There is no widespread agreement regarding the treatment of thoracolumbar burst fractures. While performing posterior short segment fixation of thoracolumbar burst fractures, we evaluated therapeutic outcomes in patients treated with screw insertion into fractured vertebral bodies without vertebroplasty. We also investigated the limitations associated with the treatment of burst fractures when vertebroplasty is not performed. Twenty-one of 51 patients with thoracolumbar burst fractures who were treated surgically in Ohta Nishinouchi Hospital were evaluated in the present study. These patients underwent posterior short segment fixation with screw insertion into the fractured vertebral bodies (only pedicle screws were inserted one level above and one level below the fractured vertebral bodies) without vertebroplasty. Vertebral angles were measured before surgery, immediately after surgery, and at the final follow-up examination. Changes in vertebral angles were compared and analyzed. The mean vertebral angles before and after surgery and at the final follow-up examination were 15.4°, 6.6°, and 9.1°, respectively. The mean postoperative correction loss was 2.5°. The therapeutic outcomes of posterior short segment fixation with screw insertion into fractured vertebral bodies without vertebroplasty were generally favorable.

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Parietal ataxia is a rare condition of hemi- or mono-ataxia caused by contralateral lesions in the parietal lobe. Parietal ataxia is categorized into sensory ataxia and pseudocerebellar ataxia, and is usually reported in single-case studies. Here we report 13 cases of hemi- or mono-ataxia caused by acute brain infarction in the parietal lobe, and discuss these cases with respect to past case studies and the MRI lesion visualizations. Patients with motor paresis were excluded from this study. Patients with sensory disturbance were categorized into a sensory ataxia group and pseudocerebellar ataxia group. Lesions on cranial MRI were classified as white matter inferior to the posterior central gyrus, posterior central gyrus, or superior or inferior parietal lobules. Six patients in the sensory ataxia group showed lesions in the gray or white matter of the posterior central gyrus. We found that parietal ataxia patients showed a high rate of decomposition and slowness in the finger-nose test and decomposition in diadochokinesis. Oscillation in the finger-nose test and slowness in diadochokinesis were more frequently observed in the patients with sensory ataxia than in those with pseudocerebellar ataxia, although the difference was not lesion dependent. This study thus found clinical differences between the sensory ataxia and pseudocerebellar ataxia groups of patients with parietal ataxia.

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The present study compared a 3-dimensional computed tomography (3DCT) classification (Nakano classification) with conventional x-ray classifications (Jensen classification and AO classification) in 44 patients with trochanteric femoral fractures, and evaluated the patterns of fracture lines using 3DCT images. The concordance rate between the Jensen and 3DCT classification, and between the AO and 3DCT classification was 65.9% and 75.0%, respectively. 3DCT scans enabled the creation of detailed images of fracture lines. The anterior fracture line was found to run along the intertrochanteric crest in 90.9% of patients, while the location of the posterior fracture line was in the same approximate position in all patients, including those with comminuted fractures (34.1%). Posterior destruction along lateral fracture lines was present in 63.6% of patients. Furthermore, the preoperative and postoperative CT images of 33 patients with fractures treated via insertion of short femoral nails demonstrated that there was difficulty reducing greater trochanteric fractures. This included reducing fracture sites separated by nail insertion (42.4%) and greater trochanteric fracture sites displaced after surgery (54.5%), suggesting that the use of short femoral nails is limited.

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In recent years, the potential of oral care in preventing aspiration pneumonia has been recognized. Consuming drinks is thought to be an easy and effective method of oral care, and the antibacterial activities of various drinks have been examined. However, the side effects associated with, for example, caffeine as an ingredient in tea (e.g. sleep disorders) need to be taken into consideration. As yet, a safe caffeine-free tea to be taken orally to prevent aspiration pneumonia has not been reported. Thus, in the present study we evaluated the antibacterial effects of hot water extracts of four teas, namely Hypericum Erectum, Crataegus cuneata, Rosa canina, and Matricaria rectita, thought to be caffeine-free. The effects of the extracts against 19 bacteria and 1 fungus were investigated by the dilution plate technique. In addition, the components of the teas were analyzed by HPLC analysis. The strongest antibacterial activity was observed for the hot water extract of H. erectum, which exhibited significant activity against oral bacteria, including Streptococcus oralis. However, the H. erectum extract did not kill microbiota, such as Escherichia coli and Lactobacillus casei. Neither hypericin nor caffeine, both of which have notable side effects, were detected in the H. erectum extract following HPLC analysis. These results suggest that H. erectum tea may be a good candidate for simple, safe oral care to prevent aspiration pneumonia in the elderly.

