Geometric Parameter Analysis of Ruptured and Unruptured Aneurysms in Patients with Symmetric Bilateral Intracranial Aneurysms: A Multicenter CT Angiography Study.

BACKGROUND AND PURPOSE: Previous studies of geometric and morphologic parameters of intracranial aneurysms have been conducted to determine rupture risk, which remains incompletely defined due to patient-specific risk factors, such as sex, hypertension, and age. To this end, we compared characteristics of ruptured and unruptured aneurysms in the same patients with symmetric bilateral intracranial aneurysms. MATERIALS AND METHODS: Between January 2008 and March 2014, 2361 patients with 2674 aneurysms were diagnosed by CT angiography or surgical findings at 4 medical centers. Geometric and morphologic parameters examined for symmetric bilateral intracranial aneurysms comprised aneurysm wall regularity, size, neck width, aspect ratio, size ratio, neck-to-parent artery ratio, and area ratio. Univariate and multivariate statistical analyses were performed to determine independent risk factors for rupture. RESULTS: Sixty-three patients (48 women, 15 men; mean age, 62.5 ± 9.8 years) with symmetric bilateral aneurysms were eligible for the study and were included. The most frequent aneurysm location was the posterior communicating artery. Univariate analysis disclosed that aneurysm size, aspect ratio, size ratio, area ratio, and irregular wall differed between patients with ruptured and unruptured aneurysms. Multivariate analysis indicated that aspect ratio of ≥1.6 (adjusted OR, 9.521; 95% CI, 2.182-41.535), area ratio of ≥1.5 (adjusted OR, 4.089; 95% CI, 1.247-13.406), and irregular shape (adjusted OR, 10.443; 95% CI 3.394-32.135) were significant predictive factors for aneurysm rupture after adjustment for aneurysm size. CONCLUSIONS: An aspect ratio of ≥1.6, area ratio of ≥1.5, and irregular wall are associated with aneurysm rupture independent of aneurysm size and patient characteristics. These characteristics alone can help in distinguishing ruptured bilateral intracranial aneurysms from unruptured ones.

A new area in the human brain associated with learning and memory: immunohistochemical and functional MRI analysis.

Previous studies identified a new brain area, the marginal division (MrD), at the caudomedial border of the neostriatum in the brain of the rat, cat and monkey. The MrD was distinguishable from the rest of the striatum by the presence of spindle-shaped neurons, specific connections, and dense immunoreactivity for neuropeptides and monoamines in fibers, terminals and neuronal somata. Behavioral testing demonstrated that the MrD contributes to learning and memory in the rat. In the present study, the structure and the function of the MrD were investigated in the human brain. The presence of spindle-shaped neurons and the distribution of neurotransmitters in the MrD were evaluated by immunocytochemical methods. The function of the MrD was identified with functional magnetic resonance imaging (fMRI) of healthy volunteers tested with an auditory digital working memory task. Highly active areas were observed in the prefrontal cortex and MrD with left sided predominance during performance of the task, but other parts of the neostriatum were not excited and the MrD was not activated in a control test of non-working memory. The results of the present investigation therefore indicate the existence of a new area associated with learning and memory function in the human brain. The MrD probably plays an important role in the execution of digital working memory and appears to link the limbic system and the basal nucleus of Meynert. The MrD may also be involved in the mechanism of Alzheimer's disease.

[Effects and mechanism of thrombin on the expression of tissue factor activity in cultured bovine aortic endothelial cells].

OBJECTIVE: To explore the effects and mechanism of thrombin on the expression of tissue factor (TF) activity in cultured bovine aortic endothelial cells(BAECs). METHODS: BAECs were cultured according to Schwartz's method, and one stage clotting time assay was used to measure TF activity. RESULTS: 1. Thrombin enhanced the expression of TF activity in cultured BAECs. 2. A23187, a calcium ionophore, induced slightly the expression of TF activity, but markedly promoted the thrombin-induced TF activity in BAECs(P < 0.05). 3. TFP, a Ca2+/CaM inhibitor, inhibited the inductive effects of thrombin. 4. Pentoxifylline, a phosphodiesterase inhibitor, inhibited thrombin-induced TF activity in BAECs. CONCLUSION: Thrombin can induce the expression of TF activity in cultured BAECs, and the processes of signal transduction may be associated with Ca2+/CaM-dependent pathway and cAMP.

