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PubMed2004

Limited effect of anthropogenic habitat fragmentation on molecular diversity in a rain forest skink, Gnypetoscincus queenslandiae.

To examine the effects of recent habitat fragmentation, we assayed genetic diversity in a rain forest endemic lizard, the prickly forest skink (Gnypetoscincus queenslandiae), from seven forest fragments and five sites in continuous forest on the Atherton tableland of northeastern Queensland, Australia. The rain forest in this region was fragmented by logging and clearing for dairy farms in the early 1900s and most forest fragments studied have been isolated for 50-80 years or nine to 12 skink generations. We genotyped 411 individuals at nine microsatellite DNA loci and found fewer alleles per locus in prickly forest skinks from small rain forest fragments and a lower ratio of allele number to allele size range in forest fragments than in continuous forest, indicative of a decrease in effective population size. In contrast, and as expected for populations with small neighbourhood sizes, neither heterozygosity nor variance in allele size differed between fragments and sites in continuous forests. Considering measures of among population differentiation, there was no increase in FST among fragments and a significant isolation by distance pattern was identified across all 12 sites. However, the relationship between genetic (FST) and geographical distance was significantly stronger for continuous forest sites than for fragments, consistent with disruption of gene flow among the latter. The observed changes in genetic diversity within and among populations are small, but in the direction predicted by the theory of genetic erosion in recently fragmented populations. The results also illustrate the inherent difficulty in detecting genetic consequences of recent habitat fragmentation, even in genetically variable species, and especially when effective population size and dispersal rates are low.

Animals↗
PubMedDate not supplied

Long-term results of ankle fractures with a posterior malleolar fragment.

The aim of this study was to evaluate 1) long-term results of ankle fractures with a posterior malleolar fragment, and 2) the need for fixation of fragments smaller than 25%. Forty-five patients with ankle fractures and a posterior malleolar fragment were evaluated. Mean follow-up was 13 years (range, 2-24). The size and fixation of the fragment were registered. Outcome was assessed using an Ankle Fracture Scoring System (maximum: 150 points), a 10-point Numeric Scale for Pain (1 = no pain, 10 = unbearable pain) and an OsteoArthritis Score (0 = no osteoarthritis, 3 = severe osteoarthritis). The mean Ankle Fracture Scoring System, Numeric Scale for Pain and Osteoarthritis-score were 124, 2.5, and 1.2, respectively. The mean size of fixated fragments was significantly larger than that of nonfixated fragments (30% versus 16%). Those patients in which the posterior malleolar fragment was fixated did not have a statistically significant better outcome than those patients in which the fragments were not fixated (Ankle Fracture Scoring System: 119 versus 126, Numeric Scale for Pain: 2.6 versus 2.4, Osteoarthritis-score: 1.0 versus 1.2). There was no significant correlation between outcome and size of unfixated fragments. Fracture-dislocation was seen more often in combination with larger fragments (24% versus 15%) and resulted in statistically significant worse long-term outcome than nondislocated fractures, except for pain (Ankle Fracture Scoring System: 115 versus 134, Osteoarthritis-score: 1.7 versus 0.8). In conclusion, patients showed good results after 13 years follow-up and there was no evidence for the need for fixation of fragments smaller than 25%.

Adult↗
PubMed2003

[A new method for the evaluation of stone fragmentation after ESWL].

INTRODUCTION: Efficacy of ESWL treatment can be evaluated by determining the number and size of urinary stone fragments. However, the available methods for classification of stone fragments are inaccurate. Therefore, a method for semi-automatic determination of fragment size and number after ESWL was developed. METHODS: Artificial struvite stones (BON[N]-STONES) were disintegrated with a lithotriptor (Siemens, Lithostar plus) by application of 50 and 200 shock waves at 19 kV. The stone fragments were collected and pre-sorted on cascade sieves. Pictures taken of the fractions were digitalized and the images optimized in edge sharpness, contrast, and colour depth using an image processing software. Finally, the pixel number of each fragment was determined and the real area was calculated. Fragment size and volume were then depicted by frequency of occurrence in a histogram. RESULTS: Fragments with a diameter ranging from 0.3 - 5 mm could be determined by the system described. About 2,000 - 3,600 fragments were generated in this size range from the artificial struvite stones. With low shock-wave application, a considerable number of fragments larger than 2 mm could be observed. By increasing the impact to 200, more than 90 % of the stone volume was found in fragments smaller than 2 mm (previously 50 %). CONCLUSION: The system described enables a qualitative and quantitative description of stone fragmentation after ESWL not achieved thus far.

