1.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
2.Regenerative Functions of Regulatory T Cells and Current Strategies Utilizing Mesenchymal Stem Cells in Immunomodulatory Tissue Regeneration
Jinsung AHN ; Bowon KIM ; Alvin Bacero BELLO ; James J. MOON ; Yoshie ARAI ; Soo-Hong LEE
Tissue Engineering and Regenerative Medicine 2025;22(2):167-180
BACKGROUND:
Regulatory T cells (Tregs) are essential for maintaining immune homeostasis and facilitating tissue regeneration by fostering an environment conducive to tissue repair. However, in damaged tissues, excessive inflammatory responses can overwhelm the immunomodulatory capacity of Tregs, compromising their functionality and potentially hindering effective regeneration. Mesenchymal stem cells (MSCs) play a key role in enhancing Treg function. MSCs enhance Treg activity through indirect interactions, such as cytokine secretion, and direct interactions via membrane proteins.
METHODS:
This review examines the regenerative functions of Tregs across various tissues, including bone, cartilage, muscle, and skin, and explores strategies to enhance Treg functionality using MSCs. Advanced techniques, such as the overexpression of relevant genes in MSCs, are highlighted for their potential to further enhance Treg function. Additionally, emerging technologies utilizing extracellular vesicles (EVs) and cell membrane-derived vesicles derived from MSCs offer promising alternatives to circumvent the potential side effects associated with live cell therapies. This review proposes approaches to enhance Treg function and promote tissue regeneration and also outlines future research directions.
RESULTS
AND CONCLUSION: This review elucidates recent technological advancements aimed at enhancing Treg function using MSCs and examines their potential to improve tissue regeneration efficiency.
3.Increased Neutrophil Elastase in Affected Lobes of Bronchiectasis and Correlation of Its Levels between Sputum and Bronchial Lavage Fluid
Lam NGUYEN-HO ; Hoang Kim Tu TRINH ; Vu LE-THUONG ; Kieu Minh LE ; Van Thanh Niem VO ; Diem My VU ; Ngoc TRAN-VAN ; James D. CHALMERS
Tuberculosis and Respiratory Diseases 2025;88(2):399-407
Background:
Neutrophil elastase (NE) has been proposed as a potential biomarker for evaluating the severity and prognosis of bronchiectasis. This study aimed to compare bronchial lavage quantification of NE levels and activities with those of sputum.
Methods:
A cross-sectional study was conducted in which 24 Vietnamese adults with bronchiectasis were enrolled from June 2023 to August 2023. All participants underwent bronchoscopy to collect bronchial lavage fluid (BLF) from two bronchial locations: one in the region with the greatest bronchial dilatation and one in the normal bronchi or in patients with all lobes affected, the least abnormal lobe (abnormal BLF [ABLF] and normal BLF [NBLF], respectively). Spontaneously expectorated sputum was also collected.
Results:
Out of 24 cases, the prevalence of mild, moderate and severe bronchiectasis was 14/24 (58.4%), 5/24 (20.8%), and 5/24 (20.8%), respectively. NE concentration and activity were significantly higher in sputum and ABLF than in NBLF (p<0.001). Sputum and ABLF were highly correlated (r=0.841, p<0.001) with no significant difference in NE activity between sputum and ABLF. Higher levels of NE activity were seen in more severe bronchiectasis than in mild bronchiectasis in all samples but were only statistically significant for NE activity in sputum (r=0.418, p=0.042).
Conclusion
NE activity and concentration are elevated in areas of the lung most affected by bronchiectasis. Sputum is a valid surrogate of pulmonary NE levels, as they correlate strongly with ABLF and confirm in a Vietnamese population the relationship between NE activity and disease severity.
