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1.
Surg Neurol Int ; 15: 350, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39372974

RESUMEN

Background: Vertebral artery (VA) stump syndrome (VASS) is an embolic source for cerebral infarction (CI) in the posterior circulation after VA occlusion. Case Description: A 63-year-old patient with a history of hypertension presented to our emergent department with dizziness, vomiting, and gait disturbance. Head magnetic resonance imaging (MRI) showed acute CIs in the bilateral cerebellar hemispheres and the vermis. Magnetic resonance angiography revealed patency of the VA and basilar artery. Left subclavian artery digital subtraction angiography (DSA) revealed severe left VA orifice stenosis and collateral flow from the deep cervical artery into the left V2 segment. Right VA angiography showed retrograde flow to the left V4 segment, branching bihemispheric posterior inferior cerebellar artery (PICA), and to-and-flow appearance in the proximal PICA segment and VA. VASS was diagnosed, and conservative treatment with aspirin was administered. Worsened nausea and gait disturbance had developed during hospitalization. MRI revealed an enlarged posterior circulation CI. Follow-up DSA revealed proximal to-and-flow appearance translocation to the proximal V4 segment and poor PICA flow. We performed proximal V4 segment parent artery occlusion (PAO) by endovascular therapy. No recurrence of symptoms or CI was observed. The patient was discharged on day 32 of hospitalization with 1 on the modified Rankin scale. Conclusion: We reported a rare case of VASS involving bihemispheric PICA. No CI recurrence was observed after performing PAO of the proximal V4 segment. When treating acute cases of bilateral cerebellar CI due to VASS, the contribution of PICA variations should be considered.

2.
Surg Neurol Int ; 15: 351, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39373003

RESUMEN

Background: Spontaneous direct vertebral artery-external vertebral venous plexus (VA-EVVP) fistula is a rare disease that presents in patients with neurofibromatosis type 1 (NF-1) or trauma. Case Description: An 82-year-old female patient with no neurological deficits or trauma presented to our hospital with right hemianopsia. Head magnetic resonance imaging (MRI) revealed left occipital cerebral infarction and magnetic resonance angiography demonstrated high signal intensity in the left transverse sinus (TS). The attending doctor diagnosed an old infarction on the left occipital lobe and dural arteriovenous fistula (AVF) in the TS. After 3 years after the first diagnosis, her new attending doctor re-checked the MRI and performed digital subtraction angiography (DSA). The DSA examination revealed a single-hole AVF between the vertebral artery and external vertebral plexus at the C2 level, which was diagnosed as upper cervical VA-EVVP. The patient presented with tinnitus due to a high-flow VA-EVVP fistula, so we performed coil embolization of the fistula under general anesthesia using a double-catheter technique and achieved subtotal embolization, which diminished the intracranial reflux. The 6-month follow-up DSA image revealed complete obliteration of the AVF. Conclusion: We report a rare case of upper cervical VA-EVVP fistula in a patient with no history of trauma and relevant medical conditions. Coil embolization of the fistula was performed using a combination of balloon-assisted and double-catheter techniques. Although the patient showed residual shunt flow after the intervention, follow-up DSA revealed complete obliteration. These findings should provide novel insights for the treatment strategy against VA-EVVP fistula.

3.
World Neurosurg ; 187: 99-100, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38636637

RESUMEN

A 77-year-old man presented with progressive consciousness disturbance, presumably caused by a backward fall. Head computed tomography findings showed a large intracerebral hemorrhage in the left parietal lobe. Radiated fractures with an oval depression of the bilateral parietal bone crossing the midline were noted. Surgical evacuation of the hemorrhage was performed via a left-sided parietal craniotomy, during which fragments from the fracture with eggshell-like thinning were noted. Biparietal thinning is an uncommon condition noted in radiological findings of a symmetrical oval depression of bilateral parietal bones with reduced diploe thickness. Cases of traumatic brain injury in patients with biparietal thinning have rarely been reported. This condition should be recognized as a possible predisposing factor for traumatic brain injury.


