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[PMID]:27775474
[Au] Autor:Ulndreaj A; Tzekou A; Mothe AJ; Siddiqui AM; Dragas R; Tator CH; Torlakovic EE; Fehlings MG
[Ad] Endereço:1 Division of Genetics and Development, Toronto Western Research Institute and University of Toronto Spinal Program, Krembil Neuroscience Center, University Health Network , Toronto, Ontario, Canada .
[Ti] Título:Characterization of the Antibody Response after Cervical Spinal Cord Injury.
[So] Source:J Neurotrauma;34(6):1209-1226, 2017 Mar 15.
[Is] ISSN:1557-9042
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The immune system plays a critical and complex role in the pathobiology of spinal cord injury (SCI), exerting both beneficial and detrimental effects. Increasing evidence suggests that there are injury level-dependent differences in the immune response to SCI. Patients with traumatic SCI have elevated levels of circulating autoantibodies against components of the central nervous system, but the role of these antibodies in SCI outcomes remains unknown. In rodent models of mid-thoracic SCI, antibody-mediated autoimmunity appears to be detrimental to recovery. However, whether autoantibodies against the spinal cord are generated following cervical SCI (cSCI), the most common level of injury in humans, remains undetermined. To address this knowledge gap, we investigated the antibody responses following cSCI in a rat model of injury. We found increased immunoglobulin G (IgG) and IgM antibodies in the spinal cord in the subacute phase of injury (2 weeks), but not in more chronic phases (10 and 20 weeks). At 2 weeks post-cSCI, antibodies were detected at the injury epicenter and co-localized with the astroglial scar and neurons of the ventral horn. These increased levels of antibodies corresponded with enhanced activation of immune responses in the spleen. Higher counts of antibody-secreting cells were observed in the spleen of injured rats. Further, increased levels of secreted IgG antibodies and enhanced proliferation of T-cells in splenocyte cultures from injured rats were found. These findings suggest the potential development of autoantibody responses following cSCI in the rat. The impact of the post-traumatic antibody responses on functional outcomes of cSCI is a critical topic that requires further investigation.
[Mh] Termos MeSH primário: Autoanticorpos/imunologia
Medula Cervical/lesões
Traumatismos da Medula Espinal/imunologia
[Mh] Termos MeSH secundário: Animais
Células Produtoras de Anticorpos/imunologia
Astrócitos/imunologia
Modelos Animais de Doenças
Feminino
Ratos
Ratos Wistar
Baço/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1089/neu.2016.4498


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[PMID]:29419660
[Au] Autor:Kim JE; Lee MK; Lee DK; Choi SS; Park JS
[Ad] Endereço:Department of Anesthesiology and Pain medicine, Korea University, Guro Hospital, Seoul, Republic of Korea.
[Ti] Título:Continuous cervical epidural block: Treatment for intractable hiccups.
[So] Source:Medicine (Baltimore);97(6):e9444, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intractable hiccups, although rare, may result in severe morbidity, including sleep deprivation, poor food intake, respiratory muscle fatigue, aspiration pneumonia, and death. Despite these potentially fatal complications, the etiology of intractable hiccups and definitive treatment are unknown. This study aimed to evaluate the effectiveness of continuous cervical epidural block in the treatment of intractable hiccups.Records from 28 patients with a history of unsuccessful medical and invasive treatments for hiccups were evaluated. Continuous cervical epidural block was performed with a midline approach at the C7-T1 or T1-T2 intervertebral space with the patient in the prone position. The epidural catheter was advanced through the needle in a cephalad direction to the C3-C5 level. Catheter placement was confirmed using contrast radiography. A 6-mL bolus of 0.25% ropivacaine was injected, and a continuous infusion of 4 mL/h of ropivacaine was administered through the epidural catheter using an infuser containing 0.75% ropivacaine (45 mL ropivacaine and 230 mL normal saline). When the hiccups stopped and did not recur for 48 hours, the catheter was removed.Cumulative complete remission rates were 60.71% after the first cervical epidural block, 92.86% after the second, and 100% after the third. One patient complained of dizziness that subsided. No other adverse effects were reported.Continuous C3-C5 level cervical epidural block has a successful remission rate. We suggest that continuous cervical epidural block is an effective treatment for intractable hiccups.
