India China Trade Relations Impact on Economy: A Review Study

In this paper I have studies that both China and India have an extended history of international trade going back centuries ago, both their economies were until recently highly protected and controlled to a large extent albeit that their political systems are very different. China is still a very unique case in the sense that while it has allowed its economy to be opened to Capitalists MNCs, it is still governed by the Communist Party with a strong leadership not giving away state power. China and India are two neighboring countries in Asia who share the two largest population of the world and in fact added together they represent nearly one third of humanity. Globalization has imposed internal pressure and external pressure to bear on both India and China. For most Chinese and Indians alike, economic life is hard despite the fact that reforms and globalization have created various new opportunities

Revascularizacion cerebral en el moyamoya del adulto / Cerebral revascularization in adult moyamoya

Introducción: el Moyamoya (MM) es una enfermedad crónica esteno-oclusiva de los vasos arteriales intracraneanos asociado al desarrollo secundario de arteriolas dilatadas en la base del cerebro. La historia natural de la enfermedad predispone a infartos y/o hemorragias cerebrales. El objetivo del presente trabajo es mostrar nuestra experiencia en el manejo quirúrgico del MM del adulto. Material y método: se realizó una revisión retrospectiva de 11 pacientes adultos con diagnóstico de MM tratados entre mayo 2014 y mayo 2020. Se analizaron las historias clínicas, estudios diagnósticos, protocolos y videos operatorios. En el preoperatorio se utilizó la escala angiográfica de Suzuki y para la valoración clínica pre y postoperatoria la escala de Rankin modificada. Resultados: se operaron 11 pacientes (8 femeninos), 9 son portadores de EMM y 2 con SMM secundario a NF1 y enfermedad de Hashimoto. Se realizaron 16 procedimientos de revascularización en 11 pacientes (en 5 pacientes la revascularización cerebral fue bilateral), 12 fueron combinados (bpTS más EDMS) y en 4 sólo sinangiosis tipo EDAMS.El aumento del flujo sanguíneo cerebral se constató en todos los casos mediante ADC luego de los 6 meses de la cirugía. La permeabilidad del bpTS se comprobó en 10 de 12 bpTS (83.3 %) y la revascularización de la sinangiosis fue muy buena en todos los pacientes. El 82 % de los pacientes mejoraron un punto o más en la escala de Rankin y un paciente presentó un infarto frontal en TAC postoperatoria sin repercusión clínica. Conclusiones: la evolución natural de la enfermedad conduce al deterioro neurológico por ACV isquémico y/o hemorrágico. En nuestra experiencia, la mejor opción terapéutica en el adulto es la revascularización cerebral combinada porque disminuye la incidencia de ACV con resultados favorables y escasa morbilidad

Introduction: Moyamoya is a chronic steno-occlusive disease of the intracranial vessels associated to the secondary development of dilated arterioles at the base of the brain. The natural history of the disease predisposes to cerebral infarcts and/or hemorrhages. The objective of this paper is to show our experience and surgical management of adult moyamoya. Materials and Methods: retrospective review of 11 adult patients with moyamoya treated from May 2014 to May 2020 was performed. Clinical charts, neuroimaging studies, operative records and surgical videos were analyzed. The Suzuki scale was used as a preoperative score, and the modified Rankin scale was used for pre and postoperative clinical assessment. Results: Eleven patients (8 females) were operated at our Institution: 9 are MMD and 2 MMS secondary to NF1 and Hashimoto disease. We performed 16 cerebral revascularizations in 11 patients (in 5 patients thecerebral revascularization was bilateral), 12 were combined (STA-MCA bypass plus EDMS) and in only 4 EDAMS synangiosis was done.The increase in cerebral blood flow was verified in all cases by follow-up DSA at 6 months. The STA-MCA bypass permeability was verified in 10 of 12 cases (83.3%) and the revascularization by synangiosis was demonstrated in all patients. Clinical follow-up showed that 82 % of the patients improved one point or more on the modified Rankin scale and one patient presented a frontal infarction on postoperative CT without clinical worsening. Conclusions: The natural course of the disease leads to neurological deterioration due to ischemic and hemorrhagic stroke. According to our experience, the best therapeutic option in adults is combined cerebral revascularization because it decreases the incidence of stroke with good results and low morbidity

Rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis technique / 器官移植

Objective To explore the feasibility of rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis (MCA) technique. Methods Twelve healthy adult crossbred dogs were evenly divided into the MCA and hand suturing (HS) groups according to the anastomosis method between abdominal aorta and artificial blood vessels. The intraoperative duration of abdominal aorta occlusion, intraoperative condition of anastomotic stoma and postoperative imaging examination of anastomotic stoma were compared between two groups. Results The intraoperative duration of abdominal aorta occlusion in the MCA group was significantly shorter than that in the HS group [(5.2±2.3) min vs. (24.4±4.3) min, P < 0.001]. No anastomotic leakage of blood or anastomotic stenosis occurred in the MCA group during the operation. Intraoperative anastomotic leakage of blood occurred in all of the 6 dogs in the HS group. Among them, 1 dog died of excessive blood loss, and 2 dogs experienced mild anastomotic stenosis due to repeated repair. Postoperative color Doppler ultrasound and angiography showed smooth blood flow at the anastomotic stoma without stenosis or thrombosis in the MCA group. In the HS group, 4 dogs presented with anastomotic stenosis on angiography at postoperative 4 weeks. Conclusions MCA technique may achieve rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models, which reduces the incidence of anastomotic complications and accelerates postoperative recovery.

Decompressive craniectomy for malignant middle cerebral artery territory infarct: an institutional experience

Background: Decompressive craniectomy is the surgical procedure to reduce intracranial pressure, refractory to medical measures. We have described our experience associated with the clinical profile, radiological profile, postoperative status and long term outcome in patients with malignant middle cerebral artery (MCA) territory infarct.Methods: Data were collected from patients who underwent hemispheric decompressive craniectomy for malignant MCA territory infarct in our hospital from May 2014 to June 2019. Clinical, radiological, surgical profile and long term outcome were studied.Results: There were a total of 51 patients aged between 28 years to 76 years. Hypertension (70%) was the most common comorbidity associated. All the patients had at least one focal neurological deficit at the time of presentation. Mean time from the first symptoms to surgery was 2.4 days (about 58 hours). 7 patients died within one month of the surgery. Two third improved objectively within 1 month of surgery. Out of 44 patients, who survived beyond one month, none of the patients were functionally independent after one year of surgery (modified Rankin scale (mRS) of 0 or 1). The patients had a mean mRS of 3.8 at one year.Conclusions: Over several decades decompressive craniectomy has been found to be the most effective measure to reduce mortality and morbidity associated with malignant MCA territory infarct. Early surgery (<48 hours) in patients with good Glasgow Coma scale score reduces the mortality. Larger multicentric trials are required to look at the long term effect on morbidity and mortality.

Análise do efeito do tratamento com nanopartículas de prata (AGNO3 ) revestidas com pectina sobre a angiogênese induzida pelas células do Tumor de Ehrlich em modelo da membrana corioalantoidea / Analysis of the effect of treatment of silver nanoparticles (AgNO3 ) with pectin-coated on ehrlich tumor cell-induced angiogenes in the chorioalantoid membrane model

Avaliou-se a interferência das nanopartículas de prata sobre a angiogênese relacionada ao crescimento tumoral. A pesquisa científica foi realizada através da incubação de 42 ovos embrionados de galinhas. Após 24 horas de incubação, esses mesmos ovos foram separados em seis grupos contendo sete ovos cada, para os tratamentos com: Grupo 1: Soro fisiológico; Grupo 2: Tumor de Ehrlich (TE); Grupo 3: Nanopartículas de prata; Grupo 4: Prednisolona; Grupo 5: Nanopartículas de prata e Tumor de Ehrlich; Grupo 6: Prednisolona e Tumor de Ehrlich. Após o tempo total de incubação, as membranas corioalantoideas (MCAs) foram removidas, e analisadas através do microscópio de luz e fotografadas. O grupo 1 apresentou um padrão normal de crescimento e foi utilizado como controle negativo; O grupo 2 apresentou um aumento na quantidade de vasos sanguíneos; o grupo 3 apresentou baixa interferência na angiogenese embrionária e não contribuiu para o desenvolvimento do tumor; O grupo 4 demonstrou diminuição no desenvolvimento de vasos sanguíneos; O grupo 5 indicou que as nanopartículas de prata, quando associadas ao TE, não favorece o desenvolvimento tumoral e o grupo 6 demonstrou que o fármaco prednisolona associado ao TE, se comporta como um excelente inibidor de neoangiogese tumoral. Considera-se através da técnica realizada a possibilidade de utilizar nanopartículas de prata para o tratamento de células tumorais de Ehrlich, porém devem ser realizados testes confirmatórios para estudar a relação da substância descrita às células tumorais empregadas.