Asunto(s)
Lesiones Traumáticas del Encéfalo , Hueso Parietal , Humanos , Masculino , Anciano , Lesiones Traumáticas del Encéfalo/diagnóstico por imagen , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/cirugía , Hueso Parietal/diagnóstico por imagen , Hueso Parietal/lesiones , Hueso Parietal/cirugía , Tomografía Computarizada por Rayos X , Lóbulo Parietal/diagnóstico por imagen , Craneotomía , Accidentes por Caídas
4.
CEN Case Rep ; 13(1): 1-8, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-37010722

RESUMEN

A 42-year-old man showed marked hypokalemia after kidney transplantation. He was diagnosed with hypertension and suffered from acute myocardial infarction at 33 and 38 years of age. At 40 years of age, hemodialysis was introduced. A left adrenal tumor was noted and suspected as a non-functional adrenal adenoma at that time. Therefore, he received a living-donor kidney transplant at 42 years of age. After kidney transplantation, the serum creatinine level dropped. His blood pressure remained high, and the serum potassium level decreased. The PRA and PAC were elevated, and ARR was not elevated. Based on the results of various confirmatory tests and vein sampling, he was diagnosed with excessive secretion of renin from the native kidneys that was complicated by primary aldosteronism (PA), and left nephrectomy and adrenalectomy were performed. The overproduction of aldosterone in the resected adrenal adenoma and over secretion of renin in the kidney with arteriolosclerosis were immunohistologically confirmed. After surgery, the PAC decreased, but the PRA did not decrease. The postoperative serum potassium level improved, and the blood pressure was well controlled with a small dose of medication. This is the first reported case of PA with hyperreninemia after kidney transplantation. It should be noted that PA in dialysis patients and kidney transplant recipients may not fulfill the usual diagnostic criteria of an elevated ARR. In such patients, PA should be suspected based on the absolute value of the PAC and responsiveness to ACTH stimulation, and adrenal and renal vein sampling is required for a definitive diagnosis.


Asunto(s)
Adenoma , Hiperaldosteronismo , Trasplante de Riñón , Masculino , Humanos , Adulto , Hiperaldosteronismo/diagnóstico , Hiperaldosteronismo/etiología , Hiperaldosteronismo/cirugía , Renina , Trasplante de Riñón/efectos adversos , Diálisis Renal/efectos adversos , Potasio , Adenoma/complicaciones , Adenoma/patología
5.
EMBO J ; 42(18): e112305, 2023 09 18.
Artículo en Inglés | MEDLINE | ID: mdl-37609947

RESUMEN

Nanog and Oct4 are core transcription factors that form part of a gene regulatory network to regulate hundreds of target genes for pluripotency maintenance in mouse embryonic stem cells (ESCs). To understand their function in the pluripotency maintenance, we visualised and quantified the dynamics of single molecules of Nanog and Oct4 in a mouse ESCs during pluripotency loss. Interestingly, Nanog interacted longer with its target loci upon reduced expression or at the onset of differentiation, suggesting a feedback mechanism to maintain the pluripotent state. The expression level and interaction time of Nanog and Oct4 correlate with their fluctuation and interaction frequency, respectively, which in turn depend on the ESC differentiation status. The DNA viscoelasticity near the Oct4 target locus remained flexible during differentiation, supporting its role either in chromatin opening or a preferred binding to uncondensed chromatin regions. Based on these results, we propose a new negative feedback mechanism for pluripotency maintenance via the DNA condensation state-dependent interplay of Nanog and Oct4.


Asunto(s)
Células Madre Embrionarias de Ratones , Imagen Individual de Molécula , Animales , Ratones , Retroalimentación , Cromatina/genética , Diferenciación Celular
6.
J Nippon Med Sch ; 90(3): 246-252, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37380475

RESUMEN

Intestinal homeostasis is maintained by strict regulation of stem cell function. In mammals, several signaling pathways, including the formation of stem cell niches, are involved in stem cell regulation. However, little is known of the molecular mechanisms involved in postembryonic maturation of the vertebrate intestine, that is, the acquisition of cell renewal systems, including stem cell development and niche formation. Using thyroid hormone (TH) -dependent intestinal remodeling during amphibian metamorphosis as a model to study these mechanisms, we found that several signaling pathways, including the SHH/BMP4, WNT, Notch, and Hippo pathways, are regulated by TH and involved in stem cell regulation. In this review, we highlight findings regarding the role of these signaling pathways and discuss potential future avenues of study.


