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Biomedical subjects

A Minami

Publications and source records attributed to A Minami.

At least 37 records · Page 2Linked to original sources
PubMed1999

Identification of macrophage migration inhibitory factor (MIF) in rat peripheral nerves: its possible involvement in nerve regeneration.

Macrophage migration inhibitory factor (MIF) is known as a pluripotent immunoregulatory cytokine involved in T-cell activation and inflammatory responses; however, no study on this protein in the peripheral nervous systems has been carried out. We here demonstrated for the first time expression of MIF mRNA and MIF protein in rat sciatic nerves by reverse transcription-polymerase chain reaction, Western blotting, and immunohistochemistry. Immunohistochemical analysis revealed positive staining of MIF, which was largely observed in Schwann cells. Furthermore, we examined MIF mRNA expression in the sciatic nerves by Northern blot analysis in the case of nerve transection. In both proximal and distal segments, the level of MIF mRNA started to increase 12 h after the nerve transection. The level remained high from 24 h up to day 7 after the injury. During the period from days 14 to 21, MIF mRNA sharply decreased to the pre-transection level. In immunohistochemistry, positive staining of MIF was largely observed in axons as well as non-neuronal cells in proximal segments at day 4 after transection. In the distal segments, contrastingly, endoneurial fibroblasts or Schwann cells migrating into neuronal fibers showed positive staining with Wallerian degeneration. Although the precise functions of MIF in the peripheral nerves remain to be elucidated, the present results could represent a major departure from the current state of knowledge, revealing a novel function in the degenerative-regenerative process.

Animals↗
PubMed1999

Two cases of inflammatory bowel disease with multiple myeloma.

A significant increase has been reported in reticuloendothelial neoplasms in patients with inflammatory bowel diseases. We present two rare cases of multiple myeloma in patients with inflammatory bowel diseases. One was in a 58-year-old woman with ulcerative colitis, and the other was in a 59-year old woman with Crohn's disease. In both patients, multiple myeloma occurred during long-term observation of inflammatory bowel disease and during the inactive stage of intestinal inflammation. The multiple myeloma appeared to have resulted from monoclonal gammopathy of undertermined significance in both patients, and was diagnosed by characteristic serum and bone marrow findings. Our findings suggested that multiple myeloma should be particularly considered in women of middle or advanced age with ulcerative colitis or Crohn's colitis and serum monoclonal gammopathy.

Female↗
PubMed1999

Surgical repair of acute collateral ligament injuries in digits with the Mitek bone suture anchor.

Eighteen acute grade III collateral ligament injuries were treated by using the Mitek bone suture anchor. Seven were thumb metacarpophalangeal joint injuries, and eleven were finger proximal interphalangeal joint injuries. Seventeen patients were followed more than 12 months after surgery. All patients were able to use the digits in daily living activities within 5 weeks after surgery, and return to their original work or sports activities within 12 weeks. Pain was completely relieved in 15 patients. Loss of joint motion averaged 7 degrees. In all joints the postoperative lateral stress angle was within 10 degrees of that of the contralateral digit.

Adolescent↗
PubMed1999

The effects of wrist distraction on carpal kinematics.

Changes in carpal kinematics under wrist distraction were studied in fresh cadaveric specimens. A magnetic tracking device measured kinematic motions of the scaphoid, lunate, and third metacarpal relative to the fixed radius in 3 planes of passive motion (coronal, sagittal, and "dart throwers") under progressive distraction loads. The change in percent contribution of the radiocarpal and midcarpal joints was calculated. Radiocarpal motion during extension was decreased as increasing traction was applied, but it increased with flexion. Motion of the scaphoid relative to the lunate was smaller in the oblique plane, resulting in less radiocarpal motion than in the sagittal plane. In the coronal plane, traction had little effect on radial deviation, but ulnar angulation of the scaphoid was greater with ulnar deviation of the wrist. These results suggest that different degrees of tension exist in the palmar and dorsal ligaments with the wrist under traction and during different planes of wrist motion. If wrist motion is desired during fixed traction, such as used clinically with external fixation, the dart-throwers motion (wrist extension with radial deviation and wrist flexion with ulnar deviation) appears to have the least impact on radiocarpal motion. If greater radiocarpal motion is desired, however, such as during postoperative mobilization, flexion-extension and radioulnar deviation will create more radiocarpal motion than the dart-thrower's motion.

