Trans-Sacral Epiduroscopic-Assisted 1,414-nm Nd:YAG Laser Decompression for Lumbar Discal Cyst: A Report of 9 Cases

Prevalence of lumbar discal cyst is very low, it can cause low back pain and radiating leg pain when present. Currently, trans-sacral epiduroscopic-assisted, 1,414-nm Nd:YAG laser decompression (SELD) is commonly used for spinal pathologies. However, the use of the laser for spinal procedures can be limited due to the risk of thermal injury. We reviewed nine consecutive patients who underwent SELD ablation for discal cyst between 2014 and 2015. Each patient underwent diagnostic imaging, including simple radiographs, computed tomography with discography, and magnetic resonance imaging (MRI). Pain relief and clinical outcome assessment of patient satisfaction was the primary outcome measure. All patients presented with back pain and unilateral radiating pain. The discal cyst was located in the lumbar region in all patients. Preoperative MRI showed a connection between the cyst and the involved intervertebral disc. All patients obtained immediate relief of symptoms after the discal cyst was treated with a SELD-assisted, 1,414-nm Nd:YAG laser. The mean visual analogue scale (VAS) for back pain was 7.89±0.78 preoperatively, 1.67±1.50 at the 1-month follow up, and 0.38±0.5 at the final follow up (p<0.01). All patients obtained excellent or good outcomes according to the modified MacNab's criteria. There were no complications. These cases demonstrated that trans-sacral, epiduroscopic-assisted, 1,414-nm Nd:YAG laser decompression was a safe, viable, and efficacious option for treating lumbar discal cyst because it lowers the risk of muscle injury and can be performed under local anesthesia

How Does Chronic Back Pain Influence Quality of Life in Koreans: A Cross-Sectional Study

Study DesignA cross-sectional study.PurposeTo explore the impact of chronic low back pain (CLBP) on individuals' quality of life; to understand current treatment practices and level of satisfaction with treatment in patients with CLBP.Overview of LiteratureAssessing subjective, patient-reported outcomes such as quality of life is essential to health care research.MethodsInfluences of the CLBP were analyzed via a questionnaire, which contained the character of CLBP, effect of pain management, Korean version Oswestry Disability Index (K-ODI) and Korean version of 12-item Short Form Health Survey (SF-12v2).ResultsOf 3,121 subjects who responded, 67.3% had moderate to severe pain; 43.5% presented prolonged CLBP of more than two years; and 32.4% had suffered from sleep disturbance due to pain. 22.8% of the patients were not satisfied with current pain management. The mean K-ODI score was 37.63; and it was positively correlated with the mean pain intensity (r=0.6, p<0.001). The SF-12v2 result was negatively correlated with mean pain intensity (PCS: r=-0.5, p<0.001; MCS: r=-0.4, p<0.001) and also negatively correlated with the K-ODI score (PCS: r=-0.75, p<0.001; MCS: r=-0.5, p<0.001). The conformity between patients and doctors in pain assessment was fair (κ=0.2463).ConclusionsCLBP negatively affects quality of life. Of total 22.8% of the patients were not satisfied with current pain management. Such needs to be taken more seriously by doctors for improvement of satisfaction and quality of life in patients with CLBP

Super-hydration and reduction of manganese oxide minerals at shallow terrestrial depths

Manganese oxides are ubiquitous marine minerals which are redox sensitive. As major components of manganese nodules found on the ocean floor, birnessite and buserite have been known to be two distinct water-containing minerals with manganese octahedral interlayer separations of similar to 7 angstrom and similar to 10 angstrom, respectively. We show here that buserite is a super-hydrated birnessite formed near 5 km depth conditions. As one of the most hydrous minerals containing ca. 34.5 wt. % water, super-hydrated birnessite, i.e., buserite, remains stable up to ca. 70 km depth conditions, where it transforms into manganite by releasing ca. 24.3 wt. % water. Subsequent transformations to hausmannite and pyrochroite occur near 100 km and 120 km depths, respectively, concomitant with a progressive reduction of Mn4+ to Mn2+. Our work forwards an abiotic geochemical cycle of manganese minerals in subduction and/or other aqueous terrestrial environments, with implications for water storage and cycling, and the redox capacity of the region

Overexpression of arabidopsis YUCCA6 in potato results in high-auxin developmental phenotypes and enhance

Indole-3-acetic acid (IAA), a major plant auxin, is produced in both tryptophan-dependent and tryptophanindependent pathways. A major pathway in Arabidopsis thaliana generates IAA in two reactions from tryptophan. Step one converts tryptophan to indole-3-pyruvic acid (IPA) by tryptophan aminotransferases followed by a rate-limiting step converting IPA to IAA catalyzed by YUCCA proteins. We identified eight putative StYUC (Solanum tuberosum YUCCA) genes whose deduced amino acid sequences share 50%-70% identity with those of Arabidopsis YUCCA proteins. All include canonical, conserved YUCCA sequences: FATGY motif, FMO signature sequence, and FAD-binding and NADPbinding sequences. In addition, five genes were found with ~50% amino acid sequence identity to Arabidopsis tryptophan aminotransferases. Transgenic potato (Solanum tuberosum cv. Jowon) constitutively overexpressing Arabidopsis AtYUC6 displayed high-auxin phenotypes such as narrow downward-curled leaves, increased height, erect stature, and longevity. Transgenic potato plants overexpressing AtYUC6 showed enhanced drought tolerance based on reduced water loss. The phenotype was correlated with reduced levels of reactive oxygen species in leaves. The results suggest a functional YUCCA pathway of auxin biosynthesis in potato that may be exploited to alter plant responses to the environment. © 2012 The Author

Incidence of Hypertension in Korea: 5-Year Follow-up Study

Limited data are available about the incidence of hypertension over the 5-yr in non-hypertensive subjects. The study subjects were 1,806 subjects enrolled in a rural area of Daegu, Korea for a cohort study from August to November 2003. Of them, 1,287 (71.3%) individuals had another examination 5 yr later. To estimate the incidence of hypertension, 730 non-hypertensive individuals (265 males; mean age = 56.6 ± 11.1 yr-old) at baseline examination were analyzed in this study. Hypertension was defined as either a new diagnosis of hypertension or self-reports of newly initiated antihypertensive treatment; prehypertension was if the systolic blood pressure was 120-139 mmHg and/or diastolic blood pressure was 80-89 mmHg. During the 5-yr follow-up, 195 (26.7%) non-hypertensive individuals developed incident hypertension. The age-adjusted 5-yr incidence rates of hypertension were 22.9% (95% confidence interval [CI] = 19.9-29.0) in overall subjects, 22.2% (95% CI = 17.2-27.2) in men, and 24.3% (95% CI = 20.4-28.2) in women. The incidence rates of hypertension significantly increased with age. In the multivariate analysis, prehypertension (Odds ratio [OR] 2.25; P < 0.001) and older age (OR 2.26; P = 0.010) were independent predictors for incident hypertension. In this rapidly aging society, population-based preventive approach to decrease blood pressure, particularly in subjects with prehypertension, is needed to reduce hypertension