Experience with resorbable sonic pins for the attachment of distraction devices in posterior cranial vault distraction operations.

BACKGROUND: Distraction techniques are effective methods for the treatment of craniosynostoses when a significant gain of an intracranial volume is required. However, this technique raises some challenges at different stages of the treatment. While installing the distractors in patients with thin calvarial bone, there is a risk of dural damage from the titanium screws. The need for wide exposure of the devices and the screws during removal causes soft tissue damage and bleeding. OBJECTIVE: This study aimed to evaluate sonic pin use in the distraction procedures. METHODS: Resorbable sonic pins were used in 11 consecutive posterior cranial vault distraction procedures to attach distraction devices to the calvarial bone. RESULTS: This method allowed for a less traumatic and faster removal of the devices without the risk of leaving foreign bodies in the wound. In three out of 11 cases on follow-up, displacement of proximal distractor footplate and partial relapse of distraction were detected. Though there was a smaller volume increase in these patients, all of them benefited clinically from the PCVD and did not require reoperations. CONCLUSIONS: This method allows a strong and stable attachment of the distractor devices to the cranial vault bones with a reduced risk of dural tears due to the screws. It also allows for easier and less traumatic device removal.

Introduction of spring-assisted cranioplasty for scaphocephaly in Russia: first cases evaluated using detailed craniometry and principal component analysis.

Spring-assisted cranioplasty (SAC) was recently introduced in Moscow. This study provides a detailed analysis of the results of the first 14 SAC cases in Russia. The patients underwent a computed tomography scan before surgery and prior to spring removal 3 months later. Fourteen cases (10 males and 4 females) were operated on, with a mean surgery time of 56 ± 14 min. All operations were uneventful, with a mean hospital stay of 4.2 days. Detailed craniometry of the 10 male patients and their matched controls revealed that SAC induced changes in the shape of the entire skull. The cranial index of the male patients increased from 68.2 to 72.3, whereas it remained stable at ∼80 for the controls. The anterior and middle skull heights were significantly larger in cases as compared with controls but shifted toward normal levels following SAC. Additionally, SAC increased parietal bone curvature, and principal component analysis showed that post-SAC morphological changes in patients were comparable to normal growth changes in the skull morphology of the controls. However, several months after the operation, patients continued to display a clearly distinct cranial morphology as compared with that of controls. These results indicated that SAC is a safe technique that showed good surgical results immediately after introduction.

Novel mitochondria-targeted antioxidants: plastoquinone conjugated with cationic plant alkaloids berberine and palmatine.

PURPOSE: To develop effective mitochondria-targeted antioxidants composed entirely of natural constituents. METHODS: Novel mitochondria-targeted antioxidants were synthesized containing plant electron carrier and antioxidant plastoquinone conjugated by nonyloxycarbonylmethyl residue with berberine or palmatine, penetrating cations of plant origin. These compounds, SkQBerb and SkQPalm, were tested in model planar phospholipid membranes and micelles, liposomes, isolated mitochondria and living cells. RESULTS: SkQBerb and SkQPalm penetrated across planar bilayer phospholipid membrane in their cationic forms and accumulated in mitochondria isolated or in living human cells in culture. Reduced forms of SkQBerb and SkQPalm as well as C10Berb and C10Palm (SkQBerb and SkQPalm analogs lacking plastoquinol moiety) revealed radical scavenging activity in lipid micelles and liposomes, while oxidized forms were inactive. In isolated mitochondria and in living cells, berberine and palmatine moieties were not reduced, so antioxidant activity of C10Berb and C10Palm was not detected. SkQBerb and SkQPalm inhibited lipid peroxidation in isolated mitochondria at nanomolar concentrations; their prooxidant effect was observed at 1,000 times higher concentrations. In human cell cuture, nanomolar SkQBerb and SkQPalm prevented fragmentation of mitochondria and apoptosis induced by exogenous hydrogen peroxide. CONCLUSION: This is the first successful attempt to construct mitochondria-targeted antioxidants composed entirely of natural components, namely plastoquinone, nonyl, acetyl and berberine or palmatine residues.

Advanced craniofacial juvenile nasopharyngeal angiofibroma. Description of surgical series, case report, and review of literature.

BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor occurring almost exclusively in adolescent and young adult males. The tumor is characterized by slow progression, aggressive growth, high vascularization, and increased rate of persistence and recurrence. The aim of this study was to describe a case of giant JNA from our practice and discuss the controversies of surgical treatment of advanced JNA. MATERIAL AND METHODS: A series of 29 consecutive male patients with JNA Fisch grade III and IV was surgically treated in Burdenko Neurosurgical Institute from 2000 until 2008. In the vast majority of cases, endovascular embolization and surgical removal via orbitozygomatic approach were applied. RESULTS: Gross total resection was achieved in 24 cases (83%). Complications were encountered in eight cases. No mortality was observed. In three patients, the diseases recurred. An illustrative case is described. CONCLUSION: Surgical treatment is the basic tactics in management of extensive JNA including endovascular embolization and resection of the tumor. We recommend using orbitozygomatic approach or its modifications in JNA. Radiation therapy may be recommended for patients with small residual tumor.

Prevention of cardiolipin oxidation and fatty acid cycling as two antioxidant mechanisms of cationic derivatives of plastoquinone (SkQs).

The present state of the art in studies on the mechanisms of antioxidant activities of mitochondria-targeted cationic plastoquinone derivatives (SkQs) is reviewed. Our experiments showed that these compounds can operate as antioxidants in two quite different ways, i.e. (i) by preventing peroxidation of cardiolipin [Antonenko et al., Biochemistry (Moscow) 73 (2008) 1273-1287] and (ii) by fatty acid cycling resulting in mild uncoupling that inhibits the formation of reactive oxygen species (ROS) in mitochondrial State 4 [Severin et al. Proc. Natl. Acad. Sci. USA 107 (2009), 663-668]. The quinol and cationic moieties of SkQ are involved in cases (i) and (ii), respectively. In case (i) SkQH2 interrupts propagation of chain reactions involved in peroxidation of unsaturated fatty acid residues in cardiolipin, the formed SkQ- being reduced back to SkQH2 by heme bH of complex III in an antimycin-sensitive way. Molecular dynamics simulation showed that there are two stable conformations of SkQ1 with the quinol residue localized near peroxyl radicals at C9 or C13 of the linoleate residue in cardiolipin. In mechanism (ii), fatty acid cycling mediated by the cationic SkQ moiety is involved. It consists of (a) transmembrane movement of the fatty acid anion/SkQ cation pair and (b) back flows of free SkQ cation and protonated fatty acid. The cycling results in a protonophorous effect that was demonstrated in planar phospholipid membranes and liposomes. In mitochondria, the cycling gives rise to mild uncoupling, thereby decreasing membrane potential and ROS generation coupled to reverse electron transport in the respiratory chain. In yeast cells, dodecyltriphenylphosphonium (capital ES, Cyrillic12TPP), the cationic part of SkQ1, induces uncoupling that is mitochondria-targeted since capital ES, Cyrillic12TPP is specifically accumulated in mitochondria and increases the H+ conductance of their inner membrane. The conductance of the outer cell membrane is not affected by capital ES, Cyrillic12TPP.

Oxidizability of cardiac cardiolipin in Triton X-100 micelles as determined by using a Clark electrode.

The kinetics of the chain free-radical oxidation of cardiolipin (CL), a unique phospholipid containing four linoleate moieties, have been studied for the first time. The technique based on monitoring oxygen consumption by using a Clark electrode was applied to determine the oxidizability of CL during its initiated oxidation in aqueous Triton X-100 micelles in 50mM phosphate buffer, pH 7.40, at 37 degrees C. The oxidizability was characterized by the k(2)/(sqrt[2k(3)]) ratio, where k(2) and k(3) are the rate constants for the reaction of chain propagation (LO(2)+LH-->LOOH+L) and chain termination (2LO(2)-->products), correspondingly. The oxidizability of CL (in M(-0.5)s(-0.5)) was found to be of 0.62+/-0.07 (calculated on the basis of a single linoleate fragment) that is twice as much than the oxidizability of methyl linoleate (0.32+/-0.04) determined in the same testing systems. It has been shown that the increase in k(2)/(sqrt[2k(3)]) by a factor of two when going from the oxidation of ML to that of CL is almost completely determined by the increase in k(2).

An attempt to prevent senescence: a mitochondrial approach.

