The Effects of Baicalein on Osteoclast Differentiation from Bone Marrow Derived Macrophage / 체질인류학회지

As prediction of rapidly aging society, bone health is considered increasingly important and received more attention than ever. Bone health is regulated by balancing between bone resorptive osteoclasts and bone formative osteoblasts. Disruption of balance between bone-resorbing osteoclasts and bone-forming osteoblasts results in bone disease. Natural products have recently received much attention as an alternative tool for the development of novel therapeutic strategy. Baicalein is reported it has anti-cancer, anti-inflammatory and antioxidant effects. Baicalein also has been known that it has both promotive effect on MC3T3-E1 cell line and inhibitory effect on RAW 264.7 cell line. However, the inhibitory mechanism of baicalein using bone marrow derived macrophages (BMMs) on osteoclast differentiation remains not clear. In this study, the suppressive mechanism by baicalein on osteoblast differentiation was evaluated. Bicalein inhibited receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclast differentiation in BMMs in a dose dependent manner without any toxicity. Baicalein suppressed phosphorylation of protein kinaseB (Akt), c-Jun N-terminal kinases (JNK) and phosphoinositide-specific phospholipaseCgamma2 (PLCgamma2). Furthermore, Baicalein suppressed the induction of RANKL-induced c-Fos and Nuclear factor of activated T cell c1 (NFATc1), essential genes on osteoclastogenesis. In BMMs, Bicalein inhibited the mRNA expression of tartrate-resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), cathepsinK, dendritic cell-specific transmembrane protein (DC-STAMP). Moreover, baicalein promoted differentiation of osteoblast on bone marrow stromal cells (BMSCs). Taken together, these results suggest that baicalein has a potential for treating bone lytic diseases, such as osteoporosis, periodontitis, and rheumatoid arthritis.

Comparative Analysis between Male and Female Osteoporotic Compression Fractures in Elderly Patients / 대한신경손상학회지

OBJECTIVE: Osteoporosis results in increased fragility of the bone and thereby predisposes the patients to have a fracture with relatively little trauma. Osteoporosis is more common in women, however, its incidence in men is also increasing. Purpose of this article is to assess the clinical difference between male and female patient, and the effects of vertebroplasty or kyphoplasty. METHODS: Between January 2009 and December 2012, total 198 patients have undergone vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures and we selected 54 patients (27 male and 27 female) in this retrospective study. We investigated the difference of clinical characteristics between male and female osteoporotic vertebral compression fractures. RESULTS: There were no significant differences between the 2 groups in terms of distribution of body mass index, diabetes mellitus, hypertension, stroke, previous vertebroplasty or kyphoplasty. However, bone mineral density and vertebral compression fracture induced by trauma were significantly higher in male group. And preoperative visual analogue scale (VAS) is higher in male group. CONCLUSION: Osteoporotic vertebral compression fracture induced by trauma is more frequent in men. Higher VAS score before operation in men might reflect this difference in etiology. The VAS scores decreased after operation in both men and women, suggesting vertebroplasty or kyphoplasty is effective in osteoporotic compression fracture regardless of etiology.

Comparative Analysis between Male and Female Osteoporotic Compression Fractures in Elderly Patients / 대한신경손상학회지

OBJECTIVE: Osteoporosis results in increased fragility of the bone and thereby predisposes the patients to have a fracture with relatively little trauma. Osteoporosis is more common in women, however, its incidence in men is also increasing. Purpose of this article is to assess the clinical difference between male and female patient, and the effects of vertebroplasty or kyphoplasty. METHODS: Between January 2009 and December 2012, total 198 patients have undergone vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures and we selected 54 patients (27 male and 27 female) in this retrospective study. We investigated the difference of clinical characteristics between male and female osteoporotic vertebral compression fractures. RESULTS: There were no significant differences between the 2 groups in terms of distribution of body mass index, diabetes mellitus, hypertension, stroke, previous vertebroplasty or kyphoplasty. However, bone mineral density and vertebral compression fracture induced by trauma were significantly higher in male group. And preoperative visual analogue scale (VAS) is higher in male group. CONCLUSION: Osteoporotic vertebral compression fracture induced by trauma is more frequent in men. Higher VAS score before operation in men might reflect this difference in etiology. The VAS scores decreased after operation in both men and women, suggesting vertebroplasty or kyphoplasty is effective in osteoporotic compression fracture regardless of etiology.

