A prospective study.
To evaluate the effectiveness of prophylactic C4/C5 microforaminotomy with open-door laminoplasty for cervical myelopathy in preventing postoperative C5 palsy.
Postoperative C5 ...palsy is a common complication of cervical laminoplasty. Although the etiology of C5 palsy and preventive measures remain unclear, we hypothesize that C5 palsy is caused by C5 nerve root impairment induced by potential C4/C5 foraminal stenosis and posterior shifting of the spinal cord after laminoplasty.
The study included 141 consecutive patients with cervical myelopathy (103 men and 38 women) who underwent open-door laminoplasty with prophylactic bilateral C4/C5 foraminotomy between 2009 and 2010. These were designated as the foraminotomy group (FG). One hundred forty-one consecutive patients (100 men and 41 women) who underwent open-door laminoplasty without prophylactic foraminotomy during 2006 to 2008 served as a control group. This was the nonforaminotomy group (NFG). The incidence of C5 palsy, operation time, blood loss, and the number of decompressed disc levels were recorded.
The incidence of C5 palsy was 1.4% (2 of 141 cases) in the FG, and 6.4% (9 of 141 cases) in the NFG. The mean operation times were 129 and 102 minutes, respectively. There were significant differences in the incidence of C5 palsy and operation time (both comparisons, P < 0.05). There were no significant differences in blood loss or the number of decompressed disc levels (both comparisons, P > 0.05).
Prophylactic bilateral C4/C5 microforaminotomy significantly decreased the incidence of postoperative C5 palsy. These results suggest that the main etiology of C5 palsy was C5 root impairment. However, 2 patients experienced C5 palsy despite undergoing prophylactic foraminotomy, which indicated that other factors including spinal cord impairment after acute decompression against cervical canal stenosis may also be considered as minor etiologies of C5 palsy. We conclude that prophylactic C4/C5 foraminotomy was an effective preventive measure against postoperative C5 palsy after laminoplasty.
Teriparatide (TPTD) administration has a potent osteogenic action and promotes the healing of osteoporotic vertebral fractures (OVFs). We aimed to investigate the outcomes of vertebroplasty with ...posterior spinal fusion (VP + PSF) and determine the impact of perioperative TPTD administration. We included 73 patients (18 male and 55 female patients; mean age: 78 years) with thoracolumbar OVFs who underwent VP + PSF and were followed-up for at least 2 years. Twenty-three patients who received TPTD perioperatively for > 3 months were included in the TPTD group, and the remaining 50 patients were included in the non-TPTD group. Radiographic findings regarding sagittal alignment and clinical outcomes in both groups were compared. The mean duration of TPTD administration was 17.5 ± 5.0 months (range 4-24 months). The mean loss of correction of local kyphosis angle in the TPTD group (4.0°) was lesser than that in the non-TPTD group (7.5°; p < 0.05); however, no significant differences were observed between the groups regarding global sagittal alignment, the occurrence of subsequent vertebral fractures, pedicle screw loosening and treatment-efficacy rates of clinical outcomes. Local kyphosis correction in patients who underwent VP + PSF for OVFs could be maintained through perioperative TPTD administration; however, TPTD administration had little effect on clinical outcomes.
Nanofabrication based on block copolymer self-assembly is one of the most promising methods for producing nanopatterns with a sub-10 nm feature size. Although polystyrene-block-poly(methyl ...methacrylate) (PS-b-PMMA) has been widely studied as a suitable template for nanofabrication, the insufficient incompatibility between the PS and PMMA blocks makes it difficult to achieve a microphase separation with the domain spacing of less than ca. 20 nm. We now present a simple and efficient method for the postpolymerization modification of PS-b-PMMA for effectively increasing the incompatibility between the two blocks, so that microphase separation can be achieved even at a low degree of polymerization. The ester–amide exchange reactions of PS-b-PMMA with primary and secondary amines were performed to introduce a small number of methacrylamides into the PMMA block to increase its hydrophilicity. The results of small-angle X-ray scattering measurements performed on bulk samples showed that the modified PS-b-PMMA self-assembled to form a lamellar phase even at the extremely low molecular weight of 8.5 kg mol–1 due to the increased incompatibility between the blocks. The smallest domain spacing of the modified PS-b-PMMA observed in this study was 11.1 nm. That is to say, the smallest feature size was 5.6 nm. The modified PS-b-PMMA thin film showed well-aligned line patterns via the graphoepitaxy directed self-assembly process, demonstrating that these materials obtained from PS-b-PMMA have the potential to be used for sub-10 nm nanofabrication applications.
