ABSTRACT
OBJECTIVE: To investigate the radiological and clinical outcomes of different surgical approaches in cervical spinal trauma in northeastern of Iran. METHODS: The present study was conducted retrospectively from January 2011 to December 2017 in Mashhad, Iran. The demographic characteristics, hospitalization duration, and patient's surgery detail data were extracted from the patients' medical records. The follow-up period was at least six months after surgery. RESULTS: This study was conducted on 72 patients and the majority (n=51; 70.8 %) of them were male. Moreover, the participants; mean age was determined at 40.7±16.5 years. In total, 33 (45.8%), 13(18.1%), and 11 patients (15.3%) were operated using the anterior, posterior, and combined approaches in one round, respectively. It should be mentioned that 15 (20.8%) patients underwent the combined approach in two rounds. Early mortality was observed in 22 (30.6%) patients in the admission period. According to the follow-up X-ray results, the type of approach showed no relationship with non-fusion, malalignment, cage subside, and adjacent disk narrowing (p>0.05). CONCLUSION: According to the obtained results, there was no significant association between neurological and radiological outcomes among approaches. A high mortality rate was noted in combined surgery at one round, and the posterior approach is the best option when our goal is to correct lordosis.
ABSTRACT
BACKGROUND: Fas (Apo-1/CD95) and its specific ligand (FasL) are key elements in apoptosis. They have been studied in different malignancies but there are few published studies about the soluble forms of these markers (i.e. sFas/sFasL) in gastric cancer. We have compared the serum levels of sFas/sFasL in gastric adenocarcinoma patients and cases with pre-neoplastic lesions as potential markers for early diagnosis, and investigated their relation with clinicopathological characteristics. METHODS: Fifty-nine newly-diagnosed cases of gastric adenocarcinoma who had undergone gastrectomy, along with 62 endoscopically- and histologically-confirmed non-cancer individuals were enrolled in this study. sFas/sFasL serum levels were detected by Enzyme Linked Immunosurbent Assay. RESULTS: Mean serum sFas level was significantly higher in gastric cancer patients than in control group (305.97 +/- 63.71 (pg/ml) vs. 92.98 +/- 4.95 (pg/ml), P < 0.001); while the mean serum level of sFasL was lower in patients with gastric adenocarcinoma (0.138 +/- 0.04 (pg/ml) vs. 0.150 +/- 0.02 (pg/ml), P < 0.001). Mean serum levels of sFas/sFasL were significantly different in both intestinal/diffuse and cardiac/non-cardiac subtypes when compared to the control group (P < 0.001). There was an increase in the serum level of sFas from the first steps of pre-neoplastic lesions to gastric adenocarcinoma (P < 0.001). Patients who had no lymph node involvement (N0) showed significantly higher serum levels of sFas compared to others (P = 0.044). CONCLUSIONS: Production of sFas may play a critical role in the carcinogenesis of intestinal-type gastric cancer. sFas serum level may serve as a non-invasive tool for early diagnosis of gastric cancer.