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Biomedical subjects

K Mashiba

Publications and source records attributed to K Mashiba.

11 recordsLinked to original sources

Clinical comparison of the scanning CO2 laser and conventional surgery in the treatment of ingrown nail deformities.

AIM: To compare statistically the clinical effects and postoperative course of the scanning CO(2) laser and conventional surgical method to evaluate the clinical effectiveness of the former for the treatment of ingrown nail deformities. METHODS: We performed vaporization of the nail matrix using the scanning CO(2) laser in 25 cases with ingrown nail deformities. RESULTS: In 21 cases, the recurrence of ingrown nail deformity was not observed during follow-up. All cases were free of postoperative infection. Use of the scanning CO(2) laser reduced postoperative pain, and all patients were able to return to their daily activities by day 3 post-surgery without any problems. CONCLUSIONS: Statistically, the operating time and the duration of postoperative pain were reduced significantly by the scanning CO(2) laser. Furthermore, patients treated with CO(2) laser were able to return to daily life significantly sooner.

Adult↗

The difference in E-cadherin expression between nonvascularized and vascularized nerve grafts: study in the rat sciatic nerve model.

BACKGROUND: We investigated the expression of E-cadherin during nerve regeneration after nonvascularized and vascularized nerve grafts. MATERIALS AND METHODS: We used the rat sciatic nerve model. E-cadherin expression was detected by Western blot analysis and immunofluorescent staining with anti E-cadherin monoclonal antibody. The level of E-cadherin expression was calculated as the amount relative to that of E-cadherin expression of normal control nerve. Furthermore, repair of the neural tissue structure was examined by toluidine blue staining. RESULTS: In both cases, the level of E-cadherin expression decreased at first, and then gradually increased. The maximum level was 1.61 +/- 0.066-fold in the nonvascularized nerve graft and 2.254 +/- 0.071-fold in the vascularized nerve graft. From the 1st to the 16th postoperative weeks, the level of E-cadherin expression in the vascularized nerve graft was significantly higher than that in the nonvascularized nerve graft. In the immunofluorescent staining, E-cadherin expression was almost negative or decreased immediately after the operation, but the degree of expression was gradually increased in Schwann cells. The degree of E-cadherin expression in the vascularized nerve graft was greater than that in the nonvascularized nerve graft. In toluidine blue staining, the velocity of tissue repair was more rapid in the vascularized nerve graft than in the nonvascularized graft. CONCLUSION: These results demonstrate that the E-cadherin expression of grafted nerve was increased during the nerve regeneration, and the expression was mainly observed in Schwann cells. Because the level of E-cadherin expression was significantly higher in the vascularized nerve graft than in the nonvascularized nerve graft, the level of E-cadherin expression may affect the rapidity of nerve regeneration.

Animals↗

Detection of E-cadherin expression after nerve repair in a rat sciatic nerve model.

The authors investigated E-cadherin expression during nerve regeneration after nerve suture using the rat sciatic nerve model. Five rats were used during each postoperative period. E-cadherin expression was detected by Western blot analysis and immunofluorescent staining with an anti-E-cadherin monoclonal antibody. The level of E-cadherin expression was calculated as the amount relative to that found in normal control nerve. The level of E-cadherin expression was decreased at first, and then gradually increased. The maximum level of E-cadherin was 1.92 +/- 0.07 fold in the sutured nerve. The level of E-cadherin expression in the sutured nerve was significantly greater (p < 0.0001) than that of the normal control nerve from postoperative day 3 to 21, and that of sutured nerve returned to the control level by postoperative day 28. The immunofluorescent staining results indicated that E-cadherin expression was almost negative or decreased immediately after the operation, but the degree of expression increased gradually in Schwann's cells. The degree of E-cadherin expression was significantly greater than that of normal control nerves from postoperative day 7 to 14, and returned to the control level by postoperative day 21. These results demonstrate that E-cadherin expression increases during nerve regeneration, and the expression was observed mainly in Schwann's cells. The degree of E-cadherin expression may affect the rate of nerve regeneration.

Animals↗

Experience with surgical treatment of hidradenitis suppurativa.

