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Page 20 of 24 Neuroimmunol Neuroinflammation 2019;6:15 I http://dx.doi.org/10.20517/2347-8659.2019.019
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responses caused by the three H2S donors on K -evoked [3H]D-aspartate release. Glibenclamide (300
µM), an inhibitor of KATP channels reversed the inhibitory action elicited by GYY 4137 and L-cysteine
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but not that of N-acetyl cysteine on K -induced [3H]D-aspartate release, suggesting a distinct and
unique mechanism for the L-cysteine prodrug. The inhibitory effect of GYY 4137 and L-cysteine on
neurotransmitter release was reversed by the non-specific inhibitor of NO synthase (NOS), L-NAME (300
µM). Furthermore, a specific inhibitor of inducible NOS, aminoguanidine (10 µM) mitigated the inhibitory
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action of L-cysteine on K -evoked [3H]D-aspartate release. We conclude that both donors and substrates
for H2S production can inhibit amino acid neurotransmission in bovine isolated retinae, an effect that
is dependent, at least in part, upon the intramural biosynthesis of this gas, and on the activity of KATP
channels and NOS enzyme (Bankhele et al. Neurochem Res 2018;43:692).

28. Surgical outcome of pediatric spinal cord tumor

Shiro Imagama

Department of Orthopaedic and Spine Surgery, Nagoya University Graduate School of Medicine, Nagoya-city,
Japan

Aim: The objective of this study was to examine the long-term surgical outcomes of pediatric spinal cord
tumor in a prospective multicenter database.

Methods: Of 48,901 surgical cases in our database, 1046 (2.1%) involved patients under 20 years old. Among
these, 47 cases (0.1%; male 28, female 19; mean age 11.1 years; and mean follow-up: five years) were spinal
cord tumors with clinical records, plain radiographs, and MRI. The patient characteristics, symptoms
at onset, tumor resection, surgical procedure, postoperative radiotherapy and chemotherapy, surgical
outcome, and kyphotic change at final follow-up were examined. Statistical analysis was performed by
unpaired t-test and Fisher exact test.

Results: Intradural extramedullary, intramedullary, and extradural tumors accounted for 50%, 33%, and 17%
of the 47 cases, respectively. A thoracic spine tumor was most common (40%). The common pathological
diagnoses were ependymoma (n = 8), neurinoma (n = 7), and neurofibroma (n = 6), including high-
grade malignant spinal tumor. The most common symptom at onset was pain (50%), followed by motor
palsy (34%), gait disturbance (18%), and bladder disturbance (15%). In 35% of the cases, pain was the
only preoperative symptom. Total resection was achieved in 61% and subtotal resection in 22% of cases,
and radiotherapy and chemotherapy were performed postoperatively in 18% and 14%, respectively.
The recurrence rate was 24%, and these cases were treated with additional surgery and chemotherapy.
Postoperative improvement of symptoms occurred in 38 cases (81%), but there were four deaths due to a
malignant tumor. Progression of spinal kyphosis (> 5°) occurred in 18 cases (38%), with an average of 11°.
Postoperative kyphosis was significantly related to postoperative radiation therapy (P < 0.05), but not to the
number of laminectomy levels.

Conclusion: In pediatric spinal tumor, the main symptom at onset was pain without neurological deficit.
Postoperative radiotherapy may be effective, but postoperative kyphotic changes are a concern in these
patients.