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2.
Asian Spine J ; 17(5): 835-841, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37408488

ABSTRACT

STUDY DESIGN: Retrospective study. PURPOSE: This research aimed to assess the clinical outcomes of patients with traumatic cervical spine dislocation who underwent closed reduction employing our approach. OVERVIEW OF LITERATURE: Bedside closed reduction is the quickest procedure for repairing traumatic cervical spine dislocations; nevertheless, it also possesses the risk of neurological deterioration. METHODS: For closed reduction, the patient's head was elevated on a motorized bed, the cervical spine was placed at the midline, traction of 10 kg was applied, the motorized bed was gradually returned to a flat position, the head was lifted off the bed, and the cervical spine was slowly adjusted to a flexed position. The weight of traction was elevated by 5-kg increments until the positional shift was attained. Subsequently, the bed was gradually tilted while traction was applied again to return the cervical spine to the midline position. RESULTS: Of the 43 cases of cervical spine dislocation, closed reduction was carried out in 40 cases, of which 36 were successful. During repositioning, three patients experienced a temporary worsening of their neck pain and neurological symptoms that enhanced when the cervical spine was flexed. Closed reduction was conducted while the patient was awake; nevertheless, sedation was needed in three cases. Among the 24 patients whose pretreatment paralysis had been characterized by American Spinal Injury Association Impairment Scale (AIS) grades A-C, seven patients (29.2%) demonstrated an enhancement of two or more AIS grades at the last observation. CONCLUSIONS: Our closed reduction approach safely repaired traumatic cervical spine dislocations.

3.
Injury ; 54(8): 110826, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37286444

ABSTRACT

BACKGROUND: Patients with heel pad degloving injury frequently develop ischemic necrosis of the area, necessitating soft-tissue reconstruction surgery. We have developed a technique for arterialization of the plantar venous system via vein graft (APV) as the primary revascularization treatment. The objective of this study was to clarify both the utility of APV for the preservation of degloved heel pads and the impact of this preservation on clinical outcomes. METHODS: Ten consecutive cases of degloving injury with devascularized heel pad were treated at a single trauma center from 2008 to 2018. Five cases underwent APV and five underwent conventional primary suture (PS) as the initial treatment. We evaluated the course according to the frequency of heel pad preservation, additional intervention after heel pad necrosis, post-operative complications, and outcomes using the Foot and Ankle Disability Index score (FADI) at the time of last follow-up. RESULTS: Among the five cases that underwent APV, the heel pad was preserved in three cases and flap surgery was required in two cases. All cases that underwent PS developed necrosis of the heel pad, requiring skin graft in one case and flap surgery in four. One skin graft case and one free flap case after PS developed plantar ulcers. The three cases with preserved heel pads exhibited higher FADI than the seven cases that developed necrosis. CONCLUSION: APV showed a relatively high frequency of heel pad preservation, which otherwise was uniformly lacking. Functional outcomes were improved in cases with preserved heel pad compared to those that developed necrosis and underwent additional tissue reconstruction.


Subject(s)
Degloving Injuries , Foot Injuries , Free Tissue Flaps , Soft Tissue Injuries , Humans , Degloving Injuries/surgery , Heel/surgery , Heel/blood supply , Heel/injuries , Skin Transplantation/methods , Foot Injuries/surgery , Soft Tissue Injuries/surgery , Necrosis/surgery
4.
World Neurosurg ; 171: e859-e863, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36627018

