ABSTRACT
Objective@#Acute mechanical thrombectomy (AMT) in patients with acute ischemic stroke from large vessel occlusion (LVO) is performed without directly identifying the occluded vessels. In this study, we evaluated whether 1.5 T magnetic resonance imaging (MRI) with 3D-fast imaging employing steady-state acquisition (FIESTA) could visualize the occluded intracranial middle cerebral artery (MCA) and internal carotid artery (ICA) before AMT. @*Methods@#This retrospective study included 21 consecutive patients who underwent time-of-flight magnetic resonance angiography (TOF MRA) and 3D-FIESTA MRI immediately before AMT. The patients also underwent TOF MRA after AMT and achieved TICI 2b or 3 by AMT at our hospital between February 2018 and April 2019. When LVO in the anterior circulation was detected by TOF MRA, 3D-FIESTA MRI was additionally performed. Then, the occluded intracranial MCA and ICA, including their branches, were constructed on the workstation with volume rendering. The obtained images were fused with the TOF MRA images to create combined 3D images. @*Results@#The length and top-to-bottom distance of the affected M1 segment (calculated by the ipsilateral-to-contralateral ratio) were 1.29 and 1.17, respectively, on 3D-FIESTA MRI before AMT and 1.34 and 1.24, respectively, on TOF MRA after AMT. We assessed the number of M2 segments branching from the affected M1/M2 junction and visualized the affected anterior temporal artery. The 3D-FIESTA MRI before AMT and TOF MRA after AMT were consistent in all patients, except for two who moved vigorously during imaging. @*Conclusions@#Images acquired by 1.5T 3D-FIESTA MRI can visualize to predict the existing path of the occluded MCA and ICA before AMT in patients with LVO of the anterior circulation.
ABSTRACT
Objective@#Acute mechanical thrombectomy (AMT) in patients with acute ischemic stroke from large vessel occlusion (LVO) is performed without directly identifying the occluded vessels. In this study, we evaluated whether 1.5 T magnetic resonance imaging (MRI) with 3D-fast imaging employing steady-state acquisition (FIESTA) could visualize the occluded intracranial middle cerebral artery (MCA) and internal carotid artery (ICA) before AMT. @*Methods@#This retrospective study included 21 consecutive patients who underwent time-of-flight magnetic resonance angiography (TOF MRA) and 3D-FIESTA MRI immediately before AMT. The patients also underwent TOF MRA after AMT and achieved TICI 2b or 3 by AMT at our hospital between February 2018 and April 2019. When LVO in the anterior circulation was detected by TOF MRA, 3D-FIESTA MRI was additionally performed. Then, the occluded intracranial MCA and ICA, including their branches, were constructed on the workstation with volume rendering. The obtained images were fused with the TOF MRA images to create combined 3D images. @*Results@#The length and top-to-bottom distance of the affected M1 segment (calculated by the ipsilateral-to-contralateral ratio) were 1.29 and 1.17, respectively, on 3D-FIESTA MRI before AMT and 1.34 and 1.24, respectively, on TOF MRA after AMT. We assessed the number of M2 segments branching from the affected M1/M2 junction and visualized the affected anterior temporal artery. The 3D-FIESTA MRI before AMT and TOF MRA after AMT were consistent in all patients, except for two who moved vigorously during imaging. @*Conclusions@#Images acquired by 1.5T 3D-FIESTA MRI can visualize to predict the existing path of the occluded MCA and ICA before AMT in patients with LVO of the anterior circulation.
ABSTRACT
Background@#Sulfated polysaccharides have specific antiviral activities, which biological mechanism is assumed to the electrostatic interaction between (+)-charged virus surface glycoproteins and (-)-charged sulfate groups. @*Objective@#For the elucidation of the mechanism, several oligopeptides referenced by the sequence of Human Immunodeficiency Virus glycoprotein 120 (HIV gp120) and hemagglutinin (HA) of influenza A and B were synthesized by a peptide synthesizer and the interaction with structurally distinct sulfated polysaccharides such as curdlan sulfate and dextran sulfate was analyzed by SPR. @*Method@#In this study, six oligopeptides were synthesized from the sequence of the V3 loop, C-terminus, and CD4 binding domain in the HIV gp120. Oligopeptide A from the V3 loop comprises 20 amino acids with seven positively charged lysine and arginine in the sequence. The basic amino acids were relatively dispersed along the sequence compared with that of oligopeptide B. Likewise, oligopeptide B from the C–terminus comprises seven lysine and arginine, also oligopeptide of Influenza A/Yamagata HA and Influenza A/Brisbane HA comprises 23 amino acids with eight positively charged lysine and arginine in the sequence. Oligopeptide C from the CD4 binding domain and Influenza B /Hong Kong from the HA comprises one lysine and next to the biotin. The biotinylated peptides were synthesized by a microwave assisted solid phase peptide synthesizer using Fmoc protected amino acids. The peptides were purified by RP-HPLC and identified the structure by using MALDI TOF MS.@*Result@#Peptides A and B from HIV gp120 were found to have interacted strongly with dextran and curdlan sulfates, however, the peptide C without positively charged amino acids showed no interaction. These results suggest that the interaction was due to the electrostatic interaction between negatively charged sulfate groups and positively charged amino groups of the peptides. The results of influenza HAs, influenza A (Yamagata and Brisbane) and B (Hong Kong) viruses, are also presented.@*Conclusion@#Curdlan and dextran sulfates were found to increase the interaction with increasing the molecular weights and degree of sulfation (DS), which were found to be important factors for the antiviral activity of sulfated polysaccharides. Based on the above, suggesting the antivirus mechanism of sulfated polysaccharides to be the electrostatic interaction of negatively charged sulfated polysaccharides and virus surface glycoprotein at the positively charged amino acid regions.
ABSTRACT
Behçet’s disease (BD) is a multisystem inflammatory disease of unknown origin. Rarely, BD occurs together with myelodysplastic syndrome (MDS). Interestingly, it is speculated that these are not simple coexistence but that the etiology of intestinal BD is at least partly derived from MDS itself. Furthermore, there is a relationship between MDS in patients with intestinal BD and trisomy 8. Immunosuppressive agents alone are insufficient to control MDS-associated BD, and many of these patients die of infection or hemorrhage. Surgery is considered for intestinal BD patients who are unresponsive to medical treatment or those with bowel complications such as perforation or persistent bleeding. We report a case of intestinal BD associated with MDS and trisomy 8. The patient was unresponsive to oral steroids and immunosuppressive treatment; the patient improved by surgical repair of a bowel perforation. Five years after the surgery, the patient is free of recurrence and not on medication. Our experience suggests that surgery may provide an effective therapeutic option for the treatment of MDS-related BD.