Gene expression of periostin in the early stage of fracture healing detected by cDNA microarray analysis.

To comprehensively evaluate gene expression in the early stage of fracture healing, we used a cDNA microarray with 2304 cDNA clones derived from an oligo-capped mouse embryo library. Closed mid-diaphyseal fractures were created in mouse tibiae and expression profiles were analyzed 3 days after fracture. Six genes were up-regulated in comparison to those in unfractured bones and these included three genes previously identified but never shown to be present in fractures, periostin, calumenin, and FHL-1.

Transplanted hematopoietic stem cells from bone marrow differentiate into neural lineage cells and promote functional recovery after spinal cord injury in mice.

Recovery in central nervous system disorders is hindered by the limited ability of the vertebrate central nervous system to regenerate lost cells, replace damaged myelin, and re-establish functional neural connections. Cell transplantation to repair central nervous system disorders is an active area of research, with the goal of reducing functional deficits. Recent animal studies showed that cells of the hematopoietic stem cell (HSC) fraction of bone marrow transdifferentiated into various nonhematopoietic cell lineages.

Long-term outcomes of surgical treatment for tethered cord syndrome.

Surgical outcomes for tethered spinal cord syndrome (TCS) associated with low-lying conus medullaris were evaluated. We investigated the long-term results of untethering the spinal cord and dural plasty in surgical patients with a wide age range. Improvement of bladder dysfunction and suppression of leg deformity progression were noted in two pediatric patients.

Surgical treatment of cervical spondylotic myelopathy associated with athetoid cerebral palsy.

After a mean follow-up period of 7 years (range 4-17 years), we reviewed the cases of 14 patients who underwent surgical treatment for cervical spondylotic myelopathy associated with athetoid cerebral palsy. All of the patients who underwent anterior decompression and arthrodesis showed degeneration and increased range of motion of the adjacent disc despite halo-vest immobilization postoperatively. Laminoplasty is useful in cases in which physiological lordosis is present preoperatively, whereas a case with preoperative kyphotic deformity showed increased neurological symptoms and deterioration of activities of daily living postoperatively due to increased kyphotic deformity and canal stenosis.

Factors predicting the prognosis of lumbar radiculopathy due to disc herniation.

This study was designed to determine the prognostic factors in unilateral lumbar radiculopathy due to herniated nucleus pulposus (HNP); this was done by prospectively investigating the clinical course of consecutive patients with HNP. The study population consisted of 131 patients who complained primarily of unilateral leg pain, and who were examined by magnetic resonance imaging (MRI) to establish a definite diagnosis. Patients with a questionable diagnosis were excluded.

Relation between the painful shoulder and the cervical spine with narrow canal in patients without obvious radiculopathy.

It is well known that cervical radiculopathy sometimes causes shoulder pain. Hypothesizing that the cause of painful shoulder is related to the cervical spine in the absence of obvious radiculopathy, we measured the anteroposterior diameter of the spinal canal and the range of motion of the cervical spine in patients with painful shoulder on lateral cervical radiographs of the spine. Painful shoulder was diagnosed in 76 patients (24 men and 52 women; mean age 57.

Association of the human NPPS gene with ossification of the posterior longitudinal ligament of the spine (OPLL).

OPLL (ossification of the posterior longitudinal ligament of the spine) is a common form of human myelopathy with a prevalence of as much as 4% in a variety of ethnic groups. To clarify the genetic factors that predispose to OPLL, we have studied ttw (tiptoe walking), a mouse model that presents ectopic ossification of the spinal ligaments similar to OPLL and have found that the ttw phenotype is caused by the nonsense mutation of the gene encoding nucleotide pyrophosphatase (NPPS), a membrane-bound glycoprotein thought to produce inorganic pyrophosphate, a major inhibitor of calcification and mineralization. To investigate a possible role of NPPS in the etiology of OPLL, we have examined its genetic variations in OPLL patients.

Cloning of translocation breakpoints associated with Shwachman syndrome and identification of a candidate gene.

Shwachman syndrome is an autosomal-recessive disorder characterized by exocrine pancreatic insufficiency, bone-marrow dysfunction, and metaphyseal chondrodysplasia. A de novo balanced translocation was recently documented in a patient with this disease. Toward isolating the gene(s) responsible for Shwachman syndrome, we cloned and sequenced the translocation breakpoints in the DNA of this patient.

Genomic organization, mapping, and polymorphisms of the gene encoding human cartilage intermediate layer protein (CILP).

The CILP gene encodes a proform of two polypeptides. One of them, cartilage intermediate layer protein (CILP), is a non-collagenous protein recently isolated from human articular cartilage. The other is homologous to a porcine nucleotide pyrophosphohydrolase (NTPPHase) whose enzymatic activity is highest in articular tissue.

Calcitonin simultaneously regulates both periosteal hyperostosis and trabecular osteopenia in the spinal hyperostotic mouse (twy/twy) in vivo.

The twy (tiptoe-walking-Yoshimura) mouse, established in Japan in 1978 by brother-sister mating of ICR strain mice, is a valuable mutant as a model of ossification of the posterior longitudinal ligament (OPLL). OPLL causes severe myelopathy and has been thought to be very similar to ankylosing spinal hyperostosis (ASH) and diffuse idiopathic skeletal hyperostosis (DISH). In the twy mouse, both an increase in vertebral cortical membranous bone formation and a decrease in trabecular bone mass due to accelerated bone resorption occur simultaneously.

