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Lower back pain (LBP) is a prevalent spinal symptom at the lumbar region of the spine, which severely effects quality of life and constitutes the number one cause of occupational disability. Degeneration of the intervertebral disc (IVD) is one of the well-known causes contributing to the LBP. Therapeutic biomaterials inducing IVD regeneration are promising candidates for IVD degeneration treatments. Here, we demonstrate a collagen peptide presenting nanofiber scaffold to mimic the structure and function of the natural extracellular matrix of the tissue for IVD regeneration. The collagen peptide presenting nanofiber was designed by using a Pro-Hyp-Gly (POG) peptide sequence on a self-assembling peptide amphiphile molecule, which assembled into nanofibers forming scaffolds. Injection of collagen peptide presenting peptide nanofiber scaffold into the degenerated rabbit IVDs induced more glycosaminoglycan and collagen deposition compared to controls. Functional recovery of the tissue was evaluated by degeneration index score, where the bioactive scaffold was shown to provide functional recovery of the IVD degeneration. These results showed that the collagen peptide presenting nanofiber scaffold can prevent the progression of IVD degeneration and provide further functional recovery of the tissue.

The highly complex nature of spinal cord injuries (SCIs) requires design of novel biomaterials that can stimulate cellular regeneration and functional recovery. Promising SCI treatments use biomaterial scaffolds, which provide bioactive cues to the cells in order to trigger neural regeneration in the spinal cord. In this work, the use of peptide nanofibers is demonstrated, presenting protein binding and cellular adhesion epitopes in a rat model of SCI. The self‐assembling peptide molecules are designed to form nanofibers, which display heparan sulfate mimetic and laminin mimetic epitopes to the cells in the spinal cord. These neuroactive nanofibers are found to support adhesion and viability of dorsal root ganglion neurons as well as neurite outgrowth in vitro and enhance tissue integrity after 6 weeks of injury in vivo. Treatment with the peptide nanofiber scaffolds also show significant behavioral improvement. These results demonstrate that it is possible to facilitate regeneration especially in the white matter of the spinal cord, which is usually damaged during the accidents using bioactive 3D nanostructures displaying high densities of laminin and heparan sulfate‐mimetic epitopes on their surfaces.

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Abstract Aim of the Study: Clinical consequences of endoscopic endonasal approach (EEA) for Cushing Diseases (CD) were investigated in a single-center series based on definitions and assessments of recurrence and remission. Materials and Methods: 825 patients evaluated, including 64 patients with CD, who underwent EEA at the Ankara University Neurosurgery Department and evaluated retrospectively between the years 2014 and 2021. Postoperative next-morning cortisol and adrenocorticotrophic hormone (ACTH) values were used to assess postoperative endocrinological remission. Results: Twenty-two patients had macroadenoma, and 40 had microadenoma. In 2 patients, no lesions were detected in the sellar region, a diagnosis of magnetic resonance imaging (−) CD was made. Clinical and biochemical follow-ups in Cushing's disease are very important due to risk of recurrence. Regardless of remission, the effect of duration of glucocorticoid use after surgery on recurrence was examined. Glucocorticoid therapy was given in 46 patients (71%) after pituitary surgery. No recurrence was observed in 20 patients whose treatment duration was longer than 1 year. In 12 patients, the glucocorticoid therapy duration was ranged from 6 months to 12 months, and 4 patients showed recurrence. The glucocorticoid therapy duration of >6 months predicted that recurrence would not occur (p 6 months after surgery predicts that recurrence will not occur. Long-term glucocorticoid therapy after surgery suggests surgical success. The mainstay of CD treatment is appropriate postoperative follow-up and administration of the necessary medical and surgical interventions. Keywords: ACTH, Cortisol, Cushing disease, Endonasal endoscopic approach, Recurrence, Remission ÖZET Çalışmanın Amacı: Bu çalışmada, Cushing Hastalığı (CH) için endoskopik endonazal yaklaşımın (EEY) klinik sonuçları, remisyon ve nüks tanımları ve değerlendirmelerine dayalı olarak tek merkezli bir seride araştırıldı. Gereç ve Yöntemler: Ankara Üniversitesi İbni Sina Hastanesi Nöroşirürji Anabilim Dalı'nda 2014-2021 yılları arasında EEY uygulanan 825 hasta arasında CH’ lığı tanısı alan 64 hastanın verileri retrospektif olarak değerlendirildi. Postoperatif ertesi sabah kortizol ve adrenokortikotropik hormon (ACTH) değerleri postoperatif endokrinolojik remisyonu değerlendirmek için kullanıldı. Bulgular: Yirmi iki hastada makroadenom ve 40 hastada mikroadenom saptandı. 2 hastada sellar bölgede lezyon saptanmadı, manyetik rezonans görüntüleme (-) CH tanısı kondu. Kırk hasta kadın, 12 hasta erkekti. CH'de yüksek nüks insidansı nedeniyle, yıllık klinik ve biyokimyasal takipler çok önemlidir. Remisyondan bağımsız olarak ameliyat sonrası glukokortikoid kullanım süresinin nüks üzerine etkisi incelendi. Hipofiz cerrahisi sonrası 46 hastaya (%71) glukokortikoid tedavisi verildi. Tedavi süresi 1 yıldan uzun olan 20 hastada nüks gözlenmedi. 12 hastada glukokortikoid tedavi süresi 6 ay ile 1 yıl arasında değişmekteydi ve 4 hastada nüks görüldü. 6 aydan uzun glukokortikoid tedavi süresinin nüksün olmayacağını saptadığı öngörüldü (p

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