A Study of 179 Patients with Degenerative Stenosis of the Lumbosacral Spine to Evaluate Differences in Quality of Life and Disability Outcomes at 12 Months, Between Conservative Treatment and Surgical Decompression.

BACKGROUND This prospective study included 179 patients with degenerative stenosis of the lumbosacral spine and aimed to evaluate the outcomes of conservative treatment and surgical decompression on quality of life and disability over 12 months. MATERIAL AND METHODS The surgery group consisted of 96 patients with degenerative stenosis of the lumbosacral spine who qualified for surgical decompression, while the conservative-treatment group included 83 patients who qualified for conservative treatment. We used the Satisfaction with Life Scale questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire, the Visual Analog Scale to assess the severity of pain, the Oswestry Low Back Pain Disability Questionnaire to assess the degree of disability, and the Sexual Satisfaction Scale at 0, 1, 6, and 12 months after treatment. RESULTS Statistical analysis showed a positive relationship between conservative and surgical treatment and quality of life (P<0.05). A significant reduction in the severity of pain (P<0.05) and the degree of disability (P<0.05) were both recorded during the 12-month followup period in both groups. Women of both groups declared significantly lower satisfaction than men at every time point (P<0.05). CONCLUSIONS Most patients in both groups declared an improvement in their quality of life, with the surgery group showing a higher percentage of responses that their quality of life had improved. Based on the results obtained from the FACIT-F questionnaire, degenerative stenosis of the lumbosacral spine had a non-root effect on the patients' lives in the surgery group.

Presentation, Diagnosis, and Management of Lower Back Pain Associated with Spinal Stenosis: A Narrative Review.

Lower back pain (LBP) is an extremely common symptom experienced by people of all ages and is also one of the most frequent causes of disability worldwide. This article aims to review the presentation, diagnosis, and management of lower back pain associated with spinal stenosis. The paper we prepared was classified as a "literature narrative review." Nonetheless, when searching for manuscripts included in our work and reviewing them critically, we concentrated on the keywords: "lower back pain", "lumbar spine stenosis", "diagnostic", "rehabilitation", "neurosurgery", "spine", and "elderly". The incidence of chronic lower back pain (CLBP) increases linearly starting with the third decade of life until 60 years old, and it more often affects women. The course of non-specific LBP above all depends on factors not connected with the spine, which include psychological, behavioral, and social factors, determined by the way the condition is perceived by the patient the environment. Lumbar spine stenosis (LSS) is an age-related process of degeneration of the intervertebral discs, ligamentum flavum, and facet joints, which results in narrowing of the space around the neurovascular structures of the spine. Diagnosis of spinal pain syndromes includes radiography (RTG), computed tomography (CT), and magnetic resonance imaging (MRI). Based on the results of imaging studies, neurological examination, and the severity of the disease, treatment can consist of analgesics and rehabilitation, or, when conservative methods are insufficient, surgical treatment is indicated.

Preliminary Studies of Antimicrobial Activity of New Synthesized Hybrids of 2-Thiohydantoin and 2-Quinolone Derivatives Activated with Blue Light.

Thiohydantoin and quinolone derivatives have attracted researchers' attention because of a broad spectrum of their medical applications. The aim of our research was to synthesize and analyze the antimicrobial properties of novel 2-thiohydantoin and 2-quinolone derivatives. For this purpose, two series of hybrid compounds were synthesized. Both series consisted of 2-thiohydantoin core and 2-quinolone derivative ring, however one of them was enriched with an acetic acid group at N3 atom in 2-thiohydantoin core. Antibacterial properties of these compounds were examined against bacteria: Staphylococcus aureus, Bacillus subtilis, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae. The antimicrobial assay was carried out using a serial dilution method to obtain the MIC. The influence of blue light irradiation on the tested compounds was investigated. The relative yield of singlet oxygen (1O2*, 1Δg) generation upon excitation with 420 nm was determined by a comparative method, employing perinaphthenone (PN) as a standard. Antimicrobial properties were also investigated after blue light irradiation of the suspensions of the hybrids and bacteria placed in microtitrate plates. Preliminary results confirmed that some of the hybrid compounds showed bacteriostatic activity to the reference Gram-positive bacterial strains and a few of them were bacteriostatic towards Gram-negative bacteria, as well. Blue light activation enhanced bacteriostatic effect of the tested compounds.

Genetic Diversity of Symbiotic Green Algae of Paramecium bursaria Syngens Originating from Distant Geographical Locations.

