Video-assisted lateral intertransverse process arthrodesis. Validation of a new minimally invasive lumbar spinal fusion technique in the rabbit and nonhuman primate (rhesus) models

STUDY DESIGN: Cadaveric anatomic and in vivo survival animal studies were performed to develop a new arthrodesis technique for the lumbar spine. OBJECTIVES: To examine the feasibility, efficacy, and safety of a minimally invasive lumbar intertransverse process arthrodesis technique using an osteoinductive growth factor (rhBMP-2) delivered in a collagen sponge carrier. The technique was first developed using a rabbit model and modified for the nonhuman primate (rhesus monkey), a larger animal with the most similar bone biology to humans. SUMMARY OF BACKGROUND DATA: The morbidity of conventional posterolateral lumbar intertransverse process arthrodesis includes graft donor site morbidity; paraspinal muscle devascularization, denervation, and scarring and nonunion in up to 36% of patients. Minimally invasive anterior lumbar interbody arthrodesis techniques have been developed, but these often require a metal implant and carry risks to major vessels and development of retrograde ejaculation. A minimally invasive technique for posterolateral intertransverse process arthrodesis has not been described previously. METHODS: In Part 1, we examined seven New Zealand white rabbits and five rhesus monkeys at necropsy and during nonsurvival surgeries to determine the best access routes and to develop special instruments for video-assisted lateral intertransverse process arthrodesis. In Part 2, 38 New Zealand white rabbits underwent L4-L5 intertransverse process arthrodesis: the "OPEN" group (n = 16) underwent a standard open muscle-splitting approach using rhBMP-2 (bone morphogenetic protein) and collagen as a bone graft substitute; the "video-assisted control" group (n = 6) underwent video-assisted lateral intertransverse process arthrodesis with the collagen implant only (no growth factor); and the "video-assisted-BMP" group (n = 16) underwent video-assisted lateral intertransverse process arthrodesis with rhBMP-2 and collagen as the graft material. In Part 3, rhesus monkeys (n = 4) underwent video-assisted lateral intertransverse process arthrodesis using rhBMP-2 and collagen after laminectomy of L4-L5. RESULTS: In Part 1, we identified expedient, minimally invasive routes to the intertransverse process interval appropriate for each species: an intermuscular approach for the rabbit and a lateral, extramuscular approach for the rhesus monkey. In Part 2, all rabbits in the OPEN and video-assisted-BMP groups achieved solid intertransverse process lumbar fusions when assessed at 10 weeks. There were no neurologic impairments nor any difference between the two groups in the frequency of postoperative infection or other complications. None of the animals in the video-assisted control group showed evidence of fusion. In Part 3, exposure, decortication and grafting with rh-BMP-2 and collagen was accomplished successfully in all four monkeys through the video-assisted minimally invasive approach without complications. CONCLUSION: Video-assisted lateral intertransverse process arthrodesis is a feasible, effective, and safe method of lumbar spinal fusion in the rabbit and rhesus monkey. Use of this arthrodesis procedure will minimize the morbidity of paraspinal muscle denervation and devascularization seen with open intertransverse process fusion techniques, and the use of an osteoinductive growth factor will eliminate the problem of graft donor site morbidity and possibly increase the chances for successful fusion.     

Role of ERAB/L-3-hydroxyacyl-coenzyme A dehydrogenase type II activity in Abeta-induced cytotoxicity

