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BACKGROUND: The transient receptor potential vanilloid subtype 3 (TRPV3) channel is activated by innocuous temperature and several chemical stimuli. It is proposed to be involved in pathological pain development and is therefore considered a potential target for treating pain. Local anesthetics have been used for patients with both acute and chronic pain. Although blockage of the voltage-gated sodium channel is the primary mechanism by which local anesthetics exert their effects, they cannot be explained by this mechanism alone, especially in pathologic states such as chronic pain. Indeed, the effects of local anesthetics on multiple targets involved in the pain pathway have been reported. It has also been suggested that modulating the function of transient receptor potential (TRP) channels (eg, TRPV1 and transient receptor potential ankyrin 1 [TRPA1]) is one of the mechanisms of action of local anesthetics. However, the effects of local anesthetics on TRPV3 have not been reported. METHODS: We expressed TRPV3 in Xenopus oocytes and investigated the effects of local anesthetics on 2-aminoethoxydiphenyl borate (2APB)-induced currents using 2-electrode voltage-clamp techniques. RESULTS: Clinically used local anesthetics inhibited the 2APB-activated currents from the TRPV3 channel in a concentration-dependent manner at pharmacologically relevant concentrations with half maximal inhibitory concentration (IC50) values of 2.5 (lidocaine), 1.4 (mepivacaine), 0.28 (ropivacaine), and 0.17 (bupivacaine) mmol/L, respectively. Conversely, these local anesthetics also directly induced currents at higher concentrations, although these currents were quite small compared to the 2APB-induced currents. We found that the inhibition of TRPV3 by lidocaine is noncompetitive and independent of intracellular signaling cascades. 2APB-induced TRPV3 currents were reduced by extracellular N-(2,6-dimethylphenylcarbamoylmethyl) triethylammonium bromide (QX-314) but not by intracellular QX-314 nor benzocaine. Moreover, lidocaine showed a use-dependent block in TRPV3 inhibition. Finally, QX-314 appeared to slightly permeate the activated TRPV3 channel pore based on examination of oocytes coexpressing TRPV3 and a sodium channel. These results suggest that local anesthetics could inhibit TRPV3 channel function by extracellular interactions of their charged forms with the channel pore. CONCLUSIONS: Local anesthetics inhibited TRPV3 2APB-induced currents at pharmacologically relevant concentrations when TRPV3 was expressed in Xenopus oocytes. These effects seem to occur via an extracellular interaction between the charged form of the anesthetic with the TRPV3 channel pore. These results help to elucidate the mechanisms of action of local anesthetics.
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Anestésicos Locales/administración & dosificación , Oocitos/efectos de los fármacos , Oocitos/fisiología , Canales Catiónicos TRPV/antagonistas & inhibidores , Canales Catiónicos TRPV/fisiología , Potenciales de Acción/efectos de los fármacos , Potenciales de Acción/fisiología , Animales , Relación Dosis-Respuesta a Droga , Femenino , Xenopus laevisRESUMEN
Smoking increases the risk of atherosclerosis-related events, such as myocardial infarction and ischemic stroke. Recent studies have examined the expression levels of altered microRNAs (miRNAs) in various diseases. The profiles of tissue miRNAs can be potentially used in diagnosis or prognosis. However, there are limited studies on miRNAs following exposure to cigarette smoke (CS). The present study was designed to dissect the effects and cellular/molecular mechanisms of CS-induced atherosclerogenesis. Apolipoprotein E knockout (ApoE KO) mice were exposed to CS for five days a week for two months at low (two puffs/min for 40 min/day) or high dose (two puffs/min for 120 min/day). We measured the area of atherosclerotic plaques in the aorta, representing the expression of miRNAs after the exposure period. Two-month exposure to the high dose of CS significantly increased the plaque area in aortic arch, and significantly upregulated the expression of atherosclerotic markers (VCAM-1, ICAM-1, MCP1, p22phox, and gp91phox). Exposure to the high dose of CS also significantly upregulated the miRNA-155 level in the aortic tissues of ApoE KO mice. Moreover, the expression level of miR-126 tended to be downregulated and that of miR-21 tended to be upregulated in ApoE KO mice exposed to the high dose of CS, albeit statistically insignificant. The results suggest that CS induces atherosclerosis through increased vascular inflammation and NADPH oxidase expression and also emphasize the importance of miRNAs in the pathogenesis of CS-induced atherosclerosis. Our findings provide evidence for miRNAs as potential mediators of inflammation and atherosclerosis induced by CS.
