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The Notch signaling pathway has been recognized as a key factor for the pathogenesis of T-cell acute lymphoblastic leukemia (T-ALL), because of the high incidence of activating mutations of Notch1. Notch inhibition could serve as a new treatment strategy for T-ALL; however, the attempts to perturb Notch signaling pathways have been unsuccessful so far. In this study, we found that proteasome inhibitors exert cytotoxic effects on T-ALL cells with constitutive activation of Notch1 to a similar extent as myeloma cells. The proteasome inhibitor bortezomib repressed the transcription of Notch1 and downstream effectors including Hes1, GATA3, RUNX3 and nuclear factor-κB (NF-κB) (p65 and p50), coincided with downregulation of the major transactivator Sp1 and its dissociation from Notch1 promoter. Overexpression of the Notch1 intracellular domain (NICD) significantly ameliorated bortezomib-induced cytotoxicity against T-ALL cells. Drug combination studies revealed that bortezomib showed synergistic or additive effects with key drugs for the treatment of T-ALL such as dexamethasone (DEX), doxorubicin and cyclophosphamide, which were readily abolished by NICD overexpression. The synergy of bortezomib and DEX was confirmed in vivo using a murine xenograft model. Our findings provide a molecular basis and rationale for the inclusion of proteasome inhibitors in treatment strategies for T-ALL. [ABSTRACT FROM AUTHOR]

t(17;19)-acute lymphoblastic leukemia (ALL) shows extremely poor prognosis. E2A-HLF derived from t(17;19) blocks apoptosis induced by the intrinsic mitochondrial pathway and has a central role in leukemogenesis and chemoresistance. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is expressed on cytotoxic T cells and natural killer cells and binds with death receptors (DR4/DR5), inducing apoptosis by dual activation of intrinsic and extrinsic pathways, and TRAIL mediates the graft-versus-leukemia (GVL) effect after allogeneic stem cell transplantation (allo-SCT). We found that cell lines and patients' samples of t(17;19)-ALL expressed death receptors for TRAIL, and recombinant soluble TRAIL immediately induced apoptosis into t(17;19)-ALL cell lines. E2A-HLF induced gene expression of DR4/DR5, which was dependent on the DNA-binding and transactivation activities of E2A-HLF through the 5′ upstream region of the start site at least in the DR4 gene. Introduction of E2A-HLF into non-t(17;19)-ALL cell line upregulated DR4 and DR5 expression, and sensitized to proapoptotic activity of recombinant soluble TRAIL. Finally, a newly diagnosed t(17;19)-ALL patient underwent allo-SCT immediately after induction of first complete remission, and the patient has survived without relapse for over 3-1/2 years after allo-SCT. These findings suggest that E2A-HLF sensitizes t(17;19)-ALL to the GVL effect by upregulating death receptors for TRAIL. [ABSTRACT FROM AUTHOR]

Aims/objective: Nephropathy, a major complication of diabetes, is the leading cause of end-stage renal disease. Recent studies have demonstrated that podocyte injury is involved in the onset of and progression to renal insufficiency. Here, we describe a novel, highly sensitive ELISA for detecting urinary podocalyxin, a glycoconjugate on the podocyte apical surface that indicates podocyte injury, particularly in the early phase of diabetic nephropathy. Methods: Urine samples from patients with glomerular diseases ( n = 142) and type 2 diabetes ( n = 71) were used to quantify urinary podocalyxin by ELISA. Urine samples were obtained from 69 healthy controls for whom laboratory data were within normal values. Podocalyxin was detected in urine by immunofluorescence, immunoelectron microscopy and western blotting. Results: Morphologically, urinary podocalyxin was present as a vesicular structure; western blotting showed it as a positive band at 165-170 kDa. Levels of urinary podocalyxin were elevated in patients with various glomerular diseases and patients with diabetes. In patients with diabetes, urinary podocalyxin was higher than the cut-off value in 53.8% patients at the normoalbuminuric stage, 64.7% at the microalbuminuric stage and 66.7% at the macroalbuminuric stage. Positive correlations were observed between urinary podocalyxin levels and HbA, urinary β microglobulin, α microglobulin and urinary N-acetyl- β- d-glucosaminidase, although urinary podocalyxin levels were not correlated with other laboratory markers such as blood pressure, lipid level, serum creatinine, estimated GFR or proteinuria. Conclusions/interpretation: Urinary podocalyxin may be a useful biomarker for detecting early podocyte injury in patients with diabetes. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented related to acute lymphoblastic leukemia (ALL).

