• 【支架时代黎明时进行的未破裂颅内动脉瘤的线圈栓塞术:日本神经内血管疗法注册中心(JR-NET)的结果3。】 复制标题 收藏 收藏
    DOI:10.2176/nmc.st.2019-0210 复制DOI
    作者列表:Satow T,Ikeda G,Takahashi JC,Iihara K,Sakai N,Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators.
    BACKGROUND & AIMS: :Endosaccular coiling is recognized as a feasible method for treating unruptured intracranial aneurysms (UIAs). We retrospectively reviewed cases of UIAs treated by coiling in the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3, a nationwide survey of NET between 2010 and 2014, the beginning period of intracranial stents in Japan. Data were extracted for 6844 UIAs (6619 procedures) from 40,169 registered records of all NETs in the JR-NET 3 databases. The features of the aneurysms and procedures, immediate radiographic findings, procedure-related complications, and clinical outcomes at 30 days after the procedures were assessed. Of 6844 UIAs, 81.8% were located in the anterior circulation. The mean patient age was 61.3 years (72.4% females). Compared with the preceding JR-NET 1 and 2, there were significant increases (P <0.05) in the rates of the following in JR-NET 3: wide-necked and small UIAs measuring <10 mm (from 56.4% to 58.8%), adjunctive techniques (54.8% to 71.8%), and stent usage (1.1% to 22.1%). Both pre- (85.6% to 96.7%) and post-procedural (84.0% to 94.6%) antiplatelet therapy were more frequently administered in JR-NET 3. Although procedure-related complication rates did not differ between the two groups, ischemic complication rates increased from 4.6% to 5.9%, leading to an increase in the 30-day morbidity (modified Rankin Scale >2) from 2.1% to 2.8%. In conclusion, introduction of neck-bridge stent was associated with an increase in cases of wide-necked aneurysms. However, the ischemic complication rate increased despite the greater use of periprocedural antiplatelet therapy.
    背景与目标: :囊状内盘绕术被认为是治疗未破裂颅内动脉瘤(UIA)的可行方法。我们回顾性研究了日本神经内膜血管治疗注册中心(JR-NET)3中盘绕治疗的UIA病例,JR-NET是2010年至2014年(日本颅内支架起始时期)的全国性NET调查。从JR-NET 3数据库中所有NET的40,169个注册记录中提取了6844个UIA(6619个过程)的数据。评估术后30天的动脉瘤和手术的特征,即时影像学发现,与手术相关的并发症以及临床结局。在6844个UIA中,有81.8%位于前循环中。患者平均年龄为61.3岁(女性为72.4%)。与先前的JR-NET 1和2相比,JR-NET 3中的下列比率显着增加(P <0.05):颈宽小于10 mm的小UIA(从56.4%增至58.8%) ,辅助技术(54.8%至71.8%)和支架使用率(1.1%至22.1%)。在JR-NET 3中,抗血小板治疗前(85.6%至96.7%)和术后(84.0%至94.6%)抗血小板治疗均更频繁。尽管两组的手术相关并发症发生率无差异,但缺血性并发症发生率从4.6%增加到5.9%,导致30天发病率(Rankin量表修正为> 2)从2.1%增加到2.8%。总之,颈桥支架的引入与宽颈动脉瘤病例的增加有关。然而,尽管更多地使用了围手术期抗血小板治疗,但缺血性并发症的发生率却有所增加。
  • 【MORC2通过其C末端卷曲螺旋结构域的二聚化可增强染色质动力学并促进DNA修复。】 复制标题 收藏 收藏
    DOI:10.1186/s12964-019-0477-5 复制DOI
    作者列表:Xie HY,Zhang TM,Hu SY,Shao ZM,Li DQ
    BACKGROUND & AIMS: :Decondesation of the highly compacted chromatin architecture is essential for efficient DNA repair, but how this is achieved remains largely unknown. Here, we report that microrchidia family CW-type zinc finger protein 2 (MORC2), a newly identified ATPase-dependent chromatin remodeling enzyme, is required for nucleosome destabilization after DNA damage through loosening the histone-DNA interaction. Depletion of MORC2 attenuates phosphorylated histone H2AX (γH2AX) focal formation, compromises the recruitment of DNA repair proteins, BRCA1, 53BP1, and Rad51, to sites of DNA damage, and consequently reduces cell survival following treatment with DNA-damaging chemotherapeutic drug camptothecin (CPT). Furthermore, we demonstrate that MORC2 can form a homodimer through its C-terminal coiled-coil (CC) domain, a process that is enhanced in response to CPT-induced DNA damage. Deletion of the C-terminal CC domain in MORC2 disrupts its homodimer formation and impairs its ability to destabilize histone-DNA interaction after DNA damage. Consistently, expression of dimerization-defective MORC2 mutant results in impaired the recruitment of DNA repair proteins to damaged chromatin and decreased cell survival after CPT treatment. Together, these findings uncover a new mechanism for MORC2 in modulating chromatin dynamics and DDR signaling through its c-terminal dimerization.
