Search PubMed⌕ Search

Biomedical subjects

Shinya Kawai

Publications and source records attributed to Shinya Kawai.

At least 19 recordsLinked to original sources
PubMed2003

Ulnar variance and the role of joint levelling procedure for Kienböck's disease.

Forty patients with Kienböck's disease were reviewed to determine the relationship between ulnar variance and the development of Kienböck's disease in a Japanese cohort. The joint levelling procedures designed to correct ulnar variance were evaluated in 11 patients after a mean of 9.7 years following surgery. The mean ulnar variance was 0.50+/-1.67 in patients with Kienböck's disease and 0.56+/-1.76 in a control group. The onset of wrist symptoms in a younger age group was noticed after sports injuries, whereas older patients had no distinct history of trauma. Joint levelling procedures produced good clinical results, but carpal height ratio, Stahl's index and radioscaphoid angle were not improved, as evidenced radiographically. Our study suggests that in a Japanese cohort ulnar minus variance is not an important factor in the aetiology of Kienböck's disease. Although joint levelling procedures improved the clinical results, they did not reverse lunate collapse or carpal alignment.

Adolescent↗
PubMed2003

Patellar tendon rupture and marked joint instability after total knee arthroplasty.

BACKGROUND: Patellar tendon rupture is a rare complication of total knee arthroplasty (TKA). Multiple repair methods have been described in the literature. METHODS: A 66-year-old woman suffered a patellar tendon re-rupture and marked joint instability within 6 months after revision TKA. She underwent re-revision TKA and extensor mechanism reconstruction with femoral quadriceps tendon and augmentation by a Leeds-Keio ligament. RESULT: It was fairly difficult to acquire a satisfactory range of motion as well as gain in knee extension capacity by eliminating the extension lag. CONCLUSION: Patellar tendon ruptures after TKA should be repaired as soon as they are recognized.

Aged↗
PubMed2003

Down-regulation of an anionic peroxidase in transgenic aspen and its effect on lignin characteristics.

It is generally accepted that peroxidases catalyze the final step in the biosynthesis of lignin. In this study, to examine how expression of prxA3a, a gene for an anionic peroxidase, might be related to lignification in plant tissues, we produced transgenic tobacco plants that harbored a gene for beta-glucuronidase (GUS) fused to the prxA3a promoter. Histochemical staining for GUS activity indicated that the prxA3a promoter was active mainly in the lignifying cells of stem tissues. Further, to examine the effects of suppressing the expression of prxA3a, we transferred an antisense prxA3a gene construct into the original host, hybrid aspen ( Populus sieboldii x P. gradidentata), under the control of the original promoter of the prxA3a gene. Eleven transformed aspens were obtained and characterized, and the stable integration of the antisense construct was confirmed by PCR and Southern blotting analysis in all these lines. Assays of enzymatic activity showed that both total peroxidase activity and acidic peroxidase activity were lower in most transgenic lines than in the control plants. In addition, the reduction of peroxidase activity was associated with lower lignin content and modified lignin composition. Transgenic lines with the highest reduction of peroxidase activity displayed a higher syringyl/vanillin (S/V) ratio and a lower S+V yield, mainly because of a decreased amount of V units. Thus, our results indicate that prxA3a is involved in the lignification of xylem tissue and that the down-regulation of anionic peroxidase alters both lignin content and composition in hybrid aspen.

Down-Regulation↗
PubMed2003

Magnetic resonance imaging diagnosis and new classification of the osteoporotic vertebral fracture.

