Kunihiko Murai

In vivo cell tracking by bioluminescence imaging after transplantation of bioengineered cell sheets to the knee joint

In our previous studies, we have demonstrated effective regeneration of cartilage through the creation and application of layered cell sheets that combine both chondrocytes and synovial cells. In this study, we were able to demonstrate that cells derived from cell sheets can survive for long periods after transplantation into rat knee joints having osteochondral defects. We established a method for generating cell sheets from firefly luciferase-expressing chondrocytes obtained from transgenic Lewis rats, and carried out allogenic transplantation of these cell sheets into wild-type Lewis rats. We then administered luciferin and monitored the survival of the transplanted cells by using bioluminescence imaging (BLI). Our data showed that the transplanted cells survived and could be detected for more than 21 months, which was longer than expected. Furthermore, the BLI data showed that the transplanted cells remained in the knee joint and did not migrate to other parts of the body, thus confirming the safety of the cell sheets. In this study, we monitored the duration of survival of cell sheets composed of only chondrocytes, only synovial cells, or both chondrocytes and synovial cells, and found that all three types of cell sheets survived for an extended period of time.

Epiduroscopy for intractable low back pain or sciatica in operated and non-operated back patients: results from The Japan Society of Epiduroscopy

Abstract Objectives: Several studies have demonstrated the advantages of epiduroscopy versus conservative therapies for low back pain with few studies evaluating the results in operated and non-operated back patients. We compared the effects and complications of epiduroscopy between these patients. Patients and methods: A multi-institutional, prospective, clinical study was performed in 183 patients whose low back and leg pain had failed to respond to conservative therapies. Patients were divided into an operated back (Op) group and a non-operated (Non-op) group. Japanese Orthopedic Association (JOA) score, the Japanese version of the Roland-Morris Disability Questionnaire (JRMDQ) scores, and 100-mm visual analogue scales (VAS) for leg pain, leg numbness, low back pain and dissatisfaction with ADL were recorded before and at 1 month and 3 months after epiduroscopy. Results: All scores significantly improved at 1 month and 3 months after epiduroscopy in both groups. JOA scores in the Non-op group were sign...

Adhesions in the epidural space caused by frequent epidural blocks

We report a case of adhesions in the epidural space caused by more than 200 times epidural blocks that were observed with epiduroscopy. A 41-year-old man had repeatedly undergone lumbar epidural blocks to treat pain in his leg, resulting in decreased efficacy of the epidural block. We described endoscopic findings that these adhesions were mostly consisted of adhesions formed from the soft connective tissue.