Multi-level isolated spinous process fractures with delayed deterioration observed radiographically: A case report

AbstractWe describe a rare case of multi-level isolated spinous process fractures not clearly detected on admission and subsequently diagnosed on radiography 2months after traumatic injury. Early recognition of a small crack in the spinous process and treatment with rest and immobilization is crucial to prevent chronic back pain or stiffness

Ordering and Fluctuation of Orbital and Lattice Distortion in Perovskite Manganese Oxides

Roles of orbital and lattice degrees of freedom in strongly correlated systems are investigated to understand electronic properties of perovskite Mn oxides such as La_{1-x}Sr_{x}MnO_{3}. An extended double-exchange model containing Coulomb interaction, doubly degenerate orbitals and Jahn-Teller coupling is derived under full polarization of spins with two-dimensional anisotropy. Quantum fluctuation effects of Coulomb interaction and orbital degrees of freedom are investigated by using the quantum Monte Carlo method. In undoped states, it is crucial to consider both the Coulomb interaction and the Jahn-Teller coupling in reproducing characteristic hierarchy of energy scales among charge, orbital-lattice and spin degrees of freedom in experiments. Our numerical results quantitatively reproduce the charge gap amplitude as well as the stabilization energy and the amplitude of the cooperative Jahn-Teller distortion in undoped compounds. Upon doping of carriers, in the absence of the Jahn-Teller distortion, critical enhancement of both charge compressibility and orbital correlation length is found with decreasing doping concentration. These are discussed as origins of strong incoherence in charge dynamics. With the Jahn-Teller coupling in the doped region, collapse of the Jahn-Teller distortion and instability to phase separation are obtained and favorably compared with experiments. These provide a possible way to understand the complicated properties of lightly doped manganites.Comment: 22 pages RevTeX including 25 PS figures, submitted to Phys.Rev.B, replaced version; two figures are replaced by Fig.17 with minor changes in the tex

Acute internal carotid artery occlusion after carotid endarterectomy

AbstractWe report two cases of acute carotid artery (CA) occlusion following carotid endarterectomy (CEA). Case 1: a 58-year-old man was admitted with transient right-sided hemiparesis. Magnetic resonance imaging (MRI) and MR angiography (MRA) revealed cerebral infarction in the left cerebral hemisphere and left CA stenosis. Ten days after admission, he underwent CEA. 24h after surgery, he developed right hemiplegia. MRI and MRA demonstrated a slightly enlarged infarction and left internal carotid artery (ICA) occlusion. Emergency reoperation was performed and complete recanalization achieved. The patient made a clinically significant recovery. Case 2: a 65year-old man underwent a right-sided CEA for an asymptomatic 80% CA stenosis. 48h after surgery, his family noticed he was slightly disorientated. MRI and MRA revealed multiple infarctions and right ICA occlusion. He was treated with antiplatelet therapy without reoperation because sufficient cross-flow from the left ICA through the anterior communicating artery was demonstrated by angiography, and his neurological symptoms were mild. His symptoms gradually alleviated and he was discharged 14days after surgery. With ICA occlusion after CEA, immediate re-operation is mandatory with severe neurological symptoms, whereas individualized judgement is needed when the symptoms are mild