Asunto(s)
Intestinos , Células Madre , Humanos , Animales , Diferenciación Celular , Hormonas Tiroideas , Transducción de Señal , Mamíferos
7.
Vitam Horm ; 122: 1-22, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36863790

RESUMEN

In the amphibian intestine during metamorphosis, most of the larval epithelial cells undergo apoptosis, while a small number of the epithelial cells dedifferentiate into stem cells (SCs). The SCs actively proliferate and then newly generate the adult epithelium analogous to the mammalian counterpart, which is continuously renewed from the SCs throughout adulthood. This larval-to-adult intestinal remodeling can be experimentally induced by thyroid hormone (TH) through interacting with the surrounding connective tissue that develops as the stem cell niche. Thus, the amphibian intestine provides us a valuable opportunity to study how the SCs and their niche are formed during development. To clarify the TH-induced and evolutionally conserved mechanism of SC development at the molecular level, numerous TH response genes have been identified in the Xenopus laevis intestine over the last three decades and extensively analyzed for their expression and function by using wild-type and transgenic Xenopus tadpoles. Interestingly, accumulating evidence indicates that thyroid hormone receptor (TR) epigenetically regulates the expression of TH response genes involved in the remodeling. In this review, we highlight recent progress in the understanding of SC development, focusing on epigenetic gene regulation by TH/TR signaling in the X. laevis intestine. We here propose that two subtypes of TRs, TRα and TRß, play distinct roles in the intestinal SC development via different histone modifications in different cell types.


Asunto(s)
Epigénesis Genética , Receptores de Hormona Tiroidea , Adulto , Animales , Humanos , Receptores de Hormona Tiroidea/genética , Diferenciación Celular , Anfibios/genética , Intestinos , Mamíferos
8.
Surg Neurol Int ; 14: 428, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38213445

RESUMEN

Background: Traumatic intracranial aneurysms (TICAs) are rare and known to rupture easily and have a high mortality rate. Case Description: An 87-year-old male patient with no neurological deficits presented to our hospital after head trauma. Computed tomography (CT) revealed a tentorial acute subdural hematoma (ASDH). The patient was managed conservatively and discharged home six days after hospitalization. Two days later, the patient returned with a severe headache. CT showed that the ASDH had enlarged and extended from the tentorium to the convexity. CT angiography and digital subtraction angiography revealed a pseudoaneurysm in a branch of the left posterior inferior temporal artery. The patient was diagnosed with an enlarged ASDH due to a ruptured TICA that arose from the P3 segment. We performed endovascular intervention with parent artery occlusion (PAO) using n-butyl-2-cyanoacrylate (NBCA). The parent artery was accessed through the left posterior communicating artery because left vertebral angiography revealed an aplastic left P1 segment. After navigating the microcatheter near the aneurysm, we injected 33% NBCA into the parent artery. The pseudoaneurysm disappeared after injection. The patient was discharged on hospital day 25 despite persistent delirium. Conclusion: This is the first report of a TICA arising from the P3 segment that was treated with PAO using NBCA. TICAs are rare; however, a TICA must be considered when an enlarged hematoma caused by head injury is detected.

9.
Intern Med ; 61(23): 3553-3558, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-35527024

RESUMEN

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease. Lupus nephritis (LN) is a major risk factor for mortality in SLE, and glomerular "full-house" immunofluorescence staining is a well-known characteristic of LN. However, some cases of non-lupus glomerulonephritis can also present with a "full-house" immunofluorescence pattern. We recently encountered a patient with full-house nephropathy (FHN) during adalimumab administration for Crohn's disease. IgA nephropathy or idiopathic FHN was diagnosed, and treatment with steroids was started, after which there was improvement in proteinuria. The prognosis of FHN has been reported to be poor; therefore, aggressive treatment is required for such patients.


