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A quantitative analysis was performed of substance P-like immunoreactivity (SPLI) and of bendorphin-like immunoreactivity (b-ENDLI), in the cerebrospinal¯uid (CSF) in various diseases. The results reported to date have not been consistent. The purpose of this study was to investigate whether or not the concentration of SPLI or that of b-ENDLI in CSF demonstrated any potential for assessing the degree of subjective pain in various spinal diseases. SPLI in CSF was measured by radioimmunoassay in 158 patients with a spinal disease; involving 57 patients with a lumbar disc herniation (LDH), 38 with lumbar canal stenosis (LCS), 46 with cervical myelopathy (CM) and 17 with cervical radiculopathy (CR), and also in 20 healthy controls. b-ENDLI in CSF was measured in 25 of these same patients; involving 12 with LDH, seven with LCS and six with CM, and also ®ve of the same controls. The concentration of serum SPLI was also measured in 50 of these 158. The severity of pain was self-evaluated by each patient using a linear visual analogue scale (VAS). Their Japanese Orthopaedic Association (JOA) score was also calculated objectively using the clinical ®ndings. Correlations were investigated among the concentrations of SPLI and b-ENDLI in the CSF and the VAS and JOA clinical assessments of these patients. The concentration of SPLI in CSF was signi®cantly higher in various spinal diseases than in controls (P50.05), and was correlated with the severity on the VAS and with the JOA score. However, b-ENDLI was not correlated with either the VAS or the JOA score. We conclude that the measurement of the SPLI concentration in CSF has the potential for assessing objectively the severity of pain associated with various spinal diseases.

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Chikuho Rosai Hospital Acromioclavicular injuries in children are very rare, and comfused with the fractures of the distal end of the clavicle. Rockwood reported that the clavicle was displaced superiorly out of the periosteal tube and coracoclavicular ligaments remain intact to the periosteal tube. The first case was an 11-year-old boy with the type III acromioclavicular injury. Conservative treatment was done. Seven weeks after injury, he had no symptoms and there was new bone formation under the original clavicle. The second case was a 15-year-old boy with the type III injury. Open reduction and transarticular K-wire fixation was carried out. K-wire was removed 4months after operation with successful clinical and roentgenographic results. The third case was a 12-year-old boy with the type II injury. Non-operative treatment was carried out successfully. ‚Í ‚ ¶ ‚ß ‚É •¬Ž™ ‚Ì OE¨•OE¨•½ŠÖ•ß '¹ •• ‚Í ‚«‚í ‚ß‚Ä‚Ü‚ê ‚È‚à‚Ì ‚Å‚ ‚é. Rockwood1)‚ç ‚É‚ae‚é ‚AE,•¬Ž™ ‚Ì •ê • ‡ ‚Í •oe-OE‚ae‚èèÕ'Ñ‚Ì ‚Ù‚¤‚ª ‹-‚¢ ‚½‚ß ‚É‚Ù‚AE ‚ñ ‚Ç‚Ì •ê • ‡ ‚Í èÕ'Ñ‚ª •oe-OE‚É•t '… ‚µ‚½‚Ü‚Ü •oe‚Ì ‚Ý‚ª 'E•o ‚· ‚épseudodislocation‚Ì OE^ ‚ðŽae ‚é ‚AE ‚³ ‚ê ‚Ä‚¢ ‚é.‚± ‚Ì •ê • ‡,'¹ OEû •½•oeèÕ'Ñ‚Í •³ •í ‚É•Û ‚½‚ê ‚Ä‚¢ ‚é ‚É‚à‚©‚©‚í ‚ç‚¸,X•ü ‚ÅOE''¤ ‚É"ä ‚× ‚é ‚AE ‰G