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Indirect bypass surgery is an effective treatment for moyamoya disease (MMD), but the success of the surgery depends on the formation of spontaneous collateral vessels, which cannot be accurately predicted before surgery. Developing a prediction nomogram model for neoangiogenesis in patients after indirect revascularization surgery can aid surgeons in identifying suitable candidates for indirect revascularization surgery. This retrospective observational study enrolled patients with MMD who underwent indirect bypass surgery from a multicenter cohort between December 2010 and December 2018. Data including potential clinical and radiological predictors were obtained from hospital records. A nomogram was generated based on a multivariate logistic regression analysis identifying potential predictors of good neoangiogenesis. A total of 263 hemispheres of 241 patients (mean ± SD age 24.38 ± 15.78 years, range 1–61 years) were reviewed, including 168 (63.9%) hemispheres with good postoperative collateral formation and 95 (36.1%) with poor postoperative collateral formation. Based on multivariate analysis, a nomogram was formulated incorporating four predictors, including age at operation, abundance of ICA moyamoya vessels, onset type, and Suzuki stage. The C-index for this nomogram was 0.80. Calibration curve and decision-making analysis validated the fitness and clinical application value of this nomogram. The nomogram developed in this study exhibits high accuracy in predicting good neoangiogenesis after indirect revascularization surgery in MMD patients. This model can be very helpful for clinicians when making decisions about surgical strategies for MMD patients in clinical practice. [ABSTRACT FROM AUTHOR]

The greater amberjack is a very important fishery species with high commercial value, and it is distributed worldwide. Transcriptome-based studies on S. dumerili have been limited by an inadequate reference genome and a lack of well-annotated full-length transcripts. In this study, a total of 12 tissues from juvenile and adult fish both sexes were collected for next-generation RNA sequencing (RNA-seq) and full-length isoform sequencing (Iso-seq). For Iso-seq, a total of 163,218, 149,716, and 189,169 high-quality unique transcript sequences were obtained, with an N50 of 5,441, 5,255, and 5,939, from juvenile, adult male and adult female S. dumerili, respectively. We integrated the Iso-seq and RNA-seq data to construct a comprehensive gene annotation and systematically profiled the dynamics of gene expression across the 12 tissues. Our gene models had greater detail and accuracy than those from NCBI and Ensembl, with more precise polyA locations. These resources serve as a foundation for functional genomic studies and provide valuable insights into the molecular mechanisms underlying the development, reproduction and commercial traits of amberjack. [ABSTRACT FROM AUTHOR]

Arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) are uncommon conditions with complex angioarchitecture. The objective of this study was to identify the angioarchitectural features of CCJ-AVF that were predictive of clinical presentation and neurological function. The study encompassed a total of 68 consecutive patients with CCJ-AVF at two neurosurgical centers between 2014 and 2022. Additionally, a systematic review was conducted, including 68 cases with detailed clinical data obtained via PubMed database spanning 1990 to 2022. Clinical and imaging data were collected and pooled together to analyze factors associated with subarachnoid hemorrhage (SAH), myelopathy, and modified Rankin scale (mRS) at presentation. The mean age of the patients was 54.5 ± 13.1 years, with 76.5% of them being male. The most common feeding arteries were V3-medial branches (33.1%), and drainage was frequently through the anterior or posterior spinal vein/perimedullary vein (72.8%). SAH was the most common presentation (49.3%), and an associated aneurysm was identified as a risk factor for SAH (adjusted OR, 7.44; 95%CI, 2.89–19.15). Anterior or posterior spinal vein/perimedullary vein (adjusted OR, 2.78; 95%CI, 1.00–7.72) and male gender (adjusted OR, 3.76; 95%CI, 1.23–11.53) were associated with higher risk for myelopathy. Myelopathy at presentation was an independent risk factor for unfavorable neurological status (adjusted OR per score, 4.73; 95%CI, 1.31–17.12) in untreated CCJ-AVF. The present study identifies risk factors associated with SAH, myelopathy, and unfavorable neurological status at presentation in patients with CCJ-AVF. These findings may help treatment decisions for these complex vascular malformations. [ABSTRACT FROM AUTHOR]

