This polymorphism affects the secretion of NPY and causes multipl

This polymorphism affects the secretion of NPY and causes multiple physiological effects in humans. The sequence of NPY mRNA contains two in frame kozak sequences that allow translation click here initiation to shift, and translation of two proteins. In addition to mature NPY(1-36) also a putative truncated NPY(17-36) with mitochondrial targeting signal

is produced. The purpose of this study was to investigate the protein mobility of the putative mitochondrial fragment and the effect of the L7P polymorphism on the cellular level using GFP tagged constructs. The mobility was studied with fluorescence recovery after photobleaching technique in a neuronal cell line. We found that the mobility of the secretory vesicles with NPY(1-36) in cells with L7P genotype was increased in comparison to vesicle mobility in cells with the more abundant L7L genotype. The mobility in the cells with the putative mitochondrial construct was found to be very low. According to the results of the present study, the mitochondrial truncated peptide stays in the mitochondrion. It can be hypothesized that this could be one of the factors affecting energy balance of the membranes of the mitochondrion. (C) 2008 Elsevier Ireland Ltd. All rights reserved.”
“The iliac branched device (IBD) is the only totally

endovascular option to preserve flow to the internal find more science iliac artery for the treatment of aorto-iliac or solitary iliac artery aneurysms. This technique involves the use of two parallel guide wires, including the indwelling through-and-through wire and a wire to introduce the bridging stent-graft. We describe a technique which uses “”tromboned”" sheaths (ie, a 7F ANL 1 inside a 10F Balkin sheath) for increased cross-over stability and avoids problems associated with the use of parallel wires inside one sheath. In addition, reduction of the gap between the IBD and the origin of the internal iliac artery

may result in a more stable position of the device. (J Vasc Surg 2008;48:1605-8.)”
“A recent study has demonstrated that the G-protein coupled receptor GPR120 is expressed in the taste bud cells in rats. In this study, we have identified the types of taste cell that express GPR120 in C57/BL6 mice. Double immunostaining for GPR120 and the markers of type II taste cells (phospholipase-C beta 2 and alpha-gustducin) revealed that the majority of the GPR120-positive taste cells are type II taste cells. In contrast, it was observed that GPR120 was rarely colocalized with the marker of type III cells (neuronal cell adhesion molecule). These results suggested that GPR120 is mainly expressed in the type II taste cells and might function as a sensor for dietary fat. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

All rights reserved “
“Purpose: We analyzed the effect of co

All rights reserved.”
“Purpose: We analyzed the effect of concomitant prolapse surgery performed at the time of sling surgery on short-term postoperative outcomes

in women with urinary incontinence.

Materials and Methods: We analyzed 1999 to 2001 Medicare claims data on a 5% national random sample of female beneficiaries who underwent sling procedures. Subjects were tracked for 12 months after surgery to assess short-term complications. Concomitant prolapse repairs and prolapse repairs performed in the first 12 months after sling surgery were identified by CPT-4 procedure codes. Postoperative complications and treatments were identified by ICD-9 diagnosis codes and CPT-4 procedure codes, respectively. Bivariate and multivariate analyses were performed to measure the effect of concomitant prolapse surgery on sling outcomes.

Results: GSK126 molecular weight Concomitant prolapse repairs were performed in 34.4% of sling cases. Women who underwent prolapse repair at the time of the sling surgery were significantly more likely to be diagnosed with postoperative outlet obstruction (9.4% vs 5.5%, p < 0.007) than those who did not. Women who underwent concomitant prolapse repair were less likely to undergo a repeat procedure for stress incontinence in postoperative year 1 (4.7% vs 10.2%, p = 0.0005). Multivariate analysis revealed that women

who underwent prolapse Selleck 4EGI-1 repair at the time of the sling surgery were significantly less likely to undergo a reoperation for prolapse within 1 year after the sling surgery (OR 0.31, 95% CI 0.22-0.44).

