Purpose: Developmentally regulated GTP-binding protein 2 (DRG2) regulates microtubule dynamics and G2/M arrest during docetaxel treatment. Poly ADP-ribose polymerase (PARP) acts as an important repair system for DNA damage caused by docetaxel treatment. This study investigated whether DRG2 expression affects response to PARP inhibitors (olaparib) using prostate cancer cell lines PC3, DU145, LNCaP-FGC, and LNCaP-LN3. Materials and Methods: The cell viability and DRG2 expression levels were assessed using colorimetric-based cell viability assay and western blot. Cells were transfected with DRG2 siRNA, and pcDNA6/V5-DRG2 was used to overexpress DRG2. Flow cytometry was applied for cell cycle assay and apoptosis analysis using the Annexing V cell death assay. Results: The expression of DRG2 was highest in LNCaP-LN3 and lowest in DU145 cells. Expressions of p53 in PC3, DU145, and the two LNCaP cell lines were null-type, high-expression, and medium-expression, respectively. In PC3 (DRG2 high, p53 null) cells, docetaxel increased G2/M arrest without apoptosis; however, subsequent treatment with olaparib promoted apoptosis. In DU145 and LNCaP-FGC (DRG2 low), docetaxel increased sub-G1 but not G2/M arrest and induced apoptosis, whereas olaparib had no additional effect. In LNCaP-LN3 (DRG2 high, p53 wild-type), docetaxel increased sub-G1 and G2/M arrest, furthermore olaparib enhanced cell death. Docetaxel and olaparib combination treatment had a slight effect on DRG2 knockdown PC3, but increased apoptosis in DRG2-overexpressed DU145 cells. Conclusions DRG2 and p53 expressions play an important role in prostate cancer cell lines treated with docetaxel, and DRG2 levels can predict the response to PARP inhibitors.

Carpal tunnel syndrome (CTS) is a common form of hand mononeuropathy that is typi-cally caused by median nerve compression. Although it is often idiopathic, CTS can also result from various conditions, including space-occupying lesions. Tumoral calcinosis, a rare condition characterized by periarticular deposition of calcified masses, is an un-common cause of secondary CTS. We present a case of a 78-year-old woman with idio-pathic tumoral calcinosis that caused secondary CTS. Despite conservative treatments, her symptoms persisted, and diagnostic imaging, including radiographs, computed to-mography, and magnetic resonance imaging, revealed a calcified mass in the carpal tun-nel. A surgical intervention involving carpal tunnel release and excisional biopsy con-firmed the diagnosis of tumoral calcinosis. Postoperatively, the patient showed complete resolution of symptoms, with no recurrence on follow-up radiographs. This case high-lights the importance of considering space-occupying lesions, such as tumoral calcinosis, as a rare but treatable cause of secondary CTS.

Background: To evaluate the clinical impact of intraoperative tranexamic acid administration in minimizing intraoperative blood loss and transfusion requirements during minimally invasive scoliosis surgery (MISS). Methods: Consecutive data were collected from 97 patients with adolescent idiopathic scoliosis who underwent MISS between 2021 and 2023. Tranexamic acid was first introduced in June 2022. Surgical outcomes, complications, and blood parameters were compared between group A (no tranexamic acid) and group B (tranexamic acid). Results: Forty-three patients underwent surgery without intraoperative tranexamic acid (group A), and 54 underwent surgery with tranexamic acid (group B). Variables including age, height, weight, body mass index, hospital stay duration, Cobb angle, correction rate, curve type, fusion extent, and pre- and postoperative hemoglobin levels were not significantly different between the 2 groups (all p > 0.50). On average, 2.03 red blood cell (RBC) transfusions were administered. Group A required 2.6 units, whereas group B required 1.7 units, representing a significant reduction (p = 0.005). Postoperatively, an average of 0.5 RBC units were administered.Group A required 0.9 units, and group B required 0.3 units, with a significant difference (p = 0.001). No significant difference was found in the hemoglobin level between the day before surgery and postoperative days 1 and 4 (all p > 0.05). Significant differences were observed between the 2 groups in the estimated blood loss change (1,358 vs. 1,118 mL, p = 0.035) and Hemovac volume (1,063.26 vs. 910.65 mL, p = 0.002). Eleven patients in group A required thoracentesis or chest tube insertion after MISS, whereas those in Group B did not require invasive procedures. Conclusions In MISS, tranexamic acid reduced blood transfusion needs, Hemovac volume, incidence and severity of hemothorax, and pleural effusion were associated with thoracoplasty.