The radiation-induced reactions of ligands play an important role in the sensitization of metal oxide nanocluster resists. However, the details in the radiation chemistry of ligands for metal oxide ...nanocluster resists are still unknown. In this study, the radiation-induced reactions of carboxylic acid ligands were investigated using a pulse radiolysis method. The rate constants for the reactions of molecular and ionic forms of tiglic, angelic, o-toluic, and p-toluic acids with hydrated electrons were determined. The rate constants for the reactions of tiglic, angelic, benzoic, o-toluic, and p-toluic acids with dodecane radical cations were also determined. The radical ions of tiglic and angelic acids were more unstable than those of benzoic, o-toluic, and p-toluic acids. The results obtained in this study indicate that the molecular structures of ligands affect their reactivity to cationic and anion species and the stability of their radical cations and anions.
Introduction: We performed sublaminar taping stabilisation at the proximal adjacent segment to prevent adjacent segmental disease (ASD). The purpose of this study was to examine the effectiveness of ...sublaminar taping stabilisation.Methods: Forty-two patients underwent L4/5/S1 interbody fusion with L3 sublaminar taping stabilisation (SLT group), and 73 patients underwent L4/5/S1 interbody fusion alone (control group). We evaluated the clinical findings, including the operation time, volume of blood loss, recovery rate based on the Japanese Orthopaedic Association score, and reoperation rate. Furthermore, we evaluated the patients radiologically to examine the global alignment, Pfirrmann classification, slip distance, disc height, posterior opening angle, and presence or absence of radiological ASD.Results: Clinical examination revealed no significant differences between the two groups. In contrast, the slip distance and posterior opening angle were significantly reduced in the SLT group. In addition, the rate of radiological ASD was significantly decreased in the SLT group.Conclusions: These results suggest that sublaminar taping may decrease the risk of radiological ASD. Moreover, sublaminar taping stabilisation may reduce the need for reoperation due to ASD.
The resolution of lithography used for the high-volume production of semiconductor devices has been improved to meet the market demands for highly integrated circuits. With the reduction in feature ...size, the molecular size becomes non-negligible in the resist material design. In this study, the excluded volume effects caused by adding high-concentration acid generators were investigated for triphenylsulfonium nonaflate. The resist film density was measured by X-ray diffractometry. The dependences of absorption coefficient and protected unit concentration on acid generator weight ratio were calculated from the measured film density. Using these values, the effects on the decomposition yield of acid generators, the protected unit fluctuation, and the line edge roughness (LER) were evaluated by simulation on the basis of sensitization and reaction mechanisms of chemically amplified extreme ultraviolet resists. The positive effects of the increase in acid generator weight ratio on LER were predominant below the acid generator weight ratio of 0.3, while the negative effects became equivalent to the positive effects above the acid generator weight ratio of 0.3 owing to the excluded volume effects.
