Opinions of Students on the Contribution of the DIVA 3D Virtual Dissection Table to the Teaching of Anatomy at the Faculty of Medicine and Odontostomatology of Bamako

Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.

Image-Based Brachytherapy in Cervical Cancer: Review and Experiences in Faculty of Medicine, Chiang Mai University

Cervical cancer is the one of the most common cancer in female patients inThailand. Radiotherapy has the role for the treatment of cervical cancer by postoperative, radical and palliative treatments. For radical radiotherapy, the combination of external beam radiation therapy and brachytherapy will be used to increase the tumor dose to curative goal. With the new development of medical images (Computed tomography (CT), Magnetic Resonance Imaging (MRI) or Ultrasonography (US)), the treatment with brachytherapy will be developed from point-based to volume-based concepts. Many studies reported the benefit of image-based brachytherapy over conventional brachytherapy and clinical benefit of using image-based brachytherapy in the treatment of cervical cancer.

Treatment Results of Adjuvant Brachytherapy as Monotherapy in Endometrial Cancer: A Retrospective Study from Faculty of Medicine, Chiang Mai University

Purpose: To report the retrospective study of using intravaginal brachytherapy as adjuvant monotherapy for endometrial cancer. Materials and Methods: From 2001-2009, 47 patients who received completely surgical staging for endometrial carcinoma and were designed by multidisciplinary team were enrolled. All patients received intravaginal brachytherapy (IVBT) with the dose of 5.5 - 7 Gy in 2 - 6 fractions. The treatment results and late toxicities were evaluated and recorded. Results: At the median follow-up time of 44 months, the local control, disease-free survival, metastasis-free survival and overall survival rates were 100%, 97.9%, 97.9% and, 97.9%, respectively. Only age showed the statistical significance with the p-value of 0.046. Two patients (4.3%) developed late genitourinary toxicity. Conclusion: The using of adjuvant IVBT as monotherapy for endometrial carcinoma is feasible.

Self Evaluation in Department of Communicable Diseases, Faculty of Medicine, Tehran University of Medical Sciences

Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.

Adjuvant External Beam Radiotherapy ±Brachytherapy in Endometrial Cancer: A Retrospective Study from Faculty of Medicine, Chiang Mai University

Purpose: To report the retrospective study of external beam radiotherapy (EBRT) ± intravaginal brachytherapy (IVBT) as adjuvant treatment for endometrial cancer. Materials and Methods: From 2001-2009, 152 patients received complete surgical staging for endometrial carcinoma and were designed by a multidisciplinary team to receive EBRT ± IVBT. The treatment results and late toxicities were evaluated and recorded. Results: At the median follow-up time of 43 months, the disease-free survival, metastasis-free survival and overall survival rates were 96.9%, 96.9% and 96.9%, respectively. Stage and age showed the statistical significance with the p-value of less than 0.001. From five to ten percent of patients developed Grades 1-2 late gastrointestinal and genitourinary toxicities, respectively. Conclusion: The using of adjuvant EBRT ± IVBT for endometrial?carcinoma yielded treatment results and acceptable toxicities.

Reference values for selected hematological, biochemical and physiological parameters of Sprague‐Dawley rats at the Animal House, Faculty of Medicine, University of Colombo,Sri Lanka

Background: Lack of available reference values in a research setting under local conditions can be a drawback for beginners, as the accuracy of data from control samples cannot be checked at the beginning of a research project. This affects comparisons with data from test samples. To avoid these complications in their research projects,beginners tend to have a greater number of animals in the control group compared to test groups in order to have control group measurements within 2 SDs of the mean.Methods: As non-availability of reference values was a long-felt need, the described project was conducted in order to establish a reference database for selected haematological, biochemical and physiological parameters using apparently healthy Sprague-Dawley rats bred in the Animal House of Faculty of Medicine, University of Colombo(UCFM).Results: Differences in mean values of packed cell volume(PCV), mean corpuscular volume(MCV) and mean corpuscular hemoglobin concentration(MCHC), serum creatinine and blood glucose levels between the two genders were statistically significant. Lipid profile measurements did not differ significantly between genders, but mean and median values of triglycerides(TG) between male and female rats showed a difference of more than 10 mg/dL. The liver enzymes alkaline phosphatase(AP)and aspartate aminotransferase(AST) were also statistically significantly different between sexes. Despite wide variation in mean alanine aminotransferase(ALT)between sexes, the difference was not statistically significant.Conclusion: The findings of this project should support to a certain extent the"Reduction" aspect of the 3 Rs concept of Russell and Burch by reducing the number of Sprague-Dawley rats used in future research projects at UCFM.

