Differences of means within groups were evaluated by ANOVA and Du

Differences of means within groups were evaluated by ANOVA and Dunnett post hoc. A significant levels was set at P < 0.05.

Results. Concentration levels of drugs varied greatly in different regions of spinal tuberculosis vertebrae. Concentration levels of isoniazid and rifampin were higher than the effective bactericidal concentration (EBC) level and that of pyrazinamide was five BI2536 times of the minimal inhibitory concentration in the region II of abnormal osseous

tissues and the ilium of nonsclerotic group. Three drugs achieved EBC in the region I of abnormal osseous tissues in the nonsclerotic group but not in the sclerotic group. Except pyrazinamide no drugs and their metabolite were identified in the foci of the sclerotic group, whereas there is trace of drugs and their metabolite in the foci of the nonsclerotic group.

Conclusion. Three drugs resulted in an effective bactericidal concentration level in osseous tissues around the foci of spinal tuberculosis except the osseous tissues 4 mm surrounding the sclerotic wall. The results

suggested that osseous tissues within 4 mm surrounding the sclerotic wall should be excised during the surgery.”
“Standardized psychological assessment of candidates for reconstructive hand transplantation (RHT) is a new approach in transplantation medicine. Currently, international guidelines and standardized criteria for the evaluation are GSK923295 research buy not established. Patients suffering from the loss of a hand or an

upper extremity have to cope with multiple challenges. For a selected group of patients, RHT represents an option for restoring natural function and for regaining daily living independence. The identification of at-risk patients and those requiring ongoing counseling due to poor coping or limited psychological resources are the primary focus of the psychological assessment. We have developed the Innsbruck Psychological Screening Program for Reconstructive Transplantation (iRT-PSP) which utilizes JQ1 datasheet a semi-structured interview and standardized psychological screening procedures and continuous follow-up ratings. Between January 2011 and October 2011, four candidates were evaluated using the iRT-PSP. Psychological impairments including social withdrawal, embarrassment, reduced self-esteem, and a depressive coping style were identified and poor quality of life was reported. The motivation for transplantation was diverse, depending on many factors such as bi- or unilateral impairment, native or accidental loss of hand, and social integration.”
“Recent studies have highlighted the importance of the complete resection of a brain tumour but the task often remains a challenge for the neurosurgeon. New technologies which add objective information beyond visualisation provided by the traditional operating microscope are required.

5 +/- 6 6 versus 31 5 +/- 10 1; p<0 001) and (4) among patient

5 +/- 6.6 versus 31.5 +/- 10.1; p<0.001) and (4) among patients with acute pyelonephritis, patients

with bacteremia had a significantly lower mean plasma concentration of sTRAIL (pg/mL) Selleckchem Prexasertib than those without bacteremia (15.1 +/- 4.8 versus 24.7 +/- 4.6; p<0.001).

Conclusion: Women with uncomplicated pregnancies are associated with a significantly lower mean maternal plasma concentration of sTRAIL than that observed in non-pregnant women. Moreover, a further decrease in plasma sTRAIL concentration was observed in pregnant women with acute pyelonephritis, and this could account, at least in part, for the exaggerated intravascular inflammatory response previously reported in pyelonephritis during pregnancy.”
“Background and aims: Surgeons have traditionally tried to avoid any complex surgical procedures in Crohn’s patients with complex perianal diseases

because of the fear of complications, worsening the patients condition and risking an eventual proctectomy. The introduction of biological therapy has changed the management of Crohn’s disease. This study assesses the long-term success of addressing defects in anal sphincter and complex fistula when patients receive anti-INF-alpha antibodies.

Methods: Ten consecutive patients were prospectively scheduled for induction therapy with 5 mg/kg Infliximab at week 0, 2 and selleck screening library 6 and maintenance every 8 weeks associated with azathioprine. Elective surgery was performed conducting a simultaneous approach to the sphincter defect and fistula tracts. Outcomes were long-term continence, complications which were assessed by a Wexner’s score along with a complementary questionnaire. Statistical analysis was performed using general linear model of repeated measures.

Results: Three patients had complications related to surgery: two abscesses and low inter-sphincteric fistula and one case of rectal stenosis causing fecal urgency.

