Changes in saccadic eye movement and smooth pursuit gain in patients with acquired comitant esotropia after strabismus surgery

This study investigates the change in horizontal saccadic eye movement and smooth pursuit in patients with acquired comitant esotropia (ACE), before and after strabismus surgery. The horizontal saccades and pursuit in 11 patients with ACE were recorded using a video eye-tracker under binocular viewing before and after strabismus surgery. Participants were instructed to fixate on the new target as rapidly as possible when it randomly appeared at either 18.3° rightward or 18.3° leftward. For smooth pursuit, participants were asked to track, as accurately as possible, a step-ramp target moving at ±6.1°/s. The asymmetry of adduction-abduction and the binocular coordination in gains of saccade and pursuit were compared between the pre- and post-surgical data. The asymmetry of adduction-abduction saccade gain in each eye after surgery tended to be smaller than that before surgery. The binocular coordination of saccade showed significant improvement after surgery in only the non-dominant eye direction. Adduction-abduction asymmetry in the smooth pursuit gain in each eye after surgery tended to be smaller than before surgery. After surgery, the binocular coordination of pursuit was improved significantly in both directions. In patients with ACE, binocular coordination of saccade and smooth pursuit was poor. Binocular coordination of saccade and pursuit seems to be improved due to the improvement in ocular deviation angle and binocular visual function after surgery

Histological Evaluation of Lumbar Spine Changes in Rats with Collagen-induced Arthritis

【Background】 To histologically evaluate lumbar involvement in rheumatoid arthritis (RA) by investigating rats with collagen-induced arthritis (CIA) and to assess the potential effects of RA on the discovertebral joints and facet joints. 【Methods】 Seven-month-old female Sprague-Dawley rats were divided into groups with CIA and without CIA (control). All rats were sacrificed at 8 weeks after initial sensitization and the lumbar spine (L5/6) was harvested. Then the lumbar spine block specimens were stained with Villaneuva bone stain and sectioned in the midsagittal plane. The left facet joints were also sectioned in the midaxial plane. Specimens were studied under a microscope and infiltration of inflammatory cells was investigated. 【Results】 In the CIA group, lumbar lesions were observed in 13/18 rats (76%). Lymphocytes infiltrated into the anterior rim of the vertebral bodies only in 2 rats, while lymphocytes infiltrated the facet joints only in 4 rats. Both sites were involved in 7 rats. In addition, osteoclasts invaded the anterior rim of the vertebral bodies and formed cavities that also contained lymphocytes. Formation of pannus was seen in the facet joints in 11/18 rats. 【Conclusion】 In CIA rats, infiltration of inflammatory cells into the anterior rim of the vertebral bodies alone or into the facet joints alone was demonstrated in 2 rats and 4 rats, respectively, while both sites were involved in 7 rats. Therefore, lesions at the anterior rim of the vertebral body did not arise secondary to facet joint involvement, but were caused by CIA along with synovial lesions of the facet joints

Influence of Diabetes Mellitus on Surgical Outcomes in Patients with Cervical Myelopathy: A Prospective, Multicenter Study

[Study Design] Multicenter, prospective study. [Purpose] To investigate the effects of diabetes mellitus (DM) on surgical outcomes in patients with cervical myelopathy. [Overview of Literature] To date, few studies have investigated the influence of postoperative blood glucose or glycated hemoglobin (HbA1c) levels on surgical outcomes. [Methods] The participants were patients who underwent surgery for the treatment of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. The 61 cases were evaluated preoperatively and 1 year postoperatively using the Japanese Orthopaedic Association (JOA) scores and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The study variables included fasting blood glucose and HbA1c levels measured preoperatively and at 1 week, 4 weeks, and 1 year postoperatively; the F-wave conduction velocity, latency, rate of occurrence, and M-wave latency in the ulnar and tibial nerves were measured preoperatively and at 1 year postoperatively. The patients were divided into a group without diabetes (N group, 42 patients) and a group with diabetes (DM group, 19 patients). We then assessed the associations between the surgical outcomes and each of the study variables. [Results] JOA scores significantly improved in both groups; however, no significant between-group differences were found. There was no significant improvement in the JOACMEQ scores, which assessed cervical function, upper and lower limb function, and bladder function in both groups. We then subdivided the DM group into those with a good control of HbA1c after 1 year (DMG group, 12 patients) and those with HbA1c deterioration after 1 year (DMB group, seven patients), prior to comparing the surgical outcomes. The JOACMEQ scores for upper and lower limb function significantly improved in the DMG group (p<0.01). Compared with the DMB group, there were no significant increases in upper or lower limb function scores in the DMG group. [Conclusions] Poor glycemic control might prevent postoperative functional recovery of the spinal cord

