1.Vagus nerve stimulation therapy improves quality of life in patients with intractable postencephalitic epilepsy, a study of five patients
Ayataka FUJIMOTO ; Toru OKANISHI ; Mitsuyo NISHIMURA ; Sotaro KANAI ; Keishiro SATO ; Hideo ENOKI
Neurology Asia 2018;23(1):1-5
Introduction: To evaluate the utility of vagus nerve stimulation (VNS) therapy for patients with intractable postencephalitic epilepsy in the reduction of seizure frequency and quality of life (QOL). Methods: We studied five patients with intractable postencephalitic epilepsy, the age ranged from 21 to 46 years. QOL of the patients was evaluated with the questionnaire, QOLIE-31-P. Results: VNS therapy improved seizure frequency in four patients (80%). One patient (20%) had no reduction of seizure frequency. Three patients had improvements in QOLIE-31-P (p < 0.024) and became socially independent. Two other patients continued to be dependent, and have lesser degree of improvements in their QOLIE-31-P scores.Conclusion: VNS is effective for patients with intractable postencephalitic epilepsy and is able to improve the QOL.
2.Angiopoietin-Like Protein 2 Induces Synovial Inflammation in the Facet Joint Leading to Degenerative Changes via Interleukin-6 Secretion
Kazuki SUGIMOTO ; Takayuki NAKAMURA ; Takuya TOKUNAGA ; Yusuke UEHARA ; Tatsuya OKADA ; Takuya TANIWAKI ; Toru FUJIMOTO ; Yuichi OIKE ; Eiichi NAKAMURA
Asian Spine Journal 2019;13(3):368-376
STUDY DESIGN: Experimental human study. PURPOSE: To determine whether angiopoietin-like protein 2 (ANGPTL2) is highly expressed in the hyperplastic facet joint (FJ) synovium and whether it activates interleukin-6 (IL-6) secretion in FJ synoviocytes. OVERVIEW OF LITERATURE: Mechanical stress-induced synovitis is partially, but significantly, responsible for degenerative and subsequently osteoarthritic changes in the FJ tissues in patients with lumbar spinal stenosis (LSS). However, the underlying molecular mechanism remains unclear. IL-6 is highly expressed in degenerative FJ synovial tissue and is responsible for local chronic inflammation. ANGPTL2, an inflammatory and mechanically induced mediator, promotes the expression of IL-6 in many cells. METHODS: FJ tissues were harvested from five patients who had undergone lumbar surgery. Immunohistochemistry for ANGPTL2, IL-6, and cell markers was performed in the FJ tissue samples. After cultured synoviocytes from the FJ tissues were subjected to mechanical stress, ANGPTL2 expression and secretion were measured quantitatively using real-time quantitative reverse-transcription–polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA), respectively. Following ANGPTL2 administration in the FJ synoviocytes, anti-nuclear factor-κB (NF-κB) activation was investigated using immunocytochemistry, and IL-6 expression and secretion were assayed quantitatively with or without NF-κB inhibitor. Moreover, we assessed whether ANGPTL2-induced IL-6 modulates leucocyte recruitment in the degenerative process by focusing on the monocyte chemoattractant protein-1 (MCP-1) expression. RESULTS: ANGPTL2 and IL-6 were highly expressed in the hyperplastic FJ synovium samples. ANGPTL2 was co-expressed in both, fibroblast-like and macrophage-like synoviocytes. Further, the expression and secretion of ANGPTL2 in the FJ synoviocytes increased in response to stimulation by mechanical stretching. ANGPTL2 protein promoted the nuclear translocation of NF-κB and induced IL-6 expression and secretion in the FJ synoviocytes. This effect was reversed following treatment with NF-κB inhibitor. Furthermore, ANGPTL2-induced IL-6 upregulated the MCP-1 expression in the FJ synoviocytes. CONCLUSIONS: Mechanical stress-induced ANGPTL2 promotes chronic inflammation in the FJ synovium by activating IL-6 secretion, leading to FJ degeneration and subsequent LSS.
Chemokine CCL2
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Enzyme-Linked Immunosorbent Assay
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Humans
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Immunohistochemistry
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Inflammation
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Interleukin-6
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Spinal Stenosis
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Stress, Mechanical
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Synovial Membrane
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Synovitis
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Zygapophyseal Joint
3.Freeze-Dried Human Platelet-Rich Plasma Retains Activation and Growth Factor Expression after an Eight-Week Preservation Period.
