Search PubMed⌕ Search

Biomedical subjects

K Tsunoda

Publications and source records attributed to K Tsunoda.

At least 91 records · Page 5Linked to original sources
PubMed1993

Changes in carpal alignment following radial osteotomy for Kienböck's disease.

Changes in carpal alignment following radial osteotomy were studied in 30 patients with Kienböck's disease. The carpal height ratio and carpal-ulnar distance ratio were significantly less in wrists with Kienböck's disease than unaffected wrists. This observation implies proximal-ulnar translation of the capitate. In addition, the lunate-covering ratio increased significantly, reflecting radial translation of the lunate. Radial osteotomy corrected ulnar translation of the capitate and increased the radial translation of the lunate, thus increasing the lunate-covering ratio. The increased lunate-covering ratio is believed to increase the area of distribution of the axial load through the lunate by increasing the contact area with the radius. The satisfactory clinical outcome of radial osteotomy is believed to be due to this effect on carpal alignment.

Adolescent↗
PubMed1993

Scaphoid non-union: factors affecting the functional outcome of open reduction and wedge grafting with Herbert screw fixation.

50 patients with scaphoid non-union were treated by open reduction, anterior wedge bone grafting and internal fixation using the Herbert screw. Intra-operative image intensifier control enabled us to insert the screw into the scaphoid accurately. An excellent or good functional outcome was less likely when more than 5 years had elapsed since injury, the non-union was in the proximal third, when sclerosis of the proximal fragment was present, and when reduction of carpal and scaphoid deformity was unsatisfactory. These four factors are believed to be the primary determinants affecting the functional results of the surgical treatment of scaphoid non-union, even when bony union is achieved.

Adolescent↗
PubMed1993

The aetiological significance of work-load in the development of osteoarthritis of the distal interphalangeal joint.

The incidence of Heberden's nodes was determined in three groups of Japanese women with different occupations to investigate the role of work-load in their pathogenesis. School cooks (n = 260), each of whom prepared 150 to 450 lunches daily, pre-school cooks (n = 222), each of whom prepared 30 to 80 lunches daily, and municipal employees (n = 298) underwent physical examination and X-ray of the hand if pathology was present. The incidence of Heberden's nodes and X-ray incidence of osteoarthritis was 19.2% and 13.5%, 8.6% and 5.4%, 5.9% and 2.0% among school cooks, pre-school cooks and municipal workers, respectively. The incidence of Heberden's nodes and osteoarthritis was significantly higher among school cooks. These findings support the concept that work-load is an aetiological factor in the pathogenesis of Heberden's nodes and also support Radin's hypothesis that women's daily work pattern explains the increased incidence of DIP joint osteoarthritis in women.

Adult↗
PubMed1993

Hypotensive effect of losartan, a nonpeptide angiotensin II receptor antagonist, in essential hypertension.

We examined the chronic effects of losartan (DuP 753), a novel orally active angiotensin II receptor antagonist, on blood pressure and renal function in eight hospitalized patients with essential hypertension. After a control period of 1 week, losartan was administered orally once a day for 2 to 4 weeks in increasing doses of 12.5, 25, 50, and 100 mg, until blood pressure in the supine position decreased more than 20 mm Hg (systolic) and 10 mm Hg (diastolic) (or 13 mm Hg in mean blood pressure). The average dose of losartan was 59.4 +/- 43.7 (mean +/- SD) mg/day. Systolic, diastolic, and mean blood pressures, according to 24 h monitoring, fell significantly, from 151.9 +/- 6.8 to 137.2 +/- 7.9 mm Hg, from 90.6 +/- 3.7 to 81.0 +/- 3.7 mm Hg, and from 111.1 +/- 4.6 to 99.7 +/- 5.0 mm Hg, respectively (mean +/- SE, P < .01 for each), with no change in circadian rhythm or variability of blood pressure. Reduction in blood pressure was slightly greater during daytime than during sleep time. Unlike peptide angiotensin II antagonists, losartan did not exert pressor action. No significant alterations were observed in body weight, serum electrolytes, creatinine clearance, urine volume, or urinary excretion of sodium. Losartan significantly lowered serum uric acid concentration from 5.5 +/- 0.4 to 4.8 +/- 0.3 mg/dL (P < .05). Urinary excretion of uric acid increased significantly from 498.9 +/- 64.4 to 540.6 +/- 66.6 mg/day (P < .05). Plasma renin activity rose significantly but plasma aldosterone concentration did not change with the losartan treatment. These results suggest that losartan has a long-acting hypotensive effect with a hypouricemic action in essential hypertension.

Adult↗
PubMed1993

Late cardiac strangulation due to an iatrogenic pericardial defect.

A 14-year-old boy developed broad posterolateral myocardial infarction. During cardiac surgery at age five, a small pericardial window had been made. Autopsy revealed an extensive left-sided pericardial defect and necrosis of the left ventricular free wall, which had herniated and strangulated through the enlarged pericardial defect.

Adolescent↗
PubMed1993

Radial osteotomy for Kienböck's disease evaluated by magnetic resonance imaging. 24 cases followed for 1-3 years.

