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Flow diversion of a middle cerebral artery pseudoaneurysm secondary to a gunshot wound: A case report

  • Justin C. Gelman;Max Shutran;Michael Young;Philipp Taussky;Rafael A. Vega;Rocco Armonda;Christopher S. Ogilvy
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.434-439
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    • 2023
  • Pseudoaneurysms are rare but devastating complications of penetrating head traumas. They require rapid surgical or endovascular intervention due to their high risk of rupture; however, complex presentations may limit treatment options. Our objective is to report a case of severe vasospasm, flow diversion, and in-stent stenosis complicating the treatment of a middle cerebral artery pseudoaneurysm following a gunshot wound. A 33-year-old woman presented with multiple calvarial and bullet fragments within the right frontotemporal lobes and a large right frontotemporal intraparenchymal hemorrhage with significant cerebral edema. She underwent an emergent right hemicraniectomy for decompression, removal of bullet fragments, and evacuation of hemorrhage. Once stable enough for diagnostic cerebral angiography, she was found to have an M1 pseudoaneurysm with severe vasospasm that precluded endovascular treatment until the vasospasm resolved. The pseudoaneurysm was treated with flow diversion and in-stent stenosis was found at 4-month follow-up angiography that resolved by 8 months post-embolization. We report the successful flow diversion of an middle cerebral artery (MCA) pseudoaneurysm complicated by severe vasospasm and later in-stent stenosis. The presence of asymptomatic stenosis is believed to be reversible intimal hyperplasia and a normal aspect of endothelial healing. We suggest careful observation and dual-antiplatelet therapy as a justified approach.

Carnosine and Retinol Synergistically Inhibit UVB-Induced PGE2 Synthesis in Human Keratinocytes through the Up-Regulation of Hyaluronan Synthase 2

  • In Guk Park;Sun Hee Jin;Seungchan An;Min Won Ki;Won Seok Park;Hyoung-June Kim;Yongjoo Na;Minsoo Noh
    • Biomolecules & Therapeutics
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    • v.32 no.5
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    • pp.635-639
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    • 2024
  • Skin aging results from complex interactions of intrinsic and extrinsic factors, leading to structural and biochemical changes such as wrinkles and dryness. Ultraviolet (UV) irradiation leads to the degradation of hyaluronic acid (HA) in the skin, and the fragmented HA contributes to inflammation. This study revealed that the synergistic combination of carnosine and retinol (ROL) increases HA production in normal human epidermal keratinocytes (NHEKs) by upregulating hyaluronan synthase 2 (HAS2) gene transcription. Simultaneously, the combined treatment of carnosine and ROL significantly attenuates UVB-induced prostaglandin E2 (PGE2) synthesis in NHEKs. A significant correlation exists between the increase of HA synthesis and the inhibition of PGE2 production. This study suggests that combined treatment of carnosine and ROL can improve skin aging phenotypes associated with UVB irradiation.

On the buckling of smart beams in racket frames for enhancing the player's control using numerical solution and sinusoidal shear deformation theory

  • Liyan Li;Maryam Shokravi;S.S. Wang
    • Steel and Composite Structures
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    • v.52 no.6
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    • pp.657-662
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    • 2024
  • In the present analysis, the buckling behavior of smart beams integrated into racket frames for enhancing player control was examined by numerical solutions and sinusoidal shear deformation theory. The smart beam under consideration is subjected to an external voltage in the thickness direction. The integration of this smart material into the structure of the racket should optimize performance, improving the racket's stability and responsiveness during play. In this, an accurate representation of complex shear effects is made by using a sinusoidal shear deformation theory, while the solution of the resulting governing equations is made by numerical methods. The critical buckling loads and the characteristics of deformation obtained through the analysis provide insight into some design parameters controlling and influencing stability. Obtained results are validated with other published works. The length and thickness of the beam, elastic medium, boundary condition, and influence of external voltages have been represented for buckling load in the structure. These results will help in designing smart racket frames using smart beams to provide more precision and control for the players in an intelligent way.

Relation of Health Status, Nutrient Intake, and Dietary Self-Efficacy to the Obesity Levels of Male Workers (남성 근로자의 비만정도에 따른 건강상태와 영양상태 및 식이 자기효능감과의 관계)

