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Activity concentrations in food and drink, represented by water and vegetables, have been monitored continuously since the Fukushima Daiichi Nuclear Power Plant accident, with a focus on radioactive cesium. On the other hand, iodine-131 was not measured systematically in the early phase after the accident. The activity concentrations of iodine-131 in food and drink are important to estimate internal exposure due to ingestion pathway. When the internal dose from ingestion in the evacuation areas is estimated, water is considered as the main ingestion pathway. In this study, we estimated the values of activity concentrations in water in the early phase after the accident, using a compartment model as an estimation method. The model uses measurement values of activity concentration and deposition rate of iodine-131 onto the ground, which is calculated from an atmospheric dispersion simulation. The model considers how drinking water would be affected by radionuclides deposited into water. We estimated the activity concentrations of water on Kawamata town and Minamisouma city during March of 2011 and the committed effective doses were 0.08 mSv and 0.06 mSv. We calculated the transfer parameters in the model for estimating the activity concentrations in the areas with a small amount of measurement data. In addition, we estimated the committed effective doses from vegetables using atmospheric dispersion simulation and FARMLAND model in case of eating certain vegetables as option information.

The Fukushima Daiichi Nuclear Power Plant accident caused a release of radionuclides. Radionuclides were deposited on the ground not only in Fukushima prefecture but also in nearby prefectures. Since the accident, measurement of radiation in environment such as air dose rate and deposition density of radionuclides has been performed by many organizations and universities. In particular, Japan Atomic Energy Agency (JAEA) has been performing observations of air dose rate using a car-borne survey system continuously and over wide areas. In our study, using the data measured by JAEA, we estimated effective dose from external exposure in the six prefectures adjacent to Fukushima prefecture. Since car-borne survey was started a few months later after the accident, measured air dose rate in this method is mainly contributed by 137Cs and 134Cs whose half-lives are relatively long. Therefore, based on air dose rate of 137Cs and 134Cs and the ratio of deposition density of short-half-life nuclides to that of 137Cs and 134Cs, we also estimated effective dose contributed from not only 137Cs and 134Cs but also other short-half-life nuclides. We compared the effective dose estimated by the method above with that of UNSCEAR and measured data using personal dosimeters in some areas.

TAS‐303 (4‐piperidinyl 2,2‐diphenyl‐2‐[propoxy‐1,1,2,2,3,3,3‐d7] acetate hydrochloride) is a novel selective noradrenaline reuptake inhibitor being developed for the treatment of stress urinary incontinence. An in vitro study and a physiologically based pharmacokinetic model simulation showed that TAS‐303 had inhibitory potential against cytochrome P450 (CYP) 3A. This open‐label, single‐group study investigated the effect of TAS‐303 on CYP3A activity by evaluating the pharmacokinetics (PK) of single‐dose oral simvastatin 5 mg or intravenous midazolam 1 mg after repeated oral administration of TAS‐303 3 mg in 12 healthy participants. TAS‐303 plus simvastatin resulted in a 1.326‐fold and a 1.420‐fold increase of simvastatin in peak plasma concentration and area under the plasma concentration‐time curve from time zero to time t, where t is the final time of detection (AUC0‐t), respectively. The addition of midazolam resulted in a 1.090‐fold increase in the midazolam AUC0‐t. TAS‐303 had a weak PK interaction with simvastatin but no apparent interaction with midazolam. TAS‐303 at 3 mg/day is a weak inhibitor of intestinal but not hepatic CYP3A activity. No clinically important safety concerns related to TAS‐303 were raised. [ABSTRACT FROM AUTHOR]

Massive release of radioactive materials into the atmosphere occurred due to the Fukushima Daiichi Nuclear Power Station (FDNPS) accident in March 2011. The World Health Organization (WHO) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) reported the results of dose estimation to assess the health effect of the accident and both reports state that their assessments of internal and external exposure doses contain certain uncertainties due to uncertainties inherent to the basic data. Therefore, estimation of the internal dose from tap water was conducted in this study by utilizing a database of deposition calculated by an atmospheric transfer, dispersion and deposition model (ATDM) in conjunction with the newly obtained data on the volume of daily water intake obtained by a web-based survey. The median mean and 95-percentile of thyroid equivalent doses were estimated for 1-year and 10-year children and adults in 12 municipalities in the evacuation area in Fukushima prefecture. The present mean thyroid dose estimations for 1-year children (0.4–16.2 mSv) are smaller than the corresponding values in the UNSCEAR 2013 report (1.9–49 mGy). Dose-modifying factors in the Japanese or local community are discussed. [ABSTRACT FROM AUTHOR]