Asunto(s)
Enfermedad de Crohn , Glomerulonefritis por IGA , Lupus Eritematoso Sistémico , Nefritis Lúpica , Humanos , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/tratamiento farmacológico , Nefritis Lúpica/complicaciones , Nefritis Lúpica/tratamiento farmacológico , Nefritis Lúpica/diagnóstico , Lupus Eritematoso Sistémico/complicaciones , Glomerulonefritis por IGA/complicaciones , Glomerulonefritis por IGA/diagnóstico , Proteinuria/complicaciones
10.
Cell Tissue Res ; 388(2): 313-329, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35211820

RESUMEN

During amphibian metamorphosis which is triggered by thyroid hormone (TH), the small intestine is extensively remodeled from the larval to adult form. In the Xenopus laevis intestine, some of the larval epithelial cells dedifferentiate into adult stem cells, which newly form the adult epithelium similar to the mammalian one. We have previously shown that TH-activated Shh, Wnt and Notch signaling pathways play important roles in adult epithelial development. Here we focus on the Hippo signaling pathway, which is known to interact with these pathways in the mammalian intestine. Our quantitative RT-PCR analysis indicates that the expression of genes involved in this pathway including YAP1, TAZ, TEAD1 and core kinases is differently regulated by TH in the metamorphosing intestine. Additionally, we show by in situ hybridization and immunohistochemistry that the transcriptional co-activator YAP1, a major effector of the Hippo signaling, is expressed in the adult stem cells and connective tissue cells surrounding them and that YAP1 protein is localized in either nucleus or cytoplasm of the stem cells. We further show that YAP1 binds its binding partner TEAD1 (transcription factor) in vivo and that their interaction is inhibited by verteporfin (VP). More importantly, by using VP in organ culture of the tadpole intestine, we experimentally demonstrate that the inhibition of YAP1-TEAD1 interaction decreases both TH-induced stem cells expressing LGR5 and nearby connective tissue cells in number and proliferation, leading to the failure of adult epithelial development. Our results indicate that YAP-TEAD complex is required for stem cell development during intestinal remodeling.


Asunto(s)
Células Madre Adultas , Intestinos , Animales , Larva/metabolismo , Mamíferos/metabolismo , Metamorfosis Biológica , Hormonas Tiroideas/metabolismo , Hormonas Tiroideas/farmacología , Xenopus laevis
11.
Clin Neurol Neurosurg ; 212: 107049, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34871990

RESUMEN

BACKGROUND: The 10-meter walking test (10 MWT) is widely used during a cerebrospinal fluid tap test (CSFTT) for idiopathic normal-pressure hydrocephalus (iNPH). However, various previous studies and guidelines do not specify whether to adopt a comfortable walking speed or maximum walking speed when implementing the 10 MWT. In this study, we analyzed the values of comfortable and maximum walking speeds during the CSFTT in patients who underwent shunt surgery to determine which walking form is desirable for evaluation. METHODS: The patients were 29 consecutive cases in which a CSFTT was performed, followed by shunting, between October 2012 and April 2019. Data on the 10 MWT comfortable walking speed and maximum walking speed were collected, as were data on the timed up and go (TUG) test and Mini-Mental State Examination (MMSE). We analyzed the rate of change in comfortable walking speed and maximum walking speed before CSFTT and on the first day after CSFTT, and the amount of improvement compared to baseline ability. In addition, diagnostic performance was compared using a receiver operating characteristic (ROC) analysis. RESULTS: Twenty-eight patients who underwent shunt surgery improved their symptoms and were designated as shunt responders. The remaining patient who underwent surgery was considered a non-responder with no improvement in symptoms. The parameters of the shunt responders that changed were muscle strength, the 10 MWT, and the TUG test, and there was no significant change in cognitive function. The rate of change, amount of change, and sensitivity were large at a comfortable walking speed, but ROC analysis showed that the maximum walking speed had a large area under the curve and excellent specificity. The higher the preoperative gait function, the lower the improvement rate of gait function. DISCUSSION: The comfortable walking speed is easy to measure, but its specificity is inferior to the maximum walking speed. However, the maximum walking speed may be affected by the ceiling effect and measurement errors. Despite this, we concluded that the maximum walking speed had a better diagnostic performance. Because the causes of gait disturbance in iNPH include decreased muscle output, postural instability, and gait rhythm disorder, and maximum walking speed is strongly related to each of these factors, this accounts for the changes in maximum walking speed. CONCLUSION: In conclusion, although comfortable walking speed was easy to measure in terms of changes and had high sensitivity, the maximum walking speed had the highest specificity and comprehensive diagnostic performance. It is recommended that maximum walking speed be evaluated when making a definitive diagnosis of iNPH.


