AIM： To clarify the prevalence of defensive medicine and the specific defensive medicine practices among gastroenterologists in Japan. METHODS： A survey of gastroenterologists in Hiroshima, Japan, was conducted by m...AIM： To clarify the prevalence of defensive medicine and the specific defensive medicine practices among gastroenterologists in Japan. METHODS： A survey of gastroenterologists in Hiroshima, Japan, was conducted by mail in March 2006. The number of gastroenterologists reporting defensive medicine behaviors or changes in their scope of practice and the reported defensive medicine practices, i.e., assurance and avoidance behaviors, were examined. RESULTS： A total of 131 （77%） out of 171 gastroenterologists completed the survey. Three （2%） respondents were sued, and most respondents （96%） had liability insurance. Nearly all respondents （98%） reported practicing defensive medicine. Avoidance behaviors, such as avoiding certain procedures or interventions and avoiding caring for high-risk patients, were very common （96%）. Seventy-five percent of respondents reported often avoiding certain procedures or interventions. However, seasoned gastroenterologists （those in practice for more than 20 years） adopted avoidance behaviors significantly less often than those in practice for less than 10 years. Assurance behaviors, i.e., supplying additional services of marginal or no medical value, were also widespread （91%）. Sixty-eight percent of respondents reported that they sometimes or often referred patients to other specialists unnecessarily. CONCLUSION： Defensive medicine may be highly prevalent among gastroenterologists throughout 3apan, with potentially serious implications regarding costs, access, and both technical and interpersonal quality of care.展开更多
BACKGROUND X-ray gastric cancer(GC)screening has been shown to decrease mortality.Population-based X-ray GC screening has been performed in Hiroshima Prefe-cture,Japan,since 1983 but time trends and the efficacy of th...BACKGROUND X-ray gastric cancer(GC)screening has been shown to decrease mortality.Population-based X-ray GC screening has been performed in Hiroshima Prefe-cture,Japan,since 1983 but time trends and the efficacy of the method over 39 years have not been assessed.METHODS This was a population-based retrospective study.The data were derived from aggregated data of the Hiroshima Regional Health Medical Promotion Organization,including the number and rate of participants and those requiring esophagogastroduodenoscopies(EGDs),the number and rate of participants diagnosed as having GC,and the positive predictive value of the abnormal findings detected by X-ray and confirmed by EGDs.The number and rate of esophageal cancers were also collected.Further,the cost of detecting one GC was evaluated.RESULTS The number of participants has decreased during the last four decades,from 39925 in 1983 to 12923 in 2021.The rate of those requiring EGDs decreased significantly in recent years(P<0.001).The number of participants diagnosed as having GC has also declined,from 76 to 10 cases.However,the rate of cases diagnosed as GC among the participants remained around 0.1%.The positive predictive value increased significantly in recent years except during 1983-1991.The number and rate of accidentally detected esophageal cancers have risen recently,from 0%in 2008 to 0.02%in 2021,one-fifth of the diagnosis rate of GC.One GC diagnosis costs approximately 4200000 Japanese Yen(30000 United States Dollars)for the X-ray screenings and EGDs.CONCLUSION X-ray GC screening in Hiroshima has been efficient,but one challenge is the cost.Esophageal cancers may also need to be considered because they have gradually increased in recent years.展开更多
Boninitic rocks and associated high-magnesian basalt and high-iron tholeiite in the Xiangcheng area constitute the basal horizon of the arc volcanic sequence in the Triassic Yidun Island-Arc, southwestern China. The b...Boninitic rocks and associated high-magnesian basalt and high-iron tholeiite in the Xiangcheng area constitute the basal horizon of the arc volcanic sequence in the Triassic Yidun Island-Arc, southwestern China. The boninite occurs as pillow, massive and ocellar lavas; the last one possesses well-developed globular structure and alternates with the former two. The boninite is characterized by the absence of phenocrysts of olivine and low-Ca pyroxenes and by low CaO/Al2O3 ratios (<0.67) and high Cr (>1000 ppm) and Ni (>250 ppm). The normalized abundance patterns (NAP) of trace elements to primitive mantle are similar to the NAP of low-Ca modern boninites and SHMB in the Archaean and Proterozoic.展开更多