• Changes in nine chemicals in manuka honey by thermal treatments were analyzed. • Methylglyoxal (MGO) and 2′-methoxyacetophenone (MAP) were lost by high heating. • MGO was lost by generation of adducts with l -proline, lysine, and arginine residues. • MAP was released in the gaseous form into the headspace on heating. Reports on the thermal stability of manuka honey in terms of food processing have been few. This study investigated changes in nine characteristic chemicals of manuka honey during heating. Among these, methylglyoxal (MGO) and 2′-methoxyacetophenone (MAP) were significantly decreased by heating at 90 °C. To elucidate the mechanism for this decrease, artificial honey was prepared from sugars and water with MAP or MGO and then heated. The decrease of MGO was enhanced with l -proline, lysine, or arginine derivatives, accompanied by formation of 2-acetyl-1-pyrroline, MGO-derived lysine dimer, or argpyrimidine, respectively, suggesting that an amino–carbonyl reaction is one pathway for the loss of MGO. The decrease of MAP in the artificial honey depended on the volume of headspace in a vessel. MAP from heated manuka honey was also detected in the gas phase, indicating that MAP was vaporized. Heating could thus reduce the beneficial and/or signature molecules in honey. [ABSTRACT FROM AUTHOR]

Background: Transsacral epiduroscopic laser decompression (SELD) is a very noninvasive surgery, so it is effective for elderly patients and athletes and is a new and minimally invasive therapeutic technique that may be useful in many patients with discogenic low-back pain (LBP) having high signal intensity zone (HIZ) in magnetic resonance imaging (MRI). We investigated the clinical outcomes of SELD in Japanese patients with discogenic LBP having HIZ as a first trial. Methods: The subjects consisted of 52 patients who underwent SELD and were followed up for at least 6 months. All patients with LBP with HIZ were operative using the SELD technique. Outcomes of the patients were assessed with visual analogue scale (VAS) for LBP, the Oswestry disability index (ODI), and the EuroQol 5 dimension (EQ-5D). Statistical analyses were carried out using a paired t -test. A p -value of <0.05 was considered significant. For statistical analysis, we used the SPSS software program. Results: At 12 months after the procedure, the average VAS score for LBP fell to 1.2 from 5.6 ( p -value <0.05). The ODI score also dropped from the preoperative level of 22.3 to 8.8. The EQ-5D score also significantly increased from the preoperative level of 0.865 (SD 0.10) to 0.950 (SD 0.05). Eight cases of intraoperative cervical pain were observed as complications with no cases of hematomas, infections, and postoperative neurosis was observed. Conclusions: SELD provides a novel minimally invasive technique capable of performing multilevel intervertebral surgery. We believe that SELD is an effective method of treating discogenic LBP due to HIZs.

Leptosperin (methyl syringate β-d-gentiobioside) is abundantly found in manuka honey, which is widely used because of its antibacterial and possible anti-inflammatory activities. The aim of this study was to examine the molecular mechanism underlying the metabolism of leptosperin. Five phytochemicals (leptosperin, methyl syringate (MSYR), glucuronate conjugate of MSYR (MSYR-GA), sulfonate conjugate of MSYR (MSYR-S), and syringic acid (SYR)) were separately incubated with HepG2 and Caco-2 cells. After incubation, we found that the concentration of MSYR decreased, whereas the concentrations of SYR, MSYR-GA, and MSYR-S increased. By profiling with inhibitors and carboxylesterases (CES1, 2), we found that the conversion from MSYR to SYR was mediated by CES1. Lipopolysaccharide-stimulated RAW264.7 cells restored MSYR-GA to MSYR possibly by the secreted β-glucuronidase. All of the mice administered with leptosperin, MSYR, or manuka honey showed higher MSYR (13.84 ± 11.51, 14.29 ± 9.19, or 6.66 ± 2.30 nM) and SYR (1.85 ± 0.66, 6.01 ± 1.20, or 8.16 ± 3.10 nM) levels in the plasma compared with that of the vehicle controls (3.33 ± 1.45 (MSYR) and 1.85 ± 0.66 (SYR) nM). The findings of our study indicate that the unique metabolic pathways of these compounds may account for possible functionalities of manuka honey.

