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High Glucose Accelerates Autophagy in Adult Rat Intervertebral Disc Cells.

Chae Gwan KONG ; Jong Beom PARK ; Man Soo KIM ; Eun Young PARK

Asian Spine Journal.2014;8(5):543-548. doi:10.4184/asj.2014.8.5.543

STUDY DESIGN: In vitro cell culture. PURPOSE: The purpose of this study was to investigate the effect of high glucose on autophagy in adult rat intervertebral disc cells. OVERVIEW OF LITERATURE: Diabetes mellitus is considered to be an important etiologic factor for intervertebral disc degeneration, resulting in degenerative disc diseases. A glucose-mediated increase of autophagy is a major causative factor for the development of diseases associated with diabetes mellitus. However, no information is available for the effect of high glucose on autophagy in adult intervertebral disc cells. METHODS: Nucleus pulposus and annulus fibrosus cells were isolated from 24-week-old adult rats, cultured and placed in either 10% fetal bovine serum (normal control) or 10% fetal bovine serum plus two different high glucose concentrations (0.1 M and 0.2 M) (experimental conditions) for one and three days, respectively. The expressions of autophagy markers, such as beclin-1, light chain 3-I (LC3-I) and LC3-II, autophagy-related gene (Atg) 3, 5, 7 and 12, were identified and quantified. RESULTS: Two high glucoses significantly increased the expressions of beclin-1, LC3-II, Atg3, 5, 7, and 12 in adult rat nucleus pulposus and annulus fibrosus cells in a dose- and time-dependent manner. The ratio of LC3-II/LC3-I expression was also increased in a dose-respectively time-dependent manner. CONCLUSIONS: The results suggest that autophagy of adult nucleus pulposus and annulus fibrosus cells might be a potential mechanism for the intervertebral disc degeneration in adult patients with diabetes mellitus. Thus, the prevention of autophagy in adult intervertebral disc cells might be considered as a novel therapeutic target to prevent or to delay the intervertebral disc degeneration in adult patients with diabetes mellitus.
Adult* ; Animals ; Autophagy* ; Cell Culture Techniques ; Diabetes Mellitus ; Glucose* ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Rats*

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Investigation of Efficacy of Mitomycin-C, Sodium Hyaluronate and Human Amniotic Fluid in Preventing Epidural Fibrosis and Adhesion Using a Rat Laminectomy Model.

Elif BOLAT ; Erdogan KOCAMAZ ; Zeki KULAHCILAR ; Ali YILMAZ ; Abdullah TOPCU ; Mevci OZDEMIR ; Mehmet Erdal COSKUN

Asian Spine Journal.2013;7(4):253-259. doi:10.4184/asj.2013.7.4.253

STUDY DESIGN: A retrospective study. PURPOSE: The aim of this study was to evalute the effects of mitomycin-C, sodium hyaluronate and human amniotic fluid on preventing spinal epidural fibrosis. OVERVIEW OF LITERATURE: The role of scar tissue in pain formation is not exactly known, but it is reported that scar tissue causes adhesions between anatomic structures. Intensive fibrotic tissue compresses on anatomic structures and increases the sensitivity of the nerve root for recurrent herniation and lateral spinal stenosis via limiting movements of the root. Also, neuronal atrophy and axonal degeneration occur under scar tissue. METHODS: The study design included 4 groups of rats: group 1 was the control group, groups 2, 3, and 4 receieved antifibrotic agents, mitomycin-C (group 2), sodium hyaluronate (group 3), and human amniotic fluid (group 4). Midline incision for all animals were done on L5 for total laminectomy. Four weeks after the surgery, the rats were sacrificed and specimens were stained with hematoxylin-eosin and photos of the slides were taken for quantitive assesment of the scar tissue. RESULTS: There was no significant scar tissue in the experimental animals of groups 2, 3, and 4. It was found that there was no significant difference between drug groups, but there was a statistically significant difference between the drug groups and the control group. CONCLUSIONS: This experimental study shows that implantation of mitomycin-C, sodium hyaluronate and human amniotic fluid reduces epidural fibrosis and adhesions after spinal laminectomy in rat models. Further studies in humans are needed to determine the complications of the agents researched.
Amniotic Fluid* ; Animals ; Atrophy ; Axons ; Cicatrix ; Equidae ; Female ; Fibrosis* ; Humans* ; Hyaluronic Acid* ; Laminectomy* ; Mitomycin* ; Models, Animal ; Neurons ; Rats* ; Retrospective Studies ; Sodium* ; Spinal Stenosis

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Comment on: Sciatica in the Young.

