Search

Objective To describe a method to display the three‐dimensional distribution of intraosseous arteries in the femoral head by vascular corrosion casting. Methods An experimental study was done to expose the intraosseous arteries of the femoral head by a microperfusion corrosion method between January 2021 and May 2021. Specimens were 23 swine femoral heads (12 female specimens and 11 male specimens, where age of swine ranged from 8 to 12 months, and the weight was approximately 150 kg). The femoral heads were microperfused with the vascular casting resin through retinacular arteries, and the bone of the femoral head was dissolved with 50% sodium hydroxide and 10% hydrochloric acid and rinsed under the microscope until the vessel casts were completely exposed. The distribution and anastomosis of the arteries in the femoral head were observed under direct vision and microscopy. The diameter of the artery in the femoral head was measured at 0.5 cm after its entry into the bone of the femoral head with a microscale under the microscope. The number of internal arteries with diameter ≥0.05 mm was counted. The number and diameter of the main trunk of the epiphyseal arteries in the femoral head between male and female swine were compared. Results The vascular casting specimen of the swine femoral head was successfully produced by using epoxy resin as a casting agent, and the three‐dimensional intraosseous vascular structures were clearly visible. The number of epiphyseal arteries in male and female swine was 8.55 ± 2.15 and 8.83 ± 2.15 (t = −0.31, p = 0.38), respectively. The diameters of the superior epiphyseal arteries in male and female swine were 0.35 ± 0.09 and 0.31 ± 0.08 mm (t = 1.03, p = 0.16), the diameters of the inferior epiphyseal arteries were 0.47 ± 0.05 and 0.49 ± 0.09 mm (t = −0.57, p = 0.29), and the diameters of the anterior epiphyseal arteries were 0.34 ± 0.08 and 0.33 ± 0.13 mm (t = 0.32, p = 0.37). There was no significant difference in the number and diameter of the main trunk of intraosseous arteries between male and female swine (p > 0.05). The main trunk of intraosseous arteries formed an anastomosis in the center of the femoral head. Among 23 swine femoral head samples, three types of intraosseous anastomosis were observed, including 13 (57%) posterior superior‐posterior inferior, seven (30%) posterior inferior‐anterior, and three (13%) uniform intraosseous anastomosis. Conclusion The microperfusion corrosion method can produce the vascular casting specimen of swine femoral head revealing the three‐dimensional structure of the intraosseous artery, which clearly shows the origin, course and branches, and diameter, as well as the anastomosis, of nutrient arteries in the femoral head. This method provides a simple and rapid technique for quantifying and visualizing intraosseous arteries.

Background New York City Emergency Medical Services implemented a prehospital triage protocol using a modified Speech–Los Angeles Motor Scale to identify patients with large‐vessel occlusion. Patients with Speech–Los Angeles Motor Scale ≥4 and last known well within 5 hours were routed to the nearest thrombectomy‐capable stroke center. Our aim was to describe the Speech–Los Angeles Motor Scale Triage Positive (STP) cohort and compare to a cohort that ultimately underwent endovascular thrombectomy (EVT) but were missed by the protocol (not triaged as Speech–Los Angeles Motor Scale positive [NSTP]). Methods A prospectively collected database identified patients arriving within 5 hours from last known well between April 2019 and March 2020. STP patients (N=145) were assessed for medical history, acute stroke time metrics, and clinical accuracy. NSTP (N=65) was subdivided into those who arrived directly to a thrombectomy‐capable stroke center (direct NSTP, N=30), and those transferred to a thrombectomy‐capable stroke center (transferred NSTP, N=35). Comparisons were made between the cohorts that underwent EVT. Results In the STP cohort, stroke was diagnosed in 110 of 145 (75.9%) patients: 31 hemorrhagic, 79 ischemic. There were 45 patients (31.0%) with large vessel occlusion and 34 (23.4%) underwent EVT. STP and NSTP subgroups had no difference in first medical contact‐to‐intravenous thrombolysis (≈90 minutes) despite STP patients taking 5 minutes longer to arrive. Ambulance travel times were similar (11 minutes). First medical contact‐to‐arterial access was similar in STP (137.9 minutes) and direct NSTP (137.9 minutes) groups but significantly shorter against transferred NSTP (252.1 minutes; P

Cerebral ischemia is one of the leading causes of human mortality and disability worldwide. The treatment of cerebral ischemia is refractory due to its short therapeutic window and lack of effective clinical drugs. Mitophagy, the autophagic elimination of damaged mitochondria, attenuates neuronal injury in cerebral ischemia, indicating the potential of mitophagy inducers as therapies for cerebral ischemia. We previously determined that, by enhancing autophagy flux, the steroidal alkaloid tomatidine can function as a neuroprotective agent against ischemic injury. However, its effects on mitophagy remain unknown. For this purpose, neuroblastoma cell lines Neuro‐2a and SH‐SY5Y were subjected to ischemic injury induced by oxygen–glucose deprivation/reperfusion (OGD/R) and then treated with tomatidine. OGD/R induced a general decrease of cellular contents, and this study revealed that tomatidine had no impact on mitophagy. In addition, tomatidine did not affect mitochondrial contents, including translocase of outer mitochondrial membrane 20 and voltage‐dependent anion channel 1, in either OGD/R‐treated or intact SH‐SY5H cells. Our results indicate that tomatidine exhibits its neuroprotective effects by enhancing autophagy, but in a potentially mitophagy‐independent manner, and provide insights for further investigation into its mechanism(s) and potential therapeutic use against cerebral ischemia.