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• C1-C2 angle correlates with C2-C7 SVA and C2-C7 angle pre-/postoperatively. • Postop C2-C7 SVA showed significant correlation with postop NDI. • Postoperative C2-C7 SVA is affected by preop C2-C7 SVA and C1-C2 fixation angle. • C1-C2 fixation angle and preop C2-C7 SVA should be considered. The C1-C2 angle has been shown to correlate with subaxial alignment under various conditions. The aim of this study was to evaluate the correlation between the C1-C2 fixation angle and subaxial sagittal alignment as well as the impact of the sagittal vertical axis (SVA) on functional outcomes in traumatic atlantoaxial (A-A) instabilities. The data of 36 patients who underwent posterior C1-C2 fixation for traumatic A-A instability between December 2005 and September 2015 were retrospectively reviewed. Radiographic parameters, including the C1-C2 angle, occipitocervical angle, C2-C7 angle, and C2-C7 SVA, were measured before surgery and at 1-year follow-up. Clinical outcomes were measured using the visual analogue scale (VAS) and Neck Disability Index (NDI). The preoperative and postoperative relationships between parameters were analyzed. In preoperative and postoperative radiographs, the C1-C2 angle correlated with the C2-C7 angle (r = −0.347, p = 0.038, and r = −0.339, p = 0.043, respectively) and the C2-C7 SVA (r = 0.648, p < 0.001, and r = 0.436, p = 0.008, respectively). The postoperative C2-C7 SVA was directly proportional to the preoperative C2-C7 SVA and postoperative C1-C2 angle (postoperative C2-C7 SVA = 0.72 + 0.669 × [preoperative C2-C7 SVA] + 0.555 × [postoperative C1-C2], r2 = 0.677, p < 0.001). The postoperative C2-C7 SVA correlated with postoperative VAS (r s = 0.382, p = 0.021) and NDI (r s = 0.476, p = 0.003). The postoperative C2-C7 SVA was affected by the preoperative C2-C7 SVA and the postoperative C1-C2 angle and showed significant positive correlation with postoperative NDI. The C1-C2 fixation angle and the preoperative C2-C7 SVA should be carefully considered to avoid postoperative sagittal imbalance. [ABSTRACT FROM AUTHOR]

Background Microscopic anterior cervical foraminotomy (MACF) is a surgical technique for unilateral cervical radiculopathy that preserves segmental motion and avoids adjacent segmental degeneration, but little is known of its long-term outcomes. Methods A retrospective minimum 10-year follow-up study was conducted on patients treated by 1 surgeon. Clinical outcomes were assessed using a visual analog scale of neck and arm pain, Neck Disability Index, and Odom criteria. Surgical outcomes were assessed using additional procedure rates. Radiologic outcomes were estimated by measuring disc heights, segmental angles, and range of motion at the surgical level and adjacent segments, and so on. Results Of the 94 patients who underwent MACF between January 2000 and December 2004 by 1 surgeon, 69 were enrolled in this study. Median follow-up period was 11.9 years (range, 10.0–14.5 years). Visual analog scales for neck or arm pain and Neck Disability Index improved significantly during follow-up period (P < 0.001). Also, according to the Odom criteria, an excellent or good outcome was achieved in 62 patients (89.9%) at final follow-up. An additional procedure was performed in 10 patients (14.5%) for symptom recurrence during the follow-up period. The only risk factor found to be related to the need for an additional procedure was a small preoperative range of motion at the surgical level (P = 0.018). Although mean disc height at the surgical level decreased significantly (from 6.23 ± 1.10 to 5.17 ± 1.12 mm; P = 0.004), adjacent discs were not significantly affected. Conclusions Although some radiologic results have shortcomings, the results of this study suggest that MACF has favorable long-term outcomes. Highlights • The long-term clinical and radiologic outcomes of microscopic anterior cervical foraminotomy is documented. • The outcomes were favourable despite some drawbacks with the radiologic results (decrease in disc height). • Comparison with other surgical methods is not possible due to the cross-sectional design and different surgical indications. [ABSTRACT FROM AUTHOR]