Ophthalmic Artery Occlusion After Carotid Revascularization

Distal embolization resulting from carotid angioplasty and stenting (CAS) occurs mainly in the cerebral hemisphere. We report a case of ophthalmic artery occlusion after carotid revascularization. A 75-year old man received emergency CAS for cervical internal carotid artery occlusion. Two months later, the patient was readmitted for decreased visual acuity. We found ophthalmic artery occlusion that was not noticed soon after CAS. Although ophthalmic artery occlusion after CAS is rare, endovascular neurosurgeons should be aware of this potential complication.

Clinical and Angiographic Outcomes of Wingspan Stent Placement for Treatment of Symptomatic Intracranial Stenosis: Single Center Experience with 19 Cases

OBJECTIVE: The limitations of medical management of symptomatic intracranial arterial stenosis (ICS) have prompted development of new strategies, including endovascular treatment. However, stenting of symptomatic ICS remains investigational. Here, we have reported and analyzed a series of 19 endovascular procedures involving placement of a Wingspan stent. METHODS: We conducted a retrospective review of a series of ICS in which patients were treated with percutaneous transarterial balloon angioplasty and stent placement (PTAS). Patients included in the study were diagnosed as symptomatic ICS between May 2010 and September 2011. RESULTS: Nineteen patients (median age, 65 years; 12 males, seven women) were treated with the Wingspan stent system for symptomatic ICS ranging from 50% to 99%. The technical success rate was 100%. The location of ICS included the internal carotid (n = 5; 1 petrous, 3 cavernous, and 1 clinoid segments), vertebral (n = 1; V4 segment), basilar (n = 1), and middle cerebral (n = 12; 9 M1, 3 M2) arteries. There was no occurrence of procedure-related mortality. Periprocedural morbidity occurred in two cases (10.5%), including carotid-cavernous fistula (n = 1) and subarachnoid hemorrhage (n = 1). No ipsilateral stroke was recorded beyond 30 days during a mean follow-up period of 13.2 months (range 9-19 months). Restenosis (> 50%) was observed in one patient (6.3%), who was asymptomatic, on follow-up imaging. CONCLUSION: Wingspan stent for symptomatic ICS can be performed with a high rate of technical success and acceptable periprocedural morbidity rates. Our initial experience indicates that this procedure represents a viable treatment option for this patient population.

Intracranial Lipoma in Medulla Oblongata

Intracranial lipomas are rare, and most of these tumors are found in the region of the corpus callosum, followed by cerebellopontine angle. We present a case of a intracranial lipoma in 30-year-old man. Brain computed tomography (CT) scan and magnetic resonance images (MRI) showed a mass in the medulla oblongata extending to foramen magnum. The histopathologically, diagnosis of lipoma was confirmed. Although there were several cases of cervical intraspinal lipoma extending into posterior cranial fossa, there have been no previous reports of a lipoma arising from the medulla oblongata that extended into the foramen magnum. We describe a rare case of intradural subpial lipoma in the medulla oblongata with a review of the literature.

Clipping of the Anterior Communicating Artery Aneurysm without Sylvian Fissure Dissection

OBJECTIVE: The focus of aneurysm surgery is eliminating unnecessary operative manipulations and preparing the surgeon for any crises that might arise. With this concept in mind, we have tried resection of the gyrus rectus without routine sylvian fissure dissection in selected patients with anterior communicating artery (ACom) aneurysms, and compared these results with those from the conventional transsylvian approach. METHODS: This retrospective study included 231 surgically treated patients with ACom aneurysms from March, 1997 to May, 2005. The patients were divided into two groups : Group A (96 with sylvian fissure dissection, March, 1997-December, 2000) and Group B (135 without sylvian fissure dissection, January, 2001-May, 2005). Overall surgical outcomes were compared, and operative times have been prospectively recorded since January, 04 to evaluate how this maneuver affected the length of surgical procedures. RESULTS: All aneurysms were satisfactorily clipped, and there was no evidence of increased number of procedure-related retraction injuries in group B. Overall outcome was good in 186 (80.5%); 76 (79.2%) in group A, and 110 (81.5%) in group B (x2 test, p=0.79). In good clinical grade of group A, good outcome was observed in 60 patients (89.6%) and in group B, 97 patients (94.2%) (Fisher's exact test, p=0.38) (Fig. 2). CONCLUSION: In this study, eliminating the step of sylvian fissure dissection by gentle lateral basal-frontal retraction to the side of the sylvian fissure did not increase morbidity and mortality. However, we do not intend to modify the standard approach to the ACom aneurysm that is familiar to and has been mastered by many others. Rather, we report our experience on the basis of our anatomic understanding of the technique and its results.