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Biomedical subjects

A Minami

Publications and source records attributed to A Minami.

At least 91 records · Page 5Linked to original sources
PubMed1992

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↗
PubMed1992

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↗
PubMed1992

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↗
PubMed1991

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↗
PubMed1991

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↗
PubMed1991

Hemiresection-interposition arthroplasty of the distal radioulnar joint associated with repair of triangular fibrocartilage complex lesions.

Sixteen wrists of 15 patients with traumatic triangular fibrocartilage complex tears were treated by hemiresection-interposition arthroplasty of the distal radioulnar joint combined with repair of the torn triangular fibrocartilage complex. The surgical procedure was performed to avoid impingement of the ulnar head against the reconstructed triangular fibrocartilage complex. Most of the wrists showed a positive ulnar variance. The average age of the patients was 39 years. Follow-up averaged 41 months. Complete relief of pain was obtained in 10 wrists. Slight pain persisted in 6 wrists, although it was less than before surgery. The range of motion of the wrist joint and forearm improved postoperatively. Grip strength in all wrists increased. Postoperative complications occurred in 7 wrists of 6 patients: reoperation in 2 wrists, fracture in 1, and tendinitis of the extensor carpi ulnaris in 4. All 15 patients subsequently returned to their previous occupations.

Adult↗
PubMed1991

Diagnosis of radial nerve palsy caused by ganglion with use of different imaging techniques.

Clinical features of six cases of radial nerve compression syndrome as a result of ganglion at the elbow are reported. The usefulness of different imaging techniques for detecting the location of ganglion is compared. The posterior interosseous nerve was involved in two patients, the radial sensory nerve in one patient, and both nerves in three patients. Ultrasonography, computed tomography, and magnetic resonance imaging revealed the location of the ganglion in every patient. Ultrasonography was most convenient for screening examination when it was difficult to clearly define a ganglion by palpation. In all patients, a ganglion arose from the anterior capsule of the elbow joint. Dynamic factors in addition to compression of the nerve by ganglion may influence occurrence of the nerve palsy.

Adult↗
PubMed1991

Cholera enterotoxin production in Vibrio cholerae O1 strains isolated from the environment and from humans in Japan.

Vibrio cholerae O1 strains isolated from various sources in Japan over the years 1977 through 1987 were examined to confirm the presence or absence of the cholera enterotoxin (CT) gene and production of CT and to determine the kappa-phage type. The CT gene was detected in none of 225 isolates from natural waters but was present in all of the 10 isolates from environmental waters implicated in domestic cholera cases, in 64 strains (26.6%) of the 241 isolates from imported seafoods, in 43 strains (95.6%) of the 45 isolates from domestic cholera cases, and in 119 strains (93.7%) of the 127 isolates from imported cholera cases. The results suggest that the CT gene-positive strains of V. cholerae O1 have been imported into Japan through seafoods and/or by travelers. Sporadic cholera cases have resulted in contamination of the surrounding environment, but the CT gene-positive strains may not have persisted in natural waters to serve as a reservoir for epidemic cholera. The commercially available VET-RPLA kit (a latex agglutination kit for immunological detection of CT) detected production of CT in all of the CT gene-positive strains, indicating that there was no silent CT gene in the test strains. There was a strong correlation between the kappa-phage type and the presence or absence of the CT gene, suggesting a significant clonal difference between CT gene-positive and -negative strains. Five CT gene-negative strains isolated from imported cholera cases (travelers with mild diarrhea) induced a considerable amount of fluid accumulation in rabbit and/or suckling mouse intestines, indicating production of an enterotoxic factor(s) other than CT.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Reverse-flow vascularized fibular graft: a new method.

The reverse-flow island flap is a relatively recent concept. We have applied this concept to the vascularized bone graft. We report a new method of the reverse-flow vascularized fibular graft for two patients with a pseudarthrosis and massive bone defect of the tibia. The peroneal artery and venae comitantes were severed proximally and elevated with the fibula while maintaining distal vascular continuity. The reverse-flow vascularized fibula was grafted to the posterior aspect of the bone defect of the tibia. Bony union was obtained in both cases. The reverse-flow vascularized fibular graft has many advantages compared with free vascularized fibular graft.

Adult↗
PubMed1990

Reconstruction of the central slip by the transverse retinacular ligament for boutonnière deformity.

A method of repair of boutonnière deformity is described, using the transverse retinacular ligament. Six fingers in five patients were treated by this procedure. The deformity was improved in all fingers; complete or almost complete correction was obtained in four fingers and incomplete correction in two. However, severe limitation of flexion of the D.I.P. joint appeared in two fingers after surgery. This procedure is not indicated for boutonnière deformities with severe contracture of the lateral band; its best indication is in cases in which the central slip is defective and conservative treatment is not effective.

