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  • 1
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    Tarsal Tunnel Syndrome in Hemodialysis Patients : A Case Series
    SAGE Publications ; 2013
    In:  Foot & Ankle International Vol. 34, No. 3 ( 2013-03), p. 439-444
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 34, No. 3 ( 2013-03), p. 439-444
    Abstract: The purpose of our study was to investigate tarsal tunnel syndrome (TTS) arising in patients who have undergone maintenance dialysis at our facility and to evaluate the frequency, pathological characteristics, and diagnosis of TTS. Methods: We evaluated 1011 patients (mean age 65.1 years) undergoing maintenance dialysis from 2000 to 2006 at our hospital. In patients diagnosed with TTS, we examined clinical symptoms and imaging findings. In addition, we evaluated intraoperative findings in patients who had undergone surgery. A follow-up study was conducted for at least 1 year. Results: Five patients (7 ankles) (mean age 57.8 years) were diagnosed as have TTS, with a mean dialysis duration of 23.4 years (range, 7-30 years). With conservative treatment consisting of rest and a steroid injection, 4 ankles showed improvement. Surgery was performed on 3 ankles. Amyloidoma, nodular tumor fragile deposits in the soft tissue or thecal surface, proliferation of the synovial tendon sheath, and thickened joint capsule were recognized in 3 ankles, and a concomitant ganglion was recognized in 1 ankle. Histologically, the deposition of hyaline material was recognized in all tissues, including the walls of the ganglion or joint capsule, by staining to a pale red color using Congo red stain. An immunohistochemical study indicated positive staining by β-2 microglobulin staining. The flexor retinaculum was thin in all cases, with retinaculum-like thickness not found in carpal tunnel syndrome. Conclusions: We believe that the occurrence of TTS in dialysis patients was 0.5%, with a tendency to be more prevalent among patients undergoing maintenance dialysis for 5 or more years. The pathological process of TTS may be different from that of carpal tunnel syndrome. Level of Evidence: Level IV, retrospective case series.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/1071100712466388
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2129503-7
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  • 2
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    Prevalence and Clinical Characteristics of Osteochondritis Dissecans of the Humeral Capitellum Among Adolescent Baseball Players
    SAGE Publications ; 2014
    In:  The American Journal of Sports Medicine Vol. 42, No. 8 ( 2014-08), p. 1963-1971
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 42, No. 8 ( 2014-08), p. 1963-1971
    Abstract: The prevalence and clinical characteristics of osteochondritis dissecans (OCD) of the humeral capitellum among adolescent baseball players are unknown. Purpose: To determine the OCD prevalence in adolescent competitive baseball players and to investigate the clinical characteristics of these patients. Study Design: Cross-sectional and case-control study; Level of evidence, 3. Methods: A total of 2433 baseball players (mean age, 14.5 ± 1.5 years) belonging to junior high school and high school baseball clubs were enrolled. Players completed a questionnaire, and the elbow of each player’s throwing arm was assessed by ultrasonography. Participants with abnormal results on ultrasonography were further examined through radiographic study. The OCD lesions were classified into stages based on radiographic results, and demographic data were compared between players with and without OCD lesions. Results: Osteochondritis dissecans of the humeral capitellum was found in 82 (3.4%) elbows by ultrasonography. Players with an OCD lesion began playing baseball at an earlier age ( P = .016), had a longer duration of competitive play ( P = .0013), and had experienced more present ( P = .0025) and past ( P 〈 .0001) elbow pain compared with players without a lesion. There were no differences between the 2 groups in the position played ( P = .26). Sixty-eight patients underwent further radiographic examination for OCD (radiography, computed tomography, magnetic resonance imaging). Of these players, 10 (14.7%) were classified as having stage I OCD (radiolucent stage); 26 (38.2%), stage II (fragmentation stage); 9 (13.2%), stage III (loose body stage); 9 (13.2%), stage IV (residual stage); and 14 (23.5%), stage V (postoperative stage). Conclusion: The prevalence of OCD of the humeral capitellum, including latent cases, was 3.4% among adolescent baseball players. Players with OCD lesions began playing baseball at earlier ages, had played for longer periods, and had experienced more elbow pain. The player’s current baseball position may not be related to the existence of OCD lesions in adolescents.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546514536843
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2063945-4
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  • 3
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    The protective effect of a leucocyte removal filter on the lung in open-heart surgery for ventricular septal defect
    SAGE Publications ; 1998
    In:  Perfusion Vol. 13, No. 1 ( 1998-01), p. 27-34
    Details
    In: Perfusion, SAGE Publications, Vol. 13, No. 1 ( 1998-01), p. 27-34