Endoplasmic reticulum-associated amyloid beta-peptide (Abeta)-binding protein (ERAB)/L-3-hydroxyacyl-CoA dehydrogenase type II (HADH II) is expressed at high levels in Alzheimer's disease (AD)-affected brain, binds Abeta, and contributes to Abeta-induced cytotoxicity. Purified recombinant ERAB/HADH II catalyzed the NADH-dependent reduction of S-acetoacetyl-CoA with a Km of approximately 68 microM and a Vmax of approximately 430 micromol/min/mg. The contribution of ERAB/HADH II enzymatic activity to Abeta-mediated cellular dysfunction was studied by site-directed mutagenesis in the catalytic domain (Y168G/K172G). Although COS cells cotransfected to overexpress wild-type ERAB/HADH II and variant beta-amyloid precursor protein (betaAPP(V717G)) showed DNA fragmentation, cotransfection with Y168G/K172G-altered ERAB and betaAPP(V717G) was without effect. We thus asked whether the enzyme might recognize alcohol substrates of which the aldehyde products could be cytotoxic; ERAB/HADH II catalyzed oxidation of a variety of simple alcohols (C2-C10) to their respective aldehydes in the presence of NAD+ and NAD-dependent oxidation of 17beta-estradiol. Addition of micromolar levels of synthetic Abeta(1-40) to purified ERAB/HADH II inhibited, in parallel, reduction of S-acetoacetyl-CoA (Ki approximately 1.6 microM), as well as oxidation of 17beta-estradiol (Ki approximately 3.2 microM) and (-)-2-octanol (Ki approximately 2.6 microM). Because micromolar levels of Abeta were required to inhibit ERAB/HADH II activity, whereas Abeta binding to ERAB/HADH II occurred at much lower concentrations (Km approximately 40-70 nM), the latter more closely simulating Abeta levels within cells, Abeta perturbation of ERAB/HADH II was likely to result from mechanisms other than the direct modulation of enzymatic activity. Cells cotransfected to overexpress ERAB/HADH II and betaAPP(V717G) generated malondialdehyde-protein and 4-hydroxynonenal-protein epitopes, which were detectable only at the lowest levels in cells overexpressing either ERAB/HADH II or betaAPP(V717G) alone. Generation of such toxic aldehydes was not observed in cells contransfected to overexpress Y168G/K172G-altered ERAB and betaAPP(V717G). We conclude that the generalized alcohol dehydrogenase activity of ERAB/HADH II is central to the cytotoxicity observed in an Abeta-rich environment.     

The diarylprolinol silyl ether system: a general organocatalyst

The past few decades have witnessed some of the most important and revolutionizing advances in the field of asymmetric catalysis. Chemists no longer rely solely on natural sources as the starting point of their synthetic strategy, as in chiral pool or auxiliary-based synthesis. Instead, naturally occurring chiral motifs are selected and, either unchanged or after modification, used in substoichiometric amounts as chiral catalysts or ligands. In this way, they effectively transfer their chirality to prochiral substrates, thereby rapidly amplifying and diversifying the arsenal of useful chiral building blocks available to the synthetic community. A long-standing goal in the pursuit of new catalytic systems is the discovery of general catalysts. Ideally, such catalytic systems should be capable of promoting a large number of enantioselective reactions, via multiple modes of activation, with good substrate tolerance and high stereoselectivity. In this Account, we describe the synthetic usefulness, efficiency, selectivity, and robustness of the diarylprolinol silyl ether system as the catalyst in various reactions of aldehydes. Based on the diarylprolinol silyl ether system, several studies on enamine-mediated transformations of saturated aldehydes have resulted in the introduction of different functionalities into the α-position of aldehydes in a highly stereoselective manner. This HOMO-activation concept was later extended to include α,β-unsaturated aldehydes, which after condensation with the aminocatalyst generate a dienamine species capable of undergoing stereoselective Diels-Alder-type reactions. As a result, the effective functionalization of the γ-position of the aldehyde is achieved. Recently, the activation principle was further developed to include 2,4-dienals, which form trienamine intermediates upon condensation with the aminocatalyst. The trienamines effectively react with carbon-centered dienophiles, forming aldehyde products having up to four contiguous stereocenters. Because of the concerted nature of the reaction and the efficient catalyst shielding of the β-position, the stereoinduction is achieved at the remote ε-position of the original aldehyde. Complementary to the enamine-mediated activations, α,β-unsaturated aldehydes can also be efficiently functionalized by applying the diarylprolinol silyl ether system via conjugate addition through iminium-ion-mediated processes, that is, LUMO-activation. In such reactions, the aminocatalyst not only effectively shields one of the enantiotopic faces of the enal, it also ensures excellent chemoselectivity, affording 1,4-adducts as the only products. Several different carbon and heteroatom nucleophiles can be added in a highly stereoselective fashion. The ability of the catalysts to participate in various enamine- and iminium-ion-mediated processes also makes them ideal for the sequential addition of nucleophiles and electrophiles in a cascade manner. These cascade reactions thereby afford access to products having at least two stereocenters. In the years to come, the diarylprolinol silyl ether catalysts will probably maintain their prominent position as general catalysts in the field of aminocatalysis. Moreover, recent efforts devoted to mechanistic studies might soon engender further advances with this versatile catalytic system, particularly in the areas of activation modes, catalyst loadings, and industrial applications.     

