Taketsugu Fujibuchi

Expression and phosphorylation of TOPK during spermatogenesis

Among normal organs and tissues, the MAPKK‐like mitotic protein kinase TOPK is expressed exclusively in the testis. We analyzed the expression and phosphorylation of TOPK to address the functional role of this kinase during spermatogenesis. TOPK protein is expressed mainly in the cytosol of spermatocytes and spermatids, but not in spermatids and spermatogonia in situ. TOPK‐Thr‐9, a cdk1/cyclin B target residue, was specifically phosphorylated during mitotic and meiotic phases, while TOPK‐Thr‐198, a key amino acid for the ATP pocket, was constantly phosphorylated irrespective of the cell cycle. These data indicate that spermatogenic germ cells with vital proliferation activity express TOPK. As TOPK‐Thr‐9 was phosphorylated during both mitosis and meiosis, TOPK was indicted to play a role in cytokinesis and/or chromosomal segregation but not in DNA replication.

Reconstruction surgery for patients with musculoskeletal tumor, using a pasteurized autogenous bone graft.

BackgroundThe pasteurized autogenous bone graft (PABG) is a new method to reuse resected and diseased autogenous bones after heat treatment at a comparatively low temperature (60°C–65°C).MethodsThe subjects of this study were ten patients with musculoskeletal tumor who underwent surgery with a PABG in the 6 years between 1995 and 2000.ResultsThe pasteurized bone developed into bone union in all patients, except for the elderly patients who required repeat surgery. There were no infected patients. The PABG was performed by three different types of reconstruction, a segmental method, an intercalary method, and a combination method with an artificial joint as a spacer. No local recurrence of tumor the pasteurized bone was observed from in any patient.ConclusionThe PABG appears to be a comparatively easy, safe, inexpensive, and effective reconstruction method for musculoskeletal tumors.

SYNOVIAL HEMANGIOMA OF THE KNEE JOINT IN A 3-YEAR-OLD GIRL

Synovial hemangioma has been reported to be relatively rare, and usually occurs in childhood and adolescence. However, there are a few reports of the disease in infants. In this report, we diagnosed synovial hemangioma in a 3-year-old girl who had swelling and pain in her left knee. Gadolinium-enhanced magnetic resonance imaging revealed abnormal intensity in an intra-articular lesion. We performed arthroscopy, and arrived at a final diagnosis based on a scopic biopsy. Synovial hemangioma should be considered as a possible diagnosis in infants with swelling and pain in the knee.

Mycetoma of foot: a rare case report and review of the literature.

Mycetoma is a chronic infectious disease caused by Actinomycetes, Nocardia, Madurello, Exophiala and Scedosporium, in which a granuloma with draining lesions occur in the foot. It is frequently found in tropical or subtropical regions where people walk barefoot.10,12,25 We report a case of mycetoma in which the patient had never been abroad and whose route of infection was unknown. It was difficult to differentiate from a musculoskeletal tumor.

Definitive intraoperative radiotherapy for musculoskeletal sarcomas and malignant lymphoma in combination with surgical excision

AbstractBackground. The purpose was to estimate retrospectively the outcome of patients with musculoskeletal sarcoma or malignant lymphoma treated with intraoperative radiotherapy (IORT). Methods. Between 1988 and 1999, definitive IORT in combination with surgical excision was performed in 24 patients with musculoskeletal sarcoma (malignant fibrous histiocytoma, 10; osteosarcoma, 6; liposarcoma, 2; chondrosarcoma, 1; synovial sarcoma, 1; Ewings sarcoma, 1; angiosarcoma, 1; epithelioid sarcoma, 1; malignant schwannoma, 1) and 3 patients with malignant lymphoma. The tumor was excised by marginal margin excision, intralesional margin excision, or wide margin excision; 15–45 Gy electrons was then delivered to the affected sites. Results. In the 8 patients without distant metastases at the first visit, 4 patients are alive 6.5–11.5 years after IORT, and 4 patients died <4.5 years after IORT. The incidence of local recurrence was 13%. In the 19 patients with distant metastases at the first visit, 3 patients are alive 2.5–6.7 years after IORT, and 16 patients died 0.2–5.7 years after IORT. The incidence of local recurrence was 45%. Complications after IORT were found in 5 patients: neuropathy, 1 patient; skin necrosis, 1 patient; myelopathy, 1 patient; enteritis ileus, 1 patient; and edema, 1 patient. Conclusion. IORT with a radiation dose of 15–45 Gy in combination with surgical excision appeared to be useful for local control and to be more effective in patients without distant metastases at the first visit than in patients with distant metastases.

Polyostotic fibrous dysplasia with gigantism and huge pelvic tumor: a rare case of McCune–Albright syndrome

We report a rare case of polyostotic fibrous dysplasia on endocrine hyperfunction with elevated human growth hormone and normal serum level of prolactin. There were some differential points of gender, gigantism, endocrine function, and GNAS gene from McCune–Albright syndrome. Malignant transformation was suspected in the pelvic tumor from imaging because rapid growth of the tumor by imaging was observed; however, no malignant change occurred in this case.

Cytogenetic study of secondary malignancy in giant cell tumor.

