Optimal Ratio of Wnt3a Expression in Human Mesenchymal Stem Cells Promotes Axonal Regeneration in Spinal Cord Injured Rat Model

Objective@#: Through our previous clinical trials, the demonstrated therapeutic effects of MSC in chronic spinal cord injury (SCI) were found to be not sufficient. Therefore, the need to develop stem cell agent with enhanced efficacy is increased. We transplanted enhanced Wnt3asecreting human mesenchymal stem cells (hMSC) into injured spines at 6 weeks after SCI to improve axonal regeneration in a rat model of chronic SCI. We hypothesized that enhanced Wnt3a protein expression could augment neuro-regeneration after SCI. @*Methods@#: Thirty-six Sprague-Dawley rats were injured using an Infinite Horizon (IH) impactor at the T9–10 vertebrae and separated into five groups : 1) phosphate-buffered saline injection (injury only group, n=7); 2) hMSC transplantation (MSC, n=7); 3) hMSC transfected with pLenti vector (without Wnt3a gene) transplantation (pLenti-MSC, n=7); 4) hMSC transfected with Wnt3a gene transplantation (Wnt3a-MSC, n=7); and 5) hMSC transfected with enhanced Wnt3a gene (1.7 fold Wnt3a mRNA expression) transplantation (1.7 Wnt3a-MSC, n=8). Six weeks after SCI, each 5×105 cells/15 µL at 2 points were injected using stereotactic and microsyringe pump. To evaluate functional recovery from SCI, rats underwent Basso-Beattie-Bresnahan (BBB) locomotor test on the first, second, and third days post-injury and then weekly for 14 weeks. Axonal regeneration was assessed using growth-associated protein 43 (GAP43), microtubule-associated protein 2 (MAP2), and neurofilament (NF) immunostaining. @*Results@#: Fourteen weeks after injury (8 weeks after transplantation), BBB score of the 1.7 Wnt3a-MSC group (15.0±0.28) was significantly higher than that of the injury only (10.0±0.48), MSC (12.57±0.48), pLenti-MSC (12.42±0.48), and Wnt3a-MSC (13.71±0.61) groups (p<0.05). Immunostaining revealed increased expression of axonal regeneration markers GAP43, MAP2, and NF in the Wnt3a-MSC and 1.7 Wnt3a-MSC groups. @*Conclusion@#: Our results showed that enhanced gene expression of Wnt3a in hMSC can potentiate axonal regeneration and improve functional recovery in a rat model of chronic SCI.

Optimal Ratio of Wnt3a Expression in Human Mesenchymal Stem Cells Promotes Axonal Regeneration in Spinal Cord Injured Rat Model

Objective@#: Through our previous clinical trials, the demonstrated therapeutic effects of MSC in chronic spinal cord injury (SCI) were found to be not sufficient. Therefore, the need to develop stem cell agent with enhanced efficacy is increased. We transplanted enhanced Wnt3asecreting human mesenchymal stem cells (hMSC) into injured spines at 6 weeks after SCI to improve axonal regeneration in a rat model of chronic SCI. We hypothesized that enhanced Wnt3a protein expression could augment neuro-regeneration after SCI. @*Methods@#: Thirty-six Sprague-Dawley rats were injured using an Infinite Horizon (IH) impactor at the T9–10 vertebrae and separated into five groups : 1) phosphate-buffered saline injection (injury only group, n=7); 2) hMSC transplantation (MSC, n=7); 3) hMSC transfected with pLenti vector (without Wnt3a gene) transplantation (pLenti-MSC, n=7); 4) hMSC transfected with Wnt3a gene transplantation (Wnt3a-MSC, n=7); and 5) hMSC transfected with enhanced Wnt3a gene (1.7 fold Wnt3a mRNA expression) transplantation (1.7 Wnt3a-MSC, n=8). Six weeks after SCI, each 5×105 cells/15 µL at 2 points were injected using stereotactic and microsyringe pump. To evaluate functional recovery from SCI, rats underwent Basso-Beattie-Bresnahan (BBB) locomotor test on the first, second, and third days post-injury and then weekly for 14 weeks. Axonal regeneration was assessed using growth-associated protein 43 (GAP43), microtubule-associated protein 2 (MAP2), and neurofilament (NF) immunostaining. @*Results@#: Fourteen weeks after injury (8 weeks after transplantation), BBB score of the 1.7 Wnt3a-MSC group (15.0±0.28) was significantly higher than that of the injury only (10.0±0.48), MSC (12.57±0.48), pLenti-MSC (12.42±0.48), and Wnt3a-MSC (13.71±0.61) groups (p<0.05). Immunostaining revealed increased expression of axonal regeneration markers GAP43, MAP2, and NF in the Wnt3a-MSC and 1.7 Wnt3a-MSC groups. @*Conclusion@#: Our results showed that enhanced gene expression of Wnt3a in hMSC can potentiate axonal regeneration and improve functional recovery in a rat model of chronic SCI.

