Marrow mesenchymal cells (MSCs) contain stem cells and possess the ability to regenerate bone, cartilage, and fibrous tissues. Here, we applied this regenerative ability to intervertebral disc ...regeneration therapy in an attempt to develop a new spinal surgery technique.
We analyzed the regenerative restoration ability of autologous MSCs in the markedly degenerated intervertebral discs.
Fusion for lumbar intervertebral disc instability improves lumbago. However, fused intervertebral discs lack the natural and physiologic functions of intervertebral discs. If intervertebral discs can be regenerated and repaired, then damage to adjacent intervertebral discs can be avoided. We verified the regenerative ability of MSCs by animal studies, and for the first time, performed therapeutic intervertebral disc regeneration therapy in patients and obtained favorable findings.
Subjects were 2 women aged 70 and 67 years; both patients had lumbago, leg pain, and numbness. Myelography and magnetic resonance imaging showed lumbar spinal canal stenosis, and radiograph confirmed the vacuum phenomenon with instability. From the ilium of each patient, marrow fluid was collected, and MSCs were cultured using the medium containing autogenous serum. In surgery, fenestration was performed on the stenosed spinal canal and then pieces of collagen sponge containing autologous MSCs were grafted percutaneously to degenerated intervertebral discs.
At 2 years after surgery, radiograph and computed tomography showed improvements in the vacuum phenomenon in both patients. On T2-weighted magnetic resonance imaging, signal intensity of intervertebral discs with cell grafts was high, thus indicating high moisture contents. Roentgenkymography showed that lumbar disc instability improved. Symptom was alleviated in both patients.
The intervertebral disc regeneration therapy using MSC brought about favorable results in these 2 cases. It seems to be a promising minimally invasive treatment.
Acute rupture of the knee extensor mechanism after patellectomy is extremely rare. We present the case of a patient with acute patellar tendon rupture who had undergone patellectomy 53 years before. ...Twelve days after the injury, the ruptured patellar tendon was repaired with end-to-end suture. Postoperatively, we splinted the knee for 6 weeks but permitted the patient to walk without limiting weight bearing at 1 week postoperatively. At one-year follow-up, the patient is able to move his knee almost full range of motion and the Lysholm knee score is 81. The patient is satisfied with the outcome. This is the first report to treat acute rupture of the patellar tendon in a patient who had undergone patellectomy. Although careful rehabilitation is required, end-to-end suture might be an adequate surgical procedure for acute rupture of the knee extensor mechanism after patellectomy.
The use of heavy ion beams is an effective method for inducing mutations in plants. After irradiation with beams of Nitrogen (N) or Neon (Ne), the frequency of flower color mutants increased through ...the regeneration of stem or leaf without lateral meristem in an interspecific hybrid of Torenia. From anthocyanin assay results, mutants were divided into two groups. One group involved the deletion of the blue gene (DFR). The other group involved the deletion or duplication of a gene related to pigment production. The results show that heavy ion beams are effective in obtaining artificial mutants.
Sterile mutants of Verbena×hybrida were isolated at high frequency from nodal cultures of developed plants irradiated with heavy-ion beams. Sixty four in vitro-cultured nodes of fertile cultivars ...‘Temari Sakura’ (FS), ‘Temari Coral Pink’ (FC) and ‘Temari White’ (FW) were irradiated with 1 to 10Gy of 14N-ion beam (1890MeV). Lateral shoot development of FS, FC and FW was not affected by irradiation with up to 10Gy. After open-pollination, shoots with inflorescence forming unenlarged ovaries were selected and propagated several times by cutting. Shoots were grown to flowering and the selection process for isolating stable sterile mutants was carried out by the same method. Finally, one mutant out of 104 FS lateral shoots (5Gy), one mutant out of 115 FC shoots (5Gy) and 3 mutants out of 108 FC shoots (10Gy) were successfully isolated. With the exception of sterility all these mutants showed normal morphology. Two sterile mutants SS and SC, which were isolated from 5Gy-irradiated FS and FC, respectively, were characterized by their flowering habits. These two mutants grew well, had a larger number of inflorescences, and a better longevity compared with their parental cultivars. These results show that heavy-ion beam irradiation is an excellent tool for isolating sterile mutants without alterations in others important traits at a high frequency. In addition, the characterization of SS and SC indicated that they have different sterile phenotypes: male and female gametes of SS are non-functional, in contrast, SC exhibits self-incompatibility, which results in mutants unable to produce seeds.
A retrospective study comparing cervical laminoplasty with or without muscle release for the treatment of cervical myelopathy resulting from athetoid cerebral palsy.
To assess the effectiveness of ...muscle release in the treatment of athetoid cerebral palsy.
