Perkutana laserska dekompresija diska u psa - prikaz slučaja.

Percutaneous laser disc decompression (PLDD) is a minimally invasive technique for treatment of lumbar disc herniation in human medicine. There is little information available concerning PLDD usage in dogs. The article describes treatment of a disc protrusion in a dog with percutaneous laser disc decompression (PLDD). To the authors’ knowledge the presented technique is described here for the first time in a dog with thoracolumbar disc herniation. The surgical procedure was performed in a dog with Th13-L1 disc protrusion using a photofiber device, which was inserted into the intervertebral space under C-arm control. The purpose of this report is to evaluate PLDD effectiveness in Hansen type II disc herniation in a dog.Perkutana laserska dekompresija diska (PLDD) minimalno je invazivna tehnika za liječenje hernije lumbalnog diska u humanoj medicine. Ima malo informacija o upotrebi PLDD u pasa. U članku je opisano liječenje protruzije diska perkutanom laserskom dekompresijom u psa. U ovom radu ta je tehnika prvi put opisana u psa s hernijacijom torakolumbalnog diska. Kirurški zahvat proveden je na psu s protruzijom Th13-L1 diska upotrebom aparata pomoću kojeg se laserska zraka optičkom niti uvede kroz tanku iglu u intervertebralni prostor pod rendgenskom kontrolom. Svrha je ovog izvješća procijeniti učinkovitost PLDD kod II. stupnja hernijacije po Hansenu u psa

The feasibility of the CD271+ and CD271– mesenchymal stromal cell enrichment toward nucleus pulposus-like cells

Introduction. Factors promoting nerve cell ingrowth are considered responsible for chronic back pain resulting from the intervertebral disc degeneration (IDD). One of the recent exploratory IDD treatments is stem cell transplantation therapy. The CD271 (low-affinity nerve growth factor receptor) has been identified as a mark­er of the most homogeneous mesenchymal stem cell (MSC) subset. It is capable of promoting differentiation along adipogenic, osteogenic and chondrogenic lineages and producing significantly higher levels of cytokines as compared to the total population of plastic adherence-mesenchymal stem cells (PA-MSCs). We investigated the ability of CD271+ MSCs to differentiate into chondrocyte-like cells of the nucleus pulposus (NP) of intervertebral disc. We also examined CD271– MSCs, using PA-MSCs as a control cell population. Material and methods. Bone marrow derived PA-MSCs and its two subsets, CD271– MSCs and CD271+ MSCs, were seeded in collagen scaffolds. After two weeks of growth in NP-differentiation medium, RNA was isolated from cells-scaffold constructs and was analyzed by q-PCR for expression of NP markers. Glycosaminoglycans were analyzed biochemically directly in cells-scaffold constructs. Results. Expression of NP markers — extracellular matrix components such as aggrecan, collagen type II and glycosaminoglycans on both RNA and the protein levels — was significantly higher in CD271– MSCs compared to the CD271+ MSCs and PA-MSCs cell populations. Conclusions. CD271– MSCs may be superior candidates for NP restorative treatment compared to CD271+ MSCs and PA-MSCs due to their ability of expressing NP-supporting extracellular matrix components at levels higher than the other two studied MSC subsets

