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Biomedical subjects

A Fukui

Publications and source records attributed to A Fukui.

At least 37 records · Page 2Linked to original sources
PubMed1996

Closed rupture of the flexor digitorum profundus tendon of the little finger caused by calcification of the triangular-fibrocartilage.

A case of rupture of flexor digitorum profundus tendon of the little finger caused by calcification of the triangular fibrocartilage (TFC) is reported. At operation, a round defect of the TFC and rupture of the flexor digitorum profundus tendon (FDP) of the little finger were observed. The defect of TFC was repaired using the palmaris tendon and FDP of the little finger was woven into FDP of the ring finger. Eleven months after operation, the patient had almost full flexion and extension of the distal and proximal interphalangeal joints.

Aged↗
PubMed1996

Innervated radial thenar flap for sensory reconstruction of fingers.

A radial thenar flap, which is supplied by the superficial palmar branch of the radial artery and innervated by the superficial branch of the radial nerve, was used in four patients for sensory reconstruction of the fingers. Two patients had degloving injuries of the hand and two had amputation injuries of the thumb. Three of the cases underwent free-flap transfers, and one case underwent a reverse-flow island flap. The size of these flaps was about 3 x 5 cm except in one case, where a 15 x 5 cm flap combined with a radial forearm flap was used. Sensory reinnervation was excellent and donor site morbidity was minimal in all four cases. An innervated radial thenar flap from the ipsilateral hand offers an alternative choice to reconstruct large palmar defects of the fingers.

Adolescent↗
PubMed1996

Treatment of massive hemorrhage with liposome encapsulated human hemoglobin (NRC) and hydroxyethyl starch (HES) in beagles.

The efficacy of NRC as a substitute for blood transfusion for treatment of acute, massive hemorrhage was evaluated in this study. Fourteen beagles, anesthetized with a mixture of 50% nitrous oxide, 0.97% sevoflurane and oxygen and ventilated by a respirator, were hemodiluted by withdrawal of 12 ml/kg of blood and infusion of isovolemic HES (hemodilution: HD) four times every 10 min. Then the animals were divided into two groups; an HES group, in which the same HDs were continued and an NRC group, in which the HDs were done with NRC. The hematocrit value decreased to 11% in the HES group after eight HDs and to 13% in the NRC group, which had a 3.9% NRCcrit value during the same period. In the NRC group, Cao2 decreased to 7.9 ml/min, which was significantly higher than the 5.9 ml/dl of the HES group. Oxygen consumption decreased to 56 ml/min in the HES group, but in the NRC group, it dropped to 74 ml/min, which was significantly higher than that of the HES group. Cardiac output increased to 1.2 times that of the control after eight HDs and arterial mean pressure decreased to approximately 60%. The above data indicated that NRC delivered sufficient oxygen to tissues, substituting for circulating red cells and maintained aerobic metabolism. Therefore, it should be possible to use NRC successfully for the treatment of cute, massive hemorrhage.

Animals↗
PubMed1996

Increasing coronary perfusion pressure on diastolic and systolic performance is less pronounced in right ventricle than in left ventricle.

OBJECTIVE: Little is known as to whether an increase in coronary perfusion pressure can alter the right ventricular (RV) distensibility and the contractile function as it does in the case of the LV. METHODS: In eight isolated isovolumically contracting canine hearts, RV and LV volumes and coronary perfusion were independently controlled. Effects of an increase in coronary perfusion pressure (from 73 +/- 1 to 152 +/- 6 mmHg) on the end-diastolic and end-systolic pressure-volume relations in both RV and LV were assessed. RESULTS: Following an increase in coronary perfusion, and at a similar volume of the ventricles, end-diastolic pressure was elevated by 2.8 +/- 0.8 mmHg in RV and 8.9 +/- 2.0 mmHg in LV (P < 0.01; RV vs LV), and the slope of RV end-systolic pressure-volume relation, Ees, increased by 11 +/- 6% (P < 0.05) and that of the LV Ees by 21 +/- 5% (P < 0.01). The percent change of RV pressure-volume area (PVA) was less than that in LV-PVA (26 +/- 9 vs 48 +/- 11%; P < 0.05). CONCLUSIONS: Accordingly, increases in coronary perfusion pressure and/or flow decreased the RV distensibility and enhanced the RV contractile function, the extent of which, however, was less than that in the LV.

Animals↗
PubMed1996

[Effect of aprotinin on endothelial cell functions during cardiopulmonary bypass].

Fourteen patients undergoing cardiac or great vessel surgery using cardiopulmonary bypass (ECC) were divided into two groups. Group A of 7 patients received 2 x 10(6) units of aprotinin (apr) 15 min before ECC and 0.5 x 10(6) unit immediately after the ECC. Group B of 7 patients received 0.5 x 10(6) unit of aprotinin 15 min before ECC and 2 x 10(6) units immediately after the ECC. Several physiological parameters were measured two hours before ECC, immediately after the cessation of the ECC and 4 hours thereafter. No difference was noted in coagulation time, which remained within normal range, and postoperative hemorrhage between the groups after ECC. Although thrombomodulin, ELAM-1 and ICAM-1 tended to decrease slightly in the two groups immediately after ECC, recovery of the thrombomodulin was much more rapid in the A group than in the B group. On the other hand, blood endothelin level and von Willebrand factor activity were elevated progressively after the ECC. Blood granulocyte-elastase activity and IL-8 increased markedly immediately after the ECC and then tended to decrease. These data indicate that no marked damage would be caused on the endothelial cells during ECC which was carried out using a relatively small dose of apr. However, the protective effect of apr remained to be clarified in the future.

