Stent-assisted Coiling for Ruptured Basilar Artery Dissecting Aneurysms: An Initial Experience of Four Cases

No treatment strategy has been established for subarachnoid hemorrhages due to basilar artery (BA) trunk dissecting aneurysms. Our aim was to report our initial experience performing stent-assisted coiling (SAC) for ruptured BA dissecting aneurysms to validate the effectiveness of this treatment. We experienced four consecutive cases of ruptured dissecting BA trunk aneurysm treated with SAC between 2008 and 2014 at three institutions. Aneurysm rebleeding was prevented without causing severe brainstem ischemia in all cases. In our opinion, both the blockage of the inflow to aneurysms and the preservation of the antegrade flow of the BA can be achieved by SAC, although controversies regarding long-term stability and appropriate antiplatelet therapy remain.     

The optimal management of ruptured basilar artery dissecting aneurysms: a case series and scoping review

Neurosurgical Review - The natural history of ruptured basilar artery dissecting aneurysms (BADAs) remains unclear compared to that of ruptured vertebral artery dissecting aneurysms (VADAs). In...     

Characterization of the promoter region of the human PARG gene and its response to PU.1 during differentiation of HL‐60 cells

The metabolism of poly(ADP‐ribose) plays important roles in the nuclear function of mammalian cells. Previously, we analyzed expression of the poly(ADP‐ribose) glycohydrolase (PARG) gene during HL‐60 cell differentiation and found that expression was greatly reduced by 4 h after 12‐O‐tetradecanoyl‐phorbol‐13‐acetate (TPA) treatment and returned to the initial level within 20 h. In the present study, a 2.1‐kb fragment of the 5′‐flanking (promoter) region of the human PARG gene was isolated from the HL‐60 genome by polymerase chain reaction and ligated into a luciferase‐expression vector, pGL3, to generate the pPARG‐Luc#2 reporter plasmid. Deletion analysis revealed that a 75‐nt sequence is required for basal promoter activity and TPA responsiveness. Mutations in this 75‐nt sequence reduced promoter activity and the TPA response of HL‐60 cells. TFSEARCH analysis revealed that Ets family binding motifs are located in the 75‐nt sequence. Chromatin immunoprecipitation assay, electrophoretic mobility shift assay and competition analysis indicated that PU.1 (Spi‐1) binds to the 75‐nt sequence. Moreover, co‐transfection of HL‐60 cells with a PU.1 expression plasmid and pPARG‐Luc indicated that PU.1 down‐regulate the PARG promoter. These results suggest that PARG gene expression is modulated by PU.1 during TPA‐induced differentiation of HL‐60 cells.     

Subdural hematoma associated with dural metastasis--case report--

A 56-year-old female presented with acute subdural hematoma associated with dural metastasis. The patient had been treated for breast cancer with disseminated bone and lung metastases. Evacuation of the hematoma with local management of the tumor and bleeding successfully improved her neurological condition and she underwent postoperative radiotherapy. This condition is especially associated with dural metastasis from adenocarcinoma (most frequently stomach cancer) and the clinical outcome depends on the general condition of the patient and the status of the coagulation disorders. If the tumors are multiple, as in this case, extreme caution should be paid to recurrent bleeding in the ipsilateral or contralateral side.