Asunto(s)
Derivaciones del Líquido Cefalorraquídeo , Hidrocéfalo Normotenso/diagnóstico , Hidrocéfalo Normotenso/fisiopatología , Punción Espinal , Velocidad al Caminar/fisiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Estudios Retrospectivos , Sensibilidad y Especificidad , Prueba de Paso
12.
J Stroke Cerebrovasc Dis ; 30(7): 105773, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33865230

RESUMEN

BACKGROUND: Duplication of the middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery (ICA). Aneurysms at the origin of a DMCA have been reported; however, most have been treated with clipping surgery. Here, we describe two cases of aneurysms at the origin of a DMCA treated with coil embolization. CASE PRESENTATION: Case 1: A seventy-three year-old man presented with severe headache and was diagnosed with subarachnoid hemorrhage (SAH). Digital subtraction angiography (DSA) and 3-dimensional (3-D) DSA showed an aneurysm arising from a DMCA. Coil embolization was performed with DMCA patency. The patient had an uneventful postoperative course. CASE 1: A 44-year-old woman presented with a history of clipping for an IC-anterior choroidal artery (AchA) aneurysm 8 years prior. Magnetic resonance imaging (MRI) showed regrowth of the aneurysm. 3-D DSA showed an IC-DMCA aneurysm located laterally and distal to the AchA. The DMCA arose from the bottom of the aneurysm. Coil embolization was performed without DMCA occlusion and showed no postoperative ischemic changes. CONCLUSION: An IC-DMCA aneurysm is rare and may be misdiagnosed as an AchA aneurysm. Clinicians should perform a 3D-DSA evaluation if the aneurysm arises from the lateral wall of the IC to obtain a precise diagnosis and to preserve the DMCA during coil embolization.


Asunto(s)
Embolización Terapéutica/instrumentación , Aneurisma Intracraneal/terapia , Arteria Cerebral Media/anomalías , Adulto , Anciano , Angiografía de Substracción Digital , Angiografía Cerebral , Diagnóstico Diferencial , Femenino , Humanos , Imagenología Tridimensional , Aneurisma Intracraneal/diagnóstico por imagen , Masculino , Arteria Cerebral Media/diagnóstico por imagen , Valor Predictivo de las Pruebas , Resultado del Tratamiento
13.
J Neuroendovasc Ther ; 15(7): 467-474, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-37502781

RESUMEN

Objective: We report two patients with unruptured large aneurysms treated by overlapping stent-assisted coil embolization using low-profile visualized intraluminal support (LVIS) stents. Case Presentation: Case 1: An 80-year-old woman presented with abducens nerve palsy due to an internal carotid artery aneurysm. Case 2: A 75-year-old man presented with a partially thrombosed fusiform aneurysm in the vertebral artery (VA). Both patients were treated by overlapping LVIS stent-assisted coil embolization (overlapping LSACE). Digital subtraction angiography (DSA) a few months after embolization demonstrated complete occlusion of the aneurysm, although immediate angiography revealed dome filling. Conclusion: Overlapping LSACE may be an effective treatment method for aneurysms that are difficult to treat by standard SACE and result in better flow-diverting effects.

