7 mu M NAA and 1 1 mu M BAP The period for dark and light cultur

7 mu M NAA and 1.1 mu M BAP. The period for dark and light culture was 20 days. Shoots were multiplied on MS medium, 30 g.L-1 sucrose supplemented with 1.1 mu M BAP. Shoots were elongated on MS medium free of plant growth regulators. Shoots were rooting on half-strength MS salts. Acclimatization was performed in a hydroponics floating system. Moreover, the shoot multiplication in liquid medium with different CaCl2 levels was carried out under agitation. Organogenesis selleck compound of cotyledonary nodes was characterized by simultaneous occurrence of shoot and callus. Shoots presented hyperhydricity under liquid medium, however, the CaCl2 reduces the hyperhydricity in

liquid medium; nevertheless, it SRT2104 had been not effective in eliminating hyperhydricity due to toxicity of

chlorine. The hydroponics acclimatization results in 90% plant survival. An efficient protocol for micropropagation of E. saligna was suitable established and can be used for clonal propagation or genetic transformation.”
“Addiction has been characterized as an attentional bias towards drug-related cues. In two experiments we investigate the effects of non-words that have been associatively trained to addiction-related images in a group of marijuana and cocaine users. These associated non-words were presented along with unstudied non-words in a subsequent addiction Stroop task. Results indicate a slowdown in responding to the colour of non-words that were paired with cocaine-related images compared with non-cocaine related images. The slowdown was also characterized as a carryover effect, with the largest effect occurring on trials following the addiction-associated non-word. No effects were found for marijuana images associated with non-words.”
“Animal models of ototoxicity represent an elementary tool in otolaryngologic research. Such models are usually created via the consecutive injection of ototoxic drugs

or the co-administration of ethacrynic acid and low-dose ototoxic drugs. Injection via the round window membrane (RWM) is one approach that allows for local drug delivery into the inner ear. In this study, 47 guinea pigs received an injection of varying GSI-IX nmr doses of cisplatin via the RWM, and data concerning the animals’ auditory brainstem responses, hair cells, and spiral ganglion neurons were analyzed. Our results indicate the high efficiency and generally small reaction of the subjects, suggesting that the application of cisplatin via the RWM is an effective animal model for ototoxicity research.”
“Background: Some reports have described the midst of the lumen of the bony eustachian tube to meet the lumen of the external ear canal more nearly straight in ears afflicted with otitis media.\n\nObjectives: To determine whether the “auditory tube angle” indeed is more nearly straight in ears with evidence of childhood otitis media.

It has been suggested that one reason for these inconsistencies m

It has been suggested that one reason for these inconsistencies may be that in complex diseases, such as cancer, multiple genes belonging to one or more physiological pathways are associated with the outcomes. Thus, a possible approach

to improve list stability is to integrate biological information from genomic databases in the learning process; however, a comprehensive assessment based on different types of biological information is still lacking in the literature. In this work we have compared the effect of using Selleck I BET 762 different biological information in the learning process like functional annotations, protein-protein interactions and expression correlation among genes.\n\nResults: learn more Biological knowledge has been codified by means of gene similarity matrices and expression data linearly transformed in such a way that the more similar two features are, the more closely they are mapped. Two semantic similarity matrices, based on Biological Process and Molecular Function Gene Ontology annotation, and geodesic distance applied on protein-protein interaction networks, are the best performers in improving list stability maintaining almost equal prediction accuracy.\n\nConclusions: The performed analysis supports the idea that when some features are strongly correlated

to each other, for example because are close in the protein-protein interaction network, then they might have similar importance and are equally relevant for the task at hand. Obtained results can be a starting point for additional experiments on combining similarity matrices in order to obtain even more stable lists of biomarkers. The implementation of the classification algorithm is available at the link: http://www.math.unipd.it/dasan/biomarkers.html.”
“Objective. This study aimed to evaluate the presence and importance of pain catastrophizing among men diagnosed with chronic abacterial