Farzad OMIDI-KASHANI ; Ebrahim Ghayem HASANKHANI ; Ehsan RAFEEMANESH

Asian Spine Journal.2014;8(5):704-704. doi:10.4184/asj.2014.8.5.704

No abstract available.
Sciatica*

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Sciatica in the Young.

Sim Sai TIN ; Viroj WIWANITKIT

Asian Spine Journal.2014;8(5):703-703. doi:10.4184/asj.2014.8.5.703

No abstract available.
Sciatica*

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Evidence-Based of Nonoperative Treatment in Adolescent Idiopathic Scoliosis.

Hak Sun KIM

Asian Spine Journal.2014;8(5):695-702. doi:10.4184/asj.2014.8.5.695

Until now because there are many published journals with a variety of opinions so I will stratify these articles by giving weighted value on grade evaluation which depend on each institution (written author and co-authors) and external evaluate status (SCI, SCIE, impact factor) rather than the outcomes provided by each article. Consequently, before evaluating publicized papers, study quality assessment of each interesting paper should be performed by mean of gauging the quality of evidence. Reviewing these articles, a grade of medical literature was divided into the following 5 levels as level I (randomized controlled study), level II (non-randomized controlled study), level III (case-control study), level IV (case series), and level V (expert opinions). However, in present article I concluded only involved medical literatures with weighted value of level I and II evidence.
Adolescent* ; Braces ; Humans ; Orthotic Devices ; Scoliosis*

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Extraosseous Thoracic Foraminal Osteoblastoma: Diagnostic Dilemma and Management with 3 Year Follow-Up.

Shailesh Ramakant HADGAONKAR ; Ashok Kumar SHYAM ; Kunal Chandrakant SHAH ; Ketan Shripad KHURJEKAR ; Parag Kantilal SANCHETI

Asian Spine Journal.2014;8(5):689-694. doi:10.4184/asj.2014.8.5.689

Osteoblastomas are bone forming lesions arising mainly from posterior elements of the vertebra. They are commonly encountered in the cervical and lumbar regions. We present a case of a thoracic osteoblastoma which is extra osseous and is not communicating with any part of the vertebra present intraforaminally. This is a rare presentation of an osteoblastoma. Imaging studies do not accurately diagnose the osteiod lesion. The size of the lesion and cortical erosion seen on the computed tomography scan help in differentiating the osteoid osteoma and osteoblastoma, but they are less sensitive and specific. Thus a histopathology is the investigation of choice to diagnose the osteoblastoma. Early and adequate removal of mass prevents malignant transformation, metastasis, and recurrence. In our case we excised the pars interarticularis unilaterally, removed the osteoid mass intact, and performed unilateral instrumented fusion. There was no recurrence and solid fusion was seen at 3 years follow up.
Follow-Up Studies* ; Lumbosacral Region ; Neoplasm Metastasis ; Osteoblastoma* ; Osteoma, Osteoid ; Recurrence ; Spine

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Seropositive Neuromyelitis Optica imitating an Intramedullary Cervical Spinal Cord Tumor: Case Report and Brief Review of the Literature.

Peter Yat Ming WOO ; Jennifer Hiu Fung CHIU ; Kar Ming LEUNG ; Kwong Yau CHAN

Asian Spine Journal.2014;8(5):684-688. doi:10.4184/asj.2014.8.5.684

A 44-year-old woman with progressive cervical myelopathy and central cord syndrome was noted to have an extensive cervical intramedullary contrast-enhancing lesion on magnetic resonance imaging (MRI). The lesion resembled a spinal astrocytoma or ependymoma that required surgical intervention. She was subsequently diagnosed to have neuromyelitis optica (NMO), a rare idiopathic inflammatory demyelinating disorder, when the clinical examination revealed left optic atrophy. This was confirmed by a test showing seropositivity for NMO-immunoglobulin (IgG). Disease control was achieved with corticosteroids and immunosuppressive therapy. We report a rare case of a patient with NMO who had MRI features that could have easily led to the condition being misdiagnosed as a spinal cord tumor. The importance of careful history taking, awareness of typical radiological findings and the usefulness of serum NMO-IgG as a diagnostic tool are emphasized.
Adrenal Cortex Hormones ; Adult ; Astrocytoma ; Central Cord Syndrome ; Demyelinating Diseases ; Ependymoma ; Female ; Humans ; Magnetic Resonance Imaging ; Neuromyelitis Optica* ; Optic Atrophy ; Spinal Cord Diseases ; Spinal Cord Neoplasms*

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Drop Metastasis of Adrenocorticotropic Hormone-Producing Pituitary Carcinoma to the Cauda Equina.

