Tuberculous arthritis of the knee: MR findings.
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Arthritis, Infectious↗
Biomedical subjects
K Shino
Publications and source records attributed to K Shino.
A new method using computed tomographic scan to measure the rectus femoris-patellar tendon Q-angle comparison with conventional method.
The Q-angle should be the angle generated by a line connecting the anteroinferior iliac spine (AIIS), the bottom of the groove of the femoral condyle, and the tibial tubercle. The Q-angle was measured by computed tomography (CT) in 43 lower limbs with recurrent patellar dislocation and 26 normal controls. The mean Q-angle was 20 degrees in the dislocated group and 13 degrees in controls, a significant difference. No significant difference was found in the Q-angle between the dislocated and control groups using the conventional method. Lower limb rotation had little effect on accuracy of the method.
Adolescent↗
[Speech development test for one-year-old infants: I. Test content].
A new speech development test was prepared for one-year-old infants. The test consists of three parts: test I, II, and III. The overall test originally comprised a total of 98 test items (47 for Test I, 32 for Test II and 19 for Test III). Test I (for pre-speech language) Section 1 Situation of language i) Differentiation of information to be communicated ii) Comprehension of speech-related situation (Initiation of "signe", and comprehension of objects and events by means of speech) Section 2 Development of symbolizing function (Development and transformation of ability to handle and manipulate objects) section 3 Representing the function of language (First utterance, and acquisition of meaningful words after first utterance) Test II (for speech comprehension) Ability to name concrete objects, and to relate objects to their uses and functions; comprehension of words representing spatial concept such as quantity, number and dimensions, as well as words representing color or position. Test III (for speech expression) Ability to verbalize or name concrete objects, and to verbalize the conduct and state of a person. For infants, language is an objective to be achieved, while for adults it is the mean of thinking and communicating. Despite this difference the scope of this test comprises two major aspects common to the language-related experience of infants and of adults: pragmatics and vocabulary.
Age Factors↗
[Speech development test for one-year-old infants: II. Test statistics].
The test result of language ability for infants of second year of life was examined statistically. In descriptive statistics, average score, standard deviation, and proportion of right answers for all test items for each age group subjects were included. Then factor analysis was carried out to determine the structural characteristics of the test. The analysis revealed that test pertains of the following five stages. First two stage of five were overlapped with the previously reported result for pre-speech language test for infant within one year of life. Then, the stage was determined as follows; (4) Initial language acquirement and differentiation of language functions (5) Speech increasing stage (increase of spontaneously uttered words and understood words related to persons and objects) (6) Differentiation of expressed words (expression of words differentiated to suit objects) (7) Understanding of words representing actions or conditions (8) Understanding of words representing uses or functions, and verbalization of words representing actions or movements In spite of the fact that six and seven stage represent the same development level in term of chronological age, they were distinctive into those which achieve speech understanding earlier (stage 7), and others whose development centers on speech expression (stage 6). Then reliability and validity was performed. Reliability: (1) As to homogeneity, the reliability coefficients were calculated on the 60 test items by Spearman-Brown's odd-even method. (2) As to inter-rater reliability, Pearson's product movement correlation coefficient was calculated based on the results produced by two separate experienced testers. (3) As to test stability, reliability was determined through repetitive testing.(ABSTRACT TRUNCATED AT 250 WORDS)
Age Factors↗
Surface blood flow and histology of human anterior cruciate ligament allografts.
We measured surface blood flow in 53 anterior cruciate ligaments (ACLs) reconstructed with allogeneic tendon grafts using laser Doppler flowmetry and examined their histology through biopsy specimens procured during second-look arthroscopy to investigate the fate of ACL allografts on a long-term basis. The age of the grafts, i.e., time from the reconstruction to the second-look arthroscopy, ranged from 6 to 89 months. Six-month grafts showed significantly higher blood flow than the other older ones from 12 to 89 months, which showed a blood flow level equivalent to normal control ACLs. Histological studies revealed that ACL allografts remodeled with time, and that they reached stability by 18 months postimplantation. These results confirmed the concepts of age-dependent remodeling of allografts and their longevity in the human knee joint.