AIM:To examine the frequency and prevention of musculoskeletal pain in Japanese gastrointestinal endoscopists and non-endoscopist physicians.METHODS:Questionnaires were sent to 275 endoscopists and 173 non-endoscopist...AIM:To examine the frequency and prevention of musculoskeletal pain in Japanese gastrointestinal endoscopists and non-endoscopist physicians.METHODS:Questionnaires were sent to 275 endoscopists and 173 non-endoscopists working in Hiroshima University Hospital and its affiliated hospitals.RESULTS:The completed questionnaires were returned by 190(69%)endoscopists and 120(69%)non-endoscopists.The frequency of pain in the hand and wrist,and especially the left thumb,was significantly higher in endoscopists than in non-endoscopists(17%vs 6%,P=0.004).Using multivariate analysis,the only significant factor associated with this pain was the age of the endoscopist(odds ratio 2.77,95%confidence interval,1.23-6.71,P=0.018).Interestingly,endoscopists had made significantly fewer modifications to their endoscopic practices than non-endoscopists(12%vs 33%,P <0.0001)to prevent pain.CONCLUSION:Pain in the hand and wrist may be endoscopy-related.However,endoscopists made little modifications in practice to prevent such pain.More attention to prevention appears necessary.展开更多
Post cam mechanism of Posterior Stabilized (PS) knee prostheses is useful to realize intrinsic stability for cases with severe degeneration. However, some retrieval studies report severe failure of the polyethylene ti...Post cam mechanism of Posterior Stabilized (PS) knee prostheses is useful to realize intrinsic stability for cases with severe degeneration. However, some retrieval studies report severe failure of the polyethylene tibial post. We thought that severe failures were caused by high loads during daily activities. In the current study, we performed a compression test and a finite element analysis of the mechanical forces produced in the tibial post in posterior-stabilized knee prostheses in order to develop a specification for the tibial posts found in the polyethylene inserts of PS knee prostheses. Anterior tibial post impingement and posterior tibial post impingement were simulated. The surface pressure values detected in the compression test were consistent with those obtained in the FE analysis. Of the three designs, the lowest von Mises stress values were generated inside the round tibial post;therefore, tibial posts should be round. The risk of tibial post failure was low when 500 or 1000 N was loaded onto the knee joint. It was suggested that tibial post failure occurs when the shear strain at the base of the tibial post exceeds 0.1.展开更多
Background. Interest in tuberculosis has recently been revived, espec ially in association with the onset of acquired immunodeficiency syndrome (AIDS). In Jap an, the incidence of tuberculosis has declined since the 1...Background. Interest in tuberculosis has recently been revived, espec ially in association with the onset of acquired immunodeficiency syndrome (AIDS). In Jap an, the incidence of tuberculosis has declined since the 1950s, but has shown a tendency to increase in the past 10 years. Meth ods. To determine the patterns of prevalence of cutaneous tuberculosis in Jap an, data for cutaneous tuberculosis cases recorded between 1906 and 2002 were ob tained from the dermatologic clinic of Kyushu University Hospital. The populatio n of tuberculosis-infected patients was stratified into groups encompassing 10 -year periods. Each patient group was then classified as having true tuberculo sis or tuberculid, as well as being classified by gender. The total number of pa tients with cutaneous tuberculosis analyzed was 1324. Results. The incidence of cutaneous tuberculosis, both true tuberculosis and tuberculid, decreased between 1906 and 1935, increased between 1936 and 1955, and decreased again from 1955. The incidence of true tuberculosis was higher than that of tuberculid between 19 06 and 1925. The incidence rates of true tuberculosis and tuberculid were equal from 1926 to 1945, and since 1946 the incidence of tuberculid has been higher th an that of true tuberculosis. The incidence of tuberculid decreased between 1986 and 1995, but showed a dramatic increase between 1996 and 2000. The frequency o f cutaneous tuberculosis was highest in the 10- 49 year age group before 1980, but since 1981 has been highest in groups over 40 years of age. Conclusions. The incidence of cutaneous tuberculosis in Japan is decreasing and shows a shift to wards older generations. However, there is an increase in the incidence of tuber culid, especially in elderly female patients.展开更多
