Comparison of treatment outcomes and complications of coil embolization in elderly and very elderly patients with cerebral aneurysms: a propensity score matching analysis.

PURPOSE: This single center study aims to compare the treatment outcomes and procedure-related complications of coil embolization in elderly patients (60-79 years) and very elderly patients (aged 80 years or older) with cerebral aneurysms. METHODS: Data was collected from 504 elderly patients aged 60 years or older who underwent coil embolization for intracranial aneurysms from 2018 to 2021. The study evaluated patient-related and anatomical factors and assessed various outcomes, comparing results between groups using statistical analysis and propensity score matching. RESULTS: A total of 503 cerebral aneurysms were analyzed from individuals aged 60-79 years (n = 472) and those aged 80 years or older (n = 31). The majority of the aneurysms were unruptured with an average size of 3.5 mm in height and 3.4 mm in width. The patients were compared using 1:1 propensity score matching, and no significant differences were found in factors other than age and aortic elongation. Logistic analysis revealed that being over 80 years old and having a severe aortic arch elongation were identified as risk factors for procedure-related events in both total and unruptured cases. CONCLUSIONS: The study compared coil embolization treatment for cerebral aneurysms in patients aged 60-79 and over 80, finding no significant difference in treatment outcomes except for procedure-related events. Procedure-related events were associated with severe aortic arch elongation and being over 80 years old. Coil embolization can be considered safe and effective for patients over 80, but further trials are needed for accurate conclusions.

Is a small coil more effective as a finishing coil for the embolization of intracranial aneurysms? Outcomes using GALAXY G3™ MINI micro-coils as finishing coils in a single center.

OBJECTIVE: The purpose of this study was to compare the outcomes of coil embolization using a 0.009 inches primary outer diameter coil as finishing coil (FC) to that of 0.01 inches. METHODS: From February and August 2020, 131 aneurysms that performed coil embolization using FC with a second loop diameter of 1 mm, were reviewed retrospectively, conducting propensity score matching and logistic regression analysis. Angiographic results such as, occlusion grade, packing density, failure and event were compared between 0.009 inches coil of GALAXY G3™ MINI microcoil (n = 54) and 0.01 inches coils (n = 77). RESULTS: There were no statistically significant differences between two groups, but more events occurred in the 0.009 group. (Odds ratio, 3.65; 95% CI, 1.06-12.55; P = 0.031) In the results of coil embolization, successful occlusion occlusion (complete occlusion and residual neck) was identified more in the 0.01 group. After propensity score matching, the variables in each group were similar, but the successful occlusion was higher in the 0.01 group as in the total population. Events tended to occur more frequently in the 0.009 inch group, and logistic regression analysis showed slightly higher events in the angled microcatheter. (48.3% versus 76.9%., P = 0.075), Also, the 0.009 inch FC is an independent risk factor. (Odds ratio, 3.84; 95% CI, 1.07-13.80; P = 0.039). CONCLUSIONS: Using 0.01 inches coils as FC increased the packing density after the procedure, and showed more successful occlusion than using a 0.009 inches coil. The probability of unexpected events was observed more than three times in the 0.009 inch group.

Discovery of Two Chrysosporium Species with Keratinolytic Activity from Field Soil in Korea.

In an ongoing survey of Korean indigenous fungi, two fungal strains (KNU16-74 and KNU16-99) belonging to the genus Chrysosporium were isolated from field soil in Gyeongnam, Korea. Morphological characterization and phylogenetic analysis using sequence of the internal transcribed spacer regions were carried out to confirm its precise identification. These strains were identified as Chrysosporium indicum (KNU16-74) and Chrysosporium fluviale (KNU16-99). To examine the keratin degradation efficiency of these two fungal species, human hair strands were incubated with fungus culture. Results revealed that these two fungal species have the ability to degrade keratin substrate. This is the first report of these two species in Korea.

Contrast-Induced Acute Kidney Injury after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage.

PURPOSE: Contrast-induced acute kidney injury (CI-AKI) is associated with poor outcomes after percutaneous coronary intervention. However, CI-AKI has rarely been evaluated within the neurovascular field. The aim of this study was to investigate the incidence and clinical implication of CI-AKI after coil embolization in patients with an aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Between January 2005 and March 2016, 192 patients who underwent coil embolization were enrolled in this study. CI-AKI was defined as an increase from baseline serum creatinine concentration of >25% or >0.5 mg/dL within 72 hours after coil embolization. A poor clinical outcome was defined as a score of ≥3 on the modified Rankin Scale at one-year post-treatment. RESULTS: A total of 16 patients (8.3%) died as a result of medical problems within one year. CI-AKI was identified in 14 patients (7.3%). Prominent risk factors for one-year mortality included CI-AKI [odds ratio (OR): 16.856; 95% confidence interval (CI): 3.437-82.664] and an initial Glasgow Coma Scale (GCS) score ≤8 (OR: 5.565; 95% CI: 1.703-18.184). A poor clinical outcome was associated with old age (≥65 years) (OR: 7.921; 95% CI: 2.977-21.076), CI-AKI (OR: 11.281; 95% CI: 2.138-59.525), an initial GCS score ≤8 (OR 31.02; 95% CI, 10.669-90.187), and a ruptured aneurysm (p=0.016, OR: 4.278) in posterior circulation. CONCLUSION: CI-AKI seems to be an independent predictor of the overall outcomes of aSAH after endovascular treatment.

