Finger drop sign as a new variant of acute motor axonal neuropathy.

We propose the finger drop sign as a new clinical variant of acute motor axonal neuropathy (AMAN) defined by immunological and radiological evidence. We identified eight consecutive patients who had AMAN. All of them developed prominent involvement of the finger extensors. We performed magnetic resonance imaging (MRI) of the extremity muscles and serological assays for antiganglioside antibodies and Campylobacter jejuni. Patients with AMAN showed characteristic and a markedly sustained weakness of the finger extensors with a distinctive pattern of the finger drop sign. Limb MRI revealed unevenly distributed abnormal signals in the muscles mainly innervated by the posterior interosseous nerve. All tested patients showed positivity for immunoglobulin G antibody against ganglioside complex of GM1 and phosphatidic acid. A pathophysiological understanding of this unique syndrome can provide further insight into antiganglioside-antibody-mediated axonal injury in Guillain-Barré syndrome.

Comparison of MR findings of acute traumatic peripheral nerve injury and acute compressive neuropathy in a rat model.

PURPOSE: The treatment strategy is different for acute traumatic peripheral nerve injury and acute compressive neuropathy. This study aimed to compare magnetic resonance imaging (MRI) features of acute traumatic peripheral nerve injury and acute compressive neuropathy in a rat model. MATERIALS AND METHODS: Twenty female Sprague-Dawley rats were divided into two groups. In the crush injury group (n = 10), the unilateral sciatic nerve was crushed using forceps to represent acute traumatic peripheral nerve injury. In the compression injury group (n = 10), the unilateral sciatic nerve was ligated using silk to represent acute compressive neuropathy. The MRI of eight rats from each group were acquired on postoperative days 3 and 10. Fat-suppressed T2-weighted images were acquired. Changes in the injured nerve were divided into three grades. A Fisher's exact test was used to compare the changes in the nerves of the two groups. Histological staining and a western blot analysis were performed on one rat in each group on day 3. Neurofilament, myelin basic protein (MBP), and p75NTR staining were performed. Expression of neurofilament, MBP, p75NTR, and c-jun was evaluated by western blot analysis. RESULTS: MR neurography revealed substantial nerve changes in the compression injury group compared with the crush injury group at two-time points (p = 0.001 on day 3, p = 0.026 on day 10). The histopathological analysis indicated the destruction of the axon and myelin, mainly at the injury site and the distal portion of the injury in the crush injury group. It was prominent in the proximal portion, the injury site, and the distal portion of the injury in the compression injury group. The degree of axonal and myelin destruction was more pronounced in the compression injury group than in the crush injury group. CONCLUSION: MR neurography showed prominent and long-segmental changes associated with the injured nerve in acute compressive neuropathy compared with acute traumatic peripheral nerve injury.

Ultrasonography of Malignant Clear Cell Hidradenoma: A Case Report.

Clear cell hidradenoma is a tumor that originates from a sweat gland and typically involves the dermis and subcutaneous tissue. Malignant clear cell hidradenoma is very rare, and surgical excision is usually performed without imaging. There are few reports of the ultrasonographic findings of malignant clear cell hidradenomas. Herein, we present the ultrasonographic characteristics of a malignant clear cell hidradenoma.

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Magnetic resonance neurography (MRN) has been increasingly used in recent years for the assessment of peripheral neuropathies. Fat suppression T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) have typically been used to provide high contrast MRN. Isotropic 3-dimensional (3D) sequences with fast spin echo, post-processing imaging techniques, and fast imaging methods, among others, allow good visualization of peripheral nerves that have a small diameter, complex anatomy, and oblique course within a reasonable scan time. However, there are still several issues when performing high contrast and high resolution MRN including standard sequence; fat saturation techniques; balance between resolution, field of view, and slice thickness; post-processing techniques; 2D vs. 3D image acquisition; different T2 contrasts between proximal and distal nerves; high T2 signal intensity of adjacent veins or joint fluid; geometric distortion; and appropriate p-values on DWI. The proper understanding of these issues will help novice radiologists evaluate peripheral neuropathies using MRN.

Effect of Hybrid Kernel and Iterative Reconstruction on Objective and Subjective Analysis of Lung Nodule Calcification in Low-Dose Chest CT.