Adult↗
Arthroscopic stapling for detached superior glenoid labrum.
Superior labral tears of the shoulder involve the biceps tendon and labrum complex which may be detached, displaced inferiorly, and interposed between the glenoid and the humeral head. We have treated ten young athletes with painful shoulders due to this lesion by arthroscopic stapling. Arthroscopy at the time of staple removal, after three to six months, showed that all the lesions had been stabilised. Clinical review at over 24 months showed an excellent or good result in 80%. The two relative failures were due in one to residual subacromial bursitis, and the other to multidirectional shoulder instability. Arthroscopic stapling can restore the shoulder anatomy, and it is recommended for active adolescent athletes with this lesion.
Adolescent↗
Reconstruction of lateral ligaments of the ankle with allogeneic tendon grafts.
Fresh frozen allogeneic tendon was used to reconstruct the lateral ligaments in 17 ankles. Two or more years later, 13 returned for follow-up examination. The mean age at operation was 23 years (range 15 to 39); the interval between injury and operation varied from six months to 20 years. There were no infections and no immunological rejections, and according to Sefton's criteria, nine patients were excellent and four good. No patient complained of instability of the ankle and stress radiography confirmed this improvement. Allograft reconstruction of the lateral ligaments of the ankle is a new method of treatment which restores stability without sacrificing normal tendons.
Adolescent↗
Reconstruction of the anterior cruciate ligament using allogeneic tissues: overview and current practice.
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Animals↗
Experimental ligament reconstruction by allogeneic tendon graft in a canine model.
The revascularization and remodelling of fresh-frozen allografts used to replace the anterior cruciate (ACL) and medial collateral ligaments (MCL) of the knee were studied by microangiographic, histological and biomechanical methods. The allografts were produced from the patellar tendons of dogs. No bone was attached on either end. The tissue was frozen and thawed immediately before grafting. The grafts were shaped to either 4 to 4.5 mm (for ACL or MCL) or 8 to 9 mm wide (for ACL), and fixed into the drill holes made in the femur and tibia with sutures and buttons after excision of the original ligaments. The animals were sacrificed from 3 to 52 weeks postoperatively. Microangiographically, the ACL and MCL allografts were revascularized from the sixth postoperative week, and later developed an intrinsic vascular pattern similar to that of a normal ACL or MCL. Histologically, both the allografts regained a fibrous framework similar to that of normal ligaments, and showed no evidence of immunological rejection. Biomechanical tests on the ACL allografts showed that their mean maximum tensile loads at 52 weeks were 36% of those for the control ACLs, or 27% of those for the allografts before reconstruction. The tests on the MCL allografts showed that their maximum tensile loads at 52 weeks were 73% of those for the normal MCLs, or 60% of those for the allografts before reconstruction.
Angiography↗
Replacing the medial collateral ligament with an allogenic tendon graft. An experimental canine study.
In order to determine whether an allogeneic tendon could be used to replace an extra-articular ligament, the right medial collateral ligament from 11 adult dogs was replaced with a fresh-frozen allogeneic patellar tendon. At each of 3, 6, 15, 30 and 52 weeks postoperatively, one dog was killed for micro-angiographical and histological studies; at 52 weeks the remaining six dogs were killed for tensile testing. Micro-angiograms showed that the allogeneic tendon was revascularised with infiltration of the mesenchymal cells from the surrounding tissues and both ends of the graft. Histologically, the alignment of the fibroblasts and collagen bundles became more regular over time, without any immunological rejection. A biomechanical study performed at 52 weeks found no significant difference in stiffness or ultimate load between normal and reconstructed ligaments. Fresh-frozen allogeneic tendons are therefore considered useful for extra-articular ligament reconstruction.
Angiography↗
[Test method for pre-speech language: I. Outline of test].
