Stent Application for the Treatment of Cerebral Aneurysms

Rapid and striking development in both the techniques and devices make it possible to treat most of cerebral aneurysms endovascularly. Stent has become one of the most important tools in treating difficult aneurysms not feasible for simple coiling. The physical features, the dimensions, and the functional characteristics of the stents show considerable differences. There are also several strategies and tips to treat difficult aneurysms by using stent and coiling. Nevertheless, they require much experience in clinical practice as well as knowledge of the stents to treat cerebral aneurysms safely and effectively. In this report, a brief review of properties of the currently available stents and strategies of their application is presented

Reanalysis Product-Based Nonstationary Frequency Analysis for Estimating Extreme Design Rainfall

Nonstationarity is one major issue in hydrological models, especially in design rainfall analysis. Design rainfalls are typically estimated by annual maximum rainfalls (AMRs) of observations below 50 years in many parts of the world, including South Korea. However, due to the lack of data, the time-dependent nature may not be sufficiently identified by this classic approach. Here, this study aims to explore design rainfall with nonstationary condition using century-long reanalysis products that help one to go back to the early 20th century. Despite its useful representation of the past climate, the reanalysis products via observational data assimilation schemes and models have never been tested in representing the nonstationary behavior in extreme rainfall events. We used daily precipitations of two century-long reanalysis datasets as the ERA-20c by the European Centre for Medium-Range Weather Forecasts (ECMWF) and the 20th century reanalysis (20CR) by the National Oceanic and Atmospheric Administration (NOAA). The AMRs from 1900 to 2010 were derived from the grids over South Korea. The systematic errors were downgraded through quantile delta mapping (QDM), as well as conventional stationary quantile mapping (SQM). The evaluation result of the bias-corrected AMRs indicated the significant reduction of the errors. Furthermore, the AMRs present obvious increasing trends from 1900 to 2010. With the bias-corrected values, we carried out nonstationary frequency analysis based on the time-varying location parameters of generalized extreme value (GEV) distribution. Design rainfalls with certain return periods were estimated based on the expected number of exceedance (ENE) interpretation. Although there is a significant range of uncertainty, the design quantiles by the median parameters showed the significant relative difference, from −30.8% to 42.8% for QDM, compared with the quantiles by the multi-decadal observations. Even though the AMRs from the reanalysis products are challenged by various errors such as quantile mapping (QM) and systematic errors, the results from the current study imply that the proposed scheme with employing the reanalysis product might be beneficial to predict the future evolution of extreme precipitation and to estimate the design rainfall accordingly

Role of G{alpha}12 and G{alpha}13 as Novel Switches for the Activity of Nrf2, a Key Antioxidative Transcription Factor

G{alpha}12 and G{alpha}13 function as molecular regulators responding to extracellular stimuli. NF-E2-related factor 2 (Nrf2) is involved in a protective adaptive response to oxidative stress. This study investigated the regulation of Nrf2 by G{alpha}12 and G{alpha}13. A deficiency of G{alpha}12, but not of G{alpha}13, enhanced Nrf2 activity and target gene transactivation in embryo fibroblasts. In mice, G{alpha}12 knockout activated Nrf2 and thereby facilitated heme catabolism to bilirubin and its glucuronosyl conjugations. An oligonucleotide microarray demonstrated the transactivation of Nrf2 target genes by G{alpha}12 gene knockout. G{alpha}12 deficiency reduced Jun N-terminal protein kinase (JNK)-dependent Nrf2 ubiquitination required for proteasomal degradation, and so did G{alpha}13 deficiency. The absence of G{alpha}12, but not of G{alpha}13, increased protein kinase C {delta} (PKC {delta}) activation and the PKC {delta}-mediated serine phosphorylation of Nrf2. G{alpha}13 gene knockout or knockdown abrogated the Nrf2 phosphorylation induced by G{alpha}12 deficiency, suggesting that relief from G{alpha}12 repression leads to the G{alpha}13-mediated activation of Nrf2. Constitutive activation of G{alpha}13 promoted Nrf2 activity and target gene induction via Rho-mediated PKC {delta} activation, corroborating positive regulation by G{alpha}13. In summary, G{alpha}12 and G{alpha}13 transmit a JNK-dependent signal for Nrf2 ubiquitination, whereas G{alpha}13 regulates Rho-PKC {delta}-mediated Nrf2 phosphorylation, which is negatively balanced by G{alpha}12

Adjuvant Coil Assisted Glue Embolization of Vein of Galen Aneurysmal Malformation in Pediatric Patients

PurposeAdjuvant coils may offer advantages in flow control during glue embolization of high flow vein of Galen aneurysmal malformation (VGAM) patients but involves specific issues such as feasibility, durability and coil mass effect. The purpose of this study is to assess the outcome of adjuvant coils in addition to transarterial glue embolization for treatment of these patients.Materials and MethodsFive pediatric VGAM patients (age range; 11 weeks to 2 yrs 2 mos) with high flow fistulous angioarchitecture were treated with adjuvant coils 1) in the distal feeding artery and/or 2) in the vein of Galen followed by glue embolization of the shunt. The angiographic / clinical outcomes were assessed.ResultsAdjuvant coils were deployed in the distal feeding artery (n=3), vein of Galen pouch plus distal feeding artery (n=2). Additional transarterial glue embolization of the fistulae was successfully performed (n=4). Complete occlusion was achieved with coils in one case. Complete occlusion was achieved for all mural type cases (n=4). Residual feeders remained in a case of choroidal type of VGAM. No complications were noted related to the treatment. All patients showed normal development on follow up (range: 7.6 to 88.8 mo, mean 49.3 mo). Initial hydrocephalus improved on follow up despite coil mass effect in dilated vein of Galen.ConclusionAdjuvant coils for flow control with glue embolization may be a safe and effective treatment method for VGAM patients with high flow fistulous feeders