Biomechanical Phenomena↗
PubMed1999

Cilostazol, a phosphodiesterase inhibitor, improves insulin sensitivity in the Otsuka Long-Evans Tokushima Fatty Rat, a model of spontaneous NIDDM.

AIM: Angiotensin converting enzyme inhibitors and alpha1-adrenergic blockers improve insulin sensitivity, the mechanism of which was considered, at least in part, to be due to the increased blood flow to muscle. The present study aimed to clarify whether cilostazol, a phosphodiesterase inhibitor, improves insulin sensitivity in a model of spontaneous non-insulin dependent diabetes mellitus (NIDDM), Otsuka Long-Evans Tokushima Fatty (OLETF) rat. METHODS: OLETF rats were divided into the two groups at the age of 16 weeks: the cilostazol-supplemented group (cilostazol 40 mg/kg/day) and the normal-diet group. As a non-diabetic control, we used Long-Evans-Tokushima-Otsuka rats (non-diabetic rats). Oral glucose tolerance test and hyperinsulinemic euglycemic clamp was performed at the ages of 23 and 25 weeks, respectively. Serum levels of lipids and leptin were measured. RESULTS: Body weight and abdominal fat was increased in OLETF rats but cilostazol supplementation did not alter them. Insulin sensitivity, as measured by the hyperinsulinemic euglycemic clamp technique, was significantly decreased in OLETF rats (glucose infusion rate: 73.5 +/- 10.0 vs. 41.5 +/- 9.8 micromol/min/kg body weight, p < 0.01). Cilostazol supplementation improved insulin sensitivity partially but significantly 51.0 +/- 5.7 micromol/min/kg body weight, p < 0.05) in OLETF rats at 25 weeks of age, although it did not decrease serum levels of glucose, lipids or leptin. However, this effect was not observed in non-diabetic rats. CONCLUSION: Cilostazol, which is used in diabetic patients for the treatment of obstructive disease of artery, is expected to have a beneficial effect on insulin sensitivity in NIDDM.

Abdomen↗
PubMed1999

Limited wrist fusions: comparison of results 22 and 89 months after surgery.

Limited wrist arthrodeses were performed to treat wrist diseases other than rheumatoid arthritis. The purpose of this study was to evaluate whether clinical and radiographic results noted 22 months after the procedure were maintained on re-examination an average of 89 months (range, 66-148 months) after the procedure. The study comprised 17 wrists. The average patient age was 42 years (range, 11-65 years). Two patients, both with Kienböck's disease, were lost to follow-up. Four radiocarpal and 11 intercarpal arthrodeses were performed. The range of motion between the first and second follow-up examination showed no significant difference. Grip strength likewise was nearly identical at both visits. At the last follow-up visit, progression of osteoarthrosis about the fusion area was noted in only 1 patient. These results suggest that the clinical and radiographic results at 22 months were maintained at the final follow-up visit and that the effect of limited wrist fusion does not deteriorate.

Adolescent↗
PubMed1999

Total wrist arthrodesis using bowed crossed K-wires.

A method of total wrist arthrodesis using a combination of autogenous iliac crest bone graft and "bowed" crossed Kirschner wires is described. The method of bowing the K-wires results in a compressive force on the iliac bone graft. This technique resulted in bony union of 22 wrists in 20 patients. The mean time to union was 12 weeks (range, 8-14 weeks). There were no major postoperative complications. The advantages of this technique are its simplicity, versatility, and reliability which mean that special internal fixation devices are not needed.

Adult↗
PubMed1999

Distally-based free vascularized tissue grafts in the lower leg.

In the field of orthopaedic surgery, the lower leg is often treated by free vascularized tissue grafts. In performing these grafts for reconstruction of the lower leg, the anterior tibial artery and its venae comitantes are frequently selected as anastomosing recipient vessels. However, due to the deep location of the anterior tibial vessels, it is extremely difficult to accomplish antegrade microsurgical anastomoses between the donor vessels and the anterior tibial vessels. This technical difficulty often leads to the possibility of immediate postoperative arterial and venous occlusion. To resolve this problem, the idea of a reverse-flow island flap has been applied to the free vascularized tissue grafts for reconstruction of the lower leg, based on both artery and vein reconstructed with retrograde blood flow. To evaluate clinical outcomes of the procedure mentioned, the postoperative results of 14 patients were reviewed. The free vascularized grafts consisted of seven vascularized fibular grafts with peroneal flaps, six vascularized latissimus dorsi myocutaneous flaps, and one vascularized groin flap. Venous congestion of the flap was not observed and all flaps survived. Bone union was obtained in seven patients treated with vascularized fibular grafts. There were no serious postoperative complications. Distally-based free vascularized tissue grafts in the lower leg are useful procedures in reconstruction of massive bone defects and osteomyelitis of the tibia, and for skin defects on the anterior aspect of the lower leg.

