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BACKGROUND AND PURPOSE: Achieving complete recanalization with the front-line endovascular thrombectomy device improves the outcome of acute stroke. The aim of this study was to evaluate whether various thrombectomy techniques including contact aspiration, stent retriever thrombectomy, and combination therapy differ in first-pass effect and distal emboli in acute large-vessel occlusion simulated using 3D printed nontortuous and tortuous cerebrovascular anatomy models. MATERIALS AND METHODS: 3D printed flow models were manufactured using angiographic data of nontortuous and acutely angulated tortuous vascular anatomy from real patients. Three thrombectomy techniques, contact aspiration, stent retriever, and combined methods, were tested under proximal protection with the balloon-guiding catheter. The first-pass effect and distal emboli rates were analyzed in addition to the thrombectomy-failure mechanisms of the respective techniques. RESULTS: A total of 30 thrombectomy experiments were performed. The overall incidence of first-pass effect in the nontortuous and tortuous anatomy was 80.0% versus 46.7%. The overall incidence of distal emboli in the nontortuous and tortuous anatomy was 26.7% versus 46.7%. The contact aspiration technique showed better first-pass effect (80.0%) and distal emboli rates (20%) in the tortuous model compared with other techniques. The combined technique did not show remarkable superiority of the first-pass effect and distal emboli in either the nontortuous or tortuous anatomy. Shearing off of the thrombus was the main mechanism of thrombectomy failure in the combined group. CONCLUSIONS: The tortuous vascular anatomy may worsen the first-pass effect and distal emboli rates. The combined techniques failed to show improvement in outcome due to the shearing-off phenomenon of the thrombus during retrieval.
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Isquemia Encefálica , Procedimientos Endovasculares , Accidente Cerebrovascular , Trombosis , Humanos , Resultado del Tratamiento , Trombectomía/métodos , Procedimientos Endovasculares/métodos , Stents , Impresión TridimensionalRESUMEN
BACKGROUND AND PURPOSE: The efficacy of mechanical thrombectomy methods may differ depending on the characteristics of the occlusion. The purpose of this study was to compare the recanalization efficacy and treatment outcome of a stent retriever versus contact aspiration in patients with acute basilar artery occlusion according to the angiographic characteristics of the occlusion. MATERIALS AND METHODS: One hundred sixty-one patients with acute basilar artery occlusion who underwent mechanical thrombectomy were retrospectively analyzed. A stent retriever was compared with contact aspiration thrombectomy according to the clot meniscus sign, defined as a meniscoid/tram-track-like sidewall contrast opacification of the thrombus. A propensity score matching analysis was performed. Clinical/angiographic characteristics and treatment and clinical outcomes were compared. RESULTS: Overall, a stent retriever (n = 118) and contact aspiration (n = 43) did not show significant differences in the successful recanalization (82.2% versus 86.0%) and good clinical outcome rates (32.2% versus 39.5%). In patients with the positive meniscus sign, contact aspiration was associated with shorter procedural time (44 versus 26 minutes, P = .018), a lower number of passes (2 versus 1, P = .041), a higher complete recanalization rate (58.8% versus 85.7%, P = .021), and a higher rate of first-pass effect (27.9% versus 53.6%, P = .031) compared with a stent retriever. After propensity score matching, contact aspiration was associated with higher complete recanalization rates (59.3% versus 85.7%, P = .033). No significant differences in the outcomes were noted between a stent retriever and contact aspiration in patients negative for the meniscus sign. CONCLUSIONS: The efficacy of the mechanical thrombectomy techniques may differ according to the angiographic characteristics of occlusion in patients with basilar artery occlusion. Contact aspiration may be more effective in terms of recanalization compared with a stent retriever in patients with the clot meniscus sign.
