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ABSTRACT: Expansive laminoplasty for ossification of the posterior longitudinal ligament (OPLL) has had favorable outcomes. Many modifications of expansive laminoplasty have been developed, including expansive laminoplasty with and without spinous process spacers (SPS). The purpose of this study was to determine whether surgical outcomes were similar between expansive laminoplasty surgeries with and without SPS.Of 109 consecutive patients undergoing surgery for OPLL, 68 patients undergoing expansive laminoplasty were included in the study after excluding patients with other conditions affecting their functional status. The patients were divided into 2 groups based on their K-line, which connects the midpoints of the spinal canal at C2 and C7. Patients were further divided into 2 subgroups: those undergoing expansive laminoplasty without SPS (without SPS group) and those undergoing expansive laminoplasty with SPS (with SPS group). Surgical outcomes were evaluated between K-line (+) and K-line (-) groups. After dividing those groups further into the with SPS and without SPS groups, the differences in surgical outcomes were evaluated again.No significant difference existed in the recovery rate between the with SPS and without SPS groups and between the K-line (+) and K-line (-) groups. When the surgical outcome was only evaluated in the K-line (+) group, the recovery rate 1 year postoperatively was higher in patients without SPS than in those with SPS. Therefore, for patients with K-line (+), the possibility exists that SPS can restrict the posterior shift of the spinal cord and affect the surgical outcome.
Orthopedics 04/2013; 36(4):e494-e500. · 2.66 Impact Factor
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ABSTRACT: The effects of BPs on bone formation during mechanical loading are still unknown. In this study, we evaluated the effect of minodronate on the cortical bone response to mechanical loading applied using a 4-point bending device. We used six-month old female Wistar rats and randomized into five groups (N=10/group): Vehicle administration (VEH), low dose minodronate administration (MINL, 0.01 mg/kg BW), middle dose minodronate administration (MIN-M, 0.1 mg/kg BW), high-dose minodronate administration (MIN-H 1 mg/kg BW), and very high-dose minodronate administration (MIN-VH, 10 mg/kg BW). Minodronate or vehicle was administered orally using the feeding needle at a dosage 3 times/week for 3weeks. Loads on the right tibia at 38 N for 36 cycles at 2Hz were applied in vivo by 4-point bending on the same day for 3weeks. After calcein double labeling the rats were sacrificed and tibial cross sections were prepared from the region with maximal bending at the central diaphysis. Histomorphometry was performed at the entire periosteal and endocortical surface of the tibiae, dividing the periosteum into lateral and medial surfaces. The formation surface was reduced significantly in MIN-H and MIN-VH groups at the medial surface, and in MIN-VH group at the endocortical surface of the loaded tibia (p<0.01 vs. VEH). The mineral appositional rate was reduced significantly in MIN-H and MIN-VH groups at the endocortical surface of the loaded tibia (p<0.01 vs. VEH). The bone formation rate was significantly reduced in MIN-H group at the medial surface, and in MIN-H and MIN-VH groups at the endocortical surface of the loaded tibia (p<0.01 vs. VEH). However, no significant differences were observed in any parameters between the VEH group and either the MIN-L or MIN-M groups for the both the loaded and non-loaded tibiae. Based on previous preventive studies in OVX rats, the optimal dose of minodronate for the treatment of osteoporosis would be 0.03 mg/kg (0.21 mg/kg/week). Therefore, we used 0.1 mg/kg of minodronate 3 times/week (0.30 mg/kg/week) that was close to 0.21 mg/kg/week. In conclusion, minodronate does not reduce the cortical bone response to mechanical loading at the optimal dose for the treatment of osteoporosis in rat model.
