ABSTRACT: Study Design. A retrospective clinical study with scoliosis associated airflow obstruction due to endothoracic vertebral hump.Objectives. The purpose of this study is to evaluate and present anatomical features of scoliosis patients who showed airflow obstruction caused by endothoracic vertebral hump.Summary of Background Data It is well known that severe scoliosis causes airflow restriction due to thoracic cage deformity. There have been few reports of clinical data and anatomical features on scoliosis associated with airflow obstruction due to endothoracic vertebral hump.Methods. The subjects were 6 patients. The diagnoses were idiopathic scoliosis in three patients, symptomatic scoliosis in two, and thoracogenic scoliosis in one. The radiological outcome, co-morbidities, pre- and post-operative respiratory function and surgical complication were analyzed.Results. Four patients had preoperative atelectasis on the convex side of the lower lobe and improved after the operations. All patients showed main thoracic curves and its apex was located at T7 to T9. All patients had lordoscoliosis except one, who demonstrated kyphosing scoliosis. The correction rate was 78%(62.8 - 83.5%). Preoperative thoracic lordosis within the range of -5 to -47 degrees was postoperatively corrected to a substantially normal kyphosis within the range of 9 to 24 degrees. The average vital capacity, percent VC improved from 0.72 L (0.33-1.17 L) to 1.21 L (0.82-1.71 L), 45.5%(37.3 - 50.8%) to 63.7%(41.0 - 88.6%) relatively.Spine Penetration Index improved from 23%(18-35%) to 16%(13-19%). Endothoracic hump ratio improved from 1.34 (0.98-1.93) to 1.12 (0.86-1.28).Conclusions. Each patient with symptomatic scoliosis and thoracogenic scoliosis required relatively long periods of respiration management. Patients having lordoscoliosis with an apex located between T7 and T9 may develop airflow obstruction due to an EVH. Correction of lordoscoliosis through anterior and posterior approaches successfully improved EHR and atelectasis in all patients.

Inflammatory process is involved in the pathogenesis of diabetic nephropathy. In this article, we show that cholecystokinin (CCK) is expressed in the kidney and exerts renoprotective effects through its anti-inflammatory actions. DNA microarray showed that CCK was upregulated in the kidney of diabetic wild-type (WT) mice but not in diabetic intracellular adhesion molecule-1 knockout mice. We induced diabetes in CCK-1 receptor (CCK-1R) and CCK-2R double-knockout (CCK-1R(-/-),-2R(-/-)) mice, and furthermore, we performed a bone marrow transplantation study using CCK-1R(-/-) mice to determine the role of CCK-1R on macrophages in the diabetic kidney. Diabetic CCK-1R(-/-),-2R(-/-) mice revealed enhanced albuminuria and inflammation in the kidney compared with diabetic WT mice. In addition, diabetic WT mice with CCK-1R(-/-) bone marrow-derived cells developed more albuminuria than diabetic CCK-1R(-/-) mice with WT bone marrow-derived cells. Administration of sulfated cholecystokinin octapeptide (CCK-8S) ameliorated albuminuria, podocyte loss, expression of proinflammatory genes, and infiltration of macrophages in the kidneys of diabetic rats. Furthermore, CCK-8S inhibited both expression of tumor necrosis factor-α and chemotaxis in cultured THP-1 cells. These results suggest that CCK suppresses the activation of macrophage and expression of proinflammatory genes in diabetic kidney. Our findings may provide a novel strategy of therapy for the early stage of diabetic nephropathy.

Capnometer has been widely used as a respiratory monitor. Stable carbon dioxide (CO(2)) monitoring of non-intubated patient is especially problematic due to the frequent occurrence of tube obstruction and it could be even more difficult when oxygen is being administered. Oxygen is often administered by an oxygen mask or oxygen nasal cannula; however there are some problems with these methods. For oxygen masks, it is necessary to provide high-flow oxygen to prevent rebreathing of exhaled CO(2), and as for oxygen nasal cannula, it is incapable of increasing the oxygen concentration and patient may feel uncomfortable during oxygen administration because it could dry nasal mucous. To solve these problems, we developed a novel mainstream capnometer system, which provides stable monitoring of exhaled CO(2) while administering oxygen. This capnometer system has a mask with an opening large enough to facilitate the observation of patient's nose and mouth and the procedures such as daily oral care. Furthermore, the outer rim of the mask is designed to effectively retain oxygen flow without causing rebreathing.

The most important issue in the assessment of fracture healing is to acquire information about the restoration of the mechanical integrity of bone. Echo tracking (ET) can noninvasively measure the displacement of a certain point on the bone surface under a load. Echo tracking has been used to assess the bone deformation angle of the fracture healing site. Although this method can be used to evaluate bending stiffness, previous studies have not validated the accuracy of bending stiffness. The purpose of the present study is to ensure the accuracy of bending stiffness as measured by ET. A four-point bending test of the gap-healing model in rabbit tibiae was performed to measure bending stiffness. Echo tracking probes were used to measure stiffness, and the results were compared with results of stiffness measurements performed using laser displacement gauges. The relationship between the stiffness measured by these two devices was completely linear, indicating that the ET method could precisely measure bone stiffness.