The purpose of this study was to investigate the usefulness of magnetic resonance imaging (MRI) in the diagnosis of, and when deciding on treatment policies for, vertebral fractures in patients with osteoporosis by comparing the diagnostic success rates for such fractures using MRI and plain radiographs. We also devised a new classification of vertebral fractures in osteoporotic patients based on MRI findings. The subjects were 34 patients with a total of 316 osteoporosis-related vertebral fractures treated in our department during the past 2 years. They consisted of 30 women and 4 men with an average age of 82 years (range 61-95 years). The site diagnostic rates of plain radiographs and MRI for the vertebral fractures were compared, and changes in signal intensity of the fractured vertebrae in MRI were examined. The areas of change in signal intensity in T1-weighted sagittal images were classified into six types: total, anterior, posterior, superior, inferior, central. The site diagnostic rate for vertebral fractures was 98% for MRI, which was better than the 87% obtained with plain radiographs. Changes in signal intensity in the vertebrae showed no intraspinal protrusion in the inferior and superior types, and neurological stability was achieved; but there was a high frequency of intraspinal protrusion in the total and posterior types.

Aged↗
PubMed2003

Unilateral drop finger due to cervical spondylosis at the C6/7 intervertebral level.

A 64-year-old man who presented right drop fingers without pyramidal signs due to cervical spondylosis is reported. Magnetic resonance imaging showed a high signal intensity change on T2-weighted scans of the spinal cord at the C6/7 intervertebral level. Evoked spinal cord potentials following ulnar nerve stimulation were attenuated at the C6/7 intervertebral level. Compound muscle action potentials (CMAPs) following right cervical nerve root stimulation were recorded from the extensor digitorum communis. CMAPs following right C8 nerve root stimulation were evoked with small amplitudes. Small polyphasic CMAPs with prolonged onset latency were recorded following right C7 nerve root stimulation. Simultaneous C7 radiculopathy and C8 segmental spinal cord lesion due to cervical spondylosis at the C6/7 intervertebral level were the causes of drop fingers in the present case. Unilateral drop finger is a clinical symptom commonly associated with posterior interosseus nerve palsy, but mention should be made about cervical lesions causing drop finger. Electromyographic abnormalities of the triceps and first dorsal interosseus muscle were the key findings for differentiating the cause from paralysis of the posterior interosseous nerve.

Cervical Vertebrae↗
PubMed2003

Does cortical motor neuron excitability change in peripheral nerve injury?

OBJECTIVE: To investigate changes in cortical motor neuron excitability after peripheral nerve injury, evoked spinal cord potentials (ESCPs) following hemispheric transcranial magnetic stimulation (TMS) were recorded in awake patients with unilateral brachial plexus injury. METHODS: ESCPs following hemispheric TMS were recorded in 6 patients with unilateral complete type brachial plexus injury. Studies were performed within 6 months from the time of injury. ESCPs were recorded from posterior epidural space using catheter electrodes. Hemispheric TMS was applied on the motor cortex using a figure-of-8 coil. The threshold of ESCPs following hemispheric TMS was measured. The number, latency, and amplitude of ESCPs following high stimulus hemispheric TMS were measured and compared. RESULTS: No significant change was observed in the threshold of ESCPs following TMS contra-lateral to the injured upper limb compared to that following TMS contra-lateral to the intact upper limb. Several ESCP components were recorded following high stimulus hemispheric TMS. No significant changes were observed in comparison with number, latency and amplitude of ESCPs following high stimulus TMS contra-lateral to the injured upper limb and those following TMS contra-lateral to the intact upper limb. CONCLUSIONS: From a study of ESCPs following single TMS, no evidence was obtained that cortical motor neuron excitability changes in patients with traumatic unilateral brachial plexus injury at relatively early stages. We investigated the changes of cortical motor neuron excitability in patients with brachial plexus injury from the ESCPs following TMS. In single TMS, our data gave no evidence for cortical excitability changes at relatively early stages.

Adolescent↗
PubMed2003

Detachment analysis of the translocated W chromosome shows that the female-specific randomly amplified polymorphic DNA (RAPD) marker, female-218, is derived from the second chromosome fragment region of the translocated W chromosome of the sex-limited p(B) silkworm (Bombyx mori ) strain.

