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Mori T.,Keio University | Tanaka M.,Kanagawa Cancer Center | Kobayashi T.,Tokyo Metropolitan Komagome Hospital | Ohashi K.,Tokyo Metropolitan Komagome Hospital | And 11 more authors.
Biology of Blood and Marrow Transplantation

Although the use of cord blood transplantation (CBT) is increasing, the optimal methods for conditioning and graft-versus-host disease (GVHD) prophylaxis remain to be established. Among previous reports, the Institute of Medical Science, University of Tokyo (IMSUT) has reported remarkably favorable results of CBT for hematologic malignancies as a single-institute experience. The aim of the present multicenter prospective study was to assess the safety and efficacy of CBT performed precisely according to IMSUT transplantation procedures. Thirty-three adult patients with hematologic malignancies, such as acute leukemia, chronic myelogenous leukemia, or myelodysplastic syndrome, either lacking an HLA-identical sibling/HLA-matched unrelated donor or requiring urgent transplantation were enrolled. Conditioning consisted of total body irradiation (12 Gy), cytarabine, and cyclophosphamide. Cyclosporine A and methotrexate were used for GVHD prophylaxis. Diagnoses were acute leukemia in 26 patients, chronic myelogenous leukemia in 4, and myelodysplastic syndrome in 3; 12 patients were in first complete remission, and the others were in advanced stages at the time of CBT. Thirty-one patients achieved engraftment, and the cumulative incidence of grade II-IV acute GVHD was 45% (95% confidence interval, 28%-62%). With a median follow-up of 46.2 months in 16 surviving patients, the 1-year cumulative incidence of nonrelapse mortality was 15% (95% confidence interval, 5%-30%). Causes of nonrelapse mortality were infection (n = 4) and graft failure (n = 1). The overall and disease-free survival rates were 51% (95% CI, 34%-68%) and 42% (95% CI, 26%-59%), respectively. These results suggest that the IMSUT CBT procedures can safely provide a high disease-free survival rate in patients with high-risk hematologic malignancies. © 2013 American Society for Blood and Marrow Transplantation. Source

Koda M.,Chiba Aoba Municipal Hospital | Dezawa M.,Tohoku University | Toyama Y.,Chiba University | Yoshinaga K.,Chiba Rehabilitation Center

The aim of this study was to evaluate whether transplantation of human bone marrow stromal cell-derived Schwann cells (hBMSC-SC) promotes functional recovery after contusive spinal cord injury of adult rats. Human bone marrow stromal cells (hBMSC) were cultured from bone marrow of adult human patients and induced into Schwann cells (hBMSC-SC) in vitro. Schwann cell phenotype was confirmed by immunocytochemistry. Growth factors secreted from hBMSC-SC were detected using cytokine antibody array. Immunosppressed rats were laminectomized and their spinal cords were contused using NYU impactor (10g, 25mm). Nine days after injury, a mixture of Matrigel and hBMSC-SC (hBMSC-SC group) was injected into the lesioned site. Five weeks after transplantation, cresyl-violet staining revealed that the area of cystic cavity was smaller in the hBMSC-SC group than that in the control group. Immunohistochemstry revealed that the number of anti-growth-associated protein-43-positive nerve fibers was significantly larger in the hBMSC-SC group than that in the control group. At the same time, the number of tyrosine hydroxylase- or serotonin-positive fibers was significantly larger at the lesion epicenter and caudal level in the hBMSC-SC group than that in the control group. In electron microscopy, formation of peripheral-type myelin was recognized near the lesion epicenter in the hBMSC-SC group. Hind limb function recovered significantly in the hBMSC-SC group compared with the control group. In conclusion, the functions of hBMSC-SC are comparable to original Schwann cells in rat spinal cord injury models, and are thus potentially useful treatments for patients with spinal cord injury. © 2010 Japanese Society of Neuropathology. Source

Kawabe J.,Chiba University | Koda M.,Chiba Aoba Municipal Hospital | Hashimoto M.,Chiba University | Fujiyoshi T.,Chiba University | And 4 more authors.
Journal of Neurosurgery: Spine

