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Purpose: To investigate intraoperative kinematics during passive flexion using a surgical navigation system for knees undergoing posterior stabilized (PS) total knee arthroplasty (TKA) with an asymmetric helical post-cam design using navigation system., Methods: In total, 45 knees with both pre- and postoperative kinematic data available were included in the study. Intraoperative kinematic measurements were performed during the course of surgery using the software incorporated in the navigation system. Measurements were performed at the following two time points: (1) before TKA procedure and (2) after TKA implantation. Among the kinematic parameters studied, anterior/posterior translation and axial rotation during flexion were subjected to the analysis., Results: Before surgery, physiologic anterior/posterior translational pattern of the tibia during flexion (rollback of the femur) was found in only 15.6% of the knees. After TKA implantation, postoperative kinematic measurement showed no significant change in the tibial translational during knee flexion. Similarly, with regard to rotation, non-physiologic external tibial rotation in early flexion was observed in the majority of the knees before surgery, and this abnormal kinematic pattern remained after the TKA procedure., Conclusions: The intraoperative three-dimensional motion analysis using a navigation system showed that the physiologic kinematic pattern (anterior translation and internal rotation of the tibia during flexion) of the knee was distorted in osteoarthritic knees undergoing TKA. The abnormal kinematic pattern before surgery was not fully corrected even after implantation of the PS TKA designed to induce natural knee motion; however, no clear relationship between the intraoperative kinematic pattern and knee flexion angle at one year was demonstrated, and the effect of knee kinematics on postoperative knee function and patient's satisfaction is still unclear.

Aim: Continuous renal replacement therapy (CRRT) with a cytokine-adsorbing hemofilter (CAH) is effective in the treatment of sepsis. Two filter types, namely polymethyl methacrylate (PMMA) and surface-treated AN69 (AN69ST) hemofilters, have been successfully used for CRRT, but no direct comparisons have been published to date. This study compared the efficacy, as measured by 28-day survival rates, of PMMA and AN69ST hemofilters in patients receiving CAH-CRRT., Methods: This retrospective observational study reviewed the medical records of 142 patients who received CAH-CRRT between November 2013 and February 2015., Results: The 28-day survival rates were higher in the AN69ST group than in the PMMA group for patients with or without sepsis (all patients, 79.4% versus 54.1%; patients with sepsis, 77.3% versus 50.0%; patients without sepsis, 83.3% versus 57.5%; P  < 0.05). No significant differences were observed regarding 28-day survival rates of patients with or without sepsis (AN69ST, 77.3% versus 83.3%; P  = 0.51; PMMA, 50.0% versus 57.5%; P  = 0.61) using the same hemofilter., Conclusion: The AN69ST hemofilter could be more effective than PMMA hemofilters for improving the survival outcomes of patients with or without sepsis.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that starts in early childhood and has a comprehensive impact on psychosocial activity and education as well as general health across the lifespan. Despite its prevalence, the current diagnostic criteria for ADHD are debated. Saccadic eye movements are easy to quantify and may be a quantitative biomarker for a wide variety of neurological and psychiatric disorders, including ADHD. The goal of this study was to examine whether children with ADHD exhibit abnormalities during a visually guided pro-saccadic eye-movement and to clarify the neurophysiological mechanisms associated with their behavioral impairments. Thirty-seven children with ADHD (aged 5-11 years) and 88 typically developing (TD) children (aged 5-11 years) were asked to perform a simple saccadic eye-movement task in which step and gap conditions were randomly interleaved. We evaluated the gap effect, which is the difference in the reaction time between the two conditions. Children with ADHD had a significantly longer reaction time than TD children (p < 0.01) and the gap effect was markedly attenuated (p < 0.01). These results suggest that the measurement of saccadic eye movements may provide a novel method for evaluating the behavioral symptoms and clinical features of ADHD, and that the gap effect is a potential biomarker for the diagnosis of ADHD in early childhood.

