Comparison of percutaneous vertebroplasty with and without interventional tumor removal for spinal metastatic tumor without epidural involvement.

AIM: To evaluate the efficacy of percutaneous vertebroplasty (PVP) combined with interventional tumor removal (ITR) in providing pain relief, reducing disability, and improving functional performance in patients with malignant vertebral compression fractures without epidural involvement. METHODS: Patients with malignant vertebral compression fractures (n=58) were treated with either PVP+ITR (n=31, group A) or PVP alone (n=27, group B). A 14 G needle was inserted into the vertebral body, and the tract was sequentially dilated with working cannulae. When the last working cannula had reached the distal pedicle of vertebral arch, ITR was performed with a marrow nucleus rongeurs inserted through the working cannula. Finally, cement was injected into the excavated vertebral body. Patients were followed up at 1, 3, and 6 months after the procedure, and every 6 months thereafter. RESULTS: The overall excellent and good pain relief rate during follow-ups was significantly better in group A than in group B (94% vs.56%; p=0.002). The average VAS, ODI, and KPS scores at 3 months, 6 months, 1-year, and >1 year were all significantly lower in group A than in group B (p<0.05). The mean cement filling volume and the stability of the treated vertebrae were significantly higher in group A than in group B (p<0.05). CONCLUSIONS: The combination of PVP+ITR is a safe and effective procedure, capable of providing significantly greater pain relief and vertebral stability than PVP alone in patients with malignant vertebral compression fractures.

TcOPT3, a member of oligopeptide transporters from the hyperaccumulator Thlaspi caerulescens, is a novel Fe/Zn/Cd/Cu transporter.

BACKGROUND: Thlaspi caerulescens is a natural selected heavy metal hyperaccumulator that can not only tolerate but also accumulate extremely high levels of heavy metals in the shoots. Thus, to identify the transportors involved in metal long-distance transportation is very important for understanding the mechanism of heavy metal accumulation in this hyperaccumulator. METHODOLOGY/PRINCIPAL FINDINGS: We cloned and characterized a novel gene TcOPT3 of OPT family from T. caerulescens. TcOPT3 was pronouncedly expressed in aerial parts, including stem and leaf. Moreover, in situ hybridization analyses showed that TcOPT3 expressed in the plant vascular systems, especially in the pericycle cells that may be involved in the long-distance transportation. The expression of TcOPT3 was highly induced by iron (Fe) and zinc (Zn) deficiency, especially in the stem and leaf. Sub-cellular localization showed that TcOPT3 was a plasma membrane-localized protein. Furthermore, heterogonous expression of TcOPT3 by mutant yeast (Saccharomyces cerevisiae) complementation experiments demonstrated that TcOPT3 could transport Fe(2+) and Zn(2+). Moreover, expression of TcOPT3 in yeast increased metal (Fe, Zn, Cu and Cd) accumulation and resulted in an increased sensitivity to cadmium (Cd) and copper (Cu). CONCLUSIONS: Our data demonstrated that TcOPT3 might encode an Fe/Zn/Cd/Cu influx transporter with broad-substrate. This is the first report showing that TcOPT3 may be involved in metal long-distance transportation and contribute to the heavy metal hyperaccumulation.