Association of TaqI (rs731236) Polymorphism of Vitamin D Receptor Gene with Lumbar Degenerative Disc Disease.

BACKGROUND: Lumbar degenerative disc disease (LDDD) significantly contributes to low back pain, with a complicated etiology involving genetic and environmental facts. The aim of study was to investigate the association between the TaqI (rs731236) polymorphism of the vitamin D receptor (VDR) gene with LDDD. METHODS: In total, 248 patients with symptomatic LDDD and 146 control subjects were examined. The evaluation of clinical features of patients with LDDD comprised radiodiagnostic magnetic resonance imaging, neurologic examinations, pain scores including the visual analog scale (VAS), and disability investigation with Oswestry Disability Index (ODI). Genotyping of the VDR gene polymorphism was conducted using polymerase chain reaction-based methods. RESULTS: Individuals of the LDDD group who were VDR TaqI AA genotype carriers were significantly greater than the other group (P = 0.014), whereas those with GG genotype were significantly lower (P = 0.028) in the patient group. In addition, VAS and ODI scores were significantly lower in the GG genotype carrier group, whereas AA genotype carriers had the greatest scores (P = 0.004). Carrying the G allele decreased the risk of LDDD 1.7 times (P = 0.014) and carrying the A allele enhanced the risk 1.8 times (P = 0.028). Moreover, G-allele carriers had significantly lower VAS (P = 0.002) and ODI scores (P < 0.0001). CONCLUSIONS: VDR TaqI (rs731236) GG genotype and G allele have protective potential, whereas the AA genotype and A allele are risk factors for LDDD. The findings reveal a statistically significant association of the TaqI (rs731236) polymorphism of VDR gene polymorphism with LDDD. This result highlights the potential role of genetic factors in developing LDDD and suggests avenues for future research in genetic screening and personalized treatment strategies.

Serum miRNA-582-5p and miRNA-363 as Potential Non-Invasive Biomarkers for Glioblastoma Multiforme.

AIM: To determine expression levels of miRNA-582-5p and miRNA-363 in serum of patients with Glioblastoma Multiforme and assess their biomarker potential. MATERIAL AND METHODS: The study population consisted of 71 subjects including 35 patients and 36 healthy controls. Realtime polymerase chain reaction was used to determine serum expression levels of miRNA-582-5p and miRNA-363 in patients and control individuals. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic potential of miRNA-582-5p and miRNA-363. Serum caspase-9 level was measured using enzyme-linked immunosorbent assay. RESULTS: Normalized expression levels of miRNA-582-5p and miRNA-363 were calculated using the 2-ΔΔCt method. We found that miRNA-582-5p and miRNA-363 were significantly upregulated in patients compared with healthy controls. High levels of miRNA- 582-5p (Fold change 2.86, p < 0.0001) and miRNA-363 (Fold change 3.51, p < 0.0001) were significantly associated with Glioblastoma Multiforme. Additionally, ROC analyses demonstrated that levels of miRNA-582-5p [area under the curve (AUC)=0.938, p=0.0001] and miRNA-363 [AUC=0.951, p=0.0001] were significantly different between the groups. In contrast, there was no correlation between levels of serum caspase-9 and those of miRNA-582-5p (p=0.144) or miRNA-363 (p=0.050). CONCLUSION: High serum levels of miRNA-582-5p and miRNA-363 are associated with Glioblastoma Multiforme, and are potential biomarkers.

Determination of IDH1, IDH2, MGMT, TERT and ATRX Gene Mutations in Glial Tumors.

