Biomedical subjects
Publications and source records attributed to T Ogino.
Trigger wrist is a rare condition. This report describes a case with trigger wrist secondary to a partial laceration of the flexor digitorum superficialis tendon of the ring finger. No previous reports are available in the literature.
Thirteen patients with lunate and perilunar dislocations were treated in our department in the last five years. Ten out of the thirteen patients were followed more than eight months with an average of two years and two months. Two out of the ten patients followed failed to obtain normal anatomical carpal architecture. These two patients were treated by arthrodesis of the wrist and proximal row carpectomy, respectively. The remaining eight patients, that obtained reduction, were classified into three groups according to existence of gap between the scaphoid and lunate, and incongruity between the lunate and triquetrum. Patients with a gap between the scaphoid and lunate of more than 3 millimetres after reduction of their dislocations had poor clinical results. This suggests significant correlation between clinical results and carpal instabilities.
A case of dislocation of the hamate bone, associated with palmar ridge fracture of the trapezium, is described. The mechanism of this injury is thought to be traction force through the transverse carpal ligament caused by a flattening of the transverse carpal arch.
Two cases of epiphyseal destruction resulting from frostbite in the hands of children are reported. The most significant change observed on the x-ray film was the absence of the epiphyses. Stunted growth and mild flexion deformity of the fingers are characteristic sequelae.
The specificity of childhood epilepsy was characterized by investigating the evolutional changes with age and prognoses of age-dependent epileptic encephalopathy from the developmental aspect through a long-term follow-up. Three types of age-dependent epileptic encephalopathy showed mutual evolutional changes at certain ages. This indicated an important role of the brain development in the clinicoelectroencephalographical manifestations of age-dependent epileptic encephalopathy. Furthermore, the evolutional changes demonstrated an association with organic brain damage and etiology in addition to the age factors. The evolutional changes occurred more frequently in the cases with overt organic brain pathology. The prognosis was poorer in cases which underwent an evolutional change.
High-resolution proton magnetic resonance spectroscopy was used to analyze human cerebrospinal fluid obtained from patients with several neurological problems. The major metabolites measured included glucose, lactate, glutamine, citrate, inositol, acetate, creatine, creatinine, beta-hydroxybutyrate, alanine, and pyruvate. A drug vehicle, propylene glycol, was also measured. Alterations in the cerebrospinal fluid of these metabolites provided information concerning metabolism of the brain. Magnetic resonance spectroscopy offered a simple and rapid means of assessing these and other exogenous and endogenous compounds in diseases affecting the nervous system.
CRP, alpha 1-acid glycoprotein and haptoglobin were studied in 13 septic shock neonates. Endotoxin was recovered from eight infants. Serum cortisol concentration from infants with endotoxemia (917 +/- 596 ng/ml) was significantly higher than that from infants without endotoxemia (398 +/- 239 ng/ml). Serum cortisol correlated well with immature neutrophil counts defined as the unit "band/neutrophil". Increased cortisol level and immature neutrophil counts preceded the elevation of CRP, alpha 1-acid glycoprotein and haptoglobin in four extremely premature neonates. We conclude that positive interactions between endotoxin, cortisol and acute phase protein synthesis are present in the initial period of infection, and delayed acute phase protein synthesis is suspected in extremely premature neonates.
The use of a monoclonal antibody against the thymidine analogue bromodeoxyuridine together with an in vitro labeling technique allowed rapid determination of the labeling index in human tumors. The labeling index estimated by these relatively simple immunofluorescence or immunoenzymatic staining methods was equivalent to that obtained by autoradiography. The interpretation of the preparations is easy since there is a minimum of background staining. This immunohistochemical technique combined with in vitro labeling provides a suitable alternative for determining the labeling index of human tumors.
The growth rate of 49 cases with recurrent gastric cancer was investigated with two tumor markers (AFP & CEA). The average doubling time of liver metastases (24.7 +/- 11.9 days) in 18 cases was significantly shorter from that of lymph node metastases (41.1 +/- 22.4 days) in 13 cases and of peritonitis carcinomatosa (42.2 +/- 19.6 days) in 18 cases. Latent period of recurrent cancer calculated by these doubling times was ranged from 1.0 to 3.5 years (mean 1.7 years) in liver metastases, from 1.0 to 5.0 years (mean 2.7 years) in lymph nodes metastases and from 1.5 to 6.0 years (mean 2.7 years) in peritonitis carcinomatosa. Only in liver metastases, positive correlation between the doubling time (X) and the duration of survival (Y) was observed by expressing the formula Y = 0.45 X-0.58 (R = 0.661, p less than 0.05). It is noteworthy that there is a significant correlation in spite of large differences in background subjects (systemic condition, size of metastatic lesion, etc.) and the growth rate of tumor is considered to play a very important role for determining the degree of biological malignancy of individual cancer patients in relation to survival.
