INTRODUCTIONSpontaneous spinal epidural hematomas (SSEHs) are rare in childhood, especially in infants. CASE REPORTWe present the case of a 17-month-old-boy with trisomy 21 and a large SSEH. He was ...hospitalized for acute onset paraplegia after 6 days of irritability. Nine days after symptom onset, magnetic resonance imaging (MRI) of the spine revealed an extensive epidural hematoma between C7 and T5 causing severe spinal cord compression. After a coagulation disorder was ruled out (12 days after onset), he underwent emergency hemilaminectomy with evacuation of the hematoma. His neurologic impairment gradually improved, and 4 months after surgery he was back to his neurologic baseline. At 18 months after surgery, he was walking independently, although he had some developmental disabilities due to trisomy 21. CONCLUSIONSOnly 20 cases of SSEH in infancy have been previously reported, and this is the first report of SSEH in an infant with developmental disabilities. Because of the non-specific symptoms and difficulty obtaining MRIs in infants, particularly in those with developmental disabilities, the diagnosis and treatment of SSEH may be delayed. However, early diagnosis with MRI and early evacuation of SSEH in patients with severe neurological impairments is important for good outcomes. Attention must be paid to postoperative spinal deformity in infants.
BACKGROUNDJeune syndrome (asphyxiating thoracic dystrophy) is an autosomal recessive disorder with constriction and narrowing of the thorax. To our knowledge, there are no reports regarding spinal ...deformity and correction in Jeune syndrome. Herein, we report two cases of spinal correction in patients with Jeune syndrome, and review the literature. CASE PRESENTATIONWe experienced cases of spinal scoliosis in an adolescent boy and a young adult woman, both with Jeune syndrome. Their spinal deformities had progressed by the time they came to our hospital for surgical correction. After preoperative evaluation of their general condition, including respiratory function in detail to confirm that they could undergo surgery, we treated both cases with posterior spinal correction and fusion. Spinal correction was performed safely and there were no severe complications, including respiratory depression, associated with surgery, and relatively satisfactory correction was obtained in both cases. In case 1, coronal deformity was corrected from 70° to 36° and from 82° to 42°, respectively. In case 2, Cobb angle was corrected from 52° to 20° and from 55° to 21°. CONCLUSIONSPosterior spinal correction can be performed safely in young patients with Jeune syndrome who have survived their infant stage and matured without a severe general condition.
INTRODUCTIONSuicidal jumper's fracture (unstable sacral fracture) is characterized not only by multiple fractures including thoracolumbar fractures, but also major chest and abdominal injuries. Early ...stabilization of these fractures and early ambulation are required for the treatment and management of chest and abdominal injuries. We present 3 cases of suicidal jumper's fracture with thoracolumbar burst fracture, treated with minimally invasive posterior fixation surgery, which is a combination of percutaneous pedicle screws (PPS) and the mini-open Galveston technique. CASE REPORTSCase 1. A 50-year-old woman was injured by a fall from the 5th floor of a building as the result of a suicide attempt. Computed tomography revealed an H-shaped unstable sacral fracture and thoracolumbar fractures with major chest and abdominal injuries. For early stabilization of spinopelvic instability and early ambulation, we treated the patient with PPS and the mini-open Galveston technique. Her early postoperative emergence from bedrest contributed to the improvement of her general condition. One year after surgery at the final follow-up, she was able to walk with a T-cane without any motor, bladder, or bowel dysfunction (BBD) and achieved almost complete healing of the fractures. Cases 2 and 3. A 25-year-old woman (Case 2) and a 43-year-old woman were injured in falls. They had multiple injuries including unstable sacral fractures, and thoracolumbar fractures with major chest and abdominal injuries. We treated these patients with PPS and the mini-open Galveston technique. One year after surgery, they were able to walk with a T-cane and achieved almost complete healing of thoracolumbar fractures, but delayed healing of an unstable sacral fracture in Case 2, and remaining BBD in Case 3. CONCLUSIONPPS and the mini-open Galveston technique is a good approach to fixation because they are minimally invasive and provide moderately rigid fixation, especially in patients with multiple trauma whose general condition is poor.