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Aterosclerosis/metabolismo , Fumar Cigarrillos/efectos adversos , MicroARNs/genética , Animales , Aorta/metabolismo , Aorta/patología , Apolipoproteínas E/genética , Aterosclerosis/etiología , Aterosclerosis/genética , Quimiocina CCL2/genética , Quimiocina CCL2/metabolismo , Grupo Citocromo b/genética , Grupo Citocromo b/metabolismo , Molécula 1 de Adhesión Intercelular/genética , Molécula 1 de Adhesión Intercelular/metabolismo , Ratones , MicroARNs/metabolismo , NADPH Oxidasa 2/genética , NADPH Oxidasa 2/metabolismo , NADPH Oxidasas/genética , NADPH Oxidasas/metabolismo , Molécula 1 de Adhesión Celular Vascular/genética , Molécula 1 de Adhesión Celular Vascular/metabolismoRESUMEN
Resolution of acute epidural hematoma (AEDH) usually takes several weeks. The authors present an infantile case of AEDH that rapidly decreased within a day and review the literature. A 7-month-old boy fell from a height of approximately one meter and sustained a head injury. On presentation, a skull fracture in the right temporoparietal region was found and a small AEDH was observed on computed tomography (CT) 1 hr after the injury. He was transferred to our institute because of growing AEDH, shown by CT images taken 3 hr after the injury. We decided to treat him conservatively as he did not exhibit any neurological deficits on admission. CT images 24hr after the injury showed significant reduction of the AEDH. There was also an increase in the subcutaneous hematoma. Follow-up CT images did not show enlargement of the AEDH. The patient was discharged with no neurological deficits 3 days after admission. Rapid resolution of the AEDH might have been due to transmigration of the hematoma into the epicranial layer through the fracture gap.
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Hematoma Epidural Craneal/diagnóstico por imagen , Fracturas Craneales/diagnóstico por imagen , Accidentes por Caídas , Hematoma Epidural Craneal/etiología , Humanos , Imagenología Tridimensional , Lactante , Masculino , Fracturas Craneales/complicaciones , Tomografía Computarizada por Rayos XRESUMEN
Metronidazole is a widely used antibiotic against anaerobic bacteria and protozoa. We report two cases of metronidazole-induced encephalopathy(MIE)during treatment of a brain abscess with metronidazole. The patients developed mental disturbance, and brain MRI showed reversible signals on DWI, FLAIR, and T2. Case 1: A 48-year-old woman was admitted to our hospital with a cerebellar abscess. We initiated treatment with oral metronidazole. After taking the medication, she developed mental disturbance, and her brain MRI showed a hyperintensity within the corpus callosum. We suspected metronidazole toxicity and discontinued metronidazole treatment. The symptoms resolved rapidly within a week, and the hyperintensity on the MRI disappeared. Case 2: A 22-year-old man was admitted to our hospital with a brain abscess. We initiated treatment with oral metronidazole. On day 38, he developed mental disturbance, and his MRI showed hyperintensities within the bilateral dentate nuclei and corpus callosum. These symptoms were consistent with MIE. After cessation of metronidazole, his symptoms and abnormal MRI signals completely disappeared.