ABSTRACT

BACKGROUND: Early decompressive surgery within 24 hours improves the functional outcome of patients with traumatic spinal cord injury; however, little is known about the effect of early surgery for spontaneous spinal epidural hematoma (SSEH). In this study, we aimed to investigate the effectiveness of ultraearly hematoma evacuation (<12 hours) for SSEH. METHODS: Patients with SSEH treated with surgical hematoma evacuation at our institution between January 2000 and July 2021 were retrospectively analyzed. Neurologic function was evaluated using the American Spinal Injury Association Impairment Scale (AIS). AIS grades A-C were defined as severe, and grades D and E as mild. AIS grades D and E at the final follow-up were considered favorable outcomes. Preoperative status and postoperative treatment results were compared between patients who had hematoma evacuation within 12 hours of onset and those who underwent surgery after 12 hours. RESULTS: Twenty-five consecutive patients were included in the analysis. Preoperatively, 23 patients (92.0%) had severe AIS. Fourteen (56.0%) patients underwent early surgery. At the final follow-up, 21 patients (84.0%) achieved favorable outcomes. Patients treated with ultraearly surgery had significantly better outcomes (100% vs. 63.6%, P = 0.03). Additionally, the time from onset to surgery was significantly shorter in patients with AIS improvement by 2 or more grades than that in patients with AIS improvement of 1 or less (median 8 hours vs. 14 hours, P = 0.0001). CONCLUSIONS: Ultraearly surgery within 12 hours for SSEH was associated with better functional outcomes.


Subject(s)
Hematoma, Epidural, Spinal , Spinal Cord Injuries , Humans , Hematoma, Epidural, Spinal/surgery , Retrospective Studies , Treatment Outcome , Neurosurgical Procedures/adverse effects , Spinal Cord Injuries/surgery , Magnetic Resonance Imaging
7.
J Nippon Med Sch ; 90(1): 126-135, 2023 Mar 11.
Article in English | MEDLINE | ID: mdl-36436914

ABSTRACT

Hemophagocytic lymphohistiocytosis (HLH) involves pathological histiocytes and phagocytosis of normal blood cells through activation of inflammatory cytokines. We report a case of Epstein-Barr virus-HLH in a 75-year-old woman who presented with fever, thrombocytopenia, and loss of consciousness. Epstein-Barr virus-HLH was diagnosed after we identified massive hemophagocytosis in bone marrow and Epstein-Barr virus DNA in cerebrospinal fluid. The HLH-2004 protocol was applied, and lactate dehydrogenase levels-which reflect HLH disease status-decreased. However, persistent loss of consciousness and multiple organ failure led to the patient's death on day 18. Most cases of primary and secondary HLH involve pediatric patients; adult cases are rare. Few cases of central nervous system involvement in older adults have been reported. Therefore, accumulation of more data will help in developing better treatment strategies.


Subject(s)
Epstein-Barr Virus Infections , Lymphohistiocytosis, Hemophagocytic , Female , Humans , Child , Aged , Lymphohistiocytosis, Hemophagocytic/complications , Herpesvirus 4, Human , Epstein-Barr Virus Infections/complications , Central Nervous System , Unconsciousness/complications
8.
JAMA Netw Open ; 4(11): e2133604, 2021 11 01.
Article in English | MEDLINE | ID: mdl-34751757