BACKGROUND/AIM: The most frequent and dangerous kind of primary brain tumor is glioblastoma multiforme (GBM). The survival rates associated with GBM are very short and molecular markers for predicting survival are needed. The aim of our study was to evaluate isocitrate dehydrogenase 1 and 2 (IDH1, IDH2), telomerase reverse transcriptase (TERT), O-6- methylguanine-DNA methyltransferase (MGMT) and alpha-thalassemia/mental retardation, X-linked (ATRX) genes with next-generation sequencing (NGS) to find potential pathological mutations and their effect on survival. MATERIALS AND METHODS: Thirty patients who had undergone craniotomy and were diagnosed with high-grade glioma were evaluated for this study. Peripheral blood samples were obtained from all participants. IDH1, IDH2, TERT, MGMT and ATRX genes were evaluated with next-generation sequencing from the samples. Survival analysis evaluated the effects of all these mutations on survival. RESULTS: The median age of the patients was 58.5 (range=11- 74) years, and 56.7% (n=17) were under 60 years of age. According to sex, male patients comprised 66.7%. Targeted NGS detected 21 chromosomal aberrations. When more than three chromosomal anomalies were accepted as a reference, anomaly in three or fewer chromosomes negatively affected overall survival (hazard ratio=2.83). CONCLUSION: Targeted NGS generates therapeutically meaningful information, providing better prognostic information than conventional histology. Our study shows that NGS provides important information on survival by helping to detect chromosomal changes that can be detected in routine blood samples. It is clear that incorporating molecular diagnostics into our standard-of-care routine will help us better understand our patients' outcomes.

The Effect of Lutein on Ischemia-reperfusion-induced Vasculitic Neuropathic Pain and Neuropathy in Rats.

BACKGROUND/AIM: Neuropathic pain and neuropathy is commonly seen after ischemia-reperfusion injuries. Our aim was to evaluate the effect of lutein on ischemia-reperfusion (I/R)-induced vasculitic neuropathic pain and neuropathy in rats. MATERIALS AND METHODS: An hour before anesthesia, 6 Albino Wistar male rats with I/R were orally administered with 1 mg/kg lutein (LIR group). Two groups of 6 such rats who underwent surgery were provided with 0.5 ml distilled water (as solvent) either via oral administration (SIR group) or by gavage (sham group or SG). One hour following the administration, the later femoral arteries of the LIR and SIR rats were closed using a sterile silk thread and ischemia was induced in the sciatic nerve for 4 h, followed by reperfusion for 24 h. The femoral artery of the SG group was not closed with suture. Next, 1 mg/kg lutein was re-administered only to the LIR group for 1 h, followed by measurement of the paw pain thresholds by the Basile Algesimeter. The levels of malondialdehyde (MDA), total glutathione (tGSH), nuclear factor-kB (NF-κB), and tumor necrosis factor-alpha (TNF-α) in the sciatic nerve tissues were measured, and the tissues were histopathologically examined. RESULTS: We found that the MDA, NF-κB, and TNF-α levels were higher and the tGSH level was lower in the SIR group relative to those in the LIR group, and the differences were statistically significant. Significant histopathological damage was noted in the SIR group, whereas the LIR group demonstrated protection from oxidative damage. CONCLUSION: Lutein is potentially useful in the treatment of I/R-related neuropathy and neuropathic pain.

A comparative study for glioma classification using deep convolutional neural networks.