Bone 11/2012; · 4.02 Impact Factor
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ABSTRACT: We present a case of intra- and extra-articular localized pigmented villonodular synovitis (PVNS) of the right knee joint separately. A 14-year-old girl presented with a painful mass over the medial aspect of the right knee. MRI demonstrated nodular masses located in the anteromedial area of the knee joint and on the surface of the deep medial collateral ligament outside the joint. Arthroscopic and open synovectomy were performed for both lesions. Histopathology confirmed diagnosis of localized PVNS and pigmented villonodular bursitis, respectively. Our case highlights that localized PVNS are likely to occur in intra- and extra-articular regions separately.
European Journal of Orthopaedic Surgery & Traumatology 11/2012; · 0.10 Impact Factor
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ABSTRACT: INTRODUCTION: Angiosarcoma of bone is an uncommon primary bone neoplasm that is composed of tumor cells that show endothelial differentiation. This is an aggressive malignancy characterized by frequent local recurrence and distant metastases. The majority of patients die within one year of diagnosis, and this shows that angiosarcoma of bone is an aggressive high-grade tumor. CASE PRESENTATION: We present the case of a 65-year-old Japanese woman who had primary angiosarcoma of the proximal humerus with a pathological fracture. An open biopsy confirmed a diagnosis of primary angiosarcoma of bone. Our patient was treated with neoadjuvant chemotherapy and wide resection. One month after surgery, she developed multifocal distant metastasis to her liver and spleen. CONCLUSIONS: Angiosarcoma of the humerus is extremely rare. Radiographically, there is no specific finding associated with angiosarcoma of bone as opposed to other malignant bone tumors. The cornerstone of treatment is en bloc resection followed by as much adjuvant radiation therapy as possible. However, the role of chemotherapy remains undefined, and better systemic agents are clearly needed.
Journal of Medical Case Reports 10/2012; 6(1):347.
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ABSTRACT: Advances in chemotherapy for various malignancies have contributed to the increased life expectancy of patients. If such a patient has a concurrent infection, his/her oncologist would hesitate to perform prompt chemotherapy owing to the risk of inducing sepsis. Therefore, the treatment of infection would have priority over initiating chemotherapy for the malignancy. We present a 69-year-old female with malignant lymphoma requiring prompt chemotherapy who also demonstrated spinal infection with Mycobacterium tuberculosis and a 66-year-old male with esophageal cancer who also demonstrated spinal infection with Staphylococcus aureus. Anterior debridement and interbody fusion were performed for both patients. One patient died of malignant lymphoma 4 years after surgery, and the other is still alive and has remained disease-free 4 years after surgery. Saving the life of a patient with malignancy would be difficult without prompt chemotherapy. Conservative treatment for spinal infection requires prolonged antibiotic treatment, and there is no guarantee that the spinal infection would be controlled only with antibiotics. Therefore, early surgical intervention would be an alternative option under such a condition.
European Journal of Orthopaedic Surgery & Traumatology 09/2012; · 0.10 Impact Factor
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ABSTRACT: Far-out syndrome is a rare condition. To our knowledge, this is the first report of far-out syndrome in a hemiplegic patient.
A 57-year-old woman was referred to our hospital with a 4-month history of pain extending from the right buttock to the lateral
area below the knee. She had become left hemiplegic due to a cerebral hemorrhage 5years before her first consultation at
our hospital. Plain films showed right lateral osteophytes of the L5-S1 disk space, which had not been demonstrated on plain
films taken 3years before the onset of cerebral hemorrhage. On computed tomograms (CT) after radiculography, impingement
of the right L5 spinal nerve was observed between lateral osteophytes of L5-S1 and the sacral ala. Since there was no response
to conservative treatment for 5months, resection of the sacral ala only was performed posteriorly via Wiltse's lateral approach.
Just after surgery, complete pain relief was obtained. CT after radiculography would be an alternative imaging study for a
patient with little evidence of impingement on other images. Although it remains speculation, these osteophytes may form from
increased stress on one side versus the other in a hemiplegic patient.
KeywordsLumbosacral spine-Radiculopathy-Far-out syndrome-Hemiplegia
04/2012; 1(2):91-93.
