Fracture of the distal radius is very common, especially in elder people. Loss of reduction of the fracture often develop into symptomatic malunion or nonunion. Three cases of malunion following Colles's fracture, one case of nonunion following Smith's fracture, and one case of nonunion following Colles's farcture are reported in this study. All cases were female and mean age was 75.2 years at the time of operation. All patients underwent collective open-wedge osteotomy, and bone graft (harvested from ulna) according to Sauve-Kapandji's or Darrach procedure. The mean follow-up period was nine months. Functional and radiological outcomes improved in all cases.
The purpose of this study was to determine the prevalence of cuff tear and acromioclavicular joint (ACJ) osteoarthrosis by magnetic resonance imaging (MRI) evaluation in symptomatic shoulders. MRI was performed on 124 shoulders in 115 patients whose age ranged from 16 to 83 years (average: 58.0 years). There were 74 men (79 shoulders) and 41 women (45 shoulders). The patients were divided into three groups according to age; A group (10 shoulders: 16-29 years), B group (43 shoulders: 30-59 years), and C group (71 shoulders: 60-83 years). Rotator cuff tears and ACJ osteoarthrosis were graded on scales 0 to 3 (normal, increased signal intensity, incomplete, complete), and 1 to 4 (none, mild, moderate, severe), respectively. There was a significant difference in the severity of the cuff tears and the ACJ osteoarthrosis with respect to age. 20% of the shoulders were graded incomplete or complete cuff tears in group A, 88% in group B, and 93% in group C. No shoulders were graded moderate or severe ACJ changes in group A, 63% in group B, and 93% in group C. There was a definite correlation between the cuff tears and ACJ osteoarthrosis. MRI of the symptomatic shoulders indicated well correlation between the rotator cuff tears and ACJ osteoarthrosis.
Postoperative results were evaluated in 9 patients (5 males and 4 females) with ossification of spinal ligaments in the cervical and thoracic spine. The mean follow-up period was 14.2 months. The age at the time of operation ranged from 45 to 79 years with a mean of 58.2 years. Cervical laminoplasty and thoracic laminectomy were performed on 9 patients, simultaneously or additionally.The mean recovery rate using Hirabayashi's method was 51.6%. In the simultaneous decompression group, the operative result was better. The operative result of the extensive ossification group was worse than that of localized group.We consider simultaneous decompression to be effective in patients with ossification of spinal ligaments in both the cervical and thoracic spines, and whose spinal cord is compressed at multiple levels.
Anti-angiogenesis therapy is considered to be a new approach to various human cancers because angiogenesis is crucial for tumor growth. Moreover, ultrasound energy has been shown to enhance an anti-tumor effect of a chemotherapeutic agent in vitro and in vivo. Uterine sarcoma is the most malignant neoplasm among the known uterine malignancies, which has a poor response to any chemotherapeutic agent currently used and also radiotherapy. Our previous study showed anti-tumor effect of TNP-470 (an analogue of fumagillin), an angiogenesis inhibitor, for human uterine sarcoma, in vitro and in vivo. This study firstly examined the therapeutic effect of angiogenesis inhibitor combined with low-intensity ultrasound irradiation for human cancer in vivo and evaluated its vascularity on real-time using a microbubble ultrasound contrast agent (Optison̈). The uterine sarcoma xenografts were treated by ultrasound with an intensity of 2.0 w/cm2 1MHZ for 4 min three times per week each after subcutaneous injection of TNP-470 at a dose of 30 mg/kg and this therapy was continued for eight weeks. The reduction of the volume as well as the weight of the xenografts was significantly shown by this combined therapy, in comparison to a group of the drug used alone, ultrasound irradioation alone, or in the controls. No major side effect was observed in any mice of the groups. The effect of anti-angiogenesis for this tumor was remarkably demonstrated on real-time by contrasted color ultrasound, non-invasively. The microvessel density of the tumors was significantly decreased in this combination therapy compared to other groups. These results suggest that there is an accelerated (boosting) effect of ultrasound for anti-angiogenesis drug therapy for human uterine sarcoma and this combination therapy might be a potential candidate for a new cancer treatment.