[Mh] Termos MeSH primário: Amidas/administração & dosagem
Bloqueio Nervoso Autônomo
Soluço
Injeções Epidurais/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestésicos Locais/administração & dosagem
Bloqueio Nervoso Autônomo/efeitos adversos
Bloqueio Nervoso Autônomo/métodos
Cateterismo/métodos
Medula Cervical/efeitos dos fármacos
Medula Cervical/fisiopatologia
Tontura/etiologia
Feminino
Soluço/diagnóstico
Soluço/fisiopatologia
Soluço/terapia
Seres Humanos
Masculino
Meia-Idade
Recidiva
Indução de Remissão/métodos
República da Coreia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 0 (Anesthetics, Local); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009444


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[PMID]:29049229
[Au] Autor:Lee DG; Chang MC
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
[Ti] Título:Neck-to-shoulder pain as an unusual presentation of pulmonary embolism in a patient with cervical spinal cord injury: A case report.
[So] Source:Medicine (Baltimore);96(42):e8288, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Information on referred pain can be helpful for diagnosing diseases of the visceral organs. Here, the authors report a patient with cervical spinal cord injury (SCI) who had referred pain at the right side from the neck to shoulder, as a presentation of pulmonary embolism (PE). PATIENT CONCERNS: A 55-year-old man with complete tetraplegia, due to cervical SCI after C5 and C6 vertebral body fracture, complained of right neck-to-shoulder pain (numerical scale rating: 6). Despite pain medication (meloxicam 15 mg, gabapentin 400 mg, and propacetamol HCl 1 g), the pain was not reduced. Along with right neck-to-shoulder pain, he presented mild fever (37.8°C) and mildly elevated respiratory rate (20 breaths/min). D-dimer level was also mildly elevated to 6.09 mg/mL (normal value: < 0.5 mg/mL). DIAGNOSES: Computed tomography pulmonary angiography revealed PE in the right lower lobe pulmonary artery. INTERVENTIONS: For managing PE, rivaroxaban was administered for three days. OUTCOMES: After the administration of rivaroxaban, the patient's pain completely disappeared. LESSONS: This study shows that pain at the neck-to-shoulder area can occur following unexpected causes such as PE. Not limited to PE, the evaluation of diseases in the thoracic or abdominal organs is recommended if patients with cervical SCI present refractory pain in the dermatomes innervated by high cervical nerve roots.
[Mh] Termos MeSH primário: Cervicalgia/etiologia
Embolia Pulmonar/complicações
Embolia Pulmonar/diagnóstico
Dor de Ombro/etiologia
Traumatismos da Medula Espinal/complicações
[Mh] Termos MeSH secundário: Medula Cervical
Seres Humanos
Masculino
Meia-Idade
Embolia Pulmonar/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008288


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[PMID]:28942925
[Au] Autor:Wang X; Liu Y; Li X; Zhang Z; Yang H; Zhang Y; Williams PR; Alwahab NSA; Kapur K; Yu B; Zhang Y; Chen M; Ding H; Gerfen CR; Wang KH; He Z
[Ad] Endereço:F.M. Kirby Neurobiology Center, Boston Children's Hospital and Department of Neurology, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
[Ti] Título:Deconstruction of Corticospinal Circuits for Goal-Directed Motor Skills.
[So] Source:Cell;171(2):440-455.e14, 2017 Oct 05.