Složen protokol liječenja bolesnika s amiotrofičnom lateralnom sklerozom

Amyotrophic lateral sclerosis is a progressive and fatal degenerative neuromuscular disease with few if any treatment options and physical rehabilitation addressing specific deficits is the most frequent form of therapy. Patients also suffer from depression and increased anxiety. Our purpose was to assess the neurorehabilitation effectiveness in a patient with amyotrophic lateral sclerosis who underwent stem cell transplantation but refused physiotherapy due to depression. Disease progression was followed using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale bimonthly for six months pre- and then post-stem cell transplantation. Psychological traits were assessed using six standardized tests. Quantitative electroencephalogram diagnostics was performed before the first and after the last neurofeedback session, and sessions were conducted on a 3-times-a-week basis. The physiotherapy protocol included proprioceptive neuromuscular facilitation, electrical modalities unit applied to the lumbar spine area, and breathing, relaxation and walking exercises, among others. Increased motivation and marked decrease in the pain level was associated with the patient’s willingness to complete physiotherapy, which resulted in improvements in most neuromuscular deficits and in increased respiratory capacity. During the 12 post-rehabilitation months, progression of the disease decelerated, and a positive behavioral change was noted. The study suggested that neurofeedback could be used as a neurorehabilitation component of the personalized complex rehabilitation protocol in patients with amyotrophic lateral sclerosis.Amiotrofična lateralna skleroza je progresivna i smrtonosna degenerativna neuromuskularna bolest za koju postoji malo, ako uopće ijedna mogućnost liječenja pa je najčešći oblik terapije fizikalna rehabilitacija usmjerena na točno određene nedostatke. Ovi bolesnici pate i od depresije te pojačane anksioznosti. Cilj istraživanja bio je procijeniti učinkovitost neurorehabilitacije u bolesnika s amiotrofičnom lateralnom sklerozom koji je podvrgnut transplantaciji matičnih stanica, ali je zbog depresije odbio fizikalnu terapiju. Progresija bolesti praćena je pomoću revidirane Ljestvice za funkcionalnu ocjenu amiotrofične lateralne skleroze svaka dva mjeseca kroz šest mjeseci prije te nakon transplantacije matičnih stanica. Psihološke značajke procjenjivane su pomoću šest standardiziranih testova. Kvantitativna elektroencefalografska dijagnostika provedena je prije prvog i nakon posljednjeg neurofeedback tretmana, koji su se provodili tri puta na tjedan. Protokol fizikalne terapije obuhvaćao je, među ostalim, proprioceptivnu neuromuskularnu facilitaciju, jedinicu električnih modaliteta primijenjenu u području lumbalne kralježnice te vježbe disanja, opuštanja i hodanja. Pojačana motivacija i znatno sniženje razine boli bili su udruženi s bolesnikovim pristankom na potpunu fizikalnu terapiju, što je rezultiralo poboljšanjem većine neuromuskularnih nedostataka i povećanim dišnim kapacitetom. Tijekom 12 mjeseci nakon rehabilitacije progresija bolesti se usporila i zabilježena je pozitivna promjena ponašanja. Ovo istraživanje je pokazalo da se neurofeedback može primijeniti kao neurorehabilitacijska sastavnica personaliziranog složenog protokola rehabilitacije u bolesnika s amiotrofičnom lateralnom sklerozom

Różnicowanie popromiennej martwicy i wznowy złośliwego guza mózgu u pacjentów leczonych przy pomocy brachyterapii Ir 192 metodą HDR w oparciu o analizę spektroskopową widma metabolitów z użyciem H1-MRS

Background: Computerized tomography (CT) with contrast infusion and Magnetic Resonance Imaging (MRI) do not differentiate radionecrosis and malignant tumor recurrence. Proton Magnetic Resonance Spectroscopy seems to be a new radiological method that could solve this problem. The aim of the study was to evaluate the usability of H1-MRS in patients after brachytherapy. Material/Methods: Sixty patients were treated by Ir 192 HDR brachytherapy because of malignant brain tumors (gliomas and brain metastases). Prospectively, 4 months after brachytherapy, 24 patients underwent MRI and H1-MRS examinations. All patients qualified for the prospective study were in good general condition before and after the brachytherapy (Karnofsky Performance Score (KPS) > 60%). Results: Combined assessment of MRI and H1-MRS gave us the possibility to differentiate the observed pathological changes. In 18 cases (75%) there was a decrease in tumor volume. The tumor infiltration area was larger than the necrotic area in 5 cases. An isolated recurrence mass was observed in only one case. Neurosurgical brain decompression with pathological mass resection was needed in 6 patients with increased intracranial pressure and enhanced neurological deficits. Histopathological examination confirmed the diagnosis revealed in the H1-MRS examination in each case. Conclusions: Proton Magnetic Resonance Spectroscopy is helpful in evaluating the influence of radiation on the tumor and the surrounding brain tissue. Moreover, it solves the problem of differentiating between radionecrosis and tumor recurrence

