Use of the halo-pelvic apparatus for treatment of fracture-dislocations of the thoracic and lumbar spines accompanied by paraplegia

Twenty-five cases of paraplegia due to fracture-dislocations of the thoracic and lumbar vertebrae were treated using the halo-pelvic apparatus. Thirteen of them only needed the apparatus, two underwent laminectomy, and ten had posterior spinal fusion in addition. The advantages of this method are that gentle reduction can be achieved without severe complications, and that posterior spinal fusion can be performed with this apparatus on, thus enabling an early start to the subsequent exercise program and minimal absence from work.</p

A new nail-plate for treatment of fracture of the neck of the femur

Operative treatment of fractures of the neck and trochanter of the femur does not always produce a satisfactory result. This is usually due to biomechanical problems with the available internal fixation methods. We studied the anatomy of the neck of the femur by roentgenograms and sectional specimens from 70 cadavers. In addition, various nail-plates were subjected to buckling tests and, by simultaneously attaching a strain-gauge, stress distribution was calculated. The results of these preliminary studies were then used to design a new nail-plate better than those available at present. Testing of this new nail-plate confirmed that it had a strength equal to that of the Holt nail-plate (the strongest of the available nail-plates).</p

Evaluation of physical properties of thin film and measurement of unsteady thermal stress

Winding defect such as the roll wrinkles or slips to lose the value of the product. Winding defect is caused by the internal stress condition in the roll and the temperature change of the roll after winding. Therefore, it is essential to analyze the internal stress theoretically. However, the tendency of internal stress to occur as the film thickness becomes thin is not known. The internal stress of the roll was measured at each temperature. Further changes in internal stress were also measured by changing the ambient temperature around the roll.The winding device used in this research is a structure reproducing the unwinding and the rewinding in the roll-to-roll production system. A film-like pressure sensor was used to measure the radial internal stress of the roll. After winding up the film, the internal stress in the radial direction inside the roll was measured when the temperature around the roll was heated for 12 hours. Measurement frequency was measured for internal stress every hour.In the PET film with a film thickness of 40 μm, the internal stress in the radial direction inside the roll was measured when the roll surrounding temperature was heated for 12 hours. For the middle and outer layers, the internal stress gradually increased with the lapse of time. It is considered that this increased the pressure by thermal expansion from the outer peripheral side of the roll. However, the value of the stress in the inner layer decreased greatly. This is thought to be caused by uneven heating due to the heat source, winding wrinkles occurred in the vicinity of the sensor sandwiched between the rolls, and stress relaxation occurred

LINE-1 hypomethylation status of circulating cell-free DNA in plasma as a biomarker for colorectal cancer.

Colorectal cancer (CRC) is a serious public health problem and non-invasive biomarkers improving diagnosis or therapy are strongly required. Circulating cell-free DNA (cfDNA) has been a promising target for this purpose. In this study, we evaluated the potential of long interspersed nuclear element-1 (LINE-1) hypomethylation as a blood biomarker for CRC. LINE-1 hypomethylation level in plasma cfDNA in 114 CRC patients was retrospectively examined by absolute quantitative analysis of methylated alleles real-time PCR, and was expressed using LINE-1 hypomethylation index (LHI) [unmethylated copy number/ (methylated copy number + unmethylated copy number)]. Greater LHI values indicated enhanced hypomethylation. In our clinicopathological analysis, CRC patients with large tumors (≥6.0 cm), advanced N stage (≥2), and distant metastasis (M1) had statistically significantly higher cfDNA LHI than other CRC patients, suggesting cfDNA LHI as a disease progression biomarker for CRC. Furthermore, early stage I/II (n = 57) as well as advanced stage III/IV (n =57) CRC patients had significantly higher cfDNA LHI than healthy donors (n=53) [stage I/II: median 0.369 (95% confidence interval, 0.360-0.380) vs. 0.332 (0.325-0.339), P \u3c 0.0001; stage III/IV: 0.372 (0.365-0.388) vs. 0.332 (0.325-0.339), P \u3c 0.0001]. The receiver operating characteristic analysis showed that cfDNA LHI had the detection capacity of CRC with area under the curve(AUC) of 0.79 and 0.83 in stage I/II and stage III/IV CRC patients, respectively. The present study demonstrated for the first time the potential of plasma cfDNA LHI as a novel biomarker for CRC, particularly for early stage detection

