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Biomedical subjects

H Takami

Publications and source records attributed to H Takami.

At least 145 records · Page 8Linked to original sources
PubMed1997

Flexor digitorum profundus avulsion with associated fracture of the distal phalanx.

Two unusual cases of flexor digitorum profundus avulsion with an associated fracture of the distal phalanx are reported. In one case the injury consisted of avulsion of a large bone fragment from the distal phalanx and an associated profundus avulsion from the fragment. The other case showed simultaneous shaft fracture of the distal phalanx with avulsion of the profundus tendon, which could not be included in the existing classification of profundus injuries. The latter injury was misdiagnosed initially.

Adult↗
PubMed1997

Attritional flexor tendon ruptures after a malunited intra-articular fracture of the distal radius.

Rupture of the flexor tendon following Colles fracture is uncommon. In all reported cases it occurred as a complication of an extra-articular, displaced fracture of the distal radius. We report a case in which flexor tendon rupture occurred 30 years after a comminuted intra-articular fracture of the distal end of the radius. There have been no reports of delayed flexor tendon rupture after an intra-articular fracture of the distal radius in young adults.

Colles' Fracture↗
PubMed1997

Vascularized fibular grafts for the reconstruction of segmental tibial bone defects.

Free vascularized fibular grafts were employed in seven patients with large tibial defects following trauma or resection of tumour. All patients were followed for more than 5 years. Tibial union and excellent functional results were achieved in all seven patients. Free vascularized fibular transfer seems to be an effective method of treatment for massive segmental bone defects.

Adolescent↗
PubMed1997

Aspirin effects on colonic mucosal bleeding: implications for colonic biopsy and polypectomy.

BACKGROUND: Many patients who require endoscopic treatments such as biopsy and polypectomy are given antiplatelet agents reluctantly. We have studied the effects of aspirin on colonic mucosal hemostasis. METHODS AND PATIENTS: We developed a new endoscopic device to make a standard incision (7-mm length) on the colonic mucosa to study colon bleeding time. We measured the colon bleeding time of normal colonic mucosa in 47 cases. The colon bleeding time and skin bleeding time (Simplate method) were measured before and one hour after aspirin ingestion (990 mg) in ten healthy subjects. RESULTS: The bleeding time of normal colonic mucosa was 156 +/- 71 (mean +/- standard deviation) seconds. Significant prolongation was noted in both skin bleeding time (357 +/- 192 vs. 477 +/- 183 seconds; P < 0.05) and colon bleeding time (155 +/- 47 vs. 244 +/- 169 seconds; P < 0.05) after aspirin ingestion. CONCLUSIONS: Bleeding time was measured safely under direct colonoscopic visualization. Aspirin prolonged the colon bleeding time. Therefore, endoscopists should be aware of a risk of abnormal bleeding after endoscopic biopsy and polypectomy in patients with aspirin use. Two days were necessary for colon bleeding time to become normalized in patients with aspirin use.

Aspirin↗
PubMed1997

Isolated volar displaced fracture of the ulnar condyle at the base of the index metacarpal: a case report.

A case involving a displaced fracture of the ulnar condyle at the base of the second metacarpal without concomitant dislocation of the second carpometacarpal joint is described. It seems probable that the fracture was produced by simultaneous volar subluxation of the base of the third metacarpal that reduced spontaneously. Open reduction and internal fixation of the fracture with Kirschner wires achieved satisfactory results.

Adolescent↗
PubMed1997

Large volar plate avulsion fracture of the base of the middle phalanx with rotational displacement: a report of three cases.

Three cases of large volar plate avulsion fracture at the base of the middle phalanx with significant displacement are reported. In each case, the fracture fragment involved about 30% of the articular surface and was rotated 90 degrees. The proximal interphalangeal (PIP) joint showed loss of volar stability with hyperextension stress. This unusual variant of volar plate injury is thought to be caused by subluxation of the PIP joint. All patients underwent open reduction and internal fixation. The fracture healed in anatomic alignment without articular incongruity or instability in all cases.

Adolescent↗
PubMed1997

Genetic mapping using microcell-mediated chromosome transfer suggests a locus for Nijmegen breakage syndrome at chromosome 8q21-24.

