Surgical Management of Spinal Epidural Disease: An Update

Management of spinal cord compression from metastatic malignant disease remains unsatisfactory. Results of surgical decompression are at best less than those of radiation therapy alone. However, new surgical approaches now focus on removing the anterior-situated tumor tissue which produces neural compression in about 85% of the cases. The results of these procedures that allow removal of the ventrally compressing tumor show significant improvement in the management of patients with spinal epidural disease. We review the surgical strategy of these new approaches and the attendant results

Transport der Myeloperoxidase in die azurophilen Granula von HL-60 Zellen

Das kationische Hämoprotein Myeloperoxidase (MPO) ist Bestandteil der azurophilen Granula der neutrophilen Granulozyten. In dieser Studie sollte ein möglicher Transportweg dieses Enzyms in die azurophilen Granula von HL-60 Zellen untersucht werden. Als Arbeitsgrundlage diente die Entdeckung, dass das ebenfalls positiv geladene Lysozym durch Bindung an das Chondroitinsulfat (CS) des Serglycins (Kolset et al., 1996) in die Lysosomen transportiert wird (Lemansky und Hasilik, 2001). Die Affinitätschromatographie zeigte, dass reife MPO mit gleicher Bindungsstärke wie proMPO an CS-Sepharose bindet. Dies belegt, dass die gesamte MPO mit den GAGSeitenketten von Serglycin interagieren kann und könnte bedeuten, dass das Propeptid nicht alleine, wie von Andersson et al. (1998), und Bülow et al. (2002) postuliert, für den Transport der MPO entscheidend ist. Die Absenkung des pH-Wertes auf 3,5, was zu einer Teil-Entladung der Glucuronsäurereste (pKa 3,6) führt, hatte keinen Einfluss auf die Bindung der MPO an die CS-Sepharose. Ein pH-abhängiger Abkopplungsmechanismus der MPO vom Serglycin ist somit nicht zu erwarten, was mit früheren experimentellen Befunden gut übereinstimmt (Hasilik et al., 1984). Das Sortieren der MPO und des Serglycins in die azurophilen Granula geschieht bei HL-60 Zellen nur zu etwa 50%. Es konnte gezeigt werden, dass unter dem Einfluss von TPA der überwiegende Teil der restlichen Menge von MPO (39%) bzw. des Serglycins (44%) sezerniert werden. Diese Effekte auf das targeting lassen den Schluss zu, dass das basische MPO-Protein und das saure Proteoglykan Serglycin evtl. als Verbund in die Granula transportiert werden. Die Ausbildung solcher Komplexe konnte nach Markierung von HL-60 Zellen mit [35S]Sulfat und Quervernetzung mit DSP mittels Koimmunpräzipitation nachgewiesen werden. Das Auftragen der in Anwesenheit von TPA-sezernierten Proteine auf eine CSSepharose-Säule führte zur Bindung von verschiedenen Polypeptiden. Dieses Ergebnis spricht dafür, dass Serglycin neben der MPO auch andere, vermutlich kationische Proteine binden und möglicherweise in die azurophilen Granula transportieren kann.Als eine Negativkontrolle für den Serglycin-Transportweg wurde das Procathepsin D untersucht. Dieses lysosomale Enzym, mit nicht ausgeprägtem basischen Charakter, band zwar an CS-Sepharose, jedoch war diese Bindung so schwach, dass kationische Proteine das Procathepsin D in HL-60 Zellen wahrscheinlich vom Serglycin verdrängen würden

Der Einfluss unterschiedlicher resistenter Stärken auf die Fettsäureoxidation und den respiratorischen Quotienten bei gesunden Erwachsenen

Untersucht wird die metabolische Wirkung resistenter Stärken (RS) auf die Fettsäureoxidation und den respiratorischen Quotienten (RQ) mittels 13C-Atemgasanalyse und indirekter Kalorimetrie. Die simultane zwanzigtägige Supplementation von Kartoffelfaser- und Markerbsenstärke bewirkt keine Veränderung der Fettsäureoxidation, die Supplementation hochamylosehaltiger Maisstärke, die einen höheren RS- und RS2-Gehalt aufweist, steigert die Fettsäureoxidation signifikant. Der RQ bleibt jeweils konstant. Ergebnisfolgernd werden Mechanismen der Einflussnahme von RS auf die Fettsäureoxidation erörtert

knowledgenet a benchmark dataset for knowledge base population

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Variabilidade fenotípica da conformação corporal de equídeos das raças brasileiro de hipismo, Bretão Postier e Jumento Brasileiro / Phenotypic variability of the body conformation of brazilian sport horse, Postier Breton and Brazilian Donkey equid breeds

Com o objetivo de identificar variabilidade fenotípica na conformação corporal de equídeos, foram realizadas mensurações lineares e angulares em animais das raças Brasileiro de Hipismo, Bretão Postier e Jumento Brasileiro, pertencentes ao PRDTA – Alta Mogiana. Os dados foram comparados pelo teste T de médias, sendo considerando significativo se P<0,05. O grupo que mais diferiu quanto às medidas lineares e angulares foi o Jumento Brasileiro, pois pertence à espécie asinina. Dentre os equinos, a raça Bretão Postier apresentou maior divergência, com tendência de maiores perímetros e menores comprimentos. De acordo com as análises realizadas, há evidência de variabilidade fenotípica na conformação corporal, tanto entre como dentre os rebanhos avaliados. A existência de variabilidade fenotípica dentro de rebanhos indica a existência de variabilidade genética, e possível resposta à seleção mediante programa de melhoramento genético