A 67-year-old man noticed paresthesia in both legs in July 2011. Three days later, he was found on a street where he was unable to stand up. On admission, the deep sensation in both legs was severely disturbed, but their muscle strength remained normal. Cranial nerves and autonomic functions were normal. The deep tendon reflexes were diminished in both legs. Magnetic resonance imaging of the spine was normal. Motor nerve conduction studies revealed normal conduction velocity, amplitude, and F-wave latency. However, sensory nerve conduction studies revealed severe reduction of amplitude in the upper and lower extremities. Cerebrospinal fluid analysis showed normal cell counts but elevated protein levels. Screening for glycolipid antibodies showed a selective increase of galactocerebroside (Gal-C) IgG antibody. We diagnosed him with pure-sensory-type Guillain-Barré syndrome (GBS). We administered intravenous immunoglobulin (IVIG) for 5 days. After IVIG therapy, his gait disturbance improved slightly but the disturbance of deep sensation remained severe and he was transferred to a rehabilitation ward 53 days after admission. To the best of our knowledge, this is the first report of a case of pure-sensory-type GBS with Gal-C antibody alone. This case suggests a close relationship between Gal-C antibody and sensory nerve disturbance.

Recent studies have demonstrated that immune cells play an important role in the pathogenesis of many neurological conditions. Immune cells constantly survey the brain microvasculature for irregularities in levels of factors that signal homeostasis. Immune responses are initiated when necessary, resulting in mobilisation of the microglial cells resident in the central nervous system (CNS) and/or of infiltrating peripheral cells. However, little is known about the kinetics of immune cells in healthy and diseased CNS, because it is difficult to perform long-term visualisation of cell motility in live tissue with minimal invasion. Here, we describe highly sensitive in vivo MRI techniques for sequential monitoring of cell migration in the CNS at the single-cell level. We show that MRI combined with intravenous administration of super-paramagnetic particles of iron oxide (SPIO) can be used to monitor the transmigration of peripheral phagocytes into healthy or LPS-treated mouse brains. We also demonstrate dynamic cell migration in live animal brains with time-lapse MRI videos. Time-lapse MRI was used to visualise and track cells with low motility in a control mouse brain. High-sensitivity MRI cell tracking using SPIO offers new insights into immune cell kinetics in the brain and the mechanisms of CNS homeostasis.

Most of computer-assisted planning systems need to determine the anatomical axis based on the anterior pelvic plane (APP). We analysed that our new system is more reproducible for determination of APP than previous methods. A pelvic model bone and two subjects suffering from hip osteoarthritis were evaluated. Multidetector-row computed tomography (MDCT) images were scanned with various rotations by MDCT scanner. The pelvic rotation was calibrated using silhouette images. APP was determined by an optimisation technique. The values of variation of APP caused by pelvic rotation were analysed with statistical analysis. APP determination with calibration and optimisation was most reproducible.The values of variance of APP were within 0.05° in model bone and 0.2° even in patient pelvis. Furthermore, the values of variance of APP with calibration/optimisation were significantly lower in comparison without calibration/optimisation. Both calibration and optimisation are actually required for determination of APP. This system could contribute to the evaluation of hip joint kinematics and computer-assisted surgery.

Newborn's brain has a various shape, and easily changes with not only brain developing and cerebral diseases. Although the brain segmentation in MR images is an effective way to quantify the brain shape and size, there are few studies in neonatal brain MR image analysis. This paper introduces a novel method based on fuzzy connectedness (FC) with fuzzy object model (FOM). FOM is built from a training dataset, and gives fuzzy degree belonging to parenchyma with respect to location and intensity. FC is calculated from object affinity and homogeneous affinity, and the object affinity is given by the FOM. The method first segments the white matter, and then segments the surrounding cortex. The propose method has been applied to 10 newborn subjects whose revised age was between -1 month and +2 month. Leave-on-out cross-validation (LOOCV) was conducted, and the mean false-positive volume fraction was 1.33%, the mean false-negative volume fraction was 2.90%, and geometric-mean was 1.42%.