    Abstract: We elucidated the protective effect of a leucocyte removal filter on cardiopulmonary bypass (CPB)-induced lung dysfunction during open-heart surgery for ventricular septal defect (VSD). Forty-six VSD patients were divided into two groups: (a) a control group of 22 patients in whom the banked blood was used to prime the CPB circuit, and (b) a leucocyte removal group of 24 patients in whom a leucocyte removal filter was used for priming and every supplement of banked blood during and after the operation. The respiratory index immediately after the CPB was significantly lower in the leucocyte removal group than in the control group (2.23 ± 0.22 vs 3.90 ± 0.68; p 〈 0.05). The duration of stay in the intensive care unit was significantly shorter in the leucocyte removal group (3.0 ± 0.4 vs 4.1 ± 0.4 days; p 〈 0.05). These data suggest that the use of a leucocyte removal filter for blood added to the CPB prime or administered after CPB may have protective effects on lung function after open heart surgery for VSD patients.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/026765919801300104
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1998
    detail.hit.zdb_id: 2029611-3
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  • 4
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    Plasma adrenomedullin level after cardiopulmonary bypass
    SAGE Publications ; 1998
    In:  Perfusion Vol. 13, No. 5 ( 1998-09), p. 334-337
    Details
    In: Perfusion, SAGE Publications, Vol. 13, No. 5 ( 1998-09), p. 334-337
    Abstract: Adrenomedullin is an intrinsic vasodilator which is metabolized mainly in the pulmonary circulation. We measured plasma levels of adrenomedullin in children with congenital cyanotic heart disease (CY group, n = 6), children with high pulmonary blood flow due to congenital heart disease (PH group, n = 8), and in adults with mitral valve disease (MV group, n = 7) before and 3 h after cardiopulmonary bypass (CPB). Before CPB, the adrenomedullin level was the highest in the MV group, possibly due to chronic heart failure. Three hours after CPB, the plasma adrenomedullin level (pg/ml) increased to 1712.7 ± 498.4 in the CY group, 167.6 ± 26.4 in the PH group, and 1404.3 ± 313.7 in the MV group, the level in the PH group being significantly lower than the rest. In the PH group, there was a statistically significant negative correlation between the mean pulmonary arterial pressure at the preoperative catheter study, and the adrenomedullin level 3 h after CPB. These results illustrate that the adrenomedullin level increased after CPB, but that the increase was less marked in the PH group, implying that where the pulmonary vasculature was damaged most, this results in increased vasoconstriction.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/026765919801300509
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1998
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  • 5
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    Early Clinical Results of Arthroscopically Assisted Drilling via the Radius in a Distal-to-Proximal Direction for Osteochondritis Dissecans of the Elbow
    SAGE Publications ; 2019
    In:  Orthopaedic Journal of Sports Medicine Vol. 7, No. 9 ( 2019-09), p. 232596711986893-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 7, No. 9 ( 2019-09), p. 232596711986893-
    Abstract: We have previously reported the technique of arthroscopically assisted drilling of osteochondritis dissecans (OCD) lesions of the elbow via the radius in a distal-to-proximal direction. With this technique, the entire OCD lesion can be drilled vertically under arthroscopic guidance with pronation and supination of the forearm and flexion and extension of the elbow joint. Purpose: To retrospectively evaluate return to sport, range of motion, and the Japanese Orthopaedic Association–Japan Elbow Society Elbow Function Score (JOA-JES score) after treatment of an elbow OCD lesion by drilling through the radius. Study Design: Case series; Level of evidence, 4. Methods: From November 2003 to January 2006, a total of 7 male adolescent baseball players with OCD lesions of the elbow were treated through use of arthroscopically assisted drilling via the radius. The stage of the OCD lesion was evaluated based on preoperative plain radiographs. Patients were observed for a minimum of 36 months, and clinical analysis included time for return to sport, elbow range of motion, and the JOA-JES score before intervention and at final follow-up. Results: We evaluated all 7 patients at a mean follow-up time of 36.1 months (range, 24-68 months). The stage of the OCD lesion on plain radiography was “translucent” in 1 patient, “sclerotic” in 5 patients, and “loosening” in 1 patient. The mean range of motion before surgery was 131.2° and –4.7° in flexion and extension, respectively, and this improved to 138.6° and 1.1° at final follow-up. The improvement in extension was statistically significant ( P = .04). The mean JOA-JES score of 83.0 before surgery significantly improved to 94.0 at final follow-up ( P 〈 .001). One patient required excision of a free body at 51 months postoperatively, but all patients returned to sports early and without pain at an average of 4.6 months postoperatively. No feature of osteoarthrosis was noted on radiography on the final examination in any patient. Conclusion: The findings of this study demonstrate that arthroscopically assisted drilling of an elbow OCD lesion through the radial head allows for early return to sporting activities as well as improved motion and functional scores.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967119868937