Antioxidants specifically addressed to mitochondria have been studied to determine if they can decelerate senescence of organisms. For this purpose, a project has been established with participation of several research groups from Russia and some other countries. This paper summarizes the first results of the project. A new type of compounds (SkQs) comprising plastoquinone (an antioxidant moiety), a penetrating cation, and a decane or pentane linker has been synthesized. Using planar bilayer phospholipid membrane (BLM), we selected SkQ derivatives with the highest permeability, namely plastoquinonyl-decyl-triphenylphosphonium (SkQ1), plastoquinonyl-decyl-rhodamine 19 (SkQR1), and methylplastoquinonyldecyltriphenylphosphonium (SkQ3). Anti- and prooxidant properties of these substances and also of ubiquinonyl-decyl-triphenylphosphonium (MitoQ) were tested in aqueous solution, detergent micelles, liposomes, BLM, isolated mitochondria, and cell cultures. In mitochondria, micromolar cationic quinone derivatives were found to be prooxidants, but at lower (sub-micromolar) concentrations they displayed antioxidant activity that decreases in the series SkQ1=SkQR1>SkQ3>MitoQ. SkQ1 was reduced by mitochondrial respiratory chain, i.e. it is a rechargeable antioxidant. Nanomolar SkQ1 specifically prevented oxidation of mitochondrial cardiolipin. In cell cultures, SkQR1, a fluorescent SkQ derivative, stained only one type of organelles, namely mitochondria. Extremely low concentrations of SkQ1 or SkQR1 arrested H(2)O(2)-induced apoptosis in human fibroblasts and HeLa cells. Higher concentrations of SkQ are required to block necrosis initiated by reactive oxygen species (ROS). In the fungus Podospora anserina, the crustacean Ceriodaphnia affinis, Drosophila, and mice, SkQ1 prolonged lifespan, being especially effective at early and middle stages of aging. In mammals, the effect of SkQs on aging was accompanied by inhibition of development of such age-related diseases and traits as cataract, retinopathy, glaucoma, balding, canities, osteoporosis, involution of the thymus, hypothermia, torpor, peroxidation of lipids and proteins, etc. SkQ1 manifested a strong therapeutic action on some already pronounced retinopathies, in particular, congenital retinal dysplasia. With drops containing 250 nM SkQ1, vision was restored to 67 of 89 animals (dogs, cats, and horses) that became blind because of a retinopathy. Instillation of SkQ1-containing drops prevented the loss of sight in rabbits with experimental uveitis and restored vision to animals that had already become blind. A favorable effect of the same drops was also achieved in experimental glaucoma in rabbits. Moreover, the SkQ1 pretreatment of rats significantly decreased the H(2)O(2) or ischemia-induced arrhythmia of the isolated heart. SkQs strongly reduced the damaged area in myocardial infarction or stroke and prevented the death of animals from kidney ischemia. In p53(-/-) mice, 5 nmol/kgxday SkQ1 decreased the ROS level in the spleen and inhibited appearance of lymphomas to the same degree as million-fold higher concentration of conventional antioxidant NAC. Thus, SkQs look promising as potential tools for treatment of senescence and age-related diseases.

Chain-breaking antioxidant activity of reduced forms of mitochondria-targeted quinones, a novel type of geroprotectors.

The chain-breaking antioxidant activities of reduced form of novel type of geroprotectors, mitochondria-targeted quinones (QH(2)) have quantitatively been measured for the first time. To this end, the chain peroxidation of methyl linoleate (ML) in Triton micelles was used as a kinetic testing model. The studied QH(2) were lipophilic triphenylphosphonium cations conjugated by an aliphatic linker to an antioxidant, i.e. a ubiquinol moiety (MitoQH(2)) or plastoquinol moiety (SkQH(2)). The antioxidant activity was characterized by the rate constant k(1) for the reaction between QH(2) and the lipid peroxyl radical (LO(2) (.)) originated from ML: QH(2) + LO(2) (.) --> HQ(.) + LOOH. All the tested QH(2) displayed a pronounced antioxidant activity. The oxidized forms of the same compounds did not inhibit ML peroxidation. The value of k(1) for SkQH(2) far exceeded k(1) for MitoQH(2). For the biologically active geroprotectors SkQ1H(2), the k(1) value found to be as high as 2.2 x 10(5) M(-) (1)s(-) (1), whereas for MitoQH(2), it was 0.58 x 10(5) M(-) (1)s(-) (1). The kinetic behavior of QH(2) suggested that SkQ1H(2) can rather easily diffuse through lipid-water microheterogeneous systems.