• Novel therapeutic strategies for analgesic development are required. • α-Mangostin has analgesic effects, although the mechanism is unknown. • α-Mangostin hyperpolarized membrane potential by activating K2P channels. • TTX-sensitive Na V channels are inhibited by α-mangostin in cultured DRG neurons. • α-Mangostin inhibits capsaicin-induced, but not proton-activated, TRPV1 current. α-Mangostin is a xanthone isolated from the pericarps of mangosteen fruit with, and has analgesic properties. Although the effects suggest an interaction of α-mangostin with ion channels in the nociceptive neurons, electrophysiological investigation of the underlying mechanism has not been performed. We hypothesized that α-Mangostin exerts its analgesic effects by modulating the activity of various ion channels in dorsal root ganglion (DRG) neurons. We performed a whole-cell patch clamp study using mouse DRG neurons, HEK293T cells overexpressing targeted ion channels, and ND7/23 cells. Molecular docking (MD) and in silico absorption, distribution, metabolism, and excretion (ADME) analyses were conducted to obtain further insights into the binding sites and pharmacokinetics, respectively. Application of α-mangostin (1–3 µM) hyperpolarized the resting membrane potential (RMP) of small-sized DRG neurons by increasing background K + conductance and thereby inhibited action potential generation. At micromolar levels, α-mangostin activates TREK-1, TREK-2, or TRAAK, members of the two-pore domain K + channel (K2P) family known to be involved in RMP formation in DRG neurons. Furthermore, capsaicin-induced TRPV1 currents were potently inhibited by α-mangostin (0.43 ± 0.27 µM), and partly suppressed tetrodotoxin-sensitive voltage-gated Na+ channel (Na V) currents. MD simulation revealed that multiple oxygen atoms in α-mangostin may form stable hydrogen bonds with TREKs, TRAAK, TRPV1, and Na V channels. In silico ADME tests suggested that α-mangostin may satisfy the drug-likeness properties without penetrating the blood–brain barrier. The analgesic properties of α-mangostin might be mediated by the multi-target modulation of ion channels, including TREK/TRAAK activation, TRPV1 inhibition, and reduction of the tetrodotoxin-sensitive Na V current. The findings suggest that the phytochemical can be a multi-ion channel-targeting drug and an alternative drug for effective pain management. [ABSTRACT FROM AUTHOR]

This paper presents a simple model to predict the flame speed and the blast pressure during an unconfined gas explosion. The proposed model is a modification to the fractal-based model proposed by Gostintsev et al. In the original model, the flame radius, r , is expressed as a function of time, t , as r / ( κ / ε S L ) = c g [ t / ( κ / ε 2 S L 2 ) ] α , where κ is the thermal diffusivity, ε is the volumetric expansion ratio, S L is the laminar burning velocity, c g is the model constant, and α is the acceleration exponent. The present model expresses model constant c g using the properties of gas mixture. In this study, field experiments of gas explosion are conducted for hydrogen/air, methane/air, and propane/air mixtures confined in a 1- or 27-m 3 regular cubic plastic tent. The experimental results demonstrate the nature of self-similarity in the explosions and the experimental acceleration exponent associated with a fractal dimension is evaluated. The model is developed by using the concept of self-similarity and an acoustic theory. The predicted flame speed and the blast pressure are compared with experimental data of larger-scale hydrogen/air, methane/air and propane/air explosions under a wide range of conditions. The model predictions agree reasonably well with the experimental data, validating the proposed model. [ABSTRACT FROM AUTHOR]