[Is] ISSN:1097-4172
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Corticospinal neurons (CSNs) represent the direct cortical outputs to the spinal cord and play important roles in motor control across different species. However, their organizational principle remains unclear. By using a retrograde labeling system, we defined the requirement of CSNs in the execution of a skilled forelimb food-pellet retrieval task in mice. In vivo imaging of CSN activity during performance revealed the sequential activation of topographically ordered functional ensembles with moderate local mixing. Region-specific manipulations indicate that CSNs from caudal or rostral forelimb area control reaching or grasping, respectively, and both are required in the transitional pronation step. These region-specific CSNs terminate in different spinal levels and locations, therefore preferentially connecting with the premotor neurons of muscles engaged in different steps of the task. Together, our findings suggest that spatially defined groups of CSNs encode different movement modules, providing a logic for parallel-ordered corticospinal circuits to orchestrate multistep motor skills.
[Mh] Termos MeSH primário: Medula Cervical/fisiologia
Destreza Motora
Vias Neurais
[Mh] Termos MeSH secundário: Animais
Cálcio/análise
Córtex Cerebral/citologia
Córtex Cerebral/fisiologia
Medula Cervical/citologia
Membro Anterior/fisiologia
Articulações/fisiologia
Camundongos
Camundongos Endogâmicos C57BL
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
SY7Q814VUP (Calcium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171111
[Lr] Data última revisão:
171111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170926
[St] Status:MEDLINE


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[PMID]:28885343
[Au] Autor:Yang XX; Huang ZQ; Li ZH; Ren DF; Tang JG
[Ad] Endereço:aDepartment of Orthopedics, Beijing North Hospital of the China North Industries Group Corporation, Beijing bDepartment of Orthopedics, First Affiliated hospital of Zhengzhou University, Zhengzhou cDepartment of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian dDepartment of Orthopedics, First Affiliated Hospital of PLA General Hospital, Beijing, People's Republic of China.
[Ti] Título:Risk factors and the surgery affection of respiratory complication and its mortality after acute traumatic cervical spinal cord injury.
[So] Source:Medicine (Baltimore);96(36):e7887, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index). Besides these, we gathered the general information such as age, gender, smoking history, and use of steroids. The study compared perioperative parameters; surgery-related and instrumentation- and graft-related complication rates; clinical parameters; patient satisfaction; and radiologic parameters. Variations like gender (odds ratio [OR] = 1.269, 95% confidence interval [CI] [0.609-2.646]), smoking history (OR = 2.902, 95% CI [1.564-5.385]), AIS grade (grade A) (OR = 6.439, 95% CI [3.334-12.434]), neurological level (C1-C4) (OR = 2.714, 95% CI [1.458-5.066]), and steroid use (OR = 2.983, 95% CI [1.276-6.969]) have a facilitated effect on RC. When we estimated surgery-related affection, only the time of surgery and anterior approach compared with posterior has significant difference in RC (P < .05). Between death and survival group, the aspect of age, non-surgical, CPIS, AIS grade, and BMI have statistically significant difference. Survival analysis reveals significant difference in aforementioned groups. In patients suffering from acute TCSCI, those who are old, have long smoking history, complete spinal cord injury, C1-C4, high CPIS, and fat have high incidence of RC and mortality.
[Mh] Termos MeSH primário: Medula Cervical/lesões
Transtornos Respiratórios/etiologia
Transtornos Respiratórios/mortalidade
Traumatismos da Medula Espinal/mortalidade
Traumatismos da Medula Espinal/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Traumatismos da Medula Espinal/complicações
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007887


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[PMID]:28880879
[Au] Autor:Takase H; Kurihara Y; Yokoyama TA; Kawahara N; Takei K
[Ad] Endereço:Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
[Ti] Título:LOTUS overexpression accelerates neuronal plasticity after focal brain ischemia in mice.