Deactivation of V2O5-WO3-TiO2 SCR catalyst at a biomass-fired combined heat and power plant

The deactivation of a commercial type V₂O₅-WO₃-TiO₂ monolith catalyst under biomass combustion was studied at a full-scale grate-fired power plant burning straw/wood using a slip stream pilot scale reactor. The aerosols in the flue gas consisted of a mixture of potassium chloride and sulphate. Three catalyst elements were exposed at 350 °C, and one element was exposed at 250 °C for comparison. The catalyst activity was measured in the reactor at the exposure temperature by addition of NH₃ and extra NO. The activity, in terms of a first-order rate constant, dropped by 52% after about 1140 h indicating a very fast deactivation compared to coal firing. It was also found that the reactor temperature was not of importance for the deactivation rate. SEM-EDX analysis showed that particle deposition and pore blocking contributed to the deactivation by decreasing the diffusion rate of NO and NH₃ into the catalyst. However, potassium also penetrated into the catalyst wall and the resulting average K/V ratio in the catalyst structure was high enough (about 0.3–0.5) for a significant chemical deactivation. Chemisorption studies carried out in situ showed that the amount of chemisorbed NH₃ on the catalyst decreased as a function of exposure time, which reveals that Brøndsted acid sites had reacted with potassium compounds and thereby rendered inactive. When washed by 0.5 M H₂SO₄ the regenerated catalyst regains a higher activity than that of the fresh catalyst at temperatures higher than 300 °C, but even though reactivation is possible, the deactivation rate appears too high for practical use of the SCR process in straw combustion.     

Deactivation of V2O5-WO3-TiO2 SCR catalyst at biomass fired power plants: Elucidation of mechanisms by lab- and pilot-scale experiments

In this work, deactivation of a commercial type V₂O₅-WO₃-TiO₂ catalyst by aerosols of potassium compounds was investigated in two ways: (1) by exposing the catalyst in a lab-scale reactor to a layer of KCl particles or fly ash from biomass combustion; (2) by exposing full-length monolith catalysts to pure KCl or K₂SO₄ aerosols in a bench-scale reactor. Exposed samples were characterized by activity measurements, SEM-EDX, BET/Hg-porosimetry, and NH₃ chemisorption. The work was carried out to support the interpretation of observations of a previous study in which catalysts were exposed on a full-scale biomass fired power plant and to reveal the mechanisms of catalyst deactivation.Slight deactivation (about 10%) was observed for catalyst plates exposed to a layer of KCl particles at 350 °C for 2397 h. No deactivation was found for catalyst plates exposed for 2970 h to fly ash (consisting mainly of KCl and K₂SO₄) collected from an SCR pilot plant installed on a straw-fired power plant. A fast deactivation was observed for catalysts exposed to pure KCl or K₂SO₄ aerosols at 350 °C in the bench-scale reactor. The deactivation rates for KCl aerosol and K₂SO₄ aerosol exposed catalysts were about 1% per day and 0.4% per day, respectively.SEM analysis of potassium-containing aerosol exposed catalysts revealed that the potassium salt partly deposited on the catalyst outer wall which may decrease the diffusion rate of NO and NH₃ into the catalyst. However, potassium also penetrated into the catalyst wall and the average K/V ratios (0.5–0.75) in the catalyst structure are high enough to explain the level of deactivation observed. The catalyst capacity for NH₃ chemisorption decreased as a function of exposure time, which reveals that Brønsted acid sites had reacted with potassium compounds and thereby rendered inactive in the catalytic cycle. The conclusion is that chemical poisoning of active sites is the dominating deactivation mechanism, but physical blocking of the surface area may also contribute to the loss of activity in a practical application. The results support the observation and mechanisms of deactivation of SCR catalysts in biomass fired systems proposed in a previous study [Y. Zheng, A.D. Jensen, J.E. Johnsson, Appl. Catal. B 60 (2005) 253].     

Simple tool to evaluate the impact of daylight on building energy consumption

This paper presents a simple building simulation tool for integrated daylight and thermal analysis. The tool is capable of importing the thermal and visual properties for different glazings and shading positions from the Window Information System (WIS) program. A coupled ray-tracing and radiosity methodology is used to derive the daylight levels for different sky conditions. Both detailed daylight distribution for a particular day and time and hourly discrete values on a yearly basis may be obtained. For an integrated simulation the hourly daylight levels are fed into an existing simple thermal simulation program capable of calculating energy demand and the indoor environment. Straightforward control systems for general and task lighting systems have been implemented together with a shading control strategy that adjusts the shading according to the indoor operative temperature, the risk of glare and the profile angle of the sun. The implemented daylight calculation method allows for shades from the window recess and overhang, and for distant shades blocking the sky vault. Comparisons with the ray-tracing program Radiance show that the accuracy of this approach is adequate for predicting the energy implications of photoresponsive lighting control. The amount of input is small, which makes the tool useful for integrated daylight optimisation in the early design process.