Objective: To evaluate the differences in subjective calcification detection rates and objective calcium volumes in lung nodules according to different reconstruction methods using hybrid kernel (FC13-H) and iterative reconstruction (IR). Materials and Methods: Overall, 35 patients with small (< 4 mm) calcified pulmonary nodules on chest CT were included. Raw data were reconstructed using filtered back projection (FBP) or IR algorithm (AIDR-3D; Canon Medical Systems Corporation), with three types of reconstruction kernel: conventional lung kernel (FC55), FC13-H and conventional soft tissue kernel (FC13). The calcium volumes of pulmonary nodules were quantified using the modified Agatston scoring method. Two radiologists independently interpreted the role of each nodule calcification on the six types of reconstructed images (FC55/FBP, FC55/AIDR-3D, FC13-H/FBP, FC13-H/AIDR-3D, FC13/FBP, and FC13/AIDR-3D). Results: Seventy-eight calcified nodules detected on FC55/FBP images were regarded as reference standards. The calcium detection rates of FC55/AIDR-3D, FC13-H/FBP, FC13-H/AIDR-3D, FC13/FBP, and FC13/AIDR-3D protocols were 80.7%, 15.4%, 6.4%, 52.6%, and 28.2%, respectively, and FC13-H/AIDR-3D showed the smallest calcium detection rate. The calcium volume varied significantly with reconstruction protocols and FC13/AIDR-3D showed the smallest calcium volume (0.04 ± 0.22 mm3), followed by FC13-H/AIDR-3D. Conclusion: Hybrid kernel and IR influence subjective detection and objective measurement of calcium in lung nodules, particularly when both techniques (FC13-H/AIDR-3D) are combined.

Ultrasonographic Findings of Scleredema Adultorum of Buschke Involving the Posterior Neck.

Objective: To describe the clinical and ultrasonographic (US) findings in patients with scleredema adultorum of Buschke, who presented with sclerotic skin on their posterior neck. Materials and Methods: After obtaining IRB approval, eight patients with scleredema adultorum of Buschke were enrolled. They underwent US examination of their posterior neck. The diagnoses were confirmed pathologically. The clinical history and US images were evaluated retrospectively. Dermal thickness was compared between the patient group and the age- and sex-matched control group. Results: The patients included seven males and one female with a mean age of 51.5 years. All patients presented with thickening of the skin and/or a palpable mass on the posterior neck. Five (62.5%) of the eight patients showed erythematous discoloration. Six patients (75.0%) had a history of diabetes. The Hemoglobin A1c level was found to be increased in all patients. US images did not show any evidence of a soft tissue mass or infection. The mean dermal thickness in patients (7.01 ± 1.95 mm) was significantly greater than that in the control group (3.08 ± 0.87 mm) (p = 0.001). Multiple strong echogenic spots in the dermis were seen in all patients. Seven patients (87.5%) showed posterior shadowing in the lower dermis. Conclusion: When a patient with a history of diabetes presents with a palpable mass or erythematous discoloration of the posterior neck and US shows the following imaging features: 1) no evidence of a soft tissue mass or infection, 2) thickening of the dermis, 3) multiple strong echogenic spots and/or posterior shadowing in the dermis, scleredema adultorum of Buschke should be considered in the differential diagnosis.

Effects of Valproic Acid on Morphology, Proliferation, and Differentiation of Mesenchymal Stem Cells Derived From Human Gingival Tissue.

PURPOSE: Valproic acid (VPA), a histone deacetylase inhibitor, has been shown to affect cell growth and differentiation in various in vitro and in vivo models. The aim of this study is to evaluate the effects of VPA on viability and osteogenic differentiation of mesenchymal stem cells derived from the human gingival tissue. MATERIALS AND METHODS: Stem cells derived from the gingiva were grown in the presence of VPA at concentrations ranging from 0.125 to 8 mM. Cell morphology was assessed on days 3, 5, and 7, and cell proliferation was analyzed on the same days using a Cell Counting Kit-8 (CCK-8). Alizarin Red-S staining was used to assess differentiation of the stem cells. RESULTS: The control group showed a normal fibroblast morphology when cultured in growth media. The shape of cells in the 8 mM group was more flat than cells in other groups, and fewer cells were present. A statistically significant decrease in cell proliferation was seen in the 8 mM group. Results of Alizarin Red-S staining showed a significant decrease in mineralization in the 8 mM group. CONCLUSIONS: Taken together, this study demonstrated that VPA, at the tested concentrations, decreases the viability of stem cells derived from the human gingiva. The decreases in osteogenic differentiation were achieved via the decrease of Rux2 expression. The concentration and application time of VPA treatment should be meticulously controlled to minimize any detrimental effects.

