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1.
J Chin Med Assoc ; 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38973054

RESUMEN

BACKGROUND: Despite the widespread use of the Wingspan stent system for treating severe medically refractory intracranial artery stenosis (SMR-ICAS), a new Credo stent system was approved because it could integrate stent delivery within the balloon catheter. However, the therapeutic outcomes of these two systems have not been compared. This preliminary study aimed to compare the results of percutaneous angioplasty and stenting (PTAS) in SMR-ICAS patients treated with either Wingspan or Credo stents within the anterior circulation. METHODS: SMR-ICAS patients with more than 70% stenosis in the anterior circulation who underwent PTAS using either the Wingspan or Credo stent system were analyzed. We evaluated the technical success, safety, and outcomes of the two stent systems. RESULTS: A total of 29 patients were analyzed, including 17 patients treated with Wingspan stents and 12 with Credo stents. The outcomes of the Wingspan stent vs. Credo stent were as follows: technical success (16/17 [94%] vs. 11/12 [92%], p = 1.00); periprocedural intracranial hemorrhage (2/17 [12%] vs. 0/12 [0%], p = 0.50); silent embolic ischemic lesions on peri-procedural MRI (13/17 [76%] vs. 7/12 [58%], p = 0.42); and significant (more than 50%) in-stent restenosis in one year (4/17 [24%] vs. 2/12 [17%], p = 1.00). No recurrent stroke or mortality was noted within 30 days after the procedures or during the one-year follow-up period. CONCLUSION: The technical success, safety, and outcomes of the Credo stent system were comparable to those of the Wingspan stent system in the management of SMR-ICAS patients. Further large-scale studies are warranted to substantiate these findings.

2.
Oncol Res ; 32(7): 1197-1207, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38948022

RESUMEN

Breast cancer, a predominant global health issue, requires ongoing exploration of new therapeutic strategies. Palbociclib (PAL), a well-known cyclin-dependent kinase (CDK) inhibitor, plays a critical role in breast cancer treatment. While its efficacy is recognized, the interplay between PAL and cellular autophagy, particularly in the context of the RAF/MEK/ERK signaling pathway, remains insufficiently explored. This study investigates PAL's inhibitory effects on breast cancer using both in vitro (MCF7 and MDA-MB-468 cells) and in vivo (tumor-bearing nude mice) models. Aimed at elucidating the impact of PAL on autophagic processes and exploring the potential of combining it with trametinib (TRA), an MEK inhibitor, our research seeks to address the challenge of PAL-induced drug resistance. Our findings reveal that PAL significantly decreases the viability of MCF7 and MDA-MB-468 cells and reduces tumor size in mice while showing minimal cytotoxicity in MCF10A cells. However, PAL also induces protective autophagy, potentially leading to drug resistance via the RAF/MEK/ERK pathway activation. Introducing TRA effectively neutralized this autophagy, enhancing PAL's anti-tumor efficacy. A combination of PAL and TRA synergistically reduced cell viability and proliferation, and in vivo studies showed notable tumor size reduction. In conclusion, the PAL and TRA combination emerges as a promising strategy for overcoming PAL-induced resistance, offering a new horizon in breast cancer treatment.


Asunto(s)
Autofagia , Neoplasias de la Mama , Piperazinas , Piridinas , Piridonas , Pirimidinonas , Ensayos Antitumor por Modelo de Xenoinjerto , Humanos , Animales , Autofagia/efectos de los fármacos , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Neoplasias de la Mama/metabolismo , Piridinas/farmacología , Piridinas/uso terapéutico , Piridonas/farmacología , Piridonas/uso terapéutico , Femenino , Pirimidinonas/farmacología , Pirimidinonas/uso terapéutico , Ratones , Piperazinas/farmacología , Piperazinas/uso terapéutico , Línea Celular Tumoral , Resistencia a Antineoplásicos/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Sinergismo Farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ratones Desnudos , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Inhibidores de Proteínas Quinasas/farmacología , Inhibidores de Proteínas Quinasas/uso terapéutico , Supervivencia Celular/efectos de los fármacos , Células MCF-7
3.
World Neurosurg ; 2024 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-38897401

