Treatment of a fusiform vertebral aneurysm with double stent placement. A technical case report and review of the literature

A 34-year-old man admitted to another hospital presented with sudden onset of headache. The CT scan was unremarkable, but magnetic resonance angiography revealed a fusiform aneurysm in the left vertebral artery. Six days later, the patient was sent to our institution for further diagnosis and treatment. Cerebral angiography confirmed a fusiform aneurysm located in the right vertebral artery. At first, we placed a neuroform-3 stent and could see contrast medium stasis in the aneurysm, so we did not fill coils into the aneurysm. Four months later, the patient was admitted for rechecking. DSA showed the aneurysm remained and we placed a LEO stent in the lumen of the Neuroform stent. A control DSA eight months later showed the aneurysm had almost healed. Overlapping stents may induce spontaneous thrombosis of vertebral artery aneurysms and facilitate parent artery reconstruction through flow remodeling and stent endothelialization. This technique may be an option in treating dissecting or fusiform intracranial aneurysms that are not amenable to open surgical treatment or endovascular coil embolization.

Successful Management of Hemorrhagic Complications during Onyx-18 Embolization of Cerebral Arteriovenous Malformations

The most frequent and devastating complication of the endovascular treatment of cerebral AVMs is hemorrhage. This report describes three patients with cerebral AVM who encountered bleeding during Onyx-18 embolization. The bleeding was discovered promptly during the procedure and hemorrhage quickly prevented using Onyx-18. All three patients recovered without any new neurological symptoms. Early detection and prevention of bleeding are very important during interventional procedures to avoid craniotomy and improve the prognosis of patients.

Effect of fructooligosaccharides and antibiotics on laying performance of chickens and cholesterol content of egg yolk

1. Nine hundred and sixty 25-week-old Lohmann Brown layers were randomly divided into 5 groups with 216 layers in each group. Layers in group one were fed a control diet, group 2 received the control diet plus 20 mg/kg zinc bacitracin and 4 mg/kg colistinsulfate, and the remaining three groups received control diet plus 2000, or 4000, or 6000 mg/kg fructooligosaccharide (FOS). 2. The results showed improvements in egg production, feed consumption and feed conversion of layers when 2000 mg/kg FOS was added to the diets. 3. The results also showed some additional improvements in the group supplemented with 2000 mg/kg FOS, including increases in egg shell thickness, yolk colour and Haugh unit, and decreases in yolk cholesterol concentration. 4. However, larger (excessive) doses of FOS did not improve the performance of layers.

Involvement of cysteinyl leukotriene receptors in angiogenesis in rat thoracic aortic rings

Cysteinyl leukotrienes (CysLTs) are potent inflammatory mediators that induce inflammation through the activation of CysLT1 and CysLT2 receptors. It has been reported that inflammatory mediators, such as prostaglandins, play an important role in angiogenesis. However, whether CysLTs and the receptor subtypes are involved in angiogenesis is not clarified. Here, we determined the effects of CysLT receptor agonist leukotriene D4 (LTD4) and antagonists on angiogenesis by rat thoracic aortic ring assay. We found that the microvessel growth in 25% serum-containing cultures was significantly inhibited by the CysLT1 receptor antagonist montelukast (0.1-1 microM), but not by the CysLT2 receptor antagonist BAY cyslt2 (0.1-1 microM). The microvessel growth in serum-free culture was affected neither by montelukast (0.01-1 microM) nor by BAY cyslt2 (0.1-1 microM). Furthermore, LTD4 at 100 nM significantly enhanced the microvessel growth in serum-free culture and LTD4 at 10-100 nM significantly enhanced the microvessel growth in 25% serum-containing cultures. The enhancement was abrogated by both montelukast and BAY cyslt2. Thus, CysLT1 receptors may mediate endogenously regulated microvessel growth in normal culture; whereas the exogenous agonist LTD4 induces angiogenesis through the activation of both CysLT1 and CysLT2 receptors. The CysLT receptor antagonists can be developed as angiogenesis inhibitors.

Improved ATP supply enhances acid tolerance of Candida glabrata during pyruvic acid production

AIMS

A major problem in industrial fermentation of organic acids with micro-organisms is to ensure a suitable pH in the culture broth. To circumvent this problem, we investigated the effect of citrate, which is a widely used auxiliary energy co-substrate, on cell growth, organic acid production and pH homeostasis among extracellular environment, cytoplasm and vacuole, in the pyruvic acid production by Candida glabrata CCTCC M202019 under different pH conditions.