Humans↗
PubMed1983

Neoplastic transformation by a cloned human cytomegalovirus DNA fragment uniquely homologous to one of the transforming regions of herpes simplex virus type 2.

Specific DNA fragments of human cytomegalovirus strain Towne exhibited sequence homology to the transforming regions of herpes simplex virus type 2 (HSV-2) when examined by nitrocellulose filter hybridization under nonstringent conditions. Cloned Towne Xba I fragments B and C were homologous to both Bgl II transforming fragments N and C of HSV-2 DNA, whereas cloned Towne Xba I fragment E was uniquely homologous to HSV-2 Bgl II fragment C. Furthermore, Towne Xba I fragment E exhibited homology to a unique fragment of cytomegalovirus strain AD169 but lacked homology to the recently identified Xba I transforming (focus-forming) fragment N. Normal diploid Syrian hamster embryo cells transfected with cloned Towne Xba I fragment E displayed colonies of refractile, rapidly dividing cells which escaped senescence to form immortal cell lines. At early passages, these lines exhibited growth in 2% serum and formed small (less than 0.1 mm) colonies in 0.3% agarose. Serial passaging resulted in the appearance of large (greater than 0.25 mm) colonies in agarose, indicating the involvement of more than one step in Towne Xba I fragment E-induced transformation of the diploid hamster embryo cells. NIH 3T3 cells transfected with Towne Xba I fragment E rapidly displayed large colonies in agarose and tumors in vivo.

Base Sequence↗
PubMed1992

Distribution of interspersed repeats (Alu and Kpn) on NotI restriction fragments of human chromosome 21.

Interspersed repeated sequences (Alu and Kpn) were used as probes to detect a set of Not I restriction fragments of human chromosome 21 from the hybrid cell line WAV17. Forty different Not I fragments, ranging in size from less than 0.05 megabase (Mb) to 7.0 Mb, were identified. The total length of these fragments was 47.3 Mb. This length provides an estimate of the minimum size of the chromosome and a minimum number of fragments to be ordered to create a complete restriction map. The average length Not I fragment is 1.2 Mb. Alu and Kpn fragments are not always coincident: a 2.9-Mb fragment is detected with Kpn but not with Alu, and 13 fragments, ranging from less than 0.05 Mb to 5.6 Mb, are detected with Alu but not with Kpn; the 26 remaining fragments, covering 75% (35.3 Mb) of the total length, are detected with both repetitive probes. The presence of so many noncoincident fragments and the high variation of the hybridization signal intensities of the fragments suggest a very nonuniform distribution of Kpn and Alu repeats.

Blotting, Southern↗
PubMed2003

In vitro analysis of stone fragmentation ability of the FREDDY laser.

BACKGROUND AND PURPOSE: The Frequency-Doubled Double-Pulse Nd:Yag) (FREDDY) laser (World of Medicine, Berlin Germany) is a short-pulsed, double-frequency solid-state laser with wavelengths of 532 and 1064 nm. This low-power, low-cost laser was developed for intracorporeal lithotripsy. We designed an experimental set-up to test its fragmentation efficiency at different energy and frequency settings. MATERIALS AND METHODS: Forty previously weighed plaster-of-Paris stone phantoms were divided into four groups in order to test fragmentation at 5 and 10 Hz for 2 and 4 minutes. A hands-off underwater laboratory set-up including a holder to keep the stone phantom in contact with the quartz laser fiber was utilized. The 280-microm laser fiber was cleaved and stripped between runs to ensure optimal energy delivery. After fragmentation was completed, all of the stone fragments remaining within the holder were allowed to desiccate for 48 hours and reweighed. Fragmentation was measured as the percentage weight loss. RESULTS: Stone phantoms fragmented at 5 Hz for 2 minutes sustained a mean 24% loss of weight, whereas the 4-minute treatment at 5 Hz reduced stone weight by 54%. Treatment at 10 Hz for 2 minutes demonstrated results similar to those of stones treated for 4 minutes at 5 Hz, reducing stone weight by 51%. Fragmentation at 10 Hz for 4 minutes revealed a 64% loss of mass, less than expected for these power settings. Fiber deterioration observed at the higher energy settings may be the cause of the reduced stone-fragmentation efficiency. CONCLUSIONS: Fragmentation with the FREDDY laser in the 5 Hz, 4 minutes and 10 Hz, 2 minutes protocols is comparable, suggesting that stone fragmentation correlates well with the total energy delivered to the stone. The slight drop in fragmentation efficiency at 10 Hz, 4 minutes is most likely explained by fiber damage occurring consistently at these higher energy settings. The safety profile and low investment and running costs of this laser are advantages that suggest the laser warrants further clinical trials.