Adolescent↗
PubMed1999

[Osteomyelitis].

Explore the source record for details and available documents.

Adult↗
PubMed1999

Long term outcome of osteochondritis dissecans of the humeral capitellum.

Long term outcome of osteochondritis dissecans of the humeral capitellum was determined for 53 patients. The average age of the patients at the time of treatment was 16.6 years (range, 10-34 years). The average followup was 12.6 years (range, 3-25 years). Seven of 14 (50%) patients who were treated conservatively and 18 of 39 (46%) who were treated by surgical removal of the fragment were found to have residual elbow symptoms associated with daily living activities (poor outcome). The initial radiographs of the elbow were available for 45 patients; a poor outcome was seen in six of 19 (32%) early lesions and 13 of 26 (50%) advanced lesions. Fourteen elbows had evidence of osteoarthritis on the initial radiographs, and a poor outcome was seen for nine (64%) of these elbows. After removal or detachment of the fragment, seven osteochondral defects were assessed as large, and all seven had a poor outcome. These long term results suggest that the residual elbow symptoms associated with daily living activities in approximately 50% of patients may be associated with advanced lesions, osteoarthritis of the elbow, and a large osteochondral defect.

Activities of Daily Living↗
PubMed1998

Late fracture of vascularized fibular grafts.

Subsequent fractures following the bone union were analyzed in 62 cases of vascularized fibular graft reconstruction. Fifteen cases (24%) of fractures, including four cases of two fractures, were observed. All fractures but one occurred within a year after obtaining bone union. Eighteen fractures occurred in the lower extremity. In the patients with tibial reconstructions, a significantly higher incidence of fractures was demonstrated in cases where there was a large bone defect and an inaccurate alignment of the graft. Proper graft alignment is an important factor in preventing stress fractures. Vascularized fibular grafts should be protected against excessive mechanical stresses during the first year following bony graft union.

Adult↗
PubMed1998

Biomechanical analysis of limited intercarpal fusion for the treatment of Kienböck's disease: a three-dimensional theoretical study.

Although several types of intercarpal fusion have been advocated for the treatment of Kienbock's disease, the clinical outcome of each procedure is still inconclusive. The joint load and ligament tension based on a three-dimensional model were measured to determine which intercarpal fusion procedures unload the lunate and whether they alter the force transmission through the entire wrist joint. Ten theoretical models of wrists were used to simulate three different operative procedures: capitate-hamate fusion, scapho-trapezial-trapezoidal fusion, and scaphocapitate fusion. A discrete element analysis technique was used to perform these investigations. The joint force and ligament tension of normal wrists and of simulated operative procedures were calculated according to the deformation of each spring element, simulating the articular cartilage and the carpal ligaments. Scaphocapitate and scapho-trapezial-trapezoidal fusions significantly decreased the joint force at the radiolunate joint and the lunocapitate joint compared with the intact wrist. In contrast, these fusions significantly increased this value at the radioscaphoid joint in comparison with the intact wrist. In the midcarpal joint, scaphocapitate fusion also increased the joint force at the scapho-trapezial-trapezoidal joints and at the triquetral-hamate joint, whereas scapho-trapezial-trapezoidal fusion increased it at the scapho-capitate joint. Capitate-hamate fusion yielded no significant changes of the joint forces through the entire wrist joint. In the analysis of ligament tension, scaphocapitate and scapho-trapezial-trapezoidal fusions significantly decreased the tension only in the dorsal scapholunate ligament. These findings demonstrate that scaph-ocapitate and scapho-trapezial-trapezoidal fusions are effective in decompressing the lunate. By contrast, capitate-hamate fusion is ineffective in reducing lunate compression. Although scaphocapitate and scapho-trapezial-trapezoidal fusions are recommended for the treatment of Kienbock's disease, clinicians should consider that the increase of force transmission through the radioscaphoid and the midcarpal joints may lead to early degenerative changes after these procedures have been performed.