The replication of amphiphilic systems within an inorganic silica matrix allows the study of the fundamental properties of mesostructural changes, that is, kinetic and structural parameters. Herein we report a detailed study of the transition between cubic bicontinuous mesostructure with space groups Ia ̅3d and Pn ̅3m symmetry, which are associated with the minimal G and D surfaces, respectively. The transition may be induced through micellar swelling of the anionic amphiphilic surfactant N-lauroyl alanine by trimethylbenzene. Rich kinetic behaviour is observed and has been exploited to prepare particles with biphasic structures. Transmission electron microscopy evidence indicates that there is epitaxial growth from one mesostructure to the other involving the [111] and [110] orientations of the Ia ̅3d and Pn ̅3m symmetry structures, respectively. From kinetic studies, we show that the formation of the Ia ̅3d mesophase is preceded by a hexagonal phase (plane group p6mm) and an epitaxial relationship has been observed involving the sixfold or ̅3 axis orientations of both structures. Our data suggests that the Pn ̅3m mesostructure is kinetically stable at low temperatures whereas the Ia ̅3d mesostructure is the more stable structure after prolonged periods of hydrothermal treatment. We present evidence from transmission electron microscopy and small-angle X-ray diffractograms and also electron crystallography modelling of the unit cells at particular points in the structural change.

ABSTRACT: Study Design: Case report. OBJECTIVE: The authors present the case of a 14-year-old boy with Rubinstein-Taybi syndrome (RSTS) presenting scoliosis. Summary of Background Data: There have been no reports on surgery for RSTS presenting scoliosis. METHODS: The patient was referred to our hospital for evaluation of a progressive spinal curvature. A standing anteroposterior spine radiograph at presentation to our hospital revealed an 84-degree right thoracic curve from T6 to T12, along with a 63-degree left lumbar compensatory curve from T12 to L4. We planned a two-staged surgery and decided to fuse from T4 to L4. The first operation was front-back surgery because of the rigidity of the right thoracic curve. The second operation of lumbar anterior discectomy and fusion was arranged 9 months after the first surgery to prevent the crankshaft phenomenon due to his natural course of adolescent growth. To avoid respiratory complications, the patient was put on a respirator in the ICU for several days after both surgeries. RESULTS: Full-length spine radiographs after the first surgery revealed no instrumentation failure and showed that the right thoracic curve was corrected to 31 degrees and the left lumbar curve was corrected to 34 degrees. No postoperative complications occurred after both surgeries. CONCLUSIONS: We succeeded in treating the patient without complications. Full-length spine standing radiographs at one year after the second operation demonstrated a stable bony arthrodesis with no loss of initial correction.

Aging is associated with a progressive decrease in appetite and food intake. We focused on the age-associated changes of the stimulatory effect of the appetite-regulating peptide, ghrelin. Food intake and the concentrations of acyl ghrelin and desacyl ghrelin in the plasma and in the stomach were measured with and without overnight fasting in young and old mice. Moreover, the food intake in response to the intraperitoneal administration of graded doses of acyl ghrelin was compared between young and old mice. Fasting drives food intake in young mice, but not in old mice. The concentrations of acyl ghrelin and desacyl ghrelin in the plasma and in the stomach were higher in the old mice than in the young mice. Food intake did not increase in old mice when stimulated by the administration of 1-3nmol of acyl ghrelin, which could produce a significant increase in food intake in young mice. In conclusion, food intake did not increase in old mice after either overnight fasting or the administration of acyl ghrelin. The release and synthesis of ghrelin seem to be rather higher in old mice compared to young mice. These increases might be the results of compensation for the decline of receptor (and/or post-receptor) functions.

Cage-type, two-dimensional (2D) cylindrical hexagonal (C), bicontinuous diamond (D), bicontinuous gyroid (G), and one-dimensional (1D) lamellar (L) structures of silica mesoporous crystals (SMCs) were obtained by using the anionic surfactant N-stearoyl-l-glutamic acid (C(18)GluA) as a template in the presence of the nonionic surfactant C(16)(EO)(10)(Brij-56). The mesostructures were controlled by the organic/inorganic interface curvature change induced by Brij-56. A synthesis-field diagram showed that the mesostructure changed in the sequence cage-type → C → intergrowth of C and D → intergrowth of C and G → D → G → L with increase of the amount of Brij-56. Mixed micelles were formed by the anionic and nonionic surfactants, the packing parameter g of which increased with increasing the addition amount of nonionic surfactant and the reaction temperature. The local g parameter was obtained from electron crystallography reconstruction results by calculating mean curvatures and Gaussian curvatures from the equi-electrostatic potential surface. The intergrowth of C and D and two kinds of intergrowth of C and G are also discussed.

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Aging is associated with a progressive decrease in appetite and food intake. The reasons for the decline in food intake are multifactorial, and relate to both peripheral and central mechanisms. Current studies about the regulation of food intake suggest that there are many central mediators that control the appetite. To determine the mechanism of age-associated decrease in appetite and food intake, we focused on the age-associated changes of the suppressing and stimulatory effect of some appetite-regulating peptides. At first, we examined cholecystokinin (CCK), one of the typical appetite-suppressing factors. Although sensitivity to CCK is enhanced in old animals, the mechanism underlying this effect has not been elucidated. Next, we focused on the appetite-stimulating peptides, orexin-A, neuropeptide Y (NPY) and ghrelin, which are known to play a critical role in food intake. To determine the age-associated decrease in appetite and food intake, we compared the stimulatory effect of intracerebroventricular administration of orexin-A, NPY and ghrelin. We report the studies of the age-associated changes of appetite-regulating peptides in this review.