Conclusions: Our findings suggest that addressing prolapse at the time of stress incontinence surgery may avoid an early repeat operation for either prolapse or stress incontinence. However, rates of postoperative outlet obstruction are higher.”
“The RNA binding motif protein 4 genes RBM4a and RBM4b are located on human chromosome 11q13.2 and encode highly similar proteins of 363 and 359

amino acids, respectively. They contain two RNA recognition motifs (RRMs) and a retroviral-type Zn-finger. RBM4a binds RNA, is involved in alternative splicing and is also a part of the microRNA-processing RISC complex. In particular, RBM4a is involved Forskolin price in exon 10 inclusion of the tau protein. The function of RBM4b is unknown. With new monoclonal antibodies we show that RBM4a is detectable in virtually all tissues and cell lines tested while RBM4b was only found in kidney and liver. Both RBM4a and RBM4b are nuclear phosphoproteins with half-lives of 2.5 h and 4.5 h, respectively. To our knowledge, this is the first description of RBM4b protein in human tissue. In human brain, expression of RBM4a was strongly up-regulated in cerebellum as compared to forebrain. (C) 2008 Elsevier Ireland Ltd. All rights reserved.”
“RA175/SynCAM1, a member of immunoglobulin superfamily 4 (Igsf4; recently named Cadm1), is a cell adhesion molecule involved in the formation of a functional synapse.

All rights reserved “
“Recent studies have implicated polymo

All rights reserved.”
“Recent studies have implicated polymorphisms in the 3′ untranslated region (3′UTR) of the alpha-synuclein (SNCA) gene in the development of Parkinson’s disease (PD). Single nucleotide polymorphism (SNP) rs356165

is one of polymorphisms located in the 3′UTR and its association with PD has been reported but remains controversial. Herein, we conducted a case-control study to further evaluate Veliparib the possible association between SNP rs356165 and PD in Chinese. All subjects (330 PD patients and 300 normal controls) were successfully genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. No statistically significant difference in genotype frequency between cases and controls AG-014699 chemical structure was observed (P=0.863), suggesting no association of

SNP rs356165 with PD in our population. Thus, it may be premature to conclude an association between the 3′UTR of the SNCA gene and PD, and this association should be further examined in different ethnic populations. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“In the current study, we explored whether chronic salicylate exposure could induce apoptosis in outer hair cells (OHCs) and spiral ganglion neurons (SGNs) of the cochlea. Guinea pig received sodium salicylate (400 mg/kg/d) or saline vehicle for 10 consecutive days. Programmed cell death (PCD) executioner was evaluated with immunohistochemistry detection of activated caspase-3. Apoptosis was examined with a terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) method. Repeated salicylate administration activated caspase-3 and caused apoptosis in OHCs and SGNs (p <0.01 vs. saline control for both measures and in both cell types). Cell counting showed a significant loss in OHCs (p <0.01 vs. saline control), but not in inner hair cells (IHCs). Transmission

electron microscopy (TEM) revealed chromatin Calpain condensation and nucleus margination in salicylate-treated cochlea. Scanning electron microscopy (SEM) demonstrated stereociliary bundles breakdown and fusion at the apical of OHCs, villous matter was discovered to attach on the surface of SGNs. These findings suggest that long-term administration of high-dose salicylate can activate caspase-3 pathway to induce OHC and SGN apoptosis. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Although the serotonin (5-hydroxytryptamine (5-HT)) 2A receptor has been reported to be associated with pain, no relationship has been found between single nucleotide polymorphisms in the 5-HT2A receptor gene and analgesic requirements. To clarify the mechanism of individual differences in analgesic requirements, we investigated the relationship between the 5-HT2A 102T/C gene polymorphism and analgesic requirements in 135 patients who underwent major open abdominal surgery and were managed with continuous epidural analgesia with opioids after surgery.

Gray matter (GM) atrophy

Gray matter (GM) atrophy QNZ mw and white matter lesions (WML) have been described in both conditions. Our aims were to determine the relationship of GM and WML with cognition and depressed mood in the same population. Structural brain images were obtained from 42 controls, 20 Alzheimer’s disease (AD) patients and 32 subjects

with cognitive impairment/dementia due to subcortical cerebrovascular disease (vascCIND/IVD). Images were segmented to obtain lobar GM, white matter and WML volumes. Lobar WML had a negative effect on GM in all lobes in controls, on frontal, parietal and occipital GM in AD and on frontal GM in vascCIND/IVD. Frontal, temporal and hippocampal GM were associated with cognitive functions and frontal WML load with depressed mood. Cognitive function is associated with GM atrophy and depressed mood is associated with frontal Buparlisib cell line WML This indicates that although both often occur together, depressed mood and cognitive impairment have different pathological correlates.

