記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Mesenchymal progenitors, which are resident progenitor populations residing in skeletal muscle interstitial space, contribute to pathogeneses such as fat infiltration, fibrosis, and heterotopic ossification. In addition to their pathological roles, mesenchymal progenitors have also been shown to play important roles for successful muscle regeneration and homeostatic muscle maintenance. Therefore, detailed and accurate analyses of these progenitors are essential for the research on muscle diseases and health. Here, we describe a method for purification of mesenchymal progenitors based on the expression of PDGFRα, which is a specific and well-established marker for mesenchymal progenitors, using fluorescence-activated cell sorting (FACS). Purified cells can be used in several downstream experiments including cell culture, cell transplantation, and gene expression analysis. We also describe the method for whole-mount 3-dimensional imaging of mesenchymal progenitors by utilizing tissue clearing. The methods described herein provide a powerful platform for studying mesenchymal progenitors in skeletal muscle.

DOI： 10.1007/978-1-0716-3036-5_9

PubMed

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本筋学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The main function of skeletal muscles is to generate force. The force developed by myofiber contraction is transmitted to the tendon. There are two pathways of force transmission from myofibers to tendons: longitudinal transmission that depends on tension elicited via the myotendinous junction and lateral transmission that depends on shear elicited via the interface between the myofiber surface and surrounding connective tissue. Experiments using animal muscle and mathematical models indicated that lateral transmission is the dominant pathway in muscle force transmission. Studies using rat muscle showed that the efficiency of lateral force transmission declines with age. Here, the lateral transmission of force was measured using the extensor digitorum longus muscle from young and old mice. Dependence on longitudinal transmission increased in the old muscle, and there was a trend for lower efficiency of lateral force transmission in the old muscle compared to the young muscle. There was a noticeable increase in the connective tissue volume in the old muscle; however, there was no significant change in the expression of dystrophin, a critical molecule for the link between the myofiber cytoskeleton and extracellular matrix. This study demonstrates the measurement of lateral force transmission in mouse muscles and that alteration in force transmission property may underlie age-related muscle weakness.

DOI： 10.3390/ijms222212356

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: This study aimed to determine the indications for drainage in extended haematogenous iliopsoas abscesses (IPAs), which include both primary and vertebral osteomyelitis-related IPAs. METHODS: Sixty-three IPA patients who were initially treated with only antibiotics and no drainage were enrolled. The success (S) group included patients who were cured without drainage, while the failure (F) group included those who required open or percutaneous drainage or died. RESULTS: Compared with patients in the S group, patients in the F group (n = 15) had a higher incidence of end-stage renal disease on hemodialysis, compromised immunity, vertebral osteomyelitis of the cervicothoracic spine, other musculoskeletal infections, and multilocular abscesses. The IPAs in the F group had larger transverse and longitudinal diameters. In receiver operating characteristic curve analyses for the diameter of IPAs, the most valuable cut-off points predicting the F group were a longitudinal diameter of 5.0 cm (sensitivity, 1.0; specificity, 0.67) and a transverse diameter of 2.3 cm (sensitivity, 0.73; specificity, 0.73). A combination of both diameter cut-offs had high specificity (sensitivity, 0.73; specificity, 0.90). CONCLUSIONS: Drainage should be applied in case of a larger abscess with transverse diameter ≥ 2.3 cm and longitudinal diameter ≥ 5.0 cm. Conversely, IPAs with longitudinal diameter <5 cm do not require drainage. Haemodialysis, compromised immunity, vertebral osteomyelitis of the cervicothoracic spine, and musculoskeletal infections are risk factors of conservative treatment failure.

