Endoscopic spine surgery has rapidly evolved as a minimally invasive technique for treating various spinal pathologies. However, its use in removing epidural metastatic tumors remains insufficiently explored. This video article presents 2 cases utilizing unilateral biportal endoscopic spine surgery for resection of epidural metastatic tumors causing spinal cord compression. The first case involved a 63-year-old woman with metastatic non-small cell lung cancer at T4–5, and the second case an 86-year-old man with prostate cancer metastases at T6–9. Both patients presented with motor weakness (American Spinal Injury Association [ASIA] grade C) and potential spinal instability (SINS [Spinal Instability Neoplastic Scale] score 7). The surgical techniques emphasized precise identification and dissection of the tumor–dura interface to minimize dural injury and bleeding—an essential consideration when managing vascular lesions, particularly under antiplatelet therapy. Both cases achieved complete tumor resection with minimal blood loss (60–90 mL) and operative times of 71 and 109 minutes, respectively. Postoperatively, both patients improved to ASIA grade D and began early radiotherapy, underscoring the advantages of this minimally invasive approach in enabling prompt adjuvant treatment. Endoscopic epidural tumor removal represents a safe and less invasive alternative to open surgery for selected patients, though further long-term evaluation is warranted.

Chiari malformation, when accompanied by progressive neurological symptoms or syringomyelia, often necessitates surgical decompression. Although endoscopic spinal surgery continues to advance, its application in foramen magnum decompression remains limited. This video article demonstrates the biportal endoscopic foramen magnum decompression technique for Chiari type I malformation. We present the case of a 19-year-old female patient with progressive headache, motor weakness, and radiological evidence of 7-mm tonsillar descent with C2–7 syringomyelia. She successfully underwent biportal endoscopic foramen magnum decompression with C1 laminectomy. The procedure employed a triportal approach with safe docking on the C2 spinous process, allowing a minimally invasive C1 laminectomy and foramen magnum decompression extended to the suboccipital area. Postoperatively, computed tomography confirmed adequate decompression, and magnetic resonance imaging revealed expansion of the posterior fossa with resolution of tonsillar herniation. The patient experienced no complications or symptom recurrence at the 3-month follow-up. Despite a minor intraoperative–postoperative measurement discrepancy, which highlights the anatomical considerations required to achieve sufficient decompression, this video supports the feasibility of biportal endoscopic surgery. This approach may provide comparable clinical outcomes to conventional open surgery while offering minimally invasive advantages, though long-term follow-up remains essential.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

Endoscopic spine surgery (ESS) provides minimally invasive treatment options for a wide range of degenerative spinal disorders. However, performing a safe decompressive laminectomy, which is an essential and foundational step in ESS, can be challenging for novice surgeons, especially due to the risk of iatrogenic dural injury during flavectomy. This video article introduces the “crescent osteotomy” technique, which employs a mallet and chisel for controlled, anatomically precise resection of the ligamentum flavum. Although this approach has been adopted by some surgeons, it offers a straightforward and safe method that allows for effective additional laminectomy while facilitating easier flavectomy. The technique intentionally preserves the ligamentum flavum as a protective layer during the critical decompression phase. By doing so, the method reduces the likelihood of accidental dural tears and prevents unnecessary facet violation, making it particularly advantageous for beginning ESS surgeons. A representative case involving an 85-year-old man with L4–5 central stenosis and gait disturbance illustrates its effectiveness, with excellent postoperative neurological recovery and pain relief. The crescent osteotomy technique thus represents a feasible, efficient, and safe surgical option that enhances intraoperative control and optimizes clinical outcomes in ESS.

Unilateral biportal endoscopy offers substantial advantages in spinal surgery but continues to carry a risk of neural injury due to the difficulty of distinguishing neural structures from surrounding tissues. This video article demonstrates the intraoperative use of indigo carmine to mitigate this risk. Indigo carmine selectively stains fibrous tissue and disc material while sparing nerve roots, owing to its impermeability to intact cellular membranes. This property enhances visual differentiation and promotes surgical safety. We present 2 cases involving 64-year-old female patients who underwent discectomy for ruptured L5–S1 discs. In both cases, intraoperative injection of indigo carmine into the working field or disc space effectively delineated neural elements from adhesive tissues and disc material. Postoperative imaging confirmed successful decompression. Indigo carmine represents a useful, surgeon-friendly, cost-effective, and time-efficient adjunct that improves visualization and helps prevent iatrogenic neural injury. Its use is particularly recommended for revision surgery, complex degenerative conditions, and for endoscopic spine surgeons in training.

Reserpine is a well-known medicine for the treatment of hypertension, however the role of reserpine in cell signaling is not fully understood. Here, we report that reserpine treatment induces the phosphorylation of AMP activated protein kinase (AMPK) at threonine 172 (T172) in PC12 cells. Phosphorylation of AMPK T172 is regulated by upstream signaling molecules, and the increase of phospho-T172 indicates that AMPK is activated. When we examined the FOXO3a dependent transcription by using the FHRE-Luc reporter assay, reserpine treatment repressed the FHRE-Luc reporter activity in a dose dependent manner. Finally, we showed that reserpine treatment induced the phosphorylation of AMPK as well as cell death in MCF-7 cells. These results suggest that AMPK is a potential cellular target of reserpine.
AMP-Activated Protein Kinases* ; Animals ; Cell Death ; Hypertension ; MCF-7 Cells ; PC12 Cells ; Phosphorylation ; Reserpine* ; Threonine