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88±0.38) compared with NPT control (2.45±0.76; P less then 0.05), whereas there was a significant increase in miR-301a levels in PDAC specimens (0.89±0.28) compared with NPT control (0.25±0.41; P less then 0.05). We conclude that MnSOD expression is negatively associated with miR-301a levels in PDAC tissues, and lower miR-301a levels are associated with increased MnSOD expression and inhibition of PDAC growth.Colorectal carcinoma (CRC) is known as the most common cancer. MicroRNAs (miRNAs) have been proven to have important roles in human carcinogenesis by regulating various target genes. Recently, the downregulation of miR-582-5p had been demonstrated in CRC. However, its function and the underlying mechanism in CRC remains unknown. In this study, we found that miR-582-5p was frequently downregulated in CRC tissues compared with corresponding noncancerous tissues, as well as in CRC cell lines. Transfection with miR-582-5p mimics significantly inhibited CRC cell proliferation, invasion and arrested cell cycle at the G1/S phase, but promoted cell apoptosis. Further analysis demonstrated that miR-582-5p attenuated the expression of RAS-related GTP-binding protein (Rab27a). Luciferase reporter assay confirmed that Rab27a was a target of miR-582-5p. Mechanism analyses revealed that Rab27a overexpression significantly attenuated the inhibitory effect of miR-582-5p on CRC cell growth, invasion and cell cycle progression. Our data suggest that miR-582-5p may function as a tumor suppressor in the development of CRC by targeting Rab27a, indicating a novel therapeutic strategy for patients with CRC.The current LED lighting technology relies on the use of a driver to convert alternating current (AC) to low-voltage direct current (DC) power, a resistive p-GaN contact layer to inject positive charge carriers (holes) for blue light emission, and rare-earth doped phosphors to down-convert blue photons into green/red light, which have been identified as some of the major factors limiting the device efficiency, light quality, and cost. Here, we show that multiple-active region phosphor-free InGaN nanowire white LEDs connected through a polarization engineered tunnel junction can fundamentally address the afore-described challenges. Such a p-GaN contact-free LED offers the benefit of carrier regeneration, leading to enhanced light intensity and reduced efficiency droop. Moreover, through the monolithic integration of p-GaN up and p-GaN down nanowire LED structures on the same substrate, we have demonstrated, for the first time, AC operated LEDs on a Si platform, which can operate efficiently in both polarities (positive and negative) of applied voltage.
There is substantial heterogeneity in the number of screws used per level fused in adolescent idiopathic scoliosis (AIS) surgery. Assuming equivalent clinical outcomes, the potential cost savings of using fewer pedicle screws were estimated using a medical decision model with sensitivity analysis.
Descriptive analyses explored the annual costs for 5710 AIS inpatient stays using discharge data from the 2009 Kids' Inpatient Database (Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality), which is a national all-payer inpatient database. Patients between 10 and 17 years of age were identified using the ICD-9-CM code for idiopathic scoliosis (737.30). All inpatient stays were assumed to represent 10-level fusions with pedicle screws for AIS. High screw density was defined at 1.8 screws per level fused, and the standard screw density was defined as 1.48 screws per level fused. The surgical return for screw malposition was set at $23,762. A sensitivity analysis was performed by vae. However, such a screw construct must first be proven safe and effective.
Reducing the number of screws used in scoliosis surgery could potentially decrease national AIS hospitalization costs by up to 7%, which may improve the safety and efficiency of care. However, such a screw construct must first be proven safe and effective.
Insufficient biomechanical data exist from comparisons of the stability of expandable lateral cages with that of static transforaminal lumbar interbody fusion (TLIF) cages. The purpose of this biomechanical study was to compare the relative rigidity of L4-5 expandable lateral interbody constructs with or without additive pedicle screw fixation with that of L4-5 static TLIF cages in a novel cadaveric spondylolisthesis model.
Eight human cadaver spines were used in this study. A spondylolisthesis model was created at the L4-5 level by creating 2 injuries. First, in each cadaver, a nucleotomy from 2 channels through the anterior side was created. Second, the cartilage of the facet joint was burred down to create a gap of 4 mm. Light-emitting-diode tracking markers were placed at L-3, L-4, L-5, and S-1. Specimens were tested in the following scenarios intact model, bilateral pedicle screws, expandable lateral 18-mm-wide cage (alone, with unilateral pedicle screws [UPSs], and with bilateral pedicle screws [BPS TLIF construct with BPSs in a degenerative spondylolisthesis model.
Low lumbar osteoporotic vertebral collapse (OVC) has not been well documented compared with OVC of the thoracolumbar spine. The differences between low lumbar and thoracolumbar lesions should be studied to provide better treatment. Nimodipine nmr The aim of this study was to clarify the clinical and imaging features as well as outcomes of low lumbar OVC and to discuss the appropriate surgical treatment.
Thirty patients (10 men; 20 women; mean age 79.3 ± 4.7 years [range 70-88 years]) with low lumbar OVC affecting levels below L-3 underwent surgical treatment. The clinical symptoms, morphological features of affected vertebra, sagittal spinopelvic alignment, neurological status before and after surgery, and surgical procedures were reviewed at a mean follow-up period of 2.4 years.
