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Biomedical subjects

Takuya Sawaizumi

Publications and source records attributed to Takuya Sawaizumi.

15 recordsLinked to original sources
PubMed2006

De Quervain's disease: efficacy of intra-sheath triamcinolone injection.

The methods and clinical outcomes of intra-sheath triamcinolone injection in the treatment of de Quervain's disease are described. We used 38 hands of 36 patients. A mixture of 1 ml of triamcinolone and 1 ml of 1% lidocaine hydrochloride was injected, with an interval of 2 weeks. The fluid was injected into one point above the induration for the first 18 hands and into two points over the extensor pollicis brevis and abductor pollicis longus tendon in the induration for hands 19-38. The efficacy rate was 89%, with the treatment results of the two-point injection better than those of the one-point injection. Recurrence was observed in ten hands, and complications in 13 hands; however, over 90% of patients were satisfied with the injection. The accurate injection of triamcinolone into the sheath of both the extensor pollicis brevis and abductor pollicis longus tendon was considered very effective for de Quervain's disease.

Adult↗
PubMed2006

Validation of the Japanese Society for Surgery of the Hand Version of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH-JSSH) questionnaire.

BACKGROUND: The Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire is a region-specific, self-administered questionnaire, which consists of a disability/symptom (QuickDASH-DS) scale, and the same two optional modules, the work (DASH-W) and the sport/music (DASH-SM) modules, as the DASH. After the Japanese version of DASH (DASH-JSSH) was cross-culturally adapted and developed, we made the Japanese version of QuickDASH (QuickDASH-JSSH) by extracting 11 out of 30 items of the DASH-JSSH regarding disability/symptoms. The purpose of this study was to test the reliability, validity, and responsiveness of QuickDASH-JSSH. METHODS: A series of 72 patients with upper extremity disorders completed the QuickDASH-JSSH, the 36-Item Short-Form Health Survey (SF-36), and the Visual Analog Scale (VAS) for pain. Thirty-eight of the patients were reassessed for test-retest reliability 1 or 2 weeks later. Reliability was investigated by the reproducibility and internal consistency. To analyze the validity, a principal component analysis and the correlation coefficients between the QuickDASH-JSSH and the SF-36 were obtained. The responsiveness was examined by calculating the standardized response mean (SRM; mean change/SD) and effect size (mean change/SD of baseline value) after carpal tunnel release of the 17 patients with carpal tunnel syndrome. RESULTS: Cronbach's alpha coefficient in the QuickDASH-DS was 0.88. The intraclass correlation coefficient (ICC) for the same was 0.82. The unidimensionality of the QuickDASH-DS was confirmed. The correlation coefficients between the QuickDASH-DS and the DASH-DS, DASH-W, or the DASH-SM were 0.92, 0.81, or 0.76, respectively. The correlation coefficients between the QuickDASH-DS score and the subscales of the SF-36 ranged from -0.29 to -0.73. The correlation coefficient between the QuickDASH-DS score and the VAS for pain was 0.52. The SRM/effect size of QuickDASH-DS was -0.54/-0.37, which indicated moderate sensitivity. CONCLUSION: The Japanese version of QuickDASH has equivalent evaluation capacities to the original QuickDASH.

Arm↗
PubMed2006

Closing radial wedge osteotomy for Preiser's disease: a case report.

A case of Preiser's disease treated with closing radial wedge osteotomy is reviewed and the therapeutic effect is reported. A good result was obtained in the short term and we believe that this surgical method could become one of the choices for surgical treatment to alleviate pain in Preiser's disease.

Arthralgia↗
PubMed2005

Percutaneous leverage pinning in the treatment of Bennett's fracture.

Twelve patients (eleven males, one female; mean age 36 years) with Bennett's fracture having a gap or a step-off of more than 2 mm and in whom maintenance of the reduced position was difficult were treated by percutaneous leverage pinning. Bone union was obtained in all patients, and the wire was removed 37 days on average after the initial treatment. On the final follow-up examination, mild pain with motion was noted in two patients, and moderate to severe pain was noted in one patient. The reduction of the articular surface of the carpometacarpal joint of the thumb was confirmed by radiography; it was less than 1 mm in nine patients, less than 2 mm in two, and more than 2 mm in one. Because reduction and fixation are performed utilizing the leverage force of the wire inserted into the trapezium, percutaneous pinning has advantages, such as technical simplicity and the ability to apply tension to the fractured site.

Adolescent↗
PubMed2005

Intrasheath triamcinolone injection for the treatment of trigger digits in adult.

