Correction: Screening for osteogenic activity in extracts from Irish marine organisms: The potential of Ceramium pallidum.

[This corrects the article DOI: 10.1371/journal.pone.0207303.].

Screening for osteogenic activity in extracts from Irish marine organisms: The potential of Ceramium pallidum.

Extracts and compounds derived from marine organisms have reportedly shown some osteogenic potential. As such, these bioactives may aid in the treatment of musculoskeletal conditions such as osteoporosis; helping to address inefficacies with current treatment options. In this study, 72 fractions were tested for their in vitro osteogenic activity using a human foetal osteoblast (hFOB) cell line and bone marrow derived mesenchymal stem cells (MSCs), focusing on their cytotoxic, proliferative and differentiation effects. Extracts dissolved in dimethyl sulfoxide and ethanol showed no significant osteogenic potential. However, two extracts derived from powder residues (left over from original organic extractions) caused a significant promotion of MSC differentiation. Bioactivity from powder residues derived from the epiphytic red algae Ceramium pallidum is described in detail to highlight its treatment potential. In vitro, C. pallidum was shown to promote MSC differentiation and extracellular matrix mineralisation. In vivo, this extract caused a significant increase in opercular bone growth of zebrafish larvae and a significant increase in bone density of regenerated adult caudal fins. Our findings therefore show the importance of continued screening efforts, particularly of novel extract sources, and the presence of bioactive compounds in C. pallidum extract.

Red algal extracts from Plocamium lyngbyanum and Ceramium secundatum stimulate osteogenic activities in vitro and bone growth in zebrafish larvae.

Through the current trend for bioprospecting, marine organisms - particularly algae - are becoming increasingly known for their osteogenic potential. Such organisms may provide novel treatment options for osteoporosis and other musculoskeletal conditions, helping to address their large healthcare burden and the limitations of current therapies. In this study, extracts from two red algae - Plocamium lyngbyanum and Ceramium secundatum - were tested in vitro and in vivo for their osteogenic potential. In vitro, the growth of human bone marrow stromal cells (hBMSCs) was significantly greater in the presence of the extracts, particularly with P. lyngbyanum treatment. Osteogenic differentiation was promoted more by C. secundatum (70 µg/ml), though P. lyngbyanum had greater in vitro mineralisation potential. Both species caused a marked and dose-dependent increase in the opercular bone area of zebrafish larvae. Our findings therefore indicate the presence of bioactive components in P. lyngbyanum and C. secundatum extracts, which can promote both in vitro and in vivo osteogenic activity.

Influence of timing of surgery on Cauda equina syndrome: Outcomes at a national spinal centre.

PURPOSE: There is no doubt that the best outcome achieved in Cauda equina syndrome (CES) involves surgical decompression. The controversy regarding outcome lies with timing of surgery. This study reports outcomes on a large population based series. Timing of surgery, Cauda Equina syndrome classification based on British Association of Spine Surgeons (BASS) guidelines and co-morbid illness will be assessed to evaluate influence on outcome. MATERIALS AND METHODS: A retrospective review of all patients surgically decompressed for CES between 01/01/2008 to 01/08/2014 was conducted. Patients with ongoing symptoms were followed up for a minimum of 2 years. Cauda Equina Syndrome (CES) was classified according to the BASS criteria: CES suspicious (CESS), incomplete (CESI) and painless urinary retention (CESR). Time and symptom resolution were assessed. RESULTS: A total of 136 patients were treated for CES; 69 CESR, 22 CESI and 45 CESS. There was no statistical difference in age, sex, smoking status and alcohol status with regards to timing of surgery. No correlation between increasing co-morbidity score and poor outcome was demonstrated in any subgroupAll CESR/I patients demonstrated some improvement in bowel and bladder dysfunction post-operatively. No significant difference in improved autonomic dysfunction was demonstrated in relation to timing of surgery. CES subclassification may predict outcome of non-autonomic symptoms. Statistically better outcomes were found in CESS groups with regards to post-operative lower back pain (P 0.049) and saddle paraesthesia (P 0.02). CONCLUSION: Surgical Decompression for CES is an effective treatment that significantly improves patient symptoms including bowel and bladder dysfunction Early surgical decompression <24 h from symptom onset does not appear to significantly improve resolution of bowel or bladder dysfunction.

CT and radiographic analysis of sagittal profile changes following thoracoscopic anterior scoliosis surgery.

BACKGROUND: Previous studies report an increase in thoracic kyphosis after anterior approaches and a flattening of sagittal contours following posterior approaches. Difficulties with measuring sagittal parameters on radiographs are avoided with reformatted sagittal CT reconstructions due to the superior endplate clarity afforded by this imaging modality. METHODS: A prospective study of 30 Lenke 1 adolescent idiopathic scoliosis (AIS) patients receiving selective thoracoscopic anterior spinal fusion (TASF) was performed. Participants had ethically approved low dose CT scans at minimum 24 months after surgery in addition to their standard care following surgery. The change in sagittal contours on supine CT was compared to standing radiographic measurements of the same patients and with previous studies. Inter-observer variability was assessed as well as whether hypokyphotic and normokyphotic patient groups responded differently to the thoracoscopic anterior approach. RESULTS: Mean T5-12 kyphosis Cobb angle increased by 11.8 degrees and lumbar lordosis increased by 5.9 degrees on standing radiographs two years after surgery. By comparison, CT measurements of kyphosis and lordosis increased by 12.3 degrees and 7.0 degrees respectively. 95% confidence intervals for inter-observer variability of sagittal contour measurements on supine CT ranged between 5-8 degrees. TASF had a slightly greater corrective effect on patients who were hypokyphotic before surgery compared with those who were normokyphotic. CONCLUSIONS: Restoration of sagittal profile is an important goal of scoliosis surgery, but reliable measurement with radiographs suffers from poor endplate clarity. TASF significantly improves thoracic kyphosis and lumbar lordosis while preserving proximal and distal junctional alignment in thoracic AIS patients. Supine CT allows greater endplate clarity for sagittal Cobb measurements and linear relationships were found between supine CT and standing radiographic measurements. In this study, improvements in sagittal kyphosis and lordosis following surgery were in agreement with prior anterior surgery studies, and add to the current evidence suggesting that anterior correction is more capable than posterior approaches of addressing the sagittal component of both the instrumented and adjacent non instrumented segments following surgical correction of progressive Lenke 1 idiopathic scoliosis.