A Novel Ultrasound-guided Forearm Continuous Peripheral Nerve Block Technique Using Bidirectional Hydrodissection.

In hand surgery, postoperative rehabilitation is essential for achieving optimal functional recovery. Although continuous peripheral nerve block at the forearm level is considered a useful method for maintaining motor function while relieving pain, it has not been widely adopted due to concerns about invasiveness and the reliability of the technique. We have developed a simplified, reliable, and safe continuous peripheral nerve block technique by applying the parallel method used in conventional ultrasound-guided nerve blocks.

Free Flap Surgery for Elbow Soft Tissue Reconstruction Using the Brachial Artery as Recipient Vessel: Evaluation of MPETS Cases and Comparative Literature Review.

The elbow joint, essential for daily activities, often requires soft tissue reconstruction following trauma, infection, or tumor excision. Free flap surgery using the brachial artery (BA) as the recipient vessel offers stable vascular support, but preserving distal blood flow is crucial. Due to vessel diameter differences, end-to-side (ETS) anastomosis is usually necessary, as flow-through anastomosis can be challenging.

Regional anaesthesia-based free flap reconstruction for limb salvage in high-risk patients with refractory lower limb infections.

Background: Patients with severe comorbidities and refractory lower leg and foot infections face high risks from prolonged anaesthesia and complex soft tissue reconstruction. Our institution collaborates with anaesthetists to perform limb salvage using free flaps, primarily under combined spinal-epidural anaesthesia (CSE) without general anaesthesia (GA). This study aimed to evaluate the treatment outcomes of our limb salvage algorithm in high-risk patients.

Diacylglycerol kinase ζ is a positive insulin secretion regulator in pancreatic β-cell line MIN6.

Some isoforms of diacylglycerol (DAG) kinase (DGK), an enzyme converting DAG into phosphatidic acid, i.e., DGKα, γ and δ, have been reportedly involved in the regulation of pancreatic β-cell function.

Efficacy of superficial femoral artery as a recipient in free flap reconstruction around the knee: Four case reports and a literature review.

Purpose: Reconstructing soft tissue defects around the knee with free flaps presents challenges in recipient vessel selection. Although the superficial femoral artery (SFA) offers exposure ease and anatomical stability, concerns arise regarding its distance from the defect site, difficulty in performing anastomosis and potential peripheral ischaemia. This study aimed to reassess the suitability of SFA as a recipient vessel for knee reconstructions by examining our cases and those from previous reports.

Neurosarcoidosis Complicated by Noncommunicating Hydrocephalus with Atypical Presentation, Diagnosed and Treated with Endoscopic Surgery: A Case Report.

Neurosarcoidosis is a condition that is characterized by the occurrence of noncaseating epithelioid granulomas in various organs throughout the body, including the lungs, heart, and central nervous system. It is particularly prevalent in cases of noncommunicating hydrocephalus. While its clinical presentations may vary, neurological deficits such as hemiparesis are extremely uncommon.

Clinical outcomes of perforator-based propeller flaps versus free flaps in soft tissue reconstruction for lower leg and foot trauma: a retrospective single-centre comparative study.

Background: The efficacy and safety of perforator-based propeller flaps (PPF) versus free flaps (FF) in traumatic lower leg and foot reconstructions are debated. PPFs are perceived as simpler due to advantages like avoiding microsurgery, but concerns about complications, such as flap congestion and necrosis, persist. This study aimed to compare outcomes of PPF and FF in trauma-related distal lower extremity soft tissue reconstruction.

A simple free flap strategy using end-to-side anastomosis to the main vessels in injured extremity.

Background: During free flap surgery, the surgeon sometimes encounters problems with anastomosis such as intractable arterial spasms or vessel size discrepancy in venous anastomoses. End-to-side (ETS) anastomosis has the advantages of limited chance of vessel spasm and easy handling by adjusting for vessel size discrepancy. We introduced the arterial and venous end-to-side anastomosis (AV-ETS) strategy, which is based on the ETS anastomosis to the main artery and accompanying veins, to avoid intraoperative anastomotic problems when creating a free flap.

