Comparison of histopathologic findings of initial and recurrent lumbar disc herniation.

OBJECTIVE: Recurrent lumbar disc hernia (RLDH) is a common and challenging complication after an initial discectomy. This study aimed to investigate the relationship between the histopathologic outcomes of the initial and recurrent disc tissues. METHODS: This study investigated 70 patients who underwent a microdiscectomy and subsequently developed same-level same-side lumbar disc herniation (LDH) recurrence. The clinic, western blot, and immunohistochemical evaluations of patients with initial LDH and RLDH were conducted and statistically analyzed. RESULTS: The effect of inflammation and apoptosis in the degenerative changes of intervertebral disc hernia and increased histopathologic findings in RLDH was demonstrated. The degeneration of the hernia disc tissue is a major pathological process, which is characterized by cellular apoptosis, inflammation, and reduced synthesis of extracellular matrix. Currently, there is no clinical therapy targeting the reversal of disc degeneration. CONCLUSIONS: This, therefore, stay away from factors that increase inflammation in the intervention of intervertebral disc hernia, applying to reduce inflammation the medicines, could allow reducing disc collagen degeneration, and more successful outcomes. These findings might shed some new lights on the mechanism of disc degeneration and provide new strategies for the treatments of initial and recurrent LDH.

Effect of MCI-186 on Lipid Peroxidation in Experimental Traumatic Brain Damage in Rats.

Objective: Brain damage occurs in many clinical conditions, including trauma, ischemia, and hypertension. Reactive oxygen products and lipid peroxidation are responsible for the brain damage that occurs in these clinical conditions. We investigated whether MCI-186 (3-methyl-1-phenyl-2-pyrazoline-5-one), a free radical binding agent on lipid peroxidation, affects malondialdehyde (MDA), glutathione (GSH), and glutathione peroxidase (GPx) levels in traumatic brain damage. Methods: The traumatic brain damage model, modified by Feeney, was performed on 28 male Wistar rats separated into 4 groups. The MDA, GSH, and GPx levels in the brain tissues of each group were studied. Results: MDA levels in the traumatized group were significantly higher than those in the sham and MCI-186 groups (p<0.05), while GSH levels were significantly higher in the sham group than in the trauma and solvent groups (p<0.05). No significant difference was observed between the sham and MCI-186 groups (p>0.05). Although the average GPx level was higher in the sham and MCI-186 groups, no significant difference was found between groups. Conclusion: Reactive oxidation products significantly decreased in the MCI-186 group. Thus, MCI-186 can be used as a free radical-binding agent in traumatic brain damage.

Cytotoxic Impact of N-Oleoylethanolamine on Bone Cancer Cells.

BACKGROUND: Cancer is a complex disease that derives from the uncontrolled proliferation of cells. Bone cancer is a type of prevalent cancer that occurs both in young and adults. Bone cancer is most common in the long bones of the pelvis, arms and legs. Statistically, more than 200 cases of osteosarcoma have been reported annually in our country. Classical treatment with chemotherapeutics remains ineffective in the cure of this cancer type. Recent studies have shown that ceramide induces apoptosis at its increased levels in the cells. Thus, many studies have been conducted to cause the accumulation of ceramide molecules in the cell by different ways to induce apoptosis. NOE (Noleoylethanolamine) is a specific inhibitor of ceramidase enzymes that hydrolyze intracellular ceramides and prevent apoptosis. OBJECTIVE: This study investigates the cytotoxic and apoptosis-inducing activities of NOE on human osteosarcoma Saos-2 cells. METHODS: Cytotoxic effects were investigated by MTT colorimetric assay. For the detection of morphological and ultrastructural indicators of apoptosis, confocal and TEM techniques were used. RESULTS: Our finding indicated that NOE is effective in the inhibition of the growth of Saos-2 cells. Confocal and TEM findings showed morphological and ultrastructural changes as chromatin condensation, fragmentation of nuclei and mitochondria as well as damaged cytoskeleton and cell shrinkage. CONCLUSION: The results revealed that NOE exerts its cytotoxicity on Saos-2 cells through changing the ultrastructure and morphology of cells with clear apoptotic sparks.

Evaluation of the association between biochemical and immunohistochemical score of caspase-9 and TNFα, and the grading of lumbar disc herniation.

OBJECTIVE: The aim of our study is to investigate the influence of caspase-9 and tumour necrosis factor alpha (TNFα) in the grade of lumbar disc herniation. We determined the strength of different predictors such as age, gender, disc grading, caspase-9 and TNFα. METHODS: We retrospectively reviewed 84 patients who had discectomies. Histological and biochemical evaluations of disc specimens were performed. All patients were scanned by the magnetic resonance imaging (MRI) scanner before the operation. Masson's trichrome stain, biochemical analysis and immunohistochemical staining were performed to measure the expression levels of caspase-9 and TNFα. The results were evaluated statistically. RESULTS: This study included 84 patients (mean age: 41.59 ± 12.21 years; range: 19-76): 60 men (age 40.47 ± 12.63 years) and 24 women (44.42 ± 10.81 years). No statistically significant age difference was found between the genders (p = 0.182). MRI scans showed 16 patients had protrusion, 44 had extrusion and 24 had sequestration of discs. There was a statistically significant negative correlation between the grading of lumbar disc herniations and age (p < 0.001, r = -0.509). Histological and biochemical analyses of disc materials were done. Inflammation, collagen fibre deterioration, apoptotic process, TNFα and caspase-9 were seen to increase with increasing disc grading (p < 0.01). CONCLUSIONS: Biochemical and immunohistochemical score of caspase-9 and TNFα indicate the grading of lumbar disc herniation. As the grading of disc herniation increases, inflammation of cells and collagen fibre disruption increase and accelerate the apoptotic process. Apoptosis in disc nucleus pulposus cells may reduce disc herniation.

The Changed Route of Anterior Tibial Artery due to Healed Fracture.

We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia).

Bilateral spontaneous atraumatic rupture of the Achilles tendon in an athlete.

We report a case of spontaneous, bilateral Achilles rupture in a 33-year-old man with no specific risk factors. The rupture occurred after a heavy impact during a sports activity, and although the rupture was painful, he was able to mobilize slowly. After a clinical examination confirmed the diagnosis, ultrasonography and magnetic resonance imaging evaluation of the Achilles tendons revealed bilateral ruptures. The patient underwent bilateral conservative treatment and subsequently embarked on a comprehensive rehabilitation program with a good functional outcome at follow-up. The patient's return to premorbid work and social life was uneventful. A spontaneous rupture in a patient without any predisposing risk factors is uncommon, and for it to occur bilaterally is notably rare.

Spontaneously resorbed idiopathic syringomyelia: a case report.

A 28-year-old female patient presented with severe neck and back pain in 2003. No abnormality was observed at neurological examination. Syringomyelia in the cervical region was determined at MRI. MRI examination of the cranial, thoracal and lumbosacral regions was normal. The patient refused surgery and was followed up. A control cervical MRI 17 months later showed that the syringomyelia had disappeared. This spontaneously resorbed case of idiopathic syringomyelia, presenting solely due to neck and back pain and with a normal neurological examination, was evaluated in the light of syringomyelia pathogenesis as only three similar cases have been identified in the literature.