“To evaluate long-term clinical results of lumbar total disc replacement (TDR) compared with posterior lumbar fusion.
This prospective randomized High Content Screening controlled trial comprised 152 patients; 80 were randomized to TDR and 72 to fusion. All patients had chronic low back pain (CLBP) and
had not responded to nonsurgical treatment. Primary outcome measure was global assessment of back pain (GA), secondary outcome measures were back and leg pain, Oswestry Disability Index (ODI), EQ5D, and SF-36. All measures were collected from SweSpine (Swedish national register for spinal surgery) at 1, 2, and 5 years. Follow-up rate at 5 years was 99.3 %.
Both groups showed clinical improvement at 5-year follow-up. For GA, 38 % (30/80) in the TDR group were totally pain free vs. 15 % (11/71) in the fusion group (p < 0.003). Back pain and improvement selleckchem of back pain
were better in the TDR group: VAS back pain at 5 years 23 +/- A 29 vs. 31 +/- A 27, p = 0.009, and VAS improvement of back pain at 5 years 40 +/- A 32 vs. 28 +/- A 32, p = 0.022. ODI and improvement in ODI were also better in the TDR group: ODI at 5 years 17 +/- A 19 vs. 23 + 17, p = 0.02 and ODI improvement at 5 years 25 +/- A 18 vs. 18 +/- A 19 (p = 0.02). There was no difference in complications and reoperations between the two groups.
Global assessment of low back pain differed between the two surgical groups at all follow-up occasions. Significant differences between groups concerning back pain, pain improvement, and ODI were present at 1 year and disappeared at 2 years, but reappeared at the 5-year follow-up.”
“An acidic polygalacturonase (PG) from Aspergillus kawachii was produced by solid state fermentation employing a polyurethane foam support. The conditions used for the production of acidic PG were particle size of support (0.6 or 500 mm(3)) and fermentation time. From the factors CT99021 studied, 3 the particle size had important influence on enzyme production. The best conditions for acidic PG production were 0.6 turn particle size, 18 hr at 30 degrees C and initial pH
of 5.0. In addition, pectin was extracted from citrus pomaces (grapefruit, lime, and tangerine) by acidic PG at 50 degrees C for 24 hr with citric acid solution. Infrared spectroscopy showed that lime pomace had more high-methoxylated (65%) endogenous pectin than was obtained than from grapefruit or tangerine pomaces. The enzymatically extracted pectin yield in dry basis (d.b.) for grapefruit and lime pectins were 6.95 and 4.25%, respectively. The citric acid solution alone also contributed to pectin extraction from citrus pomaces (7-9%, d.b.). Limited pectin extraction by acidic PG from tangerine pomace was most likely due to the presence of low-methoxylated endogenous pectin. The enzymatic method for pectin extraction using acidic PG from A. kawachii is a promising technique for releasing highly polymerized pectic substances from high-methoxylated lime or grapefruit pomaces.