There was no suture dehiscence. Wexner’s score improved at 12 months (10.0 +/- 2.4 vs. 18.0 +/- 2.6; p=0.003) and over time (48 month 9.5 +/- 2.8; p=0.001). These scores were significantly worse when patients had urgency before treatment (12.8 +/- 1.2 vs. 9.5 +/- 2.8; p=0.03) but not when selleck kinase inhibitor the urgency appeared later. No patient remained incontinent to solid stools. Three patients had occasional incontinence to liquid stools associated to disease reactivation.

Conclusion: Surgical repair and immunomodulator therapy with infliximab could be an option in incontinent patients with Crohn’s disease involving both a sphincter defect and severe or refractory fistulas. (C) 2011 European Crohn’s and Colitis Organisation. Published by Elsevier B.V. All rights reserved.”
“In the present study whole genome of six Brazilian isolates of PCV2 were sequenced, analyzed and compared with 35 other sequences (24 from other countries and 17 from Brazil). The phylogenetic analysis showed that mostly Brazilian variants of PCV2 were grouped as PCV2-1.

Numerous connections exist

between proteins genetically l

Numerous connections exist

between proteins genetically linked to autosomal dominant PD, in particular a-synuclein and LRRK2, and autophagic pathways. However, proteins involved in recessive PD, such as PINK1 and Parkin (PINK2), function in the process of mitophagy, whereby damaged mitochondria are selectively engulfed by macroautophagy. This wealth of new data suggests that both autophagic pathways are potential targets for therapeutic intervention in PD and other related neurodegenerative conditions.”
“While kidney transplantation is the most cost-effective treatment available for end-stage renal disease (ESRD) and affords patients with the best quality of life, the current supply of kidneys does not meet the demand. Selleckchem ON-01910 A potential solution to increasing the supply is to compensate living donors for a kidney. The purpose of this study was to describe ESRD patient willingness to pay for a kidney. Using a self-administered https://www.selleckchem.com/products/BEZ235.html survey, 107 patients in 31 U.S. states completed the survey. The quantitative method and descriptive survey design employed descriptive, correlational, nonparametric and multivariate statistical tests to evaluate the data. Of participants, 78.5% were willing to pay for a kidney; there were significant correlations between gender, health status, household income, preferred source of a kidney and willingness

to pay. Men, patients with poor and fair health status and those with household incomes >=$50 000 were more willing to pay. Step-wise regression analysis found price and doctor’s influence accounting for 52% of variance in willingness to pay. As price increased and doctor’s opinion mattered, willingness to pay increased. This study supports development of additional studies with larger sample sizes and patients on kidney transplant waiting

“Introduction and hypothesis The aim of the study was to investigate PF-03084014 mw the variability of bony pelvis architecture from the viewpoint of transobturator sling placement.

Methods The pelvimetry was performed on 122 women who underwent pelvic computed tomography. Measurements included: the distance between the interobturator foramina line and inferior pubic symphysis (IF-PS distance) as well as pubic arch angle, pubic ramus width, and pubic symphysis length.

Results The length of the IF-PS distance varied between 7.4 and 26.9 mm (mean 15.2+4.3 mm, median 14.2 mm). The distribution of measurements was asymmetrical with a tilt of the values towards shorter distances. In 11.5% of women, the IF-PS distance was longer than 20 mm. The IF-PS distance correlated with the pubic ramus width (r=0.37, p<0.0001) and pubic arch angle (r=-0.22, p=0.017).

Conclusion The IF-PS distance varies considerably in the general population of women.

He was weaned from support after the resolution of the TLS and co

He was weaned from support after the resolution of the TLS and completed chemotherapy successfully. ECLS may have a role to play in the acute support of children with cardiorespiratory failure as a result of malignancy or the required treatment.”
“Laparoscopic sleeve gastrectomy (LSG) has become very popular nowadays among bariatric surgeons because of its surgical simplicity and good postoperative results. We present our experience

on LSG as a single stage primary bariatric procedure for learn more morbid obesity and its 1-3-year follow-up results.

Between March 2008 and March 2011, a total of 110 patients underwent laparoscopic sleeve gastrectomy. Two patients were excluded from the study and thus the prospectively maintained data of 108 patients were retrospectively reviewed and outcomes were recorded.