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Absceso Encefálico/cirugía , Encefalopatías/inducido químicamente , Metronidazol/efectos adversos , Absceso Encefálico/diagnóstico , Absceso Encefálico/patología , Encefalopatías/complicaciones , Encefalopatías/diagnóstico , Imagen de Difusión por Resonancia Magnética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto JovenRESUMEN
Reversible cerebral vasoconstriction syndrome(RCVS)is characterized by severe headache and diffuse segmental constriction of cerebral arteries that resolves spontaneously within a few months. Although manifestations of stroke are not included in diagnostic criteria of RCVS, it is known that some cases may be associated with stroke, including intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction. We present three cases of RCVS associated with various types of stroke, and then review the literature. Case 1:A 49-year-old woman presented with a headache followed by left hemiparesis and dysarthria. One month before the onset, she was transfused for severe anemia caused by uterus myoma. CT images revealed intracerebral hemorrhages in the right putamen and right occipital lobe. Angiography revealed multiple segmental constrictions of the cerebral arteries. One month after the onset, these vasoconstrictions improved spontaneously. Case 2:A postpartum 38-year-old woman who had a history of migraine presented with thunderclap headache. Imaging revealed a focal subarachnoid hemorrhage in the right postcentral sulcus and segmental vasoconstriction of the right middle cerebral artery. One week after the onset, this vasoconstriction improved spontaneously. Case 3:A 32-year-old woman who had a history of migraine presented with headache followed by left homonymous hemianopsia. Imaging revealed a cerebral infarction of the right occipital lobe and multiple constrictions of the right posterior cerebral artery. These vasoconstrictions gradually improved spontaneously.
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Infarto Cerebral/fisiopatología , Accidente Cerebrovascular/fisiopatología , Hemorragia Subaracnoidea/fisiopatología , Vasoconstricción/fisiología , Adulto , Infarto Cerebral/diagnóstico , Femenino , Humanos , Persona de Mediana Edad , Accidente Cerebrovascular/diagnóstico , Hemorragia Subaracnoidea/diagnósticoRESUMEN
Sources of Pb pollution in the local atmosphere together with Pb species, major ions, and heavy metal concentrations in a size-fractionated aerosol sample from Higashi-Hiroshima (Japan) have been determined by X-ray absorption near-edge structure (XANES) spectroscopy, ion chromatography, and ICP-MS/AES, respectively. About 80% of total Pb was concentrated in fine aerosol particles. Lead species in the coarse aerosol particles were PbC2O4, 2PbCO3 Pb(OH)2, and Pb(NO3)2, whereas Pb species in the fine aerosol particles were PbC2O4, PbSO4, and Pb(NO3)2. Chemical speciation and abundance data suggested that the source of Pb in the fine aerosol particles was different from that of the coarse ones. The dominant sources of Pb in the fine aerosol particles were judged to be fly ash from a municipal solid waste incinerator and heavy oil combustion. For the coarse aerosol particles, road dust was considered to be the main Pb source. In addition to Pb species, elemental concentrations in the aerosols were also determined. The results suggested that Pb species in size-fractionated aerosols can be used to identify the origin of aerosol particles in the atmosphere as an alternative to Pb isotope ratio measurement.
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Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Plomo/análisis , Aerosoles , Contaminantes Atmosféricos/química , Plomo/química , Espectroscopía de Absorción de Rayos XRESUMEN
The length of long bones is determined by column formation of proliferative chondrocytes and subsequent chondrocyte hypertrophy in the growth plate during bone development. Despite the importance of mechanical loading in long bone development, the mechanical conditions of the cells within the growth plate, such as the stress field, remain unclear owing to the difficulty in investigating spatiotemporal changes within dynamically growing tissues. In this study, the mechanisms of longitudinal bone growth were investigated from a mechanical perspective through column formation of proliferative chondrocytes within the growth plate before secondary ossification center formation using continuum-based particle models (CbPMs). A one-factor model, which simply describes essential aspects of a biological signaling cascade regulating cell activities within the growth plate, was developed and incorporated into CbPM. Subsequently, the developmental process and maintenance of the growth plate structure and resulting bone morphogenesis were simulated. Thus, stress anisotropy in the proliferative zone that affects bone elongation through chondrocyte column formation was identified and found to be promoted by chondrocyte hypertrophy. These results provide further insights into the mechanical regulation of multicellular dynamics during bone development.
