Byung Moon Cho

Neuroprotective effects of adipose-derived stem cells against ischemic neuronal damage in the rabbit spinal cord

Transplantation of adipose-derived stem cells (ASCs) is one of the possible therapeutic tools for ischemic damage. In this study, we observed the effects of ASCs against ischemic damage in the ventral horn of L(5-6) levels in the rabbit spinal cord. ASCs were isolated from rabbits, and cell type was confirmed by flow cytometry analysis, labeling with CM-DiI dye and differentiation into adipocytes in adipogenesis differentiation medium. ASCs were administered intrathecally into recipient rabbits (2 × 10⁵) immediately after reperfusion following a 15-min aortic artery occlusion in the subrenal region. Transplantation of ASCs significantly improved functions of the hindlimb and morphology of the ventral horn of spinal cord although CM-DiI-labeled ASCs were not observed in the spinal cord parenchyma. In addition, transplantation of ASCs significantly increased brain-derived neurotrophic factor (BDNF) levels at 72h after ischemia/reperfusion. These results suggest that transplantation of ASCs prevents motor neurons from spinal ischemic damage and reactive gliosis by increasing neurotrophic factors such as BDNF in the spinal cord.

Metastatic choriocarcinoma with multiple neoplastic intracranial microaneurysms

The authors report on a case of a metastatic choriocarcinoma that mimicked systemic necrotizing vasculitis on a cerebral angiogram. A 35-year-old woman presented with right hemiplegia and a drowsy mental state. A computed tomography (CT) scan revealed an intracerebral hemorrhage in the left frontal region. A cerebral angiogram showed multiple microaneurysms arising from the bilateral anterior cerebral arteries and middle cerebral arteries, and the renal angiogram showed multiple microaneurysms arising from the left distal renal artery. A chest CT scan revealed multiple metastatic lesions in the left lower lung field. The hematoma and microaneurysms were surgically removed. Choriocarcinoma was diagnosed after histological examination. Despite receiving postoperative chemotherapy, the patient died 1 month after the operation.

Intraoperative Endovascular Embolization of Middle Meningeal Artery and a Pseudoaneurysm by Using N-Butyl 2-Cyanoacrylate for Hemostasis during Operation of Acute Epidural Hemorrhage

A 21-year-old female presented with acute epidural hemorrhage (EDH) on the left temporal region associated with skull fracture after traffic accident. She was neurologically deteriorated at four-hour after an admission, and follow-up computed tomography revealed increased amount of EDH. Under the general anesthesia, emergency craniotomy was performed. During the surgery, massive bleeding from the base of middle cranial fossa was observed. However, we could not identify an origin of bleeding and foramen spinosum due to brain swelling and obscured surgical field. Consequently, her systolic blood pressure was dropped to 60 mm Hg with >110 beat/min of heart rate. Therefore, we decided to perform an intraoperative angiography after gauze packing into the middle cranial fossa. Intraoperative angiography showed a large pseudoaneurysm with massive contrast leakage of the middle meningeal artery (MMA). Intraoperative endovascular embolization of the pseudoaneurysm and MMA by using n-butyl-2-cyanoacrylate was done. After that, her vital sign became stable, and we could complete the operation after the achievement of adequate hemostasis. Intraoperative angiography and endovascular embolization of MMA was effective in achieving adequate hemostasis in case with brisk bleeding from the middle cranial fossa could not be controlled in an open surgical field.

Clinical Aspects of Cerebral Venous Thrombosis: Experiences in Two Institutions

Objective Cerebral venous thrombosis (CVT) is a rare condition for which few clinical reviews have been conducted in Korea. Our aim was to investigate, risk factors, clinical presentations/courses, and outcomes of 22 patients treated for CVT at two centers. Materials and Methods A retrospective analysis was conducted, selecting 22 patients diagnosed with and treated for CVT at two patient care centers over a 10-year period (January 1, 2004 to August 31, 2015). Patient data, pathogenetic concerns (laboratory findings), risk factors, locations, symptoms, treatments, and clinical outcomes were reviewed. Results Mean patient age at diagnosis was 54.41 ± 16.19. Patients most often presented with headache (40%), followed by seizure (27%) and altered mental status (18%). Focal motor deficits (5%), visual symptoms (5%), and dysarthria (5%) were less common. Important predisposing factors in CVT included prothrombotic conditions (35%), infections (14%), hyperthyroidism (18%), trauma (14%), and malignancy (4%). By location, 9 patients (40%) experienced thrombosis of superior sagittal sinus predominantly, with involvement of transverse sinus in 20 (90%), sigmoid sinus in 12 (40%), and the deep venous system in 5 (23%). Treatment generally consisted of anticoagulants (63%) or antiplatelet (23%) drugs, but surgical decompression was considered if warranted (14%). Medical therapy in CVT yields good functional outcomes. Conclusion Mean age of patients with CVT in our study exceeded that reported in Europe or in America and had difference in risk factors. Functional outcomes are good with use of antithrombotic medication, whether or not hemorrhagic infarction is evident.

Effects of adenosine monophosphate-activated kinase in the ventral horn of rabbit spinal cord after transient ischemia

Abstract Objective To investigate the effect compound C, an adenosine monophosphate-activated kinase (AMPK) inhibitor, has on motor neurons of rabbit spinal cord after ischemia/reperfusion. Design Compound C (30 mg/kg) was administered intraperitoneally to rabbits 30 minutes before ischemia and the animals were sacrificed at 15 minutes after ischemia/reperfusion to measure lactate levels and at 72 hours after ischemia/reperfusion for morphological study. Results The administration of compound C did not produce any significant changes in physiological parameters such as pH, arterial blood gas (PaCO2 and PaO2), and blood glucose in rabbit either at 10 minutes before ischemia or at 10 minutes after reperfusion. However, the administration of compound C did significantly ameliorate lactate acidosis at 15 minutes after reperfusion. In addition, the administration of compound C significantly improved the neurological scores of the rabbits and reduced the neuronal death seen in the ventral horn of their spinal cords at 72 hours after ischemia/reperfusion. Conclusions Inhibition of AMPK can ameliorate the ischemia-induced neuronal death in the spinal cord via the reduction of early lactate acidosis.