  • Jang, Hyun-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.7
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    • pp.849-858
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    • 2007
  • This study was intended to collect the baseline information on health status, nutrient intakes and dietary self-efficacy according to the obesity levels of male workers. Nutrient intakes of 224 male workers were assessed by 24 hr recall method; also, dietary attitude and dietary self-efficacy were investigated by self-administerd questionnaires. Biochemical characteristics such as blood pressure (SBP, DBP), total cholesterol(TC), hemoglobin (Hb), blood glucose (BG), SGOT, SGPT and ${\gamma}-GTP$ were assessed. Subjects were divided into normal, overweight and obese groups by body mass index (BMI). The health status was analyzed as normal group, health concerned group and disease suspected group. Weight, percent ideal body weight (PIBW), BMI and body circumference (waist, hip) and waist-hip ratio were high in the order of obese group, overweight group and normal group. Body fat mass was high also in the order of obese, overweight and normal group. Blood pressure (SBP, DBP) was the highest in obese group. SGOT, SGPT, ${\gamma}-GTP$ were higher in the obese group than normal and overweight groups. It was Proven that the percentage of those evaluated as low nutrient intakes were 71% for Ca, 50.9% for Zn, 70.5% for vitamin B2, 56.3% for vitamin C and 81.3% for folic acid. The dietary attitude scores were high according to the dietary self-efficacy. The age was positively correlated with dietary attitude, and the dietary attitude was positively correlated with dietary self-efficacy and total energy intakes. Dietary attitude showed the greatest total causal effect in relation to dietary self-efficacy. The results of this study showed some health problems and nutritional problems, indicating the need for nutritional management for male workers.

In Vitro Cytotoxicity, Skin Regeneration, Anti-wrinkle, Whitening and In Vivo Skin Moisturizing Effects of Oncheongeum (온청음 물 추출물의 세포독성, 피부재생, 주름개선, 미백 및 보습 효과)

  • An, Tteul-E-Bom;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.1
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    • pp.14-34
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    • 2016
  • Objectives: The objective of this study was to evaluate the effects of cytotoxicity, skin regeneration, anti-wrinkle, whitening and skin moisturizing of Oncheongeum (OCE).Methods: The cytotoxicity of OCE lyophilized aqueous extracts (yield=13.82%) was observed against human normal fibroblast cells and B16/F10 murine melanoma cells by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium Bromide (MTT) assay, and skin regeneration and anti-wrinkle effects were also evaluated through the assay of collagen type I synthesis compared to the transformation of the growth factor (TGF)-β1, hyaluronidase, collagenase and matrix metalloproteinase (MMP)-1 inhibitory assays compared to oleanolic acid (OA), and elastase inhibitory effects compared to phosphoramidon disodium salt (PP). In addition, OCE’s whitening effects were measured by a tyrosinase inhibitory assay and melanin formation test in B16/F10 murine melanoma cells compared to arbutin, and skin moisturizing effects were observed through a mouse skin water content test, respectively. Results: No OCE treatment-related cytotoxic effects appeared on human normal fibroblasts and B16/F10 murine melanoma cells. OCE concentration-dependently increased the collagen Type I synthesis on human normal fibroblast cells, and also effectively inhibited hyaluronidase, elastase, collagenase and MMP-1 activities. In addition, OCE inhibited melanin production of B16/F10 murine melanoma cells and activity of tyrosinase. And significant and dose-dependent increases of skin water content were detected in OCE-treated mouse skin compared to vehicle control skins. Conclusions: OCE showed favorable and sufficient effects in skin regeneration, anti-wrinkle, whitening and skin moisturizing in this experiment. But more detail mechanisms and studies on the skin protective efficiency of in vivo are needed with the screening of active biological compounds in individual OCE herbs.

Role of Growth Factors and Cytokines on Bleomycin Induced Pulmonary Fibrosis (Bleomycin 유도 폐 섬유화에 있어서 성장인자 및 Cytokine의 역할)