4.Histopathological characteristics of Epstein-Barr virus (EBV)–associated encephalitis and colitis in chronic active EBV infection
Betty A KASIMO ; James J YAHAYA ; Sun Och YOON ; Se Hoon KIM ; Minsun JUNG
Journal of Pathology and Translational Medicine 2025;59(3):188-194
Chronic active Epstein-Barr virus (CAEBV) can induce complications in various organs, including the brain and gastrointestinal tract. A 3-year-old boy was referred to the hospital with a history of fever and seizures for 15 days. A diagnosis of encephalitis based on computed tomography (CT) and magnetic resonance imaging findings and clinical correlation was made. Laboratory tests showed positive serology for Epstein-Barr virus (EBV) and negative for Rotavirus antigen and IgG and IgM antibodies for cytomegalovirus, herpes simplex virus, and varicella zoster virus, respectively. Abdominal CT showed diffuse wall thickening with fluid distension of small bowel loops, lower abdomen wall thickening, and a small amount of ascites. The biopsy demonstrated positive Epstein-Barr encoding region in situ hybridization in cells within the crypts and lamina propria. The patient was managed with steroids and hematopoietic stem cell transplantation (HSCT). This case showed histopathological characteristics of concurrent EBV-associated encephalitis and colitis in CAEBV infection. The three-step strategy of immunosuppressive therapy, chemotherapy, and allogeneic HSCT should be always be considered for prevention of disease progression.
5.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
6.Regenerative Functions of Regulatory T Cells and Current Strategies Utilizing Mesenchymal Stem Cells in Immunomodulatory Tissue Regeneration
Jinsung AHN ; Bowon KIM ; Alvin Bacero BELLO ; James J. MOON ; Yoshie ARAI ; Soo-Hong LEE
Tissue Engineering and Regenerative Medicine 2025;22(2):167-180
BACKGROUND:
Regulatory T cells (Tregs) are essential for maintaining immune homeostasis and facilitating tissue regeneration by fostering an environment conducive to tissue repair. However, in damaged tissues, excessive inflammatory responses can overwhelm the immunomodulatory capacity of Tregs, compromising their functionality and potentially hindering effective regeneration. Mesenchymal stem cells (MSCs) play a key role in enhancing Treg function. MSCs enhance Treg activity through indirect interactions, such as cytokine secretion, and direct interactions via membrane proteins.
METHODS:
This review examines the regenerative functions of Tregs across various tissues, including bone, cartilage, muscle, and skin, and explores strategies to enhance Treg functionality using MSCs. Advanced techniques, such as the overexpression of relevant genes in MSCs, are highlighted for their potential to further enhance Treg function. Additionally, emerging technologies utilizing extracellular vesicles (EVs) and cell membrane-derived vesicles derived from MSCs offer promising alternatives to circumvent the potential side effects associated with live cell therapies. This review proposes approaches to enhance Treg function and promote tissue regeneration and also outlines future research directions.
RESULTS
AND CONCLUSION: This review elucidates recent technological advancements aimed at enhancing Treg function using MSCs and examines their potential to improve tissue regeneration efficiency.
7.Increased Neutrophil Elastase in Affected Lobes of Bronchiectasis and Correlation of Its Levels between Sputum and Bronchial Lavage Fluid
Lam NGUYEN-HO ; Hoang Kim Tu TRINH ; Vu LE-THUONG ; Kieu Minh LE ; Van Thanh Niem VO ; Diem My VU ; Ngoc TRAN-VAN ; James D. CHALMERS
Tuberculosis and Respiratory Diseases 2025;88(2):399-407
Background:
Neutrophil elastase (NE) has been proposed as a potential biomarker for evaluating the severity and prognosis of bronchiectasis. This study aimed to compare bronchial lavage quantification of NE levels and activities with those of sputum.
Methods:
A cross-sectional study was conducted in which 24 Vietnamese adults with bronchiectasis were enrolled from June 2023 to August 2023. All participants underwent bronchoscopy to collect bronchial lavage fluid (BLF) from two bronchial locations: one in the region with the greatest bronchial dilatation and one in the normal bronchi or in patients with all lobes affected, the least abnormal lobe (abnormal BLF [ABLF] and normal BLF [NBLF], respectively). Spontaneously expectorated sputum was also collected.
Results:
Out of 24 cases, the prevalence of mild, moderate and severe bronchiectasis was 14/24 (58.4%), 5/24 (20.8%), and 5/24 (20.8%), respectively. NE concentration and activity were significantly higher in sputum and ABLF than in NBLF (p<0.001). Sputum and ABLF were highly correlated (r=0.841, p<0.001) with no significant difference in NE activity between sputum and ABLF. Higher levels of NE activity were seen in more severe bronchiectasis than in mild bronchiectasis in all samples but were only statistically significant for NE activity in sputum (r=0.418, p=0.042).