The interference of silver nanoparticles on angiogenesis related to tumor growth was evaluated. Scientific research was carried out by incubating 42 embryonated chicken eggs. After 24 hours of incubation, these same eggs were separated into six groups containing seven eggs each, for treatments with: Group 1: Saline; Group 2: Ehrlich's tumor (ET); Group 3: Silver nanoparticles; Group 4: Prednisolone; Group 5: Silver nanoparticles and Ehrlich's Tumor; Group 6: Prednisolone and Ehrlich's Tumor. After the total incubation time, the chorioallantoid membranes (MCAs) were removed, and analyzed using a light microscope and photographed. Group 1 showed a normal growth pattern and was used as a negative control; Group 2 showed an increase in the amount of blood vessels; group 3 showed low interference in embryonic angiogenesis and did not contribute to the development of the tumor; Group 4 demonstrated a decrease in the development of blood vessels; Group 5 indicated that silver nanoparticles, when associated with TE, do not favor tumor development and group 6 demonstrated that the drug prednisolone associated with TE, behaves as an excellent inhibitor of tumor neoangiogenesis. Through the technique performed, the possibility of using silver nanoparticles for the treatment of Ehrlich tumor cells is considered, however, confirmatory tests should be performed to study the relationship of the substance described to the tumor cells employed.

Establishment and evaluation of a monkey acute cerebral ischemia model

OBJECTIVES: Cerebral ischemia seriously threatens human health and is characterized by high rates of incidence, disability and death. Developing an ideal animal model of cerebral ischemia that reflects the human clinical features is critical for pathological studies and clinical research. The goal of this study is to establish a local cerebral ischemia model in rhesus macaque, thereby providing an optimal animal model to study cerebral ischemia. METHODS: Eight healthy rhesus monkeys were selected for this study. CT scans were performed before the operation to exclude cerebral vascular and intracranial lesions. Under guidance and monitoring with digital subtraction angiography (DSA), a microcatheter was inserted into the M1 segment of the middle cerebral artery (MCA) via the femoral artery. Then, autologous white thrombi were introduced to block blood flow. Immediately following embolization, multisequence MRI was used to monitor cerebrovascular and brain parenchymal conditions. Twenty-four hours after embolization, 2 monkeys were sacrificed and subjected to perfusion, fixation and pathological examination. RESULTS: The cerebral ischemia model was established in 7 rhesus monkeys; one animal died during intubation. DSA and magnetic resonance angiography (MRA) indicated the presence of an arterial occlusion. MRI showed acute local cerebral ischemia. HE staining revealed infarct lesions formed in the brain tissues, and thrombi were present in the cerebral artery. CONCLUSION: We established a rhesus macaque model of local cerebral ischemia by autologous thrombus placement. This model has important implications for basic and clinical research on cerebral ischemia. MRI and DSA can evaluate the models to ensure accuracy and effectiveness.

Assessing cytotoxicity and antiproliferation effects of Sida rhombifolia against MCA-B1 and A549 cancer cells

