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At the cellular level, spinal cord injury (SCI) provokes an inflammatory response that generates substantial secondary damage within the cord, but also may contribute to its repair. The aim of this study was to investigate the effects of inflammatory response associated with SCI in cutaneous wound healing and on expression of transforming growth factor-beta1 (TGF-beta1) and platelet-derived growth factor (PDGF)-A at the wound site in rats. At the 14th day analysis, the mean TGF-beta1 score in trauma group (I) was significantly lower than that in control group (C) (2.60 +/- 0.90 vs. 3.64 +/- 0.37, respectively; p < 0.05). The mean score for PDGF-A expression in group I was similar to the corresponding value in group C (2.42 +/- 0.74 vs. 2.94 +/- 0.72, respectively). Compared to group C, group I had significantly lower mean scores for epidermal and dermal regeneration, but higher mean scores for granulation tissue thickness and similar scores for angiogenesis. The dermal layer contains diffuse deposition of collagen fibers that are not organised as in control rat skin, and intraepidermal and subepidermal vasocongestion is distinct. Based on the results on the parameters evaluated in the study, experimental SCI in rats results in delay in wound healing and low intensity of TGF-beta1 in the dorsal wound-tissue specimens.

Background: The aim was to assess wound healing when parenteral fish-oil emulsion is given to rats receiving dexamethasone., Methods: For 5 days after skin wounding, group S (control; n = 7) received saline 1 mL/kg intraperitoneal (IP); group D (n = 7), dexamethasone 0.2 mg/kg IP; and group DO (n = 9), dexamethasone 0.2 mg/kg IP plus 1 mL/kg Omegaven (Fresenius Kabi, Austria). Wound specimens were assessed for hydroxyproline level, wound depth, histology (epidermal/dermal regeneration, granulation tissue thickness, and angiogenesis), and expression of transforming growth factor-beta (TGF-beta) and platelet-derived growth factor-AA (PDGF-AA)., Results: Compared with D and DO specimens, controls had higher hydroxyproline (p < .01), deeper wounds (p < .05), and better histologic scores (p < .01 angiogenesis; others p < .05). There were no significant differences between the group D and DO means for hydroxyproline level, wound depth, or histologic scores (p > .05 for all). Controls had higher TGF-beta expression scores than the other groups (p < .01 for both) and a higher PDGF-AA expression score than group DO (p < .01). Groups D and DO had statistically similar TGF-beta scores, but group D had a higher PDGF-AA score (2.71 +/- 0.75 vs 1.55 +/- 0.72, respectively; p < .05)., Conclusions: According to the parameters we studied, adding parenteral omega-3 and omega-6 fatty acids to the nutrition regimen of rats treated with dexamethasone does not seem to have adverse effects on wound healing, and effects on wound healing may not need to be considered when determining if these agents should be supplemented in nutrition support regimens.

As data elucidating the complexity of spinal cord injury pathophysiology emerge, it is increasingly being recognized that successful repair will probably require a multifaceted approach that combines tactics from various biomedical disciplines, including pharmacology, cell transplantation, gene therapy and material sciences. Recently, new evidence highlighting the benefit of physical activity and rehabilitation interventions during the post-injury phase has provided novel possibilities in realizing effective repair after spinal cord injury. However, before a comprehensive therapeutic strategy that optimally utilizes the benefits of each of these disciplines can be designed, the basic mechanisms by which these various interventions act must be thoroughly explored and important synergistic and antagonistic interactions identified. In examining the mechanisms by which physical activity-based functional recovery after spinal cord injury is effected, endogenous neural stem cells, in our opinion, engender a potentially key role. Multipotent neural stem cells possess many faculties that abet recovery, including the ability to assess the local microenvironment and deliver biofactors that promote neuroplasticity and regeneration, as well as the potential to replenish damaged or eradicated cellular elements. Encouragingly, the functional recovery owing to physical activity-based therapies appears relatively robust, even when therapy is initiated in the chronic stage of spinal cord injury. In this article, we review experimental outcomes related to our hypothesis that endogenous neural stem cells mediate the functional recovery noted in spinal cord injury following physical activity-based treatments. Overall, the data advocates the incorporation of increased physical activity as a component of the multidimensional treatment of spinal cord injury and underscores the critical need to employ research-based mechanistic approaches for developing future advances in the rehabilitation of neurological injury and disorders.

Spinal angiolipomas are extremely rare benign tumors composed of mature lipomatous and angiomatous elements. Most are symptomatic due to progressive spinal cord or root compression. This article describes the case of a 60-year-old woman who presented with a 6-month history of low back pain radiating to her right leg. The pain was multisegmental. The condition had worsened with time. Lumbar magnetic resonance imaging revealed a dorsal epidural mass at L5 and erosion of the lamina of the L5 vertebra. Laminectomy was performed, and an extradural tumor was totally excised. Neuropathologic examination identified it as a lumbar spinal angiolipoma. There was no evidence of recurrence in follow-up 12 months later. This rare clinical entity must be considered in the differential diagnosis for any spinal epidural lesion.

