Biomedical subjects
Publications and source records attributed to H Takami.
In two patients with flexor paralysis of the elbow due to a lesion of the brachial plexus, the entire latissimus dorsi muscle was transplanted to act as an elbow flexor, preserving its neurovascular pedicle. This flexorplasty proved useful for patients who had suffered a traction lesion of the upper trunk of the brachial plexus.
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An attempt has been made to determine the clinical usefulness of serum procollagen-III-peptide (P-III-P) in comparison with serum CEA and AFP in patients with solid tumor. Serum P-III-P levels were measured in 82 cases of carcinoma and 64 cases of benign disease employing an AG Radiochemishes Laboratrium RIAgnost P-III-P kit. Serum P-III-P levels of 148 healthy subjects were 8.5 +/- 2.6 ng/ml (M +/- S.D.), with an upper limit of 13.7(M + 2S.D.). The serum P-III-P level in cases of hepatocellular carcinoma was elevated to 47.5 +/- 97.5 (88.9%). Serum P-III-P levels in cases of pancreatic carcinoma were elevated slightly, whereas those for patients with carcinoma of the stomach, colorectum, esophagus, and breast were low, and their P-III-P positive rates were lower than those of their serum CEA. On the other hand, the serum P-III-P levels in benign diseases involving the liver and biliary tract were higher than those in other benign diseases. Therefore, although serum P-III-P can be a useful marker in hepatocellular carcinoma, it may possibly be difficult to discriminate it from benign diseases involving the liver and biliary tract.
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Neurovascular free flaps from the dorsum of the foot provide not only full-thickness cover with innervation but also rich blood supply to the damaged part. This report describes our experience with seven instances of free dorsalis pedis flap transfers applied for restoring sensation to the mutilated hand. The dorsalis pedis free flaps have advantages in reconstruction of the mutilated hand, when no local island tissues are available for transfer.
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Two cases of traumatic rupture of the iliacus muscle are reported. The clinical picture of this condition is characterized by pain in the groin, a tender mass in the iliac fossa, flexion contracture of the hip, and a femoral nerve palsy. Presence of a bleeding tendency should be investigated. Operative treatment is recommended for large hematomas.
Microvascular free flap transfer has added new dimensions in reconstructive surgery. The use uf musculocutaneous units as free flap donors may have additional advantages over skin units. Microvascular free musculocutaneous flaps were utilized to cover avulsion wounds in the lower leg of six patients and satisfactory results were obtained. The latissimus dorsi musculocutaneous flap proved to be well suited for free transfer to the traumatized lower extremity, because of its long dominant vascular pedicle, its large size, and the minimal functional problems that result from its use.
Though the mechanism of 201Tl accumulation in thyroid tumours is not known yet, there are some hypotheses. In order to study the mechanism, potassium contents and Na, K-ATPase, of various organs of rats and human thyroid glands were analyzed . The conclusion through these experiments is as follows, 1 as the potassium contents and Na, K-ATPase activity of thyroid glands are not obviously higher than those of other organs, the 201Tl accumulation in thyroid is thought to be not owing to the similarity to the potassium ion, 2 pointing out high activity of Na, K-ATPase in heart and kidney, the accumulation mechanism of 201Tl in these organs has high relation to this activity, 3 though there is a tendency to have higher potassium contents among thyroid tumours, the difference in potassium contents between their histopathology is small; so that the tumour specificity is not explained from the potassium contents, and 4 as for Na, K-ATPase activity of thyroid tumours, papillary adenocarcinoma and follicular adenoma, which take more in 201Tl, have tendency to show higher activity; adenomatous goitre, which take less in 201Tl, has tendency to show lower activity. We suggested that the factor relating to the accumulation mechanism of 201Tl may be multiple, and Na, K-ATPase plays an important role in 201Tl specific uptake in thyroid tumours.
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Binocular visual function after surgery for detached retina was examined in 100 patients with a visual acuity of less than 0.3 in the reattached retina and with a visual acuity of more than 1.0 in the non-detached retina: 1) There was no significant sex difference in binocular visual function. 2) There was no significant difference in binocular visual function according to postoperative interval. 3) Maintenance of postoperative binocular visual function was best in patients under 19 years of age, and grew worse with age. 4) In patients with a visual acuity of more than 0.1 in the reattached retina, simultaneous perception was good in 100%, and fusion in more than 80%. However, stereopsis was worse in most cases. 5) In patients with a visual acuity of less than 0.1 in the reattached retina, all aspects of binocular visual function were worse, except in those under 19 years of age. 6) There was no significant difference in binocular visual function between patients with and without temporary amputation of extrinsic ocular muscles at operation. 7) There was no significant difference in binocular visual function between patients with and without macular detachment before operation. 8) In the patients who had had an encircling operation, binocular visual function was worse than in those operated on with other procedures, because the former had the severest retinal detachment.
Changes in the serum levels of anterior pituitary, thyroid, parathyroid, and adrenal hormones following subtotal thyroidectomy in 31 patients with Graves' disease were investigated. In 14 patients, rapid ACTH tests were performed on the preoperative and the first, third, and seventh post-operative days. Remarkable differences were not seen with regard to the changes in anterior pituitary hormones or cortisol, compared to those seen during general surgery. As to the thyroid hormones, the serum level of triiodothyronine (T3) decreased markedly after surgery and fell to half that of the preoperative value on the first postoperative day. Thereafter, a low value of T3 was maintained during the early postoperative period. Unlike T3, the serum level of thyroxine (T4) decreased gradually until the 7th post-operative day. The levels of both epinephrine and norepinephrine increased transiently during surgery, but the serum level of norepinephrine increased again on the third postoperative day. In the postoperative period, almost half the number of patients showed an inadequate cortisol response to rapid ACTH tests. It is suggested that the unique responses, such as the rise in serum norepinephrine or an inadequate response of cortisol to ACTH, or hypocalcemia, after subtotal thyroidectomy in patients with Graves' disease is largely due to the rapid decrease of T3 in the hypothyroid state, as was noted during the postoperative period.
The levels of polyamines (putrescine, spermidine and spermine) in erythrocytes and plasma were studied using Cloudman S-91 melanoma grown in the lungs of DBA/2 mice. Polyamine levels and the numbers of tumour-cell colonies in the lungs were determined at weekly intervals. Putrescine levels in both erythrocytes and plasma significantly increased 1 week after tumour inoculation. Three weeks after inoculation, however, putrescine levels in the erythrocytes showed a greater increase than those in plasma. Spermidine and spermine levels were initially high at 2 weeks in plasma and at 4 weeks in erythrocytes. However, by 6 weeks the spermidine levels showed a greater increase in erythrocytes than in plasma. These data suggest that erythrocytes may absorb and store polyamines released into the circulation.This finding was subsequently applied to human studies. Fifty-two untreated patients with solid tumours were examined in the preoperative period. All erythrocyte polyamine levels from patients were significantly higher than those from control subjects. Plasma spermidine levels in patients were significantly higher than those in controls, whereas plasma putrescine and spermine levels showed no significant increase. The frequency of raised levels of putrescine, spermidine and spermine in erythrocytes was significantly greater than in plasma. These results suggest that polyamine levels in erythrocytes may provide useful information for the detection of cancer.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.