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• Transvenous approach to the target sinus can be difficult in the treatment of dAVFs • Transcranial and transsinusal routes are suitable in these cases • Minimally invasive, safe catheterization in the transverse sinus is needed • We could perform the treatment comfortably and safely in a hybrid operating room Using the transverse sinus as a conduit to treat a transverse sigmoid sinus dural arteriovenous fistula is uncommon. This report describes a minimally invasive direct puncture technique for the transverse sinus to treat a complex dural arteriovenous fistula in a hybrid operating room. The patient was a 64-year-old man with intractable status epilepticus. Digital subtraction angiography demonstrated a right transverse sigmoid sinus dural arteriovenous fistula (Borden type II, Cognard type IIa+b). We performed a transcranial direct puncture because the femoral vein approach was not feasible due to bilateral thrombosed sinuses. Under general anesthesia and park-bench patient positioning, the transverse sinus was exposed and catheterized, and the affected sinus was embolized using microcoils. The fistula was completely obliterated, resolving the status epilepticus. Direct puncture of the transverse sinus can be effective for treating a transverse sigmoid sinus dural arteriovenous fistula. In a hybrid operating room, combined treatments can be performed comfortably and safely in a single session of general anesthesia. This treatment option is a viable alternative when other methods are unsuccessful. [ABSTRACT FROM AUTHOR]

Endometriosis is a serious disorder that can lead to infertility. The immune system, particularly regulatory T cells (Tregs), is involved in endometriosis and infertility; however, endometriosis-associated infertility is poorly understood. Tregs, which have an immunosuppressive function, fluctuate during the menstrual cycle. They are functionally heterogeneous and can be divided into subsets, with only activated Tregs (aTregs) having a true immunosuppressive function. The purpose of this study is to investigate the role of aTregs in endometriosis and how they contribute to endometriosis-associated infertility. We enrolled 72 women with (n = 39) and without (n = 33) endometriosis. Subpopulations of Tregs were examined in normal endometrium (NE), eutopic endometrium from women with endometriosis (EE), normal peritoneal fluid (N-PF), and peritoneal fluid from women with endometriosis (E-PF) via flow cytometry. The proportion of aTregs during the ovulatory phase was higher in NE than in EE (P < 0.05), and that during ovulatory and secretory phases was significantly higher in NE than in N-PF (P < 0.01 and 0.05, respectively). aTreg populations did not significantly differ between EE and E-PF. During the ovulatory phase, the proportion of resting Treg (rTreg) in the N-PF was significantly higher than during the proliferative phase (P < 0.05). The E-PF of rTreg populations did not differ significantly throughout the menstrual cycle. We found that Treg subsets were altered in the endometrium and PF of patients with endometriosis during the menstrual cycle. Our findings, particularly the reduction of aTregs in the EE, may provide an insight into the mechanism of endometriosis-associated infertility. • We examined activated Treg distribution in women with and without endometriosis. • Activated Treg proportions were altered in the endometrium and peritoneal fluid. • Activated Treg proportions during ovulation were higher in NE than in EE. • Those during ovulatory and secretory phases were higher in NE than in N-PF. • Activated Treg alterations during menstrual cycle may be involved in endometriosis. [ABSTRACT FROM AUTHOR]

Abstract: Urinary incontinence (UI) is one of the most common and distressing conditions among nursing home residents. Although scheduled care is usually provided for them, incontinence care should be individualized regarding going to the toilet, changing diapers, and taking food and water. We have developed an individualized and comprehensive care strategy to address the problem. We conducted an intervention study that involved training chiefs of staffs, who in turn trained other staffs, and encouraging residents. A total of 153 elderly subjects selected from 1290 residents in 17 nursing homes were eligible to receive our individualized and comprehensive care. The goals of the care strategy were (i) to complete meal intake; (ii) to take fluids up to 1500ml/day; (iii) to urinate in a toilet; (iv) to spend over 6h out of bed; and (v) to reduce time spent in wet diapers. We explained the aims of our strategy to the chiefs of staff of each nursing home and instructed them to encourage residents to take an active part in our individualized and comprehensive care strategy for 12 weeks. For 3 days before and after that period, we assessed the changes in fluid volume intake, time spent in wet diapers, size of diaper pads, and urination habits. The result was that fluid volume intake significantly increased (p <0.001) while time spent in wet diapers decreased (p <0.001). The number of residents wearing diapers decreased as did the size of pads during the day (p =0.0017). The proportion of residents using diapers at night was reduced and those using toilets at night increased (p =0.007). This study suggests that such an individualized and comprehensive care strategy can offer a measurable improvement in UI care. [Copyright &y& Elsevier]