prostatitis/chronic pelvic pain syndrome (CP/CPPS) in a routine clinical setting. Material and methods. 61 men, mean age 46 +/- 11 years, with a mean CP/CPPS history of 11 +/- 11 years, completed the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), Short-Form McGill Pain Questionnaire (SF-MPQ) and Coping Strategies Questionnaire (CSQ) selleck products to evaluate pain catastrophizing, and the International Index of Erectile Function (IIEF-5). They were also scored according to the UPOINT system. Results. The patients’ mean scores were: IEEF-5 17.6 +/- 7.3, NIH-CPSI pain subscale 11.1 +/- 4.4, quality of life question 2.7 +/- 1.6, quality of life impact subscale 6.9 +/- 2.7 and CSQ catastrophizing score 15.3 +/- 9.1. Patients with a high tendency for catastrophizing (CSQ score >= 20) (28%) had higher UPOINT and pain scores, worse quality of life and quality of life impact, but did not stand out regarding voiding dysfunction and ejaculatory pain. Conclusions.

After 14 days, rhizosphere and leaf samples were analysed Salix

After 14 days, rhizosphere and leaf samples were analysed. Salix plants were able to release relatively high amounts of low molecular weight organic acids (LMWOAs) in a short period of time. The total amount of LMWOAs increased with increasing Cu concentrations. Oxalic and acetic find more acids were dominant, and act as complexing agents for Cu ions, and therefore, organic exudates should be taken into account in phytoextraction of polluted areas. The Ca/Mg ratio of the medium significantly influenced not only concentration,

but also the composition of LMWOAs. Phenolics content in leaves increased with the excess of Ca and Mg and with Cu level in the medium for all Ca/Mg ratios. The accumulation of glucose, fructose and sucrose in leaves was observed for deficiency and excess of Ca and/or Mg and Cu treatment at all Ca/Mg ratios. Excess calcium (Ca/Mg = 20:1) led to strong induction of salicylic acid biosynthesis, probably resulting from enhanced oxidative stress.”
“In telomerase negative yeast cells, Rad52-dependent recombination is activated to maintain telomeres. This recombination-mediated telomere elongation usually involves two independent pathways, type I and type II, and leads to generation of type I and type II survivors. It remains elusive whether the recombination-mediated telomere elongation selleck screening library prefers to take

place on shorter or longer telomeres. In this study, we exploited the de novo telomere addition system to examine the telomere recombination event in telomerase negative cells. We show that recombination preferentially occurs on shorter rather than longer telomeres in both pre-survivors and established type II survivors. In type II survivors, the short VII-L telomeres could invade either terminal TG(1-3) sequence or short tracts of TG(1-3) sequence in subtelomeric Y’-X and Y’-Y’ junction to initiate recombination. Unexpectedly,

short VII-L telomere recombination still takes place ML323 supplier in type II survivors lacking either Rad50 or Rad59, which are required for type II survivor generation in senescing telomerase-null cells. Our results support the notion that Rad50 and Rad59 are not essential for the maintenance of type II survivors once established.”
“Although many studies on the immune response following burn injuries have been reported, more attention has been given to the immunosuppression mechanism and mediators that shape the process of immune suppression. Specifically, information is not available concerning the immunomodulatory effects of the drugs which are involved in the immune response restoration. In this study, we investigated the effects of Cimetidine on the modulation of immune response in patients with burn injury of 20-60%. Two groups of patients were involved in this study; the patients in one group were treated with 15 mg/kg per day of Cimetidine while the patients in the other group were treated with placebo.

The cluster

solution was analysed using defined food grou

The cluster

solution was analysed using defined food groups in serves and with respect to clinical parameters and requirements for selected nutrients.\n\nRESULTS: Ulixertinib Two distinct dietary patterns were identified from the reported baseline dietary intakes. Subjects in Cluster 1 reported food patterns characterised by higher intakes of low-fat dairy and unsaturated oils and margarine and were generally more closely aligned to food choices encouraged in national dietary guidelines. Subjects in Cluster 2 reported a dietary pattern characterised by non-core foods and drinks, higher-and medium-fat dairy foods, fatty meats and alcohol. At 3 months, Cluster 2 subjects reported greater reductions in energy intake (-5317 kJ; P<0.001) and greater weight loss (-5.6 kg; P<0.05) compared with Cluster 1.\n\nCONCLUSIONS: Overweight subjects with reported dietary patterns similar to dietary guidelines at baseline may have more difficulty in reducing energy intake than those with poor dietary patterns. Correcting exposure to non-core foods and drinks was key to successful weight loss. European Journal of Clinical Nutrition (2013) 67, 330-336; doi:10.1038/ejcn.2013.26; published online selleck chemicals llc 13 February 2013″
“Background: The prevalence of obsessive-compulsive

