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Sample records for single type interbody

  1. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis

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    Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Zhang, Yupeng; Liu, Zheng

    2015-01-01

    Objective: The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation.Methods: Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reco...

  2. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, Wilco; Willems, Paul C.; van Limbeek, Jacques; Bartels, Ronald; Pavlov, Paul; Anderson, Patricia G.; Oner, Cumhur

    2011-01-01

    Background The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. Objectives To determine which technique of anterior interbody fusion

  3. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, W.; Willems, P.C.P.H.; Limbeek, J. van; Bartels, R.H.M.A.; Pavlov, P.; Anderson, P.G.; Oner, C.

    2011-01-01

    BACKGROUND: The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. OBJECTIVES: To determine which technique of anterior interbody fusion

  4. Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral brucellosis.

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    Abulizi, Yakefu; Liang, Wei-Dong; Muheremu, Aikeremujiang; Maimaiti, Maierdan; Sheng, Wei-Bin

    2017-07-14

    Spinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis. From February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53.7 ± 8.7) with lumbosacral brucellosis treated by transforaminal decompression, debridement, interbody fusion, and posterior instrumentation were enrolled. Medical records, imaging studies, laboratory data were collected and summarized. Surgical outcomes were evaluated based on visual analogue scale (VAS), Oswestry Disability Index (ODI) and Japanese Orthopaedic Association (JOA) scale. The changes in C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), clinical symptoms and complications were investigated. Graft fusion was evaluated using Bridwell grading criteria. The mean follow-up period was 24.9 ± 8.2 months. Back pain and radiating leg pain was relieved significantly in all patients after operation. No implant failures were observed in any patients. Wound infection was observed in two patients and sinus formation was observed in one patient. Solid bony fusion was achieved in 30 patients and the fusion rate was 93.8%. The levels of ESR and CRP were returned to normal by the end of three months' follow-up. VAS and ODI scores were significantly improved (P brucellosis.

  5. Axial lumbar interbody fusion: a 6-year single-center experience

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    Zeilstra DJ

    2013-08-01

    Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

  6. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

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    Xin-Lei Xia

    2015-01-01

    Full Text Available Background: The concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF with a small single posterior median incision. Methods: During the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group. The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index (ODI scores, Visual Analog Scale (VAS scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared. Results: A total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01. The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05. Conclusions: Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  7. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis.

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    Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Liu, Zheng; Zhang, Yupeng

    2015-01-01

    The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. The mean follow-up was 36.9 months (range: 24-62 months). The kyphotic angle ranged from 15.2-35.1° preoperatively, with an average measurement of 27.8°. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocyte sedimentation rate (ESR) used to judge the activity of TB. Spinal TB was completely cured in all 17 patients. There was no recurrent TB infection. The postoperative kyphotic angle was 6.6-10.2°, 8.1° in average, and there was no significant loss of the correction at final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation can be a feasible and effective method the in treatment of single-segment lumbar spinal TB.

  8. Do intraoperative radiographs predict final lumbar sagittal alignment following single-level transforaminal lumbar interbody fusion?

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    Salem, Khalid M I; Eranki, Aditya P; Paquette, Scott; Boyd, Michael; Street, John; Kwon, Brian K; Fisher, Charles G; Dvorak, Marcel F

    2018-02-16

    OBJECTIVE The study aimed to determine if the intraoperative segmental lordosis (as calculated on a cross-table lateral radiograph following a single-level transforaminal lumbar interbody fusion [TLIF] for degenerative spondylolisthesis/low-grade isthmic spondylolisthesis) is maintained at discharge and at 6 months postsurgery. METHODS The authors reviewed images and medical records of patients ≥ 16 years of age with a diagnosis of an isolated single-level, low-grade spondylolisthesis (degenerative or isthmic) with symptomatic spinal stenosis treated between January 2008 and April 2014. Age, sex, surgical level, surgical approach, and facetectomy (unilateral vs bilateral) were recorded. Upright standardized preoperative, early, and 6-month postoperative radiographs, as well as intraoperative lateral radiographs, were analyzed for the pelvic incidence, segmental lumbar lordosis (SLL) at the TILF level, and total LL (TLL). In addition, the anteroposterior position of the cage in the disc space was documented. Data are presented as the mean ± SD; a p value level using a bullet-shaped cage. A bilateral facetectomy was performed in 17 patients (20.2%), and 89.3% of procedures were done at the L4-5 and L5-S1 segments. SLL significantly improved intraoperatively from 15.8° ± 7.5° to 20.9° ± 7.7°, but the correction was lost after ambulation. Compared with preoperative values, at 6 months the change in SLL was modest at 1.8° ± 6.7° (p = 0.025), whereas TLL increased by 4.3° ± 9.6° (p level of surgery, and use of a bilateral facetectomy did not significantly affect postoperative LL. CONCLUSIONS Following a single-level TLIF procedure using a bullet-shaped cage, the intraoperative improvement in SLL is largely lost after ambulation. The improvement in TLL over time is probably due to the decompression part of the procedure. The approach, level of surgery, bilateral facetectomy, and position of the cage do not seem to have a significant effect on LL achieved

  9. A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion.

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    Singh, Kern; Nandyala, Sreeharsha V; Marquez-Lara, Alejandro; Fineberg, Steven J; Oglesby, Mathew; Pelton, Miguel A; Andersson, Gunnar B; Isayeva, Darya; Jegier, Briana J; Phillips, Frank M

    2014-08-01

    Emerging literature suggests superior clinical short- and long-term outcomes of MIS (minimally invasive surgery) TLIFs (transforaminal lumbar interbody fusion) versus open fusions. Few studies to date have analyzed the cost differences between the two techniques and their relationship to acute clinical outcomes. The purpose of the study was to determine the differences in hospitalization costs and payments for patients treated with primary single-level MIS versus open TLIF. The impact of clinical outcomes and their contribution to financial differences was explored as well. This study was a nonrandomized, nonblinded prospective review. Sixty-six consecutive patients undergoing a single-level TLIF (open/MIS) were analyzed (33 open, 33 MIS). Patients in either cohort (MIS/open) were matched based on race, sex, age, smoking status, medical comorbidities (Charlson Comorbidity index), payer, and diagnosis. Every patient in the study had a diagnosis of either degenerative disc disease or spondylolisthesis and stenosis. Operative time (minutes), length of stay (LOS, days), estimated blood loss (EBL, mL), anesthesia time (minutes), Visual Analog Scale (VAS) scores, and hospital cost/payment amount were assessed. The MIS and open TLIF groups were compared based on clinical outcomes measures and hospital cost/payment data using SPSS version 20.0 for statistical analysis. The two groups were compared using bivariate chi-squared analysis. Mann-Whitney tests were used for non-normal distributed data. Effect size estimate was calculated with the Cohen d statistic and the r statistic with a 95% confidence interval. Average surgical time was shorter for the MIS than the open TLIF group (115.8 minutes vs. 186.0 minutes respectively; p=.001). Length of stay was also reduced for the MIS versus the open group (2.3 days vs. 2.9 days, respectively; p=.018). Average anesthesia time and EBL were also lower in the MIS group (pFinancial analysis demonstrated lower total hospital direct

  10. Superior Facet Joint Violations during Single Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Preliminary Retrospective Clinical Study

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    Long Jia

    2018-01-01

    Full Text Available Background. Facet joint violation (FV was reported as variable iatrogenic damage that can be a crucial risk factor leading to the adjacent segment degeneration (ASD. “Blind” screw placement technique in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF contributes to the increasing incidence of FV that can be influenced by several potential factors. Many controversies about these factors and clinical outcomes of different types of FV patients exist, yet they have not been analyzed. Methods. 99 cases undergoing single-segment MIS-TLIF from July 2013 to December 2015 were retrospectively analyzed. Computed tomography (CT was applied to determine the incidence of FV, and then the correlation between FV and relevant factors, including gender, age, body mass index (BMI, top-screw level, and decompression, was analyzed. A total of 53 cases were followed up after one year, 31 cases in noninjury (A group and 22 patients in FV injury (B group. Results. The incidence of FV was 39. 39% (39/99 in the patients and 23.23% (46/198 in the screws. Logistic regression analysis showed that screw at L5 in patients with BMI > 30 kg/m2 was vulnerable to FV (P<0.05. Moreover, postoperative average intervertebral disc height (AIDH of fusion segment, visual analog scale (VAS, and Oswestry disability index (ODI scores improved significantly in group A and B when compared with preoperative data (P<0.05. Adjacent superior average intervertebral disc height (ASAIDH presented decrease, but adjacent superior intervertebral disc Cobb angle (ASIDCA appeared to increase in the two groups at the final follow-up compared with postoperative 3 days (P<0.05. Low back VAS and ODI scores in group A (31 cases were lower than those in group B (22 cases in the final follow-up (P<0.05. Conclusion. MIS-TLIF is an effective treatment for lumbar degenerative disease, but FV occurred at a higher incidence. Facet joints should be protected in MIS-TLIF to avoid FV.

  11. Restoration of lumbopelvic sagittal alignment and its maintenance following transforaminal lumbar interbody fusion (TLIF): comparison between straight type versus curvilinear type cage.

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    Kim, Jong-Tae; Shin, Myung-Hoon; Lee, Ho-Jin; Choi, Du-Yong

    2015-11-01

    To evaluate a radiological and clinical difference between the curvilinear type cages compared to the straight type cages for the restoration of lumbopelvic sagittal alignment and its maintenance after transforaminal lumbar interbody fusion (TLIF) procedure. 68 patients who underwent single-level TLIF using either the straight type or curvilinear type cage were retrospectively reviewed. Assessment of the lumbopelvic parameters and the height of disc space was performed before surgery as well as 2 days, 6 and 12 months after surgery. Clinical outcome was assessed using VAS and ODI. The curvilinear type cages were positioned more anteriorly than the straight type. Restoration of the segmental lordosis (SL) in the curvilinear group was significantly greater than the straight group and at 12 months of follow-up, the straight group showed greater decrease in the disc height than the curvilinear group. The straight group failed to show improvement of lumbar lordosis (LL), while the curvilinear group showed significant restoration of LL and could maintain it to the 6 months of follow-up. In both groups, pelvic tilt was significantly decreased and it lasted to 6 months in the straight group; whereas in the curvilinear group, it was maintained to the last follow-up of 12 months. There were no significant differences between the two groups in mean VAS and ODI score over the follow-up period. This study demonstrates that the curvilinear type cage is superior to the straight type cage in improving the SL and maintaining both the restored lumbopelvic parameters and elevated disc height. These results could be attributable to the anterior position of the curvilinear cage which permits easy restoration of segmental lordosis and less sinking of cages.

  12. Trends Analysis of rhBMP Utilization in Single-Level Posterior Lumbar Interbody Fusion in the United States.

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    Lao, Lifeng; Cohen, Jeremiah R; Buser, Zorica; Brodke, Darrel S; Youssef, Jim A; Park, Jong-Beom; Yoon, S Tim; Wang, Jeffrey C; Meisel, Hans-Joerg

    2017-10-01

    Retrospective study. Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used in spinal fusion surgery, but there is little information on rhBMP-2 utilization in single-level posterior lumbar interbody fusion (PLIF). The purpose of our study was to evaluate the trends and demographics of rhBMP-2 utilization in single-level PLIF. Patients who underwent single-level PLIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database, a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were recorded for each patient. Results were reported for each variable as the incidence of procedures identified per 100 000 patients searched in the database. A total of 2735 patients had single-level PLIF. The average rate of single-level PLIF with rhBMP-2 maintained at a relatively stable level (28% to 31%) from 2005 to 2009, but decreased in 2010 (9.9%) and 2011 (11.8%). The overall incidence of single-level PLIF without rhBMP-2 (0.68 cases per 100 000 patients) was statistically higher ( P level PLIF with rhBMP-2 (0.21 cases per 100 000 patients). The average rate of single-level PLIF with rhBMP-2 utilization was the highest in West (30.1%), followed by Midwest (26.9%), South (20.5%), and Northeast (17.8%). The highest incidence of single-level PLIF with rhBMP-2 was observed in the age group level PLIF. There was a 3-fold increase in the rate of PLIF without rhBMP-2 compared to PLIF with rhBMP-2, with both procedures being mainly done in patients less than 65 years of age.

  13. Single-Level Lateral Lumbar Interbody Fusion for the Treatment of Adjacent Segment Disease: A Retrospective Two-Center Study.

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    Aichmair, Alexander; Alimi, Marjan; Hughes, Alexander P; Sama, Andrew A; Du, Jerry Y; Härtl, Roger; Burket, Jayme C; Lampe, Lukas P; Cammisa, Frank P; Girardi, Federico P

    2017-05-01

    A retrospective case series. The aim of this study was to assess the postoperative outcome after single-level lateral lumbar interbody fusion (LLIF) for adjacent segment disease (ASD). Although there is a plethora of literature on ASD following traditional arthrodesis techniques, literature on ASD following LLIF is limited. Vice versa, the surgical outcome after LLIF for the treatment of ASD remains to be elucidated. Patients who underwent single-level LLIF for ASD at two institutions (March 2006-April 2012) were included, and the medical records, operative reports, radiographic imaging studies, and office records reviewed. Out of 523 LLIF patients, 52 met the inclusion criteria, and were postoperatively followed for 16.1 ± 9.8 months (range: 5-44). When comparing the pre-operative data with both the first and most recent follow-up postoperatively, LLIF resulted in a reduction in back pain (P fusion rate in patients who underwent circumferential fusion than the standalone subgroup (87.5% vs. 53.8%; P = 0.173). LLIF may be an effective surgical treatment option for ASD with regard to both the clinical and radiographic outcome in a large proportion of cases. Although standalone LLIF is associated with a narrower spectrum of adverse effects than circumferential fusion, posterior instrumentation may be necessary to increase segmental stability. 4.

  14. Effect of Mechanical Ventilation Mode Type on Intra- and Postoperative Blood Loss in Patients Undergoing Posterior Lumbar Interbody Fusion Surgery: A Randomized Controlled Trial.

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    Kang, Woon-Seok; Oh, Chung-Sik; Kwon, Won-Kyoung; Rhee, Ka Young; Lee, Yun Gu; Kim, Tae-Hoon; Lee, Suk Ha; Kim, Seong-Hyop

    2016-07-01

    The aim of study was to evaluate the effect of mechanical ventilation mode type, pressure-controlled ventilation (PCV), or volume-controlled ventilation (VCV) on intra- and postoperative surgical bleeding in patients undergoing posterior lumbar interbody fusion (PLIF) surgery. This was a prospective, randomized, single-blinded, and parallel study that included 56 patients undergoing PLIF and who were mechanically ventilated using PCV or VCV. A permuted block randomization was used with a computer-generated list. The hemodynamic and respiratory parameters were measured after anesthesia induction in supine position, 5 min after patients were changed from supine to prone position, at the time of skin closure, and 5 min after the patients were changed from prone to supine position. The amount of intraoperative surgical bleeding, fluid administration, urine output, and transfusion requirement were measured at the end of surgery. The amount of postoperative bleeding and transfusion requirement were recorded every 24 h for 72 h. The primary outcome was the amount of intraoperative surgical bleeding, and 56 patients were analyzed. The amount of intraoperative surgical bleeding was significantly less in the PCV group than that in the VCV group (median, 253.0 [interquartile range, 179.0 to 316.5] ml in PCV group vs. 382.5 [328.0 to 489.5] ml in VCV group; P patients undergoing PLIF, which may be related to lower intraoperative peak inspiratory pressure.

  15. Does Subcutaneous Infiltration of Liposomal Bupivacaine Following Single-Level Transforaminal Lumbar Interbody Fusion Surgery Improve Immediate Postoperative Pain Control?

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    Tomov, Marko; Tou, Kevin; Winkel, Rose; Puffer, Ross; Bydon, Mohamad; Nassr, Ahmad; Huddleston, Paul; Yaszemski, Michael; Currier, Bradford; Freedman, Brett

    2018-02-01

    Retrospective case-control study using prospectively collected data. Evaluate the impact of liposomal bupivacaine (LB) on postoperative pain management and narcotic use following standardized single-level low lumbar transforaminal lumbar interbody fusion (TLIF). Poor pain control after surgery has been linked with decreased pain satisfaction and increased economic burden. Unfortunately, opioids have many limitations and side effects despite being the primary treatment of postoperative pain. LB may be a form of pre-emptive analgesia used to reduce the use of postoperative narcotics as evidence in other studies evaluating its use in single-level microdiskectomies. The infiltration of LB subcutaneously during wound closure was performed by a single surgeon beginning in July 2014 for all single-level lumbar TLIF spinal surgeries at Landstuhl Regional Medical Center. This cohort was compared against a control cohort of patients who underwent the same surgery by the same surgeon in the preceding 6 months. Statistical analysis was performed on relevant variables including: morphine equivalents of narcotic medication used (primary outcome), length of hospitalization, Visual Analog Scale pain scores, and total time spent on a patient-controlled analgesia (PCA) pump. A total of 30 patients were included in this study; 16 were in the intervention cohort and 14 were in the control cohort. The morphine equivalents of intravenous narcotic use postoperatively were significantly less in the LB cohort from day of surgery to postoperative day 3. Although the differences lost their statistical significance, the trend remained for total (oral and intravenous) narcotic consumption to be lower in the LB group. The patients who received the study intervention required an acute pain service consult less frequently (62.5% in LB cohort vs. 78.6% in control cohort). The amount of time spent on a PCA pump in the LB group was 31 hours versus 47 hours in the control group ( p =0.1506). Local

  16. [Clinical outcomes of single-level lumbar spondylolisthesis by minimally invasive transforaminal lumbar interbody fusion with bilateral tubular channels].

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    Zeng, Z L; Jia, L; Yu, Y; Xu, W; Hu, X; Zhan, X H; Jia, Y W; Wang, J J; Cheng, L M

    2017-04-01

    Objective: To evaluate the clinical effectiveness of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for single-level lumbar spondylolisthesis treatment with bilateral Spotlight tubular channels. Methods: A total of 21 patients with lumbar spondylolisthesis whom underwent MIS-TLIF via bilateral Spotlight tubular channels were retrospectively analyzed from October 2014 to November 2015. The 21 patients included 11 males and 10 females ranged from 35 to 82 years (average aged 60.7 years). In term of spondylolisthesis category, there were 18 cases of degenerative spondylolisthesis and 3 cases of isthmic spondylolisthesis. With respect to spondylolisthesis degree, 17 cases were grade Ⅰ° and 4 cases were grade Ⅱ°. Besides, 17 cases at L(4-5) and 4 cases at L(5)-S(1)were categorized by spondylolisthesis levels. Operation duration, blood loss, postoperative drainage and intraoperative exposure time were recorded, functional improvement was defined as an improvement in the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) was also employed at pre and post-operation (3 months and the last follow-up), to evaluate low back and leg pain. Furthermore, to evaluate the recovery of the intervertebral foramen and of lumbar sagittal curvature, average height of intervertebral space, Cobb angles of lumbar vertebrae and operative segments, spondylolisthesis index were measured. At the last follow-up, intervertebral fusion was assessed using Siepe evaluation criteria and the clinical outcome was assessed using the MacNab scale. Radiographic and functional outcomes were compared pre- and post-operation using the paired T test to determine the effectiveness of MIS-TLIF. Statistical significance was defined as P spondylolisthesis incidence ( t =17.1, P spondylolisthesis incidence ( t =18.6, P spondylolisthesis vertebrae were restored completely. Lastly, at the last follow-up, 12 cases of grade 1 and 7 cases of grade 2 fusion were present as determined

  17. Minimally invasive transaxial lumbosacral interbody fusion: a ten year single-centre experience.

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    Zeilstra, Dick J; Staartjes, Victor E; Schröder, Marc L

    2017-01-01

    Our aim was to evaluate mid- and long-term results in a cohort of patients who underwent minimally invasive transaxial lumbosacral fixation and to identify clinical and other parameters that can aid in proper patient selection. Over a period of ten years, we assessed 164 patients who had a complete follow-up of a minimum of one year (average 54 months). On follow-up, we recorded clinical status, fusion status, visual analogue scale (VAS), Oswestry Lower Back Pain Disability Index (ODI) scores and patient satisfaction. There were no intra- or peri-operative complications. Overall clinical success rate was 73.8 %. Only sex (female), working status (still working), body mass index (BMI) (lower) and presence of Modic II changes (absent) were correlated with a good result. Transaxial fixation is a safe, minimally invasive technique that can offer good results in patients with single-level degenerative disc disease (DDD) at the lumbosacral level, with minimal operative risk.

  18. A Change in Lumbar Sagittal Alignment After Single-level Anterior Lumbar Interbody Fusion for Lumbar Degenerative Spondylolisthesis With Normal Sagittal Balance.

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    Kim, Chi Heon; Chung, Chun Kee; Park, Sung Bae; Yang, Seung Heon; Kim, Jung-Hee

    2017-08-01

    Retrospective analysis. The object is to assess the correlation between whole lumbar lordosis (LL) and the segmental angle (SA) after single-level anterior lumbar interbody fusion for degenerative lumbar spondylolisthesis. The restoration of the SA at lower lumbar spine is meaningful, considering it contributes approximately 60% of LL, and revision surgery due to flat back or adjacent segment pathology was necessary decades after the initial surgery. However, little is known about the change of whole lumbar curvature after single-level lower lumbar fusion surgery, especially for balanced spine. We included 41 consecutive patients (M:F=9:32; mean age, 59.8±9.3 y) with a single-level anterior lumbar interbody fusion surgery for low-grade degenerative spinal spondylolisthesis, with C7 plumb line of <5 cm and ≥2-year follow-up period. The operated levels were L4-L5 in 34 patients and L5-S1 in 7 patients. Whole LL, SA, pelvic tilt, and sacral slope were compared. According to the Macnab criteria, a favorable outcome (excellent, 21; good, 15) was achieved in 36/41 (88%; excellent, 21; good, 15) patients. LL and SA were significantly changed from -50.8±9.9 to -54.6±11.1 degrees and -15.6±6.1 to -18.7±5.1 degrees (P<0.01), and a positive correlation (r=0.43, P=0.01) was observed between LL and SA at postoperative month 24. The changes to the pelvic tilt and sacral slope were not significant. Whole lumbar sagittal alignment was influenced by single SA. Therefore, obtaining adequate segmental lordosis is desirable considering the effect on the whole spine for a long time.

  19. Comparison of Adjacent Segment Degeneration After Nonrigid Fixation System and Posterior Lumbar Interbody Fusion for Single-Level Lumbar Disc Herniation: A New Method of MRI Analysis of Lumbar Nucleus Pulposus Volume.

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    Yang, Shaofeng; Liu, Yanan; Bao, Zhaohua; Zou, Jun; Yang, Huilin

    2017-05-19

    To evaluate the influence of a nonrigid fixation system and posterior lumbar interbody fusion on adjacent intervertebral disc degeneration by using MRI analysis of lumbar nucleus pulposus volume for single-level lumbar disc herniation. We selected 112 patients who underwent nonrigid fixation (17 men and 44 women) or posterior lumbar interbody fusion (13 men and 38 women) for this retrospective study. Based on the T2-weighted magnetic resonance imaging (MRI) scans taken preoperatively, and 6, 12, and 24 months after surgery, the nucleus pulposus in the upper segments of the operated level was considered an ellipsoid, and their volumes were measured respectively and then compared between the two groups. The posterior lumbar interbody fusion group had significantly lower lumbar nucleus pulposus volume than the nonrigid fixation group at 12 (4.04 ± 1.42 vs. 5.25 ± 1.47 mm 3 ) and 24 months (4.16 ± 0.89 vs. 5.06 ± 1.23 mm 3 ), and had the highest nucleus pulposus. Meanwhile, the h value in the posterior lumbar interbody fusion group was notably smaller than the preoperative level at 12 (0.46 ± 0.03 vs. 0.55 ± 0.05 mm) and 24 months (0.44 ± 0.03 vs. 0.55 ± 0.05 mm). MRI analysis of lumbar nucleus pulposus volume is a new and quantitative method of analysis, which is a considerable method and contributes to the detection of severe intervertebral disc degeneration. Based on this new method, nonrigid fixation demonstrates excellent outcomes on the adjacent segment in comparison with posterior lumbar interbody fusion.

  20. Single-level lumbar pyogenic spondylodiscitis treated with mini-open anterior debridement and fusion in combination with posterior percutaneous fixation via a modified anterior lumbar interbody fusion approach.

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    Lin, Yang; Li, Feng; Chen, Wenjian; Zeng, Heng; Chen, Anmin; Xiong, Wei

    2015-12-01

    This study evaluated the efficacy and safety of mini-open anterior debridement and lumbar interbody fusion in combination with posterior percutaneous fixation for single-level lumbar pyogenic spondylodiscitis. This is a retrospective study. Twenty-two patients with single-level lumbar pyogenic spondylodiscitis underwent mini-open anterior debridement and lumbar interbody fusion in combination with posterior percutaneous fixation via a modified anterior lumbar interbody fusion (ALIF) approach. Patients underwent follow-up for 24 to 38 months. Clinical data, etiological examinations, operative time, intraoperative blood loss, American Spinal Injury Association (ASIA) grade, Japanese Orthopaedic Association (JOA) lumbar function score, visual analog scale (VAS) score, Oswestry Disability Index (ODI), postoperative complications, and the bony fusion rate were recorded. The mean operative time was 181.1 ± 22.6 minutes (range 155-240 minutes). The mean intraoperative blood loss was 173.2 ± 70.1 ml (range 100-400 ml). Infection was found in lumbar vertebrae L2-3, L3-4, and L4-5 in 2, 6, and 14 patients, respectively. Bacterial cultures were positive in 15 patients, including 4 with Staphylococcus aureus, 6 with Staphylococcus epidermidis, 4 with Streptococcus, and 1 with Escherichia coli. Postoperative complications included urinary retention, constipation, and numbness in the thigh in 5, 3, and 2 patients, respectively. Compared with before surgery, the VAS scores and ODI were significantly lower at the final follow-up, the JOA scores were significantly higher, and the ASIA grades had improved. All patients achieved good intervertebral bony fusion. Mini-open anterior debridement and lumbar interbody fusion in combination with posterior percutaneous fixation via a modified ALIF approach results in little surgical trauma and intraoperative blood loss, acceptable postoperative complications, and is effective and safe for the treatment of single-level lumbar pyogenic

  1. Subsidence as of 12 months after single-level anterior cervical inter-body fusion. Is it related to clinical outcomes?

    Science.gov (United States)

    Lee, Chang-Hyun; Kim, Ki-Jeong; Hyun, Seung-Jae; Yeom, Jin S; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2015-06-01

    Subsidence is a frequent phenomenon in the interbody fusion process in patients with anterior cervical discectomy and fusion (ACDF). There is little evidence of whether subsidence in the cervical spine has any impact on clinical outcomes. The purpose of this study is to investigate the correlation of subsidence and clinical outcomes after ACDF and to consider reasons subsidence might not cause unfavorable clinical outcomes. A total of 158 consecutive patients who underwent single-level ACDF were included. The patients were divided into a subsidence group (S-group) and a no subsidence group (N-group), with subsidence defined as a decrease by ≥3 mm in total intervertebral height (TIH). We analyzed outcomes resulting from subsidence, particularly focusing on clinical outcomes and subsequent global and segmental kyphosis using a repeated measure analysis of variance (RM-ANOVA). Subsidence occurred in 74 patients (46.8%) as of a 12-month follow-up. The S-group included 58.6% with a stand-alone cage for interbody fusion (p = 0.002). Clinical outcomes improved significantly over time (neck pain, RM-ANOVA: F(1.3, 205) = 125.1, p subsidence and clinical outcomes between the S- and N-group (neck pain, RM-ANOVA: F(2,153) = 1.04, p = 0.356, partial η(2) = 0.229; arm pain, RM-ANOVA: F(2,153) = 0.56, p = 0.571, partial η(2) = 0.142). Segmental angle increased in both groups over time and showed a statistically significant difference between the S- and N-groups (RM-ANOVA: F(3,143) = 6.148, p = 0.001, partial η(2) = 0.959). Although, global cervical angle decreased generally and displayed no statically significant difference between the S- and N-group (RM-ANOVA: F(3,119) = 2.361, p = 0.075, partial η(2) = 0.056). Radiographic subsidence after ACDF occurred in 46.8% patients as of 12 months after the single-level ACDF. The lack of correlation between bad clinical outcome and radiographic subsidence may be due to

  2. Risk factors for intervertebral instability assessed by temporal evaluation of the radiographs and reconstructed computed tomography images after L5-S1 single-level transforaminal interbody fusion: A retrospective study.

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    Kobayashi, Yoshiomi; Shinozaki, Yoshio; Takahashi, Yohei; Takaishi, Hironari; Ogawa, Jun

    2017-01-01

    Intervertebral instability risks following L5-S1 transforaminal lumbar interbody fusion (TLIF) and causes of bony bridge formation on computed tomography (CT) remain largely unknown. We evaluated the temporal changes on plain radiographs and reconstructed CT images from 178 patients who had undergone single-level L5-S1 TLIF between February 2011 and February 2015. We statistically analyzed temporal changes the L5-S1 angle on radiographs and intervertebral stability (IVS) at the last observation. Bony bridge formation between the L5-S1 vertebral bodies and the titanium cage subsidence were analyzed by using reconstructed CT. Preoperative L5-S1 angle in the non-IVS group was significantly greater than that in the IVS group. The cage subsidence was classified as follows: type A, both upper and lower endplates; type B, either endplate; or type C, no subsidence. Types B and C decreased over time, whereas type A increased after surgery. The bony bridges between vertebral bodies were found in 87.2% of patients, and 94.5% of all bony bridges were found only in the cage, not on the contralateral side. Our findings suggested that high preoperative L5-S1 angle increased the risk of intervertebral instability after TLIF. The L5-S1 angle decreased over time with increasing type A subsidence, and almost all bony bridges were found only in the cage. These results suggest that the vertebral bodies were stabilized because of cage subsidence, and final bony bridges were created. Methods to improve bony bridge creation are needed to obtain reliable L5-S1 intervertebral bone union. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Biomechanics of Nested Transforaminal Lumbar Interbody Cages.

    Science.gov (United States)

    Soriano-Baron, Hector; Newcomb, Anna G U S; Malhotra, Devika; de Tranaltes, Kaylee; Martinez-Del-Campo, Eduardo; Reyes, Phillip M; Crawford, Neil R; Theodore, Nicholas; Tumialán, Luis M

    2016-02-01

    Arthrodesis is optimized when the structural graft occupies most of the surface area within a disc space. The transforaminal corridor inherently limits interbody size. To evaluate the biomechanical implications of nested interbody spacers (ie, a second curved cage placed behind a first) to increase disc space coverage in transforaminal approaches. Seven lumbar human cadaveric specimens (L3-S1) underwent nondestructive flexibility and axial compression testing intact and after transforaminal instrumentation at L4-L5. Specimens were tested in 5 conditions: (1) intact, (2) interbody, (3) interbody plus bilateral pedicle screws and rods (PSR), (4) 2 nested interbodies, and (5) 2 nested interbodies plus PSR. Mean range of motion (ROM) with 1 interbody vs 2 nested interbodies, respectively, was: flexion, 101% vs 85%; extension, 97% vs 92%; lateral bending, 127% vs 132%; and axial rotation, 145% vs 154%. One interbody and 2 nested interbodies did not differ significantly by loading mode (P > .10). With PSR, ROM decreased significantly compared with intact, but not between interbody and interbody plus PSR or 2 interbodies plus PSR (P > .80). Mean vertical height during compressive loading (ie, axial compressive stiffness) was significantly different with 2 nested interbodies vs 1 interbody alone (P < .001) (compressive stiffness, 89% of intact vs 67% of intact, respectively). Inserting a second interbody using a transforaminal approach is anatomically feasible and nearly doubles the disc space covered without affecting ROM. Compressive stiffness significantly increased with 2 nested interbodies, and foraminal height increased. Evaluation of the clinical safety and efficacy of nested interbodies is underway.

  4. The significance of removing ruptured intervertebral discs for interbody fusion in treating thoracic or lumbar type B and C spinal injuries through a one-stage posterior approach.

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    Qian-Shi Zhang

    Full Text Available To identify the negative effect on treatment results of reserving damaged intervertebral discs when treating type B and type C spinal fracture-dislocations through a one-stage posterior approach.This is a retrospective review of 53 consecutive patients who were treated in our spine surgery center from January 2005 to May 2012 due to severe thoracolumbar spinal fracture-dislocation. The patients in Group A (24 patients underwent long-segment instrumentation laminectomy with pedicle screw-rod fixators for neural decompression. In Group B (29 patients, the patients underwent long-segment instrumentation laminectomy with pedicle screw-rod fixators for neural decompression evacuating of the ruptured disc and inserting of a bone graft into the evacuated disc space for interbody fusion. The mean time between injury and operation was 4.1 days (range 2-15 days. The clinical, radiologic and complication outcomes were analyzed retrospectively.Periodic follow-ups were carried out until an affirmative union or treatment failure took place. A progressive kyphosis angle larger than 10°, loss of disc height, pseudoarthrosis, recurrence of dislocation or subluxation, or instrument failure before fusion were considered treatment failures. Treatment failures were detected in 13 cases in Group A (failure rate was 54.2%. In Group B, there were 28 cases in which definitive bone fusion was demonstrated on CT scans, and CT scans of the other cases demonstrated undefined pseudoarthrosis without hardware failure. There were statistically significant differences between the two groups (p0.05 Fisher's exact test.Intervertebral disc damage is a common characteristic in type B and C spinal fracture-dislocation injuries. The damaged intervertebral disc should be removed and substituted with a bone graft because reserving the damaged disc in situ increases the risk of treatment failure.

  5. Prospective Study of Posterior Lumbar Interbody Fusion With Either Interbody Graft or Interbody Cage in the Treatment of Degenerative Spondylolisthesis.

    Science.gov (United States)

    Sivaraman, A; Altaf, Farhaan; Jalgaonkar, Azal; Kakkar, Rahul; Sirigiri, P B R; Howieson, A; Crawford, Robert J

    2015-10-01

    A prospective study of 2 different fusion techniques for the treatment of single-level degenerative spondylolisthesis. To determine whether the addition of an intervertebral cage improves the clinical outcome and fusion rate of patients undergoing posterior lumbar interbody fusion (PLIF) after decompression for degenerative spondylolisthesis. The surgical approach that should be used for degenerative spondylolisthesis is a controversial issue. Decompression and PLIF with an interbody cage is widely used. Theoretical advantages in favor of PLIF include anterior column support, indirect foraminal decompression, restoration of lordosis, and reduction of the slip via ligamentotaxis. Despite numerous publications, the scientific support for the PLIF method is, however, weak. A prospective study was carried out including 59 patients with degenerative spondylolisthesis. Average age of patients was 66 years: 34 males and 25 females. Patients were divided into 2 treatment groups: group 1-32 patients with PLIF with interbody graft and group 2-27 patients with PLIF with cage. Minimum 2-year follow-up. Outcomes were assessed by measuring preoperative and postoperative lordotic angles. SF-12 physical and mental health scores were recorded along with visual analogue scores for pain. Complications were also recorded. No significant difference in the postoperative lordotic angles was achieved between the 2 techniques. Nonsignificant difference in the clinical outcomes between both the techniques. We have found the use of a cage to achieve lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis does not confer any significant advantages in terms of restoration of lumbar lordosis, improvement in clinical symptoms, or relief of pain postoperatively.

  6. CHANGES IN RADIOGRAPHIC PARAMETERS AFTER MINIMALLY INVASIVE LUMBAR INTERBODY FUSION

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    Emiliano Vialle

    2015-12-01

    Full Text Available Objective : This study aims to evaluate changes in lumbosacral parameters after minimally invasive lumbar interbody fusion. The secondary aim was to evaluate whether interbody cage shape (crescent shaped or rectangular would influence the results. Method : Retrospective analysis of 70 patients who underwent one or two level lumbar interbody fusion through a minimally invasive posterolateral approach. This included midline preservation and unilateral facetectomy. Pre- and postoperative (three to six months postoperative radiographs were used for measuring lumbar lordosis (LL, segmental lordosis (SL at the level of interbody fusion, and sacral slope (SS. Further analyses divided the patients into Roussouly lumbar subgroups. Results : LL was significantly reduced after surgery (59o:39o, p=0.001 as well as the SS (33.8o:31.2o, p=0.05. SL did not change significantly (11.4:11.06, p=0.85. There were no significant differences when comparing patients who received crescent shaped cage (n=27 and rectangular cage (n=43. Hypolordotic patients (Roussouly types 1 and 2 had radiographic improvement in comparison to normolordotic and hyperlordotic groups (types 3 and 4. Conclusion : Minimally invasive lumbar interbody fusion caused reduction in lumbosacral parameters. Cage shape had no influence on the results.

  7. Comparing minimally invasive transforaminal lumbar interbody fusion and posterior lumbar interbody fusion for spondylolisthesis

    Science.gov (United States)

    Zhang, Dapeng; Mao, Keya; Qiang, Xiaojun

    2017-01-01

    Abstract Although spondylolisthesis was traditionally treated with posterior lumbar interbody fusion (PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) was recently proposed as an alternative treatment for spondylolisthesis. However, no studies have focused on the comparison of these 2 techniques’ outcome on spondylolisthesis. The operative reports and perioperative data of patients who underwent single-level primary open PLIF (n = 29) and MIS-TLIF (n = 26) for I/II spondylolisthesis were retrospectively evaluated. Patients’ demographics, operative blood loss, hospital length of stay, creatine kinase (CK) level, radiographic fusion, complications, and patient-reported outcomes were evaluated. Radiographic fusion was assessed using the Bridwell grading criteria. Preoperative and postoperative patient-reported outcomes included the visual analog scale (VAS) and Oswestry Disability Index (ODI). Average follow-up was 28 ± 3.6 months (range 24–32 months). Bed rest time, hospital stay, estimated blood loss, and operative time in the MIS-TLIF group were significantly lower than those in the PLIF group (P  .05). Compared with PLIF, MIS-TLIF for grade I/II spondylolisthesis can achieve similar reduction and fusion results with better short-term quality of life, shorter hospital stays, less estimated blood loss, and shorter operative times. PMID:28906383

  8. Cervical disc prosthesis replacement and interbody fusion — a comparative study

    Science.gov (United States)

    Yu–Hua, Jia

    2006-01-01

    The purpose of this paper is to compare the new functional intervertebral cervical disc prosthesis replacement and the classical interbody fusion operation, including the clinical effect and maintenance of the stability and segmental motion of cervical vertebrae. Twenty-four patients with single C5-6 intervertebral disk hernias were specifically selected and divided randomly into two groups: One group underwent artificial cervical disc replacement and the other group received interbody fusion. All patients were followed up and evaluated. The operation time for the single disc replacement was (130 ± 50) minutes and interbody fusion was (105 ± 53) minutes. Neurological or vascular complications were not observed during or after operation. There was no prosthesis subsidence or extrusion. The JOA score of the group with prosthesis replacement increased from an average of 8.6 to 15.8. The JOA score of the group with interbody fusion increased from an average of 9 to 16.2. The clinical effect and the ROM of the adjacent space of the two groups showed no statistical difference. The short follow-up time does not support the advantage of the cervical disc prosthesis. The clinical effect and the maintenance of the function of the motion of the intervertebral space are no better than the interbody fusion. At least 5 years of follow-up is needed to assess the long-term functionality of the prosthesis and the influence on adjacent levels. PMID:17180356

  9. Anterior Lumbar Interbody Implants: Importance of the Interdevice Distance

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    Brian R. Subach

    2011-01-01

    Full Text Available Object. The implantation of interbody fusion cages allows for the restoration of disc height and the enlargement of the neuroforaminal space. The purpose of this study was to compare the extent of subsidence occurring after conventional cage placement compared to a novel wider cage placement technique. Methods. This study is a retrospective evaluation of radiographs of patients who underwent stand-alone single level anterior lumbar interbody fusion with lordotic titanium cages and rhBMP-2. Fifty-three patients were evaluated: 39 patients had wide cage placement (6 mm interdevice distance and 14 had narrow cage placement (2 mm interdevice distance. Anterior and posterior intervertebral disc space heights were measured post-operatively and at follow-up imaging. Results. The decrease in anterior intervertebral disc space height was 2.05 mm versus 3.92 mm (<.005 and 1.08 mm versus 3.06 mm in posterior disc space height for the wide cage placement and the narrow cage placement respectively. The proportion of patients with subsidence greater than 2 mm was 41.0% in the wide cage patients and 85.7% for the narrow cage patients (<.005. Conclusions. The wider cage placement significantly reduced the amount of subsidence while allowing for a greater exposed surface area for interbody fusion.

  10. New cage for posterior minimally invasive lumbar interbody fusion: a study in vitro and in vivo.

    Science.gov (United States)

    Hong, Xin; Wu, Xiao-tao; Zhuang, Su-yang; Bao, Jun-ping; Shi, Rui

    2014-02-01

    To design a new type of interbody fusion device made of nickel titanium NiTi shape memory alloy and to compare segmental stiffness after various posterior lumbar interbody fusion (PLIF) procedures in vitro and in vivo. Twelve sheep lumbar functional spinal units were randomly allocated to four groups. One acted as controls (N); the other three were treated with autogenous iliac crest bone dowel graft (L), a threaded cylindrical titanium (KC) interbody fusion device (TFC) or a new type of interbody fusion device made of NiTi shape memory alloy (NT) containing autogenous iliac crest graft. In addition, 15 sheep were allocated to three groups; one served as controls and the other two underwent TFC (KC) or NiTi-FC (NT). Nondestructive mechanical tests were performed in pure compression, extension, lateral bending and torsion. The operated spines were photographed regularly to assess changes in interbody height and degree of fusion. The animals were killed at 6 months for histologic testing. Biomechanical tests showed both the strength and axial stiffness of the NT and KC groups were significantly higher than those of the control group and L group (P destructive load of the NiTi-TFC was 11 200 N and the safety coefficient was above 1.2. Radiological observations revealed that the bone callus around the interbody fusion device were gradually increased postoperatively (2 months, no obvious; 4 months, poorly define; 6 months, dense). The KC and NT group had lost 16% and 16.5% of their postoperative height but remained well above normal disc height (P < 0.05). Histologic examination showed new trabeculation connected with that of the host. The mechanical characteristics of the NiTi-TFC are excellent and it is safe and reliable. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  11. Plant single-cell and single-cell-type metabolomics.

    Science.gov (United States)

    Misra, Biswapriya B; Assmann, Sarah M; Chen, Sixue

    2014-10-01

    In conjunction with genomics, transcriptomics, and proteomics, plant metabolomics is providing large data sets that are paving the way towards a comprehensive and holistic understanding of plant growth, development, defense, and productivity. However, dilution effects from organ- and tissue-based sampling of metabolomes have limited our understanding of the intricate regulation of metabolic pathways and networks at the cellular level. Recent advances in metabolomics methodologies, along with the post-genomic expansion of bioinformatics knowledge and functional genomics tools, have allowed the gathering of enriched information on individual cells and single cell types. Here we review progress, current status, opportunities, and challenges presented by single cell-based metabolomics research in plants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion.

    Science.gov (United States)

    Marchi, Luis; Abdala, Nitamar; Oliveira, Leonardo; Amaral, Rodrigo; Coutinho, Etevaldo; Pimenta, Luiz

    2013-07-01

    Indirect decompression of the neural structures through interbody distraction and fusion in the lumbar spine is feasible, but cage subsidence may limit maintenance of the initial decompression. The influence of interbody cage size on subsidence and symptoms in minimally invasive lateral interbody fusion is heretofore unreported. The authors report the rate of cage subsidence after lateral interbody fusion, examine the clinical effects, and present a subsidence classification scale. The study was performed as an institutional review board-approved prospective, nonrandomized, comparative, single-center radiographic and clinical evaluation. Stand-alone short-segment (1- or 2-level) lateral lumbar interbody fusion was investigated with 12 months of postoperative follow-up. Two groups were compared. Forty-six patients underwent treatment at 61 lumbar levels with standard interbody cages (18 mm anterior/posterior dimension), and 28 patients underwent treatment at 37 lumbar levels with wide cages (22 mm). Standing lateral radiographs were used to measure segmental lumbar lordosis, disc height, and rate of subsidence. Subsidence was classified using the following scale: Grade 0, 0%-24% loss of postoperative disc height; Grade I, 25%-49%; Grade II, 50%-74%; and Grade III, 75%-100%. Fusion status was assessed on CT scanning, and pain and disability were assessed using the visual analog scale and Oswestry Disability Index. Complications and reoperations were recorded. Pain and disability improved similarly in both groups. While significant gains in segmental lumbar lordosis and disc height were observed overall, the standard group experienced less improvement due to the higher rate of interbody graft subsidence. A difference in the rate of subsidence between the groups was evident at 6 weeks (p = 0.027), 3 months (p = 0.042), and 12 months (p = 0.047). At 12 months, 70% in the standard group and 89% in the wide group had Grade 0 or I subsidence, and 30% in the standard group

  13. Evaluation of a polyetheretherketone (PEEK) titanium composite interbody spacer in an ovine lumbar interbody fusion model: biomechanical, microcomputed tomographic, and histologic analyses.

    Science.gov (United States)

    McGilvray, Kirk C; Waldorff, Erik I; Easley, Jeremiah; Seim, Howard B; Zhang, Nianli; Linovitz, Raymond J; Ryaby, James T; Puttlitz, Christian M

    2017-12-01

    The most commonly used materials used for interbody cages are titanium metal and polymer polyetheretherketone (PEEK). Both of these materials have demonstrated good biocompatibility. A major disadvantage associated with solid titanium cages is their radiopacity, limiting the postoperative monitoring of spinal fusion via standard imaging modalities. However, PEEK is radiolucent, allowing for a temporal assessment of the fusion mass by clinicians. On the other hand, PEEK is hydrophobic, which can limit bony ingrowth. Although both PEEK and titanium have demonstrated clinical success in obtaining a solid spinal fusion, innovations are being developed to improve fusion rates and to create stronger constructs using hybrid additive manufacturing approaches by incorporating both materials into a single interbody device. The purpose of this study was to examine the interbody fusion characteristic of a PEEK Titanium Composite (PTC) cage for use in lumbar fusion. Thirty-four mature female sheep underwent two-level (L 2 -L 3 and L 4 -L 5 ) interbody fusion using either a PEEK or a PTC cage (one of each per animal). Animals were sacrificed at 0, 8, 12, and 18 weeks post surgery. Post sacrifice, each surgically treated functional spinal unit underwent non-destructive kinematic testing, microcomputed tomography scanning, and histomorphometric analyses. Relative to the standard PEEK cages, the PTC constructs demonstrated significant reductions in ranges of motion and a significant increase in stiffness. These biomechanical findings were reinforced by the presence of significantly more bone at the fusion site as well as ingrowth into the porous end plates. Overall, the results indicate that PTC interbody devices could potentially lead to a more robust intervertebral fusion relative to a standard PEEK device in a clinical setting. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  14. Minimally invasive transforaminal lumbar interbody fusion with expandable versus static interbody devices: radiographic assessment of sagittal segmental and pelvic parameters.

    Science.gov (United States)

    Hawasli, Ammar H; Khalifeh, Jawad M; Chatrath, Ajay; Yarbrough, Chester K; Ray, Wilson Z

    2017-08-01

    OBJECTIVE Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been adopted as an alternative technique to hasten recovery and minimize postoperative morbidity. Advances in instrumentation technologies and operative techniques have evolved to maximize patient outcomes as well as radiographic results. The development of expandable interbody devices allows a surgeon to perform MIS-TLIF with minimal tissue disruption. However, sagittal segmental and pelvic radiographic outcomes after MIS-TLIF with expandable interbody devices are not well characterized. The object of this study is to evaluate the radiographic sagittal lumbar segmental and pelvic parameter outcomes of MIS-TLIF performed using an expandable interbody device. METHODS A retrospective review of MIS-TLIFs performed between 2014 and 2016 at a high-volume center was performed. Radiographic measurements were performed on lateral radiographs before and after MIS-TLIF with static or expandable interbody devices. Radiographic measurements included disc height, foraminal height, fused disc angle, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. Mismatch between pelvic incidence and lumbar lordosis were calculated for each radiograph. RESULTS A total of 48 MIS-TLIFs were performed, predominantly at the L4-5 level, in 44 patients. MIS-TLIF with an expandable interbody device led to a greater and more sustained increase in disc height when compared with static interbody devices. Foraminal height increased after MIS-TLIF with expandable but not with static interbody devices. MIS-TLIF with expandable interbody devices increased index-level segmental lordosis more than with static interbody devices. The increase in segmental lordosis was sustained in the patients with expandable interbody devices but not in patients with static interbody devices. For patients with a collapsed disc space, MIS-TLIF with an expandable interbody device provided superior and longer-lasting increases in

  15. Comparing minimally invasive transforaminal lumbar interbody fusion and posterior lumbar interbody fusion for spondylolisthesis: A STROBE-compliant observational study.

    Science.gov (United States)

    Zhang, Dapeng; Mao, Keya; Qiang, Xiaojun

    2017-09-01

    Although spondylolisthesis was traditionally treated with posterior lumbar interbody fusion (PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) was recently proposed as an alternative treatment for spondylolisthesis. However, no studies have focused on the comparison of these 2 techniques' outcome on spondylolisthesis.The operative reports and perioperative data of patients who underwent single-level primary open PLIF (n = 29) and MIS-TLIF (n = 26) for I/II spondylolisthesis were retrospectively evaluated. Patients' demographics, operative blood loss, hospital length of stay, creatine kinase (CK) level, radiographic fusion, complications, and patient-reported outcomes were evaluated. Radiographic fusion was assessed using the Bridwell grading criteria. Preoperative and postoperative patient-reported outcomes included the visual analog scale (VAS) and Oswestry Disability Index (ODI).Average follow-up was 28 ± 3.6 months (range 24-32 months). Bed rest time, hospital stay, estimated blood loss, and operative time in the MIS-TLIF group were significantly lower than those in the PLIF group (P  .05).Compared with PLIF, MIS-TLIF for grade I/II spondylolisthesis can achieve similar reduction and fusion results with better short-term quality of life, shorter hospital stays, less estimated blood loss, and shorter operative times.

  16. Current Status of Lumbar Interbody Fusion for Degenerative Spondylolisthesis

    Science.gov (United States)

    TAKAHASHI, Toshiyuki; HANAKITA, Junya; OHTAKE, Yasufumi; FUNAKOSHI, Yusuke; OICHI, Yuki; KAWAOKA, Taigo; WATANABE, Mizuki

    2016-01-01

    Instrumented lumbar fusion can provide immediate stability and assist in satisfactory arthrodesis in patients who have pain or instability of the lumbar spine. Lumbar adjunctive fusion with decompression is often a good procedure for surgical management of degenerative spondylolisthesis (DS). Among various lumbar fusion techniques, lumbar interbody fusion (LIF) has an advantage in that it maintains favorable lumbar alignment and provides successful fusion with the added effect of indirect decompression. This technique has been widely used and represents an advancement in spinal instrumentation, although the rationale and optimal type of LIF for DS remains controversial. We evaluated the current status and role of LIF in DS treatment, mainly as a means to augment instrumentation. We addressed the basic concept of LIF, its indications, and various types including minimally invasive techniques. It also has acceptable biomechanical features, and offers reconstruction with ideal lumbar alignment. Postsurgical adverse events related to each LIF technique are also addressed. PMID:27169496

  17. Mini-open transforaminal lumbar interbody fusion.

    Science.gov (United States)

    Tangviriyapaiboon, Teera

    2008-09-01

    To demonstrate the surgical technique and advantages of the mini-open transforaminal approach for lumbar interbody fusion (TLIF) combined with transpedicular screw fixation. Clinical and radiographic results were assessed to determine the clinical outcomes in twelve consecutive patients selected for minimally invasive access (mini-open technique) for TLIF in Prasat Neurological Institute. A retrospective analysis was performed on 12 patients (age range, 38-74 yr; mean, 54. 8 yr) who underwent mini-open transforaminal approach for lumbar interbody fusion (TLIF) combined with transpedicular screw fixation between September 2006 and June 2008. The titanium pedicle screws were introduced bilaterally through the 3.5 cm length, skin incisions with Spine Classics MLD- system retractor, autologous bone graft were inserted to perform TLIF in all patients. Eight patients were augmented anterior column support with titanium interbody cage, unilateral cage insertion in four patients and the others were inserted bilaterally interbody cages. Six patients presented with low back pain and associated radiculopathy, and six presented with low back pain only. Transforaminal lumbar interbody fusion was performed at L3-L4 in two patients, L4-L5 in four patients, L5-S1 in five patients, and two levels fusion in one patient. All patients were able to ambulate after spinal fusion. The patients were able to walk within 1.4 days (range 1-2 days). The hospital stay averaged 4.4 days (range 3-7 days). Periodic follow-up took place 1 to 21 months after surgery (mean, 7.4 months). The radiological fusion was archived in all nine patients who were operated on more than two months age. The other three patients who had been follow-up less than two months were probably fusion on the 1-month followed-up radiological examination. The use of mini-open technique for pedicle screw instrumentation with spinal fusion procedure provides excellent clinical results and may be an operation of choice for

  18. Simultaneous Lateral Interbody Fusion and Posterior Percutaneous Instrumentation: Early Experience and Technical Considerations

    Directory of Open Access Journals (Sweden)

    Doniel Drazin

    2015-01-01

    Full Text Available Lumbar fusion surgery involving lateral lumbar interbody graft insertion with posterior instrumentation is traditionally performed in two stages requiring repositioning. We describe a novel technique to complete the circumferential procedure simultaneously without patient repositioning. Twenty patients diagnosed with worsening back pain with/without radiculopathy who failed exhaustive conservative management were retrospectively reviewed. Ten patients with both procedures simultaneously from a single lateral approach and 10 control patients with lateral lumbar interbody fusion followed by repositioning and posterior percutaneous instrumentation were analyzed. Pars fractures, mobile grade 2 spondylolisthesis, and severe one-level degenerative disk disease were matched between the two groups. In the simultaneous group, avoiding repositioning leads to lower mean operative times: 130 minutes (versus control 190 minutes; p=0.009 and lower intraoperative blood loss: 108 mL (versus 93 mL; NS. Nonrepositioned patients were hospitalized for an average of 4.1 days (versus 3.8 days; NS. There was one complication in the control group requiring screw revision. Lateral interbody fusion and percutaneous posterior instrumentation are both readily accomplished in a single lateral decubitus position. In select patients with adequately sized pedicles, performing simultaneous procedures decreases operative time over sequential repositioning. Patient outcomes were excellent in the simultaneous group and comparable to procedures done sequentially.

  19. Minimally invasive transforaminal lumbar interbody fusion for spondylolisthesis and degenerative spondylosis: 5-year results.

    Science.gov (United States)

    Park, Yung; Ha, Joong Won; Lee, Yun Tae; Sung, Na Young

    2014-06-01

    Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. We determined (1) changes to the Oswestry Disability Index, (2) frequency of radiographic fusion, (3) complications and reoperations, and (4) the learning curve associated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. We reviewed our first 124 patients who underwent minimally invasive transforaminal lumbar interbody fusion to treat low-grade spondylolisthesis and degenerative lumbar diseases and did not need a major deformity correction. This represented 63% (124 of 198) of the transforaminal lumbar interbody fusion procedures we performed for those indications during the study period (2003-2007). Eighty-three (67%) patients had complete 5-year followup. Plain radiographs and CT scans were evaluated by two reviewers. Trends of surgical time, blood loss, and hospital stay over time were examined by logarithmic curve fit-regression analysis to evaluate the learning curve. At 5 years, mean Oswestry Disability Index improved from 60 points preoperatively to 24 points and 79 of 83 patients (95%) had improvement of greater than 10 points. At 5 years, 67 of 83 (81%) achieved radiographic fusion, including 64 of 72 patients (89%) who had single-level surgery. Perioperative complications occurred in 11 of 124 patients (9%), and another surgical procedure was performed in eight of 124 patients (6.5%) involving the index level and seven of 124 patients (5.6%) at adjacent levels. There were slowly decreasing trends of surgical time and hospital stay only in single-level surgery and almost no change in intraoperative blood loss over time, suggesting a challenging learning curve. Oswestry Disability Index scores improved for patients with spondylolisthesis

  20. Degenerative spondylolisthesis: contemporary review of the role of interbody fusion.

    Science.gov (United States)

    Baker, Joseph F; Errico, Thomas J; Kim, Yong; Razi, Afshin

    2017-02-01

    Degenerative spondylolisthesis is a common presentation, yet the best surgical treatment continues to be a matter of debate. Interbody fusion is one of a number of options, but its exact role remains ill defined. The aim of this study was to provide a contemporary review of the literature to help determine the role, if any, of interbody fusion in the surgical treatment of degenerative spondylolisthesis. A systematic review of the literature since 2005 was performed. Details on study size, patient age, surgical treatments, levels of slip, patient reported outcome measures, radiographic outcomes, complications and selected utility measures were recorded. Studies that compared a cohort treated with interbody fusion and at least one other surgical intervention for comparison were included for review. Only studies examining the effect in degenerative spondylolisthesis were included. Two authors independently reviewed the manuscripts and extracted key data. Thirteen studies were included in the final analysis. A total of 565 underwent interbody fusion and 761 underwent other procedures including decompression alone, interspinous stabilisation and posterolateral fusion with or without instrumentation. Most studies were graded Level III evidence. Heterogeneous reporting of outcomes prevented formal statistical analysis. However, in general, studies reviewed concluded no significant clinical or radiographic difference in outcome between interbody fusion and other treatments. Two small studies suggested interbody fusion is a better option in cases of definite instability. Interbody fusion only provided outcomes as good as instrumented posterolateral fusion. However, most studies were Level III, and hence, we remain limited in defining the exact role of interbody fusion-cases with clear instability appear to be most appropriate. Future work should use agreed-upon common outcome measures and definitions.

  1. Assessment and classification of subsidence after lateral interbody fusion using serial computed tomography.

    Science.gov (United States)

    Malham, Gregory M; Parker, Rhiannon M; Blecher, Carl M; Seex, Kevin A

    2015-07-24

    OBJECT Intervertebral cage settling during bone remodeling after lumbar lateral interbody fusion (LIF) is a common occurrence during the normal healing process. Progression of this settling with endplate collapse is defined as subsidence. The purposes of this study were to 1) assess the rate of subsidence after minimally invasive (MIS) LIF by CT, 2) distinguish between early cage subsidence (ECS) and delayed cage subsidence (DCS), 3) propose a descriptive method for classifying the types of subsidence, and 4) discuss techniques for mitigating the risk of subsidence after MIS LIF. METHODS A total of 128 consecutive patients (with 178 treated levels in total) underwent MIS LIF performed by a single surgeon. The subsidence was deemed to be ECS if it was evident on postoperative Day 2 CT images and was therefore the result of an intraoperative vertebral endplate injury and deemed DCS if it was detected on subsequent CT scans (≥ 6 months postoperatively). Endplate breaches were categorized as caudal (superior endplate) and/or cranial (inferior endplate), and as ipsilateral, contralateral, or bilateral with respect to the side of cage insertion. Subsidence seen in CT images (radiographic subsidence) was measured from the vertebral endplate to the caudal or cranial margin of the cage (in millimeters). Patient-reported outcome measures included visual analog scale, Oswestry Disability Index, and 36-Item Short Form Health Survey physical and mental component summary scores. RESULTS Four patients had ECS in a total of 4 levels. The radiographic subsidence (DCS) rates were 10% (13 of 128 patients) and 8% (14 of 178 levels), with 3% of patients (4 of 128) exhibiting clinical subsidence. In the DCS levels, 3 types of subsidence were evident on coronal and sagittal CT scans: Type 1, caudal contralateral, in 14% (2 of 14), Type 2, caudal bilateral with anterior cage tilt, in 64% (9 of 14), and Type 3, both endplates bilaterally, in 21% (3 of 14). The mean subsidence in the DCS

  2. Single bovine sperm sex typing by amelogenin nested PCR.

    Science.gov (United States)

    Colley, A; Buhr, M; Golovan, S P

    2008-10-01

    Sex-sorted bovine semen has become a valuable tool in animal production for sex preselection. Development of novel sperm sexing technologies, or evaluation of the quality of existing methods, often requires a single-sperm, sex-typing method that is reliable and easy to perform. In the present study, we report the development, validation, and application of a simple, reliable, and cost-effective method for single-sperm sex typing using nested polymerase chain reaction (PCR), based on the amelogenin gene. Several hundred single sperm were isolated using a simple manual technique, or a high-speed flow-sorter, and were successfully sex-typed using the amelogenin nested PCR. Based on the pooled results of individual sperm, there was no significant difference in the semen sex ratio of unsorted (44.6% X-sperm and 55.4% Y-sperm) or X/Y-sorted semen (91.4% X-sperm and 94.0% Y-sperm), as compared to the expected ratio in unsorted semen or the post-sorting reanalysis data, respectively. The amelogenin single-sperm sexing method was an adaptable, accurate, and reliable tool for single-sperm sex typing.

  3. Efficacy of Platelet-Rich Plasma for Bone Fusion in Transforaminal Lumbar Interbody Fusion.

    Science.gov (United States)

    Kubota, Go; Kamoda, Hiroto; Orita, Sumihisa; Inage, Kazuhidee; Ito, Michihiro; Yamashita, Masaomi; Furuya, Takeo; Akazawa, Tsutomu; Shiga, Yasuhiro; Ohtori, Seiji

    2018-02-01

    Retrospective case series. To examine the efficacy of platelet-rich plasma (PRP) for bone fusion in transforaminal lumbar interbody fusion (TLIF) using local bone grafting. Several authors have reported the efficacy of PRP for bone union in animal models. However, the use of PRP for bone fusion in TLIF surgery has not been fully explored. Twenty patients underwent single-level TLIF surgery because of L4 spondylolisthesis. An interbody fusion cage and local bone were used in nine patients (control group) and an interbody fusion cage, local bone, and PRP were used in 11 patients (PRP group). PRP was prepared from the patients' blood samples (400 mL) immediately before surgery. The duration of bone union and postoperative bone fusion rate were assessed using plain radiography at every 3 months postoperatively and computed tomography at 12 or 24 months postoperatively, respectively. Lower back pain, leg pain, and leg numbness were evaluated using the visual analog scale preoperatively and at 3, 6, 12, and 24 months postoperatively. The platelet count was 8.7 times higher in PRP than in blood. The bone union rate was significantly superior in the PRP group than in the control group (91% and 77%, respectively; p =0.035), whereas the average duration of bone union was not significantly different between the groups (7.7±0.74 and 10.0±2.00 months, respectively; p =0.131). There was no significant difference in lower back pain, leg pain, and leg numbness in both groups during follow-up ( p >0.05). Our study suggests that the use of PRP in TLIF surgery increases bone fusion rate.

  4. Single-cell LEP-type cavity on measurement stand

    CERN Multimedia

    CERN PhotoLab

    1982-01-01

    A single-cell cavity, made of copper, with tapered connectors for impedance measurements. It was used as a model of LEP-type superconducting cavities, to investigate impedance and higher-order modes and operated at around 600 MHz (the LEP acceleration frequency was 352.2 MHz). See 8202500.

  5. Origin of new Brassica types from a single intergeneric hybrid ...

    Indian Academy of Sciences (India)

    Origin of new Brassica types from a single intergeneric hybrid between B. rapa and Orychophragmus violaceus by rapid chromosome evolution and introgression ... The lines with high productivity showed not only a wide spectrum of phenotypes but also obvious variations in fatty acid profiles of seed oil and glucosinolate ...

  6. Biomechanical Analysis of an Expandable Lumbar Interbody Spacer.

    Science.gov (United States)

    Soriano-Baron, Hector; Newcomb, Anna G U S; Malhotra, Devika; Palma, Atilio E; Martinez-Del-Campo, Eduardo; Crawford, Neil R; Theodore, Nicholas; Kelly, Brian P; Kaibara, Taro

    2018-03-13

    Recently developed expandable interbody spacers are widely accepted in spinal surgery; however, the resulting biomechanical effects of their use have not yet been fully studied. We analyzed the biomechanical effects of an expandable polyetheretherketone interbody spacer inserted through a bilateral posterior approach with and without different modalities of posterior augmentation. Biomechanical nondestructive flexibility testing was performed in 7 human cadaveric lumbar (L2-L5) specimens followed by axial compressive loading. Each specimen was tested under 6 conditions: 1) intact, 2) bilateral L3-L4 cortical screw/rod (CSR) alone, 3) WaveD alone, 4) WaveD + CSR, 5) WaveD + bilateral L3-L4 pedicle screw/rod (PSR), and 6) WaveD + CSR/PSR, where CSR/PSR was a hybrid construct comprising bilateral cortical-level L3 and pedicle-level L4 screws interconnected by rods. The range of motion (ROM) with the interbody spacer alone decreased significantly compared with the intact condition during flexion-extension (P = 0.02) but not during lateral bending or axial rotation (P ≥ 0.19). The addition of CSR or PSR to the interbody spacer alone condition significantly decreased the ROM compared with the interbody spacer alone (P ≤ 0.002); and WaveD + CSR, WaveD + PSR, and WaveD + CSR/PSR (hybrid) (P ≥ 0.29) did not differ. The axial compressive stiffness (resistance to change in foraminal height during compressive loading) with the interbody spacer alone did not differ from the intact condition (P = 0.96), whereas WaveD + posterior instrumentation significantly increased compressive stiffness compared with the intact condition and the interbody spacer alone (P ≤ 0.001). The WaveD alone significantly reduced ROM during flexion-extension while maintaining the axial compressive stiffness. CSR, PSR, and CSR/PSR hybrid constructs were all effective in augmenting the expandable interbody spacer system and improving its stability. Copyright © 2018 Elsevier Inc. All

  7. Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion.

    Science.gov (United States)

    Le, Tien V; Baaj, Ali A; Dakwar, Elias; Burkett, Clinton J; Murray, Gisela; Smith, Donald A; Uribe, Juan S

    2012-06-15

    A retrospective review. The objective is to evaluate subsidence related to minimally invasive lateral retroperitoneal lumbar interbody fusion by reviewing our experience with this procedure. Polyetheretherketone intervertebral cages of different lengths, widths, and heights filled with various allograft types are commonly used as spacers in lumbar fusions. Subsidence is a potential complication. To date, there are no published reports specifically addressing subsidence, because it relates to a series of patients undergoing minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. An institutional review board-approved, retrospective review of a prospectively collected database was conducted. One hundred forty consecutive patients who underwent this procedure between L1 and L5 during a 2-year period were included. All patients had T scores of -2.5 or more. Postoperative radiographs during routine follow-ups were reviewed for subsidence, defined as any violation of the vertebral end plate. Radiographical subsidence occurred in 14.3% (20 of 140), whereas clinical subsidence occurred in 2.1%. Subsidence occurred in 8.8% (21 of 238) of levels fused. Construct length had a significant positive correlation with increasing subsidence rates. Subsidence rates decreased progressively with lower levels in the lumbar spine, but had a higher than expected rate at L4-L5. Subsidence rates of 14.1% (19 of 135) and 1.9% (2 of 103) were associated with 18-and 22-mm-wide cages, respectively. No significant trends were observed with cage lengths. Supplemental lateral plates had a higher rate of subsidence than bilateral pedicle screws. Subsidence occurred at the superior end plate 70% of the time. The use of wider intervertebral cages leads to a significantly lower rate of subsidence, but a longer cage does not necessarily offer a similar advantage. Wide cages are protective against subsidence, and the widest cages should be used whenever feasible for interbody

  8. Posterior lumber interbody fusion with pedicle screw fixation for the management of spondylolisthesis: An analysis of 40 cases

    Directory of Open Access Journals (Sweden)

    Md. Rezaul Amin

    2017-09-01

    Full Text Available Spondylolisthesis is forward slipping of upper vertebra in relations to its lower one, commonest is L4-L5. The ideal surgical treatment of spondylolisthesis is still controversial. Posterior lumber interbody fusion with pedicle fixation is one of treatment choices for the lumber spondylolisthesis. Forty patients who operated through posterior lumber interbody fusion and pedicle screw fixation by single surgeon was included from January 2012 to March 2015. Periodical follow-up was done both clinically and radiologically up to 6 months. Patient outcome was completed based on pain relief graphic rating scale and Oswestry disability index. In our series, the excellent outcome were 25 patients (62.5%, good were 12 patients (30%, and fair were 3 patients (7.5%. There were no poor outcome and no new neurological deficit. This study concludes that posterior lumber inter-body fusion with pedicle is an effective treatment for the lumber spondylolisthesis. It helps to maintain the biomechanics, associated with less complication and improve the quality of life of patient.

  9. Outcomes of autograft alone versus PEEK+ autograft interbody fusion in the treatment of adult lumbar isthmic spondylolisthesis.

    Science.gov (United States)

    Wang, Gang; Han, Dunfu; Cao, Zhenglin; Guan, Honggang; Xuan, Tianhang

    2017-04-01

    Bone resulting from a complete resection of the posterior arch can be cut into an autograft bone that contains the facet joint structure and morselised bone for interbody fusion. However, whether a strut autograft that contains this trimmed facet joint can produce the same clinical and radiographic outcomes as a cage for interbody fusion remains unclear. The aim of this study was to compare the outcomes of a local facet joint autograft alone to those of polyetheretherketone (PEEK)+autograft for posterior lumbar interbody fusion (PLIF) in the treatment of adult isthmic spondylolisthesis. A retrospective analysis was performed on 84 patients with single lumbar isthmic spondylolisthesis who were treated with a local facet joint autograft alone (group A; n=44) or PEEK+autograft (group B; n=40) in PLIF with a minimum follow-up period of 24 months. Pain and disability were assessed using the visual analogue scale, Oswestry disability index and Kirkaldy-Willis criteria. In the radiological evaluation, disc height, slippage reduction, and fusion status were examined. Postoperative complications were also monitored. At the last follow-up examination, 84.1% (37/44) of the patients in group A and 82.5% (33/40) of the patients in group B had a good outcome, and there were no significant differences between the two groups. Boh Methods led to significant improvements in disc height, and while PEEK+autograft produced a smaller loss in disc height, the difference was insignificant. The improvements in slippage and the fusion and complication rates between the two groups were similar. There were no significant differences in the clinical outcomes or radiographic improvements of both fusion methods in the treatment of adult isthmic spondylolisthesis. An autograft excised from a complete posterior arch containing a facet joint for interbody fusion is effective and affordable for treating isthmic spondylolisthesis. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Clinical Outcomes of Extreme Lateral Interbody Fusion in the Treatment of Adult Degenerative Scoliosis

    Directory of Open Access Journals (Sweden)

    Adam M. Caputo

    2012-01-01

    Full Text Available Introduction. The use of extreme lateral interbody fusion (XLIF and other lateral access surgery is rapidly increasing in popularity. However, limited data is available regarding its use in scoliosis surgery. The objective of this study was to evaluate the clinical outcomes of adults with degenerative lumbar scoliosis treated with XLIF. Methods. Thirty consecutive patients with adult degenerative scoliosis treated by a single surgeon at a major academic institution were followed for an average of 14.3 months. Interbody fusion was completed using the XLIF technique with supplemental posterior instrumentation. Validated clinical outcome scores were obtained on patients preoperatively and at most recent follow-up. Complications were recorded. Results. The study group demonstrated improvement in multiple clinical outcome scores. Oswestry Disability Index scores improved from 24.8 to 19.0 (P < 0.001. Short Form-12 scores improved, although the change was not significant. Visual analog scores for back pain decreased from 6.8 to 4.6 (P < 0.001 while scores for leg pain decreased from 5.4 to 2.8 (P < 0.001. A total of six minor complications (20% were recorded, and two patients (6.7% required additional surgery. Conclusions. Based on the significant improvement in validated clinical outcome scores, XLIF is effective in the treatment of adult degenerative scoliosis.

  11. Clinico-radiological profile of indirect neural decompression using cage or auto graft as interbody construct in posterior lumbar interbody fusion in spondylolisthesis: Which is better?

    Directory of Open Access Journals (Sweden)

    Q R Abdul

    2011-01-01

    Full Text Available Study design: A prospective clinical study of posterior lumbar interbody fusion in grade I and II degenerative spondylolisthesis was conducted between Mar 2007 and Aug 2008. Purpose: The objective was to assess the clinicoradiological profile of structural v/s nonstructural graft on intervertebral disc height and its consequences on the low back pain (LBP assessed by Visual analog score (VAS score and oswestry disability index (ODI . This study involved 28 patients. Inclusion criteria: Age of 30-70 years, symptomatic patient with disturbed Activities of daily living (ADL, single-level L4/L5 or L5/S1 grade I or grade II degenerative spondylolisthesis. Exclusion criteria: Patients with osteoporosis, recent spondylodiscitis, subchondral sclerosis, visual and cognitive impairment and all other types of spondylolisthesis. All the patients underwent short-segment posterior fixation using CD2 or M8 instrumentation, laminectomy discectomy, reduction and distraction of the involved vertebral space. In 53.5% (n = 15 of the patients, snugly fitted local bone chips were used while in 46.4% (n = 13 of the patients, cage was used. Among the cage group, titanium cage was used in nine (32.1% and PEEK cages were used in four (14.2% patients. In one patient, a unilateral PEEK cage was used. The mean follow-up period was 24 months. Among the 28 patients, 67.8% (n = 19 were females and 32.14% (n = 9 were males. 68.24% (n = 18 had L4/L5 and 35.71% (n = 10 had L5/S1 spondylolisthesis. 39.28% (n = 11 were of grade I and 60.71% (n = 17 were of grade II spondylolisthesis. Conclusions: There was a statistically significant correlation (P < 0.012 and P < 0.027 between the change in disc height achieved and the improvement in VAS score in both the graft group and the cage group. The increment in disc height and VAS score was significantly better in the cage group (2 mm ± SD vis-a-vis 7.2 [88%] than the graft group (1.2 mm ± SD vis-a-vis 5 [62 %].

  12. Intraoperative antepulsion of a posterior lumbar interbody fusion ...

    African Journals Online (AJOL)

    Spinal fusion surgery techniques develop together with technologic advancements. New complications are seen as the result of new techniques and these may be very severe due to spinal cord and vascular structures in the lumbar region. The posterior lumbar interbody fusion cage (PLIFC) was shown to enhance spinal ...

  13. Single cell transcriptional analysis reveals novel innate immune cell types

    Directory of Open Access Journals (Sweden)

    Linda E. Kippner

    2014-06-01

    Full Text Available Single-cell analysis has the potential to provide us with a host of new knowledge about biological systems, but it comes with the challenge of correctly interpreting the biological information. While emerging techniques have made it possible to measure inter-cellular variability at the transcriptome level, no consensus yet exists on the most appropriate method of data analysis of such single cell data. Methods for analysis of transcriptional data at the population level are well established but are not well suited to single cell analysis due to their dependence on population averages. In order to address this question, we have systematically tested combinations of methods for primary data analysis on single cell transcription data generated from two types of primary immune cells, neutrophils and T lymphocytes. Cells were obtained from healthy individuals, and single cell transcript expression data was obtained by a combination of single cell sorting and nanoscale quantitative real time PCR (qRT-PCR for markers of cell type, intracellular signaling, and immune functionality. Gene expression analysis was focused on hierarchical clustering to determine the existence of cellular subgroups within the populations. Nine combinations of criteria for data exclusion and normalization were tested and evaluated. Bimodality in gene expression indicated the presence of cellular subgroups which were also revealed by data clustering. We observed evidence for two clearly defined cellular subtypes in the neutrophil populations and at least two in the T lymphocyte populations. When normalizing the data by different methods, we observed varying outcomes with corresponding interpretations of the biological characteristics of the cell populations. Normalization of the data by linear standardization taking into account technical effects such as plate effects, resulted in interpretations that most closely matched biological expectations. Single cell transcription

  14. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF

    Science.gov (United States)

    Phan, Kevin; Malham, Greg; Seex, Kevin; Rao, Prashanth J.

    2015-01-01

    Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF). The indications may include: discogenic/facetogenic low back pain, neurogenic claudication, radiculopathy due to foraminal stenosis, lumbar degenerative spinal deformity including symptomatic spondylolisthesis and degenerative scoliosis. In general, traditional posterior approaches are frequently used with acceptable fusion rates and low complication rates, however they are limited by thecal sac and nerve root retraction, along with iatrogenic injury to the paraspinal musculature and disruption of the posterior tension band. Minimally invasive (MIS) posterior approaches have evolved in an attempt to reduce approach related complications. Anterior approaches avoid the spinal canal, cauda equina and nerve roots, however have issues with approach related abdominal and vascular complications. In addition, lateral and OLIF techniques have potential risks to the lumbar plexus and psoas muscle. The present study aims firstly to comprehensively review the available literature and evidence for different lumbar interbody fusion (LIF) techniques. Secondly, we propose a set of recommendations and guidelines

  15. Aluminum-rich mesoporous MFI - type zeolite single crystals

    DEFF Research Database (Denmark)

    Kustova, Marina; Kustov, Arkadii; Christensen, Christina Hviid

    2005-01-01

    are characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM), ammonia temperature programmed desorption (NH3-TPD), and N-2 adsorption measurements. The obtained zeolites combine the high crystallinity and the characteristic micropores of zeolites with an intracrystalline mesopore system....... With this technique, only zeolites with relatively low Al contents were reported (Si/Al ratio about 100). In this work, the preparation of aluminum-rich mesoporous MFI-type zeolite single crystals (Si/Al similar to 16-50) using aluminum isopropoxide as the aluminum Source is reported for the first time. All samples...

  16. Single electron transistor with P-type sidewall spacer gates.

    Science.gov (United States)

    Lee, Jung Han; Li, Dong Hua; Lee, Joung-Eob; Kang, Kwon-Chil; Kim, Kyungwan; Park, Byung-Gook

    2011-07-01

    A single-electron transistor (SET) is one of the promising solutions to overcome the scaling limit of the Metal-Oxide-Semiconductor Field Effect Transistor (MOSFET). Up to now, various kinds of SETs are being proposed and SETs with a dual gate (DG) structure using an electrical potential barrier have been demonstrated for room temperature operation. To operate DG-SETs, however, extra bias of side gates is necessary. It causes new problems that the electrode for side gates and the extra bias for electrical barrier increase the complexity in circuit design and operation power consumption, respectively. For the reason, a new mechanism using work function (WF) difference is applied to operate a SET at room temperature by three electrodes. Its structure consists of an undoped active region, a control gate, n-doped source/drain electrodes, and metal/silicide or p-type silicon side gates, and a SET with metal/silicide gates or p-type silicon gates forms tunnel barriers induced by work function between an undoped channel and grounded side gates. Via simulation, the effectiveness of the new mechanism is confirmed through various silicide materials that have different WF values. Furthermore, by considering the realistic conditions of the fabrication process, SET with p-type sidewall spacer gates was designed, and its brief fabrication process was introduced. The characteristics of its electrical barrier and the controllability of its control gate were also confirmed via simulation. Finally, a single-hole transistor with n-type sidewall spacer gates was designed.