Background: To evaluate the clinical impact of intraoperative tranexamic acid administration in minimizing intraoperative blood loss and transfusion requirements during minimally invasive scoliosis surgery (MISS). Methods: Consecutive data were collected from 97 patients with adolescent idiopathic scoliosis who underwent MISS between 2021 and 2023. Tranexamic acid was first introduced in June 2022. Surgical outcomes, complications, and blood parameters were compared between group A (no tranexamic acid) and group B (tranexamic acid). Results: Forty-three patients underwent surgery without intraoperative tranexamic acid (group A), and 54 underwent surgery with tranexamic acid (group B). Variables including age, height, weight, body mass index, hospital stay duration, Cobb angle, correction rate, curve type, fusion extent, and pre- and postoperative hemoglobin levels were not significantly different between the 2 groups (all p > 0.50). On average, 2.03 red blood cell (RBC) transfusions were administered. Group A required 2.6 units, whereas group B required 1.7 units, representing a significant reduction (p = 0.005). Postoperatively, an average of 0.5 RBC units were administered.Group A required 0.9 units, and group B required 0.3 units, with a significant difference (p = 0.001). No significant difference was found in the hemoglobin level between the day before surgery and postoperative days 1 and 4 (all p > 0.05). Significant differences were observed between the 2 groups in the estimated blood loss change (1,358 vs. 1,118 mL, p = 0.035) and Hemovac volume (1,063.26 vs. 910.65 mL, p = 0.002). Eleven patients in group A required thoracentesis or chest tube insertion after MISS, whereas those in Group B did not require invasive procedures. Conclusions In MISS, tranexamic acid reduced blood transfusion needs, Hemovac volume, incidence and severity of hemothorax, and pleural effusion were associated with thoracoplasty.

Objective: This study aimed to evaluate the therapeutic role of lymphadenectomy in patients surgically treated for clinically early-stage epithelial ovarian cancer (EOC). Methods: This retrospective, multicenter study included patients with clinically earlystage EOC based on preoperative abdominal-pelvic computed tomography or magnetic resonance imaging findings between 2007 and 2021. Oncologic outcomes and perioperative complications were compared between the lymphadenectomy and non-lymphadenectomy groups. Independent prognostic factors were determined using Cox regression analysis.Disease-free survival (DFS) was the primary outcome. Overall survival (OS) and perioperative outcomes were the secondary outcomes. Results: In total, 586 patients (lymphadenectomy group, n=453 [77.3%]; nonlymphadenectomy groups, n=133 [22.7%]) were eligible. After surgical staging, upstaging was identified based on the presence of lymph node metastasis in 14 (3.1%) of 453 patients.No significant difference was found in the 5-year DFS (88.9% vs. 83.4%, p=0.203) and 5-year OS (97.2% vs. 97.7%, p=0.895) between the two groups. Using multivariable analysis, lymphadenectomy was not significantly associated with DFS or OS. However, using subgroup analysis, the lymphadenectomy group with serous histology had higher 5-year DFS rates than did the non-lymphadenectomy group (86.5% vs. 74.4%, p=0.048; adjusted hazard ratio=0.281; 95% confidence interval=0.107–0.735; p=0.010). The lymphadenectomy group had longer operating time (p<0.001), higher estimated blood loss (p<0.001), and higher perioperative complication rate (p=0.004) than did the non-lymphadenectomy group. Conclusion In patients with clinically early-stage EOC with serous histology, lymphadenectomy was associated with survival benefits. Considering its potential harm,

