Tadpole system as new lumbar spinal instrumentation

<p>Abstract</p> <p>Background</p> <p>There have been reports of serious complications associated with pedicle screw fixation, including nerve root injuries caused by accidental screw insertion. We have developed a new system of lumbar spinal instrumentation that we call Tadpole system^®. The purposes of this report were to show the results of a biomechanical study and the short-term outcome of a clinical study, as well as to determine the usefulness of this system.</p> <p>Methods</p> <p>The Tadpole system^®lumbar spinal fusion is a hook-and-rod system according to which the spine is stabilized using 2 sets of 2 spinous processes each that are held in place by 4 hooks tandemly connected to a rod. The biomechanical study was done using 5 human lumbar cadaveric spines, and the range of motion (ROM) was examined in a non-treatment model, an injured model, a pedicle screw fixation model and a Tadpole system^®model. For the short-term clinical study the Tadpole system^®was used in 31 patients, and the factors analyzed were operation time, time required for spinal instrumentation, amount of intraoperative bleeding, postoperative improvement rate of the Japanese Orthopaedic Association (JOA) score for lumbar spinal disorders, instrumentation failure, spinous process fracture, spinal fluid leakage, nerve root injury, postoperative infection, and bone fusion 2 years after the operation.</p> <p>Results</p> <p>The ROM in the Tadpole system^®model was slightly bigger than that in the pedicle screw fixation model, but smaller than that in the normal control model. These biomechanical data indicated that the Tadpole system^®provided fairly good stability. The mean operation time was 79 min, the mean time required for spinal instrumentation was 8 min, and the mean amount of intraoperative bleeding was 340 mL. The mean postoperative improvement rate of JOA score was 70.9 ± 24.8%. Instrumentation failure (dislocation of a hook) occurred in one patient, and none of the patients developed spinous process fracture, spinal fluid leakage, nerve root injury, or postoperative infection. Two years after the operation, bone union was confirmed in 29 of the 31 patients (93.5%).</p> <p>Conclusion</p> <p>We conclude that this system is a useful, easy-to-use and safe spinal instrumentation technique for lumbar fusion surgery.</p

Intradural squamous cell carcinoma in the sacrum

<p>Abstract</p> <p>Background</p> <p>Leptomeningeal carcinomatosis occurs in patients with cancer at the rate of approximately 5%; it develops particularly in patients with breast cancer, lung cancer, melanoma, leukemia, or malignant lymphoma. We describe a rare case of leptomeningeal carcinomatosis in which spinal intradural squamous cell carcinoma with no lesions in the cerebral meninges and leptomeninx, was the primary lesion.</p> <p>Methods</p> <p>A 64-year-old man complained of sacral pain. Although the patient was treated with analgesics, epidural block and nerve root block, sacral pain persisted. Since acute urinary retention occurred, he was operated on. The patient was diagnosed as having an intradural squamous cell carcinoma of unknown origin.</p> <p>Results</p> <p>Since the patient presented with a slightly decreased level of consciousness 2 months after surgery, he was subjected to MRI scanning of the brain and spinal cord, which revealed disseminated lesions in the medulla oblongata. The patient died of pneumonia and sepsis caused by methicillin-resistant <it>Staphylococcus aureus </it>5 months after surgery.</p> <p>Conclusion</p> <p>We report the first case of a patient with intradural squamous cell carcinoma with unknown origin that developed independently in the sacrum.</p

中国系マレーシア人と適応力

Of the 30 million Chinese living all over the world, 6 million are located in Malaysia. Occupying 30% of the whole population of the country, they produce 70% of the national income, while the Malays contribute only 20% of the country\u27s production although making up 60% of the national population. Even Malaysia\u27s Prime Minister, Dr. Mahathir of Malay origin, accepts his people as not superior to their Chinese compatriots. Why? The Malays were embedded in a life of continuous and simple agriculture-fishery work ; on the other hand, the Chinese, pushed out from the Continent by calamities, were forced to try to share unfamiliar backgrounds. This same living within a homogeneous circumstance has cultivated in the Malays a mild and gentle demeanor; the cohabitation for survival in a heterogeneous environment has encouraged the Chinese to forge an even tough and rough character. Urged by global capitalism, the world is to increase the inter-connectedness among different peoples. The daily contact with the unknown judges invalid the single identity. The overseas Chinese, fostered by their multi-identities, will be even more an appropriate model of success in the internationalization of this 21st century