Objective: This study demonstrates images obtained by (90)Y bremsstrahlung emission computed tomography (BECT), and characterizes the system performance of gamma cameras. Methods: (90)Y BECT images of phantoms were acquired using a gamma camera equipped with a medium energy general purpose parallel-hole collimator. Three energy window widths of 50% (57-94 keV) centered at 75 keV, 30% (102-138 keV) at 120 keV, and 50% (139-232 keV) at 185 keV were set on a (90)Y bremsstrahlung spectrum. The images obtained with three energy windows were reconstructed using filtered back projection (FBP) and ordered subsets expectation maximization (OSEM) methods. The images of the sum window were obtained by fusing the images of the 75, 120, and 185 keV windows. Results: The OSEM method improved the full width at half maximum by 20% and the standard deviation by 9% compared with the FBP method. BECT displayed (90)Y biodistribution and quantified (90)Y activity. BECT images obtained with OSEM method using the 120 keV window showed the highest resolution and lowest uncertainty. The sum window showed the highest sensitivity, while its resolution was 10% inferior to that of the 120 keV window. One whole-body image can be taken over 100 min using the sum window. An absorber to cover the body surface reduced background by 30%. Conclusions: (90)Y BECT imaging can be used for patient assessment without modifying current treatment procedures. [ABSTRACT FROM AUTHOR]

Objective: Improvement in the diagnostic accuracy of lymph node (LN) metastases of colorectal cancer by optimizing the reconstruction parameters was studied, including a phantom study and clinical studies. Methods: In the experimental study, the contrast ratio was evaluated using a standard image quality phantom, changing the iteration number of ordered subsets expectation maximization algorithm from 2 to 6. In the clinical study, 89 patients with preoperative colorectal cancer who received 18F-2-deoxy-2-fluoro-D: -glucose positron emission tomography/computed tomography (PET/CT) were studied. Their LN metastases were visually assessed when systematically changing the iteration number, and the optimal iteration number was determined. After the appropriate cut-off value of maximum standardized uptake value was determined, the improvement of the diagnostic accuracy of LN metastases was evaluated for the proximal nodes and the distal ones using the reconstructed images with the optimal iteration number. This was compared with the conventional method that had an iteration number of 2. Results: In the phantom study, it was confirmed that the contrast ratio improved when the iteration number increased. In clinical evaluation, the optimal iteration number was determined to be 5 by visual assessment. When the cut-off value of 1.5 was used, which happened to be the best number, the sensitivity/specificity/accuracy improved from 52%/91%/72% to 77%/89%/83% for the proximal nodes, and from 63%/90%/84% to 91%85%/87% for the distal nodes, respectively. Conclusions: When the iteration number of the reconstruction algorithm was optimized, the sensitivity of LN metastasis improved by more than 20%, and the accuracy exceeded 80%. Optimization of the image reconstruction parameters in the diagnosis of LN metastases using PET/CT is clinically important. [ABSTRACT FROM AUTHOR]

Marked activation of thrombosis is common in patients undergoing total hip arthroplasty, especially during reaming of the femur and after insertion of the femoral prosthesis. This suggests that management designed to minimize deep vein thrombosis and fatal pulmonary embolism after total hip arthroplasty should be focused on the period during insertion of the femoral component. In some previous studies, a low dose of heparin administered intraoperatively was shown to suppress the formation of fibrin. The present study was performed to evaluate the influence of intraoperative heparin administration on the D-dimer level and on the prevention of pulmonary embolism after total hip arthroplasty. A total of 22 and 26 consecutive patients respectively underwent total hip arthroplasty with and without intraoperative administration of unfractionated heparin. Postoperatively, all patients wore knee-high elastic stockings and were fitted with calf-to-thigh intermittent pneumatic compression devices. Active ankle flexion and extension exercises were commenced as soon as motor function recovered. None of the 48 patients received prophylactic anticoagulants postoperatively. There was a significant difference of the mean D-dimer level on the 1st day between the patients with and without intraoperative administration of heparin (8.9 ± 6.6 vs. 15.7 ± 12.7, P < 0.05). Although there were no patients with symptomatic deep venous thrombosis and pulmonary embolism, asymptomatic pulmonary embolism was detected by pulmonary perfusion scintigraphy in three patients who did not receive intraoperative heparin. The operative blood loss and postoperative drainage were similar in both groups and no bleeding complications were observed. In conclusion, we recommend a safe and inexpensive regimen comprising 1,000 U of intravenous unfractionated heparin intraoperatively, postoperative pneumatic compression, and early active mobilization for prevention of thoromboembolic complications after total hip arthroplasty. [ABSTRACT FROM AUTHOR]

