Comparative Study of the Differences in Radiologic Results for Percutaneous Endoscopic Lumbar Foraminotomy and Microscopic or Micro-endoscopic Lumbar Foraminotomy

Objective Lumbar foraminal stenosis is a common pathology that causes back pain and radiculopathy. Percutaneous endoscopic lumbar foraminotomy (PELF) is a minimally invasive surgical procedure reported to be effective in the treatment of foraminal stenosis; however, no studies have been conducted that compare the on radiographic results of PELF and conventional techniques for the treatment of foraminal stenosis, such as microscopic foraminotomy and micro-endoscopic foraminotomy. This study aimed to report postoperative changes in the lumbar foraminal parameters on computed tomography (CT) after PELF and to compare the radiological efficacy of the PELF technique with that of the conventional techniques. Methods Radiographic evaluation of the neuroforamen was based on CT scans taken preoperatively and 3 months postoperatively in the PELF and conventional groups. The Japanese Orthopaedic Association (JOA) score for back pain, visual analog scale (VAS), and JOA back pain evaluation questionnaire (JOABPEQ) were evaluated preoperatively and at 3 months postoperatively in the PELF group. Results The PELF and conventional groups comprised 21 and 17 patients, respectively. In the PELF group, the JOA score, VAS of back pain, and JOABPEQ of low back pain showed significant improvement. There were significant increases in the foraminal area, superior foraminal width (SFW), and middle foraminal width (MFW). Additional radiological evaluation for patients who underwent microscopic or micro-endoscopic lumbar foraminotomy was almost equivalent. Conclusion Percutaneous endoscopic lumbar foraminotomy is a minimally invasive technique that is as effective as conventional techniques for the treatment of foraminal stenosis

Zoneamento do risco de incêndio florestal para o Parque Nacional de São Joaquim–SC

Os incêndios florestais são uma preocupação diária dos gestores de áreas protegidas como o Parque Nacional de São Joaquim (PNSJ). Situado no estado de Santa Catarina, protege a maior área contínua de floresta ombrófila mista (mata de araucárias) do Brasil, e também contempla áreas de campos de altitude e floresta ombrófila densa. O objetivo deste trabalho foi elaborar o zoneamento do risco de incêndio florestal integrando variáveis de influência, sendo estas: declividade do terreno, orientação das encostas, ventos predominantes, cobertura vegetal, carga de material combustível e interferência humana consolidada. Para análise e processamento das variáveis, utilizou-se um sistema de informações geográficas (SIG). A declividade e a orientação das encostas foram extraídas a partir do modelo digital do terreno. Os ventos predominantes foram identificados a partir da análise de registros meteorológicos mensais e suas relações com a precipitação, umidade relativa e temperatura média do ar. A cobertura vegetal foi obtida através de classificação supervisionada de imagens Rapid Eye. Estimou-se a carga de material combustível através de dados bibliográficos e também por modelos matemáticos. A interferência humana consolidada foi caracterizada pelos raios de influência (buffers) estimados para infraestrutura. A análise da declividade indicou que 7% da área está sob risco extremo. Quanto à orientação das encostas, observou-se que 32% da área total do PNSJ está sob risco extremo e risco muito alto, respectivamente com faces voltadas para as direções N e NW/W. Em relação aos ventos predominantes observou-se que 32% da área total sofre influência de ventos com características secas, indicando risco extremo. Considerando a cobertura vegetal, classificou-se 39% da área como riscos alto, muito alto e extremo. Para a carga de material combustível, menos de 1% da área apresentou risco alto. Quanto à presença humana na região, 8% da área mostrou-se sob algum tipo de influência (ex. rodovias, queimadas e áreas de moradia e lazer). Com esses resultados, produziu-se um zoneamento do risco de incêndio pela sobreposição dos mapas temáticos das variáveis concluindo-se que 39% da área está sob risco alto, e 7% sob risco extremo. A administração do PNSJ deve monitorar essas áreas críticas e propor medidas que evitem a ocorrência de incêndios

