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To determine the efficacy and poor prognostic factors of posterolateral full-endoscopic debridement and irrigation (PEDI) surgery for thoraco-lumbar pyogenic spondylodiscitis.We included 64 patients (46 men, 18 women; average age: 63.7 years) with thoracic/lumbar pyogenic spondylodiscitis who had undergone PEDI treatment and were followed up for more than 2 years. Clinical outcomes after PEDI surgery were retrospectively investigated to analyze the incidence and risk factors for prolonged and recurrent infection.Of 64 patients, 53 (82.8%) were cured of infection after PEDI surgery, and nine (17.2%) had prolonged or recurrent infection. Multivariate analysis demonstrated that significant risk factors for poor prognosis included a large intervertebral abscess cavity (P = 0.02) and multilevel intervertebral infections (P 0.05).PEDI treatment is an effective, minimally invasive procedure for pyogenic spondylodiscitis. However, a large intervertebral abscess space could cause instability at the infected spinal column, leading to prolonged or recurrent infection after PEDI. In cases with a large abscess cavity with or without vertebral bone destruction, endoscopic drainage alone may have a poor prognosis, and spinal fixation surgery could be considered.

OBJECTIVE Data regarding risk factors for the progression of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine are scarce. Therefore, in this study, the authors aimed to elucidate the difference in the radiographic progression pattern of OPLL and its risk factors between cervical and thoracic OPLL using longitudinally acquired whole-spine CT scans. METHODS Overall, 123 patients with symptomatic OPLL who underwent repeated whole-spine CT examinations, with an average interval of 49 months (at least 3 years) between scans, were retrospectively reviewed. Progression of OPLL was assessed to compare the distribution of OPLL over the entire spine on the initial and final CT scans. Patients were divided into a cervical OPLL (C-OPLL) group and a thoracic OPLL (T-OPLL) group according to the location of the main lesion. The progression pattern of OPLL and its risk factors were compared between the two groups using the Student t-test or Mann-Whitney U-test. RESULTS In the C-OPLL group, 15 (22.1%) of 68 patients had OPLL progression, of whom 12 patients (80.0%) had progression only in the cervical spine and 3 patients (20.0%) had progression in multiple regions (cervical and thoracic/lumbar). In the T-OPLL group, 16 (29.1%) of 55 patients had OPLL progression, of which 3 patients (18.8%) had progression only in the thoracic spine and 8 patients (50.0%) had progression in multiple regions. Young age was a common risk factor for OPLL progression regardless of the location of OPLL, and this trend was more pronounced in the T-OPLL group than in the C-OPLL group. High BMI, male sex, and multilevel, severe T-OPLL were identified as independent risk factors for progression of T-OPLL (OR 1.19, 95% CI 1.03–1.37; OR 10.5, 95% CI 1.39–81.94; and OR 1.24, 95% CI 1.16–1.45, respectively). CONCLUSIONS Patients with T-OPLL are predisposed to diffuse progression of OPLL over the entire spine, whereas patients with C-OPLL are likely to have progression in only the cervical spine. Young age and high BMI are significant risk factors for OPLL progression, especially in patients with T-OPLL. Our study highlights the need for continued follow-up in patients with T-OPLL, especially in young patients and those with obesity, for early detection of spinal cord and cauda equina symptoms due to the progression of OPLL throughout the spine.

Associated factors for and the natural course of sacroiliac (SI) joint degeneration in the normal population are unknown. The purpose of this study was to determine associated factors for and the progression rate of SI joint degeneration. We enrolled 553 healthy middle-aged subjects who underwent the first and second comprehensive health screening at an interval of 5.9 years (range 3.0–10.7 years). The medical checkup included blood tests and whole-body computed tomography. We investigated associated factors of SI joint degeneration, the relationship of the laterality of degeneration between the SI and L4/5 facet joint, L5/S facet joint, and the natural course of SI joint degeneration over time. At the first checkup, 70 subjects (12.7%) showed substantial degeneration (type 2 or 3) of the SI joints. Multivariate analysis revealed that female sex; pubic symphysis degeneration, L4/5, and L5/S facet joint degeneration; high body mass index; and several blood parameters were associated factors for SI joint degeneration. Laterality of SI joint degeneration was significantly more frequent than that of L4/5 or L5/S facet joint degeneration. Kaplan–Meier survival analysis revealed that the progression rates of SI joint degeneration from type 0 (no degeneration) or type 1 (slight degeneration) to substantial degeneration amounted to 3.4% and 35.5% after 10 years, respectively. We found substantial SI joint degeneration in 12.7% of healthy middle-aged subjects and considered it to be part of the normal aging process. There may be individual factors associated with its occurrence. These slides can be retrieved under Electronic Supplementary Material.