RESUMEN

OBJECTIVE: To investigate the long-term clinical outcomes of staged surgical resection in giant Pituitary Neuroendocrine Tumors(pitNET).Method We performed a retrospective analysis of the clinical data of 16 patients who underwent surgery. The patients were diagnosed and underwent surgery at the Department of Neurosurgery of Shiyan Taihe Hospital from January 2013 to March 2021. Among the cases, 12 patients underwent primarily transsphenoidal surgery followed by secondary transcranial surgery, while 4 patients underwent primarily transsphenoidal surgery followed by secondary transsphenoidal surgery. Before the surgery, all patients underwent a pituitary MRI scan, pituitary hormone level examination, visual acuity, and visual field examination. A pituitary MRI was rechecked within 1 week after the operation. A tumor resection rate of 100% on MRI was considered as a total resection, between 90% to 100% as a subtotal resection, and lower than 90% as a partial resection. After the surgery, regular clinical visits and telephone or internet platform follow-ups were conducted. Outcome In our clinical investigation, after staged surgery 10 patients had a total resection, 5 had a subtotal resection, and 1 had a partial resection depending on the tumor size and invasion. The clinical outcomes showed that 1 case suffered from postoperative intracranial infection, 1 case had decreased visual acuity, and 6 cases experienced decreased pituitary function after surgery.Postoperative complications were cured after symptomatic treatment, except for 1 patient who experienced decreased vision and 1 patient sufferred hypopituitarism required long-term oral levothyroxine tablet treatment. No cases of intracranial hemorrhage or death were caused by intentionally staged resection surgery. Conclusion Staged surgery for giant pitNET is a safe and effective clinical surgery strategy.

4.
AJNR Am J Neuroradiol ; 45(7): 934-942, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38871370

RESUMEN

BACKGROUND AND PURPOSE: Verbal memory decline is a common complaint of patients with severe asymptomatic stenosis of the internal carotid artery (aICS). Previous publications explored the associations between verbal memory decline and altered functional connectivity (FC) after aICS. Patients with severe aICS may show reduced perfusion in the ipsilateral territory and redistribution of cerebral blood flow to compensate for the deficient regions, including expansion of the posterior and contralateral ICA territories via the circle of Willis. However, aICS-related FC changes in anterior and posterior territories and the impact of the sides of stenosis were less explored. This study aims to investigate the altered FC in anterior and posterior circulation territories of patients with left or right unilateral aICS and its association with verbal memory decline. MATERIALS AND METHODS: We enrolled 15 healthy controls (HCs), 22 patients with left aICS (aICSL), and 33 patients with right aICS (aICSR) to receive fMRI, Mini-Mental State Examination (MMSE), the Digit Span Test (DST), and the 12-item Chinese version of Verbal Learning Tests. We selected brain regions associated with verbal memory within anterior and posterior circulation territories. Territory-related FC alterations and verbal memory decline were identified by comparing the aICSL and aICSR groups with HC groups (P < .05, corrected for multiple comparisons), respectively. Furthermore, the association between altered FC and verbal memory decline was tested with the Pearson correlation analysis. RESULTS: Compared with HCs, patients with aICSL or aICSR had significant impairment in delayed recall of verbal memory. Decline in delayed recall of verbal memory was significantly associated with altered FC between the right cerebellum and right middle temporal pole in the posterior circulation territory (r = 0.40, P = .03) in the aICSR group and was significantly associated with altered FC between the right superior medial frontal gyrus and left lingual gyrus in the anterior circulation territory (r = 0.56, P = .01) in the aICSL group. CONCLUSIONS: Patients with aICSL and aICSR showed different patterns of FC alterations in both anterior and posterior circulation territories, which suggests that the side of aICS influences the compensatory mechanism for decline in delayed recall of verbal memory.


Asunto(s)
Estenosis Carotídea , Imagen por Resonancia Magnética , Trastornos de la Memoria , Humanos , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/fisiopatología , Estenosis Carotídea/complicaciones , Masculino , Femenino , Trastornos de la Memoria/fisiopatología , Trastornos de la Memoria/diagnóstico por imagen , Trastornos de la Memoria/etiología , Persona de Mediana Edad , Anciano , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/fisiopatología , Circulación Cerebrovascular/fisiología , Aprendizaje Verbal/fisiología
5.
Biomedicines ; 12(3)2024 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-38540313

