Results: Between January of 1987 and June of 2007, a mitral ring was diagnosed in 25 patients (13 male) with a mean age at diagnosis of 36 months. The ring was identified in a single neonate but seemed to develop and progress during infancy. All but 1 patient had associated cardiac anomalies. We identified 2 distinct subtypes: “”intramitral ring” in 18 of 25 patients (72%), associated with complex valve pathology and a worse outcome, and “”supramitral ring” in 7 of 25 patients (18%), in whom the mitral apparatus was usually normal and the outcome was better. The
ring was surgically removed in 13 of 25 patients (52%) (mean Doppler gradient 15 +/- 4 mm Hg). The gradient selleck screening library decreased in 9 of 13 patients (mean diastolic transmitral gradient <= 5 mm Hg) and has remained stable during a mean follow-up of 90 months.
The mean diastolic gradient remained high (>8 mm Hg) in the other 4 patients, all with intramitral ring. All 4 patients underwent repeat mitral valvuloplasty. There were no operative or late deaths.
Conclusion: Two types of congenital mitral ring, with diverse valve pathology and outcome, were identified. Rarely seen in neonates, the ring develops and often progresses during infancy. Recognition is important because surgical results are better than for other forms of congenital mitral stenosis.”
“There is a paucity of therapies for most central nervous system (CNS) disorders. Bone marrow stromal cells (MSCs) are a mixed cell population, including stem and progenitor cells, and are currently a strong candidate for cell-based therapy MK-4827 chemical structure in “”brain attack”", including stroke, and traumatic brain injury (TBI), since they are easily isolated and can be expanded in culture from patients without ethical and technical problems. Although it has click here been suggested that trans-differentiation of MSCs into cells of neural lineage may occur in
vitro, no one has yet observed that MSCs give rise to fully differentiated and functional neurons in vivo. The overwhelming body of data indicate that bioactive factors secreted by MSCs in response to the local environment underlie the tissue restorative effects of MSCs. The MSCs that are employed in this therapy are not necessarily stem cells, but progenitor and differentiated cells that escape immune system surveillance and survive in the CNS even for transplantation of allogeneic or xenogeneic MSCs. The injured CNS is stimulated by the MSCs to amplify its intrinsic restorative processes. Treatment of damaged brain with MSCs promotes functional recovery, and facilitates CNS endogenous plasticity and remodeling. The current mini-review is mainly based on our data and focuses on possible cellular and molecular mechanisms of interaction of MSCs with glia, neurons and vessels after brain attack. The transplantation of MSCs opens up new avenues of cell therapy and may provide an effective treatment for various CNS diseases. (C) 2009 Elsevier Ireland Ltd. All rights reserved.