Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy

Introduction: Gait disturbance due to compressive cervical myelopathy has been previously described. However, data on how gait disturbance varies with the degree of lower extremity motor impairment are limited. Therefore, we investigated the characteristics of gait analysis based on severity and determined how gait disturbance progresses in compressive cervical myelopathy. Methods: We enrolled 44 patients (32 men and 12 women; mean age, 65.0 years) out of 108 consecutive patients with compressive cervical myelopathy who underwent spinal cord decompression surgery in our hospital. The exclusion criteria were inability to gait and complications affecting gait. Twenty-two patients with Japanese Orthopaedic Association scores 1 or 2 for lower extremity motor functions were assigned to the severe group, and 22 patients who scored 3 or 4 were assigned to the moderate group. Gait analysis was performed preoperatively using a long thin-type sensor sheet, and 25 healthy volunteers were assigned to the control group. Results: Stride length, swing phase, and gait speed decreased whereas step angle, stance phase, and double support duration increased as myelopathy progressed. Step width was significantly larger in the severe group than in the moderate and control groups. The cutoff values based on severe myelopathy with the inability to ascend or descend stairs without support were 60% for the stride length percentage of body height and 100 cm/s for gait speed. Conclusions: Decreases in stride length, swing phase, and gait speed and increases in step angle, stance phase, and double support duration are compensatory changes as cervical myelopathy progresses. Step width is a compensatory change that is not significantly altered in moderate myelopathy but increases when gait becomes affected, such that the patient cannot ascend or descend stairs without support

Clinical Characteristics of Corynebacterium ulcerans Infection, Japan

Corynebacterium ulcerans is a closely related bacterium to the diphtheria bacterium C. diphtheriae, and some C. ulcerans strains produce toxins that are similar to diphtheria toxin. C. ulcerans is widely distributed in the environment and is considered one of the most harmful pathogens to livestock and wildlife. Infection with C. ulcerans can cause respiratory or nonrespiratory symptoms in patients. Recently, the microorganism has been increasingly recognized as an emerging zoonotic agent of diphtheria-like illness in Japan. To clarify the overall clinical characteristics, treatment-related factors, and outcomes of C. ulcerans infection, we analyzed 34 cases of C. ulcerans that occurred in Japan during 2001–2020. During 2010–2020, the incidence rate of C. ulcerans infection increased markedly, and the overall mortality rate was 5.9%. It is recommended that adults be vaccinated with diphtheria toxoid vaccine to prevent the spread of this infection

Three-axial shape distributions of pebbles, cobbles and boulders smaller than a few meters on asteroid Ryugu

International audienceOver a broad size range, the shapes of impact fragments from catastrophic disruptions are distributed around the mean axial ratio 2: √2: 1, irrespective of experimental conditions and target materials. Although most blocks on asteroids are likely to be impact fragments, there is not enough quantitative data for reliable statistics on their three-axial lengths and/or ratios because it is difficult to precisely estimate the heights of the blocks. In this study, we evaluate the heights of blocks on asteroid Ryugu by measuring their shadows. The three-axial ratios of ~4100 small blocks with diameters from 5.0 cm to 7.6 m in Ryugu's equatorial region are investigated using eight close-up images of narrower localities taken at altitudes below 500 m, i.e. at <5.4 cm/pixel resolution, obtained immediately before the second touch-down of the Hayabusa2 spacecraft. The purpose of this study is to investigate the block shape distribution, which is important for understanding the geological history of asteroid Ryugu. Specifically, the shape distribution is compared to laboratory impact fragments. Our observations indicate that the shape distributions of blocks smaller than 1 m on Ryugu are consistent with laboratory impact fragment shape distributions, implying that the dominant shape-determining process for blocks on Ryugu was impact fragmentation. Blocks several meters in size in the equatorial region seem to be slightly flatter than the rest, suggesting that some blocks are partly buried in a bed of regolith. In conclusion, the shape distributions of blocks from several-cm to several-m in the equatorial region of asteroid Ryugu suggest that these are mainly fragments originating from the catastrophic disruption of their parent body and/or from a later impact