[So] Source:PLoS One;12(9):e0184258, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nogo receptor-1 (NgR1) and its ligands inhibit neuronal plasticity and limit functional recovery after brain damage such as ischemic stroke. We have previously shown that lateral olfactory tract usher substance (LOTUS) antagonizes NgR1-mediated signaling. Here, we investigated whether LOTUS enhances neuronal plasticity and functional recovery after brain focal ischemia in adult mice. Focal ischemic infarcts were induced in wild-type and LOTUS-overexpressing transgenic mice via middle cerebral artery occlusion. Endogenous LOTUS expression was increased in brain and cervical spinal cord of the contralateral side of ischemia in the chronic phase after brain ischemia. LOTUS overexpression accelerated midline-crossing axonal sprouting from the contralateral side to the ipsilateral side of ischemia in the medullar reticular formation and gray matter of denervated cervical spinal cord. Importantly, LOTUS overexpression improved neurological score highly correlated with laterality ratio of corticoreticular fibers of the medulla oblongata, indicating that LOTUS overexpression may overcome the inhibitory environment induced by NgR1 signaling for damaged motor pathway reconstruction after ischemic stroke. Thus, our data suggest that LOTUS overexpression accelerates neuronal plasticity in the brainstem and cervical spinal cord after stroke and LOTUS administration is useful for future therapeutic strategies.
[Mh] Termos MeSH primário: Isquemia Encefálica/metabolismo
Proteínas de Ligação ao Cálcio/metabolismo
Plasticidade Neuronal/fisiologia
[Mh] Termos MeSH secundário: Animais
Encéfalo/metabolismo
Encéfalo/patologia
Lesões Encefálicas/metabolismo
Lesões Encefálicas/patologia
Isquemia Encefálica/genética
Proteínas de Ligação ao Cálcio/genética
Medula Cervical/metabolismo
Modelos Animais de Doenças
Immunoblotting
Infarto da Artéria Cerebral Média/genética
Infarto da Artéria Cerebral Média/metabolismo
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Camundongos Transgênicos
Plasticidade Neuronal/genética
Proteínas Nogo/genética
Proteínas Nogo/metabolismo
Receptor Nogo 1/genética
Receptor Nogo 1/metabolismo
Acidente Vascular Cerebral/genética
Acidente Vascular Cerebral/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Calcium-Binding Proteins); 0 (Crtac1 protein, mouse); 0 (Nogo Proteins); 0 (Nogo Receptor 1); 0 (Rtn4r protein, mouse)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170908
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184258


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[PMID]:28834891
[Au] Autor:Vining RD; Gosselin DM; Thurmond J; Case K; Bruch FR
[Ad] Endereço:aPalmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA bCrotched Mountain Specialty Hospital, Greenfield NH cEvolution Chiropractic, Keene, NH dCheshire Medical Center/Dartmouth Hitchcock Keene, Court St, Keene, NH.
[Ti] Título:Interdisciplinary rehabilitation for a patient with incomplete cervical spinal cord injury and multimorbidity: A case report.
[So] Source:Medicine (Baltimore);96(34):e7837, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: This report describes interdisciplinary rehabilitation for a 51-year-old male recovering from incomplete cervical spinal cord injury (SCI) and multiple comorbidities following an automobile accident. PATIENT CONCERNS: The patient was admitted to a rehabilitation specialty hospital approximately 2 months post SCI and 2 separate surgical fusion procedures (C3-C6). DIAGNOSES: Clinical presentation at the rehabilitation hospital included moderate to severe motor strength loss in both upper and lower extremities, a percutaneous endoscopic gastronomy tube (PEG), dysphagia, bowel/bladder incontinence, dependence on a mechanical lift and tilting wheelchair due to severe orthostatic hypotension, and pre-existing shoulder pain from bilateral joint degeneration. INTERVENTIONS: The interdisciplinary team formally coordinated rehabilitative care from multiple disciplines. Internal medicine managed medications, determined PEG removal, monitored co-morbid conditions, and overall progress. Chiropractic care focused on alleviating shoulder and thoracic pain and improving spinal and extremity mobility. Physical therapy addressed upright tolerance, transfer, gait, and strength training. Occupational therapy focused on hand coordination and feeding/dressing activities. Psychology assisted with coping strategies. Nursing ensured medication adherence, nutrient intake, wound prevention, and incontinence management, whereas physiatry addressed abnormal muscle tone. OUTCOMES: Eleven months post-admission the patient's progress allowed discharge to a long-term care facility. At this time he was without dysphagia or need for a PEG. Orthostatic hypotension and bilateral shoulder pain symptoms were also resolved while bowel/bladder incontinence and upper and lower extremity motor strength loss remained. He was largely independent in transferring from bed to wheelchair and in upper body dressing. Lower body dressing/bathing required maximal assistance. Gait with a 2-wheeled walker was possible up to 150 feet with verbal cues and occasional stabilizing assistance. LESSONS: Several specialties functioning within an interdisciplinary team fulfilled complementary roles to support rehabilitation for a patient with SCI.
