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Biomedical subjects

K Shino

Publications and source records attributed to K Shino.

At least 73 records · Page 4Linked to original sources
PubMed1984

Replacement of the anterior cruciate ligament by an allogeneic tendon graft. An experimental study in the dog.

The revascularisation and remodelling of allografts used to replace the anterior cruciate ligament in the canine knee were studied by microangiographic, histological and biomechanical methods. The 26 allografts were obtained from the patellar tendons of other dogs and were stored by deep freezing. In a control study a strip of patellar tendon from the same leg was used as an autologous free graft. Microangiography showed that the allografts had been revascularised from the sixth postoperative week, and had later developed an intrinsic vascular pattern similar to that of a normal anterior cruciate ligament. Histologically, the allograft regained a fibrous framework similar to that of a normal ligament, and showed no evidence of immunological rejection. Biomechanical tests on the allograft replacements showed that their mean maximum tensile strength at 30 weeks was about 30% of that of the control ligaments. There were no significant differences between the mechanical properties of the allografts and the autografts.

Angiography↗
PubMed1982

[Clinical studies on cefmenoxime in the pediatric field].

Clinical studies in the field of pediatrics have been carried out with cefmenoxime (CMX), a new cephalosporin antibiotic and the following results were obtained. 1. CMX was administered intravenously by drip infusion in 23 patients with infectious diseases. These diseases consist of 10 pneumonia, 1 bronchitis, 6 upper respiratory tract infections, 2 acute pyelitis, 3 other urinary tract infections and 1 Douglas abscess. CMX was effective in all cases except 1 case of pneumonia with pyothorax. 2. No side effects have been observed in all cases. As for abnormal laboratory findings, 2 cases of eosinophilia, slight elevations of GOT in 3 cases and GPT in 2 cases were seen.

Age Factors↗
PubMed1982

[Clinical effects of netilmicin].

In the present study, we used netilmicin for the postoperative complications and obtained the following results. 1. Netilmicin was used in totally 29 cases; 23 with localized peritonitis, 4 with generalized peritonetis and 2 with wound infection. Excellent effects were obtained in 2 cases, effective results in 24 cases and ineffective results in 3 cases. The effective rate was 89.7%. 2. Adverse reactions or abnormal clinical laboratory test results which might be attributable to the use of netilmicin were not noticed.

Adult↗
PubMed1982

[Clinical application of cefsulodin in gravely ill children with Pseudomonas infection].

Our investigation of cefsulodin in pediatric Pseudomonas infect ion produced the following results. 1. Cefsulodin (CFS) was administered intravenously by one shot or drip infusion in 3 patients with Pseudomonas infections. These diseases consisted of pneumonia with IgA deficiency, ALL with opportunistic infection, UTI with paraplegia due to spina bifida. CFS was effective in all cases. 2. Transient eosinophilia was observed in 1 case. But other side effect was not noted in any cases.

Adolescent↗
PubMed1981

[Clinical studies on cefotiam in pediatric infections (author's transl)].

Our investigation of cefotiam in pediatric infection produced the following results: 1. Cefotiam was administered intravenously by one shot or drip infusion in 20 patients with infectious diseases. These diseases consisted of 13 pneumonia, 3 upper respiratory tract infections, 3 pyelonephritis, 2 other urinary tract infections and one purulent meningitis. Cefotiam was effective in all cases. 2. Transient elevation in serum GOT, GPT, Al-P and LDH was observed in 3 cases. But other side effect was not noted in any cases.

Age Factors↗
PubMed1980

A prototype apparatus for microexplosion cystolithotripsy.

We developed a prototype apparatus for microexplosion lithotripsy in the urinary bladder according to our original idea. A model calculus in a pig bladder was successfully crushed by the apparatus and was removed by aspiration.

Animals↗
PubMedDate not supplied

Chondral injury associated with acute isolated posterior cruciate ligament injury.

