Streptomyces spitsbergensis Wieczorek et al. 1993 is a later subjective synonym of Streptomyces baldaccii (Farina and Locci 1996) Witt and Stackebrandt 1991.
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DNA, Bacterial↗
Biomedical subjects
T Nishii
Publications and source records attributed to T Nishii.
Early deterioration after modified rotational acetabular osteotomy for the dysplastic hip.
We performed a modified, rotational acetabular osteotomy through a lateral transtrochanteric approach on 19 hips in 18 patients with a dysplastic joint. Six hips in six patients were operated on using the original approach. The mean age at operation was 28 years (14 to 54) and the mean period of follow-up 2.3 years (1 to 4.4). Clinical evaluation using the Merle d'Aubigne score showed excellent or good results in 76%. Radiologically, 15 hips showed good acetabular remodelling and no signs of progressive osteoarthritis. In ten hips (40%) there was chondrolysis and collapse of the transferred acetabulum or both within one year, although this gave only mild pain in some patients. Factors which were significantly associated with the grade of outcome included age at the time of operation, the thickness of the transferred acetabulum, failure to use a bone graft, and a transtrochanteric approach.
Acetabulum↗
Contralateral hip in patients with unilateral nontraumatic osteonecrosis of the femoral head.
To clarify the risk of the development of osteonecrosis of the femoral head in the contralateral hip of patients with unilateral nontraumatic osteonecrosis of the femoral head, a followup study was performed using magnetic resonance imaging. Forty-six asymptomatic contralateral hips with no evidence of osteonecrosis on magnetic resonance imaging, in patients with unilateral osteonecrosis, were subjects of this study. The period from the onset of unilateral osteonecrosis to entrance in this study ranged from 1 month to 20 years (mean, 3.1 years). There were 29 males and 17 females ranging in age from 16 to 71 years (mean, 41 years). Twenty-three patients had previous steroid therapy for various conditions: 16 had alcoholism and 7 had no etiologic factors. The followup term ranged from 3 to 8 years (average, 5.5 years). During the followup period, 1 patient (2%) had a band of low signal intensity demarcating the lesion of normal fat intensity on T1 weighted images, which progressed to collapse of the femoral head. These results suggest that in unilateral osteonecrosis cases, osteonecrosis rarely develops in the contralateral hip that has appeared normal on magnetic resonance imaging. The contralateral hip with a negative magnetic resonance imaging scan is not in Stage 0 of osteonecrosis, but is normal.
Adolescent↗
Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction.
OBJECTIVE: The objective of this study was to evaluate the effects of continuous leg traction on contrast-enhanced MR imaging of the hip joint and to determine whether MR imaging under these conditions is useful for demonstrating acetabular labral tears. DESIGN AND PATIENTS: Nineteen hips underwent MR imaging with a T1-weighted spin-echo sequence, followed by MR imaging under continuous leg traction after intravenous injection of gadolinium-DTPA. Joint fluid enhancement and labral contour detection were evaluated. Eleven hips had labral tears shown by conventional arthrography, arthroscopy and macroscopic surgical findings. Assessment of labral tears by MR imaging was correlated with the diagnosis based on these standard techniques. RESULTS AND CONCLUSIONS: Joint fluid enhancement was obtained in all hips at 30 min after injection. Superior and inferior labral surfaces were completely delineated in 1 hip on the unenhanced MR images, and in 7 and 13 hips, respectively, on the enhanced images under traction. The enhanced images under traction depicted 9 of the 11 labral tears. Comparison between the unenhanced image and the enhanced image under traction avoided mistaking undercutting of the labrum for a tear in 4 hips. Contrast-enhanced MR imaging under traction was valuable for detecting labral tears non-invasively and without radiation. Follow-up examinations using this method in patients with acetabular dysplasia can help to clarify the natural course of labral disorders and enable better treatment planning.
Acetabulum↗
Polyethylene sockets and alumina ceramic heads in cemented total hip arthroplasty. A ten-year study.
From 1981 to 1983, we implanted Bioceram type-4 and type-5 prostheses in 61 hips in 54 patients with osteoarthritis secondary to acetabular dysplasia, congenital subluxation, or congenital dislocation of the hip. Fifty-seven hips in 50 patients were followed for a mean of 11.1 years (10 to 13). The mean age of the patients at operation was 53 years (31 to 70). Functional evaluation using the Merle d'Aubigné and Postel hip score showed a 77% success rate. Radiological loosening occurred in three femoral (5%) and 16 acetabular components (28%). Autologous femoral head grafts were used in 18 hips and became incorporated, giving mechanical support to the socket except for one which occupied a large weight-bearing area and eventually collapsed. The mean polyethylene wear was 1.1 mm (0 to 3.6) and the mean wear rate was 0.10 mm/year (0 to 0.31). A high rate of wear correlated with calcar resorption (p > 0.002) but not with acetabular loosening. There was no breakage of a ceramic head. Study of the ceramic heads and polyethylene sockets retrieved after ten years showed excellent surface roughness, sphericity, and bending strength for the heads but scratches and voids were seen on the sockets.