14.
Sci Rep ; 10(1): 20715, 2020 11 26.
Artículo en Inglés | MEDLINE | ID: mdl-33244068

RESUMEN

In the Xenopus laevis intestine during metamorphosis, stem cells appear and generate the adult epithelium analogous to the mammalian one. We have previously shown that connective tissue cells surrounding the epithelium are essential for the stem cell development. To clarify whether such cells correspond to mammalian Foxl1-expressing mesenchymal cells, which have recently been shown to be a critical component of intestinal stem cell niche, we here examined the expression profile of Foxl1 in the X. laevis intestine by using RT-PCR and immunohistochemistry. Foxl1 expression was transiently upregulated only in connective tissue cells during the early period of metamorphic climax and was the highest just beneath the proliferating stem/progenitor cells. In addition, electron microscopic analysis showed that these subepithelial cells are ultrastructurally identified as telocytes like the mammalian Foxl1-expressing cells. Furthermore, we experimentally showed that Foxl1 expression is indirectly upregulated by thyroid hormone (TH) through Shh signaling and that TH organ-autonomously induces the Foxl1-expressing cells concomitantly with appearance of the stem cells in the tadpole intestine in vitro. The present results suggest that intestinal niche cells expressing Foxl1 are evolutionally conserved among terrestrial vertebrates and can be induced by TH/Shh signaling during amphibian metamorphosis for stem cell development.


Asunto(s)
Células Madre Adultas/metabolismo , Fibroblastos/metabolismo , Factores de Transcripción Forkhead/metabolismo , Mucosa Intestinal/metabolismo , Hormonas Tiroideas/metabolismo , Proteínas de Xenopus/metabolismo , Xenopus laevis/metabolismo , Células Madre Adultas/fisiología , Animales , Proliferación Celular/fisiología , Células Epiteliales/metabolismo , Células Epiteliales/fisiología , Epitelio/metabolismo , Epitelio/fisiología , Fibroblastos/fisiología , Proteínas Hedgehog/metabolismo , Mucosa Intestinal/fisiología , Intestinos/fisiología , Metamorfosis Biológica/fisiología , Modelos Animales , Transducción de Señal/fisiología , Nicho de Células Madre/fisiología , Células Madre/metabolismo , Células Madre/fisiología , Regulación hacia Arriba/fisiología , Xenopus laevis/fisiología
15.
Case Rep Nephrol Dial ; 10(1): 9-17, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32232055

RESUMEN

Tolvaptan, a vasopressin V2 receptor antagonist, was initially approved in Japan for treatment of autosomal dominant polycystic kidney disease (ADPKD). Recently, a retrospective study showed that the effect of tolvaptan on kidney function could be sustained for a long period. However, the long-term efficacy and safety of high-dose tolvaptan (120 mg/day) in individual cases remain unknown. We report here 2 Japanese ADPKD patients (males, 36 and 29 years old) treated with tolvaptan (120 mg/day) for 9 years, during which time determinations of estimated glomerular filtration rate (eGFR) and total kidney volume (TKV) were performed. In these 2 patients, eGFR prior to therapy was 57.3 and 76.3 mL/min/1.73 m2, respectively, and 30.2 and 43.5 mL/min/1.73 m2, respectively, after 9 years of tolvaptan treatment, for a relatively constant annual decline of -3.01 and -3.64 mL/min/1.73 m2, respectively. As compared to the predicted (calculated) eGFR without tolvaptan treatment, eGFR actually measured was higher by 15.3 and 12.6 mL/min/1.73 m2, respectively, after the 9-year therapy period. In addition, the rate of TKV increase was gradual, 2.4 and 4.7%, respectively, per year during the initial 3-year period, to 6.5 and 12.5%, respectively, per year in the following 6-year period. During the 9 years of treatment, neither patient showed tolvaptan-related adverse events. Our findings suggest that long-term administration of tolvaptan at a high dose is both safe and effective to preserve kidney function, though a gradual increase in TKV was seen in both of the present cases, particularly during the later phase.