Synergistic inhibition of glioma cell proliferation by Withaferin A and tumor treating fields.

Glioblastoma (GBM) is the most aggressive and lethal form of brain cancer. Standard therapies are non-specific and often of limited effectiveness; thus, efforts are underway to uncover novel, unorthodox therapies against GBM. In previous studies, we investigated Withaferin A, a steroidal lactone from Ayurvedic medicine that inhibits proliferation in cancers including GBM. Another novel approach, tumor treating fields (TTFields), is thought to disrupt mitotic spindle formation and stymie proliferation of actively dividing cells. We hypothesized that combining TTFields with Withaferin A would synergistically inhibit proliferation in glioblastoma. Human glioblastoma cells (GBM2, GBM39, U87-MG) and human breast adenocarcinoma cells (MDA-MB-231) were isolated from primary tumors. The glioma cell lines were genetically engineered to express firefly luciferase. Proliferative potential was assessed either by bioluminescence imaging or cell counting via hemocytometer. TTFields (4 V/cm) significantly inhibited growth of the four cancer cell lines tested (n = 3 experiments per time point, four measurements per sample, p < 0.02 at least; 2-way ANOVA, control vs. treatment). The combination of Withaferin A (10-100 nM) with TTFields significantly inhibited the growth of the glioma cells to a degree beyond that of Withaferin A or TTFields alone. The interaction of the Withaferin A and TTFields on glioma cells was found to be synergistic in nature (p < 0.01, n = 3 experiments). These findings were validated by both bioluminescence and hemocytometric measurements. The combination of Withaferin A with TTFields represents a novel approach to treat GBM in a manner that is likely better than either treatment alone and that is synergistic.

Potential differentiation ability of gingiva originated human mesenchymal stem cell in the presence of tacrolimus.

The aim of the present study is to evaluate the potential differentiation ability of gingiva originated human mesenchymal stem cell in the presence of tacrolimus. Tacrolimus-loaded poly(lactic-co-glycolic acid) microspheres were prepared using electrospraying technique. In vitro release study of tacrolimus-loaded poly(lactic-co-glycolic acid) microspheres was performed in phosphate-buffered saline (pH 7.4). Gingiva-derived stem cells were isolated and incubated with tacrolimus or tacrolimus-loaded microspheres. Release study of the microspheres revealed prolonged release profiles of tacrolimus without any significant initial burst release. The microsphere itself did not affect the morphology of the mesenchymal stem cells, and cell morphology was retained after incubation with microspheres loaded with tacrolimus at 1 µg/mL to 10 µg/mL. Cultures grown in the presence of microspheres loaded with tacrolimus at 1 µg/mL showed the highest mineralization. Alkaline phosphatase activity increased with an increase in incubation time. The highest expression of pSmad1/5 was achieved in the group receiving tacrolimus 0.1 µg/mL every third day, and the highest expression of osteocalcin was achieved in the group receiving 1 µg/mL every third day. Biodegradable poly(lactic-co-glycolic acid)-based microspheres loaded with tacrolimus promoted mineralization. Microspheres loaded with tacrolimus may be applied for increased osteoblastic differentiation.

Effects of tacrolimus on morphology, proliferation and differentiation of mesenchymal stem cells derived from gingiva tissue.

Tacrolimus is a 23-membered macrolide lactone with potent immunosuppressive activity that is effective in the prophylaxis of organ rejection following kidney, heart and liver transplantation. Tacrolimus also exerts a variety of actions on bone metabolism. The aim of the present study was to evaluate the effects of different concentrations of tacrolimus on the morphology and viability of human stem cells derived from the gingiva. Gingival­derived stem cells were grown in the presence of tacrolimus at final concentrations ranging from 0.001 to 100 µg/ml. The morphology of the cells was viewed under an inverted microscope and the cell viability was analyzed using Cell Counting kit­8 (CCK­8) on days 1, 3, 5 and 7. Alizarin Red S staining was used to assess mineralization of treated cells. The control group showed spindle­shaped, fibroblast­like morphology and the shapes of the cells in 0.001, 0.01, 0.1, 1 and 10 µg/ml tacrolimus were similar to those of the control group. All groups except the 100 µg/ml group showed increased cell proliferation over time. Cultures grown in the presence of tacrolimus at 0.001, 0.01, 0.1, 1 and 10 µg/ml were not identified to be significantly different compared with the control at days 1, 3 and 5 using the CCK­8 assays. Increased mineralized deposits were noted with increased incubation time. Treatment with tacrolimus from 0.001 to 1 µg/ml led to an increase in mineralization compared with the control group. Within the limits of this study, tacrolimus at the tested concentrations (ranging from 0.001 to 10 µg/ml) did not result in differences in the viability of stem cells derived from gingiva; however it did enhance osteogenic differentiation of the stem cells.

