Paraoxonase 1 Activity and Phenotype Distribution in Lumbar Disc Herniation Patients.

AIM: To compare the Paraoxonase 1 (PON1) activity and phenotype distribution between lumbar disc herniation (LDH) patients and healthy individuals. MATERIAL AND METHODS: This research included 40 LDH patients and 42 healthy individuals. Spectrophotometric assays were performed to determine the serum PON1 and arylesterase activities. The PON1 ratio, which represents the salt-stimulated PON/ arylesterase level, demonstrated a trimodal distribution. This ratio was applied to identify the different phenotypes; QQ, QR, and RR of each subject. RESULTS: The LDH patients had lower PON1 activity than the healthy individuals (p < 0.05). LDH patients had a statistically significant QQ phenotype compared to the healthy subjects (p < 0.05). CONCLUSION: LDH patients had statistically lower PON1 activity, suggesting that the low PON1 activity and PON1 QQ phenotype may be a risk factor for LDH occurrence.

Comparison of Single Lumbar Transforaminal Epidural Steroid Injections for Treatment of Early and Late Recurrent Lumbar Disc Herniation.

AIM: To compare the results of fluoroscopically guided transforaminal epidural steroid injection (TESI) for pain reduction in ipsilateral early recurrent lumbar disc herniation (RLDH) with ipsilateral late RLDH. MATERIAL AND METHODS: A total of 738 patients complaining of radicular pain due to ipsilateral early and late RLDH were assessed. Of these, TESI was administered to 390 subjects for ipsilateral early RLDH and 346 for ipsilateral late RLDH. TESIs were performed based on radicular leg pain; all subjects were followed up and reexamined after 12 weeks of the therapy. Pre- and postprocedural visual analog scale (VAS) scores and all complications were recorded for the study. RESULTS: For radicular pain, the mean pre-, and postprocedural VAS scores for ipsilateral early RLDH were 85.44 ± 6.85 and 20.16 ± 3.77 respectively. For late RLDH, the mean pre-, and postprocedural VAS scores were 72.82 ± 5.12 and 30.87 ± 4.17, respectively. A significant statistical difference for pre- and postprocedural VAS scores were observed between ipsilateral early and late recurrent disc herniation TESI groups (p < 0.05). CONCLUSION: TESI was more effective for early RLDH than for late RLDH during the 12-week follow-up period.

Biochemical, pathological and ultrastructural investigation of whether lamotrigine has neuroprotective efficacy against spinal cord ischemia reperfusion injury.

INTRODUCTION: Lamotrigine, an anticonvulsant drug with inhibition properties of multi-ion channels, has been shown to be able to attenuates secondary neuronal damage by influencing different pathways. The aim of this study was to look into whether lamotrigine treatment could protect the spinal cord from experimental spinal cord ischemia-reperfusion injury. MATERIALS AND METHODS: Thirty-two rats, eight rats per group, were randomly assigned to the sham group in which only laparotomy was performed, and to the ischemia, methylprednisolone and lamotrigine groups, where the infrarenal aorta was clamped for thirty minutes to induce spinal cord ischemia-reperfusion injury. Tissue samples belonging to spinal cords were harvested from sacrificed animals twenty-four hours after reperfusion. Tumor necrosis factor-alpha levels, interleukin-1 beta levels, nitric oxide levels, superoxide dismutase activity, catalase activity, glutathione peroxidase activity, malondialdehyde levels and caspase-3 activity were studied. Light and electron microscopic evaluations were also performed to reveal the pathological alterations. Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test was used to evaluate neurofunctional status at the beginning of the study and just before the animals were sacrificed. RESULTS: Lamotrigine treatment provided significant improvement in the neurofunctional status by preventing the increase in cytokine expression, increased lipid peroxidation and oxidative stress, depletion of antioxidant enzymes activity and increased apoptosis, all of which contributing to spinal cord damage through different paths after ischemia reperfusion injury. Furthermore, lamotrigine treatment has shown improved results concerning the histopathological and ultrastructural scores and the functional tests. CONCLUSION: These results proposed that lamotrigine may be a useful therapeutic agent to prevent the neuronal damage developing after spinal cord ischemia-reperfusion injury.