Adult↗
PubMed1990

Experimental study of radial ray deficiency.

The teratogenic mechanisms of radial ray deficiency were investigated. Radial ray deficiencies were induced in WKAH/Hkm rat foetuses by maternal administration of myleran on day 10, 10.5, or 11 of pregnancy. The skeletal anomalies in rats were similar to those in human beings, suggesting that exposure to some environmental factors at a sensitive period of embryogenesis may cause radial ray deficiency in humans. Ulnar ray deficiency has also been induced in rat foetuses by maternal administration of myleran, so it is suggested that radial deficiency and ulnar deficiency are caused by a common teratogenic mechanism in humans. However, the critical period for radial deficiency is one day later than that for ulnar deficiency in rats, which may contribute to the greater frequency of radial deficiency than ulnar deficiency in clinical cases.

Abnormalities, Drug-Induced↗
PubMed1990

The latissimus dorsi musculocutaneous flap for extremity reconstruction in orthopedic surgery.

The latissimus dorsi was transferred as a pedicle flap in ten patients and as a free vascular flap in ten others for extremity reconstruction. Group I comprised ten patients in whom the transfer was used solely to cover a skin or soft-tissue defect. Although there was partial necrosis of the transferred skin in one patient, the remaining nine patients obtained complete coverage without further reconstructive surgery. Group II comprised five patients in whom transfer of the latissimus dorsi was performed for active flexion or extension of the elbow or for abduction of the shoulder. Postoperatively, muscle strength obtained was classified from Grades 0 to 5 according to the muscle testing method. Three patients obtained muscle strength of Grade 3, while two obtained Grade 2. Group III comprised five patients who had brachial plexus palsy after high-dose irradiation. Coverage of the skin and soft tissue was performed after neurolysis of the brachial plexus palsy to free the tissue bed of scarred tissue. Postoperatively, sensory and motor disturbances were alleviated in four of five patients.

Adolescent↗
PubMed1990

Ulnar nerve neuropathy at the wrist.

Thirteen cases of ulnar nerve neuropathy at the wrist are presented. They include four cases of pure motor paresis affecting the ulnar-innervated intrinsic muscles, one case of pure sensory deficit and eight cases of mixed motor and sensory deficiency. A cyst was revealed by preoperative ultrasonography in two cases and by computerized tomography in one of them. The cause of ulnar nerve neuropathy was a tumor or tumor-like mass in six cases, long-time cycling in three cases and unknown in three cases. Surgery was performed in ten cases. Recovery of the nerve palsy was obtained in all except one case.

Adult↗
PubMed1989

Vascularized iliac osteocutaneous flap based on the deep circumflex iliac vessels: experience in 13 cases.

We have carried out 13 vascularized iliac osteocutaneous flaps (VIOF) based on the deep circumflex artery (DCIA) and accompanying veins for cases with compound skin and bone defects. Ten of 13 cases obtained bony union at both ends of the iliac crest with only VIOF. Two of the remaining 3 cases obtained bony union at one end only with the VIOF but united at another end with an additional conventional bone grafting procedure. The final case, a traumatic bone defect of the tibia, failed to obtain bony union at either end of the iliac segment. In 5 of 11 patients in which an osteocutaneous flap was used, complete skin flap survival occurred. Of the remaining 6, one flap went on to complete necrosis, and five flaps were complicated by superficial or partial necrosis. The incidence of flap complications was analysed according to the size of flap. Five flaps with complete survival averaged 6.8 x 10.6 cm in size; however, five flaps with superficial or partial necrosis averaged 10.0 x 15.8 cm. These results suggest that the maximal safe skin flap dimension from the DCIA supply alone is probably 10 x 15 cm.

Adolescent↗
PubMed1989

Clinical features and roentgenograms of symbrachydactyly.

Müller and Blauth have suggested that short webbed fingers, atypical cleft hand and acheiria develop as morphological variants of symbrachydactyly. The clinical features and roentgenograms of our 76 patients were analysed. The common features of all types of symbrachydactyly were that all cases were unilateral, various degrees of bone hypoplasia existed in the affected limbs, and in every grade there were some cases with pectoral muscle absence. There seems to be a successive process of formation of atypical cleft hand. Monodactyly and peromelia occur as a result of more severe reduction occurring in the central finger rays of symbrachydactyly of short finger type.

Female↗