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STUDY DESIGN.: Immunohistological analysis of spinal glial cells and analysis of pain behavior in the rat neuropathic pain model were investigated to clarify the function of tumor necrosis factor (TNF)-[alpha] receptors p55 type 1 and p75 type 2. OBJECTIVE.: Our objective was to investigate changes in hyperalgesia and glial cell activation after injection of antibodies to each TNF receptor in a rat sciatic nerve injury model. SUMMARY OF BACKGROUND DATA.: Recent research has revealed that activation of spinal glia plays an important role in radicular and neuropathic pain. TNF-[alpha] is reportedly a modulator for glial cell activation; however, the precise relationship between TNF-[alpha] and its 2 receptors on glial cells has not been fully delineated. METHODS.: Chronic constriction sciatic nerve injury and sham-operated rats were used. Antibodies to p55 or p75 or saline were intrathecally injected at the L5 level into rats with chronic constriction injury. Mechanical allodynia was examined for 2 weeks. Spinal cords were removed for immunohistochemical studies of ionized calcium-binding adaptor molecule 1 or glial fibrillary acidic protein. RESULTS.: Saline rats showed significantly more mechanical allodynia and the number of ionized calcium-binding adaptor molecule 1-immunoreactive microglia and glial fibrillary acidic protein-immunoreactive astrocytes were significantly increased in the saline rats compared with sham-operated rats during the 2 weeks. Injection of both antibodies significantly reduced pain behavior and anti-p55 caused significantly greater reduction compared with anti-p75. The numbers of microglia in both the antibodies groups were significantly decreased when compared with the saline group. In addition, the anti-p55 antibody suppressed microglial activation more than the anti-p75 antibody. CONCLUSION.: These results indicate that the microglial TNF-[alpha] p55 pathway played a more important role than the TNF-[alpha] p75 pathway in the pathogenesis of peripheral nerve injury pain. This suggests that future studies seeking to clarify neuropathic pain should target TNF-[alpha] and p55 receptors in microglia. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Animal model of intravertebral disc (IVD) degeneration. OBJECTIVE.: To examine production of inflammatory mediators in IVDs and neuropeptides in dorsal root ganglia (DRGs) in rat models of IVD compression and injury. SUMMARY OF BACKGROUND DATA.: Sensory nerve fibers in IVDs and inflammatory mediator responses have been verified in animal models of IVD injury. However, the IVD injury in animals incompletely models degenerated human IVDs causing discogenic low back pain, because human IVDs are also subject to compression. METHODS.: Experimental groups (controls, IVD injury, IVD compression, and their combination) of Sprague Dawley rats were prepared. Fluoro-Gold (FG; Fluorochrome, Denver, CO) was applied into coccygeal IVDs. Inflammatory mediators in IVDs, including nerve growth factor, tumor necrosis factor [alpha], interleukin 1[beta], and interleukin 6, were quantified using enzyme-linked immunosorbent assays. DRGs were immunostained for calcitonin gene-related peptide, activating transcription factor 3, and growth-associated phosphoprotein 43. RESULTS.: The upregulation of inflammatory mediators was transient in the IVD injury group but delayed and long-lasting in the IVD compression group. When the IVD injury and compression were combined, the upregulation of inflammatory mediators was long-lasting through 8 weeks. The proportion of calcitonin gene-related peptide-immunoreactive neurons among Fluoro-Gold-labeled neurons remained significantly higher in the IVD injury, compression, and combination groups than in the controls. In contrast, increases in the proportions of activating transcription factor 3-immunoreactive or growth-associated phosphoprotein 43-immunoreactive neurons in the IVD injury group animals were transient but long-lasting in the compression and combination groups compared with controls. CONCLUSION.: Disc injury in rats produces persistent increases in neuropeptides in DRGs but only transient increases in inflammatory mediators in IVDs. On the contrary, disc compression in rats produces a long-lasting increase in inflammatory mediators in IVDs and neuropeptides in DRGs. Moreover, disc compression induces persistent nerve injury and regeneration of the afferent fibers innervating IVDs. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: An immunohistological analysis of the cervical intervertebral disc (IVD). OBJECTIVE.: To investigate sensory and autonomic innervation of the rat cervical IVD. SUMMARY OF BACKGROUND DATA.: Many clinicians are challenged with treating wide-ranging chronic neck pain. Several authors have reported that sympathetic nerves participate in chronic pain, and various sympathectomy procedures can effectively treat chronic pain. METHODS.: The neuro-tracer Fluoro-gold (FG) was applied to the anterior surfaces of C5-C6 IVDs from 10 Sprague-Dawley rats to label the neurons of the innervating dorsal root ganglion (DRG), stellate ganglion (SG; sympathetic ganglion), and nodose ganglion (NG; parasympathetic ganglion). Seven days postsurgery, DRGs from level C1-C8, SG, and NG neurons were harvested, sectioned, and immunostained for calcitonin gene-related peptide (CGRP; a marker for peptide-containing neurons) and isolectin B4 (IB4; a marker for nonpeptide-containing neurons). The proportion of FG-labeled DRG neurons that were CGRP-immunoreactive (CGRP-IR), IB4-binding, and non-CGRP-IR and IB4-binding, and the proportion of FG-labeled SG neurons and NG neurons were calculated. RESULTS.: FG-labeled neurons innervating the C5-C6 IVD were distributed throughout the C2-C8 DRGs. The proportions of FG-labeled DRG neurons that were CGRP-IR, IB4-binding, non-CGRP-IR and IB4-binding, as well as SG neurons, and NG neurons were 20.6%, 3.3%, 55.7%, 8.9%, and 11.5%, respectively. The proportion of CGRP-IR FG-labeled DRG neurons was significantly higher than the proportion of IB4-binding FG-labeled DRG neurons at each level (P < 0.05). CONCLUSION.: The C5-C6 IVD was innervated multisegmentally from neurons of the C2-C8 DRG, SG, and NG. Overall, 79.6% of the nerve fibers innervating the IVD were sensory nerves and 20.4% were autonomic nerves. Furthermore, 23.9% of the nerve fibers innervating the IVD were afferent sensory pain-related nerves, 8.9% were efferent sympathetic nerves, and 11.5% were efferent parasympathetic nerves. These findings may explain the wide-ranging and chronic discogenic pain that occurs via the somatosensory and autonomic nervous system. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Immunohistological analysis of dichotomizing sensory nerve fibers projecting to the lumbar multifidus muscles and intervertebral disc (IVD), facet joint (FJ), or sacroiliac joint (SIJ) in rats. OBJECTIVE.: To elucidate dichotomizing sensory nerve fibers projecting to the lumbar multifidus muscles and to IVDs, FJs, or SIJs. SUMMARY OF BACKGROUND DATA.: Clinically, the origin of low back pain remains unknown. Multiple studies have identified lumbar muscles, IVDs, FJs, and SIJs as sources of low back pain. Pain may originate directly from lumbar muscles or be referred from the spine, or both. Dorsal root ganglion (DRG) neurons with dichotomizing axons have been reported in several species and are thought to be related to referred pain. METHODS.: We used 2 neurotracers, 1,1'-dioctadecyl-3,3,3',3'-tetramethyl-indocarbocyanine perchlorate (DiI) and fluorogold (FG), in this double-labeling study involving 30 Sprague Dawley rats. DiI was applied to lumbar multifidus muscles in all rats. Simultaneously, FG was applied to the anterior left portion of L5-L6 IVDs in the IVD group (n = 10), to the left L5-L6 FJs in the FJ group (n = 10), and to the left SIJs in the SIJ group (n = 10). Fourteen days after surgery, left DRGs from L1 to L6 were harvested, sectioned, and observed under a fluorescence microscope. RESULTS.: We verified the existence of double-labeled DRG neurons (i.e., dichotomizing sensory nerve fibers) projecting to lumbar multifidus muscles and to IVDs, FJs, or SIJs, depending on the group. The proportion of double-labeled cells in all DiI-labeled DRG neurons was higher in the FJ group (6.8%) and SIJ group (7.1%) than in the IVD group (3.1%) (P < 0.05). CONCLUSION.: Our results document the presence of dichotomizing sensory nerve fibers projecting to lumbar multifidus muscles and to IVDs, FJs, and SIJs. Referred low back muscle pain may reflect disorders of lumbar posterior structures, such as FJs and SIJs, rather than disorders of lumbar anterior structures, such as IVDs. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Prospective randomized trial. OBJECTIVE.: To examine the effect of the tumor necrosis factor alpha (TNF-[alpha]) inhibitor, etanercept, on radicular pain by its epidural administration onto spinal nerves in patients with lumbar spinal stenosis. SUMMARY OF BACKGROUND DATA.: TNF-[alpha] is thought to play a crucial role in the radicular pain caused by lumbar disc herniation and spinal stenosis. Intravenous infusion of infliximab for sciatica has been examined in 2 studies; however, the results were equivocal. METHODS.: Eighty patients with low back and radicular leg pain were investigated. We diagnosed the patients by physical examination, and X-ray and magnetic resonance imaging. In 40 patients, we epidurally administered 2.0 mL of lidocaine and 10 mg of etanercept onto the affected spinal nerve, and 2.0 mL of lidocaine and 3.3 mg of dexamethasone was used in 40 patients. Low back pain, leg pain, and leg numbness were evaluated using a visual analogue scale (VAS) and Oswestry Disability Index (ODI) score before and for 1 month after epidural administration. RESULTS.: Low back pain, leg pain, and leg numbness in the 2 groups were not significantly different before epidural administration. Epidural administration of etanercept was more effective than dexamethasone for leg pain (3 days, and 1, 2, and 4 weeks: P < 0.05), low back pain (3 days, and 1 and 2 weeks: P < 0.05), and leg numbness (3 days, and 1 and 2 weeks: P < 0.05). No adverse event was observed in either group. CONCLUSION.: Our results indicate that epidural administration of a TNF-[alpha] inhibitor onto the spinal nerve produced pain relief, but no adverse event. TNF-[alpha] inhibitors may be useful tools for the treatment of radicular pain caused by spinal stenosis. [ABSTRACT FROM AUTHOR]