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Condrocitos , Placa de Crecimiento , Humanos , Anisotropía , Desarrollo Óseo/fisiología , Diferenciación Celular , HipertrofiaRESUMEN
Human norovirus (HuNoV) is an enteric infectious pathogen belonging to the Caliciviridae family that causes occasional epidemics. Circulating alcohol-tolerant viral particles that are readily transmitted via food-borne routes significantly contribute to the global burden of HuNoV-induced gastroenteritis. Moreover, contact with enzymes secreted by other microorganisms in the environment can impact the infectivity of viruses. Hence, understanding the circulation dynamics of Caliciviridae is critical to mitigating epidemics. Accordingly, in this study, we screened whether environmentally abundant secretase components, particularly proteases, affect Caliciviridae infectivity. Results showed that combining Bacillaceae serine proteases with epsilon-poly-L-lysine (EPL) produced by Streptomyces-a natural antimicrobial-elicited anti-Caliciviridae properties, including against the epidemic HuNoV GII.4_Sydney_2012 strain. In vitro and in vivo biochemical and virological analyses revealed that EPL has two unique synergistic viral inactivation functions. First, it maintains an optimal pH to promote viral surface conformational changes to the protease-sensitive structure. Subsequently, it inhibits viral RNA genome release via partial protease digestion at the P2 and S domains in the VP1 capsid. This study provides new insights regarding the high-dimensional environmental interactions between bacteria and Caliciviridae, while promoting the development of protease-based anti-viral disinfectants.
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Bacillaceae , Polilisina , Serina Proteasas , Streptomyces , Streptomyces/enzimología , Polilisina/farmacología , Polilisina/química , Polilisina/metabolismo , Serina Proteasas/metabolismo , Bacillaceae/enzimología , ARN Viral/genética , ARN Viral/metabolismo , Humanos , Genoma Viral , Animales , Norovirus/efectos de los fármacos , Norovirus/genética , Inactivación de Virus/efectos de los fármacos , Caliciviridae/genética , Antivirales/farmacologíaRESUMEN
Biological tissues acquire various characteristic shapes through morphogenesis. Tissue shapes result from the spatiotemporally heterogeneous cellular activities influenced by mechanical and biochemical environments. To investigate multicellular tissue morphogenesis, this study aimed to develop a novel multiscale method that can connect each cellular activity to the mechanical behaviors of the whole tissue by constructing continuum-based particle models of cellular activities. This study proposed mechanical models of cell growth and proliferation that are expressed as volume expansion and cell division by extending the material point method. By simulating cell hypertrophy and proliferation under both free and constraint conditions, the proposed models demonstrated potential for evaluating the mechanical state and tracing cells throughout tissue morphogenesis. Moreover, the effect of a cell size checkpoint was incorporated into the cell proliferation model to investigate the mechanical behaviors of the whole tissue depending on the condition of cellular activities. Consequently, the accumulation of strain energy density was suppressed because of the influence of the checkpoint. In addition, the whole tissues acquired different shapes depending on the influence of the checkpoint. Thus, the models constructed herein enabled us to investigate the change in the mechanical behaviors of the whole tissue according to each cellular activity depending on the mechanical state of the cells during morphogenesis.
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Modelos Biológicos , Simulación por Computador , Morfogénesis , Proliferación Celular , Tamaño de la CélulaRESUMEN
Chibaite, a silica-framework structure with cage-like voids occupied by gaseous molecules, was found in marine sediments. Its formation age could be evaluated using electron spin resonance (ESR) if the radicals formed by natural radiation can be assumed to accumulate over time. To investigate whether hydrogen transfer reactions, where organic radicals withdraw hydrogen atoms from other molecules in adjacent cages, occur in chibaite and affect ESR dating, gamma-irradiated chibaite was measured by ESR. Methyl, ethyl, n-propyl, isopropyl, tert-butyl radicals and hydrogen atoms were created by gamma irradiation at 77 K. The amount of tert-butyl radicals increased around 240 K and the similar amount of the other organic radicals decreased simultaneously, implying that hydrogen transfer reactions occur between isobutane and the organic radicals in chibaite around 240 K and therefore would have no influence on ESR dating because the reactions are completed at the environmental temperature.