Primary breast leiomyosarcoma located in the premammary zone: a case report.

We present the case of 51-year-old woman with a primary breast leiomyosarcoma. On the postoperative screening after breast cancer surgery, a 4-mm-sized mass assessed as BI-RADS category 3 was detected on her contralateral breast. We recommended follow-up and observation. However, the lesion increased in size and became palpable. It was excised and diagnosed as primary leiomyosarcoma. We review the literature on imaging findings and management of breast leiomyosarcoma, and discuss the differential diagnoses in breast imaging.

CT-based assessment of renal function impairment in patients with acute unilateral ureteral obstruction by urinary stones.

PURPOSE: The purpose of our study was to evaluate computed tomography (CT) imaging factors related to renal function impairment in patients with acute unilateral ureteral obstruction by urinary stones. MATERIALS AND METHODS: The study included 94 patients who had acute unilateral ureteral obstruction due to a urinary stone and a normal contralateral kidney. We retrospectively investigated the serum creatinine (SCr) levels immediately prior to CT examination and at least 1 week after treatment. CT examinations were performed using a CT urography protocol, including pre- and post-contrast images. The 67 patients with a SCr change of less than 0.3 mg/dL constituted group A. The other 27 patients with a SCr decrease of more than 0.3 mg/dL constituted group B. To evaluate factors related to renal function impairment, differences in CT imaging factors between the two groups, including the cortical and medullary density, renal and pelvic anteroposterior diameter, and perinephric fluid, were statistically analyzed. RESULTS: The SCr immediately prior to CT examination significantly differed between the two groups. The follow-up SCr after resolution did not significantly differ between the two groups. The difference in the mean cortical and medullary HU on the nephrographic phase between the obstructed kidney and normal kidney was higher in group B than in group A (27.1 ± 23.1 and 69.4 ± 59.1 vs. 5.7 ± 8.8 and 31.8 ± 34.8; p < 0.001 and p = 0.004, respectively). The cut-off point for the difference in the mean cortical HU on the nephrographic phase between the obstructed kidney and normal kidney for renal function impairment was 15 HU, as determined by a receiver operating characteristic curve analysis. CONCLUSIONS: Patients with significantly impaired renal function due to an acute unilateral ureteral obstruction may show a decreased nephrogram of the affected kidney and a significant difference in the HU on the nephrographic phase between the obstructed and normal kidney.

Intra-articular fibroma of tendon sheath in a knee joint associated with iliotibial band friction syndrome.

Iliotibial band (ITB) friction syndrome is a common overuse injury typically seen in the active athlete population. A nodular lesion on the inner side of the ITB as an etiology or an accompanying lesion from friction syndrome has been rarely reported. A 45-year-old male presented with recurrent pain and a movable nodule at the lateral joint area, diagnosed as ITB friction syndrome. The nodule was confirmed as a rare intra-articular fibroma of the tendon sheath (FTS) on the basis of histopathologic findings. We describe the MRI findings, arthroscopic and pathologic features, in this case of intra-articular FTS presenting with ITB friction syndrome.

Changes in Tip-Apex Distance by Position and Film Distance Measured by Picture Archiving and Communication System (PACS).