Paramecium bursaria (Ehrenberg 1831) is a ciliate species living in a symbiotic relationship with green algae. The aim of the study was to identify green algal symbionts of P. bursaria originating from distant geographical locations and to answer the question of whether the occurrence of endosymbiont taxa was correlated with a specific ciliate syngen (sexually separated sibling group). In a comparative analysis, we investigated 43 P. bursaria symbiont strains based on molecular features. Three DNA fragments were sequenced: two from the nuclear genomes-a fragment of the ITS1-5.8S rDNA-ITS2 region and a fragment of the gene encoding large subunit ribosomal RNA (28S rDNA), as well as a fragment of the plastid genome comprising the 3'rpl36-5'infA genes. The analysis of two ribosomal sequences showed the presence of 29 haplotypes (haplotype diversity Hd = 0.98736 for ITS1-5.8S rDNA-ITS2 and Hd = 0.908 for 28S rDNA) in the former two regions, and 36 haplotypes in the 3'rpl36-5'infA gene fragment (Hd = 0.984). The following symbiotic strains were identified: Chlorella vulgaris, Chlorella variabilis, Chlorella sorokiniana and Micractinium conductrix. We rejected the hypotheses concerning (i) the correlation between P. bursaria syngen and symbiotic species, and (ii) the relationship between symbiotic species and geographic distribution.

Spine duplication or split notochord syndrome - case report and literature review.

Context: Spine duplication is a rare condition, with various extents and severe additional anomalies. The goal of this study was to describe a unique case of a boy with split notochord syndrome who was followed up from birth until maturity. Findings: Physical examination at birth showed defects of the abdominal wall and cloacal exstrophy with visible urether outlets. A transposed anus was present in the perineal region. Split bony elements of the spine with nonpalpable sacral bone were noted. A soft, skin-covered lump, with the consistency of a lipoma, was present in the sacral area. There was asymmetry of the lower limbs: the left was hypoplastic, with a deformed foot and hip. Computed tomography revealed a normal shape of the Th12 and L1 vertebrae, whereas the L2 was split. Downward from L3, there were two vertebrae at each level, with two spinal canals. The spinal cord divided into two "semicords" at the level of L1. Neurologic status and the shape of the spine remained unchanged during puberty. The last follow-up was performed at the age of 18 years. He managed to walk independently in prosthesis with visible limping. Conclusion: Spine deformities are always suspected in neonates with lipoma in the sacral region, which may sometimes be serious. Walking ability and quality of life depend on neurologic deficits; even with long duplication and double sacrum, walking can be a feasible option.

Analysis of changes in cervical spinal curvature and intervertebral disk space height following ACDF surgery in a group of 100 patients followed up for 12 months.

We analysed 100 patients following anterior cervical discectomy and fusion with interbody stabilisation with PEEK cages. Radiographs obtained preoperatively and during the 12-month follow-up were compared to track changes in overall and local cervical lordosis and disk space height. Subsidence was defined as cage migration ≥ 3 mm into the adjacent endplates. Mean change in operated disk space height was 1.13 ±â€¯1.33 mm. Subsidence was detected in 10.23% of the operated spaces. Mean change in overall cervical lordosis was 1.31 ±â€¯5.71 degrees, and mean change in local lordosis was 0.19 ±â€¯4.71 degrees. Change in overall cervical lordosis correlated with change in local lordosis (r = 0.61, p < 0.01). The greatest changes in lordosis and disk space height were noted immediately post-surgery. Baseline values were approximated gradually over time, but the post-operative values at 12 months were still higher than baseline. Disk space height change did not correlate with changes in patient-reported pain intensity at baseline (VAS 0) vs. at 12 months post-operatively (VAS 12) (r = 0.12, p < 0.05) or changes in the Neck Disability Index (NDI) at baseline (NDI 0) vs. at 12 months post-operatively (NDI 12) (r = -0.02, p = 0.05). Changes in overall cervical lordosis did not directly influence treatment outcomes assessed by comparing VAS 0 vs. VAS 12 (r = 0.13, p = 0.24) or NDI 0 vs. NDI 12 (r = -0.0005, p = 0.96). Surgical outcomes depend primarily on adequate decompression of the spinal cord and nerve roots. Post-operative radiological changes did not directly influence patients' pain level or quality of life.

Prevalence of Petrosquamosal Sinus and Its Clinical Significance: Radiologic Study and Meta-analysis.