ABCA2, a member of the ATP-binding cassette (ABC) transporter family, is localized mainly to late endosome/lysosomes of oligodendrocytes in brain, but the physiological role and function of ABCA2 are unknown. In this study, we generated mutant mice (ABCA2-null) by targeting the abca2 gene. ABCA2-null mice exhibited a phenotype including lower pregnancy rate and body weight, shorter latency period on the balance beam, and sensitization to environmental stress compared with wild type mice but no abnormality in the cytoarchitectonic and compact myelin structure or oligodendroglial differentiation. Lipid analysis of brain from 11 days to 64 weeks of age revealed significant accumulation of gangliosides along with reduced sphingomyelin (SM) from 4 weeks to 64 weeks of age and accumulation of cerebrosides and sulfatides at 64 weeks of age in ABCA2-null mice compared with wild type mice. In addition, a significant accumulation of the major ganglioside GM1 and reduced SM was detected in the myelin fraction of ABCA2-null brain. Comparison of ABCA2-null and wild type mice revealed weak ABCA2 immunoreactivity in some large pyramidal cells of wild type brain. These results suggest that ABCA2 is involved in the intracellular metabolism of sphingolipids in the brain, particularly SM and gangliosides in oligodendrocytes and certain neurons. [ABSTRACT FROM AUTHOR]

Analyzes the hemodynamic events occurring in vivo during microvascular regeneration following destruction of glomerular capillary tuft. Use of confocal laser-scanning microscope system; Elevation in arterial blood pressure; Suppression of red blood cell velocity.

The pallidothalamic tract connects the globus pallidus internus with the ventroanterior and ventrolateral parts of the thalamus. Lesioning or stimulation of the pallidothalamic tract has ameliorating effects on dyskinesia and dystonia in patients with Parkinson disease. However, the effect of the procedure on dystonia due to other etiologies has not been reported. We retrospectively analyzed patients with dystonia who underwent unilateral pallidothalamic tractotomy between July 2017 and October 2018 at Tokyo Women's Medical University Hospital. The Burke–Fahn–Marsden Dystonia Rating Scale-Movement Scale was used to evaluate the severity of dystonia at three time points (before surgery, 3 months postoperatively, and the last available follow-up). Adverse events were also evaluated. Eleven patients underwent unilateral pallidothalamic tractotomy, including 5 with generalized dystonia, 4 with segmental dystonia, and 2 with focal (cervical) dystonia. All patients had undergone unilateral pallidotomy before contralateral pallidothalamic tractotomy. The mean interval between the previous surgery (pallidotomy) and pallidothalamic tractotomy was 9.5 ± 3.1 months. The mean follow-up period was 11.5 ± 4.2 months. The Burke–Fahn–Marsden Dystonia Rating Scale-Movement Scale scores at 3 months after pallidothalamic tractotomy (5.8 ± 8.4) and at the last available follow-up (5.6 ± 8.3, P < 0.001) were significantly improved compared with that before pallidothalamic tractotomy (21.8 ± 16.3). The most common adverse event was reduced voice volume (6 patients), which was mild and did not interfere with the patient's daily activities. This study suggests that pallidothalamic tractotomy can be an alternative treatment target for dystonia. A larger and longer prospective study is needed to elucidate the safety and efficacy of pallidothalamic tractotomy for dystonia. [ABSTRACT FROM AUTHOR]

