Analysis of risk factors of pituitary neoplasms invading the sphenoidal sinus.

High-resolution computed tomography (HR-CT) can more effectively discern the relationship between pituitary neoplasms (PNs) and neighboring anatomical structures. Moreover, pathological features can facilitate a more accurate determination of the growth pattern of PNs. Consequently, integrating imaging and pathological data might enhance our predictive capability regarding the growth patterns of PNs and aid in the formulation of surgical plans. We compared HR-CT images of 54 patients and 52 volunteers. Using ITK-SNAP software, we segmented and reconstructed the anatomical features of the sphenoidal sinus (SS) and calculated its volume. A comparative analysis of the invasive attributes of the 54 PNs was carried out based on clinical features and pathological data. The average volume of the SS in the volunteer group was 11.05 (8.10) mL, significantly larger than that of the PNs group at 7.45 (4.88) mL (P = .005). The postsellar type was the most common pneumatization type, and a significantly higher proportion in the PNs group exhibited a depressed saddle base (83.3%). A notable male predominance was observed for SS invasion in the PNs group (72.7%), with the Ki-67 antigen and maximum diameter significantly higher (P < .05), showing a positive correlation. The optimal cutoff points for Ki-67 antigen and the maximum diameter of PNs were 3.25% (AUC = 0.754, Sensitivity 54.5%, Specificity 90.6%) and 24.5 mm (AUC = 0.854, Sensitivity 86.4%, Specificity 78.1%), respectively. The type of pneumatization and the morphology of the sellar-floor serve as anatomical foundations for SS invasion. Factors such as the Ki-67 antigen, the maximum diameter of PNs, and high-risk sub-types constitute risk factors for PNs invasion into the SS. These insights are of significant utility for clinicians in crafting treatment strategies for PNs.

Emergent Management of Tandem Occlusions in Anterior Circulation Stroke: A Single-Centre Experience.

OBJECTIVE: For anterior circulation tandem occlusions, the optimal management strategy for extracranial carotid lesions is controversial. We aimed to compare the efficacy and safety of acute stenting (AS) with balloon angioplasty (BA) only. METHODS: Clinical data were collected from 98 patients with anterior circulation tandem occlusion who underwent endovascular treatment at our center. Of these patients, 64 and 34 were assigned to the AS and BA groups, respectively. The clinical characteristics and outcome data of the 2 groups were analyzed and compared. RESULTS: The proportion of patients with good outcomes was 59.2%. The AS group had a higher rate of successful recanalization (98.4% vs. 82.4%, P = 0.007) and a lower rate of occlusion of the responsible vessel at 90 days (14.1% vs. 32.4%, P = 0.039) than the BA group. The AS group was also significantly better than the BA group in terms of good outcomes (67.2% vs. 44.1%, P = 0.027), but there was no significant difference between the 2 groups in terms of 90-day mortality (6.3% vs. 8.8%, P = 0.691) and asymptomatic intracranial hemorrhage (6.3% vs. 5.9%, P = 1.000). Lower baseline National Institutes of Health Stroke Scale scores were associated with good outcomes (P < 0.001), and the presence of symptomatic intracranial hemorrhage was associated with 90-day mortality (P = 0.003). CONCLUSIONS: Acute stent placement in patients with acute ischemic stroke due to anterior circulation tandem occlusion may have a better outcome than BA alone, and the safety of both approaches is comparable.

MRI Study on the Relationship Between Nerve and Blood Vessel in Unilateral Angiogenic Trigeminal Neuralgia.

BACKGROUND: Trigeminal neuralgia (TN) is a common cranial nerve disease. OBJECTIVE: To investigate the relationship between the trigeminal nerve and the responsible blood vessel in patients with unilateral vascular trigeminal neuralgia (VTN). METHODS: Thirty patients with unilateral VTN were confirmed by microvascular decompression. RESULTS: Among the 30 patients, the responsible blood vessels were present in 30 cases on the affected side and 17 cases on the uninfected side (1). The location of the intersection of the trigeminal nerve and the responsible blood vessel: the affected side is located 2/5 behind the trigeminal nerve cisternal segment; the healthy side is located 3/5 anterior to the cisternal segment (2). Symptomatic vessels were located within the cistern between the origin and 2/5ths of the cistern length, and non-symptomatic vessels were located beyond the 2/5ths location (3). Direction of intersection: on the affected side, the responsible vessel was located inside and above the trigeminal nerve in 27 cases, (27/30, 90%), and outside and below the trigeminal nerve in 3 cases (3/30, 10%). On the unaffected side, the responsible vessel was located inside and above the nerve in 16 cases (16/17, 94%) and outside and below the nerve in 1 case (1/17, 5.8%) (4). Intersection form: 3 cases (3/30, 10%) on the affected side, the responsible blood vessel contacted the trigeminal nerve, in 26 cases (26/30, 86%) the responsible blood vessel compressed the trigeminal nerve, and in 1 case (1/30, 5%) the responsible blood vessel caused the trigeminal nerve to be twisted; 8 cases (8/17, 47%) of the contralateral side contacted the trigeminal nerve with the responsible blood vessel, and in 9 cases (9/17, 53%) the responsible blood vessel compressed the trigeminal nerve. CONCLUSION: Patients with unilateral VTN have differences in the location and form of the intersection of the trigeminal nerve and the responsible vessel on the affected side and the contralateral side.