OBJECTIVE: The petrosquamosal sinus (PSS) is clinically important as it represents a potential hemorrhagic hazard during neurosurgical procedures. This double-approach radiologic study and meta-analysis aimed to assess the imaging characteristics of the PSS on computed tomography (CT) and systematically analyze its prevalence to improve imaging accuracy and assist in neurosurgical management. METHODS: The retrospective radiologic study included CT scans of 388 patients aged 18 years or older. All patients with any visible intracranial pathologies or history of head trauma were excluded. To identify articles eligible for inclusion in our meta-analysis, an extensive search was conducted through PubMed, Embase, ScienceDirect, Web of Science, and CNKI. Data extracted included investigative method, prevalence of the PSS among subjects, ethnicity, gender, side, laterality, and mean diameter. The extracted data were pooled into a meta-analysis with a random-effects model. RESULTS: The radiologic study showed that the PSS was visualized in 25.5% of the sides examined, that it was slightly more common among females (27.5%) than males (23.8%) and on the left (21.7%) than the right (29.4%). Its mean diameter was 1.14 ± 0.58 mm. The meta-analysis revealed that the overall prevalence of the PSS in the population is 11.1%, that it is more common in females (27.4%) than males (17.6%), and that a unilateral PSS is more common (78.2%) than a bilateral one (21.8%). CONCLUSIONS: As a PSS is present in about one tenth of the population, it is important to consider the possibility that it is present when undertaking neurosurgical procedures and to assess preoperative CT scans to avoid complications.

Effect of Social Factors on Surgical Outcomes in Cervical Disc Disease.

BACKGROUND: Daily clinical practice shows us how diametrically different surgical outcomes can occur in particular groups of patients sharing the same diagnosis and being subjected to the same treatment. Patient-reported outcomes appear to be significantly influenced by social factors and patients' emotional status. Data on such variables were collated and analyzed statistically with the aim of confirming our clinical observations. METHODS: We analyzed a group of 100 patients following cervical disc surgery. The clinical evaluation was based on a visual analog scale (VAS) for pain and the neck disability index (NDI). Non-clinical data comprised education status, employment status, body mass index (BMI), and history of depressive episodes in the period immediately preceding the surgery, which was investigated using the Beck Depression Inventory (BDI). RESULTS: Patients who had completed university or secondary school education had a significantly lower BMI and lower BDI scores and they reported less pain at 12 months postoperatively than patients with vocational or elementary school education only. Patients who were employed at the time of the study or were retired demonstrated significantly lower NDI scores both before the surgery and at 12 months postoperatively, as well as lower BDI scores compared to those who were unemployed or drew disability pensions. Factors such as age or BMI score did not exert a direct effect on treatment outcomes assessed as changes in the VAS and NDI scores. CONCLUSIONS: Surgical treatment for the cervical disc disease decreases pain and improves patients' quality of life. Treatment outcomes are also influenced by social factors and patients' emotional status.

The Evolutionary Relationships between Endosymbiotic Green Algae of Paramecium bursaria Syngens Originating from Different Geographical Locations.

Paramecium bursaria (Ehrenberg 1831), a freshwater ciliate, typically harbors hundreds of green algal symbionts inside the cell. The aim of present study was the molecular identification of newly analyzed P. bursaria symbionts. The second aspect of the present survey was testing a hypothesis whether endosymbionts prefer the specified syngen of the host, and the specified geographical distribution. Ten strains of endosymbionts isolated from strains of P. bursaria originating from different geographical locations were studied. We analyzed for the first time, both the fragment of plastid genome containing 3'rpl36-5' infA genes and a fragment of a nuclear gene encoding large subunit ribosomal RNA (LSU rDNA). The analysis of the LSU rDNA sequences showed the existence of 3 haplotypes and the haplotype diversity of 0.733, and 8 haplotypes for the 3'rpl36-5' infA gene fragment and haplotype diversity of 0.956. The endosymbionts isolated from P. bursaria strains were identified as Chlorella vulgaris, Ch. variabilis and Micractinium conductrix. There was no correlation between the syngen of P. bursaria and the species of endosymbiont.

Molecular Identification of Paramecium bursaria Syngens and Studies on Geographic Distribution using Mitochondrial Cytochrome C Oxidase Subunit I (COI).

Paramecium bursaria is composed of five syngens that are morphologically indistinguishable but sexually isolated. The aim of the present study was to confirm by molecular methods (analyses of mitochondrial COI) the identification of P. bursaria syngens originating from different geographical locations. Phylograms constructed using both the neighbor-joining and maximum-likelihood methods based on a comparison of 34 sequences of P. bursaria strains and P. multimicronucleatum, P. caudatum and P.calkinsi strains used as outgroups revealed five clusters which correspond to results obtained previously by mating reaction. Our analysis shows the existence of 24 haplotypes for the COI gene sequence in the studied strains. The interspecies haplotype diversity was Hd = 0.967. We confirmed genetic differentiation between strains of P. bursaria and the occurrence of a correlation between geographical distribution and the correspondent syngen.

