Glioblastoma is a tumor that is difficult to treat radically by surgery alone; presently, surgery, radiotherapy, and chemotherapy are the combined treatment of choice. In general, postoperative radiotherapy and chemotherapy are performed concurrently, but this is not a radical treatment. Using human glioblastoma cell lines (T98G and A172 cells) from the Japanese Cancer Resources Bank, irradiated glioblastoma cells were prepared under the same conditions as actual clinical therapy. To these irradiated cells, 5-fluorouracil was administered and anticancer drug sensitivity was investigated in relation to the timing of the radiotherapy. In addition, the mRNA levels of TS, DPD, and OPRT, genes that can serve as biomarkers for 5-fluorouracil, were measured to investigate anticancer drug sensitivity and gene expression. When compared to unirradiated cells and 60-Gy-irradiated cells, the cell proliferation rate for 30-Gy-irradiated cells tended to be higher and 5-fluorouracil sensitivity was the highest for the 30-Gy-irradiated cells. In other words, from the viewpoint of antitumor effects, the results suggest that the antitumor effects of sequential therapy in which radiotherapy was followed by chemotherapy were greater than those of concurrent radiotherapy and chemotherapy. A spaces needed have TS was the lowest in the 30-Gy-irradiated cells and the highest in the unirradiated cells. Because anticancer drug sensitivity was the highest with 30Gy, patients with high TS levels are thought to be resistant to 5-fluorouracil, while those with low TS levels are believed to be sensitive to the anticancer drug. The mRNA levels of DPD and OPRT did not correlate with 5-fluorouracil sensitivity. The results suggest that TS may become a biomarker for 5-fluorouracil.

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Collection of autogenous bone requires new invasion to the other healthy area. β-TCP is replaced by bone with development of bone resorption, but the intensity of β-TCP block is insufficient. We mixed titanium powders in β-TCP powders, and produced a new mold having strong intensity sufficient enough for vertebral fusion. 100% titanium, β-TCP containing 5%, 20%, or 50% of titanium, and 100% β-TCP were implanted in the tibia of rabbits. The tibia was extripated 16 weeks after implantation, and a three-point bending test was performed. The interface of the mold and the bone was observed electron microscopically at 8 and 16 weeks after implantation. The results of three-point bending test showed that the lower β-TCP containing rate was, the more the mean stress increased. In electron microscopic observation, a space was existed between the mold and the bone, and the bone was not unioned 8 weeks after operation in both 5% and 20%β-TCP. However, 16 weeks of post-operation, this space was eliminated and the bone was unioned. But no space was existed at 8 weeks after operation in 100% β-TCP. These results suggest that the higher β-TCP-containing rate was, the more early the mold was fused and stabilized at the implanted site. If the mold is not stabilized at the implanted site, micro-movement exists for a long time period, and callus formation may be stimulated. Therefore, mean stress might have been increased by callus formation in spite of low β-TCP-containing rate. A pluck intensity not affected by callus should be determined. For this purpose, it should be evaluated in the animals implanted the mold for a long period of time.

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The impulse oscillation system (IOS) can evaluate within a short amount of time total airway resistance (R5), large peripheral resistance (R20), small airway resistance (R5-R20), reactance (X5) and resonant frequency (Fres) under normal breathing. However, there are no clearly defined IOS standards. The study, therefore, examined Fres, one of the IOS parameters. The subjects, 420 patients who showed %VC ≥ 80% and FEV_1.0% ≥ 70% by spirometry, were divided into non-smoker males, non-smoker females, smoker males and smoker females with 105 subjects in each of the four groups. Fres data obtained for all subjects showed no significant differences among the four groups. Subsequently, a correlation with Fres and age, height, FEV_1.0, VC and PEFR were reviewed. There was a positive correlation between Fres and age. Fres show a negative correlation for FEV_1.0 and VC. There was a weak correlation between Fres and height and PEFR. Since IOS can be measured without any respiratory effort by patients, can obtain high temporal resolution measurements during spontaneous breathing and dose not require a special lung function laboratory, IOS would seem to be a useful tool for the study of physiological changes on respiratory functions.