This research aims to determine the cytotoxicity and antiproliferation activities of Sida rhombifolia leavesextract against cancer cells MCA-B1, A549, and normal Vero cells. Sida rhombifolia leaves were extractedwith ethanol using ultrasonication method and fractionated using n-hexane, ethyl acetate, and water. The testedsamples were ethanol extract and n-hexane fraction based on the results of cytotoxicity using the Brine ShrimpLethality Test. The antiproliferation activity test by using Trypan Blue Dye method and the cells harvested afterconfluence on the third or fourth day and the total cells were calculated by using the Neubauer Hemocytometer.The result showed that the inhibitory activity of ethanol extract at a concentration of 500 ppm is 69.44% withIC50 202.556 ppm on MCA-B1 cancer cells and 69.44% with IC50 276.836 ppm on A549 cancer cells, whilethe n-hexane fraction at a concentration of 1,000 ppm was 64.13% with IC50 425.969 ppm in MCA-B1 cancercells and 57.18% with IC50 786.617 ppm on A549 cancer cells. After being tested on normal Vero cells, theinhibition of normal Vero cells proliferation is not more than 1%. This indicates that ethanol extracts andn-hexane fraction are safe for normal cells and analysis by using LC-MS/MS showed a benzazepine compoundin the ethanol extract of S. rhombifolia is known for its role as antiproliferation. These results indicate thatS. rhombifolia leaves extract has the potential to be developed as anticancer compounds..

Multidisciplinary treatment discussion of a personalized approach of laparoscopic right hemicolectomy for variant middle colic artery and ileocolic vein / 中国肿瘤临床

Objective: To investigate the variants of middle colic artery (MCA) and ileocolic vein (ICV) and their influence on the deci-sion regarding approach of laparoscopic right hemicolectomy. Methods: We analyzed the diagnosis and treatment of one right colon cancer patient with variant MCA and ICV who was admitted to the Tianjin Medical University Cancer Hospital in March 2018. The pa-tient underwent laparoscopic right hemicolectomy via a limited medial approach after a multidisciplinary treatment (MDT) discussion. Following were the observation indicators: 1) surgical and postoperative recovery situations; 2) postoperative pathological examina-tion; and 3) follow-up situation. Results: 1) Surgical and postoperative recovery situations: the patient successfully underwent laparo-scopic right hemicolectomy via a limited medial approach. No intraoperative or postoperative complications occurred. Duration of postoperative hospital stay was 11 days. 2) Postoperative pathological examination: the number of dissected lymph nodes was 39. Postoperative pathological tumor stage was pT3N0. Postoperative pathological tumor type was moderately differentiated adenocarci-noma. 3) Follow-up situation: the patient was followed-up for 10 months with disease-free survival. Conclusions: Individual and stan-dard surgery will be the best choice for treating colon cancer patients. MDT can facilitate clinical decision-making and benefit patients.

A Clinical Study On Topographical Analysis Of Vascular Territories In Stroke With Clinical And Etiopathogenesis

Stroke incidence is currently increasing in India, compared to Western countries. Mostly it’s attributed to risk factors like hypertension, diabetes, smoking, and dyslipidemia and alcohol consumption. Risk factors are poorly controlled with insufficient infrastructure and inadequate public awareness, poor rehabilitation services contributes for increasing prevalence of the stroke with disability. This clinical study focussed on topographical analysis of vascular territories involved in stroke with clinical and etipathogeneis contributing stroke.

#meuprimeiroassédio: interações de mulheres violadas / #myfirstharassment: interactions of raped women

O rompimento da integridade física, psíquica, moral e sexual do indivíduo configura-se em um ato de violência. Mulheres de todas as idades frequentemente são vítimas de violência exercida pela "força-potência-dominação" empregada por homens e respaldada pela cultura patriarcal, que estabelece relações hierárquicas assimétricas entre os gêneros. Gênero é uma construção social que naturaliza condutas de ambos os sexos. Comumente utiliza-se a terminologia "violência de gênero" como sinônimo de violência contra a mulher. Além desse uso não evidenciar para qual dos lados, feminino ou masculino, o vetor da dominação aponta, ele também não denuncia como a dominação masculina ocorre e não analisa as relações homem-mulher resultantes deste controle. De forma a preencher essa lacuna, este trabalho utiliza o embasamento teórico-conceitual de violência patriarcal contra a mulher para problematizar as análises deste estudo, evitando dúvidas em relação a como se configura o vetor de força-potência-dominação. O assédio sexual pode ser definido como qualquer forma de violência de natureza sexual, seja por meio de agressão física ou verbal, seja por meio de outros tipos de agressão; o assédio é uma via de manifestação do poder masculino sobre o feminino. No entanto, pesquisas mostram que mulheres não reconhecem o assédio como uma violência sexual, tampouco identificam situações que configuram assédio. A partir de um episódio de assédio sexual realizado na internet contra uma criança, o projeto feminista Think Olga criou a mobilização #MeuPrimeiroAssédio buscando promover o debate para a desnaturalização de violência sexual contra a mulheres. Esta pesquisa busca identificar as identidades reveladas a partir dos papéis sociais esperados de homens e mulheres pela cultura patriarcal nas interações ocorridas via publicações de participantes da mobilização #MeuPrimeiroAssédio. É um estudo de análise de dados naturalísticos amparado na Comunicação Mediada por Computador e pelo recorte metodológico êmico da Análise de Categorizações de Pertença e de Análise da Conversa. A análise das interações revelou três categorizações de pertença: (a) Meninas: infância, socialização, percepções e culpa, evidenciando a "socialização de gênero das meninas", "como as meninas vêem o abusador" e "a culpa relatada pelas meninas", (b) Mulher Ideal, revelando as identidades de "mulher bela", "mãe ideal" e "mulher obrigada a perdoar" e (c) Mulheres corajosas, imunes e educadoras, apresentando as identidades "mulheres corajosas", "mulheres imunes" e "mulheres educadoras". Outras possíveis categorizações podem ser buscadas nas interações que fizeram parte deste estudo e, espera-se que estes achados possam contribuir para melhorar o entendimento acerca do assédio sexual que acontece em nossa sociedade.