Variations and morphometric analysis of the proximal segment of the superior cerebellar artery.

INTRODUCTION: The superior cerebral artery is a clinically significant vessel, but little is known about its radiological anatomy. The aim of this study was to describe the anatomical variations of the proximal segment of the superior cerebellar artery using Computed Tomography Angiography. MATERIALS AND METHODS: The study group consisted of 200 subjects (54.5% female, mean age ± SD 56.2 ± 17.2 years) that had undergone head Computed Tomography Angiography. Subjects with any intracranial pathologies were excluded. Images in Maximum Intensity Projections were used to study the anatomical anomalies of the superior cerebellar artery. RESULTS: In 200 subject 388 superior cerebellar arteries were found. Twelve (3.09%) SCAs were duplicated in 11 patients and all originated from the basilar artery. In 8 (4.00%) patients the superior cerebellar artery was absent. The origin of the SCA was most often bilateral, mainly from the basilar artery (76.29%). The superior cerebellar artery diameter, measured at the site of the origin, was statistically significantly different depending on the place of the origin: wider when originating from the basilar artery as a single vessel (1.48 ± 0.42 mm vs. 1.34 ± 0.52 mm; p=0.03) and narrower when originating as duplicated one (1.38 ± 0.48 mm vs. 1.46 ± 0.44 mm; p=0.55). CONCLUSION: Superior cerebellar artery usually originates bilaterally from the basilar artery as a single trunk. Its diameter is significantly wider in that type in comparison to other anatomical variations.

Identification of Paramecium bursaria syngens through molecular markers--comparative analysis of three loci in the nuclear and mitochondrial DNA.

This is the first attempt to resolve the phylogenetic relationship between different syngens of Paramecium bursaria and to investigate at a molecular level the intraspecific differentiation of strains originating from very distant geographical locations. Herein we introduce a new collection of five P. bursaria syngens maintained at St Petersburg State University, as the international collection of syngens was lost in the 1960s. To analyze the degree of speciation within Paramecium bursaria, we examined 26 strains belonging to five different syngens from distant and geographically isolated localities using rDNA (ITS1-5.8S-ITS2-5'LSU) fragments, mitochondrial cytochrome c oxidase subunit I (COI), and H4 gene fragments. It was shown that P. bursaria strains of the same syngens cluster together in all three inferred molecular phylogenies. The genetic diversity among the studied P. bursaria strains based on rDNA sequences was rather low. The COI divergence of Paramecium bursaria was also definitely lower than that observed in the Paramecium aurelia complex. The nucleotide sequences of the H4 gene analyzed in the present study indicate the extent of genetic differences between the syngens of Paramecium bursaria. Our study demonstrates the diagnostic value of molecular markers, which are important tools in the identification of Paramecium bursaria syngens.

Polymorphism of Paramecium pentaurelia (Ciliophora, Oligohymenophorea) strains revealed by rDNA and mtDNA sequences.

Paramecium pentaurelia is one of 15 known sibling species of the Paramecium aurelia complex. It is recognized as a species showing no intra-specific differentiation on the basis of molecular fingerprint analyses, whereas the majority of other species are polymorphic. This study aimed at assessing genetic polymorphism within P. pentaurelia including new strains recently found in Poland (originating from two water bodies, different years, seasons, and clones of one strain) as well as strains collected from distant habitats (USA, Europe, Asia), and strains representing other species of the complex. We compared two DNA fragments: partial sequences (349 bp) of the LSU rDNA and partial sequences (618 bp) of cytochrome B gene. A correlation between the geographical origin of the strains and the genetic characteristics of their genotypes was not observed. Different genotypes were found in Kraków in two types of water bodies (Opatkowice-natural pond; Jordan's Park-artificial pond). Haplotype diversity within a single water body was not recorded. Likewise, seasonal haplotype differences between the strains within the artificial water body, as well as differences between clones originating from one strain, were not detected. The clustering of some strains belonging to different species was observed in the phylogenies.

Molecular approach to the systematics of European Tortricini (Lepidoptera: Tortricidae).

Tortricini is a cosmopolitan tribe of the subfamily Tortricinae of the lepidopteran family Tortricidae. The most recent systematic of Tortricini are based on the external morphology of imagines and the structure of their genital organs. The present paper is the first comparative molecular study of the representatives of this tribe. We examined DNA variation in a 606 bp fragment of COI mtDNA obtained from 23 species of Tortricini and two representatives of other tribes (Archips podanus of Archipini and Aethes hartmanniana of Cochylini). The position of Spatalistis, Tortrix, Aleimma and Acleris, and some groupings of species within Acleris were confirmed by molecular data, including the synonymization of Croesia and Phylacophora with Acleris. The positions of a few groupings of the Acleris species remain unresolved.