Anatomical Dissection of the External Branch of the Superior Laryngeal Nerve to the Laboratory of Anatomy of the Faculty of Medicine of Bamako(Mali)

Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.

Hepatitis B virus genotypes in precision medicine of hepatitis Brelated hepatocellular carcinoma:Where we are now

Hepatitis B virus(HBV)infection is a major player in chronic hepatitis B that may lead to the development of hepatocellular carcinoma(HCC).HBV genetics are diverse where it is classified into at least 9 genotypes(A to I)and 1 putative genotype(J),each with specific geographical distribution and possible different clinical outcomes in the patient.This diversity may be associated with the precision medicine for HBV-related HCC and the success of therapeutical approaches against HCC,related to different pathogenicity of the virus and host response.This Editorial discusses recent updates on whether the classification of HBV genetic diversity is still valid in terms of viral oncogenicity to the HCC and its precision medicine,in addition to the recent advances in cellular and molecular biology technologies.

Use of Topical Complementary and Alternative Medicines (CAM) in Diabetic Septic Foot Disease in Makkah Region, Western of Saudi Arabia, an Exploratory Study

Diabetes is a chronic condition that is significantly impacted daily by environment. At least one in five Saudis, suffer from diabetes. “Diabetes is a pandemic of unprecedented magnitude spiraling out of control” (Boulton). Saudi Arabia ranks the second highest in the Middle East, and is the seventh in the world for the prevalence of diabetes (WHO). Diabetes mellitus (DM) has been found to be related to high mortality, morbidity accompanied by poor general health and lower quality of life. Current Saudi diabetes patients’ behaviors, practices, and beliefs regarding foot health problems such as ulcers, are not well investigated. Diabetic patients frequently utilize natural remedies and Herbs for self-medication as a part of complementary and alternative Medicine. Aim of study: To explore the widespread use of the alternative remedies in the local communities of the Western Saudi Arabia, the drives behind using and to focus on the potential adverse effects following their usage. Method: A descriptive, cross-sectional study of 386 diabetic patients with feet problems in Makkah Region, West of Saudi Arabia during the period April - June 2023. Results: Out of the 531 participants, only 386 participants reported diabetic foot disorder (DFD). Most of the participant were above 65 years of age group (24.61 %). Male (52.08%) more than female (47.92%) in the research group. All of the participants had diabetic foot disorders at least once. The prevalence of complementary and alternative medicines (CAM) use among them was 67.88%, as solitary or in combination with hospital medicines. Honey headed the list followed by myrrh and black seeds. Acquaintances advice (59.54%) was the most reason for using the alternative medicine. 60.30% of Diabetic foot patient complained of adverse effects during CAM remedies use. Conclusion: Consumption of CAM remedies among diabetic patients for Diabetic Foot Disorder (DFD) is common. Honey headed the list followed by myrrh and black seeds. Additional wide-scale research is required to establish their actual efficacy, safety and potential adverse out-comes and to generalize the outcomes.

Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

Knowledge towards Physical Medicine and Rehabilitation among Training Doctors and Medical Students at the Mohammed VI University Hospital of Marrakech

The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the knowledge, attitudes, and practices of doctors regarding physical medicine and rehabilitation and evaluate the knowledge in theoretical training related to PRM among the students. We conducted a monocentric cross-sectional analytical study, using a web-based anonymous survey, carried out among 558 undergraduate student and training doctors, randomly selected in the form of a survey on the knowledge towards Physical Medicine and rehabilitation. We received 558 survey duly completed by students of the Faculty of Medicine and Pharmacy of Marrakech (62.4%) and training doctors (37.6%). The mean age of the participants was 24.53 ± 3.9 years, with extremes ranging from 17 to 39 years. 52.7% of the participants were from the former educational reform, The predominance of participation was remarkable among pediatricians 23%, The population who knew PRM was the majority (79.3%), 40.7% of the participants were unaware of the availability of a PRM department at Mohamed VI University Hospital, 0.5% of all training doctors and medical students questioned strongly agreed with the sufficiency of their training in disability management were belonging to the new reform, 84.1% of participants had never attended or referred a patient to the PRM department. 23.2% of training doctors affirmed the referral of patients to PRM for further management. Despite the essential role of PRM in the management of diseases, it remains little known by training doctors and medical students. This lack of knowledge of PRM reflects the lack of the undergraduate and postgraduate of the medical education in the field of rehabilitation.

