The Evaluation of Lipoma Arborescens with Intermittent Knee Joint Effusion Based on an Analysis of Serum Cytokine Levels and an Immunohistological Examination: A Case Report.

We herein report a 27-year-old woman who presented with recurrent knee pain. Laboratory findings revealed minimal inflammation. Arthrography revealed structures resembling adipose tissues. Magnetic resonance imaging showed a high signal intensity of these structures, leading to the diagnosis of lipoma arborescens (LA). Synovectomy was performed. Pathology revealed adipocyte proliferation and B-cell clusters but no T-cell infiltration. A serum cytokine analysis revealed low levels of interleukin-6 and tumor necrosis factor-α compared with patients with rheumatoid arthritis. The pathogenesis of LA remains unclear, but immunostaining and serum cytokine levels may provide valuable data for future investigations.

[The Role of Pharmacists in AST in Large Hospitals and Their Training].

Since 1997, Chubu Rosai Hospital has been establishing the proper use of various antibacterial drugs through the activities of an infection control team (ICT), introduction of a notification system for specific antibacterial drug use, and intervention of ward pharmacists for individual cases. There is no infectious disease department, and we have been working closely with each other on multiple occupations. As an initiative, we established the Nagoya Southern Infection Countermeasures Meeting in 2006 and conducted antimicrobial use and resistance (AUR) surveys to promote the proper use of antimicrobial agents within the area. In April 2018, we formed an antimicrobial stewardship team (AST) and initiated activities. In addition, an AST pharmacist can share the AST results with the ward pharmacist, for proper use of antibacterial drugs and for early monitoring of infectious disease treatment and appropriate intervention, thus improving the efficiency of the ward pharmacist's work. This program will also lead to the development of training programs for the younger generation of pharmacists.

Effect of Macroscopic Grooves on Bone Formation and Osteoblastic Differentiation.

OBJECTIVES: The aim of this study is to investigate the effect of macroscopic grooves on bone formation in vivo and differentiation of human mesenchymal stem cells (hMSCs) in vitro. MATERIALS AND METHODS: The effects of macroscopic grooves on titanium alloy implants and disks were tested in rabbit tibiae and cultured hMSCs. The bone-to-implant contact (BIC) and bone area were evaluated in rabbit tibiae at 6 and 24 weeks after implant insertion. Osteoblastic differentiation was assessed by alkaline phosphatase (ALP) activity and real-time reverse-transcription polymerase chain reaction (RT-PCR) on days 7, 14, and 21. All values were statically analyzed. RESULTS: BIC and bone area inside the grooves were significantly higher than those of control implants (P < 0.05). ALP activity was significantly higher for titanium disks with macroscopic grooves than without grooves on day 14 (P < 0.05). Real-time RT-PCR showed that the expression of osteogenic genes was significantly higher for disks with grooves on day 7 (P < 0.01). CONCLUSIONS: Macroscopic grooves accelerate osteoblastic differentiation in vitro and stimulate direct bone growth and deposition within the grooves in vivo.