Abstract: Bone morphogenetic proteins (BMPs) are members of the transforming growth factor β (TGF-β) superfamily. BMPs, such as BMP2 and BMP4, exert its biological functions by interacting with membrane bound receptors belonging to the serine/threonine kinase family including bone morphogenetic protein receptor I (BMPRIA, BMPRIB) and type II (BMPRII). Functions of BMPs are also regulated in the extracellular space by secreted antagonistic regulators such as noggin. Although BMP2, BMP4, noggin, BMPRIA, BMPRIB, and BMPRII expressions have been well described in the central nervous system, little information is available for their expressions in the spinal cord. We, thus, investigated these protein expressions in the adult rat spinal cord using immunohistochemistry. Here, we show that BMP2, BMP4, noggin, BMPRIA, BMPRIB, and BMPRII are widely and differentially expressed in the spinal cord. Besides abundant BMP2, BMP4, noggin, BMPRIA, BMPRIB, and BMPRII protein expressions in neurons, we detected them also in astrocytes, oligodendrocytes, and ependymal cells. In addition, we found BMPRIA, BMPRIB, and BMPRII protein expressions in microglia. Interestingly, we also observed that these proteins are strongly expressed in many kinds of axons in both ascending and descending tracts. These data indicate that BMP2, BMP4, noggin, BMPRIA, BMPRIB, and BMPRII proteins are more widely expressed in the adult spinal cord than previously reported, and their continued abundant expressions in the adult spinal cord strongly support the idea that BMP signaling plays pivotal roles in the adult spinal cord. [Copyright &y& Elsevier]

STUDY DESIGN.: Immunohistochemical study. OBJECTIVE.: To evaluate invasive surgical approaches by analyzing the number of sensory nerve fibers at 2 back muscle sites in rats and humans and the number of injured nerve fibers innervating these 2 sites after muscle injury in rats. SUMMARY OF BACKGROUND DATA.: Several minimally invasive approaches have recently become popular in the treatment of lumbar spine disorders. Minimally invasive surgery (MIS) is not invasive to back muscle and is thought to reduce low back pain. Muscle damage has been generally evaluated by magnetic resonance imaging (MRI); however, damage to sensory nerve fibers in and around back muscle that is directly related to pain has apparently not been explored. METHODS.: Human muscle at L4-L5 was obtained from the paraspinous process (during a midline approach) and from paraspinal back muscle (during a Wiltse paraspinal approach) (n = 10 each). The muscle was sectioned and immunostained for calcitonin gene-related peptide (CGRP). To detect dorsal root ganglion (DRG) neurons innervating back muscle in rats, Fluoro-Gold (FG) was applied to the same 2 sites on the lower back muscle at L4-L5 (only application, n = 12; application of FG + muscle injury, n = 12). DRGs were harvested and immunostained for CGRP and activating transcription factor-3 (ATF-3: marker for nerve injury). The numbers of FG-labeled CGRP-immunoreactive or FG-labeled ATF-3-immunoreactive DRG neurons innervating the 2 sites were counted and compared. RESULTS.: CGRP-immunoreactive sensory nerve fibers were found at the 2 sites. The average number of CGRP-immunoreactive sensory nerve fibers in muscle obtained in a midline approach was significantly higher than that in muscle obtained in a Wiltse paraspinal approach (P < 0.01). The numbers of FG-labeled CGRP- and ATF-3-immunoreactive DRG neurons innervating paraspinous process muscle were significantly greater than those innervating paraspinal back muscle in rats (P < 0.01). CONCLUSION.: There are more CGRP-immunoreactive sensory nerve fibers and DRG neurons innervating muscle in the midline approach area than in the Wiltse paraspinal approach area in humans and rats. There are more ATF-3-immunoreactive DRG neurons innervating muscle in the midline approach area than in the Wiltse paraspinal approach area after muscle injury in rats. This result may show the differences in sensory nerve injury during the 2 surgical approaches. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Immunohistological analysis in an injured intervertebral disk (IVD) model. OBJECTIVE.: To elucidate and compare in rats the behavior of the sensory nervous system and inflammatory mediators in experimentally injured IVDs. SUMMARY OF BACKGROUND DATA.: Multiple human and animal studies have verified the presence of sensory nerve fibers in IVDs or investigated the behavior of inflammatory mediators in injured IVDs, but no in vivo study to date has examined the relationship between the 2. METHODS.: Eight-week-old female rats were used. In the disk-injured group, L5/L6 disks were injured with a 24-gauge needle; simultaneously, the neurotracer Fluoro-gold was injected into the L5/L6 IVD. The L5/L6 IVD dorsal root ganglia (DRGs) from the L1 to L6 levels, and the spinal cord was resected at several time points after surgery. Nerve growth factor, tumor necrosis factor (TNF)-[alpha] and interleukin (IL)-6 production in the IVDs were quantified using enzyme-linked immunosorbent assay. DRGs were immunostained for calcitonin gene-related peptide, and spinal cord sections were immunostained for ionized calcium-binding adaptor molecule-1 and glial fibrillary acidic protein. RESULTS.: Nerve growth factor, and TNF-[alpha] levels (through 1 week) and IL-6 levels (through 4 days) were significantly higher in the disk-injured group than in the noninjured group (P < 0.05). However, starting at 2 weeks (nerve growth factor and TNF-[alpha]) or 1 week (IL-6), the differences in inflammatory mediator levels between the 2 groups no longer were significant. In contrast, the percentage of calcitonin gene-related peptide-immunoreactive neurons among Fluoro-gold-labeled DRG neurons, and the numbers of ionized calcium-binding adaptor molecule-1-immunoreactive microglia and glial fibrillary acidic protein-immunoreactive astrocytes in the spinal dorsal horn remained significantly higher in the injured group than in the noninjured group at all-time points (P < 0.05). CONCLUSION.: Disk injury in rats produces persistent increases in neuropeptides in DRGs and glia in the spinal cord, but only transient increases in inflammatory mediators in IVDs. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Gait analysis and immunohistological analysis in a rat model of myofascial inflammation in low back. OBJECTIVE.: To investigate gait in a rat model of myofascial inflammation using the CatWalk gait analysis system. SUMMARY OF BACKGROUND DATA.: There are few reports examining low back pain behavior in animal models. The CatWalk is a computer-assisted gait analysis system that provides an automated way to assess gait function and this behavior during pain. METHODS.: In a myofascial inflammation group, 0.5 mL of 4% paraformaldehyde buffer and 0.5 mL of 5% Fluoro-Gold (FG) buffer were injected into bilateral multifidus muscles of rats. In a control group, FG buffer alone was injected. Five days after surgery, the gait of rats in both groups was investigated using the CatWalk system. In the present study a total of 36 gait parameters were quantified and used to judge pain-related behavior. Bilateral dorsal root ganglia (DRGs) from L1 to L6 levels were resected, and immunostained for calcitonin gene-related peptide (CGRP). RESULTS.: In the myofascial inflammation group, the mean duty cycle (duration of paw contact divided by time between consecutive paw contacts) of each paws (front and hind) were significantly higher and mean stride length (the distance between successive placements of the same paw) of each paws were significantly shorter compared with the control group. Furthermore, mean minimum contact intensity of the complete paw and mean contact intensity of each paws in the myofascial inflammation group were significantly higher compared with the control group. The proportion of CGRP-immunoreactive FG-labeled neurons among all FG-labeled DRG neurons in the myofascial inflammation group was significantly higher than the proportion in the control group. CONCLUSION.: These results suggest that myofascial inflammation in low back caused the changes to the rat's gait, including long stands, short stride, and strong paw contact. [ABSTRACT FROM AUTHOR]