24 patients with Kienböck's disease were followed with magnetic resonance imaging (MRI) for 1-3 years. 9 patients were treated with radial shortening, 10 with radial wedge osteotomy and 5 patients were treated non-operatively. Signal intensity of the lunate on T1-weighted or T2-weighted images increased postoperatively in all operated on patients, and normal or near-normal signal intensity was observed in 9 patients on T1-weighted images and in 15 patients on T2-weighted images postoperatively. Signal intensity did not increase in any patient treated non-operatively. The postoperative increase in signal intensity on MRI following radial shortening and radial wedge osteotomy presumably is due to revascularization of the lunate.

Adult↗
PubMed1993

[The utility of three-phase bone scintigraphy in the assessment of fractured carpal scaphoid].

Thirty-seven joints in 36 patients with a fractured carpal scaphoid were evaluated by three-phase bone scintigraphy. They were classified into two groups according to their progress. Some were in good clinical condition and some in a non-union condition. Increased blood flow in the radial arteries and ample perfusion on and around the scaphoid bones on blood flow images suggested a good clinical course. The activity and the effectiveness of remodeling correlated well with the degree of scaphoid uptake on blood pool images taken more than seven days after the injury. Scaphoid uptake was more localized or there was almost none on blood pool images in cases with nearly complete recovery while it was amply visualized on static images. Blood pool images were indispensable for analyzing lesions and evaluating the clinical course. Two typical findings of scaphoid fractures were found on both blood pool and static images. One was diffusely increased scaphoid uptake seen in cases with a good clinical course, and the other was decreased uptake at proximal fragments seen in cases with non-union. It is concluded that three-phase bone scintigraphy provides useful information for evaluating the process of scaphoid fractures which cannot be obtained by means of conventional bone scintigraphy.

Adolescent↗
PubMed1993

Sex differences in respiratory and cardiovascular effects of beta-endorphin.

An attempt was made to determine sex differences in the effects of beta-endorphin (beta-EP) on respiratory and cardiovascular systems using Wistar rats. By the intracerebroventricular administration of beta-EP (0.18 mg/kg) to normal male and female rats, respiratory rate (RR), heart rate (HR) and mean arterial blood pressure (MABP) were depressed significantly (p < 0.01 or 0.001) and CO2 in expired gas increased significantly (p < 0.01). These suppressive effects of the peptide were transiently blocked by the intravenous injection of naloxone (0.2 mg/kg). No differences in the effects of beta-EP between estrous and diestrous female rats could be detected. The effects of the peptide were significantly stronger in RR, HR and MABP for females than for males (0.001 < p < 0.05). Testectomized rats showed suppressive effects of the peptide to the same extent as intact females, but the effects in ovariectomized rats did not differ from those for intact females. In testectomized and ovariectomized rats treated with testosterone, the former showed the same results as intact males, but not the latter. The suppressive effects of beta-EP on the respiratory and cardiovascular systems are thus remarkably relieved by androgen in male rats.

Animals↗
PubMed1993

[Posterolateral rotatory instability of the elbow--a case report and anatomical study of the lateral collateral ligament].

A 20-year-old woman was referred to our clinic complaining of recurrent subluxation of her right elbow. A posterolateral rotatory instability test revealed that she had insufficiency of the lateral collateral ligament. She was surgically treated; the ligament was reconstructed by using the palmaris longus tendon. A year after operation, she had no pain in her elbow, and regained full range of elbow motion. The function of the lateral collateral ligament is often overlooked. We, therefore, dissected 24 elbow joints and studied anatomically in order to confirm the origin and insertion of the lateral collateral ligament. The ligament originates from the lateral epicondyle, and runs distally in fan shape. It further inserts partly to the annular ligament and partly to the supinator crest. After complete sectioning of the ligament, the forearm was fixed in supination, then flexed with valgus moment. This maneuver elicited subluxation of the radio-humeral joint, which was similar to what we observed in the clinical case. From these observations, we have concluded that the ligament is important for stability of elbow joint as well as the medial collateral ligament.

Adult↗
PubMed1992

The Sauvé-Kapandji procedure for chronic dislocation of the distal radio-ulnar joint with destruction of the articular surface.

The Sauvé-Kapandji procedure has been performed in 15 non-rheumatoid patients with chronic distal radio-ulnar joint dislocation accompanied by joint damage or deformity. The clinical results were favourable; wrist pain improved in all patients, wrist flexion-extension was increased by more than 10 degrees in nine patients, grip strength of at least 80% of the contralateral wrist was achieved in 11 patients, and forearm rotation was more than 150 degrees in 12 patients. However, X-ray examination revealed an unstable proximal ulnar stump and radio-ulnar convergence in all patients similar to that associated with the Darrach procedure. Although the Sauvé-Kapandji procedure can preserve ulnar support of the wrist and is believed to yield more satisfactory results than the Darrach procedure, its extensive use is not recommended for non-rheumatoid distal radio-ulnar joint disorders, but it is recommended for chronic distal radio-ulnar joint dislocation with articular injury or deformity.