Purpose: Intracranial vertebral artery dissecting aneurysm (IVADA) is a rare type of aneurysm with high morbidity and mortality. Recently, the application of pipeline embolization devices (PEDs) has been extended to IVADAs. Here, we aim to investigate the safety and effectiveness of PEDs for IVADAs. Method: We retrospectively reviewed the PLUS database to identify patients who had IVADAs and were treated with PEDs from 2014 to 2019 at 14 centers across China. Data including patient and aneurysm characteristics, procedure details, angiographic and clinical results, relationship with the ipsilateral posterior inferior cerebellar artery (PICA), and patency of the PICA following PED coverage were analyzed. Results: In this study 52 consecutive patients with 52 IVADAs were included. The mean age was 52.33 years and 82.7% were male. With a median follow-up of 10.5 months, the complete occlusion rate was 93.8% (45/48) and no recurrence or in-stent stenosis was detected. The total postoperative complication rate and mortality were 11.5% and 1.9%, respectively. Complications occurred in 9.6% (5/52) of patients within 30 days after the operation, including ischemic stroke in 3 and hemorrhagic stroke in 2. Another patient suffered an ischemic stroke at follow-up, 78.8% (41/52) PICAs were covered by PEDs, 1 case (2.4%) had a functional disability due to PICA occlusion, while 39.0% (16/41) had reduced flow during follow-up but hardly caused any obvious neurological deficits. Patients with IVADA involving PICA had a trend towards more complications (66.7% vs. 51.1%; P = 1). Conclusion: Treating IVADAs with PEDs may be a safe and effective option, with favorable clinical and angiographic outcomes; however, complications associated with this treatment should not be ignored. Registration: http://www.clinicaltrials.gov. Unique identifier: NCT03831672 [ABSTRACT FROM AUTHOR]

This study aims to investigate the correlation between AVM size and rupture by examining natural history, angioarchitecture characteristics, and quantitative hemodynamics. A retrospective review of 90 consecutive AVMs from the MATCH registry was conducted. Patients were categorized into small nidus (< 3 cm) and large nidus (≥ 3 cm) groups based on the Spetzler-Martin grading system. Natural history analysis used prospective cohort survival data, while imaging analysis examined angioarchitecture characteristics and quantitative hemodynamic parameters measured with QDSA. The small-nidus group had a significantly higher annualized rupture risk (2.3% vs. 1.0%; p = 0.011). Cross-sectional imaging revealed independent hemorrhagic risk factors, including small nidus (OR, 4.801; 95%CI, 1.280–18.008; p = 0.020) and draining vein stenosis (OR, 6.773; 95%CI, 1.179–38.911; p = 0.032). Hemodynamic analysis identified higher stasis index in the feeding artery (OR, 2.442; 95%CI, 1.074–5.550; p = 0.033), higher stasis index in the draining vein (OR, 11.812; 95%CI, 1.907–73.170; p = 0.008), and lower outflow gradient in the draining vein (OR, 1.658; 95%CI, 1.068–2.574; p = 0.024) as independent predictors of AVM rupture. The small nidus group also showed a higher likelihood of being associated with hemorrhagic risk factors. Small AVM nidus has a higher risk of rupture based on natural history, angioarchitecture, and hemodynamics. Clinical Trial Registration-URL:http://www.clinicaltrials.gov. Unique identifier: NCT04572568. [ABSTRACT FROM AUTHOR]

