Generation of structurally novel short carotenoids and study of their biological activity

Recent research interest in phytochemicals has consistently driven the efforts in the metabolic engineering field toward microbial production of various carotenoids. In spite of systematic studies, the possibility of using C(30) carotenoids as biologically functional compounds has not been explored thus far. Here, we generated 13 novel structures of C(30) carotenoids and one C(35) carotenoid, including acyclic, monocyclic, and bicyclic structures, through directed evolution and combinatorial biosynthesis, in Escherichia coli. Measurement of radical scavenging activity of various C(30) carotenoid structures revealed that acyclic C(30) carotenoids showed higher radical scavenging activity than did DL-α-tocopherol. We could assume high potential biological activity of the novel structures of C(30) carotenoids as well, based on the neuronal differentiation activity observed for the monocyclic C(30) carotenoid 4,4′-diapotorulene on rat bone marrow mesenchymal stem cells. Our results demonstrate that a series of structurally novel carotenoids possessing biologically beneficial properties can be synthesized in E. coli

Spontaneous Lead Breakage in Implanted Spinal Cord Stimulation Systems

Spinal cord stimulation (SCS) has become an established clinical option for treatment of refractory chronic pain. Current hardware and implantation techniques for SCS are already highly developed and continuously improving; however, equipment failures over the course of long-term treatment are still encountered in a relatively high proportion of the cases treated with it. Percutaneous SCS leads seem to be particularly prone to dislocation and insulation failures. We describe our experience of lead breakage in the inserted spinal cord stimulator to a complex regional pain syndrome patient who obtained satisfactory pain relief after the revision of SCS

Endovascular Embolization of Intracranial Aneurysms Using Bare Platinum Axium™ Detachable Coils: Immediate and Short-Term Follow-up Results from a Multicenter Registry

PurposeAxium™ coils were developed to improve the durability of coil-embolized cerebral aneurysms by increasing packing density. The purpose of this prospective multicenter registry was to evaluate the safety and durability of Axium™ coils.Materials and MethodsOne hundred twenty-six patients with 135 aneurysms of ≤ 15 mm in size underwent coil embolization using bare platinum coils, with Axium™ coils constituting over 50% of the total coil length. Immediate and short-term follow-up results were prospectively registered and retrospectively evaluated.ResultsOf the 135 aneurysms (83 unruptured and 52 ruptured), immediate post-embolization angiography revealed complete occlusion in 80 aneurysms (59.3%), neck remnants in 47 (34.8%), and incomplete occlusion in 8 (5.9%). The mean packing density was 42.8% (range, 9.5 - 90%) with Axium™ coil length constituting a mean of 87.9% of total coil length. The rate of procedure-related complications was 16.3%. Procedure-related permanent morbidity and mortality rates were 3.2% and 0.8%, respectively. Follow-up catheter or MR angiography, which was available in 101 aneurysms at 6 - 15 months (mean, 7.7 months), revealed stable or improved occlusion in 95 aneurysms and worsening in 6 aneurysms (5.9%). Lower packing density (< 30%) remained the only predictor for anatomical worsening on multivariable logistic regression analysis (P < 0.05).ConclusionIn this registry, Axium™ coils showed a relatively low rate of anatomical worsening on short-term follow-up imaging with an acceptable periprocedural safety profile compared to reports of other platinum coils. These results may warrant further study of long-term durability with Axium™ coils in larger populations

Screening of Brain Metastasis with Limited Magnetic Resonance Imaging (MRI): Clinical Implications of Using Limited Brain MRI During Initial Staging for Non-small Cell Lung Cancer Patients

The purpose of this prospective study was to determine whether using magnetic resonance imaging (MRI) for early screening for brain metastases (BM) can improve quality of life, survival in patients with non-small cell lung cancer (NSCLC). The study group comprised 183 patients newly diagnosed with NSCLC. All patients underwent limited brain MRI and routine workups. The control group comprised 131 patients with NSCLC who underwent limited brain MRI only if they had neurologic symptoms. The incidence of BM was 20.8% (38/183) in the study group and 4.6% (6/131) in the control group. The rate of upstaging based on the MRI data was 13.5% (15/111) overall and 15.9% (11/69) in patients that had been considered initially to be resectable surgically. There was no significant difference in survival outcome between the groups. Patients who had BM alone had a greater overall survival time (49 weeks) than those who had multiple systemic metastases (27 weeks; p=0.0307). In conclusions, limited brain MRI appears to be a useful, cost-effective method to screen for BM at the time of initial staging. And it may facilitate timely treatment of patients with NSCLC and improve their survival and quality of life

Psychometric Characteristics of the Korean Version of the Roland-Morris Disability Questionnaire

The aims of this study were; 1) to develop the final version of the Korean Roland-Morris Disability Questionnaire (RDQ), and 2) to compare the responsiveness between the RDQ and the Oswestry Disability Index (ODI) scores in patients having low back pain. The psychometric properties of the final Korean RDQ were evaluated in 221 patients. Among them, 30 patients were reliability tested. Validity was evaluated using an 11-point numerical rating scale (NRS) and the Korean ODI. The receiver operating characteristic (ROC) curve analysis of the RDQ and the ODI was compared in 54 patients with lumbar zygapophyseal (facet) joint pain. There was a moderate relationship between the RDQ and NRS (r = 0.59, P < 0.01) and a strongly positive correlation between the RDQ and the ODI (r = 0.76, P < 0.001). The Korean RDQ with the higher area under the ROC curve showed a better overall responsive performance than did the ODI in patients with lumbar facet joint pain after medial branch radiofrequency neurotomy (P < 0.01). The results of the study present the final version of the Korean RDQ is valid for assessing functional status in a Korean population with chronic low back pain