Background: To evaluate the clinical impact of intraoperative tranexamic acid administration in minimizing intraoperative blood loss and transfusion requirements during minimally invasive scoliosis surgery (MISS). Methods: Consecutive data were collected from 97 patients with adolescent idiopathic scoliosis who underwent MISS between 2021 and 2023. Tranexamic acid was first introduced in June 2022. Surgical outcomes, complications, and blood parameters were compared between group A (no tranexamic acid) and group B (tranexamic acid). Results: Forty-three patients underwent surgery without intraoperative tranexamic acid (group A), and 54 underwent surgery with tranexamic acid (group B). Variables including age, height, weight, body mass index, hospital stay duration, Cobb angle, correction rate, curve type, fusion extent, and pre- and postoperative hemoglobin levels were not significantly different between the 2 groups (all p > 0.50). On average, 2.03 red blood cell (RBC) transfusions were administered. Group A required 2.6 units, whereas group B required 1.7 units, representing a significant reduction (p = 0.005). Postoperatively, an average of 0.5 RBC units were administered.Group A required 0.9 units, and group B required 0.3 units, with a significant difference (p = 0.001). No significant difference was found in the hemoglobin level between the day before surgery and postoperative days 1 and 4 (all p > 0.05). Significant differences were observed between the 2 groups in the estimated blood loss change (1,358 vs. 1,118 mL, p = 0.035) and Hemovac volume (1,063.26 vs. 910.65 mL, p = 0.002). Eleven patients in group A required thoracentesis or chest tube insertion after MISS, whereas those in Group B did not require invasive procedures. Conclusions In MISS, tranexamic acid reduced blood transfusion needs, Hemovac volume, incidence and severity of hemothorax, and pleural effusion were associated with thoracoplasty.

Objective: This study aimed to evaluate the therapeutic role of lymphadenectomy in patients surgically treated for clinically early-stage epithelial ovarian cancer (EOC). Methods: This retrospective, multicenter study included patients with clinically earlystage EOC based on preoperative abdominal-pelvic computed tomography or magnetic resonance imaging findings between 2007 and 2021. Oncologic outcomes and perioperative complications were compared between the lymphadenectomy and non-lymphadenectomy groups. Independent prognostic factors were determined using Cox regression analysis.Disease-free survival (DFS) was the primary outcome. Overall survival (OS) and perioperative outcomes were the secondary outcomes. Results: In total, 586 patients (lymphadenectomy group, n=453 [77.3%]; nonlymphadenectomy groups, n=133 [22.7%]) were eligible. After surgical staging, upstaging was identified based on the presence of lymph node metastasis in 14 (3.1%) of 453 patients.No significant difference was found in the 5-year DFS (88.9% vs. 83.4%, p=0.203) and 5-year OS (97.2% vs. 97.7%, p=0.895) between the two groups. Using multivariable analysis, lymphadenectomy was not significantly associated with DFS or OS. However, using subgroup analysis, the lymphadenectomy group with serous histology had higher 5-year DFS rates than did the non-lymphadenectomy group (86.5% vs. 74.4%, p=0.048; adjusted hazard ratio=0.281; 95% confidence interval=0.107–0.735; p=0.010). The lymphadenectomy group had longer operating time (p<0.001), higher estimated blood loss (p<0.001), and higher perioperative complication rate (p=0.004) than did the non-lymphadenectomy group. Conclusion In patients with clinically early-stage EOC with serous histology, lymphadenectomy was associated with survival benefits. Considering its potential harm,

Background: To evaluate the clinical impact of intraoperative tranexamic acid administration in minimizing intraoperative blood loss and transfusion requirements during minimally invasive scoliosis surgery (MISS). Methods: Consecutive data were collected from 97 patients with adolescent idiopathic scoliosis who underwent MISS between 2021 and 2023. Tranexamic acid was first introduced in June 2022. Surgical outcomes, complications, and blood parameters were compared between group A (no tranexamic acid) and group B (tranexamic acid). Results: Forty-three patients underwent surgery without intraoperative tranexamic acid (group A), and 54 underwent surgery with tranexamic acid (group B). Variables including age, height, weight, body mass index, hospital stay duration, Cobb angle, correction rate, curve type, fusion extent, and pre- and postoperative hemoglobin levels were not significantly different between the 2 groups (all p > 0.50). On average, 2.03 red blood cell (RBC) transfusions were administered. Group A required 2.6 units, whereas group B required 1.7 units, representing a significant reduction (p = 0.005). Postoperatively, an average of 0.5 RBC units were administered.Group A required 0.9 units, and group B required 0.3 units, with a significant difference (p = 0.001). No significant difference was found in the hemoglobin level between the day before surgery and postoperative days 1 and 4 (all p > 0.05). Significant differences were observed between the 2 groups in the estimated blood loss change (1,358 vs. 1,118 mL, p = 0.035) and Hemovac volume (1,063.26 vs. 910.65 mL, p = 0.002). Eleven patients in group A required thoracentesis or chest tube insertion after MISS, whereas those in Group B did not require invasive procedures. Conclusions In MISS, tranexamic acid reduced blood transfusion needs, Hemovac volume, incidence and severity of hemothorax, and pleural effusion were associated with thoracoplasty.