Asymmetric dimethylarginine accumulation under hyperglycemia facilitates β-cell apoptosis via inhibiting nitric oxide production.

Low concentrations of nitric oxide (NO) produced by constitutive NO synthase (cNOS) has been shown to suppress apoptosis in pancreatic β-cells. In the present study, the influence of asymmetric dimethylarginine (ADMA), the major endogenous inhibitor of NOS, on the apoptosis-suppressive effect of NO was investigated. The expression of dimethylarginine dimethylaminohydrolase 2 (DDAH2), an ADMA-metabolizing enzyme, in INS-1 β-cells and in mouse pancreatic islets was drastically reduced by in vitro exposure to high-concentration glucose (20 mM) and by in vivo treatment of mice with the insulin receptor blocker S661, which resulted in hyperglycemia, respectively.

Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities.

Purpose: The availability of reliable and suitably sized veins is limited for creating free flaps to treat severe trauma and infection, and it is important to manage vessel size discrepancy between the recipient and flap veins. We evaluated the clinical outcomes of free flaps with large-to-small venous end-to-side (ETS) anastomoses using the microscopic parachute end-to-side (MPETS) anastomosis in soft tissue defects in the extremities. This procedure comprises mainly a wide-slit venotomy and parachute procedure at the heel.

Simultaneous Bilateral Proximal Humerus Fractures Treated with Single-Stage Bilateral Reverse Shoulder Arthroplasty.

Introduction: Simultaneous bilateral fractures of the proximal humerus are infrequent, and simultaneous bilateral three- or four-part fractures are even rarer. Reverse shoulder arthroplasty (RSA) is being used increasingly for the treatment of three- and four-part fractures of the proximal humerus. However, treatment of simultaneous bilateral fractures of the proximal humerus is difficult because of concern about postoperative immobilization and rehabilitation.

Blood flow distribution after end-to-side anastomosis with wide arteriotomy in extremity free flap surgery.

Purpose: Although many studies have investigated the optimal anastomotic procedure for the end-to-side (ETS) procedure with a free flap, no study has focused on the size of the arteriotomy. Some surgeons have recently described the effectiveness of ETS with wide arteriotomy, but the postoperative haemodynamics remains unclear for free flaps created using this technique. The aim of this study was to use ultrasonography to evaluate the postoperative blood flow distribution after ETS with a wide arteriotomy in extremity free flap surgery.

Diacylglycerol kinase δ functions as a proliferation suppressor in pancreatic β-cells.

Although an aberrant reduction in pancreatic β-cell mass contributes to the pathogenesis of diabetes, the mechanism underlying the regulation of β-cell mass is poorly understood. Here, we show that diacylglycerol kinase δ (DGKδ) is a key enzyme in the regulation of β-cell mass. DGKδ expression was detected in the nucleus of β-cells.

Reliable free flaps using the microscopic parachute end-to-side technique in severe extremity injuries.

Purpose: Although end-to-side anastomosis is an essential method for the transfer of free flaps in traumatic extremity injuries, orthoplastic surgeons have no standard technique for performing this procedure. We describe a simple and reliable end-to-side technique is modified from that commonly used by cardiovascular surgeons for free-flap transfer.

Methods: Our microscopic parachute end-to-side technique consists primarily of two simple steps.

Adipose tissue complement factor B promotes adipocyte maturation.

Objectives: It is well-known that the complement system plays an essential role in host immunity. Observational studies have indicated that complement system-related molecules such as complement factor B (CfB) and other components are correlated with obesity and/or insulin resistance parameters. In this study, we investigated the role of adipocyte-derived CfB in adipose tissue metabolism.

"Half-folded" pedicled scapular bone flap for nonunion after humeral neck fracture: A case report.

Treatment of a nonunion of the proximal humerus remains a challenge because of the small proximal fragment and poor central cancellous bone stock of the humeral head. In this report, we describe our experience using a "half-folded" pedicled scapular bone flap with an anatomical locking plate to treat an atrophic nonunion of the proximal humerus in a 64-year-old right-handed woman. The patient had fallen and experienced a common humeral neck fracture 2.

Dependence of purple membrane bump curvature on pH and ionic strength analyzed using atomic force microscopy combined with solvent exchange.