Moyamoya disease (MMD) is a chronic and progressive cerebrovascular stenosis or occlusive disease that occurs near Willis blood vessels. The aim of this study was to investigate the mutation of DIAPH1 in Asian population, and to compare the angiographic features of MMD patients with and without the mutation of the DIAPH1 gene. Blood samples of 50 patients with MMD were collected, and DIAPH1 gene mutation was detected. The angiographic involvement of the posterior cerebral artery was compared between the mutant group and the non-mutant group. The independent risk factors of posterior cerebral artery involvement were determined by multivariate logistic regression analysis. DIAPH1 gene mutation was detected in 9 (18%) of 50 patients, including 7 synonymous mutations and 2 missense mutations. However, the incidence of posterior cerebral artery involvement in mutation positive group was very higher than that in mutation negative group (77.8% versus 12%; p = 0.001). There is an association between DIAPH1 mutation and PCA involvement (odds ratio 29.483, 95% confidence interval 3.920–221.736; p = 0.001). DIAPH1 gene mutation is not a major genetic risk gene for Asian patients with moyamoya disease but may play an important role in the involvement of posterior cerebral artery. [ABSTRACT FROM AUTHOR]

Background: Glioma is the most common intracranial malignancy in adults with a high degree of malignancy and poor prognosis, which is largely attributed to the existence of glioma stem cells (GSCs). Previous evidence indicated that the matrix metalloproteinase ADAMTS1 was implicated in the process of tumor invasion, but the involvement of ADAMTS1 in glioma malignant invasion remains poorly understood. Methods: The expression and prognosis values of ADAMTS1 were investigated in patients with glioma based on ONCOMINE and GEPIA databases. ADAMTS1 expression of different malignancy grade tissues was determined by immunohistochemistry. The effects of ADAMTS1 on cell proliferation and invasion were determined by clone formation assay and Transwell migration assay. The animal experiment was performed in an intracranial orthotopic xenograft model by knockout of ADAMTS1. Stemness properties and Notch1-SOX2 pathway were examined in stable ADAMTS1 knockdown GSCs. Results: The expression levels of ADAMTS1 were significantly higher in glioma tissues and significantly correlated with the grade of malignancy and prognosis of glioma. Elevated ADAMTS1 expression was associated with SOX2, N-cadherin and the resistance of chemoradiotherapy of glioma patients. ADAMTS1 knockout suppressed the intracranial orthotopic xenograft growth and prolonged the survival of xenograft mice in vivo. Mechanistically, we found a blockade of the migration and invasiveness of GSCs and the expression levels of Notch1 and SOX2 in absence of ADAMTS1. Conclusion: As a biomarker for prediction of prognosis, ADAMTS1 may affect the invasive phenotype of GSCs by regulating Notch1-SOX2 signaling pathway, thereby promoting the invasive growth of glioma. [ABSTRACT FROM AUTHOR]

Arteriovenous malformations (AVMs) are the most common types of cerebral vascular malformations, which are dynamic lesions with de novo growth potentials. The dysfunction of endothelial cells has been postulated to play a role in the pathogenesis of brain AVMs. mTOR-FABP4 signal enhances the angiogenic responses of endothelial cells and is not activated in the normal cerebral vasculature. Herein, we investigated the hypothesis that the mTOR-FABP4 signal may be activated in brain AVMs. The abundance of molecules in mTOR-FABP4 signal expression was detected by immunohistochemistry and Western blotting; special expressing cells were further characterized by double immunofluorescence using antibodies against various cell-specific markers. Next, several functional assays were performed to analyze the influence of the mTOR-FABP4 signal on proliferation, apoptosis, migration, and vascular tube formation of endothelial cells in human umbilical vein endothelial cells (HUVECs) using rapamycin and L-leucine. The expression of mTOR, p-mTOR, and FABP4 was increased in endothelial cells of human brain AVMs. Endothelial cell mTOR and p-mTOR expression were present in 70% and 55% of brain AVMs, respectively. Moreover, a population of FABP4-positive endothelial cells was detected in 80% of brain AVMs. The mTOR-FABP4 signal was activated and inhibited by L-leucine and rapamycin in HUVECs. The proliferation, apoptosis, migration, and vascular tube formation of endothelial cells could be inhibited by rapamycin. The mTOR-FABP4 signal was activated in human brain AVMs, and the mTOR-FABP4 signal was involved in proliferation, apoptosis, migration, and the vascular tube formation of endothelial cells. Taken together, whether rapamycin has therapeutic potential for treating human brain AVMs is worthy of further study. Key messages: We confirmed that the mTOR- FABP4 pathway is activated in human brain arteriovenous malformations. We confirmed that mTOR signaling pathway affects endothelial cell function by regulating proliferation, migration, apoptosis, and tube formation of endothelial cell. Our study can provide theoretical support for mTOR pathway inhibitors in the treatment of human brain arteriovenous malformations. [ABSTRACT FROM AUTHOR]

