Borderzone Infarcts and Recurrent Cerebrovascular Events in Symptomatic Intracranial Arterial Stenosis: A Systematic Review and Meta-Analysis / 대한뇌졸중학회지

Background@#and Purpose Intracranial arterial stenosis (ICAS)-related stroke occurs due to three primary mechanisms with distinct infarct patterns: (1) borderzone infarcts (BZI) due to impaired distal perfusion, (2) territorial infarcts due to distal plaque/thrombus embolization, and (3) plaque progression occluding perforators. The objective of the systematic review is to determine whether BZI secondary to ICAS is associated with a higher risk of recurrent stroke or neurological deterioration. @*Methods@#As part of this registered systematic review (CRD42021265230), a comprehensive search was performed to identify relevant papers and conference abstracts (with ≥20 patients) reporting initial infarct patterns and recurrence rates in patients with symptomatic ICAS. Subgroup analyses were performed for studies including any BZI versus isolated BZI and those excluding posterior circulation stroke. The study outcome included neurological deterioration or recurrent stroke during follow-up. For all outcome events, corresponding risk ratios (RRs) and 95% confidence intervals (95% CI) were calculated. @*Results@#A literature search yielded 4,478 records with 32 selected during the title/abstract triage for full text; 11 met inclusion criteria and 8 studies were included in the analysis (n=1,219 patients; 341 with BZI). The meta-analysis demonstrated that the RR of outcome in the BZI group compared to the no BZI group was 2.10 (95% CI 1.52–2.90). Limiting the analysis to studies including any BZI, the RR was 2.10 (95% CI 1.38–3.18). For isolated BZI, RR was 2.59 (95% CI 1.24–5.41). RR was 2.96 (95% CI 1.71–5.12) for studies only including anterior circulation stroke patients. @*Conclusion@#This systematic review and meta-analysis suggests that the presence of BZI secondary to ICAS may be an imaging biomarker that predicts neurological deterioration and/or stroke recurrence.

Assessment of Blood Clot Composition by Spectral Optical Coherence Tomography: An In Vitro Study / 신경중재치료의학

Purpose@#Optical coherence tomography (OCT) has the potential for in vivo clot composition characterization in difficult mechanical embolectomy cases. We performed an in vitro study to determine the OCT characteristics of red blood cells (RBCs) and fibrin rich clots. @*Materials and Methods@#Analogues of 5 compositions of clots (5% to 95% RBCs from Group A to E) were created from human blood. The blood mixture was injected into the bifurcation of a 3D printed bifurcated silicone tube. The OPTISTM Integrated System (St. Jude Medical Inc.) was used to identify the magnitude of OCT signals from different compositions of clots. Martius Scarlett Blue trichrome (MSB) staining was performed to confirm the composition of RBCs and fibrin in each clot. @*Results@#Group A and B showed less signal attenuation (less than 30%) from its surface to the inside, which indicated high penetration (low-back scattering). Group C indicated intermediate signal attenuation (60%) from its surface to inside the clots, in which signals were found even at the periphery of the clot. Group D and E were superficially signal rich with more signal attenuation (more than 80%) from its surface to the inside indicating low penetration (high-back scattering). Signal-free shadowing was shown in 3 clots in Group E. MSB staining indicated color change (from red in fibrin-rich clots to yellow in RBC-rich clots). @*Conclusion@#Different compositions of clots can be assessed using OCT. Fibrin-rich clots have homogeneous signals with high penetration, while RBC-rich clots can be recognized as superficially signal rich with low penetration.

unusual case of recurrent gastric cancer long after the first gastrectomy due to adenocarcinoma

The postgastrectomy recurrence rate is as high as 30-65%, with 5-year overall survival rates of <20%. Local recurrence is very common which occurs in 38-45% of cases. The most common sites of locoregional recurrence are the gastric remnant at the anastomosis, the gastric bed, and the regional nodes. The recurrence may occur as early and late events after gastrectomy. Most recurrences are early, within three years of surgery. Numerous studies reported the late recurrences, but most of them having a survival time of less than ten years. This report elucidates a case of recurrent gastric cancer after 24 years postoperatively

Spontaneous transanal protrusion of ventriculoperitoneal catheter: a case report

Ventriculoperitoneal [VP] shunt placement that diverts the cerebrospinal fluid [CSF] into the peritoneal cavity is the most common method of treatment of hydrocephalus. This shunt has a high incidence of malfunction mainly due to catheter obstruction or infection. About 20% of these complications are abdominal that may occur at any time after shunt placement from 1 week to several years. This study reports a case of 2.5-year old child with a history of hydrocephalus who had a VP shunt placed which was protruded from the anus on the day of referral. The patient was treated successfully after extrusion of the shunt through the anus, receiving antibiotics and being carefully observed. He was discharged from the hospital after one week

[In vitro comparison of the shear bond strength of "etch and rinse" vs "self-etch" bonding systems on dentin after "nonvital tooth bleaching"]

