The Quaternary hemipelagic sediments of the Japan Sea are characterized by centimeter-to decimeter-scale alternation of dark and light clay to silty clay, which are bio-siliceous and/or bio-calcareous to a various degree. Each of the dark and light layers are considered as deposited synchronously throughout the deeper (> 500 m) part of the sea. However, attempts for correlation and age estimation of individual layers are limited to the upper few tens of meters. In addition, the exact timing of the depositional onset of these dark and light layers and its synchronicity throughout the deeper part of the sea have not been explored previously, although the onset timing was roughly estimated as~1.5 Ma based on the result of Ocean Drilling Program legs 127/128. Consequently, it is not certain exactly when their deposition started, whether deposition of dark and light layers was synchronous and whether they are correlatable also in the earlier part of their depositional history. The Quaternary hemipelagic sediments of the Japan Sea were drilled at seven sites during Integrated Ocean Drilling Program Expedition 346 in 2013. Alternation of dark and light layers was recovered at six sites whose water depths are >~900 m, and continuous composite columns were constructed at each site. Here, we report our effort to correlate individual dark layers and estimate their ages based on a newly constructed age model at Site U1424 using the best available paleomagnetic datum and marker tephras. The age model is further tuned to LR04 δ 18 O curve using gamma ray attenuation density (GRA) since it reflects diatom contents that are higher during interglacial high-stands. The constructed age model for Site U1424 is projected to other sites using correlation of dark layers to form a high-resolution and high-precision paleo-observatory network that allows to reconstruct changes in material fluxes with high spatio-temporal resolutions.

Brachial plexus injury (BPI) is a severe peripheral nerve injury affecting upper extremities, causing functional damage and physical disability. The most common cause of adult BPI is a traffic accident, and the incidence has steadily increased since the 1980s. BPIs can be divided into three types; preganglionic lesion, postganglionic lesion, and a combination of both. Whether the continuation of the root and the spinal cord is preserved is a critical factor in determining the treatment strategy. The level of lesion can be analogized by clinical manifestations. But imaging studies including computed tomography (CT) myelography and magnetic resonance imaging (MRI) as well as electrodiagnostic studies are helpful in diagnosis of BPI. If diagnostic electromyography suggests that the damage is non-degenerative, conservative management is indicated. However, a reconstructive plan should be formulated, when there is no evidence of spontaneous recovery within 6 months of injury. Operative options used in BPI include nerve grafting, neurotization (nerve transfer), and other brachial plexus reconstructive techniques including the transplantation of various structures. In this review article, the mechanism and classification of injury, clinical manifestations, updated diagnostic studies, recent treatment strategies, and pain after BPI would be discussed.

The crowned dens syndrome (CDS), also known as periodontoid calcium pyrophosphate dehydrate crystal deposition disease, is typified clinically by severe cervical pain, neck stiffness and atlantoaxial synovial calcification which could be misdiagnosed as meningitis, epidural abscess, polymyalgia rheumatica, giant cell arthritis, rheumatoid arthritis, cervical spondylitis or metastatic spinal tumor. Crystalline deposition on cervical vertebrae is less well known disease entity and only a limited number of cases have been reported to date. Authors report a case of CDS and describe the clinical feature.

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ObjectiveThe risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation.MethodsA retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored.ResultsForty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation.ConclusionModerate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS.