ABSTRACT
Purpose@#Glioblastoma (GBM) is an intractable disease for which various treatments have been attempted, but with little effect.This study aimed to measure the effect of photodynamic therapy (PDT) and sonodynamic therapy (SDT), which are currently being used to treat brain tumors, as well as sono-photodynamic therapy (SPDT), which is the combination of these two. @*Materials and Methods@#Four groups of Sprague-Dawley rats were injected with C6 glioma cells in a cortical region and treated with PDT, SDT, and SPDT. Gd-MRI was monitored weekly and 18F-FDG-PET the day before and 1 week after the treatment. The acoustic power used during sonication was 5.5 W/cm2 using a 0.5-MHz single-element transducer. The 633-nm laser was illuminated at 100 J/cm2 . Oxidative stress and apoptosis markers were evaluated 3 days after treatment using immunohistochemistry (IHC): 4-HNE, 8-OhdG, and Caspase-3. @*Results@#A decrease in tumor volume was observed in MRI imaging 12 days after the treatment in the PDT group (p<0.05), but the SDT group showed a slight increase compared to the 5-Ala group. The high expression rates of reactive oxygen species-related factors, such as 8-OhdG (p<0.001) and Caspase-3 (p<0.001), were observed in the SPDT group compared to other groups in IHC. @*Conclusion@#Our findings show that light with sensitizers can inhibit GBM growth, but not ultrasound. Although SPDT did not show the combined effect in MRI, high oxidative stress was observed in IHC. Further studies are needed to investigate the safety parameters to apply ultrasound in GBM.
ABSTRACT
OBJECTIVE: The object of this study was to evaluate the clinical and radiological outcomes of minimally invasive lateral lumbar interbody fusion. METHODS: This study included 30 patients who underwent minimally invasive lateral lumbar interbody fusion at our hospital between May 2011 and February 2012 for the following diagnoses: degenerative disc disease, adjacent-segment degeneration, degenerative spondylolisthesis and lumbar degenerative scoliosis. Pain assessment was reported from 0 to 10 using a subjective visual analog scale (VAS) upon admission and at every follow-up day. Lumbar X-rays were obtained in the standing position upon admission and the 1st and 5th postoperative day, and at every follow-up day after the operation. The heights of the intervertebral disc space and neural foramen were measured using an electronic caliper with the PACS software. The surgical outcome was assessed as excellent, good, fair or poor using the Odom scale at the last follow-up. RESULTS: The mean VAS for low back pain were 4.93+/-1.47 on admission and 2.01+/-1.35 at last follow-up, respectively, and for leg pain, the scores were 4.87+/-2.16 on admission and 1.58+/-1.52 at last follow-up. The mean height of intervertebral disc space increased by 34% (7.93+/-2.33 preoperatively, and 11.09+/-4.33 immediately after surgery, p<0.01). The mean height of neural foramen also increased by 6.4% without any statistical significance (19.17+/-2.84 preoperatively, and 20.49+/-4.50 immediately after the surgery). Minimally invasive lateral lumbar interbody fusion was successful in 27 patients (90%) at last follow-up. Surgical complications were reported as transient postoperative thigh sensory changes (5 patients, 16.7%), transient psoas muscle weakness (3 patients, 10%), cage migration (2 patients, 6.7%), lumbar plexus injury (1 patient, 3.3%), and pain aggravation (1 patient, 3.3%). CONCLUSION: The minimally invasive lateral lumbar interbody fusion is a safe and effective procedure for treating degenerative lumbar disease with good outcomes and moderate complications. Further follow-up is necessary to establish its safety and efficacy.