Phylogenetic Relationships of Japanese Auritibicen Species (Hemiptera: Cicadidae: Cryptotympanini) Inferred from Mitochondrial and Nuclear Gene Sequences.

We investigated the phylogenetic relationships and divergence times within the genus Auritibicen(Cicadidae: Cicadinae: Cryptotympanini), analyzing five Japanese species (A. japonicus, A. bihamatus,A. kyushyuensis, A. esakii and A. flammatus) and three species from East Asian mainland and Taiwan (A. atrofasciatus, A. intermedius and A. chujoi) using mitochondrial cytochrome oxidase subunit I (COI) and nuclear elongation factor 1-alpha (EF-1a) gene sequences. Although the EF-1a gene tree did not resolve the relationships among these Auritibicen species, the trees based on COI gene and the combined data set showed that Japanese taxa comprised three distinct lineages: the individual species A. flammatus and A. bihamatus, and the A. japonicus group, comprising A. japonicus, A. esakii and A. kyushyuensis from Japan and A. intermedius from Korea. In A. kyushyuensis, which comprises three populations in Kyushu, western Honshu and Shikoku, the specimens from western Honshu and Shikoku were closely related to each other, but not to the specimen from Kyushu; instead, they were sister to the Korean A. intermedius. The incongruence between the gene tree and species tree necessitates further population genetic and morphological studies to confirm the classification and species status of the western Honshu and Shikoku populations of A. kyushyuensis, which were originally described as two independent species. Divergence time estimation suggested that the most recent common ancestor of Auritibicen species studied dated back to the late Pliocene and that the species of the A. japonicus group diverged during the mid Pleistocene. Thus, the Pleistocene climatic fluctuation may have promoted the divergence of the Auritibicen species.

Color-weak compensation using local affine isometry based on discrimination threshold matching.

We develop algorithms for color-weak compensation and color-weak simulation based on Riemannian geometry models of color spaces. The objective function introduced measures the match of color discrimination thresholds of average normal observers and a color-weak observer. The developed matching process makes use of local affine maps between color spaces of color-normal and color-weak observers. The method can be used to generate displays of images that provide color-normal and color-weak observers with a similar color difference experience. It can also be used to simulate the perception of a color-weak observer for color-normal observers. We also introduce a new database of measurements of color discrimination threshold data for color-normal and color-weak observers obtained at different lightness levels in CIELUV space. The compensation methods include compensations of chromaticity using local affine maps between chromaticity planes of color-normal and color-weak observers, and one-dimensional (1D) compensation on lightness. We describe how to determine correspondences between the origins of local coordinates in color spaces of color-normal and color-weak observers using a neighborhood expansion method. After matching the origins of the two coordinate systems, a local affine map is estimated by solving a nonlinear equation, or singular-value-decomposition (SVD). We apply the methods to natural images and evaluate their performance using the semantic differential (SD) method.

Validation of Echo-Dynamography by virtual color doppler echocardiography generated from phase contrast magnetic resonance angiography datasets.

Echo-Dynamography (EDG) is a smart visualization technique in echocardiography in which two-dimensional distribution of blood flow vectors in cardiovascular system is deduced by applying fluid dynamics theories into Doppler velocity datasets. Previous validation studies such as numerical simulation of free jet model or model circulation were too simple to reproduce unstable and asymmetrical flow in left ventricle. In the present study, virtual color Doppler echocardiography is generated from PC-MRA (phase contrast magnetic resonance angiography) datasets. EDG is applied on virtual Doppler data and the blood flow vectors are compared with those of the original PC-MRA data. EDG-derived blood flow vectors showed similar pattern as the original PC-MRA data when blood flow velocity had high value. The errors were caused from underestimating the magnitude of vortex flow component in the flow field near the boundary of the left ventricular wall. The results also indicated that apical long axis view had small error compared with parasternal long axis view. Despite EDG method causes small errors, it provides important information on blood flow dynamics in most parts.

Evaluation of vortex flow in left ventricle by echo-dynamography and phase contrast magnetic resonance angiography.