PURPOSE: The tip-apex distance (TAD) is used to predict the clinical outcome of intertrochanteric fracture fixation. We aimed to measure the changes in TAD by position and film distance using Picture Archiving and Communication System (PACS). MATERIALS AND METHODS: We used a femur replica with a 10° femoral neck anteversion and a 130° neck shaft angle. Proximal femoral nail antirotation nail and a helical blade were inserted into the replica. Radiographs were taken at the neutral position and after applying 10°, 20°, 30°, 40° internal/external rotation, 10° abduction, and 10° and 40° adduction to the mechanical axis. Radiographs were taken at the replica-film distance of 10 cm and 20 cm under the same conditions, mimicking the differences in Focus-film distance (FFD), which reflect the patient's contour in clinical settings. A radiologist and an orthopedic surgeon measured the TAD twice using PACS. The average error was 2 mm (4.5%) and the standard error was ±3.04. TADs in the neutral position constituted the standard values to measure the relative errors. RESULTS: TADs increased with an increase in the external rotation and abduction of the replica. TADs decreased with an increase in the internal rotation and adduction of the replica. For comparable measurements, relative errors were higher at FFDs of 20 cm compared to FFDs of 10 cm. CONCLUSION: Since the femur is internally rotated and adducted for reduction, orthopedic surgeons would assess the lag screw to be closer to the apex of femur on intraoperative radiographs. To have a correct measurement of the TAD after fixation of intertrochanteric fractures, radiographs should be taken in neutral position and measurement errors should be considered based on the patient's size.

Diffusion tensor imaging and T2 mapping in early denervated skeletal muscle in rats.

BACKGROUND: To evaluate the temporal changes of diffusion tensor imaging (DTI) indices, T2 values, and visual signal intensity on various fat suppression techniques in the early state of denervated skeletal muscle in a rat model. METHODS: Institutional Animal Care and Use Committee approval was obtained. Sciatic nerves of eight rats were transected for irreversible neurotmesis model. We examined normal lower leg and denervated muscles at 3 days, 1 week, and 2 weeks on a 3 Tesla MR. fractional anisotropy (FA), mean apparent diffusion coefficient (mADC), and T2 values were measured by using DTI and T2 mapping scan. We subjectively classified the signal intensity change on various fat suppression images into the following three grades: negative, suspicious, and definite change. Wilcoxon-sign rank test and Kruskal-Wallis test were used for the comparison of FA, mADC, T2 values. McNemar's test was used for comparing signal intensity change among fat suppression techniques. RESULTS: FA values of denervated muscles at 3 days (0.35 ± 0.06), 1 week (0.29 ± 0.04), and 2 weeks (0.34 ± 0.05) were significantly (P < 0.05) lower than that in the control group (0.54 ± 0.17). mADC of denervated muscles decreased without statistically significant (P > 0.05) change. T2 values were significantly increased at 1 week (38.11 ± 6.42 ms, P = 0.017) and markedly increased at 2 weeks (46.53 ± 5.17 ms, P = 0.012). The grade of visual signal intensity change on chemical shift selective fat saturation, STIR and IDEAL images were identical in all cases (P = 1.000). CONCLUSION: FA and T2 values can demonstrate the early temporal changes in denervated rat skeletal muscle.

Application of 31P MR spectroscopy to the brain tumors.

OBJECTIVE: To evaluate the clinical feasibility and obtain useful parameters of (31)P magnetic resonance spectroscopy (MRS) study for making the differential diagnosis of brain tumors. MATERIALS AND METHODS: Twenty-eight patients with brain tumorous lesions (22 cases of brain tumor and 6 cases of abscess) and 11 normal volunteers were included. The patients were classified into the astrocytoma group, lymphoma group, metastasis group and the abscess group. We obtained the intracellular pH and the metabolite ratios of phosphomonoesters/phosophodiesters (PME/PDE), PME/inorganic phosphate (Pi), PDE/Pi, PME/adenosine triphosphate (ATP), PDE/ATP, PME/phosphocreatine (PCr), PDE/PCr, PCr/ATP, PCr/Pi, and ATP/Pi, and evaluated the statistical significances. RESULTS: The brain tumors had a tendency of alkalization (pH = 7.28 ± 0.27, p = 0.090), especially the pH of the lymphoma was significantly increased (pH = 7.45 ± 0.32, p = 0.013). The brain tumor group showed increased PME/PDE ratio compared with that in the normal control group (p = 0.012). The ratios of PME/PDE, PDE/Pi, PME/PCr and PDE/PCr showed statistically significant differences between each brain lesion groups (p < 0.05). The astrocytoma showed an increased PME/PDE and PME/PCr ratio. The ratios of PDE/Pi, PME/PCr, and PDE/PCr in lymphoma group were lower than those in the control group and astrocytoma group. The metastasis group showed an increased PME/PDE ratio, compared with that in the normal control group. CONCLUSION: We have obtained the clinically applicable (31)P MRS, and the pH, PME/PDE, PDE/Pi, PME/PCr, and PDE/PCr ratios are helpful for differentiating among the different types of brain tumors.