Summary Adequate tissue oxygenation is an essential factor in diabetic foot management. Hyperbaric oxygen (HBO) therapy has been successfully used as adjunctive treatment to improve the healing of diabetic foot ulcers. However, the clinical uses of HBO therapy are limited due to the low availability of HBO chambers, poor patient compliance, and high oxidative potential. Normobaric hyperoxic (NBO) therapy may be a potentially attractive alternative to HBO therapy because of its high availability, good patient compliance, and few technical requirements. Several studies on NBO therapy to attenuate infarct volume after stroke have provided compelling evidence. However, there have been no reports regarding the effect of NBO therapy in the field of wound healing. The purpose of this study was to evaluate the effect of NBO therapy on tissue oxygenation of diabetic feet. This study included 100 patients with diabetic foot ulcers (64 males and 36 females). Transcutaneous partial oxygen tension (TcPO 2 ) values of diabetic feet were measured before, during, and after NBO therapy. The mean TcPO 2 values before, during, and after therapy were 46.6 ± 21.5, 88.9 ± 48.0, and 49.9 ± 23.8 mmHg ( p < 0.001), respectively. The lower the initial TcPO 2 level, the more TcPO 2 increased. The results reveal that NBO therapy significantly increases the tissue oxygenation level of diabetic feet. [ABSTRACT FROM AUTHOR]

Highlights: [•] The flame behaviour and the blast wave of combustible gas/air mixtures were investigated by using a soap bubble method. [•] Flame is accelerated by the onset of the flame front instabilities. [•] The overpressure increases by both the increase in the absolute value of the burning velocity and the acceleration. [Copyright &y& Elsevier]

Abstract: In this study, the flame propagation behavior and the intensity of the blast wave by an accidental explosion of a hydrogen-air mixture in an open space were measured simultaneously using the soap bubble method. The results show that the flame in lean hydrogen-air mixtures propagated by spontaneous flame instabilities. The flame in rich hydrogen-air mixtures propagated smoothly in the early stage, and was intensively wrinkled and accelerated in the later stage by different type of instabilities. The flame wrinkling in the later stage of rich hydrogen flame is generated when the flame approaches the non-uniformity transition region of concentration distribution. The intensity of the blast wave of hydrogen/air mixtures is strongly affected by the acceleration of the flame propagation by these spontaneous flame disturbances. [Copyright &y& Elsevier]

Summary: In previous pilot studies, the authors reported that bone marrow stromal cells (BSCs) have a superior effect on healing of acute wounds compared with fibroblasts in vitro and in vivo. The present study was designed to compare the effect of allograft of normal BSCs with that of normal fibroblasts on the activity of diabetic fibroblasts in vitro. Diabetic fibroblasts were cultured in 24-well culture plates. Three groups were evaluated: group I, diabetic fibroblasts only; group II, diabetic fibroblasts co-cultured with normal fibroblasts; group III, diabetic fibroblasts co-cultured with normal BSCs. After 3-day incubation, cell proliferation and collagen synthesis, which are the major contributing factors in wound healing, were measured. Group III showed the highest level in both cell proliferation and collagen synthesis, followed by group II and group I (p <0.05). These results demonstrate that BSCs are superior to fibroblasts in stimulating the activity of diabetic fibroblasts. [Copyright &y& Elsevier]

