生存2、他因死1でカプランマイヤー法による累積5年生存

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Language：Japanese   Publisher：(株)南江堂  

腫瘍用人工膝関節全置換術(TKA)後の膝蓋骨の位置異常と患肢機能について検討した。大腿骨遠位部骨腫瘍に対して腫瘍用TKAを施行し、2年以上経過しX線像で膝蓋骨高位および亜脱臼位(傾斜角)の評価が可能であった23例を対象とした。膝蓋骨低位群8例、正常群15例で、平均膝屈曲角度は低位群が71.3°で、正常群の107.3°に比べて有意に小さかった。ISRと膝属曲角度には中等度の相関関係を認めた。平均ISOLSスコアは両群で有意差はなかった。膝蓋骨傾斜角亜脱臼群6、正常群17例で、平均膝関節屈曲角は亜脱臼群が76.7°で、正常群の101.2°に比べて小さい傾向があった。平均ISOLSスコアは両群で有意差はなかった。ISRと傾斜角には、中等度の負の相関関係を認め、膝蓋骨低位では傾斜角が大きくなる傾向があった。

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：日本レックリングハウゼン病学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(NPO)日本緩和医療学会  

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Language：Japanese   Publisher：(株)メジカルビュー社  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：東北整形災害外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：金原出版(株)  

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Language：Japanese   Publisher：(株)南江堂  

インフォームド・コンセントの得られた骨移植を必要とする2例から2mlの骨髄を腸骨から採取し、高純度β-リン酸三カルシウム(β-TCP)ディスク上に培養した。これを7〜9週齢のsevere combined immune deficiency(SCID)マウスの背部筋層内に移植し、9週後にディスクを採取して4%パラホルムアルデヒドにより固定し、EDTA脱灰を行った後にパラフィン包埋切片を用いて組織解析を行った。更に、以前に報告した方法に準じて連続切片を用いてヒト特異的Aluプローブとマウス特異的L1プローブを用いてDNA in situ hybridizationを行った。その結果、移植後9週で2例ともβ-TCP上に直接骨形成を認めた。ヒト特異的Aluプローブ陽性細胞はβ-TCP新生骨の境界部にのみ僅かに認め、マウス特異的L1は陰性であった。また、骨内に存在する骨細胞は、マウス特異的L1プローブに陽性かつAlu陰性であった。その他、骨周囲の血管内皮細胞や線維芽細胞の紡錘型細胞は全てL1陽性、Alu陰性で、マウス由来細胞と考えられた。一方、対照として細胞を添加しなかったβ-TCPには骨形成は認めなかった。

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Language：Japanese   Publisher：(株)南江堂  

骨・軟部腫瘍に対する穿刺吸引細胞診の有用性について検討した。骨腫瘍は178例の穿刺例のうち細胞が採取できなかった不適切材料が21例で、穿刺のみで最終診断がなされなかったもの48例にみられた。通常型の骨肉腫、Ewing肉腫、癌転移、リンパ腫では100%正診であった。感度、特異度偽陽性率、偽陰性率はそれぞれ95.5%、100%、0%、4.5%で、正診率は97.2%であった。誤診例は非定型的骨肉腫1例とgrade Iの軟骨肉腫が2例で、良性と判定された。軟部腫瘍は826例に対して穿刺が行われたが、不適切材料が109例あり、穿刺のみで最終診断がなされなかったものが394例にみられた。感度、特異度、偽陽性率、偽陰性率はそれぞれ85.5%、96、9%、2.5%、14.5%であり、正診率は91.3%であった。MFH、粘液型脂肪肉腫、横紋筋肉腫、リンパ腫、癌転移などはほぼ100%正診であった。

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J-GLOBAL

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Language：Japanese   Publisher：(株)全日本病院出版会  

血管腫の血管は壁に筋層を持たない毛細血管の構造のため、剥離操作で損傷されやすく、電気凝固に対しても抵抗性である。したがって、電気メスでは十分な止血が得られず、特に部分切除(腫瘍内切除)では大出血をきたす場合があった。我々は筋肉内血管腫に対する新しい手術手技を開発し、周囲二重結紮法(circumferential parallel ligation method;CPL法)と名づけた。CPL法は切除線の両側を針糸を用いて平行に結紮した後、結紮部の間を切開する方法である。針糸結紮は盲目的に行い、深部に向かって結紮を繰り返すことで、最終的に血管腫を腫瘍内で切除できる。従来法とCPL法で比較したところ、CPL法で有意に出血量が少なく、CPL法では全例輸血を必要としなかった。CPL法は筋肉内血管腫の切除において確実に出血がコントロールできる有用な方法である。(著者抄録)

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：AMER ASSOC CANCER RESEARCH  

Web of Science

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Language：Japanese   Publisher：(株)医学書院  

良性骨腫瘍そう爬術後に人工骨移植を行うことで優れた臨床成績が報告されている.現在わが国で広く使用されている人工骨には,ハイドロキシアパタイト,骨ペースト,β-リン酸三カルシウム(β-TCP)などがある.各材料,さらには同じ材料でもメーカーや気孔率,気孔の連通性,表面形状によりその特性が異なり,自分の使用する材料の特性をよく知ることが重要である.筆者が好んで用いているβ-TCPは初期強度は弱いが吸収置換され,旺盛な骨伝導能をもつ優れた材料であり,骨腫瘍領域において優れた臨床成績の報告が多い.(著者抄録)

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Language：Japanese   Publisher：整形外科バイオマテリアル研究会  

鍍銀染色法を用いてこの高純度β-リン酸三カルシウム(β-TCP)のマイクロポア構造内にコラーゲンの形成がみられることを報告した。今回、免疫染色と電子顕微鏡的観察を加え更なる解析を行った。8週齢のFisherラット大腿骨に小孔を作成し気孔率75%、100〜500μmのマクロポアと5μm未満マイクロポアを有するβ-TCP顆粒を移植した。ラット移植後4日ではまだ骨形成は確認されないが早期にマイクロポア内に鍍銀染色陽性所見がみられ、この線維はβ-TCP外のコラーゲン線維と一部直接結合した。免疫染色ではTCP間隙、マクロポア内の未分化な紡錘形細胞、細胞外基質、およびβ-TCPの内部表層に1型コラーゲンの陽性所見がみられた。移植後7日でβ-TCP表面には未熟骨が形成され、骨から連続するようにコラーゲン線維の形成を確認した。

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Language：Japanese   Publisher：新潟大学  

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CiNii Books

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Language：Japanese  

CiNii Article

CiNii Books

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Language：Japanese   Publisher：新潟整形外科研究会  

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Language：Japanese   Publisher：中部リウマチ学会  

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Language：Japanese   Publisher：中部リウマチ学会  

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Language：Japanese   Publisher：(公社)日本整形外科学会  

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Language：Japanese   Publisher：中部日本整形外科災害外科学会  

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Language：Japanese   Publisher：中部日本整形外科災害外科学会  

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Language：Japanese   Publisher：中部日本整形外科災害外科学会  

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Language：Japanese   Publisher：中部日本整形外科災害外科学会  

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Language：Japanese   Publisher：中部日本整形外科災害外科学会  

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Language：Japanese   Publisher：中部日本整形外科災害外科学会  

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