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Severe hand contracture treated by external fixation after proximal row carpectomy and awake tenolysis after general anesthesia: A case report

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Chinese Journal of Traumatology 2022年第1期25卷 54-58页

作者： Takuya Tsumura taiichi matsumoto Mutsumi Matsushita Katsuma Kishimoto Hayao Shiode Hiroshi Murakami Department of Orthopedic Surgery Kurashiki Central Hospital1-1-1 MiwaKurashiki710-0052Japan

Wide-awake local anesthesia has many *** describe a new method to use wide-awake local anesthesia with more flexibility.A 32-year-old man with a severe right-hand contracture after an iatrogenic tourniquet accident during an anterolateral thigh flap for a partial hand amputation underwent contracture release using external fixation after proximal row carpectomy and subsequent *** performed most of the tenolysis procedure under general anesthesia and the final stage with an intra-operative assessment of active finger movement and dissection under local *** regained his grip strength 2.5 years *** anesthesia is useful to treat a surgical site with extensive hard scars,whereas local anesthesia is useful for adjusting tension in an awake *** indication for wide-awake surgery is yet to be established;our method of combining general and local anesthesia in the tenolysis procedure illustrates the possibilities in expanding this method.

关键词： General anesthesia Ilizarov technique Tendons Carpectomy

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Protocol liver biopsy is the only examination that can detect mid-term graft fibrosis after pediatric liver transplantation

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World Journal of Gastroenterology 2014年第21期20卷 6638-6650页

作者： Yukihiro Sanada Koshi matsumoto Taizen Urahashi Yoshiyuki Ihara taiichi Wakiya Noriki Okada Naoya Yamada Yuta Hirata Koichi Mizuta Department of Transplant Surgery Jichi Medical UniversityTochigi 329-0498Japan Department of Clinical Pathology Ebina General HospitalKanagawa Prefecture 243-0433Japan

AIM:To assessed the clinical significance of protocol liver biopsy(PLB)in pediatric liver transplantation(LT).METHODS:Between July 2008 and August 2012,89and 55 PLBs were performed in pediatric patients at two and five years after LT,*** assessed the histopathological findings using the Metavir scoring system,including activity(A)and fibrosis(F),and we identified factors associated with scores of≥A1 and≥*** results clarified the timing and effectiveness of ***:The incidences of scores of≥A1 and≥F1 were 24.7%and 24.7%,respectively,at two years after LT and 42.3%and 34.5%,respectively,at five *** risk factors in a multivariate analysis of a score of≥A1 at two years included≥2 h ofcold ischemic time,no acute cellular rejection and an alanine amino transaminase(ALT)level of≥20 IU/L(P=0.028,P=0.033 and P=0.012,respectively);however,no risk factors were identified for a score of≥***,no independent risk factors associated with scores of≥A1 and≥F1 at five years were identified using multivariate analysis.A ROC curve analysis of ALT at two years for a score of≥A1 demonstrated the recommended cutoff value for diagnosing≥A1 histology to be 20 IU/*** incidence of scores of≥A2 or≥F2 at two years after LT was 3.4%(three cases),and all patients had an absolute score of≥*** contrast to that observed for PLBs at five years after LT,the incidence of scores of≥A2 or≥F2 was 20.0%(11 cases),and all patients had an absolute score of≥*** all cases,the dose of immunosuppressants was increased after the PLB,and all ten patients who underwent a follow-up liver biopsy improved to scores of≤A1 or ***:PLB at two years after LT is an unnecessary examination,because the serum ALT level reflects portal *** addition,immunosuppressive therapy should be modulated to maintain the ALT concentration at a level less than 20 IU/*** at five years is an excellent examination for the detection of early reversible graft fibrosis bec

关键词： Protocol liver biopsy Graft fibrosis Immunosuppres

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