Abstract: Bone morphogenetic proteins (BMP) are members of the transforming growth factor β (TGF-β) superfamily. BMPs exert its biological functions by interacting with membrane bound receptors belonging to the serine/threonine kinase family including bone morphogenetic protein receptor I (BMPRIA, BMPRIB) and type II (BMPRII). Although BMPR expressions have been well described in the early development of the CNS, little information is available for their expressions in the adult CNS. We, thus, investigated BMPR expressions in the adult rat CNS using immunohistochemistry. Here, we show that BMPRIA, IB and II proteins are widely expressed throughout the adult CNS. Interestingly, we observed that BMPRIA, IB and II proteins are abundantly expressed in many kinds of axons. In addition, we found that BAMRIB-IR was preferentially expressed in dendrites of many neurons throughout the CNS, while BMPRIA was mainly expressed in cell bodies, showing that BMPRIA and BMPRIB are differentially targeted in a single neuron. In addition, besides abundant BMPR expressions in neurons, we exhibited BMPR expressions in astrocytes and ependymal cells. These data indicate that BMPRs are more widely expressed throughout the adult CNS than previously reported, and their continued abundant expressions in the adult brain strongly support the idea that BMPRs play pivotal roles also in the adult brain. [Copyright &y& Elsevier]

Abstract: We focused on the linear negative thermal expansion of Y2W3O12 in a wide-temperature range and on the chemical stability of ZrSiO4 in the fabrication of the composite material ZrSiO4/Y2W3O12 with a zero-thermal-expansion. The compact composed of Y2W3O12 and ZrSiO4 had a thermal shrinkage rate smaller than that of Y2W3O12 and higher than that of ZrSiO4. SEM–EDX observation clarified that the ZrSiO4/Y2W3O12 sintered body fabricated at 1400°C for 10h had a microstructure composed of ZrSiO4 and Y2W3O12 grains, and XRD indicated that only ZrSiO4 and Y2W3O12 phases existed in the sintered body. The relative density of the ZrSiO4/Y2W3O12 sintered body reached 92%, which was larger than that of the ZrSiO4 sintered body because Y2W3O12 grains could be sintered at lower temperatures. The average linear thermal expansion coefficients of the ZrSiO4/Y2W3O12 sintered body were −0.4×10−6 and −0.08×10−6 °C−1 in the temperature ranges from 25 to 500°C and from 25 to 1000°C, respectively, which showed an almost zero-thermal-expansion. [Copyright &y& Elsevier]

Bacterial artificial chromosome (BAC) libraries have been widely used in different aspects of genome research. In this paper we report the construction of the first mungbean (Vigna radiataL. Wilczek) BAC libraries. These BAC clones were obtained from two ligations and represent an estimated 3.5 genome equivalents. This correlated well with the screening of nine random single-copy restriction fragment length polymorphism probes, which detected on average three BACs each. These mungbean clones were successfully used in the development of two PCR-based markers linked closely with a major locus conditioning bruchid (Callosobruchus chinesis) resistance. These markers will be invaluable in facilitating the introgression of bruchid resistance into breeding programmes as well as the further characterisation of the resistance locus. [ABSTRACT FROM AUTHOR]

This study aimed to determine the associations between adherence to 24-h movement behavior guidelines and self-rated health (SRH) among Japanese adolescents according to their age group. This was a cross-sectional study. Probability proportional sampling data, which were collected from six regions of Okinawa Prefecture, Japan, considering the number of schools, included 2408 fifth-grade students (aged 10–11 years) in 31 elementary schools and 4360 eighth-grade students (aged 13–14 years) in 30 junior high schools. SRH, moderate-to-vigorous physical activity (MVPA), screen time (ST), sleep duration, and confounding factors (sex, weight status, family affluence, parental support, school satisfaction, and school demands) were self-reported. The logistic regression models showed that adherence to ST and sleep recommendations in elementary school students was associated with a high prevalence of good health only, whereas adherence to only MVPA, only sleep, ST and sleep, MVPA and sleep, and all three recommendations were associated with a high prevalence of good health among junior high school students. All combinations that included achievement of the recommended sleep duration were associated with SRH. Achieving 24-h movement behavior guidelines, particularly sleep recommendations, is associated with better perceived health in school-aged children, especially in adolescents. [ABSTRACT FROM AUTHOR]