A Case of intramedullary spinal tuberculoma and multiple brain tuberculoma associated with pulmonary tuberculosis / 결핵

Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.

The Clinical Study of Hemoptysis in Lung Disease / 결핵

BACKGROUND: Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treatment treatment of hemoptysis. METHODS: We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. RESULTS: The mean age at diagnosis was 49.3 years and male to female ratio was 2.1:1. The main causes were active pulmonay pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronicbronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial artery embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases (43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. CONCLUSION: The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.

A Case of Transient Ischemic Colitis Complicated by Colonic Stricture / 대한소화기내시경학회지

Transient ischemic colitis comprises a clinical triad of lower abdominal pain, diarrhea and rectal bleeding of sudden onset, with rapid clearance of symptoms on a non-specific management regimen. The peak age incidence of ischemic colitis is in the sixth and seventh decades, as would be expected due to progressive arterial occlusion and falling cardiac function with increasing age. In this report, transient ischemic colitis was diagnosed on the basis of colonoscopic and associated histopathological findings. Colonoscopy is a useful technique in establishing the diagnosis of transient ischemic colitis. Conservative management includes repeated careful assessment, pain management and fluid replacement. Complications are rare and the prognosis is excellent. Occasionally, patients have recurrences. We report a case of transient ischemic colitis complicated by stricture formation with review of literatures.

Two Cases of Unilateral Transient Sialoadenopathy after Gastroscopy / 대한소화기내시경학회지

A case was experienced involving submandibular salivary gland swelling (sialoadenopathy), developing after gastroscopy in a 15-year-old female who was suffering from epigastric pain & diarrhea and a case of parotid salivary gland swelling after gastroscopy in a 25-year-old female who was suffering from dyspepsia and epigastric pain. Both patients were the first two cases among about 5,000 gastroscopic examinations of the stomach conducted by the authors. As soon as the gastroscope was withdrawn, unilateral swelling, which was neither painful nor tender, was found in the left submandibular salivary gland area. This swelling disappeared spontaneously in about few hours later.

A Case of Human Infection of the Larvae from Pseudoterranova Decipiens / 대한소화기내시경학회지

A case of gastric anisakiasis due to the larva of Pseudoterranova decipiences was con- firmed by a gastroendoscopic examination. A long whitish nematode larva invading the stomach wall (fundus) was discovered and was extracted using biopsy forceps after 3 days to the onset of symptoms. The worm was 42.6 X 1.1 mm size, and was identified as being a the 4th stage larva of P. decipiens, based upon its morphological characteristics, The patient, residing in Seoul, was a 51-year-old housewife, who complained of severe epi- gastric pain and recalled that she had previously eaten the raw flesh of an Astroconger myriaster in a Japanese restaurant (sushi Bar). This study probably emerges as the 7th human case of gastric anisakiasis of pseudoterranoviasis in Korea.

A Case of Gastric Carcinoma Spread to the Duodenum / 대한소화기내시경학회지

In 1861 Rokitanski laid down the law that the pyloric ring served as a barrier to the duodenal spread of gastric cancer. Although this theory was generally accepted, direct spread of gastric carcinoma into the duodenum has been reported. We report a case of gastric cancer spreading into the duodenum that was diagnosed by endoscopic duodenal biopsy and review the literature.

A Case of Henoch - Shoenlein Purpura with Duodenal Involvement / 대한소화기내시경학회지

Henoch-Shonlein(H-S) purpura, or anaphylactoid purpura is a hypersensitivity vasculitis characterized by palpable purpura usually on buttock and low extremities; arthralgia mostly polyarhtralgia in the absence of frank arthritis; gastraintestinal involvement with colicky abdominal pain, nausea, vomiting, diarrhea, constipation and bleeding; and renal involvement, manifested chiefly by hematuria and proteinuria. Gastrointestinal involvement is seen in 70 percent of pediatric patients and one third of adult patients. Any portion of the gastrointestinal tract distal to the esophagus maybe involved, but most frequently affected sites are jejunum and ileum. We report one case of H-S purpura with duodenal involvement observed in 16, male patient.

The Effect of Aging on the Left Ventricular Mass

The fundamental alterations in the cardiovascular system that occur consequent to aging are of great pratical importnace to clinicians. Senescent cardic muscle has many features of prolonged tension development, impaired relaxation and diminished response to receptor-mediated inotropic interactions. We estimated left ventricular mass by 2-D echo area-length method using a high quality planimeter. Age-related increments in left ventricular mass demostrated, but left ventricular enddiastolic cavity volumes were unaffected by age. The increase in left ventricular mass observed with aging is typical of pressuer-overload hypertrophy and its stimulus may be increased afterload from senescent changes.