Predictive factors for treatment success of epidural steroid injections in patients with lumbar spinal surgery

OBJECTIVE

The efficacy of epidural steroid injections (ESIs) in the treatment of radicular pain in patients undergoing lumbar spinal surgery is still unclear. The aim of this study was to investigate the factors affecting the success of ESIs in the treatment of ongoing radicular pain in patients undergoing lumbar spinal surgery.

PATIENTS AND METHODS

This study was designed as a single-center, retrospective study, and was conducted at a Pain Management Center of a tertiary care center. A total of 260 patients with failed back surgery syndrome who received fluoroscopy-guided lumbar ESI were included. Treatment success was defined as ≥50% reduction in the numeric rating scale score at the one-month follow-up. The patients were divided into the treatment success and the treatment failure groups.

RESULTS

The presence of spinal instrumentation was significantly lower in the treatment success group (p=0.045). Symptom duration and the numeric rating scale score at 1 hour were significantly lower in the treatment success group (p<0.05). The use of triamcinolone acetonide in the treatment success group was found to be significantly higher than in the treatment failure group (p=0.027).

CONCLUSIONS

The short duration of symptoms and the absence of instrumentation seem to be prognostic factors that positively affect the success of ESI treatment in operated patients. A ≥50% pain reduction in the first hour after the procedure is a valuable indicator that treatment success can be achieved in the short term. Finally, the steroid type can also affect the treatment results.

UV radiation resistance-associated gene (UVRAG) promotes cell proliferation, migration, invasion by regulating cyclin-dependent kinases (CDK) and integrin-β/Src signaling in breast cancer cells

Breast cancer is a highly heterogeneous group of human cancer with distinct genetic, biological and clinicopathological features. Triple-negative breast cancer (TNBC) is the most aggressive and metastatic type of breast cancer and associated with poor patient survival. However, the role of UV Radiation Resistance-Associated Gene (UVRAG) in TNBC remains unknown. Here, we report that UVRAG is highly upregulated in all TNBC cells and its knockdown leads to the inhibition of cell proliferation, colony formation and progression of cell cycle, which is associated with and reduced expression of cell cycle related protein expression, including Cyclin A2, B1, D1, cdc2 and cdk6 in TNBC cells. Inhibition of UVRAG also suppressed cell motility, migration and invasion of TNBC cells by inhibition of Integrin β1 and β3 and Src activity. Our findings suggest for the first time that UVRAG expression contributes to proliferation, cell cycle progression, motility/migration and invasion of TNBC cells. Thus, targeting UVRAG could be a potential strategy in breast cancer especially against TNBC.

Gene expressions of TRP channels in glioblastoma multiforme and relation with survival

Glioblastoma multiforme (GBM) is one of the most lethal forms of cancer in humans, with a median survival of 10 to 12 months. Glioblastoma is highly malignant since the cells are supported by a great number of blood vessels. Although new treatments have been developed by increasing knowledge of molecular nature of the disease, surgical operation remains the standard of care. The TRP (transient receptor potential) superfamily consists of cation-selective channels that have roles in sensory physiology such as thermo- and osmosensation and in several complex diseases such as cancer, cardiovascular, and neuronal diseases. The aim of this study was to investigate the expression levels of TRP channel genes in patients with glioblastoma multiforme and to evaluate the relationship between TRP gene expressions and survival of the patients. Thirty-three patients diagnosed with glioblastoma were enrolled to the study. The expression levels of 21 TRP genes were quantified by using qRT-PCR with dynamic array 48 × 48 chip (BioMark HD System, Fluidigm, South San Francisco, CA, USA). TRPC1, TRPC6, TRPM2, TRPM3, TRPM7, TRPM8, TRPV1, and TRPV2 were found significantly higher in glioblastoma patients. Moreover, there was a significant relationship between the overexpression of TRP genes and the survival of the patients. These results demonstrate for the first time that TRP channels contribute to the progression and survival of the glioblastoma patients.

Diagnostic accuracy of cone beam computed tomography and conventional multislice spiral tomography in sheep mandibular condyle fractures

OBJECTIVES

the aim of this study was to compare diagnostic accuracy of cone beam CT (CBCT) and multislice CT in artificially created fractures of the sheep mandibular condyle.

METHODS

63 full-thickness sheep heads were used in this study. Two surgeons created the fractures, which were either displaced or non-displaced. CBCT images were acquired by the NewTom 3G CBCT scanner (NIM, Verona, Italy) and CT imaging was performed using the Toshiba Aquillon multislice CT scanner (Toshiba Medical Systems, Otawara, Japan). Two-dimensional (2D) cross-sectional images and three-dimensional (3D) reconstructions were evaluated by two observers who were asked to determine the presence or absence of fracture and displacement, the type of fracture, anatomical localization and type of displacement. The naked-eye inspection during surgery served as the gold standard. Inter- and intra-observer agreements were calculated with weighted kappa statistics. The receiver operating characteristics (ROC) curve analyses were used to compare statistically the area under the curve (AUC) of both imaging modalities.

RESULTS

kappa coefficients of intra- and interobserver agreement scores varied between 0.56 - 0.98, which were classified as moderate and excellent, respectively. There was no statistically significant difference between the imaging modalities, which were both sensitive and specific for the diagnosis of sheep condylar fractures.

CONCLUSIONS

this study confirms that CBCT is similar to CT in the diagnosis of different types of experimentally created sheep condylar fractures and can provide a cost- and dose-effective diagnostic option.

Removal of Ni(II) from aqueous solution by adsorption onto hazelnut shell activated carbon: equilibrium studies

Activated carbon prepared from hazelnut shell was used as an adsorbent for the removal of Ni(II) from aqueous solution. Batch mode adsorption studies were carried out by varying initial metal ion concentration, agitation speed, temperature and particle size. A contact time of 180 min was required to reach equilibrium. The equilibrium data were analysed using the Langmuir, Freundlich and Temkin isotherms. The characteristic parameters for each isotherm were determined. The Langmuir isotherm provided the best correlation for Ni(II) onto the activated carbon. Thermodynamical parameters revealed that the adsorption of Ni(II) is exothermic in nature.