(C) 2009 Elsevier Ireland Ltd. All rights reserved.”
“Dengue viruses cause two severe diseases that alter vascular fluid barrier functions, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Preexisting antibodies to dengue virus disposes patients to immune-enhanced edema (DSS) or hemorrhagic (DHF) disease following infection by a discrete dengue virus serotype. Although the endothelium is the primary vascular fluid barrier, direct effects of dengue virus on endothelial cells (ECs) have not been considered primary factors in pathogenesis. Here, we show that dengue virus infection of human ECs elicits immune-enhancing EC responses. Our results suggest that rapid early dengue virus proliferation many within ECs is permitted by dengue virus regulation of early, but not late,

beta interferon (IFN-beta) responses. The analysis of EC responses following synchronous dengue virus infection revealed the high-level induction and secretion of immune cells (T cells, B cells, and mast cells) as well as activating and recruiting cytokines BAFF (119-fold), IL-6/8 (4- to 7-fold), CXCL9/10/11 (45- to 338-fold), RANTES (724-fold), and interleukin-7 (IL-7; 128-fold). Moreover, we found that properdin factor B, an alternative pathway complement activator that directs chemotactic anaphylatoxin C3a and C5a production, was induced 34-fold. Thus, dengue virus-infected ECs evoke key inflammatory responses observed in dengue virus patients which are linked to DHF and DSS. Our findings suggest that dengue virus-infected ECs directly contribute to immune enhancement, capillary permeability, viremia, and immune targeting of the endothelium. These data implicate EC responses in dengue virus pathogenesis and further rationalize therapeutic targeting of the endothelium as a means of reducing the severity of dengue virus disease.

Distinct biochemical mechanisms that underlie behavioral phase sh

Distinct biochemical mechanisms that underlie behavioral phase shifts may account for the differences observed in the early- vs. late-subjective XAV 939 night. (C) 2009 Elsevier Ltd. All rights reserved.”
“HIV-1 eradication from infected individuals has not been achieved with the prolonged use of highly active antiretroviral therapy (HAART). The cellular

reservoir for HIV-1 in resting memory CD4(+) T cells remains a major obstacle to viral elimination. The reservoir does not decay significantly over long periods of time but is able to release replication-competent HIV-1 upon cell activation. Residual ongoing viral replication may likely occur in many patients because low levels of virus can be detected in plasma by sensitive assays and transient episodes of viremia, or HIV-1 blips, are often observed in patients even with successful viral suppression for many years. Here we review our current knowledge of the factors contributing to viral persistence, the latent reservoir,

and blips, and mathematical models developed to explore them and their relationships. find more We show how mathematical modeling has helped improve our understanding of HIV-1 dynamics in patients on HAART and of the quantitative events underlying HIV-1 latency, reservoir stability, low-level viremic persistence, and emergence of intermittent viral blips. We also discuss treatment implications related to these studies. Ivacaftor Published by Elsevier Ltd.”
“Dopamine denervation in Parkinson’s disease and repeated Levodopa (L-DOPA) administration that induces dyskinesias are associated with an enhancement of basal ganglia neuropeptide transmission. Various adjunct non-dopaminergic treatments to Levodopa were shown to reduce and/or prevent dyskinesias. The aim of this study was to seek if non-dopaminergic drug treatments to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) lesioned monkeys combined with L-DOPA to prevent dyskinesia were associated with changes of

striatal neuropeptides. Chronic treatment with Ro 61-8048 a kynurenine hydroxylase inhibitor, docosahexaenoic acid (DHA) a polyunsaturated fatty acid (omega-3), naltrexone an opioidergic antagonist and CI-1041 an N-methyl-D-aspartate (NMDA) glutamate receptor antagonist with L-DOPA prevented dyskinesias to various extents except naltrexone whereas all MPTP monkeys treated with L-DOPA alone developed dyskinesias. Striatal preproenkephalin (PPE), preprodynorphin (PPD) and preprotachykinin A (PPT-A) mRNA levels were measured by in situ hybridization. An increase of PPE and PPD mRNA levels was observed in anterior caudate nucleus of L-DOPA treated MPTP monkeys compared to controls and to Saline-treated MPTP monkeys whereas PPT-A mRNA levels were unchanged.

