Geun Sung Song

Increase in Proliferation and Differentiation of Neural Progenitor Cells Isolated from Postnatal and Adult Mice Brain by Wnt-3a and Wnt-5a

Wnt signaling is implicated in the control of cell growth and differentiation during CNS development. These findings are based on studies of mouse and chick models. However, the action of Wnt signaling, at the cellular level, is poorly understood. In this study, we investigated the roles of Wnt-3a and Wnt-5a on differentiation and proliferation of postnatal neural progenitor cells (NPCs) in mice.NPCs were isolated from the subventricular zone (SVZ) of PN-1 and adult ICR mice. Plasmids containing active Wnt-3a or Wnt-5a were transfected to NPCs; their effects on the formation of neurospheres and differentiation into neuronal cells were then determined. Transfection of Wnt-3a and Wnt-5a plasmids promoted regeneration of neurospheres and differentiation into Map2-positive cells, and decreased differentiation into GFAP-positive cells. The conditioned media obtained from Wnt-3a or Wnt-5a transfected NPCs showed similar effects on differentiation of NPCs with cDNA transfection, although the magnitude of stimulatory effect was less than that by plasmid transfection. Wnt-3a and Wnt-5a transfection did not affect Brdu incorporation of neuronal or glial progenitors in differentiation media. Wnt-3a and Wnt-5a plasmid transfection and the treatment of Wnt-3a and Wnt-5a conditioned media increased

Beneficial effect of flavonoid baicalein in cisplatin-induced cell death of human glioma cells

β −cateninlevelsinNPCs. Wnt−3ahadagreatereffecton β

Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion

-catenin levels than Wnt-5a. The PKC inhibitor completely blocked the Wnt-5a effect on neuronal differentiation in NPCs. These findings suggest that Wnt-3a and Wnt-5a each have distinct effects on the proliferation and differentiation of NPCs in postnatal mice.

Recurrent intracranial germinoma along the endoscopic ventriculostomy tract

Flavonoids are a family of polyphenolic compounds found ubiquitously in fruits and vegetables as well as in food products and beverages derived from plants. Baicalein is a flavonoid extracted from the root of Scutellaria baicalensis Georgi, a medicinal plant traditionally used in Oriental medicine. Baicalein exerts either proapoptotic or anti-apoptotic effects in different cell types. The present study was, therefore, undertaken to examine the effect of baicalein on cisplatin-induced apoptosis of human glioma cells. Cisplatin resulted in cell death in a dose- and time-dependent manner and the cell death was attributed to apoptosis. Baicalein prevented loss of cell viability and apoptosis induced by cisplatin in a dose-dependent fashion over the concentrations of 2-10 microM. Exposure of cells to baicalein without cisplatin did not affect cell viability. Western blot analysis demonstrated that cisplatin induced activation of extracellular signal-regulated kinase (ERK), which was not affected by baicalein. Baicalein prevented Bax expression, mitochondrial depolarization, cytochrome c release from mitochondria, and caspase activation induced by cisplatin. Taken together, these findings suggest that baicalein prevents cisplatin-induced apoptosis through inhibition of the mitochondrial depolarization in human glioma cells.

Effectiveness of the laminoplasty in the elderly patients with cervical spondylotic myelopathy.

Objective This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices. Methods We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively. Results The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group. Conclusions Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

The effect of body mass index on intra-abdominal pressure and blood loss in lumbar spine surgery.

The authors report a case of a recurrent intracranial germinoma along the site of an endoscopic third ventriculostomy (ETV) after complete local tumor control using 3D conformal radiation therapy. A 13-year-old girl presented with sudden left upward gaze limitation for 4 days. A pineal region tumor and obstructive hydrocephalus were noted on magnetic resonance (MR) images. An ETV and tumor biopsy procedure were performed, which revealed the lesion to be a germinoma. The patients visual symptoms and hydrocephalus disappeared postoperatively. Chemotherapy using cisplatin, etoposide, vincristine, and cyclophosphamide was initiated on postoperative Day 10. An MR image obtained 10 weeks after surgery and 2 weeks after chemotherapy revealed a significant (> 50%) reduction of the lesion. Radiation therapy was administered at 50.4 Gy to the target and 36 Gy to the periphery. Ten months after surgery, an MR image revealed further shrinkage of the tumor mass. One year after surgery, follow-up MR imaging demonstrated a small mass lesion at the entry site of the ETV, measuring 1.0 x 1.4 x 1.5 cm. An operation was performed to remove the small lesion, and pathological findings revealed it to be of the same histology as the primary tumor.