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ABSTRACT: There have been a few reports on the surgical outcomes of cervical myelopathy in diabetic patients; however, those studies included ossification of the posterior longitudinal ligament. This study investigated whether surgical outcome of expansive laminoplasty (ELAP) for diabetic patients with cervical spondylotic myelopathy (CSM) differs from that for non-diabetic patients and determined prognostic factors in diabetic patients.
We retrospectively reviewed 78 patients with CSM after excluding the cases with other medical conditions, which could affect surgical outcome from 222 consecutive patients who had undergone ELAP between 2000 and 2008 in our hospital. The patients were divided into two groups: diabetic patients (Group 1) and non-diabetic patients (Group 2). We evaluated differences in age, gender, pre- and postoperative Japanese Orthopaedic Association (JOA) score, recovery rate (RR), symptom duration, and postoperative complications between the two groups. In Group 1, the correlation between RR and factors indicating the severity of diabetes mellitus was assessed.
There were 13 patients in Group 1 and 65 in Group 2. There was no significant difference in age, gender, JOA score before or after surgery, or symptom duration between the two groups. Group 1 showed poorer recovery of sensory and motor function in the lower extremities. A negative correlation was observed between RR and the preoperative hemoglobin A(1c) (HbA(1c)) level in Group 1.
Diabetic patients experienced benefits from ELAP similar to non-diabetic patients. A negative correlation between RR and preoperative HbA(1c) level suggests that strict blood sugar control is recommended before surgery.
Archives of Orthopaedic and Trauma Surgery 12/2011; 132(5):577-82. · 1.37 Impact Factor
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ABSTRACT: Japan has one of the most rapidly increasing numbers of elderly individuals; therefore, future trends in spinal infections in the elderly in other countries may be predicted by studying such characteristics in Japan. The purposes of this study were to identify whether the incidence of spinal infection in individuals more than 80 years old is increasing and to define its clinical characteristics.
We retrospectively reviewed the medical records of 98 patients treated in our hospital for spinal infection between 1999 and 2008. Patients were divided into two groups: those admitted to our hospital during the initial five year period, and those admitted during the latter five year period. We evaluated changes in the percentage of individuals over the age of 80 years. To define the clinical characteristics of spinal infection, patients were also divided into another set of two groups: those over 80 years and those around the age of 80 years.
The percentage of patients over 80 years with spinal infection was significantly increasing. There was no significant difference in the gender distribution, prevalence of immunocompromised hosts, common involved levels, or mortality rate between the two age groups. The pathogenic organism was isolated in 78.6%, and of these, the rate of methicillin-resistant Staphylococcus aureus or epidermidis was 2.46 times higher in the elderly group than in the younger group.
The number of patients over 80 years with spinal infection is expected to rapidly increase in aging societies. This advanced age group is more susceptible to infection with drug-resistant organisms, which makes infection management more difficult.
International Orthopaedics 12/2011; 36(6):1229-34. · 2.03 Impact Factor
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ABSTRACT: To evaluate medial radial displacement (MRD) of the medial meniscus in osteoarthritic (OA) and normal knees, with and without weight bearing, using ultrasonography (US), and to prospectively evaluate the time course of changes in MRD in OA knees.
The study subjects were 78 patients with OA of the knee (69% female; mean age 66.4 years) and 20 healthy, asymptomatic subjects (70% female; mean age 64.5 years) who served as a control group. The OA stage was determined according to the Kellgren/Lawrence (K/L) radiographic grading system. US measurement of MRD was performed with subjects in the supine and standing positions. With the exception of subjects who dropped out, 58 OA knees (followup rate 74%) were evaluated at baseline and ∼1 year later.
The medial meniscus was significantly displaced radially by weight bearing in control knees (P<0.001) and in knees with K/L grades 1-3 OA (P<0.01 for each comparison). MRD in either the supine or the standing position was not significantly different between the control knees and the K/L grade 1 knees, but significant differences were noted between the control knees and K/L grade 2 or more severe OA knees (P<0.01 for each comparison). MRD of the medial meniscus had increased significantly on followup in all knees (P<0.05 for each comparison) excluding K/L grade 4 knees in the standing position.
