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Biomedical subjects

A Minami

Publications and source records attributed to A Minami.

At least 127 records · Page 7Linked to original sources

Enhanced resistance of mice to bacterial infection induced by recombinant human interleukin-1a.

The effect of recombinant human interleukin-1a on the survival rate of Std-ddY male mice systemically infected with Pseudomonas aeruginosa 12 or Klebsiella pneumoniae P-5709 was evaluated. In P. aeruginosa infection, interleukin-1a given intramuscularly twice, 3 days and 1 day before inoculation of bacteria, most effectively protected animals from death due to infection. The effect was dose dependent, with a maximum survival rate of 92.5% at 10 micrograms per mouse, while only 8.3% of the control group survived until the end of the observation period. The 50% effective dose of interleukin-1a was 0.261 microgram per mouse. In K. pneumoniae infection, interleukin-1a given intramuscularly twice, simultaneously with and 1 day after the inoculation of bacteria, was most effective. The protective effect of interleukin-1a was again dose dependent and was generally more marked than in P. aeruginosa infection. The 50% effective dose was 0.034 microgram per mouse. In both infections, there was no significant increase in the survival rates of animals injected with human albumin or heat-inactivated interleukin-1a. These observations raise the possibility that human interleukin-1a could serve as a therapeutic tool for patients with bacterial infections.

Animals↗

Simultaneous reconstruction of bone and skin defects by free fibular graft with a skin flap.

It has been very difficult to accomplish simultaneous reconstruction of a massive defect of the long bone associated with a large skin defect. Yoshimura et al reported a new procedure using a vascularized free fibular transplant with a monitoring flap. This procedure was used in four cases that had resulted in massive bone and skin defects after wide resection of benign and malignant bone tumors occurring in the long bones. Our results using the composite vascularized fibular graft were gratifying.

Adolescent↗

Tardy ulnar nerve palsy caused by cubitus varus deformity.

Clinical features and X-rays of thirty-four cases with cubitus varus deformity were analysed in order to explain the occurrence of tardy ulnar nerve palsy caused by cubitus varus deformity. Cubitus varus cases with tardy ulnar nerve palsy, compared to cases without it, were older at the first visit to the clinic for cubitus varus deformity. There were no other differences between the two groups in clinical features. Computed tomography showed that the olecranon moved to the ulnar side against the olecranon fossa. Operative findings showed that the medial head of triceps brachii shifted medially and covered the ulnar nerve. Both from computed tomography and operative findings we conjectured the possibility that tardy ulnar nerve palsy was caused because the ulnar nerve was compressed by the forward medial movement of the medial head of the triceps brachii caused by cubitus varus deformity.

Adolescent↗

Congenital anomalies of the upper limb among the Japanese in Sapporo.

Nine hundred and forty three patients with nine hundred and fifty-five congenital upper limb anomalies are classified according to the Swanson's classification. Relative incidence of each type of anomaly, sex incidence, affected side, associated abnormalities and familial history are analysed. The occurrence of congenital upper limb anomalies is also compared with Chinese and Western studies. The characteristic feature in this series is that the incidence of typical syndactyly is not as high as expected. Two problems of Swanson's classification encountered in this analysis are discussed. One of the problems is the relation between polydactyly, syndactyly and typical cleft hand. The other is the relation between brachysyndactyly, atypical cleft hand and transverse deficiency.

Abnormalities, Multiple↗

Abductor digiti minimi opponensplasty in hypoplastic thumb.

Ten cases of hypoplastic thumbs were treated by abductor digiti minimi opponensplasty in order to restore opposition of the thumb and reform the wasted thenar eminence. In eight of these ten cases operations were combined with multiple Z-plasty or rotation flap to correct the narrowing of the first web space. Adductor plasty using extensor indicis proprius was performed in six cases to restore the stability of the metacarpophalangeal joint of the thumb and ligament reconstruction of the carpometacarpal joint in one hand. In all cases, the transferred abductor digiti minimi was strong enough to abduct the thumb and provide good functional and cosmetic results. We modified Littler's procedure by transferring the origins of abductor digiti minimi muscle from the flexor carpi ulnaris to the palmaris longus tendon. Our modified method gave a better cosmetic appearance than that provided by Littler's method.