A clinical application study of a stent placement assessment.

BACKGROUND: Atherosclerotic acute carotid occlusion is a specific type of stroke, and controversy exists regarding the surgical strategy, that is, whether an internal carotid artery stent should be placed immediately after opening the occluded vessel. There is no objective evaluation system for this procedure. In a previous study, we summarized an evaluation decision system Emergent Carotid Artery Stent placement decision Evaluation System (ECASES) for emergency stent placement. STUDY DESIGN: This is a prospective, single-center, randomized controlled trial. Patients with acute ischemic stroke caused by atherosclerotic carotid artery occlusion confirmed by imaging (computed tomography/magnetic resonance angiography/digital subtraction angiography) will be randomly divided into the study and control groups, with 101 patients in each group. The study group will undergo surgery according to the ECASES system and the control group will undergo surgery according to the operator's experience. The postoperative outcomes of the 2 groups will be compared. STUDY OUTCOMES: Primary outcome: Neurological functional status (modified Rankin Scale and National Institutes of Health Stroke Scale scores) of patients 90 days postoperatively. Secondary outcomes: neurological function changes, hemorrhage events, cerebral edema, postoperative modified treatment in cerebral infarction grade, new cerebral infarction, and reocclusion of responsible vessels. DISCUSSION: Currently, no prospective controlled data exist regarding the efficacy and safety of carotid stenting in the acute phase. Previously, we had developed an ECASES stent placement system for acute carotid artery occlusion. The present study will evaluate the efficacy and safety of ECASES in a randomized, double-blind prospective study and clarify its guiding significance in acute atherosclerotic carotid artery occlusion surgery.

Gangliosides profiling in serum of breast cancer patient: GM3 as a potential diagnostic biomarker.

Gangliosides altered during the pathological conditions and particularly in cancers. Here, we aimed to profile the gangliosides in breast cancer serum and propose potential biomarkers. LC-FTMS method was first used to identify all the ganglioside species in serum, then LC-MS/MS-MRM method was employed to quantitate the levels of gangliosides in serum from healthy volunteers and patients with benign breast tumor or breast cancer. 49 ganglioside species were determined, including GM1, GM2, GM3, GD1, GD3 and GT1 species. Compared to healthy volunteers, the levels of GM1, GM2, GM3, GD1 and GD3 displayed a rising trend in breast cancer patients. In particular, as the major glycosphingolipid component, GM3 showed excellent diagnostic accuracy in cancer serum (AUC > 0.9). PCA profile of the GM3 species showed clear distinction between normal and cancer serum. What's more, ROC curve proved great diagnostic accuracy of GM3 between cancer and benign serum. In addition, GM3 was discovered as a diagnostic marker to differentiate luminal B subtype from other subtypes. Furthermore, a positive correlation between GM3 and Ki-67 status of patients was identified. In conclusion, our results introduced the alteration patterns of serum gangliosides in breast cancer and suggested serum GM3 as a potential diagnostic biomarker in breast cancer diagnosis and luminal B subtype distinction.

Duplicated middle cerebral artery origin with an aneurysm.

RATIONALE: Middle cerebral artery (MCA) anomalies are relatively rare and often related to aneurysms. Familiarity with these anomalies is important in resolving problems that arise in the complex angioarchitecture. Reports often describe that aneurysms that are related to accessory or duplicated MCA are often located at its origin. PATIENT CONCERNS: A 59-year-old man presented with a headache for 10 days, without nausea and vomiting. The physical examination was negative. DIAGNOSIS: A computed tomography (CT) scan revealed an intracerebral hematoma in the deep right frontal lobe, near the caudate nucleus. Digital subtraction angiography (DSA) revealed an anomalous duplicated origin of the right MCA, with occlusion of the main MCA trunk as well as twisting and dilation of the accessory MCA trunk. A wide-necked aneurysm was located at a sharp curve of the tortuous accessory MCA trunk. A ruptured aneurysm related to a duplicated MCA origin was diagnosed. INTERVENTIONS: Open surgery was rejected by the patient; hence, palliative endovascular coil embolization of the larger daughter sac was performed. OUTCOMES: The postoperative course was uneventful. There was no rebleeding at 8-months follow-up. LESSONS: MCA anomalies are relatively rare and often related to aneurysms. It is important to be familiar with these anomalies as related lesions often manifest within a complex angioarchitecture. Aneurysms at the trunk of an anomalous MCA are a rare entity and open surgery may be recommended.

Overexpression of long non-coding RNA MEG3 suppresses breast cancer cell proliferation, invasion, and angiogenesis through AKT pathway.