In March 2011, the Fukushima Daiichi Nuclear Power Plant Accident occurred and a large amount of radionuclides was released. To study its effect, we estimated the internal exposure due to intake of tap water in the early phase after the accident. As the number of measured values of tap water following the accident was limited, 131I concentration in tap water was estimated by 1-compartment model using the deposition amount of radionuclides calculated by an atmospheric transport, dispersion and deposition simulation. The internal doses for the evacuees were estimated by assuming representative evacuation patterns, and the internal doses for the non-evacuees were estimated for each municipal government. In the evacuation areas, the maximum of thyroid equivalent dose of 1- and 10-year-old children and adults were 22, 11 and 4.7 mSv, respectively. The maximum of thyroid equivalent dose of those three groups in the non-evacuation areas were 9.5, 4.7 and 2.0 mSv, respectively.

As a result of the nuclear accident at the Fukushima Daiichi nuclear power station (FDNPS) after the Great East Japan Earthquake on March 11, 2011, volatile radionuclides including iodine-131 were released into the environment and contaminated open-field vegetables, raw milk, tap water, etc. It is important for the health care of residents to correctly comprehend the level of their exposure to radioactive substances released following the accident. However, an evaluation of the internal exposure doses of residents of Fukushima Prefecture as a result of the ingestion of foods, which is indicated in the report issued by United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR)1 is based on a number of assumptions. For instance, the estimation assumes that foods were ingested as usual, without regard to the places to which residents were evacuated after the accident, the places where food shipment restrictions were imposed, and so forth. The present report aims to improve the accuracy of estimation of the amount of food actually ingested at evacuation areas, in order to reduce as much as possible the level of uncertainty in conventional values estimated directly after the accident, which were in fact values based on conservative assumptions. More concretely, as basic source material to more accurately estimate internal exposure doses from food ingestion, various patterns of evacuation and dietary habits at the time of the accident of the residents of 13 municipalities in Fukushima Prefecture who were evacuated during the period from directly after the accident of March 11, 2011 until the end of March are clarified in this report. From survey results, most of the food that evacuees took immediately after the accident was confirmed to have been sourced from either stockpiles prepared before the accident, or relief supplies from outside of the affected areas. The restriction orders of food supplies such as contaminated vegetables and milk, and tap water intake were implemented within several days after the major release of radionuclides on March 15, 2011. In addition, collapse in supply chains, i.e., damage to distribution facilities, lack of transportation vehicles or electricity, and the closure of retail stores, contributed to a situation where food or supplies contaminated with iodine -131 were not consumed in large quantities in general, even before the food restriction order. Since people consumed tap water and water from other sources before the implementation of restriction orders in affected areas, we surveyed the status of water as a potential route of internal exposure.

Background and Object: Microendoscopic discectomy (MED) is still regarded as contraindicated for the treatment of recurrent lumbar disc herniation by many surgeons. Moreover, the presence of epidural scar tissue makes surgical manipulation difficult. To successfully remove the herniated disc in such cases, an open technique with a wide exposure may be required. We devised a new minimally invasive endoscopic approach, which is using a transosseous route. This is a retrospective review of a consecutive case series to examine the operative and clinical results of this new approach., Material and Methods: Fifty-seven patients who underwent surgery for recurrent lumbar disc herniation were divided into two groups based on the operative procedure. Thirty patients underwent microendoscopic transosseous discectomy (TD) and 27 underwent MED. We graded operative results and clinical outcomes using the Japanese Orthopaedic Association (JOA) score for low-back pain before surgery and 1 year after surgery and compared the scores of the two groups., Results: No conversion to open procedure was necessary in either group. The mean TD operative time was 89.2 minutes with a mean intraoperative blood loss of 16.5 mL. Mean MED operative time was 92.0 minutes with a mean blood loss of 19.3 mL. There were two dural tears in the MED group, and one tear was combined with a fracture of the inferior articular process. No dural tears occurred in the TD group. No patients in either group had experienced re-recurrence of lumbar disc herniation at the time of the last follow-up. The JOA score improved significantly after surgery in both groups (p < 0.001)., Conclusion: TD is a safe and effective surgical approach for the treatment of recurrent lumbar disc herniation. Operative time, intraoperative blood loss, and clinical results compare favorably with MED., (Georg Thieme Verlag KG Stuttgart · New York.)