Nijmegen breakage syndrome (NBS) is an autosomal recessive disorder characterized by microcephaly, short stature, immunodeficiency, and a high incidence of cancer. Cultured cells from NBS show chromosome instability, an increased sensitivity to radiation-induced cell killing, and an abnormal cell-cycle regulation after irradiation. Hitherto, patients with NBS have been divided into the two complementation groups V1 and V2, on the basis of restoration of radioresistant DNA synthesis, suggesting that each group arises from a different gene. However, the presence of genetic heterogeneity in NBS has been considered to be controversial. To localize the NBS gene, we have performed functional complementation assays using somatic cell fusion between NBS-V1 and NBS-V2 cells, on the basis of hyper-radiosensitivity, and then have performed a genomewide search for the NBS locus, using microcell-mediated chromosome transfer followed by complementation assays based on radiosensitivity. We found that radiation resistance was not restored in the fused NBS-V1 and NBS-V2 cells and that only human chromosome 8 complements the sensitivity to ionizing radiation, in NBS cell lines. In complementation assays performed after the transfer of a reduced chromosome, merely the long arm of chromosome 8 was sufficient for restoring the defect. Our results strongly suggest that NBS is a homogeneous disorder and that the gene for NBS is located at 8q21-24.

Abnormalities, Multiple↗
PubMed1997

Pristine environments harbor a new group of oligotrophic 2,4-dichlorophenoxyacetic acid-degrading bacteria.

2,4-Dichlorophenoxyacetic acid (2,4-D)-degrading bacteria were isolated from pristine environments which had no history of 2,4-D exposure. By using 2,4-D dye indicator medium or 14C-labeled 2,4-D medium, six strains were isolated from eight enrichment cultures capable of degrading 2,4-D. Phylogenetic analyses based on 16S ribosomal DNA (rDNA) sequencing and physiological properties revealed that one isolate from Hawaiian volcanic soil could be classified in the genus Variovorax (a member of the beta subdivision of the class Proteobacteria) and that the other five isolates from Hawaiian volcanic soils, Saskatchewan forest soil, and Chilean forest soil have 16S rDNAs with high degrees of similarity to those of the Bradyrhizobium group (a member of the alpha subdivision of the class Proteobacteria). All the isolates grow slowly on either nutrient media (0.1 x Bacto Peptone-tryptone-yeast extract-glucose [PTYG] or 0.1 x Luria broth [LB] medium) or 2,4-D medium, with mean generation times of 16 to 30 h, which are significantly slower than previously known 2,4-D degraders. Nutrient-rich media such as full-strength PTYG and LB medium did not allow their growth. PCR amplification using internal consensus sequences of tfdA (a gene encoding an enzyme for the first step of 2,4-D mineralization, found in pJP4 of Alcaligenes eutrophus JMP134 and some other 2,4-D-degrading bacteria) as primers and Southern hybridization with pJP4-tfdA as a probe revealed that the isolate belonging to the genus Variovorax carried the tfdA gene. This gene was transmissible to A. eutrophus JMP228 carrying a plasmid with a mutant tfdA gene. The other five isolates did not appear to carry tfdA, and 2,4-D-specific alpha-ketoglutarate-dependent dioxygenase activity could not be detected in cell lysates. These results indicate that 2,4-D-degrading bacteria in pristine environments are slow-growing bacteria and that most of their phylogenies and catabolic genes differ from those of 2,4-D degraders typically isolated from agricultural soils or contaminated environments.

2,4-Dichlorophenoxyacetic Acid↗
PubMed1997

Isolation of extradiol dioxygenase genes that are phylogenetically distant from other meta-cleavage dioxygenase genes.

meta-Cleavage dioxygenase genes were isolated from the benzoate-assimilating bacteria Pseudomonas stutzeri A401 and Pseudomonas mendocina KC37. The gene products had the enzymatic activity of 2,3-dihydroxy-biphenyl-1,2-dioxygenase. Phylogenetic analysis based on the alignment of amino acid sequences suggests that these enzymes are distantly related to other meta-cleavage enzymes and may be members of a new family of extradiol dioxygenases.

Amino Acid Sequence↗
PubMed1997

[Surgical result of left ventricular free wall rupture complicating acute myocardial infarction].

From 1980 to 1995, we experienced 20 cases of surgical repair for left ventricular free wall rupture complicating acute myocardial infarction. These were divided into three types based on their clinical symptoms; 10 of the sudden blowout type, 4 of the rapid blowout type and 6 of the oozing type. In the rapid type, unconsciousness following the onset of the blowout rupture was restored by cardiopulmonary resuscitation (CPR) or pericardiocentesis. Seven out 20 cases (35%) survived. In the sudden blowout type, only one case treated by using the pericardial patch gluing technique without cardiopulmonary bypass survived. Three out of 4 cases (75%) of the rapid blow out type survived. Three out 6 cases (50%) of the oozing type survived. The causes of death were classified as table death for 5 cases, LOS for 1 case, and cerebral death for 3 cases of the 9 fatal cases of the sudden blowout type. Hemostasis was very difficult in 1 case of the rapid type. The 3 cases of the oozing type died respectively of LOS, cerebral death and pneumonia after surgery. Pericardiocentesis or subxyphoid drainage was performed preceding the repair of the rupture in 4 cases of the rapid blowout, and in 5 cases of the oozing type. However, re-rupture occurred in 2 cases of the rapid type and in 2 cases of the oozing type. In 7 cases in whom pericardial patch gluing technique was applied, a procedure in use since 1990, all cases were safely weaned from CPB, with 4 cases out of 7 (57%) surviving. Meanwhile, in 13 cases in which infarctectomy and myocardiography was carried out, 5 cases (38%) could not be weaned from CPB. Three cases (23%) survived after infarctectomy and myocardiography. Even some cases of blowout rupture were able to survive as long as blood pressure was elevated and consciousness was restored by CPR or pericardiocentesis as in cases of the rapid type. The pericardial patch gluing technique at the infarct site proved to be an effective procedure.