The main clinical symptom was radicular leg pain. Most patients had old compression fractures at the thoracolumbar level. The affected vertebra was flat-type and concave or H-shaped type, not wedge type as often found in thoracolumbar OVC. Thnerating foraminal stenosis and/or canal stenosis. For patients with low lumbar OVC, decompression of the foraminal and canal stenosis with short fusion surgery via posterior approach can improve neurological symptoms. Since these patients are elderly with poor bone quality and other complications, treatments for both OVC and osteoporosis should be provided to achieve good clinical outcome.
The main types of low lumbar OVC were flat-type and concave type, which resulted in neurological symptoms by retropulsed bony fragments generating foraminal stenosis and/or canal stenosis. For patients with low lumbar OVC, decompression of the foraminal and canal stenosis with short fusion surgery via posterior approach can improve neurological symptoms. Since these patients are elderly with poor bone quality and other complications, treatments for both OVC and osteoporosis should be provided to achieve good clinical outcome.
The aim of the study was to investigate the safety and efficacy of minimally invasive tubular microdiscectomy for the treatment of recurrent lumbar disc herniation (LDH). As opposed to endoscopic techniques, namely microendoscopic and endoscopic transforaminal discectomy, this microscopically assisted technique has never been used for the treatment of recurrent LDH.
Thirty consecutive patients who underwent minimally invasive tubular microdiscectomy for recurrent LDH were included in the study. The preoperative and postoperative visual analog scale (VAS) scores for pain, the clinical outcome according to modified Macnab criteria, and complications were analyzed retrospectively. The minimum follow-up was 1.5 years. Student t-test with paired samples was used for the statistical comparison of pre- and postoperative VAS scores. A p value < 0.05 was considered to be statistically significant.
The mean operating time was 90 ± 35 minutes. The VAS score for leg pain was significantly reduced from 5.9 ± 2.1 preoperatively to 1.7 ± 1.3 postoperatively (p < 0.001). The overall success rate (excellent or good outcome according to Macnab criteria) was 90%. Incidental durotomy occurred in 5 patients (16.7%) without neurological consequences, CSF fistula, or negative influence to the clinical outcome. Instability occurred in 2 patients (6.7%).
The clinical outcome of minimally invasive tubular microdiscectomy is comparable to the reported success rates of other minimally invasive techniques. The dural tear rate is not associated to higher morbidity or worse outcome. The technique is an equally effective and safe treatment option for recurrent LDH.
The clinical outcome of minimally invasive tubular microdiscectomy is comparable to the reported success rates of other minimally invasive techniques. The dural tear rate is not associated to higher morbidity or worse outcome. The technique is an equally effective and safe treatment option for recurrent LDH.This study investigated the combination of environmental enrichment (EE) with cocaine-cue extinction training on reacquisition of cocaine self-administration. Rats were trained under a second-order schedule for which responses were maintained by cocaine injections and cocaine-paired stimuli. During three weekly extinction sessions, saline was substituted for cocaine but cocaine-paired stimuli were presented. Rats received 4-h periods of EE at strategic time points during extinction training, or received NoEE. Additional control rats received EE or NoEE without extinction training. One week later, reacquisition of cocaine self-administration was evaluated for 15 sessions, and then GluA1 expression, a cellular substrate for learning and memory, was measured in selected brain regions. EE provided both 24 h before and immediately after extinction training facilitated extinction learning and deterred reacquisition of cocaine self-administration for up to 13 sessions. Each intervention by itself (EE alone or extinction alone) was ineffective, as was EE scheduled at individual time points (EE 4 h or 24 h before, or EE immediately or 6 h after, each extinction training session). Under these conditions, rats rapidly reacquired baseline rates of cocaine self-administration. Cocaine self-administration alone decreased total GluA1 and/or pSer845GluA1 expression in basolateral amygdala and nucleus accumbens. Extinction training, with or without EE, opposed these changes and also increased total GluA1 in ventromedial prefrontal cortex and dorsal hippocampus. EE alone increased pSer845GluA1 and EE combined with extinction training decreased pSer845GluA1 in ventromedial prefrontal cortex. EE might be a useful adjunct to extinction therapy by enabling neuroplasticity that deters relapse to cocaine self-administration.Verotoxigenic Escherichia coli (VTEC) are significant for their low infectious dose, their potential clinical severity and the frequency with which they generate outbreaks. To describe the relative importance of different outbreak transmission routes for VTEC infection in Ireland, we reviewed outbreak notification data for the period 2004-2012, describing the burden and characteristics of foodborne, waterborne, animal contact and person-to-person outbreaks. Outbreaks where person-to-person spread was reported as the sole transmission route accounted for more than half of all outbreaks and outbreaks cases, most notably in childcare facilities. The next most significant transmission route was waterborne spread from untreated or poorly treated private water supplies. The focus for reducing incidence of VTEC should be on reducing waterborne and person-to-person transmission, by publicizing Health Service Executive materials developed for consumers on private well management, and for childcare facility managers and public health professionals on prevention of person-to-person spread.