symptoms (OCS) in patients with schizophrenia is relatively high. Antipsychotics have been found to influence OCS.\n\nObjective: To determine whether induction or severity of OCS differs during treatment with olanzapine or risperidone in young patients with early psychosis.\n\nMethods: One hundred twenty-two patients with a Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder were randomized in a double-blind design to groups of 6 weeks’ treatment with olanzapine (n = 59) or GS-7977 solubility dmso risperidone (n = 63), with a mean dose of 11.3 mg olanzapine and 3.0 mg risperidone at 6 weeks. Primary outcome measures were the mean baseline-to-end point change in total score on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).\n\nResults:

Treatment with olanzapine was associated with greater decreases in Y-BOCS total score than treatment with risperidone in total group (N = 122: -2.2 vs -0.3, z = -2.651, P < 0.01), in patients with baseline Y-BOCS total score greater than 0 (n = 58: -5.1 vs -0.4, z = -2.717, P < 0.01), and in patients with baseline Y-BOCS total score greater than 10 (n = 29: -7.1 vs -0.6, z = -2.138, P = 0.032).\n\nConclusions: In this randomized, 6-week, double-blind trial, we found a significant and clinically relevant difference in decrease in Y-BOCS scores favoring olanzapine compared with risperidone.”
“The aim of this study was to prove the concept of using a long intravenous half-life blood-pool T1 contrast agent as a new functional imaging method.

During follow-up, all events occurring between two visits, in par

During follow-up, all events occurring between two visits, in particular hospital admissions or nursing home placements were carefully recorded. Results: Annual incidences for hospitalizations were 26.2% (95% CI, 22.5 to 29.7). After two years, 202 subjects were hospitalized for 296 hospitalizations. 139 subjects were hospitalized once, 40 twice, 13 three times, 4 four times and 2 five CX-6258 in vitro times during the two-year follow-up. The

duration of hospitalization was 14.3 +/- 23.5 days. For repeated hospitalizations, the time interval between the first and the second hospitalization was 176.4 days (SD 150.2) and the cause of multiple hospitalizations was most different. Fractures and falls not causing fracture were the main reasons for hospital admission (20.9%), followed by MLN8237 datasheet cardiovascular disorders (14.5%) and by behavioural disorders (11.0%). Admission due to associated diseases or life events was the main reason for hospitalization (75.7%). Conclusions: Hospitalization is a frequent event for AD patients even at mild to moderate stage of the disease. In this cohort, the major causes for hospital admission were due to associated

diseases or life events and not due to the direct consequences of the disease itself.”
“Retained placenta is one of the most common peripartum complications in mares. It delays the recovery of the uterus, decreases fertility, and can be life-threatening. The mechanism of normal placenta release is unknown. In addition to systemic hormonal changes affecting the process of placenta separation, it is supposed that local mechanisms at the cellular level may play an important role in this process. It is known that the incidence of retained placenta correlates with reduced

expression of classic class I major histocompatibility complex protein (classic MHC I) in cows’ placentas. In mares, classic MHC I is expressed in early pregnancy, but it is unknown if classic MHC I is expressed again I-BET-762 concentration in peripartum and if reduced expression correlates with retained placenta in mares. Both early and late expression seem likely, because early expression would prepare mares to reject placenta tissues if MHC is expressed peripartum. This article discusses how MHC I is expressed in placental tissues; how it affects lymphocyte migration, metalloproteinase activation, and extra-cellular matrix remodelling in those tissues; and how various factors can affect MHC I activation. The paper also describes a hypothesis for the mechanism of placenta separation in mares based on the similarity of these processes in other species that have been more extensively studied.”
“There is no published literature detailing the demographics of paediatric amputations in the United Kingdom. We performed this review of children and adolescents referred to a regional limb-fitting centre from the 1930s to the current decade who suffered amputation as a result of trauma, and compared our data with similar cohorts from other units.