Menstrual blood, containing high iron levels, can undergo retrograde transport into the abdominal cavity. Excess iron causes oxidative stress and inflammation. Iron metabolism is regulated by hepcidin, and serum hepcidin levels are increased in patients with endometriosis; however, the functions of hepcidin in normal endometrium remain unclear. We therefore aimed to examine hepcidin concentrations in patients with endometriosis and to determine if iron accumulation and hepcidin increased the production of reactive oxygen species (ROS) and inflammation in normal endometrial cells. We determined hepcidin levels in peritoneal fluid and menstrual blood from patients with and without endometriosis (25/16 and 15/15 patients, respectively). We also examined the effects of hepcidin on ferroportin expression, iron accumulation, and ROS generation in normal endometrial stromal cells (NESCs) from 20 women who underwent surgery for uterine leiomyoma, using immunohistochemistry and immunofluorescence analyses and analyzed its effect on the expression of inflammatory cytokines by real-time polymerase chain reaction. There was no significant difference in iron concentrations in menstrual blood or peritoneal fluid between women with and without endometriosis; however, women with endometriosis had significantly higher hepcidin levels in menstrual blood. Hepcidin reduced the expression of ferroportin in NESCs and promoted the accumulation of ferrous iron. Hepcidin plus ferrous iron increased the production of ROS and inflammatory cytokines compared with ferrous iron alone. These results indicate that women with endometriosis have high hepcidin levels in menstrual blood, leading to increased iron production, oxidative stress, and inflammation, which may, in turn, promote the development of endometriosis. [Display omitted] • There is an association between hepcidin levels and endometriosis. • Hepcidin plays a major role in iron regulation in normal endometrial stromal cells. • Hepcidin promoted reactive oxygen species generation. • The hepcidin-ferroportin axis may be involved in the pathogenesis of endometriosis. [ABSTRACT FROM AUTHOR]

The intermediate water (IW) concept has been hypothesized to predict the biocompatibility of polymers and inorganic materials. This study, for the first time, prepared the composite biomaterials of poly(2-hydroxyethyl methacrylate) (PHEMA)/titanium-doped bioactive glasses (BGT) for bone regeneration by applying the IW concept. The homogeneous distribution of BGT and the mechanical stability of the composites were confirmed using X-ray diffraction, infrared spectroscopy, scanning electron microscopy, energy dispersive X-ray spectrometry, and rheological characterization. In vitro tests with immersion in simulated body fluid showed that titanium doping improved the biomineralization properties. The IW level ranged from 10.4 wt% with 0% titanium doped to 25.6 wt% with 7.5% titanium doped. Cell viability tests on osteosarcoma cells revealed that the growth rate increased with increasing titanium concentration, reaching up to 150%. Based on single-cell force spectroscopy, an appropriate titanium concentration for cell adhesion was estimated to be 5%. The hydrated PHEMA gels with 5% BGT exhibited a high IW level of 19.3% and less hydrophilic wettability than the gels without titanium or with 10% BGT. The IW concept proved to be useful for predicting the bone regeneration potential on the interfaces of the PHEMA/BGT composite hydrogels. [ABSTRACT FROM AUTHOR]

Postoperative intracerebral hemorrhage (ICH) after direct bypass surgery for Moyamoya disease could contribute to neurologic deterioration. The aim of this study was to evaluate the effectiveness of 5-day bed rest in reducing the occurrence of postoperative ICH. This study included 122 consecutive hemispheres in 87 Japanese adult MMD patients, composed of 80 control hemispheres from historical data and 42 hemispheres after 5-day bed rest. They all underwent direct bypass surgery. The incidence of postoperative ICH and neurologic deterioration assessed via the modified Rankin Scale were investigated and statistically analyzed. Postoperative ICH was observed in 9 out of the 80 (11.3%) control patients, but not in the 42 patients with 5-day bed rest. The incidence of postoperative ICH and neurologic deterioration via the modified Rankin Scale were significantly different between the 2 groups (P = 0.0268 and 0.0078, respectively). Univariate logistic analysis revealed that 5-day bed rest significantly reduced the incidence of postoperative ICH (P = 0.0048). Five-day bed rest after direct bypass surgery dramatically can reduce the incidence of postoperative ICH and neurologic deterioration after direct bypass surgery. [ABSTRACT FROM AUTHOR]