The mean patient age was 39.3 +/- 11.1 years, mean body mass index was 44.5 +/- 6.8, mean excess body weight was 54.1 +/-

16.3 kg, and the mean American Society of Anesthesiologists score was 3.1 +/- 0.57. The mean operative time for the LSG procedure was 64.8 +/- 10.6 min. The minimum follow-up duration was 6 months and maximum of 36 months. The mean postoperative percent excess body weight loss achieved was 67.5 +/- 13.0 at 1 year, 71.1 +/- 13.8 at 2 years, and 66.09 +/- 14.3 at 3 years. At the end of 3 years, there was 83.3% resolution in diabetes, 85.7% resolution in hypertension, and 85.71% resolution in dyslipidemia. There MAPK inhibitor were no reports of postoperative hemorrhage, gastric leak, deep venous thrombosis, pulmonary embolism, delayed gastric tube stricture, and operative mortality.

LSG is a safe and effective bariatric procedure with low perioperative complications.

Before it is considered as a single stage primary procedure, a long-term prospective comparative study with other bariatric procedures is required.”
“The objective of this study was to characterize the early neurodevelopmental profile of Australian infants with deformational plagiocephaly (DP). Twenty-one infants with a confirmed diagnosis of DP (mean age, 7.9 months; SD, 2.0 months) were assessed on the Bayley Scales of Infant Development, Second Edition, before treatment. As a group, infants with DP P005091 inhibitor showed significantly weaker motor skills compared with the normative population. Patients with DP did not significantly differ from normative population estimates with respect to cognitive abilities. Males with DP displayed significantly reduced motor abilities compared to females. These findings do not suggest that DP causes developmental problems, but DP could be a marker for risk of developmental problems. Screening for developmental concerns in infants with DP is therefore important.”
“Cutaneous adnexal neoplasms are complex lesions, including benign and malignant neoplasms in addition to malformations and hamartomas. They show one or several features of differentiation along follicular, sebaceous, apocrine, and eccrine lines.

Recent advances in air-coupled ultrasonic spectroscopy have enabl

Recent advances in air-coupled ultrasonic spectroscopy have enabled ultrasonic waves to be applied to the on-line and real-time assessment of the water content of different materials. In this study, this technique has been applied as a non-destructive, non-invasive, non-contact, and repeatable method for the determination of water status https://www.selleckchem.com/products/ABT-263.html in Populus3euramericana

and Prunus laurocerasus leaves. Frequency spectra of the transmittance of ultrasounds through plant leaves reveal the presence of at least one resonance. At this resonant frequency, transmittance is at its maximum. This work demonstrates that changes in leaf relative water content (RWC) and water potential (W) for both species can be accurately monitored by the corresponding changes in resonant frequency. The differential response found between both species may be due to the contrasting leaf structural

features and the differences found in the parameters derived from the P -V curves. The turgor loss point has been precisely defined by this new technique, as it is derived from the lack of significant differences between the relative water content at the turgor loss point (RWCTLP) obtained from P -V curves and ultrasonic measurements. The measurement of the turgor gradient between two different points of a naturally transpiring leaf is easily carried out with the method introduced here. Therefore, such a procedure can GW786034 be an accurate tool for the study of all processes where changes in leaf water status are involved.”
“In this research, polypropylene/wood-flour composites (WPCs) were blended with different contents of wood and/or maleated polypropylene (MAPP) and clay. We found that the addition of MAPP or clay in the formulation greatly improved the dispersion of the wood fibers in PI3K inhibitor the composite;

this suggested that MAPP or clay may have played the role of an adhesion promoter in the WPCs. The results obtained with clay indicate that it also acted as a flame retardant. The thermal tests carried out with the produced samples showed an increased crystallization temperature (T(c)), crystallinity, and melting temperature (T(m)) with wood loading. The increase of the two former parameters was explained by the incorporation of wood flour, which played the role of nucleating agent and induced the crystallization of the matrix polymer. On the other hand, the T(m) increase was ascribed to the insulating properties of wood, which hindered the movement of heat conduction. The effects of UV irradiation on T(m) and T(c) were also examined. T(c) increased with UV exposure time; this implied that UV degradation generated short chains with low molecular weight that could move easily in the bulk of the sample and, thus, catalyze early crystallization. The flexural strength and modulus increased with increasing wood-flour content.

Increased expression of receptor activator of nuclear factor kapp

Increased expression of receptor activator of nuclear factor kappa B (RANKL), macrophage-colony stimulating factor (M-CSF), presence of TNF alpha, IL-1, IL-6, IL-7, IL-17 influences pathological loss of bone mass.