Reducing serum homocysteine levels can reduce the risk of CVD whi

Reducing serum homocysteine levels can reduce the risk of CVD which can be achieved by increasing the consumption of

folic acid. Thus high risk subjects need nutrition education to control these risk factors for the prevention of this major disease.”
“Aromatic amino acids function as building blocks of proteins and as precursors for secondary metabolism. To obtain plants that accumulate tryptophan (Trp) and phenylalanine (Phe), we modified the biosynthetic pathways for these buy Nocodazole amino acids in rice and dicot species. By introducing a gene encoding a feedback-insensitive anthranilate synthase (AS) alpha subunit, we successfully obtained transgenic plants that over-accumulated Trp. In addition, we found mutant calli that accumulated Phe and Trp at high concentrations. The causal gene (mtr1-D) encoded an arogenate dehydratase (ADT)/prephenate dehydratase (PDT) that catalyzes the final reaction in Phe biosynthesis. The wild-type enzyme was sensitive to feedback inhibition by Phe, but the mutant enzyme encoded by mtr1-D was relatively insensitive. Further, detailed analysis of downstream secondary metabolism from Trp in rice revealed that the Trp pathway, by producing serotonin,

is involved in the find more defense response against pathogenic infection. Based on these findings we propose that the reactions catalyzed by AS and ADT are critical regulatory points in the biosynthesis of Trp and Phe, respectively. In addition, detailed characterization of transgenic lines that accumulate these aromatic amino acids provided new insights into the regulation of downstream secondary metabolism, translocation of aromatic amino acids, and effects of accumulation of aromatic amino acids on various agronomic traits.”
“Antipsychotic (AP) treatment-emergent extrapyramidal symptoms (EPS)

are acute adverse reactions of APs. The aim of the present study is to analyze gene-gene interactions in nine genes BVD-523 related to the mTOR pathway, in order to develop genetic predictors of the appearance of EPS. 243 subjects (78 presenting EPS: 165 not) from three cohorts participated in the present study: Cohort 1, patients treated with risperidone, (n=114); Cohort 2, patients treated with APs other than risperidone (n=102); Cohort 3, AP-naive patients with first-episode psychosis treated with risperidone, paliperidone or amisulpride, n=27. We analyzed gene-gene interactions by multifactor dimensionality reduction assay (MDR). In Cohort 1, we identified a four-way interaction, including the rs1130214 (AKT1), rs456998 (FCHSD1), rs7211818 (Raptor) and rs1053639 (DDIT4), that correctly predicted 97 of the 114 patients (85% accuracy). We validated the predictive power of the four-way interaction in Cohort 2 and in Cohort 3 with 86% and 88% accuracy respectively. We develop and validate a powerful pharmacogenetic predictor of AP-induced EPS.

They are generally expressed as recombinant proteins in bacteria,

They are generally expressed as recombinant proteins in bacteria, yeast, plant and/or animal cells in culture. Growth media are increasingly supplemented with peptones to improve Selleck AZD1390 either the cell growth or protein expression or both. To further enhance protein production, it is important to understand the effects of peptones at the cellular and molecular levels. Upon addition of a soy peptone to a cultivation medium of CHO cells,

an increased specific productivity was observed. This work aimed at elucidating which main cellular functions are affected by the presence of the peptone. Therefore, hypotheses about putative effects on recombinant protein production steps have been postulated and tested. Although the effects emerge to be multiple, it was found that the peptone increased overall protein translation and recombinant protein secretion. Nonetheless, when other cellular functions (e.g. transcription, glycosylation, proteolytic degradation) were examined, no specific effects were observed. Further experiments are needed to probe the mechanisms related to the influence of the soy peptone on these cellular functions. (C) 2011 Elsevier Ltd. All rights reserved.”
“Motivation: In early drug development, it would be beneficial to be able to identify those dynamic patterns of gene response that indicate that drugs targeting a particular https://www.selleckchem.com/epigenetic-reader-domain.html gene

will be likely or not to elicit the desired response. One approach would be to quantitate the degree of similarity between the responses that cells show when exposed to drugs, so that consistencies in the regulation of cellular response processes that produce success or failure can be more readily identified.\n\nResults: We track drug response using fluorescent proteins as transcription activity reporters. Our basic assumption is that drugs inducing very similar alteration in transcriptional regulation will produce similar temporal trajectories JNK-IN-8 on many of the

reporter proteins and hence be identified as having similarities in their mechanisms of action (MOA). The main body of this work is devoted to characterizing similarity in temporal trajectories/signals. To do so, we must first identify the key points that determine mechanistic similarity between two drug responses. Directly comparing points on the two signals is unrealistic, as it cannot handle delays and speed variations on the time axis. Hence, to capture the similarities between reporter responses, we develop an alignment algorithm that is robust to noise, time delays and is able to find all the contiguous parts of signals centered about a core alignment (reflecting a core mechanism in drug response). Applying the proposed algorithm to a range of real drug experiments shows that the result agrees well with the prior drug MOA knowledge.”
“Chemolithotrophy is a pervasive metabolic lifestyle for microorganisms in the dark ocean.