Object. Granulocyte colony-stimulating factor (G-CSF) has neuroprotective effects on the CNS. The authors have previously demonstrated that G-CSF also exerts neuroprotective effects in experimental spinal cord injury (SCI) by enhancing migration of bone marrow-derived cells into the damaged spinal cord, increasing glial differentiation of bone marrow-derived cells, enhancing antiapoptotic effects on both neurons and oligodendrocytes, and by reducing demyelination and expression of inflammatory cytokines. Because the degree of angiogenesis in the subacute phase after SCI correlates with regenerative responses, it is possible that G-CSF's neuroprotective effects after SCI are due to enhancement of angiogenesis. The aim of this study was to assess the effects of G-CSF on the vascular system after SCI. Methods. A contusive SCI rat model was used and the animals were randomly allocated to either a G-CSF - treated group or a control group. Integrity of the blood-spinal cord barrier was evaluated by measuring the degree of edema in the cord and the volume of extravasation. For histological evaluation, cryosections were immunostained with anti-von Willebrand factor and the number of vessels was counted to assess revascularization. Real-time reverse transcriptase polymerase chain reaction was performed to assess expression of angiogenic cytokines, and recovery of motor function was assessed with function tests. Results. In the G-CSF-treated rats, the total number of vessels with a diameter > 20 mm was significantly larger and expression of angiogenic cytokines was significantly higher than those in the control group. The G-CSF - treated group showed significantly greater recovery of hindlimb function than the control group. Conclusions. These results suggest that G-CSF exerts neuroprotective effects via promotion of angiogenesis after SCI. Source

Abe Y.,Chiba Rosai Hospital | Rokkaku T.,Chiba Aoba Municipal Hospital | Tokunaga S.,Chiba University | Yamada T.,Chiba Aoba Municipal Hospital | Okamoto S.,Chiba University
Journal of Plastic, Reconstructive and Aesthetic Surgery

Objective This retrospective study reports 10 patients with closed mallet thumb injury treated with surgery and compares the clinical outcomes achieved with those of previously described patients who were treated with either conservative therapy or surgery. Methods We report the outcomes of a series of 10 patients who received surgical treatment at our institutions. Due to the rarity of closed mallet thumb, a systematic review was conducted, and the results of a literature search were compared with our case series to strengthen our conclusions. The previously described patients were categorized into two groups: the surgically treated group (16 patients) and the conservatively treated group (10 patients). The following patient and injury characteristics were documented: age, gender, injured side, time from injury to treatment, mechanism of injury, extension lag at first visit, postoperative range of motion (ROM) of the interphalangeal joint, immobilization period, and follow-up period. Results Statistical analyses showed no significant differences in the clinical results, except for shorter immobilization periods between our series and the previously described patients involving conservative treatment (4.9 ± 0.9 vs. 9.5 ± 2.3 weeks, respectively; P = 0.0053). Conclusions This study suggests that surgery may result in more rapid recovery. © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Source

Tatsuno I.,Toho University | Terano T.,Chiba Aoba Municipal Hospital | Nakamura M.,Chiba City Medical Association | Suzuki K.,Chiba Foundation for Health Promotion and Disease Prevention | And 6 more authors.
Endocrine Journal

Osteoporosis causes an enormous health and economic impact in Japan. We investigated the relation between lifestyle and bone fracture in middle-aged and elderly women. This was a population-based, multicenter, cross-sectional survey for postmenopausal osteoporosis in Chiba City, Japan (Chiba bone survey). This survey included 64,809 Japanese women aged > 40 years. All participants underwent anthropometric measurements including bone mineral density (BMD) and completed a structured, nurse-assisted, self-administered questionnaire also including patient lifestyle. Bone fracture during the recent 5 years was observed in 5.3%, and the fracture group had significantly higher age, BMI, and prevalence of delivery, family histories of kyphosis and hip fracture, diabetes mellitus (DM), dyslipidemia, kidney disease, exercise, fall, and osteoporosis, and had significantly lower BMD and proportion of menstruating participants. Logistic regression analysis revealed that bone fracture was closely associated with not only low bone mass but also age, fall, family histories of kyphosis and hip fracture, DM, kidney disease, menopause, and lifestyle factors of dieting, exercise, and alcohol. Women's health care focusing on lifestyle-related fracture risks such as dieting, exercise, and alcohol appears necessary to prevent bone fracture in postmenopausal osteoporosis. © The Japan Endocrine Society. Source

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