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Biomedical subjects

K Yonenobu

Publications and source records attributed to K Yonenobu.

85 records · Page 5Linked to original sources
PubMed1984

Arthrogryposis of the hand.

Forty-five cases of arthrogryposis multiplex congenita were reviewed with respect to deformities and function of the hand. A distal predominance of the involvement and severity was apparent; hand deformity was a common manifestation in the arthrogrypotic patients. The majority of the hand deformities consisted of two types: one was a thumb-in-palm deformity with the fingers in intrinsic plus position, and another type was flexion contractures of the fingers at the interphalangeal joints. Regardless of type, hand function was impaired with severe or moderate deformity. Twenty-nine hands of 17 patients were successfully treated by surgery. Surgical methods are discussed based on an analysis of hand deformity and function.

Adolescent↗
PubMed1983

Duplication of the thumb. A retrospective review of two hundred and thirty-seven cases.

Over a twenty-two-year period, 237 patients (261 hands) with duplication of the thumb were seen in the Hand Clinic of Osaka University Hospital. Two groups were identified: Group A, 141 patients without previous surgical treatment, and Group B, ninety-six patients with residual deformity despite previous surgical treatment. Using a modification of Wassel's classification, seven types of deformity were defined. In Group A these types were identified on the basis of the observed duplications of bone and soft tissue. In all but ten of the Group-B patients preoperative roentgenograms were not available and the type of deformity had to be deduced from the residual duplicated bone, the surgical scar, and the residual deformity. Surgery, performed on 193 hands (125 in Group A and sixty-eight in Group B), attempted to restore normal anatomical relationships. The results could be evaluated in 130 hands according to the range of motion, joint stability, and alignment of the remaining thumb after an average follow-up of 35.0 months. According to the rating system described, the results were rated as good in 75.5 per cent, fair in 20.2 per cent, and poor in 4.3 per cent of the ninety-four hands in Group-A patients who were followed. In the thirty-six hands of Group-B patients who could be followed, the preoperative and postoperative scores were compared. Thirteen were not improved while the other twenty-three, sixteen improved from fair to good and seven improved from poor to fair, to give a good result in 63.9 per cent of the Group-B patients who were followed. The results in these 130 Group-A and B hands emphasize the importance of providing muscle balance and, in young patients, of performing an arthroplasty of the interphalangeal or metacarpophalangeal joint when indicated, although arthrodesis was indicated as a salvage operation for Group-B patients who were more than fifteen years old.

Adolescent↗
PubMed1982

Apert's syndrome--a report of five cases.

This report presents five cases of Apert's syndrome with features of acrocephaly, characteristic face and complete syndactyly of the hand and foot with bony fusion. Three cases out of five showed preaxial polydactylies of the foot, considered to be one of the characteristic features of Carpenter's syndrome. In the remaining two cases, the first digital ray of the foot was broad and deformed. In addition one case had a postaxial polydactyly of the hand. Three cases showed severe deformity of the shoulder; two had dysplasia and one had synchondrosis of the glenohumeral joint. On the basis of our findings in this, we feel that there is much phenotypic overlap between Apert's and Carpenter's syndrome. A polydactylous presentation of the hand and foot can be found in not a few cases of Apert's syndrome and it is not always an exclusive feature of Carpenter's syndrome.

Acrocephalosyndactylia↗
PubMed1982

Mirror hand anomaly: reconstruction of the thumb, wrist, forearm, and elbow.

Surgical procedures and the results of reconstruction of the mirror hand anomaly are presented. The thumb was reconstructed by pollicization of the radial third finger and multiple muscle transfer. The function of wrist, forearm, and elbow improved with arthroplasty of the affected joints. The results of the follow-up are satisfactory. We believe that surgical treatment of the mirror hand should be started in early life.

Arm↗
PubMed1981

Congenital central ray deficiency in the hand- a survey of 59 cases and subclassification.

Eighty-nine hands were studied in 59 patients with central ray deficiency. A subclassification into two subgroups was established based on the clinical and radiological findings-subgroup I: typical type and subgroup II: (atypical type) with type a, syndactylous type, and type b, polydactylous type. In subgroup I, the sequential severity of deficiency ranged from a partial defect of phalanges of the middle finger to a monodigit hand. The central digital elements were fused to adjacent digital rays in subgroup II-type a. Supernumerary bony elements were seen in subgroup II-type b. The close relationship between central ray deficiency, syndactyly, and polydactyly was discussed from the standpoint of development of the hand. The classification of central ray deficiency into the longitudinal deficiency category of the International Classification of Congenital Limb Malformations was recommended.

Congenital Abnormalities↗
PubMed1979

Development of spinal motoneuron innervation of the upper limb muscle in the rat.