This paper describes noninvasive cellular quantity measurement in Bone Marrow Stromal Cells/ β-tricalcium phosphate. We attempt to identify cellular quantity with an ultrasonic system. The ultrasonic waves are reflected at boundaries where there is a difference in acoustic impedances of the materials on each side of the boundary. Therefore, we focus on the reflected signal. From the obtained ultrasonic data, we extract two features; amplitude and frequency. Amplitude is obtained from the raw ultrasonic wave, and frequency is calculated from frequency spectrum obtained by applying cross-spectrum method. Therefore, we suggest the superiority of frequency to analyze Bone Marrow Stromal Cells. This study shows the ability of intervention to produce the desired beneficial effect.

Purpose: Magnetic resonance imaging (MRI) is often used to detect and treat neonatal cerebral disorders. However, neonatal MR image interpretation is limited by intra- and inter-observer variability. To reduce such variability, a template-based computer-aided diagnosis system is being developed, and several methods for creating templates were evaluated., Method: Spatial normalization for each individual's MR images is used to accommodate the individual variation in brain shape. Because the conventional normalization uses as adult brain template, it can be difficult to analyze the neonatal brain, as there are large difference between the adult brain and the neonatal brain. This article investigates three approaches for defining a neonatal template for 1-week-old newborns for diagnosing neonatal cerebral disorders. The first approach uses an individual neonatal head as the template. The second approach applies skull stripping to the first approach, and the third approach produces a template by averaging brain MR images of 7 neonates. To validate the approaches, the normalization accuracy was evaluated using mutual information and anatomical landmarks., Results: The experimental results of 7 neonates (revised age 5.6 ± 17.6 days) showed that normalization accuracy was significantly higher with the third approach than with the conventional adult template and the other two approaches (P < 0.01)., Conclusion: Three approaches to neonatal brain template matching for spinal normalization of MRI scans were applied, demonstrating that a population average gave the best results.

We developed a new posterior-stabilized total knee arthroplasty (TKA) with a unique post-cam design that induces and accommodates internal tibial rotation with deep knee flexion. To validate the design concept of this system, we conducted an image analysis study employing a computer-aided diagnosis system for 24 TKA-implanted knees. In the analysis, the tibiofemoral relationship in the following 3 postures was evaluated: standing at extension, forward lunge, and kneeling with maximum knee flexion. The results of the image analysis showed achievement of consistent internal rotation of the tibia in deep flexion with a broad contact area at the post-cam interface as intended by the original design concept of this TKA system., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Loss of communication is a critical problem for advanced amyotrophic lateral sclerosis (ALS) patients. This loss of communication is mainly caused by severe dysarthria and disability of the dominant hand. However, reports show that about 50% of ALS patients have mild cognitive dysfunction, and there are a considerable number of case reports on Japanese ALS patients with agraphia. To clarify writing disabilities in non-demented ALS patients, eighteen non-demented ALS patients and 16 controls without neurological disorders were examined for frontal cognitive function and writing ability. To assess writing errors statistically, we scored them on their composition ability with the original writing error index (WEI). The ALS and control groups did not differ significantly with regard to age, years of education, or general cognitive level. Two patients could not write a letter because of disability of the dominant hand. The WEI and results of picture arrangement tests indicated significant impairment in the ALS patients. Auditory comprehension (Western Aphasia Battery; WAB IIC) and kanji dictation also showed mild impairment. Patients' writing errors consisted of both syntactic and letter-writing mistakes. Omission, substitution, displacement, and inappropriate placement of the phonic marks of kana were observed; these features have often been reported in Japanese patients with agraphia resulted from a frontal lobe lesion. The most frequent type of error was an omission of kana, the next most common was a missing subject. Writing errors might be a specific deficit for some non-demented ALS patients.

Initially, the absorbance of MB at 665 nm decreased rapidly with increasing sodium dodecyl sulfate (SDS) concentration, but increased gradually above about 2.3x10(-3) M. However, the absorbance of MB was almost independent of the cetyltrimethylammonium bromide (CTAB) concentration. On the other hand, the absorbance of NpO was affected by addition of CTAB in a similar manner to the change in MB-SDS system, but not by addition of SDS. The absorption band of MB showed a small red-shift and a decrease in intensity upon addition of NpO, while that of NpO showed only the decrease in the intensity upon the addition of MB. These spectral changes were attributed to the formation of complexes between these dyes. The effects of anionic and cationic surfactants on the absorption spectra of mixtures of MB and NpO were also examined. Contrary to the effects on the absorption spectrum of MB and NpO, respectively, the absorbances of MB and NpO in the mixtures were changed with the additions of both anionic and cationic surfactants. The spectral changes were explained by changes in the forms of MB and NpO in the solutions with increasing surfactant concentrations.

