Infundibulum at the origin of an accessory middle cerebral artery.

We present a case of an infundibular dilation at the origin of an accessory middle cerebral artery emanating from the distal A1 segment of the anterior cerebral artery. There was also partial vessel wall enhancement along this infundibulum. To our knowledge, this is the first case report with such findings.

Neurovascular complications that can be seen in COVID-19 patients.

Coronavirus disease 2019 (COVID-19), a clinical manifestation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a global pandemic by the World Health Organization on March 11, 2020. Hypercoagulable state has been described as one of the hallmarks of SARS-CoV-2 infection and has been reported to manifest as pulmonary embolisms, deep vein thrombosis, and arterial thrombosis of the abdominal small vessels. Here we present cases of arterial and venous thrombosis pertaining to the head and neck in COVID-19 patients.

The interaction between aggrecan gene VNTR polymorphism and cigarette smoking in predicting incident symptomatic intervertebral disc degeneration.

An association between the aggrecan variable number of tandem repeat (VNTR) polymorphism and the disc degeneration has been previously reported in Finnish men, and smoking had previously been suspected of causing disc degeneration. However, the interaction between aggrecan gene VNTR polymorphism and smoking in symptomatic intervertebral disc degeneration (IDD) has not been well studied. To examine the interaction between aggrecan gene VNTR and smoking in the susceptibility of symptomatic IDD of Chinese Han in northern China, intervertebral discs of 132 participants were evaluated on magnetic resonance imaging, using decreased signal intensity. After harvesting the blood samples, the aggrecan gene VNTR region was analyzed using polymerase chain reaction (PCR). The data indicated that between the two groups, participants carrying one or two alleles ≤25 repeats who did not smoke showed a 1.102-fold increased risk for symptomatic IDD (p= 0.855; 95% confidence interval 0.389-3.119), and participants carrying two alleles >25 repeats who smoked more than 1 pack-year showed a 1.013-fold higher risk (p = 0.982; 95% confidence interval 0.333-3.084), whereas participants carrying one or two alleles ≤25 repeats who smoked more than 1 pack-year showed a 4.5-fold increased risk for symptomatic IDD (p = 0.005; 95% confidence interval 1.589-12.743). Overall, we observed an underlying additive and multiplicative interaction between the aggrecan gene VNTR polymorphism and smoking in symptomatic IDD.

Magnetic resonance venography for 3-dimensional live guidance during venous sinus stenting.

PURPOSE: The purpose of this study was to report the technique for intraprocedural guidance of endovascular Venous Sinus Stenting procedures using 3-Dimensional (3D) Magnetic Resonance Venography (MRV) as an overlay on live biplanar fluoroscopy. MATERIALS AND METHODS: Venous sinus stenting procedures performed between April and December, 2017 with 3D MRV fusion for live guidance were reviewed in this study. A thin-slice, contrast-enhanced MR Venogram was used to create 2 3D models - vessels and skull - for procedural guidance via augmented fluoroscopy (Vessel ASSIST, GE Healthcare, Chicago, IL). The skull model was used in the registration of the 3D overlay on both the frontal and lateral planes, which required 1-2 min of procedural time. The vessel model was used to mark landmarks such as the cortical vein ostia and stenosis on the 3D overlay fused with biplanar fluoroscopy. The retrospective imaging review was conducted by 3 neurointerventionalists and relied on a consensus confidence ranking on a 3-point Likert scale from 1- low confidence to 3- high confidence. The neurointerventionalists first reviewed the conventional 2-dimensional pre-stent deployment fluoroscopy images and then reviewed the corresponding images with the 3D MRV overlay. They ranked their confidence in their understanding of cortical venous anatomy for each group. Statistical analysis was performed using a Paired T Test at a 99% confidence interval. RESULTS: Ten cases were included in the retrospective image review. Operator confidence regarding the location of cortical veins was significantly increased using 3D MRV fusion during venous sinus stenting procedures (1.9 vs 2.9, p = .001). CONCLUSION: 3-Dimensional MRV fusion is feasible and helpful in understanding the venous sinus anatomy and location of important cortical veins during venous sinus stenting procedures.

Study on the optical property and biocompatibility of a tissue engineering cornea.

AIM: To study the optical property and biocompatibility of a tissue engineering cornea. METHODS: : The cross-linker of N-(3-Dimethylaminoropyl)-N'ethylcarbodiimide hydrochloride (EDC)/N-Hydroxysuccinimide (NHS) was mixed with Type I collagen at 10% (weight/volume). The final solution was molded to the shape of a corneal contact lens. The collagen concentrations of 10%, 12.5%, 15%, 17.5% and 20% artificial corneas were tested by UV/vis-spectroscopy for their transparency compared with normal rat cornea. 10-0 sutures were knotted on the edges of substitute to measure the corneal buttons's mechanical properties. Normal rat corneal tissue primary culture on the collagen scaffold was observed in 4 weeks. Histopathologic examinations were performed after 4 weeks of in vitro culturing. RESULTS: The collagen scaffold appearance was similar to that of soft contact lens. With the increase of collagen concentration, the transparency of artificial corneal buttons was diminished, but the toughness of the scaffold was enhanced. The scaffold transparency in the 10% concentration collagen group resembled normal rat cornea. To knot and embed the scaffold under the microscope, 20% concentration collagen group was more effective during implantation than lower concentrations of collagen group. In the first 3 weeks, corneal cell proliferation was highly active. The shapes of cells that grew on the substitute had no significant difference when compared with the cells before they were moved to the scaffold. However, on the fortieth day, most cells detached from the scaffold and died. Histopathologic examination of the primary culture scaffold revealed well grown corneal cells tightly attached to the scaffold in the former culturing. CONCLUSION: Collagen scaffold can be molded to the shape of soft contact corneal lens with NHS/EDC. The biological stability and biocompatibility of collagen from animal species may be used as material in preparing to engineer artificial corneal scaffold.