SUMMARY: To evaluate associated cartilaginous damage with acute isolated posterior cruciate ligament (PCL) injury without other concomitant ligamentous injury, arthroscopic evaluations were performed on 61 consecutive patients. Meniscal tear was found in 17 cases (28%). Of these, 3 had medial meniscal tear, 11 had lateral meniscal tear, and 3 had both medial and lateral meniscal tears. Longitudinal tears of anterior segment in lateral menisci were the most common (10 cases). Thirty-two patients (52%) had articular cartilage injury. Of these, 7 had damage greater than one half of the thickness of the articular cartilage, and 3 had erosion that extended to the subchondral bone. The most frequently injured location was the medial femoral condyle (19 cases, 31%). Significant cartilaginous injury could be combined in acute isolated PCL injury. Therefore, it is unreasonable to manage every acute isolated PCL-injured knee using a single treatment modality. Concomitant meniscal and articular cartilaginous lesions should be evaluated when treatment for acute PCL injury is planned.

Accidents, Traffic↗
PubMedDate not supplied

Progression of cellular repopulation and collagen synthesis in fresh-frozen allograft tendons.

The progression of cellular repopulation and collagen synthesis in fresh-frozen rat patellar tendon allografts was investigated by means of indirect immunofluorescence histologic analysis and electron microscopic techniques for 8 weeks after transplantation. In each of 10 procedures, the medial half of the patellar tendon with a tibial bone block was harvested from a Wistar rat and transplanted into a corresponding defect in the medial patellar tendon of a Lewis rat. Actin filaments in the repopulating cells and newly synthesized collagen fibrils in the graft were identified with rhodamine-phalloidin stain and with a polyclonal antibody against type III collagen aminopropeptide. On the first day after transplantation, no specific fluorescence was detected in the graft. One week later, specific labeling for fibrillar-actin (F-actin) and type III collagen aminopropeptide was detected in an area extending from the adjacent granulation tissue into the proximal end of the graft. F-actin and type III collagen aminopropeptide were aligned along the longitudinal axis of the graft and extended from the proximal suture site toward the distal portion. Two weeks after transplantation, fibrillar labeling for F-actin and type III collagen amino-propeptide showed that remodeling had extended to the midportion of the graft. Labeling throughout the entire graft was detected 4 weeks after transplantation. During the entire remodeling process, the repopulated fibroblasts consistently retained their elongated shape and their alignment with the longitudinal axis of the graft. The cells developed well-organized actin bundles at their peripheries, which identified them as having a myofibroblast phenotype. Immunofluorescence detection for type III collagen aminopropeptide also showed consistent alignment parallel to the longitudinal axis of the graft and a fibrillar arrangement. Electron microscopy revealed thinner collagen fibrils in the vicinity of the fibroblasts, which were aligned in the direction of the actin bundles. These results indicate that, during the early remodeling phase, collagen synthesis and deposition in the graft proceeds while the original alignment of the graft matrix is preserved. The close association between the alignment of actin bundles in repopulated "myofibroblastic" cells and that of newly synthesized collagen fibrils along the lines of the graft matrix may represent evidence of force transmission between the actin cytoskeleton and the linking extracellular matrix in vivo.

Journal Article↗
PubMedDate not supplied

Osteochondritis dissecans of the lateral femoral condyle of the knee joint.

Differences in the features of osteochondritis dissecans (OCD) affecting the lateral and medial femoral condyles were investigated in 13 patients (14 knees) treated from 1991 to 1994. OCD affected the lateral femoral condyle in 6 knees (lateral group) and the medial condyle in 8 knees (medial group). The lateral group was younger (mean age, 14 v. 20 years). The radiological stage (Brückl) of the lateral group was stage 2 in 3 knees and stage 3 in 3. The lateral menisci were all discoid and the condylar articular surface of the lesions was normal in two knees, softened in 3 and detached in 1. The medial group comprised 1 knee in stage 2, 1 in stage 3, 1 in stage 4, and 5 in stage 5. The OCD lesion showed softening in 2 knees and detachment in 6. Repetitive abnormal stress on weaker osteochondral structures in the growing period produced by a discoid meniscus during growth may cause OCD of the lateral femoral condyle.

Adolescent↗
PubMedDate not supplied

Preoperative anterior knee laxity did not influence postoperative stability restored by anterior cruciate ligament reconstruction.