ABSTRACT

Importance: The optimal management for acute traumatic cervical spinal cord injury (SCI) is unknown. Objective: To determine whether early surgical decompression results in better motor recovery than delayed surgical treatment in patients with acute traumatic incomplete cervical SCI associated with preexisting canal stenosis but without bone injury. Design, Setting, and Participants: This multicenter randomized clinical trial was conducted in 43 tertiary referral centers in Japan from December 2011 through November 2019. Patients aged 20 to 79 years with motor-incomplete cervical SCI with preexisting canal stenosis (American Spinal Injury Association [ASIA] Impairment Scale C; without fracture or dislocation) were included. Data were analyzed from September to November 2020. Interventions: Patients were randomized to undergo surgical treatment within 24 hours after admission or delayed surgical treatment after at least 2 weeks of conservative treatment. Main Outcomes and Measures: The primary end points were improvement in the mean ASIA motor score, total score of the spinal cord independence measure, and the proportion of patients able to walk independently at 1 year after injury. Results: Among 72 randomized patients, 70 patients (mean [SD] age, 65.1 [9.4] years; age range, 41-79 years; 5 [7%] women and 65 [93%] men) were included in the full analysis population (37 patients assigned to early surgical treatment and 33 patients assigned to delayed surgical treatment). Of these, 56 patients (80%) had data available for at least 1 primary outcome at 1 year. There was no significant difference among primary end points for the early surgical treatment group compared with the delayed surgical treatment group (mean [SD] change in ASIA motor score, 53.7 [14.7] vs 48.5 [19.1]; difference, 5.2; 95% CI, -4.2 to 14.5; P = .27; mean [SD] SCIM total score, 77.9 [22.7] vs 71.3 [27.3]; P = .34; able to walk independently, 21 of 30 patients [70.0%] vs 16 of 26 patients [61.5%]; P = .51). A mixed-design analysis of variance revealed a significant difference in the mean change in ASIA motor scores between the groups (F1,49 = 4.80; P = .03). The early surgical treatment group, compared with the delayed surgical treatment group, had greater motor scores than the delayed surgical treatment group at 2 weeks (mean [SD] score, 34.2 [18.8] vs 18.9 [20.9]), 3 months (mean [SD] score, 49.1 [15.1] vs 37.2 [20.9]), and 6 months (mean [SD] score, 51.5 [13.9] vs 41.3 [23.4]) after injury. Adverse events were common in both groups (eg, worsening of paralysis, 6 patients vs 6 patients; death, 3 patients vs 3 patients). Conclusions and Relevance: These findings suggest that among patients with cervical SCI, early surgical treatment produced similar motor regain at 1 year after injury as delayed surgical treatment but showed accelerated recovery within the first 6 months. These exploratory results suggest that early surgical treatment leads to faster neurological recovery, which requires further validation. Trial Registration: ClinicalTrials.gov Identifier: NCT01485458; umin.ac.jp/ctr Identifier: UMIN000006780.


Subject(s)
Cervical Cord/injuries , Cervical Vertebrae/injuries , Decompression, Surgical/statistics & numerical data , Spinal Cord Injuries/surgery , Time-to-Treatment/statistics & numerical data , Adult , Aged , Cervical Cord/surgery , Cervical Vertebrae/surgery , Conservative Treatment/statistics & numerical data , Decompression, Surgical/methods , Female , Humans , Male , Middle Aged , Postoperative Period , Psychomotor Performance , Recovery of Function , Spinal Cord Injuries/physiopathology , Time Factors , Treatment Outcome , Young Adult
9.
World Neurosurg ; 129: e838-e844, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31207373

ABSTRACT

BACKGROUND: Vertebral artery injuries (VAIs) caused by cervical trauma include irregularities with narrowing of the arterial wall, dissection, pseudoaneurysm formation, occlusion, and transection. Although recent guidelines have recommended anticoagulant or antiplatelet therapy to prevent subsequent stroke in patients with traumatic VAIs, regardless of the type of vascular injury, the clinical role of endovascular surgery in the treatment of traumatic VAIs remains to be elucidated. METHODS: We retrospectively evaluated the treatment outcomes of 23 patients with cervical fracture and vertebral artery occlusion (VAO) who had required cervical surgery in the acute stage. RESULTS: No patient received antiplatelet or anticoagulant therapy, because the VAs had already become occluded. After cervical surgery, 5 of the 23 patients developed radiologically confirmed thromboembolic stroke after cervical surgery. None of these 5 patients with postoperative infarction had undergone preoperative VA embolization. Univariate analysis revealed that only the implementation of preoperative VA embolization was associated with the prevention of postoperative infarction (P = 0.004). Factors such as age, reduction, level of VAO, and diabetes mellitus did not correlate with increased risk. CONCLUSIONS: The clinical role of endovascular surgery for traumatic VAI has not been previously established; however, a more specific selection of patients according to the VAI type might be necessary. Our data have indicated that preoperative embolization of the occluded VA significantly reduces the risk of postoperative infarction in a specific cohort of patients with traumatic VAI (i.e., patients with post-traumatic VAO who require cervical surgery).


