Median Nerve Neuropathy Caused by Persistent Median Artery Thrombosis.

Persistent median artery thrombosis mimicking carpal tunnel syndrome is rare. Here, we report the pathological, ultrasonography, and intraoperative findings of a case of persistent median artery thrombosis mimicking carpal tunnel syndrome. A 34-year-old man reported to our clinic with a complaint of numbness in his left thumb, index finger, and middle finger, which are innervated by the left median nerve.

Modified Posterior Trans-olecranon Approach in Tri-vision for Dubberley Type 3B Coronal Shear Fractures of the Distal Humerus.

Coronal shear fractures are rare injuries and standard treatment is yet to be determined. There is still no standard approach and fixation method for Dubberley type 3B cases, which are severe fractures that extend to the ulnar side and are accompanied by posterior comminution, making them challenging injuries. We used a modified posterior trans-olecranon approach in tri-vision in the supine position in two type 3B cases.

Outcomes of Rerouting the Palmaris Longus to Extensor Pollicis Longus Tendon Transfer through the Second Extensor Compartment for Radial Nerve Palsy.

A palmaris longus (PL) to extensor pollicis longus (EPL) is a standard tendon transfer used to restore thumb extension in patients with radial nerve palsy. This transfer is done by withdrawing the EPL from the third compartment and passing it subcutaneously to reach the PL. We modified this transfer by rerouting the EPL through the second extensor compartment to improve the retropulsion of the thumb.

Interosseous wiring for fragmented proximal phalangeal fractures.

Fragmented proximal phalangeal fractures are difficult to treat. Fixation with plate and screws often lead to contractures and extensor tendon adhesions. Interosseous wiring could prevent those complications by repairing the periosteum and avoiding direct contact between implants and extensor tendon, while a good total active motion can be achieved.

[A Case of Metastatic and Recurrent Colon Cancer Whose QOL Kept Longly by Multidisciplinary Treatment Including Six Times Surgical Operation].

The patient was 75-year-old male, he has been diagnosed as ascending colon cancer resected by rt. hemicolectomy in September 2010. Final diagnosis was tub2, T4b, N1, Cy1, M0, pStage Ⅲc.

Continuous warfarin administration versus heparin bridging therapy in post colorectal polypectomy haemorrhage: a study protocol for a multicentre randomised controlled trial (WHICH study).

Background: Endoscopic removal of colorectal adenoma is considered an effective treatment for reducing the mortality rates associated with colorectal cancer. Warfarin, a type of anticoagulant, is widely used for the treatment and prevention of thromboembolism; however, bleeding may increase with its administration after polypectomy. In recent times, a high incidence of bleeding after endoscopic polypectomy has been reported in patients receiving heparin bridge therapy.

Effectiveness of ultrasonographic evaluation under general anesthesia for radial nerve palsy associated with humeral fractures during the first operation.

Purpose: To evaluate the effectiveness of sonographic evaluation of the radial nerve at the first operation for closed humeral fracture cases.

Methods: Seventeen cases of closed humeral fractures were included in this study. These cases were categorized into two groups: Group P, consisting of seven cases with complete radial nerve palsy after the injuries; and Group C, consisting of ten cases without radial nerve palsy after the injuries.

The effectiveness of distraction lengthening in traumatic hand amputation with Ilizarov mini fixator.

Background: Bone distraction lengthening has been used for hand reconstruction. The healing process involved in this technique is affected by many factors. Here, the effectiveness and rates of healing of the phalanges and the metacarpals were evaluated in cases of traumatic finger amputation treated using an Ilizarov mini-fixator.

Evaluation of intramedullary nail fixation via the Neviaser portal for proximal humerus fracture.

Objectives: To our knowledge, no cases have been reported so far regarding the treatment of proximal humerus fracture with intramedullary nail fixation via the Neviaser portal. This study aimed at evaluating the results of intramedullary nail fixation via the Neviaser portal for proximal humerus fracture.

Methods: Four patients with 2-part proximal humerus fracture, who underwent the intramedullary nail fixation via the Neviaser portal, were included in this study.

Nutritional status and management of risks due to physical therapy in patients hospitalized for long periods.

[Purpose] This study aimed to understand the nutritional status of patients hospitalized for long periods and the risk of physical therapy (PT) for such patients. [Subjects and Methods] Participants were selected from patients who were hospitalized at a designated medical long-term care sanatorium. The participants were divided into 5 groups (A-E) depending on their mode of energy intake and ambulatory ability during PT.

Restoration of the Active Forearm Rotation Using Vascularized Free Fibular Graft and Radial Head Arthroplasty for a Wide Defect of the Proximal Radius.

In this report we present a case of re-stabilization of the proximal radius using vascularized free fibular graft combined with anconeus arthroplasty to stabilize the transplanted fibula in a patient with large loss of the proximal radius due to Ewing's sarcoma. A 20-year-old woman had Ewing's sarcoma in the proximal three-fourths of the radius. The resection of large part of the radius containing radial head were necessary for removal of the sarcoma.

Relationships Between Periventricular Epicardial Adipose Tissue Accumulation, Coronary Microcirculation, and Left Ventricular Diastolic Dysfunction.

Background: Obesity is related to left ventricular (LV) diastolic dysfunction, although its pathophysiological mechanism remains unclear. Epicardial adipose tissue (EAT) is an ectopic fat with paracrine effects on coronary circulation and myocardium. We hypothesized that left ventricle-specific (periventricular) EAT may deteriorate diastolic function by impairing coronary microcirculation.