[Mh] Termos MeSH primário: Medula Cervical
Traumatismos da Medula Espinal/reabilitação
[Mh] Termos MeSH secundário: Comorbidade
Incontinência Fecal/etiologia
Seres Humanos
Hipotensão Ortostática/etiologia
Masculino
Meia-Idade
Força Muscular/fisiologia
Dor de Ombro/etiologia
Traumatismos da Medula Espinal/complicações
Incontinência Urinária/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007837


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[PMID]:28822786
[Au] Autor:Chang KT; Lin YL; Lin CT; Hong CJ; Tsai MJ; Huang WC; Shih YH; Lee YY; Cheng H; Huang MC
[Ad] Endereço:Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
[Ti] Título:Leptin is essential for microglial activation and neuropathic pain after preganglionic cervical root avulsion.
[So] Source:Life Sci;187:31-41, 2017 Oct 15.
[Is] ISSN:1879-0631
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:AIMS: Preganglionic cervical root avulsion (PCRA) affects both the peripheral and central nervous systems and is often associated with neuropathic pain. Unlike peripheral nerve injuries (PNI), central lesions caused by disruption of cervical roots from the spinal cord following PCRA contribute to the generation of neuropathic pain. Leptin is involved in the development of neuropathic pain after PNI by affecting neurons. However, whether leptin is involved in microglial activation leading to neuropathic pain after PCRA is unknown. MAIN METHODS: Preganglionic avulsion of the left 6 -8 cervical roots was performed in C57B/6J mice and leptin-deficient mice. A leptin antagonist or leptin was administered to C57B/6J mice and leptin-deficient mice after injury, respectively. The expression pattern of spinal and supraspinal microglia was examined by immunofluorescent staining. Von Frey filaments were used to test pain sensitivity. KEY FINDINGS: Leptin is essential for the development of neuropathic pain after PCRA. Allodynia was absent in the leptin-deficient mice and the mice administered the leptin antagonist. We also found that leptin deficiency or the administration of its antagonist inhibited the development of microgliosis in the dorsal horn and brainstem. Furthermore, increase in the expression of CD86 and iNOS, and Wallerian degeneration were noted in the spinal cord. The administration of exogenous leptin to leptin-deficient mice reversed these effects. SIGNIFICANCE: We concluded that leptin is involved in the proliferation and activation of microglia, which in turn enhances the development of neuropathic pain. Blocking the effects of leptin might be a target for the treatment of neuropathic pain after PCRA.
