Tubular Microdiscectomy versus Conventional Surgery for Sciatica. A Comparative Prospective Enzyme Study

Objective Muscle injury is inevitable during surgical exposure of the spine, and it is quantified by the release of creatine phosphokinase. The aim of the present study is to make a comparison between tubular microdiscectomy and conventional microdiscectomy by using the pre- and postoperative serum concentrations of creatine phosphokinase as an indicator of muscle injury. Materials and Methods A total of 28 patients who underwent surgery for lumbar disc herniation were allocated into 2 groups: 12 patients (group A) operated by transflaval microdiscectomy, and 16 patients (group B) operated by tubular microdiscectomy. The serum concentration of total creatine phosphokinase was measured before surgery (creatine phosphokinase 1) and 1 day after surgery (creatine phosphokinase 2). Results There were 12 women and 16 men; the mean age of the patients and the mean duration of the surgery were respectively 49.5 years and 56 minutes for group A, and 47.3 years and 60 minutes for group B. The p-values of creatine phosphokinase 1, creatine phosphokinase 2 and the creatine–phosphokinase ratio were respectively 0,34; 0,31; and 0,57 (p < 0.05). Conclusion The present study demonstrated that there was no significant difference between tubular microdiscectomy and conventional microdiscectomy according to the analysis of the levels of creatine phosphokinase.

Evaluation of Gene Expression and In Vitro Enzyme Study for Antiaging Effect of Crocin and Lutein

Background: Tubular calyx of flowers of Nyctanthes arbour-tristis contains an apocarotenoid crocin, a major constituent present in saffron stigma. The flowers of N. arbortristis are readily available, hence can be an economic substitute for saffron. Lutein from flowers of Tagetes patula, is another carotenoid which is a popular antioxidant. Objective: Oxidative stress is a major contributor to the process of aging. Carotenoids are powerful antioxidants. Hence, the study was carried out to evaluate anticollagenase activity and antielastase activity using gene expression study in Human dermal fibroblasts. Methods: Crocin was isolated from the tubular calyx of Nyctanthes arbortristis using flash chromatographic technique and lutein was isolated using column chromatography. Anticollagenase and antielastase activity of crocin and lutein were carried out using collagenase from Clostridium histolyticum as enzyme and porcine pancreatic elastase. Cytotoxicity of crocin and lutein was determined in Human Dermal Fibroblast cell line (HDF) through MTT assay. In gene expression study, the HDF Cell line was inoculated with Crocin (450 and 250 ppm) and lutein (100 and 50 ppm) separately for 24 hrs and the m-RNA expression levels of COL Type-1 and elastin were determined using RT-PCR. The results were compared with standards. Result: Crocin and lutein both showed inhibition of collagenase and elastase enzyme which are responsible for aging process. The cytotoxic concentration CTC 50 (ppm) for Crocin and lutein was found to be 790.2 ppm and 137.14 ppm. Gene expression study on crocin rich extract of Nyctanthes arbortristis showed upregulation of both collagen and elastin gene whereas lutein rich extract having concentration100 μg/ml showed up regulation by 0.02 fold and concentration 50 μg/ml showed down regulation. Conclusion: In vitro collagenase and elastase enzyme study and Gene expression study showed that these carotenoids are potential antiageing agents which can be substituted to synthetic cosmeceuticals as well as saffron.

New Combinations of Mutations in VanD-Type Vancomycin-Resistant Enterococcus faecium, Enterococcus faecalis, and Enterococcus avium Strains

ABSTRACT We studied the clinical isolates Enterococcus faecium NEF1, resistant to high levels of vancomycin (MIC, 512 μg/ml) and teicoplanin (MIC, 64 μg/ml); Enterococcus faecium BM4653 and BM4656 and Enterococcus avium BM4655, resistant to moderate levels of vancomycin (MIC, 32 μg/ml) and to low levels of teicoplanin (MIC, 4 μg/ml); and Enterococcus faecalis BM4654, moderately resistant to vancomycin (MIC, 16 μg/ml) but susceptible to teicoplanin (MIC, 0.5 μg/ml). The strains were distinct, were constitutively resistant via the synthesis of peptidoglycan precursors ending in d-alanyl-d-lactate, and harbored a chromosomal vanD gene cluster that was not transferable. New mutations were found in conserved domains of VanSD: at T170I near the phosphorylation site in NEF1, at V67A at the membrane surface in BM4653, at G340S in the G2 ATP-binding domain in BM4655, in the F domain in BM4656 (a 6-bp insertion), and in the G1 and G2 domains of BM4654 (three mutations). The mutations resulted in constitutivity, presumably through the loss of the phosphatase activity of the sensor. The chromosomal Ddl d-Ala:d-Ala ligase had an IS19 copy in NEF1, a mutation in the serine (S185F) or near the arginine (T289P) involved in d-Ala1 binding in BM4653 or BM4655, respectively, and a mutation next to the lysine (P180S) involved in d-Ala2 binding in BM4654, leading to the production of an impaired enzyme. In BM4653 vanYD , a new insertion sequence, ISEfa9, belonging to the IS3 family, resulted in the absence of d,d-carboxypeptidase activity. Strain BM4656 had a functional d-Ala:d-Ala ligase, associated with high levels of both VanXD and VanYD activities, and is the first example of a VanD-type strain with a functional Ddl enzyme. Study of these five clinical isolates, displaying various assortments of mutations, confirms that all VanD-type strains isolated so far have undergone mutations in the vanSD or vanRD gene, leading to constitutive resistance, but that the Ddl host ligase is not always impaired. Based on sequence differences, the vanD gene clusters could be assigned to two subtypes: vanD-1 and vanD-4.