Coordinated generation of multiple ocular-like cell lineages and fabrication of functional corneal epithelial cell sheets from human iPS cells

We describe a protocol for the generation of a functional and transplantable corneal epithelium derived from human induced pluripotent stem (iPS) cells. When this protocol is followed, a proportion of iPS cells spontaneously form circular colonies, each of which is composed of four concentric zones. Cells in these zones have different morphologies and immunostaining characteristics, resembling neuroectoderm, neural crest, ocular-surface ectoderm, or surface ectoderm. We have named this 2D colony a 'SEAM' (self-formed ectodermal autonomous multizone), and previously demonstrated that cells within the SEAM have the potential to give rise to anlages of different ocular lineages, including retinal cells, lens cells, and ocular-surface ectoderm. To investigate the translational potential of the SEAM, cells within it that resemble ocular-surface epithelia can be isolated by pipetting and FACS sorting into a population of corneal epithelial-like progenitor cells. These can be expanded and differentiated to form an epithelial layer expressing K12 and PAX6, and able to recover function in an animal model of corneal epithelial dysfunction after surgical transplantation. The whole protocol, encompassing human iPS cell preparation, autonomous differentiation, purification, and subsequent differentiation, takes between 100 and 120 d, and is of potential use to researchers with an interest in eye development and/or ocular-surface regeneration. Experience with human iPS cell culture and sorting via FACS will be of benefit for researchers performing this protocol

FGF-2 Stimulates the Growth of Tenogenic Progenitor Cells to Facilitate the Generation of Tenomodulin-Positive Tenocytes in a Rat Rotator Cuff Healing Model.

Background: Fibroblast growth factor (FGF)–2 has the potential to enhance tendon-to-bone healing after rotator cuff (RC) injury. Hypothesis: FGF-2 stimulates tenogenic differentiation of progenitors to improve the biomechanical strength and histological appearance of repaired RCs in rats. Study Design: Controlled laboratory study. Methods: Adult male Sprague-Dawley rats (N = 156) underwent unilateral surgery to repair the supraspinatus tendon to insertion sites. The FGF-2-treated group (gelatin hydrogel containing 5 μg of FGF-2) and a control group (gelatin hydrogel only) were compared to investigate the effects of FGF-2 at 2, 4, 6, 8, and 12 weeks postoperatively. Biomechanical testing was performed at 6 and 12 weeks. Semiquantitative histological analysis and immunohistochemical analysis for the proliferating cell nuclear antigen (PCNA) were performed, and the expression of tendon-related markers, including Scleraxis (Scx) and Tenomodulin (Tnmd), was monitored by real-time reverse transcription polymerase chain reaction (RT-PCR) and in situ hybridization. SRY-box containing gene 9 (Sox9) expression was monitored by RT-PCR and immunohistochemical analysis. At 2 and 4 weeks, immunohistochemical analysis for mesenchymal stem cell (MSC) markers was also performed. Results: The FGF-2-treated group demonstrated a significant improvement in mechanical strength at 6 and 12 weeks and significantly higher histological scores than the control group at ≥4 weeks. The average incidence of PCNA-positive cells was significantly higher at 2 and 4 weeks, and more cells expressing MSC markers were detected at the insertion site in the FGF-2-treated group. The expression level of Scx increased significantly in the FGF-2-treated group from 4 to 8 weeks, while the Tnmd level increased significantly from 4 to 12 weeks postoperatively. The localization of Tnmd overlapped with the locations of reparative tissues accompanying collagen fibers with an aligned orientation. Sox9 expression was significantly upregulated at 4 weeks in the FGF-2-treated group. Conclusion: FGF-2 promotes growth of the tenogenic progenitor cells, which participate in tendon-to-bone healing, resulting in biomechanical and histological improvement of the repaired RC. Clinical Relevance: These findings provide clues regarding the clinical development of regenerative repair strategies for RC injury

オウショク ジンタイ ヘンセイ ニ オイテ Matrix metalloproteinase ワ ダンセイ センイ ノ ゲンショウ オ ソクシン スル

熊本大