The sex chromosomes of the silkworm, Bombyx mori, are designated ZW for the female and ZZ for the male. We previously characterized a female-specific randomly amplified polymorphic DNA (RAPD) marker, designated Female-218, from the translocation-bearing W chromosomes. These W chromosomes contain a region of the second chromosome, which carries visible larval markers of the p loci. We used strain TWPB in which female larvae have black skin due to the p(B) gene (T(W;2)p(B), +p/+p) while male larvae have whitish skin (+p/+p). To determine whether the Female-218 RAPD marker is derived from the "W region" or a "second chromosome fragment", we induced a detachment of the translocated W chromosome, T(W;2)p(B), by treating the eggs with hot water at an early developmental stage. After hot water treatment, we obtained 27 white female larvae out of 4850 female larvae. The Female-218 RAPD marker was not amplified in 26 out of 27 white female larvae, and was amplified from one white female larva. Moreover, we obtained 11 black male larvae out of 5377 male larvae. Eight out of 11 black male larvae became adult moths, and the Female-218 RAPD marker was amplified from all eight male moths. Examination of the genetic relationship between the Female-218 RAPD marker and the second chromosome fragment of the translocated W chromosome strongly indicates that the Female-218 RAPD marker is amplified from the region of second chromosome fragment of the T(W;2)p(B) chromosome.

Animals↗
PubMed2003

Meniscal ossification.

Meniscal ossicles are rare in the human knee. We present one case. A 57-year-old taxi driver complained of right knee pain and swelling with radiographic findings of a meniscal ossicle. Arthroscopic inspection showed a degenerative and horizontal tear and calcium deposit at the middle and posterior thirds of lateral discoid meniscus. His lateral discoid meniscus, containing the ossicle, was removed. He was asymptomatic at a 3-year follow-up.

Arthralgia↗
PubMed2003

Snapping knee caused by intra-articular tumors.

Locking of the knee can present with no history of antecedent injury. We identified impingement of intra-articular tumors in 2 cases. Intra-articular tumors are relatively rare. Mechanical symptoms were present in both cases. On physical examination, there was a palpable mass at the medial region of the patellofemoral joint. The interior had been replaced mainly by amorphous necrotic tissue. The definite diagnosis of a soft-tissue mass of the knee could not be made on histologic examination.

Adipose Tissue↗
PubMed2003

Atypical palmar fibromatosis with giant fibrous nodule: a case report.

We present an unusual case of palmar fibromatosis. A 62-year-old man had a giant fibrous nodule in the deep fascia of the right palm without any pretendinous cord or flexion deformity at the metacarpophalangeal joint. Primarily soft-tissue tumor and palmar fibromatosis were considered as differential diagnosis of nodular mass but finally the latter was confirmed histologically after resection of the giant nodule.

Diagnosis, Differential↗
PubMed2003

Recalcitrant posttraumatic nonunion of the humerus: 23 patients reconstructed with vascularized bone graft.

We treated 23 patients with recalcitrant posttraumatic humeral shaft nonunion with vascularized bone grafts (fibula 10, femur 10 and scapula 3). 21/23 patients healed primarily. Venous thrombosis in the graft necessitated postoperative thrombectomy in 2 patients. Complications at the donor site were trivial. We used a vascularized fibular graft in patients with a large bone defect and with poor intrinsic stability of the nonunion site and a corticoperiosteal femoral graft in atrophic nonunion without a substantial bone defect. The scapula graft is easy to transfer to the surgical neck of the humerus on its pedicle.

Adult↗
PubMed2003

Pedicle or free musculocutaneous flaps for shoulder defects after oncological resection.

Management of soft-tissue defects of the shoulder is described. Extensive defects of soft tissues with or without overlying skin were created after resection of sarcomas in five patients. Reconstruction was performed using musculocutaneous flaps, which included three pedicle latissimus dorsi and two free tensor fascia lata flaps. Simultaneous functioning replacement of the defects of the trapezius and deltoid muscles were each achieved in two patients. Primary wound healing was achieved, and each patient recovered good contour of the shoulder. Functional results were satisfactory in all patients with an average score of 93.4% (range, 83%-100%) using the system of the Musculoskeletal Tumor Society. The four functioning muscles recovered active contraction in the transferred position. The shoulder elevation was normal in three patients, and was 90 degrees and 30 degrees in one patient each. All patients remained disease-free at the time of latest follow-up. Thus, shoulder defects of the soft tissues can be managed appropriately with the two representative musculocutaneous flaps.