  17. Stand-Alone Lateral Interbody Fusion for the Treatment of Low-Grade Degenerative Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Luis Marchi

    2012-01-01

    Full Text Available The purpose of this paper was to investigate the stand-alone lateral interbody fusion as a minimally invasive option for the treatment of low-grade degenerative spondylolisthesis with a minimum 24-month followup. Prospective nonrandomized observational single-center study. 52 consecutive patients (67.6±10 y/o; 73.1% female; 27.4±3.4 BMI with single-level grade I/II single-level degenerative spondylolisthesis without significant spine instability were included. Fusion procedures were performed as retroperitoneal lateral transpsoas interbody fusions without screw supplementation. The procedures were performed in average 73.2 minutes and with less than 50cc blood loss. VAS and Oswestry scores showed lasting improvements in clinical outcomes (60% and 54.5% change, resp.. The vertebral slippage was reduced in 90.4% of cases from mean values of 15.1% preoperatively to 7.4% at 6-week followup (P<0.001 and was maintained through 24 months (7.1%, P<0.001. Segmental lordosis (P<0.001 and disc height (P<0.001 were improved in postop evaluations. Cage subsidence occurred in 9/52 cases (17% and 7/52 cases (13% spine levels needed revision surgery. At the 24-month evaluation, solid fusion was observed in 86.5% of the levels treated. The minimally invasive lateral approach has been shown to be a safe and reproducible technique to treat low-grade degenerative spondylolisthesis.

  18. Comparison of rigid and semi-rigid instrumentation under acute load on vertebrae treated with posterior lumbar interbody fusion/transforaminal lumbar interbody fusion procedures: An experimental study.

    Science.gov (United States)

    Önen, Mehmet Reşid; Başgül, Cemile; Yılmaz, İlhan; Özkaya, Mustafa; Demir, Teyfik; Naderi, Sait

    2018-04-01

    Rigid and semi-rigid fixations are investigated several times in order to compare their biomechanical stability. Interbody fusion techniques are also preferable for maintaining the sagittal balance by protecting the disk height. In this study, the biomechanical comparison of semi-rigid and rigid fixations with posterior lumbar interbody fusion or transforaminal lumbar interbody fusion procedures is conducted under trauma. There were four different test groups to analyze the effect of acute load on treated ovine vertebrae. First and second groups were fixed with polyetheretherketone rods and transforaminal lumbar interbody fusion and posterior lumbar interbody fusion cages, respectively. Third and fourth groups were fixed with titanium rods and posterior lumbar interbody fusion and transforaminal lumbar interbody fusion cages, respectively. The drop tests were conducted with 7 kg weight. There were six samples in each group so the drop test repeated 24 times in total. The test samples were photographed and X-rayed (laterally and anteroposteriorly) before and after drop test. Two fractures were observed on group 1. Conversely, there were no fractures observed for group 2. There were no anterior element fractures for both groups 1 and 2. However, one fracture seen on group 3 was anterior element fracture, whereas the other three were posterior element fractures. All three fractures were anterior element fractures for group 4. Treated vertebrae with polyetheretherketone rods and posterior lumbar interbody fusion cages showed the best durability to the drop tests among the groups. Semi-rigid fixation gave better results than rigid fixation according to failed segments. Posterior lumbar interbody fusion cages seem to be better option for semi-rigid fixation, however mentioned surgical disadvantages must be considered.

  19. Ceramic granules enhanced with B2A peptide for lumbar interbody spine fusion: an experimental study using an instrumented model in sheep.

    Science.gov (United States)

    Cunningham, Bryan W; Atkinson, Brent L; Hu, Nianbin; Kikkawa, Jun; Jenis, Louis; Bryant, Joseph; Zamora, Paul O; McAfee, Paul C

    2009-04-01

    New generations of devices for spinal interbody fusion are expected to arise from the combined use of bioactive peptides and porous implants. The purpose of this dose-ranging study was to evaluate the fusion characteristics of porous ceramic granules (CGs) coated with the bioactive peptide B2A2-K-NS (B2A) by using a model of instrumented lumbar interbody spinal fusion in sheep. Instrumented spinal arthrodesis was performed in 40 operative sites in 20 adult sheep. In each animal, posterior instrumentation (pedicle screw and rod) and a polyetheretherketone cage were placed in 2 single-level procedures (L2-3 and L4-5). All cages were packed with graft material prior to implantation. The graft materials were prepared by mixing (1:1 vol/vol) CGs with or without a B2A coating and morselized autograft. Ceramic granules were coated with B2A at 50, 100, 300, and 600 microg/ml granules (50-B2A/CG, 100-B2A/CG, 300-B2A/CG, and 600-B2A/CG, respectively), resulting in 4 B2A-coated groups plus a control group (uncoated CGs). Graft material from each of these groups was implanted in 8 operative sites. Four months after arthrodesis, interbody fusion status was assessed with CT, and the interbody site was further evaluated with quantitative histomorphometry. All B2A/CG groups had higher CT-confirmed interbody fusion rates compared with those in controls (CGs only). Seven of 8 sites were fused in the 50-B2A/CG, 100-B2A/CG, and 300-B2A/CG groups, whereas 5 of 8 sites were fused in the group that had received uncoated CGs. New woven and lamellar bone spanned the fusion sites with excellent osseointegration. There was no heterotopic ossification or other untoward events attributed to the use of B2A/CG in any group. Each B2A/CG treatment produced more new bone than that in the CG group. Bioactive treatment with B2A effectively enhanced the fusion capacity of porous CGs. These findings suggest that B2A/CG may well represent a new generation of biomaterials for lumbar interbody fusion and

  20. Posterior lumbar interbody fusion for aged patients with degenerative spondylolisthesis: is intentional surgical reduction essential?

    Science.gov (United States)

    Lian, Xiao-Feng; Hou, Tie-Sheng; Xu, Jian-Guang; Zeng, Bing-Fang; Zhao, Jie; Liu, Xiao-Kang; Zhao, Cheng; Li, Hao

    2013-10-01

    Surgical reduction and posterior lumbar interbody fusion (PLIF) is commonly used to recover segmental imbalance in degenerative spondylolisthesis. However, whether intentional reduction of the slipped vertebra during PLIF is essential in aged patients with degenerative spondylolisthesis remains controversial. We compared the outcomes of surgical reduction and fusion in situ among aged patients who underwent PLIF for degenerative spondylolisthesis. A prospective randomized clinical trial on the surgical treatment of degenerative spondylolisthesis patients aged older than 70 years. Between January 2006 and December 2009, 73 patients aged 70 years or older with single-level degenerative spondylolisthesis requiring surgical treatment were included in this study. Clinical outcomes were assessed using the visual analog scale, Oswestry Disability Index, and Japanese Orthopedic Association scores. Radiographic outcomes included percentage of vertebral slippage, focal lordosis, and disc height. The 73 patients were randomly assigned to two groups treated using surgical reduction (Group A, n=36) and fusion in situ (Group B, n=37). Both groups were followed up for an average of 33.2 months (range, 24-54 months). The clinical and radiographic outcomes were compared between the two groups. Surgical complications were similar in the two groups. The average operative time and blood loss during surgery did not insignificantly differ (p>.05) between the two groups. Spondylolisthesis, disc height, and focal lordosis were significantly improved postoperatively in both groups. There was no obvious difference in clinical outcomes, as assessed using the visual analog scale, Oswestry Disability Index, and Japanese Orthopedic Association scores, although the radiographic outcomes were considerably better in Group A than in Group B. Posterior lumbar interbody fusion with pedicle screws fixation, with or without intraoperative reduction, provides good outcomes in the surgical treatment of

  1. Circumferential fusion: a comparative analysis between anterior lumbar interbody fusion with posterior pedicle screw fixation and transforaminal lumbar interbody fusion for L5-S1 isthmic spondylolisthesis.

    Science.gov (United States)

    Tye, Erik Y; Tanenbaum, Joseph E; Alonso, Andrea S; Xiao, Roy; Steinmetz, Michael P; Mroz, Thomas E; Savage, Jason W

    2018-03-01

    Transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion with percutaneous pedicle screws (ALIFPS) offer significantly higher radiographic fusion rates than other fusion techniques for L5-S1 isthmic spondylolisthesis (IS). As it stands, there is a relative paucity of comparative data of the two techniques. To define the clinical, radiographic, and financial differences between TLIF and ALIFPS for L5-S1 IS. A retrospective cohort study conducted at a single tertiary care center. Sixty-six patients who underwent either TLIF or ALIPFS for L5-S1 IS at a single tertiary care center between 2009 and 2014. Quality of life outcome scores including the EuroQol-5 Dimensions (EQ-5D), Pain Disability Questionnaire (PDQ), and Patient Health Questionnaire-9 (PHQ-9). Sagittal balance parameters including: pelvic incidence, pelvic tilt, sacral slope, segmental lordosis, total lordosis, degree of slip, disc height, and L1-axis S1 distance (LASD). Cost measures included in-hospital charges, hospital length of stay (LOS), and post-admission costs accrued over 1 year. Quality of life (QoL) outcome scores, radiographic data, and financial data were collected with a minimum of 1-year follow-up. Clinical results were investigated using the PDQ, PHQ-9, and EQ-5D. Radiographic measurements included lumbar lordosis, segmental lordosis, pelvic tilt, pelvic incidence, height of disc, L-1 axis S-1 distance, and the degree of slip. Cost data were generated based on patient-level resource utilization. Comparative data were presented as median with interquartile range (IQR). Continuous variables were compared using either independent Student t tests assuming unequal variance or Mann-Whitney U tests for parametric and nonparametric variables, respectively. The minimally clinical important difference (MCID) used for each questionnaire was as follows: PDQ (26), PHQ-9 (5), and EQ-5D (0.4). A total of 66 patients met inclusion criteria. In the ALIFPS cohort, PDQ scores

  2. Double-segment Wilhelm Tell technique for anterior lumbar interbody fusion in unstable isthmic spondylolisthesis and adjacent segment discopathy.

    Science.gov (United States)

    Wenger, Markus; Vogt, Emanuel; Markwalder, Thomas-Marc

    2006-02-01

    The Wilhelm Tell technique is a novel instrumented anterior lumbar interbody fusion (ALIF) procedure using a specially designed composite carbon fibre cage and a single short-threaded cancellous screw that obliquely passes through the upper adjacent vertebral body, the interbody cage itself and through the lower adjacent vertebral body. This single-stage fusion method, which is in principle a combination of the Louis technique and modern cage surgery, is reported to have a lower rate of pseudoarthrosis formation than stand-alone cage techniques. In addition, it eliminates both the surgical trauma of paravertebral muscle retraction and the risk of neural damage by poorly located pedicular screws. This anterior approach allows decompression of neural structures within the anterior part of the spinal canal and the foraminal region. It is the purpose of this case report, to present the successful application of this novel technique in a 32-year-old woman who concurrently suffered from severe instability-related back pain from L4/5 isthmic spondylolisthesis and marked L5/S1 degenerative disc disease.

  3. The Effect of Cervical Interbody Cage Morphology, Material Composition, and Substrate Density on Cage Subsidence.

    Science.gov (United States)

    Suh, Paul B; Puttlitz, Christian; Lewis, Chad; Bal, B Sonny; McGilvray, Kirk

    2017-02-01

    Interbody cages used in spinal fusion surgery can subside into the adjacent vertebral bodies after implantation, leading to loss of spinal height, malalignment, and possible radicular symptoms. Several factors may contribute to cage subsidence. This in vitro investigation examined the possible contribution of substrate density, cage contact area (ie, cage footprint), cage filling, cage end plate surface texture, and cage material composition on the magnitude of subsidence. Commercially available cervical interbody cages of two sizes (16 × 12 mm and 17 × 14 mm) were implanted between foam blocks of two different densities and were cyclically loaded. Cages were made of titanium alloy (Ti4Al6V), silicon nitride ceramic (Si3N4), or polyether ether ketone (n = 8 cages of each material type). Additional testing was performed on Si3N4 cages of the smaller size with nontextured surfaces and with filled cores. Subsidence measurements showed that lower foam density had the greatest influence on subsidence, followed by smaller cage footprint. Cage material had no effect on subsidence. In the additional testing of small-footprint Si3N4 cages, the cages in which the core was filled with a load-bearing porous material had less subsidence in lower-density foam than the cages with an empty core had, whereas cage end plate surface texture had no effect on subsidence. Ranking of the relative impact of these factors indicated that substrate density had the greatest contribution to the measured subsidence (approximately 1.7 times and approximately 67 times greater than the contributions of cage footprint area and material, respectively). The contribution of cage footprint area to subsidence was found to be 40 times greater than the contribution of cage material to subsidence.

  4. A STUDY OF POSTERIOR LUMBAR INTERBODY FUSION WITH LOCALLY HARVESTED SPINOLAMINECTOMY BONE GRAFT AND PEDICLE SCREW FIXATION IN SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Pardhasaradhi M

    2017-08-01

    Full Text Available BACKGROUND Posterior Lumbar Interbody Fusion (PLIF and Transforaminal Lumbar Interbody Fusion (TLIF create intervertebral fusion by means of a posterior approach. Successful results have been reported with allograft, various cages (for interbody support, autograft and recombinant human bone morphogenetic protein‐2. Interbody fusion techniques facilitate reduction and enhance fusion. Corticocancellous laminectomy bone chips alone can be used as a means of spinal fusion in patients with single level instrumented PLIF. This has got a good fusion rate. PLIF with cage gives better fusion on radiology than PLIF with iliac bone graft, but no statistical difference in the clinical outcome. Cage use precludes complications associated with iliac bone harvesting. The reported adjacent segment degeneration was 40.5% and reoperation was 8.1% after 10 years of follow up. MATERIALS AND METHODS 30 cases of spondylolisthesis who attended the Orthopaedic Outpatient Department of Andhra Medical College, Visakhapatnam, from 2014 to 2016 were taken up for study. All the cases were examined clinically and confirmed radiologically. The patient’s age, sex, symptoms and duration were noted and were examined clinically for the status of the spine. Straight leg raising test was done and neurological examination of the lower limbs performed. All the patients were subjected to the radiological examination of the lumbosacral spine by taking anteroposterior, lateral (flexion and extension views, oblique views to demonstrate spondylolysis and spondylolisthesis. MRI and x-rays studies were done in all the cases to facilitate evaluation of the root compression disk changes and spinal cord changes. RESULTS In our study, we followed all the 30 patients after the surgery following procedure of removal of loose lamina, spinous process and fibrocartilaginous mass, PLIF with only the laminectomy bone mass and CD screw system fixation up to 2 years. 12 patients (40% had excellent

  5. Extreme lateral interbody fusion with posterior instrumentation for spondylodiscitis.

    Science.gov (United States)

    Blizzard, Daniel J; Hills, Christopher P; Isaacs, Robert E; Brown, Christopher R

    2015-11-01

    The purpose of this study was to evaluate our initial experience utilizing extreme lateral interbody fusion (XLIF; NuVasive, San Diego, CA, USA) with percutaneous posterior instrumentation to treat 11 spondylodiscitis patients between January 2011 and February 2014. Although medical management is the first line treatment for spondylodiscitis, many patients fail antibiotic therapy and bracing, or present with instability, neurologic deficits, or sepsis, requiring operative debridement and stabilization. High rates of fusion and infection clearance have been reported with anterior lumbar interbody fusion (ALIF), but this approach requires a morbid exposure, associated with non-trivial rates of vascular and peritoneal complications. XLIF is an increasingly popular interbody fusion technique which utilizes a fast and minimally invasive approach, sparing the anterior longitudinal ligament, and allowing sufficient visualization of the intervertebral discs and bodies to debride and place a large, lordotic cage. The outcome measures for this study included lumbar lordosis, sagittal balance, subsidence, fusion, pain, neurological deficit, and microbiology/laboratory evidence of infection. The mean follow-up time was 9.3 months. All patients had improvements in pain and neurological symptoms. The mean lordosis change was 11.0°, from 23.1° preoperatively to 34.0° postoperatively. Fusion was confirmed with CT scans in five of six patients. At the last follow-up, all patients had normalization of inflammatory markers, no symptoms of infection, and none required repeat surgical treatment for spondylodiscitis. XLIF with percutaneous posterior instrumentation is a minimally invasive technique with reduced morbidity for lumbar spine fusion which affords adequate exposure to the vertebral bodies and discs to aggressively debride necrotic and infected tissue. This study suggests that XLIF may be a safe and effective alternative to ALIF for the treatment of spondylodiscitis

  6. A new bone surrogate model for testing interbody device subsidence.

    Science.gov (United States)

    Au, Anthony G; Aiyangar, Ameet K; Anderson, Paul A; Ploeg, Heidi-Lynn

    2011-07-15

    An in vitro biomechanical study investigating interbody device subsidence measures in synthetic vertebrae, polyurethane foam blocks, and human cadaveric vertebrae. To compare subsidence measures of bone surrogates with human vertebrae for interbody devices varying in size/placement. Bone surrogates are alternatives when human cadaveric vertebrae are unavailable. Synthetic vertebrae modeling cortices, endplates, and cancellous bone have been developed as an alternative to polyurethane foam blocks for testing interbody device subsidence. Indentors placed on the endplates of synthetic vertebrae, foam blocks, and human vertebrae were subjected to uniaxial compression. Subsidence, measured with custom-made extensometers, was evaluated for an indentor seated either centrally or peripherally on the endplate. Failure force and indentation stiffness were determined from force-displacement curves. Subsidence measures in human vertebrae varied with indentor placement: failure forces were higher and indentors subsided less with peripheral placement. Subsidence measures in foam blocks were insensitive to indentor size/placement; they were similar to human vertebrae for centrally placed but not for peripherally placed indentors. Although subsidence measures in synthetic vertebrae were sensitive to indentor size/placement, failure force and indentation stiffness were overestimated, and subsidence underestimated, for both centrally placed and peripherally placed indentors. The synthetic endplate correctly represented the human endplate geometry, and thus, failure force, stiffness, and subsidence in synthetic vertebrae were sensitive to indentor size/placement. However, the endplate was overly strong and thus synthetic vertebrae did not accurately model indentor subsidence in human cadaveric vertebrae. Foam blocks captured subsidence measures more accurately than synthetic vertebrae for centrally placed indentors, but because of their uniform density were not sufficiently robust to

  7. [Costotransversectomy and interbody fusion for treatment of thoracic dyscopathy].

    Science.gov (United States)

    Sagan, Leszek M; Madany, Lukasz; Lickendorf, Marek

    2007-01-01

    Surgical treatment of a thoracic discopathy comprises 4% of all surgeries performed for discopathy. Therefore, analysis of efficacy of particular operative methods used in that scope is limited. We present our analyze modification of costotransversectomy with policarbone cage interbody fusion as the contribution to discussion on optimal operative treatment of thoracic discopathy. Results of the operative treatment of 14 cases of a thoracic discopathy are analyzed. In 12 cases neurological examination revealed radiculopathy and in 2 cases upper motor neuron involvement. All patients underwent MRI for estimation of level and morphology of discopathy. In one case there was two-level dyscopathy and in the other cases there was one-level discopathy localized in the region between fifth and twelve thoracic vertebrae. The follow up period was of 10 months to 6 years (mean 2 years and four months). During the surgery lateral upper aspect of the intervertebral disc on a one side was exposed. It was accomplished by removal of the head of the rib and the upper aspect of the pedicle located caudally to the intervertebral disc. The policarbone cage was introduced into the intervertebral space after discectomy. In the case with sudden preoperative deterioration of the lower extremities strength there was further postoperative deterioration. During follow up, continuous improvement was observed. In the 12th postoperative month the weakness was minimal. In the other cases immediate postoperative resolution of the pain syndrome and neurological deficits was observed. Postoperative imaging studies reveled appropriate decompression of the spinal canal and localization interbody implant. 1. Costotransversectomy approach leads to sufficient exposition of the anterior aspect of the spinal canal. 2. Our modification of interbody fusion with policarbone cage gives good results in fusion of compromised motion unit. It makes the approach more attractive in the light of remote surgery

  8. Effects of Addition of Preoperative Intravenous Ibuprofen to Pregabalin on Postoperative Pain in Posterior Lumbar Interbody Fusion Surgery

    Directory of Open Access Journals (Sweden)

    Hüseyin Ulaş Pınar

    2017-01-01

    Full Text Available Objective. Ibuprofen and pregabalin both have independent positive effects on postoperative pain. The aim of the study is researching effect of 800 mg i.v. ibuprofen in addition to preoperative single dose pregabalin on postoperative analgesia and morphine consumption in posterior lumbar interbody fusion surgery. Materials and Methods. 42 adult ASA I-II physical status patients received 150 mg oral pregabalin 1 hour before surgery. Patients received either 250 ml saline with 800 mg i.v. ibuprofen or saline without ibuprofen 30 minutes prior to the surgery. Postoperative analgesia was obtained by morphine patient controlled analgesia (PCA and 1 g i.v. paracetamol every six hours. PCA morphine consumption was recorded and postoperative pain was evaluated by Visual Analog Scale (VAS in postoperative recovery room, at the 1st, 2nd, 4th, 8th, 12th, 24th, 36th, and 48th hours. Results. Postoperative pain was significantly lower in ibuprofen group in recovery room, at the 1st, 2nd, 36th, and 48th hours. Total morphine consumption was lower in ibuprofen group at the 2nd, 4th, 8th, 12th, and 48th hours. Conclusions. Multimodal analgesia with preoperative ibuprofen added to preoperative pregabalin safely decreases postoperative pain and total morphine consumption in patients having posterior lumbar interbody fusion surgery, without increasing incidences of bleeding or other side effects.

  9. Complex Dynamic Scene Perception: Effects of Attentional Set on Perceiving Single and Multiple Event Types

    Science.gov (United States)

    Sanocki, Thomas; Sulman, Noah

    2013-01-01

    Three experiments measured the efficiency of monitoring complex scenes composed of changing objects, or events. All events lasted about 4 s, but in a given block of trials, could be of a single type (single task) or of multiple types (multitask, with a total of four event types). Overall accuracy of detecting target events amid distractors was…

  10. Synthesis of single wall carbon nanotubes from a lamellar type ...

    Indian Academy of Sciences (India)

    Wintec

    These nanotubes are applicable to store more hydrogen. Keywords. AlPO4-L; single wall carbon nanotubes. 1. Introduction. Carbon nanotubes (Iijima 1991) are nano-scale structures formed by self assembly. They possess excellent chemical and physical properties (Rodney and Donald 1995; Chen et al 1998) that make ...

  11. Full HPV typing by a single restriction enzyme.

    Science.gov (United States)

    Santiago, Enrique; Camacho, Lucía; Junquera, Maria Luisa; Vázquez, Fernando

    2006-09-01

    Restriction fragment length polymorphism (RFLP) methods for genotyping genital human papillomavirus (HPV) are considered labor consuming and constrained by the reduced set of restriction enzymes capable of detecting specific mutations. However, we think that these methods have not taken full advantage of the high diversity of the known restriction enzymes. We have set out to find the best restriction enzyme for HPV typing. An extensive search for enzymes was carried out by combining statistical methods and database information. The search maximized the discrimination between high- and low-risk types by examining the sequence of the L1 gene flanked by primers MY09/11. Different electrophoretic resolutions and two variations of the RFLP method were considered. HpyCH4V is the best enzyme for discriminating between risk types. Moreover, HpyCH4V generates different patterns for virtually all the HPV types. The typical pattern consists of two or three fragments, which facilitates typing in mixed infections. The typing of a set of clinical samples confirmed the expectations. This result illustrates the possibilities of statistical methods to exploit the high diversity of restriction enzymes in order to classify samples in a pre-established hierarchy of types for which DNA sequences are known.

  12. Biomechanical analysis of lateral interbody fusion strategies for adjacent segment degeneration in the lumbar spine.

    Science.gov (United States)

    Metzger, Melodie F; Robinson, Samuel T; Maldonado, Ruben C; Rawlinson, Jeremy; Liu, John; Acosta, Frank L

    2017-07-01

    Surgical treatment of symptomatic adjacent segment disease (ASD) typically involves extension of previous instrumentation to include the newly affected level(s). Disruption of the incision site can present challenges and increases the risk of complication. Lateral-based interbody fusion techniques may provide a viable surgical alternative that avoids these risks. This study is the first to analyze the biomechanical effect of adding a lateral-based construct to an existing fusion. The study aimed to determine whether a minimally invasive lateral interbody device, with and without supplemental instrumentation, can effectively stabilize the rostral segment adjacent to a two-level fusion when compared with a traditional posterior revision approach. This is a cadaveric biomechanical study of lateral-based interbody strategies as add-on techniques to an existing fusion for the treatment of ASD. Twelve lumbosacral specimens were non-destructively loaded in flexion, extension, lateral bending, and torsion. Sequentially, the tested conditions were intact, two-level transforaminal lumbar interbody fusion (TLIF) (L3-L5), followed by lateral lumbar interbody fusion procedures at L2-L3 including interbody alone, a supplemental lateral plate, a supplemental spinous process plate, and then either cortical screw or pedicle screw fixation. A three-level TLIF was the final instrumented condition. In all conditions, three-dimensional kinematics were tracked and range of motion (ROM) was calculated for comparisons. Institutional funds (Spine. The addition of a lateral interbody device superadjacent to a two-level fusion significantly reduced motion in flexion, extension, and lateral bending (pfusion construct, demonstrating ROM comparable with a traditional three-level TLIF. The data presented suggest that a lateral-based interbody fusion supplemented with additional minimally invasive instrumentation may provide comparable stability with a traditional posterior revision approach

  13. Clinical outcomes of two minimally invasive transforaminal lumbar interbody fusion (TLIF) for lumbar degenerative diseases.

    Science.gov (United States)

    Tian, Yonghao; Liu, Xinyu

    2016-10-01

    There are two modified TLIF, including MIS-TLIF and TLIF through Wiltse approach (W-TLIF). Although both of the two minimally invasive surgical procedures can be effective in the treatment for lumbar degenerative diseases, no comparative analysis has been made so far regarding their clinical outcomes. To compare the clinical outcomes of MIS-TLIF and W-TLIF for the treatment for single-segment degenerative lumbar diseases. Ninety-seven patients with single-segment degenerative lumbar disorders were included in this study. Forty-seven underwent MIS-TLIF surgery (group A). For group B, fifty patients underwent W-TLIF. The Japanese Orthopedic Association (JOA) score, the visual analog scale (VAS) of low back pain (LBP) and leg pain, MRI score and atrophy rate of CSA, interbody fusion rate were assessed during the postoperative follow-up. Incision length, blood loss, operative time, CPK, and postoperative incision pain VAS were better in group A (P degenerative disease. MIS-TLIF has less blood loss, shorter surgical incision, and less lower postoperative back pain, while W-TLIF is less expensive for hospital stay with lower exposure to X-rays.

  14. Synthesis of single wall carbon nanotubes from a lamellar type ...

    Indian Academy of Sciences (India)

    Wintec

    circular disc of fine copper mesh covered with collodion. Images were taken using a JEOL JSM-2000 EX electron microscope operated at an acceleration voltage of 200 kV. 3. Results and discussion. Figure 1 shows the as-synthesized AlPO4-L which was found to be of short range ordered lamellar type molecular ...

  15. Development of n- and p-type Doped Perovskite Single Crystals Using Solid-State Single Crystal Growth (SSCG) Technique

    Science.gov (United States)

    2017-10-09

    tried. Among them “n- and p-type doped” BaTiO3 single crystals have been successfully fabricated . And their bi- crystals containing a twin or twist...boundary are also fabricated using diffusion bonding process of two single crystal plates. These results demonstrate that the SSCG (solid-state...or Bridgman method have critical limitations; high production cost and compositional inhomogeneity throughout the crystal. These limitations result

  16. Vertebral Body Hounsfield Units are Associated With Cage Subsidence After Transforaminal Lumbar Interbody Fusion With Unilateral Pedicle Screw Fixation.

    Science.gov (United States)

    Mi, Jie; Li, Kang; Zhao, Xin; Zhao, Chang-Qing; Li, Hua; Zhao, Jie

    2017-10-01

    To assess the association between Hounsfield units (HU) measurement and cage subsidence after lumbar interbody fusion. Transforaminal lumbar interbody fusion (TLIF) with unilateral fixation becomes a popular treatment modality for lumbar degenerative disease. Cage subsidence is a potentially devastating complication after lumbar interbody fusion with unilateral fixation. Recently, a new technique for assessing bone mineral density using HU values from computed tomography has been proposed. Bone quality is believed to be one of the important factors that cause cage subsidence after TLIF. Cage subsidence after single-level (L4/5) TLIF with unilateral fixation was prospectively documented at a single institution between 2013 and 2014. Patients with cage subsidence were matched 1:1 to a control cohort without cage subsidence on the basis of age and sex. HU values were measured from the preoperative computed tomography. All patients received computed tomographic scans at a minimum of 6 months postoperatively. Sagittal images were evaluated for evidence of cage subsidence. Eighteen patients with cage subsidence were well matched 1:1 to a cohort without cage subsidence and had complete imaging data. The global lumbar HU values were significantly lower in patients with cage subsidence than in the controls (112.4±10.08 vs. 140.2±10.17; P=0.0015). Similarly, a regional assessment of HU across the fusion levels was significantly lower in patients with cage subsidence (113.4±10.47 vs. 127.9±8.13; P=0.0075). The areas under the receiver operating characteristic cure were 0.715 and 0.636 for global and regional assessment, respectively. The best cut-offs for global and regional assessment were 132 (sensitivity: 83.3%; specificity: 61.1%) and 122 (sensitivity: 72.2%; specificity: 55.6%), respectively. Lower preoperative HU values is associated with cage subsidence after TLIF with unilateral fixation. HU measurement may be used as a predictor of cage subsidence after

  17. Analysis of Internet Information on Lateral Lumbar Interbody Fusion.

    Science.gov (United States)

    Belayneh, Rebekah; Mesfin, Addisu

    2016-07-01

    Lateral lumbar interbody fusion (LLIF) is a surgical technique that is being increasingly used. The authors' objective was to examine information on the Internet pertaining to the LLIF technique. An analysis was conducted of publicly accessible websites pertaining to LLIF. The following search engines were used: Google (www.google.com), Bing (www.bing.com), and Yahoo (www.yahoo.com). DuckDuckGo (www.duckduckgo.com) was an additional search engine used due to its emphasis on generating accurate and consistent results while protecting searchers' privacy and reducing advertisements. The top 35 websites providing information on LLIF from the 4 search engines were identified. A total of 140 websites were evaluated. Each web-site was categorized based on authorship (academic, private, medical industry, insurance company, other) and content of information. Using the search term lateral lumbar interbody fusion, 174,000 Google results, 112,000 Yahoo results, and 112,000 Bing results were obtained. DuckDuckGo does not display the number of results found for a search. From the top 140 websites collected from each website, 78 unique websites were identified. Websites were authored by a private medical group in 46.2% of the cases, an academic medical group in 26.9% of the cases, and the biomedical industry in 5.1% of the cases. Sixty-eight percent of websites reported indications, and 24.4% reported contraindications. Benefits of LLIF were reported by 69.2% of websites. Thirty-six percent of websites reported complications of LLIF. Overall, the quality of information regarding LLIF on the Internet is poor. Spine surgeons and spine societies can assist in improving the quality of the information on the Internet regarding LLIF. [Orthopedics. 2016; 39(4):e701-e707.]. Copyright 2016, SLACK Incorporated.

  18. Evaluation of hip flexion strength following lateral lumbar interbody fusion.

    Science.gov (United States)

    Lee, Yu-Po; Regev, Gilad J; Chan, Justin; Zhang, Bing; Taylor, William; Kim, Choll W; Garfin, Steven R

    2013-10-01

    Lateral interbody fusion (LIF) is a minimally invasive procedure that is designed to achieve a solid interbody fusion while minimizing the damage to the surrounding soft tissue. Although short-term results have been promising, few data have been published to date regarding its risks and complication rate. The aim was to evaluate the extent of injury to the psoas muscle after the LIF procedure by measuring hip flexion strength. A prospective case series was used in the study. Hip flexion strength was measured using a handheld digital dynamometer while the patient was seated on a chair; the examiner held the device against the patient's attempt to flex the hip. Both sides were measured to compare the operated and nonoperated psoas muscles. Each side was measured three times and the average amount (in pounds) was recorded. Measurements were done before and after surgery on Day 2-3, at 2 weeks, 6 weeks, and at 3 and 6 months. Thirty-three patients were recruited for this study. Mean preoperative hip flexion strength values were 20.7±3.47 lb and 21.3±4.31 lb for operated and nonoperated legs, respectively, with no significant difference (p=.85). With a mean of 11.2±2.24 lb postoperative measurements on Day 2, the operated side showed statistically significant reduction of strength (p=.0001). The nonoperated side was also weaker postoperatively, but not significantly (mean=19.12±1.74 lb; p=.097). From the first follow-up visit at 2 weeks, the values on the operated leg had returned to baseline values (20.6, p=.97) and were not significantly different from preoperative values on either side. Hip flexion was weakened immediately after the LIF procedure, which may be attributed to psoas muscle injury during the procedure. However, this damage was temporary, with almost complete return to baseline values by 2 weeks. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Lumbar sagittal contour after posterior interbody fusion: threaded devices alone versus vertical cages plus posterior instrumentation.

    Science.gov (United States)

    Klemme, W R; Owens, B D; Dhawan, A; Zeidman, S; Polly, D W

    2001-03-01

    An observational radiographic study examining lumbar sagittal contour of patients undergoing posterior interbody arthrodesis. To compare operative alterations of lumbar sagittal contour after posterior interbody fusion using threaded interbody devices alone versus vertical cages combined with posterior compression instrumentation. Technique-related alterations of lumbar sagittal contour during interbody arthrodesis have received little attention in the spinal literature. Standing lumbar radiographs were measured for preoperative and postoperative segmental lordosis at levels undergoing posterior interbody arthrodesis using either stand-alone side-by-side threaded devices or vertical cages combined with posterior transpedicular compression instrumentation. Sagittal plane segmental correction (or loss of correction) was calculated and statistically compared. The radiographs of 30 patients (34 spinal segments) undergoing lumbar or lumbosacral arthrodesis were compared. Seventeen patients (18 segments) had undergone interbody fusion using threaded cages,whereas 13 patients (16 segments) underwent fusion using vertically oriented mesh cages combined with posterior compression instrumentation. Preoperative segmental lordosis averaged 8 degrees for both groups. For patients undergoing fusion with threaded cages, there was a mean lordotic loss of 3 degrees/segment. For patients undergoing fusion with vertically oriented mesh cages combined with posterior compression instrumentation,there was a mean lordotic gain of 5 degrees/segment. This difference in segmental sagittal plane contour was highly significant (P = 0.00). Threaded fusion devices placed under interbody distraction with the endplates parallel fail to preserve or reestablish segmental lordosis. Vertical cages, however, when combined with posterior compression instrumentation, not only maintain segmental lordosis, but also can correct sagittal plane deformity.

  20. Standard versus Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Randomized Study

    Directory of Open Access Journals (Sweden)

    Daniel Serban

    2017-01-01

    Full Text Available Symptomatic spondylolisthesis patients may benefit from surgical decompression and stabilization. The standard (S technique is a transforaminal lumbar interbody fusion (TLIF. Newer, minimally invasive (MI techniques seem to provide similar results with less morbidity. We enrolled patients with at least 6 months of symptoms and image-confirmed low-grade spondylolisthesis, at a single academic institution, between 2011 and 2015. The patients were randomized to either S or MI TLIF. The primary outcome measure was the Oswestry Disability Index (ODI improvement at 1 year. Secondary outcome measures included length of operation, estimated blood loss, length of hospitalization, and fusion rates at 1 year. Forty patients were enrolled in each group. The differences in mean operative time and estimated blood loss were not statistically significant between the two groups. The patients were discharged after surgery at 4.12 days for the S TLIF group and 1.92 days for the MI TLIF group. The ODI improvement was similar and statistically significant in both groups. The fusion was considered solid in 36 (90% of patients at 1 year in both groups. In conclusion, the two techniques provided similar clinical and radiological outcomes at 1 year. The patients undergoing MI TLIF had a shorter hospital stay. This trial is registered with NCT03155789.

  1. Accidental Durotomy in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Frequency, Risk Factors, and Management

    Directory of Open Access Journals (Sweden)

    Jan-Helge Klingler

    2015-01-01

    Full Text Available Purpose. To assess the frequency, risk factors, and management of accidental durotomy in minimally invasive transforaminal lumbar interbody fusion (MIS TLIF. Methods. This single-center study retrospectively investigates 372 patients who underwent MIS TLIF and were mobilized within 24 hours after surgery. The frequency of accidental durotomies, intraoperative closure technique, body mass index, and history of previous surgery was recorded. Results. We identified 32 accidental durotomies in 514 MIS TLIF levels (6.2%. Analysis showed a statistically significant relation of accidental durotomies to overweight patients (body mass index ≥25 kg/m2; P=0.0493. Patient age older than 65 years tended to be a positive predictor for accidental durotomies (P=0.0657. Mobilizing patients on the first postoperative day, we observed no durotomy-associated complications. Conclusions. The frequency of accidental durotomies in MIS TLIF is low, with overweight being a risk factor for accidental durotomies. The minimally invasive approach seems to minimize durotomy-associated complications (CSF leakage, pseudomeningocele because of the limited dead space in the soft tissue. Patients with accidental durotomy can usually be mobilized within 24 hours after MIS TLIF without increased risk. The minimally invasive TLIF technique might thus be beneficial in the prevention of postoperative immobilization-associated complications such as venous thromboembolism. This trial is registered with DRKS00006135.

  2. Subsidence after anterior cervical inter-body fusion. A randomized prospective clinical trial.

    Science.gov (United States)

    Kast, Erich; Derakhshani, Sharam; Bothmann, Matthias; Oberle, Joachim

    2009-04-01

    In ventral fusion after anterior cervical discectomy there is still a remarkable number of cage subsidence and segmental kyphosis seen. The aim of the present study is to assess whether the cage design influences the extent of correction loss during follow-up. Sixty patients with single-level cervical disc herniation were randomly treated with two different cervical inter-body cages (group 1: Solis cage, Stryker Company and group 2: Shell cage, AMT Company). Clinical and radiological follow-up was done before and after surgery, 3 and 6 months post-surgery. Clinical follow-up was done with the help of Odom's criteria. Both groups were similar in the baseline parameters (age, sex, treated level). Statistically, the subsidence was significantly higher at 3 and 6-month follow-ups in group 1 than in group 2, however, clinical results showed no significant differences. In 67%, subsidence was seen in the anterior lower aspect of the treated segment. Segmental kyphosis was seen in seven patients of group 1 and two patients of group 2. A significant correlation is found between Odom's criteria and subsidence. Although there was no significant difference in a short-term clinical result between the two treatment groups, we recommend the use of cages which preserve the determined segmental height and lordosis.

  3. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion

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    Xiaofeng Lian

    2016-01-01

    Full Text Available Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF. Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years. We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. “Total navigation” (complete intraoperative 3D navigation without fluoroscopy can be achieved by combining Airo navigation with navigated guide tubes for screw placement.

  4. Stand-alone anterior lumbar interbody fusion for treatment of degenerative spondylolisthesis.

    Science.gov (United States)

    Rao, Prashanth J; Ghent, Finn; Phan, Kevin; Lee, Keegan; Reddy, Rajesh; Mobbs, Ralph J

    2015-10-01

    We sought to evaluate the clinical and radiologic efficacy of stand-alone anterior lumbar interbody fusion (ALIF) for low grade degenerative spondylolisthesis, the favoured surgical management approach at our institution. The optimal approach for surgical management of spondylolisthesis remains contentious. We performed a prospective analysis of all consecutive patients with low grade lumbar spondylolisthesis who underwent ALIF between 2009 and 2013 by a single surgeon (n=27). The mean age was 64.9 years with a male to female ratio of 14:13. There were 32 levels operated and the average preoperative spondylolisthesis was 14.8%, which reduced to 6.4% postoperatively and 9.4% at the latest follow-up (p=0001). Postoperative disc height was increased to 175% of preoperative values and was statistically significant (pspondylolisthesis reduction (p=0.04) and the only clinical factor affecting reduction was body mass index (p=0.04). The present study provides encouraging short term results for stand-alone ALIF as a procedure for low grade lumbar degenerative spondylolisthesis. Future studies should include adequately powered, prospective, multicentre registry studies with long term follow-up to allow a better assessment of the relative benefits and risks. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Radiation exposure during the lateral lumbar interbody fusion procedure and techniques to reduce radiation dosage.

    Science.gov (United States)

    Tatsumi, Robert L

    2012-01-01

    Fluoroscopy is widely used in spine surgery to assist with graft and hardware placement. Previous studies have not measured radiation exposure to a surgeon during minimally invasive lateral lumbar spine surgery for single-level discectomy and interbody cage insertion. This study was performed to model and measure radiation exposure to a surgeon during spine surgery using the direct lateral lumbar procedure. The study was performed using a mannequin substituting for the surgeon and a cadaver substituting for the patient. Radiation was measured with dosimeters attached to 6 locations on the mannequin using a OEC Medical Systems 9800 C-arm fluoroscope (OEC Medical Systems, Salt Lake City, Utah). Three different fluoroscopy setups were tested: a standard imaging setup, a standard setup using pulsed-mode fluoroscopy, and a reversed setup. The experiment was tested 5 times per setup, and the dosimeters' values were recorded. The highest amount of radiation exposure occurred when obtaining an anteroposterior view of the spine in the standard setup. Compared with the standard setup, the pulsed-mode setting decreased the radiation exposure to the mannequin by a factor of 6 times (P exposure to the mannequin by a factor of 6 times (P exposure to the eye level (P exposure. Radiation exposure to the surgeon can be greatly minimized by using either a pulsed imaging mode or the reversed setup. The reversed setup has the lowest amount of radiation exposure to the eye level.

  6. The European multicenter trial on the safety and efficacy of guided oblique lumbar interbody fusion (GO-LIF

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    Birkenmaier Christof

    2010-09-01

    Full Text Available Abstract Background Because of the implant-related problems with pedicle screw-based spinal instrumentations, other types of fixation have been tried in spinal arthrodesis. One such technique is the direct trans-pedicular, trans-discal screw fixation, pioneered by Grob for spondylolisthesis. The newly developed GO-LIF procedure expands the scope of the Grob technique in several important ways and adds security by means of robotic-assisted navigation. This is the first clinical trial on the GO-LIF procedure and it will assess safety and efficacy. Methods/Design Multicentric prospective study with n = 40 patients to undergo single level instrumented spinal arthrodesis of the lumbar or the lumbosacral spine, based on a diagnosis of: painful disc degeneration, painful erosive osteochondrosis, segmental instability, recurrent disc herniation, spinal canal stenosis or foraminal stenosis. The primary target criteria with regards to safety are: The number, severity and cause of intra- and perioperative complications. The number of significant penetrations of the cortical layer of the vertebral body by the implant as recognized on postoperative CT. The primary target parameters with regards to feasibility are: Performance of the procedure according to the preoperative plan. The planned follow-up is 12 months and the following scores will be evaluated as secondary target parameters with regards to clinical improvement: VAS back pain, VAS leg pain, Oswestry Disability Index, short form - 12 health questionnaire and the Swiss spinal stenosis questionnaire for patients with spinal claudication. The secondary parameters with regards to construct stability are visible fusion or lack thereof and signs of implant loosening, implant migration or pseudarthrosis on plain and functional radiographs. Discussion This trial will for the first time assess the safety and efficacy of guided oblique lumbar interbody fusion. There is no control group, but the results, the

  7. Effects of Strontium Ranelate on Spinal Interbody Fusion Surgery in an Osteoporotic Rat Model.

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    Tsung-Ting Tsai

    Full Text Available Osteoporosis is a bone disease that afflicts millions of people around the world, and a variety of spinal integrity issues, such as degenerative spinal stenosis and spondylolisthesis, are frequently concomitant with osteoporosis and are sometimes treated with spinal interbody fusion surgery. Previous studies have demonstrated the efficacy of strontium ranelate (SrR treatment of osteoporosis in improving bone strength, promoting bone remodeling, and reducing the risk of fractures, but its effects on interbody fusion surgery have not been adequately investigated. SrR-treated rats subjected to interbody fusion surgery exhibited significantly higher lumbar vertebral bone mineral density after 12 weeks of treatment than rats subjected to the same surgery but not treated with SrR. Furthermore, histological and radiographic assessments showed that a greater amount of newly formed bone tissue was present and that better fusion union occurred in the SrR-treated rats than in the untreated rats. Taken together, these results show significant differences in bone mineral density, PINP level, histological score, SrR content and mechanical testing, which demonstrate a relatively moderate effect of SrR treatment on bone strength and remodeling in the specific context of recovery after an interbody fusion surgery, and suggest the potential of SrR treatment as an effective adjunct to spinal interbody fusion surgery for human patients.

  8. Single Microwave-Photon Detector using an Artificial Lambda-type Three-Level System

    Science.gov (United States)

    2016-01-11

    Single microwave -photon detector using an artificial Λ-type three-level system Kunihiro Inomata,1∗†, Zhirong Lin,1†, Kazuki Koshino,2, William D...are those of the author and are not necessarily endorsed by the United States Government. Single microwave -photon detector using an artificial Λ-type...in both the optical and the microwave domains. However, the energy of mi- crowave quanta are four to five orders of magnitude less than their optical

  9. Estimating Intervention Effects across Different Types of Single-Subject Experimental Designs: Empirical Illustration

    Science.gov (United States)

    Moeyaert, Mariola; Ugille, Maaike; Ferron, John M.; Onghena, Patrick; Heyvaert, Mieke; Beretvas, S. Natasha; Van den Noortgate, Wim

    2015-01-01

    The purpose of this study is to illustrate the multilevel meta-analysis of results from single-subject experimental designs of different types, including AB phase designs, multiple-baseline designs, ABAB reversal designs, and alternating treatment designs. Current methodological work on the meta-analysis of single-subject experimental designs…

  10. Miniopen Oblique Lateral L5-S1 Interbody Fusion: A Report of 2 Cases

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    Keijiro Kanno

    2014-01-01

    Full Text Available Extreme lateral interbody fusion (XLIF has been widely used for minimally invasive anterior lumbar interbody fusion (ALIF, but an approach to L5-S1 is difficult because of the iliac crest. In the current study, we present 2 cases using minimally invasive oblique lateral interbody fusion (OLIF of L5-S1. The patients showed foraminal stenosis between L5 and S1 and severe low back and leg pain. The patients were placed in a lateral decubitus position and underwent OLIF surgery (using a cage and bone graft from the iliac crest without posterior decompression. Posterior screws were used in the patients. Pain scores significantly improved after surgery. There was no spinal nerve, major vessel, peritoneal, or urinary injury. OLIF surgery was minimally invasive and produced good surgical results without complications.

  11. Segmental stability and compressive strength of posterior lumbar interbody fusion implants.

    Science.gov (United States)

    Tsantrizos, A; Baramki, H G; Zeidman, S; Steffen, T

    2000-08-01

    Human cadaveric study on initial segmental stability and compressive strength of posterior lumbar interbody fusion implants. To compare the initial segmental stability and compressive strength of a posterior lumbar interbody fusion construct using a new cortical bone spacer machined from allograft to that of titanium threaded and nonthreaded posterior lumbar interbody fusion cages, tested as stand-alone and with supplemental pedicle screw fixation. Cages were introduced to overcome the limitations of conventional allografts. Radiodense cage materials impede radiographic assessment of the fusion, however, and may cause stress shielding of the graft. Multisegmental specimens were tested intact, with posterior lumbar interbody fusion implants inserted into the L4/L5 interbody space and with supplemental pedicle screw fixation. Three posterior lumbar interbody fusion implant constructs (Ray Threaded Fusion Cage, Contact Fusion Cage, and PLIF Allograft Spacer) were tested nondestructively in axial rotation, flexion-extension, and lateral bending. The implant-specimen constructs then were isolated and compressed to failure. Changes in the neutral zone, range of motion, yield strength, and ultimate compressive strength were analyzed. None of the stand-alone implant constructs reduced the neutral zone. Supplemental pedicle screw fixation decreased the neutral zone in flexion-extension and lateral bending. Stand-alone implant constructs decreased the range of motion in flexion and lateral bending. Differences in the range of motion between stand-alone cage constructs were found in flexion and extension (marginally significant). Supplemental posterior fixation further decreased the range of motion in all loading directions with no differences between implant constructs. The Contact Fusion Cage and PLIF Allograft Spacer constructs had a higher ultimate compressive strength than the Ray Threaded Fusion Cage. The biomechanical data did not suggest any implant construct to

  12. Repeated adjacent-segment degeneration after posterior lumbar interbody fusion.

    Science.gov (United States)

    Okuda, Shinya; Oda, Takenori; Yamasaki, Ryoji; Maeno, Takafumi; Iwasaki, Motoki

    2014-05-01

    One of the most important sequelae affecting long-term results is adjacent-segment degeneration (ASD) after posterior lumbar interbody fusion (PLIF). Although several reports have described the incidence rate, there have been no reports of repeated ASD. The purpose of this report was to describe 1 case of repeated ASD after PLIF. A 62-year-old woman with L-4 degenerative spondylolisthesis underwent PLIF at L4-5. At the second operation, L3-4 PLIF was performed for L-3 degenerative spondylolisthesis 6 years after the primary operation. At the third operation, L2-3 PLIF was performed for L-2 degenerative spondylolisthesis 1.5 years after the primary operation. Vertebral collapse of L-1 was detected 1 year after the third operation, and the collapse had progressed. At the fourth operation, 3 years after the third operation, vertebral column resection of L-1 and replacement of titanium mesh cages with pedicle screw fixation between T-4 and L-5 was performed. Although the patient's symptoms resolved after each operation, the time between surgeries shortened. The sacral slope decreased gradually although each PLIF achieved local lordosis at the fused segment.

  13. Transforaminal lumbar interbody fusion using one diagonal fusion cage with unilateral pedicle screw fixation for treatment of massive lumbar disc herniation.

    Science.gov (United States)

    Zhao, Chang-Qing; Ding, Wei; Zhang, Kai; Zhao, Jie

    2016-09-01

    Large lumbar or lumbosacral (LS) disc herniations usually expand from the paramedian space to the neuroforamen and compress both the transversing (lower) and the exiting (upper) nerve roots, thus leading to bi-radicular symptoms. Bi-radicular involvement is a statistically significant risk factor for poor outcome in patients presenting with far lateral or foraminal disc herniation after facet preserving microdecompression. There is evidence showing that patients suffering from large lumbar disc herniations treated with interbody fusion have significant superior results in comparison with those who received a simple discectomy. We report our experiences on managing large LS disc herniation with bi-radicular symptoms by transforaminal lumbar interbody fusion (TLIF) using one diagonal fusion cage with unilateral pedicle screw/rod fixation. Twenty-three patients who suffered from single level lumbar or LS disc herniation with bi-radicular symptoms treated with unilateral decompression and TLIF using one diagonal fusion cage with ipsilateral pedicle screw/rod fixation operated between January 2005 and December 2009, were included in this study. Operation time and blood loss were recorded. The pain and disability status were pre- and postoperatively evaluated by the visual analog score (VAS) and Oswestry Disability Index (ODI). Interbody bony fusion was detected by routine radiographs and computed tomography scan. Adjacent segment degeneration was detected by routine radiographs and magnetic resonance imaging examination. Overall outcomes were categorized according to modified Macnab classification. The patients were followed up for an average of 44.7 months. Pain relief in the VAS and improvement of the ODI were significant after surgery and at final followup. No severe complications occurred during hospital stay. Interbody bony fusion was achieved in every case. No cage retropulsion was observed, while 3 cases experienced cage subsidence. Adjacent segment degeneration

  14. The NEtherlands Cervical Kinematics (NECK Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomised multicenter study

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    van den Akker Elske

    2010-06-01

    Full Text Available Abstract Background Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc degeneration. A comparative cost-effectiveness study focused on adjacent segment degeneration and functional outcome has not been performed yet. We present the design of the NECK trial, a randomised study on cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in patients with cervical disc herniation. Methods/Design Patients (age 18-65 years presenting with radicular signs due to single level cervical disc herniation lasting more than 8 weeks are included. Patients will be randomised into 3 groups: anterior discectomy only, anterior discectomy with interbody fusion, and anterior discectomy with disc prosthesis. The primary outcome measure is symptomatic adjacent disc degeneration at 2 and 5 years after surgery. Other outcome parameters will be the Neck Disability Index, perceived recovery, arm and neck pain, complications, re-operations, quality of life, job satisfaction, anxiety and depression assessment, medical consumption, absenteeism, and costs. The study is a randomised prospective multicenter trial, in which 3 surgical techniques are compared in a parallel group design. Patients and research nurses will be kept blinded of the allocated treatment for 2 years. The follow-up period is 5 years. Discussion Currently, anterior cervical discectomy with fusion is the golden standard in the surgical treatment of cervical disc herniation. Whether additional interbody fusion or disc prothesis is necessary and cost-effective will be determined by this trial

  15. Rapid single step subcloning procedure by combined action of type II and type IIs endonucleases with ligase

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    Klingenspor Martin

    2007-11-01

    Full Text Available Abstract Background The subcloning of a DNA fragment from an entry vector into a destination vector is a routinely performed task in molecular biology labs. Results We here present a novel benchtop procedure to achieve rapid recombination into any destination vector of choice with the sole requirement of an endonuclease recognition site. The method relies on a specifically designed entry vector and the combined action of type II and type IIs endonucleases with ligase. The formulation leads to accumulation of a single stable cloning product representing the desired insert carrying destination vector. Conclusion The described method provides a fast single step procedure for routine subcloning from an entry vector into a series of destination vectors with the same restriction enzyme recognition site.

  16. Rapid single step subcloning procedure by combined action of type II and type IIs endonucleases with ligase.

    Science.gov (United States)

    Fromme, Tobias; Klingenspor, Martin

    2007-11-26

    The subcloning of a DNA fragment from an entry vector into a destination vector is a routinely performed task in molecular biology labs. We here present a novel benchtop procedure to achieve rapid recombination into any destination vector of choice with the sole requirement of an endonuclease recognition site. The method relies on a specifically designed entry vector and the combined action of type II and type IIs endonucleases with ligase. The formulation leads to accumulation of a single stable cloning product representing the desired insert carrying destination vector. The described method provides a fast single step procedure for routine subcloning from an entry vector into a series of destination vectors with the same restriction enzyme recognition site.

  17. The use of a single volar locking plate for AO C3-type distal radius fractures.

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    Earp, Brandon E; Foster, Brian; Blazar, Philip E

    2015-12-01

    A single volar locking plate (VLP) is now frequently used for open reduction and internal fixation (ORIF) of many types of distal radius fractures. Comminuted intra-articular distal radius fractures (AO C3-type) are typically the most challenging to surgically treat. No studies directly address the adequacy of a VLP alone for maintaining reduction of AO C-type fractures. We hypothesized that a single VLP provides an effective method for maintaining reduction for these fractures. We retrospectively evaluated radiographs of a series of AO C-type fractures. Seventy-seven patients with 77 AO C3-type fractures were identified from billing records and were eligible for the study. All patients were treated by fellowship-trained hand surgeons. Radiographs at the time of union were compared to those from immediately postoperatively. Sixty-nine of 77 (89.6 %) fractures treated with VLP fixation alone for AO C3-type distal radius fractures united without loss of reduction. Eight of 77 (10.4 %) patients treated with VLP for AO C3 fractures lost reduction. The most common fracture fragment to lose reduction was the lunate fossa (5 of 8); loss of reduction of the scaphoid fossa die-punch fragment (2 of 8) and the radial styloid (1 of 8) were also seen. The majority (89.6 %) of AO C3-type fractures treated with a single volar locking plate come to union without loss of reduction. Level IV.

  18. Fusion Rate and Clinical Outcomes in Two-Level Posterior Lumbar Interbody Fusion.

    Science.gov (United States)

    Aono, Hiroyuki; Takenaka, Shota; Nagamoto, Yukitaka; Tobimatsu, Hidekazu; Yamashita, Tomoya; Furuya, Masayuki; Iwasaki, Motoki

    2018-04-01

    Posterior lumbar interbody fusion (PLIF) has become a general surgical method for degenerative lumbar diseases. Although many reports have focused on single-level PLIF, few have focused on 2-level PLIF, and no report has covered the fusion status of 2-level PLIF. The purpose of this study is to investigate clinical outcomes and fusion for 2-level PLIF by using a combination of dynamic radiographs and multiplanar-reconstruction computed tomography scans. This study consisted of 48 consecutive patients who underwent 2-level PLIF for degenerative lumbar diseases. We assessed surgery duration, estimated blood loss, complications, clinical outcomes as measured by the Japanese Orthopaedic Association score, lumbar sagittal alignment as measured on standing lateral radiographs, and fusion status as measured by dynamic radiographs and multiplanar-reconstruction computed tomography. Patients were examined at a follow-up point of 4.8 ± 2.2 years after surgery. Thirty-eight patients who did not undergo lumbosacral fusion comprised the lumbolumbar group, and 10 patients who underwent lumbosacral fusion comprised the lumbosacral group. The mean Japanese Orthopaedic Association score improved from 12.1 to 22.4 points by the final follow-up examination. Sagittal alignment also was improved. All patients had fusion in the cranial level. Seven patients had nonunion in the caudal level, and the lumbosacral group (40%) had a significantly poorer fusion rate than the lumbolumbar group (97%) did. Surgical outcomes of 2-level PLIF were satisfactory. The fusion rate at both levels was 85%. All nonunion was observed at the caudal level and concentrated at L5-S level in L4-5-S PLIF. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. [The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease].

    Science.gov (United States)

    Hu, Xu-Dong; Ma, Wei-Hu; Jiang, Wei-Yu; Ruan, Chao-Yue; Chen, Yun-Lin

    2017-02-25

    To evaluate the early efficacy and safety of extreme lateral interbody fusion (XLIF) combined with percutaneous pedicle screw fixation for lumbar degenerative disease. From January 2013 to June 2014, 13 patients with degenerative lumbar disease were treated with XLIF combined with percutaneous pedicle screw fixation, including 8 cases of lumbar instability, 5 cases of mild to moderate lumbar spondylolisthesis;there were 5 males and 8 females, aged from 56 to 73 years with an average of 62.1 years. All patients were single segment fusion. Operation time, perioperative bleeding and perioperative complications were recorded. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy. Interbody fusion rate was observed and the intervertebral foramen area changes were compared preoperation and postoperation by X-rays and CT scanning. The mean operation time and perioperative bleeding in the patients respectively was(62.8±5.2) min and(82.5±22.6) ml. One case occurred in the numbness of femoribus internus and 1 case occurred in the muscle weakness of hip flexion after operation, both of them recovered within 2 weeks. All the patients were followed up from 12 to 19 months with an average of 15.6 months. VAS was decreased from preoperative 7.31±0.75 to 2.31±0.75 at final follow-up( P degenerative disease.

  20. Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis.

    Science.gov (United States)

    Sato, Jun; Ohtori, Seiji; Orita, Sumihisa; Yamauchi, Kazuyo; Eguchi, Yawara; Ochiai, Nobuyasu; Kuniyoshi, Kazuki; Aoki, Yasuchika; Nakamura, Junichi; Miyagi, Masayuki; Suzuki, Miyako; Kubota, Gou; Inage, Kazuhide; Sainoh, Takeshi; Fujimoto, Kazuki; Shiga, Yasuhiro; Abe, Koki; Kanamoto, Hiroto; Inoue, Gen; Takahashi, Kazuhisa

    2017-03-01

    Extreme lateral interbody fusion provides minimally invasive treatment of spinal deformity, but complications including nerve and psoas muscle injury have been noted. To avoid nerve injury, mini-open anterior retroperitoneal lumbar interbody fusion methods using an approach between the aorta and psoas, such as oblique lumbar interbody fusion (OLIF) have been applied. OLIF with percutaneous pedicle screws without posterior decompression can indirectly decompress the spinal canal in lumbar degenerated spondylolisthesis. In the current study, we examined the radiographic and clinical efficacy of OLIF for lumbar degenerated spondylolisthesis. We assessed 20 patients with lumbar degenerated spondylolisthesis who underwent OLIF and percutaneous pedicle screw fixation without posterior laminectomy. MR and CT images and clinical symptoms were evaluated before and 6 months after surgery. Cross sections of the spinal canal were evaluated with MRI, and disk height, cross-sectional areas of intervertebral foramina, and degree of upper vertebral slip were evaluated with CT. Clinical symptoms including low back pain, leg pain, and lower extremity numbness were evaluated using a visual analog scale and the Oswestry Disability Index before and 6 months after surgery. After surgery, significant increases in axial and sagittal spinal canal diameter (12 and 32 %), spinal canal area (19 %), disk height (61 %), and intervertebral foramen areas (21 % on the right side, 39 % on the left), and significant decrease of upper vertebral slip (-9 %) were found (P spondylolisthesis with back and leg symptoms.

  1. Clinical outcomes and considerations of the lumbar interbody fusion technique for lumbar disk disease in adolescents.

    Science.gov (United States)

    Kwon, Dae-Woong; Kim, Kyung-Hyun; Park, Jeong-Yoon; Chin, Dong-Kyu; Kim, Keun-Su; Cho, Young-Eun; Kuh, Sung-Uk

    2013-08-01

    The posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) techniques are commonly used surgical methods for wide indications such as degeneration or trauma. Although they are rarely required for lumbar disk disease in younger patients, there are a few children and adolescents who are indicated for PLIF or TLIF for other reasons, such as congenital severe stenosis with or without lumbar instability that requires wide decompression or severe bony spur that need to be removed. In such cases, different pathophysiology and outcomes are expected compared with adult patients. We retrospectively reviewed data of 23 patients who underwent PLIF or TLIF surgery when less than 20 years old. Clinical and radiographic outcomes were assessed during a mean of 36.4 months follow-up period. The indications of lumbar interbody fusion, success of fusion, complications, and visual analog scale (VAS) were analyzed. Radiographs of all patients taken 6 months after the surgery showed fusion. Clinical outcome was also satisfactory, with improvement of VAS score from 7.7 preoperatively to 2.3 at 6 months after surgery. Only one patient had reoperation due to adjacent segment disease. For adolescent patients with severe bony spur, massive central disk rupture, or severe spondylolisthesis, lumbar interbody fusion surgery has good surgical outcome with few complications.

  2. Clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion in primary versus revision surgery

    NARCIS (Netherlands)

    Hentenaar, B.; Spoor, A. B.; Malefijt, J. de Waal; Diekerhof, C. H.; den Oudsten, B. L.

    2016-01-01

    Purpose The aim of this study is to compare the clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion (MI-PLIF) in revision and primary cases. Methods In a retrospective study, we compared the clinical and radiological results of MI-PLIF for lytic

  3. Outcome in the treatment of discopathy by interbody fusion with the posterior approach using metal cages.

    Science.gov (United States)

    Milecki, Marcin; Lukawski, Stanisław; Rapała, Kazimierz; Białecki, Jerzy

    2004-06-30

    Background. Discopathy most often occurs in persons from 20 to 50 years old, in the period of greatest physical and intellectual capacity, and thus poses a major social problem. The goal of our research was to evaluation the outcome of interbody fusion performed with metal cages. Material and methods. We operated 52 patients ranging in age from 29 to 60, who presented with prolapse of the nucleus pulposus (21 patients), instability (8 patients), lumbar stenosis (11 patients), and recurrent discopathy with spondylolisthesis (12 patients). Interbody fusion was performed on these patients from the posterior approach using metal implants. Results. Applying both subjective and radiological criteria, we obtained good outcome in 36 cases, satisfactory in 12 cases, and unsatisfactory in 4 cases. A follow-up at 4 years after surgery showed that the solution was effective in preventing lumbar stenosis and intervertebral instability. However, there were still difficulties in the assessment of bone union. Conclusions. Maintaining or expanding the height of the interbody space by using implants is indicated by radiography in our material to be the most important surgical intervention justifying the use of this method. Interbody fusion in discopathy using metal implants is a logical solution to prevent secondary stenosis of the vertebral canal and intervertebral instability. The outcomes obtained at 4-year follow-up should be regarded as satisfactory.

  4. Inactivation of single-chain urokinase-type plasminogen activator by thrombin in human subjects

    NARCIS (Netherlands)

    Braat, E. A.; Levi, M. [=Marcel M.; Bos, R.; Haverkate, F.; Lassen, M. R.; de Maat, M. P.; Rijken, D. C.

    1999-01-01

    Thrombin cleaves single-chain urokinase-type plasminogen activator (scu-PA) into a virtually inactive two-chain form (tcu-PA/T), a process that may protect a blood clot from early fibrinolysis. It is not known under what circumstances tcu-PA/T can be generated in vivo. We have studied the occurrence

  5. Identifying types of physical activity with a single accelerometer: Evaluating laboratory trained algorithms in daily life

    NARCIS (Netherlands)

    Cuba Gyllensten, I.; Bonomi, A.G.

    2011-01-01

    Accurate identification of physical activity types has been achieved in laboratory conditions using single-site accelerometers and classification algorithms. This methodology is then applied to free-living subjects to determine activity behaviour. This study aimed at analysing the reproducibility of

  6. Fusão intersomática lombar transforaminal: experiência de uma instituição Fusión intersomática lumbar transforaminal: la experiencia de una institución Transforaminal lumbar interbody fusion: a single-center experience

    Directory of Open Access Journals (Sweden)

    Vinicius de Meldau Benites

    2012-12-01

    del dolor y/o claudicación neurogénicas en comparación con el status preoperatorio. Solamente cinco pacientes continuaron usando alguna medicación analgésica. Cinco pacientes presentaran alguna complicación, pero sólo dos de ellas están relacionadas directamente al procedimiento. CONCLUSIONES: Es una técnica segura, posible de ser realizada en todos los niveles de la columna lumbar y es aplicable a la mayoría de las enfermedades que afectan a esta región de la columna.OBJECTIVE: Describe the early results and experience from a reference center in spine surgery in São Paulo, Brazil with transforaminal lumbar interbody fusion (TLIF technique in its various indications. METHODS: We retrospectively reviewed the medical records of 25 patients who underwent surgery with TLIF technique in 2011. One patient was excluded because we considered that TLIF was not the most important technique used. The indications were 9 lumbar disc herniations, 7 spondylolistheses, 4 revision surgeries of which 2 were for pseudoarthroses and 2 for low back pain, and finally, 4 lumbar spinal stenoses. RESULTS: All the patients reported low back pain and/or neurologic claudication improvement when comparing to preoperative status. Only five patients continued using analgesics. Five patients presented some complication, but only two of them were related to the procedure. CONCLUSIONS: TLIF is a safe technique which can be performed at any lumbar level of the lumbar spine and is applicable to the majority of diseases that affect this region.

  7. Esthetic outcome of single implant crowns following type 1 and type 3 implant placement: a systematic review.

    Science.gov (United States)

    Shi, Jun-Yu; Wang, Ren; Zhuang, Long-Fei; Gu, Ying-Xin; Qiao, Shi-Chong; Lai, Hong-Chang

    2015-07-01

    The aim of the current review was to systematically appraise the esthetic outcome of soft tissue around single implant crowns following type 1 and type 3 implants placement in published dental literature. A PubMed, Embase, and the Cochrane Central Register of Controlled Trials search up to March 2013 was conducted for articles published in the dental literature and limited to human trials with no language restricted. Furthermore, the reference lists of related articles were systematically screened, and additional manual searches were also performed. The primary outcome was pink esthetics score (PES). The electronic search in the database of PubMed, Embase, and the Cohrane Central Register of Controlled Trials resulted in the identification of 463 titles. These titles were initially screened by the two independent reviewers for possible inclusion. Screening the abstracts and titles led to 28 articles for future full-text consideration. From these articles, 18 studies were excluded. Manual search identified one article. After quality assessment, eight studies were included in this review. This review showed that no significant difference of PES index could be found between type 1 and type 3 implant placement. According to the current evidence, short-term esthetic outcomes of peri-implant soft tissue did not show significant difference following type 1 and type 3 implants placement with well-selected patients. However, caution should be taken for clinicians to extrapolate this result to all types of patients, as more randomized clinical trials are needed for long-term soft-tissue esthetic outcome in patients with high esthetic risk following type 1 implant placement. PES frequency, peri-implant condition and other risk factors for peri-implantitis are recommended to be reported for future studies. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Scheduling of hybrid types of machines with two-machine flowshop as the first type and a single machine as the second type

    Science.gov (United States)

    Hsiao, Ming-Chih; Su, Ling-Huey

    2018-02-01

    This research addresses the problem of scheduling hybrid machine types, in which one type is a two-machine flowshop and another type is a single machine. A job is either processed on the two-machine flowshop or on the single machine. The objective is to determine a production schedule for all jobs so as to minimize the makespan. The problem is NP-hard since the two parallel machines problem was proved to be NP-hard. Simulated annealing algorithms are developed to solve the problem optimally. A mixed integer programming (MIP) is developed and used to evaluate the performance for two SAs. Computational experiments demonstrate the efficiency of the simulated annealing algorithms, the quality of the simulated annealing algorithms will also be reported.

  9. Cell type discovery and representation in the era of high-content single cell phenotyping.

    Science.gov (United States)

    Bakken, Trygve; Cowell, Lindsay; Aevermann, Brian D; Novotny, Mark; Hodge, Rebecca; Miller, Jeremy A; Lee, Alexandra; Chang, Ivan; McCorrison, Jamison; Pulendran, Bali; Qian, Yu; Schork, Nicholas J; Lasken, Roger S; Lein, Ed S; Scheuermann, Richard H

    2017-12-21

    A fundamental characteristic of multicellular organisms is the specialization of functional cell types through the process of differentiation. These specialized cell types not only characterize the normal functioning of different organs and tissues, they can also be used as cellular biomarkers of a variety of different disease states and therapeutic/vaccine responses. In order to serve as a reference for cell type representation, the Cell Ontology has been developed to provide a standard nomenclature of defined cell types for comparative analysis and biomarker discovery. Historically, these cell types have been defined based on unique cellular shapes and structures, anatomic locations, and marker protein expression. However, we are now experiencing a revolution in cellular characterization resulting from the application of new high-throughput, high-content cytometry and sequencing technologies. The resulting explosion in the number of distinct cell types being identified is challenging the current paradigm for cell type definition in the Cell Ontology. In this paper, we provide examples of state-of-the-art cellular biomarker characterization using high-content cytometry and single cell RNA sequencing, and present strategies for standardized cell type representations based on the data outputs from these cutting-edge technologies, including "context annotations" in the form of standardized experiment metadata about the specimen source analyzed and marker genes that serve as the most useful features in machine learning-based cell type classification models. We also propose a statistical strategy for comparing new experiment data to these standardized cell type representations. The advent of high-throughput/high-content single cell technologies is leading to an explosion in the number of distinct cell types being identified. It will be critical for the bioinformatics community to develop and adopt data standard conventions that will be compatible with these new

  10. Finite Element Analysis of Doorframe Structure of Single Oblique Pole Type in Container Crane

    Science.gov (United States)

    Cheng, X. F.; Wu, F. Q.; Tang, G.; Hu, X.

    2017-07-01

    Compared with the composite type, the single oblique pole type has more advantages, such as simple structure, thrift steel and high safe overhead clearance. The finite element model of the single oblique pole type is established in nodes by ANSYS, and more details are considered when the model is simplified, such as the section of Girder and Boom, torque in Girder and Boom occurred by Machinery house and Trolley, density according to the way of simplification etc. The stress and deformation of ten observation points are compared and analyzed, when the trolley is in nine dangerous positions. Based on the result of analysis, six dangerous points are selected to provide reference for the detection and evaluation of container crane.

  11. Single Muscle Fiber Proteomics Reveals Fiber-Type-Specific Features of Human Muscle Aging

    Directory of Open Access Journals (Sweden)

    Marta Murgia

    2017-06-01

    Full Text Available Skeletal muscle is a key tissue in human aging, which affects different muscle fiber types unequally. We developed a highly sensitive single muscle fiber proteomics workflow to study human aging and show that the senescence of slow and fast muscle fibers is characterized by diverging metabolic and protein quality control adaptations. Whereas mitochondrial content declines with aging in both fiber types, glycolysis and glycogen metabolism are upregulated in slow but downregulated in fast muscle fibers. Aging mitochondria decrease expression of the redox enzyme monoamine oxidase A. Slow fibers upregulate a subset of actin and myosin chaperones, whereas an opposite change happens in fast fibers. These changes in metabolism and sarcomere quality control may be related to the ability of slow, but not fast, muscle fibers to maintain their mass during aging. We conclude that single muscle fiber analysis by proteomics can elucidate pathophysiology in a sub-type-specific manner.

  12. Clinical study of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability

    OpenAIRE

    GUO, SHUGUANG; SUN, JUNYING; TANG, GENLIN

    2013-01-01

    The aim of this study was to observe the clinical effects of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability. The 48 patients comprised 27 males and 21 females, aged 47?72 years. Three cases had first and second degree lumbar spondylolisthesis and all received bilateral vertebral lamina fenestration for posterior lumbar interbody fusion (PLIF) using a threaded fusion cage (TFC), which maintains the three-column...

  13. Subsidence following anterior lumbar interbody fusion (ALIF): a prospective study.

    Science.gov (United States)

    Rao, Prashanth J; Phan, Kevin; Giang, Gloria; Maharaj, Monish M; Phan, Steven; Mobbs, Ralph J

    2017-06-01

    Anterior lumbar interbody fusion (ALIF) is a widely used surgical technique for disorders of the lumbar spine. One potential complication is the subsidence of disc height in the post-operative period. Few studies have reported the rate of subsidence in ALIF surgery prospectively. We prospectively evaluated the rate of subsidence in adult patients undergoing ALIF. Results were obtained by reviewing scans of 147 patients. Disc heights were measured on radiographic scans taken pre-operatively in addition to post-operatively immediately, at 6 weeks and at 18 months. The anterior and posterior intervertebral disc heights were measured. Subsidence was defined as greater than or equal to 2 mm loss of height. A total of 15 patients (10.2%) had subsidence, with 7 being male. Each case was of delayed cage subsidence (DCS) >6 weeks postoperatively. The mean subsidence was 4.7 mm (range, 2.4-7.8). Mean anterior disc height was 8.6±0.4 mm preoperatively, which improved to 15.1±0.5 mm at latest follow-up. Mean posterior disc height was 4.7±0.2 mm preoperatively, which improved to 8.7±0.4 mm at latest follow-up. The mean lumbar lordosis (LL) angle was 42.5°±10.8° and the mean local disc angle (LDA) was 6.7°±4.0°. The 91.2% (n=114/125) of patients with appropriate radiological follow-up demonstrated fusion by latest follow-up. There was no correlation between subsidence rate with patient reported outcomes [Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form 12 Item survey (SF-12)] and fusion rates. There was a significant negative correlation between LL and extent of subsidence (Pearson correlation =-0.754, P=0.012). In conclusion, we found that the subsidence rate at follow-up was generally low following standalone ALIF for this patient series. Patient clinical outcomes and bony fusion rates were not significantly influenced by subsidence.

  14. Study on the anatomy of the lumbosacral anterior great vessels pertinent to L5/S1 anterior interbody surgery with computer tomography angiography.

    Science.gov (United States)

    Liu, Liehua; Liang, Yong; Zhou, Qiang; Zhang, Hong; Wang, Haoming; Li, Songtao; Zhao, Chen; Hou, Tianyong; Liu, Ling

    2014-12-01

    We investigate the anatomy of the lumbosacral anterior great vessels using computer tomography (CT) angiography before L5/S1 anterior interbody surgery. Sixty-two adult patients were selected. The location of the abdominal aortic bifurcation and common iliac venous confluence in the lumbar vertebrae and the anatomic parameters of the iliac vascular space (e.g., distances from the included angle vertex of the iliac vascular space to the median sagittal plane and to the inferior boundary of L5 and distances between the left and right iliac vessels on the inferior boundary of L5 and on the superior boundary of S1) were analysed. Overall, 67.73% of the 62 cases had an abdominal aortic bifurcation located at L4 and L4/5 intervertebral disc; 61.29%, the common iliac venous confluence located at L5. The four distances mentioned above were 0.98 cm ± 0.38 cm, 2.01 cm ± 1.26 cm, 3.11 cm ± 1.35 cm and 4.34 cm ± 1.10 cm, respectively. A classification system of types A, B and C was developed. The calculated L5/S1 intervertebral space exposure percentages of types A, B and C were 32.21%, 82.58% and 54.68%, respectively. During L5/S1 anterior interbody surgery, type B intervertebral discs can be exposed conveniently, preventing injury of the iliac vessels, which was also observed in 54.68% and 32.21% of the type C and type A discs, respectively. Because the type A intervertebral disc has minimal exposure, the risk of iliac vascular injury is relatively high in these patients.

  15. Multicolor imaging of cancer cells with fluorophore-tagged aptamers for single cell typing.

    Science.gov (United States)

    Wang, Song; Kong, Hao; Gong, Xiaoyun; Zhang, Sichun; Zhang, Xinrong

    2014-08-19

    The discrimination of the type of cancer cells remains challenging due to the subtle differences in their expression of membrane receptors. In this work, we developed a multicolor cell imaging method for distinguishing the type of cancer cells with fluorophore-tagged aptamers. We found that the interaction between aptamers and cancer cells was affected by both of the sequence of aptamers and the labeled dyes. As the co-ownership of biomarkers for different cancer cell lines, the fluorophore-tagged aptamers interacted with different cancer cell lines in different degree, resulting in a distinct color to discriminate the type of cancer cells at single cell level. Taking advantage of the cross-reactive ability of the fluorophore-tagged aptamers, we could not only distinguish the cancerous cells quickly from large quantities of noncancerous cells, but also identify the type of the cancerous cells. This work has potential application for cancer diagnostic and therapy in the future.

  16. Structural modeling of dahlia-type single-walled carbon nanohorn aggregates by molecular dynamics.

    Science.gov (United States)

    Hawelek, L; Brodka, A; Dore, John C; Hannon, Alex C; Iijima, S; Yudasaka, M; Ohba, T; Kaneko, K; Burian, A

    2013-09-19

    The structure of dahlia-type single-walled carbon nanohorn aggregates has been modeled by classical molecular dynamics simulations, and the validity of the model has been verified by neutron diffraction. Computer-generated models consisted of an outer part formed from single-walled carbon nanohorns with diameters of 20-50 Å and a length of 400 Å and an inner turbostratic graphite-like core with a diameter of 130 Å. The diffracted intensity and the pair correlation function computed for such a constructed model are in good agreement with the neutron diffraction experimental data. The proposed turbostratic inner core explains the occurrence of the additional (002) and (004) graphitic peaks in the diffraction pattern of the studied sample and provides information about the interior structure of the dahlia-type aggregates.

  17. RADIAL VELOCITIES OF GALACTIC O-TYPE STARS. II. SINGLE-LINED SPECTROSCOPIC BINARIES

    International Nuclear Information System (INIS)

    Williams, S. J.; Gies, D. R.; Hillwig, T. C.; McSwain, M. V.; Huang, W.

    2013-01-01

    We report on new radial velocity measurements of massive stars that are either suspected binaries or lacking prior observations. This is part of a survey to identify and characterize spectroscopic binaries among O-type stars with the goal of comparing the binary fraction of field and runaway stars with those in clusters and associations. We present orbits for HDE 308813, HD 152147, HD 164536, BD–16°4826, and HDE 229232, Galactic O-type stars exhibiting single-lined spectroscopic variation. By fitting model spectra to our observed spectra, we obtain estimates for effective temperature, surface gravity, and rotational velocity. We compute orbital periods and velocity semiamplitudes for each system and note the lack of photometric variation for any system. These binaries probably appear single-lined because the companions are faint and because their orbital Doppler shifts are small compared to the width of the rotationally broadened lines of the primary.