The breaking of physical, psychological, moral and sexual integrity of the individual is an act of violence. Women of all ages are often victims of violence exercised by the "force-power-domination" employed by men and backed up by patriarchal culture, which establishes asymmetrical hierarchical relations between genders. Gender is a social construction that naturalizes conduct of both sexes. The term "gender violence" is commonly used as synonym for violence against women. Besides not evincing which side, either male or female, the vector of domination points to, this terminology also does not denounce how male domination occurs and does not analyze man-woman relations resulting from this control. In order to fill this gap, this work uses the theoretical-conceptual basis of patriarchal violence against women to discuss the analysis of this study, avoiding doubts regarding how the force-power-domination vector is configured. Sexual harassment can be defined as any form of sexual violence, whether through physical or verbal aggression or through other types of aggression; harassment is a way of manifestation of male power over the feminine. However, researches show that women do not recognize harassment as sexual violence, nor do they identify situations that constitute harassment. From an online sexual harassment episode against a child, the feminist project Think Olga created the #MeuPrimeiroAssédio (#MyFirstHarassment) mobilization to promote the debate on the denaturalization of sexual violence against women. This research aims to identify the identities revealed from the expected social roles of men and women by the patriarchal culture in the interactions that took place via the publications of participants of the mobilization #MeuPrimeiroAssédio. It is a study of naturalistic data analysis based on the Computer-Mediated Communication (CMC) and the methodological cutoff of the Membership Categorization Analysis (MCA) and Conversation Analysis (CA). The analysis of the interactions revealed three Membership Categorizations: (a) Girls: childhood, socialization, perceptions and guilt, evidencing the "gender socialization of girls", "how girls see the abuse perpetrator" and "guilt reported by girls" (b) Ideal Woman, revealing the identities of "beautiful woman," "ideal mother" and "woman obligated to forgive," and (c) courageous, immune and educating women, presenting the identities "brave women", "immune women" and "Educating women". Other possible categorizations can be sought in the interactions that were part of this study, and it is hoped that these findings may contribute to improve the understanding about sexual harassment that happens in our society.

Emergent Double-barrel Bypass Shortly after Intravenous Administration of Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke

Although intravenous recombinant tissue plasminogen activator (IV rt-PA) is effective in many cases of acute ischemic stroke, the neurologic symptoms can worsen after IV rt-PA because of sustained vessel occlusion. For such cases, several reperfusion modalities are available, including intra-arterial thrombolysis (IAT), carotid endarterectomy, and superficial temporal artery-middle cerebral artery (STA-MCA) bypass. Invasive procedures, such as major surgery, should be generally avoided within 24 hours after the administration of IV rt-PA. A 66-year-old man with no previous medical history developed left hemiparesis. A computed tomography scan revealed no acute lesion and he received IV rt-PA within 1.5 hours after symptom onset. Emergent magnetic resonance imaging showed significant diffusion-perfusion mismatch. He received IAT 2 hours after IV rt-PA administration, but IAT failed because of total occlusion of the cervical internal carotid artery. We initially planned to perform STA-MCA bypass the next morning because he had received IV rt-PA, but, 8 hours after IV rt-PA administration, his hemiparesis worsened from motor grade 3/4 to motor grade 1/2. Because of the large perfusion defect in both MCA divisions, double-barrel STA-MCA bypass was performed 10 hours after IV rt-PA administration. His symptoms rapidly improved after surgery and his modified Rankin Scale score 3 months later was grade 0. We suggest that emergent double-barrel bypass can be a viable option in patients who have perfusion defects of both MCA divisions in acute ischemic stroke after IV rt-PA administration.