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We examined clinical results, image findings (osteolysis, radiolucent line, change in femur and stress shielding) and issues in cases that underwent cementless total hip arthroplasty (THA), which had been started in 1987 at our department. The cases is repoted at a minimum 10 years of follow-up. The subjects were 186 joints in 155 patients which included 14 joints in 12 males and 172 joints in 143 females; these patients had been followed for 10 or more postoperative years and had resulted in revision after surgery was performed. The mean age at the time of operation was 56.4 years. A questionnaire survey was also conducted by telephone for patients who were difficult to follow for 10 years or more. The JOA score improved from 50.0 points before operation to 84.1 points after operation. The survival rate calculated using the Kaplan-Meier cumulative survival curve was 95.9% for 10 years and 89.9% for 15 years with the surgery performed on the cup side, and 97.9% for 10 years and 94.1% for 15 years on the stem side. The results were more satisfactory than those obtained for the patients who underwent cemented total hip arthroplasty at our department. Concerning the models used, H/G was used first and afterward AML, Anatomic, Metasul were used frequently and each device had its own features. Revision was required in 21 cases. Examination of individual cases revealed problems in the activities or age of the patients themselves, technical problems, and/or problems of the device itself. However, we consider that patient satisfaction and improvement of ADL were achieved from the overall results.

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Cementless total hip arthroplasty (cementless THA) is a surgical approach established as a treatment for coxarthrosis. However, this approach is very invasive and associated with many worrying factors including whether the operation is safe especially in an elderly patient, whether stable primary fixation is available and whether walking is achieved immediately after operation or in the long term. This study investigated the usefulness of cementless THA with emphasis on comparison with clinical results of the femoral head prosthetic replacement performed for femoral neck fractures. The subjects were 133 joints in patients aged 75 years and older who underwent cementless THA at our department. The radiographic evaluation was used to examine biological fixation and the incidence of stress shielding by the implant according to the classification of Engh. Although a variety of components were used, the biological fixation did not differ among components. There were no findings showing obvious implant loosening by bone ingrowth fixation in 96% of the subjects and by fibrous fixation in the remaining 4%, and none of the patients required re-replacement. Stress shielding was found at a high frequency with AML models. Strong fixation was obtained in the distal region of the femur but atrophy of the proximal cortical bone became remarkable at the same time, although none of the cases had any clinical issue. A high incidence of stress shielding occurred in cases of 13-mm stem size and over, canal-flare index under3, and cortical index under 0.4. We consider treating preservation bone quality and select the stem to maintain as much bone stock as possible in case of wide marrow cavity. Clinical results were evaluated by follow-up examination of outpatients, death rates during 1-5 postoperative years, and the walking status at discharge from hospital up to 5 postoperative years in the following three groups: THA, monopolar head and bipolar head. No significant difference was observed between the monopolar and bipolar groups. The follow-up rate as outpatients and survival rate of the THA group were higher in comparison to those of the other two groups. About 90% of patients were ambulant or walked with a cane immediately after discharge from hospital. Both pain and ADL, parameters set by the Japanese Orthopaedic Association to evaluate hip joint function, improved remarkably in comparison to the preoperative condition. The cementless THA is considered to be relatively satisfactory and effective and does note present serious complications.

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Leukocyte-derived chemotaxin 2 (LECT2) is one of the cytokines related to hepatic injury. However, knowledge of the role of LECT 2 in chronic viral hepatitis is still incomplete. In this study the behavior of LECT2 in various conditions of chronic viral hepatitis was examined and compared with the appearance of hepatitis-related cytokines including IL-8 and IL-18. Hepatic specimens, 76 for study and 5 as a control, were obtained by needle biopsy. Of the study specimens, 11 were hepatitis B cases and 65 were hepatitis C. All specimens were examined histologically and immunohistochemically using anti-LECT2-antigen, anti-IL-S-atigen and anti-IL-18-antigen as primary antigens. The condition of chronic viral hepatitis including grading (activity) and staging (fibrosis) were histopathologically determined according to the Modified HAI Score. Immunohistopathological examination of IL-8 and IL18 revealed mesenchymal cells including Kupffer cells and endothels; and LECT2 in hepatic cells showed some differences between the expression of cystokines and the phase of viral hepatitis. Though the expression rates increased with the degree of grading, IL-8 and LECT2 also appeared in normal hepatic tissues. In conclusion, immunohistochemical examination of some cytokines such as LECT2, IL-8 and IL-18 is useful to determine the grade of chronic viral hepatitis. In addition, over-expression of LECT2 and IL-18 suggest the process to recovery and of LECT2 suggesting the reserve potentiality of rest hepatic cells in chronic viral hepatitis.

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A young rugby hootball player aged 24 year old fell down on the ground. His right ring finger with subcutaneous rupture of the FDP tendon with avulsion and transverse fracture at the base of the distal phalanx was treated successfully. The transverse fracture was fixed with Kirschner's wire and avulsed fragment which has tendon insertion was reduced and fixed with soft wire strongly. His finger has completely normal ROM and no pain post operatively. There were only 4 reports about this type of injury in Japan, including our case.

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