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Menisco , Arteria Basilar , Humanos , Estudios Retrospectivos , Stents , Accidente Cerebrovascular , Trombectomía , Trombosis , Resultado del TratamientoRESUMEN
AIM: To evaluate the clinical significance of hyperattenuating lesions on CT after mechanical thrombectomy for acute ischaemic stroke, and to identify imaging factors that predict symptomatic haemorrhage and unfavourable outcomes. MATERIALS AND METHODS: Seventy-eight patients with acute ischaemic stroke in the anterior circulation who underwent mechanical thrombectomy were evaluated. All patients underwent post-interventional unenhanced computed tomography (CT) within 24 h and follow-up CT or magnetic resonance imaging (MRI) within 7 days. Baseline characteristics and clinical outcomes were compared between patients with and without hyperattenuating lesions. In patients with hyperattenuating lesions, clinical and imaging factors that predict symptomatic haemorrhage and unfavourable outcomes were determined. RESULTS: Fifty-six of 78 patients (71.8%) demonstrated hyperattenuating lesions on post-interventional CT. Patients with hyperattenuating lesions showed lower Alberta Stroke Program Early CT score (ASPECTS), persistent/symptomatic haemorrhage, and unfavourable outcomes than those without. In patients with hyperattenuating lesions, larger hyperattenuating lesion volume (>21.3 ml; OR, 55.60, p<0.001) and perilesional oedema (OR, 46.04, p=0.015) were independent factors predicting symptomatic haemorrhage. Older age (OR, 1.2, p=0.006) and lower ASPECTS (OR, 0.45, p=0.046) were independent factors predicting unfavourable outcomes in patients with hyperattenuating lesions. Adding the volume of the hyperattenuating lesion to age and ASPECTS increased the predictive performance of unfavourable outcomes (area under the curve 0.874 versus 0.934, p=0.043). CONCLUSIONS: Hyperattenuating lesions on post-interventional CT are associated with increased risk of symptomatic haemorrhage and unfavourable outcomes. Larger hyperattenuating lesion volume is an independent factor of symptomatic haemorrhage and it has added predictive value for unfavourable outcomes.
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Hemorragias Intracraneales/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/cirugía , Trombectomía/métodos , Anciano , Medios de Contraste , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Interpretación de Imagen Radiográfica Asistida por Computador , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To report the incidence of rhegmatogenous retinal detachment (RRD) and associated risk factors after cataract surgery using the bag-in-the-lens (BIL) intraocular lens (IOL) implantation technique. SETTING: Department of Ophthalmology, Antwerp University Hospital, Belgium. DESIGN: Prospective cohort study. METHODS: All consecutive BIL IOL surgeries performed between January 2001 and December 2010 were included, with the exclusion of combined procedures and IOL exchanges. The incidence of RRD was reported first in the total cohort, then in a subgroup of patients with 1 year to 5 years of follow-up, and finally in the group remaining after exclusion of all risk factors, except gender. Risk factors associated with RRD were examined using multiple Cox regression analysis with a random intercept. RESULTS: Rhegmatogenous RD was diagnosed in 36 eyes (1.06%) of 3385 BIL cases, with a mean follow-up of 48.28 ± 40.05 months (range 0 to 195 months). The 2-year cumulative RRD incidence rate was 0.66% (17 cases in 1024 eyes; 0.00% in patients without risk factors). The 5-year cumulative RRD incidence rate was 1.17% (26 cases in 931 eyes; 0.15% without risk factors). Five risk factors were confirmed: male sex, age less than 60 years at the time of surgery, axial length 25.0 mm or greater, a history of contralateral RD, and intraoperative surgical complications. CONCLUSIONS: The incidence of RRD after BIL IOL implantation is comparable with that of lens-in-the-bag (LIB) implantation. This larger study provided a longer follow-up and suggested that RRD incidence is even lower than that previously reported. This study also confirmed intraoperative surgical complications as an additional risk factor for RRD development, as already described with LIB implantation.
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Facoemulsificación , Desprendimiento de Retina , Estudios de Cohortes , Estudios de Seguimiento , Humanos , Incidencia , Implantación de Lentes Intraoculares , Masculino , Persona de Mediana Edad , Facoemulsificación/efectos adversos , Complicaciones Posoperatorias/epidemiología , Estudios Prospectivos , Desprendimiento de Retina/epidemiología , Desprendimiento de Retina/cirugía , Estudios RetrospectivosRESUMEN
BACKGROUND AND PURPOSE: Flow-diverter treatment for previously stented aneurysms has been reported to be less effective and prone to complications. In this study, we evaluated the effectiveness and safety of flow diverters for recurrent aneurysms after stent-assisted coiling. MATERIALS AND METHODS: Patients who underwent flow-diverter placement for recurrent aneurysms after stent-assisted coiling between March 2015 and March 2019 were recruited. Clinical and radiographic characteristics and clinical and angiographic outcomes were retrospectively evaluated. RESULTS: Among 133 patients who underwent flow-diverter insertion, 17 (male/female ratio = 5:12; mean age, 53.8 years) were treated for recurrent aneurysms after stent placement with (n = 16) or without (n = 1) coiling. Eight patients initially presented with subarachnoid hemorrhage; 7, with headache; and 2, with visual field defects. Angiographic morphology included large/giant saccular in 12 patients, dissecting in 2, fusiform in 1, traumatic pseudoaneurysm in 1, and ruptured blood blister-like aneurysm in 1. The duration between the first treatment and flow-diverter placement ranged from 2 weeks to 15 months (median, 6 months). Flow-diverter placement was successful in all cases without any complications. All patients had favorable outcomes (mRS, 0-2), without any newly appearing symptoms. Aneurysms were followed up with conventional angiography at least once in 6-18 months. Sixteen aneurysms showed complete occlusion, and 1 aneurysm was enlarged. CONCLUSIONS: Results from this case series investigating flow-diverter placement for recurrent aneurysms after stent-assisted coiling suggested that the procedure is safe and effective. Further study in a larger population may be warranted.