Results showed that the addition of B animalis decreased the pH

Results showed that the addition of B. animalis decreased the pH (p smaller than 0.05), but it had no effect on physicochemical properties, including overrun and melting behavior of ice cream from goat’s milk (p bigger than 0.05). After 120 days of frozen storage, a survival rate of 84.7% was registered. With regard to cell viability during gastrointestinal conditions, the exposure to bile and pancreatin resulted

in the decline of 3.82 log cycles in ice cream samples previously stored at -18 degrees C for 120 days. Overall, the goat’s milk ice cream with B. animalis received good sensory scores and satisfactory probiotic viability (6-7 log CFU/g) was maintained throughout the 120 days of frozen storage. Therefore, this research shows that goat’s milk ice cream is an adequate

delivery vehicle for the probiotic bacteria B. animalis. (C) 2014 Elsevier Ltd. All rights reserved.”
“Di-aryl nucleoside Vorinostat phosphotriesters have been explored as a new type of pronucleotides for the purpose of anti-HIV-1 therapy and efficient synthetic protocols, based on H-phosphonate chemistry, have been developed for the preparation of this class of compounds. It was found that anti-HIV-1 activity of the phosphotriesters bearing an antiviral nucleoside moiety (AZT, ddA) and also ddU was due, Selleck Bcl-2 inhibitor at least partially, to intracellular conversion into the corresponding nucleoside 5′-monophosphates, and their efficiency correlated well with the pK(a) values of the aryloxy groups present. (C) 2009 Elsevier Ltd. All rights reserved.”
“Expression of apoptosis-related proteins on tumour cells has been shown in several experimental models to be an efficient mechanism for a counterattack against host anti-tumour immune responses in solid tumours. Here we provide a clinical evidence for such a tumour immune escape mechanism by demonstrating tumour to T cell-directed death receptor signalling (TRAIL/TRAIL-Receptor (TRAIL-R)) in colorectal cancer (CRC). In a series of patients with CRC and completed 5-year follow up, we investigated apoptosis and expression Selleck Vactosertib levels of apoptosis-related proteins. Gene and protein profiles in

the tumours demonstrated intratumoural upregulated gene expression for Fas, Fas-L, TRAIL, TRAIL-R and TNF-alpha (RT-qPCR). Levels of terminaldeoxynucleotidyl transferase-mediated deoxyuridinetriphosphate nick-end labelling (TUNEL)-positive events were positively correlated with TRAIL-R1-expression on tumour infiltrating immune cells. Among the immune cells, preferentially CD8+ T cells were found to express TRAIL-R1 while serial immunostaining in the same patient tumours showed abundant apoptotic (TUNEL-positive) immune cells. In conclusion, our results in tumour samples from CRC patients suggest TRAIL-R1-mediated apoptotic depletion of infiltrating immune cells (CD8+) in response to TRAIL expression by the tumour itself.

Redox proteomics allows the identification of specific targets of

Redox proteomics allows the identification of specific targets of protein oxidation in

a biological sample. Using proteomic techniques, apolipoprotein A-I (ApoA-I) has been found at decreased levels in subjects with a variety of neurodegenerative disorders including in the serum and cerebrospinal fluid (CSF) of Alzheimer disease (AD), Parkinson disease (PD), and Down syndrome (DS) with gout subjects. ApoA-I plays roles in cholesterol transport and regulation of inflammation. Redox proteomics further showed ApoA-I to be highly oxidatively modified and particularly susceptible to modification by 4-hydroxy-2-trans-nonenal (HNE), a lipid peroxidation product. In the current review, we discuss the consequences of oxidation of ApoA-I in terms of neurodegeneration. ROS-associated chemotherapy related ApoA-I oxidation leads to elevation