DOI： 10.1016/j.jos.2020.10.023

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本筋学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Skeletal muscle is a vital organ for a healthy life, but its mass and function decline with aging, resulting in a condition termed sarcopenia. The etiology of sarcopenia remains unclear. We recently demonstrated that interstitial mesenchymal progenitors are essential for homeostatic muscle maintenance, and a diminished expression of the mesenchymal-specific gene Bmp3b is associated with sarcopenia. Here, we assessed the protective function of Bmp3b against sarcopenia by generating conditional transgenic (Tg) mice that enable a forced expression of Bmp3b specifically in mesenchymal progenitors. The mice were grown until they reached the geriatric stage, and the age-related muscle phenotypes were examined. The Tg mice had significantly heavier muscles compared to control mice, and the type IIB myofiber cross-sectional areas were preserved in Tg mice. The composition of the myofiber types did not differ between the genotypes. The Tg mice showed a decreasing trend of fibrosis, but the degree of fat infiltration was as low as that in the control mice. Finally, we observed the preservation of innervated neuromuscular junctions (NMJs) in the Tg muscle in contrast to the control muscle, where the NMJ degeneration was conspicuous. Thus, our results indicate that the transgenic expression of Bmp3b in mesenchymal progenitors alleviates age-related muscle deterioration. Collectively, this study strengthens the beneficial role of mesenchymal Bmp3b against sarcopenia and suggests that preserving the youthfulness of mesenchymal progenitors may be an effective means of combating sarcopenia.

DOI： 10.3390/ijms221910246

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A 21-year-old man consulted our hospital for treatment of a spinal giant cell tumor (GCT) of Enneking stage III. Lower lumbar-spine tumors and severe spinal canal stenosis are associated with high risk for surgical mor-bidity. Stability was temporarily secured with a percutaneous pedicle screw fixation in combination with deno-sumab, which shrank the tumor. Total en bloc spondylectomy was then performed 6 months after initiation of denosumab, and the patient was followed for 3 years. There was no local recurrence, and bony fusion was obtained. Minimally invasive surgery and denosumab allowed safer and easier treatment of a collapsing lower lumbar extra-compartmental GCT.

DOI： 10.18926/AMO/61442

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY DESIGN: Retrospective multi-center study. OBJECTIVE: To identify the morphological features of costovertebral joints and ribs in surgically managed cervical injury patients with diffuse idiopathic skeletal hyperostosis (DISH) and to examine its impact on their vital prognosis. SUMMARY OF BACKGROUND DATA: Several reports have indicated that DISH is an independent risk factor for mortality after spinal fracture. The reason for the high mortality in cervical injury patients with DISH is unclear, although some reports have suggested a possible association between pulmonary complications and mortality. METHODS: From 1999 to 2017, a total of 50 DISH patients (44 males) with cervical spine injuries who underwent spinal surgery were enrolled (average age 74 yrs). Prognosis and clinical risk factor data were collected; the morphological features of the patients' costovertebral joints and ribs were evaluated with computed tomography. The influence of each proposed risk factor and thoracic morphological feature on mortality was tested with univariate and multivariate analyses. RESULTS: The survival rate at 5 years after surgery was 52.3%. Nineteen (38%) patients died, and the most common cause of death was pneumonia (68%). Costovertebral bone excrescences and rib hyperostosis were found to be thoracic pathognomonic signs; their frequencies were 94% and 82%, respectively, and these conditions occurred in an average of 7.0 joints and 4.7 bones, respectively. The results of the log-rank test showed a significant difference in age, injury severity score (ISS), costovertebral bone excrescences, and rib hyperostosis. The results of age-adjusted multivariate analysis indicated that age (hazard ratio [HR] = 8.65, 95% confidence interval [CI] = 1.10-68.28, P = 0.041) and rib hyperostosis (HR = 3.82, 95% CI = 1.38-10.57, P = 0.010) were associated with mortality. CONCLUSION: Reduced chest wall mobility associated with rib hyperostosis in cervical spine injury patients with DISH leads to a poor prognosis. LEVEL OF EVIDENCE: 3.