Rheumatoid arthritis is an important risk factor

of generalised osteoporosis and fractures, involved in FRAX (fracture risk assessment) algorythm. Generalised osteoporosis in patients with RA has a multifactorial aetiology. Its development reflects effects of both: factors linked to the disease (presence of proinflammatory cytokines, disability of the patients, applied therapy) and classical risk factors of osteoporosis (e. g. advanced age, sex, post-menopausal period, genetic predisposition, low peak bone mass, low body weight, deficiency of calcium and vitamin D, tobacco smoking).”

analyses of polluted soils are selleck products limited in their ability to determine all hazardous compounds, their bioavailability, and their combined effects on living organisms. Bioassays, on the other hand, can evaluate environmental quality more accurately. This study assesses the genotoxic potential of water extracts from soil polluted with metals (Pb, Cd, and Zn) by the former lead smelter in Zerjav, Slovenia using comet assay with Tetrahymena thermophila and human hepatoma cells (HepG2). In addition, the toxicity of soil samples and their extracts was evaluated using Vibrio fischeri and delayed fluorescence of Lemna minor. Chemical analyses of metals using atomic absorption spectrophotometry (AAS) was performed for comparison. Measurements of the total metal concentrations showed R788 that four click here of five plots near the former lead smelter were highly contaminated with Pb, Cd, and Zn, but the amount of metals in water/soil extracts was low at all the sampling plots.

Genotoxicity was demonstrated using T thermophila for the majority of the extracts, and HepG2 cells for only some of the extracts. Whereas V fischeri indicated a gradual decrease in soil toxicity with greater distance from the smelter, the toxicity of extracts did not correlate with proximity. Low concentrations of metals in water extracts stimulated L. minor growth. The results indicate that comet assay with T thermophila and HepG2 cells and the BSPT with V fischeri are suitable protocols for screening the genotoxic and toxic potential of water/soil extracts by comet assay, whereas chemical analyses of total metal concentrations in soil do not solely suffice for evaluating metal pollution in the environment. Biological assays are thus crucial for risk assessment. (C) 2008 Wiley Periodicals, Inc. Environ Toxicol 24: 472-483, 2009.”
“Objective: The treatment of nasopharyngeal stenosis is challenging because of a high incidence of recurrence after surgical correction. Therefore, many treatment modalities are being tried to cure this problem.

“SETTING: A DOTS clinic in an academic tertiary referral h

“SETTING: A DOTS clinic in an academic tertiary referral hospital in South India.

OBJECTIVE: To evaluate the performance

of two rapid enzyme-linked immunoassays (EIAs) for the detection of human immunodeficiency virus (HIV) infection in sputum samples of patients with tuberculosis (TB).

DESIGN: We prospectively recruited 522 consecutive outpatients presenting to the DOTS clinic with confirmed TB of any type to undergo HIV testing using reference serum EIA and index-blinded parallel sputum HIV testing GSK2126458 in vivo with two rapid EIAs designed for oral mucosal transudate.

RESULTS: HIV positivity was 14.9% (95%CI 12.1-18.4). Compared to reference serum EIA, the Oraquick (TM) assay was 93.1% sensitive (95%CI 83.8-97.4) and 95.3% specific (95%CI 92.7-96.9), while the Aware

(TM) assay was 92.3% sensitive (95%CI 83.4-96.8) and 96.6% specific (95%CI 94.4-98.0). The positive predictive values were respectively 77.0% and 82.7%. After freezing of sputum, the sensitivity of both assays declined, but the specificity significantly increased. Higher sputum volume reduced the odds of obtaining a true result with both assays.

CONCLUSION: HIV testing of fresh sputum is not sufficiently accurate for LSD1 inhibitor anonymous HIV surveillance among TB patients in a setting of low (<10%) HIV prevalence. Freezing sputum samples and limiting sputum volume for HIV testing may improve assay specificity.”
“Proliferative (cellular) nodules (PN) which mimic malignant melanoma clinically and histologically are described in congenital melanocytic nevi (CMN) and may pose significant diagnostic challenges. We report the case of a 10-day-old male with a giant congenital nevus involving the neck, upper chest, back, and left shoulder containing several nodular lesions, some crusted. Biopsy of a nodule revealed densely packed nevus cells with hyperchromatic round to oval and occasionally irregularly shaped