RESUMEN

Though tremendous advances have been made in the field of in vitro fertilization (IVF), a portion of patients are still affected by embryo implantation failure issues. One of the most significant factors contributing to implantation failure is a uterine condition called displaced window of implantation (WOI), which refers to an unsynchronized endometrium and embryo transfer time for IVF patients. Previous studies have shown that microRNAs (miRNAs) can be important biomarkers in the reproductive process. In this study, we aim to develop a miRNA-based classifier to identify the WOI for optimal time for embryo transfer. A reproductive-related PanelChip® was used to obtain the miRNA expression profiles from the 200 patients who underwent IVF treatment. In total, 143 out of the 167 miRNAs with amplification signals across 90% of the expression profiles were utilized to build a miRNA-based classifier. The microRNA-based classifier identified the optimal timing for embryo transfer with an accuracy of 93.9%, a sensitivity of 85.3%, and a specificity of 92.4% in the training set, and an accuracy of 88.5% in the testing set, showing high promise in accurately identifying the WOI for the optimal timing for embryo transfer.

6.
Biomedicines ; 12(3)2024 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-38540311

RESUMEN

Histamine modulates immunity by binding to histamine receptor 2 (H2R). Cimetidine, an H2R antagonist that inhibits gastric acid secretion and treats gastrointestinal ulcers, interferes with histamine-mediated immunomodulation and may have anticancer activity. This study examined cimetidine's effect on the anticancer effect of anti-PD-L1 in colon cancer. The MTT assay, colony formation assay, and DNA histograms assessed cell viability, clonogenicity, and cell cycle distribution, respectively. Flow cytometry measured H2R and PD-L1 expression and estimated specific immune cell lineages. For the in vivo study, tumor cells were subcutaneously implanted into the right flank of BALB/c mice. Cimetidine had no significant effect on CT26 cell viability, clonogenicity, or cell cycle distribution. It also did not affect H2R and PD-L1 expression levels in CT26 cells. In vivo, anti-PD-1 and anti-PD-L1 suppressed CT26 tumor growth, whereas cimetidine showed mild antitumor activity. In the combined experiment, cimetidine significantly attenuated anti-PD-1 and anti-PD-L1' antitumor effects without major toxicity. In the tumor microenvironment, anti-PD-L1 increased CD3+ T, CD4+ T, and CD8+ T cells and M1 macrophages. Combined treatment with cimetidine reversed this. Cimetidine also reversed anti-PD-1 and anti-PD-L1's decrease in circulating and tumor-associated neutrophils. Cimetidine attenuated anti-PD-L1's antitumor effect and modulated the tumor microenvironment in colon cancer.

7.
J Environ Manage ; 356: 120586, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38513581

RESUMEN

Simultaneous capture of formaldehyde (HCHO) and carbon dioxide (CO2) in indoor air is promising of achieving indoor-air purification. Of all potential adsorbents, hexagonal boron nitride (h-BN) is one of the most suitable species owing to facile formation of attraction points. Therefore, in this study, performances of HCHO and CO2 being adsorbed over pure/modified h-BN are systematically investigated via density functional theory (DFT) calculations. Minutely speaking, direct interaction between HCHO and CO2, single-point adsorption enhancement of HCHO over modified h-BN, co-adsorption reinforcement of HCHO/CO2 as well as relevant thermodynamic characteristics are major research contents. According to calculation results, there is relatively strong attraction between HCHO and CO2 owing to hydrogen bonds, which is in favor of co-adsorption of HCHO/CO2. As to single-adsorption of HCHO, C-doped h-BN shows better adsorption features than P-doped h-BN and C/P-doped h-BN is slightly weakened in adsorption ability due to surficial deformation caused by P atoms. For co-adsorption of HCHO/CO2, CO2 is the protagonist via formation of quasi-carbonate with the help of delocalized π-orbital electrons. Regarding effects of temperatures on adsorption strengths, they depend on interelectronic interactions among dopant atoms and finally derives from dispersion of π bonds across adsorbents. Overall, this study provides detailed mechanisms for co-capture of HCHO/CO2 to accomplish indoor-air purification.


Asunto(s)
Dióxido de Carbono , Formaldehído , Adsorción , Formaldehído/química , Compuestos de Boro
8.
Mar Pollut Bull ; 200: 116097, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38310723

RESUMEN

Frequent algal blooms in the nearshore area of the East China Sea (ECS) pose a serious threat to both the marine environment and human health. Climate and environmental changes play an important role in the occurrence of diatoms and dinoflagellates blooms. Using the MODIS-Aqua 1-km satellite observations, the outbreaks of dinoflagellate and diatom blooms in the ECS coast in summer during 2003-2022 were mapped. Our results found that although the bloom frequency of dinoflagellate was consistently higher than diatoms, its bloom intensity showed a slightly decline trend in recent decades. The driving factors analysis showed that river runoff and sediments discharge played different effect on the formation of diatom and dinoflagellate blooms. Besides, our results compared the effect of El Niño and La Niña on bloom occurrences. This study was supposed to provide detailed insights into algal blooms, with important implications for relevant meteorological and climate changes in coastal regions.