  • Lee, Yong-Hee;Jung, Soon-Hee;Ahn, Chul-Min;Kim, Sung-Kyu;Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.871-888
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    • 1997
  • Background : It is now thought that the earliest manifestation of idiopathic pulmonary fibrosis is alveolitis, that is, an accumulation of inflammatory and immune effector cells within alveolar walls and spaces. Inflammatory cells including alveolar macrophages and resident normal pulmonary tissue cells participate through the release of many variable mediators such as inflammatory growth factors and cytokines, which contribute to tissue damage and finally cause chronic pulmonary inflammation and fibrosis. This study was performed to investigate the source and distribution pattern of transforming growth factor-${\beta}_1$(TGF-${\beta}_1$), platelet derived growth factor(PDGF), basic fibroblast growth factor(bFGF), interleukin 1(IL-1), interleukin 6(IL-6), tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and the role of these mediators on bleomycin(BLM)-induced pulmonary injury and fibrosis in rats. Method : Wistar rats were divided into three groups(control group, BLM treated group, BLM and vitamine E treated group). Animals were sacrificed periodically at 1, 2, 3, 4, 5, 7, 14, 21, 28 days after saline or BLM administration. The effects were compared to the results of bronchoalveolar lavage fluid analysis, light microscopic findings, immunohistochemical stains for six different mediators(TGF-${\beta}_1$, PDGF, bFGF, IL-1, IL-6 and TNF-$\alpha$) and mRNA in situ hybridization for TGF-${\beta}_1$. Results : IL-1 and IL-6 are maximally expressed at postbleomycin 1~7th day which are mainly produced by neutrophils and bronchiolar epithelium. It is thought that they induce recruitment of inflammatory cells at the injury site. The expression of IL-1 and IL-6 at the bronchiolar epithelium within 7th day is an indirect evidence of contribution of bronchiolar epithelial cells to promote and maintain the inflammatory and immune responses adjacent to the airways. TNF-$\alpha$ is mainly produced by neutrophils and bronchiolar epithelial cells during 1~5th day, alveolar macrophages during 7~28th day. At the earlier period, TNF-$\alpha$ causes recruitment of inflammatory cells at the injury site and later stimulates pulmonary fibrosis. The main secreting cells of TGF-${\beta}_1$ are alveolar macrophages and bronchiolar epithelium and the target is pulmonary fibroblasts and extracellular matrix. TGF-${\beta}_1$ and PDGF stimulate proliferation of pulmonary fibroblasts and TGF-${\beta}_1$ and bFGF incite the fibroblasts to produce extracellular matrix. The vitamine E and BLM treated group shows few positive cells(p<0.05). Conclusion : After endothelial and epithelial injury, the neutrophils and bronchiolar epithelium secrete IL-1, IL-6, TNF-$\alpha$ which induce infiltration of many neutrophils. It is thought that variable enzymes and $O_2$ radicals released by these neutrophils cause destruction of normal lung architecture and progression of pulmonary fibrosis. At the 7~28th day, TGF-${\beta}_1$, PDGF, bFGF, TNF-$\alpha$ secreted by alveolar macrophages sting pulmonary fibroblasts into proliferating with increased production of extracellular matrix and finally, they make progression of pulmonary fibrosis. TNF-$\alpha$ compares quite important with TGF-${\beta}_1$ to cause pulmonary fibrosis. Vitamine E seems to decrease the extent of BLM induced pulmonary fibrosis.

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A Study on the Effect of Herbal-acupuncture with Asari Herba Cum Radice solution at Joksamni(ST36) on Collagen-induced arthritis (족삼리(足三里) 세신약침(細辛藥鍼)이 생쥐의 Collagen-induced arthritis에 미치는 영향)

  • Hwang, Kyu-jeong;Kim, Young-il;Lee, Byung-ryul
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.227-241
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    • 2005
  • Objective & Methods : The purpose of this study is to observe the effects of Asari Herba Cum Radice herbal-acupuncture solution(AHCR-HAS) on arthritis of mice induced by Collagen II at Joksamni(ST36). The author performed several experimental items. First, it is the cell survival rate of mice lung fibroblasts and expression of TNF-${\alpha}$ in synovial cells. Second, it is the incidence rate of arthritis and the weight of spleen. Third, it is the levels of IL-6, TNF-${\alpha}$, INF-${\gamma}$, IgG, IgM and anti-collagen II in serum Fourth, it is histological analysis of the mice joint. Fifth, it is expression ratio of CD3e+ to CDl9+ cell, CD4+ to CD8+ cell, CD69+/CD3e+ cells, CD11+/CD19+ cells and CD11b+/Gr-1+ cells. Result : 1. The highest survival rate of mice lung fibroblasts were measured in the 1% AHCR-HAS, and the expression of TNF-${\alpha}$ in synovial cells were significantly decreased in the 1% AHCR-HAS. 2. In the AHCR-HA I & AHCR-HAII groups, the incidence of arthritis and the weight of spleen were significantly decreased. 3. In AHCR-HAI & AHCR-HAII groups, the levels of IL-6, INF-${\gamma}$, TNF-${\alpha}$, IgG, IgM and anti-collagen II in serum of CIA mice were significantly decreased. 4. In histology, the cartilage destruction and synovial cell proliferation were decreased in the AHCR-HA I & AHCR-HAII groups, and the collagen fiber expressions in the AHCR-HA I & AHCR-HAII groups were similar with that of the Normal group. 5. In the AHCR-HA I & AHCR-HA II groups, the expression ratio of CD3e+ to CD19+ cell and CD4+ to CD8+ cell were similarly maintained as Normal group in lymph nodes, and CD69+/CD3e+ cells and CD11a+/CD19+ cells were decreased in Iymph nodes, and CD11b+/Gr-1+ cells were decreased in synovium. Conclusion : Taking all these observations into account, AHCR-HA is considered to be effective in prophylaxis and treatment of rheumatoid arthritis, and then more effective in prophylaxis than treatment, so put to practical use in future rheumatoid arthritis clinic.