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2706251-X
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  • 6
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    Vascularity Visualized by Doppler Sonography as a Predictor of Healing Potential of the OCD of the Humeral Capitellum
    SAGE Publications ; 2016
    In:  Orthopaedic Journal of Sports Medicine Vol. 4, No. 7_suppl4 ( 2016-07-01), p. 2325967116S0016-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 4, No. 7_suppl4 ( 2016-07-01), p. 2325967116S0016-
    Abstract: The significance of vascularity visualized by Doppler sonography in osteochondritis dissecance (OCD) lesion of the humeral capitellum is unclear. The objectives of this study were twofold: 1) to evaluate the relationship between Doppler ultrasound (US) signals observed in OCD lesion of the humeral capitellum and X-ray stage; 2) to determine if the presence of Doppler US signals in OCD lesion of the humeral capitellum could be the predictor of healing potential. Methods: Fifty patients with OCD of the humeral capitellum treated conservatively were enrolled in this study. During the conservative treatment period, Doppler sonography was performed on affected elbow to assess the presence of vascularity in the OCD lesion (Figure 1), and radiographic examination were evaluated on the same day to determine the X-ray stage (stage I: radiolucent stage, stage II: fragmentation stage, and stage III: loose body stage) of the OCD lesion (Figure 2). Radiographic examination of the elbow was examined after 6 weeks to evaluate the healing of the lesion. If the size of the lesion decreased or new bone formations were observed around the fragments, the healing of the lesion was considered to be improve. The χ2 test was used to determine if the presence of Doppler US signals were related to X-ray stage and the improvement of the healing. P 〈 0.05 was considered significant for all statistical analyses. Results: The Doppler US signals in OCD lesions were positive in 23 patients and negative in 27 patients. Of these patients, 19 were X-ray stage I, 17 were stage II, and 9 were stage III. The healing of OCD lesions improved in 78.2% for the positive Doppler US signal group, but only 18.5% for the negative Doppler US signal group (Figure 3). The presence of the Doppler US signal was significantly related to the improvement of healing (P = 0.00002). The Doppler US signal were positive in 78.9% for stage I, 36.4% for stage II, and 0.0% for stage III (Figure 4). The presence of Doppler US signal was significantly related to early X-ray stage (P = 0.0002). Conclusion: From this study, the presence of vascularity in the OCD lesion of the humeral capitellum is important for the improvement of healing during the conservative treatment period. The vascularity visualized by Doppler sonography could be a useful predictor for healing potential of the OCD of the humeral capitellum when treated conservatively.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967116S00168
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2706251-X
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  • 7
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    Prevention of Elbow Injuries in Young Baseball Players: A 6-year Longitudinal Study
    SAGE Publications ; 2018
    In:  Orthopaedic Journal of Sports Medicine Vol. 6, No. 7_suppl4 ( 2018-07-01), p. 2325967118S0012-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 6, No. 7_suppl4 ( 2018-07-01), p. 2325967118S0012-
    Abstract: Injuries in young baseball players are on the rise. However, there are few large-scale related to injury prevention activities. We have continued an injury prevention project in Kyoto, Japan since 2010. The aim of this study was to verify the preventive effect of our project. Methods: We offered medical screening of elbow for elementary and junior high school players. We examined their elbow manually, performed ultrasonography and guided the players how to check their elbow themselves. Additionally, we instructed baseball coaches and parents regarding injury prevention annually. In this study, a cumulative total of 2624 baseball players (mean age 11.0±0.6) who participated in our injury prevention project (2010-2016) were enrolled. We asked them to answer the questionnaire to investigate the experience of elbow pain and evaluated the tenderness of humeral medial epicondyle and range of motion. Ultrasonography of humeral capitellum and medial epicondyle was examined. Subjects with abnormalities on ultrasonography were further examined through radiographic study and osteochondritis dissecans of the humeral capitellum (OCD) was diagnosed. Humeral medial epicondyle apophysitis was diagnosed with abnormalities of ultrasonography, and physical findings. The annual incidence were investigated and analyzed statistically. P 〈 0.05 was considered significant for all statistical analysis. Results: The mean prevalence rate of OCD was 1.1% and flexion restriction was 12.3%. There were no significant differences in annual incidence. However, the experience rate of elbow pain was 14.4% in 2010 and 4.4% in 2016, tenderness of humeral epicondyle was 32.2% and 5.8%, extension restriction was 12.5% and 6.9%, and humeral medial epicondyle apophysitis was 22.1% and 5.3%, respectively, that significantly reduced year by year (Table 1). Conclusion: There has been increasing recognition for the importance of preventing the overuse injuries among young baseball players. However, large-scale and longitudinal evaluation studies for preventing elbow injuries have not been reported. The prevalence rates of elbow injuries have generally reduced year by year, which indicates that annual medical screening and educational project for young baseball players, coaches and parents would be an effective approach for preventing elbow injury. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967118S00128