The purpose of this study is to determine infants' preliminary linguistic ability. For this a pre-speech language test method has been developed. The test method is as follows. First, a definition of language is given. Then the development process in infancy is explained according to the definition. Subsequently, the test items are decided according to the above process. (1) Definition of language: It is difficult to define language because of its many aspects. Here, for the language definition, the aspects are restricted to the following based on the properties of natural language. Section-1 Situation of language i) Formation of communication ii) Understanding and grasping of situation circumstance Section-2 Development of symbolizing function Section-3 Representing the function of language (generally, articulation of babbling and functional change) (2) Development of language: the above three aspects develop and change from preterm infancy to late infancy. The development process is as follows. Section-1 i) The formation of communication is confirmed by action situations between baby and mother. The actions include a steady gaze in the early stage and talking baby talk later. Requests for instruction assistance and emotional communication appear with gradual differentiation of communication. Section-1 ii) Understanding and grasping of the situation circumstance is confirmed with response to action from mother to baby in the early stage. These are then confirmed with the ability to understand the action and situation of surroundings as time and space extensity, and to give appropriate appeal to the surroundings. Subsequently, understanding with language only is acquired by daily experience, including language and understanding of the surrounding.(ABSTRACT TRUNCATED AT 250 WORDS)
Age Factors↗
[Test method for pre-speech language: II. Outline of test result].
UNLABELLED: The tests as reported in the previous paper were conducted on 281 healthy babies. The test included 47 items. An accomplished item was accorded one point, and the total points were counted. RESULTS: descriptive statistics: i) Table 4 shows the proportion of right answers of each item by age (day). The day when the item was accomplished was definite and showed the properties of development. ii) Fig. 1 and table 1 showed the relationship between the total points and the age (day). The total points increased linearly with age (day). Discussion of test properties: i) Reliability: special attention was devoted to maintain consistent conditions on item formation to increase reliability. Consequently, the confidence coefficient was 0.989 in all cases. ii) VALIDITY: predictive validity was tested. The changes in language ability were investigated in 90 cases for observation over the passage of time (including cases other than those for standardization). The cases were divided into three groups by age (0-200, 201-400, 401-day) (Table 7). For an estimated value, the PPV was 0.60-0.67 and the NPV was 0.94-1.00 (Table 8). The NPV was higher than the PPV. iii) Test construction and figure of test construction: it was found that the test construction was composed of five factors and had stages of development as follows. (1) Initial call, communication (2) Positive appeal to the surrounding (3) Stage just before speech (4) Initial language acquirement and differentiation of language function (5) Speech-increasing stage The items included in each factor (each stage) are shown in the Fig. 1. profile in the previous paper.(ABSTRACT TRUNCATED AT 250 WORDS)
Age Factors↗
Arthroscopic follow-up of anterior cruciate ligament reconstruction using allogeneic tendon.
We have made a long-term arthroscopic study of anterior cruciate ligament (ACL) reconstructions using cryopreserved allogeneic tendon in 49 knees. Not only the reconstructed ACL itself, but also the entire joints were arthroscopically evaluated from 18 through 59 months postoperatively. Physical examinations at the arthroscopic follow-up revealed that Lachman's sign was negative in 45 and mildly positive in 4 patients and that the pivot-shift sign was negative in 46 and mildly positive in 3 patients. ACL grafts did not show any biodegradation with time but maintained a thick and viable appearance, although 3 of the taut ones showed partial necrosis in the anterolateral part. Fibrillation of the patellofemoral articular surface was commonly found, although no patients complained of anterior knee pain. Degenerative changes were usually found in those patients who had resumed strenuous activity without their menisci being intact. Follow-up arthroscopy was useful for monitoring the overall structures inside the post-operative knees, enabling us to persuade the patients to regulate their activity on the basis of objective evidence.
Adult↗
Maturation of allograft tendons transplanted into the knee. An arthroscopic and histological study.
