Experimental Demonstration of the Thin-Film Liquid-Metal Jet as a Charge Stripper.

For high-power heavy ion accelerators, the development of a suitable charge stripper, which can handle intense beams, is essential. This Letter describes the first experimental demonstration of a heavy ion liquid lithium charge stripper. A 10-20 µm thick liquid lithium jet flowing at >50 m/s was formed and confirmed stable when bombarded by various heavy ion beams, while increasing the charge state of the incoming beams to the desired charge state range. This demonstration proved the existing power limitation with the conventional strippers can be overcome by the liquid-metal stripper, opening completely new possibilities in high-power accelerator development.

An assessment of the evaporation and condensation phenomena of lithium during the operation of a Li(d,xn) fusion relevant neutron source.

The flowing lithium target of a Li(d,xn) fusion relevant neutron source must evacuate the deuteron beam power and generate in a stable manner a flux of neutrons with a broad peak at 14 MeV capable to cause similar phenomena as would undergo the structural materials of plasma facing components of a DEMO like reactors. Whereas the physics of the beam-target interaction are understood and the stability of the lithium screen flowing at the nominal conditions of IFMIF (25 mm thick screen with +/-1 mm surface amplitudes flowing at 15 m/s and 523 K) has been demonstrated, a conclusive assessment of the evaporation and condensation of lithium during operation was missing. First attempts to determine evaporation rates started by Hertz in 1882 and have since been subject of continuous efforts driven by its practical importance; however intense surface evaporation is essentially a non-equilibrium process with its inherent theoretical difficulties. Hertz-Knudsen-Langmuir (HKL) equation with Schrage's 'accommodation factor' η = 1.66 provide excellent agreement with experiments for weak evaporation under certain conditions, which are present during a Li(d,xn) facility operation. An assessment of the impact under the known operational conditions for IFMIF (574 K and 10-3Pa on the free surface), with the sticking probability of 1 inherent to a hot lithium gas contained in room temperature steel walls, is carried out. An explanation of the main physical concepts to adequately place needed assumptions is included.

The maturation of grafted bone after posterior lumbar interbody fusion with an interbody carbon cage: a prospective five-year study.

We evaluated the maturation of grafted bone in cases of successful fusion after a one- or two-level posterior lumbar interbody fusion (PLIF) using interbody carbon cages. We carried out a five-year prospective longitudinal radiological evaluation of patients using plain radiographs and CT scans. One year after surgery, 117 patients with an early successful fusion were selected for inclusion in the study. Radiological evaluation of interbody bone fusion was graded on a 4-point scale. The mean grades of all radiological and CT assessments increased in the five years after surgery, and differences compared to the previous time interval were statistically significant for three or four years after surgery. Because the grafted bone continues to mature for three years after surgery, the success of a fusion should not be assessed until at least three years have elapsed. There were no significant differences in the longitudinal patterns of grafted bone maturity between iliac bone and local bone. However, iliac bone grafting may remodel faster than local bone.

The treatment of refractory atlanto-axial rotatory fixation using a halo vest: results of a case series involving seven children.

We reviewed seven children with torticollis due to refractory atlanto-axial rotatory fixation who were treated in a halo vest. Pre-operative three-dimensional CT and sagittal CT imaging showed deformity of the superior articular process of C2 in all patients. The mean duration of halo vest treatment was 67 days (46 to 91). The mean follow-up was 34 months (8 to 73); at the latest review six patients demonstrated remodelling of the deformed articular process. The other child, who had a more severe deformity, required C1-2 fusion. We suggest that patients with atlanto-axial rotatory fixation who do not respond to conservative treatment and who have deformity of the superior articular process of C2 should undergo manipulative reduction and halo-vest fixation for two to three months to induce remodelling of the deformed superior articular process before C1-2 fusion is considered.

C5 palsy after cervical laminoplasty: a multicentre study.

We have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the deltoid, with or without involvement of the biceps, but with no loss of muscular strength in any other muscles. The clinical features and radiological findings of patients with (group P; 43 patients) and without (group C; 100 patients) C5 palsy were compared. CT scanning of group P revealed a significant narrowing of the intervertebral foramen of C5 (p < 0.005) and a larger superior articular process (p < 0.05). On MRI, the posterior shift of the spinal cord at C4-5 was significantly greater in group P, than in group C (p < 0.01). This study is the first to correlate impairment of the C5 nerve root with a C5 palsy. It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.

[Acute pulmonary thromboembolism in polysplenia syndrome].

We present a case of azygos continuation of the inferior vena cava, combined with polysplenia syndrome in a 72-year-old woman who presented with circulatory collapse due to acute pulmonary thromboembolism. Patients with polysplenia have multiple spleens, and their splenic function is usually normal, but this case was not. In this case, defective splenic function was associated with a high risk of fulminant bacterial infections, especially with encapsulated bacteria. The clinical features and prognosis of this entity are discussed.

