Preliminary Experience with 3-Dimensional Exoscope-Assisted Laryngoplasty.

Objective: Laryngoplasty requires the manipulation of the vocal folds, which are not visible during the operation. The widespread use of this technique is limited by the need for adequate knowledge of anatomy, the small surgical field, and the high level of skill required for the procedure. An exoscope has been developed to provide a stereoscopic view similar to that of a microscope while using the same compact endoscopic tool.

Development of fluorescence-labeled antibody for immune checkpoint inhibitor using engineered probiotics.

Here, we developed a genetically modified lactic acid bacteria (gmLAB) that produces green fluorescent protein (GFP)-conjugating, anti-programmed death-ligand 1 (PD-L1) single-chain variable fragments (scFv) for use as an anti-cancer device that targets immune checkpoint molecules. Since PD-L1 plays a key role as an immune checkpoint molecule in the tumor microenvironment, inhibition and detection of PD-L1 are important in cancer research. The anti-PD-L1 scFv was designed based on atezolizumab, a humanized IgG1 monoclonal antibody, and integrated into a lactococcal GFP gene expression vector.

[Anatomy for Endoscopic Endonasal Skull Base Surgery].

Endoscopic endonasal skull base surgery has become popular due to its minimally invasive nature to the patient and the development of various medical devices. The reason why it is considered less invasive is that it is possible to reach the anterior skull base lesion using the corridor of the nasal cavity and paranasal sinuses. The roles of the nasal sinuses include acting as breathing pathways, warming, humidifying, and filtering of inhaled air, olfaction, and being a resonant cavity, all of which are important for a comfortable life, and the loss of these functions reduces the quality of life.

Comparison of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion as Corrective Surgery for Patients with Adult Spinal Deformity-A Propensity Score Matching Analysis.

Lateral lumbar interbody fusion (LLIF) is increasingly performed as corrective surgery for patients with adult spinal deformity (ASD). This paper compares the surgical results of LLIF and conventional posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) in ASD using a propensity score matching analysis. We retrospectively reviewed patients with ASD who received LLIF and PLIF/TLIF, and investigated patients' backgrounds, radiographic parameters, and complications.

Impact of body mass index on surgical outcomes and complications in adult spinal deformity.

Background: Several studies have reported that overweightness and obesity are associated with higher complication rates in lumbar spine surgery. However, little is known about the effect of obesity on postoperative complications in adult spinal deformity (ASD) surgery, especially in the elderly. This study aimed to examine the effect of body mass index (BMI) on surgical outcomes and postoperative complications in elderly ASD patients undergoing surgical correction in Japan.

Accuracy of pedicle screw insertion for unilateral open transforaminal lumbar interbody fusion: a side-by-side comparison of percutaneous and conventional open techniques in the same patients.

Background: The aim of the study was to compare the accuracy of percutaneous pedicle screw (PPS) insertion (P-side) with that of conventional open screw insertion (O-side) during unilateral open transforaminal lumbar interbody fusion (TLIF) in the same patients. We also sought to determine the incidence of pedicle screw misplacement and to identify relevant risk factors.

Methods: The study was a retrospective analysis of prospectively collected data for 766 pedicle screws placed in 181 consecutive patients who underwent a unilateral open-TLIF procedure in the lumbosacral spine.

Cervical Spinal Cord Injury Associated With Neck Flexion in Posterior Cervical Decompression.

Study Design: A retrospective analysis of prospectively collected data of 179 consecutive patients who underwent intraoperative neurophysiological monitoring during posterior cervical spine surgery for compression myelopathy.

Objective: To evaluate preoperative factors in patients with deteriorating spinal cord function due to flexion of the neck during posterior cervical spine surgery by observing changes in waveforms on intraoperative monitoring.

Summary Of Background Data: We encountered several cases of intraoperative monitoring warning alerts because of neck flexion during posterior cervical spine surgery.

Visualization of the electrical activity of the cauda equina using a magnetospinography system in healthy subjects.

Objective: To establish a method to measure cauda equina action fields (CEAFs) and visualize the electrical activities of the cauda equina in a broadly aged group of healthy adults.