In Vitro Techniques↗
PubMed2004

Two-dimensional conformation-dependent electrophoresis (2D-CDE) to separate DNA fragments containing unmatched bulge from complex DNA samples.

DNA fragments containing mispaired and modified bases, bulges, lesions and specific sequences have altered conformation. Methods for separating complex samples of DNA fragments based on conformation but independent of length have many applications, including (i) separation of mismatched or unmatched DNA fragments from those perfectly matched; (ii) simultaneous, diagnostic, mismatch scanning of multiple fragments; (iii) isolation of damaged DNA fragments from undamaged fragments; and (iv) estimation of reannealing efficiency of complex DNA samples. We developed a two-dimensional conformation-dependent electrophoresis (2D-CDE) method for separating DNA fragments based on length and conformation in the first dimension and only on length in the second dimension. Differences in migration velocity due to conformation were minimized during second dimension electrophoresis by introducing an intercalator. To test the method, we constructed 298 bp DNA fragments containing cytosine bulges ranging from 1 to 5 nt. Bulge-containing DNA fragments had reduced migration velocity in the first dimension due to altered conformation. After 2D-CDE, bulge-containing DNA fragments had migrated in front of an arc comprising heterogeneous fragments with regular conformation. This simple and robust method could be used in both analytical and preparative applications involving complex DNA samples.

Cytosine↗
PubMed1986

Unfolding and refolding of the constant fragment of the immunoglobulin light chain containing an intramolecular mercury bridge.

The conformation of the constant fragment of the immunoglobulin light chain in which the intrachain disulfide bond is replaced by the bond S-Hg-S (CL-Hg fragment), was as compact as that of the intact CL fragment, but its stability to guanidine hydrochloride was lower than that of the intact CL fragment [Goto, Y. & Hamaguchi, K. (1986) Biochemistry in press]. The kinetics of reversible unfolding and refolding of the CL-Hg fragment by guanidine hydrochloride were studied and compared with those for the intact CL and reduced CL fragments [Goto, Y. & Hamaguchi, K. (1982) J. Mol. Biol. 156, 891-910, 911-926]. The unfolding kinetics were explained on the basis of a three-species mechanism, U1----U2----F, where U1 and U2 are respectively slow-folding and fast-folding species of unfolded protein, and F is folded protein. However, an additional isomerization, though its contribution to the overall reaction process is small, had to be taken into account to explain the refolding kinetics. The kinetic properties of interconversion between U1 and U2 were similar to those for the intact CL and reduced CL fragments. This suggested that the same prolyl residue is involved in the isomerization reactions in the unfolded states of the intact CL, reduced CL, and CL-Hg fragments. The rate constant for the unfolding process, F to U2, was about 20 times greater than those for the intact CL and reduced CL fragments, while the rate constant for the refolding process, U2 to F, lay between the values for the intact CL and the reduced CL fragment. The free energy profiles of unfolding and refolding of the intact CL, reduced CL, and CL-Hg fragments were compared.

Bridged-Ring Compounds↗
PubMed2005

In vitro comparison of stone retropulsion and fragmentation of the frequency doubled, double pulse nd:yag laser and the holmium:yag laser.