5-fold when visualized with Coomassie The majority of those spot

5-fold when visualized with Coomassie. The majority of those spots were isolated and identified using peptide Mocetinostat nmr mass fingerprinting. Fractionation also provided detection of 63 new phosphorylated protein spots and enhanced the visibility of 15 phosphorylated protein spots, using 2-D electrophoretic separation and an in-gel

phosphoprotein stain. Application of this methodology toward other legumes, such as peanut, bean, pea, alfalfa and others, also containing high amounts of storage proteins, was examined, and is reported here.”
“Much of the information on safety and efficacy of drugs in older people is obtained after marketing. Pharmacoepidemiologic studies play an increasing role in obtaining this information. Pharmacoepidemiologic studies contribute significantly to knowledge of risks associated with medicines in older people and less so to that of benefits. Recent

improvements in methodology in both pharmacoepidemiology and geriatric medicine have improved the validity and reduced the bias of these studies. Pharmacoepidemiologic studies are a critical component of assessing the risks of medicines in older people. Where possible, findings of pharmacoepidemiologic studies Belnacasan ic50 should be tested with well-conducted interventional randomized trials in relevant populations of older people.”
“Representation of time may affect pain perception. We investigated a group of volunteers looking at different clocks while they were being exposed to the same intensity of pain in two experiments. In one case, they saw the actual time, while in the other, they gazed at a clock that made it seem like the stimulation was shortened, even though it wasn’t. These results show that simply believing that time is on your side can make anything more bearable. The results were not influenced by the color of the clock (red or green), or the presence of indexes such as (sad or smiling) smileys. The effects were maximal for high intensities of stimulation (pain threshold +1 degrees C) if the

stimulation lasted for at least 25s but were absent if the stimulation was short (15 min). These results suggest that pain modulation by time context is mainly available for long and intense painful stimulations. The right upper and posterior parietal cortex may support this effect. These findings Phloretin are discussed with regard to previous literature of pain modulations but also with regard to the concept of the “”pain matrix”", its inputs and the temporal dynamics of its constitutive responses. (C) 2012 Elsevier Masson SAS. All rights reserved.”
“It is generally accepted that protein complexes play an active role in avoiding the protein degradation of the thermophiles. Thermoanaerobacter tengcongensis was cultured at three different temperatures (55, 75 and 80 degrees C) and the extracts of protein complexes were prepared.

The frequent tonic-clonic seizures in pregnancy was also associat

The frequent tonic-clonic seizures in pregnancy was also associated with a poor memory as evidenced by decrease in distance swam in the target

quadrant by the offspring of the kindled mother in the adulthood. Data obtained from shuttle-box studies showed that retention latencies of pups born to kindled dams were significantly reduced compared to those born to control dams. The hippocampus, amygdala and frontal cortex are very important for memory consolidation and our data suggest that subsequent developmental events are not sufficient to overcome this website the adverse effects of prenatal exposure to maternal seizures to these regions of the brain. These observations may have clinical implications for cognitive and memory dysfunction associated with epilepsy during pregnancy. Published by Elsevier Ltd on behalf of IBRO.”
“The posterior subregion of the dorsomedial striatum (pDMS) has been implicated in spatial learning. Here we investigated the role of buy HSP990 dopamine (DA) signals in the pDMS in place and response learning using a T-maze task. Rats subjected to a DA depletion of the pDMS and sham controls were trained for 7 days to retrieve food from the west arm of the maze starting from the south, that is to make a left turn at the choice point. On day 8, a probe test was given in which the starting arm was inserted as the north

arm. On days 9-16 animals received further training, and on day 17, a second probe test was performed. We examined whether animals responded on probe tests according to a response strategy (left turn at choice point) or to a place strategy (right turn at choice point). Our results revealed that, unlike sham controls, rats with a pDMS DA depletion preferentially used a response rather than a place strategy already on the first probe test. These findings provide further support for a role of the pDMS in spatially guided behavior and indicate that DA signals in the pDMS are critical for the use