Background Context: The diagnosis of discogenic low back pain (LBP) from disc degeneration of the lumbar spine is often evaluated with discography. Noninvasive, simple screening methods other than invasive discography are useful, as evidence supporting clinical findings and magnetic resonance imaging (MRI) have come to the forefront.Purpose: To investigate disc height (DH) discrepancy between supine and standing positions on simple radiography to clarify its clinical screening value in individuals with discogenic LBP.Study Design/settings: Retrospective matched cohort design.Patient Sample: Ninety-two patients with early to middle stage disc degeneration (Pfirrmann grade II, III, or IV).Outcome Measures: Each subject underwent simple radiographs and MRI. Baseline characteristics, including demographic data and MRI findings, and radiological findings, including DH discrepancy, segmental angle, and sagittal balance, were analyzed. DH discrepancy ratio was calculated as (1 - [calibrated DH on standing radiography/calibrated DH on supine radiography]) × 100%.Methods: We matched LBP group of 46 patients with intractable discogenic pain (≥7 of visual analog scale scores) confirmed by discography with control group of 46 patients with similar stage disc degeneration with mild LBP (≤4 of visual analog scale scores). Binary regression analysis, receiver operating characteristic curve analysis, and cut-off value for diagnosis were used to evaluate and clarify diagnostic value of various factors.Results: There was no significant difference between the two groups in terms of baseline characteristics, including age, sex, body mass index, pathological level, and magnetic resonance findings such as disc degeneration, high intensity zone, and para-spinal muscle volume. Among the various radiological findings, the calibrated mean DH in the standing position (20.87±5.65 [LBP group] vs. 26.95±3.02 [control group], p<.001) and the DH discrepancy ratio (14.55±6.13% [LBP group] vs. 1.47±0.75% [control group], p=.007) were significantly different between the two groups. The cut-off value for DH discrepancy ratio to screen discogenic LBP was ≥6.04%. Additionally, as a compensation for pain, sagittal vertical axis (3.43±2.03 cm [LBP group] vs. -0.54±3.05 cm [control group], p=.002) and pelvic incidence (54.74±6.76° [LBP group] vs. 43.98±8.67° [control group]; p=.006) were different between the two groups.Conclusions: The results suggest that DH discrepancy between the supine and standing positions could be a screening metric for discogenic LBP in early to middle stage disc degeneration of the lumbar spine. [ABSTRACT FROM AUTHOR]

Background To prevent risk of iatrogenic instability after surgery for upper lumbar disc herniation, we adapted a microsurgical translaminar approach (keyhole laminotomy), which allows less destructive laminotomy. We compared results of translaminar and interlaminar approaches. Methods The study enrolled 48 patients who underwent single-level discectomy in the upper lumbar spine (L1-2 or L2-3). Patients were allocated to 2 groups: a translaminar group (n = 20) or an interlaminar group (n = 28). Mean patient age was 57.04 ± 12.77 years, and median follow-up duration was 3.5 years (range, 1.0–7.0 years). Clinical and radiologic data were retrospectively reviewed. Results Baseline characteristics, including age, sex, surgical level, and preoperative symptoms, were nonsignificantly different. At 1 year after surgery, improvement in leg pain as determined by visual analog scale was nonsignificantly different. Improvement in visual analog scale for back pain was significantly greater in the translaminar group compared with interlaminar group (mean 4.00 ± 1.56 vs. 2.45 ± 2.01, P < 0.001). Surgical outcome was not different between groups. Mean decrease in disc height at operated level was not significantly different between groups. Mean increase in segmental range of motion at surgical levels was significantly greater in the interlaminar group (−3.38 ± 4.03° vs. 1.10 ± 3.03°, P = 0.010), and mean recovery of total lumbar lordosis was significantly greater in the translaminar group (9.80 ± 5.96° vs. 0.43 ± 8.45°, P = 0.021). Conclusions The translaminar approach provides a safe and effective alternative to the classic interlaminar approach for upper lumbar disc herniation. Highlights • Microsurgical interlaminar approach for upper lumbar disc herniation increases risk of postoperative spinal instability. • Microsurgical translaminar approach ensures access to migrated disc fragments and disc space in upper lumbar spine. • Translaminar approach group achieved better radiologic outcomes and more favorable clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: The prevalence of allergic rhinitis (AR) is increasing worldwide. Allergic diseases develop in susceptible subjects when they are exposed to specific environmental factors. Objective: We analyzed changes in the prevalence of AR and identified genetic and environmental factors in early childhood that affect risk. Methods: We used the International Study of Asthma and Allergies in Childhood questionnaire to collect data on AR, allergies, and environmental exposures from 4554 elementary school students from 5 areas of Seoul, Korea, in 2008. We also obtained DNA from 1050 subjects from 1 area of Seoul for genotype analysis of IL13. Results: We identified genetic and environmental factors during infancy and early childhood that increased the risk for current AR (resulting in a diagnosis of AR and AR symptoms in the past 12 months) in elementary school–aged children. These included allergic disease in parents and antibiotic use in infants, allergic disease in parents and exposure of infants to mold, and allergic disease in parents and moving an infant to a newly built house. The risk of current AR also increased in subjects with GA or AA at nucleotide 2044 in IL13 who had been exposed to mold in the home during infancy (adjusted odds ratio, 3.27; 95% CI, 1.75-6.11) compared with subjects who had GG at this position and had not been exposed to mold (adjusted odds ratio, 3.27; 95% CI, 1.75-6.11). Conclusion: The prevalence of AR is increasing in Korean children. Children with a family history of allergic disease and exposure to specific environmental risk factors during infancy are more likely to have AR. Children with GA or AA at IL13(+2044) are at increased risk for AR when exposed to mold in the home during the first year of life. [ABSTRACT FROM AUTHOR]