Phthalate esters (PAEs) are prone to migrate from the plastic containers into oil during production and storage process. Owing to the trace amount of PAEs and complex sample matrix, it is of great importance to explore a facile and sensitive way to extract and detect PAEs from oil samples. In this work, magnetic covalent organic framework nanospheres (Fe3O4@COF(TbBD)) were fabricated by the aldehyde-amine condensation between benzidine (BD) and 1,3,5-triformylbenzene (Tb) on the surface of Fe3O4 nanoparticles with the help of ultrasonic treatment. The new type nanomaterials were firstly used to the magnetic solid-phase extraction (MSPE) of seven PAEs in edible vegetable oils prior to high performance liquid chromatography coupled with a diode array detector (HPLC–DAD). In order to achieve the best extraction efficiency, several key parameters were optimized. Under optimal conditions, the proposed Fe3O4@COF(TbBD)-MSPE-HPLC–DAD method possessed high sensitivity (0.55–0.95 µg/kg for LODs and 1.80–3.10 µg/kg for LOQs), good linearity (R2 ≥ 0.9983), and satisfactory recoveries (80.2–102.9%). The RSDs for intra-day was less than 6.1%, and inter-day was less than 7.9%. This work not only proposed a rapid and reliable approach for determining PAEs in edible vegetable oils but also broadened the application of magnetic COFs in food determination. [ABSTRACT FROM AUTHOR]

MiR-143-3p is aberrantly expressed in patients with ischemic stroke and associated with ischemic brain injury. However, the underlying mechanisms are largely unknown. Here, we confirmed circ_0025984 and TET1 as a sponge and target of miR-143-3p, respectively, by luciferase reporter assay. In astrocytes, OGD significantly decreased circ_0025984 and TET1 levels but increased miR-143-3p levels, which was also observed in brains of mice with MCAO. Treatment with miR-143-3p inhibitor or circ_0025984 significantly decreased astrocyte apoptosis and autophagy, as well as cerebral injury and neuron loss in mice with MCAO. Notably, TET1 overexpression decreased astrocyte apoptosis and autophagy and induced promoter hypomethylation and expression of ORP150. Our results demonstrated for the first time that circ_0025984 protects astrocytes from ischemia-induced autophagy and apoptosis by targeting the miR-143-3p/TET1 pathway and might inhibit cerebral injury induced by ischemic stroke. Furthermore, our data revealed the important positive regulation of ORP150 by TET1, which could be associated with its neuroprotective role. [ABSTRACT FROM AUTHOR]

This study aims to investigate the long-term outcomes of unruptured giant intracranial aneurysms (GIAs) with different treatment modalities and to analyze the factors affecting prognosis. We performed a retrospective medical record review of patients with unruptured GIAs treated at our institution from 2011 to 2018. Prognosis was compared to the best medical treatment without intervention (conservative treatment, CT) and surgical (ST) or endovascular (ET) treatment. Risk factors for mortality were investigated. A total of 276 patients were included in this study. Patients received CT in 16.3%, ST in 30.1%, and ET in 53.6% of cases. After an average 7-year follow-up, the rupture rate after CT was 22.2%, accounting for an annual rupture rate of 7.3%. The postoperative complication rate was 30.1% and 8.1% after ST and ET, respectively. The recurrence rate after ET was 10.1%, compared with ST which was 1.2%. The follow-up mortality in unruptured GIAs was 26.7% after CT, 7.2% after ST, and 5.4% after ET. Older age (50~59, HR 5.877; 60~69, HR 8.565), size ≥ 40 mm (HR 3.916), and posterior circulation location (HR 6.411) were associated with increased mortality. ET significantly decreased mortality (HR 0.191). Unruptured GIAs warrant treatment if feasible due to the high rupture rate and mortality of the natural history. Older age, posterior circulation location, and larger size are risk factors for poor prognosis. Both ST and ET showed a lower mortality rate than CT. ST showed less likely recurrence compared to ET, while ET had a lower complication rate than ST. [ABSTRACT FROM AUTHOR]