Self-Expandable Metal Stent Placement as a Bridge to Laparoscopic or Open Surgery for Obstructive Colorectal Cancer: Short-Term Outcomes of Nineteen Consecutive Cases

Purpose Laparoscopic colorectal resection is a feasible and less invasive procedure with short-term advantages compared with open surgery; however, the evidence for its efficacy for treating obstructive colorectal cancer (CRC) is lacking. In this study, we aimed to determine short-term outcomes of SEMS placement for obstructive CRC followed by laparoscopic colorectal resection.Methods As of August 2013, 51 patients with obstructive CRC underwent stent insertion. Thirty-two patients received palliation therapy not intended for tumor resection. After decompression of the proximal intestine, nine and 10 patients underwent laparoscopic and open surgery, respectively. Clinicopathological, intraoperative, and postoperative data were retrospectively collected.Results There were no differences in resection rates and curabilities between the two groups. All surgeries were performed with a single-stage anastomosis, and no anastomotic leakage was observed. There was one patient with abdominal morbidity in the open group (Open) and none in the Lap group. There was no mortality in either group. Time to flatus (3.4 ± 1.8 days, Lap; 2.6 ± 1.1 days, Open) and time to oral intake (7.9 ± 2.5 days, Lap; 7.7±1.9 days, Open) were similar between the groups. Postoperative hospitalization times for the Lap group were shorter, but the difference was not statistically significant (15.2 ± 3.9 days, Lap; 21 ± 11.7 days, Open, p = 0.21).Conclusion Our findings indicate that laparoscopic surgery combined with preoperative stent placement is feasible as well as safe compared with open surgery for obstructive CRC

Current status of delirium assessment tools in the intensive care unit: a prospective multicenter observational survey

Delirium is a critical challenge in the intensive care unit (ICU) or high care unit (HCU) setting and is associated with poor outcomes. There is not much literature on how many patients in this setting are assessed for delirium and what tools are used. This study investigated the status of delirium assessment tools of patients in the ICU/HCU. We conducted a multicenter prospective observational study among 20 institutions. Data for patients who were admitted to and discharged from the ICU/HCU during a 1-month study period were collected from each institution using a survey sheet. The primary outcome was the usage rate of delirium assessment tools on an institution- and patient-basis. Secondary outcomes were the delirium prevalence assessed by each institution's assessment tool, comparison of delirium prevalence between delirium assessment tools, delirium prevalence at the end of ICH/HCU stay, and the relationship between potential factors related to delirium and the development of delirium. Result showed that 95% of institutions used the Intensive Care Delirium Screening Checklist (ICDSC) or the Confusion Assessment Method for the ICU (CAM-ICU) to assess delirium in their ICU/HCU, and the remaining one used another assessment scale. The usage rate (at least once during the ICU/HCU stay) of the ICDSC and the CAM-ICU among individual patients were 64.5% and 25.1%, and only 8.2% of enrolled patients were not assessed by any delirium assessment tool. The prevalence of delirium during ICU/HCU stay was 17.9%, and the prevalence of delirium at the end of the ICU/HCU stay was 5.9%. In conclusion, all institutions used delirium assessment tools in the ICU/HCU, and most patients received delirium assessment. The prevalence of delirium was 17.9%, and two-thirds of patients had recovered at discharge from ICU/HCU

The Effect of Interim FDG-PET-guided Response-Adapted Therapy in Pediatric Patients with Hodgkin’s Lymphoma (HL-14) : Protocol for a Phase II Study

This trial enrolls patients with untreated Hodgkin’s lymphoma aged<20 years at diagnosis and examines the effects of omitting radiation therapy if the FDG-positron emission tomography (PET) findings after two completed cycles of combination chemotherapy are negative. It thereby aims to determine whether patients who truly require radiation therapy can be identified by FDG-PET. If so, this modality could be used to omit radiation therapy for all other patients, decreasing the risk of serious long-term complications without affecting survival rates. The outcomes of patients for whom FDG-PET is used to assess early treatment response will also be determined