Objective: This study aimed to evaluate the therapeutic role of lymphadenectomy in patients surgically treated for clinically early-stage epithelial ovarian cancer (EOC). Methods: This retrospective, multicenter study included patients with clinically earlystage EOC based on preoperative abdominal-pelvic computed tomography or magnetic resonance imaging findings between 2007 and 2021. Oncologic outcomes and perioperative complications were compared between the lymphadenectomy and non-lymphadenectomy groups. Independent prognostic factors were determined using Cox regression analysis.Disease-free survival (DFS) was the primary outcome. Overall survival (OS) and perioperative outcomes were the secondary outcomes. Results: In total, 586 patients (lymphadenectomy group, n=453 [77.3%]; nonlymphadenectomy groups, n=133 [22.7%]) were eligible. After surgical staging, upstaging was identified based on the presence of lymph node metastasis in 14 (3.1%) of 453 patients.No significant difference was found in the 5-year DFS (88.9% vs. 83.4%, p=0.203) and 5-year OS (97.2% vs. 97.7%, p=0.895) between the two groups. Using multivariable analysis, lymphadenectomy was not significantly associated with DFS or OS. However, using subgroup analysis, the lymphadenectomy group with serous histology had higher 5-year DFS rates than did the non-lymphadenectomy group (86.5% vs. 74.4%, p=0.048; adjusted hazard ratio=0.281; 95% confidence interval=0.107–0.735; p=0.010). The lymphadenectomy group had longer operating time (p<0.001), higher estimated blood loss (p<0.001), and higher perioperative complication rate (p=0.004) than did the non-lymphadenectomy group. Conclusion In patients with clinically early-stage EOC with serous histology, lymphadenectomy was associated with survival benefits. Considering its potential harm,

Background: The lumbosacral (LS) junction has a higher nonunion rate than other lumbar segments, especially in long-level fusion. Nonunion at L5–S1 would result in low back pain, spinal imbalance, and poor surgical outcomes. Although anterior column support at L5–S1 has been recommended to prevent nonunion in long-level LS fusion, fusion length requiring additional spinopelvic fixation (SPF) in LS fusion with anterior column support at L5–S1 has not been evaluated thoroughly. This study aimed to determine the number of fused levels requiring SPF in LS fusion with anterior column support at L5–S1 by assessing the interbody fusion status using computed tomography (CT) depending on the fusion length. Methods: Patients who underwent instrumented LS fusion with L5–S1 interbody fusion without additional augmentation and CT > 1 year postoperatively were included. The fusion rates were assessed based on the number of fused segments. Patients were divided into two groups depending on the L5–S1 interbody fusion status: those with union vs. those with nonunion. Binary logistic regression analyses were performed to identify risk factors for LS junctional nonunion. Results: Fusion rates of L5–S1 interbody fusion were 94.9%, 90.3%, 80.0%, 50.0%, 52.6%, and 43.5% for fusion of 1, 2, 3, 4, 5, and ≥ 6 levels, respectively. The number of spinal levels fused ≥ 4 (p < 0.001), low preoperative bone mineral density (BMD; adjusted odds ratio [aOR], 0.667; p = 0.035), and postoperative pelvic incidence (PI) – lumbar lordosis (LL) mismatch (aOR, 1.034; p = 0.040) were identified as significant risk factors for nonunion of L5–S1 interbody fusion according to the multivariate logistic regression analysis. Conclusions Exhibiting ≥ 4 fused spinal levels, low preoperative BMD, and large postoperative PI–LL mismatch were identified as independent risk factors for nonunion of anterior column support at L5–S1 in LS fusion without additional fixation. Therefore, SPF should be considered in LS fusion extending to or above L2 to prevent LS junctional nonunion.