Multilineage-differentiating stress-enduring (Muse) cells are endogenous pluripotent stem cells that can be isolated based on stage-specific embryonic antigen-3 (SSEA-3), a pluripotent stem cell-surface marker. However, their capacities for survival, neurotrophic factor secretion, and neuronal and glial differentiation are unclear in rodents. Here we analyzed mouse adipose tissue-derived Muse cells in vitro. We collected mesenchymal stem cells (MSCs) from C57BL/6 J mouse adipose tissue and separated SSEA-3+, namely Muse cells, and SSEA-3–, non-Muse cells, to assess self-renewability; pluripotency marker expression (Nanog, Oct3/4, Sox2, and SSEA-3); spontaneous differentiation into endodermal, mesodermal, and ectodermal lineages; and neural differentiation capabilities under cytokine induction. Neurally differentiated Muse and non-Muse cell functions were assessed by calcium imaging. Antioxidant ability was measured to assess survival under oxidative stress. Brain-derived neurotrophic factor (BDNF), vascular endothelial cell growth factor (VEGF), and hepatocyte growth factor (HGF) secretion were analyzed in enzyme-linked immunosorbent assays. SSEA-3+ Muse cells (6.3 ± 1.9% of mouse adipose-MSCs), but not non-Muse cells, exhibited self-renewability, spontaneous differentiation into the three germ layers, and differentiation into cells positive for Tuj-1 (27 ± 0.9%), O4 (17 ± 3.4%), or GFAP (23 ± 1.3%) under cytokine induction. Neurally differentiated Muse cells responded to KCl depolarization with greater increases in cytoplasmic Ca2+ levels than non-Muse cells. Cell survival under oxidative stress was significantly higher in Muse cells (50 ± 2.7%) versus non-Muse cells (22 ± 2.8%). Muse cells secreted significantly more BDNF, VEGF, and HGF (273 ± 12, 1479 ± 7.5, and 6591 ± 1216 pg/mL, respectively) than non-Muse cells (133 ± 4.0, 1165 ± 20, and 2383 ± 540 pg/mL, respectively). Mouse Muse cells were isolated and characterized for the first time. Muse cells showed greater pluripotency-like characteristics, survival, neurotrophic factor secretion, and neuronal and glial-differentiation capacities than non-Muse cells, indicating that they may have better neural-regeneration potential.

Introduction: Fluoroscopy-guided selective nerve root block (SNRB) is useful for the diagnosis and treatment of nerve root pain. However, the procedure exposes the surgeon's hands to radiation. Therefore, the purpose of this randomized prospective study was to assess the radiation exposure per unit time of the surgeon's fingers during performance of a lumbosacral SNRB and to calculate the annual exposure time limits for four hand-protection methods. Methods: We prospectively recruited patients scheduled for an SNRB and measured the radiation exposure using a ringtype passive radiation dosimetry device attached to the distal phalanx of the index finger of the hand performing the needle placement. Patients were randomly divided into the following four groups: a) the direct exposure group, b) the 0.03-mmPb glove group, c) the 0.25-mmPb glove group, and d) the forceps group (in which the needle was held using forceps such that the fingers did not enter the irradiation field). Results: We recruited 40 consecutive patients (16 men and 24 women), with a mean age of 69 years. In all cases, SNRB was successfully performed without complications. The average exposure per hour for each of the four groups was as follows: 0.67 ± 0.56 mSv/s in the direct exposure group, 0.12 ± 0.07 mSv/s in the 0.03-mmPb glove group, 0.019 ± 0.02 mSv/s in the 0.25-mmPb glove group, and 0.001 ± 0.004 mSv/s in the forceps group (p < 0.01). The average annual exposure time limit was 12.4 min in the direct exposure group, 67.9 min in the 0.03-mmPb glove group, 7.5 h in the 0.25-mmPb glove group, and 5.0 days in the forceps group. Conclusions: Using a radiation reduction glove or forceps greatly decreased the radiation exposure and increased the annual exposure time limit for SNRB.

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This study assessed risk factors accounting for urinary tract infections (UTIs) to determine whether preoperative asymptomatic UTI (aUTI) could be used to predict UTIs in patients after spinal surgery. Overview of Literature: UTI is a spinal surgery complication that increases the incidence of surgical site infections. However, the risk factors for UTIs after spinal surgery remain unclear. Methods: This study included 509 (mean age, 54.5 years; 239 males and 270 females) patients who underwent posterior spine surgery at the department of the current study. First, clean catch urine was collected, after which a urine culture was performed for all patients before surgery. Preoperative detection of the aUTI (>105 colony-forming units/mL) rate was then determined. Subsequently, risk factors for postoperative UTI were evaluated using logistic regression analysis with the following as independent variables: age, sex, obesity, diabetes, spinal cord tumor, the preoperative Japanese Orthopedic Association (JOA) score, JOA-bladder function, preoperative urine culture positivity, aUTI, preoperative Escherichia coli detection, the postoperative catheter placement period, instrumentation, number of surgical levels, surgery duration, and blood loss. Results: The preoperative aUTI and postoperative UTI incidences were 8.1% and 4.1%, respectively. Furthermore, multivariate logistic analysis showed that the risk factor for postoperative UTI was preoperative aUTI (odds ratio, 4.234; 95% confidence interval, 1.532-11.702; p=0.005). Conclusions: Preoperative aUTI is a risk factor for UTI in patients after spinal surgery.

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