Protocol biopsies were performed to detect and treat sub‐clinical rejection in eight living related pediatric renal transplant recipients who had been withdrawn from steroids. Low‐grade tubulitis (t1) and mononuclear cell interstitial inflammation (i1), typical of borderline rejection and low‐grade interstitial fibrosis (ci1), and tubular atrophy (ct1), characteristic of chronic rejection, appeared frequently in protocol biopsies more than 3 yr after steroid withdrawal. In contrast, early‐type glomerulitis (g), allograft glomerulopathy (cg), arteriolar hyaline thickening (ah), intimal arteritis (v), and fibrous intimal thickening (cv) were not observed in protocol biopsies after steroid withdrawal. Low‐dose pulse therapy (methylprednisolone (MP) 250 or 500 mg/d for 3 d) was administered to five patients for borderline and/or acute grade 1a rejection, as determined by protocol biopsies in the absence of clinical rejection. No oral steroids were administered. Renal function in all patients remained satisfactory, without proteinuria, in follow‐up periods ranging from 22 to 68 months after steroid withdrawal. Of the eight patients, three grew to almost normal height (>mean – 2SD) and four exhibited catch‐up growth. Thus, steroid withdrawal can be safe and improves growth in pediatric renal transplant recipients if undertaken with careful clinical follow‐up, including protocol biopsies. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to investigate whether glomerular sclerosis (GS) at the time of engraftment affects subsequent morphology and clinical course of renal allografts. Eighty-one renal transplant recipients were recruited for this study. Protocol biopsies of the renal allografts were performed at engraftment, as well as at 1, 3, 5, and 7 years after transplantation. All cases were divided into 2 groups based on the presence of GS at engraftment, namely, non-GS and GS groups. Morphological changes in the renal allografts were graded from 0 to 3+ based on the severity of chronic allograft nephropathy (CAN) of the Banff classification based on 5 factors: percentage of GS, extent of interstitial fibrosis, tubular atrophy, arterial intimal thickening, and arteriolar hyalinosis. Furthermore, the level of serum creatinine (s-Cr) at each year was examined by recipient age and gender, donor age and gender, type of donor (living/cadaver), delayed graft function, acute rejection within 1 year after transplantation, mean blood pressure, and use of calcineurin inhibitors as well as the presence of GS at engraftment. The extent of GS at engraftment significantly correlated with donor age (P = .0038) but with a weak correlation coefficient. Although the severity of CAN developed gradually in both non-GS and GS groups, differences in morphological changes at engraftment between the 2 groups persisted throughout 7 years. Donor age and recipient gender influenced s-Cr significantly. In conclusion, the presence of GS at engraftment aggravates subsequent morphological changes and affects short-term but not long-term allograft prognosis. [Copyright &y& Elsevier]

Introduction/Background The halo-vest brace has been a common mode for immobilization of the cervical spine. The incidence of complications such as pin loosing and infection are known in patients with halo-vest fixation. Dysphagia is one of the most serious complications seen with the use of a halo-vest brace. The aim of this study was to elucidate factors associated with the incidence of dysphagia in patients treated using a halo-vest brace in terms of not only demographic data, but also radiological findings of the cervical spine. Material and method We retrospectively reviewed medical records and radiological measurements using lateral plain X-rays of the cervical spine in patients who had undergone halo-vest fixation in our institute between January 2006 and August 2016. Severity of dysphagia was assessed using the Food Intake Level Scale (FILS) from medical records. Patients were classified into non-dysphagia (FILS level: 10) and dysphagia (FILS level: 1–9) groups. Results Forty-three patients were attributed for analysis. Twenty-eight patients were classified into non-dysphagia group, 15 patients were classified into dysphagia group. Mean age was grater ( P = 0.041), length of ICU stay was longer ( P = 0.002), and frequency of tracheostomy was larger ( P = 0.043) in the dysphagia group. Mean O-C2 angle was smaller in the dysphagia group ( P = 0.027). Body mass index [odds ratio (OR) = 0.522, 95% confidence interval (CI) = 0.377–0.934, P = 0.024], ICU stay (OR = 1.302, 95% CI = 1.272–10.624, P = 0.016), and O-C2 angle (OR = 0.911, 95% CI = 0.833–0.996, P = 0.041) remained independent risk factors related to incidence of dysphagia. Spearman rank correlation showed a negative linear correlation between ICU stay and FILS level ( r = 0.476, P = 0.001) and a positive linear correlation between O-C2 angle and FILS level ( r = 0.385, P = 0.011). Conclusion This study suggested the significance of O-C2 angle as well as ICU stay for incidence and severity of dysphagia in patients with halo-vest fixation. [ABSTRACT FROM AUTHOR]

Provides information on a study which examined the optical transmittances of anodic alumina films which contain nematic liquid crystals in columnar pores. Methods; Results; Conclusion.

Recent studies have reported that calcitonin gene-related peptide (CGRP) contributes to joint pain. However, regulation of the CGRP/CGRP receptor signalling in osteoarthritis (OA) is not fully understood. To investigate the regulation of CGRP/CGRP receptor signalling by macrophages in the synovial tissue (ST) of OA joints, we characterized the gene expression profiles of CGRP and CGRP receptors in the ST of OA mice (STR/Ort). In addition, we examined whether macrophage depletion by the systemic injection of clodronate-laden liposomes affected the expression of CGRP and CGRP receptors in ST. CD11c1 macrophages in the ST of STR/Ort and C57BL/6J mice were analysed by flow cytometry. Real-time polymerase chain reaction (PCR) was used to evaluate the expression of interleukin (IL)-1β, CGRP, calcitonin receptor-like receptor (CLR) and receptor activity-modifying protein 1 (RAMP1) in F4/80+ and F4/80-- cells. The effects of IL-1β on the expression of CGRP and CLR by cultured synovial cells were also examined. The percentage of CD11c+ macrophages in the ST of STR/Ort was higher than that in C57/BL6J mice. Notably, the F4/801 cell fraction expressed IL-1+ highly, whereas the F4/80- cell fraction expressed CGRP, CLR, and RAMP1 highly. In addition, expression of the IL-1β and CLR genes was increased in ST, but was decreased upon macrophage depletion, and the IL-1β treatment of cultured synovial cells up-regulated CLR. Taken together, the present findings suggest that synovial macrophages are the major producers of IL-1β and regulators of CLR in OA mice. Therefore, macrophages and IL-1β may be suitable therapeutic targets for treating OA pain. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Povidone-Iodine preparation is used as a disinfectant in otological surgeries. The ototoxicity of Povidone-Iodine preparation was evaluated using infant, young and adult guinea pigs. The effects of different concentrations and of different exposure durations on compound action potentials were also studied. Materials & methods: Povidone-Iodine was used to fill one middle ear cavity of the guinea pig, and the compound action potential (CAP) was measured from the round window membrane at 24h, 7 days, and 28 days. The contralateral side was filled with saline as control. Test sounds used were clicks and tone bursts of 2, 4, and 8kHz. Results: At 24h, Povidone-Iodine solution showed a significant toxic effect in the infant group. In the young animal group, no toxic effect was seen. In the adult group, a mild degree of deafness for 2kHz was found. At 7 days, the young group showed significant hearing loss for all frequencies, but the adult group did not show any hearing loss. With a half strength solution, both young and adult group did not show hearing loss. At 28 days, with a full strength solution, hearing loss became prominent for all sound stimulation. With 1/8th dilution, the young group showed a moderate hearing loss, but the adult group did not. Conclusion: The thicker round window membrane in human is expected to provide more protection to the human cochlea than in the guinea pig model that we have studied. Mild hearing loss at 24h and 7 days using 10% solution, but no hearing loss with 5% solution at 7 days may indicate that rinsing of the middle ear cavity with saline during surgery should minimize the ototoxic effect of this product. The age of the animals does influence the outcome of the ototoxicity experiment. From this experiment, Povidone-Iodine preparations in the infant should be used with caution. Povidone scrub should not be used for otologic surgery. [Copyright &y& Elsevier]

Background: Alcohol is the most commonly used substance among Japanese adolescents, although its use has been declining recently. However, little is known whether the declining trend in adolescent drinking can be found across all sociodemographic characteristics. This study explored time trends in alcohol use among Japanese adolescents by sociodemographic characteristics between 2008 and 2016. Methods: A repeated cross-sectional study was conducted using data from three prefectural-wide surveys of public high schools in Okinawa Prefecture, Japan, in 2008, 2012, and 2016. The study participants comprised 7,807 students in grades 10 to 12 (15- 18 years). Alcohol use was defined as drinking one or more alcoholic beverages on at least one day in the past month. Demographic characteristics included grade, sex, and region, and socioeconomic status (SES) was assessed by family structure, parental education, and school type. Time trends in alcohol use over time by each sociodemographic group were assessed by the Cochran-Armitage test for trend. Results: The overall prevalence of adolescent alcohol use significantly reduced from 20.7% (95% CI 19.1-22.3%) in 2008 to 9.5% (95%CI 8.4-10.6%) in 2016. Similar reducing trends in adolescent alcohol use were found across all of the demographic characteristics as well as the SES groups (all P for trends <0.001). During the survey periods, there were no sex differences in alcohol use prevalence, while alcohol use was more prevalent among old graders. Alcohol use was also more prevalent among low SES groups than high SES groups. However, family structure in 2016 did not show significant differences in alcohol use. Conclusions: Alcohol use among Japanese adolescents has been declining over time and this downward trend was similar for all demographic and socioeconomic subgroups. Further adolescent drinking prevention efforts should be implemented across all population subgroups. Moreover. monitoring of adolescent alcohol use should be continued. Key messages: ) This study found that adolescent alcohol use in Japan has been decreasing over time across all population subgroups. ) The finding is a desired outcome from the viewpoint of the public health impact. [ABSTRACT FROM AUTHOR]

