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Although cervical anterior osteophytes accompanying diffuse idiopathic skeletal hyperostosis (DISH) are generally asymptomatic, large osteophytes sometimes cause swallowing disorders. Surgical resection of the osteophyte has been reported to be an effective treatment; however, little study has been given to the recurrences of osteophytes. A prospective study was performed for seven patients who underwent surgical resection of cervical anterior osteophytes for the treatment of recalcitrant dysphagia caused by osteophytes that accompanied DISH. The seven patients were six men and one woman ranging in age from 55 to 78 years (mean age = 65 years). After a mean postoperative follow-up period of 9 years (range: 6-13 years), surgical outcomes were evaluated by symptom severity and plain radiographs of the cervical spine. On all operated intervertebral segments, the effect of postoperative intervertebral mobility (range of movement[1 degree) on the incidence of recurrent osteophytic formation (width [2 mm) was analyzed by Fisher's exact test. Complete relief of the dysphagia was obtained within one month postoperatively in five patients, while it was delayed for 3 months in two patients.All of the patients developed recurrent cervical osteophytic formation, with an average increase rate of approximately 1 mm/year following surgical resection. Of the 20 operated intervertebral segments, the incidence of recurrent osteophytes was significantly higher (P = 0.0013) in the 16 segments with mobility than in the four segments without mobility. Five of the seven patients remained asymptomatic, although radiological recurrence of osteophytes was seen at the final follow-up. The two remaining patients complained of moderate dysphagia 10 and 11 years after surgery, respectively; one of these two required re-operation due to progressive dysphagia 11 years postoperatively. In patients with cervical DISH and dysphagia, surgical resection of osteophytes resulted in a high likelihood of the recurrence of osteophytes. Therefore, attending surgeons should continue to follow these patients postoperatively for more than 10 years in order to assess the regrowth of osteophytes that may contribute to recurrent symptoms.

Motoneurons and oligodendrocytes in the embryonic spinal cord are produced from a restricted domain of the ventral ventricular zone, termed the pMN domain. The pMN domain is the site of expression of two basic helix-loop-helix transcription factors, Olig1 and Olig2, which are essential for motoneuron and oligodendrocyte development. Previous lineage-tracing experiments using Olig1-Cre and Olig2-GFP mice suggested that motoneurons and oligodendrocytes, but not astrocytes, are produced from the pMN domain. However, important questions remain, including the fate of neuroepithelial cells in the pMN domain, and specifically whether motoneurons and oligodendrocytes are the only types of cells produced in the pMN domain. We performed lineage-tracing experiments using a tamoxifen-inducible Cre-recombinase inserted into the Olig2 locus. We demonstrated that motoneurons and oligodendrocyte progenitors are derived from the Olig2+ progenitors in the pMN domain, and also found that a subset of astrocytes at the ventral surface of the spinal cord and ependymal cells at the ventricular surface are also produced from the pMN domain. These findings demonstrate that motoneurons and oligodendrocytes are not the only cell types originating from this domain.

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Article abstractObjective: To investigate the relationship between leukoaraiosis (LA), which has been considered as an intermediate substitute of ischemic brain damages, and metabolic syndrome (MetS) that attracts attention as a risk factor for cerebrovascular diseases, in healthy subjects derived from various age groups. Methods:We studied 1,030 healthy persons at ages between 28 and 78 years (mean, 52.7 years) with no past history of stroke who visited a health care facility for routine health checkups. MetS was defined using the criteria of the National Cholesterol