Development status of novel spectral imaging techniques and application to traditional Chinese medicine

Traditional Chinese medicine(TCM)is a treasure of the Chinese nation,providing effective solutions to current medical requisites.Various spectral techniques are undergoing continuous development and provide new and reliable means for evaluating the efficacy and quality of TCM.Because spectral techniques are noninvasive,convenient,and sensitive,they have been widely applied to in vitro and in vivo TCM evaluation systems.In this paper,previous achievements and current progress in the research on spectral technologies(including fluorescence spectroscopy,photoacoustic imaging,infrared thermal imaging,laser-induced breakdown spectroscopy,hyperspectral imaging,and surface enhanced Raman spectroscopy)are discussed.The advantages and disadvantages of each technology are also presented.Moreover,the future applications of spectral imaging to identify the origins,components,and pesticide residues of TCM in vitro are elucidated.Subsequently,the evaluation of the efficacy of TCM in vivo is presented.Identifying future applications of spectral imaging is anticipated to promote medical research as well as scientific and technological explorations.

Isoform-and cell-state-specific APOE homeostasis and function

Apolipoprotein E is the major lipid transporter in the brain and an important player in neuron-astrocyte metabolic coupling.It ensures the survival of neurons under stressful conditions and hyperactivity by nourishing and detoxifying them.Apolipoprotein E polymorphism,combined with environmental stresses and/or age-related alterations,influences the risk of developing late-onset Alzheimer’s disease.In this review,we discuss our current knowledge of how apolipoprotein E homeostasis,i.e.its synthesis,secretion,degradation,and lipidation,is affected in Alzheimer’s disease.

On the functions of astrocyte-mediated neuronal slow inward currents

Slow inward currents are known as neuronal excitatory currents mediated by glutamate release and activation of neuronal extra synaptic N-met hyl-D-aspartate receptors with the contribution of astrocytes.These events are significantly slower than the excitatory postsynaptic currents.Parameters of slow inward currents are determined by seve ral factors including the mechanisms of astrocytic activation and glutamate release,as well as the diffusion pathways from the release site towards the extra synaptic recepto rs.Astrocytes are stimulated by neuronal network activity,which in turn excite neurons,forming an astrocyte-neuron feedback loop.Mostly as a consequence of brain edema,astrocytic swelling can also induce slow inward currents under pathological conditions.There is a growing body of evidence on the roles of slow inward currents on a single neuron or local network level.These events often occur in synchro ny on neurons located in the same astrocytic domain.Besides synchronization of neuronal excitability,slow inward currents also set synaptic strength via eliciting timing-dependent synaptic plasticity.In addition,slow inward currents are also subject to non-synaptic plasticity triggered by long-la sting stimulation of the excitatory inputs.Of note,there might be important regionspecific differences in the roles and actions triggering slow inward currents.In greater networks,the pathophysiological roles of slow inward currents can be better understood than physiological ones.Slow inward currents are identified in the pathophysiological background of autism,as slow inward currents drive early hypersynchrony of the neural networks.Slow inward currents are significant contributors to paroxysmal depolarizational shifts/interictal spikes.These events are related to epilepsy,but also found in Alzheimer's disease,Parkinson's disease,and stroke,leading to the decline of cognitive functions.Events with features overlapping with slow inward currents(excitatory,N-methyl-Daspartate-receptor mediated currents with astrocytic contribution) as ischemic currents and spreading depolarization also have a well-known pathophysiological role in worsening consequences of stroke,traumatic brain injury,or epilepsy.One might assume that slow inward currents occurring with low frequency under physiological conditions might contribute to synaptic plasticity and memory formation.However,to state this,more experimental evidence from greater neuronal networks or the level of the individual is needed.In this review,I aimed to summarize findings on slow inward currents and to speculate on the potential functions of it.

