Repair of olecranon fractures using fiberWire without metallic implants: report of two cases

Olecranon fractures are a common injury in fractures. The tension band technique for olecranon fractures yields good clinical outcomes; however, it is associated with significant complications. In many patients, implants irritate overlying soft tissues and cause pain. This is mostly due to protrusion of the proximal ends of the K-wires or by the twisted knots of the metal wire tension band. Below we described 2 cases of olecranon fractures treated with a unique technique using FiberWire without any metallic implants. Technically, the fragment was reduced, and two K-wires were inserted from the dorsal cortex of the distal segment to the tip of the olecranon. K-wire was exchanged for a suture retriever, and 2 strands of FiberWire were retrieved twice. Each of the two FiberWires was manually tensioned and knotted on the posterior surface of the olecranon. Bony unions could be achieved, and patients had no complaint of pain and skin irritation. There was only a small loss of flexion and extension in comparison with that of the contralateral side, and the patient did not feel inconvenienced in his daily life. Using the method described, difficulty due to K-wire or other metallic implants was avoided

Rare Lipomatous Tumors with Osseous and/or Chondroid Differentiation in the Oral Cavity Report of Two Cases and Review of the Literature

The purpose of this study was to determine the clinicopathological and immunohistochemical features of lipoma/fibrolipoma with rare occasions as osseous and/or chondroid differentiation in the oral cavity. Two cases of the tumors, who presented with a painless, relatively hard mass on the oral mucosa, were studied. These were consisted of a well-circumscribed mass of fatty tissue with chondroid and significant fibrous component intermixed with the lobules of fat cells with chondroid and woven bone component, respectively. Immunohistochemical study revealed that peripheral spindle cells around chondroid tissue stained diffusely for S-100 α & β and Sox-9, though peripheral spindle cells around osteoid tissue only stained for RUNX-2. According to review of the literature, lipoma/fibrolipoma with osseous and/or chondroid differentiation was 18 cases. Also fibrolipoma with osseous and chondroid differentiation is the first to be reported here. These results indicated that the cartilage/bone is produced by differentiation of undifferentiated mesenchymal cells of stroma

extubation failure due to subglottic stenosis

Background : This report describes a case of dynamic inspiratory airway collapse concomitant with subglottic stenosis in a patient who previously underwent tracheostomy that led to repeated post-operative extubation failure. Case presentation : A 43-year-old woman who had undergone tracheostomy 25 years previously was admitted to our intensive-care unit (ICU) after coronary artery bypass graft surgery. On postoperative day (POD) 0, she was extubated, but stridor was observed. We suspected upper airway obstruction and she was therefore reintubated. Before reintubation, urgent laryngotracheoscopy revealed dynamic inspiratory airway collapse and obstruction concomitant with subglottic stenosis. Preoperative computed tomography showed mild subglottic stenosis. Although intravenous corticosteroids were administered to prevent tracheal mucosal edema and a cuff leak test was confirmed to be negative, she developed extubation failure on POD6. On POD12, we performed tracheostomy to reduce mechanical irritation from the endotracheal tube. Mechanical ventilation was withdrawn and she discharged from the ICU. On POD33, her tracheostomy tube was removed and she remained clinically asymptomatic. Conclusions : We should be aware of the history of tracheostomy, especially at high tracheostomy sites, even in the absence of respiratory symptoms as risk factors for dynamic inspiratory airway collapse concomitant with subglottic stenosis contributing to repeated respiratory failure after extubation

アタラシイ ニホンゴ ノウリョク シケン ノ タメノ ゴイ ヒョウ サクセイ ニ ムケテ

日本語能力試験の実施機関である国際交流基金と日本国際教育支援協会は「日本語能力試験の改善に関する検討会」を2005年に発足させたが、2009年からの新試験開始を目指して各分科会は日々調査研究を重ねている。本稿は、分科会の一つである出題基準分科会漢字表・語彙表部会が行っている語彙表作成作業の2007年9月現在の中間報告である。 部会の活動は、この2年間で4つの段階を経た。作成方針と選別方針を決定し、データベースに関する調査および整備をする第一段階、語彙の選別をする第二段階、語彙の再選別及び記述方法の検討をする第三段階、語彙の再選別と初出級の検討をする第四段階である。実際にどのようなデータベースを使い、どのような検討を重ね、どのような選別作業をしたのか。本稿ではそれぞれの段階ごとに具体的な例を挙げながら報告をする。また、それとともに今後考えていかなければならない課題についても言及する。The Japan Foundation and Japan Educational Exchanges and Services inaugurated an "Examination Committee on Improving Japanese Language Proficiency Test" in 2005, and have been conducting research on the New Test to be incorporated in 2009. There are various revisions to be made. This is an interim report as of September 2007, on the working of vocabulary list which has been made by the kanji and vocabulary list subdivision of the Test Content Specifications division. The activities of the subdivision have been divided into four stages during these two years. The first stage is for decisions on the policy for composition and selection, and research on the database. The second stage is for the selection of vocabulary. The third stage is for discussion on the re-selection and description of vocabulary. The forth stage is for re-selection of vocabulary and for each level to be decided