Adult↗
PubMed1992

Small adrenocortical tumors without apparent clinical endocrine abnormalities. Immunolocalization of steroidogenic enzymes.

Immunohistochemical analysis of steroidogenic enzymes (P-450 side-chain cleavage, 3 beta-hydroxysteroid dehydrogenase, P-450 C21-hydroxylase, P-450 17 alpha-hydroxylase and P-450 11 beta-hydroxylase) was performed on fifteen cases of small adrenocortical adenomas, which were detected incidentally in hormonally asymptomatic patients (non-functioning adrenocortical tumor), in order to study steroidogenesis in these tumors. Immunolocalization revealed that all cases examined expressed all the enzymes in the adrenocortical steroidogenic pathway to various degrees, and in twelve cases abnormalities of precursor hormones and steroid metabolites were clinically observed. Attached non-neoplastic adrenals were present in twelve cases. Among these twelve cases, eight showed cortical atrophy, especially in the zona fasciculata. These atrophied adrenals expressed little immunoreactivity of the enzymes examined. These results strongly indicate that most of small non-functioning adrenocortical tumors have the capacity to produce biologically active steroids including cortisol, although not necessarily associated with hypercorticism. Especially in the cases with cortical atrophy in attached non-neoplastic adrenals, it is considered that autonomous neoplastic production and secretion of cortisol may be insufficient to cause clinical and routine laboratory abnormalities but sufficient to subtly alter the hypothalamic-pituitary-adrenal axis by suppressing ACTH and/or CRF secretion and to result in adrenocortical atrophy. It should be recognized that corticosteroidogenesis does take place in the majority of clinically small non-functioning adrenocortical tumors incidentally detected in hormonally asymptomatic patients when managing these patients.

Adenoma↗
PubMed1992

Interaction of ANP with endothelin on cardiovascular, renal, and endocrine function.

To assess the interaction of endothelin (ET) with atrial natriuretic peptide (ANP) on cardiovascular and renal function, arginine vasopressin (AVP) release, and the renin-angiotensin-aldosterone system, either a low or high dose of ET (4 or 12 pmol.kg-1.min-1) was administered with ANP (26 pmol.kg-1.min-1) for 45 min after the initial infusion of ANP alone in anesthetized dogs. In the other groups, either ANP or saline alone was administered for 90 min. ANP alone decreased blood pressure (BP), cardiac output (CO), plasma aldosterone, and plasma renin activity (PRA), increased urinary Na and K excretion (UNaV and UKV, respectively) and urine flow (UF), but did not affect plasma AVP. The low dose of ET had no effect on these ANP-induced changes. However, the high dose of ET curtailed the responses to ANP, increased BP and PRA, and decreased UNaV, UKV, and UF associated with decreased renal plasma flow and glomerular filtration rate. High ET also further potentiated the decrease in CO and the increase in total peripheral resistance induced by ANP and increased plasma AVP. These results indicate that a dose of ET one-half that of ANP (on the molar ratio) may have completely counteracted vascular, hormonal, and renal responses to ANP.

Aldosterone↗
PubMed1992

Xeroderma pigmentosum variant associated with multiple skin cancers and a lung cancer.

A 65-year-old Japanese man with a xeroderma pigmentosum (XP) variant, XP127TO, is described. The XP127TO skin fibroblasts exhibited the typical XP variant characteristics of a 1.5-fold higher sensitivity than normal cells to the lethal effect of 254 nm ultraviolet (UV) light and the normal level of unscheduled DNA synthesis induced by 254 nm UV. Caffeine dose-dependently increased the cytotoxic effect of 254 nm UV on XP127TO cells. Clinically, the patient developed not only 3 cutaneous squamous cell carcinomas on sun-exposed areas but also an adenocarcinoma of the upper lobe of the right lung. A review of the 14 documented Japanese XP patients with nonskin malignancies indicates that the incidence of nonskin malignancy in XP patients is much lower than that of skin cancer in XP but higher than that in the general population.

Adenocarcinoma, Papillary↗
PubMed1992

Beta-endorphin secretion at the time of sudden death due to cardiac or respiratory failure.

Using male and female Wistar rats, pituitary response to cardiac and respiratory failure type (CFT and RFT) sudden death caused by the intravenous administration of KC1 and SCC, respectively, was examined by analyzing variation in pituitary immunoreactive beta-endorphin (IR-beta-EP) levels determined by radioimmunoassay after death and in circulating IR-beta-EP levels during periods of agony. In the pituitary gland of both sexes which differed significantly in ratio of the organ weight to body weight for CFT and RFT (CFT greater than RFT), IR-beta-EP was significantly less in RFT than in CFT (p less than 0.05). No variation in plasma IR-beta-EP was noted during short periods of agony in CFT, but it markedly increased during long periods of agony in RFT. The highest elevation at 2 or 4 minutes after SCC administration was about 3 times the preadministration value for IR-beta-EP in males (p less than 0.01). But elevation in females was lower than in males. Rise plasma IR-beta-EP during agony of RFT is regarded to be of pituitary origin due to dexamethasone treatment. The pituitary was thus concluded to respond more to the fatal agony in RFT than in CFT.

Animals↗