Methods: Using a 124-channel magnetospinography (MSG) system with superconducting interference devices, the CEAFs of 43 healthy volunteers (22-64 years of age) were measured after stimulation of the peroneal nerve at the knee. Reconstructed currents were obtained from the CEAFs and superimposed on the X-ray image.

A multi-train electrical stimulation protocol facilitates transcranial electrical motor evoked potentials and increases induction rate and reproducibility even in patients with preoperative neurological deficits.

This study sought to evaluate the facilitation effect of repetitive multi-train transcranial electrical stimulation (mt-TES) at 2 repetition rates on transcranial electrical motor evoked potential (Tc-MEP) monitoring during spinal surgery, and to assess the induction rate in patients with impaired motor function from a compromised spinal cord or spinal nerve. We studied 32 consecutive patients with impaired motor function undergoing cervical or thoracic spinal surgery (470 muscles). A series of 10 TESs with 5 pulse trains were preoperatively delivered at 2 repetition rates (1 and 5 Hz).

Magnetospinography visualizes electrophysiological activity in the cervical spinal cord.

Diagnosis of nervous system disease is greatly aided by functional assessments and imaging techniques that localize neural activity abnormalities. Electrophysiological methods are helpful but often insufficient to locate neural lesions precisely. One proposed noninvasive alternative is magnetoneurography (MNG); we have developed MNG of the spinal cord (magnetospinography, MSG).

Dual signal subspace projection (DSSP): a novel algorithm for removing large interference in biomagnetic measurements.

Objective: In functional electrophysiological imaging, signals are often contaminated by interference that can be of considerable magnitude compared to the signals of interest. This paper proposes a novel algorithm for removing such interferences that does not require separate noise measurements.

Approach: The algorithm is based on a dual definition of the signal subspace in the spatial- and time-domains.

2,2'-Bipyridyl formation from 2-arylpyridines through bimetallic diyttrium intermediate.

An alkylyttrium complex supported by an ,'-bis(2,6-diisopropylphenyl)ethylenediamido ligand, (ArNCHCHNAr)Y(CHSiMe)(THF) (, Ar = 2,6- PrCH), activated an -phenyl C-H bond of 2-phenylpyridine () to form a (2-pyridylphenyl)yttrium complex () containing a five-membered metallacycle. Subsequently, a unique C(sp)-C(sp) coupling of 2-phenylpyridine proceeded through a bimetallic yttrium intermediate, derived from an intramolecular shift of the yttrium center to an -position of the pyridine ring in , to yield a bimetallic yttrium complex () bridged by two-electron reduced 6,6'-diphenyl-2,2'-bipyridyl. Aryl substituents at the -position of the pyridine ring were key in order to destabilize the μ,κ-(C,N)-pyridyldiyttrium intermediate prior to the C(sp)-C(sp) bond formation.

Lumbosacral pedicle screw placement using a fluoroscopic pedicle axis view and a cannulated tapping device.

Background: Pedicle screw insertions are commonly used for posterior fixation to treat various spine disorders. However, the misplacement of pedicle screws can lead to disastrous complications. Inaccurate pedicle screw placement is relatively common even when placement is performed under fluoroscopic control.

Spinal deformity caused by hyperimmunoglobulin E syndrome: clinical article.

Hyperimmunoglobulin E syndrome (HIES) is a rare primary immunodeficiency syndrome characterized by recurrent staphylococcal infections in the skin and lungs, with an incidence of less than one case per million persons. Skeletal and connective tissue abnormalities, such as scoliosis, osteoporosis, pathological fractures, and hyperextensive joints, are other manifestations of HIES. However, only one report documents the use of implants to treat spinal deformity caused by HIES, which was discovered following corrective surgery resulting in postoperative infection.

Spiropyran as a reusable chemosensor for selective colorimetric detection of aromatic thiols.

Design of optical molecular probes for selective detection of aromatic thiols has attracted much attention. Although several types of probes have been proposed, all of them exhibit colorimetric or fluorometric response via irreversible reaction with aromatic thiols and cannot be reused. Here we report that a spiropyran dye is the first example of a reusable chemosensor for aromatic thiols.

Selective fluorometric detection of aromatic thiols by a chemosensor containing two electrophilic sites with different local softness.