A surgical orthodontic case with multiple tooth losstreated by bite splint with CAD/CAM method

Recently, the number of middle–aged and elderly orthognathic surgery patients with un-healthy oral conditions has been increasing. Although an interdisciplinary approach in-volving orthodontist, oral surgeon and prosthodontist is required in orthognathic surgery of these patients, deciding the jaw position after orthognathic surgery is difficult due to unhealthy oral conditions such as edentulous jaw and tooth loss. In the recently study, preoperative simulation methods for orthognathic surgery have been developed through the use of virtual reality computed technology. A male first examined at the age of 36 years and 7 months was diagnosed as having mandibular protrusion with multiple tooth loss and mandibular deviation. The patient was treatedinterdisciplinary by a team of specialists in surgical orthodontic, dental prosthetic and periodontal treatment. Using the interdisciplin-ary approach and haptic device with virtual tactile perception showed satisfactory results loss treated with orthognathic surgery

Adrenal androgen levels as predictors of outcome in castration-resistant prostate cancer patients treated with combined androgen blockade using flutamide as a second-line anti-androgen

金沢大学附属病院泌尿器科Objectives: To analyze the clinical effects of flutamide as a second-line anti-androgen for combined androgen blockade in patients with castration-resistant prostate cancer (CRPC) initially treated with bicalutamide as a first-line anti-androgen. Methods: Our study population consisted of 16 patients with CRPC who were treated with flutamide (375 mg daily) as second-line hormonal therapy. Dehydroepiandrosterone (DHEA), androstenedione, androstenediol, testosterone and dihydrotestosterone were measured to investigate the relationship between plasma androgens and outcome following treatment. Furthermore, adrenal androgen levels in a medium of adrenal cancer cell line were also measured. Results: Second-line hormonal therapy using flutamide resulted in a reduction of the prostate-specific antigen (PSA) level in 14 (87.5%) of 16 patients. A PSA decline greater than 50% was observed in 8 (50%) of the 16 patients. The duration of median responsiveness was 6.25 months. PSA elevation of baseline androstenediol level was a predictive factor of PSA responsiveness. The lower DHEA group improved the duration of responsiveness to flutamide. In vitro, 3 μmol/L flutamide suppressed DHEA, androstenedione and androstenediol synthesis compared with bicalutamide in a medium of adrenal cancer cell line. Conclusions: Our data show that flutamide suppresses the adrenal androgens in comparison with bicalutamide. The responsiveness and response duration of flutamide can be predicted in patients with a higher baseline androstenediol level and a lower DHEA level. Metabolites from adrenal androgens contribute to the progression of prostate cancer. © 2010 The Japanese Urological Association

Expression and Significance of Angiopoietin-1, 2 and Tie-2 Receptor in Human Extrahepatic Bile Duct Carcinoma: Correlation with Clinicopathological Factors

Extrahepatic bile duct cancer is a high mortal malignancy. Angiopoietin (Ang) and its receptor Tie, which are known to contribute to angiogenesis, have recently been reported to participate in the proliferation and differentiation of malignant tumor cells. The aim of this study is to investigate the expression and the significance of Ang-1, 2 and Tie-2 in extrahepatic bile duct carcinoma cells. We used immunohistochemistry to study 119 cases of surgically resected human extrahepatic bile duct carcinoma, and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) to confirm the expression of Ang-1, 2 and Tie-2 mRNA. Among these 119 cases, 52 (43.7%), 50 (42.0%) and 89 (74.8%) cases showed positive staining for Ang-1, 2 and Tie-2, respectively, in bile duct carcinoma cells. In 38 cases of normal mucosa, 6 (15.8%), 10 (26.3%) and 9 (23.7%) cases were positive for Ang-1, 2 and Tie-2, respectively. The positivity for Ang-1 and Tie-2 in normal mucosa was significantly different from all carcinomas (p<0.01 and p<0.001, respectively). We found no significant correlation between Ang-1 and Ang-2 expression and other clinicopathological factors such as histological differentiation, grade of tumor invasion or survival rate after surgery. In contrast, Tie-2 expression correlated significantly with degree of desmoplasia, cancer stage and survival of patients. RT-PCR analyses of five surgically resected tumor samples and three human bile duct cancer cell lines all showed positive expression of Ang-1, 2 and Tie-2 mRNAs. High expressions of Ang-1, 2 and Tie-2 in human extrahepatic bile duct carcinoma cells suggested that Ang-Tie system may be involved in the progression of human bile duct cancer