The purpose of this study is to describe our technique of intrasheath triamcinolone injection for trigger digit and to evaluate the treatment outcome. Seventy-two patients of 81 digits treated with intrasheath triamcinolone injection were followed up for at least one year and interviewed in our clinic. The injection was performed in all patients by one of the authors at two-week intervals. The amount used was 1 ml (10 mg) of triamcinolone and was mixed with 1 ml of 1% lidocaine and tried precise injection into the tendon sheath. According to the evaluation method developed by Patel and Moradia, they were excellent in 67 digits, good in ten digits, fair in three digits, and poor in one digit. Satisfactory results were obtained in 95% of the digits, and the effectiveness rate was higher than previously reported. But it should also be noted that triamcinolone easily induces local side effects such as dermatitis.

Adult↗
PubMed2003

MR imaging for preoperative diagnosis and assessment of local tumor extent on localized giant cell tumor of tendon sheath.

OBJECTIVE: The purpose of this study was to clarify the usefulness of MR imaging for preoperative diagnosis and evaluation of the extent of localized giant cell tumor of tendon sheath (GCTTS). DESIGN AND PATIENTS: We retrospectively reviewed the MR images of 25 patients with surgically proved GCTTS (seven males and 18 females; mean age, 41 years) including five recurrences. T1- and T2-weighted imaging was carried out on 24 and 22 lesions, respectively. Gadolinium-enhanced images were obtained for 20 lesions. We evaluated the tumor extent around the phalanx (the degree of circumferential occupation by a tumor around the phalanx on an axial plane) and involvement of the bone, joint, and tenosynovial space by both MR imaging and surgery (gold standard). RESULTS: MR signal intensities of the GCTTSs were consistently equal to those of skeletal muscle or between those of muscle and fat on T1-weighted images; on T2-weighted images, the signal intensities tended to be between those of muscle and fat. Most lesions were inhomogeneous due to low-signal-intensity areas, and enhanced following gadolinium administration. The tumor extent around the phalanx was 168.5 +/- 99.2 degrees (63-360 degrees). MR imaging did not identify the bone involvement (five lesions), but depicted the involvement of the joint in four of five lesions and the tenosynovial space in nine of ten lesions. CONCLUSIONS: This study confirms that MR imaging is able to depict the characteristic internal signal of GCTTS. Moreover, it can accurately assess the tumor size and degree of extent around the phalanx, which can affect the type of surgical approach.

Adolescent↗
PubMed2003

Stabilized subcutaneous transposition of the ulnar nerve.

We treated 50 patients (average age 47.9 years) with a stabilized subcutaneous transposition of the ulnar nerve. The average follow-up period was 42.4 months. The indication was cubital tunnel syndrome in 19 patients and injuries around the elbow in 31 patients. Postoperatively, satisfactory results were obtained in all the patients, and there was no complication or aggravation of the preoperative symptoms. None of the patients experienced slipping back of the nerve to the cubital tunnel. In the 31 patients with injuries around the elbow, there was only one patient with transient aggravation of parasthaesiae in the ulnar nerve region. Stabilized subcutaneous transposition is a simple and less invasive procedure that can facilitate decompression and prevent slipping back of the nerve. This procedure also can be applied to patients with injuries around the elbow that require ulnar nerve transfer.

Adolescent↗
PubMed2003

Supernumerary extensor pollicis longus tendon: a case report.

We report a rare case in which the extensor pollicis longus (EPL) tendon was separated into 2 slips at the site of origin, ran an abnormal course across the wrist, and combined in the vicinity of the metacarpophalangeal (MCP) joint; the tendon on the radial side passed through another tendon sheath between the first and second compartments and the tendon on the ulnar side passed over the extensor retinaculum.

Adult↗
PubMed2003

Lengthening of the amputation stumps of the distal phalanges using the modified Ilizarov method.

PURPOSE: The purpose of this study was to introduce the technique for distraction lengthening of the traumatic amputation stumps of distal phalanges less than 10 mm long by using the Ilizarov minifixator (Ito Medical Instruments, Tokyo, Japan) and to report the treatment results and the problems we encountered. METHOD: Six patients (3 men and 3 women) underwent lengthening of the traumatic amputation stumps of distal phalanges using the Ilizarov minifixator. The mean pre-operative length of the distal phalanges was 6.0 mm and the mean deficiency in length was 9.5 mm compared with the contralateral finger or thumb. RESULTS: In 5 of the 6 patients callus lengthening was completed without early consolidation or bone failure related to the traction wires. The mean gain in lengthening of the distal phalanx was 6.8 mm and the mean final length of the distal phalanx was 12.8 mm. After surgery 4 patients had onychoplasty and advancement flap coverage of the distal phalangeal tip because of excessive skin tension and 1 patient had arthrodesis because of flexion contracture of the distal interphalangeal joint. The patients were satisfied with the cosmetic improvement of their fingertips. CONCLUSIONS: Although this callus distraction method required multiple surgical procedures it is considered worthy of more frequent application especially in young patients.

