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Burns J.E.,University of California at Irvine | Tanaka T.,Kikkoman General Hospital | Ueno T.,Cancer Institute Hospital | Nakamura T.,Keio University | Yoshioka H.,University of California at Irvine
Radiographics | Year: 2011

Diagnosis of injuries to the ligamentous structures of the wrist can be a challenge, particularly when there is involvement of the small, complex structures of the proximal wrist. Recent advances in magnetic resonance (MR) imaging, especially in spatial and contrast resolution, have facilitated more precise visualization of these structures. However, there are a number of pitfalls that may cause difficulty in diagnosis of injuries to the triangular fibrocartilage complex (TFCC), lunotriquetral ligament, and scapholunate ligament. Use of inappropriate MR imaging sequences and MR imaging artifacts may decrease the accuracy of diagnosis of injuries to the TFCC and wrist ligaments, whereas variant anatomy of the proximal wrist structures may mimic disease of the TFCC and wrist ligaments. Knowledge of the detailed anatomy of the wrist, as well as variant patterns of structure morphology and signal intensity, can help differentiate actual disease from normal or variant appearances at assessment with MR imaging. ©RSNA, 2011.

Murai S.,Ichihara Hospital | Tanaka T.,Kikkoman General Hospital | Aoki M.,Sapporo Daiichi Hospital
Journal of Orthopaedic Research | Year: 2012

In this study, we observed a combinatorial relationship between intrinsic and extrinsic muscles to extend the distal phalanx via the terminal tendon of the finger extensor. Eleven fresh-frozen human cadaver digit rays were used in these experiments (four index, four middle, three ring digits). All fingers had full joint motion without degenerative diseases. Fingers were individually mounted in a custom built jig fixed by a 1-mm Kirschner wire that was driven into the rotational center of the distal interphalangeal (DIP) and proximal interphalangeal joints. Loads were applied to the extensor digit and dorsal interosseous tendons without flexor tendons, via sutures attached over low-friction pulleys. Extension forces that crossed the DIP joint were measured by a force transducer coupled with a materials-testing machine. We observed a steep inclination of the extensor forces produced by the intrinsic muscles, and there were no significant differences in comparisons among loads (200, 400, 600, and 800 g). The inclination slope increased with an increase of load (p < 0.001). Additionally, the inclinations of the non-linear phases among all finger types were not statistically different. Thus, the contribution between the extrinsic and intrinsic muscles in providing extensor forces to the distal phalanx was similar. © 2011 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Takeuchi R.,University of Tsukuba | Kamada H.,University of Tsukuba | Mishima H.,University of Tsukuba | Mukai N.,University of Tsukuba | And 2 more authors.
Journal of Pediatric Orthopaedics Part B | Year: 2014

MRI findings for 51 hips in 45 pediatric patients (mean age 2.3 years; range, 1.1-4.1 years) with suspected acetabular dysplasia or residual subluxations were analyzed retrospectively. We attempted to predict the growth of osseous acetabulum and future acetabular coverage on MRI performed at 2 years of age. The cut-off value of the cartilaginous angle was 18° for the cartilage acetabular index and 13° for the cartilage center edge angle. However, follow-up assessments to monitor the progress of changes in the congruity between femoral head and acetabular development are important. © Lippincott Williams and Wilkins.

To assess the comparative effectiveness of a monovalent and a pentavalent rotavirus vaccine (RV1 and RV5), a Bayesian network meta-analysis was conducted. Data of randomized trials from the Cochrane Review in 2012 were extracted and synthesized. For the prevention of severe rotavirus disease up to 2 years, no statistical difference was found in the effectiveness between the 2 types of vaccine (odds ratio: 2.23, 95% credible interval: 0.71-5.20). Similarly, the comparative effectiveness of RV1 and RV5 appeared equivalent for other rotavirus-associated outcome measures, such as prevention of severe disease up to 1 year and all severity of rotavirus infections for up to both 1- and 2-year follow-ups. These results indicates that, overall, RV1 and RV5 offer similar benefits to prevent rotavirus diseases; nonetheless, credible intervals are generally wide, highlighting the necessity of further meta-analyses including updated information or, ideally, controlled trials comparing both vaccines directly. © 2014 Landes Bioscience.

Takeuchi M.,Kikkoman General Hospital | Kano H.,Teikyo University | Takahashi K.,Teikyo University | Iwata T.,Tokyo Kasei University
BMJ Open | Year: 2015

Introduction: Use of inhaled corticosteroid (ICS) is the mainstream maintenance therapy for paediatric asthma. Several forms of ICS are available, but the relative effectiveness among ICS has not been well investigated in published, randomised, controlled trials. The paucity of direct comparisons between ICS may have resulted in insufficient estimation in former systematic reviews/meta-analyses. To supplement the information on the comparative effectiveness of ICS for paediatric asthma, we plan to conduct a network metaanalysis that will enable summary of direct and indirect evidence. Methods and analysis: We will retrieve randomised, controlled trials that examined the effectiveness of ICS for paediatric asthma from the PubMed and Cochrane Central Register of Controlled Trials. After one author scans the title and abstract for eligible studies, two authors will independently review study data and assess the quality of the study. Studies of children (≤18 years old) with chronic asthma or recurrent wheezing episodes will be included if they used ICS for ≥4 weeks. We will define a priori core outcomes and supplemental outcomes of paediatric asthma, including exacerbation, healthcare use and pulmonary function. Studies reporting a minimum of one core outcome will be entered into the systematic review. After the systematic review is performed, extracted data of relevant studies will be synthesised in the Bayesian framework using a random-effects model. Ethics and dissemination: The results will be disseminated through peer-reviewed publications and conference presentations. Protocol registration number: UMIN (000016724) and PROSPERO (CRD42015025889).

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