Masanori Nakashima

Characterization of cells cultured from human giant-cell tumors of bone. Phenotypic relationship to the monocyte-macrophage and osteoclast.

Cell culture techniques were used to clarify the histogenesis of giant-cell tumor of bone. Even after passage, nearly all of the mononuclear cells possessed tartrate-resistant acid phosphatase and receptors for eel calcitonin, which are both phenotypic markers for osteoclasts. Eel calcitonin produced an increase in the cyclic adenosine monophosphate (cAMP) content of the mononuclear cells. More than 90% of mononuclear tumor cells expressed monocyte markers; flow cytometric C3b receptor, a macrophage marker, was also detected in a few cells. These findings demonstrate that the mononuclear cells expressed phenotypes of both the osteoclast and monocyte-macrophage and that they originate in a monocyte-macrophage-osteoclast lineage. Giant-cell tumor of bone may thus provide a good model for investigating the mechanism of bone resorption in which cells of osteoclast lineage play a central role.

Prognostic factors in giant cell tumor of bone a modified histological grading system useful as a guide to prognosis

SummaryAn analysis of 26 patients with giant cell tumor of bone was carried out to determine the clinical and pathological factors affecting the prognosis of the tumor, with a follow-up program of more than 3 years. The physical characteristics of the pathological features were measured objectively using an image analyzer. A significant correlation between the therapeutic procedures and recurrence of the tumor was found, but no pathological variables were significantly correlated. Excision or resection en bloc should be performed for the initial treatment of the tumor. Local recurrence could not be predicted on the basis of histological grading. Stromal cell atypia was significantly correlated with metastasis, but multinucleated giant cells bore no correlation to either recurrence or metastasis. The use of a modified histological grading system based not on variations of the stroma and giant cells but only on the atypia of mononuclear stromal cells, either malignant or classical, is recommended for the clinical assessment of the tumor.

The Problem of Operative Treatment for Femoral Neck Fractures in the Elderly

We investigated the relationship of functional prognosis and preoperative period in 44 patients over the age of 65 with a femoral neck fracture. 23 cases were operated within 5 days from injury, 7 cases between 6-9 days, 10 cases between 10-19 days and 4 cases over 20 days. There was no significant difference in the functional prognosis among each group. But it seemed that, in early operative 23 cases, the periods of admission were shorter than those in other cases. As most of elderly patients have multiple-system complications, life-threatening problems must be recognized and addressed. Furthermore, operative treatment should be done as early as possible.

Bone Mineral Density by Digital Image Processing Method in Patients with Osteoporsis

Bone mineral density (BMD) in the second metacarpal bone was measured by Digital Image Processing method (DIP) in 146 female patients with senile osteoporosis. There was a significant correlation between age and the BMD, and also a correlation between BMD and the jidai index, which evaluated the degree of bone atrophy of the lumbar spine.The fracture and deformity of the spine with osteoporosis was showed to depend on the degree of BMD of the second metacarpal bone.When the BMD increased more than 2.1mm Al., the spine might not have the danger of the fracture and deformity.We showed that the DIP method was a useful parameter in osteoporosis.