Biomedical subjects

G Hirata

Publications and source records attributed to G Hirata.

At least 19 recordsLinked to original sources

PubMed2001

Effect of femoral and tibial component position on patellar tracking following total knee arthroplasty: 10-year follow-up of Miller-Galante I knees.

Rotational alignment of the femoral and tibial components using computed tomography (CT) was evaluated to establish if errors of alignment have a significant effect on patellofemoral complications. From 1987-1990, 54 knees in 39 patients were replaced with the Miller-Galante I knee system. Of these, 10 patients (13 knees) comprised this study. All patients had osteoarthritis. Mean patient age at surgery was 70.3 years. Mean follow-up was 10.3 years. On CT, rotational position of the femoral component relative to the epicondylar axis and the position of the tibial component relative to the tibial tubercle were evaluated. Patellar displacement and patellar tilt angle also were evaluated when the knee was flexed at 30 degrees. Mean rotation of the femoral component was 6.1 degrees of internal rotation (2.7 degrees-11.2 degrees). Mean rotation of the tibial component was 16.7 degrees of internal rotation (2.4 degrees-27.7 degrees). Mean lateral patellar tilt angle was 2.9 degrees (-6.0 degrees-11.9 degrees), and mean lateral displacement was 2.7 mm (-3.2-8.9 mm). Rotational position of both the femoral and tibial components showed a statistically significant correlation with the patellar tilt angle. This study showed the internally rotated femoral and tibial component were related to the patellar maltracking. This malalignment of the components, as well as nonanatomical patellar groove and metal-backed patellar component, could be one of the causes of the patellofemoral complications with the Miller-Galante I knee.

Aged↗

PubMed2001

A new concept for precise patella resection in total knee arthroplasty.

We developed a new patella-cutting guide that simplifies proper alignment and enables resection of the correct thickness of bone. This guide consists of a central shaft, two support frames, and a ring. The ring consists of upper and lower disks, with a slot between the disks. The central shaft and the lower disk have holes for fixation pins. The distance from the distal end of the central shaft to the lowest level of the slot is 8 mm. Bone of the same thickness as that of the patellar component can be automatically resected using this guide. A feeler gauge is inserted through the slot, and the periarticular region is felt. This procedure enables the guide to be set at the correct angulation. A laboratory study using fresh-frozen cadaver patella specimens and a clinical study showed that proper alignment and proper resection were achieved using this guide.

Arthroplasty, Replacement, Knee↗

PubMed2000

Aminobisphosphonate (YM175) inhibits bone destruction in rat adjuvant arthritis.

This study was designed to examine the effects of an aminobisphosphonate (YM175, which is also called incadronate) on bone destruction in rat adjuvant arthritis (AA). Thirty-five female Lewis rats were given an intradermal injection of heat-killed Mycobacterium butyricum and randomly allocated to five groups (seven rats/group). In the three YM175-treated (0.01, 0.1 and 1 mg/kg per day) groups, YM175 was injected subcutaneously every day from day 0 to day 42. The effects of YM175 in AA rats were evaluated according to an arthritis score, hind paw volume, and radiological and histological examinations. The results showed that YM175 suppressed the radiological and histopathological changes, as well as the joint swelling, in rat AA in a dose-dependent manner. The number of tartrate-resistant acid phosphatase (TRAP)-positive cells (osteoclasts and preosteoclasts or osteoclast precursors) in bone mar-row spaces and granulation tissue in the YM175-treated groups was also reduced in a dose-dependent manner. This study provides the first evidence that YM175, among aminobisphosphonates, not only inhibits bone destruction in rat AA, probably by reducing osteoclast numbers, but that it also suppresses joint inflammation. These results suggest that YM175 may be a useful drug for the prophylactic treatment of both bone destruction and joint inflammation in patients with rheumatoid arthritis.

Animals↗

PubMed2000

Anatomic variations should be considered in total knee arthroplasty.