Echo-dynamography (EDG) is a method for visualizing left ventricular (LV) blood flow based on cardiac Doppler measurement in which blood flow component perpendicular to the ultrasonic beam is deduced by applying fluid dynamics theories to two-dimensional (2D) distribution of blood flow component along the ultrasonic beam. EDG has been validated by numerical simulation and particle image velocimetry of model circulation. However, these validations were too simple to reproduce unstable and asymmetrical flow in a beating heart. In the present study, EDG is compared with three-directional (3D) blood flow distribution on the same plane obtained with phase contrast magnetic resonance angiography (PCMRA) for clinical validation. Moreover, the location and vorticity of the vortex flow in LV are measured quantitatively and the relation to echocardiographic parameters of systolic and diastolic functions is discussed. 3D components of blood flow on a plane were obtained with triple scans of the same plane with ECG trigger and breath holding; 1) phase encode (x-axis), 2) read out (y-axis) and 3) slice selection (z-axis). After the acquisition of MRA dataset, color Doppler dataset of the same plane was acquired and 2D velocity distribution was obtained with EDG in MATLAB programs. EDG and PCMRA showed similar velocity vector distribution and formation of LV vortex flow. The vortex at mid diastolic phase was strongly affected by early diastolic filling while the vortex at isometric contraction was affected by atrial filling. EDG gained a new insight on systolic-diastolic coupling from the view point of LV blood flow such as LV vortex formation.

Selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials in elderly patients with cervical spondylotic myelopathy: a preliminary report.

STUDY DESIGN: A preliminary report of a new operative method termed selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials (SCEPs) in elderly patients with cervical spondylotic myelopathy. OBJECTIVE: To introduce the method and clinical results for selective laminoplasty. SUMMARY OF BACKGROUND DATA: Clinical results for conventional laminoplasty and anterior decompression and fusion guided by SCEPs have been reported. However, there have been no reports that consider SCEP results for selecting the optimal level in lamioplasty for cervical spondylotic myelopathy. METHODS: Seven elderly patients who underwent selective laminoplasty were followed for a minimum of 12 months. The T2-high-intensity area on magnetic resonance imaging, the responsible level detected by SCEPs, and the laminoplasty level were recorded. The operative time, intraoperative bleeding, clinical results including the Japanese Orthopaedic Association score, recovery rate, Nurick grading scale, and visual analog scale of axial pain were investigated preoperatively and postoperatively. RESULTS: The responsible intervertebral levels were at C3-C4 in 3 patients and at C4-C5 in 4 patients. These were identical for SCEP recorded after median nerve stimulation and transcranial electric stimulation. High-intensity area on T2-weighted magnetic resonance imaging was seen in 6 patients (3 at C3-C4 and 3 at C4-C5). The average operative time was 106 minutes and the average amount of bleeding was 20 mL. Neurologic recovery was achieved in all patients except 1 who had severe myelopathy. Visual analog scales of axial pain were 41.3 + or - 33.9 before surgery and 18.0 + or - 19.4 at final follow-up. The Japanese Orthopaedic Association score and the Nurick grade improved in 6 patients but did not change in 1 patient. CONCLUSIONS: Preliminary clinical results for selective laminoplasty were satisfactory in all but 1 case. Although long-term results are not yet available, we consider this method to be less invasive and capable of giving satisfactory clinical results and benefits for elderly patients.

Dynamic electrophysiological examination of cervical flexion myelopathy.

Cervical flexion myelopathy is thought to arise following compression of the spinal cord by vertebrae or intervertebral discs and dura mater, or from overstretching of the spinal cord induced by cervical spinal flexion. However, the influence of spinal flexion on the spinal cord and the detailed origins of this disease are unknown. In this article the authors report a case of cervical flexion myelopathy in which dynamic electrophysiological examination was performed using an epidural electrode. This investigation showed the real-time influence of flexion of the cervical spine on spinal cord function. This technique was considered to be useful for diagnosis and in decision making for treatment. Anterior fusion was the optimal surgical method for treating this disease.

Biomechanical study of cervical flexion myelopathy using a three-dimensional finite element method.

