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(of diseases) arising from an unknown cause; "idiopathic epilepsy"

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特発性疾患の(病気の原因があいまいな,また不明な場合)

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1. 骨壊死症（無血管性骨壊死症） osteonecrosis avascular necrosis of bone
2. 小児における股関節痛の概要 overview of hip pain in childhood
3. 小児における跛行の原因に関する概要 overview of the causes of limp in children
4. 妊娠中および産後の筋骨格系の変化および疼痛 musculoskeletal changes and pain during pregnancy and postpartum
5. 癌性疼痛症候群の概要 overview of cancer pain syndromes

English Journal

External and internal bone micro-architecture in normal and Kienböck's lunates: A whole-bone micro-computed tomography study.

Low SC1, Bain GI, Findlay DM, Eng K, Perilli E.Author information 1Discipline of Orthopaedics and Trauma, The University of Adelaide, Adelaide, South Australia, Australia.AbstractKienböck's disease is idiopathic osteonecrosis of the lunate, leading to its fracture and collapse. This study compares internal and external bone micro-architecture of normal and fractured lunates (Kienböck's), by using high-resolution three-dimensional (3D) micro-computed tomography (micro-CT) on the whole bone of the two lunate types, and histology. Fractured Kienböck-diseased lunates were obtained from patients undergoing proximal-row-carpectomy, while normal cadaveric lunates served as controls. 3D-micro-CT-imaging of control lunates revealed an encircling cortex surrounding trabecular bone. Trabeculae were arranged in a radial pattern, spanning from the distal to the proximal subchondral plate. Kienböck's lunates exhibited clear fracture lines, with fragmented bone, both proximally and distally, in areas the radially-patterned trabeculae and enveloping cortex were absent, producing height loss. In trabecular bone, Kienböck's lunates revealed increased bone volume fraction, trabecular thickness and number, and decreased trabecular separation and structure model index. Histologically, Kienböck's lunates revealed osteonecrosis, as well as remodeling fronts with osteoblasts and osteoid surrounding bone marrow. Whole-bone high-resolution 3D examination of normal and Kienböck's diseased lunates contributes to a better understanding of micro-architectural changes occurring in the pathology. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:826-833, 2014.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society.J Orthop Res.2014 Jun;32(6):826-33. doi: 10.1002/jor.22611. Epub 2014 Mar 10.
Kienböck's disease is idiopathic osteonecrosis of the lunate, leading to its fracture and collapse. This study compares internal and external bone micro-architecture of normal and fractured lunates (Kienböck's), by using high-resolution three-dimensional (3D) micro-computed tomography (micro-CT) o
PMID 24615945

The apoptosis of osteoblasts and osteocytes in femoral head osteonecrosis: its specificity and its distribution.

Mutijima E1, De Maertelaer V, Deprez M, Malaise M, Hauzeur JP.Author information 1Department of Pathology, CHU Sart Tilman, Sart Tilman, 4000, Liège, Belgium, E.Mutijima@chu.ulg.ac.be.AbstractThe pathogenesis of nontraumatic osteonecrosis (ON) remains unclear. Some studies have suggested that nontraumatic ON is attributed to increased osteocytic apoptosis. To test this hypothesis, a controlled study must compare the apoptosis of osteocytes and osteoblasts in cases of ON and osteoarthritis (OA). To assess either the localized or diffuse patterns of this increased osteocytic and osteoblastic apoptosis, we evaluated both the proximal and distal regions of necrotic areas. Femoral heads resected for total hip prosthesis were included for this study. Of these, 10 were ON cases-three were induced by corticosteroids, three by alcohol abuse, one resulted from trauma, one resulted from hyperlipemia, and two were idiopathic-10 were osteoarthritis cases, and 1 from a patient suffering from a subcapital fracture. The TUNEL reaction was used to detect the apoptosis in osteoblasts and osteocytes. A semi-quantitative evaluation was conducted, at both distal and proximal areas relative to the lesions, specifically in the area surrounding the necrotic region in the osteonecrosis cases, in the eburnated bone in the osteoarthritis cases, and in the subchondral bone fracture. The apoptosis of osteoblasts and osteocytes was statistically more frequent in the regions close to the necrotic areas in the ON group. No difference was found in the unpaired areas. In the ON group, no difference was found in terms of the etiological factors. During ON, the apoptosis of osteocytes and osteoblasts is increased proximally to the necrotic regions in the patients presenting with osteoarthritis and subcapital fractures. This increase was found not only in the corticosteroid-induced ON cases but also in the idiopathic and alcohol abuse- and trauma-induced ON cases.
Clinical rheumatology.Clin Rheumatol.2014 Apr 15. [Epub ahead of print]
The pathogenesis of nontraumatic osteonecrosis (ON) remains unclear. Some studies have suggested that nontraumatic ON is attributed to increased osteocytic apoptosis. To test this hypothesis, a controlled study must compare the apoptosis of osteocytes and osteoblasts in cases of ON and osteoarthriti
PMID 24733252

An Exploratory Clinical Trial for Idiopathic Osteonecrosis of Femoral Head by Cultured Autologous Multipotent Mesenchymal Stromal Cells Augmented with Vascularized Bone Grafts.

Aoyama T1, Goto K, Kakinoki R, Ikeguchi R, Ueda M, Kasai Y, Maekawa T, Tada H, Teramukai S, Nakamura T, Toguchida J.Author information 11 Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University , Kyoto, Japan .AbstractIdiopathic osteonecrosis of femoral head (ION) is a painful disorder that progresses to collapse of the femoral head and destruction of the hip joint. Although its precise pathology remains unknown, the loss of blood supply causing the loss of living bone-forming cells is a hallmark of the pathophysiology of osteonecrosis. Transplantation of multipotent mesenchymal stromal cells (MSCs) is a promising tool for regenerating the musculoskeletal system. The aim of the present study was to assess the safety and efficacy of transplantation of cultured autologous bone marrow-derived MSCs mixed with β-tricalcium phosphate (β-TCP) in combination with vascularized bone grafts for the treatment of advanced stage ION in a clinical trial. Ten patients with stage 3 ION were enrolled in this study. Autologous bone marrow-derived MSCs were cultured with autologous serum, and cells (0.5-1.0×108) were transplanted after mixing with β-TCP granules in combination with vascularized iliac bone grafts. Patients were assessed 24 months after treatment. The primary and secondary endpoints were progression of the radiological stage and changes in bone volume at the femoral head, and clinical score, respectively. Nine of ten patients completed the protocol, seven of whom remained at stage 3, and the remaining two cases progressed to stage 4. The average bone volume increased from 56.5±8.5 cm3 to 57.7±10.6 cm3. The average clinical score according to the Japan Orthopaedic Association improved from 65.6±25.5 points to 87.9±19.0 points. One severe adverse event was observed, which was not related to the clinical trial. Although the efficacy of cell transplantation was still to be determined, all procedures were successfully performed and some young patients with extensive necrotic lesions with pain demonstrated good bone regeneration with amelioration of symptoms. Further improvements in our method using MSCs and the proper selection of patients will open a new approach for the treatment of this refractory disease.
Tissue engineering. Part B, Reviews.Tissue Eng Part B Rev.2014 Apr 9. [Epub ahead of print]
Idiopathic osteonecrosis of femoral head (ION) is a painful disorder that progresses to collapse of the femoral head and destruction of the hip joint. Although its precise pathology remains unknown, the loss of blood supply causing the loss of living bone-forming cells is a hallmark of the pathophys
PMID 24593258