1. LOGO Dr. Shahrokh Yousefzadeh-Chabok Associate Professor of Neurosurgery, Guilan Road Trauma Research Center, Guilan University Comparing GCSF and Stem Cells Obtained From Mesenchymal Cells in Healing of Spinal Cord Injured of Rat

2. LOGO Study Design Sham Alone Laminectomy, Without SCI Control Laminectomy

3. LOGO Study Design

4. LOGO

6. Within 14 injury day Acute: Acute: Between 14 days and 8 weeks. Sub acute: More than 8 weeks. Chronic: SCI

7. LOGO  Muscles complications  Neuropathic Pain Complication of BMSCT

8. LOGO  GM- CSF (Grunulocyte macrophaye-colony stimulating factor)  G-CSF (Grunulocyte-colony stimulating factor)  Erythropoitin Hematopoietic Cytokine

9. LOGO  Decrease apoptosis an improvement of Neurologic Function (Neuroprotective Effect) GCSF Effect

10. LOGO  Fever > 39 0 C  Cord Transection MRI  Ventilator assisted Breathing  (ASIA) grade A, B Exclusion Criteria of GCSF

11. LOGO as a growth Factor for hematopoitic progenitor cells to Treat of Nentopenia Hematopoietic: Hematopoietic: mobilization of peripheral blood-drieved hematopoeitic stem cells for tr ansplantation to treat of Neuronal Injury & Stork Nonhematopoitic : Nonhematopoitic : GCSF (Granulocyte-colony Stimulating Factor) Function

12. LOGO  5 mg/kg/ Day for 5 days  10 mg/kg/ Day for 5 days Dose of GCSF

13. LOGO GCSF in Acute Phase of SCI  Mobilization of bone-marrow derived cell to injury site of spinal cord  Suppresses Neuronal Apoptosis  Suppresses the death of Oligodendrocyte  Protect myelin  Suppresses the expression of cytokine such as TNF-α and IL-1B

14. LOGO GCSF in Subacute Phase of SCI Neuroprotective effects via angiogenesis after SCI

15. LOGO Exclusion Criteria  16 years old < age < 75 years old  High dose MPss (solumedrol)  Intracerebral Pathology (Tumor, Ischemia, Infections)  History of major bleeding requiring transfusion  History of leukopenia, thrombocytopenia hepatic or renal dysfunction, sever heart failure, splenomegaly  Malignance  pregnancy

16. LOGO  Hematopoietic Stem Cell  Mesenchymal Stem Cell  Endothelial Progenitor Cell  Macrophage  lymphocyte BMC Sources

17. LOGO  fever twice daily for 7 days  CBC once daily for 7 days  ASI Score  ASI impairment score(AIS) Post Operative Exam

18. LOGO Mild Complication  Pneumonia,Peptic Ulcer, Hepatopathy  Fever, Headache, Nausea Vomiting  Low Back Pain, Pelvic Pain

19. LOGO Sever Complication  MI  CVA  Spleen rupture

20. LOGO Mesenchymal Stem Cell Effects  Neroprotection  Neurogenesis  Neuroplasticity

21. LOGO  Bone marrow  umbilical cord  Aniniotic fluid  Addipose tissure Mesenchymal Stem Cell Sources

22. LOGO  Decreased apopetotic cell death  Increase of Neurogeneration  Synaptogenesis  Remyelination  Angiogenesis  Re-formation of BBB The Effects of MSC

23. LOGO In Experimental Study of MSC in Rat  Increase in axonal fiber density synaptogenesis and myelination  Secretion of trophic factor (BDNF…..)  Decrease glial scar thickness  Enhance annual growth in the penumbra  Anti inflammation by suppression of T-cell,inhabit of B-cell and IgG Production

24. LOGO Advantage of Cell Transplant  Easily localized the treatment of affected site  supply a variety of trophic factor  Persistence of long time to affect the environment injured tissue  Increased the host cell

25. LOGO