Deaf or hard-of-hearing people need support services such as real-time captioning. It is fairly common for captionists to be unable to perform captioning services. In order to address this problem, ...we proposed a Mobile-type Remote-captioning System. The main characteristic of our system is to use two functions of one mobile phone (e.g. the iPhone 3G/3GS, Apple Computer, Inc.) at the same time. The two functions are to display the captions input by the captionists (data communications) and to call the captionists to transmit the speaker's speech to the captionists (telephone call). The purpose of our research was to make clear the differences with the existing system, and to discover the advantages and faults of our system. In this study, we investigated these issues using a questionnaire for captionists who had used our system. As a result, we found that our system is suitable for a situation in which the speaker and the deaf or hard-of-hearing person are communicating while walking together (e.g. excursions, plant tours), whether indoors or outdoors. In addition, it reduces the stress that can be caused to deaf or hard-of-hearing children by having adults (captionists) other than teachers in the classroom.
The characteristics of
Rhodobacter capsulatus ST410, a mutant of the wild strain B100 lacking hydrogenase activity, were investigated from the viewpoint of hydrogen production. When 30 mM
dl-malate ...and 7 mM
l-glutamate were used as carbon and nitrogen sources, respectively, in an argon atmosphere, a specific hydrogen evolution rate of 0.14 ml/h/mg-dry cells was obtained at 6600 lx and 33°C. The evolution rate strongly depended on the light intensity: the higher the light intensity, the larger the evolution rate became up to at least 6600 lx.
R. capsulatus ST410 converted 60 mM malate to hydrogen at a yield of 68%, calculated as a percentage of the stoichiometric maximum for the complete conversion of the carbon source to H
2 and CO
2. On the other hand, when the wild strain was used under the same conditions, the yield was only 25%.
R. capsulatus ST410 converted not only malate but also glucose and cellobiose to hydrogen with good yields (60% for 30 mM glucose and 66% for 7.5 mM cellobiose). Ethanolamine was found to be a good nitrogen source, which permitted a large amount of hydrogen to be evolved and also depressed the cell growth to low levels.
We measured prostaglandin E2 and leukotriene B4 in the aqueous humor of baboon eyes, 1 or 8 days after phacoemulsification, with or without posterior chamber lens implantation. We also evaluated the ...effects of steroid eye drops and cyclooxygenase inhibitor eye drops on the synthesis of these mediators of inflammation. Eyes that had undergone phacoemulsification showed significant elevation of prostaglandin E2 at both postoperative periods compared with normal, phakic control eyes. The level of prostaglandin E2 was significantly (P less than .05) higher in eyes with posterior chamber lens implantation than in those without it, and was significantly (P less than .05) higher on the eighth than on the first postoperative day. The amount of leukotriene B4 was below the detection limit, except in the few eyes in which complications developed. Cyclooxygenase inhibitor eye drops significantly reduced the amount of prostaglandin E2 on both postoperative days, while steroid eye drops had no such effect.
Influences of continuous annealing conditions on strength and ductility of 0.1%C-1.0%Mn cold-rolled dual phase steel were investigated as a preliminary study to find the concepts on optimum ...microstructure which gives high strength and good ductility. It was found that the highest strength ductility balance is obtained by the two phase microstructure consisting of a small amount of carbon enriched martensite and fully ductile ferrite. In applying the results to the production of TS980MPa grade cold-rolled steel, the appropriate strengthening methods were discussed. Consequently, it was found that some solution hardening of ferrite should be added, because of the both limitations in carbon enrichment in martensite phase and in increase in its volume fraction for maintaining good ductility.The additional investigation showed that hardening by silicon is most desirable. Spot weldability and phosphatability were also considered for the determination of steel chemistry. The result of mill production carried out upon these basic investigations indicated that the developed TS980MPa grade steel is applicable to the stringent cold forming for such as a door impact beam bracket.
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