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Biomedical subjects

A Minami

Publications and source records attributed to A Minami.

At least 73 records · Page 4Linked to original sources

The Sauvé-Kapandji procedure for osteoarthritis of the distal radioulnar joint.

The Sauvé-Kapandji procedure has been performed in 15 patients with primary and secondary osteoarthritis of the distal radioulnar joint. The average age of the patients was 45 years (range, 31-63 years). There were 12 men and 3 women. The follow-up period averaged 2 years and 11 months. Postoperative pain relief was good in all wrists. The preoperative range of motion of the wrist joint averaged 50 degrees extension and 44 degrees flexion. Forearm motion averaged 66 degrees pronation and 64 degrees supination. Postoperatively, the range of motion improved to 55 degrees extension and 51 degrees flexion at the wrist and forearm motion improved to 78 degrees pronation and 82 degrees supination. Although all wrists also showed an increased grip strength and improved range of motion over preoperative values, these did not have statistical significance. Postoperative x-ray evaluation showed an unstable proximal stump and radioulnar convergence in 12 wrists. Our clinical and x-ray film findings suggest that the Sauvé-Kapandji procedure is a satisfactory procedure for patients with osteoarthritis of the distal radioulnar joint.

Adult↗

[Endoscopic lithotomy using sublingual nitroglycerin].

After medical sphincter dilation using sud-lingual nitroglycerin, endoscopic removal of common bile duct stones in 15 patients was carried out. Complete stone removal was obtained in 14 of 15 patients. Only 0.3 mg to 0.6 mg nitroglycerin was needed to give an enough dilation of the orifice for cannulating the basket catheter into the bile duct. Mechanical lithotriptor was smoothly cannulated in one patient because of possible impaction. Blood pressure was dropped transiently in one patient by nitroglycerin, however, the general condition of the patient was stable. This procedure is safe, easy and effective in preserving sphincter function. Acute cholecystitis, a common complication of persistent gallbladder stone after endoscopic sphincterotomy, may be avoided by employing this method. More clinical studies, on long term and in a large scale of patients, are necessary to reduce complications that usually occur after sphincterotomy.

Female↗

Transient and specific expression of a cysteine endopeptidase associated with autolysis during differentiation of Zinnia mesophyll cells into tracheary elements.

Endopeptidase activities during the differentiation of Zinnia cells into tracheary elements (TEs) were examined with several peptidyl 4-methyl-7-coumarylamido (MCA) as substrates. The activity that hydrolysed carbobenzoxy-Phe-Arg-MCA (Z-Phe-Arg-MCA) at pH 5 increased in a differentiation-related manner: this activity, which was not observed in freshly isolated mesophyll cells was induced by the combination of alpha-naphthaleneacetic acid (NAA) and 6-benzyladenine (BA) that is necessary for differentiation of TEs, but not by NAA or BA alone. The activity in cells cultured in TE-inductive medium that contained both NAA and BA increased very rapidly between the 48th and 60th hours of culture, when the number of TE increased rapidly. A protease responsible for this activity with a molecular mass of 30 kDa was partially purified from cells which had been cultured in the TE-inductive medium and included many immature TEs. Strong inhibition by [L-3-trans-carboxyoxiran-2-carbonyl]-L-Leu- -agmatin (E-64), and activation by dithiothreitol (DTT) indicated that this protease belongs to a family of cysteine endopeptidases (EC 3.4.22).

Amino Acid Sequence↗

Direct dissolution of gallstones with methyl tert-butyl ether (MTBE) via endoscopic transpapillary catheterization in the gallbladder (ETCG).

In a pilot study of direct dissolution therapy of gallstones with methyl tert-butyl ether (MTBE), endoscopic transpapillary catheterization in the gallbladder (ETCG) was performed. Complete dissolution was seen in 8 out of 12 (66%) patients and partial dissolution was seen in 2 (16%) patients. In one of the 8 complete dissolution patients, combined extracorporeal shock wave lithotripsy (ESWL) and dissolution therapy was carried out successfully. These 8 patients were followed up for 12-20 months with regular ultrasonography. During this period, 1 patient underwent laparoscopic cholecystectomy due to stone recurrence. Thickening of the gallbladder wall was seen in 2 patients, but there were no other complications. Using Tsuchiya's classification based on ultrasound, complete dissolution was seen in type Ia stones. This pilot study suggests that the direct dissolution of gallstones with MTBE via ETCG might be a useful and safe non-invasive treatment in patients with cholesterol stones in preserved gallbladders.

Adult↗

Extensive subcutaneous calcification of the forearm in systemic lupus erythematosus.