Yasuhiro SHIGA ; Go KUBOTA ; Sumihisa ORITA ; Kazuhide INAGE ; Hiroto KAMODA ; Masaomi YAMASHITA ; Toru ISEKI ; Michihiro ITO ; Kazuyo YAMAUCHI ; Yawara EGUCHI ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Koki ABE ; Hirohito KANAMOTO ; Masahiro INOUE ; Hideyuki KINOSHITA ; Takeo FURUYA ; Masao KODA ; Yasuchika AOKI ; Tomoaki TOYONE ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2017;11(3):329-336
STUDY DESIGN: Controlled laboratory study. PURPOSE: This study aimed to evaluate the efficacy of platelet-rich plasma (PRP) stored at room temperature (RT), frozen, or after freeze-drying. OVERVIEW OF LITERATURE: PRP enriches tissue repair and regeneration, and is a novel treatment option for musculoskeletal pathologies. However, whether biological activity is preserved during PRP storage remains uncertain. METHODS: PRP was prepared from blood of 12 healthy human volunteers (200 mL/person) and stored using three methods: PRP was stored at RT with shaking, PRP was frozen and stored at −80℃, or PRP was freeze-dried and stored at RT. Platelet counts and growth factor content were examined immediately after preparation, as well as 2, 4, and 8 weeks after storage. Platelet activation rate was quantified by flow cytometry. RESULTS: Platelet counts were impossible to determine in many RT samples after 2 weeks, but they remained at constant levels in frozen and freeze-dried samples, even after 8 weeks of storage. Flow cytometry showed approximately 80% activation of the platelets regardless of storage conditions. Almost no growth factors were detected in the RT samples after 8 weeks, while low but significant expression was detected in the frozen and freeze-dried PRP. Over time, the mean relative concentrations of various growth factors decreased significantly or disappeared in the RT group. In the frozen group, levels were maintained for 4 weeks, but decreased significantly by 8 weeks (p <0.05). The freeze-dried group maintained baseline levels of growth factors for the entire 8-week duration. CONCLUSIONS: Freeze-drying enables PRP storage while maintaining bioactivity and efficacy for extended periods.
Blood Preservation
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Flow Cytometry
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Freeze Drying
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Healthy Volunteers
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Humans*
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Intercellular Signaling Peptides and Proteins
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Pathology
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Platelet Activation
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Platelet Count
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Platelet-Rich Plasma*
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Regeneration
4.An Interim Report on Result of Knee Pain Chart Accumulation
Toshikatsu KITADE ; Shoji SHINOHARA ; Masanori AKANUMA ; Fujio ITO ; Jun TANABE ; Masayoshi HYODO ; Akiya KATAOKA ; Kaji SHIBA ; Futami KOSAKA ; Yuji MIYAKE ; Toshifumi TARAHARA ; Zaigen OH ; Toshikazu TAKAGI ; Keiji YOSHIKAWA ; Takumi ITO ; Yasuzo KURONO ; Toru SATO ; Masaaki SHINOHARA ; Hiroshi SANADA ; Katsuhiko MATSUMOTO ; Hiromitsu TANIMURA ; Renpu FUJIMOTO ; Tetsusai YAMAMOTO ; Mitsuru NAKAMURA ; Takao SAKAI ; Tabasu MATSUMOTO ; Takaharu IKEUCHI
Journal of the Japan Society of Acupuncture and Moxibustion 1987;37(4):250-256
5.Rehabilitation after Forequarter Amputation for Left Scapula Chondrosarcoma:A Case Report
Yudai FUJIMOTO ; Takaaki TANAKA ; Toru WAKAMATSU ; Seiji IKEDA ; Yuji KATO ; Norifumi NAKA
The Japanese Journal of Rehabilitation Medicine 2020;57(4):364-369
Forequarter amputation is a rare procedure, performed mainly for patients with malignant bone and soft tissue tumors. The present case involved a 59-year-old man with left scapula chondrosarcoma. Rehabilitation began on the second day after amputation for a left shoulder chondrosarcoma. We performed early mobilization, wound management, mirror therapy for phantom pain, strength training for the remaining muscles, and activities of daily living (ADL)/instrumental ADL (IADL) training for only the remaining upper limb. In addition, we made a shoulder disarticulation prosthesis. Six months after the operation, the International Society of Limb Salvage-Musculoskeletal Tumor Society functional score was 36.7% for 6 items and 73.3% for 3 items, while the Disability of Arm, Shoulder and Hand score was 31.7. The patient-reported outcome had a low score because of the lack of an upper limb, including the scapula. However, when he was discharged from the hospital, he gained self-care independence with only the remaining upper limb and resumed fishing as a hobby. We suggest that rehabilitation after forequarter amputation requires careful intervention based on a deep evaluation of the patient's ADL/IADL, hobbies, and quality of life, in accordance with the patient's lifestyle.