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Gases , Hidrógeno , Radiación de Fondo , Butanos , Espectroscopía de Resonancia por Spin del ElectrónRESUMEN
Murine norovirus (MNV) is used widely as a practical alternative to human norovirus (HuNoV). Plaque-forming assays for MNV are important for developing therapeutic agents against HuNoV infections. Although agarose-overlay MNV assays have been reported, recent improvements in cellulose derivatives suggest that they could be optimized further, particularly with respect to improving the overlay material. To determine which overlay material is optimal for the MNV plaque assay, we compared four typical cellulose derivatives [microcrystalline cellulose (MCC), hydroxyethyl cellulose (HEC), hydroxypropyl methylcellulose (HPMC), and carboxymethyl cellulose (CMC)] with conventional agarose. We found that 3.5% (w/v) MCC-containing medium provided clear round-shaped plaques on RAW 264.7 cells 1 day after inoculation; the visibility of plaques was comparable with that of the original agarose-overlay assay. Removing residual MCC powder from the MCC-overlay assay before fixing was important for obtaining distinct plaques that are clearly countable. Finally, after calculating the plaque diameter as a percentage of well diameter, we found that 12- and 24-well plates were better than other plates for accurate plaque counting. The MCC-based MNV plaque assay is cost-effective and rapid, and produces plaques that are easy to count. Accurate virus quantification using this optimized plaque assay will enable reliable estimation of norovirus titers.
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Norovirus , Animales , Ratones , Humanos , Análisis Costo-Beneficio , Sefarosa , Celulosa , Ensayo de Placa ViralRESUMEN
Tau PET tracers are expected to be sufficiently sensitive to track the progression of age-related tau pathology in the medial temporal cortex. The tau PET tracer N-(4-[18F]fluoro-5-methylpyridin-2-yl)-7-aminoimidazo[1,2-a]pyridine ([18F]SNFT-1) has been successfully developed by optimizing imidazo[1,2-a]pyridine derivatives. We characterized the binding properties of [18F]SNFT-1 using a head-to-head comparison with other reported 18F-labeled tau tracers. Methods: The binding affinity of SNFT-1 to tau, amyloid, and monoamine oxidase A and B was compared with that of the second-generation tau tracers MK-6240, PM-PBB3, PI-2620, RO6958948, JNJ-64326067, and flortaucipir. In vitro binding properties of 18F-labeled tau tracers were evaluated through the autoradiography of frozen human brain tissues from patients with diverse neurodegenerative disease spectra. Pharmacokinetics, metabolism, and radiation dosimetry were assessed in normal mice after intravenous administration of [18F]SNFT-1. Results: In vitro binding assays demonstrated that [18F]SNFT-1 possesses high selectivity and high affinity for tau aggregates in Alzheimer disease (AD) brains. Autoradiographic analysis of tau deposits in medial temporal brain sections from patients with AD showed a higher signal-to-background ratio for [18F]SNFT-1 than for the other tau PET tracers and no significant binding with non-AD tau, α-synuclein, transactiviation response DNA-binding protein-43, and transmembrane protein 106B aggregates in human brain sections. Furthermore, [18F]SNFT-1 did not bind significantly to various receptors, ion channels, or transporters. [18F]SNFT-1 showed a high initial brain uptake and rapid washout from the brains of normal mice without radiolabeled metabolites. Conclusion: These preclinical data suggest that [18F]SNFT-1 is a promising and selective tau radiotracer candidate that allows the quantitative monitoring of age-related accumulation of tau aggregates in the human brain.
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Enfermedad de Alzheimer , Enfermedades Neurodegenerativas , Humanos , Ratones , Animales , Enfermedades Neurodegenerativas/metabolismo , Enfermedad de Alzheimer/metabolismo , Piridinas/farmacocinética , Encéfalo/metabolismo , Proteínas tau/metabolismo , Tomografía de Emisión de PositronesRESUMEN
Selenium (Se) is an important trace element in the environment, but the interaction of Se with calcite that may control the fate and geochemical behavior of Se is not fully understood. In this study, the molecular-scale mechanism for the uptake of selenite in calcite was investigated by a combination of laboratory experiments, extended X-ray absorption fine structure (EXAFS) spectroscopy, and quantum chemical calculations. Results showed that selenite can be largely distributed to calcite at circumneutral pH. The local structure of Se in calcite obtained from EXAFS analyses, in combination with quantum chemical calculations, demonstrated that selenite can be incorporated into calcite by substituting for the carbonate, and that the geometric incompatibility of selenite could be accommodated by a slight expansion of crystal volume. The findings from this study suggest that calcite could be a potential Se sink, providing an important insight into the understanding of the mobility and geochemical behavior of Se in the subsurface environments particularly in the groundwater system.