Metallic spinal implants are used to correct spinal deformity and to stabilize the unstable spinal column (instability) for many different pathologies such as trauma, degenerative changes, and tumors. The spinal implants maintain the stability at the site of instability until the solid bony fusion is completed. In the early years of spinal instrumentation surgery, since spinal implants were not able to provide adequate stability after surgery, patients were forced to be bed bound for several months until complete bony fusion was obtained. With the development of recent spinal implants with an excellent mechanical stability, patients are now able to ambulate at 1 or 2 days after surgery. The development of metallic implants for the spine has contributed significantly to save the lives and the quality of life (QOL) of those suffering from various destructive disorders of the spine. In the recent years, as to the rapid increase in the elderly population in the developed countries, there is a steadily rise in the number of surgical treatments for adult spinal deformities with metallic spinal implants.

Background Intramedullary hyperintense lesions associated with spinal cord edema on T2-weighted MR images (T2WI) are rare findings in patients with cervical spondylosis and are poorly characterized. We investigated the clinical characteristics of spinal cord edema due to cervical spondylosis (SCECS). Methods In total, 214 patients with cervical spondylotic myelopathy who underwent surgery between April 2007 and March 2017 were divided into SCECS and non-SCECS groups with SCECS defined as follows: (1) intramedullary signal intensity (ISI) of the cervical spinal cord in sagittal T2WI extending to more than one vertebral body height; (2) “fuzzy” ISI, recognized as a faint intramedullary change with a largely indistinct and hazy border; and (3) a larger sagittal diameter of the spinal cord segment with ISI just above or below the cord compression area compared with areas of the cervical spine without ISI. Radiographic parameters, demographic characteristics, and the Japanese Orthopedic Association (JOA) surgical outcomes score were compared between the groups. Results Seventeen patients (7.9%) were diagnosed with SCECS. These patients were younger than those in the non-SCECS group [median (interquartile range), 64 (20) vs. 69 (15) years, respectively, p = 0.016], and the disease duration from onset to surgery was significantly shorter in the SCECS group than in the non-SCECS group [6 (7) vs. 20 (48) months, respectively]. No significant difference was observed between groups with respect to sex, radiologic findings, or surgical outcomes. Conclusion The disease showed an earlier onset and more rapid progression in the patients with SCECS than in those without SCECS.

FASN is a multifunctional enzyme that catalyzes de novo biosynthesis of long-chain saturated fatty acid, and alteration of this enzyme may affect economic traits including fatty acid composition. Sequencing the coding sequence (CDS) of the FASN gene has so far been done only partially for dairy cattle. In this study, the CDS of the FASN gene of eight Holstein cattle was sequenced to detect nucleotide polymorphisms. We could identify 13 single nucleotide polymorphisms (SNPs) of which five were non-synonymous mutations (H1390Y, I1856L, T1950A, W1955R and T2264A). The association between these SNPs and economic traits was analyzed using 198 Holstein dams. Genotypes of H1390Y corresponded to those of the I1856L in the group, suggesting these SNPs were linked. Furthermore, the T1950A was suggestively linked with the W1955R. The association study revealed that T1950A/W1955R had an effect on milk fat content and the C14 Index. This will help to understand the complex association between the FASN gene and economic traits.

Poly(phenylene sulfide) (PPS) multi-filaments were continuously drawn and annealed. The maximum values of birefringence, crystallinity, tensile strength and Young′s modulus in the drawn and annealed PPS filament were 249×10−3 ‚ 27%, 5.3 cN/dtex and 64 cN/dtex‚ respectively. The orientation-induced crystallization was observed at 150×10-3 of birefringence. The crystal orientation factor f′ was estimated by wide angle X-ray diffraction. The λnet was estimated by the strain shifting of true stress - true strain curve to the master curve. The orientation estimated by the λnet differed from that estimated by birefringence. The fiber structure development and the mechanical properties of resultant fibers were discussed in terms of orientation parameters, which were birefringence‚ network draw ratio (λnet) and crystal orientation factor (f′). The birefringence shows a good correlation with the Young’s modulus. On the other hand, λnet shows a good correlation with the tensile strength. The f′ shows good correlations with both Young′s modulus and tensile strength‚ however‚ they tend to saturate at high f′. The melting temperature of PPS changed from 280.1oC to 288.7oC with the increase of birefringence and λnet.