Objective: To evaluate selected laboratory components of a comprehensive periodic health evaluation program for patients with spinal cord injury and disorders (SCI/D)., Design: A retrospective study., Setting: A Department of Veterans Affairs spinal cord injury center., Participants: Community-dwelling male veterans with SCI/D (N=350)., Interventions: Not applicable., Main Outcome Measures: Proportion of laboratory tests that resulted in new diagnoses (diagnostic yield) and proportion of laboratory tests that resulted in changes in management (therapeutic yield)., Results: Although abnormality rates for many routine laboratory tests were high (up to 31.5%), diagnostic and therapeutic yields were low (<1.5%), with the exception of glucose (therapeutic yield, 3.4%) and lipid tests (up to a 4.1% diagnostic and 15.2% therapeutic yield)., Conclusions: Our data revealed that diagnostic and therapeutic yields for many laboratory components of the annual PHE program for veterans with SCI/D were low, consistent with findings in the general ambulatory population. Further data collection, particularly prospective longitudinal data, may help optimize the selection and frequency of laboratory tests performed as part of this program.

Recent reports indicate that cerebellar hemorrhage after spinal surgery is infrequent, but it is an important and preventable problem. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanisms are unknown. This report details the case of a 48-year-old woman who developed remote cerebellar hemorrhage after spinal surgery. The patient presented with a herniated lumbar disc, spinal stenosis, and spondylolisthesis, and underwent multiple-level laminectomy, discectomy, and transpedicular fixation. The dura mater was opened accidentally during the operation. There were no neurologic deficits in the early postoperative period; however, 12 h postsurgery the patient complained of headache. This became more severe, and developed progressive dysarthria and vomiting as well. Computed tomography demonstrated small sites of remote cerebellar hemorrhage in both cerebellar hemispheres. The patient was treated medically, and was discharged in good condition. At 6 months after surgery, she was neurologically normal. The case is discussed in relation to the ten previous cases of remote cerebellar hemorrhage documented in the literature. The only possible etiological factors identified in the reported case were opening of the dura and large-volume cerebrospinal fluid loss.

Objective: This experimental study assessed the usefulness of a rat model of corneal angiogenesis for assessing the angiogenic activity of cerebrovascular malformations (CVMs) over time. It is the first investigation to have focused on dynamic quantification of angiogenesis related to CVMs (i.e., assessing changes over time as opposed to one point in time) and the first to have compared different CVMs and other tissues in this way., Methods: The CVM specimens were from 15 randomly selected arteriovenous malformation (AVM) cases, 15 randomly selected cavernous malformation cases, and 2 venous angioma cases. All the samples came from surgical resections performed in the Marmara University Department of Neurosurgery and the Marmara University Institute of Neurological Sciences between January 1998 and January 2003. Glioblastoma multiforme tissues, normal adult brain tissues, and normal brain artery tissues were used as controls. Tissue from each specimen was implanted in one corneal micropocket in each cornea of a single rat, and the level of angiogenic activity in the cornea was graded (low, moderate, or high) at Days 1 through 9 after tissue implantation. Another set of rats was subjected to the same corneal implantation procedure, and two widely accepted indicators of neovascularization, microvessel counts and vascular endothelial growth factor expression, were assessed at Days 3, 5, 7, and 9 after surgery. The tissue-group results for grade of angiogenic activity, microvessel count, and grade of vascular endothelial growth factor expression were compared., Results: Of the three CVM types, the AVMs showed the highest angiogenic activity, cavernous malformations exhibited some degree of angiogenic activity (less than AVMs but more than normal brain artery tissue), and angiogenesis induction by venous angiomas was comparable to that of normal brain artery tissue. Corneas implanted with the AVM samples showed Grade 1 angiogenesis on Day 2, Grade 2 angiogenesis on Day 4, and Grade 2.5 angiogenesis on Day 8. Cavernous malformation samples caused Grade 1 angiogenesis after Day 5, and grading remained less than 1.5. Venous angioma samples resulted in angiogenesis graded less than 1., Conclusion: The results showed that this rat model of corneal angiogenesis is of value for assessing the angiogenic potential of CVMs and for evaluating details of the neovascularization process over time. Further investigation of CVMs with this model might yield information about how angiogenesis can be modulated, and this could lead to development of biological treatments that inhibit this process.

This study investigated the neuroprotective effects of magnesium sulfate prophylaxis and vitamin E prophylaxis in a rat model of spinal cord radiation injury. Groups were subjected to different treatment conditions for 5 days prior to irradiation, and outcomes were evaluated on the basis of lipid peroxidation levels in cord tissue. Four groups of rats were investigated: no radiation/treatment (n = 4), intraperitoneal (i.p.) saline 1 ml/day (n = 6), i.p. vitamin E 100 mg/kg/day (n = 6), and i.p. magnesium sulfate 600 mg/kg/day (n = 6). The thoracic cord of each non-control rat was exposed to 20 Gy radiation in a LINAC system using 6 MV x-rays, and malondialdehyde (MDA) levels (reflecting lipid peroxidation level) were determined 24 hours post-irradiation. The MDA levels in thoracic cord segments from the control rats were used to determine baseline lipid peroxidation. The mean levels in the control, saline-only, vitamin E, and magnesium sulfate groups were 12.12 +/- 0.63, 27.0 +/- 2.81, 17.71 +/- 0.44, and 14.40 +/- 0.47 nmol/mg tissue, respectively. The MDA levels in the saline-only group were significantly higher than baseline, and the levels in the vitamin E group were significantly lower than those in the saline group (P < 0.05 for both). The levels in the magnesium sulfate group were dramatically lower than those in the saline group (P < 0.001). The results indicate that i.p. magnesium sulfate has a marked neuroprotective effect against radiation-induced oxidative stress in the rat spinal cord., (Copyright 2004 Elsevier Inc.)