Case Report: Stem cell therapy in amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease leading to loss of upper and lower motor neurons at both spinal and bulbar levels. For patients with ALS rehabilitation is important to maintain functional independence, ensure safety and optimize quality of life but is not curative. Stem cell therapy (SCT) provides a new approach to treat previously incurable diseases although peer reviewed published evidence has shown no benefit in ALS for slowing disease progression or functional loss. This case report presents a patient with ALS who underwent SCT but deteriorated rapidly after the procedure. Whether the deterioration was due to the natural progress of the disease or expedited by SCT remains unknown. The ethical considerations of how marketing influences healthcare and individuals’ decisions in desperate situations along with reasons for taking desperate measures are discussed. Patient education and open communication with ALS patients are imperative in gaining patient satisfaction and overcoming ill effects that marketing could have on unconventional methods of intervention. Raising awareness about the availability and access to multidisciplinary care, the timing of decisions with regards to symptom management and end of life care have proven to enhance the quality of life for such patients.

Mechanism and Prevention of Spiral Ganglion Neuron Degeneration in the Cochlea

Sensorineural hearing loss (SNHL) is one of the most prevalent sensory deficits in humans, and approximately 360 million people worldwide are affected. The current treatment option for severe to profound hearing loss is cochlear implantation (CI), but its treatment efficacy is related to the survival of spiral ganglion neurons (SGNs). SGNs are the primary sensory neurons, transmitting complex acoustic information from hair cells to second-order sensory neurons in the cochlear nucleus. In mammals, SGNs have very limited regeneration ability, and SGN loss causes irreversible hearing loss. In most cases of SNHL, SGN damage is the dominant pathogenesis, and it could be caused by noise exposure, ototoxic drugs, hereditary defects, presbycusis, etc. Tremendous efforts have been made to identify novel treatments to prevent or reverse the damage to SGNs, including gene therapy and stem cell therapy. This review summarizes the major causes and the corresponding mechanisms of SGN loss and the current protection strategies, especially gene therapy and stem cell therapy, to promote the development of new therapeutic methods.

ST-elevation myocardial infarction complicated by cardiac arrest in a young patient with familiar dyslipidemia

Coronary heart disease in young patients always poses great challenges for every healthcare system with differences in clinical manifestations, etiology, epidemiology, angiographic characteristics and prognosis. The objective of this study was to describe a case of ST-elevation myocardial infarction complicated by cardiac arrest in a young patient with familial dyslipidemia. A 30-year-old male visited our hospital with typical angina. During the examination, he suffered a sudden loss of consciousness, the monitor showed ventricular fibrillation. After successful resuscitation of cardiac arrest, electrocardiography showed apparent ST-elevation from V2 to V6 leads consistent with the diagnosis of anterolateral infarction. Emergency coronary angiogram showed severe three-vessel lesions including complete occlusion of the LAD artery and 80 - 90% stenosis of the other two coronary branches. Our patient’s coronary arteries were revascularized using drug-eluting stents in LAD artery and subsequently RCA artery, stem cell therapy was applied during the interventional process. Routine laboratory test results showed dyslipidemia and his family records suggested familiar (hereditary) dyslipidemia which affected his mother and sister. 1-month follow-up echocardiography showed a drastic improvement of LVEF by roughly 15%. The combination of revascularization, stem cell therapy, and lipid-lowering therapy has shown a good therapeutic effect.