Background: The insulin-like growth factor-1 (IGF-1) receptor (R)-induced phosphatidylinositol 3-kinase (PI3K)/AKT and mitogen-activated protein kinase (MAPK)/ERK signal transduction cascade, which have critical roles...Background: The insulin-like growth factor-1 (IGF-1) receptor (R)-induced phosphatidylinositol 3-kinase (PI3K)/AKT and mitogen-activated protein kinase (MAPK)/ERK signal transduction cascade, which have critical roles in prevention of apoptosis and regulation of cell cycle progression, plays an important role in tumorigenesis. The expression of IGF-1R, AKT and ERK1/2 has been described in some human malignancies, but not in extramammary Paget’s disease (EMPD). Objectives: To study the expression of IGF-1R, p-AKT and p-ERK1/2 in EMPD and to evaluate the relationships among them. Methods: Thirty-six tissue samples of 34 patients with primary EMPD were subjected to immunohistochemical staining for IGF-1R, p-AKT and p-ERK1/2. Results: Of thirty-six EMPD tissue samples, 34, 34 and 28 were positive for IGFIR, p-AKT and p-ERK1/2 expression, respectively; 27, 23 and 17 of the 36 specimens stained positive for IGF-IR, p-AKT and p-ERK1/2 in more than half of Paget’s cells, respectively. There were significant correlations between the IGF-1R and p-AKT expression as well as between IGF-1R and p-ERK1/2 expression. Taken together, these results indicate that IGF-1R is overexpressed, and AKT and ERK1/2 are frequently phosphorylated in EMPD. Conclusions: Our study shows that the expression of IGF-1R and the induction of p-AKT and the p-ERK1/2 pathwaymay play an important role in the pathogenesis of EMPD. The IGF-IR system might be a potential therapeutic target in EMPD.展开更多
Background: High-risk human papillomavirus (hrHPV) type E6 and E7 oncoproteins contribute to oncogenesis in multiple ways by modulating the activities of host components in cell-cycle regulation including the expressi...Background: High-risk human papillomavirus (hrHPV) type E6 and E7 oncoproteins contribute to oncogenesis in multiple ways by modulating the activities of host components in cell-cycle regulation including the expression of p16 protein (p16) and human telomerase reverse transcriptase (hTERT). The expression of p16 and hTERT protein in Bowenoid papulosis (BP) has not been studied. Methods: Biopsy samples of BP from 26 patients were subjected to in situ hybridization for various HPV strains and immunohistochemical staining for p16 and hTERT. Results: Among the 26 biopsy specimens, in situ hybridization using DNA probes for HPV 16/18 revealed positivity in 18 specimens (69.2%), one of which also showed positivity with the probes for HPV 6/11. HPV 31/33/35 was found in three specimens (11.5%). Two specimens (7.7%) were positive for unclassified HPV. Twenty-one BP specimens that were infected with hrHPV were positive for p16 and/or hTERT. Moderate or strong and diffuse immunostaining was observed for p16 in 15 hrHPV-infected specimens and for hTERT in 16 hrHPVinfected specimens. The expression of p16 or hTERT was each significantly associated with the presence of hrHPV. Conclusions: hrHPVs were involved in inducing p16 and hTERT overexpression in BP. Moreover, our results suggested that immunohistochemical p16 and hTERT expression might be a useful marker of hrHPV infection in BP.展开更多
The Gacun Kuroko-type deposit, Southwestern China, is hosted in rhyolitic rocks associated with the underlying mafic rocks occurred in the - 1000 m deep fault - bounded basin within the intra -arc rifting zone which f...The Gacun Kuroko-type deposit, Southwestern China, is hosted in rhyolitic rocks associated with the underlying mafic rocks occurred in the - 1000 m deep fault - bounded basin within the intra -arc rifting zone which formed on the Triassic Yidun island - arc. Two vertically separated alteration systems are recognized: one is conformable or semiconformable alteration zone developed in - 150 m thick mafic unit 1-1.5 km below the massive sulfide ore body; the other is discordant alteration pipe directly surrounded around stockwork ore within rhyolitic unit. The lower conformable alteration zone extending for several kilometers along strike is characterized by silicification and epidotization which result in the development of quartz vein and quartz-epidote vein systems in mafic lava flows and replacement of primary minerals and groundmass in spilitized mafic volcanics and dikes by quartz, epidote - group minerals and sodic plagioclase. Sulfides often occur in the vein system and altered mafic volcanics. Quartz solubility relation indicates that silicification is a consequence of interaction of Si- saturated fluids with mafic rocks in a higher temperature system (T>340℃), intensifying by intrusion of mafic dike or high-level acidic magma chamber. The alteration pipe of diameter about 2 km shows a similar mineralogical zoning to Kuroko deposits of Japan. The sequence is quartz + hyalophane; sericite + chlorite + quartz and zeolite-like zones from core to margins of the pipe. The chlorite core only occurs in the root part of the alteration pipe and downwards transfers into epidote - chlorite and epidote - quartz vein swarm extending 500 m downwards. The felsic rocks away from the orebody and alteration pipe took place district-scale alteration, which has typical low-temperature mineral association: illite + albite + quartz + calcite. Whole -rock and quartz δ18O values indicate that district - scale alteration is a result of interaction of seawater with rocks at lower temperature (T<200℃)under water-dominated condit展开更多