16.
Gen Comp Endocrinol ; 292: 113441, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32084349

RESUMEN

In the intestine during metamorphosis of the frog Xenopus laevis, most of the larval epithelial cells are induced to undergo apoptosis by thyroid hormone (TH), and under continued TH action, the remaining epithelial cells dedifferentiate into stem cells (SCs), which then newly generate an adult epithelium analogous to the mammalian intestinal epithelium. Previously, we have shown that the precursors of the SCs that exist in the larval epithelium as differentiated absorptive cells specifically express receptor tyrosine kinase-like orphan receptor 2 (Ror2). By using Ror2 as a marker, we have immunohistochemically shown here that these SC precursors, but not the larval epithelial cells destined to die by apoptosis, express TH receptor α (TRα). Upon initiation of TH-dependent remodeling, TRα expression remains restricted to the SCs as well as proliferating adult epithelial primordia derived from them. As intestinal folds form, TRα expression becomes localized in the trough of the folds where the SCs reside. In contrast, TRß expression is transiently up-regulated in the entire intestine concomitantly with the increase of endogenous TH levels and is most highly expressed in the developing adult epithelial primordia. Moreover, we have shown here that global histone H4 acetylation is enhanced in the SC precursors and adult primordia including the SCs, while tri-methylation of histone H3 lysine 27 is lacking in those cells during metamorphosis. Our results strongly suggest distinct roles of TRα and TRß in the intestinal larval-to-adult remodeling, involving distinctive epigenetic modifications in the SC lineage.


Asunto(s)
Epigénesis Genética , Regulación del Desarrollo de la Expresión Génica , Intestinos/crecimiento & desarrollo , Metamorfosis Biológica/genética , Receptores de Hormona Tiroidea/metabolismo , Células Madre/citología , Xenopus laevis/genética , Acetilación , Animales , Regulación del Desarrollo de la Expresión Génica/efectos de los fármacos , Histonas/metabolismo , Larva/metabolismo , Metilación , ARN Mensajero/genética , ARN Mensajero/metabolismo , Receptores de Hormona Tiroidea/genética , Células Madre/metabolismo , Factores de Tiempo , Xenopus laevis/metabolismo
18.
Oper Neurosurg (Hagerstown) ; 19(1): 76-83, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-31584072

RESUMEN

BACKGROUND: With the recent advances in endovascular treatment devices, it has become standard in wide-neck or large intracranial aneurysms to perform coil embolization with adjunctive techniques. However, device-related perioperative complications have been reported because of the use of more complex systems. OBJECTIVE: To investigate patients who developed multiple parenchymal lesions after undergoing coil embolization for treating an unruptured intracranial aneurysm. METHODS: This study investigated 305 consecutive patients who underwent coil embolization of unruptured intracranial aneurysms between 2015 and 2017. Delayed inflammatory changes referred to the delayed observation of multiple cerebral white matter lesions on follow-up magnetic resonance imaging at an area corresponding to the perfused area of the treatment target vessel. The timing and pattern of onset, device used, the combined use of adjunctive techniques, and the clinical course after steroid treatment were retrospectively investigated. RESULTS: The 7 patients (2.3%) who showed delayed inflammatory changes were all women with a mean age of 59 yr. A mean duration from treatment to onset was 28 d. Symptoms were convulsions in 3 patients, hemiplegia in 2 patients, and homonymous hemianopia in 1 patient. All 7 patients were treated with adjunctive technique including stents, double catheter method, and balloon assist. Response to steroid treatment was satisfactory both clinically and on imaging in all 7 patients. Skin patch test was positive for nickel allergy in 2 patients. CONCLUSION: Clinicians must be fully aware of symptomatic delayed inflammatory changes may occur after endovascular aneurysmal treatment with the use of various devices.