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Prótesis Vascular , Embolización Terapéutica/métodos , Procedimientos Endovasculares/instrumentación , Aneurisma Intracraneal/terapia , Reoperación/instrumentación , Adulto , Anciano , Embolización Terapéutica/instrumentación , Procedimientos Endovasculares/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Stents , Resultado del TratamientoRESUMEN
BACKGROUND AND PURPOSE: Mechanical thrombectomy with proximal flow control and forced aspiration may improve the outcome of endovascular revascularization therapy for patients with acute stroke. The purpose of this study was to compare the impact of balloon-guiding catheter locations in patients treated for anterior circulation acute ischemic stroke using mechanical thrombectomy. MATERIALS AND METHODS: The influence of the balloon-guiding catheter location (proximal, balloon-guiding catheter tip proximal to C1 vertebral body; distal, between the skull base and the C1 vertebral body) was analyzed in patients with acute anterior circulation stroke treated with stent-retriever thrombectomy. The baseline angiographic/clinical characteristics, time intervals, recanalization rates, and clinical outcomes were compared. RESULTS: The clinical analysis included 102 patients (mean age, 69.5 ± 12.8 years; male/female ratio = 52:50). The balloon-guiding catheter was located distally in 49 patients and proximally in 53 patients for flow control and forced aspiration during stent retrieval. The puncture-to-recanalization time was shorter in the distal group than in the proximal group (40 versus 56 minutes, P = .02). Successful and complete recanalizations were more frequently achieved in the distal group compared with the proximal group (98.0% versus 75.5%. P = .003; 67.3% versus 45.3%, P = .04, respectively). Multivariate analysis showed that the distal catheterization location was independently associated with successful recanalization (adjusted OR, 13.4; 95% CI, 2.4-254.8; P = .02). CONCLUSIONS: Location of the balloon-guiding catheter has a significant impact on recanalization in patients with acute stroke. The balloon-guiding catheter should be positioned as distally as safely possible in the cervical ICA for maximally effective thrombectomy.
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Procedimientos Endovasculares/métodos , Accidente Cerebrovascular/cirugía , Trombectomía/métodos , Anciano , Anciano de 80 o más Años , Prótesis Vascular , Cateterismo/instrumentación , Cateterismo/métodos , Catéteres , Procedimientos Endovasculares/instrumentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Stents , Trombectomía/instrumentación , Resultado del TratamientoRESUMEN
Background: In contrast to its well-known endocrine function, the role of inhibin in cancer development and therapeutic response is unclear. Salmonella, particularly less toxic attenuated Salmonella strains, are used to treat cancer in two ways. First, Salmonella accumulate around tumors, penetrate the cell barrier, and replicate inside the tumors. Second, Salmonella can act as a vehicle for delivering anticancer agents or proapoptotic genes to attack tumors. In this study, we aimed to develop a suitable cancer therapeutic strategy by genetically modifying attenuated Salmonella typhimurium to harbor short hairpin RNA (shRNA) expression plasmids targeting alpha subunit of inhibin (sh-INHA). Methods: We analyzed the expression of human INHA in normal and cancer cells and tissues. We developed genetically engineered attenuated S. typhimurium harboring sh-INHA (S. typhimurium/sh-INHA) and assessed its cancer therapeutic effects by using cell culture models and syngeneic mouse tumor models. Results: INHA expression levels were markedly higher in colon cancer and melanoma cells and tissues than in their normal counterparts. Suppression of INHA expression mildly reduced cancer cell survival and induced caspase activation and downregulation of anti-apoptotic Bcl-2 and Bcl-xL expressions. Although the genetically engineered S. typhimurium mildly interfered with the invasion of S. typhimurium into host colon cancer and melanoma cells, S. typhimurium/sh-INHA caused remarkable cytotoxicity in cancer compared with unmodified S. typhimurium or S. typhimurium expressing a control scrambled shRNA (S. typhimurium/sh-Cont). Salmonella typhimurium/sh-INHA-treated mice also showed a significantly inhibited growth of colon cancers and melanomas, with a survival advantage. Conclusion: Our results suggest that tumor-targeted therapy using S. typhimurium/sh-INHA may provide a novel cancer treatment option.