nuclei. There was no necrosis or pushing border, and the nodule blended with the adjacent nevus; however, the lesion demonstrated a significant number of mitoses (27 per mm(2)) and a 60% labeling index with Ki-67. Further analysis by fluorescence in situ hybridization (FISH) with a 4-color probe set targeting 6p25, 6q23, 11q13, and centromere 6 revealed increased chromosomal copy numbers of all 4 probes, which was interpreted as evidence mTOR target of polyploidy. In addition, analysis of DNA copy number changes using a single nucleotide polymorphism microarray (Affymetrix, Santa Clara, CA) showed no chromosomal aberrations. The diagnosis of PN in a giant congenital nevus was eventually rendered. At 13-month follow-up, the nodules showed no evidence of growth. Our case illustrates that PNs in the neonatal period might demonstrate extreme mitotic activity. This feature is worrisome when encountered in melanocytic lesions; however, it should not trigger by itself a diagnosis of melanoma in the absence of other histologic criteria of malignancy.

Chloroformic extract showed the highest antifungal activity and t

Chloroformic extract showed the highest antifungal activity and three compounds were identified in this extract: Apigenine-7-methylether (1), nordihydroguaiaretic acid (2) and 3,4′-dihydroxy-3′,4-dimethoxy-6,7′-cyclolignan (3). Compound 3 is described for the first time in the

species and exhibited strong antifungal activity in vitro (Fusarium graminearum MIC = 15.6 mu g/mL) and in vivo producing decreasing disease on glasshouse-grown wheat plants reducing damping-off (14% in pre emergency) and Severity Index from 2.6 upto 1.1. In this study selleck screening library it is clear that the application of botanical products from L. divaricata can be effective in the management of seedling blight and crown rot of wheat. (C) 2012 Elsevier B.V. S63845 All rights reserved.”
“Purpose of review

Despite the widespread use

of dopamine agonists for patients with prolactinomas and symptomatic idiopathic hyperprolactinemia for many decades, the optimal treatment strategy and duration of treatment is still not evident. This review highlights the effects of dopamine agonist withdrawal in patients with idiopathic hyperprolactinemia and prolactinomas in detail, including the factors influencing the success of treatment outcome.

Recent findings

It appeared that a subgroup of patients with a high likelihood of achieving remission could be identified on clinical criteria, which were incorporated in the Pituitary Society 2006 consensus guidelines. A recent systematic review and meta-analysis, however, demonstrated that the pooled proportion of patients with persisting normoprolactinemia after dopamine agonist withdrawal was only 21%, with a higher treatment success

in idiopathic hyperprolactinemia (32%), compared with both microprolactinomas (21%) and macroprolactinomas (16%). In a random effects meta-regression, longer treatment duration was associated with treatment success. The probability of treatment success was highest when cabergoline was used for at least 2 years. Recommendations have now been adjusted accordingly in the 2011 Endocrine Society Practical guideline.


Hyperprolactinemia will recur after dopamine agonist withdrawal in a considerable proportion of patients, but not all dopamine agonists have comparable efficacy. The optimal withdrawal strategy still needs to be determined Selonsertib in further studies.”
“Background and objective:

The use of the impulse oscillometry system (IOS) allows differentiated lung function testing with a minimum of cooperation at normal tidal breathing. The aim of this cross-sectional study was to assess the association of body mass (overweight and obese) with oscillometric parameters in preschool children.


A preschool medical check of 518 children (age 6.01 +/- 0.25 years) included IOS recordings of airway resistance and lung reactance (MasterScreen IOS, CareFusion, Hochberg, Germany).

The introduction of IA into the polymerization system was found t

The introduction of IA into the polymerization system was found to be propitious for the preoxidation of the PAN polymers, and the characteristic absorption bands of C N, C=O, or O-H existed in the polymer main chains. With an increase in the required amount of IA in the polymerization system, the exothermic figure of the exotherms became broader, and the intensity of the C=O and O-H absorption bands became stronger. (C) 2008 Wiley

Periodicals, Inc. J Appl Polym Sci 111: 3163-3169,2009″
“BACKGROUND Aging in the lower face leads to lines, wrinkles, depression of the corners of the mouth, and changes in lip volume and lip shape, with increased sagging of the skin of the jawline. Refined, easy-to-use, validated, buy Dihydrotestosterone objective standards assessing the severity of these changes are required in clinical research and practice.