Gliomas are a type of central nervous system (CNS) tumor that accounts for the most of malignant brain tumors. The World Health Organization (WHO) divides gliomas into four grades based on the degree of malignancy. Gliomas of grades I-II are considered low-grade gliomas (LGGs), whereas gliomas of grades III-IV are termed high-grade gliomas (HGGs). Accurate classification of HGGs and LGGs prior to malignant transformation plays a crucial role in treatment planning. Magnetic resonance imaging (MRI) is the cornerstone for glioma diagnosis. However, examination of MRI data is a time-consuming process and error prone due to human intervention. In this study we introduced a custom convolutional neural network (CNN) based deep learning model trained from scratch and compared the performance with pretrained AlexNet, GoogLeNet and SqueezeNet through transfer learning for an effective glioma grade prediction. We trained and tested the models based on pathology-proven 104 clinical cases with glioma (50 LGGs, 54 HGGs). A combination of data augmentation techniques was used to expand the training data. Five-fold cross-validation was applied to evaluate the performance of each model. We compared the models in terms of averaged values of sensitivity, specificity, F1 score, accuracy, and area under the receiver operating characteristic curve (AUC). According to the experimental results, our custom-design deep CNN model achieved comparable or even better performance than the pretrained models. Sensitivity, specificity, F1 score, accuracy and AUC values of the custom model were 0.980, 0.963, 0.970, 0.971 and 0.989, respectively. GoogLeNet showed better performance than AlexNet and SqueezeNet in terms of accuracy and AUC with a sensitivity, specificity, F1 score, accuracy, and AUC values of 0.980, 0.889, 0.933, 0.933, and 0.987, respectively. AlexNet yielded a sensitivity, specificity, F1 score, accuracy, and AUC values of 0.940, 0.907, 0.922, 0.923 and 0.970, respectively. As for SqueezeNet, the sensitivity, specificity, F1 score, accuracy, and AUC values were 0.920, 0.870, 0.893, 0.894, and 0.975, respectively. The results have shown the effectiveness and robustness of the proposed custom model in classifying gliomas into LGG and HGG. The findings suggest that the deep CNNs and transfer learning approaches can be very useful to solve classification problems in the medical domain.

Multi-Level Anterior Cervical Decompression in Multi-Level Cervical Spondylotic Myelopathy without Extending the Corpus Resection: A Cadaveric Study of a Novel Surgical Technique.

AIM: To perform three-level decompression with a single-level corpectomy by modifying the fusion with anterior cervical corpectomy (ACC-F) method on a cadaver. MATERIAL AND METHODS: The anterior cervical region of four whole-head cadavers was dissected. The corpectomy was performed under a surgical microscope with a MT4-20+ ultrasonic bone dissector (UBD) tip. Superior and inferior decompression were conducted and viewed with a 70° neuroendoscope using two types (vertically and horizontally oriented) of specially designed 23 mm-long, 90°-angled UBD tips. RESULTS: After neck dissection and the removal of the thyroid and cricoid cartilages, C5 corpectomy and adjacent-level discectomies were performed. Following discectomy and corpectomy, superior and inferior decompression were conducted with specially designed UBD tips and viewed with a 70° neuroendoscope. A three-level anterior cervical decompression was provided with a single-level corpectomy. CONCLUSION: This study demonstrated that two more level decompression is possible with a single-level corpectomy in the cervical region using the new technique.

The Effect of Rutin on Experimental Traumatic Brain Injury and Edema in Rats.

BACKGROUND/AIM: The aim of the study was to evaluate the effect of rutin, which is a vitamin P1 flavonoid with anti-inflammatory and anti-edema effects, on traumatic brain injury (TBI) and edema in rats. MATERIALS AND METHODS: Rats were divided into 3 groups as sham group without brain trauma (SG), brain trauma without medication (BT) group and Rutin treated brain trauma (RBT) group. Fifty mg/kg rutin was administered to the RBT group once a day for three days. On the fourth day, rats were sacrificed. Extracted brain tissues were examined biochemically and histopathologically. RESULTS: We found that the levels of malondialdehyde, nuclear factor-kappa B and tumor necrosis factor-alpha decreased, and those of total glutathione increased significantly. Furthermore, rutin administration reduced pyramidal neuron degeneration and poly-morpho-nuclear-leucocyte accumulation due to trauma in brain tissue, while eliminating edema. CONCLUSION: Rutin might be effective in the treatment of TBI and TBI-related brain edema.

Investigation of the Effects of MicroRNA-221 Expression Levels in Glioblastoma Multiforme Tumors.

BACKGROUND/AIM: The aim of our study was to examine miRNA-221 as a candidate biomarker to define prognosis and/or classification for glial tumors. MATERIALS AND METHODS: This study included 39 patients who underwent glial tumor surgery and 40 healthy individuals as the control group. miRNA expression levels were determined by real-time polymerase chain reaction (RT-PCR). Receiver operating characteristic curve analysis was used for analyzing the predictive ability of miRNA-221. RESULTS: The levels of miRNA-221 expression were determined by comparing the ΔCT values of miRNAs and the internal control. When the expression levels of miRNA-221 were compared according to the ΔCT method, miRNA-221 was found to be significantly increased in the patient group compared to the control group (p<0.0001). CONCLUSION: Increased expression levels of miRNA-221 could be a biomarker for glial tumors.