    背景与目标: :高度紧凑的染色质结构的去污对于有效的DNA修复是必不可少的,但是如何实现这一点仍然未知。在这里,我们报告微裂口虫家族CW型锌指蛋白2(MORC2),一种新鉴定的ATPase依赖的染色质重塑酶,是DNA损伤后通过松散组蛋白-DNA相互作用造成核小体失稳所必需的。 MORC2的耗尽会减弱磷酸化的组蛋白H2AX(γH2AX)的病灶形成,损害DNA修复蛋白,BRCA1、53BP1和Rad51募集到DNA损伤的部位,并因此在用破坏性DNA的治疗药物喜树碱(CPT)处理后降低细胞存活率)。此外,我们证明MORC2可以通过其C末端卷曲螺旋(CC)结构域形成同型二聚体,这一过程在响应CPT诱导的DNA损伤时得到了增强。 DNA损伤后,MORC2中C末端CC结构域的缺失会破坏其同二聚体的形成,并削弱其破坏组蛋白与DNA相互作用的能力。一致地,二聚化缺陷的MORC2突变体的表达导致DNA修复蛋白募集到受损的染色质上受损,并降低了CPT处理后的细胞存活率。这些发现共同揭示了MORC2通过其c端二聚化调节染色质动力学和DDR信号传导的新机制。
  • 【年轻患者血管畸形的可分离球囊阻塞。】 复制标题 收藏 收藏
    DOI:10.1016/0167-5273(96)02707-6 复制DOI
    作者列表:Sreeram N,Miller P,John P
    BACKGROUND & AIMS: :Two patients (11 and 23 months old, respectively) had successful transcatheter occlusion of congenital arterio-venous or veno-venous malformations using detachable silicone balloons. Patient 1 with a cervicofacial hemangioma had selective embolization of the feeding artery with two balloons. Patient 2, with a veno-venous malformation between a systemic vein and pulmonary vein also had selective embolization of the lesion with two balloons. Follow-up examinations confirm a successful outcome in both cases.
    背景与目标: :两名患者(分别为11和23个月大)使用可拆卸的硅胶气球成功地经导管阻塞了先天性动静脉或静脉-静脉畸形。患有宫颈面血管瘤的患者1通过两个球囊选择性地栓塞了供血动脉。在全身静脉和肺静脉之间存在静脉-静脉畸形的患者2,也有两个球囊对病变进行了选择性栓塞。随访检查均证实这两种情况均成功。
  • 【肺动静脉畸形栓塞后使用可拆卸的硅胶球囊进行长期随访。】 复制标题 收藏 收藏
    DOI:10.1007/s00270-007-9256-6 复制DOI
    作者列表:Andersen PE,Kjeldsen AD
    BACKGROUND & AIMS: :Long-term follow-up results after embolization of 13 pulmonary arteriovenous malformations in 10 patients by use of 14 detachable silicone balloons are given. Patients were followed for a mean of 99 months (range, 63-123 months) with chest x-rays and for a mean of 62 months (range, 3-101 months) with pulmonary angiography. Fifty-four percent of the balloons were deflated at latest radiographic chest film follow-up, but at pulmonary angiographic follow-up all embolized malformations were without flow irrespective of whether or not the balloons were visible. Detachable silicone balloons are not available anymore, but use of these balloons for embolization of pulmonary arteriovenous malformations has been shown to be a safe and precise method, with immediate occlusion of the feeding artery and with long-lasting occlusion, even though many balloons deflate with time, leaving a fibrotic scar replacing the pulmonary arteriovenous malformation. No case of recanalization has been discovered, and these results seem to justify a reduced number of controls of these balloon-embolized malformations.
    背景与目标: :通过使用14个可拆卸硅胶球囊对10例患者的13种肺动静脉畸形栓塞后的长期随访结果。对患者进行了平均99个月(63-123个月)的胸部X光检查,对平均62个月(3-101个月)的肺动脉造影进行了随访。在最新的X线胸片随访中,有54%的气球放气,但在肺部血管造影随访中,无论是否可见气球,所有栓塞畸形均无血流。可拆卸的硅胶球囊已不再可用,但已证明将这些球囊用于肺动静脉畸形的栓塞术是一种安全,精确的方法,即使许多球囊会随着时间的推移而feeding缩进食动脉,也可长期闭塞。时间,留下的纤维化疤痕替代了肺动静脉畸形。没有发现再通的病例,这些结果似乎证明减少了这些球囊栓塞畸形对照的数量。
  • 【1.5T轨道的表面线圈磁共振成像。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:1988-11-01
    来源期刊:Rofo
    DOI:10.1055/s-2008-1048391 复制DOI
    作者列表:Wilms G,Marchal G,Decrop E,van Hecke P,Baert A,Dralands G
    BACKGROUND & AIMS: :MRI of the orbit at 1.5-Tesla was performed in 5 healthy volunteers and 30 patients with a variety of pathological intraocular or intraconal conditions. Major advantages of MRI over CT include higher spatial resolution, higher tissue contrast, possibility of direct multiplanar imaging, absence of bony and dental artifacts, and of ionising radiation. Specific indications of MRI in orbital pathology concern differentiation of uveal melanoma from subretinal haemorrhage, identification of lesions of the orbital apex, the orbital fissure or the optic canal, differentiation of inflammatory pseudotumour from malignant lesions, determination of the posterior extension of lesions of the optic nerve, and detection of abnormal flow in normal or hypertrophic intraorbital vessels. Limitations are due to motion artifacts on T2 weighted sequences, less accurate visualisation of calcification, poor specificity of some findings, and absence of signal from cortical bone.