Background: For optimal health benefits, the Canadian 24-Hour Movement Guidelines for Children and Youth (aged 5-17 years) recommend an achievement of]60 minutes of moderate-tovigorous physical activity (MVPA), <2 h of recreational screen time (ST), and 9-11 h for 5-13 years or 8-10 h for 14-17 years of sleep time (SLT) each day. There is little evidence showing the proportion of the recommendation in Japan, so we need to investigate. The aim of this study thus was to reveal the compliance to the recommendation with a large sample of Japanese elementary and junior high school children. Methods: This study included 2408 students enrolled in fifth grade (aged 10-11 years) in 31 elementary schools, and 4360 students enrolled in eighth grade (aged 13-14 years) in 30 junior high schools. Each behaviour was assessed by a self-reported questionnaire. To analyze the differences in adherence to the recommendation between the school-aged group, we conducted a chi-analysis. Results: Overall, only 4% of participants complied with all three recommendations, and 20% of the students did not comply with any of the recommendations ()2=1390.87;p<.001). Compared with MVPA and ST, SLT had a trend to be likely to achieve the recommendation in each school-age group. Elementary school students had a higher percentage of nonadherence to all recommendations (39%) than junior high school students (10.3%). The adherence to the recommendation of the ST & SLT simultaneously had no differences in each age group (11.5% for elementary schoolers and 12.7% for junior high schoolers). However, adherence to the recommendation of MVPA only, ST only, and MVPA & ST were higher in elementary schoolers, and the adherence to the recommendation of SLT only and MVPA & SLT were higher in junior high schoolers. Conclusions: The proportion of adherence to at least one of the three recommendations is better in junior high school students than elementary school students in Okinawa, Japan. Key messages: · Health behaviour required improvement may differ by age group. · It is necessary for particularly elementary school children in Okinawa to take proper countermeasures to improve the movement behaviours. [ABSTRACT FROM AUTHOR]

Nerve growth factor (NGF) functions to modulate osteoarthritis (OA)-associated pain. Although recent studies suggest that tumour necrosis factor (TNF)-α and interleukin (IL)-1β mediate NGF activity in human synovial fibroblasts, the regulation of NGF expression in human synovial macrophages remains unclear. Here, we examined the role of macrophages in the production and regulation of synovial (SYN) NGF in osteoarthritic knee joints by examining the mRNA expression of TNF-α and IL-1β in freshly isolated CD14-positive (macrophage-rich fraction) and CD14-negative cells (fibroblast-rich fraction) in synovial tissue from OA patients by quantitative polymerase chain reaction. We also examined the effects of IL-1β and TNF-α on NGF mRNA expression in cultured CD14-positive (macrophage-rich fraction) and CD14-negative cells (fibroblast-rich fraction). In addition, to examine the contribution of macrophages to NGF, TNF-α and IL-1β expression, we injected clodronate liposomes systemically into STR/Ort mice, an osteoarthritis animal model, to deplete macrophages. TNF-α and IL-1β mRNA levels in CD14-positive cells from the SYN of OA patients was significantly higher than that in CD14-negative cells, while NGF expression did not differ markedly between the two cell fractions. In addition, treatment of human cultured CD14-positive and -negative cells with IL-1β and TNF-α enhanced NGF mRNA and protein levels. Expression of NGF, IL-1β and TNF-α was also reduced significantly in STR/Ort mice upon macrophage depletion. These findings suggest that IL-1β and TNF-α regulate NGF expression and production in synovial macrophages and fibroblasts in osteoarthritic joints. [ABSTRACT FROM AUTHOR]

To understand more clearly the link between osteoarthritis and hyperlipidaemia, we investigated the inflammatory macrophage subsets and macrophage-regulated matrix metalloprotease-3 (MMP-3) and A disintegrin and metalloprotease with thrombospondin motifs-4 (ADAMTS4) in synovial (ST) and adipose tissues (AT) of osteoarthritic mice with hyperlipidaemia (STR/Ort). CD11c+F4/80+CD11b+ macrophage populations in the ST and AT of 9-month-old STR/Ort and C57BL/6J mice were characterized and compared by flow cytometry and real-time polymerase chain reaction (PCR) analyses. Expression of tumour necrosis factor (TNF)-α, MMP-3 and ADAMTS4, and the response of these factors to anionic liposomal clodronate induced-macrophage depletion were also evaluated by real-time PCR. Expression of TNF-α in CD11c+ cells, which were isolated by magnetic beads, was compared to CD11c- cells. In addition, the effect of TNF-α on cultured synovial fibroblasts and adipocytes was investigated. CD11c+F4/80+CD11b+ macrophages were increased in ST and AT of STR/Ort mice. The CD11c+ cell fraction highly expressed TNF-α. Expression of TNF-α and MMP3 was increased in ST and AT, and was decreased upon macrophage depletion. TNF-α treatment of cultured synovial fibroblasts and adipocytes markedly up-regulated MMP-3. CD11c+F4/80+CD11b+ macrophages were identified as a common inflammatory subset in the AT and ST of STR/Ort mice with hyperlipidaemia. The induction of inflammation in AT and ST may be part of a common mechanism that regulates MMP3 expression through TNF-α. Our findings suggest that increased numbers of CD11c+ macrophages and elevated levels of TNF-α and MMP-3 in AT and ST may explain the relationship between hyperlipidaemia and OA. [ABSTRACT FROM AUTHOR]