Subject(s)
Embolization, Therapeutic/methods , Postoperative Complications/prevention & control , Spinal Fractures/complications , Thromboembolism/prevention & control , Vertebral Artery/surgery , Adult , Aged , Aged, 80 and over , Blood Vessel Prosthesis , Brain Ischemia/prevention & control , Cervical Vertebrae , Endovascular Procedures/methods , Female , Humans , Male , Middle Aged , Spinal Fractures/surgery , Stroke/prevention & control , Thromboembolism/etiology , Vertebral Artery/injuries
10.
J Orthop Surg Res ; 14(1): 475, 2019 Dec 30.
Article in English | MEDLINE | ID: mdl-31888719

ABSTRACT

BACKGROUND: Titanium plate (TP) and hydroxyapatite (HA) spacers are widely used during open-door laminoplasty, performed with the patient in a prone position. Reducing operative time is an important consideration, particularly to reduce the risk of postoperative complications in older patients. The purpose of this retrospective cohort study was to compare the operative time for open-door laminoplasty using TP or HA spacers. METHODS: Consecutive patients with a spinal cord injury, without bone injury, and ≥ 50 years of age were included. Multivariate regression analysis was used to compare the operative time between patients in the TP and HA group, adjusting for known factors that can influence surgical and postoperative outcomes. Propensity score matching was used to confirm the robustness of the primary outcome. The cumulative incidence of postoperative complications over 1-year after surgery was also compared. RESULTS: Of the 164 patients forming our study group, TP spacers were used in 62 and HA in 102. Operative time was significantly shorter for the TP (128 min) than HA (158 min) group (p < 0.001). Both multivariate and propensity score matching analyses confirmed a significant reduction in operative time for the TP, compared to HA, group (regression coefficient, - 30 min and - 38 min, p < 0.001 and p < 0.001, respectively). There was no significant difference in the cumulative incidence of postoperative complications. CONCLUSIONS: The use of TP spacers reduced the operative time for cervical open-door laminoplasty by about 30 min, compared to the use of HA spacers, with no difference in the rate of postoperative complications.


Subject(s)
Bone Plates , Durapatite , Laminoplasty/instrumentation , Laminoplasty/methods , Operative Time , Spinal Cord Injuries/surgery , Titanium , Aged , Cohort Studies , Female , Humans , Incidence , Male , Middle Aged , Postoperative Complications/epidemiology , Retrospective Studies
11.
Acute Med Surg ; 4(3): 271-277, 2017 07.
Article in English | MEDLINE | ID: mdl-29123874

ABSTRACT

Aim: Hemorrhage from pelvic fracture is a major cause of mortality after blunt trauma. Several studies have suggested that early fibrinogen supplementation improves outcomes of traumatic hemorrhage. Thus, we revised our massive transfusion protocol (MTP) in April 2013 to include early off-label administration of fibrinogen concentrate. The objective of this study was to evaluate the impact of the revision on the short-term outcomes of pelvic fracture patients. Methods: This was a single-center, retrospective, cohort study. A total of 224 consecutive pelvic fracture patients hospitalized in Saitama Medical Center (Saitama, Japan), 115 before the revision (Group E) and 109 after (Group L), were enrolled. Characteristics of the patients were compared between the groups. Impacts of the revision were evaluated by hazard ratios adjusted for characteristics, injury severity, and coagulation status using Cox's multivariate proportional hazard model. The impact was also evaluated by log-rank test and relative risk of 28-day mortality between the groups. Results: The characteristics were equivalent between the groups. The multivariate analysis revealed that the revision of MTP was significantly related to improved survival with an adjusted hazard ratio (95% confidence interval) of 0.45 (0.07-0.97). The log-rank test gave χ2-test values of 5.2 (P = 0.022) and 6.7 (P = 0.009), and the relative risks were 0.37 (0.15-0.91) and 0.33 (0.13-0.84), in patients with all Injury Severity Scores and Injury Severity Score ≥21, respectively. Conclusion: The revision of MTP to include aggressive off-label treatment with fibrinogen concentrate was related to improved short-term outcomes of severe pelvic fracture patients. However, due to the limitations of the study, the improvement could not be attributed totally to the revision.

