Dynamic effects of the Nuss procedure on the spine in asymmetric pectus excavatum

ObjectiveThis study aimed to elucidate dynamic effects of the Nuss procedure on the spine in the treatment of patients with pectus excavatum with asymmetric thoraces.MethodsTwenty-five patients with pectus excavatum who underwent the Nuss procedure were categorized into 4 groups by preoperative morphology of the spine and thoracic asymmetry. In group 1 (n = 8), the right side of the thorax was concave and the spine bowed to the right. In group 2 (n = 4), the right side of the thorax was concave and the spine bowed to the left. In group 3 (n = 5), the left side of the thorax was concave and the spine bowed to the right. In group 4 (n = 8), the left side of the thorax was concave and the spine bowed to the left. With computed tomographic data, finite-element models were produced to simulate each patient's thorax. Thereafter, dynamic response patterns of the spine to the Nuss procedure were examined. Validity of these biomechanical findings was verified by referring to clinical outcomes.ResultsIn group 1 and group 4 models, deformed spines were straightened; in group 2 and group 3 models, spinal bowing increased. These biomechanical findings were compatible with clinical evaluations.ConclusionsPerformance of the Nuss procedure for asymmetric pectus excavatum exerts dynamic influence on the spine. Response patterns of the spine are predictable from morphologic relationships between the asymmetric patterns of the anterior thoracic wall and the spine

Characterization of mouse switch variant antibodies by matrix-assisted laser desorption ionization mass spectrometry and electrospray ionization mass spectrometry

The amino acid sequences of mouse monoclonal antibodies have been characterized completely by mass spectrometry. Antibodies used in the present study were derived from mouse switch variant cell lines that produce four kinds of immunoglobulin Gs (IgGs). The amino acid sequences of these antibodies had not been estimated from the corresponding DNA sequence, so the sequences of IgGs derived from other strains were used as references in this study. Intra- and interchain disulfide bonds of the IgGs were reduced and carboxymethylated and the products were subjected to proteolytic digestion. The existence of N-linked oligosaccharides also was taken into account. The capabilities and limitations of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry and capillary liquid chromatography-electrospray ionization mass spectrometry are discussed in the structural characterization of the antibodies. Based on our results, allotypes of the antibodies examined are discussed. This study shows that amino acid sequences of proteins, such as IgG, can be investigated without information about the corresponding DNA sequence if appropriate reference sequences derived from other strains can be used

ADH Responses to Thoracic and Abdominal Surgery under Epidural Anesthesia

Changes of plasma ADH concentration were studied during thoracic and abdominal operations under epidural anesthesia comnbimed with nitrous oxide inhalation. In abdominal surgeries, ADH level was elevated by operative invasion as usually reported, significantly by peritoneal irritation particularly. In thoracic surgeries, on the other hand, ADH level showed a rise by operative invasion, but little significant change was observed by irritation to the pleura. There was no significant difference in ADH level between the high frequency positive-pressure ventilation group and the intermittent positive-pressure ventilation group

Postoperative Coagulation Changes in Patients with esophageal carcinoma

Postoperative coagulation changes were studied in 50 patients with esophageal carcinomas for 7 days following operation. Of these, 12 patients were examined further for changes in platelet aggregation rate as an index of platelet function. Just after operation, both platelet count and aggregation rate decreased, but at day 2 when the platelet count reached its lowest point, platelet aggregation returned to the preoperative level. Altough platelet aggregation decreased again, it recovered to the preoperative level earlier than did the platelet count. Changes in prothrombin time, activated partial thromboplastin time and fibrinogen and FDP-E levels may suggest pre-DIC state

Mandibular movement during sleep bruxism associated with current tooth attrition

Patient: Observation of attrition patterns suggests that mandibular movement in sleep bruxism (SB) may be associated with current tooth attrition. The aim of this study was to confirm this phenomenon by investigating mandibular movement and masseter muscle activity. The subject was a healthy 21-year-old Japanese male. We recorded biological signals including mandibular movement and masseter electromyograms (EMGs) with a polysomnograph. Based on the EMG using Okura’s criteria, SB events were classified into clenching, grinding and mixed types according to mandibular movement criteria. The close-open mandibular movement cycles (CO-cycles) during grinding and mixed type events were selected based on mandibular movement trajectories. Discussion: Fifty-eight CO-cycles were selected in seven grinding and three mixed types. We found that SB mandibular movements associated with current tooth attrition. Excessive lateral movements (ELM) beyond the canine edge-to-edge position were observed in the closing (10.3%) and opening (13.8%) phases of the CO-cycle. Total masseter muscle activity was significantly higher during voluntary grinding (VGR) than during CO-cycle including ELM (working side: P = 0.036, balancing side: P = 0.025). However, in the middle and late parts of the opening phase, working side masseter muscle activity was significantly higher during CO-cycle including ELM than during VGR (P = 0.012). In the early part of the closing phase, balancing side masseter muscle activity was significantly higher during CO-cycle including ELM than during VGR (P = 0.017). Conclusion: These findings suggest that excessive forceful grinding during ongoing SB events may have caused canine attrition in this patient

Effects of Histamine Receptor Blockers and the Rate of Administration of Morphine on Cardiovascular System