Purple membrane (PM), which is a membrane patch formed by the self-assembly of the membrane protein bacteriorhodopsin (bR) with archaeal lipids, is a good subject for studying the mechanism for the supramolecular structural formation of membrane proteins. Several studies have suggested that PM is not simply planar but that it has a curvature. Atomic force microscopy (AFM) studies also indicate the presence of dome-like structures (bumps) on the cytoplasmic surface of PM.

Circulating TNF receptor 2 is closely associated with the kidney function in non-diabetic Japanese subjects.

Aim: Chronic kidney disease (CKD) is associated with cardiovascular events. Tumor necrosis factor (TNF) and/or its receptors have been postulated to be involved in renal pathophysiology. It is unclear whether an increased TNF system activity is present before the development of apparent CKD.

The inflammation-lipocalin 2 axis may contribute to the development of chronic kidney disease.

Background: Chronic kidney disease (CKD) is an important risk factor for coronary heart disease, and previous studies indicated the involvement of low-grade inflammation in the pathogenesis of CKD.

Methods: The study was designed to (i) identify and confirm genes and their products upregulated in mesangial cells cocultured with endotoxin-stimulated macrophages and (ii) determine the clinical relevance of genes and proteins upregulated in mesangial cells under inflammatory conditions by an epidemiological approach.

Results: DNA microarray analysis revealed upregulated expression of many genes and their products including several cytokines and chemokines, as well as the inflammatory marker, lipocalin 2 gene.

Lifestyle factors associated with gastroesophageal reflux disease in the Japanese population.

Background: We aimed to clarify the lifestyle factors associated with erosive esophagitis and non-erosive reflux disease (NERD) in a Japanese population.

Methods: Among 886 subjects who underwent health screening, we selected, according to their scores on the FSSG (frequency scale for symptoms of gastroesophageal reflux disease; GERD) questionnaire and the findings of upper gastrointestinal endoscopy, 138 subjects with erosive esophagitis (EE), 148 subjects with NERD (absence of esophagitis, FSSG score ≥8, and acid reflux-related symptoms score ≥4), and 565 control subjects (absence of esophagitis and FSSG score ≤7). We compared clinical characteristics and various lifestyle factors in these three groups.

Reduction of visceral fat correlates with the decrease in the number of obesity-related cardiovascular risk factors in Japanese with Abdominal Obesity (VACATION-J Study).

Aim: Visceral fat accumulation is associated with obesity-related cardiovascular risk factor accumulation and atherosclerosis. The present study investigated whether one-year reduction of the visceral fat area (VFA) correlates with a decrease in the number of such factors in Japanese with or without visceral fat accumulation.

Methods: The study subjects comprised 5,347 Japanese, who underwent health check-ups in 2007 and 2008, including measurements of VFA and subcutaneous fat area (SFA) by computed tomography at 9 centers in Japan.

Smoking and adipose tissue inflammation suppress leptin expression in Japanese obese males: potential mechanism of resistance to weight loss among Japanese obese smokers.

Background: The effect of smoking on leptin regulation is controversial. Smoking may induce low-grade inflammation. Recent series of studies indicated the critical role of macrophage migration in the establishment of adipose tissue inflammation.

Smoking, white blood cell counts, and TNF system activity in Japanese male subjects with normal glucose tolerance.

Background: Cigarette smokers have increased white blood cell (WBC) counts and the activation of tumor necrosis factor (TNF). The effect of smoking on WBC counts and TNF system activity, however, has not been separately investigated yet.

Subjects And Methods: One hundred and forty-two Japanese male subjects with normal glucose tolerance were recruited.

Absolute value of visceral fat area measured on computed tomography scans and obesity-related cardiovascular risk factors in large-scale Japanese general population (the VACATION-J study).

Background: The management of cardiovascular risk factors is important for prevention of atherosclerotic cardiovascular diseases (ACVD). Visceral fat accumulation plays an important role in the clustering of cardiovascular risk factors, leading to ACVD. The present study investigated the gender- and age-specific relationship between obesity-related cardiovascular risk factor accumulation and computed tomography (CT)-measured fat distribution in a large-scale Japanese general population.