Objective: We studied the improvement of the detect-ability of lymph node (LN) metastases from colorectal cancer in (18)F-fluorodeoxyglucose positron emission tomography (FDG PET)/computed tomography (CT) by analyzing the acquired counts with a statistical method. Methods: Thirty-nine metastatic LNs from 32 cases with colorectal cancer were included in this study. "Uptake region" was defined as the site where counts were higher than the average plus 3 standard deviations (SDs) on each transaxial image of FDG PET. After the initial uptake regions were selected, these high accumulation areas were automatically excluded from consideration thereafter. This method was repeated and new uptake regions were identified. This method was repeated up to five times. After that, the stacked-up uptake regions were compared with computed tomography (CT) images, and the high accumulation areas that were superimposed on the normal structures, such as intestine, vessels, and ureters, were excluded from the consideration. The remaining uptake regions were diagnosed as metastatic LNs, and the detectability of LN metastases was calculated. We then compared these statistical results with the results obtained on the basis of visual assessments by radiologists. Results: Our proposed method showed the best results when the procedures were repeated three times in the light of detectability. After being repeated three times, this method detected 15/23 (65.2%) metastatic LNs in the first LN group, 16/16 (100%) in the second-third LN groups and 31/39 (79.4%) in the total LNs, whereas the radiologists diagnosed 8/23 (34.8%) of metastatic first LNs, 12/16 (75.0%) in the second-third LNs and 20/39 (51.3%) in the total LNs. A statistically significant difference was observed between the result of iteration number 3 and that by radiologists as for the second-third LNs and the total LNs. Conclusions: This study suggests that our proposed statistical method could improve the detectability of LN metastases from colorectal cancer. Our method will help radiologists to detect small metastatic lesions such as LN metastases. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Orthopaedic Surgery & Traumatology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hypercalcemia is relatively rare but clinically important complication in childhood leukemic patients. To clarify the clinical characteristics, mechanisms of hypercalcemia, response to management for hypercalcemia, incidence of t(17;19) and final outcome of childhood acute lymphoblastic leukemia (ALL) accompanied by hypercalcemia, clinical data of 22 cases of childhood ALL accompanied by hypercalcemia (>12 mg/dl) reported in Japan from 1990 to 2005 were retrospectively analyzed. Eleven patients were 10 years and older. Twenty patients had low white blood cell count (<20 × 109/l), 15 showed hemoglobin8 g/dl and 14 showed platelet count 100 × 109/l. Parathyroid hormone-related peptide (PTHrP)-mediated hypercalcemia was confirmed in 11 of the 16 patients in whom elevated-serum level or positive immunohistochemistry of PTHrP was observed. Hypercalcemia and accompanying renal insufficiency resolved quickly, particularly in patients treated with bisphosphonate. t(17;19) or add(19)(p13) was detected in five patients among 17 patients in whom karyotypic data were available, and the presence of E2A-HLF was confirmed in these five patients. All five patients with t(17;19)-ALL relapsed very early. Excluding the t(17;19)-ALL patients, the final outcome of ALL accompanied by hypercalcemia was similar to that of all childhood ALL patients, indicating that the development of hypercalcemia itself is not a poor prognostic factor.Leukemia (2007) 21, 288–296. doi:10.1038/sj.leu.2404496; published online 21 December 2006 [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Orthopaedic Surgery & Traumatology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Orthopaedic Surgery & Traumatology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Orthopaedics is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although various operative procedures have been applied for advanced or terminal osteoarthritis of the hip joints in relatively young patients, the long-term results are controversial. Since 1974, we have performed the triple-cup arthroplasty developed by Aoki in 110 patients who were comparatively young. The triple-cup assembly is composed of stainless-steel outer and inner cups between which a high density polyethylene cup is incorporated, so that there are basically four mobile surfaces, but the major movement is actually taking place between the outer cup and the plastic cup [8]. We have sometimes encountered migration of the cups, which caused hip joint pain and decreased the range of motion. Revision surgery was required for 25 hip joints in 21 patients (23%). The acetabulum was very thin in almost all cases, so that reaming of the cavity had to be restricted to the minimum possible. The femoral head in the cup was often covered with a layer of fibrous tissue. We could utilize the femoral head as a bone graft, even though the residual volume of bone varied in each case. The result of revision surgeries after the triple-cup arthroplasty was good clinically and radiographically at last follow-up. [ABSTRACT FROM AUTHOR]