12.
Acta Med Okayama ; 71(5): 427-432, 2017 Oct.
Article in English | MEDLINE | ID: mdl-29042701

ABSTRACT

Cervical spine dislocation and fracture of a transverse process are isolated risk factors for vertebral artery injuries (VAIs), which can cause a life-threatening ischemic stroke. Since in vivo experiments are not possible, it has not been unclear whether damage to or extension of vertebral arteries is more predictive of a VAI. To identify the imaging characteristics associated with VAI, we analyzed 36 vertebral arteries from 22 cervical spine dislocation patients who underwent computed tomography angiography (Aug. 2008-Dec. 2014). We evaluated (1) the posttraumatic elongation of the vertebral artery and (2) the presence of fracture involving the transverse foramen. VAI was found in 20 (56%) of the 36 vertebral arteries. The rate of residual shift (vertebral artery elongation) was not markedly different between the VAI and no-VAI groups. However, the rate of >1 mm displacement into the foramen and that of fracture with gross displacement (≥2 mm) differed significantly between the groups. We found that greater displacement of fractured transverse processes with cervical spine dislocation was a risk factor for VAI. These results suggest that direct damage to the vertebral arteries by transverse process fragments is more likely to predict a VAI compared to elongation, even in cervical spine dislocation.


Subject(s)
Cervical Vertebrae/injuries , Joint Dislocations/complications , Spinal Injuries/complications , Vertebral Artery/injuries , Adolescent , Adult , Aged , Female , Humans , Joint Dislocations/pathology , Male , Middle Aged , Risk Factors , Spinal Fractures/complications , Spinal Fractures/pathology , Spinal Injuries/pathology , Young Adult
13.
Eur Spine J ; 26(4): 1272-1276, 2017 04.
Article in English | MEDLINE | ID: mdl-28247074

ABSTRACT

PURPOSE: Reduction of cervical facet dislocation should be performed as soon as possible to depressurize neuron cells although some randomized control studies defined early reduction as over 24 h after trauma. The purpose of this study was to define the actual time limit for early reduction in patients with complete motor paralysis. METHODS: Cervical spine dislocation patients with complete motor paralysis admitted between April 2007 and December 2014 were analyzed as retrospective cohort study. We separated the patients into three groups according to the number of hours lapsed between the trauma and reduction, within 4 h (very early group), >4-6 h (early group), and >6 h (delayed group). We compared the neurological outcomes, patient injury patterns, the arrival time at the hospital, and the injury severity score (ISS). RESULTS: Of 30 patients who enrolled, 8 (27%) were recovered to American Spinal Injury Association Impairment Scale Grades C-E. The delayed group had poorer neurological outcomes than the very early group and early group, although no significant differences were noted in the recovery rate between the very early group and early groups. The injury pattern, arrival time, and ISS were not found to be associated with the neurological outcome. CONCLUSION: Our data suggest that early (<6 h) reduction of cervical spine dislocation is associated with favorable neurological outcome as compared with those performed after 6 h.