[Midterm restenosis of freestyle valved conduit in an adult tetralogy of Fallot].

We report a case of midterm restenosis of freestyle valved conduit implanted between the right ventricle and the pulmonary artery. A 69-year-old woman visited our hospital with dyspnea and general fatigue and was diagnosed as tetralogy of Fallot. Total corrective surgery including patch closure of ventricular septal defect was performed using the freestyle valve with the Hemashield prothesis to reconstruct the right ventricle to the pulmonary artery. The catheterization revealed almost normal right ventricular pressure on 40th postoperative day, but the opening of the valve was limited. Twenty-two months later she visited our hospital with severe right heart failure. The pressure gradient over the valve was 122 mmHg and the leaflet of the freestyle valve was markedly thickened causing severe stenosis. Use of the freestyle valve for the right ventricular out flow tract reconstruction has to be further studied.

[A case of arterial metastasis to the thoracic aorta and lower extremities of an adenocarcinoma of unknown primary site].

A 66-year-old woman experienced a left femoral artery occlusion as a result of an adenocarcinoma embolization. A progressive tumor in the thoracic aorta was observed on a contrast-enhanced chest CT. The tumor was diagnosed as a metastatic lesion of unknown primary site and was thought to be the origin of the embolization. Metastasis to the wall of the thoracic aorta has not been previously reported, although arterial metastasis is common. We report a very rare case of a metastatic carcinoma to the thoracic aorta.

Correlation between the age of pinealectomy and the development of scoliosis in chickens.

STUDY DESIGN: Pinealectomy induces experimental scoliosis in chickens. This study analyzed the correlation between the age at which pinealectomy was performed and the development of scoliosis in chickens. OBJECTIVE: To investigate the differences in the rate or magnitude of scoliosis and the type of curvature in chickens pinealectomized at different times after hatching. SUMMARY OF BACKGROUND DATA: Scoliosis develops in almost all chickens pinealectomized within 3 days after hatching, but there are no data on whether the condition will develop in chickens pinealectomized earlier or later after hatching. METHODS: In this study, 106 female white leghorn chickens were divided into six groups: four pinealectomy groups (pinealectomy was performed 2, 4, 11, or 18 days after hatching in Groups P-2, P-4, P-11, and P-18, respectively), a control group (Group C), and a sham operation group (Group S). Ventrodorsal radiographs of the spine were taken at 4-week intervals until the age of 12 weeks. At 12 weeks, a 1-mL sample of blood was taken from the heart at the middle of the dark cycle, and the serum melatonin concentration was measured by radioimmunoassay. RESULTS: At the age of 12 weeks, scoliosis was present in 63.6% of the chickens in Group P-2, 72.7% in Group P-4, 81% in Group P-11, and 70% in Group P-18, and the Cobb angles in the scoliotic chickens averaged 32.6, 29.8, 23.8, and 22.3 degrees in the respective groups. There were no significant differences in the rate or magnitude of scoliosis and the type of curvature among the pinealectomy groups at the age of 12 weeks. At the age of 12 weeks, the serum melatonin levels at the middle of the dark cycle in the pinealectomized chickens were significantly lower than those of chickens in Groups C and S. However, there were no differences in the serum melatonin levels between scoliotic and nonscoliotic pinealectomized chickens. CONCLUSIONS: Findings from this study show that scoliosis develops in 60% to 80% of chickens pinealectomized within 18 days after hatching, and that scoliotic development is not influenced by the age at which pinealectomy is performed. However, this study suggests that melatonin plays a complicated role in spinal development, inasmuch as the serum melatonin levels after pinealectomy approximated zero. Yet scoliosis did not develop in all pinealectomized chickens.

[Overview of sleep medicine and sleep respiratory disorders centers in Japan].

Sleep medicine in Japan evolved gradually, beginning with sleep research being conducted in the late 1960's exclusively on the university basis. Japan Sleep Society was founded in 1977 mainly by psychiatrists. Recently public awareness regarding sleep related breathing disorders has been raised as a result of a media campaign in Japan. However, the medical service system is unable to appropriately meet the needs of caring for sleep-disordered patients due to insufficient reimbursement and the lack of well-trained technical personnel. So far only several sleep centers existed in Japan. To make sleep be included in the mainstream of the health care system, the educational system and throughout society, many tasks remains to be done by healthcare professionals and government.

Lumbopelvic lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain.