[Mh] Termos MeSH primário: Fratura Avulsão/fisiopatologia
Leptina/fisiologia
Microglia/fisiologia
Neuralgia/prevenção & controle
[Mh] Termos MeSH secundário: Animais
Antígeno B7-2/biossíntese
Tronco Encefálico/efeitos dos fármacos
Tronco Encefálico/patologia
Proliferação Celular/fisiologia
Medula Cervical/lesões
Feminino
Fratura Avulsão/complicações
Fratura Avulsão/patologia
Gliose/prevenção & controle
Leptina/antagonistas & inibidores
Leptina/genética
Leptina/farmacologia
Masculino
Camundongos
Camundongos Transgênicos
Microglia/efeitos dos fármacos
Neuralgia/complicações
Óxido Nítrico Sintase Tipo II/biossíntese
Medição da Dor/efeitos dos fármacos
Medula Espinal/efeitos dos fármacos
Medula Espinal/metabolismo
Medula Espinal/patologia
Corno Dorsal da Medula Espinal/efeitos dos fármacos
Corno Dorsal da Medula Espinal/patologia
Degeneração Walleriana/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (B7-2 Antigen); 0 (Leptin); EC 1.14.13.39 (Nitric Oxide Synthase Type II); EC 1.14.13.39 (Nos2 protein, mouse)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170821
[St] Status:MEDLINE


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[PMID]:28799855
[Au] Autor:Morota N; Ihara S; Ogiwara H; Tamura G
[Ad] Endereço:Division of Neurosurgery, Tokyo Metropolitan Children's Medical Center; and.
[Ti] Título:Surgical management of cervical spine deformity in chondrodysplasia punctata.
[So] Source:J Neurosurg Pediatr;20(4):378-387, 2017 Oct.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Chondrodysplasia punctata (CDP), a rare skeletal dysplasia, can lead to cervical spine instability and deformity. However, an optimal neurosurgical intervention has yet to be established. Thus, a retrospective study was conducted to assess the efficacy of various surgical interventions for children with CDP. METHODS The authors retrospectively reviewed 9 cases of CDP in which cervical decompression with or without posterior fusion was performed between April 2007 and May 2016. Patient demographics, preoperative clinical conditions, radiographic findings, surgical procedures, and the postoperative course were analyzed in detail. RESULTS A total of 12 operations were carried out in 9 patients (8 male, 1 female) during the study period. The patients' ages at the initial surgery ranged from 2 months to 2 years. Seven of the children had CDPX1, 1 had CDPX2, and 1 had tibia-metacarpal type CDP (CDP-TM). The lesion occurred at the craniovertebral junction (CVJ) in 7 cases and involved a subaxial deformity in 2 cases. The initial surgery was C-1 laminectomy with occipitocervical fusion (OCF) followed by halo external fixation in 5 cases, OCF alone in 1 case, and C-1 laminectomy alone in 3 cases. Three children required additional surgery. In one of these cases, a staged operation was required because the patient's head was too small to attach a halo ring at the time of the initial procedure (C-1 laminectomy). In another case, OCF was performed 11 months after C-1 laminectomy because of intramedullary signal change on serial MRI, although the child remained asymptomatic. In the third case, additional posterior fusion was performed 17 months after an initial laminectomy and OCF due to newly developed cervical dislocation caudal to the original fusion. This last patient required a third operation 9 months after the second because of deep wound infection. Surgery improved the motor function of all 7 children with CDPX1, but 3 children who had already suffered respiratory failure preoperatively required continued respiratory support. At the time of this report, 7 of the 9 children were alive and in stable condition. One child died due to restrictive respiratory insufficiency, and another died in an accident unrelated to CDP. CONCLUSIONS Surgical decompression with or without fusion for CVJ and subaxial cervical lesions in infants and toddlers with CDP generally saves lives and increases the likelihood of motor function recovery. However, in this case series the patients' preoperative condition had a strong effect on postoperative respiratory function. The surgery was not straightforward, and a second operation was required in some cases. Nevertheless, the findings indicate that early surgical intervention for CDP with cervical involvement is feasible, suggesting that the role of neurosurgery should be reevaluated.