The Evaluation of Glutathione Reductase and Malondialdehyde Levels in Patients With Lumbar Disc Degeneration Disease.

BACKGROUND/AIM: Increased oxidative stress plays a crucial role in pathogenesis of various diseases. The present study aims to investigate glutathione reductase (GR) and malondialdehyde (MDA) enzymes as markers of oxidative stress mechanisms in lumbar disc degeneration disease (LDDD). PATIENTS AND METHODS: The study group consisted of 39 patients diagnosed with LDD and 37 healthy individuals in the control group. The enzyme-linked immunosorbent assay (ELISA) method was used to determine serum GR and MDA levels in the two study groups. RESULTS: Serum GR levels were significantly lower (p=0.008), while MDA levels were significantly higher in the patient group compared to the controls (p=0.025). CONCLUSION: Oxidative stress mechanisms play a crucial role in disc degeneration and GR deficiency could be an eligible risk factor for LDDD.

The Evaluation of Proteoglycan Levels and the Possible Role of ACAN Gene (c.6423T>C) Variant in Patients with Lumbar Disc Degeneration Disease.

BACKGROUND/AIM: The present study aimed to investigate the role of an aggrecan (ACAN) gene variant and proteoglycan levels in the risk of lumbar degenerative disc disease (LDDD). MATERIALS AND METHODS: A total of 108 patients with LDDD and 103 healthy controls were enrolled. Molecular assessment of the ACAN gene (c.6423T>C) variant was determined by real time-polymerase chain reaction. Proteoglycan levels in serum were measured with enzyme-linked immunosorbent assay. RESULTS: The frequency of all alleles and genotypes in all study groups were distributed according to the Hardy-Weinberg equilibrium. In addition, no association between the ACAN gene (c.6423T>C) variant and presence of risk factors for LDDD was detected. However, proteoglycan levels were significantly lower in patients with LDDD compared to the control group (p<0.00001). CONCLUSION: Our findings suggest that proteoglycan has emerged as a potential novel biomarker which might be used for prediction of LDDD risk.

Association of rs2228570 Polymorphism of Vitamin D Receptor Gene with Lumbar Degenerative Disc Disease.

AIM: To investigate the association between the vitamin D receptor (VDR) gene rs2228570 FokI polymorphism and the development of lumbar degenerative disc disease (LDDD) in the Turkish population. MATERIAL AND METHODS: This was a prospective case-control study that included 45 patients with LDDD and 49 healthy individuals (control group). The clinical investigations of the LDDD patients consisted of neurological examinations, lumbar magnetic resonance imaging studies, visual analog scale (VAS) scores, and Oswestry Disability Index scores. The VDR gene rs2228570 FokI polymorphism was analyzed via a real-time polymerase chain reaction. RESULTS: Individuals with the VDR GG genotype had a significantly increased risk of LDDD, while those with the AG genotype had a significantly decreased risk. In addition, the A allele may have a protective effect against LDDD in the Turkish population. Moreover, the VAS pain results showed that the GG genotype had a significantly higher score than the others. CONCLUSION: VDR rs2228570 AG genotype is at a decreased risk and the GG genotype is at an increased risk of LDDD in the Turkish population. Since genetic polymorphisms often show ethnic differences, further functional studies are needed to evaluate the genotype and phenotype correlations in large cohorts of various ethnicities.

Long-Term Outcomes of a New Minimally Invasive Approach in Chiari Type 1 and 1.5 Malformations: Technical Note and Preliminary Results.