    背景与目标: :在5名健康志愿者和30名患有各种病理性眼内或圆锥内疾病的患者中进行了1.5-Tesla眼眶的MRI检查。 MRI优于CT的主要优点包括更高的空间分辨率,更高的组织对比度,直接多平面成像的可能性,无骨和牙齿伪影以及电离辐射。眼眶病变的MRI特定指征涉及葡萄膜黑色素瘤与视网膜下出血的区别,眼眶顶点,眼眶裂孔或视神经管的病变的识别,炎性假瘤与恶性病变的区别,对视神经病变的向后扩展的确定神经,以及正常或肥大的眶内血管中异常血流的检测。局限性是由于T2加权序列上的运动伪影,钙化的可视化效果较差,某些发现的特异性差以及皮质骨信号缺失所致。
  • 【人工卷曲螺旋蛋白单层的力调制电导。】 复制标题 收藏 收藏
    DOI:10.1002/bip.22181 复制DOI
    作者列表:Atanassov A,Hendler Z,Berkovich I,Ashkenasy G,Ashkenasy N
    BACKGROUND & AIMS: :Studies of charge transport through proteins bridged between two electrodes have been the subject of intense research in recent years. However, the complex structure of proteins makes it difficult to elucidate transport mechanisms, and the use of simple peptide oligomers may be an over simplified model of the proteins. To bridge this structural gap, we present here studies of charge transport through artificial parallel coiled-coil proteins conducted in dry environment. Protein monolayers uniaxially oriented at an angle of ∼ 30° with respect to the surface normal were prepared. Current voltage measurements, obtained using conductive-probe atomic force microscopy, revealed the mechano-electronic behavior of the protein films. It was found that the low voltage conductance of the protein monolayer increases linearly with applied force, mainly due to increase in the tip contact area. Negligible compression of the films for loads below 26 nN allowed estimating a tunneling attenuation factor, β(0) , of 0.5-0.6 Å(-1) , which is akin to charge transfer by tunneling mechanism, despite the comparably large charge transport distance. These studies show that mechano-electronic behavior of proteins can shed light on their complex charge transport mechanisms, and on how these mechanisms depend on the detailed structure of the proteins. Such studies may provide insightful information on charge transfer in biological systems.
    背景与目标: 近年来,通过跨两个电极的蛋白质进行电荷传输的研究一直是研究的重点。但是,蛋白质的复杂结构使得难以阐明转运机制,并且简单肽寡聚物的使用可能是蛋白质的过度简化模型。为了弥合这种结构缺口,我们在这里介绍了在干燥环境中通过人工平行卷曲螺旋蛋白进行电荷传输的研究。制备相对于表面法线单轴取向约30°的蛋白质单分子层。使用导电探针原子力显微镜获得的当前电压测量结果揭示了蛋白质膜的机械电子行为。已经发现,蛋白质单层的低电导率随着施加的力线性增加,这主要是由于尖端接触面积的增加。对于低于26 nN的负载,薄膜的压缩可忽略不计,因此可以估算出隧穿衰减因子β(0)为0.5-0.6Å(-1),尽管电荷传输距离相对较大,但类似于通过隧穿机制进行的电荷转移。这些研究表明,蛋白质的机电行为可以阐明其复杂的电荷传输机制,以及这些机制如何依赖于蛋白质的详细结构。这样的研究可以提供有关生物系统中电荷转移的有见地的信息。
  • 【含有109B的卷曲螺旋结构域是HIF1α调控的基因,对人类神经胶质瘤的进展至关重要。】 复制标题 收藏 收藏
    DOI:10.1186/s12967-017-1266-9 复制DOI
    作者列表:Xu R,Han M,Xu Y,Zhang X,Zhang C,Zhang D,Ji J,Wei Y,Wang S,Huang B,Chen A,Zhang Q,Li W,Sun T,Wang F,Li X,Wang J
    BACKGROUND & AIMS: BACKGROUND:The coiled-coil domain is a structural motif found in proteins that participate in a variety of biological processes. Aberrant expression of such proteins has been shown to be associated with the malignant behavior of human cancers. In this study, we investigated the role of a specific family member, coiled-coil domain containing 109B (CCDC109B), in human gliomas. METHODS AND RESULTS:We confirmed that CCDC109B was highly expressed in high grade gliomas (HGG; WHO III-IV) using immunofluorescence, western blot analysis, immunohistochemistry (IHC) and open databases. Through Cox regression analysis of The Cancer Genome Atlas (TCGA) database, we found that the expression levels of CCDC109B were inversely correlated with patient overall survival and it could serve as a prognostic marker. Then, a serious of cell functional assays were performed in human glioma cell lines, U87MG and U251, which indicated that silencing of CCDC109B attenuated glioma proliferation and migration/invasion both in vitro and in vivo. Notably, IHC staining in primary glioma samples interestingly revealed localization of elevated CCDC109B expression in necrotic areas which are typically hypoxic. Moreover, small interfering RNA (siRNA) and specific inhibiters of HIF1α led to decreased expression of CCDC109B in vitro and in vivo. Transwell assay further showed that CCDC109B is a critical factor in mediating HIF1α-induced glioma cell migration and invasion. CONCLUSION:Our study elucidated a role for CCDC109B as an oncogene and a prognostic marker in human gliomas. CCDC109B may provide a novel therapeutic target for the treatment of human glioma.
