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Roanoke, VA, United States

Bae H.,Spine Institute | Bae H.,Spine Center | Hatten H.P.,Indian River Radiology | Linovitz R.,Core Orthopedic Medical Center | And 8 more authors.
Spine | Year: 2012

STUDY DESIGN.: Randomized, controlled, prospective (AAOS therapeutic level I) trial conducted under Food and Drug Administration Investigational Device Exemption hypothesized noninferiority of a novel bioactive composite material to polymethylmethacrylate (PMMA). OBJECTIVE.: To determine the safety and efficacy of a new, nonresorbable bioactive composite (Cortoss) compared with PMMA, the standard treatment of vertebral compression fractures (VCFs). SUMMARY OF BACKGROUND DATA.: Vertebroplasty with PMMA, the widely adopted treatment for VCFs nonresponsive to conservative care, provides effective, immediate pain relief, but the material has received criticism for its properties. A new bioactive composite material designed specifically for vertebroplasty showed promising results in animals and nonrandomized clinical studies and was subsequently compared with PMMA in a randomized study. This study represents the first prospective study evaluating vertebroplasty comparing PMMA with another material with 24-month follow-up. METHODS.: Using 2:1 randomization, vertebroplasty was performed with Cortoss on 162 patients and PMMA on 94 patients. Inclusion criteria were painful osteoporotic VCFs with a visual analogue scale pain score of at least 50 mm on a 100-mm scale and at least 30% disability as measured by the Oswestry Disability Index. Evaluations at pretreatment, treatment day, and 7 posttreatment intervals out to 24 months included pain, disability, neurological status, adverse events, quality of life, patient satisfaction, analgesic use, and independently reviewed radiographs. RESULTS.: Noninferiority of Cortoss relative to PMMA was observed, with Cortoss-treated patients experiencing significant pain relief at 3 months (P = 0.0395) and better maintenance or improvement in function at 24 months (P = 0.0299). Incidence of serious device-related adverse events was 4.3% in both groups; none were life threatening. CONCLUSION.: Vertebroplasty using either Cortoss or PMMA provides effective, immediate, and lasting pain relief and prevents further loss of function. Both materials performed comparably at most time points; Cortoss demonstrated better results for pain reduction at 3 months and for function at 24 months. © 2012, Lippincott Williams & Wilkins. Source


Ortiz O.,Winthrop University | Mathis J.M.,Center for Advanced Imaging
Neuroimaging Clinics of North America | Year: 2010

Vertebral augmentation techniques use image guidance for the percutaneous placement of spinal implants that stabilize a painful osteoporotic or pathologic vertebral compression fracture. The initial implant, acrylic bone cement, was injected through a bone needle into the vertebral body, a procedure referred to as vertebroplasty. A modification of this procedure, kyphoplasty, entails the temporary use of an inflatable balloon tamp before cement injection. Other techniques and the equipment required to perform these vertebral augmentation procedures have evolved significantly during the past two decades. It is now possible to perform vertebral body reconstruction in patients with painful fractures of compromised vertebrae with excellent outcomes in terms of sustainable pain relief and marked reduction in patient morbidity. © 2010 Elsevier Inc. Source


Ouyang Y.,University of Florida | Chen Y.,University of Florida | Wu Y.,Center for Advanced Imaging
International Journal of Bioinformatics Research and Applications | Year: 2014

We propose a model for simultaneous Orientation Distribution Function (ODF) reconstruction and regularisation. The ODFs are represented by real spherical harmonic functions, and we propose to solve the spherical harmonic coefficients of the ODFs, with spatial regularisation by minimising the Vectorial Total Variation (VTV) of the coefficients. The proposed model also incorporates angular regularisation of the ODFs using Laplace-Beltrami operator on the unit sphere. A modified primal-dual hybrid gradient algorithm is applied to solve the model efficiently. The experimental results indicate better directional structures of reconstructed ODFs. Copyright © 2014 Inderscience Enterprises Ltd. Source


Kravets E.,Institute of Medical Microbiology and Hospital Hygiene | Degrandi D.,Institute of Medical Microbiology and Hospital Hygiene | Weidtkamp-Peters S.,Center for Advanced Imaging | Ries B.,Institute of Biochemistry | And 9 more authors.
Journal of Biological Chemistry | Year: 2012

One of the most abundantly IFN-γ-induced protein families in different cell types is the 65-kDa guanylate-binding protein family that is recruited to the parasitophorous vacuole of the intracellular parasite Toxoplasma gondii. Here, we elucidate the relationship between biochemistry and cellular host defense functions of mGBP2 in response to Toxoplasma gondii. The wild type protein exhibits low affinities to guanine nucleotides, self-assembles upon GTP binding, forming tetramers in the activated state, and stimulates the GTPase activity in a cooperative manner. The products of the two consecutive hydrolysis reactions are both GDP and GMP. The biochemical characterization of point mutants in the GTP-binding motifs of mGBP2 revealed amino acid residues that decrease the GTPase activity by orders of magnitude and strongly impair nucleotide binding and multimerization ability. Live cell imaging employing multiparameter fluorescence image spectroscopy (MFIS) using a Homo-FRET assay shows that the inducible multimerization of mGBP2 is dependent on a functional GTPase domain. The consistent results indicate that GTP binding, self-assembly, and stimulated hydrolysis activity are required for physiological localization of the protein in infected and uninfected cells. Ultimately, we show that the GTPase domain regulates efficient recruitment to T. gondii in response to IFN-γ. © 2012 by The American Society for Biochemistry and Molecular Biology, Inc. Source


Liu J.,University of Queensland | Yan J.,University of Queensland | Greer J.M.,University of Queensland | Read S.J.,Royal Brisbane and Womens Hospital | And 4 more authors.
International Journal of Neuroscience | Year: 2014

Human adrenomedullin (ADM), a 52-amino acid peptide, belongs to the calcitonin/calcitonin gene-related peptide (CGRP)/amylin peptide family. ADM acts as a multifunctional regulatory peptide and is upregulated in response to hypoxia. Previous microarray studies have found increased ADM gene (ADM) expression in peripheral blood cells of patients with stroke, however, it is unknown if an increased ADM level is correlated with severity of human ischemic stroke. This study investigated ADM expression in peripheral blood leukocytes (PBL) of healthy controls and subjects at day 1, week 1 and week 3 postacute ischemic stroke using rtPCR methodology. We found that ADM expression was significantly upregulated on the first day of stroke compared to the healthy subjects and the disease controls; the levels remained elevated for up to week 3. Further, ADM expression at day 1 was correlated with stroke severity measured by the National Institute of Healthy Stroke Scale (NIHSS), the modified Barthel Index (mBI) and the modified Rankin Scale (mRS). This could indicate that ADM expression level is related to the severity of tissue damage. We suggest that increased ADM expression in PBL after acute ischemic stroke is most likely to indicate that these cells have been subjected to hypoxia and that the magnitude of expression is likely to be related to the volume of hypoxic tissue. Hypoxia can affect lymphocytes function and could affect the immune response to stroke. The correlation of ADM expression level with the measures of stroke severity implicates ADM -a potential blood bio-marker in studies of ischemic stroke. Copyright © 2014 Informa Healthcare USA, Inc. Source

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