Epidemic management in a measles outbreak in 2023,the return of vaccine-preventable diseases:A single center,retrospective observational study

Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023,at Marmara University Pendik Training and Research Hospital.The effects of vaccination status and underlying disease on the clinical course,treatments,and complications were evaluated.Results:In total,117 patients were enrolled in the study with a median age of 80 months(IQR:32.5-125.0).Twelve patients with contact history were asymptomatic and had an underlying disorder,and intravenous immunoglobulin was given to them for post-exposure prophylaxis.Fifty-one patients had confirmed measles diagnosis.Ribavirin treatment was given to three patients(a newborn,a girl with rhabdomyosarcoma,and a healthy boy)with respiratory distress.Seventy-eight percent of confirmed measles cases were unvaccinated,and all hospitalized cases were unvaccinated or under-vaccinated.Four full-vaccinated children had confirmed measles infection.Measles PCR from nasopharyngeal swabs was negative in all of them,and their diagnosis was established with anti-measles IgM positivity.Conclusions:The measles vaccine is the most effective way to protect from measles and measles-related complications.Although measles can also occur in fully vaccinated patients,the disease is milder than in unvaccinated patients.Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.

Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases:A systematic review and meta-analysis

BACKGROUND In hepatology,the clinical use of endoscopic ultrasound(EUS)has experienced a notable increase in recent times.These applications range from the diagnosis to the treatment of various liver diseases.Therefore,this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver diseases.AIM To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and efficacy.METHODS PubMed,Medline,Cochrane Library,Web of Science,and Google Scholar databases were extensively searched until October 2023.The methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias tool.In addition,statistical analyses were performed using the Comprehensive Meta-Analysis software.RESULTS Overall,45 articles on EUS were included(28 on diagnostic role and 17 on therapeutic role).Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4%for focal liver lesions(FLL)and 96.6%for parenchymal liver diseases.EUS-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases(3.1%and 8.7%,respectively).Analysis of data from four studies showed that EUS-guided liver abscess had high clinical(90.7%)and technical success(90.7%)without significant complications.Similarly,EUS-guided interventions for the treatment of gastric varices(GV)have high technical success(98%)and GV obliteration rate(84%)with few complications(15%)and rebleeding events(17%).CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.

Bridging the gap:Unveiling the crisis of physical inactivity in inflammatory bowel diseases

In this editorial we comment on the article titled“Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The BE-FIT-IBD study”published in a recent issue of the World Journal of Gastroen-terology 2023;29(41):5668-5682.Inflammatory bowel diseases(IBD)are emerging as a significant global health concern as their incidence continues to rise on a global scale,with detrimental impacts on quality of life.While many advances have been made regarding the management of the disease,physical inactivity in these patients represents an underexplored issue that may hold the key for further and better understanding the ramifications of IBD.Chronic pain,fatigue,and fear of exacerbating symptoms promotes physical inactivity among IBD patients,while the lack of clear guidelines on safe exercise regimens contributes to a norm of physical inactivity.Physical activity(PA)is accepted to have a positive effect on disease outcomes and quality of life,while inactivity exacerbates comorbidities like cardiovascular disease and mental health disorders.The“BE-FIT-IBD”study,focusing on PA levels and barriers in IBD patients of Southern Italy,revealed that a significant proportion(42.9%)were physically inactive.This lack of PA is attributed to barriers such as fear of flare-ups and misconceptions about exercise exacerbating the disease.The study also highlighted the need for better communication between healthcare providers and patients regarding the benefits of PA and safe incorporation into lifestyles.Moreover,physical inactivity may also contribute to disability in IBD patients,having a great impact on employment status.Of note is the fact that IBD also comes with an important psychological burden with relevant evidence suggesting that regular PA can improve mood,reduce anxiety,and enhance mental health.The“BE-FIT-IBD”study advocated for the integration of PA into IBD management,emphasizing the bidirectional link between PA and IBD.Regular exercise can influence the course of IBD,potentially reducing symptom severity and prolonging remission periods.As such,it is mandatory that healthcare providers actively educate patients,dispel misconceptions,and tailor exercise recommendations to improve the quality of life and reduce IBD-related complications.