Background: Exacerbations of childhood asthma and rhinovirus infections both peak during the spring and fall, suggesting that viral infections are major contributors to seasonal asthma morbidity. Objectives: We sought to evaluate rhinovirus infections during peak seasons in children with asthma and to analyze relationships between viral infection and illness severity. Methods: Fifty-eight children aged 6 to 8 years with asthma provided 5 consecutive weekly nasal lavage samples during September and April; symptoms, medication use, and peak flow were recorded. Rhinoviruses were identified by using multiplex PCR and partial sequencing of viral genomes. Results: Viruses were detected in 36% to 50% of the specimens, and 72% to 99% of the viruses were rhinoviruses. There were 52 different strains (including 16 human rhinovirus C) among the 169 rhinovirus isolates; no strains were found in more than 2 collection periods, and all but 2 children had a respiratory tract infection. Virus-positive weeks were associated with greater cold and asthma symptom severity (P < .0001 and P = .0002, respectively). Furthermore, virus-positive illnesses had increased duration and severity of cold and asthma symptoms and more frequent loss of asthma control (47% vs 22%, P = .008). Although allergen-sensitized versus nonsensitized children had the same number of viral infections, the former had 47% more symptomatic viral illnesses (1.19 vs 0.81 per month, P = .03). Conclusions: Rhinovirus infections are nearly universal in children with asthma during common cold seasons, likely because of a plethora of new strains appearing each season. Illnesses associated with viruses have greater duration and severity. Finally, atopic asthmatic children experienced more frequent and severe virus-induced illnesses. [Copyright &y& Elsevier]

Nutritional status, iron-deficiency-related biochemical indices, and immunologic patterns of female Judo athletes and control subjects were evaluated. The subjects’ 3-d food records showed that 41.0 kcal/kg of energy was consumed daily and the contributions of protein, fat, and carbohydrate to total energy intake were 12.5%, 29.2%, and 58.3%, respectively. The reported vitamin intakes of athletic subjects were above those of the recommended daily allowance, however, calcium and iron intakes were less than 100% of the recommended daily allowance. Intakes of energy, protein, phosphate, vitamin B1, and vitamin B2 were higher in the athletes than in the control subjects. Analysis using the Nutrient Adequacy Ratio and the Index of Nutritional Quality showed that athletic subjects had more desirable patterns than the control subjects. There was no any indication of anemia, which often occurs as a result of hemodilution in strenuously trained athletes. The subjects’ immunologic patterns showed a slight immunosuppression. Iron, vitamin B1, niacin intakes were positively correlated with immunoglobulin (Ig) G levels in the athletes. The relation between nutrient intakes and the immune systems of endurance-trained athletes needs further investigation. [Copyright &y& Elsevier]

A proton linac based boron neutron capture therapy system (A-BNCT, 10MeV, 4mA) was successfully developed in Korea. We performed in vitro experiments with U87 and SAS cells and revealed the efficacy of a binary therapy BNCT using epithermal neutrons and boronophenylalanine (BPA). The results revealed that BNCT showed cancer cell selectivity and caused cell death. Further in vitro studies can be a valuable method to characterize an A-BNCT system. We expect BNCT to become a treatment option for cancer patients. • Proton Linac based BNCT (A-BNCT) has been developed in Korea. • Cell death was confirmed in U87 and SAS cells using an A-BNCT system. • We are performing preclinical trials and clinical trials with an A-BNCT system. [ABSTRACT FROM AUTHOR]