When porosity and macro-pore size differ in the same ceramic, the mode of bone regeneration and the degradation of ceramics in vivo is said to be different. However, the reactions in vivo of ceramics that have a different microstructure with the same porosity and the same macro-pore size, are not so far known. In this study, two kinds of β-tricalcium phosphate (TCP) that had different microstructures but the same porosity and macro-pore size, were manufactured. These TCP were implanted in the distal femurs of 20 mature male rabbits, and their respective areas of ceramics and of regenerated bone were measured after 4, 12 and 24 wk. In both TCPs, the regenerated bone similarly decreased from 4–24 wk in a different way. The area of ceramics in one of these TCPs significantly decreased gradually throughout the observation period. On the other hand, the other TCP showed no marked decrease during the same period. This suggested a possibility that the difference in micro-structure has a large effect on the reaction of the ceramics in the bone. [ABSTRACT FROM AUTHOR]

Twelve amateur veteran soccer players (average age 40.1 +/- 5.4 years), who began playing in their teens and who were admitted with symptoms most likely to be related to cervical spondylosis, were examined by cervical radiography. Abnormal radiographic findings included: calcification of anterior longitudinal ligament (25%), anterior (75%) and posterior vertebral spurs (75%), ossicle between spinous processes (75%), calcification of nuchal ligament (Barsony) (58%), ossicle on spinous process (25%), and bony spur of Luschka's joints (83%). It was shown in the stress distribution by finite element method analysis that the stress in heading the ball was applied mainly to the lower parts of the cervical spine. The results of this analysis also corresponded well with some of the radiographic findings. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Orthopaedic & Traumatic Surgery / Archiv für Orthopädie, Mechanotherapie und Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Orthopaedic & Traumatic Surgery / Archiv für Orthopädie, Mechanotherapie und Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Orthopaedic & Traumatic Surgery / Archiv für Orthopädie, Mechanotherapie und Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The effects of 1α-hydroxyvitamin D [1α(OH)D] on bone mineral density, fracture incidence, and bone metabolism were evaluated by a double-blind, placebo-controlled study. Eighty postmenopausal osteoporotic Japanese women (71.9±7.3 years, mean±SD) were randomly assigned to 1 μg of 1α(OH)D daily or inactive placebo for 1 year. All patients were given supplemental calcium (300 mg of elemental calcium daily). Lumbar (L2-L4) bone mineral density (BMD) determined by dual energy X-ray absorptiometry increased 0.65% with 1α(OH)D treatment and decreased 1.14% with placebo ( P=0.037). BMD in both the femoral neck and Ward's triangle did not yield any significant differences between the two groups, whereas trochanter BMD in the 1α(OH)D-treated group increased 4.20% and decreased 2.37% with placebo ( P=0.055). X-ray analysis demonstrated that new vertebral fractures occurred in two patients with 1α(OH)D and in seven patients with placebo. The vertebral fracture rate in the treated group was significantly less (75/1000 patient years) than in the control group (277/1000 patient years; P=0.029). Hypercalcemia (12.1 mg/100 ml) occurred in one patient receiving 1α(OH)D; however, the serum calcium level in this patient promptly decreased to the reference range after cessation of the treatment. There were no significant changes in serum creatinine level in either group. A significant increase in urinary excretion of calcium was found but there was no significant change in urinary excretion of hydroxyproline in the treated group. The serum level of bone-derived alkaline phosphatase activity significantly decreased by−26±26 (mU/ml) after the treatment ( P=0.003). These results indicate that 1α(OH)D treatment is effective for maintaining trabecular bone mass and prevents further vertebral fractures without any serious adverse effects in postmenopausal osteoporosis. [ABSTRACT FROM AUTHOR]