Ulnolunate Ligament Avulsion Fracture of the Lunate: A Case Report.

Traumatic lunate fractures are very rare and those treatments require an understanding of anatomical features. We present a case of an ulnolunate ligament avulsion fracture of the lunate that was successfully repaired by surgical fixation with open reduction and internal fixation. We believe that restoration of ulnolunate ligament function is important to prevent further deterioration of wrist function after this injury.

Evaluation of flexor pollicis longus tendon attrition using color Doppler imaging after volar plate fixation for distal radius fracture.

Purpose: Early diagnosis of attritional wear of the flexor pollicis longus (FPL) tendon is essential in preventing subsequent tendon rupture. There are currently few objective methods of assessing FPL attrition. We hypothesized that color Doppler imaging could visibly detect FPL tendon attrition, and analyzed our results.

[Percutaneous Transhepatic Cholangiodrainage to Alleviate Symptoms of Afferent Loop Obstruction--A Case Report].

The patient, a 78-year-old man, had undergone distal gastrectomy for a gastric ulcer 35 years previously. As melena was observed, he was referred to our department, and was subsequently diagnosed with residual gastric cancer and ascending colon cancer. Peritoneal metastasis of gastric cancer was found, and palliative surgeries, including right hemicolectomy, total gastrectomy, and Roux-en-Y reconstruction were performed.

Sonographic evaluation of effects of the volar plate on trigger finger.

Background: We evaluated trigger fingers ultrasonographically and clarified differences between fingers with and without continuous locking or snapping symptoms according to the thicknesses of the A1 pulley, flexor tendon and volar plate.

Methods: We evaluated 26 trigger fingers, divided into two groups: Group 1, 14 fingers with locking or snapping; and Group 2, 12 fingers without such symptoms. We also evaluated 26 contralateral fingers as controls (Control 1 and 2 groups).

Comparison of effects of sitagliptin and voglibose on left ventricular diastolic dysfunction in patients with type 2 diabetes: results of the 3D trial.

Background: Left ventricular (LV) diastolic dysfunction is frequently observed in patients with type 2 diabetes. Dipeptidyl peptidase-4 inhibitor (DPP-4i) attenuates postprandial hyperglycemia (PPH) and may have cardio-protective effects. It remains unclear whether DPP-4i improves LV diastolic function in patients with type 2 diabetes, and, if so, it is attributable to the attenuation of PPH or to a direct cardiac effect of DPP-4i.

Multicenter investigations of the prevalence of abdominal aortic aneurysm in elderly Japanese patients with hypertension.

Background: Physical examination as an initial screening tool to diagnose abdominal aortic aneurysm (AAA) has lost favor over the past 20 years. This multicenter cohort study aimed to determine the prevalence of AAA in elderly Japanese patients with hypertension (HT) and to clarify the diagnostic accuracy of physical examination using a pocket-sized ultrasound imaging device (the "pocket-echo"). METHODS AND RESULTS: A total of 1,731 patients with HT aged >60 years from 20 collaborating institutions were enrolled in this study.

[Advanced gastric cancer(Stage IV)leading to perforation during chemotherapy with S-1 plus cisplatin].

A 60-year-old man was diagnosed with advanced gastric cancer(Type 3)with multiple liver and lymph node metastases. The clinical stage was determined to be T3(SS), N2, M1, P0, H1, Stage IV, and a chemotherapy regimen of S-1 plus cisplatin (CDDP)was selected for treatment. During 3 courses of chemotherapy, the patient complained of severe abdominal pain, and an urgent laparotomy was performed with a tentative diagnosis of perforated gastric cancer.

Persistent epicardial adipose tissue accumulation is associated with coronary plaque vulnerability and future acute coronary syndrome in non-obese subjects with coronary artery disease.

Objective. Epicardial adipose tissue (EAT) is recognized as a novel risk factor for coronary artery disease (CAD), and its contribution is thought to be stronger in non-obese patients than in obese patients. However, the prognostic impact of the progression of EAT accumulation after comprehensive management for atherosclerotic risk factors remains unclear.

[A case of Stage IV gastric cancer in which a partial response was maintained for four years with multidisciplinary treatment].

The patient was a 63-year-old man with Stage IV gastric cancer (cT3, cNX, cM1[LYN]). After chemotherapy with S-1 plus paclitaxel (PTX), a partial response was achieved, and distal gastrectomy was subsequently performed. During continued chemotherapy with S-1 plus PTX after surgery, enlarged lymph nodes (#16) were observed.

The utility of fully automated real-time three-dimensional echocardiography in the evaluation of left ventricular diastolic function.

Background: A novel real-time three-dimensional echocardiography (RT3DE) system allows fully automated quantification of the left ventricular (LV) volume throughout a cardiac cycle. This study aimed to investigate whether an LV time-volume curve, obtained using fully automated RT3DE, is useful in the evaluation of LV diastolic function.

Methods: First, 15 patients underwent simultaneous standard two-dimensional echocardiography (2DE), RT3DE, and cardiac catheterization to measure the time constant of the isovolumic-pressure decline (τ).

Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure.

Background: Remote ischemic conditioning (RIC) is a treatment modality that suppresses inflammation and improves endothelial function, which are factors involved in the pathogenesis of heart failure (HF) with reduced left ventricular ejection fraction. Coronary flow reserve (CFR) is a physiological index of coronary microcirculation and is noninvasively measured by transthoracic Doppler echocardiography (TTDE). This study aimed to investigate the effects of RIC on CFR in healthy subjects and patients with HF, through the assessment by TTDE.