OBJECT: The goal of this study was to perform a biomechanical study of cervical flexion myelopathy (CFM) using a finite element method. METHODS: A 3D finite element model of the spinal cord was established consisting of gray matter, white matter, and pia mater. After the application of semi-static compression, the model underwent anterior flexion to simulate CFM. The flexion angles used were 5 degrees and 10 degrees , and stress distributions inside the spinal cord were then evaluated. RESULTS: Stresses on the spinal cord were very low under semi-static compression but increased after 5 degrees of flexion was applied. Stresses were concentrated in the gray matter, especially the anterior and posterior horns. The stresses became much higher after application of 10 degrees of flexion and were observed in the gray matter, posterior funiculus, and a portion of the lateral funiculus. CONCLUSIONS: The 5 degrees model was considered to represent the mild type of CFM. This type corresponds to the cases described in the original report by Hirayama and colleagues. The main symptom of this type of CFM is muscle atrophy and weakness caused by the lesion of the anterior horn. The 10 degrees model was considered to represent a severe type of CFM and was associated with lesions in the posterior fand lateral funiculi. This type of CFM corresponds to the more recently reported clinical cases with combined long tract signs and sensory disturbance.

Cervical hemilaminoplasty: technical note.

Ten patients with cervical spinal schwannomas were operated using a new posterior approach, termed cervical hemilaminoplasty. A thread wire saw (T-saw) was used to cut the lamina at the center of the spinous process and at the unilateral pars interarticularis on the affected side. The unilateral lamina, the inferior articular process, and half of the spinous process were resected as a single mass. After tumor excision, the resected lamina was restored to the original site and fixed. Fusion technique was not required. The mean number of resected and restored lamina was 1.5. No instability of the cervical spine was detected using flexion/extension x-ray photography. Although worsening of radicular motor function was observed in 2 cases, the weakness was not permanent and both cases showed full recovery. Postoperative magnetic resonance imaging was performed in 7 of the 10 cases and showed no recurrences. Cervical hemilaminoplasty is a useful posterior approach method for spinal tumors and especially dumbbell-type tumors. This method provides wide exposure of the foramen and of the inside of the canal. Furthermore, it allows reconstruction of the posterior element of the spinal canal and results in good stability.

Intraoperative electrophysiologic studies on the functions of nerve roots involved in cervical dumbbell-shaped schwannoma and their clinical utility.

BACKGROUND: It is difficult to expect the degree of neurologic deficits after resection of involved nerve roots before and during the surgery for cervical dumbbell-shaped schwannoma. We present the results of studies for cervical nerve root functions in patients with cervical schwannoma using intraoperative electrophysiologic assessment and the potential of their clinical relevance is also discussed. OBJECTIVE: To present the utility of intraoperative electrophysiologic studies to detect the functions of the nerve roots involved in cervical schwannoma and adjacent nerve roots. METHODS: Five patients with dumbbell-shaped cervical schwannoma arising from the cervical nerve roots composing the brachial plexus were studied. Compound muscle action potentials (CMAPs) after stimulation of nerve roots involved in the schwannoma were recorded from upper limb muscles anatomically correspond to their myotome. Adjacent nerve roots were also stimulated. Motor-evoked potentials (MEPs) after transcranial electric stimulation were also recorded during surgery. In 3 patients, sensory nerve action potentials (SNAPs) after digital nerve stimulation were also recorded from cervical nerve roots. RESULTS: In 4 patients, CMAPs after stimulation of cervical nerve roots involved with the schwannoma were not obtained or were very small compared with those obtained after stimulation of adjacent nerve roots. In 2 of 4 patients, SNAPs after digital nerve stimulation were recorded with small amplitude from the nerve roots involved in schwannoma. Minimal (n=2, within 80% attenuation of amplitude) or no changes (n=2) were observed after total resection of the schwannoma and no apparent motor weakness occurred in these 4 patients. In a patient with cervical schwannoma involved in C8 nerve root, CMAPs with large amplitude were recorded after stimulation of the C8 nerve root. SNAPs after stimulation of digit V were recorded with larger amplitude from the T1 root compared with those recorded from the C8 nerve root. Intradural parts of the tumor arising from C8 posterior rootlets were completely removed after transaction of posterior rootlets. During removal of intraforaminal parts of the tumor, motor evoked potentials were decreased over 50% of controls. Incomplete removal was chosen to avoid deterioration of motor function. Transient dysesthesia of digit V and slight weakness occurred after surgery. CONCLUSIONS: The residual function of motor and sensory nerve roots involved with cervical schwannoma differed between individuals and could be detected using intraoperative electrophysiologic assessment.

Peripheral neuropathies associated with rheumatoid synovial cysts of the elbow joint: three case reports.