Eighty-six chronic anterior cruciate ligament (ACL)-injured patients were quantitatively measured for anterior knee stability preoperatively and at 2 years or later (mean, 30 months) postoperatively to examine the influence of preoperative knee laxity on the postoperative knee stability restored by the ACL reconstruction using multiplied hamstring tendon graft. The patients were divided into 3 groups according to the preoperative injured minus normal anterior laxity difference (AL-D) (group I [n = 27] <5 mm, group II [n = 48] 5 to 9 mm, group III [n = 11] >10 mm). The 3 groups were comparable in gender, age, meniscal status, graft excursion measured during operation, time from injury to operation, and activity level. The postoperative AL-D in group I was 0.8 +/- 1. 7 mm, that in group II was 1.1 +/- 1.6 mm, and in group III was 1.5 +/- 1.4 mm. There were no significant statistical differences among these 3 groups. With our surgical technique including postoperative rehabilitation, patients with severe instability could be treated successfully without needing any additional procedures such as extra-articular augmentation or specially designed postoperative rehabilitation programs.

Adolescent↗
PubMedDate not supplied

Reconstruction of the anterior cruciate ligament using allogeneic tendon. Long-term followup.

Eighty-four patients who underwent ACL reconstruction with fresh-frozen allogeneic tendon were reviewed and evaluated with subjective and functional rating scales, physical examinations, instrumented anterior drawer tests, isokinetic testing, and arthroscopy. The average followup was 57 months (range, 36 to 90 months) and the average age at operation was 22 years (range, 16 to 37 years). The subjective and functional results were rated as excellent in 48 patients (57%), good in 31 (37%), and fair in 2 (2%). Three patients (3%) experienced a retear of the ACL. Physical examinations and instrumented anterior drawer tests showed that satisfactory anterior stability was restored in 88% of the patients. Isokinetic evaluations demonstrated that the extension torque of the involved knee recovered to a slightly lower level than that of the controls, although the flexion torque recovered to a level equivalent to that of the controls. Arthroscopic evaluations revealed that the allografts were elaborately remodeled, viable, and taut. There was no sign of immunologic rejection at any time postoperatively. Additional extraarticular procedures, consisting of both pes anserinus transfer on the medial side and iliotibial band reinforcement on the lateral side, had no effect on the results.

Adult↗
PubMedDate not supplied

Articular cartilage lesions in ankles with lateral ligament injury. An arthroscopic study.

To investigate intraarticular lesions producing persistent postoperative pain, we arthroscopically examined 31 ankles in 31 patients (15 women and 16 men) with lateral ligament injury. The patients ranged in age from 15 to 33 years, with a mean of 20 years. Nine patients were freshly injured, and 22 patients had chronic injuries. All of the patients underwent arthroscopic examination immediately before the ligament operation. Chondral lesions were found in 89% of the freshly injured ankles and 95% of the ankles with chronic injuries. Most of these lesions were in the medial half of the ankle joint, especially in the anteromedial edge of the tibial plafond. After followup for 1 year postoperatively, persistent pain was noted in 4 patients who had chondral lesions of greater than one-half the thickness of the articular cartilage. Pain and tenderness were localized at the anteromedial joint line, corresponding to the location of the chondral lesions. Chondral lesions of greater than one-half the thickness of the articular cartilage were found in 8 ankles in the chronic injury group, but there were none in the fresh injury group. Thus, in lateral ligament injuries of the ankle, the longer the time elapsed from the initial injury, the more severe the associated chondral lesions became. These chondral lesions appear to cause persistent pain.

Acute Disease↗
PubMedDate not supplied

Deterioration of patellofemoral articular surfaces after anterior cruciate ligament reconstruction.

One hundred eighty-seven patients who had undergone intraarticular anterior cruciate ligament reconstruction using either a fresh-frozen allogeneic tendon or central third autogenous pateller tendon 3 to 89 months previously were arthroscopically evaluated. The focus was on secondary changes of the patellofemoral joint at the time of second-look arthroscopy. Overall, 93 knees deteriorated, 74 knees remained unchanged, and 14 improved. The deteriorative changes were predominantly located around the central ridge of the patellae, although all but two knees remained free from anterior knee pain. Statistical multivariate analysis showed surgical approach by conventional medial parapatellar incision and use of the central one-third of the autogenous patellar tendon graft as possible risk factors for the deterioration, although chi-square analysis failed to demonstrate statistical significance for the latter.

Adolescent↗
PubMedDate not supplied

Quantitative evaluation after arthroscopic anterior cruciate ligament reconstruction. Allograft versus autograft.