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Neoplasias del Colon/terapia , Terapia Genética/métodos , Inhibinas/genética , Melanoma/terapia , ARN Interferente Pequeño/administración & dosificación , Neoplasias Cutáneas/terapia , Animales , Línea Celular Tumoral/trasplante , Colon/patología , Neoplasias del Colon/patología , Modelos Animales de Enfermedad , Femenino , Técnicas de Silenciamiento del Gen , Vectores Genéticos/genética , Humanos , Inhibinas/metabolismo , Melanoma/patología , Ratones , Plásmidos/genética , ARN Interferente Pequeño/genética , Salmonella typhimurium/genética , Piel/patología , Neoplasias Cutáneas/patologíaRESUMEN
OBJECTIVE: This research examines the benefits of caffeine absorption on hair stiffness. To test hair stiffness, we have developed an evaluation method that is not only accurate, but also inexpensive. Our evaluation method for measuring hair stiffness culminated in a model, called the Stiffness-Angle Law, which describes the elastic properties of hair and can be widely applied to the development of hair care products. METHODS: Small molecules (≤500 g mol-1 ) such as caffeine can be absorbed into hair. A common shampoo containing 4% caffeine was formulated and applied to hair 10 times, after which the hair stiffness was measured. The caffeine absorption of the treated hair was observed using Fourier-transform infrared spectroscopy (FTIR) with a focal plane array (FPA) detector. Our evaluation method for measuring hair stiffness consists of a regular camera and a support for single strands of hair. After attaching the hair to the support, the bending angle of the hair was observed with a camera and measured. Then, the hair strand was weighed. The stiffness of the hair was calculated based on our proposed Stiffness-Angle Law using three variables: angle, weight of hair and the distance the hair was pulled across the support. RESULTS: The caffeine absorption was confirmed by FTIR analysis. The concentration of amide bond in the hair certainly increased due to caffeine absorption. After caffeine was absorbed into the hair, the bending angle and weight of the hair changed. Applying these measured changes to the Stiffness-Angle Law, it was confirmed that the hair stiffness increased by 13.2% due to caffeine absorption. CONCLUSION: The theoretical results using the Stiffness-Angle Law agree with the visual examinations of hair exposed to caffeine and also the known results of hair stiffness from a previous report. Our evaluation method combined with our proposed Stiffness-Angle Law effectively provides an accurate and inexpensive evaluation technique for measuring bending stiffness of human hair.
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Cafeína/metabolismo , Cabello , Cafeína/química , Humanos , Peso Molecular , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
BACKGROUND AND PURPOSE: There is an uncertainty about the association between intracranial aneurysms and aortic dissection. We aimed to determine the prevalence of intracranial aneurysms in patients with aortic dissection and evaluate the independent risk factors for the presence of intracranial aneurysms in these patients. MATERIALS AND METHODS: Seventy-one patients with a confirmed aortic dissection who underwent additional brain imaging were enrolled as the aortic dissection group, and 2118 healthy individuals with brain imaging, as controls. Demographic data were obtained from their medical records, including age, sex, comorbidities, and arch vessel involvement of aortic dissection. Two readers reviewed all brain images independently regarding the presence, morphology, size, and location of intracranial aneurysms. Baseline characteristics were compared between the aortic dissection group and controls by propensity score matching, and logistic regression analysis was performed for independent risk factors for the presence of intracranial aneurysms. RESULTS: The prevalence of intracranial aneurysms was 12.96% in the aortic dissection group and 1.85% in controls (P = .022). The mean diameter of intracranial aneurysms was significantly larger in the aortic dissection group (5.79 ± 3.26 mm in aortic dissection versus 3.04 ± 1.57 mm in controls; P = .008), and intracranial aneurysms of >7 mm were also more common in the aortic dissection group (28.6% in aortic dissection versus 5.3% in controls, P = .003). On multivariate analysis, arch vessel involvement of aortic dissection was an independent risk factor for the presence of intracranial aneurysms (odds ratio, 6.246; 95% confidence interval, 1.472-26.50; P = .013). CONCLUSIONS: Patients with aortic dissection have a high prevalence of intracranial aneurysms, and selective screening for brain vessels could be considered in these patients with arch vessel involvement. A further prospective study is needed to demonstrate a substantial prevalence of intracranial aneurysms.