    背景与目标: 背景:卷曲螺旋结构域是在参与多种生物学过程的蛋白质中发现的结构基序。已经表明这种蛋白质的异常表达与人类癌症的恶性行为有关。在这项研究中,我们调查了一个特定的家庭成员,包含109B(CCDC109B)的卷曲螺旋域在人类神经胶质瘤中的作用。
    方法和结果:我们使用免疫荧光,免疫印迹分析,免疫组化(IHC)和开放式数据库证实了CCDC109B在高级别胶质瘤(HGG; WHO III-IV)中高表达。通过癌症基因组图谱(TCGA)数据库的Cox回归分析,我们发现CCDC109B的表达水平与患者的总体生存率呈负相关,并且可以作为预后的标志物。然后,在人神经胶质瘤细胞系U87MG和U251中进行了严重的细胞功能测定,这表明CCDC109B的沉默在体外和体内均减弱了神经胶质瘤的增殖和迁移/侵袭。值得注意的是,原发性神经胶质瘤样本中的IHC染色有趣地揭示了在通常缺氧的坏死区域中CCDC109B表达升高的定位。此外,小的干扰RNA(siRNA)和HIF1α的特异性抑制剂导致CCDC109B在体外和体内的表达降低。 Transwell分析进一步表明,CCDC109B是介导HIF1α诱导的神经胶质瘤细胞迁移和侵袭的关键因素。
    结论:我们的研究阐明了CCDC109B在人类神经胶质瘤中作为癌基因和预后标志物的作用。 CCDC109B可为治疗人脑胶质瘤提供新的治疗靶标。
  • 【腔内腹腔动脉瘤修复后10年,致命的盘绕迁移到胃中。】 复制标题 收藏 收藏
    DOI:10.1016/j.jvir.2006.10.003 复制DOI
    作者列表:Dinter DJ,Rexin M,Kaehler G,Neff W
    BACKGROUND & AIMS: :Celiac trunk aneurysms are rare and can be treated with coil embolization. Migration of the coil with erosion of the arterial wall and further perforation to an extravascular structure, although infrequent, can occur. The authors describe a lethal aortogastric fistula in a patient who had undergone embolization of a celiac trunk aneurysm with tungsten coils and alcohol prolamine solution 10 years earlier. Gastroscopy, performed due to acute hematemesis, showed the coil placed 10 years previously inside the stomach without active bleeding. Two days later, the patient died of a recurrent gastrointestinal bleeding. Autopsy showed abscess formation at the celiac trunk resulting in an aortogastric fistula. The authors discuss the possible cause of this remote complication of the embolotherapy.