Study Design: A prospective interventional trial, using a rat model of lumbar interbody fusion. Objective: To examine the potential efficacy of platelet-rich plasma (PRP) for lumbar interbody fusion, using hydroxyapatite (HA). Summary Of Background Data: PRP is an autologous product containing a high concentration of platelets in a small volume of plasma and has osteoinductive effects. HA has osteoconductive ability and has been used in combination with autogenous bone for spine fusion. However, reports using PRP with HA for spine fusion are very few. The purpose of this study was to examine the efficacy of PRP with HA for spinal interbody fusion and at the same time to estimate the change in immunoreactivity of the inflammatory neuropeptide, calcitonin gene-related peptide (CGRP), in dorsal root ganglion (DRG) neurons innervating spinal discs. Methods: A total of 35 Sprague-Dawley rats were used in this study. Twenty-one rats were used for conducting interbody fusion experiments, 7 rats were used as immunostaining controls, and 7 other rats were used as blood donors for making PRP. L5-L6 interbody fusion was performed on 21 rats using HA + PRP (n = 7), HA + platelet-poor plasma (n = 7), or HA + saline (n = 7). Simultaneously, Fluoro-Gold neurotracer was applied to the intervertebral space to detect DRG neurons innervating the discs. L5-L6 lumbar radiographs were obtained and lumbar DRGs were immunostained for CGRP. The rate of bone union and the change in CGRP immunoreactive DRG neurons innervating the discs were evaluated and compared among groups. Results: All L5-L6 lumbar discs were fused in the PRP + HA group (fused 7/total 7), whereas only 1 case was fused in the platelet-poor plasma group (1 of 7) and no cases in the HA-only group (0 of 7), which was a significant difference. Upon immunohistochemical analysis, CGRP-positive neurons innervated L5-L6 intervertebral discs in nonunion cases, and these were significantly increased compared with those in union cases. Conclusion: Our study suggests that using PRP with HA was beneficial for spine fusion. This combination may promote bone union and also decrease inflammatory neuropeptide in sensory neurons innervating the discs. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Prospective study of 212 patients with groin pain but without low back pain. OBJECTIVE.: To evaluate discogenic groin pain without low back pain or radicular pain. SUMMARY OF BACKGROUND DATA.: Patients feel low back pain originating from discogenic disease. It has been reported that the rat lower lumbar discs are innervated mainly by L2 dorsal root ganglion neurons. Thus, it is possible that patients feel referred groin pain corresponding to the L2 dermatome originating from intervertebral discs; however, the referred pain has not been fully clarified in humans. METHODS.: We selected 5 patients with groin pain alone for investigation. The patients suffered from groin pain and showed disc degeneration only at 1 level (L4-L5 or L5-S1) on magnetic resonance imaging. Patients did not show any hip joint abnormality on radiography or magnetic resonance imaging. To prove that their groin pain originated in degenerated intervertebral discs, we evaluated changes in groin pain after infiltration of lidocaine into hip joints and examined pain provocation on discography, pain relief by anesthetic discoblock, and finally anterior lumbar interbody fusion surgery. RESULTS.: All patients were negative for hip joint block, positive for pain provocation on discography, and positive for pain relief by anesthetic discoblock. Furthermore, bony union was achieved 1 year after anterior interbody fusion surgery in all patients, and visual analogue scale score of groin pain was significantly improved at 1 year after surgery in all patients (P < 0.05). CONCLUSION.: In the current study, we diagnosed discogenic groin pain, using magnetic resonance imaging, infiltration of lidocaine into the hip joint, pain provocation on discography, pain relief by anesthetic discoblock, and lumbar surgery. It is important to consider the existence of discogenic groin pain if patients do not show low back pain. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Retrograde neurotracing and immunohistochemical investigation of brain-derived neurotrophic factor (BDNF)-related sensory innervation of punctured lumbar intervertebral discs (IVDs) in rat dorsal root ganglia (DRG). OBJECTIVE.: To investigate the association between BDNF and sensory innervation of multiple-punctured lumbar IVD in rats. SUMMARY OF BACKGROUND DATA.: BDNF-a neurotrophin in DRG neurons-is anterogradely transported to the spinal cord and transmits pain signals. Its presence in the peripheral sites of degenerative IVDs has been recently reported, although its association with discogenic pain remains unclear. METHODS.: Forty female Sprague-Dawley rats were equally divided into four groups: naïve, sham, and two agent-treated groups (vehicle [saline-treated] group and anti-BDNF [anti-BDNF antibody] group). L5-L6 IVDs of the agent-treated rats were exposed and injured by repeated punctures. The retrograde neurotracer Fluoro-Gold (FG) and treatment agents were intradiscally applied. In the sham group, FG alone was applied onto uninjured IVD. One week later, L1-L3 DRGs were harvested and immunolabeled for the inflammatory pain-related calcitonin gene-related peptide (CGRP), that is, the pain marker. The proportions of FG-labeled CGRP-immunoreactive (-ir) DRG neurons were assessed. Each L5-L6 IVD was resected for measuring the BDNF concentration using enzyme-linked immunosorbent assay. RESULTS.: FG-labeled DRG neurons were almost equally prevalent at each DRG level. The proportions of FG-labeled CGRP-ir DRG neurons in the two agent-treated groups were significantly elevated (average 37.9% ± 7.2% and 25.4% ± 9.1%; vehicle and anti-BDNF groups, respectively; P < 0.05) in comparison with the naïve and sham groups (19.6% ± 1.3% and 19.2% ± 3.6%, respectively) and were significantly decreased in the anti-BDNF group in comparison with the vehicle group (P < 0.05). BDNF concentrations were elevated maximally in the vehicle group (18.5 ± 5.2 pg/g) but suppressed in the anti-BDNF group (14.0 ± 3.0 pg/g). CONCLUSION.: Direct intradiscal application of the anti-BDNF antibody significantly suppressed both CGRP production and the local concentration of BDNF. Our results indicate a possible association between the local production of BDNF and the pathophysiology of discogenic pain. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Prospective trial. OBJECTIVE.: To examine the difference in bone union and clinical results after one-, two-, and three-level instrumented posterolateral fusion surgery using a local bone graft. SUMMARY OF BACKGROUND DATA.: The iliac crest bone graft technique for lumbar posterolateral fusion surgery is widely used; however, donor site problems such as pain and sensory disturbance have been reported. Local bone has been used for fusion surgery; however, its reliability as a graft for multiple segments has not been fully reported. METHODS.: One hundred twenty-two patients diagnosed with degenerated spondylolisthesis were divided into three groups [spondylolisthesis at 1 level (n = 42), at 2 levels (n = 40), and at 3 levels (n = 40)]. All patients underwent decompression and instrumented posterolateral fusion with a local bone graft. The amount of bone graft, proportion of patients with (rate) and duration of bone union, Visual Analog Scale (VAS) score, Japanese Orthopedic Association Score (JOAS), and Oswestry Disability Index (ODI) were evaluated before and 2 years after therapy. RESULTS.: VAS score, JOA score, and ODI were not significantly different among the three groups before and after surgery (P > 0.05). Average amount of local bone graft used for one segment significantly decreased in proportion to the number of fusion levels (P < 0.05). The rate of bone union was 88% in the one-level group, 85% in the two-level group, and 62.5% in the three-level group, which was significantly lower than that in the one- and two-level groups (P < 0.05). CONCLUSION.: If one- and two-level posterolateral fusion were performed, the local bone graft technique provides a good and uniform bone union rate; however, for three-level fusion poor results were obtained because of an insufficient amount of local bone. [ABSTRACT FROM AUTHOR]

With 5 figures and 2 tables Use of resistance genes would be the most effective way to address Fusarium wilt caused by Fusarium oxysporum f.sp. melonis in melon. In this study, based on the BAC 31O16 sequence which contains the cluster of melon resistance gene homologue, we developed four new DNA markers linked to Fom‐1, a dominant resistance gene against F. oxysporum f.sp. melonis races 0 and 2. Linkage analysis using 125 F2 plants derived from the cross between P11 (fom‐1fom‐1) and MR‐1 (Fom‐1Fom‐1) indicated that Fom‐1 was located between CAPS markers C‐MRGH12 and 62‐CAPS at a distance of 0.4 and 1.2 cM, respectively. Map position of Fom‐1 was confirmed using another mapping population consisting of 104 recombinant inbred lines derived from the cross P11 × MR‐1. The analysis of 43 fixed lines and 27 commercial F1 hybrids showed that the developed DNA markers linked to Fom‐1 correctly predicted the genotype in relation to the variety, suggesting that the region around the Fom‐1 locus is very polymorphic or there is no linkage disequilibrium between the locus and the marker loci. [ABSTRACT FROM AUTHOR]

Conclusion: Using a guinea pig model of experimental endolymphatic hydrops, click sounds of altered polarity showed different latencies and amplitudes in hydropic compared with normal cochleae. Latency changes appeared as early as 1 week after endolymphatic obstruction. This method can help diagnose endolymphatic hydrops. Objective: The goal of the study was to develop an objective electrophysiological diagnosis of endolymphatic hydrops. Materials and methods: Endolymphatic hydrops were created surgically in guinea pigs. The latency and the amplitude of the eighth cranial nerve compound action potential (CAP) for click sounds of altered polarity were measured up to 8 weeks after the surgery. Results: At early stages after surgery, the latency for condensation clicks became longer, and at later stages the latencies for both condensation and rarefaction became longer. The discrepancy in the latencies for rarefaction and condensation click sounds (rarefaction minus condensation) became larger by the first week after surgery, but no further discrepancy occurred thereafter. Compared with latency changes, amplitude changes in the CAP were rapid and progressive following surgery, suggesting ongoing damage to hair cells. [ABSTRACT FROM AUTHOR]

