To avoid complications associated with plating in anterior cervical discectomy and fusion (ACDF), stand-alone anchored PEEK cage was developed and favourable outcomes with a low rate of dysphasia have been described. The objective of this study was to compare the clinical and radiological outcomes of ACDF using a standalone anchored PEEK cage (PREVAIL; Medtronic Sofamor Danek, Memphis, TN) with those of a PEEK cage with plating in a prospective randomized manner. Fifty patients with single-level cervical radiculopathy were randomly assigned to a PREVAIL or a PEEK cage with plating. Following 3, 6, 12, and 24 months, clinical and radiological outcomes were assessed. The mean surgical time for the patients with a PREVAIL was significantly shorter than that for those with a PEEK cage with plating. The clinical outcomes evaluated by visual analogue scale for pain and the Odom's criteria were comparable between both the groups. Both the groups demonstrated the high fusion rate (92% in PREVAIL; 96% in PEEK cage with plating). The subsidence rate and the improvement of cervical alignment were comparable between both the groups. The incidence of adjacent-level ossification was significantly lower for patients with a PREVAIL than that for those with a PEEK cage with plating. The rate of dysphasia graded by the method of Bazaz and measurement of prevertebral soft tissue swelling indicated no significant differences between both the groups. Our prospective randomized study confirmed that stand-alone anchored PEEK cage is a valid alternative to plating in ACDF with a low rate of adjacent-level ossification. However, the potential to reduce the incidence of dysphasia was not confirmed.

To clarify the demographic characteristics of the prevalence of hepatitis C virus (HCV) infection in Osaka, Japan, where hepatocellular carcinoma is common, we investigated the screening data of antibody to HCV (anti-HCV, DAINABOTHCVPHA, second generation assay) in 197,600 voluntary blood donors residing in Osaka. The study found that age-standardized prevalence of anti-HCV was significantly higher than that of HBsAg (2.25 cf 0.86 percent among males, P < 0.001; 2.17 cf 0.55 percent among females, P < 0.001. It was much higher in the blood donors aged 55-64 years than in those aged 16-54 years (8.49 cf 1.32 percent among males, P < 10(-5); 7.26 cf 1.42 percent among females, P < 10(-5)). The prevalence of anti-HCV among males was significantly higher than that of females in the younger (25-34 years) generations (1.02 to 1.49 percent cf 0.71 to 1.13 percent, P < 0.05). A similar tendency was observed in the prevalence of high-titer (> or = 2(12)) anti-HCV. The number of coinfection (both HBsAg and anti-HCV seropositive) was very small, and it was not statistically different from the expected number.

Introduction The relation between radiological abnormalities on lumbar spine and low back pain (LBP) has been debated, presumably because of potential biases related to heterogeneity in selection of the subjects, radiological abnormalities at entry, or its cross-sectional observation in nature. Therefore, the aim of this study of a selected population of asymptomatic Japanese Self Defense Forces (JSDF) young adults male with normal lumbar radiographs was to investigate the incidence of newly developed lumbar degenerative changes at middle age and to study their association to LBP. Subjects and methods In 1990, 84 JSDF male military servicemen aged 18 years, without a history of LBP and radiological abnormal findings, were enrolled. After 20 years, 84 subjects were underwent repeated X-ray and completed questionnaires on current LBP and lifestyle factors. Results The prevalence of LBP was demonstrated 59 %, with 85 % of them showing mild pain. Analysis of lumbar radiographs revealed that 48 % had normal findings and 52 % had degenerative changes. The association between LBP and life style factors was not demonstrated. Lumbar spine in subjects with LBP was more degenerated than in those without. Although disc space narrowing and LBP did not achieve a statistical significance, a significant correlation existed between vertebral osteophyte and LBP in univariate and multivariate analysis (OR 3.0;). Discussion and conclusionsThis longitudinal study demonstrated the significant association between vertebral osteophyte and incidence of mild LBP in initially asymptomatic and radiologically normal subjects. These data provide the additional information concerning the pathology of LBP, but further study is needed to clarify the clinical relevance.

The probability of developing hepatocellular carcinoma (HCC) among hepatitis C virus (HCV) carriers during their life‐time is unknown. This paper addresses the estimation of the cumulative risk of HCC among HCV carriers using cross‐sectional data. Age‐specific prevalences of HCV carriers among the general population were estimated according to 5‐year age group, based on the data of 2nd‐generation anti‐HCV assay in blood donors resident in Osaka (33,226 males and 29,054 females). Seropositivity of anti‐HCV among 422 HCC cases, and the Osaka Cancer Registry data on HCC were used in the estimations of 5‐year age‐specific incidence rates of HCV‐linked HCC. Using these data, the cumulative risk, i.e., the probability of contracting HCC within the following 15 years in 50‐year‐old HCV carriers, was estimated as 28% for males and 6% for females.

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