We have performed an arthroscopic and histological study of the remodelling process of allogeneic tendons transplanted into the human knee as anterior cruciate ligament substitutes. Arthroscopic observations from six weeks to 55 months after operation showed that the grafts were viable, and that early surface hypervascularity subsided with time; moreover, these appearances remained unchanged from 11 months postoperatively onwards. Histological studies from three to 55 months after operation showed that all the grafts were infiltrated with fibroblasts, and that cellularity in their substance reduced with time, remaining unchanged from 18 months onwards; the collagen bundles were aligned as in a normal ligament from six months onwards. These findings suggest that the grafts reach maturity within the first 18 months and remain unchanged as viable ligaments thereafter.
Adolescent↗
Subluxation of the patella. Computed tomography analysis of patellofemoral congruence.
Fifty patients who had patellar subluxation and thirty control subjects were examined using axial roentgenograms of the patellofemoral joint that were made with the knee in 30 and 45 degrees of flexion, as well as computed tomography scans that were made with the knee in full extension. The amount of lateral patellar tilt was quantitatively assessed using the lateral patellofemoral angle, as described by Laurin et al., and the congruence angle, as described by Merchant et al. In both the control subjects and the patients, the angle of Laurin et al. changed significantly when the knee was flexed from full extension to 30 degrees. The difference between the groups was statistically significant at each angle of flexion of the knee, and the difference between the groups was most prominent on the computed tomography scans that were made with the knee in full extension (p less than 0.001). In the patients, the average congruence angle (as described by Merchant et al.) was 5 degrees and in the control subjects, -10 degrees. This indicated that, in our patients, the extent of the patellar subluxation was less than that in previously reported series, and, as a result, the sensitivity of the congruence angle in diagnosing patellar subluxation was only 0.30. In contrast, the sensitivity and specificity of the computed tomography scans for diagnosing patellar subluxation were 0.96 and 0.90, respectively--that is, they were higher than the values that were obtained using any axial roentgenograms. Thus, our results indicated that patellar subluxation can be detected more accurately by using computed tomography with the knee in full extension than by using conventional axial roentgenograms.
Adolescent↗
Measurement of anterior instability of the knee. A new apparatus for clinical testing.
We have developed an apparatus to measure the anteroposterior stability of the knee to forces of up to 250 N, applied at 20 degrees of flexion. We measured anterior laxity at 200 N, anterior stiffness at 50 N and total laxity at +/- 200 N. A study of cadaveric knees revealed that the soft tissues surrounding the bones had a significant influence on the force-displacement curve, and emphasised that differences between injured and normal pairs of knees are much more important than the absolute values of the parameters. In 61 normal volunteers we found no significant left to right differences in anterior laxity at 200 N and anterior stiffness at 50 N. In 92 patients with unilateral anterior cruciate deficiency there were significant differences (p less than 0.0005) in anterior laxity, anterior stiffness and total laxity, the injured-normal differences averaging 6.7 mm, 1.3 N/mm, and 8.1 mm respectively.
Adult↗
The voluntarily evoked posterolateral drawer sign in the knee with posterolateral instability.
Posterolateral instability of the knee refers to a ligamentous lesion that allows abnormal posterior and posterolateral subluxation of the tibial plateau. This condition is caused by injuries of the posterolateral structures (arcuate ligament complex) and the posterior cruciate ligament. Ten patients could produce the instability voluntarily by active muscle pull. Electromyographic studies clearly demonstrated that the biceps femoris muscle acted as a major subluxor and the popliteus as a reducer. The operative findings of the patients were not different from those of the patients who could not subluxate voluntarily. The active muscle pull of the popliteus is a key to treatment of posterolateral instability.
Accidents, Traffic↗
Reconstruction of the anterior cruciate ligament by allogeneic tendon graft. An operation for chronic ligamentous insufficiency.
We describe the use of allogeneic human tendon as an intra-articular replacement for the anterior cruciate ligament. Depending on the type and degree of functional instability we recommend the addition, in some cases, of supplementary extra-articular procedures. We have reviewed 31 patients at least two years after operation and have found that 30 of them had been able to return to full sporting activities. The indications for operation and the techniques are discussed and the use of allogeneic tendon is recommended.
Adolescent↗