CP 456773 of peripheral levels of tumor necrosis factor-a (TNF-a) that can cross the blood-brain barrier (BBB) causing a signaling cascade that can contribute to neuronal death, likely a contributor to what patients refer to as chemobrain. Current evidence suggests ApoA-I to be a promising diagnostic PRIMA-1MET concentration marker as well as a potential target for therapeutic strategies in these neurodegenerative disorders.”
“Background: This study was conducted to identify administrative wards (lots) with unacceptable levels of full child immunisation coverage, and to identify factors associated with achievement of a complete child immunisation schedule in Ibadan North East (IBNE) and Ido local government areas (LGAs) of Oyo State, Nigeria.\n\nMethods: A cross-sectional survey involving 1178 mothers, 588 from IBNE LGAs and 590 from Ido LGAs, with children 12-23 months of age was conducted. Children were considered ‘fully-immunised’ if they received all

the vaccines included in the immunisation schedule. Lot quality assurance sampling was used to determine lots with acceptable and non-acceptable coverage. Samples were weighted based on the population by lot to estimate overall coverage in the two Trichostatin A solubility dmso LGAs and a logistic regression model was used to identify factors associated with the fully immunised child.\n\nResults: Mean age of the mothers was 28.5+/-5.6 and 28.1+/-6.0 years in IBNE and Ido LGAs, respectively. Eleven of 12 wards in IBNE and all the wards in Ido had unacceptable coverage. The proportion of fully immunised children was 40.2% in IBNE and 41.3% in Ido. Maternal age >= 30 years, retention of an immunisation card, completion of tertiary education, or secondary education, hospital birth and first-order birth were significant predictors of complete childhood immunisation.\n\nConclusion: The level of full immunisation coverage was unacceptable in almost all the wards.

For applications with a moderate number of variables, resampling-

For applications with a moderate number of variables, resampling-based techniques have been developed for diagnosing and improving multivariable regression models. Deriving models for high-dimensional molecular data has led to the need for adapting these techniques to settings where the number of variables is much larger than the number of observations. Three studies with a time-to-event outcome, of which one has high-dimensional data, are used to illustrate several techniques.

Investigations at the covariate level and at the predictor level are seen to provide considerable insight into model stability Captisol nmr and performance. While some areas are indicated where resampling techniques for model building still need further refinement,

our case studies illustrate that these techniques can already be recommended for wider use.”
“Study Design: Retrospective review of consecutive case series.\n\nObjective: To assess the safety and efficacy of the microendoscopic approach for treatment of recurrent lumbar disc herniation.\n\nSummary of Background Data: The standard surgical approach for the treatment of recurrent disc herniation uses an open technique with a wide exposure. Many would consider a minimally invasive approach such as microendoscopic discectomy (MED) to be contraindicated in the setting of recurrent disc herniation.\n\nMethods: Sixteen consecutive patients with recurrent lumbar disc herniation who PF-02341066 supplier failed conservative management underwent MED. Before surgery and at follow-up, patients completed the Oswestry Disability Index, SF-36, and assessment of leg pain using the Visual Analog Scale. Outcome was also assessed using modified McNab criteria.\n\nResults: No case required conversion to an open procedure. Mean operative time was 108 minutes, and mean estimated blood loss was 32 mL. The only surgical complications were 2 durotomies that were treated with dural sealant without sequelae. Mean hospital BIIB057 price stay was 23 hours, and mean follow-up was 14.7 months. Approximately 80% of patients had good or excellent outcomes based

on modified McNab criteria. The remaining 3 patients had fair outcomes, and no patient had a poor outcome. All standardized measures improved significantly, including mean Visual Analog Scale for leg pain (8.2 to 2.2, P < 0.001), mean Oswestry Disability Index (59.3 to 26.7, P < 0.001), SF-36 Physical Component Summary score (28.3 to 42.4, P < 0.001), and SF-36 Mental Component Summary score (38.2 to 48.3, P < 0.001). As of last follow-up no patient has showed recurrence of herniation or evidence of delayed instability.\n\nConclusions: MED is a safe and effective surgical approach for the treatment of recurrent lumbar disc herniation. Standardized measures of outcome show that MED for recurrent herniation produces improvement in pain, disability, and functional health that is at least comparable with outcomes reported for conventional open microdiscectomy.