Asunto(s)
Diatomeas , Dinoflagelados , Humanos , Eutrofización , China , Estaciones del Año , Floraciones de Algas Nocivas
9.
Brain Commun ; 6(1): fcad349, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38162905

RESUMEN

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy, caused by cysteine-altering variants in NOTCH3, is the most prevalent inherited cerebral small vessel disease. Impaired cerebral interstitial fluid dynamics has been proposed as one of the potential culprits of neurodegeneration and may play a critical role in the initiation and progression of cerebral small vessel disease. In the present study, we aimed to explore the cerebral interstitial fluid dynamics in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy and to evaluate its association with clinical features, imaging biomarkers and disease severity of cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy. Eighty-one participants carrying a cysteine-altering variant in NOTCH3, including 44 symptomatic cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy patients and 37 preclinical carriers, and 21 age- and sex-matched healthy control individuals were recruited. All participants underwent brain MRI studies and neuropsychological evaluations. Cerebral interstitial fluid dynamics was investigated by using the non-invasive diffusion tensor image analysis along the perivascular space method. We found that cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy patients exhibited significantly lower values of diffusion tensor image analysis along the perivascular space index comparing to preclinical carriers and healthy controls. For the 81 subjects carrying NOTCH3 variants, older age and presence of hypertension were independently associated with decreased diffusion tensor image analysis along the perivascular space index. The degree of cerebral interstitial fluid dynamics was strongly related to the severity of cerebral small vessel disease imaging markers, with a positive correlation between diffusion tensor image analysis along the perivascular space index and brain parenchymal fraction and negative correlations between diffusion tensor image analysis along the perivascular space index and total volume of white matter hyperintensity, peak width of skeletonized mean diffusivity, lacune numbers and cerebral microbleed counts. In addition, diffusion tensor image analysis along the perivascular space index was a significant risk factor associated with the development of clinical symptoms of stroke or cognitive dysfunction in individuals carrying NOTCH3 variants. In cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy patients, diffusion tensor image analysis along the perivascular space index was significantly associated with Mini-Mental State Examination scores. Mediation analysis showed that compromised cerebral interstitial fluid dynamics was not only directly associated with cognitive dysfunction but also had an indirect effect on cognition by influencing brain atrophy, white matter disruption, lacunar lesions and cerebral microbleeds. In conclusion, cerebral interstitial fluid dynamics is impaired in cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy and its disruption may play an important role in the pathogenesis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy. Diffusion tensor image analysis along the perivascular space index may serve as a biomarker of disease severity for cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy.

10.
Carbohydr Polym ; 327: 121653, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38171675

RESUMEN

Fenugreek (Trigonella foenum-graecum L) galactomannan play an important role in the food and pharmaceutical sectors due to its attractive physicochemical properties. In this study, the changes of structure, properties and biological activity of fenugreek galactomannan (FG) during germination are analyzed by the activity and mechanism of endogenous enzymes (α-D-galactosidase and ß-D-mannanase). The enzymes generally increased during germination and synergistically altered the structure of GM by cutting down the main chains and removing partial side residues. The mannose to galactose ratio (M/G) increased from 1.11 to 1.59, which is accompanied by a drastic decrease in molecular weight from 3.606 × 106 to 0.832 × 106 g/mol, and the drop of viscosity from 0.27 to 0.06 Pa·sn. The degraded macromolecules are attributed to the increase in solubility (from 64.55 % to 88.62 %). In terms of antioxidation and antidiabetic ability, germinated fenugreek galactomannan has the ability to scavenge 67.17 % ABTS free radicals and inhibit 86.89 % α-glucosidase. This galactomannan with low molecular weight and excellent biological activity precisely satisfies the current demands of pharmaceutical reagents and food industry. Seeds germination holds promise as a means of industrial scale production of low molecular weight galactomannans.