Comparison in pediatric hemorrhagic arteriovenous malformations (AVMs) to clarify the long-term neurological outcomes and prognostic predictors after surgical intervention was relatively rare, especially in the selection of surgical timing. The objective of this study was to elucidate these points. The authors retrospectively reviewed the pediatric hemorrhagic AVMs resected in their neurosurgical department between March 2010 and June 2017. The natural history was represented by rupture risk. Neurological outcome was assessed with the modified Rankin Scale (mRS) for children. Multivariate logistic regression analyses were used to assess the risk factors for disability (mRS > 2). The hemorrhagic early phase was defined as less than 30 days after bleeding. The corresponding prognosis of different surgical timing (early intervention or delayed intervention) was compared after propensity-score matching (PSM). A total of 111 pediatric hemorrhagic AVM patients were evaluated. The average patient age was 11.1 ± 4.0 years, with a mean follow-up of 4.3 ± 2.1 years. The annualized rupture risk was 9.3% for the pediatric hemorrhagic AVMs, and the annualized re-rupture risk was 9.8%. 7.2% of the patients had disabilities (mRS > 2) and 82.0% achieved neurological deficit-free (mRS < 2) at the last follow-up. Pre-treatment mRS (P = 0.042) and flow-related aneurysms (P = 0.039) were independent factors for long-term disability. In terms of short-term outcomes, early intervention was better than delayed intervention (P = 0.033), but the long-term outcomes were similar between the two groups (P = 0.367). Surgical intervention for pediatric hemorrhagic AVMs is recommended, most of the patients can achieve good neurological outcomes. Moreover, early surgical intervention is preferred after the initial hemorrhage. [ABSTRACT FROM AUTHOR]

Keywords: Keyhole approach; Neurosurgery; Brain tumor; Aneurysm; Expert consensus EN Keyhole approach Neurosurgery Brain tumor Aneurysm Expert consensus 1 17 17 02/03/21 20210201 NES 210201 Qin Lan and Michael Sughrue contributed equally to this work. For anterior communicating artery aneurysms, the sylvian fissure is usually located at the lateral third of the bone window; two-thirds of the brain tissue exposed under the bone window is the frontal lobe, and the remaining third is the temporal lobe. For middle cerebral artery aneurysms or lateral posterior communicating artery aneurysms, the sylvian fissure is usually placed in the center of the bone window so that the temporal lobe can be slightly retracted after opening the sylvian fissure. It is extremely difficult to modify the surgical corridor during an operation [[62]]; for most aneurysm cases with intraoperative bleeding, the surgeon will control the bleeding and clip the aneurysm on his own, as space for the assistant to operate is limited [[38], [62]]. Technique for intraoperative aneurysm rupture The surgical procedures for aneurysm clipping using the keyhole approach are the same as those for the conventional microsurgical technique, even in the case of treating ruptured aneurysms. [Extracted from the article]