Corneal astigmatism correction with scleral flaps in trans-scleral suture-fixed posterior chamber lens implantation: a preliminary clinical observation.

AIM: To study the impact of scleral flap position, under which the posterior chamber intraocular lenses (PC-IOL) were sulcus-fixed by trans-scleral suture, on cornea astigmatism. METHODS: Twenty-six aphakic or cataract eyes were comprised in this prospective noncomparative case series study. Eleven eyes had traumatic cataract removed without sufficient capsular support, 3 had blunt trauma with subluxated traumatic cataract, 8 had undergone vitreoretinal surgery and 4 had congenital cataract removed. The average age was 54 years (range 21-74 years), with 17 men and 7 women. The foldable PC-IOL was fixed in sulcus by trans-scleral suture. The incision for IOL implantation was made 1mm posterior to limbus along the steepest meridian of cornea, while scleral flaps to bury the knots of trans-scleral suture were made along the flattest meridian. All the surgeries were performed by a single doctor (Ma L), and the follow up was at least 13 months (range 13-28 months). The preoperative, 3 months and 1 year postoperative corneal curvature along the steepest and flattest cornea meridian and overall cornea astigmatism were compared. RESULTS: The curvature along the steepest meridian changed from 44.25±2.22D preoperatively to 44.08±2.16D at 3 months postoperatively, and 43.65±5.23D at 1 year postoperatively (P>0.05); the curvature along the flattest meridian changed from 41.24±2.21D preoperatively to 43.15±3.94D at 3 months postoperatively, and 42.85±5.17D at 1 year postoperatively (P<0.05); and the surgery induced astigmatism (SIA) on cornea was calculated by vector analysis, which was 2.42±2.13D at 3 months postoperatively, and 2.18±3.42D at 1 year postoperatively, the difference was statistically significant (P<0.05). CONCLUSION: The scleral flap made along the flattest meridian, under which the posterior chamber intraocular lenses (PCIOL) were sulcus-fixed by trans-scleral suture, can steepen the cornea in varying degrees, thus reducing preexisting corneal astigmatism.

Association between the expression of aggrecan and the distribution of aggrecan gene variable number of tandem repeats with symptomatic lumbar disc herniation in Chinese Han of Northern China.

STUDY DESIGN: Case-control study. OBJECTIVE: To examine the association between the expression of aggrecan and the aggrecan gene variable number of tandem repeats (VNTR) polymorphism with symptomatic lumbar disc herniation (LDH) in Chinese Han of Northern China. SUMMARY OF BACKGROUND DATA: Aggrecan fragments have been found in human degenerated discs, and an association between the aggrecan VNTR polymorphism and intervertebral disc degeneration has been previously reported in middle-aged Finnish men. However, the relationship between the munity of symptomatic LDH with the expression of aggrecan and aggrecan gene VNTR has not been well studied. METHODS: The disease group consisted of 70 patients already diagnosed with symptomatic LDH. The control group consisted of 14 patients restricted to spinal trauma and 113 healthy blood donors without symptoms of LDH who were not diagnosed with LDH. Disc tissue samples were obtained from surgical operations, and blood samples were donated from all participants. The aggrecan expression in isolated tissues was assessed by Western blot using specific antibodies. The aggrecan gene VNTR region was analyzed by polymerase chain reaction. RESULTS: The aggrecan expression positive rate of control group was statistically and significantly higher (P < 0.001) than that of the disease group. Moreover, there was a statistically significant higher frequency of allele 25 or allele 21 in disease group compared with controls (P(A25) = 0.003416 and P(A21) = 0.000716). Compared with the participants with 2 alleles > 25 repeats, subjects with 1 or 2 alleles < or = 25 repeats statistically and significantly overrepresented the disease group without the expression of aggrecan (P < 0.001). CONCLUSION: The findings suggest a relation between aggrecan and symptomatic LDH, where symptomatic LDH has a lower tendency of allele repeats. In addition, this study observed an association between the distribution of aggrecan gene VNTR polymorphism and the expression of aggrecan in symptomatic LDH.

Analysis of protein-protein interactions and proteomic profiles of normal human lenses.

PURPOSE: To investigate proteomic profiles of normal human lenses and their key proteins in protein-protein interactions (PPIs). MATERIALS AND METHODS: Water-soluble and water-insoluble proteins extracted from human lenses were first separated by one-dimensional sodium dodecyl sulfate polyacrylamide gel, and then in-gel digested with trypsin into peptides eluted by reversed-phase high-performance liquid chromatography. The eluted peptides were analyzed by linear ion trap tandem mass spectrometry (MS/MS). The raw data was filtered by TurboSEQUEST algorithm. The reverse database was used for peptide false-positive rate estimation. A network chart was constructed by the identified lens PPIs in accordance with interaction database systems. RESULTS: From normal human lenses 339 proteins in total were identified, including many formerly unidentified low-abundance proteins. Key proteins we recognized included plectin, actin, spectrin (alpha, beta), vimentin, 14-3-3 protein (beta/alpha, zeta/delta, epsilon, gamma, eta), TSC2, guanine nucleotide-releasing protein, laminin gamma, mitogen-activated protein kinase, alpha-A-crystallin, heat-shock protein (alpha, beta), glyceraldehyde 3-phosphate dehydrogenase, and collagen IV alpha. CONCLUSIONS: Key proteins of normal human lenses were studied by constructing a network chart of the identified lens PPIs. The results suggest that linear ion trap MS/MS is an effective tool for detecting low-abundance proteins of human lenses. This study provides valuable data for further proteomic research of the human lens development and lens diseases.