Child↗

Correlation between clinical results and carpal instabilities in patients after reduction of lunate and perilunar dislocations.

Thirteen patients with lunate and perilunar dislocations were treated in our department in the last five years. Ten out of the thirteen patients were followed more than eight months with an average of two years and two months. Two out of the ten patients followed failed to obtain normal anatomical carpal architecture. These two patients were treated by arthrodesis of the wrist and proximal row carpectomy, respectively. The remaining eight patients, that obtained reduction, were classified into three groups according to existence of gap between the scaphoid and lunate, and incongruity between the lunate and triquetrum. Patients with a gap between the scaphoid and lunate of more than 3 millimetres after reduction of their dislocations had poor clinical results. This suggests significant correlation between clinical results and carpal instabilities.

Adolescent↗

Long-term results of Kienböck's disease treated by excisional arthroplasty with a silicone implant or coiled palmaris longus tendon.

Of 32 patients with Kienböck's disease, 19 had lunate silicone implant replacements, and 13 had coiled palmaris longus tendon replacement. The carpal height was measured and osteoarthritic changes were noted in plain x-ray films before and after the operation. Follow-up periods ranged from 3 to 11 years, with an average of 6 years 4 months. In patients in the mild stages of the preoperative carpal collapse, both excisional arthroplasties had good clinical results. The x-ray films showed that a silicone implant played a more important role in preventing further carpal collapse than a palmaris longus tendon replacement in patients in the early carpal collapse stage. However, the clinical results of the silicone implant replacement were unsatisfactory because of the postoperative progression of osteoarthritic changes or subluxation of the prosthesis in the advanced stages of carpal collapse. The palmaris longus tendon replacement gave satisfactory results in four of seven patients with advanced carpal collapse. These results suggest that silicone implant replacement is indicated primarily in patients with the early stages of carpal collapse, and replacement of the palmaris longus tendon is rarely recommended in either the early or late stages of carpal collapse.

Adult↗

Microsurgical reconstructive surgery following wide resection of bone and soft tissue sarcomas in the upper extremities.

A preliminary report is presented of six cases of microsurgical tissue transfer following wide tumor resection, utilizing free vascularized fibula graft (five cases) and free vascularized muscle graft (one case). In five cases, the grafted tissue survived completely, and the attempted functional reconstruction was successful. Although the follow-up period has been relatively short, there has been no local recurrence or distant metastasis in any of the cases.

Adolescent↗

Clear cell chondrosarcoma. A report of two cases and review of literature.

Two cases of clear cell chondrosarcoma located in the distal femur and proximal humerus are reported. Both patients were men aged 35 and 51 years. Their initial symptom was a pathologic fracture. Roentgenographically, one patient showed a purely lytic lesion and another lytic with centrally radiodensity. Microscopic examination revealed that the tumor cells have a centrally placed vesicular nucleus surrounded by a clear cytoplasm, with distinct boundaries. Their cytoplasm stained with S-100 protein by the peroxidase-antiperoxidase method. We found 36 reported cases (including the two reported here), and delineated the clinico-pathologic characteristics of the disease.

Adult↗

Midcarpal instability following malunion of a fracture of the distal radius. A case report.

The authors report a case of midcarpal instability following a malunited fracture of the distal radius. After corrective osteotomy of the radius the wrist became stable and the symptoms were completely relieved. The instability in such cases is due to subluxation of the capitate on the lunate with the wrist in radial abduction. This in turn is due to a reversal of the normal palmar tilt of the articular surface of the radius. In the mechanics of the normal wrist this palmar tilt allows the lunate to slide forwards during radial abduction, so enabling the capitate to maintain collinearity with the vertical axis of the radius. This situation can be restored by corrective osteotomy, as in the present case, with complete relief of symptoms.

Adult↗

Ligament stability of the metacarpophalangeal joint: a biomechanical study.

