The association between clinical symptoms of lumbar spinal stenosis and MRI axial imaging findings.

PURPOSE: In diagnosing lumbar spinal stenosis (LSS), Magnetic Resonance Imaging (MRI) is appropriate to confirm the presence of anatomical stenosis of the spinal canal or compression of the nerve roots. However, it is known that morphological LSS is often present in asymptomatic subjects. There is still controversy about the relationship between anatomical LSS and symptomatic LSS. The aim of this study was to assess the association between qualitative imaging findings on MRI of the lumbar spine and symptomatic LSS. PATIENTS AND METHODS: This was a cross-sectional study of 239 volunteers from an epidemiological survey that included 1,862 participants in total. MRI of the lumbar spine was evaluated in four categories: morphological grading of central stenosis and lateral recess stenosis, presence of the sedimentation sign, and severity of facet joint effusion. The relationship between these morphological evaluations and typical LSS symptoms as assessed by the self-administered, self-reported history questionnaire for lumbar spinal stenosis (LSS-SSHQ) was investigated by multiple logistic regression analysis. RESULTS: The odds ratio of the most severe central stenosis to no stenosis was 15.5 (95%CI: 1.4-164.9). Only the most severe central stenosis was associated with typical LSS symptoms, but not all cases with typical LSS symptoms were due to severe central stenosis. CONCLUSION: Extreme severe central stenosis was strongly related to typical LSS symptoms. However, although subjects with severe central stenosis showed symptoms suggestive of LSS, these subjects did not always show typical LSS symptoms.

Performance evaluation of an Indoxyl Sulfate Assay Kit "NIPRO".

Background The relationship between renal disease and cardiovascular disease (CVD) is currently known as cardiorenal syndrome. Indoxyl sulfate (IS) is one of the uremic toxins that accelerates the progression of cardiorenal syndrome. This report presents a new method for measuring IS in a simpler way. Methods We evaluated the analytical performance of an IS Assay Kit "NIPRO" loaded on LABOSPECT 008. The evaluated analytical performances included accuracy, precision, dilution linearity, limit of detection (LOD), limit of quantitation (LOQ), recovery test, interference test and comparison against assays performed by high-performance liquid chromatography (HPLC). Results Total precision showed a <5.3% coefficient of variation at IS concentrations of 3.57-277.73 µmol/L, and satisfactory results were observed in the dilution linearity, LOD, LOQ, recovery and interference tests. The IS Assay Kit "NIPRO" showed a high correlation with the HPLC conventional method (r = 0.993). Conclusions The IS Assay Kit "NIPRO" demonstrated satisfactory analytical performance, and this suggests it could shortly become another common method to measure circulating IS.

Tectonic setting for Tsunemori Formation in the Permian accretionary complex of the Akiyoshi Belt, Southwest Japan.

The purpose of this study is to reexamine the age, depositional environment, and tectonic setting of the Tsunemori Formation. This study provides a new tectonic model on the formation of Tsunemori Formation, which is a key formation to understand the Late Permian subduction and accretionary processes in Japan. The sedimentation age of the Tsunemori Formation is late Middle Permian to early Late Permian, based on radiolarians, such as Follicucullus cf. scholasticus Ormiston and Babcock reported in this study. This paper disproves the previous theory of atoll carbonates collapse at the trench for the Akiyoshi Limestone. Most of sedimentary rocks of the Tsunemori Formation is not pervasively sheared, are less deformed compared with sedimentary rocks of the typical accretionary complexes. There is no layer parallel or sub-parallel thrusting in the turbidite sequences of the Tsunemori Formation. Mudstone of turbidite and pebbly mudstone is lack of fissility and scaly cleavages. The styles of deformation, occurrence of reworked fossils, presence of calcarenite and limestone breccia suggest that the Tsunemori Formation was not a part of accretionary wedges, but possibly was fore arc or slope basin deposits. Presence of reworked fossils, calcarenite, limestone breccia suggest that a part of the provenance of Tsunemori Formation are limestone exposed at the arc trench gap, which was moved upward to reach the arc trench gap where the Akiyoshi Limestone provides its fragments and blocks into forearc and/or slope basins. Therefore, Tsunemori Formation is a deposit in the forearc basin and/or slope basin rather than trench deposits.