Computed tomography-guided removal of a misplaced acetabular screw.

Open reduction and internal fixation with multiple screws and plates is the treatment of choice in patients with complex acetabular fractures. Two cases of a misplaced acetabular screw were detected on post-operative imaging, and referred to us for CT-guided removal of the misplaced screw. With the patients in the decubitus position, preliminary images were obtained to determine the puncture site and angle of approach. A k-wire was advanced to the head of the screw, over which we inserted a cannulated screwdriver and removed the screw. At each step all procedures were monitored with CT. The average total procedure time was 30 min. We observed no significant complications during or after the procedure. CT-guided removal of a misplaced acetabular screw seems to be a simple and safe procedure.

An initial randomised study assessing free-breathing CCTA using 320-detector CT.

OBJECTIVES: To evaluate the feasibility of free-breathing coronary computed tomography angiography (CCTA) in adults using with a 320-detector multidetector CT (MDCT). METHODS: In 74 patients who underwent CCTA, 37 CCTA examinations were performed during free-breathing, and the remaining 37 CCTA examinations were produced with the standard breath-holding method. The quality scores for 16 segments of all coronary arteries were analysed and defined as: 1 (excellent), 2 (good), and 3 (poor). The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and effective radiation dose of each image were compared between the two methods. RESULTS: No significant differences were observed in the quality scores between the breath-holding and free-breathing methods (1.10 ± 0.31 vs. 1.12 ± 0.33; P = 0.443). The SNR and CNR were not significantly different between the two methods. The overall mean effective radiation dose revealed no significant difference between the two methods (P = 0.585). CONCLUSIONS: Free-breathing CCTA using 320-detector MDCT showed no significant difference in image quality compared with standard breath-holding CCTA. For patients with difficulties of breath-holding or non-negligible apnoea-related heart rate variability, free-breathing CCTA can be an alternative solution for coronary artery evaluation. KEY POINTS: • Cardiac CT is becoming widely used and some patients are inevitably breathless. • Multidetector CT (e.g. 320) offers new opportunities for the breathless patient. • Free breathing images yielded similar image quality to those obtained using breath-holding. • However, a possibility of higher radiation dose precludes its routine application.

Proteomic analysis of proteins associated with cellular senescence by calorie restriction in mesenchymal stem cells.

Mesenchymal stem cells (MSCs) hold great promise for use in cell-based therapies because of their multipotency and simple methods for in vitro expansion. However, during in vitro expansion, MSCs will age and lose their multipotency and proliferation capability. Previous studies have reported that calorie restriction (CR) increases proliferation of MSCs and decreases apoptosis. Therefore, in this study, we examined the effect of low glucose (LG) on human bone marrow-derived MSCs. Proliferation under low glucose (LG, 1.4 mM) conditions was compared with that under normal glucose (NG, 5.5 mM) conditions. In addition, comparative studies of population doubling (PD), ß-galactosidase (ß-GAL) activity, reactive oxygen species (ROS) generation and differentiation capacity (osteocytes and adipocytes) in NG and LG conditions were performed. In addition, protein expression patterns were compared between NG and LG conditions and several proteins were found to be up- or down-regulated under the glucose restriction condition (LG condition). As a result, CR does not seem to have a significant effect on proliferation, ROS generation, glucose consumption concentration, population doublings, and adipogenic differentiation of MSCs. Interestingly, however, the differentiation potential into osteocytes was maintained under CR and a lower senescence-associated ß-galactosidase (ß-GAL) activity was observed under CR than under the NG condition. In addition, we determined three up-regulated proteins (aldehyde dehydrogenase, neuropolyprptide h3, and prolyl 4-hydroxylase alpha subunit) and seven down-regulated proteins (laminin-binding protein, actin, sec 13 protein, alpha soluble N-ethylmaleimide-sensitive fusion protein (NSF)- attachment protein (SNAP), manganese superoxide dismutase, proteasome alpha 1 subunit, and ribosomal protein S12) via two-dimensional electrophoresis analysis. These results imply that differentially expressed proteins under the LG condition may provide further information on the aging and differentiation of stem cells.