BACKGROUND: The treatment options for patients with Chiari malformation type 1 (CM1) and Chiari malformation type 1.5 (CM1.5) have not yet been standardized. In these malformations, the main factors include obstruction at the level of the foramen magnum and dural and ligamentous thickening. Here we present our outcomes of surgery and decompression using a minimally invasive surgery (MIS) technique. METHODS: Sixty-one patients admitted to our clinics between 2009 and 2016 due to CM1 or CM1.5 and who had undergone MIS were investigated retrospectively. All patients were followed up for a mean period of 55 months, both clinically and radiologically, and the outcomes were recorded. RESULTS: All 61 patients underwent foramen magnum decompression through a 1.5-cm mini-open incision, C1 laminectomy and C2 medial inner side tour, posterior atlanto-occipital membrane removal, external dural delamination, and widening of the internal dura with longitudinal incisions. Fifty-six patients (91.8%) were satisfied with the outcome, 4 patients (6.5%) remained the same, and 1 patient (1.6%) reported a poor outcome. Forty-five percent of the patients with syringomyelia demonstrated resolution within 2 years, and 92% demonstrated resolution in 5 years. Scoliosis was seen in 5 patients (8.1%). The rate of benefit from the surgical procedure was statistically significant (P = 0.0045), and no patient required additional surgery because of poor decompression. CONCLUSIONS: MIS is effective for uncomplicated cases of CM1 and CM1.5 due to its minimal connective and muscular tissue damage, short surgical duration, short recovery time, early mobilization, effective posterior foramen magnum widening, lack of liquor fistula development, and better clinical and radiologic improvement during long-term follow-up.

Spinal Tuberculosis Mimicking Failed Back Surgery.

BACKGROUND The aim of this study was to draw attention to rare spinal infections in recurrent failed spinal surgeries. CASE REPORT A 59-year-old female was admitted to the hospital for back pain, which was assessed as a 9 on the visual analogue scale (VAS); the patient reported tiredness and night sweats. She had an operation for L3-4 far lateral disc herniation four years ago. Then another operation for L4-5 disc herniation six months ago and immediately three months later she has an operation with L3-4-5 fixation again. She had hypothyroidism, diabetes mellitus, and hypertension. Her daughter was cured of pulmonary tuberculosis 20 years ago. We performed an operation by L4-5 discectomy; all granulation formation with inflammatory processes were debrided and irrigated with antibiotics at levels of L3-5. The old fixation was controlled and replaced. Her back pain improved immediately after surgery; she had a score of 2 on the VAS. Two days after her surgery, our Infection Disease Department reported acid resistant bacillus (ARB+) in samples and began anti-tuberculosis medication. CONCLUSIONS Spinal infections should always be taken into consideration in recurrent failed back surgeries.

Morphometric analysis of posterior fossa and craniovertebral junction in subtypes of Chiari malformation.

OBJECTIVES: Chiari malformations (CMs) are a group of disorders defined by anatomic anomalies of the cerebellum, brainstem, and craniovertebral junction (CVJ). In this study, we aimed to investigate morphometry of posterior fossa and CVJ in subtypes of CM and in control group, and to bring up a matter a correlation with demographic data and subtypes of CM. PATIENTS AND METHODS: The study group included patients managed for CM between 2012 and 2016 and control group. Radiological evaluation was studied by special programs and formulas. Intracranial volumes and morphometric datas of posterior fossa and CVJ were recorded retrospectively. RESULTS: Of the 141 patients, 91 had CM and 50 were control group participants. Mean age was 34.75. Patients were classified as CM-0 (n:10), CM-1 (n:45), CM-1.5 (n:21), CM-2 (n:15). There were statistically significance between Chiari subtypes by syringomyelia (SM) presence (p ˂ 0.01), SM localization (p ˂ 0.01), posterior fossa volume (PFV) (p ˂ 0.01), length of clivus (LoC) and length of subocciput (LoSO) (p ˂ 0.01 for both), angle between clivus and subocciput (C-SO angle) (p ˂ 0.01), and clivo-dental angle (C-D angle) (p ˂ 0.01). CONCLUSION: On morphometric comparison of CM subtypes we concluded that etiological differences lead to morphological differences. CM-2 has remarkable differences from both other subtypes and the control group.