METHODS AND RESULTS

Analysis of intracellular ATP regeneration, cytoplasmic and vacuolar pH values under different culture conditions points towards a relief of stress when C. glabrata is exposed to lower pH, if citrate is added. When 50 mmol l(-1) citrate was added to the culture medium, the intracellular ATP concentrations increased by 20·5% (pH 5·5), 20·4% (pH 5·0) and 39·3% (pH 4·5), and higher pH gradients among the culture broth, cell cytoplasm and vacuoles resulted. As a consequence, the cell growth and pyruvic acid production of C. glabrata CCTCC M202019 were significantly improved under pH 5·0 and 4·5.

CONCLUSIONS

The acid tolerance of yeast can be improved by enhancing the ATP supply, which helps to maintain higher pH gradients in the system.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results presented here expand our understanding of the physiological characteristics in eukaryotic micro-organisms under low pH conditions and provide a potential route for the further improvement of organic acids production process by process optimization or metabolic engineering.

Delta15N of soil N and plants in a N-saturated, subtropical forest of southern China

We investigated the delta(15)N profile of N (extractable NH(4)(+), NO(3)(-), and organic N (EON)) in the soil of a N-saturated subtropical forest. The order of delta(15)N in the soil was EON > NH(4)(+) > NO(3)(-). Although the delta(15)N of EON had been expected to be similar to that of bulk soil N, it was higher than that of bulk soil N by 5 per thousand. The difference in delta(15)N between bulk soil N and EON (Delta(15)N(bulk-EON)) was correlated significantly with the soil C/N ratio. This correlation implies that carbon availability, which determines the balance between N assimilation and dissimilation of soil microbes, is responsible for the high delta(15)N of EON, as in the case of soil microbial biomass delta(15)N. A thorough delta(15)N survey of available N (NH(4)(+), NO(3)(-), and EON) in the soil profiles from the organic layer to 100 cm depth revealed that the delta(15)N of the available N forms did not fully overlap with the delta(15)N of plants. This mismatch in delta(15)N between that of available N and that of plants reflects apparent isotopic fractionation during N uptake by plants, emphasizing the high N availability in this N-saturated forest.

Myogenic activity in autoregulation during low frequency oscillations

Lower body negative pressure (LBNP) was applied in eight human subjects to trigger low frequency oscillations in order to study the nature of functional coupling between the hemodynamic and autonomic nervous systems, with particular focus on how the myogenic response fits within this coupling. To this end muscle sympathetic nerve activity (MSNA), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) were measured at baseline and during LBNP and were then examined in both the time and frequency domains. At the height of low frequency oscillations (~0.1Hz) there was a strong coupling between all the five indices, marked by perfect alignment of their oscillatory frequencies. Results in the time domain show that a fall in MAP is followed by a fall in TPR at 1.58s SD 0.69), a rise in heart rate at 2.64s (SD 0.98), a rise in cardiac output at 3.72s (SD 0.60), a peak in MSNA at 5.71s (SD 1.27) and, finally, a rise in TPR at 7.13s (SD 1.02). A possible interpretation of the latter is that a drop in MAP first triggers a drop in TPR via a myogenic response before the expected rise in TPR via a rise in MSNA. In other words, following a drop in arterial pressure, myogenic response controls vessel diameter before this control is taken over by MSNA. These findings provide a possible resolution of a longstanding conceptual argument against attributing a significant role for the myogenic response in blood flow autoregulation.

Giant vertebrobasilar aneurysm treated with bilateral vertebral artery occlusion. Two case reports

Giant vertebrobasilar aneurysms constitute a relatively uncommon subgroup of aneurysms with a high mortality rate. These aneurysms are often difficult to treat with conventional clipping or coiling because of their location and their morphology. Here we describe two patients with giant vertebrobasilar aneurysms, both of which were successfully treated with bilateral vertebral artery occlusion. This approach is suggested as a definitive treatment for vertebrobasilar aneurysms in appropriate circumstances.

Localization of muscarinic receptors M1R, M2R and M3R in the human colon

BACKGROUND

Muscarinic acetylcholine receptors (MR) are involved in multiple intestinal reflexes. The cellular localization of subtypes of MRs within enteric circuits mediating muscle and mucosal reflexes remains to be demonstrated. This study aimed to localize the three functionally significant subtypes of MRs in human colon.