While anterior and/or posterior spinal fusion has been generally accepted as necessary in surgical treatment for cervical myelopathy due to athetoid cerebral palsy, several studies have shown relatively favorable results following laminoplasty. Better results can be obtained by combining muscle release. METHODS.: Study participants were 10 patients who underwent cervical laminoplasty combined with muscle release (mean age, 44.6 years) and 15 patients who underwent cervical laminoplasty alone (mean age, 48.2 years). Therapeutic outcomes 1 year after surgery, as assessed by Kurokawa's methods and JOA scores, were compared between groups.
Recovery rate 1 year after surgery was significantly higher for the muscle release group than for the control group. In both groups, recovery rates were significantly better for patients who could walk before surgery.
Cervical laminoplasty combined with muscle release for the treatment of cervical myelopathy due to athetoid cerebral palsy is effective in simplifying postoperative therapy and improving JOA scores.
Despite recent advancements in rheumatoid arthritis (RA) pharmacotherapy, surgeons still encounter severely damaged knees. The purpose of the present study was to analyze the mid-term clinical ...results of total knee arthroplasty (TKA) with metal block augmentation and stem extension.
A total of 26 knees in 21 patients who underwent primary TKA with metal block augmentation and stem extension were retrospectively reviewed. All patients with a mean age of 63 years had RA for a mean duration of 15 years. Functional and radiographic results as well as complications were evaluated at the mean follow-up period of 6 years after TKA. Eight knees were lost follow-up after the two-year evaluation.
Tibial bone defects with average depth of 19 mm were preoperatively recognized in all 26 knees. The postoperative joint line was reconstructed on average 11 mm above the fibular head using average thickness of 11 mm tibial inserts and 9 mm metal blocks with stem extension. Significant improvements (p < 0.05 for all comparisons) were observed postoperatively in maximum extension angle from -10° to -1°, range of motion from 101 ° to 115 °, and Knee Society Score (knee score/function score) from 35/18 to 90/64. Non-progressive radiolucent lines beneath the metal block and osteosclerotic changes around the medullary stem were found in 16 knees (62%) and 14 knees (54%), respectively. There was two failures (8%): fragile supracondylar femur fractures and knee instability. No knees showed any radiographic implant loosening, dislocation, polyethylene insert breakage, peroneal palsy, or infection.
Primary TKA with metal block augmentation and stem extension could effectively restore function in RA patients with advanced forms of knee joint destruction, and be reliable and durable for a mean postoperative period of 6 years. Further study is needed to determine the long-term results of TKA using metal block augmentation and stem extension.
A 38-year-old man presented with untreated congenital kyphosis associated with progressive spastic gait. To prevent progression of the spastic paralysis, rigid correction of the severe spinal ...deformity arising from the congenital kyphosis was performed by one-stage posterior closing-wedge osteotomy, without occurrence of neurological complications. Progression of the paralysis has not been identified for 30 months after the operation and a slight improvement in gait was recognized. The current case is categorized as type I deformity of congenital kyphosis in the upper thoracic spine, which is normally treated surgically before the adolescent growth phase begins.
We previously used heavy-ion beam irradiation to generate a self-incompatible mutant of Verbena×hybrida ‘Temari Coral Pink’ (SC), which exhibits a late-acting self-incompatibility system. In the ...present study, the behavior of pollen tubes and seed productivity after self-pollination were comparatively investigated in SC and wild species Verbena peruviana (VP), one of the parental species of Verbena×hybrida. Although reciprocal cross-pollination between VP and SC produced seeds with high frequencies, namely 57.1% for SC×VP and 59.7% for VP×SC, self-pollinated VP flowers produced no seeds. In the latter, almost all of the pollen germinated on the stigma, but further growth of the pollen tube was inhibited at the upper part of the style. These observations of pollen tube behavior may indicate that the SI system of VP was different from that of SC. VP may possess a homomorphic gametophytic SI system, which is characterized by the inhibition of pollen tube growth at style. We propose a set of SC and VP as a novel model plants for genetic analysis of the SI mechanism in the Verbenaceae family.
Pseudohomozygous familial hypercholesterolemia is a rare condition of unknown etiology. Sitosterolemia is a rare autosomal recessively inherited disorder that is characterized by premature coronary ...artery disease, cutaneous xanthomas, and increased plasma plant sterols and 5a-stanols. Only a few cases of both sitosterolemia and pseudohomozygous familial hypercholesterolemia have been reported. In this study, we report two sisters with both conditions. With a low-cholesterol diet (<250 mg/day), serum cholesterol concentration decreased rapidly to an almost normal level and cutaneous xanthomas gradually regressed and finally disappeared ; however, plant sterol levels did not change during the period. Plant sterols should be measured in patients considered to have pseudohomozygous familial hypercholesterolemia. The two conditions in this family may have been the results of a single gene mutation. The findings also indicate that low cholesterol diet therapy is effective for the treatment of hypercholesterolemia but not of sitosterolemia in this family.
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