カナダの多民族社会 : 民族の共生

Canadian Multicultural Society - the co-living of plural ethnic groups In the year 2000, the number of international immigrants totaled almost 200 million. In the past century, the world\u27s population tripled, and masses of emigrants left their homelands, not being absorbed in their own countries. In addition, the population in the developing world is estimated to increase to 3 billion in 50 years. Canada has been seeking ways for its diverse population to coexist with its inherent pluralistic values. The Multicultural Act has its limitations, being accused by some of promoting ethnic isolation as well as national disbanding. However, this legislation should be tolerated because it concerns a totally new, epoque making national policy in the midst of an era of transition of the state of the world as a result of the recent relocation of massive numbers of people. If Canada can be free of German Neo-Nazi skinheads and the issue of Muslim women\u27s headscarves in France, for example, it is thanks to this "slogan" of self-change for a cosmopolitan future

バングラデシュにおけるクリエンテリスモ

Bangladesh, born in 1971 and ranked by the World Bank Poverty Index 67^ among 78 countries (1997), still remains one of the least developed nations, devoid of the history of her own national dynasty, the basement of a concentration of autonomous powers and collaboration among the people. The inhabitants of Bangladesh, scattered and less solid, have been obliged-for their survival-to depend upon local bosses who have used these farmers for their own personal gain ; thus was established the basic form of "Patron-Client Relationship" which keeps the people of modern day Bangladesh from cultivating self-reliance, developing mutual cooperation amongst themselves, and creating an independent middle class. This so-called "clientelism" is also a seed bed of curruption. Everyone from major politicians to minor officials who retain any kind of vested rights indulges in lucrative dealings with businessmen through receiving a bribe called "speed money". Supervisors are bought and checks don\u27t function, so that, following the investigation published by Transparency International in the year 2002, only 4% of the cases charged with corruption have been convicted ; and finally, out of 102 countries surveyed, the Corruption Perception Index ranks this country at the very bottom at 102^. Are there any hopeful prospects for settling with this "endemic disease" of corruption and advancing the nation forward ? The solution must be carried out by entrepreneurs\u27 self-reliant efforts as well as by NGOs\u27 positive activities, all keeping a distance from politics

コロンビア ボトムアップへの期待

"Bottom Up" might be still considered as a possible model case for "take off" of the third world. Japan after the Meiji owes his economic success to this active participation of massive subordinates, however, if this historical achievement of ours could not be adapted to, for example, Latin American world, evidently, it is because they have had their own peculiar life backgrounds characterized mainly by their patron-client relationship. This "clientelismo" has hindered the people, illiterate and disadvantaged, from cultivating their own will, decision making and then acting; they have been rendered passive, isolated one another among themselves, waiting for "charity deeds" their patron bestows to their clients. The leaders have been indifferent of national welfare and the people apathetic of even regional development.In the midst of recently accelerated globalization the difference between developed and underdeveloped countries appears more and more distinct. The government threatened by the very retard of the nation has started to try to mold private power, nevertheless, the real formation of "Bottom Up" can be hardly attained by "Top Down" but by "stand firm" of the awakened desperates. The following is a case study on this subject in Colombia

Improving bonding strength by non-thermal atmospheric pressure plasma-assisted technology for A5052/PEEK direct joining

The direct bonding of A5052 aluminum (Al) alloy to the engineering polymer poly(ether ether ketone) (PEEK) using an atmospheric pressure plasma-assisted process was demonstrated. The effect of plasma irradiation on the bonding surface of metal resin on the bonding strength following thermal press fitting method was investigated. Specimens bonded by plasma irradiation on the PEEK surface only showed a high tensile shear stress of 15.5 MPa. With increasing plasma irradiation time, the bond strength of the samples bonded to the PEEK surface by plasma irradiation increased. The increase in the bond strength between metals and polymers following direct bonding is caused by the addition of oxygen functional groups on the polymer. In contrast, specimens in which only the Al was exposed to the plasma showed a decrease in bond strength compared with unirradiated samples. This reduction in bond strength is attributed to the forming magnesium oxide, which forms in the early stages of participation due to plasma irradiation.The version of record of this article, first published in International Journal of Advanced Manufacturing Technology, is available online at Publisher’s website: https://doi.org/10.1007/s00170-023-12747-