MRD of the medial meniscus increased with weight bearing and during followup. These findings suggest a close association between extraarticular displacement of the medial meniscus and progression of OA.
Arthritis & Rheumatism 09/2011; 64(1):173-80. · 7.87 Impact Factor
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ABSTRACT: This study was a retrospective analysis of 53 adult patients with septic arthritis (SA) of the knee or hip treated during the years from 1955 to 2005 in Tottori University Hospital in Japan. Patients with postoperative infection, infection caused by trauma, and periprosthetic infection were excluded. The 50-year period between 1955 and 2005 was divided into five periods: there were 5 patients in the first decade, 9 in the second decade, 11 in the third decade, 10 in the fourth decade, and 18 in the fifth decade. All SA occurred in the knee until the fourth decade. Five cases of septic arthritis in the hip occurred in the fifth decade. In contrast to the decrease in direct infections (post intraarticular injection), hematogenous infections were observed to increase after 1986. The rate of SA caused by Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus, MRSA) had been highest during the 50 years. Infections caused by MRSA, comprising 22% of all staphylococcal infection, occurred in the fifth decade. The numbers of patients with comorbid conditions such as diabetes increased during the 50-year period. This study indicated that patients with SA have been increasing in number. Furthermore, hematogenous SA has been increasing. The increase in occurrence of SA could result from increase in opportunistic infection, occurrence of SA of the hip, and increase in MRSA infection.
Journal of Infection and Chemotherapy 05/2011; 17(5):666-70. · 1.80 Impact Factor
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Hideki Nagashima,
Toshiyuki Dokai,
Hirokazu Hashiguchi,
Hiroyuki Ishii,
Yasuhiro Kameyama,
Yuji Katae,
Yasuo Morio,
Tsugutake Morishita,
Masaaki Murata,
Yoshiro Nanjo,
Toshiaki Takahashi,
Atsushi Tanida,
Shinji Tanishima,
Koji Yamane, Ryota Teshima
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ABSTRACT: With the aging of the population in developed countries, spine surgeons have recently been more likely to encounter elderly patients in need of treatment. This study investigated whether decompression surgery for cervical spondylotic myelopathy (CSM) in elderly patients aged 80 years or older would likely be a reasonable treatment. We retrospectively reviewed 605 consecutive patients with cervical myelopathy who underwent decompression surgery between 2004 and 2008. Patients with other conditions that could affect functional status or compression factors other than spondylosis were excluded from this study. Of the remaining 189 patients, 161 with CSM whose condition could be evaluated 6 months after surgery were analyzed. The patients were divided into two age groups: 80 years or older (Group A, 37 patients) and younger than 80 years of age (Group B, 124 patients). We evaluated the differences in symptom duration, clinical data, involved levels, surgical outcome, comorbidities, and postoperative complications between the two groups. The symptom duration was significantly shorter in Group A. The average JOA scores preoperatively and 6 months postoperatively were significantly lower in Group A; however, there was no significant difference in the recovery ratio. There were no significant differences in the percentages of patients with comorbidities or those with postoperative complications. Elderly patients aged 80 years or older regained approximately 40% of their function postoperatively, and the incidence of postoperative complication was similar to that in younger patients. Since this age group shows a rapid deterioration after onset, prompt decompression surgery is required.