We report two cases with long-standing systemic lupus erythematosus (SLE) who developed widespread calcification in subcutaneous tissue and peri-articular structures. To our knowledge only 26 case reports have appeared concerning this abnormality in SLE. However, there has been no report of calcification in an SLE patient in the literature of orthopaedic surgery. The calcifications of the forearm were marginally removed because of pain surrounding them. X-ray analysis revealed that the calcification was made of pure calcium phosphate.

Adult↗

Long-term results of Kienböck's disease treated by triscaphe arthrodesis and excisional arthroplasty with a coiled palmaris longus tendon.

Fifteen patients with Kienböck's disease were treated with scaphotrapeziotrapezoidal arthrodesis and lunate excisional arthroplasty with a coiled palmaris longus tendon replacement. Patients were classified into five groups preoperatively according to Lichtman's classification: stage IIIA, 1 patient; stage IIIB, 11; and stage IV, 3. After an average follow-up period of 57 months, the clinical results were evaluated by the method described by Lichtman et al. Twelve patients were rated as satisfactory, and three patients were rated as unsatisfactory. Clinical results were good with regard to pain relief and grip strength, but poor with regard to range of motion of the wrist. Five patients revealed postoperative progression of osteoarthritic changes at the radioscaphoid joint, and this appeared to be a main factor influencing clinical results. Two of these five patients had subsequent wrist arthrodesis. We conclude that stage IIIB is a specific indication for scaphotrapeziotrapezoidal arthrodesis.

Adult↗

Ileal lymphoma in swine.

Eleven cases of alimentary lymphoma affecting the ileum were observed among 26 cases of swine lymphoma detected by meat inspection in Kochi, Japan. The ileal lymphomas were located in the Peyer's patches, along with early involvement of regional lymph nodes, and showed a characteristic pattern of follicular invasion leading to diffuse growth. Following the National Cancer Institute Working Formulation, 10 neoplasms were classified as diffuse, large, noncleaved cell lymphomas and one neoplasm was a diffuse, mixed, small to large cell lymphoma. Both types of lymphoma featured numerous intermingled "starry sky" histiocytes. The lymphoma cells tended to infiltrate into the muscular layer of the ileum in an "Indian file" pattern. Two cases also showed transserosal metastasis into the abdomen and leukemic change. The lymphoma cells showed membrane positivity for alkaline phosphatase and diffuse cytoplasmic staining for acid phosphatase and non-specific esterase. Monoclonal intracytoplasmic immunoglobulins were demonstrated in nine neoplasms (IgM-lambda in seven, IgG-lambda in one, and IgG-kappa in one). In the areas of follicular invasion, an attenuated network of follicular dendritic cells was visualized via an antiserum against the beta subunit of S-100 protein. Ultrastructurally, strands of dilatated rough endoplasmic reticulum and scattered or clustered dense bodies were noted. When compared with feline and human alimentary lymphoma, including Burkitt's lymphoma, the present neoplasms possessed distinctive features, such as originating in Peyer's patches, transserosal metastasis, and predominantly large B cell type with IgM-lambda type immunoglobulin expression, although some features were similar.

Animals↗

Camptodactyly caused by abnormal insertion and origin of lumbrical muscle.

A 12-year-old boy had camptodactyly of the little finger. Operative findings revealed an abnormal origin of the lumbrical muscle from the transverse carpal ligament, and abnormal insertion into the tendon sheath of the flexor digitorum superficialis tendon. No similar case has been reported in the literature.

Child↗

Repair and/or reconstruction of scapholunate interosseous ligament in lunate and perilunate dislocations.

This study was undertaken to ascertain whether repair and/or reconstruction of the scapholunate interosseous ligament can prevent or reduce the occurrence of carpal instability and improve the clinical results. Thirty-two patients with lunate and perilunate dislocations were treated in the last 12 years. Of the 32, only 2 patients were seen within 4 weeks of injury, and the remaining 30 patients were seen and treated more than 4 weeks after the dislocation. Patients were followed for an average of 5 years. The scapholunate interosseous ligament was repaired and reconstructed in 12 patients (group 1). In 20 patients the ligament was not repaired or reconstructed (group 2). Clinical results were expressed by a modification of the point score method of Green and O'Brien. The scapholunate angles were measured on the lateral x-ray films with the wrist in neutral position. In group 1 clinical results averaged 82 points, while in group 2 they averaged 59 points. The scapholunate angles in group 1 averaged 50 degrees whereas in group 2 they averaged 69 degrees. These clinical and x-ray film results suggest that scapholunate interosseous ligament repair and/or reconstruction can prevent or reduce the occurrence of carpal instability and improve clinical results.