An unusual case of post-operative spondylitis caused by mycobacterium intracellulare in an immunosuppressed patient.

Objective The purpose of this study is to evaluate clinical and radiological outcomes analysis of the laminoplasty in the elderly patients, and to compare with the non-elderly patients. Methods A retrospective study of the short term result in patients who had treated with the laminoplasty for cervical spondylotic myelopathy (CSM) was performed. From January 2008 to December 2012, total 62 patients were operated with single open-door technique because of CSM; 28 patients were the elderly and 34 patients were the non-elderly. We evaluated some factors including sex, symptom duration, estimated blood loss during operation, operation time, hospitalization day, complications, pre- and postoperative modified Japanese Orthopedic Association (mJOA) score, recovery rate of mJOA score, achieved mJOA score, mean cervical canal width and expansion ratio of antero-posterior diameter in order to identify difference between the two group. Clinical outcomes were calculated with the recovery rate of mJOA score at the time of one year after operation. Results Mean age were 71.9 in the elderly group and 52.9 in the non-elderly group. Although postoperative mJOA score in the elderly group was lower than that of the non-elderly group, achieved mJOA score was statistically same between the two groups. Other clinical and radiological outcomes were also statistically same. Conclusion We conclude that the laminoplasty also assures good clinical outcomes in the elderly patients with CSM, same as in the non-elderly group.

Neurologic Complication Following Spinal Epidural Anesthesia in a Patient with Spinal Intradural Extramedullary Tumor

Objective The purpose of this prospective study was to evaluate the effects of body mass index (BMI) on intra-abdominal pressure (IAP) and intraoperative blood loss (IBL) during lumbar spinal surgery. Methods Thirty patients scheduled for single level posterior lumbar interbody fusion were allocated equally to a normal group (Group 1, BMI;18.5-22.9 kg/m2), an overweight group (Group 2, BMI; 23-24.9 kg/m2), and an obese group (Group 3, BMI; 25.0-29.9 kg/m2) according to BMI. IAP was measured using a urinary bladder catheter; 1) supine after anesthesia induction, 2) prone at skin incision, 3) prone at the end of surgery. In addition, IBL was also measured in the three groups. Results IAP in the supine position was not significantly different in groups 1, 2, and 3 (2.7 mm Hg, 3.0 mm Hg, and 4.2 mm Hg, respectively) (p=0.258), and IAP in the prone position at incision increased to 7.8 mm Hg, 8.2 mm Hg, and 10.4 mm Hg, respectively, in the three groups, and these intergroup differences were significant, especially for Group 3 (p=0.000). IAP at the end of surgery was slightly lower (7.0 mm Hg, 7.7 mm Hg, and 9.2 mm Hg, respectively). IBLs were not significantly different between the three groups. However, IBLs were found to increase with IAP in the prone position (p=0.022) and BMI (p<0.05). Conclusion These results show that BMI affects IAP in the prone position more than in the supine position during lumbar spinal surgery. In addition, IBLs were found to increase with IAP in the prone position and with BMI. Thus, IBLs can be expected to be higher in morbidly obese patients due to an increased IAP.

Guillain-Barre Syndrome Following Spinal Fusion for Thoracic Vertebral Fracture

There are few reported cases of post-operative spondylitis caused by Mycobacterium intracellulare. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, Mycobacterium intracellulare was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure.

Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature

Paraplegia following spinal epidural anesthesia is extremely rare. Various lesions for neurologic complications have been documented in the literature. We report a 66-year-old female who developed paraplegia after left knee surgery for osteoarthritis under spinal epidural anesthesia. In the recovery room, paraplegia and numbness below T4 vertebra was checked. A magnetic resonance image (MRI) scan showed a spinal thoracic intradural extramedullary (IDEM) tumor. After extirpation of the tumor, the motor weakness improved to the grade of 3/5. If a neurologic deficit following spinal epidural anesthesia does not resolve, a MRI should be performed without delay to accurately diagnose the cause of the deficit and optimal treatment should be rendered for the causative lesion.