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

PURPOSE: Susceptibility vessel sign (SVS) on gradient echo image, which is caused by MR signal loss due to arterial thrombosis, has been reported in acute middle cerebral artery (MCA) infarction. However, the reported sensitivity and diagnostic accuracy of SVS have been variable. Susceptibility-weighted imaging (SWI) is a newly developed MR sequence. Recent studies have found that SWI may be useful in the field of cerebrovascular diseases, especially for detecting the presence of prominent veins, microbleeds and the SVS. The purpose of this study was to evaluate the diagnostic values of SWI for the detection of hyperacute MCA occlusion. MATERIALS AND METHODS: Sixty-nine patients (37 males, 32 females; 46-89 years old [mean, 69.1]) with acute stroke involving the MCA territory underwent MR imaging within 6 hours after the symptom onset. MR examination included T2, FLAIR (fluid-attenuated inversion recovery), DWI, SWI, PWI (perfusion-weighted imaging), contrast-enhanced MR angiography (MRA) and contrast-enhanced T1. Of these patients, 28 patients also underwent digital subtraction angiography (DSA) within 2 hours after MR examination. Presence or absence of SVS on SWI was assessed without knowledge of clinical, DSA and other MR imaging findings. RESULTS: On MRA or DSA, 34 patients (49.3%) showed MCA occlusion. Of these patients, SVS was detected in 30 (88.2%) on SWI. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SWI were 88.2%, 97.1%, 96.8%, 89.5% and 92.8%, respectively. CONCLUSION: SWI was sensitive, specific and accurate for the detection of hyperacute MCA occlusion.

Sequência anemia-policitemia em gêmeos: definição, classificação e tratamento / Twin anemia-polycythemia sequence: definition, classification and treatment

A presença de anastomoses vasculares placentárias nas gestações gemelares monocoriônicas favorece o surgimento de complicações graves como a Síndrome de Transfusão Feto-Fetal (STFF) e a Sequência Anemia-Policitemia em Gêmeos (TAPS). STFF e TAPS são ambas formas crônicas de transfusão feto-fetal. TAPS, descrita em 2007, é caracterizada por anemia crônica no gêmeo doador e policitemia no gêmeo receptor, na ausência de discordância no volume de líquido amniótico, característica da STFF clássica. O diagnóstico pode ser feito pré- e pós-natal. O critério diagnóstico pré-natal é baseado na discordância intergemelar da medida do Doppler do pico de velocidade sistólica da artéria cerebral média (PSV-ACM). O diagnóstico pós-natal é baseado na grande diferença da hemoglobina intergemelar, ao nascimento, e reticulocitose no gêmeo doador.(AU)

The presence of placental vascular anastomoses in monochorionic twins favors the development of several complications like Twin-Twin Transfusion Syndrome (TTTS) and Twin Anemia-Polycythemia Sequence (TAPS). TTTS and TAPS are both chronic forms of fetofetal transfusion. TAPS, described on 2007, is characterized by chronic anemia in the donor twin and polycythemia in the recipient twin, in the absence of amniotic fluid volume discordances, characteristic of classical TTTS. The diagnostic can be made pree posnatally. The prenatal diagnostic criteria is based on the inter-twin discordance in Doppler measurement of peak systolic velocity in the middle cerebral artery (MCA-PSV). The postnatal diagnosis is based on large intertwin hemoglobin difference at birth and retoculocytosis in the donor twin.(AU)

Protein-RNA interactions in Escherichia coli:a genome-wide study / 军事医学

Objective To conduct a pilot study on genome-wide in vivo protein-RNA interactions in E.coli.Methods Bacterial lysate was treated with RNase before the RNA fragments protected by proteins were extracted from treated lysate and used to construct cDNA library that was applied to high-throughput sequencing .Finally, the transcripts bound by proteins were obtained by bioinformatics analysis .Results A total of 3193 transcripts were obtained , including 2234 mRNAs, 47 sRNAs, 39 tRNAs, 11 rRNAs, and 862 intergenic regions .Conclusion Some information of transcripts interacting with proteins in E.coli is acquired , which will facilitate further studies of protein-RNA interactions .