of a place strategy. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Increasing evidence suggests that plastic changes underlying skill learning may occur at early stages of neural processing. isothipendyl However, whether visual perceptual learning (PL) is accompanied by neuronal plasticity phenomena in the primary visual cortex (V1) is yet unknown. Here, we provide the first evidence that practice with specific visual stimuli (gratings) induces long-term potentiation (LTP) of synaptic responses in the rat V1. We report that in rats which have improved through practice their ability to discriminate between two gratings of different spatial frequency, the input/output curves of field potentials evoked in layers II-III of V1 slices by stimulation of either vertical and horizontal connections are shifted leftward compared to controls. Thus, visual PL is followed by potentiation of synaptic transmission both in vertical and horizontal connections (mimicry).

In conclusion, the high-level secretion of F solani cutinase in

In conclusion, the high-level secretion of F. solani cutinase in P. pastoris was demonstrated for the first time and would be a promising alternative to many expression systems previously used for the large-scale production of F solani cutinase in Saccharomyces cerevisiae as well as Escherichia coli. (C) 2009 Elsevier Inc. All Selonsertib cost rights reserved.”
“Brain development is sensitive to an individual’s interaction with its environment. Deprivation of natural environmental stimulation especially in the phase after weaning has long-lasting consequences on neuroplasticity. However, previous findings concerning the effects of rearing environment on adult hippocampal cell proliferation and neurogenesis in rodents remain contradictory. To address

the question, whether the variability of hippocampal plasticity in response to environmental conditions is a unique feature at least in mice, the present study Alisertib datasheet examined the effects of social and physical deprivation during brain development on hippocampal cell production and survival in adults of three mouse strains (Mus muscu/us) with different domestication background: outbred CD1, inbred C57Bl/6 and the F2-descendants of wild-caught

house mice. Wheel running increased cell proliferation rates in the dentate gyrus of CD 1 and C57Bl/6 mice reared under socially and physically deprived conditions, but not from enriched conditions. In wild house mice, neither the rearing conditions nor the wheel-running challenge did affect proliferative activity. This indicates, on the one hand, that wild house mice

are more robust in their regulation of hippocampal cell proliferation against environmental influences and, on the other hand, that domestication and rearing background of laboratory animals impact neuroplastic potentials and responsiveness to external stimuli in adulthood. (C) 2012 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Purpose: A novel nomogram using the RENAL ([R]adius maximal diameter in cm, [E]xophytic/endophytic properties, [N]earness of the tumor to the collecting system or sinus in mm, [A]nterior/Posterior, [L]ocation relative to the polar lines and [H]ilar) Isotretinoin nephrometry score was developed to predict high grade renal cell carcinoma. It showed good performance in internal evaluation. We externally validated the prediction model.

Materials and Methods: We identified a cohort of 391 Chinese patients in whom renal cell carcinoma was surgically resected at our institution from 2008 to 2011. Fuhrman grade was reviewed by an experienced genitourinary pathologist and radiological images were independently assessed by 2 senior urologists. Using a 2-tiered system high grade disease was defined as Fuhrman grade III/IV. The statistical performance of the prediction model was evaluated by discrimination, calibration and clinical usefulness.

Results: Of the 391 patients 45.5% were considered to have high grade tumors. External validation of the nomogram revealed an AUC of 0.73.

(C) 2009 Elsevier Ltd All rights reserved “
“Multiple myelo

(C) 2009 Elsevier Ltd. All rights reserved.”
“Multiple myeloma is the

most common indication for high-dose chemotherapy with autologous stem cell support (ASCT) in North America today. Stem cell procurement for ASCT has most commonly been performed with stem cell mobilization using colony-stimulating factors with or without prior chemotherapy. The target find more CD34+ cell dose to be collected as well as the number of apheresis performed varies throughout the country, but a minimum of 2 million CD34+ cells/kg has been traditionally used for the support of one cycle of high-dose therapy. With the advent of plerixafor (AMD3100) (a novel stem cell mobilization agent), it is pertinent to review the current status of stem cell mobilization for myeloma as well as the role of autologous stem cell transplantation in this disease. On June 1, 2008, a panel of experts was convened by the International Myeloma Foundation to address issues regarding stem cell mobilization and autologous transplantation in myeloma in the context of new therapies. The panel was asked to discuss a variety of issues regarding stem cell collection and selleck kinase inhibitor transplantation in myeloma especially with the arrival of plerixafor. Herein, is a summary of their deliberations and