European Spine Journal 02/2011; 20(2):240-6. · 1.97 Impact Factor
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ABSTRACT: We studied the effect of raloxifene (RAL) on arthritis and bone mineral density (BMD) in rats with collagen-induced arthritis (CIA). Seven-month-old female Sprague-Dawley rats were divided into five groups: rats without CIA (CNT), CIA rats that underwent ovariectomy (OVX) and were treated with RAL (CIA + OVX + RAL), CIA rats that underwent OVX and were treated with vehicle (CIA + OVX + Veh), CIA rats that had sham surgery and were treated with RAL (CIA + sham + RAL), and CIA rats that had sham surgery and were treated with vehicle (CIA + sham + Veh). RAL was orally administered at 10 mg/kg every day for 3 weeks, beginning 1 week after initial sensitization until death at 4 weeks. Every week until death, we evaluated hind paw thickness and arthritis score. BMD was measured by peripheral quantitative computed tomography at the distal metaphysis and the diaphysis of the femur; we also performed histomorphometry of the proximal tibia and histological evaluation of arthritis. RAL administration suppressed hind paw thickness and arthritis score and prevented decreases in BMD and cortical thickness. In the histomorphometric analysis, bone-resorption parameters were significantly lower in the RAL groups than in the Veh groups. RAL significantly inhibited synovial proliferation in CIA rats. RAL effects on arthritis and bone were apparent regardless of whether an animal had undergone OVX. RAL could suppress arthritis and bone loss in estrogen-replete or -depleted rats. These findings, using an animal model, indicate the potential usefulness of RAL as an effective treatment for premenopausal RA patients as well as postmenopausal ones.
Calcified Tissue International 02/2011; 88(2):87-95. · 2.38 Impact Factor
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ABSTRACT: Subdural haematomas co-existing in the cranium and spine are considered extremely rare. We report 2 cases demonstrating the condition described here with a review of literature. One of these 2 patients was the first case in which the spinal lesion was found before the cranial lesion. A 66-year-old man without trauma presented with paraparesis accompanied by severe leg pain. The patient was diagnosed as having spinal subdural haematoma extending from L1 to S1 vertebral levels with magnetic resonance images (MRI). Two days after admission, the patient developed disorientation and abnormal behavior; therefore, computed tomography (CT) of brain was performed, and chronic cranial subdural haematoma was observed. A 60-year-old man who developed headache showing gradually progressive was diagnosed as having cranial subdural haematoma on CT. Three days after admission, he became insomnolent due to severe low back pain radiating to ankle. On MRI, subdural haematoma was found extending from L3/4 to S2 vertebral levels. Only brain surgery was performed for all cases by the neurosurgeons. Paraparesis and severe leg pain, which were derived from spinal lesions, showed recovery approximately 2 weeks after onset and spinal subdural haematoma was completely resolved on MRI obtained 2 or 5 months after onset, respectively. There is a possibility that the incidence of spinal subdural haematoma concurrent with cranial subdural haematoma could be underestimated because the doctor had not obtained CT or MRI of the brain. Doctors should aware of such a condition and check patients with spinal subdural haematoma for neurological signs derived from brain lesions. Spontaneous resolution of spinal subdural haematoma was observed; therefore, surgery for this condition should be indicated only for patients with moderate or severe paraparesis or paraparesis deteriorated.
British Journal of Neurosurgery 10/2010; 24(5):537-41. · 0.88 Impact Factor
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ABSTRACT: There have been few reports describing substances related to oxidative and intermediary metabolism in the cerebrospinal fluid (CSF) in patients with spinal degenerative disorders. This study investigated whether the concentrations of metabolites in the CSF differed between patients with spinal degenerative disorders and controls, and whether the concentrations of these metabolites correlated with the severity of symptoms. CSF samples were obtained from 30 patients with cervical myelopathy (Group M), 30 patients with lumbar radiculopathy (Group R), and 10 volunteers (control). Metabolites in these CSF samples were measured by nuclear magnetic resonance spectroscopy. There were no differences in the concentrations of lactate, alanine, acetate, glutamate, pyruvate, or citrate between Groups M and R, between Group M and the control, or between Group R and the control. In Group M, neither symptom duration nor the Japanese Orthopaedic Association score correlated with the concentration of any metabolite. In Group R, the symptom duration positively correlated with the concentration of lactate, glutamate, and citrate in CSF. The duration of nerve root block showed a negative correlation with the concentrations of acetate in CSF of the patients in Group R. In patients with lumbar radiculopathy, there is a possibility of increased aerobic metabolic activity or decreased gluconeogenic activity in patients with shorter symptom duration, and increased aerobic metabolic activity in patients with severe inflammation around a nerve root.