Preliminary Study of Neurocognitive Dysfunction in Adult Moyamoya Disease and Improvement after Superficial Temporal Artery-Middle Cerebral Artery Bypass

OBJECTIVE: Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease of unknown etiology. In addition, the neurocognitive impairment of adults with MMD is infrequently reported and, to date, has not been well described. We attempted to determine both the neurocognitive profile of adult moyamoya disease and whether a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis can improve the neurocognitive impairment in exhibiting hemodynamic disturbance without stroke. METHODS: From September 2010 through November 2012, 12 patients with angiographically diagnosed MMD underwent STA-MCA anastomosis for hemodynamic impairment. Patients with hypoperfusion and impaired cerebrovascular reserve (CVR) capacity but without evidence of ischemic stroke underwent a cognitive function test, the Seoul Neuropsychological Screening Battery (SNSB). Five patients agreed to undergo a follow-up SNSB test. Data from preoperative and postoperative neurocognitive function tests were compared and analyzed. RESULTS: Five of 12 patients were enrolled. The median age was 45 years (range, 24-55 years). A comparison of preoperative to postoperative status of SNSB, memory domain, especially delayed recall showed significant improvement. Although most of the domains showed improvement after surgery, the results were not statistically significant. CONCLUSION: In our preliminary study, large proportions of adult patients with MMD demonstrate disruption of cognitive function. This suggests the possibility of chronic hypoperfusion as a primary cause of the neurocognitive impairment. When preoperative and postoperative status of cognitive function was compared, memory domain showed remarkable improvement. Although further study is needed, neurocognitive impairment may be an indication for earlier intervention with reperfusion procedures that can improve cognitive function.

The Usefulness of the Ivy Sign on Fluid-Attenuated Intensity Recovery Images in Improved Brain Hemodynamic Changes after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis in Adult Patients with Moyamoya Disease

OBJECTIVE: MR perfusion and single photon emission computerized tomography (SPECT) are well known imaging studies to evaluate hemodynamic change between prior to and following superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis in moyamoya disease. But their side effects and invasiveness make discomfort to patients. We evaluated the ivy sign on MR fluid attenuated inversion recovery (FLAIR) images in adult patients with moyamoya disease and compared it with result of SPECT and MR perfusion images. METHODS: We enrolled twelve patients (thirteen cases) who were diagnosed with moyamoya disease and underwent STA-MCA anastomosis at our medical institution during a period ranging from September of 2010 to December of 2012. The presence of the ivy sign on MR FLAIR images was classified as Negative (0), Minimal (1), and Positive (2). Regions were classified into four territories: the anterior cerebral artery (ACA), the anterior MCA, the posterior MCA and the posterior cerebral artery. RESULTS: Ivy signs on preoperative and postoperative MR FLAIR were improved (8 and 4 in the ACA regions, 13 and 4 in the anterior MCA regions and 19 and 9 in the posterior MCA regions). Like this result, the cerebrovascular reserve (CVR) on SPECT was significantly increased in the sum of CVR in same regions after STA-MCA anastomosis. CONCLUSION: After STA-MCA anastomosis, ivy signs were decreased in the cerebral hemisphere. As compared with conventional diagnostic modalities such as SPECT and MR perfusion images, the ivy sign on MR FLAIR is considered as a useful indicator in detecting brain hemodynamic changes between preoperatively and postoperatively in adult moyamoya patients.