The effect of anatomic variations on the operative techniques used in total knee arthroplasty (TKA) was assessed. In 133 Japanese patients with medial osteoarthritis (OA), six parameters were measured on anteroposterior radiographs of the lower extremities taken with the patients in the supine position. The results showed that the characteristics of the knees were bowing of the femoral shaft and proximal tibia vara, with lateral offset of the tibial shaft with respect to the center of the tibial plateau. The angle between a perpendicular to the mechanical axis and the tangent to the distal femoral condyles can be used in determining the external rotation of the femoral component. This angle was more than 3 degrees in 20% of the patients. The femoral component should therefore be externally rotated more than 3 degrees relative to the posterior condylar line in such patients. Because the center of the tibial plateau is located medial to the central line of the tibial shaft in knees with medial OA, the central point of the tibial articular surface should not be used for alignment of the tibial component. The medial offset stem of the tibial component may impinge against the medial wall. Anatomic variations should be evaluated before TKA is attempted.

Aged↗

PubMed2000

Tibial tubercle malposition in patellar joint instability: a computed tomograpy study in full extension and at 30 degree flexion.

We evaluated the tibial tubercle position in knees with patellar instability. CT in full extension and at 30 degree flexion was used in 18 knees with instability and 18 control knees. Scans were taken at the level of the femoral epicondyles, tibial tubercle and distal tibia. We found that in full extension, the tibial tubercle was in a more lateral position in the unstable than in the control knees. At 30 degree flexion, the tibial tubercle in the unstable knees rotated internally, but it was never within the normal range. CT scans taken in full extension and at 30 degree flexion seem to be of value for ascertaining the degree of tibial tubercle malposition during knee flexion in patellar instability.

Adolescent↗

PubMed1996

[Influences of a shiitake (Lentinus edodes)-fructo-oligosaccharide mixture (SK-204) on experimental pulmonary thrombosis in rats].

Effects of the mixture (SK-204) consisting of dried shiitake mushroom (Lentinus edodes) treated with wet-heating and fructo-oligosaccharides (7:3) on the experimental models of pulmonary thrombosis induced by lactic acidosis in rats were evaluated. Chronic oral administration (10 weeks) of SK-204 significantly prevented the thrombus formation on this thrombosis model. However, decreases in the numbers of platelet and fibrinogen level by lactate were not changed by SK-204. These results suggest that SK-204 have an anti-thrombotic action, which is due to neither the inhibition of platelet aggregation nor coagulation, but probably due to the promotion of fibrinolysis and thrombolysis.

Animals↗

PubMed1995

Pregnancy complicated by von Hippel-Lindau disease.

BACKGROUND: Von Hippel-Lindau disease is an autosomal-dominant genetic disorder with variable penetrance characterized by multiorgan hemangioblastomas and a predisposition to carcinoma. CASE: A 23-year-old pregnant woman at 35 weeks' gestation, with a family history of von Hippel-Lindau disease, presented with paraplegia caused by an acute intramedullary hemorrhage from a spinal hemangioma at the thoracic (T) 4-5 level. An unruptured hemangioblastoma was noted at the T7-8 level. A T3-6 laminectomy resulted in the improvement of symptoms. The postoperative period was complicated by autonomic dysreflexia and preterm labor. The woman was delivered by cesarean under epidural anesthesia. CONCLUSION: Pregnant patients with von Hippel-Lindau disease present problems related to hemangioblastomas of the central nervous system. Imaging studies of the central nervous system are mandatory for prompt recognition and treatment of complications related to intramedullary hemorrhage. If spinal hemangioblastomas are identified, cesarean delivery may be the most sensible choice.

Adult↗

PubMed1994

Long-term tocolysis with combined intravenous terbutaline and magnesium sulfate: a 10-year study of 1000 patients.