The corresponding hemodynamic changes of the internal carotid artery (ICA) after the revascularization surgery for moyamoya disease (MMD) remain unclear. The aim of this study was to analyze the hemodynamic changes of the ipsilateral ICA after the combined direct and indirect extracranial-intracranial (EC-IC) bypass. MMD patients undergoing combined EC-IC bypass were retrospectively reviewed. The mean transit time (MTT) of ICA was evaluated by color-coding angiography before revascularization and at follow-up. The MTT defined as the blood transit time between the end of cervical portion (C1) and the C7 segment of ICA. The clinical prognosis was assessed with Matsushima grading system, moyamoya vessel reduction system, and modified Rankin Scale (mRS). The correlation between hemodynamic parameter and prognosis was analyzed. Subgroup analysis was conducted between different presentations and different ages. Fifty-one patients were identified and the mean imaging follow-up interval was 5.5 months. The ICA-MTT was increased after the combined revascularization (P < 0.001) compared with contralateral ICA. Faster preoperative ICA-MTT was significantly associated with improved mRS in the ischemic group (P = 0.05). The increased ICA-MTT was significantly associated with favorable neoangiogenesis (P = 0.04), moyamoya vessel reduction (> 50%) (P = 0.023), and improved mRS score (P = 0.008). In subgroup analysis, the correlation in the ischemic subgroup and adult subgroup remained significant. In this cohort, the ICA-MTT increased after the combined EC-IC bypass, and there was a positive correlation between the increased blood transit time and favorable outcomes. Color-coding DSA proved to be useful as a quantitative and serial method to monitor postoperative courses after revascularization in MMD. [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM) is one of the most malignant neural tumors, and patients with GBM often die soon after the onset. The pathogenesis of GBM is very complicated, and there is no effective treatment for GBM. The current research results show that a variety of microRNA (miRNA) are involved in the regulation of GBM occurrence and development through specific signal pathways. Meanwhile, as a non-invasive biological indicator, there is an important clinical value of miRNA in the diagnosis and prognosis of GBM. The research of targeted miRNA treatment for GBM is still in the cell and animal model stage, although the basic research shows a good result, there is still a certain distance to the clinical application. [ABSTRACT FROM AUTHOR]

Objective: Indirect bypass surgery, which induces spontaneous neoangiogenesis in ischemic brain tissue and improves cerebral blood flow, is an effective treatment for moyamoya disease (MMD). The time course of neoangiogenesis development has not yet been investigated. This study aimed to determine the critical period of neovascularization after indirect bypass in MMD patients. Methods: Patients with MMD who underwent indirect bypass surgery at Peking University International Hospital between January 2015 and October 2017 were retrospectively reviewed. Surgically treated hemispheres with short-term (3–6 months) and long-term (1 year) follow-up digital subtraction angiography (DSA) were included. The effects of revascularization were evaluated on lateral and anteroposterior views using angiography and compared between two follow-ups of the same hemisphere. Results: This study included 25 hemispheres from 24 MMD patients (mean age: 22.48 ± 14.83 years), among whom 13 were pediatric patients and 12 were adults. Qualitative measurements including the Matsushima scale and coverage of neoangiogenesis on anteroposterior views were not significantly different between the short term and long term (P = 0.083 and P = 0.157, respectively). Quantitative measurements including the greatest width and height of the area covered by neovascularization on lateral views of DSA and the greatest depth of neovascularization penetration on anteroposterior views (P = 0.488, 0.298 and 0.527, respectively) were also not significantly different. The mean count of newly formed veins was more at long-term than short-term follow-up (5.5 ± 2.5 vs. 5.1 ± 2.4, P = 0.005). Subgroup analysis of pediatric patients and adults yielded the same results as in the whole series. Conclusion: After indirect bypass surgery, the major time window of arterial neoangiogenesis development was within 6 months after surgery. The general effect of revascularization was very similar in the short and long term; therefore, a follow-up angiography scheduled at 6 months after surgery is recommended. Growth of veins might continue after 6 months. [ABSTRACT FROM AUTHOR]

