• Title/Summary/Keyword: Caudal spinal cord

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New Technical Tip for Anterior Cervical Plating : Make Hole First and Choose the Proper Plate Size Later

  • Park, Jeong-Yoon;Zhang, Ho-Yeol;Oh, Min-Chul
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.212-216
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    • 2011
  • Objective : It is well known that plate-to-disc distance (POD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our hypothesis was that the new technical tip may increase POD as compared with the standard anterior cervical plating procedure. Methods : We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). POD and ratios between POD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases. Results : The mean durations of follow-up were $16.42{\pm}5.99$ (Group A) and $19.83{\pm}6.71$ (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad POD (5.43 versus 3.46 mm, p=0.005) and cephalad POD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal POD (5.92 versus 5.06 mm), caudal POO/ABH (0.37 versus 0.32) and clinical results. Conclusion : The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

Embryonal Neuromesodermal Progenitors for Caudal Central Nervous System and Tissue Development

  • Shaker, Mohammed R.;Lee, Ju-Hyun;Sun, Woong
    • Journal of Korean Neurosurgical Society
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    • v.64 no.3
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    • pp.359-366
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    • 2021
  • Neuromesodermal progenitors (NMPs) constitute a bipotent cell population that generates a wide variety of trunk cell and tissue types during embryonic development. Derivatives of NMPs include both mesodermal lineage cells such as muscles and vertebral bones, and neural lineage cells such as neural crests and central nervous system neurons. Such diverse lineage potential combined with a limited capacity for self-renewal, which persists during axial elongation, demonstrates that NMPs are a major source of trunk tissues. This review describes the identification and characterization of NMPs across multiple species. We also discuss key cellular and molecular steps for generating neural and mesodermal cells for building up the elongating trunk tissue.

Clinicoradiologic Characteristics of Intradural Extramedullary Conventional Spinal Ependymoma (경막내 척수외 뇌실막세포종의 임상 영상의학적 특징)

  • Seung Hyun Lee;Yoon Jin Cha;Yong Eun Cho;Mina Park;Bio Joo;Sang Hyun Suh;Sung Jun Ahn
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1066-1079
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    • 2023
  • Purpose Distinguishing intradural extramedullary (IDEM) spinal ependymoma from myxopapillary ependymoma is challenging due to the location of IDEM spinal ependymoma. This study aimed to investigate the utility of clinical and MR imaging features for differentiating between IDEM spinal and myxopapillary ependymomas. Materials and Methods We compared tumor size, longitudinal/axial location, enhancement degree/pattern, tumor margin, signal intensity (SI) of the tumor on T2-weighted images and T1-weighted image (T1WI), increased cerebrospinal fluid (CSF) SI caudal to the tumor on T1WI, and CSF dissemination of pathologically confirmed 12 IDEM spinal and 10 myxopapillary ependymomas. Furthermore, classification and regression tree (CART) was performed to identify the clinical and MR features for differentiating between IDEM spinal and myxopapillary ependymomas. Results Patients with IDEM spinal ependymomas were older than those with myxopapillary ependymomas (48 years vs. 29.5 years, p < 0.05). A high SI of the tumor on T1W1 was more frequently observed in IDEM spinal ependymomas than in myxopapillary ependymomas (p = 0.02). Conversely, myxopapillary ependymomas show CSF dissemination. Increased CSF SI caudal to the tumor on T1WI was observed more frequently in myxopapillary ependymomas than in IDEM spinal ependymomas (p < 0.05). Dissemination to the CSF space and increased CSF SI caudal to the tumor on T1WI were the most important variables in CART analysis. Conclusion Clinical and radiological variables may help differentiate between IDEM spinal and myxopapillary ependymomas.