[Effects of Buyang huanwu decoction on the release of vWF and the expression of tissue factor induced by tumor necrosis factor alpha in cultured bovine aortic endothelial cells].

OBJECTIVE: To study the effects of Buyang huanwu decoction (BHD) on the release of von Willebrand factor(vWF) and the expression of tissue factor(TF) activity induced by tumor necrosis factor alpha (TNF alpha) in cultured bovine aortic endothelial cells (BAECs). METHODS: BAECs from neonatal cox were cultured and 4-8 passages were used. Cells were incubated for 8 hours after addition of different treatments. The supernatant was used to measure vWF and BAECs lysate to determine TF activity. RESULTS: 1. Compared with the control, TNF alpha enhanced the expression of TF activity(12.79 +/- 2.59 vs. 4.69 +/- 0.83, P < 0.01) and the effects were in dose-dependent manner(r = 0.9712, P < 0.01); BHD inhibited the effects of TNF alpha(P < 0.01). 2. Compared with the control, TNF alpha promoted the release of vWF from endothelial cells (13.28 +/- 4.76 vs. 6.42 +/- 2.84, P < 0.01) and BHD inhibited the effect of TNF alpha(P < 0.01). CONCLUSION: BHD can inhibit the expression of TF and the release of vWF induced by TNF alpha.

["Bu-yang huanwu tang" inhibited the pathogentic process of atherosclerosis induced by cholesterol-rich diet in rabbits].

BACKGROUND AND OBJECTIVE: "Bu-yang huanwu tang", a decoction of Chinese herbs widely used in the treatment for cardio- and cerebro-vascular diseases, has been demonstrated to be able to inhibit platelet adhesion and aggregation, to lower blood lipids, to regulate vascular tone from animal experiments. The aim of this study is to determine whether this decoction inhibits the pathogentic process of atherosclerosis induced by cholesterol-rich diet in rabbits. METHODS: Three groups of rabbits received the following different diets for 9 weeks: 1. standard diet; 2. atherogenic diet(standard diet plus 1% cholesterol and 3.3% fat); 3. atherogenic diet plus this decoction(5 g.kg-1.d-1). Plasma lipids, 6-keto-PGF1 alpha, endothelin levels were detected and the histological atherosclerotic changes were evaluated. RESULTS: This decoction inhibited the progression of aortic and abdominal aortic intimal plaques and reduced aortic intimal thickening. CONCLUSION: The anti-atherogenic mechanism might be related to the decrease of plasma cholesterol and triglycerides and the increase of PGI2. The facts suggest that "Bu-yang huanwu tang" has antiatherogenic and antithrombotic effects.

[Expression of tissue factor of astrocytes and its signal transductional pathways].

The aim of this study was to observe the expression of tissue factor (TF) of astrocytes in basic culture medium and under the condition stimulated by thrombin and to explore the relevant signal transduction pathways. The results showed that 4-bromo calcium ionophore (A23187) and phorbol 12-myristate 13-acetate (PMA) enhanced significantly the TF expression of astrocytes, but the expression was decreased markedly by trifluoperazine (TFP) and 1-(5-isoquinolinyl sulfonyl)-3-methyl-piperazine (H7) in the basic medium. Thrombin increased significantly the TF expression of astrocytes, which was obviously inhibited by TFP and H7. The results above indicate that astrocytes can express TF activity in the basic medium, which is promoted by thrombin, probably through some pathways involving Ca2+/CaM and protein kinase C (PKC).

[Therapeutic effect of verapamil in hypertension: an analysis of 52 cases].

Fifty-two cases of hypertension were treated with verapamil. The obvious effective rate was 86.5% and the total effective rate 98.1%. The antihypertensive effect of verapamil was confirmed, as compared with nifedipine. A preliminary approach of the dosage of verapamil showed that a total dose of 120-240 mg daily could achieve satisfactory result clinically in most patients.