Pyrazole derivatives were originally suggested as selective blockers of the transient receptor potential cation 3 (TRPC3) and channel. In particular, pyr3 and 10 selectively inhibit TRPC3, whereas pyr2 (BTP2) and 6 inhibit ORAI1. However, their effects on background K + channel activity have not been elucidated. In this study, the effects of BTP2, pyr3, pyr6, and pyr10 were studied on cloned human TWIK-related K + channels (TREKs) and TWIK-related acid-sensitive K + channel 2 (TASK-2) channels, which modulate Ca 2+ signaling by controlling membrane potential, in HEK293T-overexpressing cells by using a whole-cell patch clamp technique. Pyr3 potently inhibited TREK-1 (I TREK1 ), TREK-2 (I TREK2 ), and TASK2 current (I TASK-2 ) with half-maximal inhibitory concentrations (IC 50 ) of 0.89±0.27, 1.95±1.44, and 2.42±0.39 µM, respectively. BTP2 slightly inhibited I TASK-2 (80.3±2.5% at 100 μM). In contrast, pyr6 at 100 µM potentiated I TREK1 and I TREK2 by approximately 2.6- and 3.6-fold compared to the control and inhibited I TASK2 (38.7±9.2%). Pyr10 showed a subtype-specific inhibition of I TREK1 but not I TREK2 . It also inhibited I TASK2 (70.9±3.1% at 100 μM). To the best of our knowledge, this study is the first to describe the differential modulation of TREKs and TASK2 channels by pyrazole derivatives, previously used as inhibitors of TRPC3 and ORAI1. Therefore, studies using these drugs should consider their modulation of other channels such as TREK and TASK-2. [ABSTRACT FROM AUTHOR]

Abstract: The increase of cytoplasmic Ca2+ concentration (Δ[Ca2+]c) in response to antigenic stimulation is a critical step of signals activating immune responses. In addition, the voltage-gated K+ channels (Kv) in T lymphocytes draw attention as an effective target of immune-modulation. Caffeic acid phenethyl ester (CAPE), an active component of propolis, shows strong anti-inflammatory effects and T cell suppression. Although various mechanisms have been suggested for the action of CAPE, the effects of CAPE on intracellular Ca2+ signaling and ion channels are unknown. Here we investigated the effects of CAPE on Δ[Ca2+]c, Ca2+-release activated Ca2+ current (I CRAC), and Kv current (I Kv) in Jurkat T cells, and on Ca2+-activated K+ channel current (I SK4) overexpressed in HEK-293 cells. I CRAC was induced by dialyzing T cells and Orai1/STIM1 overexpressing HEK293 cells with InsP3/BAPTA-containing pipette solution. CAPE concentration-dependently decreased both T cell receptor (CD3)- and thapsigargin-induced Δ[Ca2+]c. The phosphorylation of PLCγ1 by CD3 stimulation was not affected by CAPE. I CRAC was almost completely blocked by 25 μM CAPE. CAPE also inhibited the I Kv and I SK4. Albeit the strong inhibition of Ca2+ influx via CRAC, the suppression of IL-2 secretion by CAPE was similarly observed in human peripheral T cells when the CRAC pathway was circumvented by ionomycin. Although the unspecific inhibition of ion channels by CAPE suggested an intriguing mechanism, the effects of CAPE on signaling pathways other than I CRAC seem to play dominant roles in the immunomodulation by CAPE. [Copyright &y& Elsevier]