Adult↗
PubMed1995

"Plasmatic imbibition" in the rabbit flow-through venous flap, using horseradish peroxidase and fluorescein.

In the present study, the phenomenon of "plasmatic imbibition" was investigated histologically in a rabbit flow-through venous flap model, using horseradish peroxidase and fluorescein. Horseradish peroxidase introduced between the flap and the recipient bed, produced brown staining of the entire contact surface 10 min postoperatively. At 30 min, erythrocytes in the flow-through vein stained red. The flap and the erythrocytes became more intensely stained over time. When horseradish peroxidase was introduced from a central artery after a Silastic sheet had been inserted between the flap and recipient bed, the flap color became a soft brown and the erythrocytes of the flow-through vein stained red 10 min postoperatively. In the experimental groups subjected to fluorescein, introduced between the graft (or flap) and the recipient bed, fluorescence was seen 10 min postoperatively, except in the flow-through vein. At 30 and 120 min, the whole graft (or flap) showed fluorescence. Fluorescein was introduced into the femoral vein after flap elevation, or a Silastic sheet was inserted between the flap and the recipient bed. At 10 min, these groups showed a weak fluorescence only in the flow-through vein; subsequently, at 120 min, the flow-through vein and its surrounding tissue showed fluorescence, but the flap showed none. Plasmatic imbibition was proved to be acting in the flow-through vein, and it is considered as important a phenomenon in flap survival as venous flow itself.

Animals↗
PubMed1995

Partial soleus muscle island flap transfer using minor pedicles from the posterior tibial vessels.

A new method for partial soleus muscle island flap transfer using minor pedicles from the posterior tibial vessels was designed and executed. A portion of the soleus muscle body that was slightly wider than the defect was harvested with minor pedicles. The muscle flap was transposed by turning it over or by creating an island flap. Skin grafts were applied to the exposed muscle. This new type of muscle flap was applied to six patients with a pretibial skin defect at the lower third of the leg. It was used for treatment of an open fracture with an associated skin defect in four patients, chronic osteomyelitis in one patient, and a recurrent stasis ulcer in one patient. In all patients the transferred muscle flap survived completely.

Aged↗
PubMed1995

Comparison of mesoderm-inducing activity with monomeric and dimeric inhibin alpha and beta-A subunits on Xenopus ectoderm.

Activin possesses mesoderm-inducing activity, erythroid-differentiating activity, and follicle-stimulating hormone-releasing activity. The chemical structures of the activin molecule are formed by a combination of two beta-subunit peptides of inhibin. Inhibin is a dimer consisting of an alpha and beta subunit. To examine the mesoderm-inducing activity of these substances, we tested several configurations including: (1) two types of alpha-subunit peptide; (2) two types of inhibin A and B dimer; (3) beta A-subunit peptide monomer; (4) three types of activins A, AB and B, and (5) follistatin (activin-binding protein) by the animal cap assay using Xenopus laevis ectoderm, and by the erythroid-differentiating factor (EDF) test. Activins, which are composed of dimeric inhibin beta A- or beta B-subunit peptides, had the highest mesoderm-inducing and EDF activities. The monomeric beta A-subunit peptide exhibited mesoderm-inducing and EDF activities that were much lower than activin A. The inhibitory effect of follistatin on mesodermal induction by the beta A-subunit peptide was also lower than that of activin. Both inhibins A and B had very weak mesoderm-inducing activity and no EDF activity. The two types of inhibin alpha-subunit monomer had little mesoderm-inducing activity and no EDF activity. The mesoderm induction caused by activin A was not suppressed by the addition of the alpha-subunit monomer and inhibin. The mesoderm-inducing activity in relation to the chemical structures of the monomeric and/or dimeric inhibin alpha and beta A subunits is discussed.

Activins↗
PubMed1995

[Hemostatic mechanism associated with aprotinin during and after the extracorporeal circulation for cardiac and great vessel surgery].

It has been reported that aprotinin (apr) is effective for hemostasis during and after the extracorporeal circulation (ECC) for cardiac or great vessel surgery. However its mechanism remains still obscure. In this study, we observed relationships between changes in interleukin-8 (IL-8), endothelial factors, or D-dimer and aprotinin administered before and after the ECC. Fourteen patients in whom cardiac or great vessel surgery was done using ECC were divided randomly into two groups. Seven subjects in Group I (G-I) were infused 10(6) KIU of apr immediately after anesthesia, immediately before and after the ECC, respectively, and 10(6) KIU of apr were also added during the ECC. Seven other subjects (G-II) were infused 10(6) KIU of apr immediately before and at three hours after the ECC, and also 2 x 10(6) KIU of apr immediately after the ECC. No marked hemorrhagic tendency was noted in all subjects and increase in plasma D-dimer was not marked. Immediately after the ECC, granulocyte elastase in plasma increased markedly in both groups but subsequently decreased in the G-II alone while it remained unchanged in the G-I. Similar changes were observed in plasma IL-8 values. During the ECC, intercellular adhesion molecule-1 in plasma decreased in both groups but von Willebrand factor activity decreased in the G-I alone. From the above data, the hemostatic effect of apr may contribute to protect the dysfunction of endothelial cells or to enhance recovering from the dysfunction during the ECC.