Stroke in young diver with patent foramen ovale

Patent foramen ovale (PFO) is the most common cause of right-to-left shunt which carries a significant risk for stroke when associated with venous thrombosis, coagulation abnormalities or other conditions. We present a young male in whom diving was associated with stroke in a subject with otherwise clinically silent PFO. Kardiol Pol 2012; 70, 1: 55–5

Therapeutic Potential of Olfactory Ensheathing Cells and Mesenchymal Stem Cells in Spinal Cord Injuries

Spinal cord injury (SCI) is a devastating neurological condition that affects individuals worldwide, significantly reducing quality of life, for both patients and their families. In recent years there has been a growing interest in cell therapy potential in the context of spinal cord injuries. The present review aims to discuss and compare the restorative approaches based on the current knowledge, available spinal cord restorative cell therapies, and use of selected cell types. However, treatment options for spinal cord injury are limited, but rehabilitation and experimental technologies have been found to help maintain or improve remaining nerve function in some cases. Mesenchymal stem cells as well as olfactory ensheathing cells seem to show therapeutic impact on damaged spinal cord and might be useful in neuroregeneration. Recent research in animal models and first human trials give patients with spinal cord injuries hope for recovery

Influence of Bone Marrow-Derived Mesenchymal Stem Cell Therapy on Oxidative Stress Intensity in Minimally Conscious State Patients

Neurological disorders, including minimally conscious state (MCS), may be associated with the presence of high concentrations of reactive oxygen species within the central nervous system. Regarding the documented role of mesenchymal stem cells (MSCs) in oxidative stress neutralization, the aim of this study is to evaluate the effect of bone marrow-derived MSC (BM-MSC) transplantation on selected markers of oxidative stress in MCS patients. Antioxidant capacity was measured in cerebrospinal fluid (CSF) and plasma collected from nine patients aged between 19 and 45 years, remaining in MCS for 3 to 14 months. Total antioxidant capacity, ascorbic acid and ascorbate concentrations, superoxide dismutase, catalase, and peroxidase activity were analyzed and the presence of tested antioxidants in the CSF and plasma was confirmed. Higher ascorbic acid (AA) content and catalase (CAT) activity were noted in CSF relative to plasma, whereas superoxide dismutase (SOD) activity and total antioxidant capacity were higher in plasma relative to CSF. Total antioxidant capacity measured in CSF was greater after BM-MSC transplantations. The content of ascorbates was lower and CAT activity was higher both in CSF and plasma after the administration of BM-MSC. The above results suggest that MSCs modulate oxidative stress intensity in MCS patients, mainly via ascorbates and CAT activity

Safety of intrathecal injection of Wharton’s jelly-derived mesenchymal stem cells in amyotrophic lateral sclerosis therapy

Animal experiments have confirmed that mesenchymal stem cells can inhibit motor neuron apoptosis and inflammatory factor expression and increase neurotrophic factor expression. Therefore, mesenchymal stem cells have been shown to exhibit prospects in the treatment of amyotrophic lateral sclerosis. However, the safety of their clinical application needs to be validated. To investigate the safety of intrathecal injection of Wharton’s jelly-derived mesenchymal stem cells in amyotrophic lateral sclerosis therapy, 43 patients (16 females and 27 males, mean age of 57.3 years) received an average dose of 0.42 × 106 cells/kg through intrathecal administration at the cervical, thoracic or lumbar region depending on the clinical symptoms. There was a 2 month interval between two injections. The adverse events occurring during a 6-month treatment period were evaluated. No adverse events occurred. Headache occurred in one case only after first injection of stem cells. This suggests that intrathecal injection of Wharton’s Jelly-derived mesenchymal stem cells is well tolerated in patients with amyotrophic lateral sclerosis. This study was approved by the Bioethical Committee of School of Medicine, University of Warmia and Mazury in Olsztyn, Poland (approval No. 36/2014 and approval No. 8/2016). This study was registered with the ClinicalTrials.gov (identifier: NCT02881476) on August 29, 2016