  18. Comprehensive Identification and Spatial Mapping of Habenular Neuronal Types Using Single-Cell RNA-Seq.

    Science.gov (United States)

    Pandey, Shristi; Shekhar, Karthik; Regev, Aviv; Schier, Alexander F

    2018-04-02

    The identification of cell types and marker genes is critical for dissecting neural development and function, but the size and complexity of the brain has hindered the comprehensive discovery of cell types. We combined single-cell RNA-seq (scRNA-seq) with anatomical brain registration to create a comprehensive map of the zebrafish habenula, a conserved forebrain hub involved in pain processing and learning. Single-cell transcriptomes of ∼13,000 habenular cells with 4× cellular coverage identified 18 neuronal types and dozens of marker genes. Registration of marker genes onto a reference atlas created a resource for anatomical and functional studies and enabled the mapping of active neurons onto neuronal types following aversive stimuli. Strikingly, despite brain growth and functional maturation, cell types were retained between the larval and adult habenula. This study provides a gene expression atlas to dissect habenular development and function and offers a general framework for the comprehensive characterization of other brain regions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Charge collection measurements in single-type column 3D sensors

    International Nuclear Information System (INIS)

    Scaringella, M.; Polyakov, A.; Sadrozinski, H.F.-W.; Bruzzi, M.; Tosi, C.; Boscardin, M.; Piemonte, C.; Pozza, A.; Ronchin, S.; Zorzi, N.; Dalla Betta, G.-F.

    2007-01-01

    We report on charge collection studies on 3D silicon detectors of single-type column n-diffusions in p-substrate, configured either as strip or as pad detectors. The charge is generated by penetrating beta particles from a 90 Sr source which, together with a scintillation counter, serves as an electron telescope. The charge collection as a function of bias voltage is compared with the depletion thickness derived from the measured C-V characteristics

  20. Charge collection measurements with p-type Magnetic Czochralski silicon single pad detectors

    International Nuclear Information System (INIS)

    Tosi, C.; Bruzzi, M.; Macchiolo, A.; Scaringella, M.; Petterson, M.K.; Sadrozinski, H.F.-W.; Betancourt, C.; Manna, N.; Creanza, D.; Boscardin, M.; Piemonte, C.; Zorzi, N.; Borrello, L.; Messineo, A.

    2007-01-01

    The charge collected from beta source particles in single pad detectors produced on p-type Magnetic Czochralski (MCz) silicon wafers has been measured before and after irradiation with 26 MeV protons. After a 1 MeV neutron equivalent fluence of 1x10 15 cm -2 the collected charge is reduced to 77% at bias voltages below 900 V. This result is compared with previous results from charge collection measurements

  1. Identification of soybean proteins from a single cell type: The root hair

    Energy Technology Data Exchange (ETDEWEB)

    Brechenmacher, Laurent; Nguyen, Tran H.; Hixson, Kim K.; Libault, Marc; Aldrich, Joshua T.; Pasa-Tolic, Ljiljana; Stacey, Gary

    2012-11-01

    Root hairs are a terminally differentiated single cell type, mainly involved in water and nutrient uptake from the soil. The soybean root hair cell represents an excellent model for the study of single cell systems biology. In this study, we identified 5702 proteins, with at least two peptides, from soybean root hairs using an accurate mass and time tag approach, establishing the most comprehensive proteome reference map of this single cell type. We also showed that trypsin is the most appropriate enzyme for soybean proteomic studies by performing an in silico digestion of the soybean proteome database using different proteases. Although the majority of proteins identified in this study are involved in basal metabolism, the function of others are more related to root hair formation/function and include proteins involved in nutrient uptake (transporters) or vesicular trafficking (cytoskeleton and RAB proteins). Interestingly, some of these proteins appear to be specifically expressed in root hairs and constitute very good candidates for further studies to elucidate unique features of this single cell model.

  2. A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT).

    Science.gov (United States)

    de Kunder, Suzanne L; Rijkers, Kim; van Kuijk, Sander M J; Evers, Silvia M A A; de Bie, Rob A; van Santbrink, Henk

    2016-10-06

    With a steep increase in the number of instrumented spinal fusion procedures, there is a need for comparative data to develop evidence based treatment recommendations. Currently, the available data on cost and clinical effectiveness of the two most frequently performed surgeries for lumbar spondylolisthesis, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF), are not sufficient. Therefore, current guidelines do not advise which is the most appropriate surgical treatment strategy for these patients. Non-randomized studies comparing TLIF and PLIF moreover suggest that TLIF is associated with fewer complications, less blood loss, shorter surgical time and hospital duration. TLIF may therefore be more cost-effective. The results of this study will provide knowledge on short- and long-term clinical and economical effects of TLIF and PLIF procedures, which will lead to recommendations for treating patients with lumbar spondylolisthesis. Multicenter blinded Randomized Controlled Trial (RCT; blinding for the patient and statistician, not for the clinician and researcher). A total of 144 patients over 18 years old with symptomatic single level lumbar degenerative, isthmic or iatrogenic spondylolisthesis whom are candidates for LIF (lumbar interbody fusion) surgery through a posterior approach will be randomly allocated to TLIF or PLIF. The study will consist of three parts: 1) a clinical effectiveness study, 2) a cost-effectiveness study, and 3) a process evaluation. The primary clinical outcome measures are: change in disability measured with Oswestry Disability Index (ODI) and change in quality adjusted life years (QALY) measured with EQ-5D-5L. Secondary clinical outcome measures are: Short Form (36) Health Survey (SF-36), VAS back pain, VAS leg pain, Hospital Anxiety Depression Scale (HADS), complications, productivity related costs (iPCQ) and medical costs (iMCQ). Measurements will be carried out at five fixed time points (pre

  3. Empagliflozin/linagliptin single-pill combination therapy for patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Jain, Rajeev Kumar

    2017-04-01

    Type 2 diabetes mellitus (T2DM) is typically progressive, with sequential addition of therapies often needed to address increasing hyperglycemia over the disease course. Using treatments in combination may be preferred to sequential addition, as a means of providing a more rapid clinical response and potentially avoiding clinical inertia. In such cases, a single-pill combination can help to reduce pill burden. Although various single-pill combinations of oral glucose-lowering agents are available, empagliflozin/linagliptin was the first approved combination of a sodium glucose co-transporter 2 (SGLT2) inhibitor with a dipeptidyl peptidase 4 (DPP-4) inhibitor in the United States. Areas covered: Two publications of the clinical trial investigating the efficacy and safety of single-pill combinations of empagliflozin/linagliptin in treatment-naive or metformin-treated patients with T2DM (NCT01422876) are reviewed, and their potential impact on clinical practice is discussed. Expert opinion: The study discussed provides evidence for the efficacy and safety of empagliflozin/linagliptin single pills. Addition of an empagliflozin/linagliptin single pill may be considered in patients with inadequate glycemic control on metformin, or as an alternative to first-line treatment with empagliflozin or linagliptin when metformin is not suitable, particularly in patients with very poor glycemic control, or those who need to achieve target more quickly.

  4. submitter Search for singly produced vector-like down-type quarks in single-lepton final states with ATLAS

    CERN Document Server

    Rehnisch, Laura

    A search for vector-like and excited down-type (Q = 1/3) quarks with the ATLAS detector is presented in this thesis. The existence of these quarks is predicted by various models beyond the Standard Model, motivated by some limitations of that theory. Quarks from two specific models are searched for in single production mode, as this is predicted to yield higher cross-sections than pair production in the investigated mass range. The search focuses on decays of the heavy quarks to a W boson and a top quark, the latter of which subsequently decays almost exclusively into another W boson and a bottom quark. Requiring one of the two W bosons to decay leptonically leads to final states containing exactly one lepton (electron or muon in this case), several jets, one of which can be identified as originating from a bottom quark, and some amount of missing energy in the transverse plane stemming from the neutrino of the leptonic W decay. The reconstructed mass of the heavy quark is used to discriminate between signal ...

  5. Comparison Between Posterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Lan, Tao; Hu, Shi-Yu; Zhang, Yuan-Tao; Zheng, Yu-Chen; Zhang, Rui; Shen, Zhe; Yang, Xin-Jian

    2018-04-01

    To compare the efficacy and safety in the management of lumbar diseases performed by either posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). Interbody fusion is considered the "gold standard" in the treatment of lumbar degenerative diseases. Both PLIF and TLIF have been advocated, and it remains controversial as to the best operative technique. The electronic databases including Embase, PubMed, and Cochrane library were searched to identify relevant studies up to September 2017. The primary outcomes were fusion rate, complications, and clinical satisfaction. The secondary outcomes were length of hospitalization, operation time, blood loss, postoperative visual analog scale, Oswestry Disability Index, and Japanese Orthopaedic Association Score. Data analysis was conducted with RevMan 5.3 software. A total of 16 studies involving 1502 patients (805 patients in PLIF group and 697 in TLIF group) were included in the meta-analysis. The pooled analysis showed that there was no significant difference in terms of fusion rate (P > 0.05) and clinical satisfaction (P > 0.05) between the 2 groups. TLIF was superior to PLIF with significantly lower incidence of nerve root injury (P 0.05) and graft malposition (P > 0.05). PLIF required significant longer operation time (P degenerative lumbar diseases. However, TLIF was superior to PLIF with shorter operation time, less blood loss, and lower incidence of nerve root injury and dural tear. There is no significant difference between both groups regarding wound infection and graft malposition. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Association between ABO blood type and live-birth outcomes in single-embryo transfer cycles.

    Science.gov (United States)

    Pereira, Nigel; Patel, Hency H; Stone, Logan D; Christos, Paul J; Elias, Rony T; Spandorfer, Steven D; Rosenwaks, Zev

    2017-11-01

    To investigate the association between ABO blood type and live-birth outcomes in patients undergoing IVF with day 5 single-embryo transfer (SET). Retrospective cohort study. University-affiliated center. Normal responders, blood type and live birth, while controlling for confounders. Odds ratios (OR) with 95% confidence intervals (CI) for live birth were estimated. A total of 2,329 patients were included. The mean age of the study cohort was 34.6 ± 4.78 years. The distribution of blood types was as follows: A = 897 (38.5%); B = 397 (17.0%); AB = 120 (5.2%); and, O = 1,915 (39.3%) patients. There was no difference in the baseline demographics, ovarian stimulation, or embryo quality parameters between the blood types. The unadjusted ORs for live birth when comparing blood type A (referent) with blood types B, AB, and O were 0.96 (95% CI, 0.6-1.7), 0.72 (95% CI, 0.4-1.2), and 0.96 (95% CI. 0.6-1.7), respectively. The adjusted ORs for live birth remained not significant when comparing blood type A to blood types B, AB, and O individually. No difference in birth weight or gestational age at delivery was noted among the four blood types. Our findings suggest that ABO blood type is not associated with live-birth rate, birth weight, or gestational age at delivery in patients undergoing IVF with day 5 SET. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Comparison Study Based on End Plate Subsidence and Cystic Change in Individuals Older and Younger than 65 Years.

    Science.gov (United States)

    Lin, Guang-Xun; Quillo-Olvera, Javier; Jo, Hyun-Jin; Lee, Hyeong-Jin; Covarrubias-Rosas, Claudia Angelica; Jin, Chengzhen; Kim, Jin-Sung

    2017-10-01

    To compare the outcomes between patients older and younger than 65 years who underwent single-level minimally invasive transforaminal interbody fusion (MI-TLIF) surgery. This study is a retrospective analysis of 76 patients who underwent MI-TLIF between April 2012 and June 2016. Group A consisted of 35 patients (subsidence, end plate cyst formation, and fusion rate were assessed. The mean age of the study subjects was 65.3 years, and the mean duration of follow-up was 18.98 months. Group B had a higher rate of comorbidities compared with group A (90.24% vs. 57.14%, respectively; P subsidence or positive cyst sign between the groups. MI-TLIF presented similar safeness and acceptable outcomes and complication rate in both groups. Cyst formation may be aggravated by cage subsidence, because cage subsidence was a useful potential predictor of cyst formation. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Rate of graft bone filling by transforaminal lumber interbody fusion (TLIF) with mesh cages

    International Nuclear Information System (INIS)

    Miura, Kazuto; Kawaji, Youichi; Matsuba, Atsushi; Kouda, Hisao

    2007-01-01

    Compared to posterior lumber interbody fusion (PLIF), the transforaminal lumber interbody fusion (TLIF) procedure has a latent disadvantage in terms of bone grafting because of being a unilateral approach. We calculated the rate of graft bone filling in TLIF cases by postoperative CT and evaluated the clinical results. The rate of filling in the TLIF cases was not significantly less than in the PLIF cases. The results also showed no significant difference between TLIF and PLIF. An adequate amount of bone were grafted into the intervertebral space even by the unilateral TLIF approach, however the procedure is not easy. An incidental dural tear occurred in 1 case each treated by TLIF and PLIF. The exposure of the dural tube increases the risk of epidural bleeding and neural tissue injury. We recommend TLIF for discopathy, foraminal stenosis, and repeat surgery to avoid latent risk. (author)

  9. EFFICACY OF PLATELET-RICH PLASMA IN EXPERIMENTAL INSTRUMENTED INTERBODY SPINAL FUSION

    Directory of Open Access Journals (Sweden)

    Gianfilippo Caggiari

    2016-04-01

    Full Text Available Introduction. This study aimed to analyze the influence of Platelet-Rich Plasma (PRP on bone growth in experimental instrumented interbody spinal fusion (IISF. Methods. 16 adult sheep underwent IISF at L3–L4 level using a cylindrical threaded expanding titanium cage with morselized iliac crest cancellous autograft. In 8 animals (Group I this was augmented with PRP, in the remaining 8 (Group II, it was not. Radiographs of the spine were taken preoperatively and at 1, 3, and 6 months, moreover autoptic vertebral samples were obtained and evaluated histologically and by CT scan at 8 months. Results. Histological analysis revealed more evident new bone formation with bony bridge into the cages in Group I than Group II. There were relevant differences between the groups with regard to interbody fusion calculated using trabecular bone score (p<0.05.

  10. Overpowering posterior lumbar instrumentation and fusion with hyperlordotic anterior lumbar interbody cages followed by posterior revision: a preliminary feasibility study.

    Science.gov (United States)

    Kadam, Abhijeet; Wigner, Nathan; Saville, Philip; Arlet, Vincent

    2017-12-01

    OBJECTIVE The authors' aim in this study was to evaluate whether sagittal plane correction can be obtained from the front by overpowering previous posterior instrumentation and/or fusion with hyperlordotic anterior lumbar interbody fusion (ALIF) cages in patients undergoing revision surgery for degenerative spinal conditions and/or spinal deformities. METHODS The authors report their experience with the application of hyperlordotic cages at 36 lumbar levels for ALIFs in a series of 20 patients who underwent revision spinal surgery at a single institution. Included patients underwent staged front-back procedures: ALIFs with hyperlordotic cages (12°, 20°, and 30°) followed by removal of posterior instrumentation and reinstrumentation from the back. Patients were divided into the following 2 groups depending on the extent of posterior instrumentation and fusion during the second stage: long constructs (≥ 6 levels with extension into thoracic spine and/or pelvis) and short constructs (lumbar lordosis increased from 44.3° to 59.8° (p lumbar levels that have pseudarthrosis from the previous posterior spinal fusion. Meticulous selection of levels for ALIF is crucial for safely and effectively performing this technique.

  11. Minimally Invasive Transforaminal Lumbar Interbody Fusion at L5-S1 through a Unilateral Approach: Technical Feasibility and Outcomes

    Directory of Open Access Journals (Sweden)

    Won-Suh Choi

    2016-01-01

    Full Text Available Background. Minimally invasive spinal transforaminal lumbar interbody fusion (MIS-TLIF at L5-S1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. Objective. To determine the clinical and radiological outcomes of MIS-TLIF for treatment of single-level spinal stenosis low-grade isthmic or degenerative spondylolisthesis at L5-S1. Methods. Radiological data and electronic medical records of patients who underwent MIS-TLIF between May 2012 and December 2014 were reviewed. Fusion rate, cage position, disc height (DH, disc angle (DA, disc slope angle, segmental lordotic angle (SLA, lumbar lordotic angle (LLA, and pelvic parameters were assessed. For functional assessment, the visual analogue scale (VAS, Oswestry disability index (ODI, and patient satisfaction rate (PSR were utilized. Results. A total of 21 levels in 21 patients were studied. DH, DA, SLA, and LLA had increased from their preoperative measures at the final follow-up. Fusion rate was 86.7% (18/21 at 12 months’ follow-up. The most common cage position was anteromedial (15/21. The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up. PSR was 88%. Cage subsidence was observed in 33.3% (7/21. Conclusions. The clinical and radiologic outcomes after MIS-TLIF at L5-S1 in patients with spinal stenosis or spondylolisthesis are generally favorable.

  12. Pyogenic lumbar spondylodiscitis treated with transforaminal lumbar interbody fusion: safety and outcomes.

    Science.gov (United States)

    Shetty, Ajoy Prasad; Aiyer, Siddharth N; Kanna, Rishi Mugesh; Maheswaran, Anupama; Rajasekaran, Shanmuganathan

    2016-06-01

    Our aim was to study the safety and outcomes of posterior instrumentation and transforaminal lumbar interbody fusion (TLIF) for treating pyogenic lumbar spondylodiscitis. Retrospective analysis was performed on prospectively collected data of 27 consecutive cases of lumbar pyogenic spondylodiscitis treated with posterior instrumentation and TLIF between January 2009 and December 2012. Cases were analysed for safety, radiological and clinical outcomes of transforaminal interbody fusion using bone graft ± titanium cages. Interbody metallic cages with bone graft were used in 17 cases and ten cases used only bone graft. Indications for surgical treatment were failed conservative management in 17, neurodeficit in six and significant bony destruction in four. There were no cases reporting cage migration, loosening, pseudoarthrosis or recurrence of infection at a mean follow-up of 30 months. Clinical outcomes were assessed using Kirkaldy-Willis criteria, which showed 14 excellent, nine good, three fair and one poor result. Mean focal deformity improved with the use of bone graft ± interbody cages, and the deformity correction was maintained at final follow-up. Mean pre-operative focal lordosis for the graft group was 8.5° (2-16.5°), which improved to 10.9 °(3.3-16°); mean pre-operative focal lordosis in the group treated with cages was 6.7 °(0-15°), which improved to 7°(0-15°) . TLIFs with cages in patients with pyogenic lumbar spondylodiscitis allows for acceptable clearance of infection, satisfactory deformity correction with low incidence of cage migration, loosening and infection recurrence.

  13. Anterior lumbar interbody fusion with integrated fixation and adjunctive posterior stabilization: A comparative biomechanical analysis.

    Science.gov (United States)

    Yeager, Matthew S; Dupre, Derrick A; Cook, Daniel J; Oh, Michael Y; Altman, Daniel T; Cheng, Boyle C

    2015-10-01

    Interbody fusion cages with integrated fixation components have become of interest due to their ability to provide enhanced post-operative stability and mitigate device migration. A recently approved anterior lumbar interbody fusion cage with integrated fixation anchors has yet to be compared in vitro to a standard polyetheretherketone cage when used in combination with an interspinous process clamp. Twelve human cadaveric lumbar segments were implanted at L4-L5 with a Solus interbody cage (n=6) or standard polyetheretherketone cage (n=6) following Intact testing and discectomy. Each cage was subsequently evaluated in all primary modes of loading after supplementation with the following posterior constructs: interspinous process clamp, bilateral transfacet screws, unilateral transfacet screw with contralateral pedicle screws, and bilateral pedicle screws. Range of motion results were normalized to Intact, and a two-way mixed analysis of variance was utilized to detect statistical differences. The Solus cage in combination with all posterior constructs provided significant fixation compared to Intact in all loading conditions. The polyetheretherketone cage also provided significant fixation when combined with all screw based treatments, however when used with the interspinous process clamp a significant reduction was not observed in lateral bending or axial torsion. Interbody cages with integrated fixation components enhance post-operative stability within the intervertebral space, thus affording clinicians the potential to utilize less invasive methods of posterior stabilization when seeking circumferential fusion. Interspinous process clamps, in particular, may reduce peri-operative and post-operative comorbidities compared to screw based constructs. Further study is necessary to corroborate their effectiveness in vivo. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. [Anterior interbody fusion of cervical spine with case-plate PCB].

    Science.gov (United States)

    Radek, M; Radek, A; Zapałowicz, K; Maciejczak, A

    2001-01-01

    Two cases with cervical discopathy and radiculopathy are presented. Discectomy and anterior interbody fusion with cage-plate PCB manufactured by French company Scient'x was performed. Authors present the shape of the implant and technical details of implantation. The paper discusses the advantages of the PCB which simplifies and shortens the operation procedure, minimizes the risk of traditional bone graft harvesting and provides immediate stabilization of the operated segment.

  15. Biomechanical evaluation of a spherical lumbar interbody device at varying levels of subsidence

    Science.gov (United States)

    Rundell, Steven A.; Isaza, Jorge E.; Kurtz, Steven M.

    2011-01-01

    Background Ulf Fernström implanted stainless steel ball bearings following discectomy, or for painful disc disease, and termed this procedure disc arthroplasty. Today, spherical interbody spacers are clinically available, but there is a paucity of associated biomechanical testing. The primary objective of the current study was to evaluate the biomechanics of a spherical interbody implant. It was hypothesized that implantation of a spherical interbody implant, with combined subsidence into the vertebral bodies, would result in similar ranges of motion (RoM) and facet contact forces (FCFs) when compared with an intact condition. A secondary objective of this study was to determine the effect of using a polyetheretherketone (PEEK) versus a cobalt chrome (CoCr) implant on vertebral body strains. We hypothesized that the material selection would have a negligible effect on vertebral body strains since both materials have elastic moduli substantially greater than the annulus. Methods A finite element model of L3-L4 was created and validated by use of ROM, disc pressure, and bony strain from previously published data. Virtual implantation of a spherical interbody device was performed with 0, 2, and 4 mm of subsidence. The model was exercised in compression, flexion, extension, axial rotation, and lateral bending. The ROM, vertebral body effective (von Mises) strain, and FCFs were reported. Results Implantation of a PEEK implant resulted in slightly lower strain maxima when compared with a CoCr implant. For both materials, the peak strain experienced by the underlying bone was reduced with increasing subsidence. All levels of subsidence resulted in ROM and FCFs similar to the intact model. Conclusions The results suggest that a simple spherical implant design is able to maintain segmental ROM and provide minimal differences in FCFs. Large areas of von Mises strain maxima were generated in the bone adjacent to the implant regardless of whether the implant was PEEK or Co

  16. Symptomatic Adjacent Segment Pathology after Posterior Lumbar Interbody Fusion for Adult Low-Grade Isthmic Spondylolisthesis

    OpenAIRE

    Sakaura, Hironobu; Yamashita, Tomoya; Miwa, Toshitada; Ohzono, Kenji; Ohwada, Tetsuo

    2013-01-01

    The incidence of symptomatic adjacent segment pathology (ASP) after fusion surgery for adult low-grade isthmic spondylolisthesis (IS) has been reported to be relatively low compared with other lumbar disease entities. However, there has been no study of symptomatic ASP incidence using posterior lumbar interbody fusion (PLIF) with pedicle screw instrumentation. We investigated the incidence of symptomatic ASP after PLIF with pedicle screw instrumentation for adult low-grade IS and identified s...

  17. Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis: Comparison Between Isthmic and Degenerative Spondylolisthesis.

    Science.gov (United States)

    Kim, Jong Yeol; Park, Jeong Yoon; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun

    2015-11-01

    Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is a common surgical option for degenerative spondylolisthesis (DS). However, its effectiveness for isthmic spondylolisthesis (IS) is still controversial. No current studies have directly compared perioperative and postoperative results including various radiological parameters between IS and DS after MIS TLIF. The purpose of this study is to compare the clinical and radiological results between isthmic and degenerative spondylolisthesis after MIS TLIF. This is a retrospective study of 41 patients who underwent MIS TLIF for single-segment, grade 1 or 2 IS (n = 18) and DS (n = 23). The same surgical techniques and procedure were applied to both groups. Perioperative outcomes (operation time, blood loss, hospital stay, complications); clinical outcomes (visual analog scale [VAS], Oswestry Disability Index [ODI]); radiological parameters (disk height, degree of spondylolisthesis, slip angle, lumbar lordosis, segmental lordosis, sacropelvic parameters: pelvic incidence, sacral slope, pelvic tile); and fusion rates using computed tomography scanning were compared between groups at 1 year postoperatively. There were no significantly different perioperative results between groups. Mean VAS and ODI scores improved significantly postoperatively in both groups but were not significantly different between groups at each follow-up point. Radiological parameters were not significantly different between groups except disk height and degree of spondylolisthesis. The disk heights were increased postoperatively (IS: 6.79-9.22 mm; DS: 8.18-8.97 mm) in both groups, and there were significant differences preoperatively. In addition, disk height restoration was greater for IS than DS (2.43 mm vs. 0.79 mm, P = 0.01). However, postoperative disk heights were not significantly different between groups. The degree of spondylolisthesis was significantly different between groups both preoperatively (16.77% vs. 11.33%, P

  18. Graft Subsidence and Revision Rates Following Anterior Cervical Corpectomy: A Clinical Study Comparing Different Interbody Cages.

    Science.gov (United States)

    Weber, Michael H; Fortin, Maryse; Shen, Jian; Tay, Bobby; Hu, Serena S; Berven, Sigurd; Burch, Shane; Chou, Dean; Ames, Christopher; Deviren, Vedat

    2017-11-01

    Retrospective cohort study. To assess the subsidence and revision rates associated with different interbody cages following anterior cervical corpectomy and reconstruction. Different interbody cages are currently used for surgical reconstruction of the anterior and middle columns of the spine following anterior cervical corpectomy. However, subsidence and delayed union/nonunion associated with allograft and cage reconstruction are common complications, which may require revision with instrumentation. We reviewed the cases of 75 patients who underwent cervical corpectomy and compared the radiographic graft subsidence and revision rates for fibula allograft, titanium mesh cage, titanium expandable cage, and carbon fiber cages. Subsidence was calculated by comparing the immediate postoperative lateral x-ray films to those obtained during follow-up visits. The average graft subsidence was 3 mm and revision rate was 25% for fibula allograft versus 2.9 mm and 11.1%, 2.9 mm and 18.8% for titanium mesh cages and titanium expandable cages, respectively. The average graft subsidence for carbon fiber cages was 0.7 mm with no revision surgery in this subset. Our findings suggest that subsidence and revision rates following anterior corpectomy and interbody fusion could be minimized with the use of a carbon fiber cage.

  19. [Treatment of degenerative lumbar spondylolisthesis by transforaminal lumbar interbody fusion with microendoscopic surgery].

    Science.gov (United States)

    Zhou, Wei; Li, Li-Jun; Tan, Jun

    2010-04-01

    To investigate the effect of treating degenerative lumbar spondylolisthesis by transforaminal lumbar interbody fusion with microendoscopic surgery. From Jan. 2006 to Jan. 2009, one hundred fifty patients who underwent transforaminal lumbar interbody fusion with microendoscopic surgery were analyzed retrospectively. The diagnosis was degenerative lumbar spondylolisthesis in 84 cases of grade I, and 66 cases of grade II. There were 88 males and 62 females. Preoperatively, at 1 week and 3 months postoperatively, the pain was evaluated with visual analogue scale (VAS) scoring system and therapeutic effect was observed with modified Prolo scoring system. In complications, dural tear happened in 3 cases, biological glues were used for dural tear sealing and neither cerebrospinal fluid leak was found. One case suffered from intervertebral Infection and muscle weakness of foot was found in one case, either was cured after symptomatic treatment. Operative time averaged 160 minutes (120-280 min). Estimated blood loss averaged 210 ml (100-450 ml). The postoperative follow-up ranged from 6 to 36 months (averaged 15.2 months). Preoperatively,at 1 week and 3 months postoperatively, VAS scores were respectively 7.9 +/- 2.1, 2.2 +/- 0.6, 3.2 +/- 1.1 (P surgery transforaminal lumbar interbody fusion technique is indicated for lumbar vertebral instability, localized intervertebral disc disorder and lumbar spondylolisthesis with stenotic nerve root or tube below grade II. This technique has advantages of minimal invasion and early functional recovery.

  20. POSTERIOR LUMBAR INTERBODY FUSION AND INSTRUMENTED POSTEROLATERAL FUSION IN ADULT SPONDYLOLISTHESIS: ASSESSMENT AND CLINICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Rajarajan

    2015-11-01

    Full Text Available OBJECTIVE: Aim of this study is to assess and compare the outcomes of posterior lumbar interbody fusion (PLIF and posterolateral fusion (PLF in adult isthmic spondylosthesis. BACKGROUND: Posterolateral fusion has been considered the best method and widely been used for surgical treatment of adult spondylolisthesis.Superior results have subsequently been reported with interbody fusion with cages and posterior instrumentation MATERIALS AND METHODS: Thirty six patients with isthmic spondylolisthesis were operated. One group (20 patients had decompression and posterolateral fusion (PLF with a pedicle screw system; other group (16 patients was treated by decompression, posterior lumbar interbody fusion (PLIF and a Pedicle screw system. In both groups adequate decompression was done RESULTS: Seventy seven percent of the patients had a good result with (PLIF and 68 percent with posterolateral fusion (PLF. However there was no statistical difference in cases with low grade slipping, whereas the difference was significant for cases with high grade slipping. Fusion rate was 93% with (PLIF and 68% with (PLF, but without any significant incidence in the functional outcome. 78% has relief of sciatica and neurogenic claudication. CONCLUSION: Based on these findings we found that for high grade spondylolisthesis which requires reduction or if the disc space is still high posterior lumbar inter body fusion is preferable. For low grade spondylolisthesis or if the disc space is narrow posterolateral fusion is preferable. A successful result of fusion operation depends on adequate decompression which relieves radicular symptoms.

  1. Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Perspective on Current Evidence and Clinical Knowledge

    Directory of Open Access Journals (Sweden)

    Ali Habib

    2012-01-01

    Full Text Available This paper reviews the current published data regarding open transforaminal lumbar interbody fusion (TLIF in relation to minimally invasive transforaminal lumbar interbody fusion (MI-TLIF. Introduction. MI-TLIF, a modern method for lumbar interbody arthrodesis, has allowed for a minimally invasive method to treat degenerative spinal pathologies. Currently, there is limited literature that compares TLIF directly to MI-TLIF. Thus, we seek to discuss the current literature on these techniques. Methods. Using a PubMed search, we reviewed recent publications of open and MI-TLIF, dating from 2002 to 2012. We discussed these studies and their findings in this paper, focusing on patient-reported outcomes as well as complications. Results. Data found in 14 articles of the literature was analyzed. Using these reports, we found mean follow-up was 20 months. The mean patient study size was 52. Seven of the articles directly compared outcomes of open TLIF with MI-TLIF, such as mean duration of surgery, length of post-operative stay, blood loss, and complications. Conclusion. Although high-class data comparing these two techniques is lacking, the current evidence supports MI-TLIF with outcomes comparable to that of the traditional, open technique. Further prospective, randomized studies will help to further our understanding of this minimally invasive technique.

  2. Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Perspective on Current Evidence and Clinical Knowledge

    Science.gov (United States)

    Habib, Ali; Smith, Zachary A.; Lawton, Cort D.; Fessler, Richard G.

    2012-01-01

    This paper reviews the current published data regarding open transforaminal lumbar interbody fusion (TLIF) in relation to minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). Introduction. MI-TLIF, a modern method for lumbar interbody arthrodesis, has allowed for a minimally invasive method to treat degenerative spinal pathologies. Currently, there is limited literature that compares TLIF directly to MI-TLIF. Thus, we seek to discuss the current literature on these techniques. Methods. Using a PubMed search, we reviewed recent publications of open and MI-TLIF, dating from 2002 to 2012. We discussed these studies and their findings in this paper, focusing on patient-reported outcomes as well as complications. Results. Data found in 14 articles of the literature was analyzed. Using these reports, we found mean follow-up was 20 months. The mean patient study size was 52. Seven of the articles directly compared outcomes of open TLIF with MI-TLIF, such as mean duration of surgery, length of post-operative stay, blood loss, and complications. Conclusion. Although high-class data comparing these two techniques is lacking, the current evidence supports MI-TLIF with outcomes comparable to that of the traditional, open technique. Further prospective, randomized studies will help to further our understanding of this minimally invasive technique. PMID:22928099

  3. Synthesis and characterization of p-type boron-doped IIb diamond large single crystals

    International Nuclear Information System (INIS)

    Li Shang-Sheng; Li Xiao-Lei; Su Tai-Chao; Jia Xiao-Peng; Ma Hong-An; Huang Guo-Feng; Li Yong

    2011-01-01

    High-quality p-type boron-doped IIb diamond large single crystals are successfully synthesized by the temperature gradient method in a china-type cubic anvil high-pressure apparatus at about 5.5 GPa and 1600 K. The morphologies and surface textures of the synthetic diamond crystals with different boron additive quantities are characterized by using an optical microscope and a scanning electron microscope respectively. The impurities of nitrogen and boron in diamonds are detected by micro Fourier transform infrared technique. The electrical properties including resistivities, Hall coefficients, Hall mobilities and carrier densities of the synthesized samples are measured by a four-point probe and the Hall effect method. The results show that large p-type boron-doped diamond single crystals with few nitrogen impurities have been synthesized. With the increase of quantity of additive boron, some high-index crystal faces such as {113} gradually disappear, and some stripes and triangle pits occur on the crystal surface. This work is helpful for the further research and application of boron-doped semiconductor diamond. (cross-disciplinary physics and related areas of science and technology)

  4. One-Level or Multilevel Interbody Fusion for Multilevel Lumbar Degenerative Diseases: A Prospective Randomized Control Study with a 4-Year Follow-Up.

    Science.gov (United States)

    Li, Tiefeng; Shi, Lei; Luo, Yibin; Chen, Deyu; Chen, Yu

    2018-02-01

    The treatment of multilevel lumbar degenerative disease (LDD) is complicated and challenging, and the optimal surgical strategy remains controversial. To compare the differences in clinical and radiologic outcomes and in complications after 1-level interbody fusion versus multilevel interbody fusion for the treatment of multilevel LDD. A total of 100 patients with multilevel LDD were randomized in a 1:1 ratio into the 1-level interbody fusion group or the multilevel interbody fusion group. Clinical and radiologic results and major complications in the 2 groups were analyzed. Clinical outcomes were assessed using the Visual Analog Scale for radicular and back pain, the Oswestry Disability Index, and the short-form 36 physical score. Clinical status was assessed by the Whitecloud classification. Radiologic evaluation included assessment of lumbar lordosis, pelvic incidence, and sacral slope. There were no significant differences in clinical and radiologic results between the 2 groups. Procedure duration and intraoperative blood loss were significantly greater in the multilevel interbody fusion group than in the 1-level interbody fusion group; the multilevel interbody fusion group also had greater incidences of temporary nerve root palsy, wound infection, and adjacent segment disease. A hybrid technique including 1-level interbody fusion and multilevel posterolateral fusion is recommended for patients with multilevel LDD. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Single-pill combination therapy for type 2 diabetes mellitus: linagliptin plus empagliflozin.

    Science.gov (United States)

    Aronson, Ronnie

    2015-05-01

    Treatment of type 2 diabetes mellitus invariably requires the use of multiple daily medications which can impact negatively on patient adherence. As a result, there is growing interest in the use of single-pill combinations that can reduce the pill burden. Many such formulations incorporate metformin, although this agent is not suitable for all patients. The single-pill combination of the dipeptidyl peptidase-4 inhibitor linagliptin with the sodium glucose co-transporter 2 inhibitor empagliflozin offers a new and attractive option, given their complementary mechanisms of action. Publications with titles containing the keywords 'linagliptin' or 'empagliflozin' were identified from a non-systematic search of PubMed without date restrictions, together with abstracts presented at the annual meetings of the American Diabetes Association and the European Association for the Study of Diabetes 2012-2014. ClinicalTrials.gov was searched for entries containing these two keywords. Additional references known to the author were included. The efficacy and safety of linagliptin and empagliflozin as monotherapy or in combination with other oral antidiabetic drugs has been established through extensive clinical trial programs. Studies specifically evaluating the efficacy/safety of a dipeptidyl peptidase-4 inhibitor/sodium glucose co-transporter 2 inhibitor in combination are limited, but do include two studies of linagliptin/empagliflozin of up to 52 weeks in duration. These studies show that the single-pill combination of linagliptin and empagliflozin produced clinical improvements in glycemic control that were generally superior to the improvements seen with linagliptin and empagliflozin alone, but with a safety profile comparable to that of the individual constituents. The single-pill combination of linagliptin and empagliflozin, with their complementary mechanisms of action, is a promising treatment option for patients with type 2 diabetes mellitus. It would reduce the daily

  6. Single-channel L-type Ca2+ currents in chicken embryo semicircular canal type I and type II hair cells.

    Science.gov (United States)

    Zampini, Valeria; Valli, Paolo; Zucca, Giampiero; Masetto, Sergio

    2006-08-01

    Few data are available concerning single Ca channel properties in inner ear hair cells and particularly none in vestibular type I hair cells. By using the cell-attached configuration of the patch-clamp technique in combination with the semicircular canal crista slice preparation, we determined the elementary properties of voltage-dependent Ca channels in chicken embryo type I and type II hair cells. The pipette solutions included Bay K 8644. With 70 mM Ba(2+) in the patch pipette, Ca channel activity appeared as very brief openings at -60 mV. Ca channel properties were found to be similar in type I and type II hair cells; therefore data were pooled. The mean inward current amplitude was -1.3 +/- 0.1 (SD) pA at - 30 mV (n = 16). The average slope conductance was 21 pS (n = 20). With 5 mM Ba(2+) in the patch pipette, very brief openings were already detectable at -80 mV. The mean inward current amplitude was -0.7 +/- 0.2 pA at -40 mV (n = 9). The average slope conductance was 11 pS (n = 9). The mean open time and the open probability increased significantly with depolarization. Ca channel activity was still present and unaffected when omega-agatoxin IVA (2 microM) and omega-conotoxin GVIA (3.2 microM) were added to the pipette solution. Our results show that types I and II hair cells express L-type Ca channels with similar properties. Moreover, they suggest that in vivo Ca(2+) influx might occur at membrane voltages more negative than -60 mV.

  7. A new type of single-phase five-level inverter

    Science.gov (United States)

    Xu, Zhi; Li, Shengnan; Qin, Risheng; Zhao, Yanhang

    2017-11-01

    At present, Neutral Point Clamped (NPC) multilevel inverter is widely applied in new energy field. However, it has some disadvantages including low utilization rate of direct current (DC) voltage source and the unbalance of neutral potential. Therefore, a new single-phase five level inverter is proposed in this paper. It has two stage structure, the former stage is equivalent to three level DC/DC converter, and the back stage uses H bridge to realize inverter. Compared with the original central clamp type inverter, the new five level inverter can improve the utilization of DC voltage, and realize the neutral point potential balance with hysteresis comparator.

  8. Posterolateral fusion with interbody for lumbar spondylolisthesis is associated with less repeat surgery than posterolateral fusion alone.

    Science.gov (United States)

    Macki, Mohamed; Bydon, Mohamad; Weingart, Robby; Sciubba, Daniel; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Bydon, Ali; Witham, Timothy

    2015-11-01

    Posterior or transforaminal lumbar interbody fusions (PLIF/TLIF) may improve the outcomes in patients with lumbar spondylolisthesis. This study aims to compare outcomes after posterolateral fusion (PLF) only versus PLF with interbody fusion (PLF+PLIF/TLIF) in patients with spondylolisthesis. We retrospectively reviewed103 patients who underwent first-time instrumented lumbar fusions for degenerative or isthmic spondylolisthesis. Anterior techniques and multilevel interbody fusions were excluded. All patients were followed for at least 2 years postoperatively. Clinical outcomes including back pain, radiculopathy, weakness, sensory deficits, and loss of bowel/bladder function were ascertained from clinic notes. Radiographic measures were calculated with Tillard percentage of spondylolisthesis. Reoperation for progression of degenerative disease, a primary endpoint, was indicated for all patients with (1) persistent or new-onset neurological symptoms; and (2) radiographic imaging that correlated with clinical presentation. Of the 103 patients, 56.31% were managed with PLF and 43.69% with PLF+PLIF/TLIF. On radiographic studies, spondylolisthesis improved by a mean of 13.06% after PLF+PLIF/TLIF versus 5.67% after PLF (pspondylolisthesis. Patients with interbody fusions were less likely to undergo reoperation for degenerative disease progression compared to non-interbody fusions. However, greater listhesis correction and decreased reoperation in the PLF+PLIF/TLIF cohort should be weighed with favorable clinical outcomes in the PLF cohort. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. High speed single nucleotide polymorphism typing of a hereditary haemochromatosis mutation with capillary array electrophoresis microplates.

    Science.gov (United States)

    Medintz, I; Wong, W W; Sensabaugh, G; Mathies, R A

    2000-07-01

    A single nucleotide polymorphism (SNP) typing assay is developed and evaluated on a microfabricated capillary array electrophoresis system. Using fluorescently labeled allele-specific primers, the S65C (193A-->T) substitution associated with hereditary haemochromatosis in the HFE gene is genotyped. The covalently labeled polymerase chain reaction (PCR) products are separated on a microfabricated radial capillary array electrophoresis microplate using nondenaturing gel media in under two minutes. Detection is accomplished with a laser-excited rotary confocal scanner. The Rox-labeled A-allele specific amplicon (211 bp) is differentiated from the R110-labeled T-allele specific amplicon (201 bp) by both size and color. This study demonstrates the feasibility of using allele-specific PCR with covalently labeled primers for high speed fluorescent SNP typing on microfabricated radial capillary array electrophoresis microplates.

  10. Laser microdissection and DNA typing of cells from single hair follicles.

    Science.gov (United States)

    Di Martino, D; Giuffrè, G; Staiti, N; Simone, A; Todaro, P; Saravo, L

    2004-12-02

    Isolation and identification of single cells from tissue samples or smears assume a great relevance in pathological and forensic applications; in this latter field, the possibility to identify a specific genetic profile can be obtained by short tandem repeat (STR) typing, allowing to achieve a scientific proof important in law courts. It is well known that DNA extraction may be performed from several tissue fragments, blood traces, spermatozoa as well as telogen hair. However, in the last case, few follicle cells are coupled to a great amount of keratin reducing the efficiency of DNA amplification. Recently, the introduction of laser microdissection technique has greatly improved the capability to select single cells without any cross-contamination. In the present report, we have performed a laser microdissection using a Leica AS LMD (Leica Microsystems, Germany), utilized on cutting the telogen hair in order to exclusively collect the lower part of the follicle and reduce keratin contamination. In this way we can accurately extract an adequate amount of DNA, successfully typed by STR profile.

  11. Fusion and subsidence rate of stand alone anterior lumbar interbody fusion using PEEK cage with recombinant human bone morphogenetic protein-2.

    Science.gov (United States)

    Behrbalk, Eyal; Uri, Ofir; Parks, Ruth M; Musson, Rachel; Soh, Reuben Chee Cheong; Boszczyk, Bronek Maximilian

    2013-12-01

    Anterior lumbar interbody fusion (ALIF) is an established treatment for structural instability associated with symptomatic disk degeneration (SDD). Stand-alone ALIF offers many advantages, however, it may increase the risk of non-union. Recombinant human bone morphogenetic protein-2 (BMP-2) may enhance fusion rate but is associated with postoperative complication. The optimal dose of BMP-2 remains unclear. This study assessed the fusion and subsidence rates of stand-alone ALIF using the SynFix-LR interbody cage with 6 ml/level of BMP-2. Thirty-two ALIF procedures were performed by a single surgeon in 25 patients. Twenty-five procedures were performed for SDD without spondylolisthesis (SDD group) and seven procedures were performed for SDD with grade-I olisthesis (SDD-olisthesis group). Patients were followed-up for a mean of 17 ± 6 months. Solid fusion was achieved in 29 cases (90.6 %) within 6 months postoperatively. Five cases of implant subsidence were observed (16 %). Four of these occurred in the SDD-olisthesis group and one occurred in the SDD group (57 % vs. 4 % respectively; p = 0.004). Three cases of subsidence failed to fuse and required revision. The body mass index of patients with olisthesis who developed subsidence was higher than those who did not develop subsidence (29 ± 2.6 vs. 22 ± 6.5 respectively; p = 0.04). No BMP-2 related complications occurred. The overall fusion rate of stand-alone ALIF using the SynFix-LR system with BMP-2 was 90.6 %, comparable with other published series. No BMP-2 related complication occurred at a dose of 6 mg/level. Degenerative spondylolisthesis and obesity seemed to increase the rate of implant subsidence, and thus we believe that adding posterior fusion for these cases should be considered.

  12. Distinct circular single-stranded DNA viruses exist in different soil types.

    Science.gov (United States)

    Reavy, Brian; Swanson, Maud M; Cock, Peter J A; Dawson, Lorna; Freitag, Thomas E; Singh, Brajesh K; Torrance, Lesley; Mushegian, Arcady R; Taliansky, Michael

    2015-06-15

    The potential dependence of virus populations on soil types was examined by electron microscopy, and the total abundance of virus particles in four soil types was similar to that previously observed in soil samples. The four soil types examined differed in the relative abundances of four morphological groups of viruses. Machair, a unique type of coastal soil in western Scotland and Ireland, differed from the others tested in having a higher proportion of tailed bacteriophages. The other soils examined contained predominantly spherical and thin filamentous virus particles, but the Machair soil had a more even distribution of the virus types. As the first step in looking at differences in populations in detail, virus sequences from Machair and brown earth (agricultural pasture) soils were examined by metagenomic sequencing after enriching for circular Rep-encoding single-stranded DNA (ssDNA) (CRESS-DNA) virus genomes. Sequences from the family Microviridae (icosahedral viruses mainly infecting bacteria) of CRESS-DNA viruses were predominant in both soils. Phylogenetic analysis of Microviridae major coat protein sequences from the Machair viruses showed that they spanned most of the diversity of the subfamily Gokushovirinae, whose members mainly infect obligate intracellular parasites. The brown earth soil had a higher proportion of sequences that matched the morphologically similar family Circoviridae in BLAST searches. However, analysis of putative replicase proteins that were similar to those of viruses in the Circoviridae showed that they are a novel clade of Circoviridae-related CRESS-DNA viruses distinct from known Circoviridae genera. Different soils have substantially different taxonomic biodiversities even within ssDNA viruses, which may be driven by physicochemical factors. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  13. THE DISTRIBUTION OF DIFFERENT TYPES OF DIABETES IN CHILDHOOD: A SINGLE CENTER EXPERIENCE.

    Science.gov (United States)

    Haliloğlu, Belma; Abali, Saygın; Buğrul, Fuat; Çelik, Enes; Baş, Serpil; Atay, Zeynep; Güran, Tülay; Turan, Serap; Bereket, Abdullah

    2017-11-24

    Type 1 diabetes (T1D) is the most common cause of diabetes in childhood but type 2 diabetes (T2D) and maturity onset diabetes of the young (MODY) are emerging and noteworthy causes of diabetes in youths. The aim of the study is to determine the distribution, trends and clinical features of the different types of diabetes in childhood in a tertiary single-center. Children and adolescents aged 0-18 years who were diagnosed "diabetes/persistent hyperglycemia" between January 1999 and December 2016, were reviewed. Clinical and laboratory characteristics of the patients at the diagnosis and type of diabetes were recorded. The mean age of 835 patients (48.7% females) at diagnosis was 8.8±4.4 years. Eighty-four percent of the patients were diagnosed with T1D, 5.7% with T2D, 5.3% with clinical MODY and 5% with other types of diabetes. The frequency of all DKA and severe DKA in T1D were 48.4% and 11.6%, respectively. Fourteen patients (29.2%) with T2D presented with ketosis and 2 of them (4.2%) had DKA at diagnosis. Antibody positivity was 83.1% in T1D and 14.8% in T2D. A statistically significant increase in the frequency of T2D has clearly been demonstrated in recent years with a frequency of 1.9%, 2.4% and 7.9% in 1999-2004, 2005-2010 and 2011-2016, respectively (pchildhood, a trend towards increase in the frequency of T2D in recent years is notable in our population.

  14. Is Body Mass Index a Risk Factor for Revision Procedures After Minimally Invasive Transforaminal Lumbar Interbody Fusion?

    Science.gov (United States)

    Narain, Ankur S; Hijji, Fady Y; Bohl, Daniel D; Yom, Kelly H; Kudaravalli, Krishna T; Singh, Kern

    2018-02-01

    Retrospective cohort study. To determine if an association exists between body mass index (BMI) and the rate of revision surgery after single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). MIS TLIF is an effective treatment for lumbar degenerative disease. Previous studies in the orthopedic literature have associated increased BMI with increased postoperative complications and need for revision. Few studies have evaluated the association between BMI and the risk for revision after minimally invasive spinal procedures. A surgical registry of patients who underwent a single-level MIS TLIF for degenerative pathology between 2005 and 2014 was reviewed. Patients were stratified based on BMI category: normal weight (BMIrevision fusion procedure within 2 years after MIS TLIF using multivariate Cox proportional hazards survival analysis modeling. In total, 274 patients were analyzed; of these, 52 (18.98%) were normal weight, 101 (36.86%) were overweight, 62 (22.63%) were obese I, and 59 (21.53%) were obese II-III. On multivariate Cox proportional hazards survival analysis modeling, BMI category was not associated with undergoing a revision procedure within 2 years after MIS TLIF (P=0.599). On multivariate analysis, younger age (P=0.004) was associated with increased risk of undergoing a revision after MIS TLIF. The results of this study suggest that increasing BMI is not a risk factor for undergoing a revision procedure after MIS TLIF. As such, patients with high BMI should be counseled regarding having similar rates of needing a revision procedure after MIS TLIF as those with lower BMI. Level IV.

  15. Plasminogen Activator Inhibitor Type-1 Tag Single-Nucleotide Polymorphisms in Patients with Diabetes Mellitus Type 2 and Diabetic Retinopathy.

    Science.gov (United States)

    Siokas, Vasileios; Dardiotis, Efthimios; Sokolakis, Thomas; Kotoula, Maria; Tachmitzi, Sophia V; Chatzoulis, Dimitrios Z; Almpanidou, Pavlina; Stefanidis, Ioannis; Hadjigeorgiou, Georgios M; Tsironi, Evangelia E

    2017-07-01

    There is accumulating evidence for genetic susceptibility to the development of diabetic retinopathy (DR). The role of plasminogen activator inhibitor-1 (PAI-1) in DR risk remains controversial. The present study was designed to investigate possible influence of PAI-1 gene region polymorphisms on the risk of DR and on the risk of developing DR early vs late in the course of type 2 diabetes mellitus (T2DM). A total of 138 patients with DR, 107 patients with T2DM without DR, and 315 healthy controls were recruited. To cover the majority of the genetic variability across the extended region of PAI-1 gene, five tag single-nucleotide polymorphisms (SNPs) from the HapMap using a pairwise approach and an r 2 ≥ 0.8 and a minor allele frequency (MAF) of >0.05 were identified. Using logistic regression analyses, tag SNPs and haplotypes were tested for associations with DR risk and risk of DR development early or late in the course of T2DM. The generalized odds ratio (OR G ) was calculated to estimate the mutational load effect on DR development among all participants. Corrections for multiple comparisons were carried out (p-value < 0.01). A significant effect of rs2070682 on the risk of early DR onset was found in the codominant model of inheritance [odds ratio, OR (95% confidence interval, CI): 5.04 (1.47-17.28), p = 0.018]. However, this association marginally did not survive multiple testing corrections. No other significant association between PAI-1 tag-SNPs and haplotypes was revealed. Furthermore, no significant mutational load effect of PAI-1 tag SNPs on the risk of DR development in T2DM course was found. In conclusion, the present study does not provide any strong evidence that PAI-1 gene variants are implicated in the risk of DR or the development of DR during T2DM course.

  16. [COMPARISON OF EFFECTIVENESS AND CHANGE OF SAGITTAL SPINO-PELVIC PARAMETERS BETWEEN MINIMALLY INVASIVE TRANSFORAMINAL AND CONVENTIONAL OPEN POSTERIOR LUMBAR INTERBODY FUSIONS IN TREATMENT OF LOW-DEGREE ISTHMIC LUMBAR SPONDYLOLISTHESIS].

    Science.gov (United States)

    Sun, Xin; Zeng, Rong; Li, Guangsheng; Wei, Bo; Hu, Zibing; Lin, Hao; Chen, Guanghua; Chen, Siyuan; Sun, Jiecong

    2015-12-01

    To compare the effectiveness and changes of sagittal spino-pelvic parameters between minimally invasive transforaminal lumbar interbody fusion and conventional open posterior lumbar interbody fusion in treatment of the low-degree isthmic lumbar spondylolisthesis. Between May 2012 and May 2013, 86 patients with single segmental isthmic lumbar spondylolisthesis (Meyerding degree I or II) were treated by minimally invasive transforaminal lumbar interbody fusion (minimally invasive group) in 39 cases, and by open posterior lumbar interbody fusion in 47 cases (open group). There was no significant difference in gender, age, disease duration, degree of lumbar spondylolisthesis, preoperative visual analogue scale (VAS) score, and Oswestry disability index (ODI) between 2 groups (P>0.05). The following sagittal spino-pelvic parameters were compared between 2 groups before and after operation: the percentage of slipping (PS), intervertebral height, angle of slip (AS), thoracolumbar junction (TLJ), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), spino-sacral angle (SSA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI). Pearson correlation analysis of the changes between pre- and post-operation was done. Primary healing of incision was obtained in all patients of 2 groups. The postoperative hospital stay of minimally invasive group [(5.1 ± 1.6) days] was significantly shorter than that of open group [(7.2 ± 2.1) days] (t = 2.593, P = 0.017). The patients were followed up 11-20 months (mean, 15 months). The reduction rate was 68.53% ± 20.52% in minimally invasive group, and was 64.21% ± 30.21% in open group, showing no significant difference (t = 0.725, P = 0.093). The back and leg pain VAS scores, and ODI at 3 months after operation were significantly reduced when compared with preoperative ones (P 0.05). The postoperative other sagittal spino-pelvic parameters were significantly improved (P 0.05), but there was no significant

  17. Study of the signal formation in single-type column 3D silicon detectors

    International Nuclear Information System (INIS)

    Piemonte, Claudio; Boscardin, Maurizio; Bosisio, Luciano; Dalla Betta, Gian-Franco; Pozza, Alberto; Ronchin, Sabina; Zorzi, Nicola

    2007-01-01

    Because of their superior radiation resistance, three-dimensional (3D) silicon sensors are receiving more and more interest for application in the innermost layers of tracker systems for experiments running in very high luminosity colliders. Their short electrode distance allows for both a low depletion voltage and a high charge collection efficiency even at extremely high radiation fluences. In order to fully understand the properties of a 3D detector, a thorough characterization of the signal formation mechanism is of paramount importance. In this work the shape of the current induced by localized and uniform charge depositions in a single-type column 3D detector is studied. A first row estimation is given applying the Ramo theorem, then a more complete TCAD simulation is used to provide a more realistic pulse shape

  18. High efficiency 40 K single-stage Stirling-type pulse tube cryocooler

    Science.gov (United States)

    Wu, X. L.; Chen, L. B.; Pan, C. Z.; Cui, C.; Wang, J. J.; Zhou, Y.

    2017-12-01

    A high efficiency single-stage Stirling-type coaxial pulse tube cryocooler (SPTC) operating at around 40 K has been designed, built and tested. The double-inlet and the inertance tubes together with the gas reservoir were adopted as the phase shifters. Under the conditions of 2.5 MPa charging pressure and 30 Hz operating frequency, the prototype has achieved a no-load temperature of 23.8 K with 330 W of electric input power at a rejection temperature of 279 K. When the input power increases to 400 W, it can achieve a cooling capacity of 4.7 W/40 K while rejecting heat at 279 K yielding an efficiency of 7.02% relative to Carnot. It achieves a cooling capacity of 5 W/40 K with an input power of 450 W. It takes 10 minutes for the SPTC to cool to its no-load temperature of 40 K from 295 K.

  19. Stochastic gravitational wave background from the single-degenerate channel of type Ia supernovae

    International Nuclear Information System (INIS)

    Falta, David; Fisher, Robert

    2011-01-01

    We demonstrate that the integrated gravitational wave signal of type Ia supernovae (SNe Ia) in the single-degenerate channel out to cosmological distances gives rise to a continuous background to spaceborne gravitational wave detectors, including the Big Bang Observer and Deci-Hertz Interferometer Gravitational wave Observatory planned missions. This gravitational wave background from SNe Ia acts as a noise background in the frequency range 0.1-10 Hz, which heretofore was thought to be relatively free from astrophysical sources apart from neutron-star and white-dwarf binaries, and therefore a key window in which to study primordial gravitational waves generated by inflation. While inflationary energy scales of > or approx. 10 16 GeV yield inflationary gravitational wave backgrounds in excess of our range of predicted backgrounds, for lower energy scales of ∼10 15 GeV, the inflationary gravitational wave background becomes comparable to the noise background from SNe Ia.

  20. The contribution of single photon emission computed tomography in the clinical assessment of Alzheimer type dementia

    International Nuclear Information System (INIS)

    Boudousq, V.; Collombier, L.; Kotzki, P.O.

    1999-01-01

    Interest of brain single-photon emission computed tomography to support clinical diagnosis of Alzheimer-type dementia is now established. Numerous studies have reported a decreased perfusion in the association cortex of the parietal lobe and the posterior temporal regions. In patients with mild cognitive complaints, the presence of focal hypoperfusion may increase substantially the probability of the disease. In addition, emission tomography emerges as a helpful tool in situation in which there is diagnostic doubt. In this case, the presence of temporo-parietal perfusion deficit associated with hippocampal atrophy on MRI or X-ray computed tomography contributes to diagnostic accuracy. However, some studies suggest that emission tomography may be useful for preclinical prediction of Alzheimer's disease and to predict cognitive decline. (author)

  1. Phonon-limited mobility in n-type single-layer MoS2 from first principles

    DEFF Research Database (Denmark)

    Kaasbjerg, Kristen; Thygesen, Kristian S.; Jacobsen, Karsten W.

    2012-01-01

    We study the phonon-limited mobility in intrinsic n-type single-layer MoS2 for temperatures T > 100 K. The materials properties including the electron-phonon interaction are calculated from first principles and the deformation potentials and Frohlich interaction in single-layer MoS2 are establish...

  2. Oscillations of a single Abrikosov vortex in hard type-II superconductors

    Science.gov (United States)

    Rusakov, V. F.; Chabanenko, V. V.; Nabiałek, A.; Chumak, O. M.

    2017-06-01

    During the last decade, detection and manipulation of single vortex lines in bulk superconductors have been achieved experimentally. Electrodynamic response of pinned vortices in the high-frequency range is instrumental in studying specific aspects of their behavior. The present paper reviews the state of the art in studies of the oscillations of a single Abrikosov vortex in type II superconductors. The equations for free and forced oscillations of a single elastic vortex line are analyzed taking into account different forces affecting its motion: pinning, elasticity, viscosity and the Lorenz force. The equations also account for the inertial properties of a vortex due to various mechanisms of massiveness. The nature and magnitude of the vortex effective mass caused by some of the mechanisms are discussed in the paper. The roles of each force and inertia in the free oscillation spectrum are thoroughly analyzed. For the De Gennes and Matricon mode (at about a megahertz) with parabolic dispersion and the pinning force taken into account, there is an activation threshold. Taking into account the effective vortex mass in the equation of motion leads to the occurrence of a high-frequency mode (at about a terahertz) in the oscillation spectrum which is also of the activation nature. Estimations of the characteristic frequencies for these modes are given for two common superconductors, NbTi and anisotropic YBaCuO. The paper also presents the features of the resonant behavior of an elastic massive vortex line arising under an external uniform harmonic driving force that decays into the bulk of the sample, taking into account all the above forces. The frequency and temperature dependences of the energy absorption by a vortex line are analyzed. Maximum absorption in the low-frequency mode corresponds to the threshold frequency, while that in the high-frequency mode corresponds to the vortex cyclotron frequency. Vortex manipulation experiments and vortex dynamics simulation

  3. Load-sharing through elastic micro-motion accelerates bone formation and interbody fusion.

    Science.gov (United States)

    Ledet, Eric H; Sanders, Glenn P; DiRisio, Darryl J; Glennon, Joseph C

    2018-02-13

    Achieving a successful spinal fusion requires the proper biological and biomechanical environment. Optimizing load-sharing in the interbody space can enhance bone formation. For anterior cervical discectomy and fusion (ACDF), loading and motion are largely dictated by the stiffness of the plate, which can facilitate a balance between stability and load-sharing. The advantages of load-sharing may be substantial for patients with comorbidities and in multilevel procedures where pseudarthrosis rates are significant. We aimed to evaluate the efficacy of a novel elastically deformable, continuously load-sharing anterior cervical spinal plate for promotion of bone formation and interbody fusion relative to a translationally dynamic plate. An in vivo animal model was used to evaluate the effects of an elastically deformable spinal plate on bone formation and spine fusion. Fourteen goats underwent an ACDF and received either a translationally dynamic or elastically deformable plate. Animals were followed up until 18 weeks and were evaluated by plain x-ray, computed tomography scan, and undecalcified histology to evaluate the rate and quality of bone formation and interbody fusion. Animals treated with the elastically deformable plate demonstrated statistically significantly superior early bone formation relative to the translationally dynamic plate. Trends in the data from 8 to 18 weeks postoperatively suggest that the elastically deformable implant enhanced bony bridging and fusion, but these enhancements were not statistically significant. Load-sharing through elastic micro-motion accelerates bone formation in the challenging goat ACDF model. The elastically deformable implant used in this study may promote early bony bridging and increased rates of fusion, but future studies will be necessary to comprehensively characterize the advantages of load-sharing through micro-motion. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Titanium vs. polyetheretherketone (PEEK) interbody fusion: Meta-analysis and review of the literature.

    Science.gov (United States)

    Seaman, Scott; Kerezoudis, Panagiotis; Bydon, Mohamad; Torner, James C; Hitchon, Patrick W

    2017-10-01

    Spinal interbody fusion is a standard and accepted method for spinal fusion. Interbody fusion devices include titanium (Ti) and polyetheretherketone (PEEK) cages with distinct biomechanical properties. Titanium and PEEK cages have been evaluated in the cervical and lumbar spine, with conflicting results in bony fusion and subsidence. Using Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines, we reviewed the available literature evaluating Ti and PEEK cages to assess subsidence and fusion rates. Six studies were included in the analysis, 3 of which were class IV evidence, 2 were class III, and 1 was class II. A total of 410 patients (Ti-228, PEEK-182) and 587 levels (Ti-327, PEEK-260) were studied. Pooled mean age was 50.8years in the Ti group, and 53.1years in the PEEK group. Anterior cervical discectomy was performed in 4 studies (395 levels) and transforaminal interbody fusion in 2 studies (192 levels). No statistically significant difference was found between groups with fusion (OR 1.16, 95% C.I 0.59-2.89, p=0.686, I 2 =49.7%) but there was a statistically significant the rate of subsidence with titanium (OR 3.59, 95% C.I 1.28-10.07, p=0.015, I 2 =56.9%) at last follow-up. Titanium and PEEK cages are associated with a similar rate of fusion, but there is an increased rate of subsidence with titanium cage. Future prospective randomized controlled trials are needed to further evaluate these cages using surgical and patient-reported outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Complete cage migration/subsidence into the adjacent vertebral body after posterior lumbar interbody fusion.

    Science.gov (United States)

    Corniola, Marco V; Jägersberg, Max; Stienen, Martin N; Gautschi, Oliver P

    2015-03-01

    A variety of implant-related short and long-term complications after lumbar fusion surgery are recognized. Mid to long-term complications due to cage migration and/or cage subsidence are less frequently reported. Here, we report a patient with a complete cage migration into the superior adjacent vertebral body almost 20 years after the initial posterior lumbar interbody fusion procedure. In this patient, the cage migration/subsidence was clinically silent, but a selective decompression for adjacent segment degenerative lumbar spinal stenosis was performed. We discuss the risk factors for cage migration/subsidence in view of the current literature. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Single-donor islet transplantation in type 1 diabetes: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Tatum JA

    2017-02-01

    Full Text Available Jacob A Tatum,* Max O Meneveau,* Kenneth L Brayman Department of Surgery, Division of Transplantation, The University of Virginia Health System, Charlottesville, VA, USA *These authors contributed equally to this work. Abstract: Type 1 diabetes mellitus is an autoimmune disorder of the endocrine pancreas that currently affects millions of people in the United States. Although the disease can be managed with exogenous insulin administration, the ultimate cure for the condition lies in restoring a patient’s ability to produce their own insulin. Islet cell allotransplantation provides a means of endogenous insulin production. Though far from perfected, islet transplants are now a proven treatment for type 1 diabetics. However, proper patient selection is critical for achieving optimal outcomes. Given the shortage of transplantable organs, selecting appropriate candidates for whom the procedure will be of greatest benefit is essential. Although many of those who receive islets do not retain insulin independence, grafts do play a significant role in preventing hypoglycemic episodes that can be quite detrimental to quality of life and potentially fatal. Additionally, islet transplant requires lifelong immunosuppression. Antibodies, both preformed and following islet infusion, may play important roles in graft outcomes. Finally, no procedure is without inherent risk and islet transfusions can have serious consequences for recipients’ livers in the form of both vascular and metabolic complications. Therefore, patient-specific factors that should be taken into account before islet transplantation include aims of therapy, sensitization, and potential increased risk for hepatic and portal-venous sequelae. Keywords: islet transplantation, diabetes mellitus type 1, brittle diabetes, single donor, patient

  7. Computational Analysis of Single Nucleotide Polymorphisms Associated with Altered Drug Responsiveness in Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Valerio Costa

    2016-06-01

    Full Text Available Type 2 diabetes (T2D is one of the most frequent mortality causes in western countries, with rapidly increasing prevalence. Anti-diabetic drugs are the first therapeutic approach, although many patients develop drug resistance. Most drug responsiveness variability can be explained by genetic causes. Inter-individual variability is principally due to single nucleotide polymorphisms, and differential drug responsiveness has been correlated to alteration in genes involved in drug metabolism (CYP2C9 or insulin signaling (IRS1, ABCC8, KCNJ11 and PPARG. However, most genome-wide association studies did not provide clues about the contribution of DNA variations to impaired drug responsiveness. Thus, characterizing T2D drug responsiveness variants is needed to guide clinicians toward tailored therapeutic approaches. Here, we extensively investigated polymorphisms associated with altered drug response in T2D, predicting their effects in silico. Combining different computational approaches, we focused on the expression pattern of genes correlated to drug resistance and inferred evolutionary conservation of polymorphic residues, computationally predicting the biochemical properties of polymorphic proteins. Using RNA-Sequencing followed by targeted validation, we identified and experimentally confirmed that two nucleotide variations in the CAPN10 gene—currently annotated as intronic—fall within two new transcripts in this locus. Additionally, we found that a Single Nucleotide Polymorphism (SNP, currently reported as intergenic, maps to the intron of a new transcript, harboring CAPN10 and GPR35 genes, which undergoes non-sense mediated decay. Finally, we analyzed variants that fall into non-coding regulatory regions of yet underestimated functional significance, predicting that some of them can potentially affect gene expression and/or post-transcriptional regulation of mRNAs affecting the splicing.

  8. Results of lumbar spondylodeses using different bone grafting materials after transforaminal lumbar interbody fusion (TLIF).

    Science.gov (United States)

    vonderHoeh, Nicolas Heinz; Voelker, Anna; Heyde, Christoph-Eckhard

    2017-11-01

    Can a mixture of hydroxyapatite (HA) and autologous bone from decompression sites produce similar results when used for transforaminal lumbar interbody fusion (TLIF)? In the current literature, autologous iliac crest bone grafts (ICBGs) have been reported the gold standard for this procedure. Indeed, to date, no clinical data have confirmed that a mixture of equal volumes of HA and local autologous bone produce similar results in term of fusion as the same volume of autologous ICBG alone. Study design/setting This study was approved by the local ethics committee and completed in a prospective, randomized, single-blinded manner. The results of lumbar fusion using TLIF and different bone grafting materials were compared. Patient sample The patient sample included patients with spinal lumbar degenerative disease. Outcome measures The clinical outcome was determined using the Oswestry Low Back Pain Disability Questionnaire (ODI) and Visual Analog Scale (VAS). The radiological outcomes and fusion rates were determined with radiographs evaluated using the McAfee criteria and computed tomography (CT) data evaluated by the Williams criteria. Three blinded investigators (one radiologist and two orthopedic surgeons) assessed the data. The secondary variables included donor site morbidity. Methods The patients were admitted to our department for orthopedic surgery with degenerative lumbar pathologies (L2-S1) that required stabilization in one or two segments using a TLIF procedure. The patients were 18-80 years old. Only those patients who had degenerative lumbar pathologies and agreed to be educated about the study were included. The patients were divided into the following two randomized groups: group A: TLIF procedure using autologous ICBGs alone; and group B: TLIF procedure using local bone from decompression site mixed with hydroxyapatite. Each group received equal graft volumes. The mixture in group B consisted of equal volumes of local autograft (5 cc) and synthetic

  9. Biomechanical Evaluation of a Novel Apatite-Wollastonite Ceramic Cage Design for Lumbar Interbody Fusion: A Finite Element Model Study.

    Science.gov (United States)

    Bozkurt, Celal; Şenköylü, Alpaslan; Aktaş, Erdem; Sarıkaya, Baran; Sipahioğlu, Serkan; Gürbüz, Rıza; Timuçin, Muharrem

    2018-01-01

    Cage design and material properties play a crucial role in the long-term results, since interbody fusions using intervertebral cages have become one of the basic procedures in spinal surgery. Our aim is to design a novel Apatite-Wollastonite interbody fusion cage and evaluate its biomechanical behavior in silico in a segmental spinal model. Mechanical properties for the Apatite-Wollastonite bioceramic cages were obtained by fitting finite element results to the experimental compression behavior of a cage prototype. The prototype was made from hydroxyapatite, pseudowollastonite, and frit by sintering. The elastic modulus of the material was found to be 32 GPa. Three intact lumbar vertebral segments were modelled with the ANSYS 12.0.1 software and this model was modified to simulate a Posterior Lumbar Interbody Fusion. Four cage designs in different geometries were analyzed in silico under axial loading, flexion, extension, and lateral bending. The K2 design had the best overall biomechanical performance for the loads considered. Maximum cage stress recorded was 36.7 MPa in compression after a flexion load, which was within the biomechanical limits of the cage. Biomechanical analyses suggest that K2 bioceramic cage is an optimal design and reveals essential material properties for a stable interbody fusion.

  10. Shape optimization for the subsidence resistance of an interbody device using simulation-based genetic algorithms and experimental validation.

    Science.gov (United States)

    Hsu, Ching-Chi

    2013-07-01

    Subsidence of interbody devices into the vertebral body might result in serious clinical problems, especially when the devices are not well designed and analyzed. Recently, some novel designs were proposed to reduce the risk of subsidence, but those designs are based on the researcher's experience. The purpose of this study was to discover the interbody device design with excellent subsidence resistance by changing the device's shape. The three-dimensional nonlinear finite element models, which consisted of the interbody device and vertebral body, were created first. Then, the simulation-based genetic algorithm, which combined the finite element model and the searching algorithm, was developed by using ANSYS® Parametric Design Language. Finally, the numerical results were carefully validated with the use of biomechanical tests. The optimum shape design obtained in this study looks like a flower with many petals and it has excellent subsidence resistance when compared with the other designs provided by the past studies. The results of the present study could help surgeons to understand the subsidence resistance of interbody devices in terms of their shapes and has directly provided the design rationales to engineers. Copyright © 2013 Orthopaedic Research Society.

  11. WHITE DWARF/M DWARF BINARIES AS SINGLE DEGENERATE PROGENITORS OF TYPE Ia SUPERNOVAE

    International Nuclear Information System (INIS)

    Wheeler, J. Craig

    2012-01-01

    Limits on the companions of white dwarfs in the single-degenerate scenario for the origin of Type Ia supernovae (SNe Ia) have gotten increasingly tight, yet igniting a nearly Chandrasekhar mass C/O white dwarf from a condition of near hydrostatic equilibrium provides compelling agreement with observed spectral evolution. The only type of non-degenerate stars that survive the tight limits, M V ∼> 8.4 on the SN Ia in SNR 0509-67.5 and M V ∼> 9.5 in the remnant of SN 1572, are M dwarfs. While M dwarfs are observed in cataclysmic variables, they have special properties that have not been considered in most work on the progenitors of SNe Ia: they have small but finite magnetic fields and they flare frequently. These properties are explored in the context of SN Ia progenitors. White dwarf/M dwarf pairs may be sufficiently plentiful to provide, in principle, an adequate rate of explosions even with slow orbital evolution due to magnetic braking or gravitational radiation. Even modest magnetic fields on the white dwarf and M dwarf will yield adequate torques to lock the two stars together, resulting in a slowly rotating white dwarf, with the magnetic poles pointing at one another in the orbital plane. The mass loss will be channeled by a 'magnetic bottle' connecting the two stars, landing on a concentrated polar area on the white dwarf. This enhances the effective rate of accretion compared to spherical accretion. Luminosity from accretion and hydrogen burning on the surface of the white dwarf may induce self-excited mass transfer. The combined effects of self-excited mass loss, polar accretion, and magnetic inhibition of mixing of accretion layers give possible means to beat the 'nova limit' and grow the white dwarf to the Chandrasekhar mass even at rather moderate mass accretion rates.

  12. Designing Kerr interactions using multiple superconducting qubit types in a single circuit

    Science.gov (United States)

    Elliott, Matthew; Joo, Jaewoo; Ginossar, Eran

    2018-02-01

    The engineering of Kerr interactions is of great interest for processing quantum information in multipartite quantum systems and for investigating many-body physics in a complex cavity-qubit network. We study how coupling multiple different types of superconducting qubits to the same cavity modes can be used to modify the self- and cross-Kerr effects acting on the cavities and demonstrate that this type of architecture could be of significant benefit for quantum technologies. Using both analytical perturbation theory results and numerical simulations, we first show that coupling two superconducting qubits with opposite anharmonicities to a single cavity enables the effective self-Kerr interaction to be diminished, while retaining the number splitting effect that enables control and measurement of the cavity field. We demonstrate that this reduction of the self-Kerr effect can maintain the fidelity of coherent states and generalised Schrödinger cat states for much longer than typical coherence times in realistic devices. Next, we find that the cross-Kerr interaction between two cavities can be modified by coupling them both to the same pair of qubit devices. When one of the qubits is tunable in frequency, the strength of entangling interactions between the cavities can be varied on demand, forming the basis for logic operations on the two modes. Finally, we discuss the feasibility of producing an array of cavities and qubits where intermediary and on-site qubits can tune the strength of self- and cross-Kerr interactions across the whole system. This architecture could provide a way to engineer interesting many-body Hamiltonians and be a useful platform for quantum simulation in circuit quantum electrodynamics.

  13. RESULTS OF TREATMENT OF CERVICAL DISCOPATHY WITH PEEK INTERBODY CAGES AT THREE LEVELS WITHOUT PLATE FIXATION

    Directory of Open Access Journals (Sweden)

    Amado González Moga

    Full Text Available ABSTRACT Objective: To present the results of treatment of patients with cervical discopathy by anterior cervical approach, discectomy and placement of a PEEK interbody cage without anterior plate fixation. Methods: Retrospective, cross-sectional study from March 2013 to March 2015. Sixteen patients with radiculopathy or clinical signs of myelopathy were included; all patients underwent cervical surgery through anterior approach, discectomy, and placement of PEEK cages on three levels. Decompression levels were determined according to the correlation between preoperative radiological and clinical findings. Results: Sixteen patients predominantly male were included, with mean age of 50 years at the onset of the condition. Ten patients had involvement of C4-C5, C5-C6, C6-C7 levels, and six patients C3-C4, C4-C5 and C5-C6. Fourteen patients had cervicobrachialgia and two myelopathy. The preoperative visual analog scale average was 8/10 and the average postoperative value at 6 months was 3/10. At 6 months, there was no radiological evidence of recurrence. One patient had non-fatal complications. Conclusions: The treatment of cervical discopathy by anterior approach with interbody fusion with PEEK cage on three levels, with no plate fixation seemed to be safe and effective with better long-term results in terms of pain and myelopathy. The clinical results compare favorably with other similar series and, most importantly, the complications associated with anterior fixation plate are avoided.

  14. Diagnostic accuracy of single photon emission CT in Alzheimer-type dementia

    International Nuclear Information System (INIS)

    Hanyu, Haruki; Abe, Shinei; Arai, Hisayuki; Asano, Tetsuichi; Iwamoto, Toshihiko; Takasaki, Masaru; Suzuki, Takanari

    1992-01-01

    To determine the diagnostic accuracy of single photon emission computed tomography (SPECT) with 123 I-IMP in Alzheimer-type dementia (ATD), we studied 46 ATD patients and 23 healthy controls. The patients fulfilled the NINCDS-ADRDA criteria for probable or definite ATD and were classified as having mild, moderate, and severe ATD by neuropsychological examinations. To assess regional cerebral blood flow, we performed qualitative SPECT image analysis without any knowledge of the subject's clinical classification. The image was regarded as abnormal if cerebral blood flow was reduced in the unlilateral or bilateral temporoparietal association areas, with or without any reduction of flow in other brain regions. The diagnostic sensitivity (abnormal image/ patient) of 123 I-IMP SPECT in mild, moderate and severe ATD was 67%, 86% and 92%, because an abnormal image was found in only 2/23 healthy controls. Eight ATD patients without reduced temporoparietal perfusion showed normal perfusion or frontal hypoperfusion. These results suggest that 123 I-IMP SPECT may provide an accurate and sensitive diagnostic marker for ATD. The detection of these characteristic abnormalities of cerebral perfusion could well be applied to the clinical diagnosis of ATD. (author)

  15. Low Temperature Characterization of PMOS-type Gate-all-around Silicon nanowire FETs as single-hole-transistors

    Science.gov (United States)

    Hong, B. H.; Hwang, S. W.; Lee, Y. Y.; Son, M. H.; Ahn, D.; Cho, K. H.; Yeo, K. H.; Kim, D.-W.; Jin, G. Y.; Park, D.

    2011-12-01

    We report the single hole tunneling characteristics observed from a PMOS-type gate-all-around silicon nanowire field-effect-transistor with the radius 5 nm and the length 44 nm. The total capacitance of the quantum dot obtained from the measured Coulomb oscillations and Coulomb diamonds matches with the ideal capacitance of the silicon cylinder. It suggests that the observed single hole tunneling is originated from the fabricated structure.

  16. Characterization of ryanodine receptor type 1 single channel activity using "on-nucleus" patch clamp.

    Science.gov (United States)

    Wagner, Larry E; Groom, Linda A; Dirksen, Robert T; Yule, David I

    2014-08-01

    In this study, we provide the first description of the biophysical and pharmacological properties of ryanodine receptor type 1 (RyR1) expressed in a native membrane using the on-nucleus configuration of the patch clamp technique. A stable cell line expressing rabbit RyR1 was established (HEK-RyR1) using the FLP-in 293 cell system. In contrast to untransfected cells, RyR1 expression was readily demonstrated by immunoblotting and immunocytochemistry in HEK-RyR1 cells. In addition, the RyR1 agonists 4-CMC and caffeine activated Ca(2+) release that was inhibited by high concentrations of ryanodine. On nucleus patch clamp was performed in nuclei prepared from HEK-RyR1 cells. Raising the [Ca(2+)] in the patch pipette resulted in the appearance of a large conductance cation channel with well resolved kinetics and the absence of prominent subconductance states. Current versus voltage relationships were ohmic and revealed a chord conductance of ∼750pS or 450pS in symmetrical 250mM KCl or CsCl, respectively. The channel activity was markedly enhanced by caffeine and exposure to ryanodine resulted in the appearance of a subconductance state with a conductance ∼40% of the full channel opening with a Po near unity. In total, these properties are entirely consistent with RyR1 channel activity. Exposure of RyR1 channels to cyclic ADP ribose (cADPr), nicotinic acid adenine dinucleotide phosphate (NAADP) or dantrolene did not alter the single channel activity stimulated by Ca(2+), and thus, it is unlikely these molecules directly modulate RyR1 channel activity. In summary, we describe an experimental platform to monitor the single channel properties of RyR channels. We envision that this system will be influential in characterizing disease-associated RyR mutations and the molecular determinants of RyR channel modulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. A new single nucleotide polymorphisms typing method and device by bioluminometric assay coupled with a photodiode array

    Science.gov (United States)

    Kamahori, Masao; Harada, Kunio; Kambara, Hideki

    2002-11-01

    Easy and inexpensive single nucleotide polymorphisms (SNPs) typing systems are required for the practice of genetic testing as well as genetic medicine. Most of the SNPs typing systems use laser-induced fluorescence detection coupled with fluorophore tagging on DNA, which are expensive. A new simple and inexpensive SNPs typing system is presented. It uses a bioluminometric assay coupled with modified primer extension reactions and an inexpensive photodiode array for the luminometric detection. The reagents consumed in the assay are also inexpensive. Although the system is very small, simple and inexpensive, it gives enough sensitivity for detecting target DNAs as small as 10 fmol, which is good enough for SNPs typing.