Capsuloligamentous contributions to metacarpophalangeal joint stability were obtained from load-displacement tests on the joints of 15 human cadavers. The contribution of each ligament to joint stability was obtained by measuring the reduction of load that induced a given joint displacement after sequential ligamentous sectioning. Four modes of joint displacement were examined: distal distraction, dorsopalmar dislocation, abduction-adduction rotations, and supination-pronation rotations. This study demonstrated that both radial and ulnar collateral ligaments play primary roles in stabilizing the metacarpophalangeal joint in all four modes of joint displacement. The accessory collateral ligaments contribute primarily to abduction-adduction rotational stability, but contribute little to stabilizing dorsopalmar dislocation or axial (supination-pronation) rotations. The palmar plate prevents dorsal dislocation only at full extension. The dorsal capsule has a moderate contribution to stability in distraction and supination-pronation rotations.

Adult↗

[A histological study on osteosarcoma. Part II: The mode of local extension of osteosarcoma].

The survival rate of patient with osteosarcoma has been increasing, owing to the development of adjuvant chemotherapy. Recently, the limb saving procedure in osteosarcoma has been attempted in many countries. Although we need knowledge about the mode of local extension of osteosarcoma in the planning of this surgery, there are few reports concerning the matter. The purpose of this paper is to make clear, morphologically, how tumor tissue extends across the epiphyseal plate, periosteum and bone marrow. The materials were 26 amputated extremities of osteosarcoma which had not received any chemotherapy or radiotherapy. Paraffin embedded macrosections were prepared and stained with HE and Masson stain. When epiphyseal plate was open or closing, 13 out of 14 cases (93%) showed transphyseal extension of tumor. Tumor extension along the vessels at the center of the plate and the epiphyseal artery was most common. Transmedullary extension showed three different types, infiltrative type (18 cases), lobular type (5 cases), and "skip" type (one case). None had capsule or pseudocapsule surrounding the tumor. As to the relationship between periosteal reaction and tumor involvement of cortex or medulla, periosteal reaction was located more proximally than cortical or medullary involvement in some cases. In other cases, however, cortical or medullary involvement was located more proximally than periosteal reaction. The gaps between the tips of the periosteal reaction and cortical or medullary involvement ranged from 0.5 to 1.5 cm. In the transperiosteal extension, it was confirmed that tumor cells had invaded the periosteum along the vessels penetrating the periosteum.

Adolescent↗

Delayed rupture of a flexor tendon secondary to fracture of the lunate.

Attritional ruptures of flexor tendons following carpal fractures are rare. The authors report a case of delayed rupture of flexor digitorum profundus of the index finger caused by fracture of the lunate. To our knowledge, this is the first report of such a tendon rupture following a fracture of the lunate.

Fractures, Bone↗

Ligamentous structures of the metacarpophalangeal joint: a quantitative anatomic study.

The ligamentous structure of the metacarpophalangeal (MCP) joint of the index finger in human cadavers was studied by gross examination and quantitative measurement. Anatomically, the collateral ligament is separable into two layers, with the precise origin arising from the metacarpal head and inserting on the proximal phalanx. Quantitatively, the change in length of the collateral ligament was studied with biplanar radiographic techniques. The distance between the origin and insertion of the collateral ligament changed in different portions of the ligament when the joint was moved from a position of hyperextension to that of flexion. When the MCP joint was flexed from 0 degree to 80 degrees, the dorsal portions of both the radial and ulnar collateral ligaments were lengthened (3-4 mm). The middle portions of both ligaments were slightly elongated (0.4-1.0 mm), and the volar portions of the ligaments were shortened (1-2 mm). When the MCP joint extended into hyperextension, the dorsal portions of the ligaments shortened 2-3 mm, the middle thirds of the ligaments shortened slightly, and the volar thirds of the ligaments lengthened. The results of this study suggest that the dorsal and volar portions of the collateral ligament provide MCP joint constraint at the flexed and extended positions, respectively.

Biomechanical Phenomena↗