Blood pressure reduction during the high dose morphine anesthesia was investigated from the point of view of histamine receptor blockers and the rate of morphine administration. It was found as the results that blood pressure reduction was prevented by the administration of the histamine receptor blockers, and the effect was almost equivalent to that caused by morphine with the rate of infusion at 2 mg/min. Safer anesthesia may be performed in term of blood pressure reduction when H1 and H2 receptor blockers and a slow infusion of morphine with small divided doses are given

Enhanced stability of hippocampal place representation caused by reduced magnesium block of NMDA receptors in the dentate gyrus

BACKGROUND: Voltage-dependent block of the NMDA receptor by Mg(2+) is thought to be central to the unique involvement of this receptor in higher brain functions. However, the in vivo role of the Mg(2+) block in the mammalian brain has not yet been investigated, because brain-wide loss of the Mg(2+) block causes perinatal lethality. In this study, we used a brain-region specific knock-in mouse expressing an NMDA receptor that is defective for the Mg(2+) block in order to test its role in neural information processing. RESULTS: We devised a method to induce a single amino acid substitution (N595Q) in the GluN2A subunit of the NMDA receptor, specifically in the hippocampal dentate gyrus in mice. This mutation reduced the Mg(2+) block at the medial perforant path–granule cell synapse and facilitated synaptic potentiation induced by high-frequency stimulation. The mutants had more stable hippocampal place fields in the CA1 than the controls did, and place representation showed lower sensitivity to visual differences. In addition, behavioral tests revealed that the mutants had a spatial working memory deficit. CONCLUSIONS: These results suggest that the Mg(2+) block in the dentate gyrus regulates hippocampal spatial information processing by attenuating activity-dependent synaptic potentiation in the dentate gyrus

Educational effects using a robot patient simulation system for development of clinical attitude

Introduction: The aim of this study was to assess the effectiveness of improving the attitude of dental students toward the use of a full-body patient simulation system (SIMROID) compared to the traditional mannequin (CLINSIM) for dental clinical education. Materials and methods: The participants were 10 male undergraduate dental students who had finished clinical training in the university hospital 1 year before this study started. They performed a crown preparation on an upper premolar tooth using SIMROID and CLINSIM as the practical clinical trials. The elapsed time for preparation was recorded. The taper of the abutment teeth was measured using a 3-dimensional shape-measuring device after this trial. In addition, a self-reported questionnaire was collected that included physical pain, treatment safety, and maintaining a clean area for each simulator. Qualitative data analysis of a free format report about SIMROID was performed using text-mining analysis. This trial was performed twice at 1-month intervals. Results: The students considered physical pain, treatment safety, and a clean area for SIMROID significantly better than that for CLINSIM (P < 0.01). The elapsed time of preparation in the second practical clinical trial was significantly lower than in the first for SIMROID and CLINSIM (P < 0.01). However, there were no significant differences between the abutment tapers for both systems. For the text-mining analysis, most of the students wrote that SIMROID was similar to real patients. Conclusion: The use of SIMROID was proven to be effective in improving the attitude of students toward patients, thereby giving importance to considerations for actual patients during dental treatment

Systematic characterization of upper critical fields for MgB2_2 thin films using the two-band superconducting theory

We present experimental results of the upper critical fields $H_{\rm c2}$ of various MgB$_2$ thin films prepared by the molecular beam epitaxy, multiple-targets sputtering, and co-evaporation deposition apparatus. Experimental data of the $H_{\rm c2}(T)$ are successfully analyzed by applying the Gurevich theory of dirty two-band superconductivity in the case of $D_{\pi}/D_{\sigma}>1$, where $D_{\pi}$ and $D_{\sigma}$ are the intraband electron diffusivities for $\pi$ and $\sigma$ bands, respectively. We find that the parameters obtained from the analysis are strongly correlated to the superconducting transition temperature $T_{\rm c}$ of the films. We also discuss the anormalous narrowing of the transition width at intermediate temperatures confirmed by the magnetoresistance measurements.Comment: 7 pages, 7 figures, submitted to Phys. Rev.

CSF tau protein is a useful marker for effective treatment of superficial siderosis of the central nervous system: Two case reports

金沢大学附属病院神経内科We report two cases of superficial siderosis (SS) of the central nervous system (CNS), which is caused by chronic haemorrhaging into the subarachnoid space with haemosiderin deposition in the superficial portion of the CNS. Patient 1 had fluid collection in the spinal canal, which was reported as the source of the chronic bleeding. Patient 2 was bleeding from thickened dura at the level of the sacral vertebrae. Both of the patients had xanthochromic cerebrospinal fluid. We surgically repaired the sources of bleeding. Subsequently the cerebrospinal fluid (CSF) cleared and their symptoms were not aggravated for about 1 year. We measured several CSF markers of SS before and after surgery. Total tau protein (CSF-t-tau), phosphorylated tau protein (CSF-p-tau), iron (CSF-iron) and ferritin (CSF-ferritin) in the CSF were highly elevated at diagnosis. After surgery, the levels of CSF-t-tau and CSF-p-tau were markedly reduced while CSF-iron and CSF-ferritin had not decreased. It is suggested that CSF-t-tau and CSF-p-tau reflected the neural damage in SS and were useful to evaluate the effectiveness of SS therapies. © 2009 Elsevier B.V. All rights reserved