Blood blister-like aneurysms (BBAs) were considered a therapeutic challenge for both microsurgeons and endovascular therapists. While a great deal of efforts had been put to refining the treatment of BBAs, the diagnostic criteria had not been established yet. In this study, we reviewed data of 43 suspicious, small (< 1 cm), broad-necked aneurysms at supraclinoid segment of internal carotid artery (ICA) in 41 patients who had been treated with microsurgery in our hospital during the past 5 years. Diagnosis of BBAs and non-blister aneurysms was based on intraoperative findings. Epidemiological, clinical, and radiological features of BBAs and non-blister aneurysms were compared. Subtypes of BBAs were also compared. Discriminant analysis was used to generate a differentiating model for BBAs. Seventeen aneurysms were diagnosed as BBAs and 26 were diagnosed as non-blister aneurysms. No significant difference regarding age, gender, association of multiple aneurysms, or location on ICA was found between the groups. Dome/neck ratio and distal angle (intersection angle of aneurysm with ICA, distal to ophthalmic artery branching site) of BBAs were smaller than those of non-blister aneurysms (P = 0.009 and P = 0.002). A discriminant function including aforementioned factors with an overall accuracy of 76.2% was yielded (P = 0.005). BBAs and non-blister aneurysms were difficult to differentiate by clinical and radiological features as they share many characteristics in common. Dome/neck ratio < 1 did not guarantee accurate diagnosis of BBAs. A discriminant function incorporating dome/neck ratio and degree of distal angle as factors might increase the accuracy of pre-surgical diagnosis of BBAs. [ABSTRACT FROM AUTHOR]

The authors attempted to demonstrate the difference in language cortex reorganization between cerebral malformations (AVMs), cavernous malformations (CMs), and gliomas by blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. Clinical and imaging data of 27 AVM patients (AVM-L group), 29 CM patients (CM-L group), and 20 glioma patients (Glioma-L group) were retrospectively reviewed, with lesions overlying the left inferior frontal gyrus (Broca area). As a control, patients with lesions involving the right inferior frontal gyrus were also enrolled, including 14 AVM patients (AVM-R group), 20 CM patients (CM-R group), and 14 glioma patients (Glioma-R group). All patients were right-handed. Lateralization indices (LI) of BOLD signal activations were calculated separately for Broca and Wernicke areas. In AVM-L group, right-sided lateralization of BOLD signals was observed in 10 patients (37.0 %), including 6 in the Broca area alone, 1 in the Wernicke area alone, and 3 in both areas. Three patients (10.3 %) of CM-L group showed right-sided lateralization in both Broca and Wernicke areas, and 1 patient (5.0 %) of Glioma-L group had right-sided lateralization in the Wernicke area alone. A significant difference of right-sided lateralization was observed between the AVM-L group and CM-L group ( P = 0.018) and also between the AVM-L group and Glioma-L group ( P = 0.027). No patient in AVM-R, CM-R, or Glioma-R groups showed right-sided lateralization. Language cortex reorganization may occur in AVM, CM, and glioma patients when the traditional language cortex was involved by lesions, but the potential of reorganization for CM and glioma patients seems to be insufficient compared with AVM patients. [ABSTRACT FROM AUTHOR]

Background: In this aging society, attention has not been fully given to brain arteriovenous malformations (AVMs) in elderly patients. This study sought to describe a single institution's experience treating arteriovenous malformations (AVMs) in elderly patients. Methods: We conducted a retrospective review of brain AVMs in elderly patients treated at our institution between 1990 and 2012 with a focus on the clinical features, risk of hemorrhage and treatment outcomes. Results: Of the 2790 patients in our AVM database, 98 patients were over the age of 60 at presentation. Forty-eight percent presented with hemorrhage. Risks of initial hemorrhage were history of hypertension, smaller AVM size (<3 cm) and exclusively deep venous drainage. Treatment modalities were microsurgical resection in 65 %, embolization alone in 10 %, stereotactic radiosurgery (SRS) in 11 % and observation in 14 %. Preoperative embolization was performed in 32 % in the surgical group. Complete obliteration was achieved in 95 % by microsurgery, 30 % by embolization alone and 45 % by SRS. Good functional outcome (modified Rankin Scale, mRS <2) was achieved in 69 % after a median follow-up of 5.8 years. Multivariate logistic analysis revealed that a pretreatment mRS score ≥2, eloquent location and higher S-M grade (IV or V) were associated with worsening functional status, whereas surgical resection was a negative factor. Posttreatment hemorrhage occurred in 8 %. AVM-related death occurred in three patients (2 by surgery and 1 by observation). Conclusions: Brain AVMs in elderly patients still pose a high risk of hemorrhage. Initial hemorrhage may be associated with a history of hypertension, AVM size and exclusively deep venous drainage. Initial mRS score ≥2, eloquent location and higher S-M grade may be associated with worsening functional status. Microsurgical resection can be safe and effective for selected patients. Preoperative embolization is helpful in patients with S-M grade IV-V AVMs. For those with surgical contraindications, SRS and observation are treatment alternatives. [ABSTRACT FROM AUTHOR]