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Disección Aórtica/complicaciones , Disección Aórtica/epidemiología , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/epidemiología , Adulto , Anciano , Disección Aórtica/diagnóstico por imagen , Aorta Torácica/diagnóstico por imagen , Angiografía Cerebral , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Aneurisma Intracraneal/diagnóstico por imagen , Estimación de Kaplan-Meier , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuroimagen , Prevalencia , Puntaje de Propensión , Estudios Prospectivos , Factores de Riesgo , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Coacervates are inevitably formed on scalp on using hair washing products. Our goal was to analyse the coacervates in detail to identify the part responsible for scalp stimulation. METHODS: Shampoo that increases coacervate formation was applied to in vitro skin and was washed. The residue was then analysed using Fourier transform infrared spectroscopy-focal plane array (FTIR-FPA) and X-ray photoelectron microscopy (XPS). And HaCaT cells were used for irritant test of coacervate. RESULTS: Through this research, it was confirmed that the coacervate was a macromolecule structurally similar to a cationic polymer and contains an anionic surfactant. Its anionic surfactant was structurally semi-stable so that it released onto scalp when it absorbs moisture. CONCLUSION: Coacervate releases sulphate bonding into the matrix when it is exposed to water. Thus, the scalp stimulation would be expected.
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Preparaciones para el Cabello/química , Irritantes/farmacología , Microscopía/métodos , Cuero Cabelludo/efectos de los fármacos , Espectroscopía Infrarroja por Transformada de Fourier/métodos , Línea Celular , HumanosRESUMEN
In this study, whole Hox gene clusters in the self-fertilizing mangrove killifish Kryptolebias marmoratus (Cyprinodontiformes; Rivulidae), a unique hermaphroditic vertebrate in which both sex organs are functional at the same time, were identified from whole genome and transcriptome sequences. The aim was to increase the understanding of the evolutionary status of conservation of this Hox gene cluster across fish species.
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Ciprinodontiformes/genética , Genes Homeobox , Familia de Multigenes , Animales , Evolución Biológica , Ciprinodontiformes/clasificación , Ciprinodontiformes/fisiología , Genoma , Filogenia , Autofecundación , Alineación de Secuencia/métodosRESUMEN
BACKGROUND AND PURPOSE: Coiling of complex aneurysms is still difficult even with current adjuvant techniques. This study sought to evaluate the safety and effectiveness of a combination of multicatheter plus stent or balloon for the treatment of complex aneurysms. MATERIALS AND METHODS: All complex aneurysms that underwent coiling with the combination technique were identified from prospectively maintained neurointerventional data bases. "Complex aneurysm" was defined as a wide-neck aneurysm with branch incorporation into or a deep lobulation of the sac. The clinical and angiographic outcomes were retrospectively analyzed. RESULTS: Sixty-two complex aneurysms (12 ruptured, 50 unruptured) in 62 patients (mean age, 57 years; male/female ratio, 12:50) were treated with a combination technique by using a multicatheter plus stent (n = 42, 3 ruptured) or balloon (n = 20, 9 ruptured). Treatment-related morbidity (grade 3 hemiparesis) occurred in 1 patient (1.6%). Except for 1 patient who had treatment-related morbidity, none of the other patients with unruptured aneurysms developed new neurologic symptoms at discharge. Nine of the 12 patients with ruptured aneurysms had good outcomes (Glasgow Outcome Score, 4 or 5) at the latest follow-up (mean, 32 months; range, 6-72 months), and 1 patient died from an initial SAH. Posttreatment control angiograms revealed complete occlusion in 27, neck remnant in 34, and incomplete occlusion in 1 aneurysm. At least 1 follow-up catheter or MR angiogram was available in 80.6% (n = 50) (mean, 21 months; range, 6-65 months). There were 4 minor and 3 major recurrences (14.0%). CONCLUSIONS: In this case series, the combination technique by using multicatheter plus stent or balloon seemed safe and effective for the treatment of complex aneurysms.