Aged↗
PubMed1997

Laparoscopic adrenalectomy in asymptomatic pheochromocytoma.

A patient with asymptomatic pheochromocytoma associated with catecholamine hypersecretion but no hypertension was treated by right laparoscopic adrenalectomy. The 63-year-old male patient was referred to us for treatment of an incidentaloma. The diameter of the adrenal tumor was 50 mm, and the peripheral blood nonrepinephrine level was 1.12 ng/ml (normal level, 0.4 ng/ml). Blood pressure was normal. A flexible electron laparoscope was used for open laparoscopy, and four trocars were inserted. The retroperitoneum was incised to the right of the inferior vena cava, and the tumor was excised. During the operation, blood pressure rose transiently, and a blocker and nitroglycerin were administered. The tumor bled extremely easily. The duration of surgery was 3 hours and 20 minutes, and blood loss was 210 ml. The excised tumor was 55 mm in diameter. The patients's postoperative course was uneventful. If the size of asymptomatic pheochromocytoma is not large, and blood pressure and cardiac function are stable, laparoscopic adrenalectomy is indicated for this type of tumor as long as it is performed by experienced surgeons.

Adrenal Gland Neoplasms↗
PubMed1997

Irreducible isolated dislocation of the radial head.

Isolated dislocation of the radial head in adults is a rare injury. A 20-year-old man received a direct blow to his elbow and sustained an isolated anterior dislocation of the radial head. Open reduction was required because soft tissue interposition prevented reduction by closed manipulation. At operation the annular ligament was found to be ruptured and interposed between the articular surfaces, preventing reduction. A satisfactory result was obtained 1 year after surgery.

Adult↗
PubMed1997

[Hematological characteristics of hypoplastic MDS patients with chromosomal abnormalities, who had been followed for aplastic anemia with normal karyotypes].

During 1990 to 1993, five patients who had been treated in our hospital for aplastic anemia (AA) with a normal karyotype, were found to have hypoplastic myelodysplastic syndromes (hMDS); three patients with RA, one RAEB, and one RAEB-T, and all of them have chromosomal abnormalities. The mean age of the hMDS patients (4 men, 1 woman) was 51.0 years (range 31-61). We retrospectively studied the hematological features of the 5 cases in the early stage without chromosomal abnormalities. They showed, 1) appearance of erythroblasts (3/5), 2) more reticulocyte counts than typical AA (mean 7.8 x 10(4)/microliter), 3) macrocytic anemia (mean MCV 106fl) in peripheral blood, 4) relative erythroid hyperplasia (M/E ratio 0.2-1.5), and 5) low lymphocyte counts (mean percentage of lymphocytes 32, 8%) in bone marrow. Considering about the differences or transformation between AA and hMDS, it is interesting that all five patients have initially had a normal karyotype and subsequently developed chromosomal abnormalities.

Adult↗
PubMed1996

Indole derivatives as a new class of steroid 5 alpha-reductase inhibitors.

A series of indole derivatives with varied substituents on the alpha, beta-unsaturated double bond were synthesized and evaluated for their ability to inhibit rat prostatic 5 alpha-reductase. Compounds possessing an ethyl substituent at the beta-position of the double bond showed potent inhibitory activity. Among them, (Z)-4-{2-[[3-[1-(4,4'-difluorobenzhydryl)indol-5-yl]-2-pentenoy l]- amino]phenoxy}butyric acid (16, KF20405) showed the maximum potency with an IC50 value of 0.48 +/- 0.086 nM, which was 20-fold higher potency than 1 (MK-906). Compound 16 effectively inhibited DHT production 4 h after a 3 mg/kg oral administration. Several potent indole derivatives, 1 and 2 ((+/-)-ONO-3805), were tested versus rat and human isozymes. Nonsteroidal inhibitors such as indole derivatives and 2 were 2-3 orders of magnitude less potent for human type 2 isozyme than steroidal inhibitor 1 and expressed a significant species deference for these isozymes.

5-alpha Reductase Inhibitors↗