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Ácido Selenioso , Selenio , Carbonato de Calcio , Carbonatos , Selenito de Sodio , Espectroscopía de Absorción de Rayos XRESUMEN
BACKGROUND/AIM: Adverse events associated with long-term bevacizumab administration for ovarian cancer have been poorly documented in Japan. This study aimed to evaluate the adverse events of bevacizumab combined with chemotherapy for treating primary and recurrent epithelial ovarian cancer in Japan. PATIENTS AND METHODS: In this single-center retrospective study, we analyzed data of patients with advanced and recurrent epithelial ovarian cancer treated with bevacizumab and chemotherapy between January 2013 and November 2019. Statistical analyses were performed using the Fisher's exact test and Kaplan-Meier method. RESULTS: A total of 46 patients were included and the follow-up time was 30 months. The median duration of bevacizumab treatment was 14 months, and the median total dose of bevacizumab was 247.5 mg/kg. The most common adverse events were hypertension (n=30; 65.2%) and proteinuria (n=24; 49%) in all grades. The onset of hypertension and proteinuria occurred at a median of 2 months and 14 months after treatment initiation in all grades, respectively. Gastrointestinal perforation occurred significantly more frequently in patients with a history of radiation therapy. CONCLUSION: This study included cases of primary advanced and recurrent epithelial ovarian cancer, and had a longer observation period and reported more adverse events of bevacizumab with chemotherapy than previous reports. The administration of bevacizumab therapy in patients with a history of radiation should be carefully considered due to increased chances of gastrointestinal perforation.
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Hipertensión , Neoplasias Ováricas , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Bevacizumab/efectos adversos , Carcinoma Epitelial de Ovario/tratamiento farmacológico , Femenino , Humanos , Hipertensión/inducido químicamente , Hipertensión/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/etiología , Proteinuria/inducido químicamente , Proteinuria/tratamiento farmacológico , Estudios RetrospectivosRESUMEN
Osteocytes are vital for regulating bone remodeling by sensing the flow-induced mechanical stimuli applied to their cell processes. In this mechanosensing mechanism, tethering elements (TEs) connecting the osteocyte process with the canalicular wall potentially amplify the strain on the osteocyte processes. The ultrastructure of the osteocyte processes and canaliculi can be visualized at a nanometer scale using high-resolution imaging via ultra-high voltage electron microscopy (UHVEM). Moreover, the irregular shapes of the osteocyte processes and the canaliculi, including the TEs in the canalicular space, should considerably influence the mechanical stimuli applied to the osteocytes. This study aims to characterize the roles of the ultrastructure of osteocyte processes and canaliculi in the mechanism of osteocyte mechanosensing. Thus, we constructed a high-resolution image-based model of an osteocyte process and a canaliculus using UHVEM tomography and investigated the distribution and magnitude of flow-induced local strain on the osteocyte process by performing fluid-structure interaction simulation. The analysis results reveal that local strain concentration in the osteocyte process was induced by a small number of TEs with high tension, which were inclined depending on the irregular shapes of osteocyte processes and canaliculi. Therefore, this study could provide meaningful insights into the effect of ultrastructure of osteocyte processes and canaliculi on the osteocyte mechanosensing mechanism.
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Membrana Celular/patología , Simulación por Computador , Imagenología Tridimensional , Osteocitos/patología , Estrés Mecánico , Modelos Biológicos , ReologíaRESUMEN
OBJECTIVE: The aim of our study is to report the outcome of our surgical procedure of conventional craniotomy for the evacuation of striatocapsular hemorrhage. PATIENTS AND METHODS: During 2004 to 2008, 75 patients were admitted to our hospital because of striatocapsular hemorrhage. We assigned thirty one (41%) of the 75 patients to surgery. We employed prognosis-based outcome analysis. RESULTS: The average volume of hematoma in surgically treated cases was 95.2 ± 52.5 (30- 223.8) mL. Mortality rate was 16% at 6 months after the onset. In the total population, a favorable outcome was achieved in 65% assessed by using the Glasogow Outcome Scale, 37.3% by using a modified Rankin Scale and 38.7% by using the Barthel index, respectively. CONCLUSION: Our observational study indicated that the outcome through conventional craniotomy and evacuation of hematoma was superior to the outcome of typical previous studies. We also illustrated our surgical procedure to emphasize operative nuances.