Bone Cements↗
Bipolar cup design may lead to osteolysis around the uncemented femoral component.
Thirty-eight patients with a total of 45 primary uncemented bipolar hemiarthroplasties with smooth femoral components were observed for an average period of 5 years. Clinical results were excellent in 17, good in 15, fair in 10, and poor in 3 hips. Radiographs showed stem loosening and bipolar head migration in 12 and 2 hips, respectively. Endocortical femoral osteolysis developed in 26 hips (58%). Eight hips required revision surgery. All the revised hips showed circumferential wear of the polyethylene insert rims without substantial wear of the bearing surface. Histologic examination of the fibrous membrane around the stem showed many polyethylene particles that had been phagocytized by macrophages or surrounded by foreign body giant cells. No metal particles were observed at this site. The intrinsic functional mechanism of the bipolar endoprosthesis leads to persistent cyclic impingement of the stem neck on the rim of the bipolar head, producing polyethylene particles and frequent stem loosening by periprosthetic osteolysis. Unless this structural problem can be corrected and the durability of the prosthesis increased, the bipolar system should not be used for hemiarthroplastic surgery.
Adult↗
Multiple lesions of osteonecrosis depicted by magnetic resonance imaging.
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Adult↗
A new genus of the order Actinomycetales, Couchioplanes gen. nov., with descriptions of Couchioplanes caeruleus (Horan and Brodsky 1986) comb. nov. and Couchioplanes caeruleus subsp. azureus subsp. nov.
During our taxonomic study of motile actinomycetes, soil isolate RA 335 was found to form a blue substrate mycelium and aerial mycelia with motile arthrospores and to have lysine as the cell wall diamino acid. Actinoplanes caeruleus IFO 13939T (T = type strain) and "Actinoplanes azureus" IFO 13993T are known to have the same characteristics. Therefore, the taxonomic position of these three strains was studied. Aerial mycelia of these strains fragmented during the growth cycle and produced motile spores arranged in chains within the mycelia. Sporangia were not observed. The strains contained menaquinone 9(H4), had guanine-plus-cytosine contents of 69.9 to 72.1 mol%, and had D-glutamic acid, D- and L-serine, glycine, L-alanine, and L-lysine as cell wall amino acids (type A3 alpha). The taxonomic characteristics of these strains differ from those of the previously described motile actinomycetes. On the basis of morphological, physiological, and chemotaxonomic data and the results of DNA-DNA hybridization and comparative 16S rRNA studies, we propose a new genus, Couchioplanes, for these organisms. The type species is Couchioplanes caeruleus comb. nov. (type strain, IFO 13939), which is divided into two subspecies, Couchioplanes caeruleus subsp. caeruleus subsp. nov. (type strain, IFO 13939) for A. caeruleus IFO 13939T and strain RA 335 and Couchioplanes caeruleus subsp. azureus (type strain, IFO 13993) for "A. azureus" IFO 13993T.
Actinomycetales↗
[Mitral annuloplasty for mitral regurgitation due to dilated cardiomyopathy--a case report].
A 74-year-old woman who had had severe mitral regurgitation (MR) due to dilated cardiomyopathy (DCM) was referred to our hospital for surgical management because she had suffered from congestive heart failure (CHF) of NYHA functional class IV in spite of maximal medical treatment. We have successfully performed mitral annuloplasty (MAP) using a Carpentier annuloplasty ring. Her postoperative course was good and her symptom improved to NYHA functional class II to III one year after the operation. However, the left ventricular functional improvement was minimal. The regurgitant fraction decreased from 0.62 to 0.11 after the operation but the left ventricular ejection fraction also decreased from 0.26 to 0.11. We had an impression that MAP could be considered as one of the procedures for severe MR due to DCM, if CHF was not controlled by any medications.
Aged↗
Hemodynamic assessment during exercise after left ventricular aneurysmectomy.
The exercise hemodynamics of eight patients who underwent cardiac catheterization were assessed at rest and during exercise, before and after left ventricular aneurysmectomy by the classical technique. Left ventricular end-diastolic volume increased before operation and then significantly decreased after the operation (p < 0.05). The ejection fraction increased from 0.27 before the operation to 0.46 after the operation (p < 0.01). The cardiac index, which was low before operation, increased within the normal range after operation. Mean systolic circumferential tension also decreased significantly (p < 0.01) after the operation. Thus, the indexes at rest showed improvement. Left ventricular end-diastolic pressure showed a decreasing tendency after the operation both at rest and during exercise in comparison with that before the operation. However, the difference was not significant. The stroke work index increased significantly during exercise after the operation (p < 0.05). Before the operation, the stroke work index did not increase despite the elevation of left ventricular end-diastolic pressure; however, after the operation, the stroke work index increased during exercise without much increase of left ventricular end-diastolic pressure. This indicated improvement in the Frank-Starling curve and recovery of preload reserve by the resection of the left ventricular aneurysm. Thus, an important factor for demonstrating improvement in postoperative cardiac function was clarified through its relation to exercise load.