Asunto(s)
Trigonella , Trigonella/química , Semillas/química , Mananos/química , Extractos Vegetales/farmacología , Galactosa/análisis
11.
Eur J Vasc Endovasc Surg ; 67(5): 708-716, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38182115

RESUMEN

OBJECTIVE: Lower neck cancers (LNCs) include specific tumour types and have some different vascular supply or collaterals from other head and neck cancers. This prospective study evaluated the outcome of endovascular management of post-irradiated carotid blowout syndrome (PCBS) in patients with LNC by comparing reconstructive management (RE) and deconstructive management (DE). METHODS: This was a single centre, prospective cohort study. Patients with LNC complicated by PCBS between 2015 and 2021 were enrolled for RE or DE. RE was performed by stent graft placement covering the pathological lesion and preventive external carotid artery (ECA) embolisation without balloon test occlusion (BTO). DE was performed after successful BTO by permanent coil or adhesive agent embolisation of the internal carotid artery (ICA) and ECA to common carotid artery, or ICA occlusion alone if the pathological lesion was ICA only. Cross occlusion included the proximal and distal ends of the pathological lesion in all patients. Re-bleeding events, haemostatic period, and neurological complications were evaluated. RESULTS: Fifty-nine patients (mean age 58.5 years; 56 male) were enrolled, including 28 patients undergoing RE and 31 patients undergoing DE. Three patients originally grouped to DE were transferred to RE owing to failed BTO. The results of RE vs. DE were as follows: rebleeding events, 13/28 (46%) vs. 10/31 (32%) (p = .27); haemostatic period, 9.4 ± 14.0 months vs. 14.2 ± 27.8 months (p = .59); neurological complication, 4/28 (14%) vs. 5/31 (16%) (p = .84); and survival time, 11.8 ± 14.6 months vs. 15.1 ± 27.5 months (p = .61). CONCLUSION: No difference in rebleeding risk or neurological complications was observed between the DE and RE groups. RE could be used as a potential routine treatment for PCBS in patients with LNC.


Asunto(s)
Embolización Terapéutica , Procedimientos Endovasculares , Neoplasias de Cabeza y Cuello , Humanos , Masculino , Persona de Mediana Edad , Femenino , Neoplasias de Cabeza y Cuello/radioterapia , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/instrumentación , Procedimientos Endovasculares/métodos , Estudios Prospectivos , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/métodos , Anciano , Resultado del Tratamiento , Stents , Implantación de Prótesis Vascular/efectos adversos , Implantación de Prótesis Vascular/instrumentación , Traumatismos por Radiación/etiología , Traumatismos por Radiación/diagnóstico , Traumatismos por Radiación/cirugía , Enfermedades de las Arterias Carótidas/terapia , Enfermedades de las Arterias Carótidas/etiología , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Adulto
12.
Stud Health Technol Inform ; 310: 1086-1090, 2024 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-38269982

RESUMEN

Clinical trial enrollment is impeded by the significant time burden placed on research coordinators screening eligible patients. With 50,000 new cancer cases every year, the Veterans Health Administration (VHA) has made increased access for Veterans to high-quality clinical trials a priority. To aid in this effort, we worked with research coordinators to build the MPACT (Matching Patients to Accelerate Clinical Trials) platform with a goal of improving efficiency in the screening process. MPACT supports both a trial prescreening workflow and a screening workflow, employing Natural Language Processing and Data Science methods to produce reliable phenotypes of trial eligibility criteria. MPACT also has a functionality to track a patient's eligibility status over time. Qualitative feedback has been promising with users reporting a reduction in time spent on identifying eligible patients.


Asunto(s)
Neoplasias , Tecnología , Humanos , Flujo de Trabajo , Ciencia de los Datos , Determinación de la Elegibilidad , Neoplasias/diagnóstico , Neoplasias/terapia
13.
Eur Radiol ; 34(1): 588-599, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37553487

