Dysphagia as the Predominant Symptom in Posterior Circulation Stroke: A Case Report.

BACKGROUND Cerebrovascular disease is a common reason for presentation to the emergency department (ED). Posterior circulation strokes can be diagnostically challenging because the presenting symptoms are often subtle or non-focal and can be missed by commonly used stroke scales. This case report describes a patient who presented to the ED with symptoms of progressive dizziness over a 12-h period, which was followed by the rapid onset of an inability to swallow and, at the time of his presentation, no other neurologic deficits. CASE REPORT The patient was a 55-year-old man with a history of diabetes, chronic obstructive pulmonary disease, tobacco and electronic cigarette use, and aortic atherosclerosis who presented to the ED for evaluation of his inability to swallow. His National Institutes of Health Stroke Scale score was zero. Non-contrast brain magnetic resonance imaging showed multiple foci of acute infarction in the left dorsolateral medulla and left cerebellar hemisphere in the posterior inferior cerebellar artery distribution. In the hospital, the patient developed an inability to stand, without loss of balance. Persistent dysphagia and inability to swallow necessitated the placement of a percutaneous endoscopic gastrostomy tube. CONCLUSIONS This case describes a relatively rare type of posterior circulation stroke. In addition to traditional risk factors, this patient had risk factors, such as electronic cigarette use, for which there is limited emerging evidence of association with stroke.

Isolation of myogenic progenitor cell population from human placenta: A pilot study.

PURPOSE: The purpose of this study was to demonstrate a method of isolating myogenic progenitor cells from human placenta chorionic villi and to confirm the myogenic characteristics of the isolated cells. METHODS: Cells were isolated from chorionic villi of a second trimester male placenta via a combined enzymatic digestion and explant culture. A morphologically distinct subpopulation of elongated and multinucleated cells was identified. This subpopulation was manually passaged from the explant culture, expanded, and analyzed by fluorescence in situ hybridization (FISH) assay, immunocytochemistry, and flow cytometry. Myogenic characteristics including alignment and fusion were tested by growing these cells on aligned polylactic acid microfibrous scaffold in a fusion media composed of 2% horse serum in Dulbecco's modified Eagle medium/high glucose. RESULTS: The expanded subpopulation was uniformly positive for integrin α-7. Presence of Y-chromosome by FISH analysis confirmed chorionic villus origin rather than maternal cell contamination. Isolated cells grew, aligned, and fused on the microfibrous scaffold, and they expressed myogenin, desmin, and MHC confirming their myogenic identity. CONCLUSION: Myogenic progenitor cells can be isolated from human chorionic villi. This opens the possibility for translational and clinical applications using autologous myogenic cells for possible engraftment in treatment of chest and abdominal wall defects.