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Embolización Terapéutica/instrumentación , Embolización Terapéutica/métodos , Aneurisma Intracraneal/terapia , Adulto , Anciano , Catéteres , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Stents , Resultado del TratamientoRESUMEN
PURPOSE: To determine the incidence of rhegmatogenous retinal detachment (RRD) and associated risk factors after phacoemulsification and bag-in-the-lens intraocular lens (IOL) implantation. SETTING: Antwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium. DESIGN: Prospective cohort study. METHODS: All consecutive bag-in-the-lens IOL implantations performed between January 2001 and December 2007 were included, with the exception of combined procedures and IOL exchanges. The retinal detachment (RD) incidence was studied in the total cohort, in a subgroup of patients with 1 to 5 years of follow-up, and finally in the group remaining after exclusion of all risk factors except gender. RESULTS: RD after bag-in-the-lens IOL implantation in 1323 eyes with an average follow-up of 44.75 months (range 0 to 152 months) was found in 19 eyes (1.44%). The 1-year RD incidence was 0.49% (5 RD cases in 1024 eyes) (0.00% in patients without risk factors). The 2-year cumulative RD incidence was 0.84% (9 RD cases in 931 eyes; 0.15% without risk factors). Four clinically significant risk factors were confirmed: male gender, young age at time of surgery (<60 years), axial myopia (axial length ≥25 mm), and history of contralateral RD in the total cohort. CONCLUSION: The RRD incidence following bag-in-the-lens IOL implantation was comparable to that seen after lens-in-the-bag (LIB) implantation. The wide variation in study design in the literature precludes direct comparison, so there is a need for standardization in evaluating RRD incidence after cataract surgery. Future prospective studies should consider patients with and without risk factors (except gender) separately. FINANCIAL DISCLOSURE: Prof. dr. M.J. Tassignon has intellectual property rights to the bag-in-the-lens intraocular lens (U.S. patent 6 027 531; EU patent 009406794; PCT/120268), which is licensed to Morcher GmbH, Stuttgart, Germany.
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Implantación de Lentes Intraoculares/efectos adversos , Facoemulsificación/efectos adversos , Desprendimiento de Retina/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Opacificación Capsular/prevención & control , Estudios de Cohortes , Femenino , Humanos , Incidencia , Implantación de Lentes Intraoculares/métodos , Lentes Intraoculares , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Diseño de Prótesis , Desprendimiento de Retina/etiología , Factores de RiesgoRESUMEN
BACKGROUND AND PURPOSE: Skull plain films of coiled aneurysms have been used in a limited role, including morphologic comparison of the coil mass. We aimed to evaluate the efficacy of skull plain films in patients treated with detachable coils by using quantitative assessment. MATERIALS AND METHODS: In this retrospective study, 78 pairs of the initial and follow-up skull anteroposterior and lateral images were reviewed independently by 2 neuroradiologists. The largest diameter, the perpendicular diameter, and area of the coil mass were measured separately on plain film, and quantitative changes of parameters were compared between subgroups, which were determined by consensus, depending on the need for retreatment. Subgroup analysis was also performed according to aneurysm size, packing attenuation, and ruptured status. RESULTS: On skull lateral images, mean quantitative changes of the largest diameter (0.53 ± 0.43 mm versus 1.17 ± 0.91 mm, P < .01), the perpendicular diameter (0.56 ± 0.48 mm versus 1.20 ± 1.05 mm, P < .01), and the area of the coil mass (5.21 ± 7.51 mm(2) versus 10.55 ± 10.93 mm(2), P < .02) differed significantly between subgroups. Receiver operating characteristic analysis showed quantitative change of the largest diameter (>1.1 mm; sensitivity, 50.0%; specificity, 90.3%), the perpendicular diameter (>.9 mm; sensitivity, 62.5%; specificity, 85.5%), and the area (>8.5 mm(2); sensitivity, 50.0%; specificity, 83.9%) on skull lateral films to be indicative of aneurysm recurrence, and the diagnostic accuracy of these parameters increased significantly in the high-packing-attenuation group. CONCLUSIONS: Quantitative measurement of the coil mass by using skull plain lateral images has the potential to predict aneurysm recurrence in follow-up evaluations of intracranial aneurysms with coiling.