Arthrodesis↗
PubMed1998

Clinical features and management of traumatic posterior interosseous nerve palsy.

The clinical features and results of treatment were reviewed in 17 traumatic palsies of the posterior interosseous nerve. Variations in clinical features depended on whether the recurrent branch or descending branch of the posterior interosseous nerve was injured. Seven patients had nerve repair, and two were treated by tendon transfers. Eight patients were treated conservatively. Sixteen of 17 patients recovered to more than M4 motor power at final follow-up. Associated muscle damage worsened the functional result.

Adolescent↗
PubMed1998

Force transmission through the wrist joint in Kienböck's disease: a two-dimensional theoretical study.

This study quantifies the changes in force and pressure distributions across the wrist joint in different stages of Kienböck's disease using a 2-dimensional computer simulation model. Twenty-four cases classified as Lichtman's stage II, IIIA, or IIIB (8 cases in each category) were analyzed using the rigid body spring model technique. A 2-dimensional model in the posteroanterior plane of the wrist was loaded through the metacarpals under a total force of 142 N. The joint forces, peak pressures, and ligament tensions calculated on the involved side were normalized against the contralateral normal side values of the same patient. The results demonstrated that significant changes of the force transmission across the wrist joint occurred only from stage IIIA to IIIB, in which scaphoid rotation was prominent. On the basis of this study, scaphoid rotation plays an important role in affecting the wrist joint contact pressure distribution. This may be responsible for the progression of Kienböck's disease.

Biomechanical Phenomena↗
PubMed1998

Functional results of low median and ulnar nerve repair with intraneural fascicular dissection and electrical fascicular orientation.

Twenty-eight low median nerve injuries and 23 low ulnar nerve injuries were repaired using intraneural fascicular dissection and electrical fascicular orientation. Eleven freshly lacerated nerves were seen within 48 hours after injury; 40 nerve lacerations were chronic. Fascicular orientation between sensory and motor fascicles at the proximal nerve end could be accurately differentiated in 47 nerves (92%) independent of whether it was acute or chronic. At the distal nerve end in fresh lacerations, the motor fascicles could be determined conclusively by muscle contraction with sequential electrical stimulation of the fascicles. In chronic nerve lacerations, the distal fascicles could be estimated anatomically after internal neurolysis. After fascicular orientation, nerves were repaired with end-to-end group fascicular suture or interfascicular sural nerve grafting. Twenty-four nerves repaired with end-to-end suture and 13 nerves repaired with nerve grafting were monitored more than 25 months. Satisfactory sensory results (i.e., S3+ or S4 functions) were obtained in 29 nerves (78%) and M4 or M5 motor functions were achieved in 29 nerves (78%). There were no patients who needed additional tendon transfers to reconstruct thumb opposition or to correct claw finger deformity. These results suggest that low median or ulnar nerve lacerations, whether acute or chronic, partial or complete, may be successfully repaired with the aid of electrical fascicular orientation with or without intraneural fascicular dissection.

Adolescent↗
PubMed1998

Ulnar shortening for triangular fibrocartilage complex tears associated with ulnar positive variance.

Twenty-five patients with triangular fibrocartilage complex (TFCC) tears associated with ulnar positive variance who did not respond to conservative management were treated by ulnar shortening. The follow-up period averaged 35 months. All patients complained of pain, restricted forearm rotation, and weakness of grip. Arthroscopy was performed in 23 of 25 wrists to assess the status of the TFCC and the degree of the degenerative change of the proximal aspect of the lunate and triquetrum. Arthroscopic findings consisted of 15 class 1 and 8 class 2 tears according to Palmer's classification. When the TFCC showed a traumatic flap tear, only the torn flap was removed arthroscopically. Ulnar shortening averaged 3 mm. Transverse osteotomies healed in all patients at a mean postoperative time of 7 weeks. Twenty-three patients had either complete relief or occasional mild pain of the wrist. Two patients with persistent pain had additional procedures performed. Postoperative x-ray films revealed slight degenerative changes at the distal radioulnar joint in 7 patients. Complications included 1 reflex sympathetic dystrophy and 2 fractures through the osteotomy site after early plate removal. Ulnar shortening is a useful procedure for TFCC tears associated with ulnar positive variance.

Adolescent↗