Currently, sustainability initiatives that use green chemistry to improve and/or protect our global environment are becoming focal issues in many fields of research. Instead of using toxic chemicals for the reduction and stabilisation of metallic nanoparticles, the use of various biological entities has received considerable attention in the field of nanobiotechnology. Among the many possible natural products, polysaccharides and biologically active plant products represent excellent scaffolds for this purpose. Polysaccharides have hydroxyl groups, a hemiacetal reducing end, and other functionalities that can play important roles in both the reduction and the stabilisation of metallic nanoparticles. Among the various categories of compounds in plants that have potent biological activities, phytochemicals are emerging as an important natural resource for the synthesis of metallic nanoparticles. The focus of this review is the application of polysaccharides and phytochemicals in the green synthesis of gold and silver nanoparticles to afford biocomposites with novel uses in nanomedicine and as nanocomposites.

The objective of this study is to evaluate the degree of symptom improvement and the change of electrophysiological and ultrasonographic findings after sonographically guided local steroid injection using an in-plane ulnar approach in carpal tunnel syndrome (CTS).Seventy-five cases of 44 patients diagnosed with CTS were included and evaluated at baseline and at 4 and 12 weeks after injection. All patients received injection with 40 mg of triamcinolone mixed with 1 mL of 1% lidocaine into the carpal tunnel using an in-plane Ultrasound (US)-guided ulnar approach, out-plane US-guided approach, and blind injection. For clinical evaluation, we used the Boston Carpal Tunnel Questionnaire (BCTQ) and electrophysiological tests. The ultrasonographic findings were also evaluated with regard to cross-sectional area and the flattening ratio of the median nerve.Subjective symptoms measured by BCTQ and median nerve conduction parameters showed significant improvement at 4 weeks in the in-plane ulnar approach group compared with the out-plane ulnar approach and blind injection. This improvement was still observed at 12 weeks. The flattening ratio and cross-sectional area of the median nerve showed a more significant decrease with the in-plane ulnar approach than with the out-plane ulnar approach and blind injection (P < 0.05).US-guided local steroid injection using an in-plane ulnar approach in the CTS may be more effective than out-plane or blind injection.

The US-guided method may facilitate identifying critical vessels at unexpected locations relative to the intervertebral foramen and avoiding injury to such vessels, which is the leading cause of the reported complications from cervical transforaminal injections. On treatment effect, using either method of epidural injections to deliver steroids for cervical radicular pain, secondary to herniated intervertebral disc or foraminal stenosis, significant improvements in function and pain relief were observed in both groups after the intervention. However, significant difference was not observed between the groups. Therefore, the ultrasound-guided method was shown to be as effective as the fluoroscopy-guided method in pain relief and functional improvement, in addition to the absence of radiation and avoiding vessel injury at real-time imaging.

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The purpose of this study is to compare changes in biochemical markers for the skeletal muscles, hepatic metabolism, and renal function based on extreme long-distance running.Among healthy amateur endurance athletes who participated in a marathon, 100 km-, or 308 km ultramarathon, 15 athletes with similar physical and demographic characteristics were chosen to be the subjects in this study, upon completion of each course. The subjects’ blood was collected before and after the course to identify biochemical markers for the skeletal muscles, hepatic metabolism, and renal function.After all of the courses, creatinine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine transaminase (ALT), blood urea nitrogen (BUN), and creatinine were found to be significantly increased compared with values obtained before the race (P <0.05 for each marker). CK, LDH, AST, and LDH were significantly higher after completion of the 100 km race than the marathon (P <0.05) and were significantly higher after the 308 km race than the marathon or 100 km race (P <0.05). Total protein was significantly lower after the 308 km race than the marathon or 100 km race (P <0.05). Albumin significantly increased after the marathon but significantly decreased after the 308 km course (P <0.05). Total and direct bilirubin were significantly increased after the 100 km and 308 km races (P <0.05), and were significantly higher after the 308 km than the marathon or 100 km course (P <0.05). BUN was significantly higher after the 100 km race than the marathon (P <0.05) and was significantly lower after the 308 km than the 100 km race (P <0.05). Creatinine was significantly higher after the marathon and 100 km than the 308 km race (P <0.05). Uric acid significantly increased after the marathon and 100 km race (P <0.05); it was significantly higher after completing the marathon and 100 km than the 308 km race (P <0.05).Muscular damage, decline in hepatic function, and hemolysis in the blood were higher after running a 308 km race, which is low-intensity running compared with a marathon, and a temporary decline in renal function was higher after completing a 100 km race, which is medium-to-high intensity.

ObjectiveTo compare the short-term effect and advantage of transforaminal epidural steroid injection (TFESI) performed using the Kambin's triangle and subpedicular approaches.MethodForty-two patients with radicular pain from lumbar spinal stenosis were enrolled. Subjects were randomly assigned to one of two groups. All procedures were performed using C-arm KMC 950. The frequency of complications during the procedure and the effect of TFESI at 2 and 4 weeks after the procedure between the two groups were compared. Short-term outcomes were measured using a visual numeric scale (VNS) and a five-grade scale. Multiple logistic regression analyses were performed to evaluate the relationship between possible outcome predictors (Kambin's triangle or subpedicular approach, age, duration of symptoms and sex) and the therapeutic effect.ResultsVNS was improved 2 weeks after the injection and continued to improve until 4 weeks in both groups. There were no statistical differences in changes of VNS, effectiveness and contrast spread pattern between these two groups. No correlation was found between the other variables tested and therapeutic effect. Spinal nerve pricking occurred in five cases of the subpedicular and in none of the cases of the Kambin's triangle approach (p<0.05).ConclusionThe Kambin's triangle approach is as efficacious as the subpedicular approach for short-term effect and offers considerable advantages (i.e., less spinal nerve pricking during procedure). The Kambin's triangle approach maybe an alternative method for transforaminal epidural steroid injection in cases where needle tip positioning in the anterior epidural space is difficult.

The ultrasound approach with color Doppler mode may avoid intravascular injection-induced complications. The results showed similar improvements in short-term pain relief, function, and patient satisfaction with both ultrasound and fluoroscopic guidance.

Background. Excessive exercise such as marathon running increases the risk of cardiovascular events that may be related to myocardial infarction and sudden death. We aimed to investigate that the exercise characteristics can be used as a novel indicator of masked hypertension. Methods. A total of 571 middle-aged recreational male marathoners were assigned to a high blood pressure group (HBPG; n = 214) or a normal blood pressure group (NBPG; n = 357). A graded exercise test was used to examine the hemodynamic response and cardiac events, and the personal exercise characteristics were recorded. Results. Systolic blood pressure and diastolic blood pressure were higher in the HBPG than in the NBPG (p < 0.05, all). The marathon history, exercise intensity, and time were longer and higher, whereas the marathon completion duration was shorter in the HBPG than in NBPG (p < 0.05, all). HBPG showed a higher frequency of alcohol consumption than NBPG (p < 0.05). Conclusion. More excessive exercise characteristics than the normative individuals. If the individuals exhibit high blood pressure during rest as well as exercise, the exercise characteristics could be used as a novel indicator for masked hypertension.