Subject(s)
Cervical Vertebrae/injuries , Disability Evaluation , Joint Dislocations/therapy , Recovery of Function , Time-to-Treatment , Zygapophyseal Joint/injuries , Adolescent , Adult , Aged , Aged, 80 and over , Cervical Vertebrae/surgery , Closed Fracture Reduction , Cohort Studies , Decompression, Surgical , External Fixators , Female , Humans , Male , Middle Aged , Open Fracture Reduction , Paralysis/etiology , Retrospective Studies , Spinal Cord Injuries/etiology , Spinal Cord Injuries/therapy , Young Adult , Zygapophyseal Joint/surgery
14.
J Sci Food Agric ; 96(4): 1150-8, 2016 Mar 15.
Article in English | MEDLINE | ID: mdl-25847473

ABSTRACT

BACKGROUND: Cocoa contains biologically active ingredients that have broad-spectrum antimicrobial activity, which includes an inhibitory effect on influenza virus infection. RESULTS: A cocoa extract (CE) was prepared by treating defatted cocoa powder with boiling water. The extract demonstrated dose-dependent inhibition of infection in Madin-Darby canine kidney (MDCK) cells infected with human influenza virus A (H1N1, H3N2), human influenza virus B and avian influenza viruses (H5N1, H5N9). CE inhibited viral adsorption to MDCK cells. Animal experiments showed that CE significantly improved survival in mice after intra-nasal administration of a lethal dose of influenza virus. In human intervention trials, participants were allocated to two groups, one in which the participants ingested cocoa for 3 weeks before and after vaccination against A(H1N1)pdm2009 influenza virus and another in which the participants did not ingest cocoa. Neutralizing antibody titers against A(H1N1)pdm2009 influenza virus increased significantly in both groups; however, the extent of the increase was not significantly different between the two groups. Although natural killer cell activity was also elevated in both groups, the increase was more substantial in the cocoa intake group. CONCLUSION: Drinking cocoa activates natural immunity and enhances vaccination-induced immune response, providing stronger protection against influenza virus infection and disease onset.


Subject(s)
Antiviral Agents/therapeutic use , Cacao , Influenza, Human/drug therapy , Phytotherapy , Plant Extracts/therapeutic use , Administration, Oral , Adult , Animals , Antiviral Agents/administration & dosage , Antiviral Agents/pharmacology , Birds , Disease Models, Animal , Dogs , Female , Humans , Influenza A Virus, H1N1 Subtype/drug effects , Influenza A Virus, H3N2 Subtype/drug effects , Influenza A Virus, H5N1 Subtype/drug effects , Influenza, Human/virology , Inhibitory Concentration 50 , Male , Mice , Mice, Inbred BALB C , Plant Extracts/administration & dosage , Plant Extracts/pharmacology
15.
Trauma Surg Acute Care Open ; 1(1): e000037, 2016.
Article in English | MEDLINE | ID: mdl-29766069

ABSTRACT

BACKGROUND: Patients with severe trauma often present with critical coagulopathy, resulting in impaired hemostasis, massive hemorrhage, and a poor survival prognosis. The efficacy of hemostatic resuscitation in correcting coagulopathy and restoring tissue perfusion has not been studied. We assessed a novel approach of pre-emptive administration of fibrinogen concentrate to improve critical coagulopathy in patients with severe trauma. METHODS: We retrospectively compared blood transfusion volumes and survival prognosis between three groups of patients with trauma, with an Injury Severity Score (ISS) ≥26 over three consecutive periods: group A, no administration of fibrinogen concentrate; group B, administration of 3 g of fibrinogen concentrate after evaluation of trauma severity and a plasma fibrinogen level <1.5 g/L; group C, pre-emptive administration of 3 g of fibrinogen concentrate immediately on patient arrival based on prehospital information, including high-severity injury or assessed need for massive transfusion before measurement of fibrinogen. RESULTS: ∼56% of patients with an ISS ≥26 and transfused with red blood cell concentrates ≥10 units, had hypofibrinogenemia (fibrinogen <1.5 g/L) on arrival. Patients who received fibrinogen concentrate in group C showed significantly higher fibrinogen levels after treatment with this agent than those in group B (2.41 g/L vs 1.88 g/L; p=0.01). Although no significant difference was observed in blood transfusion volumes between the groups, the 30-day survival of patients in group C (all, and those with an ISS ≥26) was significantly better than in group A (p<0.05). The 48-hour mortality rate in patients with an ISS ≥26 was significantly lower in group C than in group A (8.6% vs 22.9%; p=0.005). Further, among patients with an ISS ≥41, the overall mortality was significantly lower in group C than in group A (20% vs 50%; p=0.02). CONCLUSION: Pre-emptive administration of fibrinogen concentrate for patients with trauma with critical coagulopathy may contribute to improved survival. LEVEL OF EVIDENCE: Level IV.

