Objective To evaluate the clinical and functional results of a technical procedure in the surgical treatment of congenital radioulnar synostosis in children. Materials and methods A prospective study had been undertaken from January 1992 to December 2004. Thirtyfour patients with congenital radioulnar synostosis that are fixed in pronation were recruited. Congenital radioulnar synostosis was classified for two types according to Tachdjian's criteria. All patients were treated by resection of the proximal radius and the distal ulna to remove a segmental bone of both parts of the forearm. After K-wires are inserted intramedullarly into both bones, the forearm is derotated manually, followed by cast immobilization. Results There were 34 patients (52 forearms) with congenital radioulnar synostosis, whom the average age at surgery was 6 years and 3 months. There were two types of congenital radioulnar synostosis: Type 1 in six forearms (11.6%) and Type 2 in 46 forearms (88.4%). The preoperative forearm rotation ranged from 65°to 85°pronation. The postoperative forearm rotation angle was corrected from 0°to 30°; the best end position appears to be 70-100% of pronation. Of the patients, 78.8% had good or excellent results. All patients were operated on without complications; five patients had loss of correction during cast immobilization. Overall, the patient's ability to perform daily activities showed a marked improvement after surgery.Conclusion This method is a simple and safe technique to derotate the forearms of patients with congenital radioulnar synostosis that are fixed in pronation.
Perfluorooctanoic acid (PFOA) has recently attracted attention as a potential health risk following environmental contamination. However, information detailing exposure to perfluorinated carboxylic acids (PFCAs) other than PFOA is limited. We measured the concentrations of PFCAs (from perfluorohexanoic acid to perfluorotetradecanoic acid) in serum samples obtained from patients in Japan (Sendai, Takayama, Kyoto and Osaka) between 2002 and 2009, Korea (Busan and Seoul) between 1994 and 2008 and Vietnam (Hanoi) in 2007/2008. Total PFCA levels (geometric mean) were increased from 8.9 ng mL(-1) to 10.3 ng mL(-1) in Japan; from 7.0 ng mL(-1) to 9.2 ng mL(-1) in Korea; and were estimated at 4.7 ng mL(-1) in Vietnam. PFCAs of greater length than PFOA were significantly increased in Sendai, Takayama and Kyoto, Japan, and levels of long-chain PFCAs exceeded PFOA levels in serum. Among these PFCAs, perfluoroundecanoic acid (PFUnDA) was the predominant component (28.5%), followed by perfluorononanoic acid (PFNA 17.5%), perfluorodecanoic acid (PFDA 7.9%), perfluorotridecanoic acid (PFTrDA 6.1%) and perfluorododecanoic acid (PFDoDA 1.8%). Odd-numbered PFCAs (PFNA, PFUnDA and PFTrDA) were also observed in Korea and Vietnam and their presence increased significantly in Korea between 1994 and 2007/2008. The proportion of long-chain PFCAs in serum was relatively high compared to reports in Western countries. Further investigations into the sources and exposure routes are needed to predict the future trajectory of these serum PFCA levels.
Environmental specimen banks are an essential part of the infrastructure of environmental sciences. They have various functions: (1) evaluation of governmental environmental policy-making and regulations; (2) a resource for animal health evaluation; (3) research tools to investigate time trends in ecosystems; (4) detection of newly emerging chemicals in the time trends; (5) validations of computer models for environmental phenomena; (6) source identification of contaminants; (7) a tool for food safety; (8) evaluation of genetic selection pressure due to environmental changes. In this review paper, we present a detailed description of the Kyoto University Human Specimen Bank (history, protocol and questionnaires) and provide brief outlines of other representative environmental specimen banks. We then review two illustrative cases in which environmental specimen banks have unveiled insidious contaminations of polybrominated diphenyl ethers and perfluorooctanoic acids. Finally, we give a perspective of new functions for environmental specimen banks in the next 20 years.Keywords Environmental specimen banks Á Food duplicate sample Á Human breast milk Á Human blood
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