Summary: Objective: The objective of this study is to evaluate the safety of two ear drops, Ofloxacin (OFLX: Taribid Otic Solution®, Daiichi Seiyaku) and Fosfomycin sodium (FOM: Fosmicin S®, Meiji Seiyaku). Methods: Albino guinea pigs were used as experimental animals, and the ototoxicity was evaluated by means of threshold changes in the compound action potentials (CAP), when topically applied to the middle ear cavity of the guinea pig. The sound stimuli applied were; click sound, with tone bursts of 8kHz, 4kHz, and 2kHz. In one group of animals, after one application of the ear drops in the right middle ear cavity, the change in CAP was compared with a contralateral saline control at 24h, one week, and four weeks. In other group of animals, the ear drops were applied into the middle ear cavity for seven consecutive days and the CAP was measured at 24h. Results: At 24h the CAP threshold for click, 8 and 4kHz elevated significantly for both the saline and ear drop treatment, but the threshold returned to normal when measured at 7 days and 28 days. Seven consecutive days of ear drops administration resulted in no reduction in the CAP for either ear drops. Conclusions: Based on the lack of changes in the CAP, these two ear drops studied did not show any significant ototoxicities. [Copyright &y& Elsevier]

Abstract: ABO-incompatible renal transplantation (ABOIRTx) tend to lead to blood type antibody¿mediated rejection, the so-called delayed hyperacute rejection (DHAR), which results in short-term graft loss. To clarify the accurate incidence and prognostic value of DHAR among ABOIRTx, we reviewed biopsy specimens obtained from ABOKTx allografts with abrupt dysfunction during the early period after transplantation. Among 74 ABOIRTx patients, 34 patients displayed allograft dysfunction within 14 days following transplantation. The biopsy specimens were classified based on the Banff schema. The pathological diagnosis of ABO blood type antibody¿mediated humoral rejection (ABO-AMHR) was made by the following 3 findings:[1] diffuse accumulation of leukocytes in peritubular capillaries [2] glomerular thrombi [3] hemorrhage in the tubulo-interstitium Specimens with all of above-mentioned findings were categorized as severe ABO-AMHR; those with at least one findings, were categorized as mild ABO-AMHR. All patients were treated with steroid pulse therapy and/or modification of other immunosuppressants. Group 1 consisted of severe ABO-AMHR (n = 6); group 2 consisted of mild ABO-AMHR (n = 5); group 3 consisted of acute cellular rejection (n = 3); group 4 consisted of recovery phase of ATN (n = 11); group 5 consisted of calcineurin inhibitor toxicity (n = 2); and group 6 consisted of normal histology (n = 5). One of 6 patients (16%) in group 1 lost the graft because of DHAR irreversible by antirejection and anticoagulation therapy. However, there has been no clear definition of histpathological criteria for DHAR after ABO-incompatible kidney transplantation. The definition must prognosticate whether the rejection process is reversible. [Copyright &y& Elsevier]

Abstract: This report describes a successful renal Tx in a patient with chronic renal failure, caused by dysplastic kidneys, who received a cadaveric kidney with post‐infectious glomerulonephritis. Sequential renal biopsies were performed at 12 h before Tx, and at 1 h and on days 8 and 58 post‐Tx. Post‐operative hematuria disappeared on day 9 and proteinuria on day 13. Normal graft function was observed within 1 month, with histologic resolution. Our study suggests that while the donor kidney facilitates deposition of certain immune reactants, this is a host (environmental) problem and when transplanted into a new host (new environment), the problem is no longer sustained. [ABSTRACT FROM AUTHOR]

The interest in endodontic use of dental laser systems has been increasing. With the development of thin and flexible delivery systems for various wavelengths, laser applications in endodontics may become even more desirable. The aim of this study is to check the X-ray opacity of a hollow waveguide and to observe the results after laser root canal treatment. The root canal systems of 10 molars were treated endodontically by laser. For the laser radiation source, an Er:YAG laser system generating a wavelength of 2940 nm and an Alexandrite laser system generating a wavelength of 375 nm were used. The hollow waveguide used was checked under X-ray . A root canal surface treated by laser radiation was analyzed by a scanning electron microscope (SEM). The special hollow glass waveguide used was visible in the root canal system under X-ray imaging. Surface modification of the root canal after laser treatment was not found. After conventional treatment the root canal was enlarged. The surface was covered with a smear layer. After application of both laser systems, the smear layer was removed. The resulting canal surface was found to be clean and smooth. Under SEM observation open dentinal tubules were visible. No cracks were present, nor were surface modifications observed. [ABSTRACT FROM AUTHOR]

A novel micropolarizer has been fabricated from alumina and nickel by means of anodization and electroplating techniques. Making use of the anisotropic microstructure of the anodized alumina film, a lattice of nickel columns is easily constructed in the film, which works as a wire grid type polarizer. The fabricated polarizer has achieved an extinction ratio larger than 30 dB at the wavelength of 1.3 μm. [ABSTRACT FROM AUTHOR]

Study Design: A case report. Objective: An elderly patient presented with an acute lumbar spinal pseudogout attack after lumbar instrumented surgery. Summary Of Background Data: Although gout and pseudogout are common diseases causing inflammatory arthropathy in peripheral joints, involvement of the spine is uncommon. Here, we report a patient experiencing an acute lumbar spinal pseudogout attack after lumbar instrumented surgery. Methods: The patient was treated for lumbar spondylolisthesis at L4 and L5 level and afterward complained of lower back and bilateral leg pain. Conservative treatment was not effective for the patient; therefore, we preformed posterior transforaminal lumbar interbody fusion surgery. Results: The postoperative course was uneventful; however, he experienced lower back pain 4 weeks after surgery. Magnetic resonance image showed changes in signal intensities of vertebra and fluid accumulation in posterior back muscles. A biopsy was performed, but the culture was negative for infection. Calcium pyrophosphate dehydrate was detected in the fluid. Thus, conservative therapy without antibiotics was performed, and the patient's symptoms disappeared within 2 weeks. Conclusion: Here, we reported the first case of acute lumbar spinal pseudogout attack after lumbar instrumented surgery. We recommend considering pseudogout before and after surgery. [ABSTRACT FROM AUTHOR]

