Early fracture of the modular neck of a MODULUS femoral stem

AbstractWe present the case of a 46-year-old woman who underwent revision surgery approximately 4 years after total hip arthroplasty because of a fracture of the modular neck of a MODULUS femoral stem. The fractured surfaces of the retrieved implant were inspected using optical and scanning electron microscopy. Three-dimensional finite element analysis was also performed to identify the stresses that might have caused the failure. We concluded that active, obese patients who are implanted with a high-offset, small-sized modular component could experience stress-induced fractures of the modular neck, with proper fixation and osseointegration of the distal stem, especially if residual bone or tissue is present on the inner surface of the neck that could contribute to micromovement and decreased proximal fixation

Effects of Preoperative Use of an Immune-Enhancing Diet on Postoperative Complications and Long-Term Outcome: A Randomized Clinical Trial in Colorectal Cancer Surgery in Japanese Patients

Background: Despite recent advances in surgical techniques and perioperative management, postoperative infectious complications remain a problem in surgical patients. We performed a prospective randomized clinical trial to examine the effects of preoperative Immune Enhancing Diets (IEDs) on postoperative complications in Japanese patients who underwent curative colorectal cancer surgery. This study was also designed to evaluate the optimal dose of preoperative IEDs for the patients without malnutrition. Finally, we analyzed recurrence free survival (RFS) and disease-specific survival (DSS) after surgery in patients who did and did not receive IEDspreoperatively.Material and Methods: This was a prospective, randomized clinical trial conducted at the Department of Surgery, National Defense Medical College, from October 2002 to October 2005. The 88 patients undergoing colorectal surgery were enrolled and were randomly divided into 3 groups. The high- (High, N=26) and low- (Low, N=31) dose groups received normal food and, respectively, 750ml/day or 250ml/ day of IEDs for 5 days before the operation. The primary endpoint was the rates of surgical site infection (SSI) and non- infectious complications. We also evaluated the RFS and DSS rate, respectively. Results: The patients were followed for 77±10 months (9-133 months) after surgery. Incisional SSI rates in the IEDs (High and Low) groups were significantly lower than in the Control group. (0%*, 0%* and 17%) (*P<0.01 vs. Control) The incidences of the infections not involving the surgical site (non-SSI) and the lengths of hospital stay were similar among the three groups. No significant differences were observed in RFS or DSS.Conclusion: In Japanese patients undergoing colorectal cancer surgery, preoperative IEDs significantly reduced the rate of incisional SSI as compared with the control group. Very interestingly, in Japanese patients, preoperative 250ml/day IED intake may be adequate for colorectal cancer patients without malnutrition. However, with regard to the long term outcome, beneficial effects of preoperative IEDs are not evident

The Amelioration of Renal Damage in Skp2-Deficient Mice Canceled by p27 Kip1 Deficiency in Skp2−/− p27−/− Mice

SCF-Skp2 E3 ubiquitin ligase (Skp2 hereafter) targets several cell cycle regulatory proteins for degradation via the ubiquitin-dependent pathway. However, the target-specific physiological functions of Skp2 have not been fully elucidated in kidney diseases. We previously reported an increase in Skp2 in progressive nephropathy and amelioration of unilateral ureteral obstruction (UUO) renal injury associated with renal accumulation of p27 in Skp2−/− mice. However, it remains unclear whether the amelioration of renal injury in Skp2−/− mice is solely caused by p27 accumulation, since Skp2 targets several other proteins. Using Skp2−/−p27−/− mice, we investigated whether Skp2 specifically targets p27 in the progressive nephropathy mediated by UUO. In contrast to the marked suppression of UUO renal injury in Skp2−/− mice, progression of tubular dilatation associated with tubular epithelial cell proliferation and tubulointerstitial fibrosis with increased expression of collagen and α-smooth muscle actin were observed in the obstructed kidneys in Skp2−/−p27−/− mice. No significant increases in other Skp2 target proteins including p57, p130, TOB1, cyclin A and cyclin D1 were noted in the UUO kidney in Skp2−/− mice, while p21, c-Myc, b-Myb and cyclin E were slightly increased. Contrary to the ameliorated UUO renal injure by Skp2-deficiency, the amelioration was canceled by the additional p27-deficiency in Skp2−/−p27−/− mice. These findings suggest a pathogenic role of the reduction in p27 targeted by Skp2 in the progression of nephropathy in UUO mice

Geometry of the Philippine Sea plate subducting beneath the westernmost Nankai Trough

SSS035-06発表要旨 / 日本地球惑星科学連合2011年大会（2011年5月22日～5月27日, 幕張メッセ国際会議場） / 日本惑星科学連合の許諾に基づき本文ファイルを掲