Hemo-metabolic impairment in patients with ST-segment elevation myocardial infarction: Data from the INTERSTELLAR registry

Background: Not only hemo-dynamic (HD) factors but also hemo-metabolic (HM) risk factors reflecting multi-organ injuries are considered as important prognostic factors in ST-segment elevation myocardial infarction (STEMI). However, studies regarding HM risk factors in STEMI patients are currently limited. Method: Under analysis were 1,524 patients with STEMI who underwent primary percutaneous coronary intervention in the INTERSTELLAR registry. Patients were divided into HM (≥ 2 risk factors) and non-HM impairment groups. The primary outcome was in-hospital all-cause mortality, and the secondary outcome was 1-year all-cause mortality. Results: Of 1,524 patients, 214 (14.0%) and 1,310 (86.0%) patients were in the HM and non-HM impairment groups, respectively. Patients with HM impairment had a higher incidence of in-hospital mortality than those without (24.3% vs. 2.7%, p &lt; 0.001). After adjusting for confounders, HM impairment was independently associated with in-hospital mortality (inverse probability of treatment weighting [IPTW]-adjusted odds ratio: 1.81, 95% confidence interval: 1.08–3.14). In the third door-to-balloon (DTB) time tertile (≥ 82 min), HM impairment was strongly associated with in-hospital mortality. In the first DTB time tertile ( &lt; 62 min), indicating relatively rapid revascularization, HM impairment was consistently associated with increased in-hospital mortality. Conclusions: Hemo-metabolic impairment is significantly associated with increased risk of in-hospital and 1-year mortality in patients with STEMI. It remains a significant prognostic factor, regardless of DTB time

Cervical Epidural Pressure Measurement Comparison in the Prone and Sitting Positions

Background: The hanging drop technique is used for identifying the cervical epidural space, using its negative pressure. However, it is doubtful whether the epidural space intrinsically exhibits a negative pressure. We designed this study to test the hypothesis that the cervical epidural pressure (CEP) is significantly higher in the prone position than in the sitting position. To evaluate this hypothesis, we measured and compared 30 CEP values in the prone and sitting positions. Methods: We measured and compared 15 CEPs in the prone group and 15 in the sitting group using a closed pressure measurement system under fluoroscopic guidance. Results: All CEPs in the prone group were consistently positive (median, 10 mmHg; range, 4.8-18.7; mean +/- SD, 10.5 +/- 4.4) in contrast to the sitting group (median, -0.3 mmHg; range, -2.4-7.9; mean +/- SD, 0.5 +/- 2.8). CEPs in the prone group were significantly higher than in the sitting group (P < 0.001). Conclusion: CEP was found to be significantly higher in the prone position than in the sitting position. Furthermore, CEPs were not consistently negative even in the sitting position. These results suggest that the hanging drop technique is inappropriate for identifying the cervical epidural space in either the prone or sitting positions.Patel TR, 2009, NEUROSURGERY, V64, P1196, DOI 10.1227/01.NEU.0000345951.24132.7FGil NS, 2008, ANESTHESIOLOGY, V109, P67Yokoyama T, 2008, ACTA ANAESTH SCAND, V52, P256, DOI 10.1111/j.1399-6576.2007.01506.xAbbasi A, 2007, SPINE, V32, P2144Strub WM, 2007, J VASC INTERV RADIOL, V18, P1151, DOI 10.1016/i.jvir.2007.06.011Lee CJ, 2007, ANESTH ANALG, V104, P1583, DOI 10.1213/01.ane.0000264006.46379.28Visser WA, 2006, ANESTH ANALG, V103, P1318, DOI 10.1213/01.ane.0000244325.46807.b6Goel A, 2006, SPINE, V31, P1576Lirk P, 2005, BRIT J ANAESTH, V94, P852, DOI 10.1093/bja/aei133Lirk P, 2003, ANESTHESIOLOGY, V99, P1387Cluff R, 2002, ANESTH ANALG, V95, P403, DOI 10.1213/01/ANE.0000020189.99898.E3Stojanovic MP, 2002, SPINE, V27, P509Hoffmann VLH, 1999, BRIT J ANAESTH, V83, P807Manchikanti L, 1999, SPINE, V24, P1170Hodges SD, 1998, SPINE, V23, P2137Hogan QH, 1998, CAN J ANAESTH, V45, pR40TAKAHASHI K, 1995, SPINE, V20, P650CASTAGNERA L, 1994, PAIN, V58, P239OKUTOMI T, 1993, CAN J ANAESTH, V40, P1044STAV A, 1993, ACTA ANAESTH SCAND, V37, P562ZARZUR E, 1984, ANAESTHESIA, V39, P1101USUBIAGA JE, 1967, BRIT J ANAESTH, V39, P612GUTIERREZ A, 1932, REV CIR BUENOS AIRES, V12, P665JANZEN E, 1926, DTSCH Z NERVENHEILKD, V94, P280