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Oh, Younggyu,Lee, Byungjou,Lee, Subum,Kim, Junghwan,Park, Jinhoon The Korean Neurosurgical Society 2019 Journal of Korean neurosurgical society Vol.62 No.5
Objective : Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs. Methods : Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures. Results : Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months. Conclusion : We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.
NCAM140 and pCREB Expression after Tianeptine Treatment of SH-SY5Y Cells
Migyung Lee,Daeyoung Oh,MiRan Choi,YoungGyu Chai,SeokHyeon Kim,DongHoon Oh,Joonho Choi 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.3
Objective-Antidepressants modulate neuronal plasticity. Tianeptine, an atypical antidepressant, might be involved in the restoration of neuronal plasticity; it primarily enhances the synaptic reuptake of serotonin. NCAM140 is involved in neuronal development processes, synaptogenesis and synaptic plasticity. We investigated the effect of tianeptine on the expression of NCAM140 and its downstream signaling molecule in the human neuroblastoma cell line SH-SY5Y. Methods-NCAM protein expression was measured in human neuroblastoma SH-SY5Y cells that were cultivated in serum-free media and treated with 0, 10, or 20 μM tianeptine for 6, 24, or 72 hours. NCAM140 expression in the tianeptine treatment group was confirmed by Western blot, and quantified through measurement of band intensity by absorbance. CREB and pCREB expression was identified after treatment with 20 μM tianeptine for 6, 24, and 72 hours by Western blot. Results-Compared to cells treated for 6 hours, cells treated with 0 or 10 μM tianeptine for 72 hours showed a significant increase in NCAM140 expression and cells treated with 20 μM tianeptine showed a significant increase after 24 and 72 hours. The pCREB level in cells treated with 20 μM tianeptine increased in time-dependent manner. Conclusion-Our findings indicated that the tianeptine antidepressant effect may occur by induction of NCAM140 expression and CREB phosphorylation.
Current Concepts in the Treatment of Traumatic C2 Vertebral Fracture : A Literature Review
Subum Lee,Junseok W Hur,Younggyu Oh,Sungjae An,Gi-Yong Yun,Jae-Min Ahn 대한신경외과학회 2024 Journal of Korean neurosurgical society Vol.67 No.1
The integrity of the high cervical spine, the transition zone from the brainstem to the spinal cord, is crucial for survival and daily life. The region protects the enclosed neurovascular structure and allows a substantial portion of the head motion. Injuries of the high cervical spine are frequent, and the fractures of the C2 vertebra account for approximately 17–25% of acute cervical fractures. We review the two major types of C2 vertebral fractures, odontoid fracture and Hangman’s fracture. For both types of fractures, favorable outcomes could be obtained if the delicately selected conservative treatment is performed. In odontoid fractures, as the most common fracture on the C2 vertebrae, anterior screw fixation is considered first for type II fractures, and C1–2 fusion is suggested when nonunion is a concern or occurs. Hangman's fractures are the second most common fracture. Many stable extension type I and II fractures can be treated with external immobilization, whereas the predominant flexion type IIA and III fractures require surgical stabilization. No result proves that either anterior or posterior surgery is superior, and the surgeon should decide on the surgical method after careful consideration according to each clinical situation. This review will briefly describe the basic principles and current treatment concepts of C2 fractures.