症例は85歳，女性．平成20年6月に肛門部痛，下腹部痛を主訴に当科を紹介受診された．受診時には明らかなイレウス症状は認められなかったが，下部消化管内視鏡検査で肛門縁より5cmの位置に腸管内腔に突出するI型の隆起性病変を認め，一部表面不整を認めた．また骨盤部CT検査にて直腸内腔に重積腸管を示すmultiple concentric ring signを認めた．以上の所見より腸重積を合併した早期直腸癌の診断のもと手術を施行した．開腹後重積腸管のen-block切除を試みたが困難であり，用手的解除を施行した．解除時に一部直腸壁の損傷を認めたためHartmann手術を施行した．早期直腸癌に起因する腸重積症は稀であり，若干の文献的考察を加え報告する．

We screened for Japanese Black and Holstein bull sire samples to detect single nucleotide polymorphisms (SNPs) involving animo-acid substitutions in the bovine prion gene in the entire coding region of the PRNP gene. Although three silent SNPs were found, we could not detect any SNP with animo-acid substitution. We also examined the polymorphism of the octapeptide repeat number in these samples. There was no homozygous bull with repeat number 5. The frequency of heterozygous (6/5) bulls was 8% in the Japanese Black bull and 4% in the Holstein bull, respectively. The bull samples used in this study contain popular elite sires, so it appears that the polymorphisms of prion protein (PrP) are rather difficult to find in these two breeds in Japan, except for polymorphism of the octapeptide repeat number.

症例は18歳の男性, 下腹部腫瘤と頻尿を主訴に来院. 下腹部正中に小児頭大の無痛性で可動性不良の硬い腫瘤を触知した. エコー, CT, MRI, 注腸造影にて左尿管の途絶, 左水腎症, 直腸狭窄像を呈し, 骨盤腔内に最大径18cmの充実性腫瘍を認めた. 血管造影では血管に富む腫瘍を認め, 左閉鎖動脈と上直腸動脈に栄養されていた. 術前腫瘍塞栓術を施行し, 腫瘍とともに左尿管, 膀胱, 左精嚢, 直腸を合併切除した. 再建は, 左尿管と膀胱との間にS状結腸を間置し, 直腸は低位前方切除とした. 摘出標本では大小さまざまな不規則な血管腔の周囲に紡錘形の細胞の増生を認め, 分裂像や核異型性に乏しく低悪性度のhemangiopericytomaであった. 術後6年, 再発転移を認めていない. 本疾患は病理組織像のみからでは良悪性の鑑別が困難であり, 今後とも長期にわたる経過観察が必要と思われる.

For a field k, We denote the maximal abelian extension of k by k ab and (K ab r−1 ab by k ab r . In this paper, unramified Galois extensions over k ab r are constructed using Galois representations of arbitrary dimension with larger coefficient rings.

A 41-year-old woman had felt a pain and noticed a mass in the right breast since March, 1993, but she did not consult any hospital and had been treated by some folk medicien. Five months later the mass started to enlarge rapidly, and eventually it penetrated the skin to be exposed on the surface during a further 5-month period. The patient was admitted to the hospital for operation. On admission the tumor presented a cauliflower like proliferation occupying the entire right breast. It was 23×19.4cm in size, easily hemorrhagic, and discharged a large quantity of exudate. Pathological diagnosis on biopsy at another hospital indicated that the tumor was benign phyllode tumor. But we were not able to rule out a possibility of malignancy, because the tumor rapidly enlarged in one year and was huge in size. Modified radical mastectomy (Patrey method) and full-thickness graft were performed. Histopathological examination confirmed malignancy. There has been no sign of recurrence, as of about 2 years after the operation. She is doing well.

It is not always easy to make a differential diagnosis of cystic lesion of the pancreas whether it is a cyst, cystadenoma, or cystadenocarcinoma. Particularly cystic lesions with the size of less than several centimeter which can be detected by ERP, ultrasonography, and CT scan often have atypical papillary hyperplasia, which poses a problem whether it is reactive or tumorous. This paper describes our experience with a case of ductectatic type cystadenoma of the pancreas which was difficult to differentiate from mucous-producing cancer of the pancreas preoperatively. A 53-year-old was admitted to the hospital because of right hypochondraligia. Computed tomographic examination showed a low density area in the head of the pancreas. Pancreaticoduodenectomy was performed when endoscopic retrograde pancreaticography (ERP) showed dilatation of the main pancreatic duct and cystic dilatation of the lesser ducts with a filling defect. Pathological findings revealed atypical papillary hyperplasia with staining by anti-CEA monoclonal antibody and goblet cell metaplasia. Further investigations to diagnose the pancreatic cystic lesions whether cancerous or not are necessary measuring oncogene expression such as K-ras point mutation.