Superficial Temporal Artery-Middle Cerebral Artery Anastomosis for Internal Carotid Artery Occlusion by Subacute In-Stent Thrombosis after Carotid Artery Stenting

Alternative to carotid endarterectomy, carotid artery stenting (CAS) can be performed for symptomatic severe stenosis of internal carotid artery, especially for high-risk patients. Among several complications after CAS, subacute in-stent thrombosis is rare but important, because patient's condition can deteriorate rapidly. Subacute in-stent thrombosis with carotid artery occlusion can be managed by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report two cases of STA-MCA anastomosis for internal carotid artery occlusion by subacute in-stent thrombosis after CAS.

The rCBV Ratio Is a Predictive Factor for Developing Malignant Middle Cerebral Artery Infarction within 6 Hours of Symptom Onset / 대한뇌졸중학회지

BACKGROUND: Malignant middle cerebral artery (MCA) infarction is one of the leading cause of death for patients with acute MCA infarction. We investigated the predicting factors for developing malignant MCA infarction (MMI) using multi-parametric magnetic resonance imaging (MRI). METHODS: We included 159 MCA infarction patients who visited Dong-A University Stroke Center from January 2007 to December 2010 and were diagnosed MCA occlusion within 6 hours after symptom onset. All patients underwent brain MRI including diffusion and perfusion-weighted image. The definition of the malignant MCA infarction is as follows: 1) deterioration of neurological symptoms and consciousness with clinical signs of uncal herniation, and 2) at least two-thirds of the MCA territory with compression of ventricles or midline shifting. The neurological deterioration was observed for 7 days. The severity of neurological symptom and clinical outcome were assessed by using National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). RESULTS: Among 159 patients, 49 patients (30.8%) developed MMI. In a multivariate analysis, a larger diffusion volume on diffusion-weighted image, a lower regional cerebral blood volume (rCBV) ratio on perfusion-weighted image, and a higher NIHSS score on admission were identified as the predictive factors of MMI. The cut-off values of diffusion volume, NIHSS on admission and rCBV ratio were 69 mL, 15 points and 0.78. CONCLUSION: A large diffusion volume, a high NIHSS score and particularly a low rCBV ratio can predict a malignant course in MCA infarction within 6 hours of symptom onset in MCA occlusion.

Skills, safety and feasibility of long stent implants in the middle cerebral artery / 中国综合临床

Objective To discuss the skills, safety and feasibility of the long stent implants in the middle cerebral artery in brain. Methods One 58-year-old female patient suffered from recurrent right limb dysfunction was chosen as the subjective. The cerebral angiography showed long stenosis lesions (90%-95% )in left middle cerebral artery from M1 to M2, with the length of 13 - 14 mm and the vascular diameter of 2. 5mm. Under local anesthesia a 2. 5 mm × 15.0 mm rapamycin-eluting stent was implanted into left middle cerebral artery. Results The stent was successfully implanted with no residual stenosis, and with TIMI 3 level blood flow. The patient had no adverse events during 14-month follow up. Conclusion With good implanting skills,long stent implantation in middle cerebral artery is safe and feasible.

Establishing Chronic Stroke Rat Models by MCA Occlusion Using Intraluminal Filament

OBJECTIVE: Focal brain ischemia induced in rats by occlusion of middle cerebral artery (MCA) is a widely used paradigm of human brain infarct. The purpose of this study is to establish chronic stroke model by MCA occlusion using intraluminal filament in rats. METHOD: A total 44 rats were operated by modified Longa's method. The surgical procedure consisted of introducing an intraluminal filament into the internal carotid artery and advancing it intracranially to block blood flow for 60 minutes into MCA. After this procedure motor and postural change were assessed using a 0~5 point grading scale consisted of forelimb, hindlimb and circling test. Behavioral tests such as rotarod, stepping and cylinder tests were examined in the survived rats after MCA occlusion up to 14 weeks post-ischemia. Autopsy was done to evaluate the cerebral infarct volume. RESULTS: Thirteen rats were survived up to 14 weeks post-ischemia and for the severely paralyzed subjects by acute neurological severity scoring were examined with behavioral tests once a week for 14 weeks. Although rotarod test have not shown any specific changes during 14 weeks, stepping and cylinder tests have shown stabilizing pattern since 4 weeks after the procedure. CONCLUSION: MCA occlusion using intraluminal filament could be reliable method to make stroke model in rats. We concluded that 4 weeks post-ischemia by this method in rats might be regarded as chronic model.