Since bleaching causes changes on dental tissue and affects adhesive bond strengths, it is useful to recognize bonding systems which provide higher bond strengths on the dentin after bleaching. Forty eight human sound premolars were selected and sectioned 5mm below the CEJ. In order to do the bleaching process, the access cavity preparation was done and after the excavation of pulp tissue, and placement of the hybrid glass ionomer base at the apex, the teeth were bleached using the 35% hydrogen peroxide for 4 times. The teeth were then embedded in a self-cured acrylic resin and polished to obtain a flat dentin surface. The teeth were assigned into 4 groups according to the adhesive system used [n=12]: group 1: Single Bond [SB], group 2: Prime and Bond NT [P and B], group 3: Clearfil SE Bond [CSE] and group 4: Opti Bond [All in one] [OB]. The adhesive systems were used according to the manufacturer's instructions and a cylinder of composite resin Z100 was overlied. The teeth were thermocycled and the shear bond strength tests were performed in a universal testing machine with cross head speed of 1mm/min. CSE had the highest bond strength [15.18 MPa] and SB had the lowest one [8.10 MPa]. One Way ANOVA and independent sample t-test showed that the difference in bond strength values among the different types or generations of bondings was statistically significant except for the SB and P and B systems [P<0.05]. Within the limitations of this study, it is concluded that two step "self-etch" adhesives [CSE] are preferred to use for the teeth undergoing "Non vital tooth bleaching" with 35% hydrogen peroxide than the one step "self-etch" adhesives [OB] or two step "etch and rinse" adhesives [SB, P and B]

Repair of spinal cord injury by co-transplantation of embryonic stem cell-derived motor neuron and olfactory ensheathing cell

The failure of regeneration after spinal cord injury [SCI] has been attributed to axonal demyelination and neuronal death. Cellular replacement and white matter regeneration are both necessary for SCI repair. In this study, we evaluated the co-transplantation of olfactory ensheathing cells [OEC] and embryonic stem [ES] cell-derived motor neurons [ESMN] on contused SCI. OEC cultured from olfactory nerve rootlets and olfactory bulbs. ESMN was generated by exposing mouse ES cells to retinoic acid and sonic hedgehog. Thirty female rats were used to prepare SCI models in five groups. Control and medium-injected groups was subjected to induce lesion without cell transplantation. OEC or ESMN or both were transplanted into the site of the lesion in other groups. The purity of OEC culture was 95%. Motor neuron progenitor markers [Olig2, Nkx6.1 and Pax6] and motor neuron markers [Is11, Is12 and Hb9] were expressed. Histological analysis showed that significantly more [P<0.001] spinal tissue was spared in OEC, ESMN and OEC+ ESMN groups but the OEC+ ESMN group had a significantly greater percentage of spared tissue and myelination than other groups [P< 0.05]. The numbers of ESMN in co-transplanted group were significantly higher than ESMN group [P<0.05]. A significant [P<0.05] recovery of hindlimb function was observed in rats in the transplanted groups. We found that the co-transplantation of ESMN and OEC into an injured spinal cord has a synergistic effect, promoting neural regeneration, ESMN survival and partial functional recovery

protective effect of vitamin E on locus coeruleus in early model of parkinsons disease in rat: immunoreactivity evidence

Free radical formation and oxidative stress might play an important role in the pathogenesis of Parkinson's disease [PD]. In vitro data indicate that neuromelanin [NM] pigment is formed the excess cytosolic catecholamine that is not accumulated into synaptic vesicles via the vesicular monoamine transporter 2 [VMAT2]. We designed this study to investigate the neuroprotective effects of vitamin E in the early model of PD. Male rats [n = 40] with unbiased rotational behavior were randomly divided into five groups: sham operated group [SH, n = 8], vehicle-treated SH group [SH + V, n = 8], vitamin E-treated SH group [SH + E, n = 8], vehicle-treated lesion group [L + V, n = 8] and vitamin E-treated lesion group [L + E, n = 8]. Unilateral intrastriatal 6-hydroxydopamine [12.5 micro l] lesioned rats were treated intramuscularly with alpha-tocopherol acid succinate [24 I.U/kg, intramuscular [i.m.]] 1 h before surgery and three times per week for 2 month post-surgery. To evaluate the vitamin E pretreatment efficacy, tyrosine hydroxylase [TH] immunoreactivity and immunostaining intensity [ISI] for monoamine transporter 2 were used. TH immunohistochemical analyses showed a reduction of 20% in locus coeruleus [LC] cell number of vitamin E pretreated lesioned group but the cell number dropped to 60% in the lesioned group. The ISI of the cells was measured for VMAT2 in LC. Lesioned groups: 1] had the lowest VMAT2 ISI of all neurons; 2] There was an inverse relationship between VMAT2 ISI and NM pigment in the locus and 3] Neurons with the highest VMAT2 ISI also had high TH ISI. The data support the hypothesis that repeated i.m. administration of vitamin E exerts a protective effect on the LC neurons in the early model of PD

Molecular basis of meiotic maturation and apoptosis of oocytes, sperm-oocyte interactions and early cleavage of embryos in mice, role of phosphatidylinositol 3-kinase, mos, fas-fas ligand, integrin alpha 6 and MAP kinase

The interaction between molecular biology and embryology made an extensive progress in the research on gametogenesis, fertilization and early embryogenesis in mice. In this article, molecules involving in meiotic maturation and apoptosis of oocytes, sperm-oocyte interactions and early cleavage of fertilized embryos in mice are described including our recent following experiments. 1] Phosphatidylinositol 3-kinase and Akt participate in the follicle stimulating hormone-induced meiotic maturation of mouse oocytes. 2] Mos plays a crucial role in normal spindle and chromosome morphology and the reactivation of maturation promoting factor after first meiosis. 3] Follicular atresia is caused by apoptosis and the apoptosis associated with internucleosomal DNA fragmentation is directly regulated by the Fas-Fas ligand system. 4] Integrin alpha 6 beta 1 is involved in sperm-egg binding leading to fusion via direct association of the integrin alpha 6 with sperm. 5] MAP kinase cascade is activated at the M-phase and some MAP kinases other than ERKs are activated during early cleavage of fertilized eggs