Biomedical subjects

Tsutomu Akahane

Publications and source records attributed to Tsutomu Akahane.

6 recordsLinked to original sources

PubMed2006

Recurrent granulomatous tenosynovitis of the wrist and finger caused by Mycobacterium intracellulare: a case report.

We report a 65-year-old man with tenosynovitis of the wrist and finger caused by Mycobacterium intracellulare. The diagnosis was made after subsequent recurrence, when a specimen of synovial fluid was subjected to specific polymerase chain reaction and mycobacterial culture. Synovectomy and susceptibility-guided antituberculous therapy permitted complete healing of tenosynovitis.

Aged↗

PubMed2006

A transepiphyseal fracture of the proximal femur combined with a fracture of the mid-shaft of ipsilateral femur in a child: a case report and literature review.

The paper describes a rare fracture of proximal femur, classified by Delbet (Am J Surg 6:793-797, 1929) as type I (transepiphyseal type) combined with a fracture of the midshaft of ipsilateral femur in a 2-year-old child. Immediate operation with open reduction and internal fixation was successful. During the postoperative course, avascular necrosis (AVN) of capital femoral epiphysis was seen by bone scan. Applying an abduction orthosis used for the treatment of Legg-Calvè-Perthes disease, collapse of capital epiphysis was prevented. Although, a minimal area of AVN and coxa vara remained, no clinical complaints were recorded at the midterm follow-up. While reviewing the relevant literature, the type-I fractures need to be subclassified into two types for appropriate treatment and/or prediction of outcomes based on their anatomic location of the separated femoral capital epiphysis. In type Ia, femoral capital epiphysis is minimally displaced and within the acetabulum and in type Ib it is widely displaced and lying outside the capsule. Our case is a first case of a type Ib fracture of the proximal femur combined with a fracture of the midshaft of ipsilateral femur. Since the complication rate and the prognosis differed between two subclasses, type-Ib fractures need immediate surgical intervention, our case was prevented from massive AVN. And to prevent the collapse of femoral head following AVN, a major complication of the fracture of proximal femur in child, abduction orthosis is recommended as a choice of treatment.

Child, Preschool↗

PubMed2005

Serum total acid phosphatase for monitoring the clinical course of giant cell tumors of bone--26 patients with 5 local recurrences.

BACKGROUND: Giant cell tumor of bone (GCT) is a bone-destroying tumor that sometimes recurs locally after treatment. A recent study showed increased levels of serum total acid phosphatase (TACP). METHODS: We assessed TACP in the serum of 26 patients with primary GCT, and in 5 of them who developed a local recurrence. RESULTS: We found a correlation between TACP level in serum and tumor size. TACP levels that were elevated preoperatively in patients with GCT became normalized after surgery, but increased in 3 of the 5 patients with local recurrence. INTERPRETATION: TACP could be used as a tumor marker for monitoring response to treatment of GCT.

Acid Phosphatase↗

PubMed2005

Recurrence potential of diffuse-type giant cell tumor in the foot: radiologic and pathologic features.

BACKGROUND: Aggressive musculoskeletal tumors in the foot, such as diffuse-type giant cell tumors or extra-abdominal desmoid tumors, are difficult to treat because the foot does not have enough soft tissue to allow wide tumor resection. We reviewed the clinical behavior of diffuse-type giant cell tumor in the foot and evaluated the recurrence potential of these tumors from radiologic and pathologic perspectives. METHODS: Six patients with a mean age of 37.6 years were included in this study. Radiologic studies, including sonography, computed tomography (CT), magnetic resonance imaging (MRI), and bone and gallium citrate scintigraphy, were obtained followed by surgical treatment and histologic evaluation of the tumor. RESULTS: Recurrence occurred in three patients. Although CT and MRI findings were similar in the recurrent and nonrecurrent tumors, marked differences were found between the two by scintigraphy; positive radiotracer uptake to the affected foot with gallium citrate scintigraphy was noted only in recurrent tumors, although positive accumulation was seen in all patients with bone scintigraphy. Histologically, the necrotic area and mitotic activity were more apparent in recurrent than in the nonrecurrent tumors, and tumor cell dyscohesion was noted in the former, (the intercellular space was increased). CONCLUSIONS: Repeated recurrence with tumor invasion into tarsal bone resulted in breakage of the tarsal arch that supports the body's weight. Amputation would be necessary for patients in whom the disease had progressed to obtain local cure and relief of pain. In the present study, we found two features of the recurrence potential of diffuse-type giant cell tumors: sparse cell to cell contact on pathologic examination and positive accumulation in the tumor on gallium citrate scintigraphy. We concluded that giant cell tumors with these two features have a strong potential for local recurrence, and thus require intensive followup.

Adolescent↗

PubMed2004

Imaging of ancient schwannoma.

OBJECTIVE: We surveyed the clinical symptoms and radiologic features of ancient schwannoma, a rare variant of schwannoma characterized by degenerative changes. MATERIALS AND METHODS: We present the clinical, radiologic, and pathologic features in seven patients with ancient schwannoma (mean age, 62 years; range, 45-80 years) treated at our department between 1998 and 2003. RESULTS: The most characteristic clinical features were a sign like Tinel's sign and a long interval between the onset of symptoms and surgery (mean interval, 8.3 years). Ancient schwannomas can grow large; the biggest tumor seen in our study was 14 cm long. The highly accurate radiologic assessment made possible with contrast-enhanced MRI and CT scanning showed enhancement at a peridegenerative area and sometimes at a capsule. These findings differ from those of the typical schwannoma and neurofibroma patterns reported to date. Furthermore, bone scintigraphy showed uptake in the tumor, but no accumulation was seen on gallium-67 citrate scintigraphy. CONCLUSION: The characteristic clinical and radiologic findings of ancient schwannoma should make it possible to differentiate it from malignant tumors.

Aged↗

PubMed2003

Bilateral solid parameniscal masses in the knees.

Parameniscal cysts of the knee joint are usually considered to be minor asymptomatic lesions associated with meniscal injury. We report on a rare case of bilateral knee masses in the medial soft tissues that resembled parameniscal cysts in terms of location and structure. The patient was an 80-year-old woman with severe osteoarthritis. Arthroscopy detected no meniscal tears in either knee. Arthrotomy with regional excision of the masses was required. The solid masses showed a capsular outer layer that contained fibrin deposits, granulation tissue, and fibrous cartilage fragments from the meniscus. We hypothesize that these unusual masses represent senescent or "ancient" meniscal cysts, the result of long-term fibrous degeneration of previous parameniscal cysts, and may co-occur with severe osteoarthritis and meniscal degeneration.

Aged↗