Tumor Necrosis Factor-Alpha (TNF-α-308 G>A) Polymorphism in High-grade Gliomas.

BACKGROUND/AIM: High-grade gliomas (HGG) consist of anaplastic oligoastrocytomas, anaplastic oligodendrogliomas, anaplastic astrocytomas and glioblastoma multiforme. The present study aimed to evaluate TNF-α -308 G>A polymorphism in a Turkish population. PATIENTS AND METHODS: This was a prospective case-control study that included 45 patients with HGG and 49 healthy individuals. All patients were operated for intracranial tumors and the pathology results consist of high grade (Grade3 and 4) glial tumors. RESULTS: No significant differences were found between the HGG and control groups in terms of the median age (p=0.898). There were no significant differences with regard to gender (p=0.577). The TNF genotype frequency comparison between patients and controls was not statistically significant (p=0.598). CONCLUSION: TNF genotype frequency comparison between the patients and controls was not statistically significant in the Turkish population tested. However, further studies are needed to evaluate the genotype and phenotype correlations in large cohorts of various ethnicities.

Encephalocraniocutaneous Lipomatosis: Haberland Syndrome.

BACKGROUND Encephalocraniocutaneous lipomatosis (ECCL) was first announced as a new type of ectomesodermal dysgenesis in 1970 by Haberland and Perou. ECCL was first described in 1970, and approximately 60 cases have been reported since then. The classic triad of ECCL are skin, ocular, and central nervous system involvement, including conditions such as unilateral porencephalic cyst, ipsilateral lipomatous hamartoma of the scalp-eyelids-eye globe, cortical atrophy, cranial asymmetry, developmental delay, seizures, mental retardation, and spasticity of the contralateral limbs. The dermatological hallmark is a hairless fatty tissue nevus of the scalp called nevus psiloliparus. CASE REPORT An 11-year-old right-handed boy, born at full term, was referred to our clinic. His family had no consanguinity or history of neurocutaneous disease. The patient's physical examination revealed a large hairless lesion on the right frontoparietal scalp called nevus psiloliparus. Beginning from the birth, a dermolipoma (an uncommon benign tumor) was reported to have occurred on the conjunctiva, mostly ipsilateral in his right eye and present on the ipsilateral side of the neurological abnormalities shown on magnetic resonance imaging and computed tomography. The patient had muscle weakness in left upper and lower extremities. He had a mild form of mental retardation. CONCLUSIONS There is no specific treatment for ECCL. Management of ECCL is usually symptomatic. Surgical correction of a cutaneous lesion can be performed for cosmetic improvement. An early diagnosis of ECCL allows for early symptom treatment and improved patient quality of life.

Thoracic Epidural Hematoma Complicating Vertebroplasty.

BACKGROUND Percutaneous vertebroplasty procedures are commonly used to treat vertebral fractures. These techniques may be associated with major complications. CASE REPORT We present here a case of a 64-year-old female patient with T9 and T10 acute osteoporotic fractures, treated previously with vertebroplasty for four levels of osteoporotic vertebral fractures. The patient was treated by T9-T10 vertebroplasty. The post-operative neurological examination was normal. Two hours later, she progressively worsened and developed paraplegia. Magnetic resonance imaging (MRI) revealed a hyper-acute epidural hematoma over the T6 to T10 vertebrae. Evacuation of the epidural hematoma completely resolved her motor weakness. Previous literature reports one case with a thoracolumbar epidural hematoma over T11-L2 and another case with a L1 epidural hematoma after vertebroplasty. CONCLUSIONS Percutaneous vertebroplasty is generally a safe procedure but can have rare complications. Epidural hematoma after vertebroplasty is one of the uncommon complications. Before percutaneous vertebroplasty, patients should be informed about these rare complications. Prognosis is very good if early intervention is possible.

Isolated C5 Vertebrae Dislocation with Trauma: An Extremely Rare Case of Isolated C5 Dislocation.