A case of hepatocellular carcinoma was treated with anti-alpha-fetoprotein (AFP) antibody-adriamycin via the hepatic artery with induced hypertension by angiotensin II. A minor response was achieved (from 13.5 X 9.0 cm to 10.5 X 7.5 cm) and serum AFP decreased from 310,000 ng/ml to 26,000 ng/ml. The patient has been doing well during a follow-up period of one year. This result suggests that targeting chemotherapy used for each drug delivery system would be more effective if combined with two or more similar modalities.
During the last 10 years, we have experienced 41 cases of minute cancer, which is equivalent to 13.9% of all resected early stomach cancers. Out of 44 lesions in 41 cases, 17 lesions were diagnosed preoperatively, while 27 were unexpectedly detected by serial sections of the resected stomach. Most lesions were located along the lesser curvature of the body and antrum. There was no nodal involvement or vessel permeation. Histologically differentiated adenocarcinomas were encountered in 86.4%, associated with intensive intestinal mucosa in many cases. We have stressed that dye endoscopy using indigo carmine and methylene blue is very useful for the diagnosis of minute cancer.
The DNA polymerase activity, and susceptibilities to 9-beta-D-arabinofuranosyladenine(ara-A) and 1-beta-arabinofuranosylcytosine(ara-C) of a phosphonoacetic acid resistant mutant (PAA-R) of varicella-zoster virus (VZV) selected in the presence of PAA were examined. The DNA polymerase activity of PAA-R was inhibited less than that of the parent strain by PAA in vitro. PAA-R was resistant to acyclovir and also to both ara-A and ara-C. The susceptibilities to ara-A and ara-C of four acyclovir resistant mutants selected in the presence of acyclovir, and also resistant to PAA, were examined. Two variants were resistant, one was slightly resistant, and one was sensitive to both drugs. These cross-resistances and susceptibilities of VZV variants to PAA, ACV, ara-A and ara-C should be considered in chemotherapy of VZV infections.
The acyclovir resistant mutant of varicella-zoster virus ACV-R (A 8) induced the same level of thymidine kinase activity in infected cells as the parent Kawaguchi strain. However, it induced less deoxycytidine kinase activity and did not induce phosphorylating activity for the nucleotide analogue, 9-(2 hydroxy-ethoxymethyl)-guanine-(acyclovir). Another acyclovir resistant mutant, ACV-R (A 4), which is cross-resistant to phosphonoacetate and is thought to be a viral DNA polymerase mutant, induced the same level of phosphorylating activities for thymidine, deoxycytidine and acyclovir as the parent strain. The altered substrate specificity of thymidine kinase induced by ACV-R (A 8) is concluded to confer resistance to acyclovir on ACV-R (A 8).
The authors report a case of midcarpal instability following a malunited fracture of the distal radius. After corrective osteotomy of the radius the wrist became stable and the symptoms were completely relieved. The instability in such cases is due to subluxation of the capitate on the lunate with the wrist in radial abduction. This in turn is due to a reversal of the normal palmar tilt of the articular surface of the radius. In the mechanics of the normal wrist this palmar tilt allows the lunate to slide forwards during radial abduction, so enabling the capitate to maintain collinearity with the vertical axis of the radius. This situation can be restored by corrective osteotomy, as in the present case, with complete relief of symptoms.
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Two patients treated with interstitial iridium-192 irradiation are presented. A patient with stage IV A adenocarcinoma of the uterine cervix was treated with external irradiation in combination with local hyperthermia prior to the interstitial irradiation. Another patient with stage III B squamous cell carcinoma of the vagina had a hysterectomy followed by irradiation 22 years prior to the treatment. Wires of Iridium-192 were put into place in the region of the tumor to give 40 Gy to the periphery of the tumor. The patient with carcinoma of the cervix died 15 months after the treatment. The patient with carcinoma of the vagina is well and has locally controlled disease 18 months after the treatment.
The limits of FCM detection of nuclear DNA aneuploidy were determined by simulation of the relationship between the coefficient of variation (CV) and DNA difference of two populations using a microcomputer. Under ideal conditions, the minimal DNA difference necessary for a bimodal peak is almost twice the CV. When the DNA difference is below the value, a single peak with a large CV and/or a shoulder is formed. Cases with a larger CV than expected in a single population should be practically treated as a population mixed with the near-diploid line.
We calculate the CEA doubling time of liver metastasis (13 cases) from colonic cancer and studied the factors influencing the growth rate. The doubling time of liver metastasis from colonic cancer ranged from 10 to 112 days (mean 57.8 +/- 35.4 days) was found significantly different among differentiations in histological type. Namely, the doubling time of poorly differentiated adenocarcinoma was shorter than that of well differentiated adenocarcinoma. Moreover the postoperative survival time (Y: months) was found to be significantly correlated with doubling time (X: days); Y = 0.155X + 4.452, r = 0.718, p less than 0.05. These results suggest that the growth rate calculated as CEA doubling time of cancer plays an important role in determining the degree of biological behavior in colonic cancer patients.