Cardiac Output↗
Internal thoracic artery grafting for congenital coronary malformations.
We report 2 patients with congenital coronary anomalies (atresia of left main coronary artery and anomalous origin of the left coronary artery from the pulmonary artery) successfully treated with single or double internal thoracic artery grafting. Because the internal thoracic artery has a potential for circumferential as well as longitudinal development, and because of the uncertainty of ultimate vein graft function, we believe that the internal thoracic artery is the best graft material for the treatment of congenital coronary malformations requiring bypass operation in children, adolescents, or even in adults.
Child↗
[A penetrating cardiac wound by a flying metallic fragment].
A 54-year-old man suddenly felt a strike on his chest while mowing with a machine. At first he had no symptoms except for wound pain, but several hours later, he suffered from high fever with chilliness. The chest roentgenogram showed a foreign body localized within the cardiac shadow. The echocardiogram revealed that the metallic fragment was embedded in the inferior wall of the left ventricle. It appeared that the fragment entered the left ventricular cavity through his anterior chest wall, the right ventricular outflow tract and the ventricular septum. At the operation, the location of the foreign body was again confirmed by the intraoperative echocardiography and the fragment was successfully removed through a left ventricular incision under cardiopulmonary bypass. The postoperative course was uneventful and the case was reported with a review of the literature.
Echocardiography↗
Surgical treatment of renal cell carcinoma with a tumor thrombus extending into the right atrium.
We experienced surgical treatment on two patients having renal cell carcinoma with a tumor thrombus extending into the right atrium. In these patients, we performed nephrectomy, dissection of lymph nodes and removal of a tumor thrombus using cardiopulmonary bypass. One died of multiple organ failure 42 days postoperatively; the other was discharged from the hospital and is currently doing well 12 months after the operation. Cardiopulmonary bypass combined with hypothermia and low blood flow significantly facilitated removal of the tumor thrombus extending into the right atrium without the risk of pulmonary embolism or brisk hemorrhage.
Aged↗
[Clinical results, graft patency and flow reserve capacity of multiple coronary artery bypass with bilateral or sequential internal thoracic artery grafts].
Multiple coronary artery bypass grafting (CABG) was performed utilizing the internal thoracic arteries (ITA) in 87 patients ranging in age from 3 to 76 years. Bilateral ITAs were used in 67, sequential grafting was performed in 16, and the combination of both techniques was applied in 4 patients. Twelve patients had coronary arterial obstructions due to Kawasaki disease (mean age 9.7 +/- 3.3 years) and the remaining 75 patients had atherosclerotic coronary artery disease (mean age 53 +/- 10 years). Triple vessel disease and left main trunk disease occupied 85% of the patients. The number of grafts was 2 to 5 per patient with an average of 3.2 +/- 0.7 per patient. In bilateral ITA grafting, the combination of the RITA to LAD and LITA to LCX was most frequently used, and in sequential grafting, the LITA-diagonal artery-LAD was the most common use. There were no early or late mortalities in the present series. The patency rates for the RITA and LITA were 93% and 96%, respectively, and those of sequential grafting were 100% in both the proximal and distal anastomoses. The clinical outcome of multiple CABG with ITAs was quite satisfactory, and the bilateral ITAs could be used in the very wide range of patient's age from 3 to 76 years. In addition, blood flow reserve provided by bilateral ITAs was equivalent to that of the SVG alone or SVG plus ITA on the basis of the result of coronary sinus flow (CSF) measurements during exercise, and thus complete revascularization of the left ventricle could be accomplished by multiple CABG with ITAs.
Adult↗
[Surgery for postinfarction ventricular septal perforation under hypothermic fibrillatory arrest with pulsatile perfusion].