OBJECTIVE: To determine whether long-term intravenous (IV) tocolysis using combined terbutaline and magnesium sulfate is safe and effective. METHODS: One thousand consecutive women in preterm labor were treated with combination IV tocolytic therapy. Terbutaline was initiated with an infusion rate of 1.75 micrograms/minute and increased to a maximum of 80 micrograms/minute. Magnesium sulfate was infused at 2 g/hour without any bolus and increased to maintain a serum level of 6.5-7.5 mg/dL. Tocolysis was continued until fetal lung maturity was achieved or delivery occurred. RESULTS: Combination tocolytic therapy prolonged pregnancy by a mean (+/- standard deviation) of 61 +/- 23.6 days in 751 women with intact membranes and by 20.5 +/- 17.4 days in 249 with ruptured membranes. The longest durations of continuous IV tocolysis were 123 days in a patient with intact membranes and 77 days in one with ruptured membranes. The most common side effects were nausea and vomiting, followed by chest tightness and shortness of breath. CONCLUSION: Long-term IV tocolysis appeared to be safe and to have acceptable side effects, allowing patients to receive combined terbutaline and magnesium sulfate until delivery.

Adult↗

PubMed1990

Anti-vascular endothelial cell antibodies in severe preeclampsia.

There is mounting evidence to suggest that vascular endothelial cell injury plays an important role in the pathogenesis of preeclampsia. In this study an enzyme-linked immunoassay was used to demonstrate increased binding of immunoglobulins G and M to human umbilical vein endothelial cells by sera from women with severe preeclampsia as compared with normal pregnant control women. Fifty percent of women with preeclampsia versus 15.4% of control women had either immunoglobulin G or immunoglobulin M binding. In addition, immunofluorescent staining of normal renal cortical tissue with preeclamptic sera showed increased binding of immunoglobulin G to arterioles in patients with anti-vascular endothelial cell antibodies. These antibodies were not directed at HLA antigens and did not cross react with platelets. Interferon-gamma stimulation did not increase immunoglobulin binding. Antibodies to antigens expressed on vascular endothelial cells may be important in mediating the endothelial damage seen in preeclampsia.

Antibodies↗

PubMed1990

Chromosomal mosaicism in chorionic villus sampling.

The observation of multiple, chromosomally distinct cell lines in chorionic villus samples is not an unusual finding and occurs in 1 per 100 samples. This frequency is ten times greater than the level of mosaicism observed in newborn surveys and, thus, must reflect phenomenon other than true fetal mosaicism. Indeed, only 23% of mosaicism detected at CVS is confirmed in the fetus (2.3 per 1,000 CVS), which is much closer to the newborn rate (1 per 1,000). This indicates that most mosaicism encountered in CVS is unrelated to the fetal karyotype and as such is an inaccurate prediction of the fetal genotype, the purpose of prenatal diagnosis. Most of the mosaicism detected in CVS is due to confined placental mosaicism. Either as a result of error-prone cell division generating an excess of abnormal cells in extraembryonic tissues or reduced selection against aneuploid cells in these tissues allowing their persistence, chorionic villi and placenta appear to show much higher levels of mosaicism than seen in fetuses. This explains the more frequent finding of multiple cell lines in CVS than in amniocentesis or liveborn individuals. The discrepancy between levels of mosaicism present in chorionic villi and fetal tissues means that most instances of mosaicism detected in CVS are not associated with a fetal abnormality and should be evaluated by further prenatal testing, i.e., amniocentesis or fetal blood sampling. Because of the frequency of chromosomal mosaicism in CVS and its attendant need for further testing, a discussion of mosaicism should be included in counseling prior to CVS. The higher frequency of discrepant results in direct CVS preparation emphasizes the prudence of delaying decision making until the results of the CVS culture have been obtained. Although the observation of mosaicism clearly complicates genetic counseling and decision making, it does not appear to be associated with an adverse fetal outcome. Whereas most of the mosaicism observed in CVS is the result of confined placental mosaicism, other types of discrepancies also occur. Maternal cell contamination occurs in about 1% of cases, but is easily evaluated by examining the direct preparation and analyzing chromosome polymorphism. The incidence of pseudomosaicism in CVS cultures is unclear but probably low. Interestingly, CVS analysis has suggested that twinning may be a more common phenomenon at conception than reported at birth and that some discrepancies may reflect the nonviability of twins with abnormal karyotypes. Chorionic villi sampling remains a viable alternative to amniocentesis for early prenatal diagnosis. An understanding of the origins of mosaicism in CVS is necessary for

Chimera↗

PubMed1984