Percutaneous Curettage and Continuous Irrigation for MRSA Lumbar Spondylodiscitis: A Report of Three Cases

There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive

Roles of silica and lignin in horsetail (Equisetum hyemale), with special reference to mechanical properties

This research deals with detailed analyses of silica and lignin distribution in horsetail with special reference to mechanical strength. Scanning electron images of a cross-section of an internode showed silica deposited densely only around the outer epidermis. Detailed histochemical analyses of lignin showed no lignin deposition in the silica-rich outer internodes of horsetail, while a characteristic lignin deposition was noticed in the vascular bundle in inner side of internodes. To analyze the structure of horsetail from a mechanical viewpoint, we calculated the response of a model structure of horsetail to a mechanical force applied perpendicularly to the long axis by a finite element method. We found that silica distributed in the outer epidermis may play the major structural role, with lignin's role being limited ensuring that the vascular bundle keep waterproof. These results were in contrast to more modern tall trees like gymnosperms, for which lignin provides mechanical strength. Lignin has the advantage of sticking to cellulose, hemicellulose, and other materials. Such properties make it possible for plants containing lignin to branch. Branching of tree stems aids in competing for light and other atmospheric resources. This type of branching was impossible for ancient horsetails, which relied on the physical properties of silica. From the evolutional view points, over millennia in trees with high lignin content, true branching, and many chlorophyll-containing leaves developed. (C) 2012 American Institute of Physics. [https://doi.org/10.1063/1.3688253]ArticleJOURNAL OF APPLIED PHYSICS. 111(4):044703 (2012)journal articl

Percutaneous Discectomy—Continuous Irrigation and Drainage for Tuberculous Lumbar Spondylitis: A Report of Two Cases

Percutaneous curettage and continuous irrigation were performed for definitive diagnosis and treatment of tuberculous (TB) lumbar spondylitis. Under local anaesthesia, affected lumbar discs were curetted using a procedure of percutaneous nucleotomy, and in-tube and the out-tube were placed for continuous irrigation. The period of continuous irrigation was 12–16 days. Mycobacterium tuberculosis was demonstrated in case 1 by culture and PCR, whereas histology showed tuberculous lesion with caseous necrosis in both cases. Postoperative MRI showed markedly reduced abscesses after 3 months in both cases. The signal intensity in vertebral bodies was improved. In Case 2, CT observations showed remodeling over time in the vertebral body cavities. This method is advantageous in that although minimally invasive, it achieves identification of pathogenic bacteria and treatment simultaneously. This surgical procedure is expected to prove effective for both TB and pyogenic spondylitis

Structures and physiological functions of silica bodies in the epidermis of rice plants

We characterized silica structures in the epidermis of rice plant leaves and investigated their physiological functions from optical and mechanical viewpoints. By treating the distribution of silica bodies as a triangular lattice in the xy plane, and performing a theoretical optical analysis on this lattice, we discovered that a reduction in the photonic density of states may inhibit leaves of rice plant from being heated markedly higher than 20 degrees C. Ladderlike structures in the epidermis were mechanically investigated. These structures are conjectured to inhibit flat leaves from undergoing twisting torsions, which may assist the leaf to absorb sunlight more effectively for photosynthesis. (C) 2009 American Institute of Physics. [doi: 10.1063/1.3232204]ArticleAPPLIED PHYSICS LETTERS. 95(12):123703 (2009)journal articl

Orexin A Enhances Pro-Opiomelanocortin Transcription Regulated by BMP-4 in Mouse Corticotrope AtT20 Cells

