Efficacy of a new hemostatic device, Adapty , after transradial coronary angiography and intervention.

A novel hemostatic device, Adapty (Medikit, Tokyo, Japan), was developed to achieve effective and comfortable hemostasis following transradial procedures. The device consists of a pad fixed to a transparent plastic plate and a self-adhesive strap. The catheter sheath is removed from the radial artery after the pad has been positioned precisely over the puncture site, with the strap attached to the plate. Compression pressure then is adjusted with the self-adhesive strap, as is required with occlusive clamps. Patients do not need to maintain hyperextension of the wrist after the procedure. The wrist can be mobilized immediately after application. The efficacy of Adapty was evaluated in prospective observations of 200 patients. The device was successfully applied in all patients immediately after sheath removal. No patient required interruption of compression because of pain, congestion or ischemia. Complete hemostasis was obtained in 199 patients (99.5%), and the device caused no vascular complications. This study demonstrates that Adapty is highly effective for achieving hemostasis after transradial procedures.

Reduction malarplasty.

One of the most frequently requested facial contour improvement procedures in the Orient is reduction malarplasty. However, until recently, osteotomies in the malar region have been performed by means of a coronal incision that required a larger incision and more invasive procedure than many patients are comfortable with when considering an elective cosmetic surgical procedure. We have developed a reduction malarplasty method to improve facial contours that circumvents the drawbacks inherent in the conventional method. In our method, the protrusion in the cheekbone area is corrected by performing an osteotomy of the zygoma through an intraoral incision and an osteotomy of the zygomatic arch through a small preauricular incision.

Evaluation of cytotoxicity of calcium phosphate cement consisting of alpha-tricalcium phosphate and dicalcium phosphate dihydrate.

A newly developed calcium phosphate cement, MM, was evaluated for tissue irritability by means of cell cultures. In this study, MM showed extensive mild cytotoxicity compared with other cements before setting. Inhibition of adhesion of L-929 cells was not observed after contact with MM for 24 hours. The influence of MM on colony formation was approximately the same as that of another calcium phosphate cement and less than that of a glass ionomer cement. Toxicity of MM after setting was compared with four cements; another calcium phosphate cement, glass ionomer cement, silicate cement and zinc oxide eugenol cement, but MM showed the least influence on cell morphology. Judging from these results, MM appears to be less cytotoxic than the cements in current use.

[Kleeblattschädel syndrome--a case report].

The Kleeblattschädel syndrome is a type of craniofacial dysostosis having a trilobar deformity of the skull associated with congenital hydrocephalus. We present here a case of the anomaly which we operated on a patient for cranial correction and orbital decompression. The case is a 2-month-old female who was born after 40 week-gestation by spontaneous vaginal delivery with cephalic presentation and observed no abnormality in her vital signs. She was transferred to a neonatal intensive care unit because of her trilobar deformity of the head and severe proptosis. Plain X-ray films of the skull indicated a number of digital markings at the calvarium. The triobar configuration was formed by symmetrical outward protrusion of the bilateral temporal squama and bulging the vertex which made a high valt. The coronal and lambdoid sutures which were prematurely closed together could not be distinguished individually. Both sides of temporal squama were found to be quite thin. She had severe shallow orbit due to the maxillary hypoplasia. A ventriculomegaly was seen in CT scan. Cranial corrections were took place in two stages. A V-P shunt was also done. The first surgery was conducted at three months old for advancing the bifrontal part and decompression of the orbits. Bilateral frontal bone was removed by craniectomy cutting along with both sides of the prematurely closed coronal suture in the back and to the supraorbital ridge in the front after making bicoronal scalp incision on supine position.(ABSTRACT TRUNCATED AT 250 WORDS)

A case report of equivocal neoplasm originating from an apocrine gland on the eyelid.

We report a rare case of apocrine neoplasm with malignant potential. The patient, a 29-year-old man, had a nodule 1 cm in diameter on his left upper eyelid which had been growing slowly for several years. It was a cystic lesion, consisting of neoplastic cells of probable apocrine gland or Moll's gland origin. This opinion was based on the histological characteristics, which included eosinophilic cytoplasm accompanied with decapitation secretion, iron granules, and granular depositions which were stained positively with periodic acid-Schiff, with and without diastase digestion. Ferritin was found in their cytoplasm, a feature that has not been reported. It was uncertain whether the neoplasm was benign or malignant, because the cells showed nuclear atypia, characterized by variation in size and hyperchromasia, but lacked the histological features of malignancy, including infiltration into the adjacent tissue and mitosis.

Limitations of successive transradial approach in the same arm: the Japanese experience.

The transradial approach (TRA) has been used for diagnostic and interventional cardiology. It has not previously been determined how many times the same radial artery can be cannulated without complications. A total of 812 patients (502 men and 310 women) underwent angiography or angioplasty via the TRA between 1997 and 1999 at our institution with a total of 1,438 procedures. Sheaths were 5 (55%) or 6 Fr (45%). Dropout rates of 3.5% and 7.9% were found at the second TRA attempt in the men and the women, respectively. Of the 62 TRA failures, 56 (90%) were due to narrowing or occlusion of the radial artery after the previous TRA procedure. A third TRA procedure was possible in 90% of the men and 80% of the women. A fifth TRA procedure was possible in 70% of the men and 50% of the women. The dropout rates for TRA increased as successive punctures were performed. This was primarily due to vessel narrowing and occlusion occurring as a function of multiple punctures.