In this study, we extracted total RNA from 15 intracranial aneurysms and 17 superficial temporal artery samples, then performed genome-wide expression profiling using the Affymetrix U133 Plus 2.0 GeneChip. Genes that were differentially expressed between intracranial aneurysms and arterial samples were identified using significance analysis for microarrays, and the expression patterns of three randomly-selected genes were verified by real-time polymerase chain reaction analysis. We identified 3 736 differentially-expressed genes out of the 47 000 assayed transcripts. A total of 179 genes showed a >10-fold change in expression between the aneurysms and the arterial samples. Genes involved in the proliferation, migration, and apoptosis of vascular muscle cells, atherosclerosis, extracellular matrix disruption, and inflammatory reactions were associated with the formation of intracranial aneurysms. There were no significant differences in gene expression profile between unruptured and ruptured aneurysms. [ABSTRACT FROM AUTHOR]

The application of nanomaterial in cancer treatment is promising and intriguing. Anti-tumor immunotherapy has the potential to significantly improve the prognosis of cancer treatment, though the efficacy of immunotherapy generally needs further improvement. One way to improve the efficacy is using immune adjuvants, but the adjuvants for anticancer immunotherapy have to be more potent than for prophylactic vaccines. Here, we report that compared to conventional alum adjuvant, aluminum oxide nanoparticles (nano-alum) may further enhance the anticancer effects of an immunotherapy that employs tumor cell vaccine (TCV). The average tumor size tends to be lower in animals that receive the combinational treatment of nano-alum and TCV. The anticancer cytotoxicity by the lymphocytes was also significantly higher in the treatment group that received both TCV and nano-alum. These results suggest that nano-alum may potentially serve as a potent immune adjuvant and have prospective applications in anticancer immunotherapy. [ABSTRACT FROM AUTHOR]

This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage (SPH): computed tomographic-guided aspiration (CTGA) and the key-hole approach (KHA). The indications of the two approaches are also explored. From September 2001 to 2003, a total of 1077 cases of SPH distributed in 135 hospitals all over the mainland of China were included for analysis. All cases had three-month follow-up data. The study was designed in a single-blinded manner to compare the efficacies of the different approaches. There were 563 cases in the CTGA group, 165 in the KHA group, and 217 cases in the conventional open craniotomy (COC) group. In the CTGA and KHA groups, the mortalities at one month after operation (M1m) were 17.9% and 18.3%, respectively, while the mortalities at three months after operation (M3m) were 19.4% and 19.4%, respectively ( P>0.05). The postoperative complications due to CTGA (23.7%) were not significantly different from those due to KHA (25.7%) ( P = 0.420). The M3m of patients with Glasgow coma scale (GCS) ⩽8 was 3.45 and 4.0 times as much as those with GCS>8, respectively. The M3m of patients with complications was 3.92 times as much as those without complications. The M3m of patients with hemorrhage volume ⩾70 mL was 2.67 times as much as those <70 mL. The CTGA is not better than KHA in the treatment of SPH in terms of a more favorable outcome or less mortality and morbidity, but CTGA could be the first choice for those with bleeding volumes ≤50mL, while KHA is the first choice for those with bleeding volumes >50 mL. [ABSTRACT FROM AUTHOR]

The authors would like to update the affiliations and email addresses of the original publication as given in this correction. [ABSTRACT FROM AUTHOR]