Orexin is expressed mainly in the hypothalamus and is known to activate the hypothalamic-pituitary-adrenal (HPA) axis that is involved in various stress responses and its resilience. However, the effects of orexin on the endocrine function of pituitary corticotrope cells remain unclear. In this study, we investigated the roles of orexin A in pro-opiomelanocortin (POMC) transcription using mouse corticotrope AtT20 cells, focusing on the bone morphogenetic protein (BMP) system expressed in the pituitary. Regarding the receptors for orexin, type 2 (OXR2) rather than type 1 (OX1R) receptor mRNA was predominantly expressed in AtT20 cells. It was found that orexin A treatment enhanced POMC expression, induced by corticotropin-releasing hormone (CRH) stimulation through upregulation of CRH receptor type-1 (CRHR1). Orexin A had no direct effect on the POMC transcription suppressed by BMP-4 treatment, whereas it suppressed Smad1/5/9 phosphorylation and Id-1 mRNA expression induced by BMP-4. It was further revealed that orexin A had no significant effect on the expression levels of type I and II BMP receptors but upregulated inhibitory Smad6/7 mRNA and protein levels in AtT20 cells. The results demonstrated that orexin A upregulated CRHR signaling and downregulated BMP-Smad signaling, leading to an enhancement of POMC transcription by corticotrope cells

Case Report Percutaneous Curettage and Continuous Irrigation for MRSA Lumbar Spondylodiscitis: A Report of Three Cases

There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive

Effects of Wnt-β-Catenin Signaling and Sclerostin on the Phenotypes of Rat Pheochromocytoma PC12 Cells

Pheochromocytomas and paragangliomas (PPGLs) are classified into 3 major categories with distinct driver genes: pseudohypoxia, kinase signaling, and Wnt-altered subtypes. PPGLs in the Wnt-altered subtype are sporadic and tend to be aggressive with metastasis, where somatic gene fusions affecting mastermind-like 3 (MAML3) and somatic mutations in cold shock domain containing E1 (CSDE1) cause overactivation of Wnt-β-catenin signaling. However, the relation between Wnt-β-catenin signaling and the biological behavior of PPGLs remains unexplored. In rat pheochromocytoma PC12 cells, Wnt3a treatment enhanced cell proliferation and suppressed mRNA expression of tyrosine hydroxylase (TH), the rate-limiting enzyme of catecholamine biosynthesis, and dopamine secretion. We identified the expression of sclerostin in PC12 cells, which is known as an osteocyte-derived negative regulator for Wnt signaling-driven bone formation. Inhibition of endogenous Wnt pathway by XAV939 or sclerostin resulted in attenuated cell proliferation and increased TH expression. Furthermore, Wnt3a pretreatment suppressed bone morphogenetic protein (BMP)-induced Smad1/5/9 phosphorylation whereas BMPs enhanced sclerostin expression in PC12 cells. In the Wnt-altered subtype, the increased Wnt-β-catenin pathway may contribute the aggressive clinical behavior with reduced catecholamine production. Furthermore, upregulated expression of sclerostin by BMPs may explain the osteolytic metastatic lesions observed in metastatic PPGLs

Roles of silica and lignin in horsetail ( Equisetum hyemale

This research deals with detailed analyses of silica and lignin distribution in horsetail with special reference to mechanical strength. Scanning electron images of a cross-section of an internode showed silica deposited densely only around the outer epidermis. Detailed histochemical analyses of lignin showed no lignin deposition in the silica-rich outer internodes of horsetail, while a characteristic lignin deposition was noticed in the vascular bundle in inner side of internodes. To analyze the structure of horsetail from a mechanical viewpoint, we calculated the response of a model structure of horsetail to a mechanical force applied perpendicularly to the long axis by a finite element method. We found that silica distributed in the outer epidermis may play the major structural role, with lignin's role being limited ensuring that the vascular bundle keep waterproof. These results were in contrast to more modern tall trees like gymnosperms, for which lignin provides mechanical strength. Lignin has the advantage of sticking to cellulose, hemicellulose, and other materials. Such properties make it possible for plants containing lignin to branch. Branching of tree stems aids in competing for light and other atmospheric resources. This type of branching was impossible for ancient horsetails, which relied on the physical properties of silica. From the evolutional view points, over millennia in trees with high lignin content, true branching, and many chlorophyll-containing leaves developed. (C) 2012 American Institute of Physics. [https://doi.org/10.1063/1.3688253]ArticleJOURNAL OF APPLIED PHYSICS. 111(4):044703 (2012)journal articl