We present 3 cases with peripheral neuropathies of the median, posterior interosseous, and ulnar nerves associated with rheumatoid synovial cysts of the elbow joint. Magnetic resonance imaging and electrophysiological examination led to the final diagnosis of the relation to synovial cysts of the elbow joint. All patients underwent surgical decompression of these nerves and synovectomy of the elbow joint. Functional recovery was excellent in the 2 patients with median and posterior interosseous nerve palsy but incomplete in the patient with ulnar nerve palsy. Such neuropathies require consideration in the differential diagnosis of wrist and hand disability in patients with rheumatoid arthritis. This awareness should enhance early diagnosis and treatment by surgical decompression.

Investigation of motor dominant C5 paralysis after laminoplasty from the results of evoked spinal cord responses.

BACKGROUND: Postoperative motor dominant C5 paralysis was known as one of several complications after laminoplasty. Several theories have been proposed for postoperative segmental paralysis after laminoplasty, but its etiology remains unclear. OBJECTIVE: To investigate the possible mechanism for postoperative motor dominant C5 paralysis from intraoperative electrophysiological studies using evoked spinal cord potentials (ESCPs). METHODS: A total of 66 patients who had undergone laminoplasty due to compressive cervical myelopathy were studied retrospectively. In all patients, the symptomatic intervertebral levels of cervical myelopathy were identified by several types of the ESCPs. Motor dominant C5 paralysis was determined as at least 1 level down compared with pre-operative shoulder abduction according to the manual muscle testing. RESULTS: Five patients (7.6%) showed postoperative motor dominant C5 paralysis. C5 paralysis occurred from 1 to 3 days after surgery and compromised unilaterally in all 5 patients. The causes of cervical myelopathy were cervical spondylosis in 3 patients and ossification of the posterior longitudinal ligament in 2 patients. One patient with severe impairment (2 in manual muscle-testing [MMT] scale) did not show clinical recovery. The other 4 patients recovered to 4 or 5 on the MMT score from 3 to 6 months after the onset. Based on the findings of ESCPs, the C4-5 level was affected by cervical myelopathy in all 5 patients with postoperative motor dominant C5 paralysis (C4-5 level in 3 patients, both C4-5 and C5-6 levels in 2 patients). A high signal intensity area on T2-weighted magnetic resonance imaging (MRI) was observed in all patients who showed apparent motor dominant C5 paralysis in this study. CONCLUSIONS: Cervical myelopathy at the C4-5 level is a potential risk for motor dominant C5 paralysis. Although it is merely a speculation, when C5 radiculopathy occurs after laminoplasty, C5 paralysis becomes clinically apparent because the deltoid muscle gets predominantly innervated by C5 root due to intramedullary spinal cord damage on the C6 segment in C4-5 myelopathy before surgery. It may represent the high signal intensity area on T2-weighted MRI at the C4-5 level.

Epidurally recorded spinal cord evoked potentials in patients with cervical myelopathy and normal central motor conduction time measured by transcranial magnetic stimulation.

OBJECTIVE: Use epidural recording of evoked spinal cord potentials (ESCPs) to investigate the pathology of cervical spondylotic myelopathy (CSM) in patients with normal central motor conduction time (CMCT) in upper and lower limbs. METHODS: A total of 75 patients with CSM were studied. All patients were examined before surgery for motor evoked potentials (MEPs) following transcranial magnetic stimulation (TMS). They were also evaluated during surgery by epidurally recorded ESCPs following stimulation of the median nerve, brain and spine. RESULTS: Seven patients (9%) showed normal CMCT in upper and lower limbs upon TMS examination. Only the ESCPs following median nerve stimulation (MN-ESCPs) were abnormal in these patients. In 5 of the 7 patients, a marked block in conduction of MN-ESCPs was observed at the C3-4 intervertebral level. The remaining two patients showed attenuation in the amplitude of MN-ESCPs at mid-cervical levels. CONCLUSIONS: We present 7 cases of CSM with negative CMCT findings. From the MN-ESCP results, we surmise that the pathology of CSM with normal CMCT is due predominantly to dysfunction of sensory systems involved in the upper limbs. SIGNIFICANCE: Examination by TMS is useful in the diagnosis of CSM but the possibility of negative CMCT findings upon TMS must be borne in mind. Multi-functional evoked spinal cord responses demonstrate that lesions in the sensory system are the major underlying pathology.