conclusions. Leukemia (2009) 23, 1904-1912; doi: 10.1038/leu.2009.127; published online 25 June 2009″
“Vasopressin V1a receptors

in the rat brain have been studied for their role in modulating aggression and anxiety. In the current study blood-oxygen-level-dependent (BOLD) functional MRI was used to test whether V1a receptors modulate neural processing in the maternal brain when dams are exposed to a male intruder. Primiparous females were given an intracerebroventricular (ICV) injection of vehicle or VI a receptor antagonist ([deamino-Pen(1), O-Me-Tyr, Are(8)]-Vasopressin, 125 ng/10 mu L) 90-120 min before imaging. During fMRI, awake dams were presented with a male intruder threat to pups using a specialized chamber that contained separate compartments for pups and a male intruder. Our results indicate that the number of activated voxels was reduced in the cortical amygdala with VI a receptor Erythromycin blockade, while an increase was observed in the anterior olfactory nucleus and other areas. Dams treated with V1a antagonist showed significantly greater BOLD responses in the anterior olfactory nucleus, infralimbic prefrontal cortex, gustatory cortex, somatosensory cortex, and substantia innominata when presented with a novel male intruder. BOLD responses were reduced in the cortical amygdala and ventromedial hypothalamus. The V1a receptor sensitive areas play roles in the processing of smell, taste and touch and emotional reactivity.

Materials and Methods: The Boston Area Community Health Survey us

Materials and Methods: The Boston Area Community Health Survey used a multistage stratified design to recruit a random sample of 5,503 adults who were 30 to 79 years old. Urological symptoms in the American Urological Association symptom index were included in analysis.

Results: Statistically significant associations that were consistent by gender were observed between depression and all urological symptoms. Nocturia of any degree of severity or duration was associated with heart disease in men and with diabetes in women. In men a dose-response relationship was observed for the association of symptom severity and/or the duration of urinary intermittency and frequency

with heart disease, and for the association of urinary 3-Methyladenine chemical structure urgency with diabetes. VE-822 research buy In women a history of heart disease was associated with a weak stream and straining, while a history of hypertension was associated with urgency and a weak stream.

Conclusions: Results indicate a dose-response relationship in the association of the severity and duration of urological symptoms with major chronic illnesses. An association between urinary symptoms and depression was observed in men and women. In contrast, the association between lower urinary tract symptoms and heart disease, diabetes or hypertension varied

by gender, suggesting different mechanisms of association in men and women.”
“OBJECTIVE: Restoration of lumbar lordosis is a critical factor in long-term success after lumbar fusions. Transforaminal lumbar interbody fusion (TLIF) is a popular surgical technique in the lumbar spine, but few data exist on change in spinal alignment after the procedure.

METHODS: Eighty

patients who underwent TLIF surgery were retrospectively reviewed (minimum follow-up period, 2 years). Standing x-rays were assessed for changes in focal and segmental kyphosis, and tuclazepam restoration of lumbar lordosis. Improvement in spondylolisthesis, sagittal balance, and scoliosis were also assessed. Fusion was assessed as well.

RESULTS: Eighty operations were performed at 107 levels. Mean presenting lumbar Cobb angle measurement (L1-S1) was 36.3 +/- 4.5 degrees (range, 12-77 degrees). Forty patients (50%) had sagittal imbalance. Mean postoperative Cobb angle (L1-S1) was 55.1 +/- 6.6. Thirty-three of 36 patients with segmental kyphosis (92%) had restoration of lordosis. Improvement in alignment was most prominent at the surgical level (mean increase in lordosis, 20.2 +/- 4.2 degrees). The improvement in lumbar lordosis among patients undergoing multilevel TLIFs (27.3 +/- 3.4 degrees) was significantly higher compared with patients undergoing single-level operations (17.4 +/- 4.4) (Student’s t test, P = 0.0004). Thirty of the 40 patients with sagittal imbalance (75%) achieved immediate restoration of normal sagittal balance.