The short-term results of laminoplasty for cervical stenotic myelopathy were maintained over 10years in 78% of the patients with ossification of the posterior longitudinal ligament, and in most of the patients with cervical spondylotic myelopathy, except those with athetoid cerebral palsy. Double-door laminoplasty is a reliable procedure for individuals with cervical stenotic myelopathy.

No abstract

Activation of the Keap1/Nrf2 pathway and consequent induction of phase 2 antioxidant enzymes is known to afford neuroprotection. Here, we present a series of novel electrophilic compounds that protect neurons via this pathway. Natural products, such as carnosic acid (CA), are present in high amounts in the herbs rosemary and sage as ortho-dihydroquinones, and have attracted particular attention because they are converted by oxidative stress to their active form (ortho-quinone species) that stimulate the Keap1/Nrf2 transcriptional pathway. Once activated, this pathway leads to the production of a series of antioxidant phase 2 enzymes. Thus, such dihydroquinones function as redox-activated “pro-electrophiles.” Here, we explored the concept that related para-dihydroquinones represent even more effective bioactive pro-electrophiles for the induction of phase 2 enzymes without producing toxic side effects. We synthesized several novel para-hydroquinone-type pro-electrophilic compounds (designated D1 and D2) in order to analyze their protective mechanism. DNA microarray, PCR, and Western blot analyses showed that compound D1 induced expression of heat-shock proteins (HSPs), including HSP70, HSP27 and DnaJ, in addition to phase 2 enzymes such as hemeoxygenase-1 (HO-1), NADP(H) quinine-oxidoreductase1, and the Na+-independent cystine/glutamate exchanger. Treatment with D1 resulted in activation of Nrf2 and HSF-1 transcriptional elements, thus inducing phase 2 enzymes and HSPs, respectively. In this manner, D1 protected neuronal cells from both oxidative and endoplasmic reticulum (ER)-related stress. Additionally, D1 suppressed induction of GRP78, an ER chaperone protein, and inhibited hyperoxidation of peroxiredoxin 2 (PRX2), a molecule that in it reduced state can protect from oxidative stress. These results suggest that D1 is a novel pro-electrophilic compound that activates both the Nrf2 and HSF-1 pathways, and may thus offer protection from oxidative and ER stress.

The present results are consistent with those of previous in vitro studies and may explain the clinical observation that cervical extension aggravates symptoms in patients with cervical radiculopathy and that flexion often relieves them.

Since 1986, the authors have been conducting conservative treatment for idiopathic scoliosis with the combination of brace treatment and physical treatment (side shift exercise and hitch exercise). A total of 328 female patients with adolescent idiopathic scoliosis who were at least 10 years of age at the first visit, with Cobb angle of 10 degrees at the minimum and followed until after 15 years of age or skeletal maturity were included. The average Cobb angle was 32.4 degrees and the average age was 13.8 years at the first visit. Surgery was recommended when curvature progressed to >50 degrees. Twenty of 328 patients (6.1%) with more severe curves to begin with (mean Cobb angle at admission of 48.5 +/- 9.3 degrees ) progressed to 62.2 +/- 8.5 degrees and were treated with spinal fusion by the age of 16.0 +/- 2.6 years. The remaining 308 patients, of comparable age at inception of treatment but with a smaller original mean Cobb angle (32.4 +/- 11.1 degrees ), showed no significant increase in magnitude of curvature (mean 33.6 +/- 11.5 degrees ) by the time of discharge (18.6 +/- 3.1 years). The fact that curvature magnitude was maintained at <35 degrees means that these patients will have a good prognosis for avoiding dramatic progression during adulthood.

No abstract

Long-term follow-up evaluation is essential in any type of operation, particularly with patients with athetoid cerebral palsy who often undergo this operation in their 30s or 40s.

To understand cellular responses at the interface between biological system and artificial materials, we considered several surface properties of the materials. Controlled surface properties were achieved for preparation of well-defined polymer brush substrates with varying chemical structures, which were prepared by surfaceinitiated atom transfer polymerization. The substrates were covered with hydrophilic polymer brush layers with anionic groups, cationic groups, and zwitterionic groups as well as nonionic hydroxyl groups. In addition, surface covered with hydrophobic fluoroalkyl groups was prepared. Initial cell adhesion was examined using human cervical adenocarcinoma epithelial cell line, as a model cell, and the cell adhesion onto the polymer brush substrates was evaluated related with cell adhesive protein adsorption. The number and morphology of adherent cells were clearly dependent on the surface ζpotentials of polymer brush substrates. In contrast, no significant correlation was observed with respect to the hydrophilic/ hydrophobic nature of the substrate, which was evaluated by static air contact angles at the surface in water. The number of adherent cells on the substrate increased with the absolute value of the surface ζ-potentials, and the cells did not adhere onto the substrate with zero surface ζ-potential, that is the polymer brush substrate with zwitterionic groups. The amount of protein adsorbed onto the substrates influenced cell adhesion, as did the surface ζ-potentials of the substrates. Therefore, we concluded that the initial cell adhesion is correlated with the surface ζ-potential on the substrate with polymer brush structures. The surface ζ-potential will be a good parameter for designing a cell adhesion-resistance substrate to prepare temporary or single-use biomedical devices.