STUDY DESIGN: Twenty volunteers and 20 patients with no prior spine surgery had two standing lateral radiographs taken, on the average, 66 months apart and 2 weeks apart, respectively. OBJECTIVES: To first determine the reliability of the measurement techniques used, and then the longitudinal variation between radiographs for the sagittal spinopelvic alignments measured in two stable populations, the one manifesting no back symptoms (volunteers) and the other showing no changes in symptoms (patients). Pelvic morphology also was assessed quantitatively, and significant correlations for the measurements were studied. SUMMARY OF BACKGROUND DATA: There are no published studies on longitudinal variation for measurements of sagittal spinal alignments in asymptomatic control subjects or untreated patients with stable back problems. It may be helpful to know not only how much variation in alignments can be expected between radiographs of the same individual, but also which measurements and measurement techniques offer the greatest clinical reliability and application. METHODS: Each patient in this study reported mechanical type low back pain that was constant in location and character as well as clinically consistent with symptomatic degenerative lumbar disc disease. Each patient and volunteer had 36-inch-long lateral radiographs taken of the entire thoracic and lumbar spine, which included the pelvis. After intervening periods of 1 to 4 weeks (patients) and 5 to 6 years (volunteers), a second radiograph was taken for comparison. Two observers made 24 different measurements on the radiographs including determinations for lumbopelvic lordosis, pelvic balance, and pelvic morphology using the pelvic radius technique. Reliabilities, longitudinal variations, and correlations for the measurements were compared. RESULTS: The most reliable measurements were for pelvic morphology, pelvic balance, and regional lumbopelvic lordosis by the pelvic radius technique. Pelvic morphology was the most constant measurement between individual radiographs. Pelvic morphology and total lumbosacral lordosis were dependent measurements that were complementary in determining total lumbopelvic lordosis. Lumbopelvic lordosis and pelvic balance also had strong correlation, whereas lumbosacral lordosis and pelvic balance were independent measurements. CONCLUSIONS: The pelvic radius technique is recommended for evaluating lordosis to the pelvis because this approach provided not only good measurement reliability on standing radiographs for lumbopelvic lordosis, but also determination of pelvic balance over the hips and the option to assess pelvic morphology quantitatively. Lumbopelvic lordosis and pelvic balance were strongly correlative. This finding, along with higher reliability and lower longitudinal variation on repeated radiographs, indicated greater clinical application for these specific measurements.

Natural course of experimental scoliosis in pinealectomized chickens.

STUDY DESIGN: Pinealectomy induces experimental scoliosis in chickens. This study analyzed the natural course and characteristics of the scoliosis that developed after pinealectomy. OBJECTIVES: To investigate the natural course of experimental scoliosis after pinealectomy in chickens and determine its similarity to idiopathic scoliosis in humans. SUMMARY OF BACKGROUND DATA. Pinealectomy affects the systemic hormonal balance and consistently induces progressive scoliosis in chickens. METHODS: Thirty five chickens were divided into two groups, a pinealectomy group (n = 25) and a control group (n = 10). At the age of 3 days, all chickens in the pinealectomy group underwent surgery. Spinal radiographs of all chickens were taken at 2-week intervals until the age of 16 weeks. RESULTS: There was no alteration of spinal alignment in the control group. Seventeen chickens in the pinealectomy group had scoliosis (17 degrees-85 degrees) that featured a three-dimensional spinal deformity consisting of both lateral curvature and vertebral rotation with rib humps. The scoliosis progressed to become slight, moderate, or severe as the chickens grew older. Pinealectomized chickens showed several other differences from chickens of the normal control group, such as poor weight gain, underdeveloped cockscombs, and late onset of egg laying. CONCLUSIONS: The scoliosis developing in chickens after pinealectomy was similar to human idiopathic scoliosis, and thus seems to be a useful model of idiopathic scoliosis.

Correction of experimental scoliosis by rib resection in the transverse plane.

Experimental scoliosis with the potential for marked progression was treated by rib resection on the concave side of the curve, and the alterations of the rib cage and vertebrae in the transverse plane were investigated. Twenty-four chickens were divided into four equal groups (groups R, P, PR, and C) and pinealectomy was performed at 3 days of age in groups P and PR. In group R, three unilateral ribs were resected at the age of 4 weeks. In group PR, three ribs on the concave side of scoliosis were resected at 4 weeks of age if scoliosis of > 20 degrees developed before the age of 4 weeks. Group C served as a control. Spinal radiographs and computed tomography scans at the apical vertebrae were taken at 20 weeks of age, and spinal deformities were evaluated. Scoliosis developed markedly in groups R and P, whereas it was mild in group PR. The apical vertebrae rotated to the convex side of the curve in all groups, in the same way as it would in human idiopathic scoliosis. In group PR, the Cobb angle and the rotation angle of the apical vertebra were symmetrically suppressed. This study indicated that rib resection might control the progression of scoliosis not only in the frontal plane but also in the axial plane when it was done on the concave side of the scoliosis. Although this experiment succeeded in chickens, application in humans is uncertain.

Correction of scoliosis by rib resection in pinealectomized chickens.

Experimental scoliosis with the potential for marked progression was treated by rib resection without spinal fusion to investigate the corrective effect of rib resection on progressive scoliosis. Forty chickens were divided into two groups (groups A and B) and pinealectomy was performed at 3 days of age. In group B, three ribs were resected on the concave side if scoliosis of > 20 degrees developed before the age of 4 weeks. Spinal radiographs were taken until the age of 20 weeks at 4-week intervals to evaluate the scoliosis. Chickens in group A developed severe scoliosis (24-85 degrees) that progressed until 20 weeks of age, and chickens in group B showed mild scoliosis (6-56 degrees). Some degree of reprogression was found after early bone union at the sites of rib resection. Rib resection may be able to control progressive scoliosis when performed on the concave side of the curve.

[Pleural fibroma with a cavity-like air space].

A 45-year-old man was admitted to the hospital because of an increase in the size of an abnormal shadow on chest X-ray films over the preceding 5 years. A chest X-ray film on admission revealed a round air space in a mass-like shadow in the right upper lung field. Results of physical examination, sputum cytologic examination, and Ziehl-Neelsen staining were negative. Histopathological examination of a percutaneous lung biopsy specimen revealed a benign fibrous tumor of the pleura. Thoracotomy revealed a pedunculated tumor arising from the visceral pleura at the apical segment of the right upper lobe. A wedge resection was done. Histological examination revealed that the tumor consisted of regularly-shaped spindle cells with densely collagenous tissue. Normal lung tissue was found to be invaginated into the tumor tissue. These findings are consistent with the radiologic findings.

Experimental scoliosis induced by rib resection in chickens.

Factors which affected the severity of scoliosis induced by rib resection were examined. Seventy chickens were divided into a rib transection group and a rib resection group with seven subgroups, according to the number of ribs treated and the age at surgery, and examined radiographically until 20 weeks postoperatively. Rib transection group chickens showed fusion at the transected site and no marked scoliosis. In the rib resection group, the more ribs resected and the younger the age at operation, the more severely the scoliosis developed. Bone regeneration at the resection site made the progression of scoliosis milder. These findings indicate that the age at rib resection, the number of ribs that are operated on, and nonunion of the resected sites play important roles in the progression of scoliosis induced by rib resection.

[Contribution of K-channel and Na-K-ATPase to the relaxant responses of canine bronchial smooth muscle to various bronchodilators].

To determine whether activations of K-channel and Na-K-ATPase are involved in the action of bronchodilating agents, we studied the effects of various K-channel blockers and ouabain, a Na-K-ATPase inhibitor, on the relaxant responses of canine airway smooth muscle in vitro. Addition of charybdotoxin (ChTx), a Ca-activated potassium channel blocker, and ouabain had no effect on the responses to verapamil and BRL 38227, but inhibited those to salbutamol, forskolin, DBcAMP, and nitroprusside. Apamin, a low-conductance K-channel blocker, and glibenclamide, an ATP-sensitive K-channel blocker, had no effect on the smooth muscle relaxation induced by any agents. The inhibitory effect of ChTx was predominant when the concentration of bronchodilator was low, whereas the effect of ouabain was observed in the presence of a high concentration of bronchodilator. These results suggest that Ca-activated K-channel and Na-K-ATPase may participate in the relaxation induced by bronchodilators that can raise intracellular cyclic nucleotides, and that the contribution of each component differs under different concentrations of the drugs.

[Stimulation of ciliary motility by beta 3-adrenoceptor agonist rabbit tracheal epithelium].

To determine whether atypical beta-adrenoceptor (beta 3-adrenoceptor) agonist, BRL 37344, stimulates airway ciliary motility and, if so, what its mechanism of action is, we studied rabbit tracheal epithelium in vitro. Epithelial cells cultured for 7 days were mounted in the Rose chamber and ciliary beat frequency (CBF) was measured by a photoelectric method. Addition of BRL 37344 rapidly increased CBF from 15.5 +/- 0.6 to 20.3 +/- 1.4 Hz (mean +/- SE, p < 0.01), which remained elevated for at least 20 min. This effect was concentration-dependent, the maximal increase from the baseline value and the EC50 being 27.2 +/- 0.4% (mean +/- SE, p < 0.01) and 1.75 x 10(-7) M, respectively. Other beta-adrenoceptor agonists likewise increased CBF, where the rank order of potency was salbutamol (1) > BRL 37344 (0.57) >> norepinephrine (1.3 x 10(-3)). Preincubation of cells with propranolol inhibited the increase in CBF produced by salbutamol, and BRL 37344 significantly raised intracellular cyclic AMP contents. These results suggest that beta 3-adrenoceptor probably exists in rabbit tracheal epithelium and that stimulation of this type of receptor increases ciliary motility through a cyclic AMP-dependent mechanism, an effect that might be of value in enhancing mucociliary transport function in the airway.