RESUMEN

OBJECTIVES: Angioarchitectural analysis of brain arteriovenous malformations (BAVMs) is qualitative and subject to interpretation. This study quantified the morphology of and signal changes in the nidal and perinidal areas by using MR radiomics and compared the performance of MR radiomics and angioarchitectural analysis in detecting epileptic BAVMs. MATERIALS AND METHODS: From 2010 to 2020, a total of 111 patients with supratentorial BAVMs were retrospectively included and grouped in accordance with the initial presentation of seizure. Patients' angiograms and MR imaging results were analyzed to determine the corresponding angioarchitecture. The BAVM nidus was contoured on time-of-flight MR angiography images. The perinidal brain parenchyma was contoured on T2-weighted images, followed by radiomic analysis. Logistic regression analysis was performed to determine the independent risk factors for seizure. ROC curve analysis, decision curve analysis (DCA), and calibration curve were performed to compare the performance of angioarchitecture-based and radiomics-based models in diagnosing epileptic BAVMs. RESULTS: In multivariate analyses, low sphericity (OR: 2012.07, p = .04) and angiogenesis (OR: 5.30, p = .01) were independently associated with a high risk of seizure after adjustment for age, sex, temporal location, and nidal volume. The AUC for the angioarchitecture-based, MR radiomics-based, and combined models was 0.672, 0.817, and 0.794, respectively. DCA confirmed the clinical utility of the MR radiomics-based and combined models. CONCLUSIONS: Low nidal sphericity and angiogenesis were associated with high seizure risk in patients with BAVMs. MR radiomics-derived tools may be used for noninvasive and objective measurement for evaluating the risk of seizure due to BAVM. CLINICAL RELEVANCE STATEMENT: Low nidal sphericity was associated with high seizure risk in patients with brain arteriovenous malformation and MR radiomics may be used as a noninvasive and objective measurement method for evaluating seizure risk in patients with brain arteriovenous malformation. KEY POINTS: • Low nidal sphericity was associated with high seizure risk in patients with brain arteriovenous malformation. • The performance of MR radiomics in detecting epileptic brain arteriovenous malformations was more satisfactory than that of angioarchitectural analysis. • MR radiomics may be used as a noninvasive and objective measurement method for evaluating seizure risk in patients with brain arteriovenous malformation.


Asunto(s)
Malformaciones Arteriovenosas Intracraneales , Radiómica , Humanos , Estudios Retrospectivos , Imagen por Resonancia Magnética , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Convulsiones/diagnóstico por imagen , Convulsiones/complicaciones , Malformaciones Arteriovenosas Intracraneales/complicaciones , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Angiografía por Resonancia Magnética , Espectroscopía de Resonancia Magnética
14.
J Neuroradiol ; 51(1): 66-73, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37364746

RESUMEN

BACKGROUND: Although radiotherapy is common for head/neck and chest cancers (HNCC), it can result in post-irradiation stenosis of the subclavian artery (PISSA). The efficacy of percutaneous transluminal angioplasty and stenting (PTAS) to treat severe PISSA is not well-clarified. AIMS: To compare the technical safety and outcomes of PTAS between patients with severe PISSA (RT group) and radiation-naïve counterparts (non-RT group). METHODS: During 2000 and 2021, we retrospectively enrolled patients with severe symptomatic stenosis (>60%) of the subclavian artery who underwent PTAS. The rate of new recent vertebrobasilar ischaemic lesions (NRVBIL), diagnosed on diffusion-weight imaging (DWI) within 24 h of postprocedural brain MRI; symptom relief; and long-term stent patency were compared between the two groups. RESULTS: Technical success was achieved in all 61 patients in the two groups. Compared with the non-RT group (44 cases, 44 lesions), the RT group (17 cases, 18 lesions) had longer stenoses (22.1 vs 11.1 mm, P = 0.003), more ulcerative plaques (38.9% vs 9.1%, P = 0.010), and more medial- or distal-segment stenoses (44.4% vs 9.1%, P<0.001). The technical safety and outcome between the non-RT group and the RT group were NRVBIL on DWI of periprocedural brain MRI 30.0% vs 23.1%, P = 0.727; symptom recurrence rate (mean follow-up 67.1 ± 50.0 months) 2.3% vs 11.8%, P = 0.185; and significant in-stent restenosis rate (>50%) 2.3% vs 11.1%, P = 0.200. CONCLUSION: The technical safety and outcome of PTAS for PISSA were not inferior to those of radiation-naïve counterparts. PTAS for PISSA is an effective treatment for medically refractory ischaemic symptoms of HNCC patients with PISSA.