We measured the anteroposterior ligamentous laxity and thigh muscle power in 92 subjects who were rated as successes after they had undergone arthroscopic anterior cruciate ligament reconstruction for unilateral anterior cruciate ligament insufficiency 18 to 36 months previously. The subjects were divided into 2 groups according to the type of graft: fresh-frozen allogenic tendon (N = 47) or central one third of the ipsilateral patellar tendon (N = 45). Instrumented drawer tests in the Lachman position were performed to measure anterior tibial displacement at 200 N (anterior laxity). Thigh muscle power was isokinetically measured with a Cybex II dynamometer. Significantly more anterior laxity was found in the reconstructed knees than in the contralateral normal knees regardless of graft material (paired t-test, P < 0.01), except for the male allograft patients. Although the mean anterior laxity difference between sides for the allograft patients was less than that for the autogenous ones, analysis of variance failed to demonstrate a statistically significant difference between the 2 groups if the comparison was strictly made within the same sex. Thigh muscle tests revealed that extension torque in the reconstructed knees was significantly less than that in the contralateral knees and analysis of variance showed that knee extension torque at 60 deg/sec for the allograft patients was significantly better than that of the autograft ones (P < 0.05). We concluded that the allograft procedure is advantageous over the patellar tendon autograft in terms of better restoration of anterior stability.

Adolescent↗
PubMedDate not supplied

Collagen fibril populations in human anterior cruciate ligament allografts. Electron microscopic analysis.

We studied human anterior cruciate ligament allograft specimens by quantitative electron microscopy to analyze their collagen fibril populations. The specimens were procured at the time of second-look arthroscopy from the superficial region of the midzone of the anterior cruciate ligament grafts after synovial clearage. The grafts used for the anterior cruciate ligament reconstructions were from fresh-frozen allogenic Achilles, tibialis anterior or posterior, or peroneus longus or brevis tendons and had been implanted 3 to 96 months previously. By 12 months after surgery, the anterior cruciate ligament allografts consisted predominantly of small-diameter collagen fibrils (30 to 80 nm), which resulted in a unimodal pattern in the collagen fibril profile. The number of large-diameter fibrils (90 to 140 nm) within the allogenic tendon grafts had decreased. This predominance of small-diameter collagen fibrils persisted in almost all specimens older than 12 months. The anterior cruciate ligament allografts had collagen fibril profiles that did not resemble normal tendon grafts or normal anterior cruciate ligaments, even several years after surgery.

Achilles Tendon↗
PubMedDate not supplied

Anterior cruciate ligament reconstruction with multistranded autogenous semitendinosus tendon.

We evaluated 41 knees 24 to 48 months after anterior cruciate ligament reconstruction was performed using multiple autogenous semitendinosus tendons. The ipsilateral free semitendinosus tendon was tripled or quadrupled to make a graft 7 to 10 mm in diameter and more than 60 mm long. When the diameter of the graft was less than 7 mm, an ipsilateral doubled gracilis tendon was also used (in seven cases). Twenty-three patients (56%) returned to their preinjury activity levels. According to the patients' subjective assessment, 34 (83%) graded themselves as normal or nearly normal. No patient reported giving way of the knee or limitation of knee motion. The average anterior laxity difference between the involved knee and contralateral uninjured knee was 1.5 mm at 200 N. Twenty-nine patients (71%) demonstrated an anterior laxity difference of 3 mm or less when the involved knee was compared with the contralateral uninjured knee. Quadriceps muscle strength was 90% compared with the contralateral healthy limb, and hamstring muscle strength was equivalent to the contralateral limb. In our study, tripled or quadrupled semitendinosus free tendons were excellent anterior cruciate ligament grafts for restoring knee stability, recovering thigh muscle power, and preserving knee motion.

Adolescent↗
PubMedDate not supplied

MRI of fibrous cortical defect of the femur.

The MR imaging findings of 10 cases of fibrous cortical defect of the femur are presented. Although surgical biopsy was not available in the 10 cases, clinical follow-up confirmed the diagnosis. Most of the lesions were located on the posteromedial aspect of the distal femur, corresponding to the site of attachment of the extensor tendon of the adductor magnus muscle or the medial head of the gastrocnemius. They were oval in shape, and their diameter ranged from 29 x 15 mm to 8 x 6 mm, with an average of 14 mm. With MR, most of the fibrous cortical defects were imaged with iso-signal intensity to muscle on T1-weighted images and high signal intensity on T2*-weighted images. They were invariably surrounded by low signal intensity rims on both sequences, representing marginal sclerosis. The appearance seemed to be sufficiently diagnostic to obviate the need for biopsy.

Adolescent↗