    背景与目标: :腹腔干动脉瘤很少见,可以用线圈栓塞治疗。尽管不常见,但可能会发生线圈的迁移,并伴有动脉壁的侵蚀,并进一步穿孔至血管外结构。作者描述了在10年前接受钨丝线圈和醇溶谷蛋白胺溶液栓塞的腹腔干动脉瘤栓塞的患者中的致死性主动脉瘘。由于急性呕血而进行的胃镜检查显示,线圈在胃内放置了10年之久,而没有活动性出血。两天后,患者死于胃肠道出血。尸检显示在腹腔干处形成脓肿,导致主动脉瘘。作者讨论了栓塞治疗这种远程并发症的可能原因。
  • 【骨髓来源的细胞中Rho相关的含卷曲螺旋激酶2缺乏导致胆固醇外排增加和动脉粥样硬化减少。】 复制标题 收藏 收藏
    DOI:10.1161/CIRCULATIONAHA.111.086041 复制DOI
    作者列表:Zhou Q,Mei Y,Shoji T,Han X,Kaminski K,Oh GT,Ongusaha PP,Zhang K,Schmitt H,Moser M,Bode C,Liao JK
    BACKGROUND & AIMS: BACKGROUND:Macrophages play a central role in the development of atherosclerosis. However, the signaling pathways that regulate their function are not well understood. The Rho-associated coiled-coil-containing kinases (ROCK1 and ROCK2) are serine-threonine protein kinases that are involved in the regulation of the actin cytoskeleton. Recent studies suggest that ROCK1 in macrophages and bone marrow-derived cells mediates atherogenesis. However, a similar role for ROCK2 in the pathogenesis of atherosclerosis has not been determined. METHODS AND RESULTS:The bone marrows from wild-type, ROCK2(+/-), and ROCK2(-/-) mice were transplanted into irradiated recipient low-density lipoprotein receptor(-/-) mice, and atherosclerosis was induced with a 16-week high-cholesterol diet. Compared with wild-type bone marrow-transplanted mice, ROCK2(+/-) bone marrow-transplanted and ROCK2(-/-) bone marrow-transplanted mice showed substantially less lipid accumulation in the aorta (8.46±1.42% and 9.80±2.34% versus 15.64±1.89%; P<0.01 for both) and decreased atherosclerotic lesions in the subaortic sinus (158.1±44.4 and 330.1±109.5×10(3)μm(2) versus 520.2±125.7×10(3)μm(2); P<0.01 for both). These findings correlated with decreased foam cell formation (2.27±0.57 versus 4.10±0.3; P<0.01) and increased cholesterol efflux (17.65±0.6 versus 9.75±0.8; P<0.05) in ROCK2-deficient mice that are mediated, in part, through the peroxisome proliferator-activated receptor-γ/liver X receptor/ATP-binding cassette transporter A1 pathway in macrophages. CONCLUSIONS:ROCK2 contributes to atherosclerosis, in part, by inhibiting peroxisome proliferator-activated receptor-γ-mediated reverse cholesterol transport in macrophages, which contributes to foam cell formation. These findings suggest that inhibition of ROCK2 in macrophages may have therapeutic benefits in preventing the development of atherosclerosis.
    背景与目标: 背景:巨噬细胞在动脉粥样硬化的发展中起着核心作用。但是,调节其功能的信号通路尚不完全清楚。 Rho相关的含有螺旋线圈的激酶(ROCK1和ROCK2)是丝氨酸-苏氨酸蛋白激酶,参与肌动蛋白细胞骨架的调节。最近的研究表明巨噬细胞和骨髓来源的细胞中的ROCK1介导动脉粥样硬化。然而,尚未确定ROCK2在动脉粥样硬化的发病机理中的类似作用。
    方法和结果:将野生型,ROCK2(/-)和ROCK2(-/-)小鼠的骨髓移植到受辐照的低密度脂蛋白受体(-/-)小鼠中,用16诱导了动脉粥样硬化周高胆固醇饮食。与野生型骨髓移植小鼠相比,ROCK2(/-)骨髓移植和ROCK2(-/-)骨髓移植小鼠在主动脉中的脂质蓄积少得多(8.46±1.42%和9.80±2.34%与15.64±1.89%;两者均P <0.01)和主动脉下窦动脉粥样硬化病变减少(158.1±44.4和330.1±109.5×10(3)μm(2)与520.2±125.7×10(3)μm(2) ; P均<0.01)。这些发现与部分介导了ROCK2缺陷的小鼠的泡沫细胞形成减少(2.27±0.57对4.10±0.3; P <0.01)和胆固醇外排增加(17.65±0.6对9.75±0.8; P <0.05)相关。通过过氧化物酶体增殖物激活受体-γ/肝X受体/ ATP结合盒转运蛋白A1途径在巨噬细胞中。
    结论:ROCK2部分通过抑制过氧化物酶体增殖物激活的受体-γ介导的胆固醇在巨噬细胞中的逆向转运而导致动脉粥样硬化,这有助于泡沫细胞的形成。这些发现表明,巨噬细胞中ROCK2的抑制在预防动脉粥样硬化的发展中可能具有治疗益处。
  • 【[使用直接经皮穿刺椎动脉穿刺栓塞椎动脉瘤的技术报告]。】 复制标题 收藏 收藏
    DOI:10.11477/mf.1436203776 复制DOI
    作者列表:Sasaki K,Yoshida M,Mino M,Tashiro R
    BACKGROUND & AIMS: :Although direct puncture of the cervical vertebral artery(VA)is not commonly performed in neuroendovascular therapy, it is sometimes inevitable for procedural or technical reasons. We report a case of a ruptured VA aneurysm that required direct cervical VA puncture for treatment. A 79-year-old man was transferred to our hospital with the diagnosis of subarachnoid hemorrhage. Cerebral angiography revealed a right VA-posterior inferior cerebellar artery aneurysm. The aneurysm showed downward projection due to retrograde flow of the right VA caused by chronic occlusion of the right subclavian artery. For endovascular treatment, the approach through the VA union via the left VA was thought to be most appropriate;however, the left VA was very tortuous and the microcatheter could not cross the VA union. We performed percutaneous direct puncture of the left cervical VA. An 18-G intravenous catheter needle(Surflo®)was advanced and set into the C5/6 segment of the VA under biplane fluoroscopic road-mapping guidance. The microcatheter reached the aneurysm and coil embolization was successfully performed. The patient was kept intubated under general anesthesia overnight, to monitor for cervical subcutaneous hematoma. Several procedures for direct VA puncture have been reported. The major problem is the difficulty with hemostasis and maintenance of the airway is important. Although the indication is limited due to the difficulty of adjunctive techniques and postoperative antithrombotic therapy, direct VA puncture under biplane fluoroscopic guidance was useful in this case.
