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BACKGROUND: Superficial siderosis (SS) results from chronic bleeding in the subarachnoid space. SS can be classified as infratentorial SS (i-SS) and supratentorial SS (s-SS). The cochlear modiolus (CM) normally shows low signal intensity (SI) on Tl-weighted images (T1WI). We noticed persistently high SI of the CM on unenhanced thin-sliced T1WI in patients with i-SS. The purpose of this study was to evaluate the correlation between SS and high SI of the CM on unenhanced T1WI. METHODS: This retrospective study analyzed three cases with i-SS, eight cases with s-SS, and 23 normal controls (NC) evaluated on unenhanced thin-sliced T1WI with a three-dimensional spoiled gradient-recalled echo sequence. CM-T1SI scores of 0, 1, and 2 indicated low, iso, and high SI, respectively. In cases with scores of 2 evaluated several times, all scores were reviewed for each case. The CM-T1SI ratio was defined as the contrast ratio between the CM and the cerebellum. Differences between the three groups were statistically analyzed based on the CM-T1SI score and ratio. Receiver operative curve (ROC) analysis was used to determine the cut-off values for differentiating the i-SS group from the NC group based on the CM-T1SI ratio. RESULTS: Two patients with i-SS had a score of 2 on all evaluations. The CM-T1SI score and ratio differed significantly between the i-SS and NC groups. The accuracy of the CM-T1SI ratio for discriminating i-SS from NC was 98.9% at a cutoff value of 0.628. CONCLUSION: High SI of the CM on unenhanced TIWI can be an additional characteristic finding of i-SS.

Additional file 1: Supplemental Data 1. The 18-month and 36-month developmental checkups in Japan. Supplemental Data 2. Screening tools. Supplemental Data 3. Screening criteria in the Hirosaki Five-year-old Study. Supplemental Data 4. Detailed demographic information about study participants. Supplemental Data 5. Statistical methods for computing the adjusted prevalence for ASD. Supplemental Data 6a. Trend of 5-year cumulative incidence of ASD from the year 2013 - the year 2016. Supplemental Data 6b. Trend in Cumulative Incidence of ASD from 2013-2016. Supplemental Data 7. The census data reporting the number of children who moved out of Hirosaki city from 2015 – 2019.

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Background and study aims : To compare the clinical outcome of double-balloon colonoscopy (DBC) with conventional colonoscopy (CC) for colon evaluation performed by an unskilled colonoscopist. Patientes and methods : Between June 2008 and November 2008, 1544 colonoscopies were performed in our hospital. Fifty-eight patients, (29 male and 29 female ; 19-86 years; mean age, 63 years) involving 60 intubations, were enrolled in this study and were assigned randomly to the DBC or CC group. One first-year GI fellow was enrolled and performed these 60 consecutive colonoscopies (30 DBCs, 30 CCs). Completion rate of colonoscopy, cecal intubation time, and rate of analgesic agent usage were analyzed. Results : Completion of DBC was 100% (30/30), while completion of CC was 73% (22/30). There was a statistically significant difference (p < 0.05). The mean cecal intubation time was 36.2 ± 14.4 minutes (DBC) and 36.5 ± 15.2 minutes (CC). There was no statistically significant difference. Analgesic agent was used with 19 intubations (63%) (DBC) and with 27 intubations (90%) (CC) (p < 0.05). Conclusions : For inexpert endoscopists, using DBC has a higher rate of effectiveness than using CC and can decrease the discomfort of patients during colonoscopic procedures., 【目的】最近日本では大腸癌の罹患率が急速に増加しており，前癌病変の早期発見早期治療が望まれる．しかし，内視鏡医にとって，通常内視鏡を使用し盲腸まで難なく到達できるようになるまでには，訓練が必要である．又，訓練を積んだ内視鏡医においても，盲腸までの挿入到達率は平均90-95％と言われている．そこで我々は，特定の一人の初心者内視鏡医に，通常大腸内視鏡とダブルバルーン大腸内視鏡の両方を使用させ，挿入成績に関して検討を行った．【方法】施行医は，初心者内視鏡医1 名．対象は，2008年6月から2008年11 月の間に，麻生飯塚病院消化器内科に来院した患者58 人60 例（男29 人，女29 人；19 - 86 歳，平均年齢63歳）．施行前にコンピューターでランダムに，(A）ダブルバルーン大腸内視鏡（B）通常大腸内視鏡，に割付けし，その挿入成績を検討した．【結果】各々の内視鏡での盲腸挿入成績は，(A）100％（30/30 例）(B）73％（22/30 例）と両群間に差を認めた．盲腸までの挿入時間は，(A）平均36.2± 14.4分（B）平均36.5± 15.2分であり，有意差は認めなかった．検査中患者が苦痛を感じ，鎮静剤を使用した場合は，(A）63％（19/30例）(B）90％（27/30例）で，両群間に差を認めた．ダブルバルーン大腸内視鏡を使用することで，全例が挿入可能であり，苦痛度の軽減が得られた．全ての症例で偶発症はなかった．【結論】ダブルバルーン大腸内視鏡を使用することにより，初心者内視鏡医でも容易に盲腸への到達が可能であり，安全で苦痛の少ない内視鏡検査が可能になると思われた．