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 8
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    Antimicrobial megaprostheses supported with iodine
    SAGE Publications ; 2014
    In:  Journal of Biomaterials Applications Vol. 29, No. 4 ( 2014-10), p. 617-623
    Details
    In: Journal of Biomaterials Applications, SAGE Publications, Vol. 29, No. 4 ( 2014-10), p. 617-623
    Abstract: Deep infection associated with implants remains a serious complication of orthopedic surgery. We developed iodine coating for titanium implants. In this study, we performed a clinical trial of iodine-coated megaprostheses to evaluate its safety and antibacterial effects. Forty-seven patients with malignant bone tumor or pyogenic arthritis were treated using iodine-supported titanium megaprostheses between July 2008 and May 2013. The mean age was 53.6 years (range, 15–85 years). Twenty-six patients were males and 21 were females. The diagnoses included malignant bone tumor in 29 cases, infected total knee arthroplasty in 11 cases, chronic osteomyelitis due to pyogenic arthritis in six cases and loosening of total knee arthroplasty in one case. The iodine-supported implants used were 42 Kyocera Limb Salvage System and five KOBELCO K-MAX K-3. These megaprostheses were used to prevent infection in 21 patients, treat active infections in 26 patients. The mean follow-up period was 30.1 months (range, 8–50). Infection was prevented in 20 out of 21 patients. Only one patient had surgical site infection caused by Pseudomonas aeruginosa and was cured by intravenous administration of antibiotics alone without removal of the implant. In 26 treatment cases involving one- or two-stage revision surgery, infection subsided without any additional surgery. In all cases, there were no signs of infection at the time of the last follow-up. White blood cell and C-reactive protein levels returned to normal within four weeks after surgery. To confirm systemic effects of iodine, thyroid hormone levels in the blood were examined. Abnormalities of thyroid gland function were not detected. Loosening of the implants was not observed. Excellent bone ingrowth and ongrowth were found around iodine-supported megaprostheses. The iodine-supported titanium megaprostheses are highly effective and show promise for the prevention and treatment of infections in large bone defects. No cytotoxicity or adverse effects were detected with this treatment.
    Type of Medium: Online Resource
    ISSN: 0885-3282 , 1530-8022
    URL: Article
    DOI: 10.1177/0885328214539365
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2072559-0
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  • 9
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    Experience Rate of Elbow Pain and Morphological Abnormality of Humeral Medial Epicondyle among Youth Baseball Players
    SAGE Publications ; 2016
    In:  Orthopaedic Journal of Sports Medicine Vol. 4, No. 7_suppl4 ( 2016-07-01), p. 2325967116S0012-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 4, No. 7_suppl4 ( 2016-07-01), p. 2325967116S0012-
    Abstract: The aim of this study was to investigate the experience rate of elbow pain and to clarify the relationship between morphological abnormality of the humeral medial epicondyle and positions among baseball players in elementary school (ES), junior high school (JHS) and high school (HS). Methods: In this study, 4353 baseball players who participated in our medical screening (2008-2015) were enrolled. There were 1545 players from ES, 1934 players from JHS, and 874 players from HS. We asked them to answer the questionnaire to investigate the experience of elbow pain, and the position they played. Ultrasonography of the humeral medial epicondyle was examined and irregularity, fragmentation, and malunion of the humeral medial epicondyle. The results were analyzed statistically. P 〈 0.05 was considered significant for all statistical analyses. Results: The experience rates of elbow pain among players in ES, JHS, and HS were 26.0%, 27.0%, and 68.3%. The rates of abnormality of humeral medial epicondyle among players in ES, JHS, and HS were 18.2%, 36.3%, and 39.9% (Table 1). The experience rate of elbow pain among pitchers and catchers was significantly higher than the fielders in ES (Table 2), however, there were no significant differences between positions in JHS and HS (Table 3,4). According to the rate of morphological abnormalities of humeral medial epicondyle, pitchers and catchers were significantly higher than fielders in ES, while only pitchers were significantly higher than the fielders in JHS and HS (Table 2,3,4). Conclusion: The experience rate of elbow pain among baseball players rose as the age increased, and the rate in HS was almost 70%. The rates of morphological abnormality of humeral medial epicondyle among pitchers and catchers were high and the tendency was observed from a young age. The primary prevention of elbow injuries in youth baseball players of all ages should be considered.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967116S00121
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2706251-X
    SSG: 31
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