The Comparison of Outcome between Thromboaspiration and Aggressive Mechanical Clot Disruption in Treating Hyperacute Stroke Patients.

OBJECTIVE: Stroke is the third leading cause of death in the Republic of Korea. Time is the most important factor in hyperacute stroke. Yet, there had been no protocol for mechanical thrombolysis. We have treated patients with hyperacute stroke by mechanical thrombolysis for 3 years. In current study, we analyzed the outcome of mechanical thrombolysis. METHODS: From March 2008 to February 2011, 36 patients were treated with mechanical thrombolysis. Initially we treated the patients by aggressive mechanical clot disruption (AMCD) who were admitted within 6 hours after the symptom onset. If revascularization was not achieved, balloon angioplasty was performed, followed by stenting or temporary endovascular bypass was performed. The result in 15 cases was not so successful. Since then, we started using the thromboaspiration method as the first line treatment of the mechanical thrombolysis. RESULTS: After using the thromboaspiration, we had better results in recanalization rate, modified Rankin Score (mRS) and reperfusion injury compared to AMCD. The recanalization rate was 80.85%, mRS is 2.85, and there was only 0.09% hemorrhagic formation. CONCLUSION: Even though thromboaspiration is not statistically significant due to the limited numbers of patients enrolled in this study, we think it is a good way in mechanical thronbolysis for hyperacute stroke.

Nitrate removal by electro-bioremediation technology in Korean soil.

The nitrate concentration of surface has become a serious concern in agricultural industry through out the world. In the present study, nitrate was removed in the soil by employing electro-bioremediation, a hybrid technology of bioremediation and electrokinetics. The abundance of Bacillus spp. as nitrate reducing bacteria were isolated and identified from the soil sample collected from a greenhouse at Jinju City of Gyengsangnamdo, South Korea. The nitrate reducing bacterial species were identified by 16s RNA sequencing technique. The efficiency of bacterial isolates on nitrate removal in broth was tested. The experiment was conducted in an electrokinetic (EK) cell by applying 20V across the electrodes. The nitrate reducing bacteria (Bacillus spp.) were inoculated in the soil for nitrate removal process by the addition of necessary nutrient. The influence of nitrate reducers on electrokinetic process was also studied. The concentration of nitrate at anodic area of soil was higher when compared to cathode in electrokinetic system, while adding bacteria in EK (EK+bio) system, the nitrate concentration was almost nil in all the area of soil. The bacteria supplies electron from organic degradation (humic substances) and enhances NO(3)(-) reduction (denitrification). Experimental results showed that the electro-bio kinetic process viz. electroosmosis and physiological activity of bacteria reduced nitrate in soil environment effectively. Involvement of Bacillus spp. on nitrification was controlled by electrokinetics at cathode area by reduction of ammonium ions to nitrogen gas. The excellence of the combined electro-bio kinetics technology on nitrate removal is discussed.

Antihyperglycemic effect of Fomitopsis pinicola extracts in streptozotocin-induced diabetic rats.

The antihyperglycemic effect of a water extract (WE) and an alkali extract (AE) of the Fomitopsis pinicola fruit body was studied in streptozotocin (STZ)-induced diabetic rats. The STZ-induced diabetes mellitus (DM) control group lost a significant amount of body weight, whereas the normal control group (NC) gained weight; however, the DM-AE group gained a significant amount of weight, with weight gain approaching normal. Feed intake by the DM-AE group was also similar to the NC group. The liver and kidney weights per body weight increased with the STZ treatment; however, the weights were lower in the F. pinicola-treated groups and nearly normalized in the DM-AE group. The weights of the heart, lungs, and spleen were not influenced by the STZ treatment. Blood glucose levels of F. pinicola-treated DM groups were significantly lower than that of the DM group. In particular, STZ-induced hyperglycemia was remarkably inhibited by the AE-supplemented diet. Serum insulin levels were decreased with STZ injection; however, the decreased levels were almost restored to the NC level with F. pinicola supplementation. The increased serum fructosamine levels associated with hyperglycemia were decreased with the F. pinicola treatment. Cells of the pericentral regions were found to have significant swelling, and some necrotic cells were observed in the pancreas of DM animals; however, pancreatic tissue damage by STZ in the F. pinicola-supplemented diet groups was ameliorated. In this study, the AE from F. pinicola showed the highest antidiabetic effect among the treatments. These results indicate that constituents of F. pinicola may regulate hyperglycemia via either increased insulin secretion during recovery or the prevention of STZ-induced pancreatic damage. This is the first report of antihyperglycemic effects of F. pinicola in STZ-induced DM rats.