    背景与目标: :尽管在神经内血管治疗中通常不直接进行颈椎动脉(VA)的直接穿刺,但出于手术或技术原因,有时还是不可避免的。我们报告了一例需要直接进行宫颈VA穿刺治疗的VA动脉瘤破裂的病例。一名79岁男子被转移到我院诊断为蛛网膜下腔出血。脑血管造影显示右小脑后下动脉瘤。由于右锁骨下动脉的慢性闭塞引起的右VA逆行流动,动脉瘤显示出向下的投影。对于血管内治疗,认为最合适的方法是通过左VA通过VA联合;但是,左VA曲折,微导管无法穿过VA联合。我们对左颈VA进行了经皮直接穿刺。在双平面透视镜下引导下,将18G静脉导管针(Surflo ®)推进并置于VA的C5 / 6段。微导管达到了动脉瘤,并成功进行了线圈栓塞术。病人在全身麻醉下插管过夜,以监测宫颈皮下血肿。已经报道了几种直接进行VA穿刺的方法。主要问题是止血困难,气道的维护很重要。尽管由于辅助技术和术后抗血栓治疗的困难而使适应症受到限制,但在这种情况下,在双平面荧光镜引导下直接进行VA穿刺是有用的。
  • 【TMS线圈定位/保持系统,用于与fMRI交错的MR图像引导TMS。】 复制标题 收藏 收藏
    DOI:10.1016/s1388-2457(03)00232-3 复制DOI
    作者列表:Bohning DE,Denslow S,Bohning PA,Walker JA,George MS
    BACKGROUND & AIMS: OBJECTIVE:Transcranial magnetic stimulation (TMS) can be interleaved with fMRI to visualize regional brain activity in response to direct, non-invasive, cortical stimulation, making it a promising tool for studying brain function. A major practical difficulty is accurately positioning the TMS coil within the MRI scanner for stimulating a particular area of brain cortex. The objective of this work was to design and build a self-contained hardware/software system for MR-guided TMS coil positioning in interleaved TMS/fMRI studies. METHODS:A compact, manually operated, articulated TMS coil positioner/holder with 6 calibrated degrees of freedom was developed for use inside a cylindrical RF head coil, along with a software package for transforming between MR image coordinates, MR scanner space coordinates, and positioner/holder settings. RESULTS:Phantom calibration studies gave an accuracy for positioning within setups of dx=+/-1.9 mm, dy=+/-1.4 mm, dz=+/-0.8 mm and a precision for multiple setups of dx=+/-0.8 mm, dy=+/-0.1 mm, dz=+/-0.1 mm. CONCLUSIONS:This self-contained, integrated MR-guided TMS system for interleaved TMS/fMRI studies provides fast, accurate location of motor cortex stimulation sites traditionally located functionally, and a means of consistent, anatomy-based TMS coil positioning for stimulation of brain areas without overt response.
    背景与目标: 目的:经颅磁刺激(TMS)可以与功能磁共振成像相交错,以可视化对直接,非侵入性皮层刺激的反应,从而使其成为研究脑功能的有前途的工具。一个主要的实际困难是将TMS线圈准确地定位在MRI扫描仪内,以刺激大脑皮层的特定区域。这项工作的目的是为交错式TMS / fMRI研究中的MR引导TMS线圈定位设计并构建一个独立的硬件/软件系统。
    方法:开发了具有6个校准自由度的紧凑型手动铰接式TMS线圈定位器/支架,以在圆柱形RF头线圈内部使用,以及用于在MR图像坐标,MR扫描仪空间坐标和定位器之间转换的软件包/ holder设置。
    结果:幻像校准研究提供了在dx = /-1.9 mm,dy = /-1.4 mm,dz = /-0.8 mm设置中的定位精度以及在dx = /-0.8 mm,dy = /的多个设置中的定位精度。 -0.1毫米,dz = /-0.1毫米。
    结论:此独立的,集成的MR导引的TMS系统可进行TMS / fMRI交错研究,可快速,准确地定位传统功能性定位的运动皮层刺激部位,并提供一致的基于解剖的TMS线圈定位来刺激大脑区域没有明显的反应。
  • 【线圈栓塞后4周单侧多发性脑水肿的病例】 复制标题 收藏 收藏
    DOI:10.11477/mf.1436204148 复制DOI
    作者列表:Torii J,Tanei T,Naito T,Katoh T,Ishii K,Tsukamoto E,Hasegawa T
    BACKGROUND & AIMS: :Coil embolization for cerebral aneurysms can lead to various complications, such as aneurysm rupture and cerebral embolism. In recent years, foreign substance embolisms-caused by peeling off of coating materials from therapeutic devices-have been described. We report here a case of unilateral multiple cerebral edema four weeks after coil embolization. A 44-year-old woman presented with a subarachnoid hemorrhage from a right internal carotid-posterior communicating artery aneurysm, for which coil embolization was performed. Four weeks after the embolization, she developed numbness in the left side of her mouth and in her left upper extremity. Magnetic resonance images showed multiple edematous lesions in the right cerebral hemisphere. Subsequent treatment with steroids improved her symptoms and edematous cerebral lesions. Although definitive diagnosis by biopsy was not performed, her clinical course and imaging findings resembled a foreign substance embolism by hydrophilic coating. It is important to note that delayed cerebral edema due to foreign substance embolisms might occur after endovascular treatments.