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Hemorragia Cerebral/cirugía , Cuerpo Estriado/irrigación sanguínea , Craneotomía , Cápsula Interna/irrigación sanguínea , Hemorragia Cerebral/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Without early recanalization, it is well known that acute basilar artery occlusion almost always results in death or severe disability. We report three cases of basilar artery occlusion due to vertebral artery thrombo-embolism. In all cases, the cause of the strokes was artery to artery embolism from the vertebral artery origin. In case 1 and 3, despite complete occlusion of the vertebral artery origin, the thrombus was drained into the basilar artery through collateral flow from the external carotid artery. Atherosclerotic lesion of the vertebral artery origin is one of the main embolic sources of basilar artery, in which case, angioplasty or stent placement of the vertebral artery origin should be considered in addition to thrombolysis of the basilar artery.
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Embolia/complicaciones , Insuficiencia Vertebrobasilar/complicaciones , Insuficiencia Vertebrobasilar/etiología , Anciano , Angiografía , Humanos , Masculino , Accidente Cerebrovascular/etiología , Insuficiencia Vertebrobasilar/diagnóstico por imagen , Insuficiencia Vertebrobasilar/cirugíaRESUMEN
OBJECTIVE: To describe techniques of exposure for middle cerebral artery (MCA) aneurysms located at the limen recess. METHODS: A retrospective review was performed of 17 patients who underwent clipping surgery, during a 3-year period, to MCA aneurysms located at the limen recess. All clinical and imaging data were reviewed. RESULTS: Techniques required in the limen recess MCA aneurysms were: 1) Wide exposure of the sylvian fissure (from the distal part to the carotid cistern), 2) Secure the M1 proximal, 3) Temporary occlusion, 4) Perpendicular clip. Temporary occlusion was employed in 13 of 17 patients. No procedure related morbidity was observed. CONCLUSION: Difficulty lies in the circumstance that the aneurysm frequently has its orifice 270 degree, while the clip has to be applied perpendicular to the M2 axis in a narrow working space. Using temporary clip and extensive exposure may be the key to avoid brain damage in the surgery of MCA aneurysms located at the limen recess.
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Aneurisma Intracraneal/cirugía , Microcirugia/métodos , Procedimientos Neuroquirúrgicos/métodos , Procedimientos Quirúrgicos Vasculares/métodos , Adulto , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: The management of ruptured anterior communicating aneurysms remains controversial since the results of ISAT have been reported. The aim of our study is to report our decision-making process and outcome in 36 consecutive cases using endovascular coil embolization as a first choice of treatment. PATIENTS AND METHODS: Thirty-six patients were studied. Since April, 2004, the treatment modality has been decided after discussion between the endovascular and cerebrovascular surgeons, taking into account the physiological status, treatment risk and morphology of the aneurysm. RESULTS: Twelve (33%) of 36 patients were allocated to coil embolization. Factors leading to the selection of clipping surgery were decided mostly by the morphology of the aneurysm, namely, tiny in 11 (47.8%), irregular shape in 6 (26.1%), broad neck in 3 (13.0%) and bleb located at the neck in 3 (13.0%). Half of the aneurysms projecting anteriorly were treated coil embolization. CONCLUSION: The allocation rate of endovascular treatment in ruptured anterior communicating aneurysms was 33%. Endovascular treatment was effective in at least half of the anterior the projecting aneurysms.
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Aneurisma Roto/terapia , Embolización Terapéutica/métodos , Aneurisma Intracraneal/terapia , Toma de Decisiones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
We report a case of bilateral agenesis of the internal carotid artery which was revealed by oclulomotor palsy and subarachnoid hemorrhage. Angiography showed a ruptured aneurysm of the left P1-2 junction and bilateral absence of the internal carotid artery. In surgery, it was necessary to use temporary clipping several times to adjust the aneurismal clipping. Complete clipping easily compromised the middle cerebral circulation. This case suggested that STA-MCA bypass should be considered in the surgery of agenesis of the internal carotid artery in which the preoperative hemodynamic status is usually normal.