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Embolización Terapéutica/instrumentación , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/terapia , Cráneo/diagnóstico por imagen , Adulto , Anciano , Área Bajo la Curva , Angiografía Cerebral/instrumentación , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Recurrencia , Estudios Retrospectivos , Sensibilidad y EspecificidadAsunto(s)
Aneurisma Falso/etiología , Aneurisma Falso/terapia , Trastornos Cerebrovasculares/etiología , Trastornos Cerebrovasculares/terapia , Endoscopía/efectos adversos , Procedimientos Endovasculares/métodos , Adulto , Aneurisma Falso/diagnóstico por imagen , Trastornos Cerebrovasculares/diagnóstico por imagen , Humanos , Enfermedad Iatrogénica , Masculino , Radiografía , Hueso Esfenoides/cirugía , Resultado del TratamientoRESUMEN
The presence of tangles composed of phosphorylated tau is one of the neuropathological hallmarks of Alzheimer's disease (AD). Tau, a microtubule (MT)-associated protein, accumulates in AD potentially as a result of posttranslational modifications, such as hyperphosphorylation and conformational changes. However, it has not been fully understood how tau accumulation and phosphorylation are deregulated. In the present study, we identified a novel role of death-associated protein kinase 1 (DAPK1) in the regulation of the tau protein. We found that hippocampal DAPK1 expression is markedly increased in the brains of AD patients compared with age-matched normal subjects. DAPK1 overexpression increased tau protein stability and phosphorylation at multiple AD-related sites. In contrast, inhibition of DAPK1 by overexpression of a DAPK1 kinase-deficient mutant or by genetic knockout significantly decreased tau protein stability and abolished its phosphorylation in cell cultures and in mice. Mechanistically, DAPK1-enhanced tau protein stability was mediated by Ser71 phosphorylation of Pin1, a prolyl isomerase known to regulate tau protein stability, phosphorylation, and tau-related pathologies. In addition, inhibition of DAPK1 kinase activity significantly increased the assembly of MTs and accelerated nerve growth factor-mediated neurite outgrowth. Given that DAPK1 has been genetically linked to late onset AD, these results suggest that DAPK1 is a novel regulator of tau protein abundance, and that DAPK1 upregulation might contribute to tau-related pathologies in AD. Therefore, we offer that DAPK1 might be a novel therapeutic target for treating human AD and other tau-related pathologies.
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Enfermedad de Alzheimer/enzimología , Encéfalo/enzimología , Proteínas Quinasas Asociadas a Muerte Celular/metabolismo , Neuronas/enzimología , Proteínas tau/metabolismo , Factores de Edad , Enfermedad de Alzheimer/genética , Enfermedad de Alzheimer/patología , Animales , Encéfalo/patología , Estudios de Casos y Controles , Proteínas Quinasas Asociadas a Muerte Celular/deficiencia , Proteínas Quinasas Asociadas a Muerte Celular/genética , Células HEK293 , Células HeLa , Humanos , Ratones , Ratones Noqueados , Mutación , Células 3T3 NIH , Peptidilprolil Isomerasa de Interacción con NIMA , Neuritas/enzimología , Neuritas/patología , Neuronas/patología , Células PC12 , Isomerasa de Peptidilprolil/deficiencia , Isomerasa de Peptidilprolil/genética , Fosforilación , Estabilidad Proteica , Interferencia de ARN , Ratas , Factores de Tiempo , Transfección , Proteínas tau/genéticaRESUMEN
Growth traits, such as body weight and carcass body length, directly affect productivity and economic efficiency in the livestock industry. We performed a genome-wide linkage analysis to detect the quantitative trait loci (QTL) that affect body weight, growth curve parameters and carcass body length in an F2 intercross between Landrace and Korean native pigs. Eight phenotypes related to growth were measured in approximately 1000 F2 progeny. All experimental animals were subjected to genotypic analysis using 173 microsatellite markers located throughout the pig genome. The least squares regression approach was used to conduct the QTL analysis. For body weight traits, we mapped 16 genome-wide significant QTL on SSC1, 3, 5, 6, 8, 9 and 12 as well as 22 suggestive QTL on SSC2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 16 and 17. On SSC12, we identified a major QTL affecting body weight at 140 days of age that accounted for 4.3% of the phenotypic variance, which was the highest test statistic (F-ratio = 45.6 under the additive model, nominal P = 2.4 × 10(-11) ) observed in this study. We also showed that there were significant QTL on SSC2, 5, 7, 8, 9 and 12 affecting carcass body length and growth curve parameters. Interestingly, the QTL on SSC2, 3, 5, 6, 8, 9, 10, 12 and 17 influencing the growth-related traits showed an obvious trend for co-localization. In conclusion, the identified QTL may play an important role in investigating the genetic structure underlying the phenotypic variation of growth in pigs.