Surgery were performed by 2 different methods of myocardial protection in 17 patients with postinfarction ventricular septal perforation (VSP) from 1982 to 1989. Ten consecutive operations were performed using hypothermic fibrillatory arrest with pulsatile perfusion (VF group). Pulsatile flow was produced by an intra-aortic balloon pumping device. Other 7 consecutive VSP operations were performed using cardioplegic arrest (CP group). In the VF group, the mean age was 67 years (range 54 to 78 years), and VSP was located in the anterior wall in 7, in the inferior wall in 2, and in the anterior and inferior walls in 1 patients. The operation was performed 2.5 days after the onset of VSP. In the CP group, the mean age was 71 years (range 50 to 78 years), and VSP was located in the anterior wall in 6 and in the inferior wall in 1 patient. The operation was performed 4.7 days after the onset of VSP. Cardiogenic shock developed after septal rupture in 50% of the patients in the VF group and 71% in the CP group (N.S.). Prior to the operation, no significant differences were found in hemodynamic status between the 2 groups. Cardiac index in the VF group was higher than that of the CP group (p less than 0.05) shortly after cardiopulmonary bypass. The operative mortality rate was 10% in the VF group and 57% in the CP group. From these clinical results, hypothermic fibrillatory arrest with pulsatile perfusion can be beneficial as a method of myocardial protection during surgery for VSP and presently this has become the method of choice in our department.
Aged↗
Bilateral internal mammary artery grafts for coronary artery bypass operations in children.
We performed myocardial revascularization with bilateral internal mammary arteries in eight children for coronary artery complications consequent to Kawasaki disease. Subjects included seven boys and one girl, ranging in age from 3 to 13 years (mean age, 8.3 +/- 3.4 years). The body surface area ranged from 0.65 to 1.65 m2 (average, 1.08 +/- 0.35 m2). Three patients had a previous myocardial infarction. The right internal mammary artery was anastomosed to the right coronary artery and the left internal mammary artery was sutured to the left anterior descending artery in all patients. The patients received an average of 2.4 grafts. Magnifying loupes of 3.5 X were used for anastomosis with 8-0 monofilament polypropylene sutures. Subjects were followed up from 12 to 38 months (23 +/- 10.8 months) after operation. All were doing well with no recurrence of angina, and body development was normal, including the sternum and thorax according to chest x-ray films and computed tomography of the chest. Patency of the bilateral internal mammary arteries was 100% in the early (within 1 month) postoperative period and remained so in the late (over 1 year) postoperative period. Anastomotic junctions between the internal mammary artery and the coronary artery developed well angiographically in the late postoperative period. The internal mammary artery is the graft of choice for pediatric myocardial revascularization because of its excellent long-term patency and growth potential. Bilateral internal mammary arteries should be used whenever indicated, and the use of bilateral internal mammary arteries did not adversely influence chest wall development in the children.
Adolescent↗
[Surgery of aortic valvular disease with congenital bicuspid or quadricuspid aortic valve].
Twelve patients (age 18 to 69 years old) with surgical treatment for congenital bicuspid aortic valve and one (age 26 years old) for quadricuspid aortic valve were reported. These 13 patients occupied 12.3% of the total number of patients with aortic valve replacement during the same period. Among the patients with bicuspid aortic valve, 10 patients were male (83%) and 2 were female (17%). Seven patients exhibited aortic stenosis and 5 showed predominant aortic regurgitation. The mean age of patients with aortic stenosis was higher than that of patients with aortic regurgitation. (63.3 years vs 32.0 years old). Infective endocarditis occurred in 2 patients (17%). Three patients had pure aortic regurgitation without evidence of endocarditis. One 26-year-old female patient who had a quadricuspid aortic valve presented with aortic regurgitation associated with PDA. All patients underwent aortic valve replacement with no early and late deaths.
Adult↗
Clinical results and in vivo valve function after implantation of a Bicer valve prosthesis in the aortic position.
Between December 1981 and June 1987, 71 patients underwent aortic valve replacement with a Bicer monostrut tilting disc prosthesis. Clinical results and in vivo function of the artificial valve were assessed. The average age of the 71 patients at the time of operation was 51.3 +/- 11.5 years. The hospital mortality rate was 2.8% (two patients) and there were no further deaths during a mean (+/- SD) follow-up period of 2.4 +/- 1.6 years (range 1 month to 5.5 years) after surgery. There was also no occurrence of thromboembolism or valve dysfunction. Function of the Bicer valve prosthesis was assessed in 17 patients: 5 with a 21 mm valve, 7 with a 23 mm valve and 5 with a 25 mm valve. Examination was performed on average 10.3 +/- 8.1 months after surgery. Valve function was examined at rest and during exercise performed with a bicycle ergometer. Pressure gradients at rest were low: 21 mm valve = 8 mm Hg, 23 mm valve = 3 mm Hg and 25 mm valve = 2 mm Hg; the gradients during exercise were 11, 8 and 8 mm Hg, respectively. The valves had the following effective orifice area at rest: 21 mm valve = 1.54 cm2, 23 mm valve = 4.20 cm2 and 25 mm valve = 3.76 cm2; during exercise, the respective areas were 1.57, 3.48 and 3.01 cm2. These valves are deemed to be sufficiently wide for effective valve function. Aortographic observation indicated mild regurgitation that was within reasonable limits and posed no problem.(ABSTRACT TRUNCATED AT 250 WORDS)
Aortic Valve↗