Treadmill exercise improves hippocampal neural plasticity and relieves cognitive deficits in a mouse model of epilepsy

Epilepsy frequently leads to cognitive dysfunction and approaches to treatment remain limited.Although regular exercise effectively improves learning and memory functions across multiple neurological diseases,its application in patients with epilepsy remains controversial.Here,we adopted a 14-day treadmill-exercise paradigm in a pilocarpine injection-induced mouse model of epilepsy.Cognitive assays confirmed the improvement of object and spatial memory after endurance training,and electrophysiological studies revealed the maintenance of hippocampal plasticity as a result of physical exercise.Investigations of the mechanisms underlying this effect revealed that exercise protected parvalbumin interneurons,probably via the suppression of neuroinflammation and improved integrity of blood-brain barrier.In summary,this work identified a previously unknown mechanism through which exercise improves cognitive rehabilitation in epilepsy.

Seeing beneath the surface:Harnessing point-of-care ultrasound for internal jugular vein evaluation

Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.

BMPRⅡ^(+)neural precursor cells isolated and characterized from organotypic neurospheres:an in vitro model of human fetal spinal cord development

Roof plate secretion of bone morphogenetic proteins(BMPs)directs the cellular fate of sensory neurons during spinal cord development,including the formation of the ascending sensory columns,though their biology is not well understood.Type-ⅡBMP receptor(BMPRⅡ),the cognate receptor,is expressed by neural precursor cells during embryogenesis;however,an in vitro method of enriching BMPRⅡ^(+)human neural precursor cells(hNPCs)from the fetal spinal cord is absent.Immunofluorescence was undertaken on intact second-trimester human fetal spinal cord using antibodies to BMPRⅡand leukemia inhibitory factor(LIF).Regions of highest BMPRⅡ^(+)immunofluorescence localized to sensory columns.Parenchymal and meningeal-associated BMPRⅡ^(+)vascular cells were identified in both intact fetal spinal cord and cortex by co-positivity with vascular lineage markers,CD34/CD39.LIF immunostaining identified a population of somas concentrated in dorsal and ventral horn interneurons,mirroring the expression of LIF receptor/CD118.A combination of LIF supplementation and high-density culture maintained culture growth beyond 10 passages,while synergistically increasing the proportion of neurospheres with a stratified,cytoarchitecture.These neurospheres were characterized by BMPRⅡ^(+)/MAP2ab^(+/–)/βⅢ-tubulin^(+)/nestin^(–)/vimentin^(–)/GFAP^(–)/NeuN^(–)surface hNPCs surrounding a heterogeneous core ofβⅢ-tubulin^(+)/nestin^(+)/vimentin^(+)/GFAP^(+)/MAP2ab^(–)/NeuN^(–)multipotent precursors.Dissociated cultures from tripotential neurospheres contained neuronal(βⅢ-tubulin^(+)),astrocytic(GFAP+),and oligodendrocytic(O4+)lineage cells.Fluorescence-activated cell sorting-sorted BMPRⅡ^(+)hNPCs were MAP2ab^(+/–)/βⅢ-tubulin^(+)/GFAP^(–)/O4^(–)in culture.This is the first isolation of BMPRⅡ^(+)hNPCs identified and characterized in human fetal spinal cords.Our data show that LIF combines synergistically with high-density reaggregate cultures to support the organotypic reorganization of neurospheres,characterized by surface BMPRⅡ^(+)hNPCs.Our study has provided a new methodology for an in vitro model capable of amplifying human fetal spinal cord cell numbers for>10 passages.Investigations of the role BMPRⅡplays in spinal cord development have primarily relied upon mouse and rat models,with interpolations to human development being derived through inference.Because of significant species differences between murine biology and human,including anatomical dissimilarities in central nervous system(CNS)structure,the findings made in murine models cannot be presumed to apply to human spinal cord development.For these reasons,our human in vitro model offers a novel tool to better understand neurodevelopmental pathways,including BMP signaling,as well as spinal cord injury research and testing drug therapies.