We have investigated cpDNA haplotype distribution in 24 populations of Fagus crenata in the southwest of Kanto District, Japan, and clarified the extent of intermixing of haplotypes in the contact zone by additional fine-scale analysis of two areas. Two cpDNA haplotypes belonging to different lineages were detected, and their distribution had geographical structure. Intermixed populations with the two haplotypes were limited to a narrow area. The geographical boundary between the haplotypes extended from Hakone to the west of the Kanto Mountains through the northern foot of Mt Fuji. No relationship was observed between the boundary location and the current topography of the southwest of Kanto District.

Measurement of volume and surface area of the frontal, parietal, temporal and occipital lobes from magnetic resonance (MR) images shows promise as a method for use in diagnosis of dementia. This article presents a novel computer-aided system for automatically segmenting the cerebral lobes from 3T human brain MR images. Until now, the anatomical definition of cerebral lobes on the cerebral cortex is somewhat vague for use in automatic delineation of boundary lines, and there is no definition of cerebral lobes in the interior of the cerebrum. Therefore, we have developed a new method for defining cerebral lobes on the cerebral cortex and in the interior of the cerebrum. The proposed method determines the boundaries between the lobes by deforming initial surfaces. The initial surfaces are automatically determined based on user-given landmarks. They are smoothed and deformed so that the deforming boundaries run along the hourglass portion of the three-dimensional shape of the cerebrum with fuzzy rule-based active contour and surface models. The cerebrum is divided into the cerebral lobes according to the boundaries determined using this method. The reproducibility of our system with a given subject was assessed by examining the variability of volume and surface area in three healthy subjects, with measurements performed by three beginners and one expert user. The experimental results show that our system segments the cerebral lobes with high reproducibility.

A series of extraordinarily long oligothiophenes up to the 96-mer has been developed by iterative oxidative coupling of the completely beta-blocked sexithiophene. They are highly conjugated like nonsubstituted oligothiophenes, and the effective conjugation of this system is extended to 96 thiophene units and much longer than that previously speculated for polythiophenes.

6-Acyldecahydro [1,6]naphthyridines were synthesized as derivatives of matrine-type and allomatrine-type alkaloids, and the structure-activity relations were examined by the acetic acid-induced abdominal contraction test. All synthesized derivatives produced the antinociception in mice. The antinociceptive potencies of 15a-c and 16a-c were lower than those of 17a-c, 18a-c, 19a-c and 20a-c. Furthermore, those of the matrine-type derivatives 17b and 17c are greater than other derivatives. These findings suggest that less hindered tertiary amine and highly lipophilic acyl group are better functional groups for the greater antinociceptive potencies. Furthermore, these findings suggest that A or B ring of 1 and 2 are not essential for the antinociceptive effect.

N-Acyloctahydropyrido[3,2,1-ij][1,6]naphthyridines were synthesized as derivatives of matrine-type alkaloids, and the structure-activity relations were examined by the acetic acid-induced abdominal contraction test. The antinociceptive potencies of N-acyloctahydropyrido[3,2,1-ij][1,6]naphthyridines were significantly lower than those of (+)-matrine. The antinociceptive effects of N-benzyloctahydropyrido[3,2,1-ij][1,6]naphthyridines are approximately 5.6 to 6.5 times less than those of N-benzoyloctahydropyrido[3,2,1-ij][1,6]naphthyridine. These findings suggest that the amide group of matrine-type alkaloids is an essential functional group that influences antinociceptive potency. The antinociceptive effect of 4c was markedly antagonized by pretreatment with Naloxone, and that of 3c partially so.