DOI： 10.1097/BRS.0000000000003252

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

STUDY DESIGN: A retrospective long-term follow-up study. OBJECTIVE: To investigate the health-related quality of life (HRQOL) status in middle-aged patients with adolescent idiopathic scoliosis (AIS) treated non-surgically. SUMMARY OF BACKGROUND DATA: The HRQOL status using various established questionnaires for non-operated AIS patients has not been fully investigated in long-term follow-up surveys. METHODS: Inclusion criteria were non-surgical treatment for AIS, more than or equl to 30° major scoliosis at skeletal maturity (Risser grade ≥4), and age more than or equl to 30 years at the time of the survey. A total of 107 AIS patients were included and divided into three groups (single main thoracic [MT] curve group; n = 50, single thoracolumbar/lumbar [TL/L] curve group; n = 19, and double-major [DM] curve group; n = 38) based on curve location at skeletal maturity. Age- and sex-matched volunteers were selected as the control group. RESULTS: There were no significant differences in age at survey, body mass index, bone mineral density of the femoral neck, and skeletal muscle mass index among the groups. In all groups, major scoliosis progressed by approximately 0.5°/yr from the time of skeletal maturity to the survey. The thoracolumbar (TL/L) and double-major (DM) groups showed significantly worse visual analog scale scores for low back pain compared with the main thoracice (MT) group (P < 0.05). The all-scoliosis groups showed significantly worse scores for self-image domain of the Scoliosis Research Society Outcome Instrument-22 (SRS-22) than the control group (P < 0.0001). The TL/L group showed significantly worse scores for walking ability and social function domains of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) (P < 0.05). There were no significant differences in Oswestory Disability Index and Short-Form-12 among the four groups. CONCLUSION: AIS patients with single MT curve maintain equal HRQOL status compared with healthy controls. Patients with structural TL/L curves are likely to experience greater annual TL/L curve progression and have substantial low back pain or worse low back pain-specific HRQOL status during middle age. LEVEL OF EVIDENCE: 4.

DOI： 10.1097/BRS.0000000000003216

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本筋学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

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記述言語：日本語   出版者・発行元：(一社)日本骨折治療学会  

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

症例は88歳男性で、歩行困難、体幹および両下肢の知覚鈍麻を主訴とした。単純CT横断像で胸椎近傍に軟部陰影の腫大を認め、T4の椎体・椎弓根・椎弓に溶骨性変化を認め、また矢状断にて粗大な骨梁構造を認めた。MRIではT1強調像で低信号、T2強調像で高信号、Gd造影効果陽性の病変を認め、腫瘍は横断像にて脊柱管内に浸潤し、T2強調矢状断像にて髄内高信号変化を認めた。Dynamic造影CT像にて病巣部の造影遅延を確認でき、脊椎血管腫と診断した。術前血管塞栓術後、全身麻酔下にT3-5椎弓切除術およびT1-7後方固定術を施行し、椎弓切除後硬膜管側方の腫瘍も摘出した。病理所見では骨梁内に血管が入り込む所見を認め、海綿状血管腫の診断であった。術後50日目より放射線合計30Gy照射し、術後2ヵ月でT字杖歩行が可能となった。術後MRIでは胸椎近傍の腫瘍の大きさは不変であるが、脊髄の圧迫は解除されていた。術後1年経過して杖歩行で安定し、再発も認めない。

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記述言語：日本語   出版者・発行元：金原出版(株)  

＜文献概要＞近年,びまん性特発性骨増殖症(diffuse idiopathic skeletal hyperostosis;DISH)に関する報告は増加しているが,高齢化に伴い今後もその患者数は増加すると予想される。DISHは単に脊椎の癒合により可動性が低下するだけではなく全身に様々な影響を及ぼす疾患と考えられている。嚥下障害や呼吸機能の低下をきたし,時には気道閉塞が生じることもある。また,体幹の前屈障害や腰痛をきたす疾患としても報告されており,脊椎疾患の手術成績にも影響を及ぼす。さらには代謝異常とも関係があり,脳卒中や心血管イベントのリスクが高いことも報告されている。来たる人生100年時代において,骨粗鬆症やサルコペニアとともに注目すべき症候群である。

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記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：新潟市民病院  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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記述言語：日本語   出版者・発行元：東北整形災害外科学会  

当院および関連施設で脊髄癒着性くも膜炎に対して手術を行った5例の術後成績について検討した。初回手術としては、くも膜下腔-くも膜下腔バイパス(Su-Suバイパス)術が2例、嚢腫-胸腔シャント(C-Pシャント)術が1例、空洞-胸腔シャント(Sy-Pシャント)術が1例、嚢腫摘出術が1例であった。3例で追加手術を要し、うち1例はSu-Suバイパス術後のチューブ移動に対し再度Su-Suバイパス術を、1例はSu-Suバイパス術後のチューブ閉塞に対しSy-Pシャント術を、1例は嚢腫摘出後の空洞増大に対しC-Pシャント術、およびその後のチューブ閉塞に対し再度C-Pシャント術を行った。最終手術から平均24.8ヵ月の経過観察で、画像所見および症状はともに全例で改善した。改良Frankel分類での評価では、外傷後の完全運動麻痺の1例を除いて4例全例で改善を認めた。

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記述言語：日本語   出版者・発行元：新潟整形外科研究会  

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