    背景与目标: :脑动脉瘤的线圈栓塞可导致多种并发症,例如动脉瘤破裂和脑栓塞。近年来,已经描述了由于从治疗装置上剥离涂层材料而引起的异物栓塞。我们在这里报告了线圈栓塞后四周单侧多发性脑水肿的病例。一名44岁的女性因右颈内-后交通动脉瘤出现蛛网膜下腔出血,对其进行了线圈栓塞术。栓塞后四周,她的嘴左侧和左上肢出现麻木感。磁共振图像显示右脑半球有多处水肿性病变。随后使用类固醇的治疗改善了她的症状和脑水肿。尽管没有进行活检的明确诊断,但她的临床过程和影像学表现类似于亲水涂层的异物栓塞。重要的是要注意,在进行腔内治疗后,可能会因异物栓塞而导致延迟性脑水肿。
  • 【用于7 T时MRI的宽边分体式环形谐振器线圈。】 复制标题 收藏 收藏
    DOI:10.1109/TMI.2013.2253488 复制DOI
    作者列表:Freire MJ,Lopez MA,Meise F,Algarin JM,Jakob PM,Bock M,Marques R
    BACKGROUND & AIMS: :A coil design termed as broadside-coupled loop (BCL) coil and based on the broadside-coupled split ring resonator (BC-SRR) is proposed as an alternative to a conventional loop design at 7T. The BCL coil has an inherent uniform current which assures the rotational symmetry of the radio-frequency field around the coil axis. A comparative analysis of the signal-to-noise ratio provided by BCL coils and conventional coils has been carried out by means of numerical simulations and experiments in a 7T whole body system.
    背景与目标: :提出了一种称为宽边耦合环路(BCL)线圈并且基于宽边耦合裂环谐振器(BC-SRR)的线圈设计,作为7T常规环路设计的替代方案。 BCL线圈具有固有的均匀电流,可确保射频场围绕线圈轴的旋转对称性。通过在7T全身系统中进行数值模拟和实验,对BCL线圈和常规线圈提供的信噪比进行了比较分析。
  • 【在酿酒酵母中,端粒和交配型沉默需要Sir4 C末端卷曲螺旋。】 复制标题 收藏 收藏
    DOI:10.1016/j.jmb.2003.09.066 复制DOI
    作者列表:Murphy GA,Spedale EJ,Powell ST,Pillus L,Schultz SC,Chen L
    BACKGROUND & AIMS: :Saccharomyces cerevisiae Sir4p plays important roles in silent chromatin at telomeric and silent mating type loci. The C terminus of Sir4p (Sir4CT) is critical for its functions in vivo because over-expression or deletion of Sir4CT fragments disrupts normal telomeric structure and abolishes the telomere position effect. The 2.5A resolution X-ray crystal structure of an Sir4CT fragment (Sir4p 1217-1358) reveals a 72 residue homodimeric, parallel coiled coil, burying an extensive 3600A(2) of surface area. The crystal structure is consistent with results of protein cross-linking and analytical ultracentrifugation results demonstrating that Sir4CT exists as a dimer in solution. Disruption of the coiled coil in vivo by point mutagenesis results in total derepression of telomeric and HML silent mating marker genes, suggesting that coiled coil dimerization is essential for Sir4p-mediated silencing. In addition to the coiled coil dimerization interface (Sir4CC interface), a crystallographic interface between pairs of coiled coils is significantly hydrophobic and buries 1228A(2) of surface area (interface II). Remarkably, interface II mutants are deficient in telomeric silencing but not in mating type silencing in vivo. However, point mutants of interface II do not affect the oligomerization state of Sir4CT in solution. These results are consistent with the hypothesis that interface II mimics a protein interface between Sir4p and one of its protein partners that is essential for telomeric silencing but not mating type silencing.