PURPOSE: The frequency doubled, double pulse Nd:YAG (FREDDY) laser (World of Medicine, Berlin, Germany) functions through the generation of a plasma bubble. Upon bubble collapse a mechanical shock wave is generated, causing stone fragmentation. This mechanism of action is in contrast to the holmium laser, which cause stone destruction by vaporization. Observed clinical stone retropulsion and fragmentation with the FREDDY and holmium lasers has prompted a series of in vitro experiments designed to compare laser induced retropulsion and fragmentation with those of a holmium laser and pneumatic lithotrite. MATERIALS AND METHODS: For retropulsion a hands-off underwater laboratory setup, including a horizontally oriented silicone tube 1.3 cm in diameter and a holder to keep the stone phantom in contact with the quartz laser fiber or pneumatic probe, was used. Previously weighed, cylindrical Bego stone phantoms (Bego USA, Smithfield, Rhode Island) were placed in the apparatus. Stone fragmentation was performed with the FREDDY or holmium laser, or the pneumatic lithotripter. The FREDDY and holmium lasers were tested at similar pulse energy and frequency settings. As a standard for comparison, a pneumatic lithotrite was tested with a semirigid probe and single pulse settings of 100, 200 and 300 kPa. Stone phantoms underwent 30 shocks per setting. Mean net retropulsion, defined as the final resting point of the stone, as determined by direct measurement, was recorded for each setting. For fragmentation plaster of Paris stone phantoms of known weights were used to compare the fragmentation ability of each laser. Stones phantoms were placed in a hands-off underwater setup, consisting of an inverted silicon syringe and holder immersed in tap water. The laser fiber (365 microm for the holmium and 280 microm for the FREDDY) was placed through the tip of the syringe in contact with the stone phantom. A total of 24 stones were divided into 4 groups of 6 per group. Two groups were fragmented with the FREDDY laser at 300 and 400 J total energy. The other 2 groups were fragmented using the holmium laser at 300 and 480 J total energy. Fragmentation efficiency was determined as percent weight loss. RESULTS: For retropulsion at 160 mJ the FREDDY laser caused stone retropulsion to a mean distance of 7.6, 8.1 and 6.8 cm at settings of 5, 10 and 15 Hz, respectively. At 0.8 J the holmium laser retropulsed the stone to a mean distance of 3.3 and 4.9 cm at settings of 5 and 10 Hz, respectively. The pneumatic device caused stone retropulsion a mean distance of 8.5, 9.9 and 13.8 cm at pressure settings of 100, 200 and 300 kPa, respectively. The FREDDY laser generally caused less retropulsion than the pneumatic device, although this difference was only significant at the highest pneumatic lithoclast setting (p <0.05). At clinically relevant settings the FREDDY laser caused significantly more retropulsion than the holmium laser (p <0.05). For fragmentation at total energy settings of 300 and 400 J the FREDDY laser resulted in 44.9% and 86.8% weight loss, respectively (p <0.05). At settings of 300 and 480 J the holmium:YAG laser resulted in 3.3% and 7.1% weight loss, respectively (p <0.05). CONCLUSIONS: At lower frequency settings stone retropulsion was significantly greater with the FREDDY laser compared with the holmium laser. However, retropulsion was significantly less than that caused by the pneumatic lithotripter at all settings. Therefore, we recommend the use of an occlusive device, such as the Stone Cone (Boston Scientific, Natick, Massachusetts) proximal to the calculus during intracorporeal ureteral lithotripsy and in the ureteropelvic junction during percutaneous laser nephrostolithotomy. In vitro stone fragmentation was significantly greater with the FREDDY laser than with the holmium:YAG laser, suggesting that the FREDDY may offer a low cost alternative to the holmium:YAG laser lithotrite in select patients.

Equipment Design↗
PubMed2004

Correlation of percutaneous liver biopsy fragmentation with the degree of fibrosis.