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Ligamiento Genético , Sitios de Carácter Cuantitativo , Sus scrofa/fisiología , Animales , Tamaño Corporal , Peso Corporal , Cruzamientos Genéticos , Repeticiones de Microsatélite , Reacción en Cadena de la Polimerasa/veterinaria , Sus scrofa/genética , Sus scrofa/crecimiento & desarrolloRESUMEN
Changes affecting the status of health and robustness can bring about physiological alterations including hematological parameters in swine. To identify quantitative trait loci (QTL) associated with eight hematological traits (one leukocyte trait, six erythrocyte traits and one platelet trait), we conducted a genome-wide association study using the PorcineSNP60K BeadChip in a resource population derived from an intercross between Landrace and Korean native pigs. A total of 36 740 SNPs from 816 F2 progeny were analyzed for each blood-related trait after filtering for quality control. Data were analyzed by the genome-wide rapid association using mixed model and regression (GRAMMAR) approach. A total of 257 significant SNPs (P < 1.36 × 10(-6) ) on SSC3, 6, 8, 13 and 17 were identified for blood-related traits in this study. Interestingly, the genomic region between 17.9 and 130 Mb on SSC8 was found to be significantly associated with red blood cell, mean corpuscular volume and mean corpuscular hemoglobin. Our results include the identification of five significant SNPs within five candidate genes (KIT, IL15, TXK, ARAP2 and ERG) for hematopoiesis. Further validation of these identified SNPs could give valuable information for understanding the variation of hematological traits in pigs.
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Estudio de Asociación del Genoma Completo , Sitios de Carácter Cuantitativo , Sus scrofa/sangre , Sus scrofa/genética , Animales , Plaquetas/citología , Cruzamientos Genéticos , Eritrocitos/citología , Femenino , Leucocitos/citología , Masculino , Polimorfismo de Nucleótido SimpleRESUMEN
BACKGROUND AND PURPOSE: Although the stent retriever (SR) has shown a better reperfusion rate and clinical outcome than the older generation mechanical clot retrieval device, it is uncertain whether the SR is superior to intra-arterial fibrinolysis (IAF). METHODS: Ischaemic stroke patients who were treated with SR or IAF as initial endovascular treatment modality for unilateral arterial occlusion in the anterior circulation were included. Successful reperfusion was defined as Thrombolysis in Cerebral Infarction grade ≥2b. A favourable clinical outcome was defined as a modified Rankin Score ≤2 at 3 months. RESULTS: Between January 2009 and May 2012, 55 patients were treated with SR and 50 patients were treated with IAF. The baseline characteristics were similar between the two groups except for the occlusion site and rescue treatment. In binary logistic regression analysis adjusted for the occlusion site and rescue treatment, SR was independently associated with increased successful reperfusion [82.0% vs. 47.3%; odds ratio (OR) 5.21; 95% confidence interval (CI) 1.92-14.14) and a more favourable clinical outcome at 3 months (54.0% vs. 43.6%; OR 3.40; 95% CI 1.31-8.84). The frequency of symptomatic intracranial haemorrhage and mortality at 3 months was not different between the two groups. CONCLUSIONS: Stent retriever was as safe as and more effective than IAF. Our findings suggest that SR may be considered as an initial modality rather than IAF in acute stroke patients who undergo endovascular treatment.
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Stents , Accidente Cerebrovascular/terapia , Terapia Trombolítica/métodos , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/complicaciones , Femenino , Fibrinólisis , Humanos , Masculino , Persona de Mediana Edad , Reperfusión , Estudios Retrospectivos , Estadísticas no Paramétricas , Accidente Cerebrovascular/etiología , Trombectomía/métodos , Tomógrafos Computarizados por Rayos X , Resultado del TratamientoRESUMEN
Growth-related traits are complex and economically important in the livestock industry. The aim of this study was to identify quantitative trait loci (QTL) and the associated positional candidate genes affecting growth in pigs. A genome-wide association study (GWAS) was performed using the porcine single-nucleotide polymorphism (SNP) 60K bead chip. A mixed-effects model and linear regression approach were used for the GWAS. The data used in the study included 490 purebred Landrace pigs. All experimental animals were genotyped with 39 438 SNPs located throughout the pig autosomes. We identified a strong association between a SNP marker on chromosome 16 and body weight at 71 days of age (ALGA0092396, P = 5.35 × 10(-9) , Bonferroni adjusted P < 0.05). The SNP marker was located near the genomic region containing IRX4, which encodes iroquois homeobox 4. This SNP marker could be useful in the selective breeding program after validating its effect on other populations.