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Biomedical subjects

Yoichi Shimada

Publications and source records attributed to Yoichi Shimada.

62 records · Page 4Linked to original sources
PubMed2002

Combination of lumbar kyphosis, epidural lipomatosis, and perineural cyst as a cause of neurological deficit: a case report.

We describe the rare simultaneous occurrence of epidural lipomatosis and a perineural cyst at the same level, lumbar kyphosis, osteoporotic vertebral fractures, and neurological deficits. A 75-year-old corticosteroid-dependent female farmer presented with severe low back pain, progressive lumbar kyphosis, and inability to stand because of numbness and muscle weakness of both legs. Plain radiographs displayed markedly decreased bone density, significant lumbar kyphosis, and vertebral compression fractures of L2, L3, and L4. Magnetic resonance imaging of the lumbar spine revealed a perineural cyst at the L2-3 level, extensive epidural lipomatosis, and spinal canal stenosis. Laminectomy from L3 to L5 with resection of epidural fatty tissue restored her walking ability. We postulate that the osteoporotic fractures and epidural lipomatosis were induced by corticosteroid therapy. Preexisting degenerative lumbar kyphosis of the type commonly seen in elderly farmers could have promoted osteoporotic lumbar vertebral fractures at points where bending stress had been strongly exerted. The combination of a perineural cyst and epidural lipomatosis at the same level has not been reported previously.

Aged↗
PubMed2002

Occupational therapy for accessory nerve palsy after radical neck dissection.

The subjects in this study were ten patients with accessory nerve palsy after radical neck dissection. All the primary diseases that accounted for radical neck dissection were malignant tumors located at the head or neck. Every patient received occupational therapy and underwent evaluations before and after the therapy. The data we collected included the existence of resting pain and motion pain, and the active and passive range of motion during shoulder flexion and abduction. The occupational therapy programs were not adequately effective for resting and motion pain, however, every patient gained independence for activities of daily living and housekeeping activities. The occupational therapy significantly improved the patient's shoulder elevation in all movements; although, the active abduction was always significantly poor compared with flexion. In the meantime, there were no significant differences between passive shoulder flexion and abduction at all times. We can therefore understand that the accessory nerve palsy especially affects active shoulder abduction induced by the trapezius paralysis. Occupational therapy is an effective treatment for the improvement of shoulder function, however, the occupational therapy has limited effectiveness for coping with the pain.

Accessory Nerve Diseases↗
PubMedDate not supplied

Quantitative assessment of thinning of the subscapularis tendon in recurrent anterior dislocation of the shoulder by use of magnetic resonance imaging.

It is known that thinning and lengthening of the subscapularis tendon occur in shoulders with recurrent anterior dislocation. However, no studies have been performed to quantify the morphologic changes of the subscapularis tendon under such conditions. We retrospectively measured the thickness and cross-sectional area of the subscapularis tendon by use of magnetic resonance imaging in 22 shoulders in 11 patients with unilateral recurrent anterior dislocation of the shoulder. The contralateral shoulder in each patient served as a control. The thickness and cross-sectional area of the subscapularis on the affected side were smaller than those on the normal side (6.5 +/- 1.7 mm vs 8.0 +/- 1.9 mm, P = .001, and 388.6 +/- 120.0 mm 2 vs 547.9 +/- 128.5 mm 2 , P = .0001, respectively). We conclude that the subscapularis tendon undergoes an 18.7% decrease in thickness and a 29.1% decrease in cross-sectional area in shoulders with recurrent anterior dislocation.

Adolescent↗
PubMedDate not supplied

Apoptosis in the supraspinatus tendon with stage II subacromial impingement.