We previously reported that (+)-matrine and (+)-allomatrine have antinociceptive properties mediated mainly through the activation of kappa-opioid receptors. 1-Acyl-4-dialkylaminopiperidines were synthesized as the simplest derivatives of matrine, and the structure-activity relations were examined by the acetic acid-induced abdominal contraction test. The antinociceptive potencies of 1-alkyl-4-dialkylaminopiperidines were significantly lower than those of the corresponding 1-acyl-4-dialkylaminopiperidines. These findings suggest that the amide group of (+)-matrine is an essential functional group that influences antinociceptive potency.

Fifty-six patients with locally invasive bladder cancer were treated by chemotherapy with intermittent arterial infusion from an implanted reservoir and alteration of intrapelvic blood flow. The tip of an infusion catheter was inserted selectively into an internal iliac artery by an angiographic technique. Superior gluteal artery and the other internal iliac artery were then embolized with steel coils so that the drugs would perfuse throughout the tumor through a single catheter. Treatment consisted of intermittent injection of cisplatin (10 mg/body) and doxorubicin (10 mg/body) or epirubicin (10 mg/body) or pirarubicin (10 mg/body) in a ten-minute period every week (for the first 8 weeks) or every two weeks (after the 8th week). Fifty patients were objectively evaluated and the response rate was 80%. The overall survival rate in 54 patients at 1, 3, 5 and 8 years was 83.7%, 61.2%, 52.6%, and 52.6%. The 1-, 2-, 3-, 5- and 7-year disease free survival rate in evaluable 22 patients who showed a complete response (CR) was 91.8%, 85.2%, 65.6%, 58.3% and 58.3%. No serious side effects, such as severe myelosuppression or renal and/or liver dysfunction, were noted during treatment. These findings suggest that intermittent arterial chemotherapy with an implanted reservoir is clinically useful. This procedure appears safe and is easily performed in the outpatient clinic for the treatment of locally advanced bladder cancer.

The purpose of this study was to evaluate a new oily agent in targeting chemoembilization for hepatocellular carcinoma. The oily preparation was made by mixing non-iodinated poppy seed oil and a thickener to obtain the same viscosity as Lipiodol. The oily preparation and Lipiodol were compared by injecting them into the hepatic artery of rabbits inoculated with VX 2 carcinoma in their liver. On the CT scan following intra-arterial injection, tumors were visibly stained in the non-iodinated preparation group, whereas the Lipiodol group was not evaluable because of excessively high attenuation. The non-iodinated oily preparation was concluded to be of clinical significance.

The antitumor activity of an extract of seeds from Aeginetia indica L., a parasitic plant, was investigated. BALB/c mice, inoculated i.p. 1 x 10(5) syngeneic Meth A tumor cells, were administered 2.5 mg/kg A. indica extract i.p. every 2 days from day 0. The untreated mice died of an ascitic form of tumor growth within 21 days, whereas all the treated mice completely recovered from tumor challenge without any side-effects. The extract did not exert direct cytotoxic activity against Meth A in vitro. Mice that survived after the first challenge as a result of A. indica treatment overcame the rechallenge with homologous Meth A without additional administration of the extract. On the other hand, those mice could not survive after rechallenge with Meth 1 tumor cells, which were also established in BALB/c mice but were different in antigenicity from Meth A, suggesting the development of antigen-specific concomitant immunity in the A. indica-cured mice. In the induction phase of antitumor resistance in this system, CD4+ T cells appeared to be the main contributors, since in vivo administration of anti-CD4 mAb completely abolished such resistance. In contrast, anti-CD8 mAb administration did not influence the effect of A. indica. The importance of CD4+ T cells in antitumor immunity was again clarified by Winn assay; that is, spleen and lymph node cells depleted of CD4+ T cells in vitro prior to assay abolished antitumor activity on co-grafted Meth A tumor cells in vivo.

An outbreak of Yersinia pseudotuberculosis in Kurashiki, Japan is described. This is the first conclusive report of a community outbreak of this microorganism. A total of 535 pupils, five teachers, and one food attendant contracted the organism. Causative organisms were detected in 19 out of 30 patients. All isolated strains belonged to serotype VA. Out of 653 sera of the pupils, 488 showed elevated agglutinin titers ranging from 1:80 to 1:1,280 or more within a period of 3 months.