A chin cap type protractor device was used for skeletal mandibular protrusion,A case of orthodontic treatment by extracting maxillary and maxillary premolars while paying attention to lateral changes

Summary This case was a 10–years and 10–month–old girl who visited the hospital with a complaint of opposite anterior bite. Facial findings showed no anterior asymmetry, but lateral features showed a concave type. The molar relationship was Angle Class III on both sides,and the left side showed a more prominent class III relationship. Anterior cross bite and labial inclination of both upper and lower side anterior teeth were observed. The diagnosis was a case of skeletal mandibular protrusion with functional factors. It was decided to use a chin–cap type anterior traction device of the upper jaw that can promote the growth of the upper jaw and suppress the growth of the lower jaw. In the phase of adult treatment, it was decided to extract the maxillary right first premolar, the maxillary left second premolar,and the mandibular bilateral first premolar to establish Angle Class I. At the end of the dynamic treatment, the molar relationship showed Angle Class I on both the left and right sides, and a tight and stable cusp fitting was maintained. Although ANB did not change on the lateral cephalogram, labial inclination was observed on both upper and lower anterior teeth. The dynamic treatment period was 2 years and 11 months, and the end age was 18 years and 1 month. No problem was observed in the occlusal state 4 years after the device was removed, but it will be carefully observed in the future

A case of skeletal mandibular prognathism in which due to lateral incisor root resorption caused by impacted maxillary canines on both sides,lateral incisors on both sides were extracted and the canines were arranged in the side incisor area.

Summary.In this case,marked root resorption of maxillary incisors on both sides due to impaction of maxillary canines on both sides was observed.Treatment for impacted maxillary canines includes induction in the row of teeth using fenestration and traction,extraction,transplantation,observation,and so on.It is necessary to select a method of treatment taking into account the position of the crowns and roots of the impacted teeth,the amount of movement in the direction of traction,and the effect on neighboring teeth and periodontium,as well as the degree of invasiveness and the prognosis.In this case,in the first stage of treatment,the maxillary lateral incisors on both sides were extracted and fenestration and traction of the maxillary canines on both sides was performed.Subsequently,observation was conducted till the end of the growth spurt.However,because vigorous forwards growth of the mandible was observed,at the start of the second stage of treatment,skeletal mandibular prognathism accompanying loss of the maxillary lateral incisors on both sides was diagnosed.In the second stage of treatment it was decided that surgical orthodontic treatment would be performed to improve the chief complaint.However due to the patient’s desire,surgical orthodontic treatment employing osteotomy of the mandible in isolation was performed.It was feared that performing Angle Class II finishing conducted with extraction of maxillary lateral incisors and no extraction of mandibular teeth would result in the amount of recession of the mandible becoming large and retraction.Therefore,treatment consisting of extraction of mandibular second premolar teeth and Angle Class I finishing was performed,and the canines on both sides were arranged in the lateral incisor area.We report that as a result of this treatment,a favorable treatment result and stable post–treatment progress were obtained

Case of anterior teeth crowding in which canine teeth extraction was performed for maxillary left canine impaction

An impacted tooth is one that fails to erupt into the dental arch. Teeth become impacted because of dense adjacent teeth, excessive soft tissue or a genetic cause. An inadequate arch length and jaw space in which to erupt are the most common reasons for impaction. This most commonly in happens the wisdom teeth. As a general rule, many impacted teeth must be removed, and canine teeth remain impacted or undergo fenestration. In orthodontic treatment, the extraction of impacted canines is one of the treatment plans for patients with malocclusion. This report describes the orthodontic treatment of a patient with anterior tooth crowding with horizontal impaction of the maxillary left canine. A 34-year–old male patient presented with the chief complaint of crowding. Extraction of the impacted canine instead of the first premolar on the left side of the maxilla was chosen for this patient. After orthodontic treatment, there was no significant change in the facial profile, and acceptable occlusion was achieved. No relapse had been observed after two years of retention