Kenichi TAKEUCHI ; Yoko HAGIWARA ; Koichi KANAYA ; Keiji WADA ; Masahiro SHIBA ; Yoshiharu KATO

Asian Spine Journal.2014;8(5):680-683. doi:10.4184/asj.2014.8.5.680

The diagnosis of pituitary carcinoma cannot be made easily histologically, and most cases of pituitary carcinoma are diagnosed only after the clinical detection of metastasis. Distant metastasis of pituitary tumor occurs in 0.1% to 0.2% of cases and has been reported in the liver, bone and central nervous system, with only one case of metastasis to the cauda equine reported. This study describes a rare case of the drop metastasis of adrenocorticotropic hormone-producing pituitary adenocarcinoma to the cauda equina, causing cauda equina syndrome.
Adenocarcinoma ; Adrenocorticotropic Hormone ; Cauda Equina* ; Central Nervous System ; Diagnosis ; Liver ; Neoplasm Metastasis* ; Pituitary Neoplasms* ; Polyradiculopathy

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Complete Resolution of a Case of Calcific Tendinitis of the Longus Colli with Conservative Treatment.

Fumitake TEZUKA ; Toshinori SAKAI ; Ryo MIYAGI ; Yoichiro TAKATA ; Kosaku HIGASHINO ; Shinsuke KATOH ; Koichi SAIRYO ; Natsuo YASUI

Asian Spine Journal.2014;8(5):675-679. doi:10.4184/asj.2014.8.5.675

Acute calcific tendinitis of the longuscolli is a self-limiting inflammatory condition caused by calcium hydroxyapatite deposition in the longuscolli tendon. Although several case reports have described its radiological presentation, few reports provide detailed chronological accounts through symptomatic and radiologic resolution. A 59-year-old woman presented with severe neck pain and stiffness of a few days duration as well as moderate discomfort when swallowing. Lateral radiographs revealed a large calcium deposit anterior to the C1.C2 joint and swelling of the prevertebral soft tissue from C1 to C5. CT and magnetic resonance imaging showed fluid in the retropharyngeal gap.A soft collar and non-steroidal anti-inflammatory drug were prescribed, without antibiotics. At 4 months after presentation, the calcium deposit and all symptoms had resolved completely. Although this disease is comparatively rare, physicians should keep it in mind when a patient presents with acute severe neck pain.
Anti-Bacterial Agents ; Calcium ; Deglutition ; Durapatite ; Female ; Humans ; Joints ; Magnetic Resonance Imaging ; Middle Aged ; Neck Pain ; Tendinopathy* ; Tendons

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Trumpet Laminectomy Microdecompression for Lumbal Canal Stenosis.

Jefri HENKY ; Muneyoshi YASUDA ; Muhammad Zafrullah ARIFIN ; Masakazu TAKAYASU ; Ahmad FARIED

Asian Spine Journal.2014;8(5):667-674. doi:10.4184/asj.2014.8.5.667

Microsurgery techniques are useful innovations towards minimizing the insult of canal stenosis. Here, we describe the trumpet laminectomy microdecompression (TLM) technique, advantages and disadvantages. Sixty-two TLM patients with lumbar disc herniation, facet hypertrophy or yellow ligament or intracanal granulation tissue. The symptoms are low back pain, dysesthesia and severe pain on both legs. Spine levels operated Th11-S1; the patients who had trumpet-type fenestration, 62.9% had hypertrophy of the facet joint, 11.3% had intracanal granulation tissue, 79.1% had hypertrophy of the yellow ligament and 64.5% had disc herniation. The average of procedure duration was 68.9 min and intraoperative blood loss was 47.4 mL. Intraoperative complications were found in 3.2% of patients, with dural damage but without cerebrospinal fluid leakage. The TLM can be performed for all ages and all levels of spinal canal stenosis, without the complication of spondilolistesis. The TLM has a shorter duration, with minimal intraoperative blood loss.
Cerebrospinal Fluid ; Constriction, Pathologic* ; Granulation Tissue ; Humans ; Hypertrophy ; Intraoperative Complications ; Laminectomy* ; Leg ; Ligaments ; Low Back Pain ; Microsurgery ; Paresthesia ; Spinal Canal ; Spine ; Zygapophyseal Joint

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