Asunto(s)
Embolización Terapéutica , Aneurisma Intracraneal , Embolización Terapéutica/efectos adversos , Femenino , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/terapia , Imagen por Resonancia Magnética , Estudios Retrospectivos , Stents
19.
Tohoku J Exp Med ; 249(4): 275-283, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31875581

RESUMEN

Vascular calcification is a typical feature of atherosclerosis and is associated with adverse cardiovascular events such as myocardial infarction and stroke. Several studies have suggested that adenosine, an ATP metabolite may function as an endogenous regulator of arterial calcification. However, its effects on vascular smooth muscle cell calcification have not been clarified. In this study, we investigated the inhibitory effects of adenosine on vascular calcification in vitro by utilizing the culture of human aortic smooth muscle cells (HASMCs). Osteoblastic differentiation of HASMCs was induced by the treatment with oncostatin M and osteogenic differentiation medium. Adenosine and its metabolically stable analogue, 2-chloroadenosine (CADO) significantly reduced matrix mineralization and alkaline phosphatase (ALP) activities in HASMCs. The mRNA expression of tissue non-specific alkaline phosphatase (TNAP) was down-regulated by adenosine and CADO, but the mRNA expression of other osteoblastic differentiation markers, such as Runt-related transcription factor 2 (RUNX2) and bone sialoprotein (BSP)-II, was not significantly affected by these two reagents. Among the adenosine receptor (AR) subtype-selective agonists used, only IB-MECA (A3 AR-selective agonist) significantly decreased in vitro mineralization and ALP activities in HASMCs, but not with CCPA (A1 AR-selective agonist), CGS21680 (A2a AR-selective agonist), or BAY60-6583 (A2b AR-selective agonist). Importantly, IB-MECA also down-regulated expression of TNAP mRNA. Finally, knockdown of A3 AR, but not A1 AR, A2a AR, or A2b AR, significantly reversed the inhibitory actions of adenosine, CADO, or IB-MECA on in vitro calcification and ALP activities in HASMCs. These data suggest that adenosine attenuates HASMC calcification through A3 AR.


Asunto(s)
Adenosina/farmacología , Aorta/patología , Calcinosis/metabolismo , Calcinosis/patología , Miocitos del Músculo Liso/metabolismo , Miocitos del Músculo Liso/patología , Receptor de Adenosina A3/metabolismo , 2-Cloroadenosina/farmacología , Fosfatasa Alcalina/metabolismo , Humanos , Miocitos del Músculo Liso/efectos de los fármacos , Miocitos del Músculo Liso/enzimología , Oncostatina M/farmacología , Transducción de Señal/efectos de los fármacos
20.
Clin Neurol Neurosurg ; 186: 105524, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31541862

RESUMEN

OBJECTIVES: Though the Japanese version of the Montreal Cognitive Assessment (MoCA-J) scores change after a cerebrospinal fluid tap test (CSFTT), their characteristics remain unclear. To compare patient response rate to changes in cognitive function observed in the cerebrospinal fluid tap test, and to determine which group of patients were good responders. PATIENTS AND METHODS: This study included 32 patients who were suspected of having idiopathic normal pressure hydrocephalus (iNPH) between May 2017 and October 2018. Cases were divided into, following a CSFTT, a gait responder group and a non-responder group. Scores of the MoCA-J were compared and examined before, one day after, and one week after the CSFTT. RESULTS: Significant changes in MoCA-J scores were observed 1 day and 1 week after the CSFTT in the gait responder group. The change in scores was larger, and had a larger effect size, one week after the CSFTT. On assessment, MoCA-J sub-items began to show changes in attention and abstract items one day after the CSFTT, and significant changes were noted in attention and abstract items in addition to executive functions and orientation one week after the CSFTT. The degree of cognitive function before the CSFTT was less closely related to the amount of change. Changes in cognitive function can be assessed at each time point after the CSFTT, and changes in cognitive function are measured regardless of the level of cognitive function. CONCLUSION: These results suggest that evaluating patients with the MoCA-J may potentially support a more accurate iNPH diagnosis.


Asunto(s)
Cognición/fisiología , Análisis de la Marcha/métodos , Hidrocéfalo Normotenso/líquido cefalorraquídeo , Hidrocéfalo Normotenso/psicología , Pruebas de Estado Mental y Demencia , Punción Espinal/métodos , Anciano , Anciano de 80 o más Años , Femenino , Análisis de la Marcha/normas , Humanos , Hidrocéfalo Normotenso/diagnóstico , Masculino , Pruebas de Estado Mental y Demencia/normas , Estudios Retrospectivos , Punción Espinal/normas
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