Extensive rib resection followed by thoracic wall reconstruction using polytetrafluoroethylene mesh and titanium plates for refractory intercostal artery bleeding induced by severe blunt thoracic injury: report of a case.

Massive hemothorax due to multiple rib fractures and intercostal artery (ICA) injuries is one of the most lethal forms of chest trauma. Urgent thoracotomy is required; however, suturing is sometimes difficult owing to the limited operative field in the thoracic cavity and because the transected ICA retracts between the surrounding intercostal muscles. We present a patient with refractory ICA bleeding induced by severe blunt thoracic injury successfully treated with extensive rib resection followed by thoracic wall reconstruction using GORE DUALMESH and titanium plates.

Freshly isolated retinal capillaries to determine efflux transporter function at the inner BRB.

Since it has been known that in vitro cell lines for analyzing drug transport at the inner blood-retinal barrier (BRB) do not completely retain several in vivo functions, new ex vivo/in vitro methods to evaluate drug transport across the inner BRB help us understand the role of this barrier in maintaining the homeostasis of vision and regulating drug distribution to the retina. To expand the limitations of existing in vitro approaches, we established a protocol to isolate fresh rat retinal capillaries as ex vivo model of the inner BRB. Fresh retinal capillaries were prepared by applying serial filtration steps and using density gradient centrifugation.

Mobility and mortality of 340 patients with fragility fracture of the pelvis.

Purpose: To investigate prognosis of patients with fragility fracture of the pelvis (FFP) treated in a single trauma unit in Japan.

Methods: We retrospectively investigated 340 consecutive patients with FFP (40 men, 300 women; average age, 82.5 years) treated in our facility from April 2012 to April 2019.

Involvement of sodium-coupled neutral amino acid transporters (system A) in l-proline transport in the rat retinal pericytes.

The retinal pericytes contribute to the supply of collagen to the basement membrane, and thus, form the structural support of the blood-retinal barrier. Since l-proline (L-Pro) is a major component of collagen, the uptake of L-Pro is an important process for the synthesis of collagen. This study was aimed to elucidate L-Pro transport mechanism(s) in the retinal pericytes.

Multiple limb compartment syndrome as a manifestation of capillary leak syndrome secondary to metformin and dipeptidyl peptidase IV inhibitor overdose: A case report.

Rationale: Capillary leak syndrome is a condition that increases systemic capillary permeability and causes characteristic manifestations such as recurrent hypovolemia, systemic edema, and hemoconcentration. Acute limb compartment syndrome is a possible complication of severe capillary leak syndrome. However, timely diagnosis and prompt treatment are challenging because of atypical presentation.

Fragility fracture of pelvis caused by amenorrheic osteoporosis operated upon using computed-tomography-3D-fluoroscopy matching navigation system: a case report.

Introduction: Low-energy trauma fractures of older people cause fragility fractures of the pelvis (FFPs), and secondary amenorrhea triggers osteoporosis that might lead to FFPs. Anorexia nervosa is a major causative factor in secondary amenorrhea, thus, FFPs might be a problem for young anorexia nervosa patients as well as older people. Here, we report a rare case of a young woman with anorexia nervosa who had an FFP, followed by gradual progression of severe sacral deformity.

Primary bipolar hemiarthroplasty as a treatment option for unstable intertrochanteric fractures.

Objectives: Management of unstable intertrochanteric fractures is challenging, especially in patients with osteoporosis. Comminuted unstable intertrochanteric fractures require postoperative immobilization. Several recent reports have recommended hemiarthroplasty for treatment of unstable intertrochanteric fractures to avoid various immobilization-associated complications.

Effect of Retroperitoneal Pelvic Packing on Pelvic Cavity Pressure: A Cadaveric Study.

Limited clinical evidence demonstrates the effectiveness of direct retroperitoneal pelvic packing for hemorrhage control in pelvic fractures due to the difficulty in measuring pressure on the pelvic walls within the pelvic cavity after retroperitoneal pelvic packing. Using a cadaver model, the authors aimed to assess whether retroperitoneal pelvic packing generates pressure that exceeds the venous return and arterial pressure in the pelvis. The pressure on the pelvic wall was measured in 5 fresh Japanese cadavers.

A Heart-shaped Sleeve Simplifies Intramedullary Tibial Nail Insertion when Using the Suprapatellar Approach.

The suprapatellar approach for intramedullary tibial nailing has become widely accepted over the past decade. A round sleeve is passed beneath the patella to protect the surface of the patellofemoral joint (PFJ). However, the round sleeve cannot be easily stabilized in the PFJ because it does not conform to the shape of the patellar apex.

Double traction method-an easy and safe reduction method for anterior shoulder dislocations, even for non-orthopedic surgeons.

Cases: Forty-three male and 27 female patients with anterior shoulder dislocation, with an average age of 45 years, were treated with the "double traction method". The reduction is carried out by two operators, with the patient in a supine position. The first operator holds the patient's wrist and pulls gently longitudinally.

Crowned dens syndrome: reports of six cases and review of the literature.

Case: We have reported six cases of Crowned dens syndrome (CDS) diagnosed by computed tomography (CT). Presenting cases were three male and three female, aged from 45 to 89 (averaged in 72).

Outcome: All cases showed calcification around the dens of axis in CTs.

A simple reduction technique in intramedullary nailing (MICRONAIL) of distal radius fracture - intrafocal elastic-spring pinning method.

On treating distal radius fracture with intramedullary nailing (MICRONAIL, Wright Medical), completed anatomical reduction is indispensable before inserting the nail. However, complete reduction in percutaneous pinning or in Kapandji intrafocal pinning is troublesome. Thus, majority of the operation time is usually spent on reducing the fracture appropriately.

Vertical locking of the metacarpophalangeal joint in young adults.

Locking of the metacarpophalangeal joints has been occasionally reported in older adults, but reports of this problem are rare in younger individuals. We report 8 young adult patients with a metacarpophalangeal joint locked in 90° flexion after minor trauma. The cases included 6 little fingers and 2 thumbs in 1 male and 7 female patients aged 16 to 39 years.

Inhibition of STAT1 accelerates bone fracture healing.

Skeletal fracture healing involves a variety of cellular and molecular events; however, the mechanisms behind these processes are not fully understood. In the current study, we investigated the potential involvement of the signal transducer and activator of transcription 1 (STAT1), a critical regulator for both osteoclastogenesis and osteoblast differentiation, in skeletal fracture healing. We used a fracture model and a cortical defect model in mice, and found that fracture callus remodeling and membranous ossification are highly accelerated in STAT1-deficient mice.