Normal pressure hydrocephalus (NPH) is a treatable neurological condition characterized by dementia, gait disturbances, and urinary incontinence. This case study aimed to evaluate the effectiveness of surgical interve...Normal pressure hydrocephalus (NPH) is a treatable neurological condition characterized by dementia, gait disturbances, and urinary incontinence. This case study aimed to evaluate the effectiveness of surgical intervention in treating NPH associated with spinal cord tumors. A patient suffering with NPH underwent a spinal tap procedure and surgical resectioning of three neurinomas on the cauda equina. The patient exhibited marked improvement in neurological and motor symptoms related to NPH following surgical intervention. These findings suggest that surgical resectioning of neurinomas is an effective intervention for treating NPH associated with spinal cord tumors.展开更多
文摘AIM： To clarify the prevalence of defensive medicine and the specific defensive medicine practices among gastroenterologists in Japan. METHODS： A survey of gastroenterologists in Hiroshima, Japan, was conducted by mail in March 2006. The number of gastroenterologists reporting defensive medicine behaviors or changes in their scope of practice and the reported defensive medicine practices, i.e., assurance and avoidance behaviors, were examined. RESULTS： A total of 131 （77%） out of 171 gastroenterologists completed the survey. Three （2%） respondents were sued, and most respondents （96%） had liability insurance. Nearly all respondents （98%） reported practicing defensive medicine. Avoidance behaviors, such as avoiding certain procedures or interventions and avoiding caring for high-risk patients, were very common （96%）. Seventy-five percent of respondents reported often avoiding certain procedures or interventions. However, seasoned gastroenterologists （those in practice for more than 20 years） adopted avoidance behaviors significantly less often than those in practice for less than 10 years. Assurance behaviors, i.e., supplying additional services of marginal or no medical value, were also widespread （91%）. Sixty-eight percent of respondents reported that they sometimes or often referred patients to other specialists unnecessarily. CONCLUSION： Defensive medicine may be highly prevalent among gastroenterologists throughout 3apan, with potentially serious implications regarding costs, access, and both technical and interpersonal quality of care.
文摘BACKGROUND X-ray gastric cancer(GC)screening has been shown to decrease mortality.Population-based X-ray GC screening has been performed in Hiroshima Prefe-cture,Japan,since 1983 but time trends and the efficacy of the method over 39 years have not been assessed.METHODS This was a population-based retrospective study.The data were derived from aggregated data of the Hiroshima Regional Health Medical Promotion Organization,including the number and rate of participants and those requiring esophagogastroduodenoscopies(EGDs),the number and rate of participants diagnosed as having GC,and the positive predictive value of the abnormal findings detected by X-ray and confirmed by EGDs.The number and rate of esophageal cancers were also collected.Further,the cost of detecting one GC was evaluated.RESULTS The number of participants has decreased during the last four decades,from 39925 in 1983 to 12923 in 2021.The rate of those requiring EGDs decreased significantly in recent years(P<0.001).The number of participants diagnosed as having GC has also declined,from 76 to 10 cases.However,the rate of cases diagnosed as GC among the participants remained around 0.1%.The positive predictive value increased significantly in recent years except during 1983-1991.The number and rate of accidentally detected esophageal cancers have risen recently,from 0%in 2008 to 0.02%in 2021,one-fifth of the diagnosis rate of GC.One GC diagnosis costs approximately 4200000 Japanese Yen(30000 United States Dollars)for the X-ray screenings and EGDs.CONCLUSION X-ray GC screening in Hiroshima has been efficient,but one challenge is the cost.Esophageal cancers may also need to be considered because they have gradually increased in recent years.
文摘Boninitic rocks and associated high-magnesian basalt and high-iron tholeiite in the Xiangcheng area constitute the basal horizon of the arc volcanic sequence in the Triassic Yidun Island-Arc, southwestern China. The boninite occurs as pillow, massive and ocellar lavas; the last one possesses well-developed globular structure and alternates with the former two. The boninite is characterized by the absence of phenocrysts of olivine and low-Ca pyroxenes and by low CaO/Al2O3 ratios (<0.67) and high Cr (>1000 ppm) and Ni (>250 ppm). The normalized abundance patterns (NAP) of trace elements to primitive mantle are similar to the NAP of low-Ca modern boninites and SHMB in the Archaean and Proterozoic.
