A Novel Surgical Technique Using a Hockey Stick-Like Guided Knife to Go Through the Eyes of a Needle for Trigger Finger.

Trigger finger surgery is primarily managed with open surgery accompanied by 10-14 days of postoperative recovery, which may interrupt activities of daily living. In the past, we attempted to perform percutaneous surgery by inserting a hockey stick-shaped guide knife through a scalpel incision several millimeters long. Sometimes, we encounter difficult cases wherein triggering does not disappear despite repeated attempts to release the A1 pulley through the small incision, thus forcing us to extend the incision. As a result, the postoperative recovery is sometimes prolonged. We describe our experience using a novel percutaneous procedure in which a guide knife was inserted through one or two 20-gauge needle holes, instead of a scalpel skin incision, to release the A1 pulley. We describe a new method that minimizes skin and soft tissue damage and reliably shortens posttreatment recovery.

Physiological effects of γ-linolenic acid and sesamin on hepatic fatty acid synthesis and oxidation.

Interrelated effects of γ-linolenic acid (GLA) and sesamin, a sesame lignan, on hepatic fatty acid synthesis and oxidation were examined. Rats were fed experimental diets supplemented with 0 or 2 g/kg sesamin (1:1 mixture of sesamin and episesamin) and containing 100 g/kg of palm oil (saturated fat), safflower oil rich in linoleic acid, or oil of evening primrose origin containing 43% GLA (GLA oil) for 18 days. In rats fed sesamin-free diets, GLA oil, compared with other oils, increased the activity and mRNA levels of various enzymes involved in fatty acid oxidation, except for some instances. Sesamin greatly increased these parameters, and the enhancing effects of sesamin on peroxisomal fatty acid oxidation rate and acyl-CoA oxidase, enoyl-CoA hydratase and acyl-CoA thioesterase activities were more exaggerated in rats fed GLA oil than in the animals fed other oils. The combination of sesamin and GLA oil also synergistically increased the mRNA levels of some peroxisomal fatty acid oxidation enzymes and of several enzymes involved in fatty acid metabolism located in other cell organelles. In the groups fed sesamin-free diets, GLA oil, compared with other oils, markedly reduced the activity and mRNA levels of various lipogenic enzymes. Sesamin reduced all these parameters, except for malic enzyme, in rats fed palm and safflower oils, but the effects were attenuated in the animals fed GLA oil. These changes by sesamin and fat type accompanied profound alterations in serum lipid levels. This may be ascribable to the changes in apolipoprotein-B-containing lipoproteins.