Adolescent↗

Fracture through united vascularized bone grafts.

The secondary fracture rate in 53 patients undergoing vascularized bone transfer for long-bone reconstruction, with a follow-up period of at least 2 years, is evaluated in this report. Twelve fractures occurred in 10 patients. Characteristics of the fractures were: (1) most occurred at the tibia recipient site; (2) most occurred through the transferred vascularized bone segment, rather than at its junctions; and (3) all fractures occurred within 1 year following bone union. When the fracture occurred in adults, union was relatively easily obtained by application of simple external fixation; on the other hand, union was difficult to obtain in patients with congenital pseudarthrosis of the tibia.

Adult↗

Comparison of magnetic resonance imaging and computed tomography in the local assessment of osteosarcoma.

We have compared the value of magnetic resonance imaging (MRI) with computed tomography (CT) in assessing the extent and the localization of osteosarcomas. Twenty patients were examined by both systems, and the results related to the clinical and histological findings. While both investigations are valuable, MRI may be more useful for defining the local extent of an osteosarcoma.

Adolescent↗

Treatment of infected segmental defect of long bone with vascularized bone transfer.

Experience with infected pseudarthrosis with segmental osseous defect, treated by debridement and microvascular bone transfer, is reported. Fourteen patients form the basis for the study, including 12 males and two females. Patient age at the time of operation averaged 35.1 years. Follow-up averaged 52 months. The affected site included tibia (10), femur (2), and ulna (2). A total of 15 vascularized bone graft transfers were carried out for the 14 patients, with the donor bone fibula (8) and ilium (7). Bony union was ultimately obtained in all patients. In 11 patients, primary union was obtained at both ends of the transferred bone segment. In the remaining three patients, a secondary procedure, consisting of onlay nonvascularized bone autografting at one end of the vascularized transferred bone segment, was required to obtain union. Recurrent infection following union occurred in one patient. One of the two patients with active osteomyelitis at the time of vascularized bone transfer had complications from recurrent sepsis, leading to the authors' caveat that vascularized bone transfer should be deferred until such time as sepsis is inactive. Criteria used in this series for determining inactive sepsis (absence of sinus tracts, negative bacterial cultures, negative c-reactive protein, and a sedimentation rate of less than 15 mm per hour) seem appropriate. The study suggests that vascularized bone transfer is a useful procedure for the treatment of infected segmental osseous defects of long bones, of more than 3 cm extent and one month or more after inactive sepsis.

Adult↗

Kienbock's disease in an eleven-year-old girl. A case report.

Kienbock's disease occurs most frequently between 20 and 30 years of age (Gillespie, 1961). The youngest patient with Kienbock's disease in literature written in English is a 10-year-old boy (Nakamura et al., 1990). We report the case of an 11-year-old girl with Kienbock's disease whom we treated with radial shortening. Five months after surgery, radiographs showed signs of rapid disappearance of avascular necrosis of the lunate, and the patient had excellent clinical results. Two years postoperatively no recurrence of avascular necrosis of the lunate has occurred.

Age Factors↗

Extensor tendon rupture due to osteoarthritis of the distal radio-ulnar joint.

Five cases of closed rupture of the finger extensor tendon due to osteoarthritis of the distal radioulnar joint were studied. Difficulty in extension began at the little finger and extended to the ring and long fingers. Pain and swelling in the dorsal aspect of the wrist preceded the tendon rupture. Osteoarthritic changes at the distal radio-ulnar joint were more severe than those at the radio-carpal and intercarpal joints. The distal end of the ulna showed the plus variant, as well as dorsal dislocation or subluxation. All patients underwent a tendon graft or tendon transfer, with excision of the distal ulna. The tendon rupture was thought to be caused mainly by friction between the displaced distal end of the ulna and osteophytes of the distal radio-ulnar joint.

Aged↗

Accessory nerve injury: conservative or surgical treatment?

In order to clarify the functional prognosis of accessory nerve injury after nerve repair and nonsurgical treatment, 27 of our cases with accessory nerve injury were studied. 20 cases were followed up for more than 8 months. In ten cases treated conservatively, the dull feeling and hypaesthesia did not improve. However, pain and dysfunction of the shoulder improved in half of these cases. In ten cases treated surgically, nerve suture was performed in two cases, nerve graft in five cases and neurolysis in three cases. In the surgically treated group, subjective complaints disappeared in all cases, but hypaesthesia or contracture of the shoulder persisted in three cases. Surgical treatment of the accessory nerve is recommended in fresh cases with complete paralysis and in cases in which there is no sign of nerve recovery within one year after the original injury.

Accessory Nerve↗