BACKGROUND: Although fragmentation of a liver biopsy specimen has been considered to be suggestive of cirrhosis, the evidence for this is difficult to find in the published literature. AIM: To determine whether fragmentation of percutaneous liver biopsy specimens correlates with the degree of fibrosis. METHODS: One hundred and eighty-six patients underwent percutaneous liver biopsy prospectively. The specimens were measured for the length and number of fragments. The extent of fibrosis was scored by a pathologist blind to the clinical data. Length and fragmentation data were compared between the different stages. RESULTS: The overall median fragment length was 1.85 cm and the median fragment number was four. Specimens with advanced fibrosis (stages III-IV) had more fragments than those with no or mild fibrosis (stages 0-II) (P < 0.0001). The aggregate fragment length decreased with increasing stage of fibrosis (P < 0.0001). Specimens with greater than 12 fragments were seen only with advanced fibrosis. CONCLUSIONS: Fragmentation of percutaneous liver biopsy specimens is common and increases with progression from early to advanced fibrosis. Fibrotic specimens fragment more often and more extensively.

Adult↗
PubMed1975

Observations concerning the sequence of two additional specifically encapsidated RNA fragments originating from the tobacco-mosaic-virus coat-protein cistron.

The incubation of 25-S tobacco mosaic virus (TMV) protein with a mixture of RNA fragments produced by partial T1 RNase digestion of TMV RNA results in the encapsidation of only a few species of RNA. In addition to the most predominant species, fragment 1, whose sequence has been described in the prededing paper, two other species, fragment 41 and fragment 21 are coated by the protein. These two RNA fragments were purified by polyacrylamide gel electrophoresis and subjected to total digestion with pancreatic and T1 RNase. The oligonucleotides were separated by paper electrophoresis and characterized insofar as possible by digestion with the complementary ribonuclease. From the amino acid coding capacity of the oligonucleotides liberated from fragments 41 and 21 by T1 RNase digestion, it appears that these two fragments, like fragment 1, are derived from the coat protein cistron. They are situated immediately prior to fragment 1 and, together with this fragment, consitute a continuous stretch of 232 nucleotides of the cistron which codes for animo acids 53 to 130 of the coat protein. The order of the fragments in the sequence is 21-41-1. A possible model for the secondary structure of this portion of the sequence is proposed.

Amino Acid Sequence↗
PubMed1977

Characterisation of RNA fragments obtained by mild nuclease digestion of 30-S ribosomal subunits from Escherichia coli.

When Escherichia coli 30-S ribosomal subunits are hydrolysed under mild conditions, two ribonucleoprotein fragments of unequal size are produced. Knowledge of the RNA sequences contained in these hydrolysis products was required for the experiments described in the preceding paper, and the RNA sub-fragments have therefore been examined by oligonucleotide analysis. Two well-defined small fragments of free RNA, produced concomitantly with the ribonucleoprotein fragments, were also analysed. The larger ribonucleoprotein fragment, containing predominantly proteins S4, S5, S8, S15, S16 (17) and S20, contains a complex mixture of RNA sub-fragments varying from about 100 to 800 nucleotides in length. All these fragments arose from the 5'-terminal 900 nucleotides of 16-S RNA, corresponding to the well-known 12-S fragment. No long-range interactions could be detected within this RNA region in these experiments. The RNA from the smaller ribonucleoprotein fragment (containing proteins S7, S9 S10, S14 and S19) has been described in detail previously, and consists of about 450 nucleotides near the 3' end of the 16-S RNA, but lacking the 3'-terminal 150 nucleotides. The two small free RNA fragments (above) partly account for these missing 150 nucleotides; both fragments arose from section A of the 16-S RNA, but section J (the 3'-terminal 50 nucleotides) was not found. This result suggests that the 3' region of 16-S RNA is not involved in stable interactions with protein.

Base Sequence↗
PubMed2006

Influence of forest fragmentation on community structure of frogs and lizards in northeastern Costa Rica.

To better understand responses of reptiles and amphibians to forest fragmentation in the lowland Neotropics, we examined community and population structure of frogs and lizards in the fragmented landscape surrounding La Selva Biological Station in the Sarapiquí region of northeastern Costa Rica. We used diurnal quadrats and nocturnal transects to sample frogs and lizards in nine forest fragments (1-7 ha each) and La Selva (1100 ha). Species richness in all fragments combined was 85% of that found in La Selva with comparable sampling effort. Richness varied from 10 to 24 species among forest fragments, compared with 36 species at La Selva. Lizard density was higher and frog density was lower in forest fragments than in La Selva. Community composition varied among sites and by fragment size class, and species occurrence was nested with respect to fragment area. Isolation and habitat variables did not significantly affect species richness, composition, or nestedness. We classified 34% of species as fragmentation sensitive because they were absent or occurred at low densities in fragments. Nevertheless, the relatively high diversity observed in the entire set of fragments indicates that preserving a network of small forest patches may be of considerable conservation value to the amphibians and reptiles of this region.