Asunto(s)
Angioplastia de Balón , Arteria Subclavia , Humanos , Constricción Patológica , Arteria Subclavia/diagnóstico por imagen , Estudios de Casos y Controles , Estudios Retrospectivos , Angioplastia/métodos , Resultado del Tratamiento , Stents
15.
Ann Neurol ; 95(3): 583-595, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38055324

RESUMEN

OBJECTIVE: This study was undertaken to investigate migraine glymphatic and meningeal lymphatic vessel (mLV) functions. METHODS: Migraine patients and healthy controls (HCs) were prospectively recruited between 2020 and 2023. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index for glymphatics and dynamic contrast-enhanced magnetic resonance imaging parameters (time to peak [TTP]/enhancement integral [EI]/mean time to enhance [MTE]) for para-superior sagittal (paraSSS)-mLV or paratransverse sinus (paraTS)-mLV in episodic migraine (EM), chronic migraine (CM), and CM with and without medication-overuse headache (MOH) were analyzed. DTI-ALPS correlations with clinical parameters (migraine severity [numeric rating scale]/disability [Migraine Disability Assessment (MIDAS)]/bodily pain [Widespread Pain Index]/sleep quality [Pittsburgh Sleep Quality Index (PSQI)]) were examined. RESULTS: In total, 175 subjects (112 migraine + 63 HCs) were investigated. DTI-ALPS values were lower in CM (median [interquartile range] = 0.64 [0.12]) than in EM (0.71 [0.13], p = 0.005) and HCs (0.71 [0.09], p = 0.004). CM with MOH (0.63 [0.07]) had lower DTI-ALPS values than CM without MOH (0.73 [0.12], p < 0.001). Furthermore, CM had longer TTP (paraSSS-mLV: 55.8 [12.9] vs 40.0 [7.6], p < 0.001; paraTS-mLV: 51.2 [8.1] vs 44.0 [3.3], p = 0.002), EI (paraSSS-mLV: 45.5 [42.0] vs 16.1 [9.2], p < 0.001), and MTE (paraSSS-mLV: 253.7 [6.7] vs 248.4 [13.8], p < 0.001; paraTS-mLV: 252.0 [6.2] vs 249.7 [1.2], p < 0.001) than EM patients. The MIDAS (p = 0.002) and PSQI (p = 0.002) were negatively correlated with DTI-ALPS index after Bonferroni corrections (p < q = 0.01). INTERPRETATION: CM patients, particularly those with MOH, have glymphatic and meningeal lymphatic dysfunctions, which are highly clinically relevant and may implicate pathogenesis for migraine chronification. ANN NEUROL 2024;95:583-595.


Asunto(s)
Vasos Linfáticos , Trastornos Migrañosos , Humanos , Trastornos Migrañosos/diagnóstico por imagen , Evaluación de la Discapacidad , Procesamiento de Imagen Asistido por Computador , Dolor
16.
Artículo en Inglés | MEDLINE | ID: mdl-38050021

RESUMEN

Veterans are at an increased risk for prostate cancer, a disease with extraordinary clinical and molecular heterogeneity, compared with the general population. However, little is known about the underlying molecular heterogeneity within the veteran population and its impact on patient management and treatment. Using clinical and targeted tumor sequencing data from the National Veterans Affairs health system, we conducted a retrospective cohort study on 45 patients with advanced prostate cancer in the Veterans Precision Oncology Data Commons (VPODC), most of whom were metastatic castration-resistant. We characterized the mutational burden in this cohort and conducted unsupervised clustering analysis to stratify patients by molecular alterations. Veterans with prostate cancer exhibited a mutational landscape broadly similar to prior studies, including KMT2A and NOTCH1 mutations associated with neuroendocrine prostate cancer phenotype, previously reported to be enriched in veterans. We also identified several potential novel mutations in PTEN, MSH6, VHL, SMO, and ABL1 Hierarchical clustering analysis revealed two subgroups containing therapeutically targetable molecular features with novel mutational signatures distinct from those reported in the Catalogue of Somatic Mutations in Cancer database. The clustering approach presented in this study can potentially be used to clinically stratify patients based on their distinct mutational profiles and identify actionable somatic mutations for precision oncology.


Asunto(s)
Neoplasias de la Próstata , Veteranos , Masculino , Humanos , Estudios Retrospectivos , Medicina de Precisión , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/patología , Oncología Médica , Mutación
18.
J Formos Med Assoc ; 2023 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-37996326