The authors report their experience with 23 sites of hidradenitis suppurativa, including cases with musculocutaneous flap repair, and discuss the surgical methods applied. Twenty-three sites in 19 patients with chronic inflammatory skin lesions were reviewed. The lesions were divided into two groups: The limited group was comprised of mild lesions, which appear isolated and have limited abscesses without sinus tract formations. The severe group was compromised of severe lesions, which included diffuse, multiple abscesses with severe sinus tract formation and fibrosis. Nine sites were limited and 14 sites were severe. After resecting the lesion, the defect was covered with a split-thickness skin graft (four sites were limited, nine sites severe), a musculocutaneous flap (five sites severe), primary closure (four sites limited), and a local skin flap (one site limited). In six sites in 6 severe-group patients, local recurrence occurred. The local recurrence rate differed significantly between the limited and the severe groups. The reason for this may be because the lesions in the limited group could be resected completely, whereas the lesions in the severe group were diffuse and total resection was sometimes difficult for various reasons. The method of surgical repair did not affect the local recurrence rate. In recurrent cases, four sites treated with skin grafting required further surgical treatment, and two sites treated with musculocutaneous flaps were controlled with oral antibiotics. In conclusion, sufficient resection of the lesion is the most important issue in treating follicular occlusion triad disease. In lesions that can be resected completely, the surgical procedure to cover the lesions should be selected to suit the size and site of the defect. However, in cases that cannot be resected completely, a musculocutaneous flap is recommended instead of a skin graft for enhanced postoperative management of the recurring wound, and its contribution to aesthetic and functional improvement.

Adult↗

Application of artificial dermis graft to correct a depression after tissue resection.

The authors present 7 cases of artificial dermis implantation to correct a depression after tissue resection. Four of the seven cases resulted from resection of a malignant tumor (N = 3) and from a benign subcutaneous tumor (N = 1). The other 3 cases were the result of temporal muscle harvest to reconstruct facial palsy. In 1 patient a mild degree of bone deformity also existed. The pieces of artificial dermis employed varied from 35 x 40 to 40 x 80 mm in size. In 5 patients two sheets were implanted, and in 2 patients three sheets were implanted. In 2 patients the dermis sheets were covered by a pedicled temporal fascial flap with a free split-thickness skin graft because whole skin was resected as a result of a malignant skin tumor. There was no postoperative infection or allergic reaction in any of the patients. In all cases there was no postoperative contracture, and the implanted area was soft. An adequate or acceptable thickness of subcutaneous tissue was obtained. Artificial dermis may be a useful option as implantation material to correct a depression after tissue resection, especially for wide and comparatively shallow depressions.

Aged↗

Alteration of the cellular response to interleukin-1 beta by SV40 large T antigen in rheumatoid synovial fibroblasts.

The large T antigen of SV40 (LT) has been widely used to immortalize primary cells for various studies. In this study, synovial fibroblasts of a patient from rheumatoid arthritis (RA) were transformed with LT gene to analyze the effect of SV40-mediated transformation on the production of cytokines, such as IL-6, IL-8, and GM-CSF, that are under the control of interleukin-1 beta (IL-1 beta), a physiological inducer of nuclear factor kappa B (NF-kappa B). It was noted that the basal levels of GM-CSF and IL-8 were upregulated, whereas that of IL-6 was downregulated. Moreover, the extents of induction of these cytokines in response to IL-1 beta were markedly downregulated in synovial fibroblasts transformed by LT as compared from parental cells. Although IL-1 beta could translocate NF-kappa B to the nucleus in all cells, some of the transformed cells exhibited nuclear translocation of NF-kappa B even before the stimulation with IL-1 beta, suggesting that transformation of LT resulted in the constitutive activation of NF-kappa B, either directly or indirectly. In order to examine whether LT downregulate the kappa B-dependent gene expression, we performed the transient luciferase gene expression assay. We found that cotransfection of LT did not downregulate the kappa B-dependent gene expression that was stimulated with L-1 beta. These observations suggest that the apparent inhibitory effect of LT on the IL-1-induced expression of cytokines may not be through its direct action on the NF-kappa B transactivation.

