Cervical disk disease and the keyhole foraminotomy: proven efficacy at extended long-term follow up

Eighty-four consecutive patients with posterolateral cervical disk herniation treated by keyhole foraminotomy between 1980 and 1987 were reviewed. Radicular pain was the most common presenting complaint. Weakness was present in 59 patients. Sixty patients were available for long-term follow up, averaging 6.1 years. Fifty-six patients' results were graded as excellent. Three patients had good results and one fair result was noted. There were no poor results. Preoperative pain symptoms were relieved in all patients. There were no significant complications. The posterolateral keyhole foraminotomy is an efficient means of decompressing lateral soft disk herniations, without the risk of an anterior approach or iliac crest bone harvest. Careful patient selection and use of an operative microscope are essential in obtaining consistent, excellent results.     

Suppression of substance P biosynthesis in sensory neurons of dorsal root ganglion by prodrug esters of potent peptidylglycine alpha-amidating monooxygenase inhibitors

Substance P as well as many other neuropeptides are synthesized as glycine-extended precursors and converted to the biologically active C-terminal amides by posttranslational modification. The final step of posttranslational processing is catalyzed by peptidylglycine alpha-amidating monooxygenase (PAM). In a previous study, N-substituted homocysteine analogs were found to be potent inhibitors of PAM partially purified from conditioned medium of cultured rat medullary thyroid carcinoma CA-77 cells. These compounds, however, were only modest inhibitors of substance P production in cultured dorsal root ganglion cells, possibly because of poor cell penetration. Several ester derivatives of hydrocinnamoyl-phenylalanyl-homocysteine, one of the most potent PAM inhibitors, were prepared to increase the intracellular accessibility of these compounds. Hydrocinnamoyl-phenylalanyl-(S-benzoyl-homocysteine) benzyl ester was identified as the most potent compound, inhibiting substance P biosynthesis in dorsal root ganglion cells with an IC50 of 2 microM. Inhibition of PAM resulted in a concomitant increase in the glycine-extended substance p (substance P-Gly) precursor peptide. In the presence of 3 microM benzyl ester derivative, the intracellular substance P-Gly level was 2.4-fold higher while the substance P level was 2.1-fold lower than the corresponding peptides in control cells. These results suggest that PAM inhibition represents an effective method for suppression of substance P biosynthesis and, therefore, may have therapeutic utility in conditions associated with elevated substance P levels. Furthermore, PAM inhibition may also prove useful in decreasing other amidated peptides.     

Liver selenium and testis phospholipid hydroperoxide glutathione peroxidase are associated with growth during selenium repletion of second-generation Se-deficient male rats

We have previously shown that changes in glutathione peroxidase-1 (GPX1; H2O2:oxidoreductase, EC 1.11.1.9), plasma thyroid hormone and glutathione-S-transferase were not associated with changes in growth observed in second-generation (F2) severely Se-deficient rats; we also found that liver phospholipid hydroperoxide glutathione peroxidase (GPX4; EC 1.11.1.12) activity falls in first-generation (F1) Se-deficient rats to 41% of levels in Se-adequate rats. The purposes of this study were to determine the effect of F2 Se deficiency on GPX4 and to detect early changes in Se parameters associated with growth after single, small Se injections. Se-deficient male F2 weanling rats were randomly divided into two groups and fed a Se-deficient crystalline amino acid (0.003 microg Se/g diet; -Se) diet or that diet supplemented for 14 d with 0.2 microg Se/g diet (+Se) as Na2SeO3. Growth of -Se rats was 55% of the rate of +Se rats. Liver Se, GPX1 activity, GPX4 activity and testis GPX4 activity in -Se rats at 14 d were 1, 2, 23 and 13%, respectively, of levels in +Se rats. In a series of experiments, additional F2 male weanling rats were fed the -Se diet for 14 d and then were given an intraperitoneal single saline injection of 0, 1 or 5 microg Se/100 g body weight (BW) as Na2SeO3 and killed 1 or 7 d later. Rats injected with 1 or 5 microg Se/100 g BW grew 36 or 48%, respectively, above the rate of saline-injected rats. Liver Se concentration increased 367% and testis GPX4 activity doubled in rats 1 d after injection of 1 microg Se/100 g BW compared with saline-injected rats; these parameters were further elevated with 5 microg Se/100 g BW injections. Increases in liver Se and testis GPX4 activity were the parameters best associated with improved growth after Se injection, but the molecular role for Se in growth remains unclear.     

Systemic use of pentosan polysulphate in the treatment of osteoarthritis

Today's nursing students feel pressured to complete research-based professional papers. Reasons that these assignments cause feelings of anxiety may be due to learners' poor writing/thinking skills, low literacy levels, lack of attention when traditional strategies are used, or expectations of entertaining teaching methods. Creative teaching strategies, using a story-telling and personification approach, may assist nurse educators to improve students' attention, retention and comprehension of primary concepts in their nursing courses.     

The aesthetic composite bridge

New developments are constantly introduced in the search for the optimal treatment modality to restore a single anterior tooth. The patient attention has shifted to aesthetics of the restoration, biocompatibility of the dental materials utilized, conservative preparation of the teeth to be restored, and the retention of intact adjacent dentition. The learning objective of this article is to review the methods currently utilized and to present a recently introduced treatment modality--the two-component bridge, which combines the strength and resiliency of composite resin with the aesthetic advantages of porcelain. The technology of the material is reviewed, the predominantly lingual tooth preparation procedures are outlined, and the bridge try-in is described. The advantages of the two-component bridge are presented along with the contraindications and suggestions of careful case selection. Three cases with congenitally missing maxillary lateral incisors in youthful patients are presented to supplement the theoretical outline and to describe and illustrate the clinical procedure.     

Establishment and characterization of a megakaryoblast cell line with amplification of MLL

A new cell line with megakaryoblastic features, designated UoC-M1, was established from the malignant cells of a 68-year-old patient with acute myeloid leukemia. The patient's leukemic cells reacted with alpha-naphthyl acetate esterase and acid phosphatase and expressed CD7, CD24, CD34, CD38, CD45, HLA-DR and CD61. Cytogenetic analysis of the patient's malignant cells (and of the UoC-M1 cells) showed a human, male hypodiploid karyotype with many chromosome rearrangements and marker chromosomes. Spectral karyotyping (SKY) analysis complemented the G-banded karyotyping and clarified several chromosomal translocations and identified the marker chromosomes. Fluorescence in situ hybridization (FISH) and SKY analysis demonstrated that one marker chromosome contained three segments of chromosome 9 interspersed with three segments of chromosome 11, as well as a portion of chromosome 19. FISH analysis with a probe for MLL revealed that the UoC-M1 cells contained four copies of the MLL gene. Southern blot analysis determined that the MLL gene had a germline profile while Northern and Western analyses showed that the MLL mRNAs and protein were of the appropriate sizes. This is the first report of amplification of the MLL gene which may be an additional mechanism of leukemogenesis or disease progression.     

Sabotaging one''s own medical care. Prevalence in a primary care setting

Treatment of washed boar sperm with hypotonic phosphate buffer removed the acrosome, disrupted the cytoplasmic membrane and almost completely separated the heads from the mid piece-tail segment. As assessed by oxygen uptake studies and their ability to oxidize 14C-labelled substrates to 14CO2, hypotonically-treated cells exhibit low glycolytic activity yet mitochondrial activity remains high. Both lactate and glycerol 3-phosphate underwent oxidation and these substrates continued to be metabolized by this preparation which had been stored for up to 10 days at 4 degrees C. Such preparations may be of assistance in the investigation of the biochemistry of boar sperm mitochondria.