Giant cell tumor (GCT) is classified as a benign bone tumor, but it is locally aggressive, and sometimes metastasizes in a benign state. In addition, malignant transformation occurs once in a while. Most of the secondary malignancies in GCT occur after treatment of benign GCT that has included radiation therapy [1, 2]. As a cytogenetic characteristic of GCT, telomeric associations (tas) were reported [3, 4]. Tas may generate dicentric chromosomes (dic) and chromatoid breakagefusion-bridges, which lead to chromosomal instability and tumorigenesis [5, 6]. Recently, the relationship between cytogenetic abnormalities and clinical behavior in GCT has begun to be elucidated. For example, the DNA ploidy pattern may predict the recurrence potential of GCT, chromosomal abnormalities superimposed on tas are responsible for an aggressive clinical course [7], and centrosome amplification may be useful in predicting the clinical behavior of GCT [8]. Here we report a case of secondary malignancy in GCT. Malignant transformation occurred in a relatively early period, and any radiation therapy was not administered to the primary lesion. Malignant transformation was demonstrated not only by histopathological study but also by cytogenetic analysis. The recurrent tumor, which was a secondary malignancy in GCT, had a near-triploid karyotype with multiple structural abnormalities as observed in pleomorphic sarcoma, while the primary benign GCT had a near-diploid karyotype with tas and dic.

Subdural spinal granuloma resulting from Candida albicans without immunosufficiency: case report.

Study Design. This was a case of spinal subdural granuloma of Candida albicans. A high cerebrospinal fluid protein level without pleocytosis (albuminocytologic dissociation) was observed. This case proved difficult to diagnose and treat. Objectives. To clarify the important issues in regard to the diagnosis and treatment of possible spinal subdural granuloma resulting from C. albicans. Summary of Background Data. Reports on subdural infection of C. albicans are very rare. Moreover, there are no reports of cases in which patients have survived this type of infection. Methods. A 66-year-old man developed paralysis in the lower limbs, as well as vesicorectal disorder (anuresis). There were no obvious causes. Signs of meningeal irritation later appeared. A high cerebrospinal fluid protein level without pleocytosis was observed through a laboratory test. The cause of these disorders was unclear, and a final diagnosis could not be made on the basis of the test results and angiograph. Possible diagnoses included tumor, infection, and others such as Guillain-Barré syndrome. The authors therefore carried out surgery to reduce the pressure on the spinal cord and ultimately make a definitive diagnosis. Results. The final diagnosis was spinal subdural granuloma of C. albicans. Granuloma was widespread (T3–T10). Surgery, various drug treatments, and hyperbaric oxygen therapy all contributed to saving the patient’s life. Conclusion. This was a very rare case of spinal subdural granuloma resulting from C. albicans, and the authors had difficulty diagnosing and treating the patient. A distinctive gadolinium-enhanced MRI was obtained. The effect of treatment by drugs alone was limited. An intraoperative ultrasonography proved useful. The authors concluded that a combination of early surgery and hyperbaric oxygen therapy was effective.

Risk factors for neurological complications after operative treatment for schwannomas

Schwannoma is a common benign soft tissue tumor. Although schwannomas can be theoretically enucleated without nerve damage, neurological complications occasionally develop following enucleation. The aim of this study was to elucidate the incidence of and risk factors for postoperative neurological complications following schwannoma enucleation. Ninety-eight schwannomas from 95 patients that were treated by surgical excision between January 2003 and December 2014 were included in this retrospective case series study. Patients were 49 men and 46 women with a median age of 60.5years (range, 22-87years). The incidence of postoperative neurological complications was evaluated in all the patients, and characteristics, such as age, tumor size, sex, preoperative symptoms, MRI findings, tumor location, and the nerve of origin, were compared between the cases with or without complications at the last follow-up. In our study population, postoperative neurological complications were observed in 18.4% of the cases. In univariate analysis, preoperative sensory disturbance, tumor location, and the nerve of origin were associated with the incidence of postoperative neurological complications (p<0.001, p=0.034, and p=0.003, respectively). In multivariate analysis, tumors showing preoperative sensory disturbance and tumors located in the proximal aspect of the limbs were identified as independent risk factors for postoperative neurological complications (p<0.001 and p=0.014, respectively). A certain percentage of schwannoma cases undergoing enucleation would show postoperative neurological complications. Therefore, patients with schwannoma, in particular, those with risk factors for postoperative neurological complications, should be informed regarding the possibility of postoperative complications. In cases of schwannoma enucleation, the procedure should be meticulously performed to minimize the damage to the affected nerve of origin.

A case of nodular-type muscular sarcoidosis: findings of imaging, histopathology, and polymerase chain reaction

We report a case of nodular-type muscular sarcoidosis with no systemic symptoms. Thallium-201 scintigraphy showed intense uptake in the muscular lesion mimicking malignant soft tissue tumor. Magnetic resonance imaging (MRI) demonstrated characteristic signal patterns of peripheral high intensity with central low intensity (“three stripes” pattern). Microscopy revealed sarcoid granuloma with typical histopathological characteristics. Propionibacterium acnes was detected on polymerase chain reaction analysis of the excised tissue.