European Spine Journal 08/2010; 19(8):1363-8. · 1.97 Impact Factor
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ABSTRACT: Minichromosome maintenance complex (MCM2-7) and Geminin are important in the prevention of DNA re-replication in the cell cycle, and are also prognostic markers for numerous human malignancies. The present study examined Minichromosome maintenance protein 7 (MCM7) and Geminin expression in human soft tissue sarcomas (STSs) to clarify their correlation to the clinicopathological factors. Immunohistochemistry was performed to detect the expression of MCM7, Geminin and Ki-67 on paraffin-embedded sections of 109 STSs. Labeling indices (LIs) of the molecules were evaluated in the tumors. Higher LIs of MCM7, Geminin and Ki-67 were significantly correlated with distant metastasis (P<0.01), histological grade (P<0.01) and poor prognosis (P<0.01), respectively. LIs of MCM7 and Geminin were significantly correlated with Ki-67 LIs, (MCM7/Ki-67: rs=0.745, P<0.01 and Geminin/Ki-67: rs=0.604, P<0.01). Multivariate analyses showed that the higher LIs of Geminin, but not MCM7 and Ki-67, were shown to be an independent factor of poorer prognosis (relative risk 2.72, P=0.013). The immunohistochemical expression of MCM7 and Geminin may be novel and useful markers for evaluating the prognosis in patients with human STS.
Oncology letters 07/2010; 1(4):703-709. · 0.11 Impact Factor
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ABSTRACT: We report here a rare case of insufficiency fracture at the distal diaphysis of the radius in a patient with rheumatoid arthritis (RA) after synovectomy combined with the Sauvé-Kapandji procedure. A 71-year-old woman who had been diagnosed with RA had been consecutively treated with several disease-modifying antirheumatic drugs. She had undergone synovectomy of the right wrist combined with the Sauvé-Kapandji procedure, due to a tendon rupture, 2 years before the current presentation (first visit). Although she had not experienced any recent trauma, the wrist pain had increased after she had lifted up the bedding at the funeral of her friend about 1 month prior to her first visit. Radiographs of her right wrist taken at the second visit showed a fracture at the distal diaphysis of the radius at the level of the excision osteotomy of the distal ulna; however, no displacement of the distal fragment was observed. We immobilized her forearm in a long-arm cast. However, after 3 weeks of cast immobilization, a displacement of the distal fragment was observed. A manual reduction of the displacement was performed and the arm was again immobilized in a long-arm cast. However, 1 week later, a displaced distal fragment was again observed. Subsequently, she received an open reduction and internal fixation using a volar locking plate and screws with an autologous iliac crest bone graft. Bone union was completed by 8 months following the operation.
Modern Rheumatology 05/2010; 20(5):511-3. · 1.58 Impact Factor
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ABSTRACT: There have been few reports describing cytokines in the cerebrospinal fluid (CSF) of patients with spinal degenerative disorders. This study investigated whether interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) could be detected in CSF of patients with cervical myelopathy or lumbar radiculopathy and whether the concentrations of those cytokines correlated with the severity of disease conditions. CSF samples were obtained from 21 patients with cervical myelopathy (Group M) and 19 patients with lumbar radiculopathy (Group R), and six volunteers (control). The concentration of IL-6 was significantly higher in Groups M and R than in the control, possibly demonstrating spinal cord and nerve root damage, respectively. However, TNF-alpha was lower than the detection limit. IL-1beta was detected in only five samples from three patients in Group M and two volunteers in the control. The concentrations of IL-6 did not show any correlation with symptom duration, the scoring system by the Japanese Orthopaedic Association, or the duration of nerve root block. There is a possibility that the concentration of inflammatory cytokines in CSF can indicate certain pathological aspects of cervical myelopathy or lumbar radiculopathy.