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Abdominal surgery, especially liver resection and transplantation, increases body temperature during and after surgery, but the precise mechanism (s) underlying this effect are not well understood. The present study thus sought to investigate this phenomenon using an experimental rat model. Specific pathogen-free male Sprague-Dawley rats, 5 weeks of age, underwent a two-thirds partial hepatectomy (PH), one-third splenectomy, or left kidney resection, and then rectal temperature was measured for 5 consecutive days after surgery. Rectal temperature increased in PH rats to a peak on day 4, but no change in temperature was detected after splenectomy and kidney resection. In the second part of the study, we examined the influence of gadolinium chloride and interleukin-1β monoclonal antibody (IL-1β mAb) on the increase in rectal temperature following PH. Treatment of rats with 20mg/kg gadolinium chrolide or 200µg IL-1β mAb inhibited the PH-induced increase in rectal temperature and decrease in IL-1β and prostaglandin E2, which act as pyrogens to change the thermoregulatory set point in the hypothalamus. These results suggest that abdominal surgery, especially liver resection, caused an increase in endogenous pyrogen production that results in increased body temperature.

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We investigated the elasticity of the medial collateral ligament (MCL) in baseball players using ultrasound elastography (EG). We examined 72 elbows in 36 male baseball players (including 12 junior high students, 12 high school students, and 12 university students) with no history of pitching injuries. We used the Hitachi Medical Corporation HI VISION Avius, an acoustic coupler for quantification, as well as real-time tissue EG, which was applied to subjects in the supine position. Pressure was applied manually with the subject's forearm in supination, elbow joint at 30° of flexion, and shoulder joint at 90° abduction. The strain ratio (SR) of the coupler and MCL was used for evaluation. SR increased with age (P < 0.05) in both arms, and the SR in the university student group was higher than that in the other groups (P < 0.05). In addition, the throwing side exhibited significantly lower SR values compared to the non-throwing side (P < 0.05), but there was no correlation between SR and other factors. Findings and Conclusions: Elasticity in MCLs of baseball players decreases with age, and increases on the throwing side. Quantifying the elasticity of the elbow MCL in this study will facilitate future investigation of how ligament characteristics could affect MCL injuries.

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The purpose of this study was to compare the Mayo Clinic Congruent Elbow Plate System with a plate system having the same biomechanical features as a conventional non-locking system. For testing, we used a biaxial adjustable material testing machine (Mini-Bionix^®, MTS, Minnetonka, MN). A compressive load of 500 N/min was applied in the axial direction, and a torque of 30 deg/min was applied in the rotational direction to simulate internal rotation of the elbow. The relationships between force (N) and displacement (mm), and between the internal rotational angle (deg) and torque (N/m), were measured. The Mayo Clinic Congruent Elbow Plate and the two types of screws used in this study may provide sufficient fixation strength. The results obtained here warrant further studies that are more dynamic (e.g., cyclic loading and repetitive torsion tests), with a larger number of specimens, and that facilitate appropriate nomal elbow movement in daily living, to assess the utility of plate fixation with locking and non-locking systems for distal humerus fractures.

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An aneurysm of the abdominal internal organs is relatively rare. Recently, segmental arterial mediolysis (SAM) and median arcuate ligament syndrome (MALS) were identified as specific causes for aneurysms of the pancreaticoduodenal artery arcade. Herein, we report a ruptured anterior superior pancreaticoduodenal artery (ASPDA) aneurysm due to SAM that was misdiagnosed as acute pancreatitis. The patient was a 59-year-old male with acute, severe, and sharp pain in the upper abdomen. He was clinically diagnosed with acute pancreatitis based on abdominal computed tomography (CT). However, a follow-up CT scan revealed an aneurysm of the ASPDA. We therefore diagnosed this case as retroperitoneal hemorrhage due to aneurysm rupture, and we performed an angiogram and transcatheter arterial embolization to prevent aneurysm re-rupture. Based on a subsequent review of all the findings for this patient, we retrospectively determined the cause of the ASPDA aneurysm to be SAM. Such case reports are rare, and further accumulation of similar cases is necessary in the near future to establish proper diagnostic criteria and appropriate treatment protocols.

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