Efficacy of metmyoglobin and hemin as a catalyst of lipid peroxidation determined by using a new testing system.

A new quantitative approach to investigate the capability of iron heme complexes (HEM), metmyoglobin and hemin, to catalyze lipid peroxidation was elaborated. The oxidation of methyl linoleate in micellar solutions was used as a testing model. The key point was the determination of the rate of free radical generation, RIN, calculated from the rate of oxygen consumption. The HEM catalytic activity was characterized by two independent parameters: by reactivity and by its resistance to degradation. Both parameters were found to be pH-dependent. The reactivity was expressed as the effective rate constant for the reaction of HEM with lipid hydroperoxide. The resistance to degradation was characterized by the rate of the decrease in RIN with time and also by the regeneration coefficient, which shows how many active free radicals can be generated by one molecule of HEM. Both Hemin and metMB were found to be very effective catalysts even at nanomolar concentrations. The effective regeneration of active forms of HEM was observed. The catalytic activity of HEM was rapidly reduced with time. The kinetic scheme of the process under consideration was suggested, and this was applied for kinetic computer simulations.

Oxidation of tea extracts and tea catechins by molecular oxygen.

Tea polyphenols (PP) are known as potent antioxidants. At the same time, PP have been repeatedly reported to oxidize by molecular oxygen with the formation of active forms of oxygen. In this work, the Clark electrode technique was applied to study the kinetics of the autoxidation of tea extracts and individual tea PP as well as model PP, catechol, gallic acid, and pyrogallol. Aqueous extracts of both green and black teas were found to undergo extensive autoxidation under physiological conditions. The addition of superoxide dismutase (SOD) and milk resulted in a significant decrease in the rate of oxidation. Studied individually, PP were found to autoxidize at a rate, which increased with pH, proportional to PP concentration and nearly proportional to oxygen concentration. The collected data were used for the extrapolation/interpolation of the starting rates of oxidation to the standard conditions (at pH 7.40, 100 microM PP, 200 microM O2). PP oxidizability is basically determined by that of the key PP fragment (pyrogallol > gallate > catechol). Meta-OH groups do not contribute to the oxidation even at pH 13.0. Similar to tea brew, the oxidation of individual PP was inhibited by milk and SOD addition, with catechol being the only exception (the oxidation of catechol was accelerated when SOD was added). Comparison of the autoxidation of PP (o-hydroquinones) with that of p-hydroquinones (Roginsky, V.; Barsukova, T. K. J. Chem. Soc., Perkin Trans. 2 2000, 1575-1582) displays the dramatic difference both in the oxidizability and in the kinetic regularities. The difference in the kinetics has been suggested to be due to the difference in the initiation of the chain process. Whereas for p-hydroquinones the oxidation is initiated by the reaction between hydroquinone and a corresponding quinone, the oxidation of o-hydroquinones is likely started by direct interaction between substrate and molecular oxygen. As the second process is much slower, this may explain the relatively low oxidizability of PP as compared to p-hydroquinones.

Substituted p-hydroquinones as inhibitors of lipid peroxidation.

The technique based on monitoring oxygen consumption was applied to study 12 alkyl- and methoxy-substituted p-hydroquinones (QH(2)) as a chain-breaking antioxidant during the oxidation of styrene and methyl linoleate (ML) in bulk as well as ML oxidation in micellar solution of sodium dodecyl sulfate (SDS) at 37 degrees C. The antioxidant activities of QH(2) were characterized by two parameters: the rate constant k(1) for reaction of QH(2) with the peroxy radical LO(2)*: QH(2)+LO(2)*-->QH*+LOOH and the stoichiometric factor of inhibition, f, which shows how many kinetic chains may be terminated by one molecule of QH(2). In the case of styrene and ML oxidation in bulk, f values never exceed two; for the majority of QH(2), f was found to be significantly less than two due to the interaction of QH* with molecular oxygen. In the absence of superoxide dismutase (SOD), all the studied QH(2) displayed a very moderate if any antioxidant capability during ML oxidation in SDS micelles. When 20U/ml SOD was added, the majority of QH(2) showed a pronounced ability to inhibit ML oxidation, f parameter being ca. one. The features of QH(2) as an antioxidant in aqueous environment are suggested to associate with the reactivity of semiquinone (Q*(-)). Q*(-) reacts readily with molecular oxygen with formation of superoxide (O(2)*(-)); further reactions of O(2)*(-) result in fast depleting QH(2) and chain propagation. The addition of SOD results in purging a reaction mixture from O(2)*(-) and, as a corollary, in depressing undesirable reactions with the participation of O(2)*(-). With all the oxidation models, QH(2) were found to be very reactive to LO(2)*. The rate constants k(1) decreased progressively when going from the oxidation of styrene to ML oxidation in bulk and further to ML oxidation in SDS micelles.