European Spine Journal 07/2009; 18(12):1946-50. · 1.97 Impact Factor
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ABSTRACT: We retrospectively reviewed the medical charts of 210 consecutive patients treated for spinal infection in Tottori University Hospital in Japan between 1956 and 2005. Until 1995, spinal infection was under control in this series; however, during the last decade, it has been on the rise. Male predominance had been gradually progressing, and 69% of the patients were male during the last decade. Patients with spinal infection were aging, and the ratio of immunocompromised hosts dramatically increased to 53%. Until 1995, the percentage of patients with tuberculous spondylitis had been declining; however, the incidence has been on the rise during the last ten years. The organism was detected in 64% of patients treated between 1996 and 2005, of which Staphylococcus aureus was detected in 49%. Moreover, methicillin-resistant S. aureus was detected in 61% of patients with S. aureus. There were no immigrants or cases with human immunodeficiency virus in this series.
International Orthopaedics 04/2009; 34(3):395-9. · 2.03 Impact Factor
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ABSTRACT: Osteolytic disorders cause serious problems for quality of life with aging. Osteolysis is performed by osteoclasts of the hematopoietic lineage that share some characteristics with monocytes and macrophages. As osteoclast precursors (pOCs) are present in peripheral blood, their characterization in osteolytic diseases may help us to understand risk factors. Although essential factors for osteoclastogenesis have been reported, the effective induction from pOCs in human peripheral blood mononuclear cells (PBMCs) to mature osteoclasts in culture requires further improvement. The aim of this study was development of an efficient culture system for human osteoclastogenesis and providing a simple system for the enrichment of pOCs from PBMCs. We employed coculturing of human PBMCs with a mouse stromal cell line. Significant numbers of tartrate-resistant acid phosphatase-positive (TRAP(+)) multinucleated osteoclasts (MNCs), which could resorb dentine slices, were efficiently induced in this culture condition. pOCs were enriched in an anti-CD16 antibody column-passed anti-CD14 antibody-bound cell population isolated by magnetic cell sorting. We compared the percentage of the CD14(high) CD16(dull) cell population, which mainly contained pOCs in PBMCs, from age-matched patients with rheumatoid arthritis (RA) and osteoporosis (OP), but it was comparable. However, the mean number of TRAP(+) MNCs generated in cultures from PBMCs of RA was higher. In contrast, the frequency of pOCs in PBMCs from OP was relatively higher. These results suggest the characteristics of pOCs from RA and OP may be different, because single pOCs from OP gave rise to lower numbers of osteoclasts than those from RA.
Journal of Bone and Mineral Metabolism 01/2009; 27(1):57-65. · 2.27 Impact Factor
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ABSTRACT: To examine the relationship between knee deformity and osteoporosis in women with rheumatoid arthritis (RA), bone mineral density (BMD) in the lumbar spine and distal radius was measured using dual X-ray absorptiometry, and knee deformity (valgus or varus deformity) was measured using plain radiograms in 55 women with RA. Associations between knee deformity and BMD, disease related variables, including RA stage, RA duration, age, cumulative doses of administered glucocorticosteroids, body mass index, or postmenopausal period were evaluated. Cut-off values of the BMD defining RA patients with knee deformity were very close to the BMD value corresponding to 70% of young adult mean in the lumbar spine and distal radius. The femorotibial alignment was significantly correlated with age and deformity of the proximal tibia. Deformity of the proximal tibia was negatively correlated with the radial BMD and lumbar BMD. Deformity of the proximal tibia showed a significant difference between the groups of less than 5 years after menopause and the group of 5-10 years after menopause. We concluded that knee deformity in RA derived from deformity of the proximal tibia, and it was closely correlated with generalized osteoporosis.
Modern Rheumatology 02/2008; 18(1):45-51. · 1.58 Impact Factor