  18. Laser characterisation of a 3D single-type column p-type prototype module read out with ATLAS SCT electronics

    International Nuclear Information System (INIS)

    Ehrich, T.; Kuehn, S.; Boscardin, M.; Dalla Betta, G.-F.; Eckert, S.; Jakobs, K.; Maassen, M.; Parzefall, U.; Piemonte, C.; Pozza, A.; Ronchin, S.; Zorzi, N.

    2007-01-01

    In this paper measurements of a 3D single-type column (3D-stc) microstrip silicon device are shown. The 3D-stc sensor has n-type columns in p-type substrate. It has been connected to an ATLAS SCT ABCD3T chip and is readout with ATLAS SCT electronics at 40 MHz. Spatial measurements were done with a laser setup to investigate the expected low field region in 3D devices. An influence of the p-stops on the collected charge has been observed

  19. Laser characterisation of a 3D single-type column p-type prototype module read out with ATLAS SCT electronics

    Energy Technology Data Exchange (ETDEWEB)

    Ehrich, T. [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder Str. 3, 79104 Freiburg (Germany); Kuehn, S. [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder Str. 3, 79104 Freiburg (Germany)], E-mail: susanne.kuehn@physik.uni-freiburg.de; Boscardin, M.; Dalla Betta, G.-F. [ITC-irst Trento, Microsystems Division, via Sommarive, 18 38050 Povo di Trento (Italy); Eckert, S.; Jakobs, K.; Maassen, M.; Parzefall, U. [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder Str. 3, 79104 Freiburg (Germany); Piemonte, C.; Pozza, A.; Ronchin, S.; Zorzi, N. [ITC-irst Trento, Microsystems Division, via Sommarive, 18 38050 Povo di Trento (Italy)

    2007-12-11

    In this paper measurements of a 3D single-type column (3D-stc) microstrip silicon device are shown. The 3D-stc sensor has n-type columns in p-type substrate. It has been connected to an ATLAS SCT ABCD3T chip and is readout with ATLAS SCT electronics at 40 MHz. Spatial measurements were done with a laser setup to investigate the expected low field region in 3D devices. An influence of the p-stops on the collected charge has been observed.

  20. Factors associated with serum B-type natriuretic peptide in infants with single ventricles.

    Science.gov (United States)

    Butts, Ryan J; Zak, Victor; Hsu, Daphne; Cnota, James; Colan, Steven D; Hehir, David; Kantor, Paul; Levine, Jami C; Margossian, Renee; Richmond, Marc; Szwast, Anita; Williams, Derek; Williams, Richard; Atz, Andrew M

    2014-06-01

    Data regarding the value of B-type natriuretic peptide (BNP) measurements in infants with a single-ventricle (SV) physiology are lacking. This analysis aimed to describe the BNP level changes in infants with an SV physiology before and after superior cavopulmonary connection (SCPC) surgery. Levels of BNP were measured by a core laboratory before SCPC (at 5.0 ± 1.6 months) and at the age of 14 months during a multicenter trial of angiotensin-converting enzyme inhibition therapy for infants with SV. Multivariable longitudinal analysis was used to model the associations between BNP levels and three sets of grouped variables (echocardiography, catheterization, growth). Multivariable analysis was performed to assess associations with patient characteristics at both visits. Associations between BNP levels and neurodevelopmental variables were investigated at the 14 month visit because neurodevelopmental assessment was performed only at this visit. The BNP level was significantly higher before SCPC (n = 173) than at the age of 14 months (n = 134). The respective median levels were 80.8 pg/ml (interquartile range [IQR], 35-187 pg/ml) and 34.5 pg/ml (IQR, 17-67 pg/ml) (p SCPC and in 21 subjects (16 %) at the age of 14 months. In the 117 patients who had BNP measurements at both visits, the median BNP level decreased 32 pg/ml (IQR, 1-79 pg/ml) (p SCPC surgery (p SCPC surgery (p = 0.04), and a lower Bayley psychomotor developmental index (p = 0.02). The levels of BNP decreases in infants with SV from the pre-SCPC visit to the age of 14 months. A higher BNP level is associated with increased ventricular dilation in systole, increased AV valve regurgitation, impaired growth, and poorer neurodevelopmental outcomes. Therefore, BNP level may be a useful seromarker for identifying infants with SV at risk for worse outcomes.

  1. Interaction of iron status with single nucleotide polymorphisms on incidence of type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Jihye Kim

    Full Text Available The objective of this study is to find single nucleotide polymorphisms (SNPs associated with a risk of Type 2 diabetes (T2D in Korean adults and to investigate the longitudinal association between these SNPs and T2D and the interaction effects of iron intake and average hemoglobin level. Data from the KoGES_Ansan and Ansung Study were used. Gene-iron interaction analysis was conducted using a two-step approach. To select candidate SNPs associated with T2D, a total of 7,935 adults at baseline were included in genome-wide association analysis (step one. After excluding T2D prevalent cases, prospective analyses were conducted with 7,024 adults aged 40-69 (step two. The association of selected SNPs and iron status with T2D and their interaction were determined using a Cox proportional hazard model. A total of 3 SNPs [rs9465871 (CDKAL1, rs10761745 (JMJD1C, and rs163177 (KCNQ1] were selected as candidate SNPs related to T2D. Among them, rs10761745 (JMJD1C and rs163177 (KCNQ1 were prospectively associated with T2D. High iron intake was also prospectively associated with the risk of T2D after adjusting for covariates. Average hemoglobin level was positively associated with T2D after adjusting for covariates in women. We also found significant interaction effects between rs10761745 (JMJD1C and average hemoglobin levels on the risk of T2D among women with normal inflammation and without anemia at baseline. In conclusion, KCNQ1 and JMJD1C may prospectively contribute to the risk of T2D incidence among adults over the age of 40 and JMJD1C, but CDKAL1 may not, and iron status may interactively contribute to T2D incidence in women.

  2. Surface properties of alumino-silicate single-walled nanotubes of the imogolite type.

    Science.gov (United States)

    Bonelli, Barbara; Armandi, Marco; Garrone, Edoardo

    2013-08-28

    An IR spectroscopy study is reported on the nature and accessibility of external and internal surfaces of single-walled alumino-silicate nanotubes (NTs) of the imogolite type. NTs form bundles with hexagonal symmetry, in which three kinds of surfaces may be figured out: surface A is the inner surface of NTs; surface B is that between three aligned NTs in the hexagonal packing; and surface C arises from slit mesopores between bundles. Two materials were considered: proper imogolite (IMO, (OH)3Al2O3SiOH) and its methylated analogue, (Me-IMO, (OH)3Al2O3SiCH3). The chemical nature of the outer surface of NTs is the same in both materials, i.e. a curved gibbsite sheet with both Al-OH-Al and Al-O-Al groups and an amphoteric character. The inner surface is very hydrophilic in IMO NTs, lined by closely packed silanols, and hydrophobic in Me-IMO, all silanols being replaced by -SiCH3 groups. The change in chemical composition is accompanied by an increment in pore size, about 1.0 nm in IMO, and ca. 2.0 nm in Me-IMO, which implies a change in the accessibility of the B surface, not available to any molecule in IMO, and accessible in Me-IMO to small molecules like water, due to larger pores between NTs. Aluminol species at the B surface display an acidic nature, in contrast with that of the same species at surface C, because of a confinement effect.

  3. Single cell-type comparative metabolomics of epidermal bladder cells from the halophyte Mesembryanthemum crystallinum.

    Directory of Open Access Journals (Sweden)

    Bronwyn Jane Barkla

    2015-06-01

    Full Text Available One of the remarkable adaptive features of the halophyte and facultative CAM plant Mesembryathemum crystallinum are the specialized modified trichomes called epidermal bladder cells (EBC which cover the leaves, stems, and peduncle of the plant. They are present from an early developmental stage but upon salt stress rapidly expand due to the accumulation of water and sodium. This particular plant feature makes it an attractive system for single cell type studies, with recent proteomics and transcriptomics studies of the EBC establishing that these cells are metabolically active and have roles other than sodium sequestration. To continue our investigation into the function of these unusual cells we carried out a comprehensive global analysis of the metabolites present in the EBC extract by gas chromatography Time-of-Flight mass spectrometry (GC-TOF and identified 194 known and 722 total molecular features. Statistical analysis of the metabolic changes between control and salt-treated samples was used to identify 352 significantly differing metabolites (268 after correction for FDR. Principal components analysis provided an unbiased evaluation of the data variance structure. Biochemical pathway enrichment analysis suggested significant perturbations in 13 biochemical pathways as defined in KEGG. More than 50% of the metabolites that show significant changes in the EBC, can be classified as compatible solutes and include sugars, sugar alcohols, protein and non-protein amino acids, and organic acids, highlighting the need to maintain osmotic homeostasis to balance the accumulation of Na and Cl ions. Overall, the comparison of metabolic changes in salt treated relative to control samples suggest large alterations in Mesembryanthemum crystallinum epidermal bladder cells.

  4. Typing of 49 autosomal SNPs by single base extension and capillary electrophoresis for forensic genetic testing

    DEFF Research Database (Denmark)

    Børsting, Claus; Tomas Mas, Carmen; Morling, Niels

    2012-01-01

    We describe a method for simultaneous amplification of 49 autosomal single nucleotide polymorphisms (SNPs) by multiplex PCR and detection of the SNP alleles by single base extension (SBE) and capillary electrophoresis. All the SNPs may be amplified from only 100 pg of genomic DNA and the length...

  5. Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Fixation for Degenerative Lumbar Disease.

    Science.gov (United States)

    Wang, Hui-Wang; Hu, Yong-Cheng; Wu, Zhan-Yong; Wu, Hua-Rong; Wu, Chun-Fu; Zhang, Lian-Suo; Xu, Wei-Kun; Fan, Hui-Long; Cai, Jin-Sheng; Ma, Jian-Qing

    2017-08-01

    To evaluate the clinical effect of the minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation using a tubular retractor in the management of degenerative lumbar disease. A retrospective analysis was conducted to analyze the clinical outcome of 58 degenerative lumbar disease patients who were treated with minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation during December 2012 to January 2015. The spine was unilaterally approached through a 3.0-cm skin incision centered on the disc space, located 2.5 cm lateral to the midline, and the multifidus muscles and longissimus dorsi were stripped off. After transforaminal lumbar interbody fusion and posterolateral fusion the unilateral pedicle screw fixation was performed. The visual analogue scale (VAS) for back and leg pain, the Oswestry disability index (ODI), and the MacNab score were applied to evaluate clinical effects. The operation time, peri-operative bleeding, postoperative time in bed, hospitalization costs, and the change in the intervertebral height were analyzed. Radiological fusion based on the Bridwell grading system was also assessed at the last follow-up. The quality of life of the patients before and after the operation was assessed using the short form-36 scale (SF-36). Fifty-eight operations were successfully performed, and no nerve root injury or dural tear occurred. The average operation time was 138 ± 33 min, intraoperative blood loss was 126 ± 50 mL, the duration from surgery to getting out of bed was 46 ± 8 h, and hospitalization cost was 1.6 ± 0.2 ten thousand yuan. All of the 58 patients were followed up for 7-31 months, with an average of 14.6 months. The postoperative VAS scores and ODI score were significantly improved compared with preoperative data (P degenerative lumbar disease, and the short-term clinical outcome is satisfactory

  6. The inactivation of single-chain urokinase-type plasminogen activator by thrombin in a plasma milieu : effect of thrombomodulin

    NARCIS (Netherlands)

    Braat, E.A.M.; Los, P.; Rijken, D.C.

    1998-01-01

    Thrombin cleaves single-chain urokinase-type plasminogen activator (scu- PA) into a virtually inactive two-chain form (tcu-PA/T), a process which may contribute to the maintenance of a fresh blood clot. We have examined the inactivation of scu-PA by thrombin in a plasma milieu to get more insight in

  7. Types and Dynamics of Gendered Space: A Case of Emirati Female Learners in a Single-Gender Context

    Science.gov (United States)

    Alzeer, Gergana

    2018-01-01

    This article is concerned with gendered spaces as they emerge from exploring Emirati female learners' spatiality in a single-gender context. By conducting ethnographic research and utilising Lefebvre's triad of perceived, conceived and lived space for the analysis and categorisation of students' spaces, three types of gendered spaces emerged:…

  8. The influence of the type of embryo culture medium on neonatal birthweight after single embryo transfer in IVF

    NARCIS (Netherlands)

    Vergouw, C.G.; Kostelijk, E.H.; Doejaaren, E.; Hompes, P.G.A.; Lambalk, C.B.; Schats, R.

    2012-01-01

    STUDY QUESTION Does the type of medium used to culture fresh and frozenthawed embryos influence neonatal birthweight after single embryo transfer (SET) in IVF? SUMMARY ANSWER A comparison of two commercially available culture media showed no significant influence on mean birthweight and mean

  9. Lion (Panthera leo) and caracal (Caracal caracal) type IIx single muscle fibre force and power exceed that of trained humans.

    Science.gov (United States)

    Kohn, Tertius A; Noakes, Timothy D

    2013-03-15

    This study investigated for the first time maximum force production, shortening velocity (Vmax) and power output in permeabilised single muscle fibres at 12°C from lion, Panthera leo (Linnaeus 1758), and caracal, Caracal caracal (Schreber 1776), and compared the values with those from human cyclists. Additionally, the use and validation of previously frozen tissue for contractile experiments is reported. Only type IIx muscle fibres were identified in the caracal sample, whereas type IIx and only two type I fibres were found in the lion sample. Only pure type I and IIa, and hybrid type IIax fibres were identified in the human samples - there were no pure type IIx fibres. Nevertheless, compared with all the human fibre types, the lion and caracal fibres were smaller (Plion: 3008±151 μm(2), caracal: 2583±221 μm(2)). On average, the felid type IIx fibres produced significantly greater force (191-211 kN m(-2)) and ~3 times more power (29.0-30.3 kN m(-2) fibre lengths s(-1)) than the human IIax fibres (100-150 kN m(-2), 4-11 kN m(-2) fibre lengths s(-1)). Vmax values of the lion type IIx fibres were also higher than those of human type IIax fibres. The findings suggest that the same fibre type may differ substantially between species and potential explanations are discussed.

  10. Nocturnal Glucose Metabolism in Type 1 Diabetes: A Study Comparing Single Versus Dual Tracer Approaches.

    Science.gov (United States)

    Mallad, Ashwini; Hinshaw, Ling; Dalla Man, Chiara; Cobelli, Claudio; Basu, Rita; Lingineni, Ravi; Carter, Rickey E; Kudva, Yogish C; Basu, Ananda

    2015-08-01

    Understanding the effect size, variability, and underlying physiology of the dawn phenomenon is important for next-generation closed-loop control algorithms for type 1 diabetes (T1D). We used an iterative protocol design to study 16 subjects with T1D on individualized insulin pump therapy for two successive nights. Endogenous glucose production (EGP) rates at 3 a.m. and 7 a.m. were measured with [6,6-(2)H(2)]glucose as a single tracer, infused from midnight to 7 a.m. in all subjects. To explore possibility of tracer recycling due to prolonged [6,6-(2)H(2)]glucose infusion, which was highly probable after preplanned interim data analyses, we infused a second tracer, [6-(3)H]glucose, from 4 a.m. to 7 a.m. in the last seven subjects to measure EGP at 7 a.m. Cortisol concentrations increased during both nights, but changes in glucagon and insulin concentration were inconsistent. Although the plasma glucose concentrations rose from midnight to 7 a.m. during both nights, EGP measured with [6,6-(2)H(2)]glucose between 3 a.m. and 7 a.m. did not differ during Night 1 but fell in Night 2. However, EGP measured with [6-(3)H]glucose at 7 a.m. was higher than that measured with [6,6-(2)H(2)]glucose during both nights, thereby suggesting tracer recycling probably underestimating EGP calculated at 7 a.m. with [6,6-(2)H(2)]glucose. Likewise, EGP was higher at 7 a.m. with [6-(3)H]glucose than at 3 a.m. with [6,6-(2)H(2)]glucose during both nights. The data demonstrate a consistent overnight rise in glucose concentrations through increased EGP, mediated likely by rising cortisol concentrations. The observations with the dual tracer approach imply significant tracer recycling leading to underestimation of EGP measured by longer-duration tracer infusion.

  11. Vertebroplasty for adjacent vertebral fracture following lumbar interbody fusion.

    Science.gov (United States)

    Ahn, Yong; Lee, Sang-Ho

    2011-02-01

    Adjacent segment vertebral compression fracture after lumbosacral instrumented fusion has been reported to be a significant complication. Recently, percutaneous vertebroplasty (PVP) has been widely used for the treatment of non-traumatic osteoporotic vertebral fracture. However, the clinical effect of this minimally invasive treatment option to the post-fusion vertebral fracture has rarely been reported. We analysed characteristics of adjacent vertebral fractures following lumbar fusion and evaluated the clinical outcome of PVP. A total of 202 consecutive patients underwent PVP for compression fracture in our institute between January 2007 and December 2008. Among them, nine symptomatic adjacent vertebral fractures following lumbar fusion were identified. We randomly selected 50 control patients undergoing vertebroplasty for osteoporotic compression fracture in single level. We analysed the clinical data according to age, height, body weight, body mass index (BMI), and bone mineral density (BMD). Clinical outcome was assessed by a visual analogue scale (VAS) score and the rate of overall satisfaction. Fractures occurred at the cranial adjacent vertebra after fusion surgery in all cases. The mean BMD score for the spine and femur were significantly higher than the control group (p adjacent segment disease. The increased stress around the fusion segment can cause vertebral fracture even with a relatively higher BMD score. Vertebroplasty for the post-fusion vertebral fracture can be as effective as it is for the usual osteoporotic vertebral fracture.

  12. Flagella-generated forces reveal gear-type motor in single cells of the green alga, Chlamydomonas reinhardtii.

    Science.gov (United States)

    D'Souza, Jacinta S; Gudipati, Mohanram; Dharmadhikari, Jayashree A; Dharmadhikari, Aditya K; Kashyap, Abhishek; Sivaramakrishnan, Manaswini; Aiyer, Manaswini; Rao, Usha; Mathur, Deepak; Rao, Basuthkar J

    2009-03-06

    Optically trapped single cells of the biflagellated, green alga, Chlamydomonas reinhardtii, rotate. The rotational dynamics of trapped wild-type and mutant cells show that functional flagella play a decisive role: the entire flagellar apparatus (central microtubules, radial spokes, and dynein arms) is involved. Any aberration in this apparatus leads to non-functionality, indicating a gear-type mechanism. The translational and rotational motions of the wild-type and mutant cells do not differ significantly. Optical forces alone do not play a vital role in the rotational dynamics of this cellular motor, making them useful as probes of the internal dynamics without external influence.

  13. Sensitivity of the Single Particle Soot Photometer to different black carbon types

    Science.gov (United States)

    Laborde, M.; Mertes, P.; Zieger, P.; Dommen, J.; Baltensperger, U.; Gysel, M.

    2012-05-01

    Black carbon (BC) is now mainly of anthropogenic origin. It is the dominant light absorbing component of atmospheric aerosols, playing an important role in the earth's radiative balance and therefore relevant to climate change studies. In addition, BC is known to be harmful to human beings making it relevant to policy makers. Nevertheless, the measurement of BC remains biased by the instrument-based definition of BC. The Single Particle Soot Photometer (SP2), allows the measurement of the refractory BC (rBC) mass of individual particles using laser-induced incandescence. However, the SP2 needs an empirical calibration to retrieve the rBC mass from the incandescence signal and the sensitivity of the SP2 differs between different BC types. Ideally, for atmospheric studies, the SP2 should be calibrated using ambient particles containing a known mass of ambient rBC. However, such "ambient BC" calibration particles cannot easily be obtained and thus commercially available BC particles are commonly used for SP2 calibration instead. In this study we tested the sensitivity of the SP2 to different BC types in order to characterize the potential error introduced by using non-ambient BC for calibration. The sensitivity of the SP2 was determined, using an aerosol particle mass analyzer, for rBC from thermodenuded diesel exhaust, wood burning exhaust and ambient particles as well as for commercially available products: Aquadag® and fullerene soot. Thermodenuded, fresh diesel exhaust has been found to be ideal for SP2 calibration for two reasons. First, the small amount of non-BC matter upon emission reduces the risk of bias due to incomplete removal of non-BC matter and second, it is considered to represent atmospheric rBC in urban locations where diesel exhaust is the main source of BC. The SP2 was found to be up to 16% less sensitive to rBC from thermodenuded ambient particles (≤15 fg) than rBC from diesel exhaust, however, at least part of this difference can be explained

  14. Somatosensory neuron types identified by high-coverage single-cell RNA-sequencing and functional heterogeneity

    Science.gov (United States)

    Li, Chang-Lin; Li, Kai-Cheng; Wu, Dan; Chen, Yan; Luo, Hao; Zhao, Jing-Rong; Wang, Sa-Shuang; Sun, Ming-Ming; Lu, Ying-Jin; Zhong, Yan-Qing; Hu, Xu-Ye; Hou, Rui; Zhou, Bei-Bei; Bao, Lan; Xiao, Hua-Sheng; Zhang, Xu

    2016-01-01

    Sensory neurons are distinguished by distinct signaling networks and receptive characteristics. Thus, sensory neuron types can be defined by linking transcriptome-based neuron typing with the sensory phenotypes. Here we classify somatosensory neurons of the mouse dorsal root ganglion (DRG) by high-coverage single-cell RNA-sequencing (10 950 ± 1 218 genes per neuron) and neuron size-based hierarchical clustering. Moreover, single DRG neurons responding to cutaneous stimuli are recorded using an in vivo whole-cell patch clamp technique and classified by neuron-type genetic markers. Small diameter DRG neurons are classified into one type of low-threshold mechanoreceptor and five types of mechanoheat nociceptors (MHNs). Each of the MHN types is further categorized into two subtypes. Large DRG neurons are categorized into four types, including neurexophilin 1-expressing MHNs and mechanical nociceptors (MNs) expressing BAI1-associated protein 2-like 1 (Baiap2l1). Mechanoreceptors expressing trafficking protein particle complex 3-like and Baiap2l1-marked MNs are subdivided into two subtypes each. These results provide a new system for cataloging somatosensory neurons and their transcriptome databases. PMID:26691752

  15. Primary investigation of clinical application of percutaneous posterior lumbar interbody fusion

    International Nuclear Information System (INIS)

    Guo Jiang; Jiao Wencang; Chen Xiangrong; Li Xiaoyu

    2009-01-01

    Objective: To characterize the feasibility, key technology, indications and clinical outcome of percutaneous lumbar interbody fusion. Methods: Clinical data from 32 cases [16 male, 16 female, age range 31-77 years, average disease duration (5.0±2.0) years] underwent percutaneous nucleotomy and endplate curettage was retrospectively analyzed. After percutaneous nucleotomy and endplate curettage, one expandable spinal spacer B-twin was introduced into the intervertebral space and some allograft cancellous bone implanted around the B-twin. Indications for treatment included degenerative lumbar disc herniation (LDH) with intervertebral distability or I degree spondylolisthesis (21 cases), LDH with intervertebral space collapse (10 cases) and lumbar discogenic pain (1 case). The symptoms and function of all patients were evaluated before, 3 months and 12 months after the operation by clinical outcome judgment criterion of surgical treatment for low back pain formulated by JOA, and the rate of clinical improvement and treatment efficacy were calculated. The JOA scales preoperatively, postoperatively and on the final follow-up was compared using ANOVA in SPSS. The changes before and after surgery with the JOA score and the the rate of clinical improvement between 3 months and 12 months after the operation was also compared using χ 2 test. Results: The average operation time 1 hour and blood loss 0.05). Conclusions: Percutaneous posterior lumbar interbody fusion with B-twin expandable fusion cage could lead to satisfactory outcome in the treatment of degenerative disc disease and intervertebral instability, which minimize surgical soft tissue and trauma spinal damage, does not destroy the structure of spinal stability. The long-term outcome, complications and fusion rate need further observing. (authors)

  16. Spondylectomy and lateral lumbar interbody fusion for thoracolumbar kyphosis in an adult with achondroplasia

    Science.gov (United States)

    Miyazaki, Masashi; Kanezaki, Shozo; Notani, Naoki; Ishihara, Toshinobu; Tsumura, Hiroshi

    2017-01-01

    Abstract Rationale: Fixed thoracolumbar kyphosis with spinal stenosis in adult patients with achondroplasia presents a challenging issue. We describe the first case in which spondylectomy and minimally invasive lateral access interbody arthrodesis were used for the treatment of fixed severe thoracolumbar kyphosis and lumbar spinal canal stenosis in an adult with achondroplasia. Patient concerns: A 61-year-old man with a history of achondroplastic dwarfism presented with low back pain and radiculopathy and neurogenic claudication. Diagnoses: Plain radiographs revealed a high-grade thoracolumbar kyphotic deformity with diffuse degenerative changes in the lumbar spine. The apex was located at L2, the local kyphotic angle from L1 to L3 was 105°, and the anterior area was fused from the L1 to L3 vertebrae. MRI revealed significant canal and lateral recess stenosis secondary to facet hypertrophy. Interventions: We planned a front-back correction of the anterior and posterior spinal elements. We first performed anterior release at the fused part from L1 to L3 and XLIF at L3/4 and L4/5. Next, the patient was placed in the prone position. Spondylectomy at the L2 vertebra and posterior fusion from T10 to L5 were performed. Postoperative radiographs revealed L1 to L3 kyphosis of 32°. Outcomes: No complications occurred during or after surgery. Postoperatively, the patient's low back pain and neurological claudication were resolved. No worsening of kyphosis was observed 24 months postoperatively. Lessons: Circumferential decompression of the spinal cord at the apical vertebral level and decompression of lumbar canal stenosis were necessary. Front-back correction of the anterior and posterior spinal elements via spondylectomy and lateral lumbar interbody fusion is a reasonable surgical option for thoracolumbar kyphosis and developmental canal stenosis in patients with achondroplasia. PMID:29245270

  17. Subsidence of polyetheretherketone cage after minimally invasive transforaminal lumbar interbody fusion.

    Science.gov (United States)

    Kim, Moon-Chan; Chung, Hung-Tae; Cho, Jae-Lim; Kim, Dong-Jun; Chung, Nam-Su

    2013-04-01

    A retrospective case series. The aim of this study was to determine the rate of cage subsidence after minimally invasive transforaminal lumbar interbody fusion (MITLIF) conducted using a polyetheretherketone (PEEK) cage, and to identify associated risk factors. Although various rates of cage subsidence after lumbar interbody fusion have been reported, few studies have addressed subsidence rate after MITLIF using PEEK cage. A total of 104 consecutive patients who had undergone MITLIF using a PEEK cage with a minimum follow-up of 2 years were included in this study. Cage subsidence was defined to have occurred when a cage was observed to sink into an adjacent vertebral body by ≥2 mm on the postoperative or serial follow-up lateral radiographs. The demographic variables considered to affect cage subsidence were the following: age, sex, body mass index, bone mineral density, diagnosis, number of fusion segment, and the quality/quantity of back muscle, and the cage-related variables considered were: level of fusion, intervertebral angle, cage size, cage position, and postoperative distraction of disc height. Logistic regression analysis was conducted to explore relations between these variables and cage subsidence. : For the 122 cages inserted, the rate of cage subsidence was 14.8% (18 cages), and cage subsidence occurred within 7.2±8.5 (1-25) months of surgery. The odds ratios for factors found to significantly increase the risk of cage subsidence were; 1.950 (95% confidence interval, 1.002-4.224) for L5-S1 level, and 1.018 (95% confidence interval, 1.000-1.066) for anterior cage position. The rate of PEEK cage subsidence after MITLIF was relatively low. End-plate manipulation and cage insertion during MITLIF were not influenced by a small operation window.

  18. Radiographic Restoration of Sagittal Spinopelvic Alignment After Posterior Lumbar Interbody Fusion in Degenerative Spondylolisthesis.

    Science.gov (United States)

    Kong, Ling-De; Zhang, Ying-Ze; Wang, Feng; Kong, Fan-Long; Ding, Wen-Yuan; Shen, Yong

    2016-03-01

    A retrospective study. This study was aimed to analyze the changes in spinopelvic parameters after surgical correction of degenerative spondylolisthesis and to determine which deformity is most responsible for changes in sagittal spinopelvic alignment. The basic deformities of degenerative spondylolisthesis are forward slippage of the vertebral body, segmental kyphotic angle, and loss of disk height. Correction of those deformities during surgery will subsequently affect the spinopelvic parameters. A few studies have reported the changes of sagittal spinopelvic alignment after surgical treatment of isthmic spondylolisthesis. However, there appears to be relatively little information regarding degenerative spondylolisthesis. Fifty-three patients with L4-L5 degenerative spondylolisthesis were included. All patients underwent posterior lumbar interbody fusion and posterior instrumentation. Back pain, as the clinical outcome, was evaluated by visual analogue scale (VAS). The preoperative and postoperative spinopelvic parameters, including sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), and L1 axis S1 distance were measured, and then the correlations between spinopelvic parameters and local deformity parameters such as slip degree, slip angle (SA), and height of the intervertebral disk were evaluated. After surgical correction of local deformity, all spinopelvic parameters changed subsequently: PT and L1 axis S1 distance had a decrease, SS and LL had an increase. VAS score decreased from 6.1±2.3 before surgery to 2.4±1.7 at the final follow-up assessment. Patients with VAS score changes ≥3 showed significantly higher SS and LL, and lower PT compared with those with VAS score changes spondylolisthesis with posterior lumbar interbody fusion and posterior instrumentation resulted in relief of back pain, which may be associated with improvement of sagittal spinopelvic alignment. Surgeons should consider deformity parameters, especially the SA, in the surgical

  19. Posterolateral instrumented fusion with and without transforaminal lumbar interbody fusion for the treatment of adult isthmic spondylolisthesis: A randomized clinical trial with 2-year follow-up

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    Mohammad Reza Etemadifar

    2016-01-01

    Full Text Available Background: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although posterolateral fusion and pedicle screw fixation are a relatively common treatment method for the treatment of spondylolisthesis, controversy exists about the necessity of adding interbody fusion to posterolateral fusion. The aim of our study was to assess the functional disability, pain, and complications in patients with spondylolisthesis treated by posterolateral instrumented fusion (PLF with and without transforaminal lumbar interbody fusion (TLIF in a randomized clinical trial. Materials and Methods: From February 2007 to February 2011, 50 adult patients with spondylolisthesis were randomly assigned to be treated with PLF or PLF+TLIF techniques (25 patients in each group by a single surgeon. Back pain, leg pain, and disability were assessed before treatment and until 2 years after surgical treatment using visual analog scale (VAS and oswestry disability index (ODI. Patients were also evaluated for postoperative complications such as infection, neurological complications, and instrument failure. Results: All patients completed the 24 months of follow-up. Twenty patients were females and 30 were males. Average age of the patients was 53 ± 11 years for the PLF group and 51 ± 13 for the PLF + TLIF group. Back pain, leg pain, and disability score were significantly improved postoperatively compared to preoperative scores (P < 0.001. At 3 months of follow-up, there was no statistically significant difference in VAS score for back pain and leg pain in both groups; however, after 6 months and 1 year and 2 years follow-up, the reported scores for back pain and leg pain were significantly lower in the PLF+TLIF group (P < 0.05. The ODI score was also significantly lower in the PLF+TLIF group at 1 year and 2 years of follow-up (P < 0.05. One screw breakage and one superficial infection occurred in the PLF+TLIF group, which had no statistical

  20. Targeting the Immunogenetic Diseases with the Appropriate HLA Molecular Typing: Critical Appraisal on 2666 Patients Typed in One Single Centre

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    M. Guarene

    2013-01-01

    Full Text Available We compared the immunogenetic data from 2666 patients affected by HLA-related autoimmune diseases with those from 4389 ethnically matched controls (3157 cord blood donors CBD, 1232 adult bone marrow donors BMD, to verify the appropriateness of HLA typing requests received in the past decade. The frequency of HLA-B*27 phenotype was 10.50% in 724 ankylosing spondylitis, 16.80% in 125 uveitis (3.41% BMD, 4.24% CBD, P<0.0001; HLA-B*51 allele was 15.57% in 212 Behçet’s disease (12.91% BMD, 9.88% CBD, P<0.0001; the HLA-DRB1-rheumatoid arthritis (RA shared epitope was 13.72% in 554 RA (10.85% BMD, 13.48% CBD, P=0.016; the carriers of almost one of HLA-DQB1 susceptibility alleles were 84.91% in 795 celiac disease (CD and 59.37% in 256 insulin-dependent diabetes mellitus (IDDM (46.06% in 875 CBD, 42.75% in 662 BMD P<0.0001. Overall, our results show that the HLA marker frequencies were higher in patients than controls, but lower than expected from the literature data (excluding CD and IDDM and demonstrate that, in complex immunogenetic conditions, a substantial number of genetic analyses are redundant and inappropriate, burdening to the public health costs. For this reason, we suggest the Italian Scientific Society of Immunogenetics to establish guidelines to improve the appropriateness of typing requests.

  1. Common-Ground-Type Tansformerless Inverters for Single-Phase Solar Photovoltaic Systems

    DEFF Research Database (Denmark)

    Siwakoti, Yam Prasad; Blaabjerg, Frede

    2018-01-01

    This paper proposes a family of novel flying capacitor transformerless inverters for single-phase photovoltaic (PV) systems. Each of the new topologies proposed is based on a flying capacitor principle and requires only four power switches and/or diodes, one capacitor, and a small filter at the o......This paper proposes a family of novel flying capacitor transformerless inverters for single-phase photovoltaic (PV) systems. Each of the new topologies proposed is based on a flying capacitor principle and requires only four power switches and/or diodes, one capacitor, and a small filter...

  2. Minimally invasive presacral approach for revision of an Axial Lumbar Interbody Fusion rod due to fall-related lumbosacral instability: a case report

    Directory of Open Access Journals (Sweden)

    Cohen Anders

    2011-09-01

    Full Text Available Abstract Introduction The purpose of this study was to describe procedural details of a minimally invasive presacral approach for revision of an L5-S1 Axial Lumbar Interbody Fusion rod. Case presentation A 70-year-old Caucasian man presented to our facility with marked thoracolumbar scoliosis, osteoarthritic changes characterized by high-grade osteophytes, and significant intervertebral disc collapse and calcification. Our patient required crutches during ambulation and reported intractable axial and radicular pain. Multi-level reconstruction of L1-4 was accomplished with extreme lateral interbody fusion, although focal lumbosacral symptoms persisted due to disc space collapse at L5-S1. Lumbosacral interbody distraction and stabilization was achieved four weeks later with the Axial Lumbar Interbody Fusion System (TranS1 Inc., Wilmington, NC, USA and rod implantation via an axial presacral approach. Despite symptom resolution following this procedure, our patient suffered a fall six weeks postoperatively with direct sacral impaction resulting in symptom recurrence and loss of L5-S1 distraction. Following seven months of unsuccessful conservative care, a revision of the Axial Lumbar Interbody Fusion rod was performed that utilized the same presacral approach and used a larger diameter implant. Minimal adhesions were encountered upon presacral re-entry. A precise operative trajectory to the base of the previously implanted rod was achieved using fluoroscopic guidance. Surgical removal of the implant was successful with minimal bone resection required. A larger diameter Axial Lumbar Interbody Fusion rod was then implanted and joint distraction was re-established. The radicular symptoms resolved following revision surgery and our patient was ambulating without assistance on post-operative day one. No adverse events were reported. Conclusions The Axial Lumbar Interbody Fusion distraction rod may be revised and replaced with a larger diameter rod using

  3. Type-II second-harmonic-generation properties of YCOB and GdCOB single crystals.

    Science.gov (United States)

    Liu, Yanqing; Qi, Hongwei; Lu, Qingming; Yu, Fapeng; Wang, Zhengping; Xu, Xinguang; Zhao, Xian

    2015-02-09

    As excellent nonlinear optical (NLO) crystals, YCa(4)O(BO(3))(3) (YCOB) and GdCa(4)O(BO(3))(3) (GdCOB) have been paid much attention since their first appearance in 1990's. From that time to now, almost all of related researches and applications have focused on their type-I phase-matching (PM) configurations which possess large effective NLO coefficient (d(eff)). In this paper, type-II second-harmonic-generation (SHG) properties of these two crystals are reported, including PM curve, d(eff), angular acceptance and walk-off angle. Both of the type-II SHG experiments for 1064 and 1320 nm have indicated that the optimum directions which have maximum d(eff) locate in the second octant, i.e. (90° crystal, the largest type-II SHG conversion efficiency of a 1064 nm Nd:YAG pico-second laser is 55%, which reaches the same level of the optimum type-I sample. To our knowledge this is the first time that type-II SHG performance of YCOB and GdCOB crystals is investigated intensively. Our research has shown that the smaller d(eff) of type-II PM can be compensated by its larger angular acceptance and less beam walk-off. The same level SHG conversion efficiency implies for such type crystals the type-II components have the potential to replace type-I ones and obtain important NLO applications in the future.

  4. Low incidence of adjacent segment disease after posterior lumbar interbody fusion with minimum disc distraction: A preliminary report.

    Science.gov (United States)

    Makino, Takahiro; Honda, Hirotsugu; Fujiwara, Hiroyasu; Yoshikawa, Hideki; Yonenobu, Kazuo; Kaito, Takashi

    2018-01-01

    A retrospective review of prospectively collected data. To investigate the incidence of radiographic and symptomatic adjacent segment disease (ASD) and identify possible risk factors for ASD after posterior lumbar interbody fusion (PLIF) with minimum disc distraction by selecting low-height interbody cages. Excessive disc space distraction is reportedly 1 of the risk factors for ASD after PLIF; however, the incidence and other risk factors of ASD after PLIF with minimum disc distraction remain unclear. Forty-one consecutive patients who underwent PLIF at L4-L5 and were postoperatively followed up for a minimum of 2 years were included. The height and shape (box or bullet shape) of interbody cages was determined according to the disc height and morphology of the intervertebral space assessed on preoperative computed tomography scans to avoid excessive distraction. The incidence of radiographic and symptomatic ASD was evaluated and all demographic and radiographic parameters were compared between patients with and without ASD. Multivariate logistic regression analysis was performed to identify risk factors for ASD among the variables with P < .20 in univariate analysis. The overall incidence of ASD was 12.2% (5/41 patients): radiographic ASD, 7.3% (3 patients); symptomatic ASD, 4.9% (2 patients). Multivariate analysis revealed preoperative retrolisthesis of L3 on extension as the sole risk factor for ASD after PLIF with minimum disc distraction (odds ratio, 2.13; 95% confidence interval, 1.00-4.05; P = .049). The incidence of ASD in this study was lower than that of ASD in our previous study about PLIF with distraction of disc space (12.2% vs. 31.8%). Minimum disc distraction by selection of low-height interbody cages is a simple and effective method to prevent ASD at the surgeons' discretion, although preexisting retrolisthesis at the adjacent upper segment should be taken into consideration. Copyright © 2017 The Authors. Published by Wolters Kluwer Health

  5. Single microwave-photon detector using an artificial Λ-type three-level system

    Science.gov (United States)

    Inomata, Kunihiro; Lin, Zhirong; Koshino, Kazuki; Oliver, William D.; Tsai, Jaw-Shen; Yamamoto, Tsuyoshi; Nakamura, Yasunobu

    2016-07-01

    Single-photon detection is a requisite technique in quantum-optics experiments in both the optical and the microwave domains. However, the energy of microwave quanta are four to five orders of magnitude less than their optical counterpart, making the efficient detection of single microwave photons extremely challenging. Here we demonstrate the detection of a single microwave photon propagating through a waveguide. The detector is implemented with an impedance-matched artificial Λ system comprising the dressed states of a driven superconducting qubit coupled to a microwave resonator. Each signal photon deterministically induces a Raman transition in the Λ system and excites the qubit. The subsequent dispersive readout of the qubit produces a discrete `click'. We attain a high single-photon-detection efficiency of 0.66+/-0.06 with a low dark-count probability of 0.014+/-0.001 and a reset time of ~400 ns. This detector can be exploited for various applications in quantum sensing, quantum communication and quantum information processing.

  6. Lateral lumbar interbody fusion with unilateral pedicle screw fixation for the treatment of adjacent segment disease: a preliminary report.

    Science.gov (United States)

    Du, Jerry Y; Kiely, Paul D; Al Maaieh, Motasem; Aichmair, Alexander; Huang, Russel C

    2017-09-01

    To assess the clinical outcomes of 20 patients who underwent single level unilateral pedicle screw fixation following lateral lumbar interbody fusion (LLIF) for treatment of lumbar adjacent segment disease (ASD). Demographic, comorbidity, clinical assessment, peri-operative, and complication data were assessed. Visual analog scale (VAS), Oswestry disability index (ODI), and short form-12 (SF-12) were used to assess clinical outcomes. Post-operative radiographs were assessed for subsidence, cage migration, and fusion. Average age of patients was 63.2±13.7 years (range, 41-86 years), with 8 males and 12 females. Recombinant human bone morphogenic protein-2 (rhBMP-2) was utilized in 18 LLIF cages (90%) and 12 posterolateral fusions (60%). Mean operation time was 214.1±47.2 minutes (range, 146-342 minutes), mean estimated blood loss of 187.5±90.1 cc (range, 50-400 cc). No patients received a blood transfusion. There were no intra-operative complications. Mean hospital length of stay was 4.4±1.7 days (range, 2-9 days). At final follow-up (mean: 13.0±12.7 months after surgery), there was significant improvement in post-op VAS (P=0.006) score compared to pre-op, but not ODI (P=0.181), SF-12 PC (P=0.480), and SF-12 MC (P=0.937). Patients with >6 months of post-operative imaging (14/20, 70%) demonstrated successful fusion in 13 out of 14 cases (93%). There was grade 0 subsidence of adjacent cranial vertebra in all cases (100%). There was grade 0 subsidence of the adjacent caudal vertebra in 13 cases (93%) and grade 1 subsidence in 1 case (7%). There was evidence of cage migration in 3 cases (21%). There were 4 patients (20%) who experienced transient neurological deficits that eventually resolved. Two patients required surgery for further ASD. In conclusion, this pilot study suggests that patients who undergo LLIF with unilateral pedicle screw fixation for treatment of ASD may have significantly reduced pain and favorable radiographic results. Further investigation in

  7. Lateral lumbar interbody fusion with unilateral pedicle screw fixation for the treatment of adjacent segment disease: a preliminary report

    Science.gov (United States)

    Kiely, Paul D.; Al Maaieh, Motasem; Aichmair, Alexander; Huang, Russel C.

    2017-01-01

    Background To assess the clinical outcomes of 20 patients who underwent single level unilateral pedicle screw fixation following lateral lumbar interbody fusion (LLIF) for treatment of lumbar adjacent segment disease (ASD). Methods Demographic, comorbidity, clinical assessment, peri-operative, and complication data were assessed. Visual analog scale (VAS), Oswestry disability index (ODI), and short form-12 (SF-12) were used to assess clinical outcomes. Post-operative radiographs were assessed for subsidence, cage migration, and fusion. Results Average age of patients was 63.2±13.7 years (range, 41–86 years), with 8 males and 12 females. Recombinant human bone morphogenic protein-2 (rhBMP-2) was utilized in 18 LLIF cages (90%) and 12 posterolateral fusions (60%). Mean operation time was 214.1±47.2 minutes (range, 146–342 minutes), mean estimated blood loss of 187.5±90.1 cc (range, 50–400 cc). No patients received a blood transfusion. There were no intra-operative complications. Mean hospital length of stay was 4.4±1.7 days (range, 2–9 days). At final follow-up (mean: 13.0±12.7 months after surgery), there was significant improvement in post-op VAS (P=0.006) score compared to pre-op, but not ODI (P=0.181), SF-12 PC (P=0.480), and SF-12 MC (P=0.937). Patients with >6 months of post-operative imaging (14/20, 70%) demonstrated successful fusion in 13 out of 14 cases (93%). There was grade 0 subsidence of adjacent cranial vertebra in all cases (100%). There was grade 0 subsidence of the adjacent caudal vertebra in 13 cases (93%) and grade 1 subsidence in 1 case (7%). There was evidence of cage migration in 3 cases (21%). There were 4 patients (20%) who experienced transient neurological deficits that eventually resolved. Two patients required surgery for further ASD. Conclusions In conclusion, this pilot study suggests that patients who undergo LLIF with unilateral pedicle screw fixation for treatment of ASD may have significantly reduced pain and favorable

  8. Transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Ai-Min Wu

    Full Text Available A retrospective clinical study.To evaluate the efficacy and safety of transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury.Twenty-six spinal cord injured patients with thoracolumbar fracture and dislocation were treated by transforaminal decompression and interbody fusion. The operation time, intraoperative blood loss, and complications were recorded; the Cobb angle and compressive rate (CR of the anterior height of two adjacent vertebrae were measured; and the nerve injury was assessed according to sensory scores and motor scores of the American Spinal Injury Association (ASIA standards for neurological classification of spinal cord injury.The operative time was 250±57 min, and intraoperative blood loss was 440±168 ml. Cerebrospinal leakage was detected and repaired during the operation in two patients. A total of 24 of 26 patients were followed up for more than 2 years. ASIA sensory scores and motor scores were improved significantly at 3 months and 6 months after operation; the Cobb angle and CR of the anterior height of two adjacent vertebrae were corrected and showed a significant difference at post-operation; and the values were maintained at 3 months after operation and the last follow-up.We showed that transforaminal decompression together with interbody fusion is an alternative method to treat thoracolumbar fracture and dislocation.

  9. Posterior Decompression, Lumber Interbody Fusion and Internal Fixation in the Treatment of Upper Lumbar Intervertebral Disc Herniation

    Directory of Open Access Journals (Sweden)

    DONG Zhan

    2014-12-01

    Full Text Available Objective: To assess the clinical outcomes of posterior decompression, interbody fusion and internal fixationfor the treatment of the upper lumbar intervertebral disc herniation. Methods: Twelve patients with the upper lumbar intervertebral disc herniation were treated by posterior decompression, interbosy fusion and internal fixation. The time of the operation, the amount of bleeding and the clinical efficacy were evaluated. Results: The time of operation was (143±36 min and the amount of bleeding during operation was (331.5±47.9 mL. There was no spinal cord and injuries, nerve injury, epidural damage and leakage of cerebrospinal fluid. All patients were followed up for 10~19 months with the average being 12.6 months. The functional scoring of Japanese Orthopedic Association (JOA before the operation was (11.4±3.3 scores and final score after follow-up was (22.9±3.1 scores and there were statistical difference (P<0.01. Lumber interbody fusion of all patients completed successfully and the good rate after the operation was 91.7%. Conclusion: Posterior decompression, interbody fusion and internal fixation for the treatment of the upper lumbar intervertebral disc herniation was characterized by full exposure, safety and significant efficacy.

  10. Lateral Lumbar Interbody Fusion for Ossification of the Yellow Ligament in the Lumbar Spine: First Reported Case

    Directory of Open Access Journals (Sweden)

    Kengo Fujii

    2017-01-01

    Full Text Available When ossification of the yellow ligament (OYL occurs in the lumbar spine and extends to the lateral wall of the spinal canal, facetectomy is required to remove all of the ossified lesion and achieve decompression. Subsequent posterior fixation with interbody fusion will then be necessary to prevent postoperative progression of the ossification and intervertebral instability. The technique of lateral lumbar interbody fusion (LLIF has recently been introduced. Using this procedure, surgeons can avoid excess blood loss from the extradural venous plexus and detachment of the ossified lesion and the ventral dura mater is avoidable. We present a 55-year-old male patient with OYL at L3/4 and anterior spondylolisthesis of L4 vertebra, with concomitant ossification of the posterior longitudinal ligament, who presented with a severe gait disturbance. He underwent a 2-stage operation without complications: LLIF for L3/4 and L4/5 was performed at the initial surgery, and posterior decompression fixation using pedicle screws from L3 to L5 was performed at the second surgery. His postoperative progress was favorable, and his interbody fusion was deemed successful. Here, we present the first reported case of LLIF for OYL of the lumbar spine. This procedure can be a good option for OYL of the lumbar spine.

  11. Visceral, vascular, and wound complications following over 13,000 lateral interbody fusions: a survey study and literature review.

    Science.gov (United States)

    Uribe, Juan S; Deukmedjian, Armen R

    2015-04-01

    Minimally invasive lateral interbody fusion (MIS-LIF) has become a popular less invasive treatment option for degenerative spinal disease, deformity, and trauma. While MIS-LIF offers several advantages over traditional anterior and posterior approaches, the procedure is not without risk. The purpose of this study was to evaluate the incidence of visceral, vascular, and wound complications following MIS-LIF performed by experienced surgeons. A survey was conducted by experienced (more than 100 case experience) MIS-LIF surgeons active in the society of lateral access surgery (SOLAS) to collect data on wound infections and visceral and vascular injuries. Of 77 spine surgeons surveyed, 40 (52 %) responded, including 25 (63 %) orthopedic surgeons and 15 (38 %) neurosurgeons, with 20 % practicing at an academic institution and 80 % in community practice. Between 2003 and 2013, 13,004 patients were treated with MIS-LIF by the 40 surgeons who responded to the survey. Of those patients, 0.08 % experienced a visceral complication (bowel injury), 0.10 % experienced a vascular injury, 0.27 % experienced a superficial wound infection, and 0.14 % experienced a deep wound infection. The incidence of surgical site infections and vascular and visceral complications following MIS-LIF in this large series was low and compared favorably with rates for alternative interbody fusion approaches. Although technically demanding, MIS-LIF is a reproducible approach for interbody fusion with a low risk of vascular and visceral complications and infections.

  12. Alternative types of molecule-decorated atomic chains in Au–CO–Au single-molecule junctions

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    Zoltán Balogh

    2015-06-01

    Full Text Available We investigate the formation and evolution of Au–CO single-molecule break junctions. The conductance histogram exhibits two distinct molecular configurations, which are further investigated by a combined statistical analysis. According to conditional histogram and correlation analysis these molecular configurations show strong anticorrelations with each other and with pure Au monoatomic junctions and atomic chains. We identify molecular precursor configurations with somewhat higher conductance, which are formed prior to single-molecule junctions. According to detailed length analysis two distinct types of molecule-affected chain-formation processes are observed, and we compare these results to former theoretical calculations considering bridge- and atop-type molecular configurations where the latter has reduced conductance due to destructive Fano interference.

  13. Moisture supply in Danish single-family houses – the influence of occupant behaviour and type of room

    DEFF Research Database (Denmark)

    Møller, Eva B.; Hansen, Ernst Jan de Place

    2017-01-01

    . The study focuses on the dependency of number and age of occupants, occupants’ time spent in the house, square meters living space, ventilation habits and type of room. Moisture supply depends on the type of room; bathroom, basement and living room have the highest values. None of the other parameters seems......According to ISO 13788, the internal moisture supply in dwellings can be described by humidity classes defined by outdoor temperature, occupancy and ventilation. Hygrothermal measurements in indoor air in 500 Danish single-family houses were made to investigate if this corresponds with reality...

  14. Development and evaluation of one step single tube multiplex RT-PCR for rapid detection and typing of dengue viruses

    OpenAIRE

    Parida Manmohan; Shrivastava Ambuj; Santhosh SR; Dash Paban; Saxena Parag; Rao PV

    2008-01-01

    Abstract Background Dengue is emerging as a major public health concern in many parts of the world. The development of a one-step, single tube, rapid, and multiplex reverse transcription polymerase chain reaction (M-RT-PCR) for simultaneous detection and typing of dengue virus using serotype specific primers during acute phase of illness is reported. Results An optimal assay condition with zero background was established having no cross-reaction with closely related members of flavivirus (Jap...

  15. Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study.

    Science.gov (United States)

    Sakaura, Hironobu; Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

    2016-11-01

    OBJECTIVE Several biomechanical studies have demonstrated the favorable mechanical properties of the cortical bone trajectory (CBT) screw. However, no reports have examined surgical outcomes of posterior lumbar interbody fusion (PLIF) with CBT screw fixation for degenerative spondylolisthesis (DS) compared with those after PLIF using traditional pedicle screw (PS) fixation. The purposes of this study were thus to elucidate surgical outcomes after PLIF with CBT screw fixation for DS and to compare these results with those after PLIF using traditional PS fixation. METHODS Ninety-five consecutive patients underwent PLIF with CBT screw fixation for DS (CBT group; mean followup 35 months). A historical control group consisted of 82 consecutive patients who underwent PLIF with traditional PS fixation (PS group; mean follow-up 40 months). Clinical status was assessed using the Japanese Orthopaedic Association (JOA) scale score. Fusion status was assessed by dynamic plain radiographs and CT. The need for additional surgery and surgery-related complications was also evaluated. RESULTS The mean JOA score improved significantly from 13.7 points before surgery to 23.3 points at the latest follow-up in the CBT group (mean recovery rate 64.4%), compared with 14.4 points preoperatively to 22.7 points at final follow-up in the PS group (mean recovery rate 55.8%; p 0.05). Symptomatic adjacent-segment disease developed in 3 patients from the CBT group (3.2%) compared with 9 patients from the PS group (11.0%, p < 0.05). CONCLUSIONS PLIF with CBT screw fixation for DS provided comparable improvement of clinical symptoms with PLIF using traditional PS fixation. However, the successful fusion rate tended to be lower in the CBT group than in the PS group, although the difference was not statistically significant between the 2 groups.

  16. Effect of ligand substitution on the exchange interactions in {Mn12}-type single-molecule magnets

    OpenAIRE

    Boukhvalov, D. W.; Dobrovitski, V. V.; Kögerler, P.; Al-Saqer, M.; Katsnelson, M. I.; Lichtenstein, A. I.; Harmon, B. N.

    2010-01-01

    We investigate how the ligand substitution affects the intra-molecular spin exchange interactions, studying a prototypal family of single-molecule magnets comprising dodecanuclear cluster molecules [Mn12O12(COOR)16]. We identify a simple scheme based on accumulated Pauling electronegativity numbers (a.e.n.) of the carboxylate ligand groups (R). The redistribution of the electron density, controlled by a.e.n. of a ligand, changes the degree of hybridization between 3d electrons of manganese an...

  17. Impaction durability of porous polyether-ether-ketone (PEEK) and titanium-coated PEEK interbody fusion devices.

    Science.gov (United States)

    Torstrick, F Brennan; Klosterhoff, Brett S; Westerlund, L Erik; Foley, Kevin T; Gochuico, Joanna; Lee, Christopher S D; Gall, Ken; Safranski, David L

    2018-01-31

    Various surface modifications, often incorporating roughened or porous surfaces, have recently been introduced to enhance osseointegration of interbody fusion devices. However, these topographical features can be vulnerable to damage during clinical impaction. Despite the potential negative impact of surface damage on clinical outcomes, current testing standards do not replicate clinically relevant impaction loading conditions. The purpose of this study was to compare the impaction durability of conventional smooth polyether-ether-ketone (PEEK) cervical interbody fusion devices with two surface-modified PEEK devices that feature either a porous structure or plasma-sprayed titanium coating. A recently developed biomechanical test method was adapted to simulate clinically relevant impaction loading conditions during cervical interbody fusion procedures. Three cervical interbody fusion devices were used in this study: smooth PEEK, plasma-sprayed titanium-coated PEEK, and porous PEEK (n=6). Following Kienle et al., devices were impacted between two polyurethane blocks mimicking vertebral bodies under a constant 200 N preload. The posterior tip of the device was placed at the entrance between the polyurethane blocks, and a guided 1-lb weight was impacted upon the anterior face with a maximum speed of 2.6 m/s to represent the strike force of a surgical mallet. Impacts were repeated until the device was fully impacted. Porous PEEK durability was assessed using micro-computed tomography (µCT) pre- and postimpaction. Titanium-coating coverage pre- and postimpaction was assessed using scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy. Changes to the surface roughness of smooth and titanium-coated devices were also evaluated. Porous PEEK and smooth PEEK devices showed minimal macroscopic signs of surface damage, whereas the titanium-coated devices exhibited substantial visible coating loss. Quantification of the porous PEEK deformation

  18. Minimally Invasive Transforaminal Lumbar Interbody Fusion with Percutaneous Bilateral Pedicle Screw Fixation for Lumbosacral Spine Degenerative Diseases. A retrospective database of 40 consecutive treated cases and literature review.

    Science.gov (United States)

    Millimaggi, Daniele Francesco; DI Norcia, Valerio; Luzzi, Sabino; Alfiero, Tommaso; Galzio, Renato Juan; Ricci, Alessandro

    2017-04-12

    To report our results about minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) with bilateral pedicle screw fixation, in patients with degenerative lumbosacral spine disease. To describe the indications, surgical technique and results of a consecutive series of 40 patients undergone MI-TLIF. Despite the limited number of clinical studies, published data suggest tremendous potential advantages of this technique. Forty patients with radiological findings of degenerative lumbosacral spine disease were undergone MI-TLIF between July 2012 and January 2015. Clinical outcomes were assessed by means of Oswestry Disability Index (ODI) and Health Survey Scoring (SF36) before surgery and at first year follow-up. Furthermore, the following parameters were retrospectively reviewed: age, sex, working activity, body mass index (BMI), type of degenerative disease, number of levels of fusion, operative time, blood loss, length of hospital stay. Average operative time was of 230 minutes, mean estimated blood loss 170 mL, average length of hospital stay 5 days. The ODI improved from a score of 59, preoperatively, to post-operative score of 20 at first year follow-up. Average SF36 score increased from 36 to 54 (Physical Health) and from 29 to 50 (Mental Health) at first year outcome evaluation. MI-TLIF with bilateral pedicle screw fixation is an excellent choice for selected patients suffering from symptomatic degenerative lumbosacral spine disease, especially secondary to recurrent disk herniations.

  19. A single mutation in Taiwanese H6N1 influenza hemagglutinin switches binding to human-type receptors

    Energy Technology Data Exchange (ETDEWEB)

    de Vries, Robert P.; Tzarum, Netanel; Peng, Wenjie; Thompson, Andrew J.; Ambepitiya Wickramasinghe, Iresha N.; de la Pena, Alba T. Torrents; van Breemen, Marielle J.; Bouwman, Kim M.; Zhu, Xueyong; McBride, Ryan; Yu, Wenli; Sanders, Rogier W.; Verheije, Monique H.; Wilson, Ian A.; Paulson, James C.

    2017-07-10

    In June 2013, the first case of human infection with an avian H6N1 virus was reported in a Taiwanese woman. Although this was a single non-fatal case, the virus continues to circulate in Taiwanese poultry. As with any emerging avian virus that infects humans, there is concern that acquisition of human-type receptor specificity could enable transmission in the human population. Despite mutations in the receptor-binding pocket of the human H6N1 isolate, it has retained avian-type (NeuAcα2-3Gal) receptor specificity. However, we show here that a single nucleotide substitution, resulting in a change from Gly to Asp at position 225 (G225D), completely switches specificity to human-type (NeuAcα2-6Gal) receptors. Significantly, G225D H6 loses binding to chicken trachea epithelium and is now able to bind to human tracheal tissue. Structural analysis reveals that Asp225 directly interacts with the penultimate Gal of the human-type receptor, stabilizing human receptor binding.

  20. Size-controllable DNA nanoribbons assembled from three types of reusable brick single-strand DNA tiles.

    Science.gov (United States)

    Shi, Xiaolong; Chen, Congzhou; Li, Xin; Song, Tao; Chen, Zhihua; Zhang, Zheng; Wang, Yanfeng

    2015-11-21

    Precise control of nanostructure is a significant goal shared by supramolecular chemistry, nanotechnology and materials science. In DNA nanotechnology, methods of constructing desired DNA nanostructures using programmable DNA strands have been studied extensively and have become a promising branch of research, but developing universal and low-cost (in the sense of using fewer types of DNA strands) methods remains a challenge. In this work, we propose a novel approach to assemble size-controllable DNA nanoribbons with three types of reusable brick SSTs (single-stranded DNA tiles), where the control of ribbon size is achieved by regulating the concentration ratio between manipulative strands and packed single-stranded DNA tiles. In our method, three types of brick SSTs are sufficient in assembling DNA nanoribbons of different sizes, which is much less than the number of types of unique tile-programmable assembling strategy, thus achieving a universal and low-cost method. The assembled DNA nanoribbons are observed and analyzed by atomic force microscopy (AFM). Experimental observations strongly suggest the feasibility and reliability of our method.

  1. Study shows colon and rectal tumors constitute a single type of cancer

    Science.gov (United States)

    The pattern of genomic alterations in colon and rectal tissues is the same regardless of anatomic location or origin within the colon or the rectum, leading researchers to conclude that these two cancer types can be grouped as one, according to The Cancer

  2. Demographic and Clinical Characteristics of Type 1 Diabetes Mellitus in Omani Children - Single Center Experience

    Directory of Open Access Journals (Sweden)

    Saif Al-Yaarubi

    2014-03-01

    Full Text Available Objectives: To describe the demographic characteristics and clinical presentation of Omani children with type 1 diabetes mellitus at Sultan Qaboos University Hospital, Muscat, Oman. Methods: A retrospective analysis of all children with type 1 diabetes mellitus attending the Pediatric Endocrine Unit at Sultan Qaboos University Hospital, Oman from June 2006 to May 2013. Results: One hundred and forty-four patients were included in the study. The mean±SD of age at diagnosis was 6.7 ± 3.7 years. The median duration of symptoms was 10 days (IQR; 5-14. The most commonly reported presenting symptoms were polyuria (94%, polydipsia (82%, and weight loss (59%. Diabetic ketoacidosis at initial presentation was diagnosed in 31% of the patients. Different insulin regimens were prescribed: multiple daily injections in 109 (76% patients, twice daily insulin regimen in 23 (16% patients, and insulin pump therapy in 12 (8% patients. Family history of type 1 diabetes mellitus was present in 31 (22% patients. There were no significant differences in presenting complaints (polyuria, p=0.182; polydipsia, p=0.848, duration of symptoms (p=0.331, reported weight loss (p=0.753, or diabetic ketoacidosis at presentation (p=0.608 between patients with and without family history of type 1 diabetes mellitus. Conclusion: Polyuria, polydipsia and weight loss are the most common presenting symptoms. Family history of type 1 diabetes mellitus is highly prevalent among the studied patients. Diabetic ketoacidosis was found to be less common in Oman compared to other diabetes centers in the Middle East.

  3. Improving assessment of daily energy expenditure by identifying types of physical activity with a single accelerometer.

    Science.gov (United States)

    Bonomi, A G; Plasqui, G; Goris, A H C; Westerterp, K R

    2009-09-01

    Accelerometers are often used to quantify the acceleration of the body in arbitrary units (counts) to measure physical activity (PA) and to estimate energy expenditure. The present study investigated whether the identification of types of PA with one accelerometer could improve the estimation of energy expenditure compared with activity counts. Total energy expenditure (TEE) of 15 subjects was measured with the use of double-labeled water. The physical activity level (PAL) was derived by dividing TEE by sleeping metabolic rate. Simultaneously, PA was measured with one accelerometer. Accelerometer output was processed to calculate activity counts per day (AC(D)) and to determine the daily duration of six types of common activities identified with a classification tree model. A daily metabolic value (MET(D)) was calculated as mean of the MET compendium value of each activity type weighed by the daily duration. TEE was predicted by AC(D) and body weight and by AC(D) and fat-free mass, with a standard error of estimate (SEE) of 1.47 MJ/day, and 1.2 MJ/day, respectively. The replacement in these models of AC(D) with MET(D) increased the explained variation in TEE by 9%, decreasing SEE by 0.14 MJ/day and 0.18 MJ/day, respectively. The correlation between PAL and MET(D) (R(2) = 51%) was higher than that between PAL and AC(D) (R(2) = 46%). We conclude that identification of activity types combined with MET intensity values improves the assessment of energy expenditure compared with activity counts. Future studies could develop models to objectively assess activity type and intensity to further increase accuracy of the energy expenditure estimation.

  4. Optimal strategy for a single-qubit gate and the trade-off between opposite types of decoherence

    Science.gov (United States)

    Alicki, Robert; Horodecki, Michał; Horodecki, Paweł; Horodecki, Ryszard; Jacak, Lucjan; Machnikowski, Paweł

    2004-07-01

    We study reliable quantum-information processing (QIP) under two different types of environment. The first type is Markovian exponential decay, and the appropriate elementary strategy of protection of qubit is to apply fast gates. The second one is strongly non-Markovian and occurs solely during operations on the qubit. The best strategy is then to work with slow gates. If the two types are both present, one has to optimize the speed of gate. We show that such a trade-off is present for a single-qubit operation in a semiconductor quantum dot implementation of QIP, where recombination of exciton (qubit) is Markovian, while phonon dressing gives rise to the non-Markovian contribution.

  5. Optimal strategy for a single-qubit gate and the trade-off between opposite types of decoherence

    International Nuclear Information System (INIS)

    We study reliable quantum-information processing (QIP) under two different types of environment. The first type is Markovian exponential decay, and the appropriate elementary strategy of protection of qubit is to apply fast gates. The second one is strongly non-Markovian and occurs solely during operations on the qubit. The best strategy is then to work with slow gates. If the two types are both present, one has to optimize the speed of gate. We show that such a trade-off is present for a single-qubit operation in a semiconductor quantum dot implementation of QIP, where recombination of exciton (qubit) is Markovian, while phonon dressing gives rise to the non-Markovian contribution

  6. Single-Particle Tracking of Human Immunodeficiency Virus Type 1 Productive Entry into Human Primary Macrophages.

    Science.gov (United States)

    Li, Qin; Li, Wei; Yin, Wen; Guo, Jia; Zhang, Zhi-Ping; Zeng, Dejun; Zhang, Xiaowei; Wu, Yuntao; Zhang, Xian-En; Cui, Zongqiang

    2017-04-25

    Macrophages are one of the major targets of human immunodeficiency virus (HIV-1), but the viral entry pathway remains poorly understood in these cells. Noninvasive virus labeling and single-virus tracking are effective tools for studying virus entry. Here, we constructed a quantum dot (QD)-encapsulated infectious HIV-1 particle to track viral entry at a single-particle level in live human primary macrophages. QDs were encapsulated in HIV-1 virions by incorporating viral accessory protein Vpr-conjugated QDs during virus assembly. With the HIV-1 particles encapsulating QDs, we monitored the early phase of viral infection in real time and observed that, during infection, HIV-1 was endocytosed in a clathrin-mediated manner; the particles were translocated into Rab5A-positive endosomes, and the core was released into the cytoplasm by viral envelope-mediated endosomal fusion. Drug inhibition assays verified that endosome fusion contributes to HIV-1 productive infection in primary macrophages. Additionally, we observed that a dynamic actin cytoskeleton is critical for HIV-1 entry and intracellular migration in primary macrophages. HIV-1 dynamics and infection could be blocked by multiple different actin inhibitors. Our study revealed a productive entry pathway in macrophages that requires both endosomal function and actin dynamics, which may assist in the development of inhibitors to block the HIV entry in macrophages.

  7. Insertion sequence element single nucleotide polymorphism typing provides insights into the population structure and evolution of Mycobacterium ulcerans across Africa.

    Science.gov (United States)

    Vandelannoote, Koen; Jordaens, Kurt; Bomans, Pieter; Leirs, Herwig; Durnez, Lies; Affolabi, Dissou; Sopoh, Ghislain; Aguiar, Julia; Phanzu, Delphin Mavinga; Kibadi, Kapay; Eyangoh, Sara; Manou, Louis Bayonne; Phillips, Richard Odame; Adjei, Ohene; Ablordey, Anthony; Rigouts, Leen; Portaels, Françoise; Eddyani, Miriam; de Jong, Bouke C

    2014-02-01

    Buruli ulcer is an indolent, slowly progressing necrotizing disease of the skin caused by infection with Mycobacterium ulcerans. In the present study, we applied a redesigned technique to a vast panel of M. ulcerans disease isolates and clinical samples originating from multiple African disease foci in order to (i) gain fundamental insights into the population structure and evolutionary history of the pathogen and (ii) disentangle the phylogeographic relationships within the genetically conserved cluster of African M. ulcerans. Our analyses identified 23 different African insertion sequence element single nucleotide polymorphism (ISE-SNP) types that dominate in different areas where Buruli ulcer is endemic. These ISE-SNP types appear to be the initial stages of clonal diversification from a common, possibly ancestral ISE-SNP type. ISE-SNP types were found unevenly distributed over the greater West African hydrological drainage basins. Our findings suggest that geographical barriers bordering the basins to some extent prevented bacterial gene flow between basins and that this resulted in independent focal transmission clusters associated with the hydrological drainage areas. Different phylogenetic methods yielded two well-supported sister clades within the African ISE-SNP types. The ISE-SNP types from the "pan-African clade" were found to be widespread throughout Africa, while the ISE-SNP types of the "Gabonese/Cameroonian clade" were much rarer and found in a more restricted area, which suggested that the latter clade evolved more recently. Additionally, the Gabonese/Cameroonian clade was found to form a strongly supported monophyletic group with Papua New Guinean ISE-SNP type 8, which is unrelated to other Southeast Asian ISE-SNP types.

  8. Nondiabetic kidney disease in type 2 diabetic patients: A single center experience

    Science.gov (United States)

    Das, U.; Dakshinamurty, K. V.; Prayaga, A.; Uppin, M. S.

    2012-01-01

    Nondiabetic renal disease (NDRD) is seen as a cause of proteinuria and renal failure in type 2 diabetes mellitus (DM). The clinical differences between NDRD and diabetic glomerulosclerosis (DGS) are not clear. This study was done to find the spectrum of NDRD in type 2 DM patients and differences in clinical profile between NDRD and DGS patients. Data of patients with type 2 DM who underwent renal biopsy in this institute from 1990 to 2008 were analyzed retrospectively. Patients were categorized as isolated NDRD, NDRD with DGS, and isolated DGS. A total of 75 patients were included. Mean age was 45 ± 10.2 years, male to female ratio was 3.1 : 1, median duration of DM was 12 months (range, 1 year-15 years), proteinuria was 4.2 ± 3.4 g/day, and serum creatinine was 4.3 ± 3.9 mg/dl. Hypertension was observed in 63 (84%) cases and microscopic hematuria in 24 (32%) cases. Nephrotic syndrome (38.7%) was the commonest clinical presentation. Forty-eight (64%) cases had NDRD and 27 (36%) had DGS. The commonest NDRD was minimal change disease (12.5%). Three (6.3%) patients had lupus nephritis. Tubulointerstitial nephritis has been observed in 10.4% patients. No significant differences between NDRD and DGS patients were found except hypertension which was significantly high in the DGS group. Acute kidney injury and nephritic syndrome were not observed in the DGS group. In conclusion, the incidence of biopsy-proven NDRD in type 2 DM in this study was high. Kidney biopsy aided in the detection of NDRD in clinically suspected patients. PMID:23326046

  9. Mini-invasive Transforaminal Lumbar Interbody Fusion through Wiltse Approach to Treating Lumbar Spondylolytic Spondylolisthesis.

    Science.gov (United States)

    Zhou, Chao; Tian, Yong-hao; Zheng, Yan-ping; Liu, Xin-yu; Wang, Hu-hu

    2016-02-01

    To assess the clinical efficacy of mini-invasive transforaminal lumbar interbody fusion (TLIF) through the Wiltse approach for treating lumbar spondylolytic spondylolisthesis. In this retrospective controlled study, 69 cases with lumbar spondylolytic spondylolisthesis treated in Qilu hospital from April to November 2014 were randomly assigned to Wiltse approach (31 cases, 16 male, 15 female; mean age 45.1 years) and traditional approach groups (38 cases, 21 male, 17 female; 47.2 years. In the Wiltse approach group, the affected level was L4, 5 in 19 cases and L5 S1 in 12, 9 of whom had low back pain (LBP) only and 21 both LBP and leg pain. There were 17 cases of I degree and 14 of II degree spondylolisthesis. Pre-operative Japanese Orthopedic Association (JOA) score was 13.1 ± 2.6; visual analog scale (VAS) for LBP 7.4 ± 1.2; VAS for leg pain 6.1 ± 2.0 and Oswestry disability index (ODI) score 42.2% ± 1.2%. In the traditional approach group, the affected level was L4, 5 in 22 cases and L5 S1 in 16, 11 of whom had LBP only and 27 both LBP and leg pain. There were 21 cases of I degree and 17 of II degree spondylolisthesis. Pre-operative JOA score was 12.8 ± 1.2; VAS for LBP 6.9 ± 1.1; VAS for leg pain 7.1 ± 2.0 and ODI score 41.2% ± 2.0%. The JOA score, VAS for LBP and leg pain, ODI dynamic X-rays, CT and/or MR were evaluated 3 and 6 months and 1 year postoperatively. There were no differences in sex, age, affected levels, spondylolisthesis degree, pre-operative JOA score, VAS for LBP or leg pain and ODI score between the two groups (P > 0.05). The incision length, blood loss and time to achieving exposure were better in the Wiltse approach than the traditional approach group (P 0.05). The interbody fusion rate was not significantly different between the groups (P > 0.05). There were no complications of internal fixation in either group. TLIF via both approaches has satisfactory clinical efficacy. TLIF through the Wiltse approach significantly reduces the

  10. Surgical outcome of posterior lumbar interbody fusion with pedicle screw fixation for lumbar spondylolisthesis

    International Nuclear Information System (INIS)

    Shoda, Motoi; Kuno, Shigehiko; Inoue, Tatsushi

    2009-01-01

    Problems of lumbar spondylolisthesis treatment are many surgical tactics, elderly patient, osteoporosis, complications and recurrence of the symptoms. PLIF (posterior lumbar interbody fusion) and PS (pedicle screw) fixation technique for lumbar spondylolisthesis provide good patient satisfaction. Good outcome has been reported by only laminectomy alone, but patient satisfaction becomes worse year after year. The role of instrumentation for lumbar spondylolisthesis is decompression of the nerve root, correction of lumbar pathologies, bony fusion and early mobilization. We show our surgical technique and long term outcome of PLIF with PS for lumbar spondylolisthesis. Three hundred and fifty cases of lumbar spondylolisthesis were operated on in Department of Neurosurgery, Fujita Health University during the period of from December 1992 to August 2008. Patient background: age 16-84 years old (mean 62.5), Gender: male 153, female 197. Follow-up period 1-180 months (mean 61.2). Degenerative: 255, Isthmic: 63, Dysplastic: 10, Fracture: 5 and scoliosis 16 cases. Surgical procedure was PS with interbody fusion cage: 331, Hybrid cage (titanium cage with hydroxyapatite) 314, PS with Cerabone: 2 and PS with autograft: 17. CT was done to evaluate bony fusion postoperatively. Post operative improvements by JOA (Japan Orthopedic Association) score is 11.4 before surgery, 24.1 (post op. within 2 years), 25.4 (post op. 2-5 years), 25.0 (post op. 5-10 years) and 22.4 (post op. 10-15 years). Significant improvements were observed in %Slip and Slip angle but no remarkable change was observed in lumbar lordotic angle by postoperative X-ray evaluation. No root injury, and systemic complication except 4 cases of cerebrospinal fluid (CSF) leakage during surgery. Two cases were reoperated in whom cage with autograft migration due to pseudoarthrosis. Two cases had to undergo screw and cage system removal due to infection. Two cases of adjacent level stenosis had to undergo operation 10

  11. Masked Visual Analysis: Minimizing Type I Error in Visually Guided Single-Case Design for Communication Disorders.

    Science.gov (United States)

    Byun, Tara McAllister; Hitchcock, Elaine R; Ferron, John

    2017-06-10

    Single-case experimental designs are widely used to study interventions for communication disorders. Traditionally, single-case experiments follow a response-guided approach, where design decisions during the study are based on participants' observed patterns of behavior. However, this approach has been criticized for its high rate of Type I error. In masked visual analysis (MVA), response-guided decisions are made by a researcher who is blinded to participants' identities and treatment assignments. MVA also makes it possible to conduct a hypothesis test assessing the significance of treatment effects. This tutorial describes the principles of MVA, including both how experiments can be set up and how results can be used for hypothesis testing. We then report a case study showing how MVA was deployed in a multiple-baseline across-subjects study investigating treatment for residual errors affecting rhotics. Strengths and weaknesses of MVA are discussed. Given their important role in the evidence base that informs clinical decision making, it is critical for single-case experimental studies to be conducted in a way that allows researchers to draw valid inferences. As a method that can increase the rigor of single-case studies while preserving the benefits of a response-guided approach, MVA warrants expanded attention from researchers in communication disorders.

  12. Transcriptomes of major renal collecting duct cell types in mouse identified by single-cell RNA-seq.

    Science.gov (United States)

    Chen, Lihe; Lee, Jae Wook; Chou, Chung-Lin; Nair, Anil V; Battistone, Maria A; Păunescu, Teodor G; Merkulova, Maria; Breton, Sylvie; Verlander, Jill W; Wall, Susan M; Brown, Dennis; Burg, Maurice B; Knepper, Mark A

    2017-11-14

    Prior RNA sequencing (RNA-seq) studies have identified complete transcriptomes for most renal epithelial cell types. The exceptions are the cell types that make up the renal collecting duct, namely intercalated cells (ICs) and principal cells (PCs), which account for only a small fraction of the kidney mass, but play critical physiological roles in the regulation of blood pressure, extracellular fluid volume, and extracellular fluid composition. To enrich these cell types, we used FACS that employed well-established lectin cell surface markers for PCs and type B ICs, as well as a newly identified cell surface marker for type A ICs, c-Kit. Single-cell RNA-seq using the IC- and PC-enriched populations as input enabled identification of complete transcriptomes of A-ICs, B-ICs, and PCs. The data were used to create a freely accessible online gene-expression database for collecting duct cells. This database allowed identification of genes that are selectively expressed in each cell type, including cell-surface receptors, transcription factors, transporters, and secreted proteins. The analysis also identified a small fraction of hybrid cells expressing aquaporin-2 and anion exchanger 1 or pendrin transcripts. In many cases, mRNAs for receptors and their ligands were identified in different cells (e.g., Notch2 chiefly in PCs vs. Jag1 chiefly in ICs), suggesting signaling cross-talk among the three cell types. The identified patterns of gene expression among the three types of collecting duct cells provide a foundation for understanding physiological regulation and pathophysiology in the renal collecting duct.

  13. Diabetes complications in 1952 type 2 diabetes mellitus patients managed in a single institution

    International Nuclear Information System (INIS)

    Alwakeel, Jamal S.; Suliman, R.; Tarif, N.; Al-Suwaida, A.; Hammad, D.; Al-Asaad, H.; Al-Harbi, A.; Al-Mohaya, S.; Alam, A.