Dynamic motion study of the whole lumbar spine by videofluoroscopy.

Study Design: Dynamic lumbar flexion-extension motion was assessed by videofluoroscopy.

Objectives: To identify the motion patterns of the whole lumbar spine in normal subjects and in patients with low back pain or spondylolisthesis during actual movement.

Summary Of Background Data: Assessment of lumbar instability on terminal radiographs is controversial.

Mutation in Npps in a mouse model of ossification of the posterior longitudinal ligament of the spine.

Ossification of the posterior longitudinal ligament of the spine (OPLL) is a common form of human myelopathy caused by a compression of the spinal cord by ectopic ossification of spinal ligaments. To elucidate the genetic basis for OPLL, we have been studying the ttw (tiptoe walking; previously designated twy) mouse, a naturally occurring mutant which exhibits ossification of the spinal ligaments very similar to human OPLL (refs 3,4). Using a positional candidate-gene approach, we determined the ttw phenotype is caused by a nonsense mutation (glycine 568 to stop) in the Npps gene which encodes nucleotide pyrophosphatase.

Regression of cervical disc herniation observed on magnetic resonance images.

Study Design: A retrospective study of cervical disc herniation using results of repeated magnetic resonance imaging examinations.

Objectives: To clarify the cervical disc herniation morphological changes over time in order to establish a strategy for treatment.

Summary Of Background Data: In the authors' previous magnetic resonance imaging follow-up study of patients with lumbar disc herniation, spontaneous regression was observed in the sequestration-type lesions, and it was found that the tendency toward regression differed based on the anatomic position of extruded disc material.

Contrast-enhanced magnetic resonance imaging in conservative management of lumbar disc herniation.

Study Design: This study was designed to investigate the morphologic changes in contrast-enhanced magnetic resonance imaging that occur during conservative treatment of patients with unilateral leg pain resulting from herniated nucleus pulposus without significant lumbar canal stenosis.

Objectives: To compare the morphologic results with clinical outcomes to ascertain whether enhanced magnetic resonance imaging contributes to the management of lumbar disc herniation.

Summary Of Background Data: Contrast-enhanced magnetic resonance imaging has already been reported to be useful in the postoperative examination of the lumbar spine and in visualization of symptomatic nerve roots.

Sequential dynamics of monocyte chemotactic protein-1 expression in herniated nucleus pulposus resorption.

We previously demonstrated that the granulation tissues of herniated nucleus pulposus are composed of a marked infiltration of macrophages that strongly express monocyte chemotactic protein-1. Monocyte chemotactic protein-1 is a chemotactic cytokine that contributes to the activation and recruitment of macrophages. Relatively little is known about its role in the resorption process of herniated nucleus pulposus.

Evaluation of motor function during thoracic and thoracolumbar spinal surgery based on motor-evoked potentials using train spinal stimulation.

Study Design: Using compound muscle action potentials after train spinal stimulation, intraoperative motor functional monitoring was performed during thoracic and thoracolumbar spinal surgery.

Objectives: This study was designed to clarify the clinical usefulness of train spinal stimulation and to determine the critical point of compound muscle action potential change at which neurologic injury during surgery occurs.

Summary Of Background Data: In 1995 the authors reported that train spinal stimulation allows for the recording of compound muscle action potentials, even in animals and humans under general anesthesia.

Chemonucleolysis with human stromelysin-1.

Study Design: Immunohistologic analysis was performed on surgically removed samples of herniated nucleus pulposus to examine the expression of stromelysin-1. We performed in vitro and in vivo experiments to determine whether recombinant human (rh) stromelysin-1 is capable of degrading nucleus pulposus.

Objective: To analyze the production of stromelysin-1 in various types of herniated nucleus pulposus, and to examine the effects of this recombinant protein on nucleus pulposus tissues.

A cadaveric study on the stability of lumbar segment after partial laminotomy and facetectomy with intact posterior ligaments.

This study aimed to biomechanically investigate a change in the stability of decompressed segments in the degenerative lumbar spine. Cyclic loading tests to the cadaveric spinal unit were conducted in compressive and bending directions with a stepwise resection of the posterior elements such as wide fenestration (partial laminotomy), unilateral and bilateral facetectomy with the intact supra- and interspinous ligaments and spinous process. Flexion stability did not decrease significantly, and may reflect the fact that the aforementioned ligamentous structures were preserved throughout the resection process.

Upregulated expression of chemokines in herniated nucleus pulposus resorption.

Study Design: Immunohistologic examination was performed on surgically removed samples of herniated nucleus pulposus.

Objectives: To determine what cell types predominate in the granulation tissues of herniated nucleus pulposus, and to elucidate whether chemokines are involved in the resorption process of herniated nucleus pulposus. SUMMARY OF BACKGROUND DATA.

The cervical spine in athetoid cerebral palsy. A radiological study of 180 patients.

We have reviewed the cervical spine radiographs of 180 patients with athetoid cerebral palsy and compared them with those of 417 control subjects. Disc degeneration occurred earlier and progressed more rapidly in the patients, with advanced disc degeneration in 51%, eight times the frequency in normal subjects. At the C3/4 and C4/5 levels, there was listhetic instability in 17% and 27% of the patients, respectively, again six and eight times more frequently than in the control subjects.