Conclusion
NE activity and concentration are elevated in areas of the lung most affected by bronchiectasis. Sputum is a valid surrogate of pulmonary NE levels, as they correlate strongly with ABLF and confirm in a Vietnamese population the relationship between NE activity and disease severity.
8.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
9.Regenerative Functions of Regulatory T Cells and Current Strategies Utilizing Mesenchymal Stem Cells in Immunomodulatory Tissue Regeneration
Jinsung AHN ; Bowon KIM ; Alvin Bacero BELLO ; James J. MOON ; Yoshie ARAI ; Soo-Hong LEE
Tissue Engineering and Regenerative Medicine 2025;22(2):167-180
BACKGROUND:
Regulatory T cells (Tregs) are essential for maintaining immune homeostasis and facilitating tissue regeneration by fostering an environment conducive to tissue repair. However, in damaged tissues, excessive inflammatory responses can overwhelm the immunomodulatory capacity of Tregs, compromising their functionality and potentially hindering effective regeneration. Mesenchymal stem cells (MSCs) play a key role in enhancing Treg function. MSCs enhance Treg activity through indirect interactions, such as cytokine secretion, and direct interactions via membrane proteins.
METHODS:
This review examines the regenerative functions of Tregs across various tissues, including bone, cartilage, muscle, and skin, and explores strategies to enhance Treg functionality using MSCs. Advanced techniques, such as the overexpression of relevant genes in MSCs, are highlighted for their potential to further enhance Treg function. Additionally, emerging technologies utilizing extracellular vesicles (EVs) and cell membrane-derived vesicles derived from MSCs offer promising alternatives to circumvent the potential side effects associated with live cell therapies. This review proposes approaches to enhance Treg function and promote tissue regeneration and also outlines future research directions.
RESULTS
AND CONCLUSION: This review elucidates recent technological advancements aimed at enhancing Treg function using MSCs and examines their potential to improve tissue regeneration efficiency.
10.Increased Neutrophil Elastase in Affected Lobes of Bronchiectasis and Correlation of Its Levels between Sputum and Bronchial Lavage Fluid
Lam NGUYEN-HO ; Hoang Kim Tu TRINH ; Vu LE-THUONG ; Kieu Minh LE ; Van Thanh Niem VO ; Diem My VU ; Ngoc TRAN-VAN ; James D. CHALMERS
Tuberculosis and Respiratory Diseases 2025;88(2):399-407
Background:
Neutrophil elastase (NE) has been proposed as a potential biomarker for evaluating the severity and prognosis of bronchiectasis. This study aimed to compare bronchial lavage quantification of NE levels and activities with those of sputum.
Methods:
A cross-sectional study was conducted in which 24 Vietnamese adults with bronchiectasis were enrolled from June 2023 to August 2023. All participants underwent bronchoscopy to collect bronchial lavage fluid (BLF) from two bronchial locations: one in the region with the greatest bronchial dilatation and one in the normal bronchi or in patients with all lobes affected, the least abnormal lobe (abnormal BLF [ABLF] and normal BLF [NBLF], respectively). Spontaneously expectorated sputum was also collected.
Results:
Out of 24 cases, the prevalence of mild, moderate and severe bronchiectasis was 14/24 (58.4%), 5/24 (20.8%), and 5/24 (20.8%), respectively. NE concentration and activity were significantly higher in sputum and ABLF than in NBLF (p<0.001). Sputum and ABLF were highly correlated (r=0.841, p<0.001) with no significant difference in NE activity between sputum and ABLF. Higher levels of NE activity were seen in more severe bronchiectasis than in mild bronchiectasis in all samples but were only statistically significant for NE activity in sputum (r=0.418, p=0.042).
Conclusion
NE activity and concentration are elevated in areas of the lung most affected by bronchiectasis. Sputum is a valid surrogate of pulmonary NE levels, as they correlate strongly with ABLF and confirm in a Vietnamese population the relationship between NE activity and disease severity.

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