BACKGROUND Total spondylolisthesis, or dislocation of 1 cervical vertebrae, is only caused by high-energy trauma and is usually fatal. Cervical spine fractures and dislocations often cause 3-column structural damage to the cervical spine, injury to the spinal cord, and precipitating alignment of the cervical vertebrae, as well as cervical instability, which are detrimental, show poor prognosis, and are associated with high rates of mortality rate and disability. CASE REPORT We report an extremely rare case of isolated C5 dislocation caused by falling out of a tree, with sudden tetraplegia. CONCLUSIONS Total spondylolisthesis or dislocation of 1 cervical vertebrae can be surgically treated with anterior approach because it is possible to completely remove the vertebra body, intervertebral disc, and bone fragments, to directly decompress the spinal cord with stabilization.

Role of Caspase-9 Gene Ex5+32 G>A (rs1052576) Variant in Susceptibility to Primary Brain Tumors.

BACKGROUND/AIM: This study is the first to evaluate the relationship of caspase-9 (CASP-9) gene polymorphism with the risk for primary brain tumor development. MATERIALS AND METHODS: The study group included 43 glioma and 27 meningioma patients and 76 healthy individuals. CASP-9 gene Ex5+32 G>A (rs1052576) polymorphism was analyzed by real-time polymerase chain reaction (RT-PCR). RESULTS: Individuals with the CASP-9 GG genotype had significantly decreased risk of developing a glioma brain tumor (p=0.024). Additionally, the GA genotype was significantly lower in patients with glioma than the control group (p=0.019). A significantly decreased risk of developing glioma was found in the A allele carrier group (p=0.024). However, there was no statistically significant relationship between CASP-9 polymorphism and brain meningioma (p=0.493). CONCLUSION: CASP-9 (rs1052576) mutant A allele seems to be a protective factor for glioma brain tumor. Future studies with a larger sample size will clarify the possible roles of CASP-9 gene in the etiology and progression of primary brain tumors.

Neuroprotective Effects of Pregabalin Against Spinal Cord Ischemia-Reperfusion Injury in Rats.

AIM: To evaluate the effect of pregabalin pre-treatment on spinal cord ischemia-reperfusion (I/R) injury and compare with methylprednisolone (MP). MATERIAL AND METHODS: Thirty-two rats were randomly divided into four groups as follow: Group 1 (sham)(n=8), group 2 (ischemia only)(n=8), group 3 (30 mg/kg pregabalin)(n=8), and group 4 (30 mg/kg methylprednisolone)(n=8). Laparotomy was performed without aortic clamp in the sham group. All animals were sacrificed 24 hours after surgery. The spinal cord tissue samples were harvested and caspase-3 activity, tumor necrosis factor-alpha (TNF-α) and Interleukin-1 Beta (IL-1ß) levels, catalase (CAT) activity, glutathione peroxidase (GPx) activity, superoxide dismutase (SOD) levels malondialdehyde (MDA) levels and nitric oxide (NO) levels were analyzed to investigate the effects of different excitatory and inflammatory pathways in mechanism of I/R injury. Ultrastructural and histopathological examinations were carried out. Neurological recovery was measured by Basso, Beattie, Bresnahan (BBB) test and Inclined Plane Test. RESULTS: Decresead caspase-3 activity and decreased inflammatory markers like TNF-α, IL-1ß, and decresaed excitotatory pathways like CAT, GPx, MDA, NO and SOD were observed in both pregabalin pre-treatment and MP treatment groups. Pregabalin pre-treatment produced better ultrastructural results compared to MP treatment, as with histopathological examination. Pregabalin group showed better recovery compared to MP treament group according to BBB scoring system. CONCLUSION: Pregabalin pre-treatmet and MP treatment both has neuroprotective effect on I/R injury by decreasing caspase dependant apoptosis, and inflammatory and oxidative stress markers. In addition, pregabalin pre-treatment had better clinical effects compared to MP treatment.