Long non-coding RNA MEG3 has been identified as a tumor suppressor which plays important roles in tumorigenesis; however, its potential role in breast cancer has not been fully examined. Here, we showed that MEG3 was downregulated in breast cancer tissues and cell lines. Overexpression of MEG3 inhibited breast cancer cell proliferation and invasion, suggesting that MEG3 played an important role in breast cancer progression and metastasis. Moreover, MEG3 upregulation caused marked inhibition of angiogenesis-related factor expression. Conditioned medium derived from MEG3 overexpressed breast cancer cells significantly decreased the capillary tube formation of endothelial cells. Furthermore, elevated expression of MEG3 in breast cancer inhibits in vivo tumorigenesis and angiogenesis in a nude mouse xenograft model. Mechanistically, overexpression of MEG3 results in downregulation of AKT signaling, which is pivotal for breast cancer cell growth, invasion, and tumor angiogenesis. Collectively, these results suggest that MEG3 might suppress the tumor growth and angiogenesis via AKT signaling pathway and MEG3 may serve as a potential novel diagnostic and therapeutic target of breast cancer.

Effects of oxygen functional groups on the enhancement of the hydrogen spillover of Pd-doped activated carbon.

The hydrogen storage performance of Pd-doped oxidized activated carbon (Pd/AC-ox) with various oxygen contents or functional groups was investigated. The surface chemistry of the Pd/AC-ox sample was modified by treatment with hydrogen gas. Temperature-programmed desorption was performed to characterize the oxygen functional groups in each sample. In this study, low- and high-pressure hydrogen adsorption isotherm experiments were conducted using a static volumetric measurement at room temperature (RT) and pressures of up to 8 MPa. The results showed that increasing the oxygen content and functional groups on the surface of the Pd/AC-ox significantly improved the reversible RT hydrogen storage capacity due to the spillover effect. The hydrogen spillover enhancement factors at 0.12 MPa were greater than 100% for all samples. The hydrogen uptake of Pd/AC-ox1 at RT and 8 MPa with an oxygen content of 8.94 wt.% was 0.37 wt.%, which was 48% greater than that of Pd-free AC-ox (0.25 wt.%). In addition, the hydrogen uptake of Pd/AC-ox3 with lower oxygen contents demonstrates that the hydrogen spillover enhancement gradually disappears when the pressure is increased to more than 2 MPa (i.e., a transition from spillover to physisorption). The surface diffusion, or reversible adsorption, of the spiltover H atoms, which is enhanced by oxygen functional groups, was affected by a threshold amount of oxygen groups (such as hydroxyl groups).

Evidence for ambient-temperature reversible catalytic hydrogenation in Pt-doped carbons.

In situ high-pressure Raman spectroscopy, with corroborating density functional calculations, is used to probe C-H chemical bonds formed when dissociated hydrogen diffuses from a platinum nanocatalyst to three distinct graphenic surfaces. At ambient temperature, hydrogenation and dehydrogenation are reversible in the combined presence of an active catalyst and oxygen heteroatoms. Hydrogenation apparently occurs through surface diffusion in a chemisorbed state, while dehydrogenation requires diffusion of the chemisorbed species back to an active catalyst.

Nanostructure and hydrogen spillover of bridged metal-organic frameworks.

The metal-organic frameworks (MOF) with low and medium specific surface areas (SSA) were shown to be able to adsorb hydrogen via bridged spillover at room temperature (RT) up to an amount of full coverage of hydrogen in the MOF. Anomalous small-angle X-ray scattering was employed to investigate the key relationship between the structures and storage properties of the involved materials. It was found that the tunable imperfect lattice defects and the 3D pore network in the MOF crystal are the most critical structures for RT hydrogen uptake rather than the known micropores in the crystal, SSA, and Pt catalyst structure.

Characterization of pore structure in metal-organic framework by small-angle X-ray scattering.

MOF-5-like crystals were studied by small-angle X-ray scattering (SAXS) to reveal, both quantitatively and qualitatively, their real structural details, including pore surface characteristics, pore shape, size distribution, specific surface area (SSA), spatial distribution, and pore-network structure. A combined SAXS and wide-angle X-ray scattering (WAXS) experiment was conducted to investigate the variation of the pore structure with the MOF-5 crystalline phase produced at different cooling rates. The SSA of the MOF-5 crystals synthesized herein spanned a broad range from approximately 3100 to 800 m2/g. The real pore structures were divided into two regimes. In regime I the material consisted mainly of micropores of radius approximately 8 A as well as mesopores of radius 120 approximately 80 A. The structure in regime II was a fractal network of aggregated mesopores with radius >or=32 A as the monomer, reducing SSA and hydrogen uptake capacity at room temperature. The two regimes can be manipulated by controlling the synthesis parameters. The concurrent evolution of pore structure and crystalline phase during heating for solvent removal was also revealed by the in-situ SAXS/WAXS measurement. The understanding of the impact of the real pore structure on the properties is important to establish a favorable synthetic approach for markedly improving the hydrogen storage capacity of MOF-5.