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Tae Seok Jeong, Seong Son, Sang Gu Lee, Yong Ahn, Jong Myung Jung, and Byung Rhae Yoo

OBJECTIVE

The object of this study was to compare, after a long-term follow-up, the incidence and features of adjacent segment disease (ASDis) following lumbar fusion surgery performed via an open technique using conventional interbody fusion plus transpedicular screw fixation or a minimally invasive surgery (MIS) using a tubular retractor together with percutaneous pedicle screw fixation.

METHODS

The authors conducted a retrospective chart review of patients with a follow-up period > 10 years who had undergone instrumented lumbar fusion at the L4–5 level between January 2004 and December 2010. The patients were divided into an open surgery group and MIS group based on the surgical method performed. Baseline characteristics and radiological findings, including factors related to ASDis, were compared between the two groups. Additionally, the incidence of ASDis and related details, including diagnosis, time to diagnosis, and treatment, were analyzed.

RESULTS

Among 119 patients who had undergone lumbar fusion at the L4–5 level in the study period, 32 were excluded according to the exclusion criteria. The remaining 87 patients were included as the final study cohort and were divided into an open group (n = 44) and MIS group (n = 43). The mean follow-up period was 10.50 (range 10.0–14.0) years in the open group and 10.16 (range 10.0–13.0) years in the MIS group. The overall facet joint violation rate was significantly higher in the open group than in the MIS group (54.5% vs 30.2%, p = 0.022). However, in terms of adjacent segment degeneration, there were no significant differences in corrected disc height, segmental angle, range of motion, or degree of listhesis of the adjacent segments between the two groups during follow-up. The overall incidence of ASDis was 33.3%, with incidences of 31.8% in the open group and 34.9% in the MIS group, showing no significant difference between the two groups (p = 0.822). Additionally, detailed diagnosis and treatment factors were not different between the two groups.

CONCLUSIONS

After a minimum 10-year follow-up, the incidence of ASDis did not differ significantly between patients who had undergone open fusion and those who had undergone MIS fusion at the L4–5 level.

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Tae-Young Jung, Shin Jung, Hyang-Hwa Ryu, Young-Il Jeong, Yong-Hao Jin, Shu-Guang Jin, In-Young Kim, Sam-Suk Kang, and Hyung-Seok Kim

Object

Galectin-1 is highly expressed in motile cell lines. The authors investigated whether galectin-1 actually modulates the migration and invasion of human glioblastoma multiforme (GBM) cell lines, and whether its expression with respect to invasion and prognosis is attributable to certain glioma subgroups.

Methods

In the human GBM cell lines U343MG-A, U87MG, and U87MG-10′, the RNA differential display was evaluated using Genefishing technology. The results were validated by reverse transcription polymerase chain reaction and Northern blot analysis to detect possible genetic changes as the determining factors for the motility of the malignant glioma. The migration and invasion abilities were investigated in human GBM cell lines and galectin-1 transfectant using an in vitro brain slice invasion model and a simple scratch technique. The morphological and cytoskeletal (such as the development of actin and vimentin) changes were examined under light and confocal microscopy. Galectin-1 expression was assessed on immunohistochemical tests and Western blot analysis.

Results

Endogenous galectin-1 expression in the human GBM cell lines was statistically correlated with migratory abilities and invasiveness. The U87-G-AS cells became more round than the U87MG cells and lacked lamellipodia. On immunohistochemical staining, galectin-1 expression was increased in higher-grade glioma subgroups (p = 0.027).

Conclusions

Diffuse gliomas demonstrated higher expression levels than pilocytic astrocytoma in the Western blot. Galectin-1 appears to modulate migration and invasion in human glioma cell lines and may play a role in tumor progression and invasiveness in human gliomas.