構造研究に基づく南海トラフ（西部）地震発生帯のプレート形状および速度構造の3次元モデル

Great interplate earthquakes have repeatedly occurred in pairs along the Nankai Trough. In order to reduce a great deal of damage to coastal area from both strong ground motion and tsunami generation, it is necessary to understand rupture synchronization and segmentation of the Nankai megathrust earthquake. For a precise estimate of the rupture zone of the Nankai megathrust event based on the knowledge of realistic earthquake cycles and variations of magnitude, it is important to know the geometry and property of the plate boundary of the subduction seismogenic zone. To improve a physical model of the Nankai Trough seismogenic zone, the large-scale high-resolution wide-angle and reflection (MCS) seismic studies, and long-term observation have been conducted since 2008. Marine active source seismic data have been acquired along grid two-dimensional profiles having the total length of ~800km per year. A three-dimensional seismic tomography using active and passive seismic data observed both land and ocean bottom stations have been also performed. This study is part of 'Research concerning Interaction Between the Tokai, Tonankai and Nankai Earthquakes' funded by Ministry of Education, Culture, Sports, Science and Technology, Japan. The seismic survey was conducted off the Tokai area including the onshore survey across the eastern Kii Peninsula in 2012, the final year of this project. Compiling those studies provides a three-dimensional plate geometry and velocity structure models of the western Nankai Trough at the moment. Although their reliability and resolution should be evaluated, these models can be applied to a numerical simulation to examine if the observed rupture zone of the historical event can be reproduced. We will also try to construct more fine-scale model for the entire Nankai Trough area.SSS31-P15ポスター要旨 / 日本地球惑星科学連合2013年大会（2013年5月19日～5月24日, 幕張メッセ国際会議場） / 日本惑星科学連合の許諾に基づき本文ファイルを掲載http://www.godac.jamstec.go.jp/darwin/cruise/kairei/kr10-11/ehttp://www.godac.jamstec.go.jp/darwin/cruise/kairei/kr11-09/

Structural variation in the incoming Philippine Sea plate along the southwestern Nankai Trough

B32-08発表要旨, 日本地震学会2014年度秋季大会（2014年11月24日～26日, 新潟県新潟市）http://www.godac.jamstec.go.jp/darwin/cruise/kairei/kr14-05/ehttp://www.godac.jamstec.go.jp/darwin/cruise/kaiyo/ky14-07/

Structural variation in the incoming Philippine Sea plate along the Nankai Trough

The next large-thrust earthquake along the Nankai Trough, southwest Japan is concerned to occur within this century. Nonvolcanic deep low-frequency tremors and earthquakes are observed around the down-dip limit of the coseismic rupture zone of the last Tonankai and Nankai earthquakes [Obara, 2002]. One of the causes of these low-frequency seismic phenomena is considered to be fluid generated by dehydration processes from the subducting slab. It is important to investigate structural variation in the incoming Philippine Sea plate, including its fluid content to understand the generation of the low-frequency seismic phenomena as well as large-thrust earthquakes. In 2014, we conducted the seismic refraction and reflection survey in the northern margin of the Shikoku Basin, where the Philippine Sea plate is subducting beneath the Eurasia plate at the Nankai Trough. We conducted a 360km long seismic profile about 50-60km seaward of the deformation front along the Nankai Trough. 35 OBSs were deployed along the profile with the interval of 10km. A tuned airgun array shot with a total volume of 7800 cu. in. every 200m for OBSs, and 380 cu. in. every 37.5m for a 192-channel, 1.2km-long hydrophone streamer. In the time-migrated reflection section, variation in the sedimentary layer and basement reflection can be recognized off Shikoku, which may correspond with the boundary of the plate age proposed by magnetic lineation [Okino et al., 1999]. In the southwestern part of the profile, the basement reflection is not always clear, and shows smooth structure. Comparatively in the northeastern part, basement changes in depth drastically with prominent reflection signals. In the wide-angle OBS data, PS converted waves are clearly observed over along the seismic profile. In particular, PS converted waves refracted from the uppermost mantle can be remarkably recognized in the northeastern half of the profile. We will show the structural variation of the oceanic crust of the incoming plate, which may be related to the formation of the Shikoku Basin as well as the generation of the various seismic activities including the low-frequency events, by using OBS data. This study is part of ‘Research project for compound disaster mitigation on the great earthquakes and tsunamis around the Nankai Trough region’ funded by MEXT, Japan.Poster abstract T51A-4578 presented at 2014 Fall Meeting, AGU, San Francisco, Calif., 15-19 Dec.http://www.godac.jamstec.go.jp/darwin/cruise/kairei/kr14-05/ehttp://www.godac.jamstec.go.jp/darwin/cruise/kaiyo/ky14-07/