Chain-breaking antioxidant activity and cyclic voltammetry characterization of polyphenols in a range of green, oolong, and black teas.

A series of eight green, eight oolong, and 17 black teas have been analyzed for polyphenol content by absorbance at 272 nm and cyclic voltammetry response at an inert carbon electrode, a new method developed to provide a rapid measure of easily oxidizable polyphenols in beverages. The chain-breaking antioxidant activity of the teas has also been determined during the chain oxidation of methyl linoleate in a pH 7.4 micellar solution, for which realistic kinetic parameters have been derived. While higher mean values were obtained for green teas than for oolong and black teas, the differences were not large, and the spread of values within each type was considerable. The absorbance at 272 nm correlated well with the cyclic voltammetry response only for green teas and black teas taken on their own. The cyclic voltammetry measure and the antioxidant activity correlated well only for the green teas, where the polyphenol content is dominated by epigallocatechin gallate.

Chain-breaking antioxidant activity of natural polyphenols as determined during the chain oxidation of methyl linoleate in Triton X-100 micelles.

Natural polyphenols (PP) are known as potent antioxidants, which are believed to prevent many degenerative diseases, including cancer and atherosclerosis. Much attention in the literature has been given to the antioxidant activity of PP-containing products; however, information on the antioxidative properties of individual PP is rather poor and controversial. In this work, the chain-breaking antioxidant activities of several natural PP and their synthetic analogs were determined during the chain oxidation of methyl linoleate in an aqueous buffered, pH 7.40, micellar solution of Triton X-100, induced by 2,2'-azobis(2-amidinopropan) dihydrochloride at 37 degrees C. Use of the mode of the controlled chain reaction allowed separate determination of the rate constant for the reaction of PP with the lipid peroxy radical and the stoichiometric factor of inhibition (f), which shows how many kinetic chains can be terminated by one molecule of PP. All the PP studied display a pronounced antioxidant activity. A significant difference in f value between catechol derivatives and pyrogallol derivatives was found. While with pyrogallol derivatives (gallic acid, epigallocatechin, propyl gallate, myricetin), f was found to be around 2, the theoretically expected value, f, for catechol derivatives (catechol, catechin, epicatechin, quercetin, rutin, caffeic acid) was found to be within the range 3.6-6.3. The elevated antioxidant capacity of catechol derivatives may be explained by the contribution of products of PP oxidative transformation, most likely by dimers, to inhibition. With catechin, epicatechin, and quercetin, the reactivity of products exceeds that of original PP. A real chain-breaking antioxidant activity of PP is likely determined not so much by the reactivity of the original PP as by the probability of the formation of active products and their antioxidant activities. The above findings were applied to explain some features of the antioxidant activity of teas and red wines.

Chain-Breaking Antioxidant Capability of Some Beverages as Determined by the Clark Electrode Technique.

The protective effects of red wine, tea, and coffee on cancer, atheroclerosis, and other diseases are attributed to the antioxidant activity (AOA) of polyphenols, which are abundant in those beverages. We present a rational procedure for determining the total chain-breaking AOA of beverages with the use of the Clark electrode technique. The procedure is based on the steady monitoring of oxygen consumption accompanying the chain peroxidation of methyl linoleate in Triton X-100 aqueous micelles induced by 2,2'-azobis(2-amidinopropan) dihydrochloride as a source of active free radicals. AOA was characterized by the number of kinetic chains (expressed in concentration units) that could be terminated by a beverage. The procedure was applied to determine the AOA of nine red wines and single samples of green and black teas, white wine, beer, and soluble coffee. The addition of any of the studied beverages to the testing system resulted in pronounced retardation of methyl linoleate oxidation. The period of increase in the oxidation rate with time caused by antioxidant consumption was preceded by a period when the oxidation rate was visibly decreased with time (increase in inhibition). The release of polyphenols from their complexes with other components of beverages was suggested as the most probable mechanism of this event, which was observed for the first time in this study.