The effects of 1 alpha-hydroxyvitamin D3 [1 alpha(OH)D3] on bone mineral density, fracture incidence, and bone metabolism were evaluated by a double-blind, placebo-controlled study. Eighty postmenopausal osteoporotic Japanese women (71.9 +/- 7.3 years, mean +/- SD) were randomly assigned to 1 microgram of 1 alpha(OH)D3 daily or inactive placebo for 1 year. All patients were given supplemental calcium (300 mg of elemental calcium daily). Lumbar (L2-L4) bone mineral density (BMD) determined by dual energy X-ray absorptiometry increased 0.65% with 1 alpha(OH)D3 treatment and decreased 1.14% with placebo (P = 0.037). BMD in both the femoral neck and Ward's triangle did not yield any significant differences between the two groups, whereas trochanter BMD in the 1 alpha(OH)D3-treated group increased 4.20% and decreased 2.37% with placebo (P = 0.055). X-ray analysis demonstrated that new vertebral fractures occurred in two patients with 1 alpha(OH)D3 and in seven patients with placebo. The vertebral fracture rate in the treated group was significantly less (75/1000 patient years) than in the control group (277/1000 patient years; P = 0.029). Hypercalcemia (12.1 mg/100 ml) occurred in one patient receiving 1 alpha(OH)D3; however, the serum calcium level in this patient promptly decreased to the reference range after cessation of the treatment. There were no significant changes in serum creatinine level in either group. A significant increase in urinary excretion of calcium was found but there was no significant change in urinary excretion of hydroxyproline in the treated group. The serum level of bone-derived alkaline phosphatase activity significantly decreased by -26 +/- 26 (mU/ml) after the treatment (P = 0.003).(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

A microbial method to determine sulphate concentration in water was developed on the basis of sulphate-dependent acid phosphatase (APase) in whole cells of Thiobacillus thiooxidans. The activity of the APase was determined colorimetrically by using p-nitrophenylphosphate as substrate. The APase was activated by sulphate. A linear relationship was obtained between the activity of the APase and the concentration of sulphate in the range 0–0.6 mM. Therefore, the sulphate concentration was estimated from the APase activity, represented by the absorbance ( A400). The microbial method was applied to the determination sulphate in water. The lower limit of detection was 0.02 mM, the relative standard deviation being 2% for 10 measurements on a standard sample. As for practical samples, which were taken from rain, river and tap water, good agreement was obtained between the values measured by the microbial method and those given by a conventional barium chloranilate method. The relative standard deviation was 2.1% for 12 measurements of tap water. The activity of the APase was stable over a period of more than 100 days when the cells were stored in 0.1 M sodium acetate/acetic acid buffer (pH 5.0) at 4 °C. [ABSTRACT FROM AUTHOR]

A microbial sensor consisting of immobilized Thiobacillus thiooxidans, a gas-permeable membrane, and an O electrode was prepared for the determination of sulphide. When a sample solution containing sulphide was passed into the flow cell, the output of the microbial sensor decreased markedly with time until a steady state was reached. The total time required for an assay was 20-30 min by the steady-state method. In the pulse method, the total time required for an assay was about 5 min. A linear relationship was obtained between the sensor output and the concentration of sodium sulphide below 0.40 m m. The minimum detectable concentration of sodium sulphide was 0.02 m m. Selectivity of the sensor was satisfactory. The microbial sensor was applied to the determination of sulphide in spring water. A good agreement was obtained between the microbial sensor and the methylene blue method. The regression coefficient was 0.97 for five experiments. The activity of the microbial membrane was stable for more than 25 days. The response was reproducible with 2.5% of the relative standard deviation when a sample solution containing 0.2 m m sodium sulphide was employed. *** DIRECT SUPPORT *** AG903053 00005 [ABSTRACT FROM AUTHOR]

The article discusses the hematopoietic stem cell transplantation (HSCT) as treatment for X-linked thrombocytopenia, a recessive hereditary disorder, from a mild symptomatic carrier. It states a diagnosis of Wiskott-Aldrich syndrome (WAS) with lack of WAS protein expression in the absence of HSCT is poor. It notes that long-term follow-up aster HSCT is important to determine the clinical course of the patient through flow cytometry-WAS protein and polymerase chain reaction.