文摘AIM:To examine the frequency and prevention of musculoskeletal pain in Japanese gastrointestinal endoscopists and non-endoscopist physicians.METHODS:Questionnaires were sent to 275 endoscopists and 173 non-endoscopists working in Hiroshima University Hospital and its affiliated hospitals.RESULTS:The completed questionnaires were returned by 190(69%)endoscopists and 120(69%)non-endoscopists.The frequency of pain in the hand and wrist,and especially the left thumb,was significantly higher in endoscopists than in non-endoscopists(17%vs 6%,P=0.004).Using multivariate analysis,the only significant factor associated with this pain was the age of the endoscopist(odds ratio 2.77,95%confidence interval,1.23-6.71,P=0.018).Interestingly,endoscopists had made significantly fewer modifications to their endoscopic practices than non-endoscopists(12%vs 33%,P <0.0001)to prevent pain.CONCLUSION:Pain in the hand and wrist may be endoscopy-related.However,endoscopists made little modifications in practice to prevent such pain.More attention to prevention appears necessary.
文摘Post cam mechanism of Posterior Stabilized (PS) knee prostheses is useful to realize intrinsic stability for cases with severe degeneration. However, some retrieval studies report severe failure of the polyethylene tibial post. We thought that severe failures were caused by high loads during daily activities. In the current study, we performed a compression test and a finite element analysis of the mechanical forces produced in the tibial post in posterior-stabilized knee prostheses in order to develop a specification for the tibial posts found in the polyethylene inserts of PS knee prostheses. Anterior tibial post impingement and posterior tibial post impingement were simulated. The surface pressure values detected in the compression test were consistent with those obtained in the FE analysis. Of the three designs, the lowest von Mises stress values were generated inside the round tibial post;therefore, tibial posts should be round. The risk of tibial post failure was low when 500 or 1000 N was loaded onto the knee joint. It was suggested that tibial post failure occurs when the shear strain at the base of the tibial post exceeds 0.1.
文摘Background. Interest in tuberculosis has recently been revived, espec ially in association with the onset of acquired immunodeficiency syndrome (AIDS). In Jap an, the incidence of tuberculosis has declined since the 1950s, but has shown a tendency to increase in the past 10 years. Meth ods. To determine the patterns of prevalence of cutaneous tuberculosis in Jap an, data for cutaneous tuberculosis cases recorded between 1906 and 2002 were ob tained from the dermatologic clinic of Kyushu University Hospital. The populatio n of tuberculosis-infected patients was stratified into groups encompassing 10 -year periods. Each patient group was then classified as having true tuberculo sis or tuberculid, as well as being classified by gender. The total number of pa tients with cutaneous tuberculosis analyzed was 1324. Results. The incidence of cutaneous tuberculosis, both true tuberculosis and tuberculid, decreased between 1906 and 1935, increased between 1936 and 1955, and decreased again from 1955. The incidence of true tuberculosis was higher than that of tuberculid between 19 06 and 1925. The incidence rates of true tuberculosis and tuberculid were equal from 1926 to 1945, and since 1946 the incidence of tuberculid has been higher th an that of true tuberculosis. The incidence of tuberculid decreased between 1986 and 1995, but showed a dramatic increase between 1996 and 2000. The frequency o f cutaneous tuberculosis was highest in the 10- 49 year age group before 1980, but since 1981 has been highest in groups over 40 years of age. Conclusions. The incidence of cutaneous tuberculosis in Japan is decreasing and shows a shift to wards older generations. However, there is an increase in the incidence of tuber culid, especially in elderly female patients.
文摘Background: The insulin-like growth factor-1 (IGF-1) receptor (R)-induced phosphatidylinositol 3-kinase (PI3K)/AKT and mitogen-activated protein kinase (MAPK)/ERK signal transduction cascade, which have critical roles in prevention of apoptosis and regulation of cell cycle progression, plays an important role in tumorigenesis. The expression of IGF-1R, AKT and ERK1/2 has been described in some human malignancies, but not in extramammary Paget’s disease (EMPD). Objectives: To study the expression of IGF-1R, p-AKT and p-ERK1/2 in EMPD and to evaluate the relationships among them. Methods: Thirty-six tissue samples of 34 patients with primary EMPD were subjected to immunohistochemical staining for IGF-1R, p-AKT and p-ERK1/2. Results: Of thirty-six EMPD tissue samples, 34, 34 and 28 were positive for IGFIR, p-AKT and p-ERK1/2 expression, respectively; 27, 23 and 17 of the 36 specimens stained positive for IGF-IR, p-AKT and p-ERK1/2 in more than half of Paget’s cells, respectively. There were significant correlations between the IGF-1R and p-AKT expression as well as between IGF-1R and p-ERK1/2 expression. Taken together, these results indicate that IGF-1R is overexpressed, and AKT and ERK1/2 are frequently phosphorylated in EMPD. Conclusions: Our study shows that the expression of IGF-1R and the induction of p-AKT and the p-ERK1/2 pathwaymay play an important role in the pathogenesis of EMPD. The IGF-IR system might be a potential therapeutic target in EMPD.
