Current Advances in Endovascular Treatment of Intracranial Atherosclerotic Disease and Future Prospective

Objectives/BackgroundMedical therapy is the first line of treatment for intracranial atherosclerotic disease (ICAD). Percutaneous transluminal angioplasty and stenting (PTAS) are mainly considered for those patients with severe stenosis and recurrent events despite aggressive medical therapy. In this review, we discuss the application of PTAS as a treatment option for ICAD and its future prospect.Materials and MethodsWe did the literature review of the key articles and guidelines to elaborate on the role of PTAS in the management of ICAD based on the current data and expert opinion. We searched PubMed, Google Scholar, and Scopus up to August 2020, and included articles published only in the English language.ResultsSince the publication of the results from SAMMPRIS and VISSIT trials, stenting is no longer recommended for secondary stroke prevention in patients with symptomatic ICAD. However, recent clinical studies on intracranial stenting for a subgroup of ICAD patients have shown promising results, likely due to better patient selection and continued advancement of endovascular techniques.ConclusionThere exists a lack of consensus regarding the best endovascular treatment approach (e.g., angioplasty alone or balloon mounted stent vs. self-expanding stent with or without prior angioplasty) or management of in-stent restenosis. Another area of clinical controversy relates to the ideal use and duration of antiplatelet therapy.     

Benchmarking Various Radiomic Toolkit Features While Applying the Image Biomarker Standardization Initiative toward Clinical Translation of Radiomic Analysis

Journal of Digital Imaging - The image biomarkers standardization initiative (IBSI) was formed to address the standardization of extraction of quantifiable imaging metrics. Despite its effort,...     

A 62‐Year‐Old Female With an Intranasal Mass Extending into the Lamina Cribrosa

Malignant tumors with neuroendocrine differentiation of the nasal cavity include neuroendocrine carcinoma, small cell undifferentiated carcinoma, olfactory neuroblastoma (esthesioneuroblastoma), and sinonasal undifferentiated carcinoma (SNUC). The rarity of these tumors and overlapping clinical, histological and immunohistochemical findings make the correct diagnosis difficult. However accurate diagnosis is critical for therapy and the outcome differs significantly between these entities. Here we describe the case of a 62‐year‐old woman with an intranasal tumor extending into the adjacent anatomical compartments and with infiltration of the meninges. The suspected preoperative diagnosis was olfactory neuroblastoma. Histological and immunohistochemical analysis showed a lobulated tumor with neuroendocrine differentiation and we ultimately diagnosed the process as a SNUC. In this report, we discuss the differential diagnosis at hand and present histological findings found in the specimen indicating that the process originated from local glands present in the nasal mucosa.     

Expression patterns and functional evaluation of the UNC5B receptor during the early phase of peripheral nerve regeneration using the mouse median nerve model

Introduction: In this study, we evaluated the role of the Netrin‐1 receptor UNC5b (Uncoordinated), a neuronal guidance molecule, during peripheral nerve regeneration using the mouse median nerve model. Materials and methods: Using Western blot analysis, we examined the expression changes of UNC5b after transection and microsurgical repair of the mouse median nerve distal to the transection site. We evaluated the histomorphometrical changes and functional recovery of the grasping force after median nerve transection and repair in wild‐type (WT) mice and UNC5b^+/? heterozygous mice. Results: In Western blot analysis, we could show a high increase of UNC5b in the nerve segment distal to the injury site at day 14. Histomorphometrical analysis did not show any significant differences between WT animals and heterozygous animals. Using the functional grasping test, we could demonstrate that peripheral nerve regeneration is significantly diminished in heterozygous UNC5b^+/? mice. Conclusion: By using the mouse median nerve model in transgenic animals, we demonstrate that the Netrin‐1 receptor UNC5b plays an important role during peripheral nerve regeneration. © 2012 Wiley Periodicals, Inc. Microsurgery, 2013.     

Wound healing by topical application of antioxidant iron chelators: kojic acid and deferiprone

Kojic acid and deferiprone are iron chelators used for skin lightening and iron‐overload treatment, respectively. As iron chelation and free radical scavenging are principal factors for wound healing, it was hypothesised that the local application of these compounds might accelerate wound healing in rats. Ointments of 3%, 6% and 9% of deferiprone and kojic acid were prepared and topical treatment was performed on in vivo wound models for 12 days twice in day for test and control groups. Topical treatment with 3%, 6% and 9% showed significant improvement in wound healing after 4 days (P < 0·001). Topical application of 3% and 6% deferiprone enhanced wound healing after 8 days (P < 0·026 and P < 0·001, respectively). Accelerated wound healing was seen using 3% and 6% deferiprone after 12 days (P = 0·003 and P < 0·001, respectively). DPPH scavenging assay was also performed to compare the antioxidant potencies of kojic acid and deferiprone. Deferiprone had more free radical scavenging power than kojic acid. Generally, deferiprone topical treatment, accelerated wound healing more than kojic acid because of its higher antioxidant and iron chelation abilities.