    背景与目标: :酿酒酵母Sir4p在端粒和沉默交配型基因座的沉默染色质中起重要作用。 Sir4p(Sir4CT)的C端对其体内功能至关重要,因为Sir4CT片段的过度表达或缺失会破坏正常的端粒结构并消除端粒的位置效应。 Sir4CT片段(Sir4p 1217-1358)的2.5A分辨率X射线晶体结构揭示了72个残基的同二聚体,平行盘绕的线圈,掩埋了表面积较大的3600A(2)。晶体结构与蛋白质交联的结果和分析超离心结果一致,这表明Sir4CT在溶液中以二聚体形式存在。通过点诱变在体内盘绕线圈的破坏导致端粒和HML沉默交配标记基因完全被阻抑,这表明盘绕线圈二聚化对于Sir4p介导的沉默至关重要。除了卷曲的线圈二聚化界面(Sir4CC界面)外,成对的卷曲线圈之间的晶体学界面明显疏水,并掩埋了表面积(界面II)1228A(2)。值得注意的是,界面II突变体在体内端粒沉默不足,但在交配型沉默方面却不足。但是,界面II的点突变体不会影响溶液中Sir4CT的低聚状态。这些结果与接口II模仿Sir4p及其蛋白伴侣之一之间的蛋白接口这一假设相符,这对于端粒沉默而不是交配型沉默是必不可少的。
  • 【使用3T临床扫描仪和多阵列线圈为多动物腹部MR成像量身定制的强度校正方法。】 复制标题 收藏 收藏
    DOI:10.2463/mrms.2012-0038 复制DOI
    作者列表:Mitsuda M,Yamaguchi M,Nakagami R,Furuta T,Sekine N,Niitsu M,Moriyama N,Fujii H
    BACKGROUND & AIMS: PURPOSE:Simultaneous magnetic resonance (MR) imaging of multiple small animals in a single session increases throughput of preclinical imaging experiments. Such imaging using a 3-tesla clinical scanner with multi-array coil requires correction of intensity variation caused by the inhomogeneous sensitivity profile of the coil. We explored a method for correcting intensity that we customized for multi-animal MR imaging, especially abdominal imaging. METHOD:Our institutional committee for animal experimentation approved the protocol. We acquired high resolution T₁-, T₂-, and T₂*-weighted images and low resolution proton density-weighted images (PDWIs) of 4 rat abdomens simultaneously using a 3T clinical scanner and custom-made multi-array coil. For comparison, we also acquired T₁-, T₂-, and T₂*-weighted volume coil images in the same rats in 4 separate sessions. We used software created in-house to correct intensity variation. We applied thresholding to the PDWIs to produce binary images that displayed only a signal-producing area, calculated multi-array coil sensitivity maps by dividing low-pass filtered PDWIs by low-pass filtered binary images pixel by pixel, and divided uncorrected T₁-, T₂-, or T₂*-weighted images by those maps to obtain intensity-corrected images. We compared tissue contrast among the liver, spinal canal, and muscle between intensity-corrected multi-array coil images and volume coil images. RESULTS:Our intensity correction method performed well for all pulse sequences studied and corrected variation in original multi-array coil images without deteriorating the throughput of animal experiments. Tissue contrasts were comparable between intensity-corrected multi-array coil images and volume coil images. CONCLUSION:Our intensity correction method customized for multi-animal abdominal MR imaging using a 3T clinical scanner and dedicated multi-array coil could facilitate image interpretation.
    背景与目标: 目的:在单个会话中对多个小动物进行同步磁共振(MR)成像,可提高临床前成像实验的通量。使用带有多阵列线圈的3-tesla临床扫描仪进行的这种成像需要校正由线圈不均匀的灵敏度曲线引起的强度变化。我们探索了一种针对多动物MR成像(尤其是腹部成像)定制的校正强度的方法。
    方法:我们的动物实验机构委员会批准了该协议。我们使用3T临床扫描仪和定制的多阵列线圈同时获取了4个大鼠腹部的高分辨率T 1-,T 2-和T 2 *加权图像以及低分辨率质子密度加权图像(PDWI)。为了进行比较,我们还在4个单独的实验中在同一只大鼠中获得了T 1-,T 2-和T 2 *加权的体积线圈图像。我们使用内部创建的软件来校正强度变化。我们对PDWI应用阈值处理,以生成仅显示信号产生区域的二进制图像,通过将低通滤波后的PDWI除以低通滤波后的二进制图像逐像素计算出多阵列线圈灵敏度图,并除以未校正的T₁-,通过那些图的T 2或T 2 *加权图像以获得强度校正的图像。我们比较了强度校正的多阵列线圈图像和体积线圈图像之间的肝脏,脊椎管和肌肉之间的组织对比度。
    结果:我们的强度校正方法在研究的所有脉冲序列上均表现良好,并且在不降低动物实验通量的情况下校正了原始多阵列线圈图像中的变化。在强度校正的多阵列线圈图像和体积线圈图像之间,组织对比是可比的。
    结论:我们针对3D临床扫描仪和专用多阵列线圈为多动物腹部MR成像量身定制的强度校正方法可以促进图像解释。

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