Thin Li-ion batteries with a laminated film bag as a casing were developed by using a liquid electrolyte and a graphitized boron-doped mesophase-pitch-based carbon fiber (B-MCF) anode. The thin Li-ion batteries exhibited excellent discharge performance, long cycle life, and very low swelling under high-temperature storage. A 1.5 M solution of LiBF4 in an ethylene carbonate (EC)/γ-butyrolactone (GBL) (1:3 by volume) mixed solvent is advantageous for use as the electrolyte in the laminated film bag because of its high flame point of 129°C, high boiling point of 216°C, low vapor pressure, and high conductivity of 2.1 mS/cm at -20°C The B-MCF anode in the LiBF 4 -EC/GBL electrolyte exhibited a high reversible capacity of 345 mAh/g. a high coulombic efficiency of 94% at the first cycle, and high rate capability. It was demonstrated that the thin Li-ion battery with a thickness of 3.6 mm has a high energy density of 172 Wh/kg. high rate capability between 0.2 and 3C rate discharge, a high capacity ratio of 50% at 1C rate discharge and -20°C, and a long cycle life of more than 500 cycles at 1C rate charge-discharge cycling. The B-MCF anode led to the high rate discharge performance and the long cycle life of the thin Li-ion batteries using the LiBF 4 -EC/GBL electrolyte. The very low swelling and small evolution of gas under the high-temperature storage at 85°C were attributable to the stability of LiBF 4 -EC/GBL electrolyte against the fully charged LiCoO 2 cathode material.

Pulse combustion can gain high pressure flue, utilizing the combustion-driven oscillation phenomena. This well-kuown technology has been realized recently by the advance in new technology and also the demand to energy saving. The majour problems in the burner development are how to tune the total system and how to cut noise. The burner was applied as the industrial liquid heater and proved to be highly efficient, not only because of the heat transfer improvement but because of the small heater size. Applications to the painting process and to the galvanizing process were introduced.

Eight novel and four known mutations were detected in the coding sequence of the bovine fatty acid synthase (FASN) gene of an F2 population from Japanese Black and Limousin cattle. Two mutations, g.16024A>G and g.16039T>C, detected in exon 34, which determine amino acid substitutions of threonine (T) to alanine (A) and tryptophan (W) to arginine (R), were clearly separated in the parental breeds. The haplotypes (TW and AR) segregated in F2 individuals and had a significant effect on the fatty acid composition of backfat, intermuscular fat, and intramuscular fat. The TW haplotype was associated with increasing C18:0 and C18:1 content and the ratio of monounsaturated to saturated fatty acids, and decreasing C14:0, C14:1, C16:0, and C16:1 content. The two mutations were screened in two commercial Japanese Black half-sibling populations and similarly determined the contribution to the fatty acid composition of intramuscular fat. The frequency of the TW haplotype was markedly higher in Japanese Black (0.67) than in Holstein (0.17), Angus (0.02), and Hereford (0.07). We conclude that these mutations may contribute to the characteristic fatty acid composition of Japanese Black beef.

Thin Li-ion batteries with a laminated film bag as a casing were developed by using a liquid electrolyte and a graphitized boron-doped mesophase-pitch-based carbon fiber (B-MCF) anode. The thin Li-ion batteries exhibited excellent discharge performance, long cycle life, and very low swelling under high-temperature storage. A 1.5 M solution of LiBF4 in an ethylene carbonate (EC)/γ-butyrolactone (GBL) (1:3 by volume) mixed solvent is advantageous for use as the electrolyte in the laminated film bag because of its high flame point of 129°C, high boiling point of 216°C, low vapor pressure, and high conductivity of 2.1 mS/cm at -20°C The B-MCF anode in the LiBF 4 -EC/GBL electrolyte exhibited a high reversible capacity of 345 mAh/g. a high coulombic efficiency of 94% at the first cycle, and high rate capability. It was demonstrated that the thin Li-ion battery with a thickness of 3.6 mm has a high energy density of 172 Wh/kg. high rate capability between 0.2 and 3C rate discharge, a high capacity ratio of 50% at 1C rate discharge and -20°C, and a long cycle life of more than 500 cycles at 1C rate charge-discharge cycling. The B-MCF anode led to the high rate discharge performance and the long cycle life of the thin Li-ion batteries using the LiBF 4 -EC/GBL electrolyte. The very low swelling and small evolution of gas under the high-temperature storage at 85°C were attributable to the stability of LiBF 4 -EC/GBL electrolyte against the fully charged LiCoO 2 cathode material.