Animals↗
PubMed1981

Red cell fragmentation in the dog: an editorial review.

Red blood cell fragments in blood smears from dogs are described morphologically and pathogenetically. Categories include microangiopathic fragmentation, spherocytic fragmentation. Heinz body fragmentation, metabolic fragmentation associated with systemic disease, and artifactual fragmentation. Microangiopathic fragmentation is associated with direct physical damage to normal circulating red blood cells as they pass through abnormal capillary beds. Spherocytic fragmentation is a common feature of immune-mediated hemolytic anemia and results from the removal of portions of antibody-coated erythrocyte plasma membranes by phagocytes of the reticuloendothelial system. Heinz body fragmentation occurs when rigid particles of oxidized hemoglobin are torn from affected red cells as they circulate through the spleen. Metabolic fragmentation is an ill-defined syndrome most commonly associated with cholesterol loading of red cell membranes caused by lipid metabolism abnormalities. Resulting spiculated red cells are more susceptible to traumatic disruption. All the types of red cell fragmentation described in dogs have been observed and documented in man.

Animals↗
PubMed1981

Motility of basal fragments of sea urchin sperm flagella.

Both live and reactivated sea urchin sperm flagella were broken by passage through a pipette. Distal fragments stopped, but basal fragments continued to beat. Intact flagella were about 48 micrometer long; basal fragments were about 4-20 micrometer long. Beat periods of tritonated fragments were 11% shorter than those of unbroken controls, possibly reflecting decreased viscous loading; beat periods of live fragments were 18% shorter than those of unbroken controls, possibly reflecting reduced rates of ATP consumption as well as decreased viscous loading. The undulations of basal fragments were compared with those of the basal regions of unbroken flagella, using the patterns of development of the radii and angles of basal bends. Fragments closely resembled basal regions of unbroken flagella, except that bends tended to open as they approached the distal end of a fragment, so that their radii increased more rapidly than those unbroken flagella. Fragments about 4 micrometer long contained only one bend during part of the cycle, and appeared to be straight during part of the cycle. They flipped back and forth with fairly constant angular speeds and abrupt changes in direction, so that plots of angle between their distal end and base often resembled triangular waves, although the peaks of the waveforms were often rounded. This behaviour suggests a mechanism in which sliding switches between 2 modes. Both the speed of sliding and the maximum angles attained in one direction of bending were greater than those attained in the other direction, suggesting differences between the doublets on the 2 sides of the axoneme. Sliding of the doublets continued as fast speeds as the fragments straightened, in contrast to the characteristics of some curvature-sensitive models. These flagellar fragments provide a simplified system for the study of flagellar oscillations.

Animals↗
PubMed1999

Induction and regulation of macrophage metalloelastase by hyaluronan fragments in mouse macrophages.

Although the metalloproteinase murine metalloelastase (MME) has been implicated in lung disorders such as emphysema and pulmonary fibrosis, the mechanisms regulating MME expression are unclear. Low m.w. fragments of the extracellular matrix component hyaluronan (HA) that accumulate at sites of lung inflammation are capable of inducing inflammatory gene expression in macrophages (Mphi). The purpose of this study was to examine the effect of HA fragments on the expression of MME in alveolar Mphi. The mouse alveolar Mphi cell line MH-S was stimulated with HA fragments over time, total RNA was isolated, and Northern blot analysis was performed. HA fragments induced MME mRNA in a time-dependent fashion, with maximal levels at 6 h. HA fragments also induced MME protein expression as well as enzyme activity. The induction of MME gene expression was specific for low m.w. HA fragments and dependent upon new protein synthesis; it occurred at the level of gene transcription. We also examined the effect of HA fragments on MME expression in inflammatory alveolar Mphi from bleomycin-injured rat lungs. Although normal rat alveolar Mphi did not express MME mRNA in response to HA fragments, alveolar Mphi from the bleomycin-treated rats responded to HA fragment stimulation by increasing MME mRNA levels. Furthermore, baseline and HA fragment-induced MME gene expression in alveolar Mphi from bleomycin-treated rats was inhibited by IFN-gamma. These data suggest that HA fragments may be an important mechanism for the expression of MME by Mphi in inflammatory lung disorders.