16.
Rinsho Ketsueki ; 56(3): 253-60, 2015 Mar.
Article in Japanese | MEDLINE | ID: mdl-25876777

ABSTRACT

Acute lymphoblastic leukemia (ALL), a clonal expansion of hematopoietic blasts, is a highly heterogeneous disease comprising many entities for which distinct treatment strategies are pursued. Recurrent defects including chromosomal translocations, aneuploidies, and gene-specific alterations generate molecular subgroups of B- and T-ALL with differing clinical courses and distinct responses to therapy. Herein, we review the spectrum of genetic aberrations that promote acute B- and T-ALL, as well as the currently-revealed mechanisms of cell transformation and malignant progression. Although 5-year overall survival of childhood ALL patients has improved to as much as 90% due to progress in chemotherapy and other supporting therapeutic modalities, including allo-HSCT, the prognosis is still poor for the remaining 10% of cases, which consist mainly of MLL-AF4-positive ALL and bcr-abl positive ALL. The prognosis of adults with ALL is not satisfactory and adult ALL remains a challenging disease. The development of novel methodologies, including new molecular therapeutic targets, is also needed to improve the prognosis of ALL.


Subject(s)
Leukemia, Lymphoid/genetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/genetics , Translocation, Genetic/genetics , Animals , Fusion Proteins, bcr-abl/genetics , Fusion Proteins, bcr-abl/metabolism , Humans , Leukemia, Lymphoid/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Prognosis
17.
Nihon Rinsho ; 71(6): 1042-6, 2013 Jun.
Article in Japanese | MEDLINE | ID: mdl-23855211

ABSTRACT

Falls are common cause of injuries among elderly people, and fractures are the most serious consequence of falls. For seniors, hip fractures are the second major cause of bedridden. The feature and acute care of head injury, spinal cord injury, vertebrae fracture, and hip fracture are described. Just had fracture fixation, the patient can not go back to the original ADL. In order not to become bedridden, both medication and physical examination are important based on the new disease concept of locomotive syndrome. To do so, requires hospital and clinic cooperation. Sufficient cooperation is not currently possible, and spread of liaison service is essential.


Subject(s)
Accidental Falls , Activities of Daily Living , Humans , Japan , Osteoporosis/complications , Osteoporosis/drug therapy , Osteoporotic Fractures/therapy
18.
J Clin Biochem Nutr ; 44(2): 142-50, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19308268

ABSTRACT

As previously reported, the cerebral arterioles are surrounded by unique perivascular Mato cells. They contain many inclusion bodies rich in hydrolytic enzymes, and have strong uptake capacity. They are thus considered scavenger cells of vascular and neural tissues in steady-state. In this study, employing hypertensive SHR-SP (Izm) rats, the viability of Mato cells was investigated. In hypertensive rats, the capacity for uptake of horse radish peroxidase (HRP) and the activity of acid phosphatase (ACPase) of Mato cells were markedly reduced, and on electron-microscopic examination Mato cells were found to include heterogeneous contents and appeared electron-dense and degenerated. Vascular cells exhibited some signs of pathology. However, in hypertensive rats fed chow containing 0.25% cocoa, the uptake capacity and ACPase activity of Mato cells for HRP were enhanced, and on electron-microscopic examination Mato cells appeared healthy, with mitochondria with nearly normal profiles. Signs of pathology in vascular cells were also decreased. Superoxides may impair Mato cells and vascular cells.

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