    2008-01-01

    Because there is no recent update on the state of diabetes and its concomitant applications in Saudi Arabia, we undertook a study of the prevalence of health complications in patients with type 2 diabetes mellitus admitted to our institution. We conducted a retrospective review of medical results of adult Saudi patients with type 2 diabetes who were seen in clinics or admitted to the Security Forces Hospital, Riyadh, Saudi Arabia, between January 1989 and January 2004. Of 1952, 943 (48.3%) were males. For the whole study population the mean age at enrollment was 58.4+-14.2 years, the mean age at the onset of diabetes was 48.1+-12.8 years, the mean duration of diabetes was 10.4+-7.5 years, and the mean duration of follow-up was 7.9+-4.6 years. Nephropathy was the most prevalent complication, occurring in 626 patients (32.1%). Acute coronary syndrome occurred in 451 (23.1%), cataracts in 447 (22.9$), retinopathy in 326 (16.7%), and myocardial infarction in 279 (14.3%), Doubling of serum ceartinine was seen in 250 (12.8%) and 79 (4.0%) went into dialysis. Hypertension was present in 1524 (78.1%) dyslipidemia in 764 (39.1%). Overall mortality was 8.2%. Multiple complications were frequent. Males had higher prevalence of complications than females (P<.05). Mortality was significantly higher in males 92 (9.8%) than females 69 (6.8%) (P=.024). The prevalence of complications significantly increased with duration of diabetes and age (P<.05). Among Saudis, the prevalence of concomitant diabetic complications is high, with cardiovascular and renal complications the most frequent. Many patients had multiple complications. Early and frequent screening in patients with type 2 diabetes is desirable to identify patients at high risk for concomitant complications and to prevent disabilities. (author)

  14. Fabrication and Characterization of a Single Hole Transistor in p-type GaAs/AlGaAs Heterostructures

    Energy Technology Data Exchange (ETDEWEB)

    Tracy, Lisa A [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Reno, John L. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Hargett, Terry W. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    Most spin qubit research to date has focused on manipulating single electron spins in quantum dots. However, hole spins are predicted to have some advantages over electron spins, such as reduced coupling to host semiconductor nuclear spins and the ability to control hole spins electrically using the large spin-orbit interaction. Building on recent advances in fabricating high-mobility 2D hole systems in GaAs/AlGaAs heterostructures at Sandia, we fabricate and characterize single hole transistors in GaAs. We demonstrate p-type double quantum dot devices with few-hole occupation, which could be used to study the physics of individual hole spins and control over coupling between hole spins, looking towards eventual applications in quantum computing. Intentionally left blank

  15. Growth of large size lithium niobate single crystals of high quality by tilting-mirror-type floating zone method

    Energy Technology Data Exchange (ETDEWEB)

    Sarker, Abdur Razzaque, E-mail: razzaque_ru2000@yahoo.com [Department of Physics, University of Rajshahi (Bangladesh)

    2016-05-15

    Large size high quality LiNbO{sub 3} single crystals were grown successfully by tilting-mirror-type floating zone (TMFZ) technique. The grown crystals were characterized by X-ray diffraction, etch pits density measurement, Impedance analysis, Vibrating sample magnetometry (VSM) and UV-Visible spectrometry. The effect of mirror tilting during growth on the structural, electrical, optical properties and defect density of the LiNbO{sub 3} crystals were investigated. It was found that the defect density in the crystals reduced for tilting the mirror in the TMFZ method. The chemical analysis revealed that the grown crystals were of high quality with uniform composition. The single crystals grown by TMFZ method contains no low-angle grain boundaries, indicating that they can be used for high efficiency optoelectronic devices. (author)

  16. Single and multi-subject clustering of flow cytometry data for cell-type identification and anomaly detection.

    Science.gov (United States)

    Pouyan, Maziyar Baran; Jindal, Vasu; Birjandtalab, Javad; Nourani, Mehrdad

    2016-08-10

    Measurement of various markers of single cells using flow cytometry has several biological applications. These applications include improving our understanding of behavior of cellular systems, identifying rare cell populations and personalized medication. A common critical issue in the existing methods is identification of the number of cellular populations which heavily affects the accuracy of results. Furthermore, anomaly detection is crucial in flow cytometry experiments. In this work, we propose a two-stage clustering technique for cell type identification in single subject flow cytometry data and extend it for anomaly detection among multiple subjects. Our experimentation on 42 flow cytometry datasets indicates high performance and accurate clustering (F-measure > 91 %) in identifying main cellular populations. Furthermore, our anomaly detection technique evaluated on Acute Myeloid Leukemia dataset results in only <2 % false positives.

  17. Variation of power generation at different buffer types and conductivities in single chamber microbial fuel cells

    KAUST Repository

    Nam, Joo-Youn

    2010-01-15

    Microbial fuel cells (MFCs) are operated with solutions containing various chemical species required for the growth of electrochemically active microorganisms including nutrients and vitamins, substrates, and chemical buffers. Many different buffers are used in laboratory media, but the effects of these buffers and their inherent electrolyte conductivities have not been examined relative to current generation in MFCs. We investigated the effect of several common buffers (phosphate, MES, HEPES, and PIPES) on power production in single chambered MFCs compared to a non-buffered control. At the same concentrations the buffers produced different solution conductivities which resulted in different ohmic resistances and power densities. Increasing the solution conductivities to the same values using NaCl produced comparable power densities for all buffers. Very large increases in conductivity resulted in a rapid voltage drop at high current densities. Our results suggest that solution conductivity at a specific pH for each buffer is more important in MFC studies than the buffer itself given relatively constant pH conditions. Based on our analysis of internal resistance and a set neutral pH, phosphate and PIPES are the most useful buffers of those examined here because pH was maintained close to the pKa of the buffer, maximizing the ability of the buffer to contribute to increase current generation at high power densities. © 2009 Elsevier B.V. All rights reserved.

  18. Variation of power generation at different buffer types and conductivities in single chamber microbial fuel cells.

    Science.gov (United States)

    Nam, Joo-Youn; Kim, Hyun-Woo; Lim, Kyeong-Ho; Shin, Hang-Sik; Logan, Bruce E

    2010-01-15

    Microbial fuel cells (MFCs) are operated with solutions containing various chemical species required for the growth of electrochemically active microorganisms including nutrients and vitamins, substrates, and chemical buffers. Many different buffers are used in laboratory media, but the effects of these buffers and their inherent electrolyte conductivities have not been examined relative to current generation in MFCs. We investigated the effect of several common buffers (phosphate, MES, HEPES, and PIPES) on power production in single chambered MFCs compared to a non-buffered control. At the same concentrations the buffers produced different solution conductivities which resulted in different ohmic resistances and power densities. Increasing the solution conductivities to the same values using NaCl produced comparable power densities for all buffers. Very large increases in conductivity resulted in a rapid voltage drop at high current densities. Our results suggest that solution conductivity at a specific pH for each buffer is more important in MFC studies than the buffer itself given relatively constant pH conditions. Based on our analysis of internal resistance and a set neutral pH, phosphate and PIPES are the most useful buffers of those examined here because pH was maintained close to the pK(a) of the buffer, maximizing the ability of the buffer to contribute to increase current generation at high power densities. Copyright 2009 Elsevier B.V. All rights reserved.

  19. Large-scale separation of single-walled carbon nanotubes by electronic type using click chemistry

    Science.gov (United States)

    Um, Jo-Eun; Song, Sun Gu; Yoo, Pil J.; Song, Changsik; Kim, Woo-Jae

    2018-01-01

    Single-walled carbon nanotubes (SWCNTs) can be either metallic or semiconducting, making their separation critical for applications in nanoelectronics, biomedical materials, and solar cells. Herein, we investigate a novel solution-phase separation method based on click chemistry (azide-alkyne Huisgen cycloaddition) and determine its efficiency and scalability. In this method, metallic SWCNTs in metallic/semiconducting SWCNT mixtures are selectively functionalized with alkyne groups by being reacted with 4-propargyloxybenezenediazonium tetrafluoroborate. Subsequently, silica nanoparticles are functionalized with azide groups and reacted with alkyne-bearing metallic SWCNTs in the SWCNT mixture in the presence of a Cu catalyst. As a result, metallic SWCNTs are anchored on silica powder, whereas non-functionalized semiconducting SWCNTs remain in solution. Low-speed centrifugation effectively removes the silica powder with attached metallic SWCNTs, furnishing a solution of highly pure semiconducting SWCNTs, as confirmed by Raman and UV-vis/near-infrared absorption measurements. This novel separation scheme exhibits the advantage of simultaneously separating both metallic and semiconducting SWCNTs from their mixtures, being cost-effective and therefore applicable at an industrial scale.

  20. Analysis of Horse Myostatin Gene and Identification of Single Nucleotide Polymorphisms in Breeds of Different Morphological Types

    OpenAIRE

    Dall'Olio, Stefania; Fontanesi, Luca; Nanni Costa, Leonardo; Tassinari, Marco; Minieri, Laura; Falaschini, Adalberto

    2010-01-01

    Myostatin (MSTN) is a negative modulator of muscle mass. We characterized the horse (Equus caballus) MSTN gene and identified and analysed single nucleotide polymorphisms (SNPs) in breeds of different morphological types. Sequencing of coding, untranslated, intronic, and regulatory regions of MSTN gene in 12 horses from 10 breeds revealed seven SNPs: two in the promoter, four in intron 1, and one in intron 2. The SNPs of the promoter (GQ183900:g.26T > C and GQ183900:g.156T > C, the latter loc...

  1. Plutonium (TRU) transmutation and {sup 233}U production by single-fluid type accelerator molten-salt breeder (AMSB)

    Energy Technology Data Exchange (ETDEWEB)

    Furukaw, Kazuo [Tokai Univ., Kanagawa (Japan); Kato, Yoshio [Japan Atom. Ene. Res. Inst., Ibaraki (Japan); Chigrinov, Sergey E. [Academy of Science, Minsk (Belarus)

    1995-10-01

    For practical/industrial disposition of Pu(TRU) by accelerator facility, not only physical soundness and safety but also the following technological rationality should be required: (1) few R&D items including radiation damage, heat removal and material compatibility; (2) few operation/maintenance/processing works: (3) few reproduction of radioactivity; (4) effective energy production in parallel. This will be achieved by the new modification of Th-fertilizing Single-Fluid type Accelerator Molten-Salt Breeder (AMSB), by which a global nuclear energy strategy for next century might be prepared.

  2. Development of a single multi-locus sequence typing scheme for Taylorella equigenitalis and Taylorella asinigenitalis.

    Science.gov (United States)

    Duquesne, Fabien; Hébert, Laurent; Breuil, Marie-France; Matsuda, Motoo; Laugier, Claire; Petry, Sandrine

    2013-12-27

    We describe here the development of a multilocus sequence typing (MLST) scheme for Taylorella equigenitalis, the causative agent of contagious equine metritis (CEM), and Taylorella asinigenitalis, a nonpathogenic bacterium. MLST was performed on a set of 163 strains collected in several countries over 35 years (1977-2012). The MLST data were analyzed using START2, MEGA 5.05 and eBURST, and can be accessed at http://pubmlst.org/taylorella/. Our results revealed a clonal population with 39 sequence types (ST) and no common ST between the two Taylorella species. The eBURST analysis grouped the 27 T. equigenitalis STs into four clonal complexes (CC1-4) and five unlinked STs. The 12 T. asinigenitalis STs were grouped into three clonal complexes (CC5-7) and five unlinked STs, among which CC1 (68.1% of the 113 T. equigenitalis) and CC5 (58.0% of the 50 T. asinigenitalis) were dominants. The CC1, still in circulation in France, contains isolates from the first CEM outbreaks that simultaneously emerged in several countries in the late 1970s. The emergence in different countries (e.g. France, Japan, and United Arab Emirates) of STs without any genetic relationship to CC1 suggests the existence of a natural worldwide reservoir that remains to be identified. T. asinigenitalis appears to behave same way since the American, Swedish and French isolates have unrelated STs. This first Taylorella sp. MLST is a powerful tool for further epidemiological investigations and population biology studies of the Taylorella genus. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Wegner estimate and localization for alloy-type models with sign-changing exponentially decaying single-site potentials

    Science.gov (United States)

    Leonhardt, Karsten; Peyerimhoff, Norbert; Tautenhahn, Martin; Veselić, Ivan

    2015-05-01

    We study Schrödinger operators on L2(ℝd) and ℓ2(ℤd) with a random potential of alloy-type. The single-site potential is assumed to be exponentially decaying but not necessarily of fixed sign. In the continuum setting, we require a generalized step-function shape. Wegner estimates are bounds on the average number of eigenvalues in an energy interval of finite box restrictions of these types of operators. In the described situation, a Wegner estimate, which is polynomial in the volume of the box and linear in the size of the energy interval, holds. We apply the established Wegner estimate as an ingredient for a localization proof via multiscale analysis.

  4. Proton Pumping and Slippage Dynamics of a Eukaryotic P-Type ATPase Studied at the Single-Molecule Level

    DEFF Research Database (Denmark)

    Veshaguri, Salome

    In all eukaryotes the plasma membrane potential and secondary transport systems are energized by P-type ATPases whose regulation however remains poorly understood. Here we monitored at the single-molecule level the activity of the prototypic proton pumping P-type ATPase Arabidopsis thaliana isoform...... pumping rates remained constant. Titration of ATP down to ~1% of apparent Km for ATPase activity exclusively affected the distributions of the durations the pump spends in active and inactive states. The dramatic consequence of our findings is that ATP reduction decreased ATP/H+ stoichiometry of the pump....... We propose that variable ATP/H+ stoichiometry emerges as a novel mechanism for adaptation when challenged with depletion of ATP that is likely relevant for other ATPases. Such measurements will provide indispensable insights into the mechanisms of function and regulation of many other ion...

  5. Bony ingrowth potential of 3D printed porous titanium alloy: a direct comparison of interbody cage materials in an in vivo ovine lumbar fusion model.

    Science.gov (United States)

    McGilvray, Kirk; Easley, Jeremiah; Seim, Howard B; Regan, Daniel; Berven, Sigurd H; Hsu, Wellington K; Mroz, Thomas E; Puttlitz, Christian M

    2018-02-26

    There is significant variability in the materials commonly used for interbody cages in spine surgery. It is theorized that 3-D printed interbody cages utilizing porous titanium material can provide more consistent bone ingrowth and biological fixation. The purpose of this study was to provide an evidence-based approach to decision making regarding interbody materials for spinal fusion. Comparative animal study. A skeletally mature ovine lumbar fusion model was utilized for this study. Interbody fusions were performed at (L2-L3 and L4-L5) in 27 mature sheep using three different interbody cages (i.e., polyetheretherketone [PEEK], plasma sprayed porous titanium coated PEEK [PSP], and 3-D printed porous titanium alloy cage [PTA]). Non-destructive kinematic testing was performed in the three primary directions of motion. The specimens were then analyzed using micro-computed tomography (µCT); quantitative measures of the bony fusion were performed. Histomorphometric analyses were also performed in the sagittal plane through the interbody device. Outcome parameters were compared between cage designs and time-points. Flexion-extension range of motion (ROM) was statistically reduced for the PTA group as compared to the PEEK cages at 16 weeks (p-value = 0.02). Only the PTA cages demonstrated a statistically significant decrease in ROM and increase in stiffness across all three loading directions between the 8-week and 16-week sacrifice time-points (p-value ≤ 0.01). Micro-CT data demonstrated significantly greater total bone volume within the graft window for the PTA cages at both 8-weeks and 16-weeks compared to the PEEK cages (p-value < 0.01). A direct comparison of interbody implants demonstrates significant and measurable differences in biomechanical, µCT, and histologic performance in an ovine model. The 3-D printed porous titanium interbody cage resulted in statistically significant reductions in ROM, increases in the bone ingrowth profile, as well as average

  6. Kinematic efficacy of supplemental anterior lumbar interbody fusion at lumbosacral levels in thoracolumbosacral deformity correction with and without pedicle subtraction osteotomy at L3

    DEFF Research Database (Denmark)

    Dahl, Benny T; Harris, Jonathan A; Gudipally, Manasa

    2017-01-01

    of operative construction (p ≤ 0.05). Across L4-S1 and L2-S1, all instrumented constructs significantly reduced motion, in both PSO- and non-PSO groups, during all loading modes (p ≤ 0.05). CONCLUSIONS: These findings suggest anterior interbody fusion minimally immobilizes motion segments, and interbody...... devices may primarily act to maintain disc height. Additionally, lumbar osteotomy destabilizes axial rotational stability at the osteotomy site, potentially further increasing mechanical demand on posterior instrumentation. Clinical studies are needed to assess the impact of this treatment strategy....

  7. CORRECTION OF SEVERE STIFF SCOLIOSIS THROUGH EXTRAPLEURAL INTERBODY RELEASE AND OSTEOTOMY (LIEPO

    Directory of Open Access Journals (Sweden)

    Cleiton Dias Naves

    Full Text Available ABSTRACT Objective: To report a new technique for extrapleural interbody release with transcorporal osteotomy of the inferior vertebral plateau (LIEPO and to evaluate the correction potential of this technique and its complications. Method: We included patients with scoliosis with Cobb angle greater than 90° and flexibility less than 25% submitted to surgical treatment between 2012 and 2016 by the technique LIEPO at the National Institute of Traumatology and Orthopedics (INTO. Sagittal and coronal alignment, and the translation of the apical vertebra were measured and the degree of correction of the deformity was calculated through the pre and postoperative radiographs, and the complications were described. Results: Patients had an average bleed of 1,525 ml, 8.8 hours of surgical time, 123° of scoliosis in the preoperative period, and a mean correction of 66%. There was no case of permanent neurological damage and no surgical revision. Conclusion: The LIEPO technique proved to be effective and safe in the treatment of severe stiff scoliosis, reaching a correction potential close to the PEISR (Posterior extrapleural intervertebral space release technique and superior to that of the pVCR (posterior Vertebral Column Resection with no presence of infection and permanent neurological deficit. New studies are needed to validate this promising technique.

  8. Salvage Percutaneous Vertebral Augmentation Using Polymethyl Methacrylate in Patients with Failed Interbody Fusion.

    Science.gov (United States)

    Yun, Dong-Ju; Hwang, Byeong-Wook; Oh, Hyeong-Seok; Kim, Jin-Sung; Jeon, Sang-Hyeop; Lee, Sang-Ho

    2016-11-01

    Percutaneous vertebral augmentation with cement is used as a salvage procedure for failed instrumentation. Few studies have reported the use of this procedure for failed anterior lumbar fusion in elderly patients with osteoporosis and other complicated diseases who have undergone a previous major operation. Between January 2007 and December 2015, the clinical and radiographic results of 8 patients with osteoporosis who showed subsidence and migration of the implant after an initial operation were examined. After the development of implant failure, the patients underwent vertebral augmentation with polymethyl methacrylate. Mean patient age was 73.4 years (range, 67-78 years), and mean bone mineral density was -2.96 (range, -2.1 to -3.8). The mean radiologic follow-up period between augmentation and the last follow-up examination was 16 months (range, 3-38 months). Although the subjective clinical outcome was not satisfying to the patients, no loss of correction, fractures, or screw loosening occurred during the follow-up period. The injection of cement around the instrument might help to stabilize it by providing strength to the axis and preventing further loosening. This salvage procedure could be an alternative in the management of cases with failed interbody fusion. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Digitalized design of extraforaminal lumbar interbody fusion: a computer-based simulation and cadaveric study.

    Directory of Open Access Journals (Sweden)

    Mingjie Yang

    Full Text Available PURPOSE: This study aims to investigate the feasibility of a novel lumbar approach named extraforaminal lumbar interbody fusion (ELIF, a newly emerging minimally invasive technique for treating degenerative lumbar disorders, using a digitalized simulation and a cadaveric study. METHODS: The ELIF surgical procedure was simulated using the Mimics surgical simulator and included dissection of the superior articular process, dilation of the vertebral foramen, and placement of pedicle screws and a cage. ELIF anatomical measures were documented using a digitalized technique and subsequently validated on fresh cadavers. RESULTS: The use of the Mimics allowed for the vivid simulation of ELIF surgical procedures, while the cadaveric study proved the feasibility of this novel approach. ELIF had a relatively lateral access approach that was located 8-9 cm lateral to the median line with an access depth of approximately 9 cm through the intermuscular space. Dissection of the superior articular processes could fully expose the target intervertebral discs and facilitate a more inclined placement of the pedicle screws and cage with robust enhancement. CONCLUSIONS: According to the computer-based simulation and cadaveric study, it is feasible to perform ELIF. Further research including biomechanical study is needed to prove ELIF has a superior ability to preserve the posterior tension bands of the spinal column, with similar effects on spinal decompression, fixation, and fusion, and if it can enhance post-fusion spinal stability and expedites postoperative recovery.

  10. Digitalized design of extraforaminal lumbar interbody fusion: a computer-based simulation and cadaveric study.

    Science.gov (United States)

    Yang, Mingjie; Zeng, Cheng; Guo, Song; Pan, Jie; Han, Yingchao; Li, Zeqing; Li, Lijun; Tan, Jun

    2014-01-01

    This study aims to investigate the feasibility of a novel lumbar approach named extraforaminal lumbar interbody fusion (ELIF), a newly emerging minimally invasive technique for treating degenerative lumbar disorders, using a digitalized simulation and a cadaveric study. The ELIF surgical procedure was simulated using the Mimics surgical simulator and included dissection of the superior articular process, dilation of the vertebral foramen, and placement of pedicle screws and a cage. ELIF anatomical measures were documented using a digitalized technique and subsequently validated on fresh cadavers. The use of the Mimics allowed for the vivid simulation of ELIF surgical procedures, while the cadaveric study proved the feasibility of this novel approach. ELIF had a relatively lateral access approach that was located 8-9 cm lateral to the median line with an access depth of approximately 9 cm through the intermuscular space. Dissection of the superior articular processes could fully expose the target intervertebral discs and facilitate a more inclined placement of the pedicle screws and cage with robust enhancement. According to the computer-based simulation and cadaveric study, it is feasible to perform ELIF. Further research including biomechanical study is needed to prove ELIF has a superior ability to preserve the posterior tension bands of the spinal column, with similar effects on spinal decompression, fixation, and fusion, and if it can enhance post-fusion spinal stability and expedites postoperative recovery.

  11. Anterior lumbar interbody fusion with percutaneous pedicle screw fixation for multiple-level isthmic spondylolisthesis.

    Science.gov (United States)

    Hsieh, Chang-Sheng; Lee, Hyung Chang; Oh, Hyeong-Seok; Park, Sang-Joon; Hwang, Byeong-Wook; Lee, Sang-Ho

    2017-07-01

    Multiple-level lumbar isthmic spondylolisthesis is rarely reported. Here, we report 23 consecutive patients who underwent anterior lumbar interbody fusion (ALIF) with percutaneous pedicle screw fixation (PPF) for multiple-level isthmic spondylolisthesis. From June 2008 through December 2014, multiple-level lumbar isthmic spondylolisthesis was diagnosed in 23 patients (6 men, 17 women) at Wooridul Spine Hospital (Busan, South Korea). Isthmic spondylolisthesis occurred at three spinal levels in 2 patients and at two levels in 21 patients. All patients underwent ALIF with PPF. We used the Oswestry Disability Index (ODI) and visual analog scale scores to evaluate the preoperative and postoperative functional outcome, low back pain, and radicular pain. We also evaluated segmental lordosis and the fusion status using radiographs and data from computed tomography. Isthmic spondylolisthesis occurred from L3 to S1 and mostly occurred at two consecutive spinal levels (i.e., L4-L5 and L5-S1). Significant improvements in the ODI and visual analog scale were observed in patients at final follow up (pspondylolisthesis. Copyright © 2017. Published by Elsevier B.V.

  12. AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion

    Directory of Open Access Journals (Sweden)

    Rapp SM

    2011-08-01

    Full Text Available Steven M Rapp1, Larry E Miller2,3, Jon E Block31Michigan Spine Institute, Waterford, MI, USA; 2Miller Scientific Consulting Inc, Biltmore Lake, NC, USA; 3Jon E. Block, Ph.D., Inc., San Francisco, CA, USAAbstract: Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF system is a minimally invasive fusion device that accesses the lumbar (L4–S1 intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date.Keywords: AxiaLIF, fusion, lumbar, minimally invasive, presacral

  13. Sagittal Alignment as Predictor of Adjacent Segment Disease After Lumbar Transforaminal Interbody Fusion.

    Science.gov (United States)

    Sun, Jin; Wang, Jun-Jie; Zhang, Li-Wei; Huang, Hui; Fu, Na-Xin

    2018-02-01

    This study was carried out to explore the diagnostic value of sagittal measurements for adjacent segment disease after lumbar transforaminal interbody fusion (TLIF). A total of 163 subjects who underwent TLIF for lumbar disease were initially enrolled in the study from July 2013 to August 2017. Sagittal alignment including thoracic inlet and spinopelvic parameters was measured by using preoperative full-length freestanding radiographs. Multivariate logistic regression analysis was performed to evaluate these parameters as the diagnostic index for adjacent segment disease (ASD). A total of 153 patients completed the final follow-up, and the mean follow-up period was 40.6 months. There were 53 (35.3%) cases with ASD found after the TLIF in the enrolled subjects. Logistic regression analysis and receiver operating characteristic analysis confirmed that preoperative pelvic tilt (PT) of more than 24.1° and thoracic kyphosis (TK) of more than 23.3° were significant risk factors of ASD after TLIF (P < 0.05). We confirmed that PT of more than 24.3° and TK of more than 23.3° could be regarded as predictors of ASD after lumbar TLIF. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Single assay for simultaneous detection and differential identification of human and avian influenza virus types, subtypes, and emergent variants.

    Directory of Open Access Journals (Sweden)

    David Metzgar

    Full Text Available For more than four decades the cause of most type A influenza virus infections of humans has been attributed to only two viral subtypes, A/H1N1 or A/H3N2. In contrast, avian and other vertebrate species are a reservoir of type A influenza virus genome diversity, hosting strains representing at least 120 of 144 combinations of 16 viral hemagglutinin and 9 viral neuraminidase subtypes. Viral genome segment reassortments and mutations emerging within this reservoir may spawn new influenza virus strains as imminent epidemic or pandemic threats to human health and poultry production. Traditional methods to detect and differentiate influenza virus subtypes are either time-consuming and labor-intensive (culture-based or remarkably insensitive (antibody-based. Molecular diagnostic assays based upon reverse transcriptase-polymerase chain reaction (RT-PCR have short assay cycle time, and high analytical sensitivity and specificity. However, none of these diagnostic tests determine viral gene nucleotide sequences to distinguish strains and variants of a detected pathogen from one specimen to the next. Decision-quality, strain- and variant-specific pathogen gene sequence information may be critical for public health, infection control, surveillance, epidemiology, or medical/veterinary treatment planning. The Resequencing Pathogen Microarray (RPM-Flu is a robust, highly multiplexed and target gene sequencing-based alternative to both traditional culture- or biomarker-based diagnostic tests. RPM-Flu is a single, simultaneous differential diagnostic assay for all subtype combinations of type A influenza viruses and for 30 other viral and bacterial pathogens that may cause influenza-like illness. These other pathogen targets of RPM-Flu may co-infect and compound the morbidity and/or mortality of patients with influenza. The informative specificity of a single RPM-Flu test represents specimen-specific viral gene sequences as determinants of virus type, A

  15. Elevated serum triglycerides is the strongest single indicator for the presence of metabolic syndrome in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Dimou Eleni

    2006-10-01

    Full Text Available Abstract Background Patients with diabetes already fulfill one diagnostic criterion for MS according to the existing classifications. Our aim was to identify one single clinical parameter, which could effectively predict the presence of MS in patients with type 2 diabetes. Methods We studied all patients with type 2 diabetes who attended our Diabetes Outpatient Clinic during a three-month period. Waist circumference, blood pressure and serum lipids were measured. Establishment of MS diagnosis was based a on National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III criteria and b on International Diabetes Federation (IDF criteria. Receiver operating characteristic (ROC analysis was applied in order to identify the clinical parameter with the highest predictive capability for MS. Among the 500 participating patients (231 males, 269 females, MS was diagnosed in 364 patients (72.8% according to the NCEP ATP III criteria and in 408 patients (81.6% according to the IDF criteria. Results For the NCEP ATP III classification, serum triglycerides (in the overall population, waist and HDL (in female population demonstrated the highest predictive capability for MS (AUCs:0.786, 0.805 and 0.801, respectively. For the IDF classification, no single parameter reached an AUC > 0.800 in the overall population. In females, HDL displayed a satisfactory predictive capability for MS with an AUC which was significantly higher than the one in males (0.785 vs. 0.676, respectively, p Conclusion Elevated serum triglycerides strongly indicate the presence of MS in patients with type 2 diabetes. In female patients with type 2 diabetes, central obesity was the second stronger predictor of MS besides hypertriglyceridemia.

  16. A single dose of sodium nitrate does not improve oral glucose tolerance in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Cermak, Naomi M; Hansen, Dominique; Kouw, Imre W K; van Dijk, Jan-Willem; Blackwell, Jamie R; Jones, Andrew M; Gibala, Martin J; van Loon, Luc J C

    2015-08-01

    Dietary nitrate (NO3(-)) supplementation has been proposed as an emerging treatment strategy for type 2 diabetes. We hypothesized that ingestion of a single bolus of dietary NO3(-) ingestion improves oral glucose tolerance in patients with type 2 diabetes. Seventeen men with type 2 diabetes (glycated hemoglobin, 7.3% ± 0.2%) participated in a randomized crossover experiment. The subjects ingested a glucose beverage 2.5 hours after consumption of either sodium NO3(-) (0.15 mmol NaNO3(-) · kg(-1)) or a placebo solution. Venous blood samples were collected before ingestion of the glucose beverage and every 30 minutes thereafter during a 2-hour period to assess postprandial plasma glucose and insulin concentrations. The results show that plasma NO3(-) and nitrite levels were increased after NaNO3(-) as opposed to placebo ingestion (treatment-effect, P = .001). Despite the elevated plasma NO3(-) and nitrite levels, ingestion of NaNO3(-) did not attenuate the postprandial rise in plasma glucose and insulin concentrations (time × treatment interaction, P = .41 for glucose, P = .93 for insulin). Despite the lack of effect on oral glucose tolerance, basal plasma glucose concentrations measured 2.5 hours after NaNO3(-) ingestion were lower when compared with the placebo treatment (7.5 ± 0.4 vs 8.3 ± 0.4 mmol/L, respectively; P = .04). We conclude that ingestion of a single dose of dietary NO3(-) does not improve subsequent oral glucose tolerance in patients with type 2 diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. ESTIMATION OF THE SCALE PARAMETER FROM THE RAYLEIGH DISTRIBUTION FROM TYPE II SINGLY AND DOUBLY CENSORED DATA

    Directory of Open Access Journals (Sweden)

    Ahmad Saeed Akhter

    2009-01-01

    Full Text Available As common as the normal distribution is the Rayleigh distribution which occurs in works on radar, properties of sine wave plus-noise, etc. Rayleigh (1880 derived it from the amplitude of sound resulting from many important sources. The Rayleigh distribution is widely used in communication engineering, reliability analysis and applied statistics. Since the Rayleigh distribution has linearly increasing rate, it is appropriate for components which might not have manufacturing defects but age rapidly with time. Several types of electro-vacum devices have this feature. It is connected with one dimension and two dimensions random walk and is some times referred to as a random walk frequency distribution. It is a special case of Weibull distribution (1951 of wide applicability. It can be easily derived from the bivariate normal distribution with and p = 0. For further application of Rayleigh distribution, we refer to Johnson and Kotz (1994. Adatia (1995 has obtained the best linear unbiased estimator of the Rayleigh scale parameter based on fairly large censored samples. Dyer and Whisend (1973 obtained the BLUE of scale parameter based on type II censored samples for small N = 2(15. With the advance of computer technology it is now possible to obtain BLUE for large samples. Hirai (1978 obtained the estimate of the scale parameter from the Rayleigh distribution singly type II censored from the left side and right side and variances of the scale parameter. In this paper, we estimate the scale parameter of type II singly and doubly censored data from the Rayleigh distribution using Blom’s (1958 unbiased nearly best estimates and compare the efficiency of this estimate with BLUE and MLE.

  18. Induction of specific neuron types by overexpression of single transcription factors.

    Science.gov (United States)

    Teratani-Ota, Yusuke; Yamamizu, Kohei; Piao, Yulan; Sharova, Lioudmila; Amano, Misa; Yu, Hong; Schlessinger, David; Ko, Minoru S H; Sharov, Alexei A

    2016-10-01

    Specific neuronal types derived from embryonic stem cells (ESCs) can facilitate mechanistic studies and potentially aid in regenerative medicine. Existing induction methods, however, mostly rely on the effects of the combined action of multiple added growth factors, which generally tend to result in mixed populations of neurons. Here, we report that overexpression of specific transcription factors (TFs) in ESCs can rather guide the differentiation of ESCs towards specific neuron lineages. Analysis of data on gene expression changes 2 d after induction of each of 185 TFs implicated candidate TFs for further ESC differentiation studies. Induction of 23 TFs (out of 49 TFs tested) for 6 d facilitated neural differentiation of ESCs as inferred from increased proportion of cells with neural progenitor marker PSA-NCAM. We identified early activation of the Notch signaling pathway as a common feature of most potent inducers of neural differentiation. The majority of neuron-like cells generated by induction of Ascl1, Smad7, Nr2f1, Dlx2, Dlx4, Nr2f2, Barhl2, and Lhx1 were GABA-positive and expressed other markers of GABAergic neurons. In the same way, we identified Lmx1a and Nr4a2 as inducers for neurons bearing dopaminergic markers and Isl1, Fezf2, and St18 for cholinergic motor neurons. A time-course experiment with induction of Ascl1 showed early upregulation of most neural-specific messenger RNA (mRNA) and microRNAs (miRNAs). Sets of Ascl1-induced mRNAs and miRNAs were enriched in Ascl1 targets. In further studies, enrichment of cells obtained with the induction of Ascl1, Smad7, and Nr2f1 using microbeads resulted in essentially pure population of neuron-like cells with expression profiles similar to neural tissues and expressed markers of GABAergic neurons. In summary, this study indicates that induction of transcription factors is a promising approach to generate cultures that show the transcription profiles characteristic of specific neural cell types.

  19. Modal analysis and dispersion curves of an elliptical W-type single mode fiber

    Science.gov (United States)

    Prajapati, Y.; Maurya, Jitendra Bahadur; Singh, Vivek; Saini, J. P.

    2015-05-01

    In this paper, the propagation of electromagnetic waves in W-type elliptical dielectric optical fiber having various cladding layers is presented. The presented fiber has concentric core and cladding which have elliptical cross section and the refractive index of one of the inner cladding (the cladding between first clad and last clad) maximum. Using elliptic cylindrical coordinates, boundary conditions are derived and longitudinal field components for the even and odd modes are obtained. The characteristic equation for the fiber to be studied is determined by solving the Mathieu ( q > 0) and the modified Mathieu functions ( q < 0). In order to study the fundamental mode, the modal index m is put as m = 1. Finally, the cutoff frequencies for several lower order modes have been calculated and their dispersion characteristics are plotted. The effects of elliptical eccentricity e on the mode cutoff frequencies and mode transmissions are also addressed. The analysis shows that one can control the propagation property of optical fiber by increasing the number of inner claddings. These claddings provide additional degree of freedom to control the modes.

  20. Pregnancy outcomes and nutritional indices after 3 types of bariatric surgery performed at a single institution.

    Science.gov (United States)

    Mead, Nancy C; Sakkatos, Panagiotis; Sakellaropoulos, George C; Adonakis, George L; Alexandrides, Theodore K; Kalfarentzos, Fotis

    2014-01-01

    Nutritional status during pregnancy and the effects of nutritional deficiencies on pregnancy outcomes after bariatric surgery is an important issue that warrants further study. The objective of this study was to investigate pregnancy outcomes and nutritional indices after restrictive and malabsorptive procedures. We investigated pregnancy outcomes of 113 women who gave birth to 150 children after biliopancreatic diversion (BPD), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) between June 1994 and December 2011. Biochemical indices and pregnancy outcomes were compared among the different types of surgery and to overall 20-year hospital data, as well as to 56 presurgery pregnancies in 36 women of the same group. Anemia was observed in 24.2% and 15.6% of pregnancies after BPD and RYGB, respectively. Vitamin B12 levels decreased postoperatively in all groups, with no further decrease during pregnancy; however, low levels were observed not only after BPD (11.7%) and RYGB (15.6%), but also after SG (13.3%). Folic acid levels increased. Serum albumin levels decreased in all groups during pregnancy, but hypoproteinemia was seen only after BPD. Neonates after BPD had significantly lower average birth weight without a higher frequency of low birth weight defined asnutritional supplement guidelines are followed. Closer monitoring is required in pregnancies after malabsorptive procedures especially regarding protein nutrition. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  1. Cellulose synthesis in two secondary cell wall processes in a single cell type.

    Science.gov (United States)

    Mendu, Venugopal; Stork, Jozsef; Harris, Darby; DeBolt, Seth

    2011-11-01

    Plant cells have a rigid cell wall that constrains internal turgor pressure yet extends in a regulated and organized manner to allow the cell to acquire shape. The primary load-bearing macromolecule of a plant cell wall is cellulose, which forms crystalline microfibrils that are organized with respect to a cell's function and shape requirements. A primary cell wall is deposited during expansion whereas secondary cell wall is synthesized post expansion during differentiation. A complex form of asymmetrical cellular differentiation occurs in Arabidopsis seed coat epidermal cells, where we have recently shown that two secondary cell wall processes occur that utilize different cellulose synthase (CESA) proteins. One process is to produce pectinaceous mucilage that expands upon hydration and the other is a radial wall thickening that reinforced the epidermal cell structure. Our data illustrate polarized specialization of CESA5 in facilitating mucilage attachment to the parent seed and CESA2, CESA5 and CESA9 in radial cell wall thickening and formation of the columella. Herein, we present a model for the complexity of cellulose biosynthesis in this highly differentiated cell type with further evidence supporting each cellulosic secondary cell wall process.

  2. Clinical and molecular characterization of 112 single-center patients with Neurofibromatosis type 1.

    Science.gov (United States)

    Corsello, Giovanni; Antona, Vincenzo; Serra, Gregorio; Zara, Federico; Giambrone, Clara; Lagalla, Luca; Piccione, Maria; Piro, Ettore

    2018-04-04

    The aim of this retrospective study was to define clinical and molecular characteristics of a large sample of neurofibromatosis type 1 (NF1) patients, as well as to evaluate mutational spectrum and genotype-phenotype correlation. NF1 is a relatively common neurogenetic disorder (1:2500-1:3000 individuals). It is caused by mutations of the NF1 gene on chromosome 17ql1.2, with autosomal dominant pattern of inheritance and wide phenotypical variability. Café-au-lait spots (CALs), cutaneous and/or subcutaneous neurofibromas (CNFs/SCNFs), skinfold freckling, skeletal abnormalities, Lisch nodules of the iris and increased risk of learning and intellectual disabilities, as well as tumors of the nervous system and other organs are its main clinical features. The preliminary group collected 168 subjects with clinical suspicion of NF1. They were evaluated following the National Institutes of Health (NIH) criteria for NF1, revised by Gutmann et al. 1997, integrated for 67 of them by molecular testing. According to these references, 112 of 168 patients were diagnosed as NF1. The sample was characterized by an equal sex ratio (57 males, 55 females) and age distribution ranging from 10 days to 60 years of age (mean age, 13 years). A wide spectrum of clinical features has been observed in our patients. Mutational analysis resulted positive in 51 cases (76%). Twenty-four mutations detected in our cohort have not been reported to date. This study may contribute to a better definition of genotypic and phenotypic features of NF1 patients, with respect to further insights into the clinical characterization of the disease. In addition, an amplification of the spectrum of mutations in the NF1 gene has been documented.

  3. Glycogen storage disease type III in Egyptian children: a single centre clinico-laboratory study.

    Science.gov (United States)

    El-Karaksy, Hanaa; Anwar, Ghada; El-Raziky, Mona; Mogahed, Engy; Fateen, Ekram; Gouda, Amr; El-Mougy, Fatma; El-Hennawy, Ahmed

    2014-06-01

    Glycogen storage disease type III (GSD III) is an autosomal recessive disorder caused by deficiency of glycogen debrancher enzyme and is characterised by clinical variability. We herein describe the clinical and laboratory findings in 31 Egyptian patients with GSD III presenting to the Paediatric Hepatology Unit, Cairo University, Egypt. Eighteen patients (58%) were males. Their ages ranged between 6 months to 12 years. The main presenting complaint was progressive abdominal distention in 55%. Twelve patients (38.7%) had a history of recurrent attacks of convulsions; four had an erroneous diagnosis of hypocalcaemia and epilepsy. Doll-like facies was noted in 90%. Abdominal examination of all cases revealed abdominal distention and soft hepatomegaly which had bright echogenicity by ultrasound. Hypertriglyceridaemia was present in 93.6%, hyperlactacidaemia in 51.6% and hyperuricaemia in 19.4%. Liver biopsy showed markedly distended hepatocytes with well distinct cytoplasmic boundaries and 32% had macrovesicular fatty changes. Serum creatine kinase was elevated in 64.6% of patients and correlated positively and significantly with age (r=0.7 and P=<0.001), while serum triglycerides correlated negatively with age (r=-0.4 and P=0.05). Blood glucose assessment and search for hepatomegaly in an infant with recurrent seizures may prevent delay in the diagnosis. A huge soft liver reaching the left midclavicular line that appears echogenic on ultrasonography is characteristic of GSD III. A distended hepatocyte with rarified cytoplasm is pathognomonic but not diagnostic. Hypertriglyceridaemia correlates negatively with age, in contrary to CK level. Copyright © 2014 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

  4. Sensing interrogation technique for fiber-optic interferometer type of sensors based on a single-passband RF filter.

    Science.gov (United States)

    Chen, Hao; Zhang, Shiwei; Fu, Hongyan; Zhou, Bin; Chen, Nan

    2016-02-08

    In this paper, a sensing interrogation system for fiber-optic interferometer type of sensors by using a single-passband radio-frequency (RF) filter has been proposed and experimentally demonstrated. The fiber-optic interferometer based sensors can give continuous optical sampling, and along with dispersive medium a single-passband RF frequency response can be achieved. The sensing parameter variation on the fiber-optic interferometer type of sensors will affect their free spectrum range, and thus the peak frequency of the RF filter. By tracking the central frequency of the passband the sensing parameter can be demodulated. As a demonstration, in our experiment a fiber Mach-Zehnder interferometer (FMZI) based temperature sensor has been interrogated. By tracking the peak frequency of the passband the temperature variation can be monitored. In our experiment, the sensing responsivity of 10.5 MHz/°C, 20.0 MHz/°C and 41.2 MHz/°C, when the lengths of sensing fiber are 1 m, 2 m and 4 m have been achieved.

  5. Analytical and semi-analytical inverse kinematics of SSRMS-type manipulators with single joint locked failure

    Science.gov (United States)

    Xu, Wenfu; She, Yu; Xu, Yangsheng

    2014-12-01

    Redundant space manipulators, including Space Station Remote Manipulator System (SSRMS), Special Purpose Dexterous Manipulator (SPDM) and European Robotic Arm (ERA), have been playing important roles in the construction and maintenance of International Space Station (ISS). They all have 7 revolute joints arranged in similar configurations, and are referred to as SSRMS-type manipulators. When a joint is locked in an arbitrary position due to some failures, a 7R manipulator degrades to a 6R manipulator. Without a spherical wrist or three consecutive parallel joints, the inverse kinematics of the 6R manipulator is very complex. In this paper, we propose effective methods to resolve the inverse kinematics for different cases of any joint locked in an arbitrary position. Firstly, configuration characteristics of the SSRMS-type redundant manipulators are analyzed. Then, an existing of closed-form inverse kinematics is discussed for locking different joints. Secondly, D-H frames and corresponding D-H parameters of the new 6-DOF manipulator formed by locking a joint in an arbitrary position are re-constructed. A unified table is then created to describe the kinematics for all possible cases of single joint locking failure. Thirdly, completely analytical and semi-analytical methods are presented to solve the inverse kinematics equations, and the former is used for locking joint 1, 2, 6 or 7 while the latter for locking joint 3, 4 or 5. Finally, typical cases for single joint locking are studied. The results verify the proposed methods.

  6. Simultaneous isolation of emm89-type Streptococcus pyogenes strains with a wild-type or mutated covS gene from a single streptococcal toxic shock syndrome patient.

    Science.gov (United States)

    Masuno, Katsuaki; Okada, Ryo; Zhang, Yan; Isaka, Masanori; Tatsuno, Ichiro; Shibata, Shinichiro; Hasegawa, Tadao

    2014-04-01

    Streptococcal toxic shock syndrome (STSS) is a re-emerging infectious disease in many developed countries. Recent studies have suggested that mutations in CovRS, a two-component regulatory system in Streptococcus pyogenes, play important roles in the pathogenesis of STSS. However, in vivo evidence of the significance of CovRS in human infections has not been fully demonstrated. We investigated five S. pyogenes strains isolated simultaneously from the pharynx, sputum, knee joint, cerebrospinal fluid and blood of a single STSS patient. All were emm89-type strains, and multilocus sequence typing (MLST) analysis revealed that the strains of pharynx and blood were isogenic. The growth rates of the strains from pharynx and sputum were faster than those of the other strains. Protein profiles of the culture supernatants of strains from the pharynx and sputum were also different from those of the other strains. Sequence analyses revealed that strains from the knee joint, cerebrospinal fluid and blood contained a single nucleotide difference in the covS coding region, resulting in one amino acid change, compared with the other strains. Introduction of a plasmid containing the covS gene from the pharynx strain to the blood strain increased the production of SpeB protein. This suggests that the one amino acid alteration in CovS was relevant to pathogenesis. This report supports the idea that mutated CovS plays important roles in vivo in the dissemination of S. pyogenes from the upper respiratory tract of human to aseptic tissues such as blood and cerebrospinal fluid.

  7. Clinicopathological study of nondiabetic renal disease in type 2 diabetic patients: A single center experience from India

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    Kamal V Kanodia

    2017-01-01

    Full Text Available Diabetic nephropathy (DN is a major complication of diabetes mellitus (DM, leading to chronic kidney disease/end-stage renal disease. Wide spectrum of nondiabetic renal diseases (NDRD is reported in type-2 diabetes (type-2 DM. We carried out this single-center study to find clinical, laboratory, and histological features of NDRD in type-2 DM patients and to assess the prevalence of NDRD in India. A single-center retrospective study which included analysis of renal biopsies from patients with type-2 DM, performed between January 2008 and September 2016. Biopsy findings were categorized into three groups, Group-I (isolated NDRD; Group-II (NDRD superimposed on underlying DN; and Group-III (isolated DN. Out of 152 diabetic patients (111 males and 41 females, 35 (23.03% patients were of Group-I (isolated NDRD, 35 (23.03% of Group-II (NDRD superimposed on underlying DN, and 82 (53.95% of Group-III (isolated DN. The mean age (in years was 55.08 ± 10.71, 55.65 ± 8.71, and 54.45 ± 9.01 respectively in Group-I, II, and III. Nephrotic syndrome (NS was the most common clinical presentation in all groups. Duration of DM was significantly shorter in Group-I than in Group-II. Diabetic retinopathy was absent in Group-I. Proteinuria was more in Group-III than Group-I. Low serum C3 and/or C4 levels was observed in five (14.29% cases of Group-I and Group-II each and two (2.43% cases of Group-III. Nearly, 70 (46.05% patients were found to have NDRD either in isolated form or as combined lesions. The most common histological types of NDRD were acute tubulointerstitial nephritis (38.57% followed by benign nephrosclerosis (15.72%, membranous nephropathy (10%, IgA nephropathy (7.14%, and membranoproliferative glomerulonephritis (7.14%. The incidence of NDRD (with/without DN in type-2 DM is very high. Shorter duration of diabetes, hematuria, absence of retinopathy, low serum complement levels, and nephrotic range proteinuria are predictors of NDRD.

  8. Endoscope-Assisted Abscess Drainage Secondary to Endoscope-Assisted Transforaminal Lumbar Interbody Fusion: 1-Year Follow-Up.

    Science.gov (United States)

    Madhavan, Karthik; Burks, Steven Shelby; Chieng, Lee Onn; Veeravagu, Anand; Wang, Michael Y

    2017-11-01

    Endoscopic discectomy and fusions have been gaining popularity in the recent past and are noted to be safe for their application in elderly population. The procedure involves ultra-small incision for discectomy followed by placement of percutaneous screws in awake patients. Treatment of advanced spinal pathology with endoscope-assisted techniques is challenging. Although not common with the endoscopic approach, postoperative infection can be problematic, as there are no established guidelines on its management. A 76-year-old female patient underwent lumbar 4-5 endoscopic-assisted transforaminal lumbar interbody fusion for severe degenerative changes leading to back and radicular leg pain. She did well postoperatively and was discharged home the following day. She presented to the outside hospital with new onset of severe back pain, sepsis, and positive methicillin-susceptible Staphylococcus aureus with blood culture and demonstrated no improvement while on antibiotics. Initial magnetic resonance imaging revealed postoperative changes only. With positive blood culture and localized pain, she was then offered to undergo a percutaneous drainage of the abscess. Under local anesthesia and intravenous sedation, a small pocket of collection was found along the endoscopic trajectory from previous surgery. After evacuation of the collection, the interbody device was irrigated with vancomycin through endoscope. Postoperatively, immediate symptomatic improvement was noted in back pain. She was discharged home on oxacillin and continues to do well at 12 months' follow-up with excellent fusion. The present case illustrates the successful treatment of a surgical-site infection after endoscope-assisted transforaminal lumbar interbody fusion via a repeat percutaneous endoscopic approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Anterior lumbar inter-body fusion with instrumentation compared with posterolateral fusion for low grade isthmic-spondylolisthesis.

    Science.gov (United States)

    Chandra, Varun; Singh, Raj Kumar

    2016-03-01

    Spondylolisthesis presenting as low back pain is not an uncommon condition. Many of such patients are treated conservatively. For those that require surgical management, various treatment options are in vogue e.g. Postero-lateral fusion (PLF) with decompression or posterior fusion with instrumentation and anterior lumbar inter-body fusion (ALIF). Each technique has produced satisfactory outcome with benefits and disadvantages. To compare the outcome of surgical management of low grade spondylolisthesis with two treatments modalities--Postero-lateral fusion (PLF) and Anterior lumbar inter-body fusion (ALIF) with posterior instrumentation in similar patient profile. Prospective study to compare the results of two surgical treatment modalities. The selected group of patients for surgery based on definite criteria was operated by the same surgeon by two modalities: Postero-lateral fusion with decompression and Anterior Lumbar Inter-body fusion with posterior instrumentation. The outcomes were compared. Analysis of variance (ANOVA) test. Follow up was done at twelve weekly intervals up to 2 years. Both groups showed good recovery in pain as seen in Visual analogue scale (VAS) and Oswestry low back pain scoring. Intra-operative bleeding was observed to be higher in Postero-lateral fusion group. Average length of hospital stay for the patients of PLF group was 6.6 days (Range: 4-7 days) as compared to 12.5 days (Range: 10-16 days) in case of ALIF group. Treatment cost was found to be higher in patients who undergone ALIF with instrumentation. ALIF with posterior instrumentation in low grade isthmic spondylolisthesis provides satisfactory outcome in patients requiring surgical treatment. The results of pain relief and disability index are comparable to time tested posterolateral fusion. ALIF shows a tendency to faster pain relief and return to activity with less intraoperative blood requirement in low grade isthmic spondylolisthesis.

  10. Biomechanics of lumbar cortical screw-rod fixation versus pedicle screw-rod fixation with and without interbody support.

    Science.gov (United States)

    Perez-Orribo, Luis; Kalb, Samuel; Reyes, Phillip M; Chang, Steve W; Crawford, Neil R

    2013-04-15

    Seven different combinations of posterior screw fixation, with or without interbody support, were compared in vitro using nondestructive flexibility tests. To study the biomechanical behavior of a new cortical screw (CS) fixation construct relative to the traditional pedicle screw (PS) construct. The CS is an alternative to the PS for posterior fixation of the lumbar spine. The CS trajectory is more sagittally and cranially oriented than the PS, being anchored in the pars interarticularis. Like PS fixation, CS fixation uses interconnecting rods fastened with top-locking connectors. Stability after bilateral CS fixation was compared with stability after bilateral PS fixation in the setting of intact disc and with direct lateral interbody fixation (DLIF) or transforaminal lateral interbody fixation (TLIF) support. Standard nondestructive flexibility tests were performed in cadaveric lumbar specimens, allowing non-paired comparisons of specific conditions from 28 specimens (4 groups of 7) within a larger experiment of multiple hardware configurations. Condition tested and group from which results originated were as follows: (1) intact (all groups); (2) with L3-L4 bilateral PS-rods (group 1); (3) with bilateral CS-rods (group 2); (4) with DLIF (group 3); (5) with DLIF + CS-rods (group 4); (6) with DLIF + PS-rods (group 3); (7) with TLIF + CS-rods (group 2), and (8) with TLIF + PS-rods (group 2). To assess spinal stability, the mean range of motion, lax zone, and stiff zone at L3-L4 were compared during flexion-extension, lateral bending, and axial rotation. With intact disc, stability was equivalent after PS-rod and CS-rod fixation, except that PS-rod fixation was stiffer during axial rotation. With DLIF support, there was no significant difference in stability between PS-rod and CS-rod fixation. With TLIF support, PS-rod fixation was stiffer than CS-rod fixation during lateral bending. Bilateral CS-rod fixation provided about the same stability in cadaveric specimens

  11. Biomechanical effects of polyaxial pedicle screw fixation on the lumbosacral segments with an anterior interbody cage support

    Directory of Open Access Journals (Sweden)

    Chen Hsiang-Ho

    2007-03-01

    Full Text Available Abstract Background Lumbosacral fusion is a relatively common procedure that is used in the management of an unstable spine. The anterior interbody cage has been involved to enhance the stability of a pedicle screw construct used at the lumbosacral junction. Biomechanical differences between polyaxial and monoaxial pedicle screws linked with various rod contours were investigated to analyze the respective effects on overall construct stiffness, cage strain, rod strain, and contact ratios at the vertebra-cage junction. Methods A synthetic model composed of two ultrahigh molecular weight polyethylene blocks was used with four titanium pedicle screws (two in each block and two rods fixation to build the spinal construct along with an anterior interbody cage support. For each pair of the construct fixed with polyaxial or monoaxial screws, the linked rods were set at four configurations to simulate 0°, 7°, 14°, and 21° lordosis on the sagittal plane, and a compressive load of 300 N was applied. Strain gauges were attached to the posterior surface of the cage and to the central area of the left connecting rod. Also, the contact area between the block and the cage was measured using prescale Fuji super low pressure film for compression, flexion, lateral bending and torsion tests. Results Our main findings in the experiments with an anterior interbody cage support are as follows: 1 large segmental lordosis can decrease the stiffness of monoaxial pedicle screws constructs; 2 polyaxial screws rather than monoaxial screws combined with the cage fixation provide higher compression and flexion stiffness in 21° segmental lordosis; 3 polyaxial screws enhance the contact surface of the cage in 21° segmental lordosis. Conclusion Polyaxial screws system used in conjunction with anterior cage support yields higher contact ratio, compression and flexion stiffness of spinal constructs than monoaxial screws system does in the same model when the spinal segment

  12. Investigation of different cage designs and mechano-regulation algorithms in the lumbar interbody fusion process - a finite element analysis.

    Science.gov (United States)

    Postigo, Sergio; Schmidt, Hendrik; Rohlmann, Antonius; Putzier, Michael; Simón, Antonio; Duda, Georg; Checa, Sara

    2014-04-11

    Lumbar interbody fusion cages are commonly used to treat painful spinal degeneration and instability by achieving bony fusion. Many different cage designs exist, however the effect of cage morphology and material properties on the fusion process remains largely unknown. This finite element model study aims to investigate the influence of different cage designs on bone fusion using two mechano-regulation algorithms of tissue formation. It could be observed that different cages play a distinct key role in the mechanical conditions within the fusion region and therefore regulate the time course of the fusion process. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. The Type and Impact of Evidence Review Group Exploratory Analyses in the NICE Single Technology Appraisal Process.

    Science.gov (United States)

    Carroll, Christopher; Kaltenthaler, Eva; Hill-McManus, Daniel; Scope, Alison; Holmes, Michael; Rice, Stephen; Rose, Micah; Tappenden, Paul; Woolacott, Nerys

    2017-06-01

    As part of the UK National Institute for Health and Care Excellence (NICE) single technology appraisal process, independent evidence review groups (ERGs) critically appraise a company's submission relating to a specific technology and indication. To explore the type of additional exploratory analyses conducted by ERGs and their impact on the recommendations made by NICE. The 100 most recently completed single technology appraisals with published guidance were selected for inclusion. A content analysis of relevant documents was undertaken to identify and extract relevant data, and narrative synthesis was used to rationalize and present these data. The types of exploratory analysis conducted in relation to companies' models were fixing errors, addressing violations, addressing matters of judgment, and the provision of a new, ERG-preferred base case. Ninety-three of the 100 ERG reports contained at least one of these analyses. The most frequently reported type of analysis in these 93 ERG reports related to the category "Matters of judgment," which was reported in 83 reports (89%). At least one of the exploratory analyses conducted and reported by an ERG is mentioned in 97% of NICE appraisal consultation documents and 94% of NICE final appraisal determinations, and had a clear influence on recommendations in 72% of appraisal consultation documents and 47% of final appraisal determinations. These results suggest that the additional analyses undertaken by ERGs in the appraisal of company submissions are highly influential in the policy-making and decision-making process. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Exploring single nucleotide polymorphisms previously related to obesity and metabolic traits in pediatric-onset type 2 diabetes.

    Science.gov (United States)

    Miranda-Lora, América Liliana; Cruz, Miguel; Aguirre-Hernández, Jesús; Molina-Díaz, Mario; Gutiérrez, Jorge; Flores-Huerta, Samuel; Klünder-Klünder, Miguel

    2017-07-01

    To evaluate the association of 64 obesity-related polymorphisms with pediatric-onset type 2 diabetes and other glucose- and insulin-related traits in Mexican children. Case-control and case-sibling designs were followed. We studied 99 patients with pediatric-onset type 2 diabetes, their siblings (n = 101) without diabetes, 83 unrelated pediatric controls and 137 adult controls. Genotypes were determined for 64 single nucleotide polymorphisms, and a possible association was examined between those genotypes and type 2 diabetes and other quantitative traits, after adjusting for age, sex and body mass index. In the case-pediatric control and case-adult control analyses, five polymorphisms were associated with increased likelihood of pediatric-onset type 2 diabetes; only one of these polymorphisms (CADM2/rs1307880) also showed a consistent effect in the case-sibling analysis. The associations in the combined analysis were as follows: ADORA1/rs903361 (OR 1.9, 95% CI 1.2; 3.0); CADM2/rs13078807 (OR 2.2, 95% CI 1.2; 4.0); GNPDA2/rs10938397 (OR 2.2, 95% CI 1.4; 3.7); VEGFA/rs6905288 (OR 1.4, 95% CI 1.1; 2.1) and FTO/rs9939609 (OR 1.8, 95% CI 1.0; 3.2). We also identified 16 polymorphisms nominally associated with quantitative traits in participants without diabetes. ADORA/rs903361, CADM2/rs13078807, GNPDA2/rs10938397, VEGFA/rs6905288 and FTO/rs9939609 are associated with an increased risk of pediatric-onset type 2 diabetes in the Mexican population.

  15. Single nucleotide polymorphism typing of Mycobacterium ulcerans reveals focal transmission of buruli ulcer in a highly endemic region of Ghana.

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    Katharina Röltgen

    Full Text Available Buruli ulcer (BU is an emerging necrotizing disease of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. While proximity to stagnant or slow flowing water bodies is a risk factor for acquiring BU, the epidemiology and mode of M. ulcerans transmission is poorly understood. Here we have used high-throughput DNA sequencing and comparisons of the genomes of seven M. ulcerans isolates that appeared monomorphic by existing typing methods. We identified a limited number of single nucleotide polymorphisms (SNPs and developed a real-time PCR SNP typing method based on these differences. We then investigated clinical isolates of M. ulcerans on which we had detailed information concerning patient location and time of diagnosis. Within the Densu river basin of Ghana we observed dominance of one clonal complex and local clustering of some of the variants belonging to this complex. These results reveal focal transmission and demonstrate, that micro-epidemiological analyses by SNP typing has great potential to help us understand how M. ulcerans is transmitted.

  16. Analysis of horse myostatin gene and identification of single nucleotide polymorphisms in breeds of different morphological types.

    Science.gov (United States)

    Dall'Olio, Stefania; Fontanesi, Luca; Nanni Costa, Leonardo; Tassinari, Marco; Minieri, Laura; Falaschini, Adalberto

    2010-01-01

    Myostatin (MSTN) is a negative modulator of muscle mass. We characterized the horse (Equus caballus) MSTN gene and identified and analysed single nucleotide polymorphisms (SNPs) in breeds of different morphological types. Sequencing of coding, untranslated, intronic, and regulatory regions of MSTN gene in 12 horses from 10 breeds revealed seven SNPs: two in the promoter, four in intron 1, and one in intron 2. The SNPs of the promoter (GQ183900:g.26T>C and GQ183900:g.156T>C, the latter located within a conserved TATA-box like motif) were screened in 396 horses from 16 breeds. The g.26C and the g.156C alleles presented higher frequency in heavy (brachymorphic type) than in light breeds (dolichomorphic type such as Italian Trotter breed). The significant difference of allele frequencies for the SNPs at the promoter and analysis of molecular variance (AMOVA) on haplotypes indicates that these polymorphisms could be associated with variability of morphology traits in horse breeds.

  17. A novel high-resolution single locus sequence typing scheme for mixed populations of Propionibacterium acnes in vivo.

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    Christian F P Scholz

    Full Text Available The Gram-positive anaerobic bacterium Propionibacterium acnes is a prevalent member of the normal skin microbiota of human adults. In addition to its suspected role in acne vulgaris it is involved in a variety of opportunistic infections. Multi-locus sequence-typing (MLST schemes identified distinct phylotypes associated with health and disease. Being based on 8 to 9 house-keeping genes these MLST schemes have a high discriminatory power, but their application is time- and cost-intensive. Here we describe a single-locus sequence typing (SLST scheme for P. acnes. The target locus was identified with a genome mining approach that took advantage of the availability of representative genome sequences of all known phylotypes of P. acnes. We applied this SLST on a collection of 188 P. acnes strains and demonstrated a resolution comparable to that of existing MLST schemes. Phylogenetic analysis applied to the SLST locus resulted in clustering patterns identical to a reference tree based on core genome sequences. We further demonstrate that SLST can be applied to detect multiple phylotypes in complex microbial communities by a metagenomic pyrosequencing approach. The described SLST strategy may be applied to any bacterial species with a basically clonal population structure to achieve easy typing and mapping of multiple phylotypes in complex microbiotas. The P. acnes SLST database can be found at http://medbac.dk/slst/pacnes.

  18. Analysis of Horse Myostatin Gene and Identification of Single Nucleotide Polymorphisms in Breeds of Different Morphological Types

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    Stefania Dall'Olio

    2010-01-01

    Full Text Available Myostatin (MSTN is a negative modulator of muscle mass. We characterized the horse (Equus caballus MSTN gene and identified and analysed single nucleotide polymorphisms (SNPs in breeds of different morphological types. Sequencing of coding, untranslated, intronic, and regulatory regions of MSTN gene in 12 horses from 10 breeds revealed seven SNPs: two in the promoter, four in intron 1, and one in intron 2. The SNPs of the promoter (GQ183900:g.26T>C and GQ183900:g.156T>C, the latter located within a conserved TATA-box like motif were screened in 396 horses from 16 breeds. The g.26C and the g.156C alleles presented higher frequency in heavy (brachymorphic type than in light breeds (dolichomorphic type such as Italian Trotter breed. The significant difference of allele frequencies for the SNPs at the promoter and analysis of molecular variance (AMOVA on haplotypes indicates that these polymorphisms could be associated with variability of morphology traits in horse breeds.

  19. Properties and local environment of p-type and photoluminescent rare earths implanted into ZnO single crystals

    CERN Document Server

    Rita, EMC; Wahl, U; Soares, JC

    This thesis presents an experimental study of the local environment of p-type and Rare- Earth dopants implanted in ZnO single-crystals (SCs). Various nuclear and bulk property techniques were combined in the following evaluations: Implantation damage annealing was evaluated in ZnO SCs implanted with Fe, Sr and Ca. P-type dopants Cu and Ag implanted ZnO SCs were studied revealing that the solubility of Cu in substituting Zn is considerably higher than that of Ag. These results are discussed within the scope of the ZnO p-type doping problematic with these elements. Experimental proofs of the As “anti-site” behavior in ZnO were for the first time attained, i.e., the majority of As atoms are substitutional at the Zn site (SZn), possibly surrounded by two Zn vacancies (VZn). This reinforces the theoretical prediction that As acts as an acceptor in ZnO via the AsZn-2VZn complex formation. The co-doping of ZnO SC with In (donor) and As (acceptor) was addressed. The most striking result is the possible In-As “p...

  20. Effect of separator and inoculum type on electricity generation and microbial community in single-chamber microbial fuel cells.

    Science.gov (United States)

    Yu, Jaecheul; Park, Younghyun; Lee, Taeho

    2014-04-01

    Single-chamber microbial fuel cell (SMFC)-I consisted of 4 separator-electrode assemblies (SEAs) with two types of cation exchange membrane (CEM: Nafion and CMI 7000) and an anion exchange membrane (AEM: AMI 7001). SMFC-II consisted of 4 SEAs with Nafion and three types of nonwoven fabric. SMFC-I and -II were inoculated with anaerobic digested and activated sludge, respectively, and operated under fed-batch mode. In SMFC I, AEM-SEA showed a maximum power density (PDmax). Nafion-SEA showed a PDmax in SMFC II, which was similar to that of Nafion-SEA of SMFC I. Although different bacteria were developed in SMFC-I (Deltaproteobacteria and Firmicutes) and SMFC-II (Gammaproteobacteria, Betaproteobacteria and Bacteroidetes), the inoculum type little affects electricity generation. Variations of pH and oxygen in biofilm have influenced microbial community structure and electricity generation according to the electrode and separator material. Although the electricity generation of non-woven fabric-SEA was less than that of Nafion-SEA, the use of non-woven fabrics is expected to reduce the construction and operating costs of MFCs.

  1. Development and evaluation of one step single tube multiplex RT-PCR for rapid detection and typing of dengue viruses

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    Parida Manmohan

    2008-01-01

    Full Text Available Abstract Background Dengue is emerging as a major public health concern in many parts of the world. The development of a one-step, single tube, rapid, and multiplex reverse transcription polymerase chain reaction (M-RT-PCR for simultaneous detection and typing of dengue virus using serotype specific primers during acute phase of illness is reported. Results An optimal assay condition with zero background was established having no cross-reaction with closely related members of flavivirus (Japanese encephalitis, West Nile, Yellow fever and alphavirus (Chikungunya. The feasibility of M-RT-PCR assay for clinical diagnosis was validated with 620 acute phase dengue patient sera samples of recent epidemics in India. The comparative evaluation vis a vis conventional virus isolation revealed higher sensitivity. None of the forty healthy serum samples screened in the present study revealed any amplification, thereby establishing specificity of the reported assay for dengue virus only. Conclusion These findings clearly suggested that M-RT-PCR assay reported in the present study is the rapid and cost-effective method for simultaneous detection as well as typing of the dengue virus in acute phase patient serum samples. Thus, the M-RT-PCR assay developed in this study will serve as a very useful tool for rapid diagnosis and typing of dengue infections in endemic areas.

  2. Retrospective Study of Anterior Interbody Fusion Rates and Patient Outcomes of Using Mineralized Collagen and Bone Marrow Aspirate in Multilevel Adult Spinal Deformity Surgery.

    Science.gov (United States)

    Hostin, Richard; O'Brien, Michael; McCarthy, Ian; Bess, Shay; Gupta, Munish; Klineberg, Eric

    2016-10-01

    Retrospective, single-center analysis of multilevel anterior fusion rates and health-related quality-of-life outcomes of mineralized collagen and bone marrow aspirate (BMA) in anterior interbody fusion cages for spine fusion surgery. To determine the ability and effectiveness of mineralized collagen and BMA to achieve multilevel anterior spinal fusion in adult spinal deformity patients when placed in carbon fiber reinforced polymer cages. High rates of postoperative pain and nonunion can result from spine fusion procedures. Factors that affect the success of fusion include patient comorbidities, position of implant, and mechanical and biological deficiencies, as well as the choice of bone graft replacement. Analysis of radiographic images and health-related quality-of-life outcomes was performed for a consecutive series of 22 prospectively enrolled adult spinal deformity patients with 104 total anterior fusion levels. Fusions were graded by 3 blinded surgeons not involved in the operative procedure; each fusion was graded on a 1-4 scale based on fusion mass appearance. Levels with an average fusion grade of 1-2.4 were classified as fused; levels with an average grade >2.5 were classified as not fused. The mean patient age was 51.5 years (range, 38-61) with 21 females. A total of 95% of anterior operative levels were graded as fused based on flexion/extension and full-length biplane radiographs at 1 year. Computed tomography grading showed a reduced fusion rate at 87% overall. There was a statistically significant improvement in the Oswestry Disability Index and Scoliosis Research Society 22-item questionnaire scores at 1 and 2 years after index surgery. Fusion rates in multilevel anterior spinal fusion using mineralized collagen and BMA are relatively low compared with fusion rates of 95% or more reported in the existing literature on long fusions with bone morphogenetic protein.

  3. Posterior Lumbar Interbody Fusion with 3D-Navigation Guided Cortical Bone Trajectory Screws for L4/5 Degenerative Spondylolisthesis: 1-Year Clinical and Radiographic Outcomes.

    Science.gov (United States)

    Hussain, Ibrahim; Virk, Michael S; Link, Thomas W; Tsiouris, Apostolos J; Elowitz, Eric

    2018-02-01

    We describe our technique and evaluate clinical and radiographic outcomes for patients undergoing L4/5 posterior lumbar interbody fusion with 3D-navigation guided cortical bone trajectory screws (PLIF-CBT) for grade 1 or 2 degenerative spondylolisthesis with a minimum follow-up time of 12 months. A single-institution series of 18 patients was evaluated with data prospectively collected and retrospectively analyzed. Pain and disability scores were collected preoperatively and at a minimum of 12 months postoperatively, including back and bilateral leg pain visual analog scores (VAS) and Oswestry Disability Index (ODI) scores. Radiographic fusion was assessed as complete, partial, or none based on the presence of bridging bones across the disc space, posterior elements, or both. Patients demonstrated statistically significant reductions in back pain VAS (P = 0.0025), leg pain VAS (P fusion at an average of 14.9 months postoperatively was available for 16/18 patients, with 6 patients demonstrating fusion (4/6 with complete fusion; 2/6 with partial fusion). There were no instances of intraoperative complications or delayed complications requiring subsequent interventions. PLIF-CBT can be performed in a safe and reproducible fashion with excellent clinical outcomes at 1 year postoperatively. The outcomes did not correlate with fusion status, which was unexpectedly low at 37.5% without significant hardware abnormalities necessitating reoperations. PLIF-CBT offers several perioperative advantages compared with traditional open PLIF and requires longer-term studies to demonstrate its durability with regard to improvement in clinical pain and radiographic endpoints, including anterior and/or posterior element fusion. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Characterization of a novel caudal vertebral interbody fusion in a rat tail model: An implication for future material and mechanical testing

    Directory of Open Access Journals (Sweden)

    Yu-Cheng Yeh

    2017-02-01

    Conclusion: The rat caudal disc interbody fusion model proved to be an efficient, repeatable and easily accessible model. Future research into adjuvant treatments like growth factor injection and alternative fusion materials under conditions of osteoporosis using this model would be worthwhile.

  5. Uninstrumented Posterior Lumbar Interbody Fusion: Have Technological Advances in Stabilizing the Lumbar Spine Truly Improved Outcomes?

    Science.gov (United States)

    Prolo, Laura M; Oklund, Sally A; Zawadzki, Nadine; Desai, Manisha; Prolo, Donald J

    2018-04-06

    Since 1980s numerous operations have replaced posterior lumbar interbody fusion (PLIF) with human bone. These often involve expensive implants and complex procedures. Escalating expenditures in lumbar fusion surgery warrant re-evaluation of classical PLIF with allogeneic ilium and without instrumentation. The purpose of this study was to determine the long-term fusion rate and clinical outcomes of allo-PLIF. Between 1981-2006 321 patients ages 12-80, underwent 339 one- or two-level allo-PLIFs for degenerative instability and were followed 1-28 years. Fusion status was determined by radiographs and as available, by CT scans. Clinical outcome was assessed by the Economic/Functional Outcome Scale. 308 of the 321 patients were followed postoperatively (average 6.7 years, range 1-28); 297 (96%) fused. Fusion rates were lower for patients with substance abuse (89%, p=0.007). Clinical outcomes in 87% of patients were excellent (52%) or good (35%). Economic/Functional Outcome Scale scores following initial allo-PLIF on average increased 5.2 points. Successful fusion correlated with nearly a 2-point gain in outcome score (p=0.001). A positive association between a patient characteristic and outcome was observed only with age 65 and greater; whereas negative associations in clinical outcomes were observed with mental illness, substance abuse, heavy stress to low back, or industrial injuries. Total complication rate was 7%. With three decades of follow-up we found successful clinical outcomes are highly correlated with solid fusion using only allogeneic iliac bone. Copyright © 2018. Published by Elsevier Inc.

  6. Graft subsidence as a predictor of revision surgery following stand-alone lateral lumbar interbody fusion.

    Science.gov (United States)

    Tempel, Zachary J; McDowell, Michael M; Panczykowski, David M; Gandhoke, Gurpreet S; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2018-01-01

    OBJECTIVE Lateral lumbar interbody fusion (LLIF) is a less invasive surgical option commonly used for a variety of spinal conditions, including in high-risk patient populations. LLIF is often performed as a stand-alone procedure, and may be complicated by graft subsidence, the clinical ramifications of which remain unclear. The aim of this study was to characterize further the sequelae of graft subsidence following stand-alone LLIF. METHODS A retrospective review of prospectively collected data was conducted on consecutive patients who underwent stand-alone LLIF between July 2008 and June 2015; 297 patients (623 levels) met inclusion criteria. Imaging studies were examined to grade graft subsidence according to Marchi criteria, and compared between those who required revision surgery and those who did not. Additional variables recorded included levels fused, DEXA (dual-energy x-ray absorptiometry) T-score, body mass index, and routine demographic information. The data were analyzed using the Student t-test, chi-square analysis, and logistic regression analysis to identify potential confounding factors. RESULTS Of 297 patients, 34 (11.4%) had radiographic evidence of subsidence and 18 (6.1%) required revision surgery. The median subsidence grade for patients requiring revision surgery was 2.5, compared with 1 for those who did not. Chi-square analysis revealed a significantly higher incidence of revision surgery in patients with high-grade subsidence compared with those with low-grade subsidence. Seven of 18 patients (38.9%) requiring revision surgery suffered a vertebral body fracture. High-grade subsidence was a significant predictor of the need for revision surgery (p subsidence following stand-alone LLIF required revision surgery. When evaluating patients for LLIF, supplemental instrumentation should be considered during the index surgery in patients with a significant risk of graft subsidence.

  7. Elimination of Subsidence with 26-mm-Wide Cages in Extreme Lateral Interbody Fusion.

    Science.gov (United States)

    Lang, Gernot; Navarro-Ramirez, Rodrigo; Gandevia, Lena; Hussain, Ibrahim; Nakhla, Jonathan; Zubkov, Micaella; Härtl, Roger

    2017-08-01

    Extreme lateral interbody fusion (ELIF) has gained popularity as a minimally invasive technique for indirect decompression. However, graft subsidence potentially threatens long-term success of ELIF. This study evaluated whether 26-mm-wide cages can eliminate subsidence and subsequent loss of decompression in ELIF. Patients undergoing ELIF surgery using a 26-mm-wide cage were analyzed retrospectively. Patient demographics and perioperative data for radiographic and clinical outcomes were recorded. Radiographic parameters included regional sagittal lumbar lordosis and foraminal and disc height. Clinical parameters were evaluated using the Oswestry Disability Index and visual analog scale. Subsidence of 26-mm-wide cages was compared with previous outcomes of patients undergoing ELIF using 18-mm-wide and 22-mm-wide cages. There were 21 patients and 28 spinal segments analyzed. Radiographic outcome measures such as disc and foraminal height revealed significant improvement at follow-up compared with before surgery (P = 0.001). Postoperative to last follow-up cage subsidence translated into 0.34 mm ± 0.26 and -0.55 mm ± 0.64 in disc and foraminal height loss, respectively. Patients with 26-mm-wide cages experienced less subsidence by means of disc (26 mm vs. 18 mm and 22 mm, P ≤ 0.05) and foraminal height (26 mm vs. 18 mm, P = 0.005; 26 mm vs. 22 mm, P = 0.208) loss compared with patients receiving 18-mm-wide and 22-mm-wide cages. The 26-mm-wide cages almost eliminated cage subsidence in ELIF. Compared with 18-mm-wide and 22-mm-wide cages, 26-mm-wide cages significantly reduced cage subsidence in ELIF at midterm follow-up. A 26-mm-wide cage should be used in ELIF to achieve sustained indirect decompression. Copyright © 2017. Published by Elsevier Inc.

  8. The Correlation Between Cage Subsidence, Bone Mineral Density, and Clinical Results in Posterior Lumbar Interbody Fusion.

    Science.gov (United States)

    Oh, Kyu Won; Lee, Jae Hyup; Lee, Ji-Ho; Lee, Do-Yoon; Shim, Hee Jong

    2017-07-01

    A retrospective review of prospectively collected radiographic and clinical data. This study aims to investigate the relationship between cage subsidence and bone mineral density (BMD), and to reveal the clinical implications of cage subsidence. Posterior lumbar interbody fusion (PLIF) has become one of the standard treatment modality for lumbar degenerative disease. However, cage subsidence might result in recurrent foraminal stenosis and deteriorate the clinical results. Furthermore, numbers of osteoporosis patients who underwent PLIF are increasing. Therefore, the information on the correlations between cage subsidence, BMD, and clinical results will be of great significance. A total 139 segments was included in this retrospective study. We examined functional rating index (Visual Analogue Scale for pain, Oswestry Disability Index, Short Form-36 score) preoperatively, and investigated their changes after postoperative 1 year. Correlation between cage subsidence and clinical scores was investigated. Plain anteroposterior and lateral radiograph were taken preoperatively and postoperatively and during follow-up. Preoperative BMD and subsidence measured by postoperative 1 year 3-dimensional computed tomography were achieved and their correlation was assessed. All postoperative clinical scores improved significantly compared with preoperative ones (pain Visual Analogue Scale: 7.34-2.89, Oswestry Disability Index: 25.34-15.86, Short Form-36: 26.45-16.46, all Psubsidence (r=-0.285, Psubsidence (>3 mm) compared with the segments in which T score were higher than -3.0 (P=0.012), and its odds ratio was 8.44. Subsidence had no significant correlation with all clinical scores. This study revealed that cage subsidence is relevant to BMD. However, it was demonstrated that subsidence is not related to the clinical deterioration. Therefore, PLIF procedure which is conducted carefully can be a good surgical option to treat lumbar degenerative disease for osteoporotic patients.