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Anti-Obesity Effect of Enterococcus faecalis MD366 isolated from Raw Milk in Diet-Induced Obese Mice (원유에서 분리한 Enterococcus faecalis MD366가 고지방식이를 급여한 마우스의 비만 억제에 미치는 영향)

  • Park, Sun-Young;Cho, Seong-A;Han, Noo-Ri;Seong, Ki-Seung;Lim, Sang-Dong
    • Journal of Dairy Science and Biotechnology
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    • v.32 no.2
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    • pp.163-167
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    • 2014
  • This study aimed to investigate the anti-obesity effects of Enterococcus faecalis MD366, isolated from raw milk, in diet-induced obese mice. To examine the effect, male C57BL/6J mice were fed for six weeks on three different diets, i.e., a normal diet and orally administrated saline solution (ND), a high-fat diet and orally administrated saline solution (HFD), and a high-fat diet and orally administrated E. faecalis MD366 ($10^9CFU/day$) in saline solution (HFD+MD366). After six weeks, the rate of increase in body weight was 18.1% lower in the HFD+MD366 group compared to that in the HFD group. In addition, the weight of epididymal fat pad in the HFD+MD366 group was lower than that in the HFD group. The average levels of triglycerides, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) were slightly reduced in the HFD+MD366 group compared to those in the HFD group. However, there were no significant differences between the groups. Measuring the adipocytes revealed that the percentage of adipocytes with a size of $2,000{\mu}m^2$ was higher than the percentages of other size classes in ND and HFD+MD366 groups, while the percentage of adipocytes larger than $5,000{\mu}m^2$ was highest in the HFD group. The mean adipocyte size in the HFD+MD366 group was smaller than that in the HFD group.

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Effect of Radiation Dose for Radiotherapy on Ovarian Follicle Atresia in Rat (치료 방사선량이 쥐의 난포 퇴축에 미치는 영향)

  • Lee, Won-Jeong;Seon, Jong-Ryul;Yoo, Se-Jong;Ahn, Bong-Seon
    • Journal of Radiation Protection and Research
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    • v.37 no.4
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    • pp.208-212
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    • 2012
  • In previous studies, ovarian follicle in rat has been used a higher radiation dose than that for cancer radiotherapy in clinical practice. The aim of this study was to evaluate the effect of radiation dose used for cancer radiotherapy on ovarian follicle atresia in rat. Mice of 4-week-old female were whole body irradiated with 2 cGy or 2 Gy (Mevatron 67, Siemens, Germany) and sacrificed by cervical dislocation. Ovaries were collected at 24 hours after irradiation to observe the degree of follicular atresia. Ovaries were fixed in neutral formaldehyde solution for 24 hours and embedded with paraffin. Cutted in $5{\mu}m$ thickness with microtome and stained with hematoxylin and eosin (H&E) and TUNEL immunohistochemical stain, and examined histologically under a light microscope. All data were presented as mean ${\pm}SD$, calculating the ratio of normal or atretic follicles to total ovarian follicles. Statistical analysis was performed by the Mann Whitney test using the SPSS ver 19.0. Ratio of atretic to total follicles of 2 Gy group was significantly higher than control or 2 cGy groups (p<0.05). Ratio of normal to total follicles of 2 Gy group was significantly lower than control group in preantral follicle (64.0 vs. 87.7, p=0.027). Ratio of normal to total follicles of 2 cGy group was significantly increased more than control or 2 Gy groups in antral follicle, and there were no significant difference between control and 2 Gy groups (p=0.522). Radiation dose of 2 Gy for cancer radiotherapy have a significant effect on ovarian follicle atresia in rat.

Correlation between Steroid Hormone Metabolites and Leiomyomas of Uterus (자궁근종과 성호르몬 대사물과의 연관성)

  • Bai, Sang-Wook;Jung, Byung-Hwa;Chung, Bong-Chul;Jeon, Jin-Dong;Lee, Hyun-Jung;Kwon, Han-Sung;Chung, Kyung-Ah;Kim, Sei-Kwang;Park, Ki-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.28 no.4
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    • pp.279-286
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    • 2001
  • Objective: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. Materials of Methods : The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. Results: The mean ages of the patients with leiomyomas and the control group were $43.1{\pm}5.6$ and $40.6{\pm}7.2$ years, the weights were $63.4{\pm}7.3$ and $59.4{\pm}8.1\;kg$, and their heights were $155.4{\pm}4.8$ and $159.3{\pm}4.8\;cm$ respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. $17{\beta}$-estradiol, 5-AT, 11-keto ET, $11{\beta}$-hydroxy An, $11{\beta}$-hydroxy Et, THS, THA, THE, a-cortolone, a-cortol, $\beta$-cortol, $11{\beta}$-OH Et/$11{\beta}$-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. $17{\beta}$-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. $17{\beta}$-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). Conclusion: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.

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