Background: Minimally invasive surgery decreases postoperative pain and disability. However, limited views of the surgical field require extensive use of intraoperative fluoroscopy that may expose the surgical team to higher levels of ionizing radiation. Purpose: To assess the feasibility and safety of navigation-assisted fluoroscopy during minimally invasive spine surgery. Study Design: A combined cadaveric and human study comparing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) using navigation-assisted fluoroscopy with standard intraoperative fluoroscopy to determine differences in surgical times and radiation exposures. Methods: Eighteen fresh cadaveric spines underwent unilateral MIS TLIF by using either navigation-assisted fluoroscopy or standard fluoroscopy. Times for specific surgical steps were compared. In addition, a prospective short-term evaluation of the intraoperative and perioperative results of 10 patients undergoing navigation-assisted MIS TLIF (NAV group) compared with a retrospective review of 8 patients undergoing MIS TLIF performed by using standard fluoroscopy (FLUORO group). Results: In the cadaveric study, the times were similar between the NAV group and the FLUORO group for most key steps. No statistically significant differences were obtained for approach, exposure, screw insertion, facetectomy/decompression, or total surgical times. Statistically significant differences were obtained for the setup time and total fluoroscopy time. The setup time for the NAV group averaged 9.67 (standard deviation [SD], 3.74) minutes compared with 4.78 (SD, 2.11) minutes for the FLUORO group (p=.034). The total fluoroscopy time was higher for the FLUORO group compared with the NAV group (41.9 seconds vs. 28.7 seconds, p=.042). Radiation exposure was undetectable when navigation-assisted fluoroscopy is used (NAV group). In contrast, an average 12.4 milli-REM (mREM) of radiation exposure is delivered to the surgeon during unilateral MIS TLIF procedure without navigation (FLUORO group). In the clinical series, the total fluoro time for the NAV group was 57.1 seconds (SD, 37.3; range, 18-120) compared with 147.2 seconds (SD, 73.3; range, 73-295) for FLUORO group (p=.02). No statistically significant differences are noted for operating time, estimated blood loss, or hospital stay. No inadvertent durotomies, postoperative weakness, or new radiculopathy were noted in the NAV group. One inadvertent durotomy was encountered in the FLUORO group that was repaired intraoperatively without clinical sequelae. Conclusion: The use of navigation-assisted fluoroscopy is feasible and safe for minimally invasive spine surgery. Radiation exposure is decreased to the patient as well as the surgical team. [ABSTRACT FROM AUTHOR]

Abstract: Gingerol (Zingiber officinale Roscoe, Zingiberaceae) is one of the most frequently and heavily consumed dietary condiments throughout the world. The oleoresin from rhizomes of ginger contains [6]-gingerol (1-[4′-hydroxy-3′-methoxyphenyl]-5-hydroxy-3-decanone) and its homologs which are pungent ingredients that have been found to possess many interesting pharmacological and physiological activities, such as anti-inflammatory, antihepatotoxic and cardiotonic effects. However, the effects of [6]-gingerol on metastatic processes in breast cancer cells are not currently well known. Therefore, in this study, we examined the effects of [6]-gingerol on adhesion, invasion, motility, activity and the amount of MMP-2 or -9 in the MDA-MB-231 human breast cancer cell line. We cultured MDA-MB-231 cells in the presence of various concentrations of [6]-gingerol (0, 2.5, 5 and 10 μM). [6]-Gingerol had no effect on cell adhesion up to 5 μM, but resulted in a 16% reduction at 10 μM. Treatment of MDA-MB-231 cells with increasing concentrations of [6]-gingerol led to a concentration-dependent decrease in cell migration and motility. The activities of MMP-2 or MMP-9 in MDA-MB-231 cells were decreased by treatment with [6]-gingerol and occurred in a dose-dependent manner. The amount of MMP-2 protein was decreased in a dose-dependent manner, although there was no change in the MMP-9 protein levels following treatment with [6]-gingerol. MMP-2 and MMP-9 mRNA expression were decreased by [6]-gingerol treatment. In conclusion, we have shown that [6]-gingerol inhibits cell adhesion, invasion, motility and activities of MMP-2 and MMP-9 in MDA-MB-231 human breast cancer cell lines. [Copyright &y& Elsevier]