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Biomedical subjects

H Niibayashi

Publications and source records attributed to H Niibayashi.

5 recordsLinked to original sources

Survival factors in digital replantation: significance of postoperative anaemia.

Two hundred and fifty-two consecutive digital replantations and revascularizations in 201 patients were retrospectively reviewed to determine factors influencing survival. Children under 9 years of age, women, complete amputations, blood transfusions and secondary thrombectomy were poor prognostic factors. In addition, low haemoglobin and haematocrit levels during the postoperative period were associated with a higher failure rate. Inappropriate use of anticoagulants and excessive postoperative anaemia should be avoided following replantation.

Adult↗

Atlantoaxial rotatory dislocation. A case report.

STUDY DESIGN: Report of a child who sustained an acute atlantoaxial rotatory dislocation, associated with fractures of the clavicle and the temporal bone, and rupture of the alar ligament demonstrated by magnetic resonance imaging. OBJECTIVE: To describe the radiographic and pathoanatomic characteristics of the injury process. SUMMARY OF BACKGROUND DATA: Only five cases of traumatic atlantoaxial rotatory dislocation associated with fracture of the clavicle have been reported previously. This is the first report of a ruptured alar ligament demonstrated on magnetic resonance imaging in a patient with atlantoaxial rotatory dislocation associated with fractures of the clavicle and the temporal bone. METHODS: Computed tomography revealed the Type 1 rotatory dislocation described by Fielding and Hawkins, and magnetic resonance imaging delineated the ruptured alar ligament. RESULTS: Traction in a halter, followed by 6 weeks of immobilization with a cervical collar, was successful in the management of the injury. CONCLUSION: Concomitant fractures of the right temporal bone and the right clavicle may yield excessive left rotation of the atlas on the axis, resulting in the rupture of the right alar ligament. Awareness of this condition allows early diagnosis and effective conservative treatment.

Accidents, Traffic↗

Pyogenic vertebral osteomyelitis after acute bacterial prostatitis: a case report.

A case of pyogenic vertebral osteomyelitis after acute bacterial prostatitis in a 78-year-old man is reported. The rarity and subtle clinical presentation of this condition, and the delayed appearance of radiologic signs of progression to destructive osteomyelitis, contributed to a significant delay in diagnosis. An arterial blood culture positive for bacterial growth during the episode of acute prostatitis suggested that bacteremia might result from hematogenous spread of the infection to the vertebral column via the venous system. Since intensive antimicrobial therapy proved ineffective, debridement of the first and second lumbar vertebral bodies, and anterior spinal fusion from the twelfth thoracic to the third lumbar vertebrae were performed. The patient's high fever and severe lumbago subsided immediately after the surgery. The possibility of development to pyogenic vertebral osteomyelitis should be kept in mind when treating a serious genitourinary tract infection.

Acute Disease↗

m-calpain in rat growth plate chondrocyte cultures: its involvement in the matrix mineralization process.

m-Calpain, a Ca(2+)-dependent neutral cysteine proteinase (EC 3.4.22.17), has been demonstrated to be present in the lower hypertrophic zone of the rat growth plate. Using the pelleted culture system as an in vitro model of rat epiphyseal chondrocyte differentiation, we studied m-calpain contents and activities in pelleted cultures during chondrocyte differentiation and the role of m-calpain in the mineralization process. m-Calpain was demonstrated immunohistochemically in epiphyseal chondrocytes, and immunoreactive m-calpain content in cells increased with terminal differentiation into hypertrophic cells. Immunoblotting also showed the association of the increase in m-calpain in cell pellets and in cell culture medium with development of the culture. Ca(2+)-dependent caseinolytic activities of m-calpain extracted from cell pellets and from the medium increased with chondrocyte differentiation, coincident with the increase in enzyme content. The inhibition of m-calpain by the addition of calpastatin, a specific inhibitor of calpain, caused suppression of matrix mineralization in pelleted cultures; the addition of E-64c, a specific inhibitor of cysteine proteinases, during the mineralization stage also caused a significant inhibition of the matrix mineralization. The addition of E-64c resulted in altered composition of proteoglycan monomers and aggregates in cell pellets and in suppression of mineral growth. These findings support an important role of cysteine proteinases, especially m-calpain, in the regulation of the cartilage mineralization process through proteoglycan degradation.

Alkaline Phosphatase↗

Proteoglycan degradation in hemarthrosis. Intraarticular, autologous blood injection in rat knees.

We determined the degradation of articular cartilage proteoglycans in a single episode of experimental hemarthrosis in rat knees. The right knee joints of rats were injected once with autologous whole blood. Both knee joints were examined histologically. Biochemical studies of cartilage proteoglycans extracted from the knees were also conducted. Histological examination revealed an accumulation of mononuclear cells in intraarticular fibrin clots and subsynovial layers 8 hours after the injection of blood. Accordingly, initiation of proteoglycan degradation occurred 8 hours after injection of blood, lasting from 1 day of limited degradation to 3 days; recovery then occurred within 7 days. The proteoglycan degradation could be inhibited by 1 mM phenylmethylsulfonyl fluoride, a general serine proteinase inhibitor, 0.1 M 6-aminohexanoic acid, a specific inhibitor of plasminogen activators, 10 mM EDTA, and 10(-6) to 10(-8) M dexamethasone, indicating that the accumulation of mononuclear cells in intraarticular fibrin clots and subsynovial layers may play an important role in cartilage damage.

Aminocaproic Acid↗