The purpose of this study was to investigate the histopathology, including apoptosis, in the supraspinatus tendon with stage II subacromial impingement. Samples from the critical zone of the supraspinatus tendon were obtained from 5 patients with subacromial impingement syndrome and 10 autopsy cases without shoulder diseases as controls. Three-micrometer-thick sections were cut and stained with hematoxylin-eosin (H-E) for routine histologic examination. Apoptosis was detected by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) method and single-stranded deoxyribonucleic acid (ssDNA) assay in which the frequency of the apoptotic cells was expressed by the apoptotic index. Control supraspinatus tendons showed normal morphology, whereas supraspinatus tendons from shoulders with impingement showed significant mucoid degeneration. Correspondingly, few apoptotic cells were observed in control tendons, whereas a large number of apoptotic cells were observed in the degenerative area of tendons from impingement shoulders. The apoptotic indices were significantly higher in the impingement shoulders (ssDNA, 18.84% +/- 1.75%; TUNEL, 24.92% +/- 2.79%) than in the control shoulders (ssDNA, 5.22% +/- 1.30%; TUNEL, 7.01% +/- 1.05%) (P = .04 for ssDNA and P = .017 for TUNEL). Mechanical impingement seems to cause tendon degeneration and apoptosis of the tendon cells in the supraspinatus tendon in stage II impingement.

Apoptosis↗
PubMedDate not supplied

Does reaching the back reflect the actual internal rotation of the shoulder?

To clarify the relationship between the vertebral level reached by the thumb and the internal rotation angle of the humerus, 7 shoulders in healthy volunteers were examined by use of an electromagnetic tracking device. Measurements were repeated in the hanging-arm position with the thumb pointing anteriorly and at the buttock, sacrum, and each vertebral level up to T6. From the hanging-arm position to the buttock, 54.3% of internal rotation occurred (mean, 39.8 degrees ), and from the buttock to the sacrum, 11.7% occurred (mean, 8.6 degrees ). In total, 66% of internal rotation occurred from the hanging-arm position to the sacrum. Above the sacrum, the contribution of elbow flexion to the level of the vertebral spine became much greater, and internal rotation of the shoulder did not change significantly above the T12 level. We recommend that the level of the thumb below the buttock be subdivided for more accurate assessment of internal rotation.

Adult↗
PubMedDate not supplied

Expression of growth factors in the early phase of supraspinatus tendon healing in rabbits.

Growth factors are known to appear during wound healing. We hypothesized that growth factors would also appear during the healing process of a rotator cuff tear. We determined the expression of various growth factors during healing of acute rotator cuff tears in the rabbit. We made a full-thickness defect in the supraspinatus tendon of 27 Japanese white rabbits. The shoulders were harvested on days 1, 3, 5, 7, 9, 11, 14, 21, and 28 postoperatively (n = 3 at each time point). We assessed the expression of basic fibroblast growth factor, insulin-like growth factor 1, platelet-derived growth factor, and transforming growth factor beta. Basic fibroblast growth factor appeared with its peak on days 7 and 9, insulin-like growth factor 1 appeared with its peak on day 5, platelet-derived growth factor appeared with a mild expression between days 7 and 14, and transforming growth factor beta appeared with constant mild expression throughout the observation period. It is likely that each of these growth factors plays a role in the early phase of healing of the supraspinatus tendon in rabbits.

Animals↗
PubMedDate not supplied

Doxorubicin-loaded calcium phosphate cement in the management of bone and soft tissue tumors.

Several materials have been used as drug delivery systems to maintain a high concentration of anticancer drugs at localized sites. The feasibility of using doxorubicin-loaded calcium phosphate cement (CPC) as a new material, which can release the drug as well as fill a postoperative bony defect, was investigated. The mechanical strength of cylinders of doxorubicin-loaded CPC was not lower than that of CPC alone. Culture medium incubated with doxorubicin-loaded CPC from 1 to 7 days suppressed the proliferation of RMT-1 E4 rat breast cancer cells. In rabbits with doxorubicin-loaded CPC in their femurs, histological examinations showed diffuse edematous changes in the medullary space, but neither fracture nor skin necrosis occurred. Doxorubicin-loaded CPC markedly inhibited the proliferation of sarcoma 180 cells in the mouse air-pouch model. These results indicate that doxorubicin-loaded CPC may be useful in the local treatment of malignant bone and soft tissue tumors.

Animals↗