Acute paraplegia following embolization of spinal dural arteriovenous fistula / 中华医学杂志(英文版)

Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.

Expression of ubiquitin conjugating enzyme UbcH10 in brain astrocytomas / 中华神经医学杂志

Objective To investigate the expression ofubiquitin conjugating enzyme UbcH10 gene at mRNA and protein levels in brain astrocytomas and its correlation to the pathological grades of astrocytomas. Methods Quantitative real-time RT-PCR analysis, immunohistochemistry and Western blot were performed to detect the expression of UbcH10 mRNA and protein in 32 astrocytomas of different pathological grades and 6 normal brain tissues. The correlation between UbcH10 and Ki-67 immunoreactivity was examined with the Spearman's correlation coefficient. Results Statistical analysis showed significantly increased expression levels of UbcH1O mRNA in high-grade astrocytornas (64.33±60.98) in comparison with those in low-grade astrocytomas (8.36±8.15) and normal brain tissues (1.00±1.57) (P<0.05). increased UbcH10 labeling index in immunohistochemistry was also noted in high-grade astrocytomas [(9.65±5.75)%] as compared with that in low-grade astrocytomas [(4.82± 3.30)%] (P<0.05) and normal brain tissues [0%, P<0.05). Western blot demonstrated significantly higher UbcH10 protein levels in high-grade astrocytomas (0.69±0.38) than in low-grade astrocytomas (0.10±0.08, P<0.05) and normal brain tissues (0.01±0.02, P<0.05). UbcH10 positivity rate was found to positively correlate to that of Ki-67 (r=0.67, P=0.000). Conclusion Overexpression of UbcH10 may play an important role in the development and progression of astrocytomas.

Hemiparesis in carotid cavernous fistulas (CCFs): a case report and review of the literature / 中华创伤杂志(英文版)

Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low), or pathogenesis (direct or indirect). The most commonly adopted classification is that described by Barrow based on arterial supply. Traumatic CCFs are almost always direct shunts between the internal carotid artery (ICA) and the cavernous sinus. General features of CCFs, which may be apparent with any lesion, including bruit, headache, loss of vision, altered mental status and neurological deficits. Some fistulae may present primarily with hemorrhage before any evaluation can be performed. However, hemiparesis has been rarely observed. Only a literature review of Murata et al reported a case of hemiparesis caused by posttraumatic CCF, in which the fistula resulted in venous hypertension and subsequent brainstem congestion. While in our case, cerebral infarction was caused by total steal of the blood flow. The patient recovered after occlusion of the fistula with a detachable balloon.