Horseradish peroxidase was injected into the biceps brachii muscle of rats at various stages of development, from 10 days to 50 weeks. The retrogradely labeled neurons were found in the ipsilateral ventro-lateral column of the cervical cord, C4--C8, of all stages studied, but the number of labeled neurons decreased according to exponential curve as the age advanced. A striking finding was that the contralateral ventral horn cells were also labeled in the 10- and 14-day-old rats.

Animals↗
PubMed1979

[The topographical localization of spinal motoneurons of the rat and its numerical alternation in regard to development (author's transl)].

The topographical localization of spinal motoneurons innervating the forelimb muscles of the rat and its numerical alternation in regard to development was observed by HRP (horseradish peroxidase) method. HRP method is a histochemical technique to trace the cellular origin of axon terminal net work. When HRP is injected into the muscles, the enzyme is taken up by nerve endings and transported retrogradely by the axoplamic flow to the original cell body, and does not transported hematogenously and does not cross the synapse. The spinal motoneurons were found in spindle-shape longitudinal cell columns according to its innervation. The motoneurons supplying the biceps brachii muscle were located in the dorso-lateral nucleus on the anterior horn of the 4th cervical segment, and extended downward to the ventral nucleus in 8th cervical segment, forming a spindle-shape cell column. The thick spindle-shape cell column consisting of cells which innervated the triceps brachii muscle lied in the ventro-medial nucleus of the 6th, 7th and 8th cervical segment. The neurons innervating the flexor carpi ulnaris muscle were located in 7th and 8th cervical segment, but few in number compared to those of the biceps and triceps. The motoneurons innervating the biceps brachii muscle decreased in number with increasing age according to exponential curve. The total number of HRP-labeled neurons in two week old rat ranged from 2,932 to 2,017 and markedly decreased during first eight weeks, in eight week old rat ranged from 1,637 to 603. After this, they gradually decreased to 312 in 50 weeks on an average, where the number corresponded to about 13% of those of two week old rat. The data indicate that ventral horn has a great deal of excess neurons which has a distinct neuromuscular connection as suggested by Prestige, in the developmental stage of Xenopus laevis. In young rats (ten days to two weeks of age), HRP-labeled neurons were also present in the ventral horn on the non-injected side. These large and multigonal contralateral HRP-labeled neurons constituted a characteristic feature of spinal motoneurons, and distributed through the same segment as those on injected side. The total number of HRP-labeled neurons within non-injected side ranged from 563 to 197 and corresponded from one-fifth to one-tenth of that in the injected side. In five weeks or elder rat, no HRP-labeled neurons could be observed in non-injected side. This indicates that in immature rats the muscles are innervated bilaterally by the spinal nerve, since HRP is transported by retrograde axoplasmic flow and does not cross the synapse, and the bilateral motor innervation has disappeared with maturation. The bilateral motor innervation is therefore, presumed to be an immature mode of innervation limited to the early stage of life. Although bilateral motor innervation following the nerve injury in the limb at the early stage of life has been confirmed by ourselves, the significance of the immature mode of innervation is still hard to explain.

Aging↗
PubMedDate not supplied

Canal diameter, anteroposterior compression ratio, and spondylotic myelopathy of the cervical spine.

Nine patients with cervical spondylotic myelopathy, diagnosed during life, were subjected to detailed clinicopathologic study. The degree of cord destruction was in good correlation with the ratio of the anteroposterior diameter to the transverse diameter, designated as an anteroposterior compression ratio. Within the factors responsible for decrease in the ratio, developmental narrowing of the spinal canal was the most significant, and multiplicity of spondylotic protrusion less so. The former resulted in an extensive demyelination of the posterolateral funiculus and infarction of the gray matter. Recurrent trauma proved to cause distinct manifestations and cord pathology. Clinicopathologic correlations were also examined from the neurologic findings at the terminal stage.

Aged↗
PubMedDate not supplied

Longitudinal study of spinal deformity in Duchenne muscular dystrophy.

To investigate the natural course of the spinal deformity in Duchenne muscular dystrophy (DMD) and its clinical relevance, longitudinal series of spinal radiographs and medical records of 46 patients with DMD were reviewed. The natural course of the deformity was classified into three types; type 1 (n = 21), unremittent progression of scoliosis with kyphosis; type 2 (n = 18), transition from kyphosis to lordosis before age 15 years; and type 3 (n = 7), less deformity without prominent longitudinal changes. Age at loss of ambulatory ability was not a predictor of type. Neither was the age at which the Cobb angle was 30 degrees correlated with the rate of subsequent progression. Because the spinal deformity always progresses, we consider spinal surgery justifiable in type 1, when a certain strict indication exists, such as spinal deformity > 30 degrees and age < 15 years in patients with > 35% predicted value of vital capacity. In type 2, operation may be necessary in patients in whom Cobb angle will progress unremittently. There is no surgical indication for patients with type 3.

Adolescent↗