[Mh] Termos MeSH primário: Medula Cervical/anormalidades
Medula Cervical/cirurgia
Condrodisplasia Punctata/cirurgia
Descompressão Cirúrgica/métodos
Doenças da Coluna Vertebral/cirurgia
Fusão Vertebral/métodos
[Mh] Termos MeSH secundário: Parafusos Ósseos
Medula Cervical/diagnóstico por imagem
Pré-Escolar
Condrodisplasia Punctata/complicações
Condrodisplasia Punctata/diagnóstico por imagem
Feminino
Seres Humanos
Lactente
Instabilidade Articular/etiologia
Instabilidade Articular/cirurgia
Masculino
Estudos Retrospectivos
Doenças da Coluna Vertebral/etiologia
Tomógrafos Computadorizados
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170812
[St] Status:MEDLINE
[do] DOI:10.3171/2017.5.PEDS16554


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[PMID]:28771534
[Au] Autor:Suzuki H; Ahuja CS; Salewski RP; Li L; Satkunendrarajah K; Nagoshi N; Shibata S; Fehlings MG
[Ad] Endereço:Division of Genetics and Development, Krembil Research Institute, Toronto, Canada.
[Ti] Título:Neural stem cell mediated recovery is enhanced by Chondroitinase ABC pretreatment in chronic cervical spinal cord injury.
[So] Source:PLoS One;12(8):e0182339, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Traumatic spinal cord injuries (SCIs) affect millions of people worldwide; the majority of whom are in the chronic phase of their injury. Unfortunately, most current treatments target the acute/subacute injury phase as the microenvironment of chronically injured cord consists of a well-established glial scar with inhibitory chondroitin sulfate proteoglycans (CSPGs) which acts as a potent barrier to regeneration. It has been shown that CSPGs can be degraded in vivo by intrathecal Chondroitinase ABC (ChABC) to produce a more permissive environment for regeneration by endogenous cells or transplanted neural stem cells (NSCs) in the subacute phase of injury. Using a translationally-relevant clip-contusion model of cervical spinal cord injury in mice we sought to determine if ChABC pretreatment could modify the harsh chronic microenvironment to enhance subsequent regeneration by induced pluripotent stem cell-derived NSCs (iPS-NSC). Seven weeks after injury-during the chronic phase-we delivered ChABC by intrathecal osmotic pump for one week followed by intraparenchymal iPS-NSC transplant rostral and caudal to the injury epicenter. ChABC administration reduced chronic-injury scar and resulted in significantly improved iPSC-NSC survival with clear differentiation into all three neuroglial lineages. Neurons derived from transplanted cells also formed functional synapses with host circuits on patch clamp analysis. Furthermore, the combined treatment led to recovery in key functional muscle groups including forelimb grip strength and measures of forelimb/hindlimb locomotion assessed by Catwalk. This represents important proof-of-concept data that the chronically injured spinal cord can be 'unlocked' by ChABC pretreatment to produce a microenvironment conducive to regenerative iPS-NSC therapy.
[Mh] Termos MeSH primário: Condroitina ABC Liase/farmacologia
Regeneração Nervosa/efeitos dos fármacos
Traumatismos da Medula Espinal/terapia
[Mh] Termos MeSH secundário: Animais
Diferenciação Celular/efeitos dos fármacos
Células Cultivadas
Medula Cervical/lesões
Doença Crônica
Cicatriz/prevenção & controle
Potenciais Evocados/fisiologia
Membro Anterior/fisiologia
Células-Tronco Pluripotentes Induzidas/citologia
Locomoção/fisiologia
Camundongos
Camundongos Endogâmicos C57BL
Células-Tronco Neurais/citologia
Células-Tronco Neurais/efeitos dos fármacos
Células-Tronco Neurais/transplante
Neurônios/citologia
Neurônios/fisiologia
Recuperação de Função Fisiológica/efeitos dos fármacos
Medula Espinal/metabolismo
Medula Espinal/fisiologia
Traumatismos da Medula Espinal/patologia
Sinapses/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 4.2.2.20 (Chondroitin ABC Lyase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182339



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