Intra-specific differentiation of Paramecium bursaria strains by molecular methods--preliminary studies.

Ten strains of Paramecium bursaria and also P. caudatum, P. multimicronucleatum, P. tetraurelia strains (as outgroups) were characterized by using Random Amplified Polymorphic DNA (RAPD), Amplified Ribosomal DNA Restriction Analysis (ARDRA) and sequencing of the non-coding ribosomal internal transcribed spacer (ITS) regions. RAPD analysis revealed that all Paramecium bursaria strains possessed characteristic band patterns; there was a correlation between the degree of differentiation of DNA revealed by RAPD-fingerprinting and the geographic origin of a particular strain. ARDRA riboprinting (using a fragment of SSU-LSU rDNA, about 3085 bp) with restriction enzymes DraI, EcoRV, HhaI, HindIII, MspI, PstI distinguished groups of P. bursaria strains with characteristic band patterns originating from different sites. Comparison of the 550 bp ITS 1-5.8S-ITS2 fragment showed differentiation (0.9%) of the P. bursaria strains as three main groups of strains connected by site of origin in the constructed tree.

Molecular studies on intraspecific differentiation of Paramecium dodecaurelia, with description of new stands of the species (Protozoa, Ciliophora).

New stands of Paramecium dodecaurelia were found in Russia, Ukraine, Kazahstan, Poland, and Tenerife. Molecular studies (RAPD and sequencing of LSU rRNA and CO1 mtDNA gene fragments) of P. dodecaurelia strains depicted intraspecific polymorphism within the species, revealed as distinct differences between strains from the USA in comparison with strains from different regions of the Palearctic.

Atypical chest pain.

Chest pain is a common reason why patients seek medical consultation. Chest pain can be caused by life-threatening diseases and requires extensive diagnostic evaluation, especially to exclude acute cardiac pathologies. However, in the case of atypical chest pain with a normal electrocardiogram and serum levels of myocardial necrosis markers with in the reference ranges, non-cardiac causes of chest pain should be considered. This report describes the case of a 90-year-old female patient with recurrent chest pain who was eventually diagnosed with osteoporotic vertebral fractures of the thoracic spine.

Polymorphism within Paramecium sexaurelia (Ciliophora, Oligohymenophorea) and description of a new stand of the species in China.

The presence of Paramecium sexaurelia from the Paramecium aurelia complex was recorded for the first time in China (Beijing). RAPD fingerprints (band patterns) of P. sexaurelia strains, the new strain from China and others from Asia, as well as from Europe and Puerto Rico, showed polymorphism within the species as several groups of genotypes characterized by different band patterns.

Strains of Paramecium decaurelia (Ciliophora, Protozoa) from Russia with molecular characteristics of other known strains of the species.

The presence of Paramecium decaurelia from the Paramecium aurelia species complex was demonstrated in Yaroslavl, Russia, (European part, northwestern Russia) and in the Altai Mts (Asiatic part of Russia, western Siberia). RAPD-PCR fingerprints of the newly identified strains of P. decaurelia, rare throughout the world, were compared to those characteristic for the other known strains ofthe species. P. decaurelia strains show some polymorphism within species, strains from Russia have 60% similarity of band patterns, and strains from USA and Japan about 70% similarity of band patterns.

Molecular analysis (RAPD-PCR) of inter-strain hybrids of the Paramecium aurelia species complex (Ciliophora, Protozoa).

RAPD-PCR analysis showed that species of the Paramecium aurelia complex possessed characteristic band patterns and that the majority were also polymorphic intra-specifically. A comparison of band patterns was performed for some inter-strain hybrids within P. primaurelia, P. tetraurelia, P. pentaurelia, P. septaurelia, P. octaurelia, P. decaurelia, P. dodecaurelia, P. tredecaurelia, and P. quadecaurelia to band patterns characteristic for the parental strains. The investigations, however, did not reveal a close correlation between the degree of inbreeding characteristic for the species and similarity of genotypes. A low similarity of hybrid and parental band patterns was observed in P. octaurelia, P. dodecaurelia, P. quadecaurelia and also P. primaurelia. A high similarity of band patterns of hybrid and parental strains was found in P. tetraurelia, P. septaurelia, P. decaurelia, and P. tredecaurelia.