Caudal Neuromodulation with the Transforaminal Sacral Electrode (InterStim): Experience in a Pain Center Regarding 12 Implants

  • Guardo, Laura Alonso;Gala, Carlos Cano;Poveda, David Sanchez;Juan, Pablo Rueda;Sanchez Montero, Francisco Jose;Garzon Sanchez, Jose Carlos;Lamas, Juan Ignacio Santos;Sanchez Hernandez, Miguel Vicente
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.23-28
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    • 2016
  • Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

Surgical Management and Outcome of Tethered Cord Syndrome in School-Aged Children, Adolescents, and Young Adults

  • Kang, Joon-Ki;Yoon, Kang-Jun;Ha, Sang-Su;Lee, II-Woo;Jeun, Sin-Soo;Kang, Seok-Gu
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.468-471
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    • 2009
  • Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

Prevalence of tissue antigen and serum antibody for porcine reproductive and respiratory syndrome in Cheju

  • Ho, Seong-hyun;Jun, Yong-chul;Park, Choi-kyu;Lee, Chang-hee;Bae, Jong-hee
    • Korean Journal of Veterinary Research
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    • v.39 no.4
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    • pp.760-764
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    • 1999
  • A totoal of 219 pigs, 109 necropsy-pigs at the diagnostic laboratory of Cheju National University and 110 slaughter-pigs in Cheju, were evaluated for the prevalence of tissue antigen and serum antibody for spontaneus porcine reproductive and respiratory syndrome(PRRS). Tissues from 219 pigs examined for PRRS viral antigen by immmunohistochemistry included lung(cranio-ventral lobes and dorso-caudal lobes), tonsil, tracheobronchial lymph node, mesenteric lymph node, heart, kidney, liver, spleen, testis, ovary, brain, and spinal cord. Sera from 180 pigs were tested for the presence of antibody to PRRS virus by the indirect fluorescent antibody assay (IFA). In the examination of serum antibody and tissue antigen for PRRS virus, serum antibody titers were considered as positive in 10%(18/180) of animals tested and PRRS viral antigen was detected in tissues of 4%(9/219) of the pigs. PRRS virus tissue antigen was most commonly detected by immunohistochemistry in the cranio-ventral lobe and tonsil. We also confirmed the distribution of tissue antigen and prevalence of serum antibody to PRRS virus in Cheju. The detection of viral antigen by immunohistochemistry in tonsils and cranio-ventral lobes proved to be a very useful method for PRRS diagnosis.

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Pin and Bone Cement Fixation of Fifth-Sixth Lumbar Vertebral Fracture-Luxation in a Korean Goral (Nemorhaedus caudatus)

  • Choi, Seong-jae;Kim, Jong-taek;Oh, Yeon-su;Kang, Byung-Jae
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.115-118
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    • 2017
  • A Korean goral (immature, female) was presented with paraplegia following motor vehicle trauma. The patient was diagnosed with an L5-6 vertebral fracture-luxation based on digital radiographs. Surgical reduction and stabilization of the fracture-luxation were performed via a dorsal approach to the lumbar spine. It was confirmed in surgery that the patient had L5-7 spinous process fractures, L6 bilateral articular process fractures, and an L5-6 luxation. Free fragments were removed and the luxation was reduced. During reduction, caudodorsal dislocation of the L5 caudal vertebral end plate was discovered and the displaced end plate was removed. The L5-6 vertebral luxation was stabilized using pins and bone cement. However, the presence of an intact spinal cord was not confirmed. Two weeks postoperatively the patient became dyspneic and arrested. A necropsy was performed, which revealed that the surgical stabilization was intact. Pulmonary edema was identified and the immediate cause of death was determined to be systemic inflammatory response syndrome.

The Expression Patterns of Cdc25A, Cdc25B, Sox2 and Mnb in Central Nervous System in Early Chicken Embryos

  • Zhang, Hui;Qin, Junhui;Cao, Jingjing;Hei, Nainan;Xu, Chunsheng;Yang, Ping;Liu, Haili;Chu, Xiaohong;Bao, Huijun;Chen, Qiusheng
    • Asian-Australasian Journal of Animal Sciences
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    • v.22 no.6
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    • pp.781-787
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    • 2009
  • The sense and antisense digoxigenin-labeled RNA probes of four genes, Cdc25A, Cdc25B, Sox2 and Mnb, were produced by using SP6 and T7 RNA polymerases, respectively, and in vitro transcription. Expression patterns of the four genes were detected by in situ hybridization in HH (Hamburger and Hamilton) stage 10 chick embryos. In general, expression patterns of the four genes were similar. mRNA of the four genes was mostly restricted to the entire CNS (central nervous system). All were confined to an identical region, neural tube, neural groove and caudal neural plate, corresponding to the notochord or spinal cord, but there was some distinction in specific region or in concentration, for example in somites. The overlap in expression at the same developmental stage in the CNS suggests that the four genes may be functional similar or related in CNS development. Expression patterns of the four genes support specific roles of these regulators in the developing CNS.