文摘Background: High-risk human papillomavirus (hrHPV) type E6 and E7 oncoproteins contribute to oncogenesis in multiple ways by modulating the activities of host components in cell-cycle regulation including the expression of p16 protein (p16) and human telomerase reverse transcriptase (hTERT). The expression of p16 and hTERT protein in Bowenoid papulosis (BP) has not been studied. Methods: Biopsy samples of BP from 26 patients were subjected to in situ hybridization for various HPV strains and immunohistochemical staining for p16 and hTERT. Results: Among the 26 biopsy specimens, in situ hybridization using DNA probes for HPV 16/18 revealed positivity in 18 specimens (69.2%), one of which also showed positivity with the probes for HPV 6/11. HPV 31/33/35 was found in three specimens (11.5%). Two specimens (7.7%) were positive for unclassified HPV. Twenty-one BP specimens that were infected with hrHPV were positive for p16 and/or hTERT. Moderate or strong and diffuse immunostaining was observed for p16 in 15 hrHPV-infected specimens and for hTERT in 16 hrHPVinfected specimens. The expression of p16 or hTERT was each significantly associated with the presence of hrHPV. Conclusions: hrHPVs were involved in inducing p16 and hTERT overexpression in BP. Moreover, our results suggested that immunohistochemical p16 and hTERT expression might be a useful marker of hrHPV infection in BP.
基金The study is supported by Agence of International Science and Technology, Japan
文摘The Gacun Kuroko-type deposit, Southwestern China, is hosted in rhyolitic rocks associated with the underlying mafic rocks occurred in the - 1000 m deep fault - bounded basin within the intra -arc rifting zone which formed on the Triassic Yidun island - arc. Two vertically separated alteration systems are recognized: one is conformable or semiconformable alteration zone developed in - 150 m thick mafic unit 1-1.5 km below the massive sulfide ore body; the other is discordant alteration pipe directly surrounded around stockwork ore within rhyolitic unit. The lower conformable alteration zone extending for several kilometers along strike is characterized by silicification and epidotization which result in the development of quartz vein and quartz-epidote vein systems in mafic lava flows and replacement of primary minerals and groundmass in spilitized mafic volcanics and dikes by quartz, epidote - group minerals and sodic plagioclase. Sulfides often occur in the vein system and altered mafic volcanics. Quartz solubility relation indicates that silicification is a consequence of interaction of Si- saturated fluids with mafic rocks in a higher temperature system (T>340℃), intensifying by intrusion of mafic dike or high-level acidic magma chamber. The alteration pipe of diameter about 2 km shows a similar mineralogical zoning to Kuroko deposits of Japan. The sequence is quartz + hyalophane; sericite + chlorite + quartz and zeolite-like zones from core to margins of the pipe. The chlorite core only occurs in the root part of the alteration pipe and downwards transfers into epidote - chlorite and epidote - quartz vein swarm extending 500 m downwards. The felsic rocks away from the orebody and alteration pipe took place district-scale alteration, which has typical low-temperature mineral association: illite + albite + quartz + calcite. Whole -rock and quartz δ18O values indicate that district - scale alteration is a result of interaction of seawater with rocks at lower temperature (T<200℃)under water-dominated condit
文摘Normal pressure hydrocephalus (NPH) is a treatable neurological condition characterized by dementia, gait disturbances, and urinary incontinence. This case study aimed to evaluate the effectiveness of surgical intervention in treating NPH associated with spinal cord tumors. A patient suffering with NPH underwent a spinal tap procedure and surgical resectioning of three neurinomas on the cauda equina. The patient exhibited marked improvement in neurological and motor symptoms related to NPH following surgical intervention. These findings suggest that surgical resectioning of neurinomas is an effective intervention for treating NPH associated with spinal cord tumors.