A case report of 62-year-old male who was treated with a pedicled greater omentum transfer for thoracolumbar spondylitis due to methicilinresistant Staphylococcus aureus (MRSA) is given. Omentum transfer has been used in many anatomic sites such as scalp, face, oral cavity, upper digestive and respiratory tracts, chest wall, lower trunk, and lower limb since 1963. We report the successful healing to thoracolumbar spondylitis which has infectious dead space due to MRSA. Pedicled greater omentum transfer to the dead space of the infected spine is an option with recurrence of thoracolumbar spondylitis due to MRSA. [ABSTRACT FROM AUTHOR]

We report a case of traumatic separation of the proximal femoral epiphysis in a 15-month-old boy. Magnetic resonance imaging (MRI) has proved to be very useful for showing resolvable diagnosis that radiographic study cannot demonstrate during the clinical course in very young children especially unclear history of trauma. [ABSTRACT FROM AUTHOR]

A longitudinal fracture of the sacrum without an associated neurological deficit was described. A 47-year-old man was involved in a motor vehicle crash, suffering from multiple injures including a vertical displaced fracture of the sacrum unassociated with neurological deficit, fracture of the pelvis, and second lumbar burst fracture. A three-dimensional computed tomographic (CT) scanning was also discussed for proper clinical evaluation. The sacral nerve roots were pushed to either side of the fracture, there were no neurological problems in the present case. [ABSTRACT FROM AUTHOR]

We present three cases of cervical spinal fracture, involving two columns without an obvious neurological deficit. Usually if two of three columns are fractured, the injury is considered unstable structurally and clinically. Fortunately our cases did not involve sensory or motor impairment because of an enlargement of the spinal canal. [ABSTRACT FROM AUTHOR]

We investigated 270 patients (321 hips) treated by Lord-type cementless total hip arthroplasty (THA) and reported results in 234 hips that could be directly observed among 251 that were 5-year or more after operation. The mean Merle d'Aubigné and Postel hip score improved from 8.9 before operation to 15.7 at the final follow-up. However, our 20-year experience showed revision due to aseptic loosening in 27 patients. In particular, biological fixation could not be achieved in some cases treated using a screw-in ring for acetabular dysplasia or using the Fluted type stem with a smooth surface. This may be the cause of aseptic loosening, and further follow up is necessary. [ABSTRACT FROM AUTHOR]

In a case with tricuspid atresia, a coronary sinus septal defect was found and closed following Fontan's operation. This defect should be found, at latest, during surgery, otherwise Fontan's operation cannot produce functional repair. [ABSTRACT FROM AUTHOR]

An 8-year-old boy with vertebral and epidural metastases was diagnosed with Wilms' tumor associated with perilobar nephroblastomatosis (NB) based on histologic examination. During combined chemotherapy with vincristine, actinomycin D, doxorubicin, and cyclophosphamide (NWTS-3 J protocol), a rapid increase in tumor size was observed. The treatment was replaced with etoposide and carboplatin (JET regimen). A transient response was sustained for 5 months during this chemotherapy. However, regrowth of the tumor was observed and the patient died 11 months after the initial chemotherapy. [ABSTRACT FROM AUTHOR]

We document a case of bilateral ulnar nerve palsy that developed in an 27-year-old Japanese man who had bilateral hypoplasia of the humeral trochlea. Surgical management produced good results regarding the ulnar nerve palsy. The pathogenesis of the nerve paresis in this particular condition is discussed. There have been no reports outside Japan. Whether this deformity occurs only in persons of Japanese extraction or is simply overlooked by foreign surgeons is an interesting question. [ABSTRACT FROM AUTHOR]