A resorufin–dinitrophenyl ether conjugate (1) shows emission enhancement for aromatic thiols in aqueous media with a neutral–basic pH, while being nonemissive for aliphatic thiols. This is achieved by two electrophilic sites with different local softness on compound 1; the respective sites selectively react with aromatic or aliphatic thiolate anions.

Dynamic changes in spinal cord compression by cervical ossification of the posterior longitudinal ligament evaluated by kinematic computed tomography myelography.

Study Design: A prospective clinical study.

Objective: To investigate the dynamic causative factor in the pathogenesis of myelopathy in patients with cervical ossification of the posterior longitudinal ligament (OPLL) using kinematic computed tomography (CT) myelography.

Summary Of Background Data: Kinematic CT myelography is useful for dynamically evaluating the cervical spine with high-resolution images, particularly in bony compressive lesions.

Mechanism for different fluorescence response of a coumarin-amide-dipicolylamine linkage to Zn(II) and Cd(II) in water.

A coumarin-amide-dipicolylamine linkage (L) was synthesized and used as a fluorescent receptor for metal cations in water. The receptor dissolved in water with neutral pH shows almost no fluorescence due to the photoinduced electron transfer (PET) from the amide and amine nitrogens to the excited state coumarin moiety. Coordination of Zn(2+) or Cd(2+) with L creates strong fluorescence at 437 or 386 nm, respectively, due to the suppression of PET.

Thermoresponsive copolymer containing a coumarin-spiropyran conjugate: reusable fluorescent sensor for cyanide anion detection in water.

A simple copolymer consisting of N-isopropylacrylamide and coumarin-conjugated spiropyran (CS) units, poly(NIPAM-co-CS), has been synthesized. This polymer enables selective fluorometric detection of cyanide anion (CN(-)) in water at room temperature. The polymer itself shows almost no fluorescence, but shows a strong blue fluorescence in the presence of CN(-) under irradiation of UV light.

Entropy-driven thermal isomerization of spiropyran in viscous media.

Effects of solvent viscosity on the thermal isomerization properties of a spiropyran derivative have been studied in glycerol, ethylene glycol, 1,4-butanediol, and ionic liquid solutions. Thermal isomerization of the colorless spirocyclic (SP) form to the colored merocyanine (MC) form is enhanced with an increase in the concentrations of viscous solvents in solution. Equilibrium absorption analysis revealed that the enhanced SP → MC isomerization in viscous media is due to the strong solvent-solvent interaction, which suppresses the ordering of solvent molecules around the MC form.

Multicolor fluorescence of a styrylquinoline dye tuned by metal cations.

A styrylquinoline dye with a dipicolylamine (DPA) moiety (1) has been synthesized. The dye 1 in acetonitrile demonstrates multicolor fluorescence upon addition of different metal cations. Compound 1 shows a green fluorescence without cations.

Highly sensitive cyanide anion detection with a coumarin-spiropyran conjugate as a fluorescent receptor.

A coumarin-spiropyran conjugate (2) shows a CN(-)-selective fluorescence enhancement under UV irradiation. This enables accurate determination of very low levels of CN(-) (>0.5 μM).

A coumarin-thiourea conjugate as a fluorescent probe for Hg(II) in aqueous media with a broad pH range 2-12.

A coumarin-thiourea conjugate (1) behaves as a highly selective fluorescent probe for Hg(2+) in aqueous media. The probe 1 shows selective and quantitative fluorescence decrease upon Hg(2+) addition in aqueous media with a broad pH range, 2-12. Ab initio molecular orbital calculations reveal that the fluorescence decrease of 1 upon Hg(2+) addition is promoted by a Hg(2+)-induced desulfurization of the thiourea moiety, leading to a decrease in an intramolecular charge transfer (ICT) character of the excited-state coumarin moiety.

A rhodamine-cyclen conjugate as a highly sensitive and selective fluorescent chemosensor for Hg(II).

A rhodamine-cyclen conjugate (1) behaves as a highly sensitive and selective fluorescent chemosensor for Hg(2+). The high emission selectivity is due to the formation of 1-Hg(2+) 1:2 complex leading to spirocycle opening of 1.