A Morphologically Atypical Case of Atlantoaxial Rotatory Subluxation

  • Umebayashi, Daisuke;Hara, Masahito;Nishimura, Yusuke;Wakabayashi, Toshihiko
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.284-288
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    • 2014
  • A rare case of atlantoaxial rotatory subluxation occurred after pediatric cervical spine surgery performed to remove a dumbbell-shaped meningioma at the level of the C1/C2 vertebrae. This case is classified as a post-surgical atlantoaxial rotatory subluxation, but has a very rare morphology that has not previously been reported. Although there are several reports about post-surgical atlantoaxial rotatory subluxation, an important point of this case is that it might be directly related to the spinal cord surgery in C1/C2 level. On day 6 after surgery, the patient presented with the Cock Robin position, and a computed tomography scan revealed a normal type of atlantoaxial rotatory subluxation. Manual reduction was performed followed by external fixation with a neck collar. About 7 months after the first surgery, the subluxation became severe, irreducible, and assumed an atypical form where the anterior tubercle of C1 migrated to a cranial position, and the posterior tubercle of C1 and the occipital bone leaned in a caudal direction. The pathogenic process suggested deformity of the occipital condyle and bilateral C2 superior facets with atlantooccipital subluxation. A second operation for reduction and fixation was performed, and the subluxation was stabilized by posterior fixation. We encountered an unusual case of a refractory subluxation that was associated with an atypical deformity of the upper spine. The case was successfully managed by posterior fixation.

The Study on Regenerative Effects of Ginseng on Injured Axonal and Non-Neuronal cell

  • Lim, Chang-Bum;Oh, Min-Seok
    • The Journal of Korean Medicine
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    • v.29 no.5
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    • pp.14-28
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    • 2008
  • Objective : This study was carried out to understand effects of ginseng(hearinafter ; GS, Panax Ginseng) extract on regeneration responses on injured sciatic nerves in rats. Methods :Using white mouse, we damaged sciatic nerve & central nerve, and then applied GS to the lesion. Then we observed regeneration of axon and non-neuron. Results : 1. NF-200 protein immunostaining for the visualization of axons showed more distal elongation of sciatic nerve axons in GS-treated group than saline-treated control 3 and 7 days after crush injury. 2. GAP-43 protein was increased in the injured sciatic nerve and further increased by GS treatment. Enhanced GAP-43 protein signals were also observed in DRG prepared from the rats given nerve injury and GS treatment. 3. GS treatment in vivo induced enhanced neurite outgrowth in preconditioned DRG sensory neurons. In vitro treatment of GS on sensory neurons from intact DRG also caused increased neurite outgrowth. 4. Phospho-Erk1/2 protein levels were higher in the injured nerve treated with GS than saline. Phospho-Erk1/2 protein signals were mostly found in the axons in the injured nerve. 5. NGF and Cdc2 protein levels showed slight increases in the injured nerves of GS-treated group compared to saline-treated group. 6. The number of Schwann cell population was significantly increased by GS treatment in the injured sciatic nerve. GS treatment with cultured Schwann cells increased proliferation and Cdc2 protein signals. 7. GS pretreatment into the injured spinal cord generated increased astrocyte proliferation and oligodendrocytes in culture. In vitro treatment of GS resulted in more differentiated pericytoplasmic processes compared with saline treatment. 8. More arborization around the injury cavity and the occurrence at the caudal region of CST axons were observed in GS-treated group than in saline-treated group. Conclusion :GS extract may have the growth-promoting activity on regenerating axons in both peripheral and central nervous systems.

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