Adult↗
PubMed2003

Vascularized second metacarpal-base bone graft in scaphoid non-union by the palmar approach.

Vascularized second metacarpal-base bone grafting from the palmar side for scaphoid non-union was performed in seven patients (six males and one female, with a mean age of 26 years). In all patients, bone union was obtained at a mean of 10.2 weeks. In six of the seven patients, preoperative dorsal intercalated segment instability (DISI) was corrected. The results were excellent in three patients, good in two patients, and fair in two patients, showing that more than 80 percent of the patients had satisfactory results. In this procedure, the second dorsal metacarpal artery, with a large vascular diameter, is used as the pedicle, and the second metacarpal base, which is abundant in cancellous bone, is elevated on the dorsal side and grafted on the open-wedged scaphoid non-union on the palmar side. This procedure is reliable and useful, particularly for scaphoid non-union with DISI.

Adolescent↗
PubMed2003

Injury of superficial radial nerve on the wrist joint induced by intravenous injection.

Eleven cases of injury of the superficial radial nerve on the wrist joint, caused by intravenous injection of a needle. Paralysis occurred immediately after injection of a needle into the cephalic vein of the wrist joint, which was immediately recognized by the patients themselves. Six patients who had only sensory disturbance without causalgia were subjected to follow-up observation; 5 patients with causalgia were administered with steroid infiltration injection 3 to 5 times. Of the latter 5 patients, one patient underwent surgery because the steroid infiltration injection showed no effects. Four patients (36.4%) completely recovered within three months, while 7 patients (63.6%) continued to show nervous symptoms. We concluded that intravenous injection of a needle should be performed at the wrist joint only when it is inevitable.

Aged↗
PubMed2002

A report of two cases of volar and dorsal fractures of the middle phalanx caused by a basketball.

We present two rare cases of volar and dorsal fractures of the middle phalanx at the proximal interphalangeal joint (PIPJ). The first case was a 16-year-old girl. She hurt her middle finger while playing basketball. A lateral radiograph revealed volar and dorsal fractures of the middle phalanx. She underwent external immobilization of the PIPJ in 30 degrees of flexion with a splint for 3 weeks. The fractures healed 7 weeks after the injury with neither tenderness nor limitation of range of motion. The second case was a 16-year-old boy. He injured his index finger while playing basketball, and underwent immobilization of the PIPJ for 3 weeks. At 10 weeks after the injury, the dorsal fracture was almost healed, but the displacement of the volar fragment had worsened. At a 3-year follow-up, the dorsal fragment was healed, but the volar fragment remained in a site of nonunion. However, there was neither residual deformity nor restriction of movement.

Adolescent↗
PubMedDate not supplied

Surgical technique for supracondylar fracture of the humerus with percutaneous leverage pinning.

Percutaneous pinning with a leverage technique for supracondylar fracture of the humerus was performed in 36 elbows in 35 children. The patient was placed in the lateral position with the forearm hanging. Under radiographic imaging, a Kirschner wire, as a reduction pin, was inserted into the fracture line from the dorsal side, passed through the posterior cortex of the proximal fragment, and turned distally. After reduction of the posterior displacement by the leverage technique, the reduction pin was driven into the anterior cortex of the proximal fragment. Subsequently, a Kirschner wire was inserted from the lateral condyle for fixation between the proximal and distal fragments. This percutaneous pinning technique was successfully performed in 32 of 36 elbows, with excellent functional results in 28 elbows and good results in 4, as well as excellent cosmetic results in 27 elbows and good results in 5, based on the evaluation criteria of Flynn et al.

Adolescent↗
PubMedDate not supplied

Fine needle aspiration cytology of primary epithelioid sarcoma. A report of 2 cases.

BACKGROUND: Epithelioid sarcoma is a rare soft part tumor, the cytologic features of which have not been fully elucidated to date. We describe the cytologic features in 2 cases of primary epithelioid sarcoma with samples obtained by fine needle aspiration (FNA). CASES: Case 1 was a 50-year-old male who complained of a small mass in his left palm. Case 2 was a 56-year-old female who presented with a mass on the medial aspect of her right forearm. Preoperative FNA smears in both cases showed loose, aggregated and isolated tumor cells that were round to polygonal, with eccentrically located nuclei, against a background of inflammation and necrosis. The tumor cells showed moderate atypia, irregularity in size and many mitoses. In case 1 a presumptive diagnosis of epithelioid sarcoma was made by FNA cytology, while in case 2, FNA cytology revealed a high grade sarcoma with abundant matrix mimicking osteoids, difficult to differentiate from an extraskeletal osteosarcoma. CONCLUSION: Epithelioid sarcoma may be difficult to differentiate from an extraskeletal osteosarcoma in cases with abundant hyalinized collagen on FNA cytology.

Biopsy, Fine-Needle↗