Study Design: Prospective trial. Objective: To examine the clinical efficacy of teriparatide for bone union after instrumented lumbar posterolateral fusion using local bone grafting in women with postmenopausal osteoporosis. Summary Of Background Data: Intermittent parathyroid hormone (PTH) treatment increases bone mass and reduces the risk for osteoporotic vertebral fractures. Recombinant human PTH (1-34) has already been approved as a treatment for severe osteoporosis. Preclinical data support the efficacy of PTH for lumbar spinal fusion. However, clinical results of PTH for spinal fusion have not yet been reported. Methods: Fifty-seven women with osteoporosis diagnosed with degenerative spondylolisthesis were divided into 2 treatment groups, a teriparatide group (n = 29; daily subcutaneous injection of 20 μg of teriparatide) and a bisphosphonate group (n = 28; weekly oral administration of 17.5 mg of risedronate). All patients underwent decompression and 1- or 2-level instrumented posterolateral fusion with a local bone graft. Fusion rate, duration of bone union, and pain scores were evaluated 1 year after surgery. Results: Pain scores improved after surgery; however, no significant difference was noted between the groups after surgery. The rate of bone union was 82% in the teriparatide group and 68% in the bisphosphonate group. Average duration of bone union was 8 months in the teriparatide group and 10 months in the bisphosphonate group. The rate of bone union and average of duration of bone union in the teriparatide group patients were significantly superior to those in the bisphosphonate group. Conclusion: Daily subcutaneous injection of teriparatide for bone union using local bone grafting after instrumented lumbar posterolateral fusion in women with postmenopausal osteoporosis was more effective than oral administration of bisphosphonate. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Case report. OBJECTIVE.: Diagnosis of symptomatic extra-foraminal lumbosacral stenosis using diffusion tensor imaging (DTI). SUMMARY OF BACKGROUND DATA.: Conventional magnetic resonance imaging (MRI) has sometimes proved inadequate for evaluating symptomatic spinal nerve lesions. DTI has been developed to visualize anisotropy of nerve-fiber tracts to evaluate nerve degeneration. We report a case of nerve compression causing a far-out lesion diagnosed using DTI. METHODS.: A 68-year-old patient presented with an 8-month history of severe right-sided sciatica. Computed tomography and MRI showed right L5-S1 foraminal stenosis and contact of the L5 transverse process and S1 ala without canal stenosis at the L4-L5 level. We evaluated the fractional anisotropy (FA) of the right L5 spinal nerve and compared it with bilateral L3-S1 spinal nerves to determine the L5 spinal nerve compression site. RESULTS.: DTI revealed narrowing of the right L5 spinal nerve between the L5 transverse process and S1 ala. FA was significantly decreased in the right L5 spinal nerve between the L5 transverse process and S1 ala. There was no significant difference in the FA of spinal nerves between the right and left sides at L3, L4, or S1. The right L5 spinal nerve from the central spinal canal to the extra-foraminal lumbosacral lesion was exposed during surgery and found to be severely compressed by the L5 transverse process and S1 ala. Postoperatively, the patient's symptoms disappeared immediately. CONCLUSION.: We used DTI to diagnose a symptomatic lesion as an extra-foraminal lumbosacral lesion caused by compression of the L5 spinal nerve at the foramina. Because DTI can quantitatively measure damage to nerve fibers, it may be advantageous for the diagnosis of far-out syndrome. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Prospective trial. OBJECTIVE.: To examine the bone union and clinical results after unilateral or bilateral instrumented posterolateral fusion surgery using a local bone graft. SUMMARY OF BACKGROUND DATA.: The iliac crest bone graft technique for lumbar posterolateral fusion surgery is widely used; however, donor site problems such as pain and sensory disturbance have been reported. Local bone has been used for bilateral multisegment fusion surgery; however, outcomes have been poor because of insufficient amounts of local bone used. This study evaluated unilateral and bilateral posterolateral fusion at 3 levels using a local bone graft. METHODS.: Sixty-two patients diagnosed with degenerated spondylolisthesis at 3 levels were divided into 2 groups. All underwent decompression and bilateral instrumented posterolateral fusion. However, a unilateral local bone graft was used in 32 patients and bilateral local bone graft was used in 30 patients. The amount of bone grafting, proportion of patients with bone union, duration of bone union, visual analog scale score, Japanese Orthopedic Association score, and Oswestry Disability Index were evaluated before and 2 years after surgery. RESULTS.: Visual analog scale score, Japanese Orthopedic Association score, and Oswestry Disability Index were not significantly different between the 2 groups before and after surgery (P > 0.05). The amount of local bone graft used for each segment was significantly less in the bilateral group (P < 0.05). The proportion of patients with rates of bone union and instability were 86% and 9%, respectively, in the unilateral group, but significantly poorer at 60% and 34% in the bilateral group. CONCLUSION.: If multisegment fusion (3-level fusion) is performed, bilateral local bone grafting results in a poor rate of bone union because of an insufficiency of local bone. Unilateral bone grafting is recommended because better rates of bone union and stability are achieved. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: A retrospective observational study of healthy volunteers and patients with degenerative and infectious endplate abnormalities in the lumbar spine. OBJECTIVES.: Our purpose was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differentiation of degenerative and infectious endplate abnormalities using 1.5-T magnetic resonance imaging (MRI). SUMMARY OF BACKGROUND DATA.: DWI can provide valuable structural information about tissues that may be useful for clinical applications in differentiation between degenerative and infectious endplate abnormalities. METHODS.: Sixteen consecutive patients with endplate abnormalities that was detected by MRI of the lumbar spine, and 15 healthy volunteers were studied. DWI was performed using whole-body imaging with background body signal suppression with a b value of 1000 s/mm2. Apparent diffusion coefficient values of normal and abnormal vertebral bone marrow were calculated. RESULTS.: Twenty-nine vertebral abnormalities were found in 16 patients. Nine vertebral abnormalities in 5 patients were because of infections and 20 vertebral abnormalities in 11 patients were because of degenerative changes; 7 levels were classified as Modic type 1, 7 levels as type 2, and 6 levels as type 3. DWI showed hyperintensity in all patients with infection, similar to that used in positron emission tomography, but not in the intervertebral spaces of any patients with degenerative disease. Apparent diffusion coefficient values of infectious bone marrowwere significantly higher than normal and degenerative bone marrow. CONCLUSION.: DWI is useful for differentiation of degenerative and infectious endplate abnormalities. Moreover, MRI is widely used clinically because of the lack of ionizing radiation, low cost, and fast imaging time as compared with positron emission tomography. Therefore, DWI has the potential to be used as a screening tool. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Retrograde neurotracing and immunohistochemistry were used to investigate the effect of the tumor necrosis factor (TNF)-[alpha] inhibitor, etanercept, on calcitonin gene-related peptide (CGRP) expression in dorsal root ganglion (DRG) neurons innervating intervertebral discs in rats. OBJECTIVE.: To clarify the action of a TNF-[alpha] inhibitor on a sensory neuropeptide in DRG neurons innervating intervertebral discs. SUMMARY OF BACKGROUND DATA.: Degeneration of lumbar intervertebral discs is a cause of low back pain. TNF-[alpha] in the intervertebral disc is a major contributor to discogenie pain. Effects of TNF-[alpha] inhibition on CGRP expression in DRG neurons were evaluated. METHODS.: The neurotracer FluoroGold was applied to the surfaces of L4/5 discs to label their innervating DRG neurons (n = 30). Of 30 rats, 10 were in a nonpunctured disc sham surgery control group, whereas the other 20 were in experimental groups in which intervertebral discs were punctured with a 23-gauge needle. Etanercept or saline was applied into the punctured discs (n = 10 each treatment). After 14 days of surgery, DRGs from L1 to L6 were harvested, sectioned, and immunostained for CGRP. The proportion of FluoroGold-labeled CGRP-immunoreactive DRG neurons was evaluated in all groups. RESULTS.: FluoroGold-labeled neurons innervating the L4/5 disc were distributed throughout L1-L6 DRGs in all groups. Of the FluoroGold-labeled neurons, the proportion of CGRP-immunoreactive neurons was 21% ± 4% in the sham surgery control group, 32% ± 7% in the puncture + saline group, and 23% ± 4% in the puncture + etanercept group. The proportion of CGRP-immunoreactive neurons was significantly greater in the puncture + saline group compared with the sham control and puncture + etanercept groups (P < 0.01). CONCLUSION.: In this model, CGRP was upregulated in DRG neurons innervating damaged discs. However, direct intradiscal application of etanercept immediately after disc puncture suppressed CGRP expression in DRG neurons innervating injured discs. This finding may further elucidate the mechanism for the effectiveness of etanercept in upregulation of neuropeptide in DRG neurons innervating intervertebral discs. [ABSTRACT FROM AUTHOR]