Financial impact of reducing door-to-balloon time in ST-elevation myocardial infarction: a single hospital experience

<p>Abstract</p> <p>Background</p> <p>The impact of reducing door-to-balloon time on hospital revenues, costs, and net income is unknown.</p> <p>Methods</p> <p>We prospectively determined the impact on hospital finances of (1) emergency department physician activation of the catheterization lab and (2) immediate transfer of the patient to an immediately available catheterization lab by an in-house transfer team consisting of an emergency department nurse, a critical care unit nurse, and a chest pain unit nurse. We collected financial data for 52 consecutive ST-elevation myocardial infarction patients undergoing emergency percutaneous intervention from October 1, 2004–August 31, 2005 and compared this group to 80 consecutive ST-elevation myocardial infarction patients from September 1, 2005–June 26, 2006 after protocol implementation.</p> <p>Results</p> <p>Per hospital admission, insurance payments (hospital revenue) decreased ($35,043 ±$36,670 vs. $25,329 ±$16,185, P = 0.039) along with total hospital costs ($28,082 ±$31,453 vs. $18,195 ±$9,242, P = 0.009). Hospital net income per admission was unchanged ($6962 vs.$7134, P = 0.95) as the drop in hospital revenue equaled the drop in costs. For every $1000 reduction in total hospital costs, insurance payments (hospital revenue) dropped$1077 for private payers and $1199 for Medicare/Medicaid. A decrease in hospital charges ($70,430 ± $74,033 vs.$53,514 ± $23,378, P = 0.059), diagnosis related group relative weight (3.7479 ± 2.6731 vs. 2.9729 ± 0.8545, P = 0.017) and outlier payments with hospital revenue>$100,000 (7.7% vs. 0%, P = 0.022) all contributed to decreasing ST-elevation myocardial infarction hospitalization revenue. One-year post-discharge financial follow-up revealed similar results: Insurance payments: $49,959 ±$53,741 vs. $35,937 ±$23,125, P = 0.044; Total hospital costs: $39,974 ±$37,434 vs. $26,778 ±$15,561, P = 0.007; Net Income: $9984 vs.$9159, P = 0.855.</p> <p>Conclusion</p> <p>All of the financial benefits of reducing door-to-balloon time in ST-elevation myocardial infarction go to payers both during initial hospitalization and after one-year follow-up.</p> <p>Trial Registration</p> <p><b>ClinicalTrials.gov ID</b>: NCT00800163</p

Honokiol Crosses BBB and BCSFB, and Inhibits Brain Tumor Growth in Rat 9L Intracerebral Gliosarcoma Model and Human U251 Xenograft Glioma Model

BACKGROUND: Gliosarcoma is one of the most common malignant brain tumors, and anti-angiogenesis is a promising approach for the treatment of gliosarcoma. However, chemotherapy is obstructed by the physical obstacle formed by the blood-brain barrier (BBB) and blood-cerebrospinal fluid barrier (BCSFB). Honokiol has been known to possess potent activities in the central nervous system diseases, and anti-angiogenic and anti-tumor properties. Here, we hypothesized that honokiol could cross the BBB and BCSFB for the treatment of gliosarcoma. METHODOLOGIES: We first evaluated the abilities of honokiol to cross the BBB and BCSFB by measuring the penetration of honokiol into brain and blood-cerebrospinal fluid, and compared the honokiol amount taken up by brain with that by other tissues. Then we investigated the effect of honokiol on the growth inhibition of rat 9L gliosarcoma cells and human U251 glioma cells in vitro. Finally we established rat 9L intracerebral gliosarcoma model in Fisher 344 rats and human U251 xenograft glioma model in nude mice to investigate the anti-tumor activity. PRINCIPAL FINDINGS: We showed for the first time that honokiol could effectively cross BBB and BCSFB. The ratios of brain/plasma concentration were respectively 1.29, 2.54, 2.56 and 2.72 at 5, 30, 60 and 120 min. And about 10% of honokiol in plasma crossed BCSFB into cerebrospinal fluid (CSF). In vitro, honokiol produced dose-dependent inhibition of the growth of rat 9L gliosarcoma cells and human U251 glioma cells with IC(50) of 15.61 µg/mL and 16.38 µg/mL, respectively. In vivo, treatment with 20 mg/kg body weight of honokiol (honokiol was given twice per week for 3 weeks by intravenous injection) resulted in significant reduction of tumor volume (112.70±10.16 mm(3)) compared with vehicle group (238.63±19.69 mm(3), P = 0.000), with 52.77% inhibiting rate in rat 9L intracerebral gliosarcoma model, and (1450.83±348.36 mm(3)) compared with vehicle group (2914.17±780.52 mm(3), P = 0.002), with 50.21% inhibiting rate in human U251 xenograft glioma model. Honokiol also significantly improved the survival over vehicle group in the two models (P<0.05). CONCLUSIONS/SIGNIFICANCE: This study provided the first evidence that honokiol could effectively cross BBB and BCSFB and inhibit brain tumor growth in rat 9L intracerebral gliosarcoma model and human U251 xenograft glioma model. It suggested a significant strategy for offering a potential new therapy for the treatment of gliosarcoma