Study Design: A retrospective study., Purpose: To examine the effectiveness of using an electrodiagnostic technique as a new approach in the clinical diagnosis of extraforaminal stenosis at L5-S1., Overview of Literature: We introduced a new effective approach to the diagnosis of extraforaminal stenosis at the lumbosacral junction using the existing electrophysiological evaluation technique., Methods: A consecutive series of 124 patients with fifth lumbar radiculopathy were enrolled, comprising a group of 74 patients with spinal canal stenosis and a second group of 50 patients with extraforaminal stenosis at L5-S1. The technique involved inserting a pair of needle electrodes into the foraminal exit zone of the fifth lumbar spinal nerves, which were used to provide electrical stimulation. The compound muscle action potentials from each of the tibialis anterior muscles were recorded., Results: The distal motor latency (DML) of the potentials ranged from 11.2 to 24.6 milliseconds in patients with extraforaminal stenosis. In contrast, the DML in patients with spinal canal stenosis ranged from 10.0 to 17.2 milliseconds. After comparing the DML of each of the 2 groups and at the same time comparing the differences in DML between the affected and unaffected side of each patient, we concluded there were statistically significant differences (p<0.01) between the 2 groups. Using receiver operating characteristic curve analysis, the cutoff values were calculated to be 15.2 milliseconds and 1.1 milliseconds, respectively., Conclusions: This approach using a means of DML measurement enables us to identify and localize lesions, which offers an advantage in diagnosing extraforaminal stenosis at L5-S1.

Object: The authors undertook this study to document the clinical outcomes of microendoscopic laminotomy, a minimally invasive decompressive surgical technique using spinal endoscopy for lumbar decompression, in patients with lumbar spinal stenosis (LSS)., Methods: A total of 366 patients were enrolled in the study and underwent microendoscopic laminotomy between 2007 and 2010. Indications for surgery were single- or double-level LSS, persistent neurological symptoms, and failure of conservative treatment. Microendoscopy provided wide visualization through oblique lenses and allowed bilateral decompression via a unilateral approach, through partial resection of the base of the spinous process, thereby preserving the supraspinous and interspinous ligaments and contralateral musculature. Clinical symptoms and signs of low-back pain were evaluated prior to and following surgical intervention by applying the Japanese Orthopaedic Association (JOA) scoring system, Roland-Morris Disability Questionnaire (RMDQ), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and 36-Item Short Form Health Survey (SF-36). These items were evaluated preoperatively and 2 years postoperatively., Results: Effective circumferential decompression was achieved in all patients. The 2-year follow-up evaluation was completed for 310 patients (148 men and 162 women; mean age 68.7 years). The average recovery rate based on the JOA score was 61.3%. The overall results were excellent in 34.9% of the patients, good in 34.9%, fair in 21.7%, and poor in 8.5%. The mean RMDQ score significantly improved from 11.3 to 4.8 (p < 0.001). In all categories of both JOABPEQ and SF-36, scores at 2 years' follow-up were significantly higher than those obtained before surgery (p < 0.001). Twelve surgery-related complications were identified: dural tear (6 cases [1.9%]), wrong-level operation (1 [0.3%]), transient neuralgia (4 [1.3%]), and infection (1 [0.3%]). All patients recovered, and there were no serious postoperative complications., Conclusions: Microendoscopic laminotomy is a safe and very effective minimally invasive surgical technique for the treatment of degenerative LSS.

Study Design: A clinical case using a new surgical technique is reported., Objective: To report for the first time an endoscopically assisted anterior screw fixation for the Type II odontoid fracture., Summary of Background Data: Recently, many endoscopically assisted surgeries have been performed for various spinal surgery because of its minimally invasive character. However, the anterior retropharyngeal approach to the upper cervical spine using endoscopy has not been reported., Methods: A 76-year-old man was operatively managed for a Type II odontoid fracture. The operation was performed under immobilization of cervical spine using a halo vest apparatus. A skin incision 2 cm long was made on the medial border of the right sternocleidomastoid muscle at the C5-C6 intervertebral level. Blunt dissection between the neurovascular bundle laterally and the trachea and esophagus medially was performed. A processed polyethylene syringe (volume, 10 mL) was used as the tubular retractor. This retractor kept the minimum but sufficient space for the screw fixation and avoided esophageal complication. Using a cannulated screw system, a cancellous screw was inserted from the anteroinferior edge of the C2 vertebral body to the tip of the odontoid process. The drilling and the screwing process was monitored by a two-dimensional image intensifier. The entry point was monitored by endoscopy to avoid soft tissue involvement as well., Results: The operation was completed without any soft tissue complications such as esophageal injury. The blood loss was 30 mL. The procedure resulted in nonunion, partially because of patient's old age or an entry point 2 mm above the anterior caudal margin of the C2 body retrospectively., Conclusions: Although the reported odontoid fracture ended in nonunion, the authors believe their modification of the approach using an endoscope made anterior screw fixation for the odontoid fracture safer and less invasive than the original anterior retropharyngeal approach.