  9. Symptomatic adjacent segment pathology after posterior lumbar interbody fusion for adult low-grade isthmic spondylolisthesis.

    Science.gov (United States)

    Sakaura, Hironobu; Yamashita, Tomoya; Miwa, Toshitada; Ohzono, Kenji; Ohwada, Tetsuo

    2013-12-01

    The incidence of symptomatic adjacent segment pathology (ASP) after fusion surgery for adult low-grade isthmic spondylolisthesis (IS) has been reported to be relatively low compared with other lumbar disease entities. However, there has been no study of symptomatic ASP incidence using posterior lumbar interbody fusion (PLIF) with pedicle screw instrumentation. We investigated the incidence of symptomatic ASP after PLIF with pedicle screw instrumentation for adult low-grade IS and identified significant risk factors for symptomatic ASP. We retrospectively studied records of 40 consecutive patients who underwent PLIF with pedicle screw instrumentation at the Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan. The patients were followed for ≥ 4 years. Patients' medical records were retrospectively examined for evidence of symptomatic ASP. Age at time of surgery, sex, fusion level, whole lumbar lordosis, segmental lordosis, preexisting laminar inclination angle, and facet tropism at the cranial fusion segment were analyzed to identify risk factors for symptomatic ASP. Four patients (ASP group) developed symptomatic ASP at the cranial segment adjacent to the fusion. There were no significant differences in age, sex, fusion level, lumbar lordosis, segmental lordosis, or facet tropism at the cranial segment adjacent to the fusion between the ASP and the non-ASP groups. In contrast, laminar inclination angle at the cranial vertebra adjacent to the fusion was significantly higher in the ASP group than in the non-ASP group. Four patients (10%) developed symptomatic ASP after PLIF with transpedicular fixation for adult low-grade IS. Preexisting laminar horizontalization at the cranial vertebra adjacent to the fusion was a significant risk factor for symptomatic ASP.

  10. Outcomes of anterior lumbar interbody fusion surgery based on indication: a prospective study.

    Science.gov (United States)

    Rao, Prashanth J; Loganathan, Ajanthan; Yeung, Vivian; Mobbs, Ralph J

    2015-01-01

    There is limited information on clinical outcomes after anterior lumbar interbody fusion (ALIF) based on the indications for surgery. To compare the clinical and radiological outcomes of ALIF for each surgical indication. This prospective clinical study included 125 patients who underwent ALIF over a 2-year period. The patients were evaluated preoperatively and postoperatively. Outcome measures included the Short Form-12, Oswestry Disability Index, Visual Analog Scale, and Patient Satisfaction Index. After a mean follow-up of 20 months, the clinical condition of the patients was significantly better than their preoperative status across all indications. A total of 108 patients had a Patient Satisfaction Index score of 1 or 2, indicating a successful clinical outcome in 86%. Patients with degenerative disk disease (with and without radiculopathy), spondylolisthesis, and scoliosis had the best clinical response to ALIF, with statistically significant improvement in the Short Form-12, Oswestry Disability Index, and Visual Analog Scale. Failed posterior fusion and adjacent segment disease showed statistically significant improvement in all of these clinical outcome scores, although the mean changes in the Short Form-12 Mental Component Summary, Oswestry Disability Index, and Visual Analog Scale (back pain) were lower. The overall radiological fusion rate was 94.4%. Superior radiological outcomes (fusion >90%) were observed in patients with degenerative disk disease (with and without radiculopathy), spondylolisthesis, and failed posterior fusion, whereas in adjacent segment disease, it was 80%. ALIF is an effective treatment for degenerative disk disease (with and without radiculopathy) and spondylolisthesis. Although results were promising for scoliosis, failed posterior fusion, and adjacent segment disease, further studies are necessary to establish the effectiveness of ALIF in these conditions.

  11. Anterior Lumbar Interbody Fusion Integrated Screw Cages: Intrinsic Load Generation, Subsidence, and Torsional Stability.

    Science.gov (United States)

    Assem, Yusuf; Pelletier, Matthew H; Mobbs, Ralph J; Phan, Kevin; Walsh, William R

    2017-05-01

    To perform a repeatable idealized in vitro model to evaluate the effects of key design features and integrated screw fixation on unloaded surface engagement, subsidence, and torsional stability. We evaluated four different stand-alone anterior lumbar interbody fusion (ALIF) cages with two, three, and four screw designs. Polyurethane (saw-bone) foam blocks were used to simulate the vertebral bone. Fuji Film was used to measure the contact footprint, average pressure, and load generated by fixating the cages with screws. Subsidence was tested by axially loading the constructs at 10 N/s to 400 N and torsional load was applied +/-1 Nm for 10 cycles to assess stability. Outcome measures included total subsidence and maximal torsional angle range. Cages 1, 2, and 4 were symmetrical and produced similar results in terms of contact footprint, average pressure, and load. The addition of integrated screws into the cage-bone block construct demonstrated a clear trend towards decreased subsidence. Cage 2 with surface titanium angled ridges and a keel produced the greatest subsidence with and without screws, significantly more than all other cages ( P < 0.05). Angular rotation was not significantly affected by the addition of screws ( P < 0.066). A statistically significant correlation existed between subsidence and reduced angular rotation across all cage constructs ( P = 0.018). Each stand-alone cage featured unique surface characteristics, which resulted in differing cage-foam interface engagement, influencing the subsidence and torsional angle. Increased subsidence significantly reduced the torsional angle across all cage constructs. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  12. Anterior lumbar interbody fusion using a barbell-shaped cage: a biomechanical comparison.

    Science.gov (United States)

    Murakami, H; Boden, S D; Hutton, W C

    2001-10-01

    There are drawbacks to using threaded cylindrical cages (e.g., limited area for bone ingrowth and metal precluding radiographic visualization of bone healing). To somewhat offset these drawbacks, a barbell-shaped cage has been designed. The central core of the barbell can be wrapped with collagen sheets infiltrated with bone morphogenetic protein. The obvious theoretical advantages of a barbell cage have to be weighed against potential biomechanical disadvantages. Our purpose was to compare the biomechanical properties of an anterior lumbar interbody reconstruction using 18-mm-diameter threaded cylindrical cages, with a reconstruction using barbell cages (18-mm diameter and 6 mm wide at both cylindrical ends, with a round 4-mm-diameter bar joining the two ends). Twelve cadaveric lumbar motion segments were tested. Three L5-S1 segments received two threaded cylindrical cages, and three L5-S1 segments received two barbell cages. Three L3-L4 segments received one threaded cylindrical cage, and three L3-L4 segments received one barbell cage. A series of biomechanical loading sequences were carried out on each motion segment, and stiffness curves were obtained. After the biomechanical testing, an axial compressive load was applied to the motion segments until failure. They were then radiographed and bisected through the disc, and the subsidence (or penetration) of the cage(s) in the cancellous bone of the vertebral bodies was measured. There was no difference in terms of stiffness between the motion segments with the threaded cylindrical cage(s) inserted and those with the barbell cage(s) inserted (p > 0.15). The average values of subsidence was 0.96 mm for the threaded cylindrical cage group and 0.80 mm for the barbell cage group (difference not significant: p = 0.38). The results suggest that a reconstruction using barbell cages is a biomechanically acceptable alternative to one using threaded cylindrical cages.

  13. Cost-effectiveness of posterior lumbar interbody fusion in the Japanese universal health insurance system.

    Science.gov (United States)

    Fujimori, Takahito; Miwa, Toshitada; Iwasaki, Motoki; Oda, Takenori

    2018-03-01

    Globally, the cost-effectiveness of spinal surgery is becoming increasingly important. However, these data are limited to a few countries. The purpose of our study was to examine the cost/quality adjusted life year (cost/QALY) gained for posterior lumbar interbody fusion (PLIF) in the Japanese universal health insurance system. Fifty five patients underwent PLIF for lumbar degenerative spinal canal stenosis between July 2013 and September 2015 was included. Effectiveness was measured using Euro QOL 5-dimension (EQ-5D), Short-Form 8 physical component summary (PCS), and visual analog scale (VAS). The cost was calculated from the perspective of the public healthcare payer. Effectiveness and cost were measured one year after surgery. QALYs were calculated by multiplying the utility value (EQ-5D) and life years. Only direct costs were included on the basis of actual reimbursements. Cost/QALY at a 5-year time horizon with a 2% discount rate was estimated. Sensitivity analysis was performed by varying the time horizon (2 years or 10 years). The exchange rate was defined as US $1 to Japanese 100 yen. Mean total cost one year after surgery was ¥2,802,900 ($28029). Operative cost was ¥1,779,700 ($17797). Mean gained score was 0.22 in EQ-5D, 10.3 in PCS, and -44 in VAS. Cost/QALY was ¥2,697,500 ($26975). Sensitivity analysis demonstrated that cost/QALY at a 10-year time horizon was ¥1,428,300 ($14283) and that cost/QALY at a 2-year time horizon was ¥6,435,400 ($64354). Clinical outcomes after PLIF improved beyond minimum clinical improvement difference. Cost/QALY was below the widely-accepted benchmark (cost/QALY < $50000). PLIF could be regarded as cost-effective interventions. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  14. Minimally Invasive Transforaminal Lumbar Interbody Fusion for Isthmic Spondylolisthesis: In Situ Versus Reduction.

    Science.gov (United States)

    Fan, Guoxin; Gu, Guangfei; Zhu, Yanjie; Guan, Xiaofei; Hu, Annan; Wu, Xinbo; Zhang, Hailong; He, Shisheng

    2016-06-01

    The study aimed to compare the clinical outcomes of reduction versus in situ fusion with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for isthmic spondylolisthesis. Demographic, preoperative, and postoperative data were collected from the medical records. Radiographic fusion was assessed by use of the grading criteria of Bridwell. Preoperative and postoperative patient-reported outcomes including visual analog scale, Oswestry Disability Index, Japanese Orthopedic Association scale and improvement rate were calculated. Patient satisfaction was assessed with the criteria of Macnab (excellent, good, fair, poor). There were 24 patients (11 male) in the reduction group and 21 patients (10 male) in the in situ fusion group. The average follow-up was 34.75 ± 8.06 months in reduction group and 31.05 ± 6.52 months in the in situ fusion group (P = 0.101). There were no significant differences in hospital stay, estimated blood loss, blood transfusion, operation time, fusion grading, and complications between the 2 groups (P > 0.05). Spinal fusion rate was 91.67% (22/24) in the reduction group and 85.71% (18/21) in the in situ group (P = 0.835). There were no significant differences in Japanese Orthopedic Association scale, visual analog scale, and Oswestry Disability Index score between the 2 groups whenever preoperatively, 3-month postoperatively, or at the last follow-up (P > 0.05). According to the criteria of Macnab, the rate of excellent and good was 83.33% in reduction group and 80.95% in the in situ group (P = 0.899). MIS-TLIF with reduction did not induce significantly better patient-reported outcomes, spinal fusion rate, perioperative outcomes, or fewer complications in isthmic spondylolisthesis. Intentional reduction may not be a requirement in MIS-TLIF for isthmic spondylolisthesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Lumbar interbody fusion: a parametric investigation of a novel cage design with and without posterior instrumentation.

    Science.gov (United States)

    Galbusera, Fabio; Schmidt, Hendrik; Wilke, Hans-Joachim

    2012-03-01

    A finite element model of the L4-L5 human segment was employed to carry out a parametric biomechanical investigation of lumbar interbody fusion with a novel "sandwich" cage having an inner stiff core and two softer layers in the areas close to the endplates, with and without posterior fixation. Considered cage designs included: (a) cage in a homogeneous material with variable elastic modulus (19-2,000 MPa), (b) "sandwich" cage having an inner core (E=2,000 MPa) and softer layers (E=19 MPa) with variable thickness (1-2.5 mm). The latter cage was also considered in combination with posterior rods made with a material having variable elastic modulus (19-210,000 MPa). All the models were loaded with 500 N compression and moments of 7.5 Nm in flexion, extension, lateral bending and axial rotation. The homogeneous cage stabilized the segment in flexion, lateral bending and axial rotation; in extension there was a destabilization up to 60% and remarkable cage movement (1 mm). The "sandwich" cage limited this phenomenon (cage movement<0.6 mm), effectively stabilized the segment in the other directions and lowered the maximal contact pressure on the endplates, reducing the risk of subsidence. Posterior fixation reduced spinal flexibility and cage movement. The soft layers of the "sandwich" cage had the potential to limit the risk of cage subsidence and to preserve a significant loading of the structure even in combination with flexible posterior instrumentation, which may have a beneficial effect in promoting bony fusion.

  16. Network type sp3 boron-based single-ion conducting polymer electrolytes for lithium ion batteries

    Science.gov (United States)

    Deng, Kuirong; Wang, Shuanjin; Ren, Shan; Han, Dongmei; Xiao, Min; Meng, Yuezhong

    2017-08-01

    Electrolytes play a vital role in modulating lithium ion battery performance. An outstanding electrolyte should possess both high ionic conductivity and unity lithium ion transference number. Here, we present a facile method to fabricate a network type sp3 boron-based single-ion conducting polymer electrolyte (SIPE) with high ionic conductivity and lithium ion transference number approaching unity. The SIPE was synthesized by coupling of lithium bis(allylmalonato)borate (LiBAMB) and pentaerythritol tetrakis(2-mercaptoacetate) (PETMP) via one-step photoinitiated in situ thiol-ene click reaction in plasticizers. Influence of kinds and content of plasticizers was investigated and the optimized electrolytes show both outstanding ionic conductivity (1.47 × 10-3 S cm-1 at 25 °C) and high lithium transference number of 0.89. This ionic conductivity is among the highest ionic conductivity exhibited by SIPEs reported to date. Its electrochemical stability window is up to 5.2 V. More importantly, Li/LiFePO4 cells with the prepared single-ion conducting electrolytes as the electrolyte as well as the separator display highly reversible capacity and excellent rate capacity under room temperature. It also demonstrates excellent long-term stability and reliability as it maintains capacity of 124 mA h g-1 at 1 C rate even after 500 cycles without obvious decay.

  17. Single locus typing of MHC class I and class II B loci in a population of red jungle fowl.

    Science.gov (United States)

    Worley, K; Gillingham, M; Jensen, P; Kennedy, L J; Pizzari, T; Kaufman, J; Richardson, D S

    2008-05-01

    In species with duplicated major histocompatibility complex (MHC) genes, estimates of genetic variation often rely on multilocus measures of diversity. It is possible that such measures might not always detect more detailed patterns of selection at individual loci. Here, we describe a method that allows us to investigate classical MHC diversity in red jungle fowl (Gallus gallus), the wild ancestor of the domestic chicken, using a single locus approach. This is possible due to the well-characterised gene organisation of the 'minimal essential' MHC (BF/BL region) of the domestic chicken, which comprises two differentially expressed duplicated class I (BF) and two class II B (BLB) genes. Using a combination of reference strand-mediated conformation analysis, cloning and sequencing, we identify nine BF and ten BLB alleles in a captive population of jungle fowl. We show that six BF and five BLB alleles are from the more highly expressed locus of each gene, BF2 and BLB2, respectively. An excess of non-synonymous substitutions across the jungle fowl BF/BL region suggests that diversifying selection has acted on this population. Importantly, single locus screening reveals that the strength of selection is greatest on the highly expressed BF2 locus. This is the first time that a population of red jungle fowl has been typed at the MHC region, laying the basis for further research into the underlying processes acting to maintain MHC diversity in this and other species.

  18. The influence of the type of embryo culture medium on neonatal birthweight after single embryo transfer in IVF.

    Science.gov (United States)

    Vergouw, Carlijn G; Kostelijk, E Hanna; Doejaaren, Els; Hompes, Peter G A; Lambalk, Cornelis B; Schats, Roel

    2012-09-01

    Does the type of medium used to culture fresh and frozen-thawed embryos influence neonatal birthweight after single embryo transfer (SET) in IVF? A comparison of two commercially available culture media showed no significant influence on mean birthweight and mean birthweight adjusted for gestational age, gender and parity (z-scores) of singletons born after a fresh or frozen-thawed SET. Furthermore, we show that embryo freezing and thawing cycles may lead to a significantly higher mean birthweight. Animal studies have shown that culture media constituents are responsible for changes in birthweight of offspring. In human IVF, there is still little knowledge of the effect of medium type on birthweight. Until now, only a small number of commercially available culture media have been investigated (Vitrolife, Cook(®) Medical and IVF online medium). Our study adds new information: it has a larger population of singleton births compared with the previously published studies, it includes outcomes of other media types (HTF and Sage(®)), not previously analysed, and it includes data on frozen-thawed SETs. This study was a retrospective analysis of birthweights of singleton newborns after fresh (Day 3) or frozen-thawed (Day 5) SET cycles, using embryos cultured in either of two different types of commercially available culture media, between 2008 and 2011. Before January 2009, a single-step culture medium was used: human tubal fluid (HTF) with 4 mg/ml human serum albumin. From January 2009 onwards, a commercially available sequential medium was introduced: Sage(®), Quinn's advantage protein plus medium. Singletons born after a fresh SET (99 embryos cultured in HTF and 259 in Sage(®)) and singletons born after a frozen-thawed SET (32 embryos cultured in HTF only, 41 in HTF and Sage(®) and 86 in Sage(®) only) were analysed. Only patients using autologous gametes without the use of a gestational carrier were considered. Also excluded were (vanishing) twins, triplets

  19. Lateral Lumbar Interbody Fusion andin SituScrew Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine.

    Science.gov (United States)

    Choi, Young Hoon; Kwon, Shin Won; Moon, Jung Hyeon; Kim, Chi Heon; Chung, Chun Kee; Park, Sung Bae; Heo, Won

    2017-11-01

    The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved ( p fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

  20. The [Fe(III)[Fe(III)(L1)2]3] star-type single-molecule magnet.

    Science.gov (United States)

    Saalfrank, Rolf W; Scheurer, Andreas; Bernt, Ingo; Heinemann, Frank W; Postnikov, Andrei V; Schünemann, Volker; Trautwein, Alfred X; Alam, Mohammad S; Rupp, Holger; Müller, Paul

    2006-06-21

    Star-shaped complex [Fe(III)[Fe(III)(L1)2]3] (3) was synthesized starting from N-methyldiethanolamine H2L1 (1) and ferric chloride in the presence of sodium hydride. For 3, two different high-spin iron(III) ion sites were confirmed by Mössbauer spectroscopy at 77 K. Single-crystal X-ray structure determination revealed that 3 crystallizes with four molecules of chloroform, but, with only three molecules of dichloromethane. The unit cell of 3.4CHCl3 contains the enantiomers (delta)-[(S,S)(R,R)(R,R)] and (lambda)-[(R,R)(S,S)(S,S)], whereas in case of 3.3CH2Cl2 four independent molecules, forming pairs of the enantiomers [lambda-(R,R)(R,R)(R,R)]-3 and [lambda-(S,S)(S,S)(S,S)]-3, were observed in the unit cell. According to SQUID measurements, the antiferromagnetic intramolecular coupling of the iron(III) ions in 3 results in a S = 10/2 ground state multiplet. The anisotropy is of the easy-axis type. EPR measurements enabled an accurate determination of the ligand-field splitting parameters. The ferric star 3 is a single-molecule magnet (SMM) and shows hysteretic magnetization characteristics below a blocking temperature of about 1.2 K. However, weak intermolecular couplings, mediated in a chainlike fashion via solvent molecules, have a strong influence on the magnetic properties. Scanning tunneling microscopy (STM) and scanning tunneling spectroscopy (STS) were used to determine the structural and electronic properties of star-type tetranuclear iron(III) complex 3. The molecules were deposited onto highly ordered pyrolytic graphite (HOPG). Small, regular molecule clusters, two-dimensional monolayers as well as separated single molecules were observed. In our STS measurements we found a rather large contrast at the expected locations of the metal centers of the molecules. This direct addressing of the metal centers was confirmed by DFT calculations.

  1. 229 nm UV LEDs on aluminum nitride single crystal substrates using p-type silicon for increased hole injection

    Science.gov (United States)

    Liu, Dong; Cho, Sang June; Park, Jeongpil; Seo, Jung-Hun; Dalmau, Rafael; Zhao, Deyin; Kim, Kwangeun; Gong, Jiarui; Kim, Munho; Lee, In-Kyu; Albrecht, John D.; Zhou, Weidong; Moody, Baxter; Ma, Zhenqiang

    2018-02-01

    AlGaN based 229 nm light emitting diodes (LEDs), employing p-type Si to significantly increase hole injection, were fabricated on single crystal bulk aluminum nitride (AlN) substrates. Nitride heterostructures were epitaxially deposited by organometallic vapor phase epitaxy and inherit the low dislocation density of the native substrate. Following epitaxy, a p-Si layer is bonded to the heterostructure. LEDs were characterized both electrically and optically. Owing to the low defect density films, large concentration of holes from p-Si, and efficient hole injection, no efficiency droop was observed up to a current density of 76 A/cm2 under continuous wave operation and without external thermal management. An optical output power of 160 μW was obtained with the corresponding external quantum efficiency of 0.03%. This study demonstrates that by adopting p-type Si nanomembrane contacts as a hole injector, practical levels of hole injection can be realized in UV light-emitting diodes with very high Al composition AlGaN quantum wells, enabling emission wavelengths and power levels that were previously inaccessible using traditional p-i-n structures with poor hole injection efficiency.

  2. Strain typing of Zygosaccharomyces yeast species using a single molecular method based on polymorphism of the intergenic spacer region (IGS).

    Science.gov (United States)

    Wrent, Petra; Rivas, Eva-María; Peinado, José M; de Silóniz, María-Isabel

    2010-08-15

    Unlike previously reported methods that need a combination of several typing techniques, we have developed a single method for strain typing of the Zygosaccharomyces bailii, Z. mellis and Z. rouxii spoilage species. Strains belonging to other species have also been included for comparison. We have demonstrated that the IGS-PCR RFLP method has a high discriminative power. Considering the three endonucleases used in this work, we have obtained a variability of 100% for Z. mellis and Z. rouxii strains and up to 70% for Z. bailii. We have also detected two misidentified Z. mellis strains (CBS 711 and CBS 7412) which have RFLP patterns with a set of bands characteristic of Z. rouxii strains. Sequencing of 26S rDNA D1/D2 domains and the 5.8-ITS rDNA region confirmed these strains as Z. rouxii. The method also groups three certified hybrid strains of Zygosaccharomyces in a separate cluster. Copyright 2010 Elsevier B.V. All rights reserved.

  3. Effects of bovine cytochrome P450 single-nucleotide polymorphism, forage type and body condition on production traits in cattle.

    Science.gov (United States)

    Sales, M A; Larson, M J; Reiter, S T; Brown, A H; Brown, M A; Looper, M L; Coffey, K P; Rosenkrans, C F

    2012-08-01

    Relating single-nucleotide polymorphisms (SNP) to cows with acceptable productivity could benefit cattle breeders in areas where tall fescue is the predominant forage. This study aimed to (i) identify SNPs in bovine cytochrome P450 3A28 (CYP3A28) and (ii) determine the associations between SNP genotype, forage and cow body condition (BC). Genotype (CC, CG or GG) and forage [Kentucky-31 wild-type endophyte-infected tall fescue (KY+) vs. bermudagrass] effects on milk volume and quality were determined in Herd 1 cows (123 cows); in Herd 2 (99 cows), genotype and BC (low vs. moderate) effects on ovarian follicle size, calving date and calving per cent were determined; and in Herd 3 (114 cows), effects of genotype and fescue cultivar [KY+ vs. non-toxic endophyte-infected tall fescue (HiMag4)] were related to calving per cent, calving date and weaning weights of both cow and her calf. A cytosine (C) to guanine (G) transversion at base 994 (C994G) in CYP3A28 was identified. There was a genotype × forage type interaction (p productivity in cows. © 2011 Blackwell Verlag GmbH.

  4. A Single Bout of High-Intensity Interval Training Reduces Awareness of Subsequent Hypoglycemia in Patients With Type 1 Diabetes.

    Science.gov (United States)

    Rooijackers, Hanne M; Wiegers, Evita C; van der Graaf, Marinette; Thijssen, Dick H; Kessels, Roy P C; Tack, Cees J; de Galan, Bastiaan E

    2017-07-01

    High-intensity interval training (HIIT) has gained increasing popularity in patients with diabetes. HIIT acutely increases plasma lactate levels. This may be important, since the administration of lactate during hypoglycemia suppresses symptoms and counterregulation while preserving cognitive function. We tested the hypothesis that, in the short term, HIIT reduces awareness of hypoglycemia and attenuates hypoglycemia-induced cognitive dysfunction. In a randomized crossover trial, patients with type 1 diabetes and normal awareness of hypoglycemia (NAH), patients with impaired awareness of hypoglycemia (IAH), and healthy participants ( n = 10 per group) underwent a hyperinsulinemic-hypoglycemic (2.6 mmol/L) clamp, either after a HIIT session or after seated rest. Compared with rest, HIIT reduced symptoms of hypoglycemia in patients with NAH but not in healthy participants or patients with IAH. HIIT attenuated hypoglycemia-induced cognitive dysfunction, which was mainly driven by changes in the NAH subgroup. HIIT suppressed cortisol and growth hormone responses, but not catecholamine responses to hypoglycemia. The present findings demonstrate that a single HIIT session rapidly reduces awareness of subsequent hypoglycemia in patients with type 1 diabetes and NAH, but does not in patients with IAH, and attenuates hypoglycemia-induced cognitive dysfunction. The role of exercise-induced lactate in mediating these effects, potentially serving as an alternative fuel for the brain, should be further explored. © 2017 by the American Diabetes Association.

  5. A new type of FCT martensite phase in single-crystalline Fe{sub 3}Pt Invar alloy

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Masataka; Sekida, Sayaka [Department of Materials Science and Engineering, Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871 (Japan); Fukuda, Takashi, E-mail: fukuda@mat.eng.osaka-u.ac.jp [Department of Materials Science and Engineering, Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871 (Japan); Kakeshita, Tomoyuki [Department of Materials Science and Engineering, Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871 (Japan); Takahashi, Kohki; Koyama, Keiichi; Nojiri, Hiroyuki [High-Field Laboratory for Superconducting Materials, Institute for Materials Research, Tohoku University, 2-1-1 Sendai Katahira, Aoba-ku, Sendai, Miyagi 980-8577 (Japan)

    2011-08-25

    Highlights: {center_dot} TEM observations at room temperature reveal that the specimen is a single phase of L1{sub 2}-type structure. {center_dot} The spontaneous magnetization and magnetic susceptibility curves of Fe{sub 3}Pt with S = 0.88 have bend points at 60 K. {center_dot} XRD measurements reveal that this alloy exhibits a martensitic transformation to FCT and the transformation temperature is 60 K. {center_dot} The tetragonality c/a is larger than unity in the FCT martensite. {center_dot} This tetragonality is in contrast to the tetragonality c/a < 1generally observed in the FCT martensite with S < 0.8. - Abstract: Martensitic transformation in a highly ordered Fe{sub 3}Pt has been investigated by magnetization and X-ray diffraction measurements. We confirmed that a new type of face-centered tetragonal (FCT) martensite phase appears below 60 K in Fe{sub 3}Pt with a degree of order S = 0.88. The tetragonality c/a gradually increases with decreasing temperature, and is approximately 1.005 at 10 K. This is in contrast to the tetragonality c/a < 1 generally observed in the FCT martensite with a degree of order less than 0.8. The spontaneous magnetization increases in association with the transformation.

  6. Application of AERONET Single Scattering Albedo and Absorption Angstrom Exponent to Classify Dominant Aerosol Types during DRAGON Campaigns

    Science.gov (United States)

    Giles, D. M.; Holben, B. N.; Eck, T. F.; Schafer, J.; Crawford, J. H.; Kim, J.; Sano, I.; Liew, S.; Salinas Cortijo, S. V.; Chew, B. N.; Lim, H.; Smirnov, A.; Sorokin, M.; Kenny, P.; Slutsker, I.

    2013-12-01

    Aerosols can have major implications on human health by inducing respiratory diseases due to inhalation of fine particles from biomass burning smoke or industrial pollution and on radiative forcing whereby the presence of absorbing aerosol particles (e.g., black carbon) increases atmospheric heating. Aerosol classification techniques have utilized aerosol loading and aerosol properties derived from multi-spectral and multi-angle observations by ground-based (e.g., AERONET) and satellite instrumentation (e.g., MISR). Aerosol Robotic Network (AERONET) data have been utilized to determine aerosol types by implementing various combinations of measured aerosol optical depth or retrieved size and absorption aerosol properties (e.g., Gobbi et al., 2007; Russell et al., 2010). Giles et al. [2012] showed single scattering albedo (SSA) relationship with extinction Angstrom exponent (EAE) can provide an estimate of the general classification of dominant aerosol types (i.e., desert dust, urban/industrial pollution, biomass burning smoke, and mixtures) based on data from ~20 AERONET sites located in known aerosol source regions. In addition, the absorption Angstrom exponent relationship with EAE can provide an indication of the dominant absorbing aerosol type such as dust, black carbon, brown carbon, or mixtures of them. These classification techniques are applied to the AERONET Level 2.0 quality assured data sets collected during Distributed Regional Aerosol Gridded Observational Network (DRAGON) campaigns in Maryland (USA), Japan, South Korea, Singapore, Penang (Malaysia), and California (USA). An analysis of aerosol type classification for DRAGON sites is performed as well as an assessment of the spatial variability of the aerosol types for selected DRAGON campaigns. Giles, D. M., B. N. Holben, T. F. Eck, A. Sinyuk, A. Smirnov, I. Slutsker, R. R. Dickerson, A. M. Thompson, and J. S. Schafer (2012), An analysis of AERONET aerosol absorption properties and classifications

  7. The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; A double-blind randomised multicenter study

    NARCIS (Netherlands)

    M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart); W.C. Peul (Wilco); M.E. van den Akker-van Marle (Elske)

    2010-01-01

    textabstractBackground. Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is

  8. Isolated single coronary artery (RII-B type presenting as an inferior wall myocardial infarction: A rare clinical entity

    Directory of Open Access Journals (Sweden)

    Ankur C. Thummar

    2014-09-01

    Full Text Available Isolated single coronary artery without other congenital cardiac anomalies is very rare among the different variations of anomalous coronary patterns. The prognosis in patients with single coronary varies according to the anatomic distribution and associated coronary atherosclerosis. If the left main coronary artery travels between the aorta and pulmonary arteries, it may be a cause of sudden cardiac death. We present multimodality images of a single coronary artery, in which the whole coronary system originated by a single trunk from the right sinus of Valsalva with inter-arterial course of left main coronary artery. This rare type of single coronary artery was classified as RII-B type according to Lipton's scheme of classification. A significant flow-limiting lesions were found in the right coronary artery that was successfully treated with percutaneous coronary intervention.

  9. Pharmacokinetics and pharmacodynamics of saruplase, an unglycosylated single-chain urokinase-type plasminogen activator, in patients with acute myocardial infarction

    NARCIS (Netherlands)

    Koster, R. W.; Cohen, A. F.; Hopkins, G. R.; Beier, H.; Günzler, W. A.; van der Wouw, P. A.

    1994-01-01

    We examined in patients with acute myocardial infarction (AMI) the pharmacokinetics of saruplase, an unglycosylated, single chain, urokinase-type plasminogen activator (rscu-PA) by measuring urokinase-type plasminogen activator (u-PA) antigen and total u-PA activity, its conversion to active

  10. Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study

    OpenAIRE

    Ganasegeran, Kurubaran; Renganathan, Pukunan; Manaf, Rizal Abdul; Al-Dubai, Sami Abdo Radman

    2014-01-01

    Objective To determine the prevalence and factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia. Design Descriptive, cross-sectional single-centre study with universal sampling of all patients with type 2 diabetes. Setting Endocrinology clinic of medical outpatient department in a Malaysian public hospital. Participants All 169 patients with type 2 diabetes (men, n=99; women, n=70) aged between 18 and 90 years who acquired follow-up treatment from the en...

  11. Oxidative stress in patients with type 1 diabetes mellitus: is it affected by a single bout of prolonged exercise?

    Science.gov (United States)

    Francescato, Maria Pia; Stel, Giuliana; Geat, Mario; Cauci, Sabina

    2014-01-01

    Presently, no clear-cut guidelines are available to suggest the more appropriate physical activity for patients with type 1 diabetes mellitus due to paucity of experimental data obtained under patients' usual life conditions. Accordingly, we explored the oxidative stress levels associated with a prolonged moderate intensity, but fatiguing, exercise performed under usual therapy in patients with type 1 diabetes mellitus and matched healthy controls. Eight patients (4 men, 4 women; 49±11 years; Body Mass Index 25.0±3.2 kg·m(-2); HbA1c 57±10 mmol·mol(-1)) and 14 controls (8 men, 6 women; 47±11 years; Body Mass Index 24.3±3.3 kg·m(-2)) performed a 3-h walk at 30% of their heart rate reserve. Venous blood samples were obtained before and at the end of the exercise for clinical chemistry analysis and antioxidant capacity. Capillary blood samples were taken at the start and thereafter every 30 min to determine lipid peroxidation. Patients showed higher oxidative stress values as compared to controls (95.9±9.7 vs. 74.1±12.2 mg·L(-1) H2O2; pexercise (p = NS), while oxidative defence increased significantly at the end of exercise (pdiabetes exercising under their usual life conditions (i.e. usual therapy and diet). Specifically, we found that the oxidative stress was not exacerbated due to a single bout of prolonged moderate intensity aerobic exercise, a condition simulating several outdoor leisure time physical activities. Oxidative defence increased in both patients and controls, suggesting beneficial effects of prolonged aerobic fatiguing exercise.

  12. Mini-open Anterior Lumbar Interbody Fusion for Recurrent Lumbar Disc Herniation Following Posterior Instrumentation.

    Science.gov (United States)

    Mamuti, Maiwulanjiang; Fan, Shunwu; Liu, Junhui; Shan, Zhi; Wang, Chongyan; Li, Shengyun; Zhao, Fengdong

    2016-09-15

    A retrospective study. The aim of this study is to evaluate, clinically and radiographically, the efficacy of mini-open retroperitoneal anterior lumbar discectomy followed by anterior lumbar interbody fusion (ALIF) for recurrent lumbar disc herniation following primary posterior instrumentation. Recurrent disc herniation following previous disc surgery occurs in 5 to 15% of cases. This is often treated by further surgical intervention where posterior approach is generally preferred. However, posterior surgery may be problematic if the initial surgery involved posterior instrumentation. An anterior approach may be indicated in these patients, and recent findings suggest that a "mini-open" procedure may have some benefits when compared with traditional open techniques and their associated morbidities. A total of 35 recurrent lumbar disc herniation patients (10 male, 25 female) following primary posterior instrumentation with an average age of 52.8 years (range: 34-70 yrs) who underwent the mini-open ALIF procedures between August 2001 and February 2012 were evaluated retrospectively. The ALIF was performed at the levels L4-L5 (n = 14), L5-S1 (n = 15), or both L4-L5 and L5-S1 (n = 6). Visual Analog pain Scale (VAS) and Oswestry Disability Index (ODI) together with radiological results were assessed. The mean operating time, intraoperative estimated blood loss, and hospital stay were 115 minutes, 70 mL, and 6 days, respectively. No blood transfusion was needed. Transient complication was recorded in two patients. Postoperative follow-up was a minimum 24.3 months. VAS score and ODI percentage decreased significantly from 7.9 ± 0.8 and 78.8% ± 12.4% pre-operatively to 1.4 ± 0.6 and 21.7 ± 4.2% at final follow-up, respectively. There was no neurological worsening and radicular pain improved significantly compared with pre-operation in all the patients. Computed tomographic reconstruction 12 and 24 months after surgery showed bony fusion

  13. Effect of one- or two-level posterior lumbar interbody fusion on global sagittal balance.

    Science.gov (United States)

    Cho, Jae Hwan; Joo, Youn-Suk; Lim, Cheongsu; Hwang, Chang Ju; Lee, Dong-Ho; Lee, Choon Sung

    2017-12-01

    Sagittal imbalance is associated with poor clinical outcomes in patients with degenerative lumbar disease. However, there is no consensus on the impact of posterior lumbar interbody fusion (PLIF) on local and global sagittal balance. To reveal the effect of one- or two-level PLIF on global sagittal balance. A retrospective case-control study. This study included 88 patients who underwent a one- or two-level PLIF for spinal stenosis with spondylolisthesis. Clinical and radiological parameters were measured pre- and postoperatively. All patients were followed up for >2 years. Clinical outcomes included a visual analog scale, Oswestry Disability Index, and EuroQol 5-dimension questionnaire (EQ-5D). Radiological parameters were measured using whole-spine standing lateral radiographs. Fusion, loosening, subsidence rates, and adverse events were also evaluated. Patients were divided into two groups according to their preoperative C7-S1 sagittal vertical axis (SVA): Group N: SVA≤5 cm vs Group I: SVA>5 cm; they were also divided according to postoperative changes in C7-S1 SVA. Clinical and radiological outcomes were compared between the groups. All clinical outcomes and radiological parameters improved postoperatively. C7-S1 SVA improved (-1.6 cm) after L3-L5 fusion, but it was compromised (+3.6 cm) after L4-S1 fusion (p=.001). Preoperative demographic and clinical data showed no difference except in the anxiety or depression domain of EQ-5D. No differences were found in postoperative clinical outcomes. Lumbar lordosis, pelvic tilt, and thoracic kyphosis slightly improved in Group N, whereas C7-S1 SVA decreased from 9.5 cm to 3.8 cm (pfusion (L3-L5 vs L4-S1, p=.033). Global sagittal balance improved after short-level lumbar fusion surgery in patients having spinal stenosis with spondylolisthesis who showed preoperative sagittal imbalance. Restoration of sagittal balance predominantly occurred after L3-L4, L4-L5, or L3-L5 PLIF. However, no such restoration was

  14. Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion.

    Science.gov (United States)

    Bocahut, N; Audureau, E; Poignard, A; Delambre, J; Queinnec, S; Flouzat Lachaniette, C-H; Allain, J

    2017-12-30

    Few data are available on the occurrence after stand-alone lateral lumbar interbody fusion (LLIF) of implant subsidence, whose definition and incidence vary across studies. The primary objective of this work was to determine the incidence of subsidence 1 year postoperatively, using an original measurement method, whose validity was first assessed. The secondary objective was to assess the clinical impact of subsidence. Implant subsidence after stand-alone LLIF is a common complication that can adversely affect clinical outcomes. Of 69 included patients who underwent stand-alone LLIF, 67 (97%) were re-evaluated at least 1 year later. Furthermore, 63 (91%) patients had two available computed tomography (CT) scans for assessing subsidence, one performed immediately after surgery and the other 1 year later. Reproducibility of the original measurement method was assessed in a preliminary study. Subsidence was defined as at least 4mm loss of fused space height. The incidence of subsidence was 32% (20 patients). Subsidence was global in 7 (11%) patients and partial in 13 (21%) patients. Mean loss of height was 5.5±1.5mm. Subsidence predominated anteriorly in 50% of cases. The lordotic curvature of the fused segment was altered in 50% of patients, by a mean of 8°±3°. Fusion was achieved in 67/69 (97%) patients. The Oswestry score and visual analogue scale scores for low-back and nerve-root pain were significantly improved after 1 year in the overall population and in the groups with and without subsidence. Reproducibility of our measurement method was found to be excellent. Subsidence was common but without significant clinical effects after 1 year. Nevertheless, subsidence can be associated with pain and can result in loss of lumbar lordosis, which is a potential risk factor for degenerative disease of the adjacent segments. A score for predicting the risk of subsidence will now be developed by our group as a tool for improving patient selection to stand-alone LLIF

  15. Combined posteroanterior fusion versus transforaminal lumbar interbody fusion (TLIF) in thoracolumbar burst fractures.

    Science.gov (United States)

    Schmid, Rene; Lindtner, Richard Andreas; Lill, Markus; Blauth, Michael; Krappinger, Dietmar; Kammerlander, Christian

    2012-04-01

    The optimal treatment strategy for burst fractures of the thoracolumbar junction is discussed controversially in the literature. Whilst 360° fusion has shown to result in better radiological outcome, recent studies have failed to show its superiority concerning clinical outcome. The morbidity associated with the additional anterior approach may account for these findings. The aim of this prospective observational study was therefore to compare two different techniques for 360° fusion in thoracolumbar burst fractures using either thoracoscopy or a transforaminal approach (transforaminal lumbar interbody fusion (TLIF)) to support the anterior column. Posterior reduction and short-segmental fixation using angular stable pedicle screw systems were performed in all patients as a first step. Monocortical strut grafts were used for the anterior support in the TLIF group, whilst tricortical grafts or titanium vertebral body replacing implants of adjustable height were used in the combined posteroanterior group. At final follow-up, the radiological outcome was assessed by performing X-rays in a standing position. The clinical outcome was measured using five validated outcome scores. The morbidity associated with the approaches and the donor site was assessed as well. There were 21 patients in the TLIF group and 14 patients in the posteroanterior group included. The postoperative loss of correction was higher in the TLIF group (4.9°±8.3° versus 3.4°±6.4°, p>0.05). There were no significant differences regarding the outcome scores between the two groups. There were no differences in terms of return to employment, leisure activities and back function either. More patients suffered from donor-site morbidity in the TLIF group, whilst the morbidity associated with the surgical approach was higher in the posteroanterior group. The smaller donor-site morbidity in the posteroanterior group is counterbalanced by an additional morbidity associated with the anterior approach

  16. Minimally invasive lateral lumbar interbody fusion and transpsoas approach-related morbidity.

    Science.gov (United States)

    Moller, David J; Slimack, Nicholas P; Acosta, Frank L; Koski, Tyler R; Fessler, Richard G; Liu, John C

    2011-10-01

    Recently, the minimally invasive, lateral retroperitoneal, transpsoas approach to the thoracolumbar spinal column has been described by various authors. This is known as the minimally invasive lateral lumbar interbody fusion. The purpose of this study is to elucidate the approach-related morbidity associated with the minimally invasive transpsoas approach to the lumbar spine. To date, there have been only a couple of reports regarding the morbidity of the transpsoas muscle approach. A nonrandomized, prospective study utilizing a self-reported patient questionnaire was conducted between January 2006 and June 2008 at Northwestern University. Data were collected in 53 patients with a follow-up period ranging from 6 months to 3.5 years. Only 2 patients were lost to follow-up. Thirty-six percent (19 of 53) of patients reported subjective hip flexor weakness, 25% (13 of 53) anterior thigh numbness, and 23% (12 of 53) anterior thigh pain. However, 84% of the 19 patients reported complete resolution of their subjective hip flexor weakness by 6 months, and most experienced improved strength by 8 weeks. Of those reporting anterior thigh numbness and pain, 69% and 75% improved to their baseline function by the 6-month follow-up evaluations, respectively. All patients with self-reported subjective hip flexor weakness underwent examinations during subsequent clinic visits after surgery; however, these examinations did not confirm a motor deficit less than Grade 5. Subset analysis showed that the L3-4 and L4-5 levels were most often affected. The minimally invasive, transpsoas muscle approach to the lumbar spine has a number of advantages. The data show that a percentage of the patients undergoing the transpsoas approach will have temporary sensory and motor symptoms related to this approach. The majority of the symptoms are thought to be related to psoas muscle inflammation and/or stretch injury to the genitofemoral nerve due to the surgical corridor traversed during the

  17. Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Kleiner JB

    2016-05-01

    Full Text Available Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF surgery was compared to the corresponding bone graft (BG volumes inserted at the time of fusion. A novel BG delivery tool (BGDT was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD. This study was performed prospectively. Summary of background data: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods: A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results: DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion: The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk

  18. Preventive Effect of Dynamic Stabilization Against Adjacent Segment Degeneration After Posterior Lumbar Interbody Fusion.

    Science.gov (United States)

    Tachibana, Naohiro; Kawamura, Naohiro; Kobayashi, Daiki; Shimizu, Takaki; Sasagawa, Takeshi; Masuyama, Shigeru; Hirao, Yujiro; Kunogi, Junichi

    2017-01-01

    Retrospective cohort study. To investigate the effects of dynamic stabilization with sublaminar taping (ST) on the upper segment adjacent to posterior lumbar interbody fusion (PLIF). Hybrid procedures such as dynamic stabilization for adjacent segment in addition to spinal fusion have been developed for reduction of the mechanical stress and prevention of adjacent segment pathology (ASP). However, a few reports are available on hybrid procedures and their efficacy is still controversial. Of the 116 patients who underwent L4/5 PLIF between August 2006 and September 2012, 76 patients with minimum 2-year follow up were included in this study. Fifty three patients underwent L4/5 PLIF with hybrid procedure using ST on L3 lamina (group U), and 23 patients underwent conventional L4/5 PLIF (group C). The adjacent segment degeneration (ASDeg) was determined by measurements of radiograph, computed tomography, and magnetic resonance imaging; the adjacent segment disease (ASDis) was evaluated on medical records. The incidence of ASDeg at L3/4 segment of group U (3.7%) was significantly less than that of group C (30.4%) (P = 0.003), although there were no significant differences at L2/3 (group U, 7.5%; group C, 13%) or L5/S1 segment (group U, 5.7%; group C, 8.7%). On the other hand, no significant difference was found between two groups in the incidence of ASDis in L2/3 to L5/S1 levels, and no patient underwent reoperation. Bivariable and multivariable logistic regression analyses for L3/4 segment ASDeg revealed that the difference of surgical procedure was the only significant factor. The current study showed that L4/5 PLIF with hybrid procedure using ST on L3 lamina significantly reduced the incidence of L3/4 ASDeg as compared with the conventional L4/5 PLIF without compromising L2/3 or L5/S1 segment. Although further studies and longer follow up are necessary, the hybrid procedure is expected to be effective for preventing ASP. 4.

  19. Risk Factors of Adjacent Segment Disease After Transforaminal Inter-Body Fusion for Degenerative Lumbar Disease.

    Science.gov (United States)

    Yamasaki, Koji; Hoshino, Masahiro; Omori, Keita; Igarashi, Hidetoshi; Nemoto, Yasuhiro; Tsuruta, Takashi; Matsumoto, Koji; Iriuchishima, Takanori; Ajiro, Yasumitsu; Matsuzaki, Hiromi

    2017-01-15

    A retrospective study. The purpose of this study was to determine the incidence and risk factors of adjacent segment disease (ASD) after transforaminal inter-body fusion (TLIF) for degenerative lumbar disease. ASD is a major complication after spinal fusion. Many reports have been published concerning the risk factors for ASD after TLIF. A number of quantitative relationships to spino-pelvic parameters have been established. A retrospective cohort study was carried out to investigate spino-pelvic alignment in patients with ASD after TLIF. This study evaluated 263 subjects (150 subjects undergoing floating fusion (FF group), and 113 patients undergoing lumbosacral fusion (LF group)) who underwent TLIF from 2009 to 2012. The mean follow-up period was 37.6 months. Several parameters were measured using pre- and postoperative full-length free-standing radiographs, including lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), and PI-LL. Multivariate logistic regression analysis was performed to evaluate these parameters as potential risk factors of early onset radiographic ASD. Radiographic ASD was found in 65 cases (43.3%) in the FF group, and 49 cases (43.3%) in the LF group. LL improved by 7.5° and 3.9° in each group respectively after TLIF. However, PT worsened by 6.4° in the LF group. When comparing with ASD positive cases and ASD negative cases, a significant difference in preoperative PT was observed in both FF (P = 0.001) and LF groups (P = 0.0001). Logistic regression analysis and receiver operating characteristic analysis revealed that preoperative PT of more than 22.5° was a significant risk factor of the incidence of ASD after TLIF (P = 0.02; odds ratio: 5.1, 95% CI: 1.62-9.03). Patients with preoperative sagittal imbalance have a statistically significant increased risk of ASD. The risk of ASD incidence was 5.1 times greater in subjects with preoperative PT of more than 22.5°.

  20. Conduction band mass determinations for n-type InGaAs/InAlAs single quantum wells

    Energy Technology Data Exchange (ETDEWEB)

    Jones, E.D.; Reno, J.L. [Sandia National Labs., Albuquerque, NM (United States); Kotera, Nobuo [Kyushu Inst. of Tech., Iizuka, Fukuoka (Japan); Wang, Y. [Florida State Univ., Tallahassee, FL (United States). National High Magnetic Field Lab.

    1998-05-01

    The authors report the measurement of the conduction band mass in n-type single 27-ML-wide InGaAs/InAlAs quantum well lattice matched to InP using two methods: (1) Magnetoluminescence spectroscopy and (2) far-infrared cyclotron resonance. The magnetoluminescence method utilizes Landau level transitions between 0 and 14 T at 1.4 K. The far infrared cyclotron resonance measurements were made at 4.2 K and to fields as large up to 18 T. The 2D-carrier density N{sub 2D} = 3 {times} 10{sup 11} cm{sup {minus}2} at low temperatures. The magnetoluminescence technique yielded an effective conduction-band mass of m{sub c} = 0.062m{sub 0} while the far infrared cyclotron resonance measurements gave m{sub c} = 0.056m{sub 0}, where m{sub 0} is the free electron mass. Both measurements show no evidence for any significant conduction-band nonparabolicity.

  1. A Modified Model Reference Adaptive Control for a Single Motor of Latch Type Control Element Drive Mechanism

    International Nuclear Information System (INIS)

    Park, Bae Jeong

    2016-01-01

    A modified Model Reference Adaptive Control (MRAC) for a single motor of latch type Control Element Drive Mechanism (CEDM) is described herein. The CEDM has complicated dynamic characteristics including electrical, mechanical, and magnetic effects. The previous control system has utilized a Proportional-Integral (PI) controller, and the control performance is limited according to nonlinear dynamic characteristics and environmental conditions. The modified MRAC using system identification (ID) technique improves the control performance in the operating condition such as model parameter variation and environmental condition change. The modified MRAC using the identified reference model with feed-forward gain and 180Hz noise reduction filter presents better performance under normal and/or abnormal condition. The simplified reference model can make H/W implementation more practical on the viewpoint of less computation and good performance. Actually, the CEDM controller shall be capable of controlling 101 control element assemblies (CEAs) individually in the nuclear power plant. Because the load conditions and the environmental condition around the 101 CEAs are all different minutely, the proposed modified MRAC can be a good practice. The modified MRAC controller will be applied in the real nuclear power plant later and this will overcome some weak point of PI controller

  2. Factors affecting the performance of a single-chamber microbial fuel cell-type biological oxygen demand sensor.

    Science.gov (United States)

    Yang, Gai-Xiu; Sun, Yong-Ming; Kong, Xiao-Ying; Zhen, Feng; Li, Ying; Li, Lian-Hua; Lei, Ting-Zhou; Yuan, Zhen-Hong; Chen, Guan-Yi

    2013-01-01

    Microbial fuel cells (MFCs) are devices that exploit microorganisms as biocatalysts to degrade organic matter or sludge present in wastewater (WW), and thereby generate electricity. We developed a simple, low-cost single-chamber microbial fuel cell (SCMFC)-type biochemical oxygen demand (BOD) sensor using carbon felt (anode) and activated sludge, and demonstrated its feasibility in the construction of a real-time BOD measurement system. Further, the effects of anodic pH and organic concentration on SCMFC performance were examined, and the correlation between BOD concentration and its response time was analyzed. Our results demonstrated that the SCMFC exhibited a stable voltage after 132 min following the addition of synthetic WW (BOD concentration: 200 mg/L). Notably, the response signal increased with an increase in BOD concentration (range: 5-200 mg/L) and was found to be directly proportional to the substrate concentration. However, at higher BOD concentrations (>120 mg/L) the response signal remained unaltered. Furthermore, we optimized the SCMFC using synthetic WW, and tested it with real WW. Upon feeding real WW, the BOD values exhibited a standard deviation from 2.08 to 8.3% when compared to the standard BOD5 method, thus demonstrating the practical applicability of the developed system to real treatment effluents.

  3. Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients.

    Science.gov (United States)

    Wang, Michael Y; Lerner, Jason; Lesko, James; McGirt, Matthew J

    2012-08-01

    Retrospective multi-institutional database review. To determine if minimally invasive interbody fusion is associated with cost savings when compared with open surgery. Minimally invasive spine (MIS) surgeries are increasingly recognized as equivalent to open procedures. Although these techniques have been advocated for reducing pain, disability, and length of hospitalization, to date there has been little data demonstrating these benefits. This study analyzed inpatient hospital records from the Premier Perspective database (2002 to 2009), including patients who underwent a posterior lumbar fusion with interbody cage placement by ICD-9 code, and had implant charge codes that allowed determination if MIS pedicle screws were utilized. Exclusion criteria included a refusion surgery, deformity, >2 levels, and anterior fusion. Total costs were adjusted for covariates (age, sex, race, hospital geography and setting, payor, and comorbidities) using an analysis of covariance model. A total of 6106 patients were identified (1667 MIS and 4439 open). Length of stay (LOS) for 1-level MIS surgery averaged of 3.35 days versus 3.6 days for open surgery (P≤0.006). For 2-level MIS surgery LOS averaged of 3.4 days versus 4.03 days for open surgery (P≤0.001). Total inflation-adjusted acute hospitalization cost averaged $29,187 for 1-level MIS procedures versus $29,947 for open surgery, a nonsignificant difference (P=0.55). Total inflation-adjusted acute hospitalization cost averaged $2106 lower for 2-level MIS surgery (total costs of $33,879 for MIS vs. $35,984 for open surgery, P=0.0023). Cost savings were attributable primarily to lower room and board ($857), operating room ($359), pharmacy ($304), and laboratory ($166) costs in the MIS group. High variances in the 2-level open surgery with prolonged hospital stay also accounted for overall cost differences. This data from a large nationwide sample of hospitalizations demonstrates that MIS lumbar interbody fusion results in a

  4. Oxidative stress in patients with type 1 diabetes mellitus: is it affected by a single bout of prolonged exercise?

    Directory of Open Access Journals (Sweden)

    Maria Pia Francescato

    Full Text Available Presently, no clear-cut guidelines are available to suggest the more appropriate physical activity for patients with type 1 diabetes mellitus due to paucity of experimental data obtained under patients' usual life conditions. Accordingly, we explored the oxidative stress levels associated with a prolonged moderate intensity, but fatiguing, exercise performed under usual therapy in patients with type 1 diabetes mellitus and matched healthy controls. Eight patients (4 men, 4 women; 49±11 years; Body Mass Index 25.0±3.2 kg·m(-2; HbA1c 57±10 mmol·mol(-1 and 14 controls (8 men, 6 women; 47±11 years; Body Mass Index 24.3±3.3 kg·m(-2 performed a 3-h walk at 30% of their heart rate reserve. Venous blood samples were obtained before and at the end of the exercise for clinical chemistry analysis and antioxidant capacity. Capillary blood samples were taken at the start and thereafter every 30 min to determine lipid peroxidation. Patients showed higher oxidative stress values as compared to controls (95.9±9.7 vs. 74.1±12.2 mg·L(-1 H2O2; p<0.001. In both groups, oxidative stress remained constant throughout the exercise (p = NS, while oxidative defence increased significantly at the end of exercise (p<0.02 from 1.16±0.13 to 1.19±0.10 mmol·L(-1 Trolox in patients and from 1.09±0.21 to 1.22±0.14 mmol·L(-1 Trolox in controls, without any significant difference between the two groups. Oxidative stress was positively correlated to HbA1c (p<0.005 and negatively related with uric acid (p<0.005. In conclusion, we were the first to evaluate the oxidative stress in patients with type 1 diabetes exercising under their usual life conditions (i.e. usual therapy and diet. Specifically, we found that the oxidative stress was not exacerbated due to a single bout of prolonged moderate intensity aerobic exercise, a condition simulating several outdoor leisure time physical activities. Oxidative defence increased in both patients and controls, suggesting

  5. A single nucleotide polymorphism within the acetyl-coenzyme A carboxylase beta gene is associated with proteinuria in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Maeda, Shiro; Kobayashi, Masa-aki; Araki, Shin-ichi

    2010-01-01

    It has been suggested that genetic susceptibility plays an important role in the pathogenesis of diabetic nephropathy. A large-scale genotyping analysis of gene-based single nucleotide polymorphisms (SNPs) in Japanese patients with type 2 diabetes identified the gene encoding acetyl-coenzyme A ca......It has been suggested that genetic susceptibility plays an important role in the pathogenesis of diabetic nephropathy. A large-scale genotyping analysis of gene-based single nucleotide polymorphisms (SNPs) in Japanese patients with type 2 diabetes identified the gene encoding acetyl...... among patients with type 2 diabetes and proteinuria. A meta-analysis revealed that rs2268388 was significantly associated with proteinuria in Japanese patients with type 2 diabetes (p = 5.35 x 10(-8), odds ratio = 1.61, 95% Cl: 1.35-1.91). Rs2268388 was also associated with type 2 diabetes...

  6. Contact stresses modeling at the Panda-type fiber single-layer winding and evaluation of their impact on the fiber optic properties

    Science.gov (United States)

    Lesnikova, Yu I.; Smetannikov, O. Yu; Trufanov, A. N.; Trufanov, N. A.

    2017-02-01

    The impact of contact transverse forces on the birefringence of the single-mode polarization-maintaining Panda-type fiber is numerically modeled. It has been established that with a single-row power winding on a cylindrical mandrel, the fiber tension at winding is the principal factor that influences birefringence. When coiling the fiber based on the local defect microbending, the birefringence at the microbending point differs from that of the free fiber by 1.3%.

  7. Association of single nucleotide polymorphisms in TCF2 with type 2 diabetes susceptibility in a Han Chinese population.

    Directory of Open Access Journals (Sweden)

    Xuelong Zhang

    Full Text Available Hepatocyte nuclear factor 1β (HNF1β, a transcription factor encoded by the transcription factor 2 gene (TCF2, plays a critical role in pancreatic cell formation and glucose homeostasis. It has been suggested that single nucleotide polymorphisms (SNPs of TCF2 are associated with susceptibility to type 2 diabetes (T2D. However, published results are inconsistent and inclusive. To further investigate the role of these common variants, we examined the association of TCF2 polymorphisms with the risk of T2D in a Han population in northeastern China. We genotyped five SNPs in 624 T2D patients and 630 healthy controls by using a SNaPshot method, and evaluated the T2D risk conferred by individual SNPs and haplotypes. In the single-locus analysis, we found that rs752010, rs4430796 and rs7501939 showed allelic differences between T2D patients and healthy controls, with an OR of 1.26 (95% CI 1.08-1.51, P = 0.003, an OR of 1.23 (95% CI 1.06-1.55, P = 0.001 and an OR of 1.28 (95% CI 1.10-1.61, P = 0.001, respectively. Genotype association analysis of each locus also revealed that the homozygous carriers of the at-risk allele had a significant increased T2D risk compared to homozygous carriers of the other allele (OR 1.78, 95% CI 1.20-2.64 for rs752010; OR 1.82, 95% CI 1.24-2.67 for rs4430796; OR 1.95, 95% CI 1.31-2.90 for rs7501939, even after Bonferroni correction for multiple comparisons. Besides, the haplotype-based analysis demonstrated that AGT in block rs752010-rs4430796-rs7501939 was associated with about 30% increase in T2D risk (OR 1.31, 95% CI 1.09-1.57, P = 0.01. Our findings suggested that TCF2 variants may be involved in T2D risk in a Han population of northeastern China. Larger studies with ethnically diverse populations are warranted to confirm the results reported in this investigation.

  8. THE LONG-TERM RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH ISTHMIC SPONDYLOLISTHESIS USING ANTERIOR LUMBAR INTERBODY FUSION

    Directory of Open Access Journals (Sweden)

    V. M. Shapovalov

    2012-01-01

    Full Text Available The authors analyzed the long-term results of surgical treatment 47 patients with true spondylolisthesis. The follow up period ranged from 14 to 25 years. All patients underwent an isolated anterior interbody riving allograft fusion. The scales of VAS and ODI were used for subjective assessment of treatment outcomes; objective assessment was based on clinical and radiographic, CT and MRI outcomes. There were 42.6% (20 cases patients with good, 31.9% (15 cases with satisfactory and 25.5% (12 cases unsatisfactory results in the long-term follow-up. The main reasons of poor outcome were: the continued high degree of displacement of the vertebral body (17.6%, instability (38.3% and the disbalance of the lumbosacral spine (63.8%, persistent compression of neural structures (42.6%. Most patients had the combination of these factors that were existed against backdrop of progressive degenerative changes of the spine.

  9. LA PLANTA ÚNICA COMO TIPO RESISTENTE A LA ESCALA / the single plan as a type resistant to scale

    Directory of Open Access Journals (Sweden)

    Silvia Colmenares Vilata

    2014-05-01

    Full Text Available RESUMEN El sistema capitalista ha generado dos de los modelos espaciales de indiferencia funcional más extremos: por un lado, el espacio tecnificado y repetido del edificio de oficinas en altura, encarnado por la ‘planta tipo’ y, por otro, el espacio diáfano y extenso del gran contendor, que responde a la lógica de lo que llamaremos ‘planta única’. En los edificios construidos para la industria automovilística y bélica americana se encuentra el germen de un tipo que servirá de modelo para los nuevos espacios de consumo de bienes y servicios de la ciudad post-industrial. En ella, la identificación del rascacielos con el centro y del contenedor con la periferia sigue vigente, porque la densidad necesaria del primero y la ocupación extensiva del segundo hacen que resulte imposible invertir los términos. Sin embargo, ambos representan el desarrollo estrictamente pragmático de los principios de la ‘planta libre’ como sistema operativo genérico, dando lugar a construcciones de gran tamaño que ponen a prueba la resistencia a la escala del propio tipo. Tomando como referencia la neutralidad característica de la ‘planta única’ el texto analiza el comportamiento frente al cambio de tamaño de sus dos configuraciones complementarias: la gran sala hipóstila y la gran sala diáfana. SUMMARY The capitalist system has generated two of the most extreme spatial models of functional indifference: on the one hand, the technified and repeated space of the high-rise office building, incarnated by the “typical plan” and, on the other, the diaphanous and extensive space of the large container, which responds to the logic of what we will call “single plan”. In the buildings constructed for the American automobile and military industries is the germ of a type that would serve as a model for the new spaces for consumption of goods and services of the post-industrial city. In that city, the identification of the skyscraper with the

  10. Spondylectomy and lateral lumbar interbody fusion for thoracolumbar kyphosis in an adult with achondroplasia: A case report.

    Science.gov (United States)

    Miyazaki, Masashi; Kanezaki, Shozo; Notani, Naoki; Ishihara, Toshinobu; Tsumura, Hiroshi

    2017-12-01

    Fixed thoracolumbar kyphosis with spinal stenosis in adult patients with achondroplasia presents a challenging issue. We describe the first case in which spondylectomy and minimally invasive lateral access interbody arthrodesis were used for the treatment of fixed severe thoracolumbar kyphosis and lumbar spinal canal stenosis in an adult with achondroplasia. A 61-year-old man with a history of achondroplastic dwarfism presented with low back pain and radiculopathy and neurogenic claudication. Plain radiographs revealed a high-grade thoracolumbar kyphotic deformity with diffuse degenerative changes in the lumbar spine. The apex was located at L2, the local kyphotic angle from L1 to L3 was 105°, and the anterior area was fused from the L1 to L3 vertebrae. MRI revealed significant canal and lateral recess stenosis secondary to facet hypertrophy. We planned a front-back correction of the anterior and posterior spinal elements. We first performed anterior release at the fused part from L1 to L3 and XLIF at L3/4 and L4/5. Next, the patient was placed in the prone position. Spondylectomy at the L2 vertebra and posterior fusion from T10 to L5 were performed. Postoperative radiographs revealed L1 to L3 kyphosis of 32°. No complications occurred during or after surgery. Postoperatively, the patient's low back pain and neurological claudication were resolved. No worsening of kyphosis was observed 24 months postoperatively. Circumferential decompression of the spinal cord at the apical vertebral level and decompression of lumbar canal stenosis were necessary. Front-back correction of the anterior and posterior spinal elements via spondylectomy and lateral lumbar interbody fusion is a reasonable surgical option for thoracolumbar kyphosis and developmental canal stenosis in patients with achondroplasia.

  11. Posterior lumbar interbody fusion (PLIF) with cages and local bone graft in the treatment of spinal stenosis.

    Science.gov (United States)

    Trouillier, Hans; Birkenmaier, Christof; Rauch, Alexander; Weiler, Christoph; Kauschke, Thomas; Refior, Hans Jürgen

    2006-08-01

    Posterior lumbar interbody fusion (PLIF) implants are increasingly being used for 360 degrees fusion after decompression of lumbar spinal stenosis combined with degenerative instability. Both titanium and PEEK (PolyEtherEtherKetone) implants are commonly used. Assessing the clinical and radiological results as well as typical complications, such as migration of the cages, is important. In addition, questions such as which radiological parameters can be used to assess successful fusion, and whether the exclusive use of local bone graft is sufficient, are frequently debated. We prospectively evaluated 30 patients after PLIF instrumentation for degenerative lumbar spinal canal stenosis, over a course of 42 months. In all cases, titanium cages and local bone graft were used for spondylodesis. The follow-up protocol of these 30 cases included standardised clinical and radiological evaluation at 3, 6, 12 and 42 months after surgery. Overall satisfactory results were achieved. With one exception, a stable result was achieved with restoration of the intervertebral space in the anterior column. After 42 months of follow-up in most cases, a radiologically visible loss of disc space height can be demonstrated. Clinically relevant migration of the cage in the dorsal direction was detected in one case. Based on our experience, posterior lumbar interbody fusion (PLIF) can be recommended for the treatment of monosegmental and bisegmental spinal stenosis, with or without segmental instability. Postoperative evaluation is mainly based on clinical parameters since the titanium implant affects the diagnostic value of imaging studies and is responsible for artefacts. The results observed in our group of patients suggest that local autologous bone graft procured from the posterior elements after decompression is an adequate material for bone grafting in this procedure.

  12. Single-crystalline M-type Sr Hexaferrites studied by {sup 57}Fe Mössbauer spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Nagasawa, Nobumoto, E-mail: rk15v002@stkt.u-hyogo.ac.jp; Ikeda, Shugo [University of Hyogo, Graduate School of Material Science and Center for Novel Material Science under Multi-extreme Conditions (Japan); Shimoda, Aiko; Waki, Takeshi; Tabata, Yoshikazu; Nakamura, Hiroyuki [Kyoto University, Department of Material Science and Engineering (Japan); Kobayashi, Hisao [University of Hyogo, Graduate School of Material Science and Center for Novel Material Science under Multi-extreme Conditions (Japan)

    2016-12-15

    The {sup 57}Fe Mössbauer spectra of the single crystalline and the finely ground Sr{sub 1−x}La{sub x}Fe{sub 12−y}Co{sub y}O{sub 19} (x = 0 : y = 0, x = 0.192 : y = 0.152 and x = 0.456 : y = 0.225) samples have been measured to investigate the La-Co substitution effects. All observed spectra at 150 K were well fitted using the five subspectra which correspond to the five crystallographical nonequivalent Fe sites in the M-type hexaferrite, indicating that the valence changes to Fe{sup 2+} ions in the Fe{sup 3+} ions were not observed in our Sr{sub 1−x}La{sub x}Fe{sub 12−y}Co{sub y}O{sub 19} samples. In SrFe{sub 12}O{sub 19}, the relative absorption intensities in the five subspectra show the large anisotropies in the recoilless fractions at the five Fe sites whereas these anisotropies were not observed in Sr{sub 0.544}La{sub 0.456}Fe{sub 11.775}Co{sub 0.225}O{sub 19}. These results indicate the chemical compositional dependence on the anisotropies of the recoilless fractions at the five Fe sites. The substitution of a Co{sup 2+} ion for the Fe{sup 3+} ion changes the center shifts of the Fe{sup 3+} ions near the Co{sup 2+} ion by the perturbation of the Fe-O-Co hybridizations. Therefore, the Co{sup 2+} ions occupy the 4f{sub 1} and the 4f{sub 2} sites due to the chemical compositional dependences of the refined magnetic hyperfine field and center shifts of the Fe{sup 3+} ions.

  13. Single base substitution causing the fragrant phenotype and development of a type-specific marker in aromatic coconut (Cocos nucifera).

    Science.gov (United States)

    Vongvanrungruang, A; Mongkolsiriwatana, C; Boonkaew, T; Sawatdichaikul, O; Srikulnath, K; Peyachoknagul, S

    2016-09-19

    The fragrance gene, betaine aldehyde dehydrogenase 2 (Badh2), has been well studied in many plant species. The objectives of this study were to clone Badh2 and compare the sequences between aromatic and non-aromatic coconuts. The complete coding region was cloned from cDNA of both aromatic and non-aromatic coconuts. The nucleotide sequences were highly homologous to Badh2 genes of other plants. Badh2 consisted of a 1512-bp open reading frame encoding 503 amino acids. A single nucleotide difference between aromatic and non-aromatic coconuts resulted in the conversion of alanine (non-aromatic) to proline (aromatic) at position 442, which was the substrate binding site of BADH2. The ring side chain of proline could destabilize the structure leading to a non-functional enzyme. Badh2 genomic DNA was cloned from exon 1 to 4, and from exon 5 to 15 from the two coconut types, except for intron 4 that was very long. The intron sequences of the two coconut groups were highly homologous. No differences in Badh2 expression were found among the tissues of aromatic coconut or between aromatic and non-aromatic coconuts. The amino acid sequences of BADH2 from coconut and other plants were compared and the genetic relationship was analyzed using MEGA 7.0. The phylogenetic tree reconstructed by the Bayesian information criterion consisted of two distinct groups of monocots and dicots. Among the monocots, coconut (Cocos nucifera) and oil palm (Elaeis guineensis) were the most closely related species. A marker for coconut differentiation was developed from one-base substitution site and could be successfully used.

  14. Masked Visual Analysis: Minimizing Type I Error in Visually Guided Single-Case Design for Communication Disorders

    Science.gov (United States)

    Byun, Tara McAllister; Hitchcock, Elaine R.; Ferron, John

    2017-01-01

    Purpose: Single-case experimental designs are widely used to study interventions for communication disorders. Traditionally, single-case experiments follow a response-guided approach, where design decisions during the study are based on participants' observed patterns of behavior. However, this approach has been criticized for its high rate of…

  15. Effects of Calorie Restriction and Fiber Type on Glucose Uptake and Abundance of Electron Transport Chain and Oxidative Phosphorylation Proteins in Single Fibers from Old Rats.

    Science.gov (United States)

    Wang, Haiyan; Arias, Edward B; Yu, Carmen S; Verkerke, Anthony R P; Cartee, Gregory D

    2017-11-09

    Calorie restriction (CR; reducing calorie intake by ~40% below ad libitum) can increase glucose uptake by insulin-stimulated muscle. Because skeletal muscle is comprised of multiple, heterogeneous fiber types, our primary aim was to determine the effects of CR (initiated at 14 weeks old) and fiber type on insulin-stimulated glucose uptake by single fibers of diverse fiber types in 23-26-month-old rats. Isolated epitrochlearis muscles from AL and CR rats were incubated with [3H]-2-deoxyglucose ± insulin. Glucose uptake and fiber type were determined for single fibers dissected from the muscles. We also determined CR-effects on abundance of several key metabolic proteins in single fibers. CR resulted in: (a) significantly (p glucose uptake by insulin-stimulated type I, IIA, IIB, IIBX, and IIX fibers; (b) significantly (p glucose uptake in each fiber type of rat skeletal muscle in the absence of upregulation of the abundance of hexokinase II or key mitochondrial ETC and OxPhos proteins. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Is Stand-Alone Anterior Lumbar Interbody Fusion a Safe and Efficacious Treatment for Isthmic Spondylolisthesis of L5-S1?

    OpenAIRE

    Viglione, Luke L.; Chamoli, Uphar; Diwan, Ashish D.

    2017-01-01

    Study Design: A systematic review. Objective: The objective of this study was to determine the safety and efficacy of stand-alone anterior lumbar interbody fusion (sa-ALIF) for the treatment of symptomatic isthmic spondylolisthesis of L5-S1 by assessing the level of available clinical and radiographic evidence. Methods: A systematic review utilizing Medline, Embase, and Scopus online databases was undertaken. Clinical, radiographic, and adverse outcome data were extracted for the relevant ist...

  17. Preliminary results of anterior lumbar interbody fusion, anterior column realignment for the treatment of sagittal malalignment.

    Science.gov (United States)

    Hosseini, Pooria; Mundis, Gregory M; Eastlack, Robert K; Bagheri, Ramin; Vargas, Enrique; Tran, Stacie; Akbarnia, Behrooz A

    2017-12-01

    OBJECTIVE Sagittal malalignment decreases patients' quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column realignment (ALIF ACR) has been introduced as an alternative for correction of sagittal deformity. The objective of this paper was to report clinical and radiographic results for patients treated using the ALIF-ACR technique. METHODS A retrospective study of 39 patients treated with ALIF ACR was performed. Patient demographics, operative details, radiographic parameters, neurological assessments, outcome measures, and preoperative, postoperative, and mean 1-year follow-up complications were studied. RESULTS The patient population comprised 39 patients (27 females and 12 males) with a mean follow-up of 13.3 ± 4.7 months, mean age of 66.1 ± 11.6 years, and mean body mass index of 27.3 ± 6.2 kg/m 2 . The mean number of ALIF levels treated was 1.5 ± 0.5. Thirty-three (84.6%) of 39 patients underwent posterior spinal fixation and 33 (84.6%) of 39 underwent posterior column osteotomy, of which 20 (60.6%) of 33 procedures were performed at the level of the ALIF ACR. Pelvic tilt, sacral slope, and pelvic incidence were not statistically significantly different between the preoperative and postoperative periods and between the preoperative and 1-year follow-up periods (except for PT between the preoperative and 1-year follow-up, p = 0.018). Sagittal vertical axis, T-1 spinopelvic inclination, lumbar lordosis, pelvic incidence-lumbar lordosis mismatch, intradiscal angle, and motion segment angle all improved from the preoperative to postoperative period and the preoperative to 1-year follow-up (p < 0.05). The changes in motion segment angle and intradiscal angle achieved in the ALIF-ACR group without osteotomy compared with the ALIF-ACR group with osteotomy

  18. Harnessing light energy with a planar transparent hybrid of graphene/single wall carbon nanotube/n-type silicon heterojunction solar cell

    DEFF Research Database (Denmark)

    Chen, Leifeng; Yu, Hua; Zhong, Jiasong

    2015-01-01

    The photovoltaic conversion efficiency of a solar cell fabricated by a simple electrophoretic method with a planar transparent hybrid of graphenes (GPs) and single wall carbon nanotubes (SCNTs)/n-type silicon heterojunction was significantly increased compared to GPs/n-Si and SCNTs/n-Si solar cells...

  19. Erratum : Critical Properties of Spin-1 Antiferromagnetic Heisenberg Chains with Bond Alternation and Uniaxial Single-Ion-Type Anisotropy (vol 69, pg 237, 2000)

    OpenAIRE

    Chen, Wei; 飛田, 和男; Sanctuary, Bryan C.

    2008-01-01

    Original Paper :Critical Properties of Spin-1 Antiferromagnetic Heisenberg Chains with Bond Alternation and Uniaxial Single-Ion-Type AnisotropyWei Chen, Kazuo Hida and Bryan Clifford Sanctuary Journal of the Physical Society of Japan 69 (2000) pp.237-241

  20. MASH test 3-11 of the TxDOT single slope bridge rail (type SSTR) on pan-formed bridge deck

    Science.gov (United States)

    2011-03-01

    The objective of this crash test was to determine whether the TxDOT Single Slope Traffic Rail (Type : SSTR) would perform acceptably on a pan-formed deck when tested according to the guidelines set forth in : Manual for Assessing Safety Hardware (MAS...

  1. Molecular and functional identification of cyclic AMP-sensitive BKCa potassium channels (ZERO variant) and L-type voltage-dependent calcium channels in single rat juxtaglomerular cells

    DEFF Research Database (Denmark)

    Friis, Ulla G; Jørgensen, Finn; Andreasen, Ditte

    2003-01-01

    This study aimed at identifying the type and functional significance of potassium channels and voltage-dependent calcium channels (Ca(v)) in single rat JG cells using whole-cell patch clamp. Single JG cells displayed outward rectification at positive membrane potentials and limited net currents......, respectively. Double immunofluorescence confirmed the presence of BKCa and renin in the same cell. cAMP increased the outward current by 1.6-fold, and this was inhibited by 74% with iberiotoxin. Expression of the cAMP-sensitive splice variant (ZERO) of BKCa was confirmed in single-sampled JG cells by RT...... no effect. We conclude that JG cells express functional cAMP-sensitive BKCa channels (the ZERO splice variant) and voltage-dependent L-type Ca2+ channels....

  2. Dynamic stabilization for L4-5 spondylolisthesis: comparison with minimally invasive transforaminal lumbar interbody fusion with more than 2 years of follow-up.

    Science.gov (United States)

    Kuo, Chao-Hung; Chang, Peng-Yuan; Wu, Jau-Ching; Chang, Hsuan-Kan; Fay, Li-Yu; Tu, Tsung-Hsi; Cheng, Henrich; Huang, Wen-Cheng

    2016-01-01

    OBJECTIVE In the past decade, dynamic stabilization has been an emerging option of surgical treatment for lumbar spondylosis. However, the application of this dynamic construct for mild spondylolisthesis and its clinical outcomes remain uncertain. This study aimed to compare the outcomes of Dynesys dynamic stabilization (DDS) with minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the management of single-level spondylolisthesis at L4-5. METHODS This study retrospectively reviewed 91 consecutive patients with Meyerding Grade I spondylolisthesis at L4-5 who were managed with surgery. Patients were divided into 2 groups: DDS and MI-TLIF. The DDS group was composed of patients who underwent standard laminectomy and the DDS system. The MI-TLIF group was composed of patients who underwent MI-TLIF. Clinical outcomes were evaluated by visual analog scale for back and leg pain, Oswestry Disability Index, and Japanese Orthopaedic Association scores at each time point of evaluation. Evaluations included radiographs and CT scans for every patient for 2 years after surgery. RESULTS A total of 86 patients with L4-5 spondylolisthesis completed the follow-up of more than 2 years and were included in the analysis (follow-up rate of 94.5%). There were 64 patients in the DDS group and 22 patients in the MI-TLIF group, and the overall mean follow-up was 32.7 months. Between the 2 groups, there were no differences in demographic data (e.g., age, sex, and body mass index) or preoperative clinical evaluations (e.g., visual analog scale back and leg pain, Oswestry Disability Index, and Japanese Orthopaedic Association scores). The mean estimated blood loss of the MI-TLIF group was lower, whereas the operation time was longer compared with the DDS group (both p spondylolisthesis at L4-5. DDS might be an alternative to standard arthrodesis in mild lumbar spondylolisthesis. However, unlike fusion, dynamic implants have issues of wearing and loosening in the long term

  3. Fracture of the L-4 vertebral body after use of a stand-alone interbody fusion device in degenerative spondylolisthesis for anterior L3-4 fixation.