Antigens, Polyomavirus Transforming↗

Involvement of vascular endothelial growth factor in Kaposi's sarcoma associated with acquired immunodeficiency syndrome.

To examine the role of vascular endothelial growth factor (VEGF) in the development of edema associated with Kaposi's sarcoma (KS) in acquired immunodeficiency syndrome (AIDS), we exploited animal model systems to detect the activity that induces vascular hyper-permeability (VHP) using cultured AIDS-KS spindle cells. Cultured AIDS-KS spindle cells and conditioned medium (AIDS-KS-CM) that had been semi-purified through a heparin affinity column were tested for the ability to induce VHP in animals. The AIDS-KS spindle cells and AIDS-KS-CM induced VHP that was histamine-independent. The VHP-inducing activity was detected in the 0.5 M NaCl fraction from the heparin affinity column and was blocked by anti-VEGF neutralizing antibody. In addition, the production of VEGF was demonstrated in fresh AIDS-KS tissue as well as in cultured AIDS-KS cells, while control cells were negative for VEGF production. From these observations, we concluded that AIDS-KS cells produce a factor(s) that promotes VHP, and this factor could be VEGF.

Acquired Immunodeficiency Syndrome↗

[Mechanism of poor responsiveness to therapy of bacterial infection in patients with connective tissue diseases].

Infectious complications are important factors for poor prognosis of connective tissue diseases (CTD). 33% of the fatal cases with CTD were caused by infectious complications in our study. It was characteristic of infectious complications with CTD, that pneumonia was recognized in all CTD, especially, commoner in PSS, PM and OL, and frequently caused a fatal outcome. Gram negative bacillus, for instance E. coli and K. pneumoniae were frequently detected as pathogens. On the other hand, methicillin resistant Staphylococcus aureus (MRSA) was increased recently, and tuberculosis, especially atypical tuberculosis, such as, miliary and cutaneous forms were also recognized. The risk factors in the development of bacterial infections is considered to be intricately correlated with cellular and humoral immunodeficiency due to CTD or steroid hormones.

Antibody Formation↗

[A case of Legionnaires' disease due to aspiration of hot spring water and isolation of Legionella pneumophila from hot spring water].

We report a case of fulminant pneumonia that was due to aspiration of contaminated hot spring water and was not affected by beta-lactam antibiotics. We suspected that the patient had Legionnaires' disease and treated the clinical symptoms with erythromycin. Legionellaceae could not be isolated from sputum or lung biopsy material, but an elevated titer to Legionella pneumophila serogroup 4 was found by indirect immunofluorescence test. We diagnosed the patent as having Legionnaires' disease with improved clinical symptoms. Furthermore, we went to the hot spring that he visited and tried to isolate Legionellaceae. Hot spring water was collected from the bathroom and water, hot water, and shower water from the guest-room. After using a low-pH method, samples were cultured on BCYE alpha medium. Serogroups are classified by agglutination method with immune rabbit serum. As a result, we successfully isolated Legionella pneumophila serogroup 4 from hot spring water (42 degrees C) from the bath. No bacteria could be isolated from the other samples. Therefore, we believe that this case of Legionnaires' disease was caused by aspiration of contaminated hot spring water. The infection route of Legionnaires' disease is unclear. There are no previous reports of isolation of Legionellaceae from Japanese hot springs. This case would provide important information when considering the infection route of Legionnaires' disease in Japan.

Accidents↗

Lip reconstruction of comparatively large defect including the commissure using remaining lip tissue: a modification of reconstructed method.

We present two reconstructed cases after malignant skin tumor of comparatively large defects of lip including the commissure using remaining lip tissue alone. After resecting a tumor including wedge-shaped full-thickness lip tissue, a full thickness oblique incision is made at the site 5 mm distant from the contralateral commissure. The rhomboid-shaped lower lip flap is created, transposed to the defect, and sutured with the defect margin, including the upper lip, to reconstruct the commissure. The cross lip flap is created at the contralateral side of the lower lip, 5 mm from the commissure, and the defect is closed with the crosslip flap. Although our method is applicable only to selected cases, we believe that it is useful in terms of maintaining symmetry of the lip and function of the commissure in the reconstruction of comparatively large defects including the commissure.

Aged↗