Aged↗
PubMed1994

Venous flap--its classification and clinical applications.

We previously reported pedicled venous flap survival using the rat model, as well as venovenous, arteriovenous, and arterialized flow-through venous flap survival using the rabbit ear model. For this study, we utilized these flaps clinically. Five of seven pedicled venous flaps survived, displaying superficial necrosis. The others became partially necrotic; they were transferred after dissection of a long pedicle vein. Eight of nine venovenous flow-through venous flaps survived; six displayed superficial necrosis. The nonsurviving flap became completely necrotic, possibly because only one donor vein and one recipient vein were used. Six of 10 arteriovenous flow-through venous flaps survived. The remaining four became partially necrotic, possibly because only one vein was anastomosed for outflow. The arterialized flow-through venous flap survived. The pedicled venous and venovenous groups studied seem likely to survive despite superficial necrosis. However, the draining vein should not be dissected more than 5 cm, and many draining veins should be anastomosed with recipient vessels.

Adult↗
PubMed1994

Present status of replantation in Japan.

We conducted a survey among 94 members of the Japanese Society of Reconstructive Microsurgery on the present status of replantation in Japan. The results indicate that 9,664 extremities were replanted (157 upper arms, 415 forearms, 471 hands, 8,320 digits, 33 thighs, 103 calves, 37 feet, and 128 toes); 8,227 replants survived, for a success rate of 85%. The survival rate was over 90% in 23 hospitals, and 7 of these hospitals replanted more than 100 limbs. Postoperative treatment consisted of continuous intravenous infusion of urokinase (120,000-240,000 U/day), heparin (10,000-20,000 U/day), and prostaglandin E1 (80-120 micrograms/day) for 3-10 days. Fifty-six surgeons attempted replantation whenever the patient requested it. At Nara Medical University, continuous local intra-arterial infusion of anticoagulants and fibrinolytic agents has increased the survival rate of the replantation to 97%, compared with 88% when using intravenous infusion.

Alprostadil↗
PubMed1994

Identification of activins A, AB, and B and follistatin proteins in Xenopus embryos.

There are several lines of evidence that activin is a crucial molecule for mesoderm induction in early Xenopus embryos. However, it is not known what kind and what amounts of activin proteins exist in cleavage stage embryos. Three isoforms of activins, A, AB, and B, were demonstrated to be present at least in part as a complex with abundant follistatin, an activin-binding protein, in early Xenopus embryos (stage 1-5). These results suggest that activin stored in eggs has an important role for mesoderm induction during early Xenopus embryogenesis and that follistatin can modulate the function of activin in signaling developmental changes.

Activins↗
PubMed1994

Reproducibility of magnetic resonance spectroscopy in patients undergoing dialysis and evaluation of the therapeutic response of tumors.

RATIONALE AND OBJECTIVES: The reproducibility of repeated magnetic resonance (MR) spectroscopy was studied in patients undergoing dialysis and treatment of a variety of malignant tumors. METHODS: Localized MR spectra were obtained using a 1.5-T system by image-selected in vivo spectroscopy. Total metabolite signal was integrated between phosphomonoester and beta-adenosine triphosphate resonance. We termed this measurement AREA. RESULTS: Intrapatient variability was evaluated on repeated thigh muscle spectroscopy for 10 patients. Sequential spectra of 10 malignant tumors of the extremities were analyzed and compared with the histology of surgical specimens in seven patients. Intrapatient variability in AREA was calculated as 14.0%. The extent of necrosis and AREA ratio (definition: AREA post-therapy/AREA pretherapy) were as follows; 6.1% in > 90% necrosis, 43% in 50% to 90% necrosis, and 79% in < 50% necrosis. CONCLUSIONS: Localized MR spectra are fairly reproducible and may relate to treatment efficacy.

Adolescent↗
PubMed1994

Malignant lymphoma of the esophagus associated with macroglobulinemia: report of a case.

A case of non-Hodgkin's lymphoma of the esophagus in a 74 year old man is presented. Grossly, the surgically removed esophagus had a fusiform submucosal mass covered with smooth surfaced mucosa. Microscopic examination revealed that the mass consisted of a dense infiltrate of small to medium-sized lymphoid cells with plasmacytoid differentiation, leading to a diagnosis of diffuse small cell lymphoma with lymphoplasmacytic subtype. Laboratory data as well as immunohistochemical studies proved that the lymphoma produced monoclonal immunoglobulin M, giving rise to macroglobulinemia.

Aged↗