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We demonstrate enhanced differentiation of oligodendrocytes during neurogenesis of human embryonic stem cells (hESCs) using an extracellular matrix protein, vitronectin (VN). We show that VN is expressed in the ventral part of the developing human spinal cord. Combined treatment of retinoic acid, sonic hedgehog, and noggin in the presence of VN allows hESCs to differentiate into O4-positive oligodendrocytes. Particularly, VN profoundly promotes the derivation of oligodendrocyte progenitors that proliferate and differentiate into oligodendrocytes in response to mitogenic and survival factors. These results support the beneficial effect of VN on oligodendrocytic differentiation of hESCs. ; This research was supported by the Seoul Research and Business Development Program (10574) and by a Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea Government(MOST) (R01-2006-000-11364-0).

Purpose: To analyze the long-term outcomes of patients with typical trigeminal neuralgia treated with gamma knife radiosurgery (GKRS). Patients and Methods: A total of 62 consecutive patients with typical trigeminal neuralgia were treated with GKRS between 1998 and 2004. Of the 62 patients, 2 were lost to follow-up; the remaining 60 patients were followed for >12 months. The mean prescribed maximal dose was 79.7 Gy (range, 75-80), using a 4-mm shot. Results: Of the 60 patients, 48 were followed for >4 years. An additional 3 patients, followed for 70 years correlated with a favorable outcome in terms of pain recurrence after radiosurgery (hazard ratio, 0.125; 95% confidence interval, 0.016-0.975; p = .047) on multivariate analysis. Conclusion: GKRS seems to be an effective treatment modality for patients with typical trigeminal neuralgia considering the initial response rate; however, fewer than one-half of patients might continue to benefit from GKRS after long-term follow-up. Elderly patients might be good candidates for radiosurgery considering the long-term durability of efficacy. ; Supported by Nuclear Research & Development Program of the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korean government (MEST) (grant code: M20090078163); the statistical analysis was supported by the Medical Research Collaborating Center, Seoul National University Hospital. ; Guo S, 2008, STEREOT FUNCT NEUROS, V86, P135, DOI 10.1159/000120425 ; Sindou M, 2006, ACTA NEUROCHIR, V148, P1235, DOI 10.1007/s00701-006-0809-2 ; Urgosik D, 2005, J NEUROSURG, V102, P29 ; LIM M, 2005, NEUROSURG FOCUS, V18, pE9 ; Lopez BC, 2004, J NEUROL NEUROSUR PS, V75, P1019, DOI 10.1136/jnnp.2003.018564 ; Brisman R, 2004, J NEUROSURG, V100, P848 ; Kubicek GJ, 2004, STEREOT FUNCT NEUROS, V82, P244, DOI 10.1159/000083176 ; Petit JH, 2003, INT J RADIAT ONCOL, V56, P1147, DOI 10.1016/S0360-3016(03)00264-5 ; Rogers CL, 2002, J NEUROSURG, V97, P529 ; Pollock BE, 2002, J NEUROSURG, V97, P347 ; Tyler-Kabara EC, 2002, J NEUROSURG, V96, P527 ; Flickinger JC, 2001, INT J RADIAT ONCOL, V51, P449 ; Maesawa S, 2001, J NEUROSURG, V94, P14 ; Brisman R, 2000, J NEUROSURG, V93, P159 ; Nicol B, 2000, J NEUROSURG, V93, P152 ; Rogers CL, 2000, INT J RADIAT ONCOL, V47, P1013 ; LUNSFORD LD, 2000, SURG NEUROL, V54, P285 ; Regis J, 1999, NEUROSURG CLIN N AM, V10, P359 ; Young RF, 1998, STEREOT FUNCT NEUROS, V70, P192 ; Urgosik D, 1998, STEREOT FUNCT NEUROS, V70, P200 ; Lee KH, 1997, STEREOT FUNCT NEUROS, V68, P196 ; Kondziolka D, 1996, J NEUROSURG, V84, P940 ; Barker FG, 1996, NEW ENGL J MED, V334, P1077 ; ZAKRZEWSKA JM, 1993, ACTA NEUROCHIR, V122, P225 ; BROGGI G, 1990, NEUROSURGERY, V26, P783 ; VANLOVEREN H, 1982, J NEUROSURG, V57, P757 ; MENZEL J, 1975, J NEUROSURG, V42, P140 ; LEKSELL L, 1951, ACTA CHIR SCAND, V102, P316 ; 12