OBJECTIVE To establish the reliability of eight lower face scales assessing nasolabial selleck compound folds, marionette lines, upper and lower lip fullness, lip wrinkles (at rest and dynamic), the oral commissure and jawline, aesthetic areas, and the lower face unit.

METHODS AND MATERIALS Four 5-point rating scales were developed to objectively assess upper and lower lip wrinkles, oral commissures, and the jawline. Twelve experts rated identical lower

face photographs of 50 subjects in two separate rating cycles using eight 5-point scales. Inter-and intrarater reliability of responses was assessed.

RESULTS Interrater reliability was substantial or almost perfect

for all lower face scales, aesthetic areas, and the lower face unit. Intrarater reliability was high for all scales, areas and the lower face unit.

CONCLUSION Our rating scales are reliable tools for valid and reproducible assessment of the aging process in lower face areas.”
“Electron field emission (FE) from multiwall carbon nanotubes (CNTs) in gas (Ar and air) for producing microplasma AZD9291 price discharge was measured in a scanning electron microscope. The results showed that the FE properties of the CNTs were stable in Ar and air gases when the FE threshold voltages were lower than the conventional gas breakdown voltages. These results proved the probability that microplasma could be sustained by FE electrons emitted from the CNTs without ion bombardment, which could avoid the damage of the cathode.”
“BACKGROUND Sagging of the neck aesthetic area is an important indicator of age. The development of complex and globally accepted tools for proper assessment of the change in neck volume is an essential contribution to aesthetic research and the routine clinical setting.

OBJECTIVE To develop a grading scale for the objective assessment of the neck volume and to establish the reliability of this scale for clinical research and practice.

MATERIALS AND METHODS A 5-point rating scale was developed to assess neck volume objectively.

In this report, aqueous two-phase extraction (ATPE) was investiga

In this report, aqueous two-phase extraction (ATPE) was investigated as an alternative for the separation of an acidic recombinant protein, beta-glucuronidase (rGUS), from transgenic tobacco. Screening experiments by fractional factorial designs showed that PEG concentration Sapanisertib nmr and ionic strength of the system significantly affected the partitioning of native tobacco proteins and GUS. Response surface methodology was used to determine an optimized aqueous two-phase

system for the purification of rGUS from transgenic tobacco. In a 13.4% (w/w) PEG 3400/18% (w/w) potassium phosphate system. 74% of the rGUS was recovered in the top PEG-rich phase while more than 90% of the native tobacco proteins were removed in the interphase and the bottom phase. A purification factor of about 20 was achieved in this process. The most important impurity from tobacco, Rubisco, was largely removed from the rGUS in the recovered phase. (C) 2010 Elsevier B.V. All rights reserved.”
“Study Design. Basic scientific investigation exposing partially herniated discs to vibration and shock loads in both flexed and neutral


Objective. To determine the effect of vibration and posture on the exacerbation of the intervertebral disc (IVD) herniation process.

Summary click here of Background Data. There is a large body of scientific evidence to suggest that spine flexion is required in conjunction with repetitive loading to produce IVD herniation. There is also a strong epidemiological link between occupational vibration exposure and the

development of IVD herniation; however, there is little basic experimental evidence to support this link. The purpose of this investigation was to examine what effect vibration, shock, and flexed posture has on the exacerbation of pre-existing partial IVD herniations.

Methods. A total of 64 porcine motion segments were exposed to an established herniation loading protocol to produce partial DMXAA purchase herniation. These motion segments were randomly assigned to 1 of 4 loads (vibration to simulate whole-body vibration [WBV], static, vibration, and shock) and either in neutral or flexed postures making 8 experimental conditions with 8 motion segments per group. Computed tomography imaging was used to quantify herniation progression, whereas specimen height and average stiffness changes were quantified via excepted methods.

Results. The herniation protocol was very successful in producing partial herniations (58 of 64 motion segments). Combined vibration and shock loading was the most potent load type for further exacerbation of the herniation. The flexed posture did not have an influence on the distance of nucleus tracking, probably because of the height lost in the disc, although a flexed posture made the disc marginally stiffer suggesting more damage.

Conclusion. Vibration and shock loading provided sufficient mechanical injury to exacerbate pre-existing IVD herniations.