Adolescent↗
PubMed2003

The prognosis in spindle-cell sarcoma depends on the expression of cyclin-dependent kinase inhibitor p27(Kip1) and cyclin E.

The aim of the present study was to examine the prognostic significance of p27(Kip1) and cyclin E expression in patients with spindle-cell soft tissue sarcomas. In 46 cases of spindle-cell sarcoma including 17 pre-operative biopsy materials, the expression of p27(Kip1) and cyclin E was immunohistochemically examined. The expression of p27(Kip1) decreased in the nuclei of metastatic primary tumor cells (stage IV), whereas the expression of cyclin E increased in those lesions. On univariate analysis, when the expression of p27(Kip1) and cyclin E was analyzed together, patients with spindle-cell sarcoma exhibiting low expression of p27(Kip1) and high expression of cyclin E showed lower distant-metastasis-free survival (DMFS) and overall survival (OS) than those with other combinations of the two parameters (both P < 0.0001). Multivariate analysis revealed that patients with low p27(Kip1) and high cyclin E expression also showed a decrease in DMFS (P = 0.0007, relative risk = 21.3) and OS (P = 0.005, relative risk = 20.8). These results suggest that the combination analysis of p27(Kip1) and cyclin E expression even in biopsy specimens allows the prediction of the clinical behavior of spindle-cell sarcoma.

Cell Cycle Proteins↗
PubMed2002

Scaphoid fracture in the young athlete--therapeutic outcome of internal fixation using the Herbert screw.

BACKGROUND: A fractured scaphoid is a common disabling injury occurring in contact sports. This study was designed to evaluate the therapeutic outcome of Herbert screw fixation for scaphoid fracture in young athletes. METHODS: Thirty athletes with 30 scaphoid fractures were treated. According to the Herbert classification, 10 were classified as acute fracture (group I), 6 as fibrous union (group II) and 14 as pseudoarthrosis (group III). Twenty scaphoid non-unions were due to missed diagnosis or unsuccessful immobilisation. RESULTS: Bony union was evident at an average of 9.2, 8.0 and 11.9 weeks postoperatively in groups I, II and III, respectively, and times for returning to sports were 10.7, 14.0 and 22.9 weeks. The clinical outcome assessed using the Mayo wrist score was excellent in groups I (97.5 points) and II (93.3) and good in group III (85.4). CONCLUSION: Early definitive diagnosis and treatment can allow early return to sports in young athletes. The Herbert screw technique produces an excellent clinical result for scaphoid fracture.

Adolescent↗
PubMed2002

Survival analysis with p27 expression and apoptosis appears to estimate the prognosis of patients with synovial sarcoma more accurately.

BACKGROUND: Although recent experimental studies have implicated p27 as a regulator of apoptosis in a number of neoplasms, to the authors' knowledge the relation between p27 expression and apoptosis has not yet been established in synovial sarcoma. METHODS: The relation between p27, apoptosis, and clinicopathologic features were examined in 62 synovial sarcoma cases. RESULTS: p27 expression was found to be correlated inversely with the extent of apoptosis in synovial sarcomas. On survival analysis, p27 expression was found to be a significant and independent prognostic factor. Although the extent of apoptosis was determined to be prognostically significant, it failed to retain an independent and significant value on multivariate analysis. The combination of p27 expression and apoptosis allowed for the more accurate estimation of prognosis in patients with synovial sarcoma than either parameter alone. CONCLUSIONS: A combination of p27 expression and extent of apoptosis permitted the more accurate estimation ofy the prognosis of patients with synovial sarcoma.

Adolescent↗