6.Rehabilitation after Forequarter Amputation for Left Scapula Chondrosarcoma:A Case Report
Yudai FUJIMOTO ; Takaaki TANAKA ; Toru WAKAMATSU ; Seiji IKEDA ; Yuji KATO ; Norifumi NAKA
The Japanese Journal of Rehabilitation Medicine 2020;():19010-
Forequarter amputation is a rare procedure, performed mainly for patients with malignant bone and soft tissue tumors. The present case involved a 59-year-old man with left scapula chondrosarcoma. Rehabilitation began on the second day after amputation for a left shoulder chondrosarcoma. We performed early mobilization, wound management, mirror therapy for phantom pain, strength training for the remaining muscles, and activities of daily living (ADL)/instrumental ADL (IADL) training for only the remaining upper limb. In addition, we made a shoulder disarticulation prosthesis. Six months after the operation, the International Society of Limb Salvage-Musculoskeletal Tumor Society functional score was 36.7% for 6 items and 73.3% for 3 items, while the Disability of Arm, Shoulder and Hand score was 31.7. The patient-reported outcome had a low score because of the lack of an upper limb, including the scapula. However, when he was discharged from the hospital, he gained self-care independence with only the remaining upper limb and resumed fishing as a hobby. We suggest that rehabilitation after forequarter amputation requires careful intervention based on a deep evaluation of the patient's ADL/IADL, hobbies, and quality of life, in accordance with the patient's lifestyle.
7.Rehabilitation Treatment for a Patient with Fat Embolism Syndrome after Extensive Excision of Thigh Tumor and Artificial Femoral Replacement:A Case Report
Yudai FUJIMOTO ; Takaaki TANAKA ; Toru WAKAMATSU ; Nao HASHIDA ; Yurika KOSUGA ; Norifumi NAKA
The Japanese Journal of Rehabilitation Medicine 2020;():19041-
Fat embolism syndrome (FES) is a serious complication of orthopedic surgery. We describe a woman in her 30s, who experienced cerebral FES after extensive femoral tumor resection and intercalary endoprosthesis for a malignant soft tissue tumor of the thigh. Before the surgery, the patient was able to walk with a single axillary crutch, capable of independent self-care and had no cognitive problems. After the surgery, the patient developed respiratory and central nervous system symptoms, which are characteristic of FES. After critical care, we provided rehabilitation treatment, which included getting out of bed, basic motion training, cognitive rehabilitation treatment, and Activity of Daily Living (ADL) training. At the time of commencement of the rehabilitation treatment, the patient presented with higher brain dysfunctions, such as cognitive dysfunction (Mini Mental State Examination:MMSE score 21 points), attentional dysfunction and left unilateral spatial neglect (USN). However, apparent motor paralysis of the extremities was not detected. On the 95th day after the surgery, the patient’s MMSE score was 29 points, and the attentional dysfunction and USN were resolved. Additionally, the patient was again able to walk with axillary crutch. Six months after the surgery, the patient could walk independently without the aid of a crutch. One year after the surgery, the patient’s reinstated to work. Cerebral FES may be accompanied with higher brain dysfunction;present a variety of higher brain dysfunctions;however, the symptoms may be reversible and resolved with rehabilitation treatment.
8.Rehabilitation Treatment for a Patient with Fat Embolism Syndrome after Extensive Excision of Thigh Tumor and Artificial Femoral Replacement:A Case Report
Yudai FUJIMOTO ; Takaaki TANAKA ; Toru WAKAMATSU ; Nao HASHIDA ; Yurika KOSUGA ; Norifumi NAKA
The Japanese Journal of Rehabilitation Medicine 2021;58(3):333-338
Fat embolism syndrome (FES) is a serious complication of orthopedic surgery. We describe a woman in her 30s, who experienced cerebral FES after extensive femoral tumor resection and intercalary endoprosthesis for a malignant soft tissue tumor of the thigh. Before the surgery, the patient was able to walk with a single axillary crutch, capable of independent self-care and had no cognitive problems. After the surgery, the patient developed respiratory and central nervous system symptoms, which are characteristic of FES. After critical care, we provided rehabilitation treatment, which included getting out of bed, basic motion training, cognitive rehabilitation treatment, and Activity of Daily Living (ADL) training. At the time of commencement of the rehabilitation treatment, the patient presented with higher brain dysfunctions, such as cognitive dysfunction (Mini Mental State Examination:MMSE score 21 points), attentional dysfunction and left unilateral spatial neglect (USN). However, apparent motor paralysis of the extremities was not detected. On the 95th day after the surgery, the patient's MMSE score was 29 points, and the attentional dysfunction and USN were resolved. Additionally, the patient was again able to walk with axillary crutch. Six months after the surgery, the patient could walk independently without the aid of a crutch. One year after the surgery, the patient's reinstated to work. Cerebral FES may be accompanied with higher brain dysfunction;present a variety of higher brain dysfunctions;however, the symptoms may be reversible and resolved with rehabilitation treatment.