RESUMEN

BACKGROUND: The Iconographical Falls Efficacy Scale (Icon-FES) uses short phrases and images to depict activities. This study culturally adapted and validated the Taiwan Chinese version of the 30- and 10-item Icon-FESs (Icon-FESs [TW]) in community-dwelling older individuals. METHODS: The Icon-FES (TW) was developed using forward-backward translation. A total of 120 community-dwelling older individuals were recruited. They completed the Taiwan Chinese version of the Falls Efficacy Scale-International (FES-I [TC]), the Icon-FES (TW), the Mini-Mental State Examination, and the World Health Organization Quality of Life Questionnaire Brief Version (WHOQOL-BREF) and were assessed using the Berg Balance Scale and the Short Physical Performance Battery (SPPB). The Icon-FES (TW) was recompleted 1 week later. Confirmatory factor analysis was used to evaluate the overall structure and measurement properties. RESULTS: Cronbach's alpha values of 0.97 and 0.91 indicated that the 30- and 10-item Icon-FESs (TW) had high internal consistency. The 30- and 10-item Icon-FESs (TW) exhibited significantly high correlation with the FES-I (r = 0.88 and 0.84, respectively). Both versions of the Icon-FES (TW) exhibited mild correlation with the physical domain of the WHOQOL-BREF. The 30- and 10-item Icon-FESs (TW) discriminated by intensity of concern and SPPB score. Their test-retest reliability was high (intraclass correlation coefficient = 0.79 and 0.80 for the 30- and 10-item Icon-FESs (TW), respectively). Neither floor nor ceiling effects were observed. CONCLUSION: The Icon-FES (TW) is a reliable and valid questionnaire useful for assessing the levels of concern regarding falling among older adults in clinical practice and research.

19.
Environ Sci Pollut Res Int ; 30(51): 110431-110460, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37789221

RESUMEN

With the intention of separating benzene (C6H6) from indoor polluted air and collecting it in a cleaner way, it is promising of getting C6H6 adsorbed on activated carbon materials with outstanding physicochemical properties. In this study, how C6H6 is adsorbed over single-wall carbon materials and relevant adsorption processes are enhanced is thoroughly investigated via density functional theory (DFT). Especially, distinction between partial and whole effects of adsorbents on C6H6 adsorption, features of electron distribution across section of adsorption forms, and regulation mechanism of nonsteady-state adsorption for C6H6 are key points. According to calculation results, C6H6 molecules could be captured by pure single-wall carbon nanotube (CNT) through repulsive forces (quantified as 103.42 kJ/mol) from all quarters, which makes it stay in nonsteady-state adsorption forms and easily run into free state. Therefore, when external temperature increases from 0 to 300 K, molecular movement will be intense enough to help C6H6 break into another random positions instead of statistically remaining immobile. As for this problem, single-wall CNTs are modified through making defects and replacing some C atoms with N atoms, respectively. In this way, surficial electron distribution of modified adsorbents is regulated to tremendously cut down repulsive forces (quantified as 50.30 kJ/mol) and reverse nonsteady-state adsorption into near-equilibrium quasi-steady-state adsorption (single-side attraction near 100 kJ/mol). Therefore, this research would provide useful information for exploiting single-wall carbon materials as effective adsorbents of C6H6 in order to quickly achieve indoor air purification.


Asunto(s)
Contaminación del Aire , Nanotubos de Carbono , Benceno/química , Adsorción , Temperatura , Nanotubos de Carbono/química
20.
Nat Commun ; 14(1): 5561, 2023 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-37689789

RESUMEN

Silicon-stereogenic optically active silylboranes could potentially allow the formation of chiral silyl nucleophiles as well as the synthesis of various chiral silicon compounds. However, the synthesis of such silicon-stereogenic silylboranes has not been achieved so far. Here, we report the synthesis of silicon-stereogenic optically active silylboranes via a stereospecific Pt(PPh3)4-catalyzed Si-H borylation of chiral hydrosilanes, which are synthesized by stoichiometric and catalytic asymmetric synthesis, in high yield and very high or perfect enantiospecificity (99% es in one case, and >99% es in the others) with retention of the configuration. Furthermore, we report a practical approach to generate silicon-stereogenic silyl nucleophiles with high enantiopurity and configurational stability using MeLi activation. This protocol is suitable for the stereospecific and general synthesis of silicon-stereogenic trialkyl-, dialkylbenzyl-, dialkylaryl-, diarylalkyl-, and alkylary benzyloxy-substituted silylboranes and their corresponding silyl nucleophiles with excellent enantiospecificity (>99% es except one case of 99% es). Transition-metal-catalyzed C-Si bond-forming cross-coupling reactions and conjugate-addition reactions are also demonstrated. The mechanisms underlying the stability and reactivity of such chiral silyl anion were investigated by combining NMR spectroscopy and DFT calculations.

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