Introduction: In the previous study, we established a method for three-dimensional analysis of computed tomography (CT) of cervical ossification of the posterior longitudinal ligament (OPLL) to ...identify the risk factors for the progression of ossification. The aim of this study was to establish biomarkers predicting progression of ossification by considering bone metabolism.Methods: In this study, 44 OPLL patients, who underwent imaging examinations and bone metabolism tests in our hospital or related facilities, were included. The subjects consisted of 26 men and 18 women with the mean age of 61 years.Bone metabolism was measured using complete blood count, biochemical parameters, electrolyte, 25-hydroxyvitamin D (25OHD), intact parathyroid hormone (PTH), fibroblast growth factor 23 (FGF-23), procollagen type 1 amino-terminal propeptide (P1NP), tartrate-resistant acid phosphatase 5b (TRACP-5b), sclerostin and Dickkopf-related protein 1 (Dkk-1), and bone mineral density. Progression of ossification was measured using the three-dimensional analysis of the volume of ossification to calculate the annual rate of increase. Based on the previous findings of the annual rate of increase (7.5%/year) in patients with cervical OPLL after laminoplasty, in the present study, the progression group (P group) was defined as those with an annual rate of increase of ≥8%, whereas the nonprogression group (N group) was defined as those with an annual rate of increase of <8%. Univariate and multivariate analyses were used to identify related factors.Results: The mean annual rate of increase was 5.0% per year. Univariate analysis identified age (P group, 50.0 years; N group, 63.9 years), BMI (P group, 30.4 kg/m2; N group, 24.8 kg/m2), serum phosphorus level (P group, 2.7 mg/dL; N group, 3.1 mg/dL), and TRACP-5b level (P group, 303.6 mU/dL; N group, 468.3 mU/dL) as significant factors (all, p < 0.05), whereas multivariate analysis identified age as the only significant factor (p < 0.05).Conclusions: In our previous studies, younger age and obesity were identified as significant risk factors for progression of ossification. Hence, the present study's results are consistent with our previous findings. In addition, univariate analysis also identified serum phosphorus and TRACP-5b as related factors. Both factors are closely related to bone metabolism and easy to measure. Future studies are required to evaluate the factors as possible biomarkers for the progression of OPLL ossification.
The characteristics and pathogenesis of spinopelvic alignment in Parkinsons's disease (PD) patients-including differences compared to non-PD subjects and their relationships with the severity of ...PD-have not been clarified. The aim of this study was to investigate the characteristics of spinopelvic alignment in patients with PD.
Forty-eight PD patients complaining of chronic low back pain were included (PD group). The PD condition, determined using the Hoehn and Yahr (H&Y) stage and Unified Parkinson Disease Rating Scale (UPDRS) score; radiographic spinopelvic alignment; lumbar range of motion (ROM); and low back pain-related quality of life assessments were evaluated. Fifty age- and sex-matched patients with adult spinal deformities were included as controls (ASD group).
The spinopelvic alignments of the PD/ASD groups demonstrated sagittal vertical axes of 120.9/106.3 mm and pelvic incidences of 49.7/52.9°, with no significant differences. Conversely, there were significant differences in the thoracic kyphosis (TK; 27.6/16.7°), lumbar lordosis (-22.7/-7.9°), and pelvic tilt (25.3/34.4°) (all, p < 0.05). With regard to correlations with the PD condition, the H&Y stage demonstrated significant correlations with the sagittal vertical axis, thoracolumbar kyphosis, and lumbar ROM (all, p < 0.05), and the UPDRS score tended to correlate with the TK and thoracolumbar kyphosis (both, p < 0.01).
Characteristic spinal conditions in PD exist, with progressed PD condition causing stooped posture with increased thoracic or thoracolumbar kyphosis and decreased lumbar ROM; moreover, global sagittal malalignment progresses without sufficient compensatory mechanisms such as loss of TK and pelvic retroversion.
Lithium distribution in the composite electrode of an all-solid-state lithium battery was analyzed by microbeam-particle-induced X-ray emission and gamma-ray emission techniques. Two kinds of ...pellet-type cells, incorporating LiCoO2 as the cathode-active material and the superionic conductor Li10GeP2S12 as the solid electrolyte, were prepared: one in the as-prepared state and the other in the charged state. Changes in the lithium distribution near the interface of the composite cathode and separator were visualized by normalizing lithium/cobalt and lithium/germanium intensity. Lithium extraction from LiCoO2 due to charging was confirmed by the decrease in normalized intensity at the cathode composite region. The evaluation of the lithium concentration variation in the composite electrode for the all-solid-state battery during the electrochemical reactions could provide essential information for construction of a favorable composite electrode to enable preparing high-performance all-solid-state lithium batteries.
There are several options for sub-10nm fabrication such as extreme ultra violet (EUV) lithography, directed self-assembly (DSA), and ArF multiple patterning. For further extension of ArF lithography, ...one of the key challenges is cost effectiveness. In this paper, a new double patterning method - pattern split process (PSP), which is based on dual tone development is demonstrated. Different from conventional DTD, additional acid and base materials were used in this process to gain high deprotection contrast. By PSP, double pitch frequency pattern which has improved roughness was successfully obtained. Also other basic parameter such as focus margin, wafer uniformity and resolution are reported.
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