    Science.gov (United States)

    Kwon, Yoon-Kwang; Jang, Ju-Hee; Lee, Choon-Dae; Lee, Sang-Ho

    2014-06-01

    Many studies attest to the excellent results achieved using anterior lumbar interbody fusion (ALIF) for degenerative spondylolisthesis. The purpose of this report is to document a rare instance of L-4 vertebral body fracture following use of a stand-alone interbody fusion device for L3-4 ALIF. The patient, a 55-year-old man, had suffered intractable pain of the back, right buttock, and left leg for several weeks. Initial radiographs showed Grade I degenerative spondylolisthesis, with instability in the sagittal plane (upon 15° rotation) and stenosis of central and both lateral recesses at the L3-4 level. Anterior lumbar interbody fusion of the affected vertebrae was subsequently conducted using a stand-alone cage/plate system. Postoperatively, the severity of spondylolisthesis diminished, with resolution of symptoms. However, the patient returned 2 months later with both leg weakness and back pain. Plain radiographs and CT indicated device failure due to anterior fracture of the L-4 vertebral body, and the spondylolisthesis had recurred. At this point, bilateral facetectomies were performed, with reduction/fixation of L3-4 by pedicle screws. Again, degenerative spondylolisthesis improved postsurgically and symptoms eased, with eventual healing of the vertebral body fracture. This report documents a rare instance of L-4 vertebral body fracture following use of a stand-alone device for ALIF at L3-4, likely as a consequence of angular instability in degenerative spondylolisthesis. Under such conditions, additional pedicle screw fixation is advised.

  4. [Biomechanicsl evaluation of a stand-alone interbody fusion cage based on porous TiO2/glass-ceramic on the human cervical spine].

    Science.gov (United States)

    Korinth, M C; Moersch, S; Ragoss, C; Schopphoff, E

    2003-12-01

    Recently, there has been a rapid increase in the use of cervical spine interbody fusion cages, differing in design and biomaterial used, in competition to autologous iliac bone graft and bone cement (PMMA). Limited biomechanical differences in primary stability, as well as advantages and disadvantages of each cage or material have been investigated in studies, using an in vitro human cervical spine model. 20 human cervical spine specimens were tested after fusion with either a cubical stand-alone interbody fusion cage manufactured from a new porous TiO2/glass composite (Ecopore) or PMMA after discectomy. Non-destructive biomechanical testing was performed, including flexion/extension and lateral bending using a spine testing apparatus. Three-dimensional segmental range of motion (ROM) was evaluated using an ultrasound measurement system. ROM increased more in flexion/extension and lateral bending after PMMA fusion (26.5%/36.1%), then after implantation of the Ecopore-cage (8.1%/7.8%). In this first biomechanical in vitro examination of a new porous ceramic bone replacement material a) the feasibility and reproducibility of biomechanical cadaveric cervical examination and its applicability was demonstrated, b) the stability of the ceramic cage as a stand alone interbody cage was confirmed in vitro, and c) basic information and knowledge for our intended biomechanical and histological in vivo testing, after implantation of Ecopore in cervical sheep spines, were obtained.

  5. Aerosol optical properties at Lampedusa (Central Mediterranean. 2. Determination of single scattering albedo at two wavelengths for different aerosol types

    Directory of Open Access Journals (Sweden)

    D. Meloni

    2006-01-01

    Full Text Available Aerosol optical properties were retrieved from direct and diffuse spectral irradiance measurements made by a multi-filter rotating shadowband radiometer (MFRSR at the island of Lampedusa (35.5° N, 12.6° E, in the Central Mediterranean, in the period July 2001–September 2003. In a companion paper (Pace et al., 2006 the aerosol optical depth (AOD and Ångström exponent were used together with airmass backward trajectories to identify and classify different aerosol types. The MFRSR diffuse-to-direct ratio (DDR at 415.6 nm and 868.7 nm for aerosol classified as 'biomass burning-urban/industrial', originating primarily from the European continent, and desert dust, originating from the Sahara, is used in this study to estimate the aerosol single scattering albedo (SSA. A detailed radiative transfer model is initialised with the measured aerosol optical depth; calculations are performed at the two wavelengths varying the SSA values until the modelled DDR matches the MFRSR observations. Sensitivity studies are performed to estimate how uncertainties on AOD, DDR, asymmetry factor (g, and surface albedo influence the retrieved SSA values. The results show that a 3% variation of AOD or DDR produce a change of about 0.02 in the retrieved SSA value at 415.6 and 868.7 nm; a ±0.06 variation of the asymmetry factor g produces a change of the estimated SSA of <0.04 at 415.6 nm, and <0.06 at 868.7 nm; finally, an increase of the assumed surface albedo of 0.05 causes very small changes (0.01–0.02 in the retrieved SSA. The calculations show that the SSA of desert dust (DD increases with wavelength, from 0.81±0.05 at 415.6 nm to 0.94±0.05 at 868.7 nm; on the contrary, the SSA of urban/industrial (UN aerosols decreases from 0.96±0.02 at 415.6 nm to 0.87±0.07 at 868.7 nm; the SSA of biomass burning (BB particles is 0.82±0.04 at 415.6 nm and 0.80±0.05 at 868.7 nm. Episodes of UN aerosols occur usually in June and July; long lasting BB aerosol episodes

  6. Single-mode amplification in Yb-doped rod-type photonic crystal fibers for high brilliance lasers

    DEFF Research Database (Denmark)

    Poli, F.; Lægsgaard, Jesper; Passaro, D.

    2009-01-01

    to identify a proper ring characteristic that is width, position and refractive index. Then rod-type PCF designs have been optimized with a full-vector modal solver based on the finite-element method. Then, the amplification properties of the Yb-doped rod-type PCFs have been investigated by assuming a forward...

  7. Linear viral load increase of a single HPV-type in women with multiple HPV infections predicts progression to cervical cancer.

    Science.gov (United States)

    Depuydt, Christophe E; Thys, Sofie; Beert, Johan; Jonckheere, Jef; Salembier, Geert; Bogers, Johannes J

    2016-11-01

    Persistent high-risk human papillomavirus (HPV) infection is strongly associated with development of high-grade cervical intraepithelial neoplasia or cancer (CIN3+). In single type infections, serial type-specific viral-load measurements predict the natural history of the infection. In infections with multiple HPV-types, the individual type-specific viral-load profile could distinguish progressing HPV-infections from regressing infections. A case-cohort natural history study was established using samples from untreated women with multiple HPV-infections who developed CIN3+ (n = 57) or cleared infections (n = 88). Enriched cell pellet from liquid based cytology samples were subjected to a clinically validated real-time qPCR-assay (18 HPV-types). Using serial type-specific viral-load measurements (≥3) we calculated HPV-specific slopes and coefficient of determination (R(2) ) by linear regression. For each woman slopes and R(2) were used to calculate which HPV-induced processes were ongoing (progression, regression, serial transient, transient). In transient infections with multiple HPV-types, each single HPV-type generated similar increasing (0.27copies/cell/day) and decreasing (-0.27copies/cell/day) viral-load slopes. In CIN3+, at least one of the HPV-types had a clonal progressive course (R(2)  ≥ 0.85; 0.0025copies/cell/day). In selected CIN3+ cases (n = 6), immunostaining detecting type-specific HPV 16, 31, 33, 58 and 67 RNA showed an even staining in clonal populations (CIN3+), whereas in transient virion-producing infections the RNA-staining was less in the basal layer compared to the upper layer where cells were ready to desquamate and release newly-formed virions. RNA-hybridization patterns matched the calculated ongoing processes measured by R(2) and slope in serial type-specific viral-load measurements preceding the biopsy. In women with multiple HPV-types, serial type-specific viral-load measurements predict the natural history of the

  8. The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: A Pilot study

    Directory of Open Access Journals (Sweden)

    Chung Sung-Soo

    2011-04-01

    Full Text Available Abstract Background Comparatively little is known about the relation between the sagittal vertical axis and clinical outcome in cases of degenerative lumbar spondylolisthesis. The objective of this study was to determine whether lumbar sagittal balance affects clinical outcomes after posterior interbody fusion. This series suggests that consideration of sagittal balance during posterior interbody fusion for degenerative spondylolisthesis can yield high levels of patient satisfaction and restore spinal balance Methods A retrospective study of clinical outcomes and a radiological review was performed on 18 patients with one or two level degenerative spondylolisthesis. Patients were divided into two groups: the patients without improvement in pelvic tilt, postoperatively (Group A; n = 10 and the patients with improvement in pelvic tilt postoperatively (Group B; n = 8. Pre- and postoperative clinical outcome surveys were administered to determine Visual Analogue Pain Scores (VAS and Oswestry disability index (ODI. In addition, we evaluated full spine radiographic films for pelvic tilt (PT, sacral slope (SS, pelvic incidence (PI, thoracic kyphosis (TK, lumbar lordosis (LL, sacrofemoral distance (SFD, and sacro C7 plumb line distance (SC7D Results All 18 patients underwent surgery principally for the relief of radicular leg pain and back pain. In groups A and B, mean preoperative VAS were 6.85 and 6.81, respectively, and these improved to 3.20 and 1.63 at last follow-up. Mean preoperative ODI were 43.2 and 50.4, respectively, and these improved to 23.6 and 18.9 at last follow-up. In spinopelvic parameters, no significant difference was found between preoperative and follow up variables except PT in Group A. However, significant difference was found between the preoperative and follows up values of PT, SS, TK, LL, and SFD/SC7D in Group B. Between parameters of group A and B, there is borderline significance on preoperative PT, preoperative LL and last

  9. Treatment of degenerative lumbar spondylolisthesis by using minimally invasive transforaminal lumbar interbody fusion and percutaneous pedicle screw fixation

    Directory of Open Access Journals (Sweden)

    Hao WU

    2016-04-01

    Full Text Available Objective To discuss clinical therapeutic effects of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF combined with percutaneous pedicle screw fixation for degenerative lumbar spondylolisthesis (DLS.  Methods A total of 32 DLS patients treated by MIS-TLIF and percutaneous pedicle screw fixation from January 2013 to September 2015 in Xuanwu Hospital, Capital Medical University were retrospectively reviewed. Visual Analogue Scale (VAS, Oswestry Disability Index (ODI and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 scores were assessed and compared between preoperation and one week, 3 months after operation and in the last follow-up. Lumbar lordosis angle, coronal Cobb angle, coronal and sagittal body shifting, complication, the degree of spondylolisthesis (Meyerding classification and the rate of spondylolisthesis were measured according to preoperative and postoperative spinal X-ray examination. Fusion rate was evaluated according to X-rays or CT in the last follow-up, and MRI was used to assess the degree of decompression.  Results Thirty-two patients were under test with mean operation time 160 min, intraoperative blood loss 120 ml, postoperative hospital stay 7.22 d and follow-up 10.83 months. Decompression and fusion levels ranged from L2-S1 and interbody fusion was performed in 32 patients and 41 levels were fused. Compared with preoperation, the VAS and ODI scores were significantly increased at one week, 3 months after operation and in the last follow-up (P = 0.000, for all, while SF-36 score (P = 0.002, 0.000, 0.000, lumbar lordotic angle (P = 0.000, for all, coronal Cobb angle (P = 0.000, for all and slippage rate (P = 0.000, for all were significantly decreased. The fusion rate was 92.22%, and the improvement rate of ODI was (80.51 ± 6.02% in the last follow-up. There were 3 cases appeared complications, including one case of infection and 2 cases of cerebrospinal fluid (CSF fistula, and were

  10. Synthesis of a wild-type and three mutant Cucurbita maxima trypsin inhibitor-encoding genes by a single-strand approach.

    Science.gov (United States)

    Botes, D P; Qobose, M D; Corfield, V A

    1991-09-15

    A single-strand approach to gene assembly, based on a modification of an in vitro complementary oligodeoxyribonucleotide template-directed ligation of the desired sequence to a linearized vector [Chen et al., Nucleic Acids Res. 18 (1990) 871-878], is described. The gene coding for the wild-type Cucurbita maxima trypsin inhibitor of 29 amino acid residues [Bode et al., FEBS Lett. 242 (1989) 285-292], as well as three mutant forms of the gene, in which two of the three disulfide bonds have been replaced singly or as a pair, have been synthesized in a single synthesis run with minimal manual intervention. Subsequent to ligation to pUC9 and in vivo gapped duplex repair by Escherichia coli, their sequences have been verified.

  11. Comparison of the effect of multiple short-duration with single long-duration exercise sessions on glucose homeostasis in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Eriksen, L; Dahl-Petersen, I; Haugaard, Steen B

    2007-01-01

    AIMS/HYPOTHESIS: We evaluated and compared the effects on glycaemic control of two different exercise protocols in elderly men with type 2 diabetes mellitus. METHODS: Eighteen patients with type 2 diabetes mellitus carried out home-based bicycle training for 5 weeks. Patients were randomly assigned...... glucose OGTT (p = 0.04) and plasma glucose concentration areas under the curve at 120 min (p exercise groups...... increased similarly in both exercise groups. A possible explanation is that the energy expenditure associated with multiple short daily sessions may be greater than that in a single daily session. Udgivelsesdato: 2007-Nov...

  12. Types of work-related behavior and experiences and stress coping strategies among single mothers and mothers in relationships differentiating role of work satisfaction.

    Science.gov (United States)

    Napora, Elżbieta; Andruszkiewicz, Anna; Basińska, Małgorzata Anna

    2018-01-01

    The purpose of the study has been to describe functioning of single and mothers in relationships (married or in informal relationships) at work and verify if the declared degree of work satisfaction differentiates types of behavior at work and stress coping strategies in both groups of mothers. The study was conducted on equal samples of single mothers (N = 186) and mothers from 2-parent families (N = 186) using Latack Coping Scale that measures work-related stress coping strategies, the AVEM (Arbeitsbezogenes Verhaltens- und Erlebensmuster - Work-Related Behavior and Experience Pattern) questionnaire, and a survey. It showed similarity between the studied groups in terms of the measured variables. There were considerable differences between single and married mothers in terms of support seeking strategies. The interaction of work satisfaction and the type of motherhood significantly differentiates (p = 0.03) the avoidance strategy of resignation. That strategy of resignation was more frequently used by single mothers with lower work satisfaction, who were distinctly different from those whose work satisfaction was higher, and from the mothers in relationships (married or in informal relationships) (regardless of the level of their work satisfaction). Int J Occup Med Environ Health 2018;31(1):55-69. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  13. P-type single-crystalline ZnO films obtained by (Na,N) dual implantation through dynamic annealing process

    Science.gov (United States)

    Zhang, Zhiyuan; Huang, Jingyun; Chen, Shanshan; Pan, Xinhua; Chen, Lingxiang; Ye, Zhizhen

    2018-02-01

    Single-crystalline ZnO films were grown by plasma-assisted molecular beam epitaxy technique on c-plane sapphire substrates. The films have been implanted with fixed fluence of 130 keV Na and 90 keV N ions at 460 °C. It is observed that dually-implanted single crystalline ZnO films exhibit p-type characteristics with hole concentration in the range of 1.24 × 1016-1.34 × 1017 cm-3, hole mobilities between 0.65 and 8.37 cm2 V-1 s-1, and resistivities in the range of 53.3-80.7 Ω cm by Hall-effect measurements. There are no other secondary phase appearing, with (0 0 2) (c-plane) orientation after ion implantation as identified by the X-ray diffraction pattern. It is obtained that Na and N ions were successfully implanted and activated as acceptors measured by XPS and SIMS results. Also compared to other similar studies, lower amount of Na and N ions make p-type characteristics excellent as others deposited by traditional techniques. It is concluded that Na and N ion implantation and dynamic annealing are essential in forming p-type single-crystalline ZnO films.

  14. Comparing the capitalisation benefits of light-rail transit and overlay zoning for single-family houses and condos by neighbourhood type in metropolitan Phoenix, Arizona.

    Science.gov (United States)

    Atkinson-Palombo, Carol

    2010-01-01

    Light rail transit (LRT) is increasingly accompanied by overlay zoning which specifies the density and type of future development to encourage landscapes conducive to transit use. Neighbourhood type (based on land use mix) is used to partition data and investigate how pre-existing land use, treatment with a park-and-ride (PAR) versus walk-and-ride (WAR) station and overlay zoning interrelate. Hedonic models estimate capitalisation effects of LRT-related accessibility and overlay zoning on single-family houses and condos in different neighbourhoods for the system in metropolitan Phoenix, Arizona. Impacts differ by housing and neighbourhood type. Amenity-dominated mixed-use neighbourhoods-predominantly WAR communities-experience premiums of 6 per cent for single-family houses and over 20 per cent for condos, the latter boosted an additional 37 per cent by overlay zoning. Residential neighbourhoods-predominantly PAR communities-experience no capitalisation benefits for single-family houses and a discount for condos. The results suggest that land use mix is an important variable to select comparable neighbourhoods.

  15. Diagnosis of Single- or Multiple-Canal Benign Paroxysmal Positional Vertigo according to the Type of Nystagmus

    Science.gov (United States)

    Balatsouras, Dimitris G.; Koukoutsis, George; Ganelis, Panayotis; Korres, George S.; Kaberos, Antonis

    2011-01-01

    Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics. It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test. Current clinical research focused on diagnosing and treating various types of BPPV, according to the semicircular canal involved and according to the implicated pathogenetic mechanism. Cases of multiple-canal BPPV have been specifically investigated because until recently these were resistant to treatment with standard canalith repositioning procedures. Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers. We describe in detail the various types of nystagmus, according to the canals involved, which are the keypoint to accurate diagnosis. PMID:21792356

  16. Minimally invasive lateral transpsoas interbody fusion using a stand-alone construct for the treatment of adjacent segment disease of the lumbar spine: review of the literature and report of three cases.

    Science.gov (United States)

    Palejwala, Sheri K; Sheen, Whitney A; Walter, Christina M; Dunn, Jack H; Baaj, Ali A

    2014-09-01

    We describe 3 patients who presented with radiographic signs and clinical symptoms of adjacent segment disease several years after undergoing L4-S1 posterior pedicle screw fusion. All patients underwent successful lateral lumbar interbody fusion (LLIF) at 1-2 levels above their previous constructs, using stand-alone cages, with complete resolution of radiculopathy and a significant improvement in low-back pain. In addition to a thorough analysis of these cases, we review the pertinent literature regarding treatment options for adjacent segment disease and the applications of the lateral lumbar interbody technique. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Posterior lumbar interbody fusion and posterolateral fusion: Analogous procedures in decreasing the index of disability in patients with spondylolisthesis.

    Science.gov (United States)

    Alijani, Babak; Emamhadi, Mohamahreza; Behzadnia, Hamid; Aramnia, Ali; Chabok, Shahrokh Yousefzadeh; Ramtinfar, Sara; Leili, Ehsan Kazemnejad; Golmohamadi, Shabnam

    2015-01-01

    The purpose of this study was to evaluate the disability in patients with spondylolisthesis who assigned either to posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF) and to compare it between two groups. In a prospective observational study, 102 surgical candidates with low-grade degenerative and isthmic spondylolisthesis enrolled from 2012 to 2014, and randomly assigned into two groups: PLF and PLIF. Evaluation of disability has been done by a questionnaire using Oswestry Disability Index (ODI). The questionnaire was completed by all patients before the surgery, the day after surgery, after 6 months and after 1-year. There were no statistically significant differences in terms of age and sex distribution and pre-operation ODI between groups (P > 0.05). Comparison of the mean ODI scores of two groups over the whole study period showed no significant statistical difference (P = 0.074). ODIs also showed no significant differences between two groups the day after surgery, 6(th) months and 1-year after surgery (P = 0.385, P = 0.093, P = 0.122 and P = 433) respectively. Analyzing the course of ODI over the study period, showed a significant descending pattern for either of groups (P disability of patients with spondylolisthesis, and none of the fusion techniques were related to a better outcome in terms of disability.

  18. Transforaminal lumbar interbody fusion using unilateral pedicle screw fixation plus contralateral translaminar facet screw fixation in lumbar degenerative diseases.

    Science.gov (United States)

    Liu, Fubing; Jiang, Chun; Cao, Yuanwu; Jiang, Xiaoxing; Feng, Zhenzhou

    2014-07-01

    Transforaminal lumbar interbody fusion (TLIF) has been used in lumbar degenerative diseases. Some researchers have applied unilateral fixation in TLIF to reduce operational trauma without compromising the clinical outcome, but it is always suspected biomechanically unstable. The supplementary contralateral translaminar facet screw (cTLFS) seemed to be able to overcome the inherent drawbacks of unilateral pedicle screw (uPS) fixation theoretically. This study evaluates the safety, feasibility and efficacy of TLIF using uPS with cTLFS fixation in the treatment of lumbar degenerative diseases (LDD). 50 patients (29 male) underwent the aforementioned surgical technique for their LDD between December 2009 and April 2012. The results were evaluated based on visual analogue scale (VAS) of the leg and back, Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were recorded. The radiographic examinations in form of X-ray, computed tomography (CT) or magnetic resonance imaging was done preoperatively and 1 week, 3 months, 6 months, 12 months and 24 months postoperatively. The student t-test was used for comparison between the preoperative values and postoperative counterparts. P degenerative diseases short termly.

  19. Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique.

    Science.gov (United States)

    Kueper, Janina; Fantini, Gary A; Walker, Brendon R; Aichmair, Alexander; Hughes, Alexander P

    2015-04-01

    This article examines the incidence and management of vascular injury during Lateral Lumbar Interbody Fusion (LLIF). The details of the mini-open access technique are presented. A total of 900 patients who underwent a LLIF at an average 1.94 levels (range: 1-5 levels) by one of six fellowship trained surgeons on 1,754 levels from 2006 to 2013 were identified. The incidence of intraoperative vascular injury was retrospectively determined from the Operative Records. The management of vascular injury was evaluated. The mini-open access adapted by our institution for LLIF is described. The incidence of major vascular complication in our series was 1/900. The incidence of minor vascular injury was 4/900. The overall incidence of vascular injury was calculated to be 0.056 % per case and 0.029 % per level. All minor vascular injuries were identified to be segmental vessel lacerations, which were readily ligated under direct visualization without further extension of the incision with no clinical sequelae. The laceration of the abdominal aorta, the major vascular complication of this series, was emergently repaired through an exploratory laparotomy. None of the patients suffered long-term sequelae from their intraoperative vascular injuries. The mini-open lateral access technique for LLIF provides for minimal risk of vascular injury to the lumbar spine. In the rare event of minor vascular injury, the mini-open access approach allows for immediate visualization, confirmation and repair of the vessel with no long-term sequelae.

  20. Subsidence of Cylindrical Cage (AMSLU™ Cage) : Postoperative 1 Year Follow-up of the Cervical Anterior Interbody Fusion

    Science.gov (United States)

    Joung, Young Il; Ko, Yong; Yi, Hyeong Joong; Lee, Seung Ku

    2007-01-01

    Objective There are numerous reports on the primary stabilizing effects of the different cervical cages for cervical radiculopathy. But, little is known about the subsidence which may be clinical problem postoperatively. The goal of this study is to evaluate subsidence of cage and investigate the correlation between radiologic subsidence and clinical outcome. Methods To assess possible subsidence, the authors investigated clinical and radiological results of the one-hundred patients who underwent anterior cervical fusion by using AMSLU™ cage during the period between January 2003 and June 2005. Preoperative and postoperative lateral radiographs were measured for height of intervertebral disc space where cages were placed. Intervertebral disc space was measured by dividing the sum of anterior, posterior, and midpoint interbody distance by 3. Follow-up time was 6 to 12 months. Subsidence was defined as any change in at least one of our parameters of at least 3 mm. Results Subsidence was found in 22 patients (22%). The mean value of subsidence was 2.21 mm, and mean subsidence rate was 22%. There were no cases of the clinical status deterioration during the follow-up period. No posterior or anterior migration was observed. Conclusion The phenomenon of subsidence is seen in substantial number of patients. Nevertheless, clinical and radiological results of the surgery were favorable. An excessive subsidence may result in hardware failure. Endplate preservation may enables us to control subsidence and reduce the number of complications. PMID:19096571

  1. Diffuse idiopathic skeletal hyperostosis (DISH) is a risk factor for further surgery in short-segment lumbar interbody fusion.

    Science.gov (United States)

    Otsuki, Bungo; Fujibayashi, Shunsuke; Takemoto, Mitsuru; Kimura, Hiroaki; Shimizu, Takayoshi; Matsuda, Shuichi

    2015-11-01

    To elucidate the effect of diffuse idiopathic skeletal hyperostosis (DISH) on the clinical results of short-segment lumbar interbody fusion (LIF) for the treatment of degenerative lumbar spinal diseases. The 208 patients who underwent one- or two-level LIF were selected as the subjects of this study. Patients with prior lumbar fusion surgery or follow-up adjacent segment disease (ASD). The Cox proportional-hazards model was used to identify possible risk factors (DISH, age, sex, number of levels fused, level of the lowest instrumented vertebra, and laminectomy adjacent to the index fused levels) for further surgery. Among the 208 patients (39 with DISH), 21 patients required further surgery during follow-up. Cox analysis showed that DISH (hazard ratio = 5.46) and two-level fusion (hazard ratio = 2.83) were significant independent predictors of further surgery. Age, sex, level of the lowest instrumented vertebra, and laminectomy adjacent to the index fused levels were not significant predictors. DISH after short-segment LIF surgery is a significant risk factor for further surgery because of pseudoarthrosis or ASD.

  2. Comparison of Topping-off and posterior lumbar interbody fusion surgery in lumbar degenerative disease: a retrospective study.

    Science.gov (United States)

    Liu, Hai-ying; Zhou, Jian; Wang, Bo; Wang, Hui-min; Jin, Zhao-hui; Zhu, Zhen-qi; Miao, Ke-nan

    2012-11-01

    Topping-off surgery is a newly-developed surgical technique which combines rigid fusion with an interspinous process device in the adjacent segment to prevent adjacent segment degeneration. There are few reports on Topping-off surgery and its rationality and indications remains highly controversial. Our study aims to investigate the short-term and mid-term clinical results of Topping-off surgery in preventing adjacent segment degeneration when mild or moderate adjacent segment degeneration existed before surgery. The 25 cases that underwent L5-S1 posterior lumbar interbody fusion (PLIF) + L4-L5 interspinous process surgeries between April 2008 and March 2010 formed Topping-off group. The 42 cases undergoing L5-S1 PLIF surgery formed PLIF group. Both groups matched in gender, age, body mass index and Pfirrmann grading (4 to 6). The patients were evaluated with visual analogue scale (VAS) and Japanese orthopaedic association (JOA) scores before surgery and in the last follow-up. Modic changes of endplates were recorded. The follow-up averaged 24.8 and 23.7 months. No symptomatic or radiological adjacent segment degeneration was observed. There was no significant difference in intraoperative blood loss or postoperative drainage. VAS and lumbar JOA scores improved significantly in both groups (t = 12.1 and 13.5, P adjacent segment degeneration, restrict the adjacent segment's ROM in extension and prevent excessive olisthesis of adjacent segment in both extension and flexion.

  3. Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis.

    Science.gov (United States)

    Huang, Yun-Peng; Du, Cheng-Fei; Cheng, Cheng-Kung; Zhong, Zheng-Cheng; Chen, Xuan-Wei; Wu, Gui; Li, Zhe-Cheng; Ye, Jin-Duo; Lin, Jian-Hua; Wang, Li Zhen

    2016-01-01

    To investigate the biomechanical effects of the lumbar posterior complex on the adjacent segments after posterior lumbar interbody fusion (PLIF) surgeries. A finite element model of the L1-S1 segment was modified to simulate PLIF with total laminectomy (PLIF-LAM) and PLIF with hemilaminectomy (PLIF-HEMI) procedures. The models were subjected to a 400N follower load with a 7.5-N.m moment of flexion, extension, torsion, and lateral bending. The range of motion (ROM), intradiscal pressure (IDP), and ligament force were compared. In Flexion, the ROM, IDP and ligament force of posterior longitudinal ligament, intertransverse ligament, and capsular ligament remarkably increased at the proximal adjacent segment in the PLIF-LAM model, and slightly increased in the PLIF-HEMI model. There was almost no difference for the ROM, IDP and ligament force at L5-S1 level between the two PLIF models although the ligament forces of ligamenta flava remarkably increased compared with the intact lumbar spine (INT) model. For the other loading conditions, these two models almost showed no difference in ROM, IDP and ligament force on the adjacent discs. Preserved posterior complex acts as the posterior tension band during PLIF surgery and results in less ROM, IDP and ligament forces on the proximal adjacent segment in flexion. Preserving the posterior complex during decompression can be effective on preventing adjacent segment degeneration (ASD) following PLIF surgeries.

  4. A common single nucleotide polymorphism can exacerbate long-QT type 2 syndrome leading to sudden infant death

    DEFF Research Database (Denmark)

    Nof, Eyal; Cordeiro, Jonathan M; Pérez, Guillermo J

    2010-01-01

    and mutation expressed singly and in combination in Chinese ovary (CHO-K1) and COS-1 cells. An asymptomatic woman presenting after the death of her 2-day-old infant and spontaneous abortion of a second baby in the first trimester was referred for genetic analysis. The newborn infant had nearly incessant...... suggest that a common polymorphism (K897T) can markedly accentuate the loss of function of mildly defective HERG channels, leading to long-QT syndrome-mediated arrhythmias and sudden infant death....

  5. Clinical characteristics of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years: A single-center experience

    Directory of Open Access Journals (Sweden)

    Yi-Chen Chen

    2017-05-01

    Conclusion: Autoimmune destruction of pancreatic β-cells is an important cause of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years. These patients usually have a low insulin reserve and severe ketoacidosis upon diagnosis. A high index of suspicion in the presence of classic symptoms of diabetes in young children is important to prevent complications.

  6. From the Cover: Vulnerability of C6 Astrocytoma Cells After Single-Compound and Joint Exposure to Type I and Type II Pyrethroid Insecticides.

    Science.gov (United States)

    Romero, Delfina M; Berardino, Bruno G; Wolansky, Marcelo J; Kotler, Mónica L

    2017-01-01

    A primary mode-of-action of all pyrethroid insecticides (PYRs) is the disruption of the voltage-gated sodium channel electrophysiology in neurons of target pests and nontarget species. The neurological actions of PYRs on non-neuronal cells of the nervous system remain poorly investigated. In the present work, we used C6 astrocytoma cells to study PYR actions (0.1-50 μM) under the hypothesis that glial cells may be targeted by and vulnerable to PYRs. To this end, we characterized the effects of bifenthrin (BF), tefluthrin (TF), α-cypermethrin (α-CYP), and deltamethrin (DM) on the integrity of nuclear, mitochondrial, and lysosomal compartments. In general, 24- to 48-h exposures produced concentration-related impairment of cell viability. In single-compound, 24-h exposure experiments, effective concentration (EC) 15 s 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT assay) were computed as follows (in μM): BF, 16.1; TF, 37.3; α-CYP, 7.8; DM, 5.0. We found concentration-related damage in several C6-cell subcellular compartments (mitochondria, nuclei, and lysosomes) at ≥ 10 -1 μM levels. Last, we examined a mixture of all PYRs (ie, Σ individual EC 15 ) using MTT assays and subcellular analyses. Our findings indicate that C6 cells are responsive to nM levels of PYRs, suggesting that astroglial susceptibility may contribute to the low-dose neurological effects caused by these insecticides. This research further suggests that C6 cells may provide relevant information as a screening platform for pesticide mixtures targeting nervous system cells by expected and unexpected toxicogenic pathways potentially contributing to clinical neurotoxicity. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. Self-Assembly of "Chalcone" Type Push-Pull Dye Molecules into Organic Single Crystalline Microribbons and Rigid Microrods for Vis/NIR Range Photonic Cavity Applications.

    Science.gov (United States)

    Vattikunta, Radhika; Venkatakrishnarao, Dasari; Mohiddon, Mahamad Ahamad; Chandrasekar, Rajadurai

    2016-11-04

    A novel supramolecular fluorescent donor-acceptor type dye molecule, (2E,4E)-1-(2-hydroxyphenyl)-5-(pyren-1-yl)penta-2,4-dien-1-one (HPPD) self-assembles in a mixture of ethanol/chloroform through intermolecular π-π stacking (distance ca. 3.384 Å) to form J-aggregated single-crystalline microribbons displaying Fabry-Pèrot (F-P) type visible-range optical resonance. The corresponding borondifluoride dye (HPPD-BF), with a reduced HOMO-LUMO gap, self-assembles into crystalline microrods acting as an F-P type resonator in the near-infrared (NIR) range. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Component Analysis of Unsteady Hydrodynamic Force of Closed-Type Centrifugal Pump with Single Blades of Different Blade Outlet Angles

    Directory of Open Access Journals (Sweden)

    Yasuyuki Nishi

    2015-01-01

    Full Text Available Single-blade centrifugal impellers for sewage systems undergo both unsteady radial and axial thrusts. Therefore, it is extremely important for the improvement of pump reliability to quantitatively grasp these fluctuating hydrodynamic forces and determine the generation mechanism behind them. In this study, we conducted component analyses of radial and axial thrusts of closed, single-blade centrifugal pumps with different blade outlet angles by numerical analysis while considering leakage flow. The results revealed the effect of the blade outlet angle on the components of radial and axial thrusts. For increased flow rates, the time-averaged values of the pressure component were similar for all impellers, although its fluctuating components were higher for impellers with larger blade outlet angles. Moreover, the fluctuating inertia component of the impeller with a blade outlet angle of 8° decreased as the flow rate increased, whereas those with 16° and 24° angles increased. Therefore, the radial thrust on the hydraulic part was significantly higher for impellers with high blade outlet angles.

  9. New vibrational mode of the acoustic type in Nd(Pr)2 Cu O4 single crystals

    International Nuclear Information System (INIS)

    Fil', D.V.; Kolobov, I.G.; Fil', V.D.; Barilo, S.N.; Zhigunov, D.I.

    1995-01-01

    Sound velocities along main symmetry directions as well as their angle dependences in (100),(110)-type planes are measured in Nd(Pr) 2 Cu O 4 . Anomalies in the angle dependences are found, which are interpreted as a result of the interaction of elastic vibrations with an additional plane mode of the acoustic type. According to the proposed interpretation, the bare spectrum of the additional mode is two-dimensional, and the origin of the mode is connected with the electron degrees of freedom in the Cu O 2 -planes. A phenomenological model for description of acoustic mode spectra in the investigated systems is proposed. On the basis of the anion model of HTSC, a possible microscopic scenario of the appearance of the additional mode is analyzed. In the framework of the phenomenological model, the Debye temperatures are computed, which are in agreement with the specific heat data. The values of the components of the elastic moduli tensor are given

  10. Comparison of the quench and fault current limiting characteristics of the flux-coupling type SFCL with single and three-phase transformer

    International Nuclear Information System (INIS)

    Jung, Byung Ik; Cho, Yong Sun; Park, Hyoung Min; Chung, Dong Chul; Choi, Hyo Sang

    2013-01-01

    Highlight: ► Comparison of quench and fault-current-limiting behavior of SFCLs by Tr type. -- Abstract: The South Korean power grid has a network structure for the flexible operation of the system. The continuously increasing power demand necessitated the increase of power facilities, which decreased the impedance in the power system. As a result, the size of the fault current in the event of a system fault increased. As this increased fault current size is threatening the breaking capacity of the circuit breaker, the main protective device, a solution to this problem is needed. The superconducting fault current limiter (SFCL) has been designed to address this problem. SFCL supports the stable operation of the circuit breaker through its excellent fault-current-limiting operation [1–5]. In this paper, the quench and fault current limiting characteristics of the flux-coupling-type SFCL with one three-phase transformer were compared with those of the same SFCL type but with three single-phase transformers. In the case of the three-phase transformers, both the superconducting elements of the fault and sound phases were quenched, whereas in the case of the single-phase transformer, only that of the fault phase was quenched. For the fault current limiting rate, both cases showed similar rates for the single line-to-ground fault, but for the three-wire earth fault, the fault current limiting rate of the single-phase transformer was over 90% whereas that of the three-phase transformer was about 60%. It appears that when the three-phase transformer was used, the limiting rate decreased because the fluxes by the fault current of each phase were linked in one core. When the power loads of the superconducting elements were compared by fault type, the initial (half-cycle) load was great when the single-phase transformer was applied, whereas for the three-phase transformer, its power load was slightly lower at the initial stage but became greater after the half fault cycle

  11. Structure of the mycobacterial ESX-5 type VII secretion system membrane complex by single-particle analysis.

    Science.gov (United States)

    Beckham, Katherine S H; Ciccarelli, Luciano; Bunduc, Catalin M; Mertens, Haydyn D T; Ummels, Roy; Lugmayr, Wolfgang; Mayr, Julia; Rettel, Mandy; Savitski, Mikhail M; Svergun, Dmitri I; Bitter, Wilbert; Wilmanns, Matthias; Marlovits, Thomas C; Parret, Annabel H A; Houben, Edith N G

    2017-04-10

    Mycobacteria are characterized by their impermeable outer membrane, which is rich in mycolic acids 1 . To transport substrates across this complex cell envelope, mycobacteria rely on type VII (also known as ESX) secretion systems 2 . In Mycobacterium tuberculosis, these ESX systems are essential for growth and full virulence and therefore represent an attractive target for anti-tuberculosis drugs 3 . However, the molecular details underlying type VII secretion are largely unknown, due to a lack of structural information. Here, we report the molecular architecture of the ESX-5 membrane complex from Mycobacterium xenopi determined at 13 Å resolution by electron microscopy. The four core proteins of the ESX-5 complex (EccB 5 , EccC 5 , EccD 5 and EccE 5 ) assemble with equimolar stoichiometry into an oligomeric assembly that displays six-fold symmetry. This membrane-associated complex seems to be embedded exclusively in the inner membrane, which indicates that additional components are required to translocate substrates across the mycobacterial outer membrane. Furthermore, the extended cytosolic domains of the EccC ATPase, which interact with secretion effectors, are highly flexible, suggesting an as yet unseen mode of substrate interaction. Comparison of our results with known structures of other bacterial secretion systems demonstrates that the architecture of type VII secretion system is fundamentally different, suggesting an alternative secretion mechanism.

  12. Molecular Screening and Single Nucleotide Polymorphism Typing of Molluscum Contagiosum Virus (MCV) from Genital Specimens, between 2012 and 2015

    Science.gov (United States)

    Taghinezhad-S, Sedigheh; Mohseni, Amir Hossein; Keyvani, Hossein; Ghobadi, Narges

    2018-03-01

    The present study is the first comprehensive report of the Molluscum contagiosum virus (MCV) in Iran based on the molecular technique for differentiation and typing of the MCV1 and MCV2. Patients were diagnosed as having tumor-like genital warts less than 5 mm in diameter, and HIV seronegative samples were chosen for this cross-sectional study. TaqMan real-time PCR was used to identify MCV following clinical examination. Typing of the MCV-positive specimens was performed in the SNP A27451G region of MC021L gene. Of 1470 samples, 114 (7.75%) samples were positive for the MCV. From MCV-positive samples, 71.05% sequences were found to be related to the MCV1 and 28.95% to the MCV2. This assay constitutes a reliable method for identification and typing of the MCV genomic variants that could be valuable for reviewing the pathogenesis, molecular epidemiology, and the natural history of MCV-related situations.

  13. Radiographic and Clinical Outcomes of Anterior and Transforaminal Lumbar Interbody Fusions: A Systematic Review and Meta-analysis of Comparative Studies.

    Science.gov (United States)

    Ajiboye, Remi M; Alas, Haddy; Mosich, Gina M; Sharma, Akshay; Pourtaheri, Sina

    2017-06-15

    Systematic review and meta-analysis. Compare the radiographic and clinical outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF). ALIF and TLIF are 2 methods of achieving spinal arthrodesis. There are conflicting reports with no consensus on the optimal interbody technique to achieve successful radiographic and clinical outcomes. The goal of this systematic review and meta-analysis was to compare the radiographic and clinical outcomes of ALIF to TLIF. A systematic search of multiple medical reference databases was conducted for studies comparing ALIF to TLIF. Studies that included stand-alone ALIFs were excluded. Meta-analysis was performed using the random-effects model for heterogeneity. Radiographic outcome measures included segmental and overall lumbar lordosis, and fusion rates. Clinical outcomes measures included Oswestry disability index (ODI) and visual analog scale (VAS) score for back pain. The search yielded 7 studies totaling 811 patients (ALIF=448, TLIF=363). ALIF was superior to TLIF in restoring segmental lumbar lordosis at L4-L5 and L5-S1 (L4-L5; P=0.013, L5-S1; P<0.001). ALIF was also superior to TLIF in restoring overall lumbar lordosis (P<0.001). However, no significant differences in fusion rates were noted between both techniques [odds ratio=0.905; 95% confidence interval, 0.458-1.789; P=0.775]. In addition, ALIF and TLIF were comparable with regards to ODI and VAS scores (ODI; P=0.184, VAS; P=0.983). For the restoration of lumbar lordosis, ALIF is superior to TLIF. However, TLIF is comparable to ALIF with regards to fusion rate and clinical outcomes.

  14. Characterization of a novel caudal vertebral interbody fusion in a rat tail model: An implication for future material and mechanical testing.

    Science.gov (United States)

    Yeh, Yu-Cheng; Yang, Cheng-Chun; Tai, Ching-Lung; Tsai, Tsung-Ting; Lai, Po-Liang; Fu, Tsai-Sheng; Niu, Chi-Chien; Chen, Lih-Huei; Chen, Wen-Jer

    2017-02-01

    Of the proposed animal interbody fusion models, rat caudal discs have gained popularity in disc research due to their strong resemblance to human discs with respect to geometry, composition and mechanical properties. The purpose of this study is to demonstrate an efficient, repeatable and easily accessible animal model of interbody fusion for future research into mechanical testing and graft materials. Twelve 12-week-old female Sprague-Dawley (SD) rats underwent caudal interbody fusion of the third and fourth coccygeal vertebrae of the tail. Serial radiological evaluation, and histological evaluation and manual palpation after sacrifice were performed to assess the fusion quality. Mechanical testing of functional units (FUs) of non-operated and operated segments was compared using a three-point bending test. At postoperative 12 weeks, callus formation was observed at the fusion sites in all rats, with the mean radiological evaluations of 2.75/3 according to the Bransford classification. Newly formed bone tissue was also observed in all rats with the mean histological score of 5.85/7, according to the Emery grading system. No palpable gaps and obvious change of bending stiffness was observed in the operated segments. The mean bending stiffness of the FUs was statistically higher than that of the control FUs (26.57 ± 6.71 N/mm vs. 12.45 ± 3.21 N/mm, p materials under conditions of osteoporosis using this model would be worthwhile. Copyright © 2017 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  15. Lateral lumbar interbody fusion for the correction of spondylolisthesis and adult degenerative scoliosis in high-risk patients: early radiographic results and complications.

    Science.gov (United States)

    Waddell, Brad; Briski, David; Qadir, Rabah; Godoy, Gustavo; Houston, Allison Howard; Rudman, Ernest; Zavatsky, Joseph

    2014-01-01

    Lateral lumbar interbody fusion (LLIF) is not associated with many of the complications seen in other interbody fusion techniques. This study used computed tomography (CT) scans, the radiographic gold standard, to assess interbody fusion rates achieved utilizing the LLIF technique in high-risk patients. We performed a retrospective review of patients who underwent LLIF between January 2008 and July 2013. Forty-nine patients underwent nonstaged or staged LLIF on 119 levels with posterior correction and augmentation. Per protocol, patients received CT scans at their 1-year follow-up. Of the 49 patients, 21 patients with LLIF intervention on 54 levels met inclusion criteria. Two board-certified musculoskeletal radiologists and the senior surgeon (JZ) assessed fusion. Of the 21 patients, 6 patients had had previous lumbar surgery, and the cohort's comorbidities included osteoporosis, diabetes, obesity, and smoking, among others. Postoperative complications occurred in 12 (57.1%) patients and included anterior thigh pain and weakness in 6 patients, all of which resolved by 6 months. Two cases of proximal junctional kyphosis occurred, along with 1 case of hardware pullout. Two cases of abdominal atonia occurred. By CT scan assessment, each radiologist found fusion was achieved in 53 of 54 levels (98%). The radiologists' findings were in agreement with the senior surgeon. Several studies have evaluated LLIF fusion and reported fusion rates between 88%-96%. Our results demonstrate high fusion rates using this technique, despite multiple comorbidities in the patient population. Spanning the ring apophysis with large LLIF cages along with supplemental posterior pedicle screw augmentation can enhance stability of the fusion segment and increase fusion rates.

  16. Outcomes of oblique lateral interbody fusion for degenerative lumbar disease in patients under or over 65 years of age.

    Science.gov (United States)

    Jin, Chengzhen; Jaiswal, Milin S; Jeun, Sin-Soo; Ryu, Kyeong-Sik; Hur, Jung-Woo; Kim, Jin-Sung

    2018-02-20

    Oblique lateral interbody fusion (OLIF) offers the solution to problems of anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF). However, OLIF technique for degenerative spinal diseases of elderly patients has been rarely reported. The objective of this study was to determine the clinical and radiological results of OLIF technique for degenerative spinal diseases in patients under or over 65 years of age. Sixty-three patients who underwent OLIF procedure were enrolled, including 29 patients who were less than 65 years of age and 34 patients who were over 65 years of age. Fusion rate, change of disc height and lumbar lordotic angle, Numeric Rating Scale (NRS), return to daily activity, patient's satisfaction rate (PSR), and Oswestry disability index (ODI) were used to assess clinical and functional outcomes. The mean NRS scores for back and leg pain decreased, respectively, from 4.6 and 5.9 to 2.3 and 1.8 in the group A (less than 65 years) and from 4.5 and 6.8 to 2.6 and 2.2 in the group B (over 65 years) at the final follow-up period. The mean ODI scores improved from 48.4 to 24.0% in the group A and from 46.5 to 25.2% in the group B at the final follow-up period. In both groups, the NRS and ODI scores significantly changed preoperatively to postoperatively (p degenerative lumbar diseases in elderly patients showed favorable clinical and radiological outcomes.

  17. One-Level Lumbar Degenerative Spondylolisthesis and Posterior Approach: Is Transforaminal Lateral Interbody Fusion Mandatory?: A Randomized Controlled Trial With 2-Year Follow-Up.

    Science.gov (United States)

    Challier, Vincent; Boissiere, Louis; Obeid, Ibrahim; Vital, Jean-Marc; Castelain, Jean-Etienne; Bénard, Antoine; Ong, Nathalie; Ghailane, Soufiane; Pointillart, Vincent; Mazas, Simon; Mariey, Rémi; Gille, Olivier

    2017-04-15

    A monocentric open-label randomized controlled trial (MRCT). Comparison of clinical and radiological outcomes between isolated instrumented posterior fusion (PLF) and associated instrumented posterior fusion and interbody fusion by transforaminal approach (PLF + TLIF) for patients suffering from one-level lumbar degenerative spondylolisthesis (DS) undergoing surgery. DS is a common cause of symptomatic lumbar stenosis. PLF has shown better clinical outcome than decompression with noninstrumented posterolateral fusion. TLIF with interbody cage showed better fusion rate than PLF. There is a need for randomized controlled trials to compare PLF with and without TLIF as to clinical and radiological outcomes. This is a MRCT comparing PLF and TLIF techniques in surgical treatment of DS. Sixty patients were included in a secured database from 2009 to 2011 and randomized into two groups: 30 PLF with posterior pedicle screws and intertransverse autologuous graft, and 30 TLIF in which an interbody fusion by transforaminal approach was added. Data included clinical (pain and disability), surgical (blood loss and operating time), and radiological (alignment and fusion) parameters at baseline and 2-year follow-up. Comparison was made by Student t test and Chi-square test. There was a significant improvement in each group for pain and disability but no difference between the groups. Radiographic assessment showed better posterolateral fusion rate for TLIF without superiority in segmental lordosis improvement. A case of deformity cascade with spino-pelvic mismatch at baseline was noted in PLF. Posterior decompression and instrumented fusion is an efficient technique that proved its significant clinical benefit in the surgical treatment of DS. TLIF did not show its superiority neither in clinical nor alignment parameters despite a better fusion rate. These results suggest that TLIF is not mandatory in this specific indication. Sagittal alignment analysis by standing full

  18. An investigation into heterogeneity in a single vein-type uranium ore deposit: Implications for nuclear forensics

    International Nuclear Information System (INIS)

    Keatley, A.C.; Scott, T.B.; Davis, S.; Jones, C.P.; Turner, P.

    2015-01-01

    Minor element composition and rare earth element (REE) concentrations in nuclear materials are important as they are used within the field of nuclear forensics as an indicator of sample origin. However recent studies into uranium ores and uranium ore concentrates (UOCs) have shown significant elemental and isotopic heterogeneity from a single mine site such that some sites have shown higher variation within the mine site than that seen between multiple sites. The elemental composition of both uranium and gangue minerals within ore samples taken along a single mineral vein in South West England have been measured and reported here. The analysis of the samples was undertaken to determine the extent of the localised variation in key elements. Energy Dispersive X-ray spectroscopy (EDS) was used to analyse the gangue mineralogy and measure major element composition. Minor element composition and rare earth element (REE) concentrations were measured by Electron Probe Microanalysis (EPMA). The results confirm that a number of key elements, REE concentrations and patterns used for origin location do show significant variation within mine. Furthermore significant variation is also visible on a meter scale. In addition three separate uranium phases were identified within the vein which indicates multiple uranium mineralisation events. In light of these localised elemental variations it is recommended that representative sampling for an area is undertaken prior to establishing the REE pattern that may be used to identify the originating mine for an unknown ore sample and prior to investigating impact of ore processing on any arising REE patterns. - Highlights: • Demonstrating significant variation at meter scale distances. • Importance of understanding heterogeneity in aid of nuclear forensics interpretation. • Understanding local features prior to determining feed through of elements to UOCs. • Key elements, REE concentrations and patterns show significant variation

  19. Spectroscopic characterization of a single dangling bond on a bare Si(100)- c ( 4 × 2 ) surface for n - and p -type doping

    KAUST Repository

    Mantega, M.

    2012-07-19

    We investigate the charging state of an isolated single dangling bond formed on an unpassivated Si(100) surface with c(4×2) reconstruction, by comparing scanning tunneling microscopy and spectroscopy analysis with density functional theory calculations. The dangling bond is created by placing a single hydrogen atom on the bare surface with the tip of a scanning tunneling microscope. The H atom passivates one of the dimer dangling bonds responsible for the surface one-dimensional electronic structure. This leaves a second dangling at the reacted surface dimer which breaks the surface periodicity. We consider two possible H adsorption configurations for both the neutral and the doped situation (n- and p-type). In the case of n-doping we find that the single dangling bond state is doubly occupied and the most stable configuration is that with H bonded to the bottom Si atom of the surface dimer. In the case of p-doping the dangling bond is instead empty and the configuration with the H attached to the top atom of the dimer is the most stable. Importantly the two configurations have different scattering properties and phase shift fingerprints. This might open up interesting perspectives for fabricating a switching device by tuning the doping level or by locally charging the single dangling bond state. © 2012 American Physical Society.

  20. A single nucleotide polymorphism within the acetyl-coenzyme A carboxylase beta gene is associated with proteinuria in patients with type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Shiro Maeda

    2010-02-01

    Full Text Available It has been suggested that genetic susceptibility plays an important role in the pathogenesis of diabetic nephropathy. A large-scale genotyping analysis of gene-based single nucleotide polymorphisms (SNPs in Japanese patients with type 2 diabetes identified the gene encoding acetyl-coenzyme A carboxylase beta (ACACB as a candidate for a susceptibility to diabetic nephropathy; the landmark SNP was found in the intron 18 of ACACB (rs2268388: intron 18 +4139 C > T, p = 1.4x10(-6, odds ratio = 1.61, 95% confidence interval [CI]: 1.33-1.96. The association of this SNP with diabetic nephropathy was examined in 9 independent studies (4 from Japan including the original study, one Singaporean, one Korean, and two European with type 2 diabetes. One case-control study involving European patients with type 1 diabetes was included. The frequency of the T allele for SNP rs2268388 was consistently higher among patients with type 2 diabetes and proteinuria. A meta-analysis revealed that rs2268388 was significantly associated with proteinuria in Japanese patients with type 2 diabetes (p = 5.35 x 10(-8, odds ratio = 1.61, 95% Cl: 1.35-1.91. Rs2268388 was also associated with type 2 diabetes-associated end-stage renal disease (ESRD in European Americans (p = 6 x 10(-4, odds ratio = 1.61, 95% Cl: 1.22-2.13. Significant association was not detected between this SNP and nephropathy in those with type 1 diabetes. A subsequent in vitro functional analysis revealed that a 29-bp DNA fragment, including rs2268388, had significant enhancer activity in cultured human renal proximal tubular epithelial cells. Fragments corresponding to the disease susceptibility allele (T had higher enhancer activity than those of the major allele. These results suggest that ACACB is a strong candidate for conferring susceptibility for proteinuria in patients with type 2 diabetes.

  1. Transforaminal lumbar interbody fusion vs. posterolateral instrumented fusion: cost-utility evaluation along side an RCT with a 2-year follow-up

    DEFF Research Database (Denmark)

    Christensen, Ann Demant; Hoy, K.; Bunger, C.

    2014-01-01

    -utility of transforaminal lumbar interbody fusion (TLIF) compared to posterolateral instrumented fusion (PLF) from the societal perspective. 100 Patients were randomized to TLIF or PLF (51/49) and followed for 2 years. Cost data were acquired from national registers, and outcomes were measured using the Oswestry Disability...... Index and SF-6D questionnaires. Conventional cost-effectiveness methodology was employed to estimate net benefit and to illustrate cost-effectiveness acceptability curves. The statistical analysis was based on means and bootstrapped confidence intervals. Results showed no statistically significant...

  2. Additional sagittal correction can be obtained when using an expandable titanium interbody device in lumbar Smith-Peterson osteotomies: a biomechanical study.

    Science.gov (United States)

    Qandah, Nicholas A; Klocke, Noelle F; Synkowski, Jordan J; Chinthakunta, Suresh R; Hussain, Mir M; Salloum, Kanaan G; Marvin, Eric A; Bucklen, Brandon S

    2015-03-01

    Insertion of intervertebral fusion devices between consecutive Smith-Peterson osteotomies (SPOs) provides an anterior fulcrum during compression, which has been documented to improve achievable Cobb angle correction. Extension of these principles to an expandable device would theoretically provide greater surgical adjustment for flatback and scoliotic cases than a static cage. To investigate whether an expandable titanium interbody device would produce greater sagittal correction than a static spacer when used during SPO procedures. Cadaveric research was performed. Seven T10-S1 human specimens were used. Cobb angle changes and range of motion are the physiological measures. No self-report/functional measures were applicable. Bilateral pedicle screws were placed (T11-L5) before Smith-Petersen osteotomy creation from L2 to L4. A transforaminal lumbar interbody fusion titanium expandable implant was placed in each disc space from L2-L3 to L4-L5, which is currently an off-label use of this implant. Initial placement simulated a static spacer, and then incremental device expansion was performed to obtain an intermediate and final height. Lateral fluoroscopic images were taken for Cobb angle evaluation between L2 and L5, and range of motion as observed during application of pure bending moments was captured using a six degree-of-freedom spine simulator. A one-way analysis of variance with Tukey post hoc analysis was performed to determine significant differences (pcompany, where some authors are salaried employees; another author has been a paid consultant elsewhere. These financial associations were not believed to bias the results. Change in Cobb angle from L2 to L5 was significantly greater with the interbody spacer compared with SPO alone. Despite an obvious increase in lordosis with expansion height, there were no significant differences between implant expansion states for the L2-L5 Cobb angle. All instrumented constructs were statistically equivalent in every

  3. Effect of Exposure Type and Timing of Injuries in Division I College Football: A 4-year Single Program Analysis.

    Science.gov (United States)

    Krill, Michael K; Borchers, James R; Hoffman, Joshua T; Tatarski, Rachel L; Hewett, Timothy E

    2017-02-01

    Football players compete with a high risk of injury due to the sport. With the recent efforts to improve safety, the National Collegiate Athletic Association (NCAA) established new terminology to clearly define exposure types and reduce the number of high contact exposures. To compare football injury rates (IR) with a focus on game versus practice, time in season of injury, mechanism of injury and utilizing recent exposure types defined by the NCAA (live contact, full-pads and non-contact). Licensed medical professionals monitored a college football program regular season from 2012-2015. Each injury was classified by timing of the injury, mechanism of injury, and whether it occurred in game or practice. Player attendance and type of exposure (non-contact, full-pad or live contact, which involves live tackling to the ground and/or full-speed blocking and can occur in full-pad or half-pad ('shell') equipment) was documented. IR were calculated per 1000 athlete-exposures (AE). Mid-exact P tests compared rates between variables. The game IR was over three times as high as the practice IR (p injuries observed occurred from a contact mechanism (IR: 2.508/1000 AE). The highest IR during the fall football season occurred in the pre-season at 5.769/1000 AE. Overall IR observed in this cohort were lower than prior studies published before recent NCAA rule changes and guideline implementation to improve athlete safety. Athletes in this cohort were at significantly increased risk of injury from live contact exposures.

  4. Analysis on preemptive priority retrial queue with two types of customers, balking, optional re-service, single vacation and service interruption

    Science.gov (United States)

    Yuvarani, S.; Saravanarajan, M. C.

    2017-11-01

    This paper concerned with performance analysis of single server preemptive priority retrial queue with a single vacation where two types of customers are considered and they are called priority customers and ordinary customers. The ordinary customers arrive in batch into the system. The priority customers do not form any queue. After the completion of regular service, the customers may demand re-service for the previous service without joining the orbit or may leave the system. As soon as the system is empty, the server goes for vacation and the regular busy server can be subjected to breakdown. By using the supplementary variable technique, we obtain the steady-state probability generating functions for the system/orbit size. Some important system performance measures and the stochastic decomposition are discussed. Finally, numerical examples are presented to visualize the effect of parameters on system performance measures.

  5. Study of single pulsed-field magnetization of Gd-Ba-Cu-O bulk high-temperature superconductor with a split type of armature coil for rotating machinery

    International Nuclear Information System (INIS)

    Morita, E; Matsuzaki, H; Kimura, Y; Ohtani, I; Ogata, H; Izumi, M; Nonaka, Y; Murakami, M; Ida, T; Sugimoto, H; Miki, M; Kitano, M

    2006-01-01

    We employed a Gd-bulk HTS as rotating field magnet poles aiming for a smaller and lighter axial-gap-type motor. The bulk was inserted in the split-type armature pulsed copper coils and cooled down to 77 K under zero field. Employing the bulk magnet to HTS rotating machinery, the number of pulsed field magnetizations should be reduced for practical use. Thereby, a single pulsed current was applied to the pulsed copper coils to magnetize the bulk. The trapped field distribution and transient flux behaviour strongly depend on the radial dimension of the armature coil with a vortex-type winding. On decreasing the diameter of the pulsed copper armature coil, the distribution of the trapped flux density on the surface of the bulk becomes close to a conical shape. In contrast to the use of a solenoid, the application of vortex-type armature coils to magnetization of Gd-bulk HTS shows a quick intervention of the external magnetic flux into the centre of the bulk. The magnetization to the bulk HTS of the vortex-type copper coils with an optimum radius is useful and may be an effective technique for applied bulk HTS for rotating machines such as motors and/or generators

  6. Oil type and cross-linking influence growth of Aureobasidium melanogenum on vegetable oils as a single carbon source.

    Science.gov (United States)

    Peeters, Loes H M; Huinink, Hendrik P; Voogt, Benjamin; Adan, Olaf C G

    2018-03-12

    Aureobasidium melanogenum is the main fungus found in a spontaneously formed biofilm on a oil-treated wood. This dark colored biofilm functions as a protective coating. To better understand biofilm formation, in this study A. melanogenum was cultured on olive oil and raw linseed oil. Metabolic activity and oil conversion were measured. The results show that A. melanogenum is able to grow on linseed oil and olive oil as a single carbon source. The fungus produces the enzyme lipase to convert the oil into fatty acids and glycerol. Metabolic activity and oil conversion were equal on linseed oil and olive oil. The fungus was not able to grow on severe cross-linked linseed oil, meaning that the degree of cross-linking of the oil is important for growth of A. melanogenum. Dark coloring of the colony was seen on linseed oil, which might be a stress response on the presence of autoxidation products in linseed oil. The colony on olive oil showed delayed melanin production indicating an inhibitory effect of olive oil on melanin production. © 2018 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.

  7. Visualization and Comparison of Single and Combined Parametric and Nonparametric Discriminant Methods for Leukemia Type Recognition Based on Gene Expression

    Directory of Open Access Journals (Sweden)

    Ćwiklińska-Jurkowska Małgorzata M.

    2015-12-01

    Full Text Available A gene expression data set, containing 3051 genes and 38 tumor mRNA training samples, from a leukemia microarray study, was used for differentiation between ALL and AML groups of leukemia. In this paper, single and combined discriminant methods were applied on the basis of the selected few most discriminative variables according to Wilks’ lambda or the leave-one-out error of first nearest neighbor classifier. For the linear, quadratic, regularized, uncorrelated discrimination, kernel, nearest neighbor and naive Bayesian classifiers, two-dimensional graphs of the boundaries and discriminant functions for diagnostics are presented. Cross-validation and leave-one-out errors were used as measures of classifier performance to support diagnosis coming from this genomic data set. A small number of best discriminating genes, from two to ten, was sufficient to build discriminant methods of good performance. Especially useful were nearest neighbor methods. The results presented herein were comparable with outcomes obtained by other authors for larger numbers of applied genes. The linear, quadratic, uncorrelated Bayesian and regularized discrimination methods were subjected to bagging or boosting in order to assess the accuracy of the fusion. A conclusion drawn from the analysis was that resampling ensembles were not beneficial for two-dimensional discrimination.

  8. Comparison of three types of XPAD3.2/CdTe single chip hybrids for hard X-ray applications in material science and biomedical imaging

    Science.gov (United States)

    Buton, C.; Dawiec, A.; Graber-Bolis, J.; Arnaud, K.; Bérar, J. F.; Blanc, N.; Boudet, N.; Clémens, J. C.; Debarbieux, F.; Delpierre, P.; Dinkespiler, B.; Gastaldi, T.; Hustache, S.; Morel, C.; Pangaud, P.; Perez-Ponce, H.; Vigeolas, E.

    2014-09-01

    The CHIPSPECT consortium aims at building a large multi-modules CdTe based photon counting detector for hard X-ray applications. For this purpose, we tested nine XPAD3.2 single chip hybrids in various configurations (i.e. Ohmic vs. Schottky contacts or electrons vs. holes collection mode) in order to select the most performing and best suited configuration for our experimental requirements. Measurements have been done using both X-ray synchrotron beams and 241Am source. Preliminary results on the image quality, calibration, stability, homogeneity and linearity of the different types of detectors are presented.

  9. Single-Dose Metformin Enhances Bile Acid-Induced Glucagon-Like Peptide-1 Secretion in Patients With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Brønden, Andreas; Albér, Anders; Rohde, Ulrich

    2017-01-01

    -controlled, and double-blinded crossover study. Setting: This study was conducted at Center for Diabetes Research, Gentofte Hospital, Denmark. Patients: Fifteen metformin-treated patients with type 2 diabetes; all participants completed the study. Interventions: Four experimental study days in randomized order...... with administration of either 1500 mg metformin or placebo in combination with intravenous infusion of cholecystokinin (0.4 pmol × kg-1 × min-1) or saline. Main Outcome Measure: Plasma GLP-1 excursions as measured by baseline-subtracted area under the curve. Results: Single-dose metformin further enhanced bile acid...

  10. AHSG tag single nucleotide polymorphisms associate with type 2 diabetes and dyslipidemia: studies of metabolic traits in 7,683 white Danish subjects

    DEFF Research Database (Denmark)

    Andersen, Gitte; Burgdorf, Kristoffer Sølvsten; Sparsø, Thomas

    2008-01-01

    been largely successful. We related seven frequent AHSG tag single nucleotide polymorphisms to a range of metabolic traits, including type 2 diabetes, obesity, and dyslipidemia. RESEARCH DESIGN AND METHODS: The polymorphisms were genotyped in 7,683 white Danish subjects using Taqman allelic...... with dyslipidemia (P = 0.003 and P(corr) = 0.009). Thr248Met (rs4917) tended to associate with lower fasting and post-oral glucose tolerance test serum insulin release (P = 0.02, P(corr) = 0.1 for fasting and P = 0.04, P(corr) = 0.2 for area under the insulin curve) and improved insulin sensitivity estimated...

  11. Both modular and single-domain Type I polyketide synthases are expressed in the brevetoxin-producing dinoflagellate, Karenia brevis (Dinophyceae).

    Science.gov (United States)

    Van Dolah, Frances M; Kohli, Gurjeet S; Morey, Jeanine S; Murray, Shauna A

    2017-12-01

    Dinoflagellates are prolific producers of polyketide compounds, many of which are potent toxins with adverse impacts on human and marine animal health. To identify polyketide synthase (PKS) genes in the brevetoxin-producing dinoflagellate, Karenia brevis, we assembled a transcriptome from 595 million Illumina reads, sampled under different growth conditions. The assembly included 125,687 transcripts greater than 300 nt in length, with over half having >100× coverage. We found 121 transcripts encoding Type I ketosynthase (KS) domains, of which 99 encoded single KS domains, while 22 contained multiple KS domains arranged in 1-3 protein modules. Phylogenetic analysis placed all single domain and a majority of multidomain KSs within a monophyletic clade of protist PKSs. In contrast with the highly amplified single-domain KSs, only eight single-domain ketoreductase transcripts were found in the assembly, suggesting that they are more evolutionarily conserved. The multidomain PKSs were dominated by trans-acyltransferase architectures, which were recently shown to be prevalent in other algal protists. Karenia brevis also expressed several hybrid nonribosomal peptide synthetase (NRPS)/PKS sequences, including a burA-like sequence previously reported in a wide variety of dinoflagellates. This contrasts with a similarly deep transcriptome of Gambierdiscus polynesiensis, which lacked NRPS/PKS other than the burA-like transcript, and may reflect the presence of amide-containing polyketides in K. brevis and their absence from G. polynesiensis. In concert with other recent transcriptome analyses, this study provides evidence for both single domain and multidomain PKSs in the synthesis of polyketide compounds in dinoflagellates. © 2017 The Authors Journal of Phycology published by Wiley Periodicals, Inc. on behalf of Phycological Society of America.

  12. SHADOWS OF OUR FORMER COMPANIONS: HOW THE SINGLE-DEGENERATE BINARY TYPE IA SUPERNOVA SCENARIO AFFECTS REMNANTS

    Energy Technology Data Exchange (ETDEWEB)

    Gray, William J.; Raskin, Cody; Owen, J. Michael [Lawrence Livermore National Laboratory, P.O. Box 808, L-038, Livermore, CA 94550 (United States)

    2016-12-10

    Here we present three-dimensional high-resolution simulations of Type Ia supernova in the presence of a non-degenerate companion. We find that the presence of a nearby companion leaves a long-lived hole in the supernova ejecta. In particular, we aim to study the long-term evolution of this hole as the supernova ejecta interacts with the surrounding interstellar medium (ISM). Using estimates for the X-ray emission, we find that the hole generated by the companion remains for many centuries after the interaction between the ejecta and the ISM. We also show that the hole is discernible over a wide range of viewing angles and companion masses.

  13. Effects of single- and multi-substituted Zn ions in doped 122-type iron-based superconductors

    Science.gov (United States)

    Zhao, YuanYuan; Li, Bo; Li, Wei; Chen, Hong-Yi; Bassler, Kevin E.; Ting, C. S.

    2016-04-01

    Recent experiments on Zn-substituted 122-type iron-based superconductors (FeSCs) at electron- and hole-doped regions provide us with a testing ground for understanding the effect of Zn impurities in these systems. Our first-principles calculations of the electronic structure reveal that the Zn 3 d orbitals are far below the Fermi level and are chemically inactive, while the Zn 4 s orbital is partially occupied and its wave function overlaps with the 3 d orbitals of neighboring Fe ions. This suggests that the impurity effect originates in the Zn 4 s orbital, not its 3 d orbitals. Employing a phenomenological two-orbital lattice model for 122-FeSCs and the self-consistent Bogoliubov-de Gennes equations, we study how the Zn impurities suppress the superconductivity in electron- and hole-doped compounds. Our obtained results qualitatively agree with the experimental measurements.

  14. Mechanical performance of a screw-type veterinary suture anchor subjected to single load to failure and cyclic loads.

    Science.gov (United States)

    Balara, Jason M; McCarthy, Robert J; Boudrieau, Randy J; Kraus, Karl H

    2004-01-01

    To characterize the mechanical performance of a veterinary bone anchor under static and cyclic loads. Mechanical testing study. Cadaveric canine humeri. Humeri (6 pairs) were collected from skeletally mature dogs (mean [+/-SD] age, 17.2+/-2.1 months; weight, 20.8+/-1.5 kg). Bone anchors were inserted in the proximal metaphysis using nylon, and were longitudinally extracted. For the opposite humerus, anchors were subjected to longitudinal cyclic load (50% of the load at failure of their pair) for 1200 cycles then longitudinally loaded to failure. Anchors were then installed in a similar and adjacent area of these 2(nd) humeri with nylon and cyclically tested perpendicular to the axis of anchor insertion (100% of the longitudinal holding power of their pair) for 1200 cycles, then perpendicularly loaded to failure. Paired t-tests were used to compare holding power before and after longitudinal cyclic testing. Longitudinal holding power of the screw-type anchor in the proximal humerus was 385+/-30 N. Anchor pullout was the only mode of failure. Anchors in the paired humeri did not fail after 1200 cycles of 50% longitudinal loading, and post-cycle holding strength was not different (335+/-87 N; P=.32). Perpendicularly loaded anchors did not fail after 1200 cycles of 100% of opposite longitudinal holding strength, and had post-cycle perpendicular holding strengths of 514+/-72 N. Suture breakage was the mode of failure. Bone anchor holding strength is dependent on orientation of suture load. Screw-type bone anchor holding strength was not affected by longitudinal cyclic loading, and holding strengths of approximately 385 N can be expected in metaphyseal bone of large-breed mature dogs. Perpendicularly loaded anchors have higher failure loads, and holding strength of approximately 514 N can be expected in metaphyseal bone of the proximal humerus.

  15. Multiple Locus Variable-Number Tandem-Repeat and Single-Nucleotide Polymorphism-Based Brucella Typing Reveals Multiple Lineages in Brucella melitensis Currently Endemic in China

    Directory of Open Access Journals (Sweden)

    Mingjun Sun

    2017-12-01

    Full Text Available Brucellosis is a worldwide zoonotic disease caused by Brucella spp. In China, brucellosis is recognized as a reemerging disease mainly caused by Brucella melitensis specie. To better understand the currently endemic B. melitensis strains in China, three Brucella genotyping methods were applied to 110 B. melitensis strains obtained in past several years. By MLVA genotyping, five MLVA-8 genotypes were identified, among which genotypes 42 (1-5-3-13-2-2-3-2 was recognized as the predominant genotype, while genotype 63 (1-5-3-13-2-3-3-2 and a novel genotype of 1-5-3-13-2-4-3-2 were second frequently observed. MLVA-16 discerned a total of 57 MLVA-16 genotypes among these Brucella strains, with 41 genotypes being firstly detected and the other 16 genotypes being previously reported. By BruMLSA21 typing, six sequence types (STs were identified, among them ST8 is the most frequently seen in China while the other five STs were firstly detected and designated as ST137, ST138, ST139, ST140, and ST141 by international multilocus sequence typing database. Whole-genome sequence (WGS-single-nucleotide polymorphism (SNP-based typing and phylogenetic analysis resolved Chinese B. melitensis strains into five clusters, reflecting the existence of multiple lineages among these Chinese B. melitensis strains. In phylogeny, Chinese lineages are more closely related to strains collected from East Mediterranean and Middle East countries, such as Turkey, Kuwait, and Iraq. In the next few years, MLVA typing will certainly remain an important epidemiological tool for Brucella infection analysis, as it displays a high discriminatory ability and achieves result largely in agreement with WGS-SNP-based typing. However, WGS-SNP-based typing is found to be the most powerful and reliable method in discerning Brucella strains and will be popular used in the future.

  16. Molecular epidemiology of Staphylococcus aureus bacteremia in a single large Minnesota medical center in 2015 as assessed using MLST, core genome MLST and spa typing.

    Science.gov (United States)

    Park, Kyung-Hwa; Greenwood-Quaintance, Kerryl E; Uhl, James R; Cunningham, Scott A; Chia, Nicholas; Jeraldo, Patricio R; Sampathkumar, Priya; Nelson, Heidi; Patel, Robin

    2017-01-01

    Staphylococcus aureus is a leading cause of bacteremia in hospitalized patients. Whether or not S. aureus bacteremia (SAB) is associated with clonality, implicating potential nosocomial transmission, has not, however, been investigated. Herein, we examined the epidemiology of SAB using whole genome sequencing (WGS). 152 SAB isolates collected over the course of 2015 at a single large Minnesota medical center were studied. Staphylococcus protein A (spa) typing was performed by PCR/Sanger sequencing; multilocus sequence typing (MLST) and core genome MLST (cgMLST) were determined by WGS. Forty-eight isolates (32%) were methicillin-resistant S. aureus (MRSA). The isolates encompassed 66 spa types, clustered into 11 spa clonal complexes (CCs) and 10 singleton types. 88% of 48 MRSA isolates belonged to spa CC-002 or -008. Methicillin-susceptible S. aureus (MSSA) isolates were more genotypically diverse, with 61% distributed across four spa CCs (CC-002, CC-012, CC-008 and CC-084). By MLST, there was 31 sequence types (STs), including 18 divided into 6 CCs and 13 singleton STs. Amongst MSSA isolates, the common MLST clones were CC5 (23%), CC30 (19%), CC8 (15%) and CC15 (11%). Common MRSA clones were CC5 (67%) and CC8 (25%); there were no MRSA isolates in CC45 or CC30. By cgMLST analysis, there were 9 allelic differences between two isolates, with the remaining 150 isolates differing from each other by over 40 alleles. The two isolates were retroactively epidemiologically linked by medical record review. Overall, cgMLST analysis resulted in higher resolution epidemiological typing than did multilocus sequence or spa typing.

  17. Single nucleotide polymorphism-based molecular typing of M. leprae from multicase families of leprosy patients and their surroundings to understand the transmission of leprosy.

    Science.gov (United States)

    Turankar, R P; Lavania, M; Chaitanya, V S; Sengupta, U; Darlong, J; Darlong, F; Siva Sai, K S R; Jadhav, R S

    2014-03-01

    The exact mode of transmission of leprosy is not clearly understood; however, many studies have demonstrated active transmission of leprosy around a source case. Families of five active leprosy cases and their household contacts were chosen from a high endemic area in Purulia. Fifty-two soil samples were also collected from different areas of their houses. DNA was extracted from slit-skin smears (SSS) and soil samples and the Mycobacterium leprae-specific RLEP (129 bp) region was amplified using PCR. Molecular typing of M. leprae was performed for all RLEP PCR-positive samples by single nucleotide polymorphism (SNP) typing and confirmation by DNA sequencing. SSS of these five patients and six out of the total 28 contacts were PCR positive for RLEP whereas 17 soil samples out of 52 showed the presence of M. leprae DNA. SNP typing of M. leprae from all RLEP PCR-positive subjects (patients and smear-positive contacts) and 10 soil samples showed the SNP type 1 genotype. M. leprae DNA from the five leprosy patients and the six contacts was further subtyped and the D subtype was noted in all patients and contacts, except for one contact where the C subtype was identified. Typing followed by subtyping of M. leprae clearly revealed that either the contacts were infected by the patients or both patients and contacts had the same source of infection. It also revealed that the type of M. leprae in the soil in the inhabited areas where patients resided was also of the same type as that found in patients. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  18. Molecular epidemiology of Staphylococcus aureus bacteremia in a single large Minnesota medical center in 2015 as assessed using MLST, core genome MLST and spa typing.

    Directory of Open Access Journals (Sweden)

    Kyung-Hwa Park

    Full Text Available Staphylococcus aureus is a leading cause of bacteremia in hospitalized patients. Whether or not S. aureus bacteremia (SAB is associated with clonality, implicating potential nosocomial transmission, has not, however, been investigated. Herein, we examined the epidemiology of SAB using whole genome sequencing (WGS. 152 SAB isolates collected over the course of 2015 at a single large Minnesota medical center were studied. Staphylococcus protein A (spa typing was performed by PCR/Sanger sequencing; multilocus sequence typing (MLST and core genome MLST (cgMLST were determined by WGS. Forty-eight isolates (32% were methicillin-resistant S. aureus (MRSA. The isolates encompassed 66 spa types, clustered into 11 spa clonal complexes (CCs and 10 singleton types. 88% of 48 MRSA isolates belonged to spa CC-002 or -008. Methicillin-susceptible S. aureus (MSSA isolates were more genotypically diverse, with 61% distributed across four spa CCs (CC-002, CC-012, CC-008 and CC-084. By MLST, there was 31 sequence types (STs, including 18 divided into 6 CCs and 13 singleton STs. Amongst MSSA isolates, the common MLST clones were CC5 (23%, CC30 (19%, CC8 (15% and CC15 (11%. Common MRSA clones were CC5 (67% and CC8 (25%; there were no MRSA isolates in CC45 or CC30. By cgMLST analysis, there were 9 allelic differences between two isolates, with the remaining 150 isolates differing from each other by over 40 alleles. The two isolates were retroactively epidemiologically linked by medical record review. Overall, cgMLST analysis resulted in higher resolution epidemiological typing than did multilocus sequence or spa typing.

  19. Comparison of fusion rate and clinical results between CaO-SiO2-P2O5-B2O3bioactive glass ceramics spacer with titanium cages in posterior lumbar interbody fusion.

    Science.gov (United States)

    Lee, Jae Hyup; Kong, Chang-Bae; Yang, Jae Jun; Shim, Hee-Jong; Koo, Ki-Hyoung; Kim, Jeehyoung; Lee, Choon-Ki; Chang, Bong-Soon

    2016-11-01

    The CaO-SiO 2 -P 2 O 5 -B 2 O 3 glass ceramics spacer generates chemical bonding to adjacent bones with high mechanical stability to produce a union with the end plate, and ultimately stability. The authors aimed to compare the clinical efficacy and safety of CaO-SiO 2 -P 2 O 5 -B 2 O 3 glass ceramics with a titanium cage that is widely used for posterior lumbar interbody fusion (PLIF) surgery in the clinical field. This is a prospective, stratified randomized, multicenter, single-blinded, comparator-controlled non-inferiority trial. The present study was conducted in four hospitals and enrolled a total of 86 patients between 30 and 80 years of age who required one-level PLIF due to severe spinal stenosis, spondylolisthesis, or huge disc herniation. The Oswestry Disability Index (ODI), Short Form-36 Health Survey (SF-36), and pain visual analog scale (VAS) were assessed before surgery and at 3, 6, and 12 months after surgery. The spinal fusion rate was assessed at 6 and 12 months after surgery. The spinal fusion rate and the area of fusion, subsidence of each CaO-SiO 2 -P 2 O 5 -B 2 O 3 glass ceramics and titanium cage, and the extent of osteolysis were evaluated using a dynamic plain radiography and a three-dimensional computed tomography at 12 months after surgery. The present study was supported by BioAlpha, and some authors (JHL, C-KL, and B-SC) have stock ownership (CaO-SiO 2 -P 2 O 5 -B 2 O 3 glass ceramics spacer showed a similar fusion rates and clinical outcomes compared with titanium cage. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  20. Spiral-type heteropolyhedral coordination network based on single-crystal LiSrPO4: implications for luminescent materials.