A novel closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation for mallet fractures

AbstractBackgroundSome patients with mallet fractures who undergo extension block pinning complain of exposed wires, which delay their return to sports and causes inconvenience while performing tasks that require the use of hands during the early postoperative period. The purpose of this retrospective study was to present and evaluate a novel surgical procedure for mallet fractures.MethodsWe treated 20 patients (14 males and six females; mean age, 38.4 years; range 17-68 years) with displaced mallet fractures involving >30 % of the articular surface using the closed reduction and microscrew fixation between January 2009 and January 2012. The distal interphalangeal joint (DIP) joint was immobilized with a splint for 1-3 weeks on an individual case basis. According to Wehbe and Schneider’s classification, there were 12 type IB, six type IIB, and two type IA fractures. The mean follow-up duration was 12.6 months (range 6-31 months).ResultsBone union was achieved in all patients within a mean period of 6.8 weeks, with no incidence of infection, skin necrosis, permanent nail deformity, or secondary osteoarthritis. Only two complications—temporary nail ridging in one patient and a dorsal bump caused by the screw in one patient—were observed. Minimum postoperative displacement was observed in one patient, for whom immobilization with a splint was continued for 4 weeks. Articular incongruity was <1.0 mm in four patients and 1.0-2.0 mm in two patients. Mean DIP joint extension loss was 6.5° and mean flexion was 67.8°. The surgical outcomes were excellent in seven patients, good in nine, and fair in four according to Crawford’s evaluation criteria.ConclusionOur novel surgical procedure combining closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation produces good clinical results with relatively few complications

Drug-induced gingival overgrowth and its tentative pharmacotherapy

The characters in gingival fibroblasts derived from a nifedipine-reactive patient (nifedipine responder: NIFr) and those from a nifedipine-nonreactive patient (nifedipine non-responder: NIFn) are summarized, and investigated a possibility of tenidap, (±)-5-chloro-2,3-dihydro-3-(hydroxy-2-thienylmethylene)-2-oxo-1H-indole-1-carboxamide, and 18α-glycyrrhetinic acid (18α-GA) as a therapeutics for gingival overgrowth caused by calcium channel blockers. Tenidap discharges intracellular Ca2+ store, resulting in a depletion of intracellular Ca2+ store in cultured human gingival fibroblasts. It also inhibited cell growth, DNA and collagen syntheses, lowered intracellular pH in nicardipine responder cells, and enhanced matrix metalloproteinase-1 formation in NIFr cells. 18α-GA inhibited cell proliferation and G1/S transition induced in NIFr cells. It was also shown that cell cycle control proteins were down-stream targets in the growth-inhibition activity of 18α-GA in NIFr cells. These results suggest that tenidap and 18α-GA might be effective for the prevention of gingival overgrowth caused by calcium channel blockers

Transfection of T-Box Transcription Factor <i>BRACHYURY</i> and <i>SOX2</i> Synergistically Promote Self-Renewal and Invasive Phenotype in Oral Cancer Cells

Recent studies suggest that epithelial&#8315;mesenchymal transition (EMT) correlates with cancer metastasis. In addition, there is growing evidence of the association of EMT with cancer stem cells (CSCs). Recently, we showed that the T-box transcription factor BRACHYURY could be a strong regulator of EMT and the CSC phenotype, which were effectively suppressed by a BRACHYURY knockdown in an adenoid cystic carcinoma cell line. In this study, we further tested whether BRACHYURY is a regulator of cancer stemness by means of forced expression of BRACHYURY in oral cancer cell lines. BRACHYURY, SOX2, or both were stably transfected into oral carcinoma cell lines. We analysed these transfectants with respect to self-renewal phenotypes using a sphere-formation assay, and we assessed the expression levels of EMT markers and stem cell markers using real-time reverse transcription-polymerase chain reaction (RT-PCR). Cell migration and invasiveness in vitro were evaluated using a wound healing assay and a tumour cell dissemination assay, respectively. Forced expression of BRACHYURY or SOX2 slightly increased expression of EMT and stem cell markers and the self-renewal phenotype. The expression levels, however, were much lower compared to those of cancer stem cell-like cells. Forced co-expression of BRACHYURY and SOX2 strongly upregulated EMT and stem cell markers and the self-renewal phenotype. Cell migration and invasiveness in vitro were also remarkably enhanced. These synergistic effects increased expression levels of FIBRONECTIN, SNAIL, SLUG, ZEB1, and TGF-&#946;2. In particular, the effects on FIBRONECTIN and TGF-&#946;2 were significant. We found that BRACHYURY and SOX2 synergistically promote cancer stemness in oral cancer cells. This finding points to the importance of gene or protein networks associated with BRACHYURY and SOX2 in the development and maintenance of the CSC phenotype