Impairment of vascular regeneration precedes progressive glomerulosclerosis in anti-Thy 1 glomerulonephritis.. Background: It has been proposed that glomerular hemodynamic changes or glomerular growth response may promote the development of glomerulosclerosis, irrespective of its etiology. Further experimental models are needed to clarify the cellular and molecular mechanisms that lead to progressive glomerulosclerosis with an irreversible course. We designed a model of irreversible glomerulosclerosis, using anti-Thy-1.1 injection followed by uninephrectomy, and examined the role of glomerular endothelial cell responses in the process of progressive sclerotic changes. Method: Rats were injected with anti-Thy-1.1 monoclonal antibody, 1-22-3, and 30 minutes later, unilateral nephrectomy (one-kidney group) or sham operation (two-kidney group) was performed. Rats were sacrificed for histological examination on days 3, 14, 56, and 84 after injection. The density of the glomerular capillary tuft was assessed by immunofluorescent staining for endothelial specific antigens. The mRNA expression of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), platelet-endothelial cell adhesion molecule-1 (PECAM-1), and vascular endothelial growth factor (VEGF) also was followed up by reverse transcription-polymerase chain reaction (RT-PCR). Results: Semiquantitative analysis revealed that the capillary density and mRNA expression of PECAM-1, VCAM-1 and VEGF were significantly lower in the one-kidney group compared to the two-kidney group on day 14. On day 84, progressive glomerulosclerotic lesions were found, followed by a decrease of the capillary density in the one-kidney group, while the glomerular architecture recovered to an almost normal state in the two-kidney group. Conclusions: Progressive glomerulosclerosis can be induced in the rat by a one shot injection of anti-Thy 1.1 monoclonal antibody followed by unilateral nephrectomy. Thi... [ABSTRACT FROM AUTHOR]

Objective: A major concern in hormone replacement therapy is the associated increased risk of cardiovascular diseases. A progestogen without the unfavorable effects on cardiovascular disease should be explored. Monocyte adhesion to endothelial cells is an important initial event in atherosclerosis. In this study, the effects of the alternative progestogen drospirenone (DRSP) on monocyte adhesion in human umbilical venous endothelial cells (HUVECs) were examined.Study Design: In HUVECs treated with estrogens and progestogens, including DRSP and medroxyprogesterone acetate (MPA), the expression of the adhesion molecules E-selectin, P-selectin, ICAM-1, and VCAM-1 were examined by real-time PCR and using an enzyme-linked immunosorbent assay. A flow chamber system was used to investigate the effects of DRSP on U937 monocytoid cell adherence to HUVEC monolayers. All experimental data were compared using one-way Analysis of Variance.Results: Upregulation of adhesion molecule mRNA or protein was not seen in HUVECs treated with DRSP alone or with 17β-estradiol+DRSP. DRSP alone, 17β-estradiol+DRSP or ethinylestradiol+DRSP did not increase the number of adherent monocytoid cells to HUVECs in the flow chamber system. However, MPA significantly enhanced the monocytoid cell adherence (P<0.05).Conclusions: DRSP did not increase the expression of adhesion molecules or monocytoid cell adherence to endothelial cells, indicating that DRSP could reduce the risk of atherogenesis caused by MPA. These results suggest that DRSP may be an alternative to MPA in hormone replacement therapy. [ABSTRACT FROM AUTHOR]

Abstract: We previously reported that ABCA2, of the A subclass of the ATP-binding cassette (ABC) transporter superfamily, is expressed in mature oligodendrocytes and Schwann cells, the cells responsible for myelination in the brain and the peripheral nerve, respectively. However, unidentified cells expressing ABCA2 also were found. Here, we provide evidence for the expression of ABCA2 in the rodent sciatic nerve not only in Schwann cells, which express the Schwann cell marker S100β and a zinc finger transcription factor Krox20 (a marker for myelin-forming Schwann cells), but also in Krox20-negative cells, which express glial fibrillary acidic protein (GFAP), a cell adhesion molecule L1, and S100β weekly. We also analyzed developmental changes in ABCA2 expression in Schwann cells. The expression of ABCA2 in Krox20+/S100β+ Schwann cells was found initially in rat facial nerve at postnatal day (PD) 8, in half (52.4%) of the cells showing myelinization at PD 14, and in all of the cells in the adult stage. These results demonstrate that ABCA2 is expressed in non-myelin-forming as well as in myelin-forming Schwann cells, and that ABCA2 may be involved in transport of a substance associated with cellular maturation rather than initial myelin formation in both types of Schwann cells. [Copyright &y& Elsevier]