    Science.gov (United States)

    Lin, Chun Che; Shen, Chin-Chang; Liu, Ru-Shi

    2013-11-04

    Novel structures of luminescent materials, which are used as light sources for next-generation illumination, are continuously being improved for use in white-light-emitting diodes. Activator-doped known structures are reported as habitual down-conversion phosphors in solid-state lightings and displays. Consequently, the intrinsic qualities of the existent compounds produce deficiencies that limit their applications. Herein we report a spiral-network single-crystal orthophosphate (LiSrPO4) prepared in a platinum crucible with LiCl flux through crystal-growth reactions of SrCl2 and Li3PO4 in air. It crystallizes in a hexagonal system with a=5.0040(2) and c=24.6320(16) Å, V=534.15(5) Å(3), and Z=6 in the space group P6(5). The unit cell is comprised of LiO4 and PO4 tetrahedrons that form a three-dimensional LiPO4(2-) anionic framework with a helical channel structure along the c axis in which the Sr(2+) cation is accommodated. The optical band gap of this composition is about 3.65 eV, as determined by using UV/Vis absorption and diffuse reflection spectra. We used the crystal-growth method to synthesize blue- and red-emitting crystals that exhibited pure color, low reabsorption, a large Stokes shift, and efficient conversion of ultraviolet excitation light into visible light. Emphasis was placed on the development of gratifying structure-related properties of rare-earth luminescent materials and their applications. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Technical aspects of typing for HLA-DP alleles using allele-specific DNA in vitro amplification and sequence-specific oligonucleotide probes. Detection of single base mismatches

    DEFF Research Database (Denmark)

    Fugger, L; Morling, N; Ryder, L P

    1990-01-01

    The polymerase chain reaction (PCR) is an effective method for in vitro DNA amplification which combined with probing with synthetic oligonucleotides can be used for, e.g., HLA-typing. We have studied the technical aspects of HLA-DP typing with the technique. DNA from mononuclear nucleated cells...... was extracted with either a simple salting out method or phenol/chloroform. Both DNAs could be readily used for PCR. The MgC2 concentration of the PCR buffer and the annealing temperature of the thermal cycle of the PCR were the two most important variables. The MgCl2 concentration and the temperature must...... be carefully titrated for each primer pair in the PCR. The influence of mismatches between the primer and the DNA template were studied and we found that, by using primers differing only from each other at the 3' end, cross-amplification of closely homologous alleles could be avoided. Thus, single base...

  2. Comparison of semi-automated commercial rep-PCR fingerprinting, spoligotyping, 12-locus MIRU-VNTR typing and single nucleotide polymorphism analysis of the embB gene as molecular typing tools for Mycobacterium bovis.

    Science.gov (United States)

    Armas, Federica; Camperio, Cristina; Coltella, Luana; Selvaggini, Serena; Boniotti, Maria Beatrice; Pacciarini, Maria Lodovica; Di Marco Lo Presti, Vincenzo; Marianelli, Cinzia

    2017-08-04

    Highly discriminatory genotyping strategies are essential in molecular epidemiological studies of tuberculosis. In this study we evaluated, for the first time, the efficacy of the repetitive sequence-based PCR (rep-PCR) DiversiLab Mycobacterium typing kit over spoligotyping, 12-locus mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing and embB single nucleotide polymorphism (SNP) analysis for Mycobacterium bovis typing. A total of 49 M. bovis animal isolates were used. DNA was extracted and genomic DNA was amplified using the DiversiLab Mycobacterium typing kit. The amplified fragments were separated and detected using a microfluidics chip with Agilent 2100. The resulting rep-PCR-based DNA fingerprints were uploaded to and analysed using web-based DiversiLab software through Pearson's correlation coefficient. Rep-PCR DiversiLab grouped M. bovis isolates into ten different clusters. Most isolates sharing identical spoligotype, MIRU-VNTR profile or embB gene polymorphism were grouped into different rep-PCR clusters. Rep-PCR DiversiLab displayed greater discriminatory power than spoligotyping and embB SNP analysis but a lower resolution power than the 12-locus MIRU-VNTR analysis. MIRU-VNTR confirmed that it is superior to the other PCR-based methods tested here. In combination with spoligotyping and 12-locus MIRU-VNTR analysis, rep-PCR improved the discriminatory power for M. bovis typing.

  3. A single exposure to alcohol during brain development induces microencephaly and neuronal losses in genetically susceptible mice, but not in wild type mice.

    Science.gov (United States)

    de Licona, Hannah Klein; Karacay, Bahri; Mahoney, Jo; McDonald, Elizabeth; Luang, Thirath; Bonthius, Daniel J

    2009-05-01

    Maternal alcohol abuse during pregnancy can damage the fetal brain and lead to fetal alcohol syndrome (FAS). Despite public warnings discouraging alcohol use during pregnancy, many pregnant women continue to drink intermittently because they do not believe that occasional exposures to alcohol can be harmful to a fetus. However, because of genetic differences, some fetuses are much more susceptible than others to alcohol-induced brain injury. Thus, a relatively low quantity of alcohol that may be innocuous to most fetuses could damage a genetically susceptible fetus. Neuronal nitric oxide synthase (nNOS) can protect developing mouse neurons against alcohol toxicity by synthesizing neuroprotective nitric oxide. This study examined whether a single exposure to alcohol, which causes no evident injury in wild type mice, can damage the brains of mice genetically deficient for nNOS (nNOS-/- mice). Wild type and nNOS-/- mice received intraperitoneal injections of alcohol (0.0, 2.2, or 4.4mg/g body weight) either as a single dose on postnatal day (PD) 4 or as repeated daily doses over PD4-9. Brain volumes and neuronal numbers within the hippocampus and cerebral cortex were determined on PD10. Alcohol exposure on PD4-9 restricted brain growth and caused neuronal death in both strains of mice, but the severity of microencephaly and neuronal loss were more severe in the nNOS-/- mice than in wild type. The 4.4 mg/g alcohol dose administered on PD4 alone caused significant neuronal loss and microencephaly in the nNOS-/- mice, while this same dose caused no evident injury in the wild type mice. Thus, during development, a single exposure to alcohol can injure a genetically vulnerable brain, while it leaves a wild type brain unaffected. Since the genes that confer alcohol resistance and vulnerability in developing humans are unknown, any particular human fetus is potentially vulnerable. Thus, women should be counseled to consume no alcohol during pregnancy.

  4. Single-nucleotide polymorphism typing analysis for molecular subtyping ofSalmonellaTennessee isolates associated with the 2007 nationwide peanut butter outbreak in the United States.

    Science.gov (United States)

    Dong, Hee-Jin; Cho, Seongbeom; Boxrud, David; Rankin, Shelly; Downe, Francis; Lovchik, Judith; Gibson, Jim; Erdman, Matt; Saeed, A Mahdi

    2017-01-01

    In 2007, a nationwide Salmonella Tennessee outbreak occurred via contaminated peanut butter. Here, we developed a single-nucleotide polymorphism (SNP)-typing method for S . Tennessee to determine the clonal subtypes of S . Tennessee that were associated with the peanut butter outbreak. One seventy-six S . Tennessee isolates from various sources, including humans, animals, food, and the environment, were analyzed by using the SNP technique. Eighty-four representative SNP markers were selected by comparing the sequences of three representative S . Tennessee strains with different multi-locus sequence typing and variable number tandem repeats from our collection. The set of eighty-four SNP markers showed 100% typeability for the 176 strains, with the nucleotide diversity ranging from 0.011 to 0.107 (mean = 0.049 ± 0.018, median = 0.044) for each marker. Among the four clades and nine subtypes generated by the SNP typing, subtype 1, which comprised 142 S . Tennessee strains, was the most predominant. The dominance of single-strain clones in subtype 1 revealed that S . Tennessee is highly clonal regardless of outbreak-association, source, or period of isolation, suggesting the presence of an S . Tennessee strain prototype. Notably, a minimum 18 SNP set was able to determine clonal S . Tennessee strains with similar discrimination power, potentially allowing more rapid and economic strain genotyping for both outbreaks and sporadic cases. The SNP-typing method described here might aid the investigation of the epidemiology and microevolution of pathogenic bacteria by discriminating between outbreak-related and sporadic clinical cases. In addition, this approach enables us to understand the population structure of the bacterial subtypes involved in the outbreak.

  5. Clinical study on minimally invasive transforaminal lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis

    Directory of Open Access Journals (Sweden)

    Hao WU

    2016-04-01

    Full Text Available Objective To discuss the operative essentials and therapeutic effects of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis (DLS.  Methods A total of 17 DLS patients without prior spinal diseases were treated by MIS-TLIF and percutaneous pedicle screw fixation from January 2013 to September 2015 in Xuanwu Hospital, Capital Medical University. The operation time, intraoperative blood loss, hospital stay, and postoperative complication were recorded in each patient. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate postoperative improvement of low back and leg pain, and clinical effects were assessed according to Medical Outcome Study 36-Item Short-Form Health Survey (SF-36. Coronal Cobb angle, sagittal lordosis angle and spinal deviation distances on coronal and sagittal plane were measured before operation, one week, 3 months after operation and in the last follow-up in spinal full-length X-ray examination. Fusion rate was calculated according to X-ray or CT scan, and the degree of decompression was evaluated by MRI.  Results Decompression and fusion levels ranged from T12-S1 vertebrae, and interbody fusion was performed in 17 patients and 56 levels were fused. Average operation time was 200 min (180-300 min, intraoperative blood loss was 320 ml (200-1000 ml and hospital stay was 8.21 d (5-12 d. All patients were followed-up for 12.13 months (5-24 months. Compared with preoperation, VAS (P = 0.000, for all and ODI scores (P = 0.000, for all decreased significantly, SF-36 score increased (P = 0.000, for all, coronal Cobb angle (P = 0.000, for all, sagittal lordosis angle (P = 0.000, for all, coronal and sagittal deviation (P = 0.000, for all decreased significantly one week and 3 months after operation and in the last follow-up. The improvement rate of ODI was (86.51 ± 6.02%, fusion rate of vertebral bodies

  6. Trajectory of chemotherapy for patients with EGFR wild-type advanced pulmonary adenocarcinoma: a single-institution retrospective study

    Directory of Open Access Journals (Sweden)

    Minami S

    2017-02-01

    Full Text Available Seigo Minami, Yoshitaka Ogata, Shouichi Ihara, Suguru Yamamoto, Kiyoshi Komuta Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan Background: Pulmonary adenocarcinoma, recently benefited by new cytotoxic and molecularly targeted drugs, has been classified by driver mutations, such as EGFR mutations. The aim of this study was to research the proportions of patients treated with first- to third-line chemotherapy and to find influential factors for the introduction of chemotherapy and survival benefit from chemotherapy.Materials and methods: Data were collected retrospectively on patients who met the following criteria: adenocarcinoma, diagnosed between June 2007 and March 2015 at our hospital, stage IIIB or IV, and EGFR wild type. A nonchemotherapy group of patients who did not receive chemotherapy was compared with a chemotherapy group of patients who received it. The patients who had received first- to third-line chemotherapy between June 2007 and November 2015 at our hospital were also analyzed.Results: During the study period, 46 patients did not receive chemotherapy, while 148, 89, and 48 received first-, second- and third-line chemotherapy, respectively. As predictive factors for unlikely chemotherapy, multivariate logistic analysis detected Eastern Cooperative Oncology Group (ECOG performance status (PS ≥2, hemoglobin <13.2 g/dL, creatinine clearance (Ccr <50.4 mL/min, and CRP ≥0.53 mg/dL. As factors predicting shorter survival after chemotherapy, multivariate Cox proportional-hazard analyses detected age ≥75 years, ECOG PS ≥2, lower lymphocyte counts, and higher CRP for the first line; female, higher neutrophil counts, lower lymphocyte counts, reduced Ccr, hyponatremia, and shorter interval between first- and second-line chemotherapy for the second line; and age ≥75 years, body mass index <18.5 kg/m2, higher neutrophil counts, lower lymphocyte counts, hyponatremia, higher lactate dehydrogenase, and higher

  7. Analyses of herpes simplex virus type 1 latency and reactivation at the single cell level using fluorescent reporter mice

    Science.gov (United States)

    Nelson, D.; Nicoll, M. P.; Connor, V.

    2016-01-01

    Herpes simplex virus type 1 (HSV-1) establishes a latent infection in sensory neurons from which the virus can periodically reactivate. Whilst latency establishment is thought to result from a failure to express immediate-early genes, we have previously shown that subpopulations of the latent neuronal reservoir have undergone lytic promoter activation prior to latency establishment. In the present study, we have investigated the biological properties of such latently infected neuronal subpopulations using Ai6 fluorescent reporter mice. Using this system we have determined that prior ICP0 or TK promoter activation does not correlate with increased latent virus DNA loads within individual cells and that neurons with evidence of historical lytic cycle promoter activity exhibit a comparable frequency of reactivation to that of the general latent cell population. Comparison of viral DNA content within cells harbouring latent HSV-1 genomes and those undergoing the earliest stages of reactivation has revealed that reactivation can initiate from cells harbouring a wide range of HSV-1 genome copies, but that exiting latency is biased towards cells bearing higher latent virus DNA loads. PMID:26694770

  8. Variability within a single type of polyacrylonitrile-based graphite felt after thermal treatment. Part II: chemical properties

    International Nuclear Information System (INIS)

    Rabbow, Thomas J.; Trampert, Markus; Pokorny, Peter; Binder, Paul; Whitehead, Adam H.

    2015-01-01

    Graphite felts are often activated thermally before use in electrochemical reactors. This has the effect of improving wetting and decreasing charge-transfer resistance. In part I of this study, considerable variations were observed between two polyacrylonitrile (PAN)-based felts from different production charges after thermal activation, despite both charges being of the same type of felt from one supplier. A difference due to bulk crystallinity or due to pronounced core-rim structures of the fibres has been excluded. In this second part a limitation from tarry coatings, which are a possible side products of graphitization, could not be corroborated. However, differences were ascribed to variations in the surface chemistry, which was characterised by Boehm method titration and cyclic voltammetry. The composition of the oxides is discussed together with the possible role they play in the activation and wetting of the felts. The rather high amount of oxides suggests that the Boehm method measures subsurface groups in addition to surface groups. The wetting quality of activated felts can be correlated well with the concentration of neutral quinone groups, characterised by cyclic voltammetry

  9. Analysis of MUSIC-type imaging functional for single, thin electromagnetic inhomogeneity in limited-view inverse scattering problem

    Science.gov (United States)

    Ahn, Chi Young; Jeon, Kiwan; Park, Won-Kwang

    2015-06-01

    This study analyzes the well-known MUltiple SIgnal Classification (MUSIC) algorithm to identify unknown support of thin penetrable electromagnetic inhomogeneity from scattered field data collected within the so-called multi-static response matrix in limited-view inverse scattering problems. The mathematical theories of MUSIC are partially discovered, e.g., in the full-view problem, for an unknown target of dielectric contrast or a perfectly conducting crack with the Dirichlet boundary condition (Transverse Magnetic-TM polarization) and so on. Hence, we perform further research to analyze the MUSIC-type imaging functional and to certify some well-known but theoretically unexplained phenomena. For this purpose, we establish a relationship between the MUSIC imaging functional and an infinite series of Bessel functions of integer order of the first kind. This relationship is based on the rigorous asymptotic expansion formula in the existence of a thin inhomogeneity with a smooth supporting curve. Various results of numerical simulation are presented in order to support the identified structure of MUSIC. Although a priori information of the target is needed, we suggest a least condition of range of incident and observation directions to apply MUSIC in the limited-view problem.

  10. Body image mediates negative family climate and deteriorating glycemic control for single adolescents with type 1 diabetes.

    Science.gov (United States)

    Hartl, Amy C; Seiffge-Krenke, Inge; Laursen, Brett

    2015-12-01

    Glycemic control declines during adolescence, as youth with diabetes struggle with pubertal changes and a changing social world. The present study tests whether body image mediates longitudinal links between family climate and changes in adolescent glycemic control. Mediation was hypothesized for nondating adolescents but not for dating adolescents, because the former are thought to remain more family oriented than the latter. Participants were German adolescents with Type 1 diabetes (51 girls, 58 boys; M = 15.84 years, SD = 1.44). Participants reported body image and family climate. Physicians assayed blood HbA1c levels (M = 8.22%, SD = 1.80%) to measure glycemic control. For nondating adolescents, body image mediated associations between family climate and longitudinal changes in glycemic control. Poorer family climate was associated with poorer body image, which predicted deteriorating glycemic control. For dating adolescents, family climate was unassociated with changes in glycemic control. Nondating adolescents may look to parents for feedback on body image, which affects how they manage the challenges of diabetes. Parents and practitioners alike should be alert to the fact that family climate continues to be an important determinant of adolescent adjustment, particularly for those who have not moved into romantic relationships. We know that body image matters to adolescents, but for some youth, body image may be the difference between health and serious physical problems. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  11. Lumbar spine stability after combined application of interspinous fastener and modified posterior lumbar interbody fusion: a biomechanical study.

    Science.gov (United States)

    Yu, Xiuchun; Zhu, Lei; Su, Qing

    2014-05-01

    Posterior lumbar interbody fusion (PLIF) and internal fixation are commonly performed for the treatment of lower back pain due to lumbar spinal degeneration. We have developed a novel interspinous fixation device, the interspinous fastener (ISF) for potential use in the surgical management of degenerative spinal disease. The aim of this study was to assess the in vitro biomechanical characteristics of calf lumbar spine specimens after ISF fixation with modified PLIF. Ten lumbar spine (L3-L6) specimens from ten fresh calf cadavers (8-10 weeks of age) were used. Each specimen underwent sequential testing for each of the following four groups: no instrumentation (INTACT); interspinous fusion device fixation + PLIF (ISF); unilateral pedicle screw and titanium rod fixation + PLIF (UPS); bilateral pedicle screw and titanium rod fixation + PLIF (BPS). Outcome measures included angular range of motion (ROM) during unloaded and loaded (8 Nm) flexion, extension, left bending, right bending, left torsion and right torsion. For all unloaded and loaded assessments, ROM was significantly higher in the INTACT group compared with all other groups (P < 0.05). Similarly, ROM was significantly higher in the UPS group (indicating decreased stability) compared with the ISF and BPS groups (P < 0.05). The only significant difference between the ISF and BPS groups was in the ROM with unloaded extension (higher in the BPS group, P = 0.006). We found that ISF fixation with PLIF of the lower lumbar spine provided biomechanical stability that was equivalent to that associated with bilateral pedicle screw/rod fixation with PLIF. The ISF shows potential as an alternative means of fixation in the surgical management of degenerative spinal disease.

  12. Effect of Smoking Status on Successful Arthrodesis, Clinical Outcome, and Complications After Anterior Lumbar Interbody Fusion (ALIF).

    Science.gov (United States)

    Phan, Kevin; Fadhil, Matthew; Chang, Nicholas; Giang, Gloria; Gragnaniello, Cristian; Mobbs, Ralph J

    2018-02-01

    Anterior lumbar interbody fusion (ALIF) is a surgical technique indicated for the treatment of several lumbar pathologies. Smoking has been suggested as a possible cause of reduced fusion rates after ALIF, although the literature regarding the impact of smoking status on lumbar spine surgery is not well established. This study aims to assess the impact of perioperative smoking status on the rates of perioperative complications, fusion, and adverse clinical outcomes in patients undergoing ALIF surgery. A retrospective analysis was performed on a prospectively maintained database of 137 patients, all of whom underwent ALIF surgery by the same primary spine surgeon. Smoking status was defined by the presence of active smoking in the 2 weeks before the procedure. Outcome measures included fusion rates, surgical complications, Short-Form 12, and Oswestry Disability Index. Patients were separated into nonsmokers (n = 114) and smokers (n = 23). Univariate analysis demonstrated that the percentage of patients with successful fusion differed significantly between the groups (69.6% vs. 85.1%, P = 0.006). Pseudarthrosis rates were shown to be significantly associated with perioperative smoking. Results for other postoperative complications and clinical outcomes were similar for both groups. On multivariate analysis, the rate of failed fusion was significantly greater for smokers than nonsmokers (odds ratio 37.10, P = 0.002). The rate of successful fusion after ALIF surgery was found to be significantly lower for smokers compared with nonsmokers. No significant association was found between smoking status and other perioperative complications or adverse clinical outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Impaired bone mineral density as a predictor of graft subsidence following minimally invasive transpsoas lateral lumbar interbody fusion.

    Science.gov (United States)

    Tempel, Zachary J; Gandhoke, Gurpreet S; Okonkwo, David O; Kanter, Adam S

    2015-04-01

    The LLIF procedure is a useful stand-alone and adjunct surgical approach for many spinal conditions. One complication of LLIF is subsidence of the interbody graft into the vertebral bodies, resulting in severe pain, impaired arthrodesis and potentially fracture of the body. Low bone density, as measured by T score on DEXA scanning, has also been postulated to increase the risk of subsidence. A retrospective review of prospectively collected data was performed on all patients who underwent LLIF at this institution consisting of 712 levels in 335 patients. Patients with subsidence following LLIF were recorded. We utilized the T score obtained from the femoral neck DEXA scans, which is used to determine overall fracture risk. The T score of patients with subsidence was compared to those without subsidence. 20 of 57 (35 %) patients without subsidence had a DEXA T score between -1.0 and -2.4 consistent osteopenia, one patient (1.8 %) exhibited a T score less than -2.5, consistent with osteoporosis. 13 patients of 23 (57 %) with subsidence exhibited a T score between -1.0 and -2.4, consistent with osteopenia, five (22 %) exhibited a T score of -2.5 or less, consistent with osteoporosis. The mean DEXA T score in patients with subsidence was -1.65 (SD 1.04) compared to -0.45 (SD 0.97) in patients without subsidence (p subsidence. Further, they are at an increased risk of requiring additional surgery. In patients with poor bone quality, consideration could be made to supplement the LLIF cage with posterior instrumentation.

  14. Influence of Obesity on Complications, Clinical Outcome, and Subsidence After Anterior Lumbar Interbody Fusion (ALIF): Prospective Observational Study.

    Science.gov (United States)

    Phan, Kevin; Rogers, Priya; Rao, Prashanth J; Mobbs, Ralph J

    2017-11-01

    The complications associated with obesity have been well described for posterior lumbar spinal surgery. However, the influence of obesity on anterior lumbar interbody fusion (ALIF) is not well established. We aimed to compare complication risks, functional outcomes, and subsidence rates in normal-weight, overweight, and obese patients who underwent ALIF. A total of 137 consecutive patients undergoing ALIF surgery from 2012 to 2014 were followed prospectively. Patients were categorized into 3 groups according to their body mass index (BMI). Patients were evaluated preoperative and postoperatively. Outcome measures included Short Form-12, Oswestry Disability Index, surgical complications, and subsidence. There was no significant difference between the BMI groups in terms of baseline age, proportion of men, levels operated, smoking status, diabetes status, or anterior, posterior, or average disc height. There was no difference in operative duration, blood loss, or hospital stay. At 12-month follow-up, no difference was found in terms of total complications, change in Short Form-12 mental or physical component scores, or Oswestry Disability Index scores. Average disc height was significant lower for the obese group (11.3 mm) compared with the normal-weight (14.4 mm) group. Fusion rate was also significantly lower for patients who were obese (60%) compared with normal-weight (88.2%) and overweight patients (76%) (P = 0.014). Delayed subsidence rates also were similar between normal-weight and overweight patients. There were no differences in functional outcomes or complications in patients with elevated BMI compared with normal-weight patients. Fusion rates were lower for patients were obese. Obesity should not be considered a contraindication to surgery in patients with appropriate indication to undergo ALIF. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Two-level anterior lumbar interbody fusion with percutaneous pedicle screw fixation. A minimum 3-year follow-up study

    International Nuclear Information System (INIS)

    Lee, Dong-Yeob; Lee, Sang-Ho; Maeng, Dae-Hyeon

    2010-01-01

    The clinical and radiological outcomes of two-level anterior lumbar interbody fusion (ALIF) with percutaneous pedicle screw fixation (PSF) were evaluated in 24 consecutive patients who underwent two level ALIF with percutaneous PSF for segmental instability and were followed up for more than 3 years. Clinical outcomes were assessed using a visual analogue scale (VAS) score and the Oswestry Disability Index (ODI). Sagittal alignment, bone union, and adjacent segment degeneration (ASD) were assessed using radiography and magnetic resonance imaging. The mean age of the patients at the time of operation was 56.3 years (range 39-70 years). Minor complications occurred in 2 patients in the perioperative period. At a mean follow-up duration of 39.4 months (range 36-42 months), VAS scores for back pain and leg pain, and ODI score decreased significantly (from 6.5, 6.8, and 46.9% to 3.0, 1.9, and 16.3%, respectively). Clinical success was achieved in 22 of the 24 patients. The mean segmental lordosis, whole lumbar lordosis, and sacral tilt significantly increased after surgery (from 25.1deg, 39.2deg, and 32.6deg to 32.9deg, 44.5deg, and 36.6deg, respectively). Solid fusion was achieved in 21 patients. ASD was found in 8 of the 24 patients. No patient underwent revision surgery due to nonunion or ASD. Two-level ALIF with percutaneous PSF yielded satisfactory clinical and radiological outcomes and could be a useful alternative to posterior fusion surgery. (author)

  16. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series

    Directory of Open Access Journals (Sweden)

    Miller Larry E

    2011-09-01

    Full Text Available Abstract Introduction Traditional surgical management of lumbosacral spondylolisthesis is technically challenging and is associated with significant complications. The advent of minimally invasive surgical techniques offers patients treatment alternatives with lower operative morbidity risk. The combination of percutaneous pedicle screw reduction and an axial presacral approach for lumbosacral discectomy and fusion offers an alternative procedure for the surgical management of low-grade lumbosacral spondylolisthesis. Case presentation Three patients who had L5-S1 grade 2 spondylolisthesis and who presented with axial pain and lumbar radiculopathy were treated with a minimally invasive surgical technique. The patients-a 51-year-old woman and two men (ages 46 and 50-were Caucasian. Under fluoroscopic guidance, spondylolisthesis was reduced with a percutaneous pedicle screw system, resulting in interspace distraction. Then, an axial presacral approach with the AxiaLIF System (TranS1, Inc., Wilmington, NC, USA was used to perform the discectomy and anterior fixation. Once the axial rod was engaged in the L5 vertebral body, further distraction of the spinal interspace was made possible by partially loosening the pedicle screw caps, advancing the AxiaLIF rod to its final position in the vertebrae, and retightening the screw caps. The operative time ranged from 173 to 323 minutes, and blood loss was minimal (50 mL. Indirect foraminal decompression and adequate fixation were achieved in all cases. All patients were ambulatory after surgery and reported relief from pain and resolution of radicular symptoms. No perioperative complications were reported, and patients were discharged in two to three days. Fusion was demonstrated radiographically in all patients at one-year follow-up. Conclusions Percutaneous pedicle screw reduction combined with axial presacral lumbar interbody fusion offers a promising and minimally invasive alternative for the management

  17. Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF) for Spondylolisthesis in 282 Patients: In Situ Arthrodesis versus Reduction.

    Science.gov (United States)

    Scheer, Justin K; Auffinger, Brenda; Wong, Ricky H; Lam, Sandi K; Lawton, Cort D; Nixon, Alexander T; Dahdaleh, Nader S; Smith, Zachary A; Fessler, Richard G

    2015-07-01

    The benefits of spondylolisthesis reduction via minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) remain poorly understood. The purpose was to compare the complications, perioperative factors, and fusion rates in patients undergoing MI-TLIF for degenerative spondylolisthesis between those in whom reduction was or was not performed. 1) patients who underwent a 1, 2, or 3 level MI-TLIF and 2) had a preoperative diagnosis of degenerative spondylolisthesis (Meyerding grade >0). >10° coronal curves, significant sagittal malalignment, infection, and preoperative hardware failure. Patients were grouped on the basis of those who underwent reduction of the spondylolisthesis by at least 1 Meyerding grade (RED) and those who did not (NORED). A total of 282 patients were included: RED (162, 57.4%) and NORED (120, 42.6%). Mean ages (61.68 ± 10.43 vs. 61.88 ± 11.76 years, respectively, P > 0.05) and operative times (P > 0.05) were statistically similar. RED had a significantly larger EBL (280.2 ± 24.03 vs. 212.61 ± 17.54, P 0.05, for all). RED had a significantly higher percentage of patients with a successful fusion at 1 year than NORED (84.50% vs. 70.83%, P spondylolisthesis was not associated with an increase in operative time, length of stay, and perioperative and postoperative complications compared with fusion in situ. Reduction was associated with higher blood loss but also a higher rate of fusion success at 1 year. Overall, reduction did not incur additional risk and had positive perioperative outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Biomechanical Analysis of a Newly Developed Shape Memory Alloy Hook in a Transforaminal Lumbar Interbody Fusion (TLIF) In Vitro Model

    Science.gov (United States)

    Wang, Xi; Xu, Jing; Zhu, Yuexing; Li, Jiukun; Zhou, Si; Tian, Shunliang; Xiang, Yucheng; Liu, Xingmo; Zheng, Ying; Pan, Tao

    2014-01-01

    Objective The objective of this biomechanical study was to evaluate the stability provided by a newly developed shape memory alloy hook (SMAH) in a cadaveric transforaminal lumbar interbody fusion (TLIF) model. Methods Six human cadaveric spines (L1-S2) were tested in an in vitro flexibility experiment by applying pure moments of ±8 Nm in flexion/extension, left/right lateral bending, and left/right axial rotation. After intact testing, a TLIF was performed at L4-5. Each specimen was tested for the following constructs: unilateral SMAH (USMAH); bilateral SMAH (BSMAH); unilateral pedicle screws and rods (UPS); and bilateral pedicle screws and rods (BPS). The L3–L4, L4–L5, and L5-S1 range of motion (ROM) were recorded by a Motion Analysis System. Results Compared to the other constructs, the BPS provided the most stability. The UPS significantly reduced the ROM in extension/flexion and lateral bending; the BSMAH significantly reduced the ROM in extension/flexion, lateral bending, and axial rotation; and the USMAH significantly reduced the ROM in flexion and left lateral bending compared with the intact spine (p0.05). Stability provided by the USMAH compared with the UPS was not significantly different. ROMs of adjacent segments increased in all fixed constructs (p>0.05). Conclusions Bilateral SMAH fixation can achieve immediate stability after L4–5 TLIF in vitro. Further studies are required to determine whether the SMAH can achieve fusion in vivo and alleviate adjacent segment degeneration. PMID:25474112

  19. Effect of lumbar lordosis on the adjacent segment in transforaminal lumbar interbody fusion: A finite element analysis.

    Science.gov (United States)

    Zhao, Xin; Du, Lin; Xie, Youzhuan; Zhao, Jie

    2018-02-21

    Here we used a finite element (FE) analysis to investigate the biomechanical changes caused by transforaminal lumbar interbody fusion (TLIF) at the L4-L5 level by lumbar lordosis (LL) degree. A lumbar FE model (L1-S5) was constructed based on computed tomography scans of a 30-year-old healthy male volunteer (pelvic incidence = 50°, LL = 52°). We investigated the influence of LL on the biomechanical behavior of the lumbar spine after TLIF in L4-L5 fusion models with 57°, 52°, 47°, and 40° LL. The LL was defined as the angle between the superior endplate of L1 and the superior endplate of S1. A 150-N vertical axial pre-load was imposed on the superior surface of L3. A 10-N·m moment was simultaneously applied on the L3 superior surface along the radial direction to simulate the four basic physiological motions of flexion, extension, lateral bending, and torsion in the numerical simulations. The range of motion (ROM) and intradiscal pressure (IDP) of L3-L4 were evaluated and compared in the simulated cases. In all motion patterns, the ROM and IDP were both increased after TLIF. In addition, the decrease in lordosis generally increased the ROM and IDP in all motion patterns. The current FE analysis indicated that decreased spinal lordosis may evoke overstress of the adjacent segment and increase the risk of the pathological development of adjacent segment degeneration (ASD); thus, ASD should be considered when planning a spinal fusion procedure. Copyright © 2018. Published by Elsevier Inc.

  20. Biomechanical analysis of a newly developed shape memory alloy hook in a transforaminal lumbar interbody fusion (TLIF in vitro model.

    Directory of Open Access Journals (Sweden)

    Xi Wang

    Full Text Available The objective of this biomechanical study was to evaluate the stability provided by a newly developed shape memory alloy hook (SMAH in a cadaveric transforaminal lumbar interbody fusion (TLIF model.Six human cadaveric spines (L1-S2 were tested in an in vitro flexibility experiment by applying pure moments of ±8 Nm in flexion/extension, left/right lateral bending, and left/right axial rotation. After intact testing, a TLIF was performed at L4-5. Each specimen was tested for the following constructs: unilateral SMAH (USMAH; bilateral SMAH (BSMAH; unilateral pedicle screws and rods (UPS; and bilateral pedicle screws and rods (BPS. The L3-L4, L4-L5, and L5-S1 range of motion (ROM were recorded by a Motion Analysis System.Compared to the other constructs, the BPS provided the most stability. The UPS significantly reduced the ROM in extension/flexion and lateral bending; the BSMAH significantly reduced the ROM in extension/flexion, lateral bending, and axial rotation; and the USMAH significantly reduced the ROM in flexion and left lateral bending compared with the intact spine (p0.05. Stability provided by the USMAH compared with the UPS was not significantly different. ROMs of adjacent segments increased in all fixed constructs (p>0.05.Bilateral SMAH fixation can achieve immediate stability after L4-5 TLIF in vitro. Further studies are required to determine whether the SMAH can achieve fusion in vivo and alleviate adjacent segment degeneration.

  1. Spatial filtering nearly eliminates the side-lobes in single- and multi-photon 4pi-type-C super-resolution fluorescence microscopy

    Science.gov (United States)

    Kavya, M.; Regmi, Raju; Mondal, Partha P.

    2013-09-01

    Super-resolution microscopy has tremendously progressed our understanding of cellular biophysics and biochemistry. Specifically, 4pi fluorescence microscopy technique stands out because of its axial super-resolution capability. All types of 4pi-microscopy techniques work well in conjugation with deconvolution techniques to get rid of artifacts due to side-lobes. In this regard, we propose a technique based on spatial filter in a 4pi-type-C confocal setup to get rid of these artifacts. Using a special spatial filter, we have reduced the depth-of-focus. Interference of two similar depth-of-focus beams in a 4π geometry result in substantial reduction of side-lobes. Studies show a reduction of side-lobes by 46% and 76% for single and two photon variant compared to 4pi - type - C confocal system. This is incredible considering the resolving capability of the existing 4pi - type - C confocal microscopy. Moreover, the main lobe is found to be 150 nm for the proposed spatial filtering technique as compared to 690 nm of the state-of-art confocal system. Reconstruction of experimentally obtained 2PE - 4pi data of green fluorescent protein (GFP)-tagged mitocondrial network shows near elimination of artifacts arising out of side-lobes. Proposed technique may find interesting application in fluorescence microscopy, nano-lithography, and cell biology.

  2. Assessment of the efficacy and safety of single platelet-rich plasma injection on different types and grades of facial wrinkles.

    Science.gov (United States)

    Elnehrawy, Naema Y; Ibrahim, Zeinab A; Eltoukhy, Azza M; Nagy, Hala M

    2017-03-01

    Platelet-rich plasma (PRP) is considered as a growing modality for tissue regeneration and a developing research area for clinicians and researchers. PRP injection treatment provides supraphysiological concentrations of growth factors that may help in accelerated tissue remodeling and regeneration. To evaluate the efficacy and safety of single autologous PRP intradermal injection for treatment of facial wrinkles and for facial rejuvenation. A total of 20 subjects with different types of facial wrinkles were included in this study. All subjects received single PRP intradermal injection and were clinically assessed before and after treatment for a period of 8 weeks using Wrinkle Severity Rating Scale (WSRS), Skin Homogeneity and Texture (SHnT) Scale, Physician Assessment Scale, and Subject Satisfaction Scale. The mean value of WSRS reduced from 2.90 ± 0.91 before treatment to 2.10 ± 0.79 after 8 weeks of treatment. The most significant results were with younger subjects that have mild and moderate wrinkles of the nasolabial folds (NLFs). Fourteen of seventeen subjects with NLFs showed more than 25% improvement in their appearance. Side effects of PRP treatment were minimal to mild and with excellent tolerability. Single PRP intradermal injection is well tolerated and capable of rejuvenating the face and producing a significant correction of wrinkles especially the NLFs. © 2016 Wiley Periodicals, Inc.

  3. Types and microbiological spectrum of infections in patients with cirrhosis: A single-centre experience in Upper Egypt.

    Science.gov (United States)

    El-Amin, Hussein; Sabry, Abeer M M; Ahmed, Rabab E; Makhlouf, Nahed A

    2017-09-01

    Egypt has a high prevalence of hepatitis C virus (HCV) and high morbidity and mortality related to cirrhosis complications. Patients with cirrhosis have an increased risk of bacterial infections. Approximately 25-35% of cirrhotics had infections at admission or during hospitalisation. Data on infection among cirrhotics in Egypt are limited. This study aimed to determine the frequency and microbiological spectrum of infections in cirrhotics and possible risk factors. This study was conducted at a tertiary care hospital. The frequency and microbiological spectrum of infections in cirrhotics were determined. The risk factors for infection were evaluated. Of the 100 patients with liver cirrhosis, 61% had infection. Ascitic fluid infection (AFI) was the most common infection (44.3%), followed by urinary tract infection (UTI) (21.3%), respiratory tract infection (RTI) (19.7%), gastroenteritis (6.6%) and skin infection (4.9%). The only risk factor for infection among cirrhotics was diabetes mellitus (DM) (p=0.047). The mean value of mid-arm muscle circumference was significantly lower in the infected group (p=0.047). Among all the cirrhotics, 32.0% had mild to moderate malnutrition and 52.0% had severe malnutrition. The frequency of infection was higher in severe malnutrition (71.2%). The frequency of infections among cirrhotics was 61%. Many types of infections including AFI, RTI, UTI and skin infections were present in patients with liver cirrhosis, but AFI was the most common. DM was the only risk factor for infection, and independent predictors for infection were elevated WBC count and C-reactive protein levels. The frequency of infection was related to the degree of malnutrition. Copyright © 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  4. [Effect evaluation of over 5 year follow up of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion for lumbar degenerative diseases].

    Science.gov (United States)

    Wang, Chong; Ying, Jin-He; Xie, Pan-Pan; Wu, Xiao-Guang

    2016-07-25

    To evaluate the clinical effects of over 5 year follow up of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion(TLIF) in treating lumbar degenerative diseases. The clinical data of 24 patients with lumbar degenerative disease underwent unilateral pedicle screw fixation with transforaminal lumbar interbody fusion from March 2007 to October 2009, were retrospectively analyzed. There were 13 males and 11 females, aged from 34 to 68 years old with an average of 52 years. Postoperative pain and functional results were analyzed by the visual analogue scale(VAS) and Oswestry Disability Index(ODI). Radiological examination was obtained for each patient to assess the height of intervertebral space, postoperative intervertebral fusion conditions and general complications. All patients were followed up from 5 to 8 years with an average of 6.7 years. VAS scores of low back pain and leg pain decreased from preoperative 7.82±0.71, 8.42±1.24 to postoperative 1.87±0.81, 2.23±1.62, respectively( P degenerative diseases according to over 5 year follow up, however, its indications should be well considered. But the problems such as intervertebral space height of operated side loss and adjacent segment degeneration after unilateral pedicle screw fixation need further clinical study.

  5. Symptomatic ectopic bone formation after off-label use of recombinant human bone morphogenetic protein-2 in transforaminal lumbar interbody fusion.

    Science.gov (United States)

    Chen, Nan-Fu; Smith, Zachary A; Stiner, Eric; Armin, Sean; Sheikh, Hormoz; Khoo, Larry T

    2010-01-01

    Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been approved for use in the lumbar spine in conjunction with the lumbar tapered cage. However, off-label use of this osteoinductive agent is observed with anterior fusion applications as well as with both posterior lumbar interbody fusion and transforaminal lumbar interbody fusion (TLIF). Complications using rhBMP-2 in the cervical spine have been reported. Although radiographic evidence of ectopic bone in the lumbar spine has been described following rhBMP-2 use, this finding was not previously believed to be of clinical relevance. This study was a retrospective review of 4 patients who underwent minimally invasive spinal TLIF (MIS-TLIF) in which bone fusion was augmented with rhBMP-2 applied to an absorbable collagen sponge. Case presentations, operative findings, imaging data, and follow-up findings were reviewed. Four cases with delayed symptomatic neural compression following the off-label use of rhBMP-2 with MIS-TLIF were identified. Although previously believed to be only a radiographic finding, the development of ectopic bone following rhBMP-2 use in lumbar fusion can be clinically significant. This paper describes 4 cases of delayed neural compression following MIS-TLIF. The reader should be aware of this potential complication following the off-label use of rhBMP-2 in the lumbar spine.

  6. Comparison of outcomes and safety of using hydroxyapatite granules as a substitute for autograft in cervical cages for anterior cervical discectomy and interbody fusion

    Directory of Open Access Journals (Sweden)

    Hosein Mashhadinezhad

    2014-03-01

    Full Text Available Background:   After cervical discectomy, autogenetic bone is packed into the cage to increase the rate of union between adjacent vertebral bodies, but donor site–related complications can still occur. In this study we evaluate the use   of hydroxyapatite granules as a substitute for autograft for interbody fusion.     Methods:   From November 2008 to November 2011, 236 patients participated in this study. Peek cages were packed with autologous bone grafts taken from the iliac crest in 112 patients and hydroxyapatite (HA granules in 124 patients.   Patients were followed for 12 months. The patients’ neurological signs, results, and complications were fully recorded   throughout the procedure. Radiological imaging was done to assess the fusion rate and settling ratio.     Results:   Formation of bony bridges at the third month was higher in the autograft group versus the granule group. However, there was no difference between both groups at the 12-month follow-up assessment. No difference (     P > 0.05   was found regarding improvement in neurological deficit as well as radicular pain and recovery rate between the two groups. Conclusions:   Interbody fusion cage containing HA granules proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Clinical and neurological outcome, radiographic measurement and fusion rate   in cage containing HA are similar and competitive with autograft packed cages.

  7. Comparison of outcomes and safety of using hydroxyapatite granules as a substitute for autograft in cervical cages for anterior cervical discectomy and interbody fusion

    Directory of Open Access Journals (Sweden)

    Hosein Mashhadinezhad

    2014-03-01

    Full Text Available Background:   After cervical discectomy, autogenetic bone is packed into the cage to increase the rate of union between adjacent vertebral bodies, but donor site–related complications can still occur. In this study we evaluate the use   of hydroxyapatite granules as a substitute for autograft for interbody fusion.     Methods:   From November 2008 to November 2011, 236 patients participated in this study. Peek cages were packed with autologous bone grafts taken from the iliac crest in 112 patients and hydroxyapatite (HA granules in 124 patients.   Patients were followed for 12 months. The patients’ neurological signs, results, and complications were fully recorded   throughout the procedure. Radiological imaging was done to assess the fusion rate and settling ratio.     Results:   Formation of bony bridges at the third month was higher in the autograft group versus the granule group. However, there was no difference between both groups at the 12-month follow-up assessment. No difference (     P > 0.05   was found regarding improvement in neurological deficit as well as radicular pain and recovery rate between the two groups. Conclusions:   Interbody fusion cage containing HA granules proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Clinical and neurological outcome, radiographic measurement and fusion rate   in cage containing HA are similar and competitive with autograft packed cages.    

  8. Single-cell-type quantitative proteomic and ionomic analysis of epidermal bladder cells from the halophyte model plant Mesembryanthemum crystallinum to identify salt-responsive proteins.

    Science.gov (United States)

    Barkla, Bronwyn J; Vera-Estrella, Rosario; Raymond, Carolyn

    2016-05-10

    Epidermal bladder cells (EBC) are large single-celled, specialized, and modified trichomes found on the aerial parts of the halophyte Mesembryanthemum crystallinum. Recent development of a simple but high throughput technique to extract the contents from these cells has provided an opportunity to conduct detailed single-cell-type analyses of their molecular characteristics at high resolution to gain insight into the role of these cells in the salt tolerance of the plant. In this study, we carry out large-scale complementary quantitative proteomic studies using both a label (DIGE) and label-free (GeLC-MS) approach to identify salt-responsive proteins in the EBC extract. Additionally we perform an ionomics analysis (ICP-MS) to follow changes in the amounts of 27 different elements. Using these methods, we were able to identify 54 proteins and nine elements that showed statistically significant changes in the EBC from salt-treated plants. GO enrichment analysis identified a large number of transport proteins but also proteins involved in photosynthesis, primary metabolism and Crassulacean acid metabolism (CAM). Validation of results by western blot, confocal microscopy and enzyme analysis helped to strengthen findings and further our understanding into the role of these specialized cells. As expected EBC accumulated large quantities of sodium, however, the most abundant element was chloride suggesting the sequestration of this ion into the EBC vacuole is just as important for salt tolerance. This single-cell type omics approach shows that epidermal bladder cells of M. crystallinum are metabolically active modified trichomes, with primary metabolism supporting cell growth, ion accumulation, compatible solute synthesis and CAM. Data are available via ProteomeXchange with identifier PXD004045.

  9. Computational approach to predict species-specific type III secretion system (T3SS) effectors using single and multiple genomes.

    Science.gov (United States)

    Hobbs, Christopher K; Porter, Vanessa L; Stow, Maxwell L S; Siame, Bupe A; Tsang, Herbert H; Leung, Ka Yin

    2016-12-19

    Many gram-negative bacteria use type III secretion systems (T3SSs) to translocate effector proteins into host cells. T3SS effectors can give some bacteria a competitive edge over others within the same environment and can help bacteria to invade the host cells and allow them to multiply rapidly within the host. Therefore, developing efficient methods to identify effectors scattered in bacterial genomes can lead to a better understanding of host-pathogen interactions and ultimately to important medical and biotechnological applications. We used 21 genomic and proteomic attributes to create a precise and reliable T3SS effector prediction method called Genome Search for Effectors Tool (GenSET). Five machine learning algorithms were trained on effectors selected from different organisms and a trained (voting) algorithm was then applied to identify other effectors present in the genome testing sets from the same (GenSET Phase 1) or different (GenSET Phase 2) organism. Although a select group of attributes that included the codon adaptation index, probability of expression in inclusion bodies, N-terminal disorder, and G + C content (filtered) were better at discriminating between positive and negative sets, algorithm performance was better when all 21 attributes (unfiltered) were used. Performance scores (sensitivity, specificity and area under the curve) from GenSET Phase 1 were better than those reported for six published methods. More importantly, GenSET Phase 1 ranked more known effectors (70.3%) in the top 40 ranked proteins and predicted 10-80% more effectors than three available programs in three of the four organisms tested. GenSET Phase 2 predicted 43.8% effectors in the top 40 ranked proteins when tested on four related or unrelated organisms. The lower prediction rates from GenSET Phase 2 may be due to the presence of different translocation signals in effectors from different T3SS families. The species-specific GenSET Phase 1 method offers an alternative

  10. The utility of an electronic adherence assessment device in type 2 diabetes mellitus: a pilot study of single medication

    Directory of Open Access Journals (Sweden)

    Nadir Kheir

    2010-07-01

    attitudes and practices of the patients, as demonstrated by our KAP analysis and correlations.Keywords: Medication Events Monitoring System (MEMS, type 2 diabetes mellitus, drug therapy, medication adherence

  11. Setting Single or Multiple Goals for Diet and Physical Activity Behaviors Improves Cardiovascular Disease Risk Factors in Adults With Type 2 Diabetes: A Pragmatic Pilot Randomized Trial.

    Science.gov (United States)

    Swoboda, Christine M; Miller, Carla K; Wills, Celia E

    2016-08-01

    The purpose of this study was to evaluate a 4-month telephone-based goal-setting and decision support intervention among adults with type 2 diabetes mellitus (T2DM) and multiple risk factors for cardiovascular disease (CVD). A randomized pretest-posttest control group design was employed. Overweight or obese adults aged 40 to 75 years with T2DM and ≥1 additional CVD risk factor were provided with individualized CVD risk information. At baseline and each biweekly telephone call, the multiple-goal group self-selected both diet- and physical activity-related goals, the single goal group set a single goal, and the control group received information about community health resources. Dietary intake was assessed via a food frequency questionnaire, physical activity via questionnaire, and A1C and blood lipids via fasting fingerstick sample. Between-group differences for clinical (ie, A1C, blood pressure, and blood lipids), physical activity, and dietary variables were evaluated using Kruskal-Wallis, Mann-Whitney U, analysis of variance, and t tests. From pre- to postintervention, the single-goal group demonstrated significant improvement in systolic blood pressure and intake of servings of fruits, vegetables, and refined grains (all P < .05). The multiple-goal group reported significant reduction in percent energy from total, saturated, monounsaturated, and trans fat intake and significant increase in leisure time walking (all P < .05). A multiple-goal approach over 4 months can improve dietary and physical activity outcomes, while a single-goal approach may facilitate improvement in one behavioral domain. Additional research is needed to evaluate maintenance of the achieved changes. © 2016 The Author(s).

  12. IMMEDIATE RECIPROCAL CHANGES AT ADJACENT LEVEL FOLLOWING SINGLE-LEVEL ALIF

    Directory of Open Access Journals (Sweden)

    Enrique Vargas Uribe

    2015-12-01

    Full Text Available Objective : To assess the segmental sagittal parameters and the adjacent mobile segment after interbody fusion by anterior approach in single-level L5-S1. Methods : Retrospective study. Inclusion: Interbody fusion by anterior approach (10°/15° angle, due to DDD, low-grade spondylolisthesis and/or stenosis without prior lumbar fusion. Thirty-five cases were included (25 women; mean age 47±15 years. Analysis of lumbar radiographs were performed preoperatively and 3 months after surgery. The following parameters were evaluated: lumbar lordosis; segmental lordosis L4-L5 and L5-S1; sacral and L5 slope. Two independent evaluators made the measurements. Student's t test was used. Results : There was correction of lordosis at the L5-S1 level, from an average of 19° prior to surgery to 28° three months after surgery (p<0.001. It was observed reduction of the L4-L5 angle from 17° to 14° (p <0.001. Moreover, there was a small, but statistically significant, reduction of L5 inclination from 17 ° to 13 ° (p=0.007 and increase in the sacral slope from 37° to 40° (p=0.002. The change of total lumbar lordosis was not significant: 52° versus 53° (p=0.461. Before surgical correction, lordosis of the L5-S1 level contributed, on average, 37% of lumbar lordosis, and after, 54% (p<0.001. The L4-L5 level accounted for 34% and decreased to 24% (p<0.001. Conclusion : In the group studied, it was observed a decrease in lordosis of the adjacent mobile level following the treatment of the degenerate level by anterior interbody fusion and concomitant increase in lordosis.

  13. Influence of type-I fimbriae and fluid shear stress on bacterial behavior and multicellular architecture of earlyEscherichia colibiofilms at single-cell resolution.

    Science.gov (United States)

    Wang, Liyun; Keatch, Robert; Zhao, Qi; Wright, John A; Bryant, Clare E; Redmann, Anna L; Terentjev, Eugene M

    2018-01-12

    Biofilm formation on abiotic surfaces in food and medical industry can cause severe contamination and infection, yet how biological and physical factors determine cellular architecture of early biofilms and bacterial behavior of the constituent cells remains largely unknown. In this study we examine the specific role of type-I fimbriae in nascent stages of biofilm formation and the response of micro-colonies to environmental flow shear at single-cell resolution. The results show that type-I fimbriae are not required for reversible adhesion from plankton, but critical for irreversible adhesion of Escherichia coli ( E.coli ) MG1655 forming biofilms on polyethylene terephthalate (PET) surfaces. Besides establishing a firm cell-surface contact, the irreversible adhesion seems necessary to initiate the proliferation of E.coli on the surface. After application of shear stress, bacterial retention is dominated by the 3D architecture of colonies independent of the population and the multi-layered structure could protect the embedded cells from being insulted by fluid shear, while cell membrane permeability mainly depends on the biofilm population and the duration time of the shear stress. Importance Bacterial biofilms could lead to severe contamination problems in medical devices and food processing equipment. However, biofilms are usually studied at a rough macroscopic level, thus little is known about how individual bacterial behavior within biofilms and multicellular architecture are influenced by bacterial appendages (e.g. pili/fimbriae) and environmental factors during early biofilm formation. We apply Confocal Laser Scanning Microscopy (CLSM) to visualize E.coli micro-colonies at single-cell resolution. Our findings suggest that type-I fimbriae are vital to the initiation of bacterial proliferation on surfaces and that the responses of biofilm architecture and cell membrane permeability of constituent bacteria to fluid shear stress are different, which are

  14. Enrichment of HLA Types and Single-Nucleotide Polymorphism Associated With Non-progression in a Strictly Defined Cohort of HIV-1 Controllers

    Directory of Open Access Journals (Sweden)

    Samantha J. Westrop

    2017-06-01

    Full Text Available HIV-1 controllers (HIC are extremely rare patients with the ability to control viral replication, maintain unchanging CD4 T-cell count, and evade disease progression for extensive periods of time, in the absence of antiretroviral therapy. In order to establish the representation of key genetic correlates of atypical disease progression within a cohort of HIV-1+ individuals who control viral replication, we examine four-digit resolution HLA type and single-nucleotide polymorphisms (SNP previously identified to be correlated to non-progressive infection, in strictly defined HIC. Clinical histories were examined to identify patients exhibiting HIC status. Genomic DNA was extracted, and high definition HLA typing and genome-wide SNP analysis was performed. Data were compared with frequencies of SNP in European long-term non-progressors (LTNP and primary infection cohorts. HLA-B alleles associated with atypical disease progression were at very high frequencies in the group of five HIC studied. All four HIC of European ancestry were HLA-B*57+ and half were also HLA-B*27+. All HIC, including one of self-reported African ethnicity, had the HLA-Cw*0602 allele, and the HLA-DQ9 allele was present only in HIC of European ancestry. A median 95% of the top 19 SNP known to be associated with LTNP status was observed in European HIC (range 78–100%; 17/19 of the SNP considered mapped to chromosome 6 in the HLA region, whereas 2/19 mapped to chromosome 8. The HIC investigated here demonstrated high enrichment of HLA types and SNP previously associated with long-term non-progression. These findings suggest that the extreme non-progressive phenotype considered here is associated with a genetic signature characterized by a single-genetic unit centered around the HLA-B*57 haplotype and the possible additive effect of HLA-B*27.

  15. Microscopic mechanisms for long QT syndrome type 1 revealed by single-channel analysis of I(Ks) with S3 domain mutations in KCNQ1.

    Science.gov (United States)

    Eldstrom, Jodene; Wang, Zhuren; Werry, Daniel; Wong, Nathan; Fedida, David

    2015-02-01

    The slowly activating delayed rectifier current IKs participates in cardiac repolarization, particularly at high heart rates, and mutations in this K(+) channel complex underlie long QT syndrome (LQTS) types 1 and 5. The purpose of this study was to determine biophysical mechanisms of LQT1 through single-channel kinetic analysis of IKs carrying LQT1 mutations in the S3 transmembrane region of the pore-forming subunit KCNQ1. We analyzed cell-attached recordings from mammalian cells in which a single active KCNQ1 (wild type or mutant) and KCNE1 complex could be detected. The S3 mutants of KCNQ1 studied (D202H, I204F, V205M, and S209F), with the exception of S209F, all led to a reduction in channel activity through distinct kinetic mechanisms. D202H, I204F, and V205M showed decreased open probability (Po) compared with wild type (0.07, 0.04, and 0.12 vs 0.2); increased first latency from 1.66 to >2 seconds at +60 mV (I204F, V205M); variable-to-severe reductions in open dwell times (≥50% in V205M); stabilization of closed states (D202H); and an inability of channels to reach full conductance levels (V205M, I204F). S209F is a kinetic gain-of-function mutation with a high Po (0.40) and long open-state dwell times. S3 mutations in KCNQ1 cause diverse kinetic defects in I(Ks), affecting opening and closing properties, and can account for LQT1 phenotypes. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  16. Vancomycin-resistant vanB-type Enterococcus faecium isolates expressing varying levels of vancomycin resistance and being highly prevalent among neonatal patients in a single ICU

    Directory of Open Access Journals (Sweden)

    Werner Guido

    2012-05-01

    Full Text Available Abstract Background Vancomycin-resistant isolates of E. faecalis and E. faecium are of special concern and patients at risk of acquiring a VRE colonization/infection include also intensively-cared neonates. We describe here an ongoing high prevalence of VanB type E. faecium in a neonatal ICU hardly to identify by routine diagnostics. Methods During a 10 months’ key period 71 E. faecium isolates including 67 vanB-type isolates from 61 patients were collected non-selectively. Vancomycin resistance was determined by different MIC methods (broth microdilution, Vitek® 2 including two Etest® protocols (McFarland 0.5/2.0. on Mueller-Hinton/Brain Heart Infusion agars. Performance of three chromogenic VRE agars to identify the vanB type outbreak VRE was evaluated (BrillianceTM VRE agar, chromIDTM VRE agar, CHROMagarTM VRE. Isolates were genotyped by SmaI- and CeuI-macrorestriction analysis in PFGE, plasmid profiling, vanB Southern hybridisations as well as MLST typing. Results Majority of vanB isolates (n = 56, 79% belonged to a single ST192 outbreak strain type showing an identical PFGE pattern and analyzed representative isolates revealed a chromosomal localization of a vanB2-Tn5382 cluster type. Vancomycin MICs in cation-adjusted MH broth revealed a susceptible value of ≤4 mg/L for 31 (55% of the 56 outbreak VRE isolates. Etest® vancomycin on MH and BHI agars revealed only two vanB VRE isolates with a susceptible result; in general Etest® MIC results were about 1 to 2 doubling dilutions higher than MICs assessed in broth and values after the 48 h readout were 0.5 to 1 doubling dilutions higher for vanB VRE. Of all vanB type VRE only three, three and two isolates did not grow on BrillianceTM VRE agar, chromIDTM VRE agar and CHROMagarTM VRE, respectively. Permanent cross contamination via the patients’ surrounding appeared as a possible risk factor for permanent VRE colonization/infection. Conclusions Low level expression of van

  17. Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study.

    Science.gov (United States)

    Ganasegeran, Kurubaran; Renganathan, Pukunan; Manaf, Rizal Abdul; Al-Dubai, Sami Abdo Radman

    2014-04-23

    To determine the prevalence and factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia. Descriptive, cross-sectional single-centre study with universal sampling of all patients with type 2 diabetes. Endocrinology clinic of medical outpatient department in a Malaysian public hospital. All 169 patients with type 2 diabetes (men, n=99; women, n=70) aged between 18 and 90 years who acquired follow-up treatment from the endocrinology clinic in the month of September 2013. The validated Hospital Anxiety and Depression Scale (HADS), sociodemographic characteristics and clinical health information from patient records. Of the total 169 patients surveyed, anxiety and depression were found in 53 (31.4%) and 68 (40.3%), respectively. In multivariate analysis, age, ethnicity and ischaemic heart disease were significantly associated with anxiety, while age, ethnicity and monthly household income were significantly associated with depression. Sociodemographics and clinical health factors were important correlates of anxiety and depression among patients with diabetes. Integrated psychological and medical care to boost self-determination and confidence in the management of diabetes would catalyse optimal health outcomes among patients with diabetes.

  18. Progress on n-type doping of AlGaN alloys on AlN single crystal substrates for UV optoelectronic applications

    Energy Technology Data Exchange (ETDEWEB)

    Collazo, Ramon; Rice, Anthony; Tweedie, James; Sitar, Zlatko [Department of Materials Science and Engineering, North Carolina State University, Raleigh, NC (United States); Mita, Seiji; Xie, Jinqiao; Dalmau, Rafael [HexaTech, Inc., Morrisville, NC (United States)

    2011-07-15

    As the building blocks of deep UV light emitting diode (LED) technology and high-power electronic devices, AlGaN alloys have attracted considerable attention. In this study, AlGaN films with varying compositions doped with Si were deposited on homoepitaxial AlN layers grown on AlN single crystal substrates. The room temperature resistivity of AlGaN alloys of different compositions grown on AlN and sapphire substrates with a constant Si doping level of 6x10{sup 18} cm{sup -3} was compared. AlGaN films grown on AlN substrates consistently exhibited a lower n-type resistivity than those grown on sapphire. An n-type resistivity of 0.1 {omega} cm was obtained for an AlGaN film with 80% Al content and a sheet resistance of 235 {omega}/sq. for an AlGaN film with 70% Al content. The carrier activation energy as a function of Al content in AlGaN for these n-type films was measured. For compositions below 80% Al, the activation energy was around 15 meV due to impurity potential screening. For higher Al compositions, the carrier concentration was limited by a high compensation ratio, except for AlN, which has activation energy of 250 meV. (copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  19. A Simplified Semiquantitative Meal Bolus Strategy Combined with Single- and Dual-Hormone Closed-Loop Delivery in Patients with Type 1 Diabetes: A Pilot Study.

    Science.gov (United States)

    Gingras, Véronique; Haidar, Ahmad; Messier, Virginie; Legault, Laurent; Ladouceur, Martin; Rabasa-Lhoret, Rémi

    2016-08-01

    Single- and dual-hormone closed-loop systems can improve glycemic control and have the potential to reduce carbohydrate-counting burden for patients with type 1 diabetes; however, simplification of meal insulin calculation should not compromise glycemic control. We compared in a randomized outpatient pilot trial: (1) a single-hormone closed-loop system accompanied with carbohydrate-content matched boluses versus accompanied with a simplified meal bolus strategy, and (2) a dual-hormone closed-loop system accompanied with carbohydrate-content matched boluses versus accompanied with a simplified meal bolus strategy. Carbohydrate-matched boluses were based on the participant's carbohydrate meal content estimation whereas the simplified strategy involved the selection, by participants, of a semi-quantitative meal carbohydrate-content size: snack, regular, large, or very large meal. Each participant also underwent sensor-augmented pump therapy. Basal insulin delivery was more aggressive with the simplified bolus. The primary outcome was mean sensor glucose level over a 15-h daytime period. Twelve participants were recruited (48.2 ± 16.0 years old; HbA1c 7.4% ± 0.9%) to compare the two bolus strategies during single- and dual-hormone closed-loop delivery. A similar mean sensor glucose level (15 h) was achieved with the carbohydrate-matched boluses and simplified strategy using single-hormone (median [interquartile]: 7.6 [7.2-8.1] vs. 8.0 [7.0-8.6] mmol/L; P = 0.90) and dual-hormone closed-loop systems (7.6 [6.7-9.1] vs. 7.0 [6.4-8.2] mmol/L; P = 0.08). Exploratory analyses showed that, as compared with sensor-augmented pump therapy, there was an increased time spent in hypoglycemia with the simplified strategy but not with the carbohydrate-matched boluses. Though the algorithm employed in this pilot study may lead to an increased risk for hypoglycemia, this strategy has the potential to reduce the carbohydrate-counting burden in patients with type

  20. The progeny of a single virgin B cell predominates the human recall B cell response to the capsular polysaccharide of Haemophilus influenzae type b

    DEFF Research Database (Denmark)

    Barington, T; Hougs, L; Juul, L

    1996-01-01

    of Haemophilus influenzae type b coupled to tetanus toxoid. We combined affinity purification of circulating vaccine-induced Ab-secreting cells with PCR amplification of cDNA followed by cloning and sequencing. Forty-eight and 42 kappa VJ gene transcripts were analyzed from two adults, respectively. Both......Restricted V region diversity is a key feature of Abs to many haptens and simple polysaccharides. Two possible mechanisms exist: 1) selection of many clonally unrelated B cells using very similar or identical VDJ and VJ rearrangements; and 2) selection of a heavily expanded progeny of few virgin B...... cells. How many virgin B cells eventually give rise to the total Ab response to a simple Ag is a fundamental immunologic question. In this report, we address this question in human adults by analyzing the rearranged VkappaJkappa genes of B cells responding to a single dose of the capsular polysaccharide...

  1. Validation of a single nucleotide polymorphism (SNP) typing assay with 49 SNPs for forensic genetic testing in a laboratory accredited according to the ISO 17025 standard

    DEFF Research Database (Denmark)

    Børsting, Claus; Rockenbauer, Eszter; Morling, Niels

    2009-01-01

    cases and 33 twin cases were typed at least twice for the 49 SNPs. All electropherograms were analysed independently by two expert analysts prior to approval. Based on these results, detailed guidelines for analysis of the SBE products were developed. With these guidelines, the peak height ratio...... of a heterozygous allele call or the signal to noise ratio of a homozygous allele call is compared with previously obtained ratios. A laboratory protocol for analysis of SBE products was developed where allele calls with unusual ratios were highlighted to facilitate the analysis of difficult allele calls......A multiplex assay with 49 autosomal single nucleotide polymorphisms (SNPs) developed for human identification was validated for forensic genetic casework and accredited according to the ISO 17025 standard. The multiplex assay was based on the SNPforID 52plex SNP assay [J.J. Sanchez, C. Phillips, C...

  2. Moderation of effects of AAC based on setting and types of aided AAC on outcome variables: an aggregate study of single-case research with individuals with ASD.

    Science.gov (United States)

    Ganz, Jennifer B; Rispoli, Mandy J; Mason, Rose Ann; Hong, Ee Rea

    2014-06-01

    The purpose of this meta-analysis was to evaluate the potential moderating effects of intervention setting and type of aided augmentative and alternative communication (AAC) on outcome variables for students with autism spectrum disorders. Improvement rate difference, an effect size measure, was used to calculate aggregate effects across 35 single-case research studies. Results indicated that the largest effects for aided AAC were observed in general education settings. With respect to communication outcomes, both speech generating devices (SGDs) and the Picture Exchange Communication System (PECS) were associated with larger effects than other picture-based systems. With respect to challenging behaviour outcomes, SGDs produced larger effects than PECS. This aggregate study highlights the importance of considering intervention setting, choice of AAC system and target outcomes when designing and planning an aided AAC intervention.

  3. Online single particle analysis of ice particle residuals from mountain-top mixed-phase clouds using laboratory derived particle type assignment

    Science.gov (United States)

    Schmidt, Susan; Schneider, Johannes; Klimach, Thomas; Mertes, Stephan; Schenk, Ludwig Paul; Kupiszewski, Piotr; Curtius, Joachim; Borrmann, Stephan

    2017-01-01

    In situ single particle analysis of ice particle residuals (IPRs) and out-of-cloud aerosol particles was conducted by means of laser ablation mass spectrometry during the intensive INUIT-JFJ/CLACE campaign at the high alpine research station Jungfraujoch (3580 m a.s.l.) in January-February 2013. During the 4-week campaign more than 70 000 out-of-cloud aerosol particles and 595 IPRs were analyzed covering a particle size diameter range from 100 nm to 3 µm. The IPRs were sampled during 273 h while the station was covered by mixed-phase clouds at ambient temperatures between -27 and -6 °C. The identification of particle types is based on laboratory studies of different types of biological, mineral and anthropogenic aerosol particles. The outcome of these laboratory studies was characteristic marker peaks for each investigated particle type. These marker peaks were applied to the field data. In the sampled IPRs we identified a larger number fraction of primary aerosol particles, like soil dust (13 ± 5 %) and minerals (11 ± 5 %), in comparison to out-of-cloud aerosol particles (2.4 ± 0.4 and 0.4 ± 0.1 %, respectively). Additionally, anthropogenic aerosol particles, such as particles from industrial emissions and lead-containing particles, were found to be more abundant in the IPRs than in the out-of-cloud aerosol. In the out-of-cloud aerosol we identified a large fraction of aged particles (31 ± 5 %), including organic material and secondary inorganics, whereas this particle type was much less abundant (2.7 ± 1.3 %) in the IPRs. In a selected subset of the data where a direct comparison between out-of-cloud aerosol particles and IPRs in air masses with similar origin was possible, a pronounced enhancement of biological particles was found in the IPRs.

  4. Screening of 134 single nucleotide polymorphisms (SNPs) previously associated with type 2 diabetes replicates association with 12 SNPs in nine genes.

    Science.gov (United States)

    Willer, Cristen J; Bonnycastle, Lori L; Conneely, Karen N; Duren, William L; Jackson, Anne U; Scott, Laura J; Narisu, Narisu; Chines, Peter S; Skol, Andrew; Stringham, Heather M; Petrie, John; Erdos, Michael R; Swift, Amy J; Enloe, Sareena T; Sprau, Andrew G; Smith, Eboni; Tong, Maurine; Doheny, Kimberly F; Pugh, Elizabeth W; Watanabe, Richard M; Buchanan, Thomas A; Valle, Timo T; Bergman, Richard N; Tuomilehto, Jaakko; Mohlke, Karen L; Collins, Francis S; Boehnke, Michael

    2007-01-01

    More than 120 published reports have described associations between single nucleotide polymorphisms (SNPs) and type 2 diabetes. However, multiple studies of the same variant have often been discordant. From a literature search, we identified previously reported type 2 diabetes-associated SNPs. We initially genotyped 134 SNPs on 786 index case subjects from type 2 diabetes families and 617 control subjects with normal glucose tolerance from Finland and excluded from analysis 20 SNPs in strong linkage disequilibrium (r(2) > 0.8) with another typed SNP. Of the 114 SNPs examined, we followed up the 20 most significant SNPs (P < 0.10) on an additional 384 case subjects and 366 control subjects from a population-based study in Finland. In the combined data, we replicated association (P < 0.05) for 12 SNPs: PPARG Pro12Ala and His447, KCNJ11 Glu23Lys and rs5210, TNF -857, SLC2A2 Ile110Thr, HNF1A/TCF1 rs2701175 and GE117881_360, PCK1 -232, NEUROD1 Thr45Ala, IL6 -598, and ENPP1 Lys121Gln. The replication of 12 SNPs of 114 tested was significantly greater than expected by chance under the null hypothesis of no association (P = 0.012). We observed that SNPs from genes that had three or more previous reports of association were significantly more likely to be replicated in our sample (P = 0.03), although we also replicated 4 of 58 SNPs from genes that had only one previous report of association.

  5. Single-Tube Dodecaplex PCR Panel of Polymorphic Microsatellite Markers Closely Linked to theDMPKCTG Repeat for Preimplantation Genetic Diagnosis of Myotonic Dystrophy Type 1.

    Science.gov (United States)

    Lian, Mulias; Zhao, Mingjue; Lee, Caroline G; Chong, Samuel S

    2017-06-01

    Preimplantation genetic diagnosis (PGD) of myotonic dystrophy type 1 (DM1) currently uses conventional PCR to detect nonexpanded dystrophia myotonica protein kinase ( DMPK ) alleles or triplet-primed PCR to detect the CTG-expanded alleles, coupled with analysis of linked microsatellite markers to increase diagnostic accuracy. We aimed to simplify the process of identification and selection of informative linked markers for application to DM1 PGD. An in silico search was performed to identify all markers within 1-1.5 Mb flanking the DMPK gene. Five previously known (D19S559, APOC2, D19S543, D19S112, and BV209569) and 7 novel (DM45050, DM45178, DM45209, DM45958, DM46513, DM46892, and DM47004.1) markers with potentially high heterozygosity values and polymorphism information content were selected and optimized in a single-tube multiplex PCR panel. Analysis of 184 DNA samples of Chinese and Caucasian individuals (91 from unrelated, anonymized cord blood of Chinese babies born at the National University Hospital, Singapore, and 93 Caucasian DNA samples from the Human Variation Panel HD100CAU) confirmed the high polymorphism indices of all markers (polymorphism information content >0.5), with observed heterozygosity values ranging from 0.62-0.93. All individuals were heterozygous for at least 6 markers, with 99.5% of individuals heterozygous for at least 2 markers on either side of the DMPK CTG repeat. The dodecaplex marker assay was successfully validated on 42 single cells and 12 whole genome amplified single cells. The DM1 multiplex PCR panel is suitable for use in DM1 PGD either as a standalone linkage-based assay or as a complement to DMPK CTG repeat expansion-mutation detection. © 2017 American Association for Clinical Chemistry.

  6. Hydrogen gas production is associated with reduced interleukin-1β mRNA in peripheral blood after a single dose of acarbose in Japanese type 2 diabetic patients.

    Science.gov (United States)

    Tamasawa, Atsuko; Mochizuki, Kazuki; Hariya, Natsuyo; Saito, Miyoko; Ishida, Hidenori; Doguchi, Satako; Yanagiya, Syoko; Osonoi, Takeshi

    2015-09-05

    Acarbose, an α-glucosidase inhibitor, leads to the production of hydrogen gas, which reduces oxidative stress. In this study, we examined the effects of a single dose of acarbose immediately before a test meal on postprandial hydrogen gas in breath and peripheral blood interleukin (IL)-1β mRNA expression in Japanese type 2 diabetic patients. Sixteen Japanese patients (14 men, 2 women) participated in this study. The mean±standard deviation age, hemoglobin A1c and body mass index were 52.1±15.4 years, 10.2±2.0%, and 27.7±8.0kg/m(2), respectively. The patients were admitted into our hospital for 2 days and underwent test meals at breakfast without (day 1) or with acarbose (day 2). We performed continuous glucose monitoring and measured hydrogen gas levels in breath, and peripheral blood IL-1β mRNA levels before (0min) and after the test meal (hydrogen gas: 60, 120, 180, and 300min; IL-1β: 180min). The induction of hydrogen gas production and the reduction in peripheral blood IL-1β mRNA after the test meal were not significant between days 1 (without acarbose) and 2 (with acarbose). However, the changes in total hydrogen gas production from day 1 to day 2 were closely and inversely associated with the changes in peripheral blood IL-1β mRNA levels. Our results suggest that an increase in hydrogen gas production is inversely associated with a reduction of the peripheral blood IL-1β mRNA level after a single dose of acarbose in Japanese type 2 diabetic patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Ichthyophonus parasite phylogeny based on ITS rDNA structure prediction and alignment identifies six clades, with a single dominant marine type

    Science.gov (United States)

    Gregg, Jacob; Thompson, Rachel L.; Purcell, Maureen; Friedman, Carolyn S.; Hershberger, Paul

    2016-01-01

    Despite their widespread, global impact in both wild and cultured fishes, little is known of the diversity, transmission patterns, and phylogeography of parasites generally identified as Ichthyophonus. This study constructed a phylogeny based on the structural alignment of internal transcribed spacer (ITS) rDNA sequences to compare Ichthyophonus isolates from fish hosts in the Atlantic and Pacific oceans, and several rivers and aquaculture sites in North America, Europe, and Japan. Structure of the Ichthyophonus ITS1–5.8S–ITS2 transcript exhibited several homologies with other eukaryotes, and 6 distinct clades were identified within Ichthyophonus. A single clade contained a majority (71 of 98) of parasite isolations. This ubiquitous Ichthyophonus type occurred in 13 marine and anadromous hosts and was associated with epizootics in Atlantic herring, Chinook salmon, and American shad. A second clade contained all isolates from aquaculture, despite great geographic separation of the freshwater hosts. Each of the 4 remaining clades contained isolates from single host species. This study is the first to evaluate the genetic relationships among Ichthyophonus species across a significant portion of their host and geographic range. Additionally, parasite infection prevalence is reported in 16 fish species.

  8. A-11: cell type-specific and single-active-X transcription controls of newly found gene in cultured human cells

    International Nuclear Information System (INIS)

    Nadon, N.; Korn, N.; DeMars, R.

    1988-01-01

    We describe the isolation and characterization of a human X-chromosomal gene that is subject to both single-active-X control and tissue-specific control. The A-11 gene was identified by a cDNA that hydridizes to a 3.2-kb EcoR1 fragment of genomic DNA on the long arm of the human X chromosome. A-11 transcripts are normally present in fibroblasts but not in B- or T-lymphoblasts. However, A-11 transcription was activated in four of 11 independent, gamma ray-induced B-lymphoblastoid HLA antigen-loss mutants. Cell hybrids with a human fibroblast-derived active X contained A-11 transcripts but hybrids carrying the human inactive X did not. Azacytidine, a potent inhibitor of DNA methylation, readily reactivated the A-11 locus on the inactive X in hybrid cells, indicating that differential methylation is likely to be involved in the single-active-X control of A-11 transcription in fibroblasts. Failure of cells to remethylate DNA synthesized to repair gamma ray-induced damage may also have resulted in the activation of A-11 transcription among the lymphoblastoid mutants. The A-11 locus provides an opportunity to study the relationship between two types of transcriptional regulation of a gene

  9. Advances in single- and multi-stage Stirling-type pulse tube cryocoolers for space applications in NLIP/SITP/CAS

    Science.gov (United States)

    Dang, Haizheng; Tan, Jun; Zha, Rui; Li, Jiaqi; Zhang, Lei; Zhao, Yibo; Gao, Zhiqian; Bao, Dingli; Li, Ning; Zhang, Tao; Zhao, Yongjiang; Zhao, Bangjian

    2017-12-01

    This paper presents a review of recent advances in single- and multi-stage Stirling-type pulse tube cryocoolers (SPTCs) for space applications developed at the National Laboratory for Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences (NLIP/SITP/CAS). A variety of single-stage SPTCs operating at 25-150 K have been developed, including several mid-sized ones operating at 80-110 K. Significant progress has been achieved in coolers operating at 30-40 K which use common stainless steel meshes as regenerator matrices. Another important advance is the micro SPTCs with an overall mass of 300-800 g operating at high frequencies varying from 100 Hz to 400 Hz. The main purpose of developing two-stage SPTCs is to simultaneously acquire cooling capacities at both stages, obviating the need for auxiliary precooling in various applications. The three-stage SPTCs are developed mainly for applications at around 10 K, which are also used for precooling the J-T coolers to achieve further lower temperatures. The four-stage SPTCs are developed to directly achieve the liquid helium temperature for cooling space low-Tc superconducting devices and for the deep space exploration as well. Several typical development programs are described and an overview of the cooler performances is presented.

  10. Constraining the Single-degenerate Channel of Type Ia Supernovae with Stable Iron-group Elements in SNR 3C 397

    Energy Technology Data Exchange (ETDEWEB)

    Dave, Pranav; Kashyap, Rahul; Fisher, Robert [Department of Physics, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02740 (United States); Timmes, Frank [School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287 (United States); Townsley, Dean [Department of Physics and Astronomy, Box 870324, University of Alabama, Tuscaloosa, AL 35487 (United States); Byrohl, Chris [Institut für Astrophysik, Georg August Universität Göttingen, Friedrich-Hund-Platz 1, D-37077 Göttingen (Germany)

    2017-05-20

    Recent Suzaku X-ray spectra of supernova remnant (SNR) 3C 397 indicate enhanced stable iron group element abundances of Ni, Mn, Cr, and Fe. Seeking to address key questions about the progenitor and explosion mechanism of 3C 397, we compute nucleosynthetic yields from a suite of multidimensional hydrodynamics models in the near-Chandrasekhar-mass, single-degenerate paradigm for Type Ia supernovae (SNe Ia). Varying the progenitor white dwarf (WD) internal structure, composition, ignition, and explosion mechanism, we find that the best match to the observed iron peak elements of 3C 397 are dense (central density ≥6 × 10{sup 9} g cm{sup −3}), low-carbon WDs that undergo a weak, centrally ignited deflagration, followed by a subsequent detonation. The amount of {sup 56}Ni produced is consistent with a normal or bright normal SNe Ia. A pure deflagration of a centrally ignited, low central density (≃2 × 10{sup 9} g cm{sup −3}) progenitor WD, frequently considered in the literature, is also found to produce good agreement with 3C 397 nucleosynthetic yields, but leads to a subluminous SN Ia event, in conflict with X-ray line width data. Additionally, in contrast to prior work that suggested a large supersolar metallicity for the WD progenitor for SNR 3C 397, we find satisfactory agreement for solar- and subsolar-metallicity progenitors. We discuss a range of implications our results have for the single-degenerate channel.

  11. Medium-term effects of Dynesys dynamic stabilization versus posterior lumbar interbody fusion for treatment of multisegmental lumbar degenerative disease.

    Science.gov (United States)

    Wu, Haiting; Pang, Qingjiang; Jiang, Guoqiang

    2017-10-01

    Objective To compare the medium-term clinical and radiographic outcomes of Dynesys dynamic stabilization a