Animals↗
PubMed2003

Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence.

BACKGROUND: The surgical treatment of sciatica with discectomy is ineffective in a sizable percentage of patients, and reherniation occurs after 5% to 15% of such procedures. The purpose of the present study was to determine if competence of the disc anulus and the type of herniation could be used to predict postoperative clinical outcomes following lumbar discectomy. METHODS: A prospective observational study of 187 consecutive patients undergoing single-level primary lumbar discectomy was conducted. A single surgeon performed all of the procedures, and an independent examiner evaluated 180 of the patients clinically at a minimum of two and a median of six years after surgery. The extent of anular deficiency and the presence of disc fragments were determined. On the basis of these intraoperative findings, disc herniations were classified into four categories: (1) Fragment-Fissure herniations (eighty-nine patients), (2) Fragment-Defect herniations (thirty-three patients), (3) Fragment-Contained herniations (forty-two patients), and (4) No Fragment-Contained herniations (sixteen patients). The effects of disc herniation morphology and preoperative variables on subsequent clinical outcome were determined with the Student t test for continuous variables and chi-square analysis for categorical variables. RESULTS: Patients in the Fragment-Fissure group, who had disc fragments and a small anular defect, had the best overall outcomes and the lowest rates of reherniation (1%) and reoperation (1%). Patients in the Fragment-Contained group had a 10% rate of reherniation and a 5% rate of reoperation. Patients in the Fragment-Defect group, who had extruded fragments and massive posterior anular loss, had a 27% rate of reherniation and a 21% rate of reoperation. Patients in the No Fragment-Contained group did poorly: 38% had recurrent or persistent sciatica, and the standard outcomes scores were less improved compared with those in the other groups (p < 0.001). CONCLUSION: Intraoperative findings, as described in the present study, were more clearly associated with outcomes than were demographic, socioeconomic, or clinical variables. The degree of anular competence after discectomy and the type of herniation appear to have value for the prediction of the recurrence of sciatica, reoperation, and clinical outcome following lumbar discectomy. LEVEL OF EVIDENCE: Prognostic study, Level I-1 (prospective study). See p. 2 for complete description of levels of evidence.

Adult↗
PubMed1992

[Studies on the fragments of FDP in 4 patients with DIC].

We previously studied fibrinolysis and fibrinogenolysis by analyzing fragments of fibrin/fibrinogen degradation products (FDP) employing sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. In this report, we characterized the fragments of FDP in four patients with disseminated intravascular coagulation (DIC), that were caused by various diseases. In the patients suffering from acute lymphoblastic leukemia (case 1) and acute suppurative cholangitis (case 3), DD and DY/X fragments resulting from fibrinolysis accounted for the most part of the FDP fragments. In case 3, D fragments resulting from fibrinogenolysis were also observed to much less extent. In a DIC associated with acute myeloblastic leukemia (case 2), both fibrinolysis and fibrinogenolysis were increased and resulted in high levels of D, Y and DY/X fragments, concomitant with moderate levels of DD and high molecular weight (HMW) fragments in the patient's sera. The increased fibrinogenolysis in this case was attributed to accelerated activation of plasmin. In a DIC patient of case 4, who underwent an operation due to hepatocellular carcinoma, marked increase in DY/X and HMW fragments and slight increase in DD fragment were observed on the day of operation. Hyperfibrinolysis documented in case 4 was explained by both increased production of thrombin and moderately accelerated activation of plasmin. Both qualitative and quantitative changes in the fragments of FDP during the courses of treatment in two cases of DIC were also noted. In summary, each underlying disease expresses characteristic pattern of FDP fragments in DIC.

Adolescent↗