Real-time observation of glomerular hemodynamic changes in diabetic rats: Effects of insulin and ARB.Background.The progression of diabetic nephropathy is closely related to disturbances in glomerular hemodynamics, such as glomerular hypertension and/or hyperperfusion. The aim of this study was to observe and to analyze glomerular hemodynamics in rats with diabetes mellitus (DM) in vivo using confocal laser scan microscopy (CLSM). We also examined the effects of candesartan cilexetil (TCV-116), a selective angiotensin II type 1 receptor blocker (ARB), on glomerular hemodynamics in DM.Methods.Munich-Wistar rats were divided into six groups: (1) four-day control; (2) four-day DM; (3) 28-day control; (4) 28-day DM; (5) DM treated with insulin; (6) DM treated with TCV-116. The kidney-to-body weight ratio, glomerular volume, and proteinuria were estimated. Glomerular hemodynamic changes were observed using CLSM and renal expression of endothelial nitric oxide synthase (eNOS), and neuronal nitric oxide synthase (nNOS) was evaluated by immunofluorescence.Results.The kidney-to-body weight ratio, glomerular volume, the diameters of afferent arterioles (AA) and efferent arterioles (EA), erythrocyte velocities within glomeruli, and volume flow in glomerular capillary loops in four-day DM were significantly higher than in control rats, and increases were even more pronounced in the 28-day DM. TCV-116 treatment ameliorated all these findings and significantly decreased proteinuria, but there was no effect on the blood glucose level. On the other hand, insulin treatment was followed by normalization of all these changes induced in DM. Enhanced renal expression of eNOS in DM was suppressed when treated with either TCV-116 or insulin, while expression of nNOS was unaltered among the four groups.Conclusion.This imaging procedure allowed us to evaluate glomerular microcirculation in vivo, including the diameters of AA and EA, erythrocyte velocity, and volume flow. DM significantly induced glomerular hemodynamic alteration and renal hypertrophy. DM treated with either insulin or ARB ameliorated these changes. This study shows that progress in imaging technology promises to make major contributions to revealing the involvement of hemodynamic changes in glomerular diseases, aiding prognosis and the monitoring of therapeutic effects, as well. [ABSTRACT FROM AUTHOR]

We cloned the full-length cDNA of ABCA2. ABCA2 is expressed predominantly in the oligodendrocytes in the brain, and onset of ABCA2 expression in the oligodendrocytes coincides with the appearance of thick myelin basic protein (MBP)-immunolabeled myelin segments. Oligodendrocytes produce the lamellar structure myelin, which is composed of phospholipids and specific myelin proteins. We also cloned ABCA3 from human lung and found that ABCA3 is expressed predominantly at the limiting membrane of the lamellar bodies of alveolar type II cells in human lung. Pulmonary surfactant, composed mainly of phospholipids and specific surfactant proteins, is stored as lamellar bodies before exocytosis into the alveolar space. These data suggest that ABCA2 and ABCA3 are involved in membrane transport of substrates such as the lipids that are closely linked to myelin and surfactant formation processes. [Copyright &y& Elsevier]

Objective: To demonstrate the effects of the selective G protein-coupled estrogen receptor 1 (GPER) agonist G-1 in human ovarian endometriotic stromal cells (ESCs).Design: Experimental in vitro study.Setting: University hospital.Patient(s): A total of 33 patients with ovarian endometrioma.Intervention(s): Endometriotic stromal cells from ovarian chocolate cysts were treated with the GPER agonist G-1.Main Outcome Measure(s): The primary outcomes were cell proliferation, measured using the WST-8 assay; cell cycle, as analyzed using flow cytometry, fluorescent immunocytochemistry, and cytotoxicity; caspase activity, as measured by fluorescent and luminescent enzyme assays; and protein expression levels, as determined by Western blot analysis.Result(s): G-1 suppressed ESC proliferation in a concentration-dependent manner. The inhibitory effect was not blocked when GPER signaling pathways, including the GPER itself, were inhibited. G-1 induced cell cycle arrest and accumulation in the sub-G1 phase in ESCs. Immunofluorescence analysis demonstrated that G-1 interrupted microtubule assembly at the mitotic phase. G-1 also induced caspase-3-dependent apoptosis without significant cytotoxicity.Conclusion(s): G-1 suppressed proliferation and induced apoptosis in ESCs, suggesting the potential use of this compound as a therapeutic drug for the treatment of endometriosis. [ABSTRACT FROM AUTHOR]