Application of liposomes incorporating doxorubicin with sialyl Lewis X to prevent stenosis after rat carotid artery injury

Restenosis remains a serious complication that can occur after angioplasty. This study investigated the efficiency of an active targeting chemotherapy using liposomes, including doxorubicin, whose surface was decorated with sialyl Lewis X (SLX) (Dox-Lipo-SLX) to prevent stenosis after angioplasty. Its delivery was controlled via the affinity between SLX and E-selectin proteins, which are expressed on vessel walls with injury. In vitro experiments confirmed the accumulation of doxorubicin as a consequence of Dox-Lipo-SLX adhering to E-selectin-positive cells. Significant doxorubicin accumulation was observed on injured vessel walls in rats treated with Dox-Lipo-SLX. In contrast, there was little accumulation using free doxorubicin or a liposome containing doxorubicin (Dox-Lipo), but without SLX. Rats were assigned to one of four groups: Dox-Lipo-SLX, Dox-Lipo, free doxorubicin, or no treatment. Dox-Lipo-SLX, Dox-Lipo, and free doxorubicin, including a dose of 0.08 mg/kg doxorubicin, were intravenously administered three times in each group after angioplasty. The residual lumen area of rats in the group treated with Dox-Lipo-SLX was significantly larger than those in all other groups. These results demonstrate that an active targeting drug delivery system utilizing Dox-Lipo-SLX effectively prevents stenosis after angioplasty

Photodynamic Diagnosis Using 5-Aminolevulinic Acid in 41 Biopsies for Primary Central Nervous System Lymphoma

We evaluated the feasibility of 5-aminolevulinic acid (5-ALA)-mediated photodynamic diagnosis (PDD) in the biopsy for primary central nervous system lymphoma (PCNSL). 5-ALA (20 mg kg−1) was administered orally 4 hours preoperatively. Forty-one biopsies obtained under PDD in 47 consecutive biopsies (46 patients) that were finally pathologically diagnosed as PCNSL were evaluated. Positive fluorescence was observed in 34 of those 41 biopsies (82.9%). An intraoperative pathological diagnosis (IOD) of suspected PCNSL was made in 21 of the biopsies with positive fluorescence (61.8%). However, the eight IODs in the remaining 13 biopsies (23.5%) were not correct (atypical cell, 4; high-grade glioma, 1; gliosis, 1; unremarkable, 2). In those 8 biopsies, PCNSL was confirmed by the final pathological diagnosis. There was no difference in the mean Mib-1 labeling index between the biopsies with positive fluorescence (86.5%) and those without positive fluorescence (90.0%). IOD was not performed in 6 biopsies; however, 5 of those biopsies (83.3%) showed positive fluorescence and were finally pathologically diagnosed as PCNSL. Use of PDD in biopsies for patients with suspected PCNSL is a reliable way of obtaining specimens of adequate quality for the final pathological diagnosis and may lead to improved diagnostic yield in the biopsy of PCNSL

Radioprotection of eye lens using protective material in neuro cone-beam computed tomography: Estimation of dose reduction rate and image quality.

In cerebral angiography, for diagnosis and interventional neuroradiology, cone-beam computed tomography (CBCT) scan is frequently performed for evaluating brain parenchyma, cerebral hemorrhage, and cerebral infarction. However, the patient\u27s eye lens is more frequently exposed to excessive doses in these scans than in the previous angiography and interventional neuroradiology (INR) procedures. Hence, radioprotection for the lenses is needed. This study selects the most suitable eye lens protection material for CBCT from among nine materials by evaluating the dose reduction rate and image quality

Intravenous Thrombolysis Increases the First Pass Effect for Large Vessel Occlusion Treated With Mechanical Thrombectomy

Background It remains unclear whether intravenous thrombolysis (IVT) influences the incidence of the first pass effect (FPE) in patients with acute large vessel occlusion treated with mechanical thrombectomy (MT). Therefore, this study investigated the effects of IVT on FPE in patients treated with MT. Methods This is a post hoc analysis of the SKIP (Direct Mechanical Thrombectomy in Acute LVO Stroke) study, which was an investigator‐initiated, multicenter, randomized, open‐label clinical trial performed in 23 hospital networks in Japan from January 1, 2017, to July 31, 2019. Among 204 patients, 24 were excluded because they did not undergo MT. Patients treated with MT alone were compared with those treated with MT+IVT for the incidence of FPE (achieving a modified treatment in cerebral ischemia score of 2c or 3 after the first MT pass). Additional subgroup analyses were performed to investigate factors more closely related to the association between IVT and FPE. Results Among the 180 patients, 91 were treated with MT alone and 89 were treated with MT+IVT. FPE was achieved in 56 patients (31.1%). The incidence of FPE was significantly higher in patients treated with MT+IVT than in those treated with MT alone (39.3% versus 23.0%, respectively; P=0.02). In the subgroup analyses, IVT markedly increased FPE in female patients and tended to increase FPE in patients with first‐segment middle cerebral artery distal occlusion and onset to hospital arrival time >100 minutes. Conclusion IVT using alteplase increased the incidence of FPE in Japanese patients with acute ischemic stroke treated with MT. Trial Registration : Trial registration umin.ac.jp/ctr identifier: UMIN00002148

Endovascular Treatment for Basilar Artery Occlusion Caused by Radiation-induced Vertebral Artery Stenosis: Case Report

Objective: We report endovascular treatment of a patient with acute basilar artery occlusion considered to be due to an embolus from radiation-induced vertebral artery stenosis.Case Presentation: The patient was a 46-year-old male with a history of neck irradiation. He developed basilar artery occlusion. Temporary recanalization achieved by intravenous alteplase therapy and revascularization was followed by relapse. The origin of the vertebral artery was stenosed, and basilar artery was considered to have been embolized by a thrombus formed on the proximal side of the vertebral artery, where blood flow was stagnated due to reduced antegrade flow from the distal side of the stenotic vertebral artery and the increased collateral flow from the deep cervical artery. Recurrence of cerebellar infarction could be prevented by revascularization and occlusion of the parent artery.Conclusion: Acute basilar artery occlusion considered to be due to an embolus from radiation-induced vertebral artery stenosis is a rare condition, but it must be recognized as a possible cause of posterior circulation infarction