METHODS

Reverse transcriptase-PCR was used to determine expression levels of muscarinic receptor subtype (MRs) M1Rs, M2Rs and M3Rs in human colon. Indirect immunofluorescence and confocal microscopy was used to localize MRs in cryostat-cut sections of human colon. Sections were double labeled for multiple cellular and neurochemical markers. Western blotting was used to confirm specificity of the muscarinic antisera used.

KEY RESULTS

All three MR subtypes were expressed in human colon. Immunoreactivity (IR) for M2Rs and M3Rs was most abundant in circular and longitudinal muscle. M1R-IR was most abundant on myenteric and submucosal nerve cells, both cholinergic and nitrergic. M3R-IR was also present on populations on myenteric nerve cell bodies. Immunoreactivity for all three receptors was present on nerve fibers in the circular muscle.

CONCLUSIONS & INFERENCES

In the human colon, subtypes of MRs were present on multiple cell types within the enteric circuits underlying motility, secretory and vasoactive reflexes. The cellular distribution for MRs found in this study agrees with data from functional studies, providing insight into the role MRs have in mediating enteric cholinergic neurotransmission.

Midrapidity antiproton-to-proton ratio in pp collisons at sqrt[s]=0.9 and 7 TeV measured by the ALICE experiment

The ratio of the yields of antiprotons to protons in pp collisions has been measured by the ALICE experiment at sqrt[s]=0.9 and 7 TeV during the initial running periods of the Large Hadron Collider. The measurement covers the transverse momentum interval 0.45<p_{t}<1.05  GeV/c and rapidity |y|<0.5. The ratio is measured to be R_{|y|<0.5}=0.957±0.006(stat)±0.014(syst) at 0.9 TeV and R_{|y|<0.5}=0.991±0.005(stat)±0.014(syst) at 7 TeV and it is independent of both rapidity and transverse momentum. The results are consistent with the conventional model of baryon-number transport and set stringent limits on any additional contributions to baryon-number transfer over very large rapidity intervals in pp collisions.

Production and validation of Putonghua- and Cantonese-Chinese language National Institutes of Health Stroke Scale training and certification videos

BACKGROUND AND PURPOSES

The National Institutes of Health Stroke Scale (NIHSS) is an integral part of acute stroke assessment. We report our experience with new Putonghua- and Cantonese-Chinese language NIHSS (PC-NIHSS and CC-NIHSS) training and certification videos.

METHODS

A professional video production company was hired to create the training and certification videos for both PC-NIHSS and CC-NIHSS. Two training and certification workshops were held in Chengdu and Beijing, and two workshops in Hong Kong. The instruction, training and group A certification videos were presented to workshop attendees. Unweighted kappa statistics were used to measure the agreement among raters, and the inter-rater agreements for PC-NIHSS and CC-NIHSS videos were compared with those of original English language NIHSS (E-NIHSS) videos.

RESULTS

The pass rates using PC-NIHSS and CC-NIHSS videos were 79% and 82%, respectively. All possible responses on individual scale items were included. Facial palsy and limb ataxia (13%) showed poor agreement, nine (60%) to 10 (67%) items showed moderate agreement (0.4<kappa<0.75), and three (20%) to four (27%) items showed excellent agreement. When compared with E-NIHSS videos, the agreements on best gaze, visual fields, facial weakness and aphasia were less for PC-NIHSS videos, and the agreements on commands for level of consciousness and visual fields were less for CC-NIHSS videos. Nevertheless, there was no difference between PC-NIHSS or CC-NIHSS and E-NIHSS videos in the agreement on total score.

CONCLUSIONS

Compared with E-NIHSS videos, PC-NIHSS and CC-NIHSS videos show good content validity and inter-rater reliability. Availability of these videos may facilitate the proper use of NIHSS among physicians and nurses in Putonghua- or Cantonese-speaking communities.

Asymptomatic paraganglioma of the posterior mediastinum misdiagnosed until operation

A 23-year-old female patient was treated for a posterior mediastinal tumor of unknown histology. Her systemic blood pressure increased rapidly to a critical level immediately after starting surgical manipulation of the tumor, which was suggestive of a hyperfunctioning pheochromocytoma. The tumor was removed after controlling the blood pressure and was histologically diagnosed as an extra-adrenal pheochromocytoma. Further postoperative investigations showed the tumor to be a sporadic type through further postoperative investigations and the patient had subsequently an uneventful course.