A Review of the Circle of Willis: Investigative Methods, Anatomical Variations and Correlated Ischemic Brain Diseases

The Circle of Willis (CoW) is the most important collateral pathway communicating between the bilateral carotid system and the posterior circulation. Many techniques have been used to investigate the configuration and function of the CoW and their advantages and disadvantages are reviewed here. In previous studies, morphometric variation in CoW has been widely detected; however, the frequency of variation ranges largely, between 10% and 85%. Some differences in reported frequency may reflect differences in: the definition of CoW variation, the methods used to examine variation and study populations. Two conclusions, however, are clear: (i) the prevalence of variation in the posterior circle is higher than in that of the anterior circle; and (ii) variations in the CoW are correlated with cerebral or carotid vessel diseases. Although the cause of the variants remains unclear, both genetic background and hemodynamics could play important roles. Lastly, the correlation between the CoW and ischemic brain diseases is discussed. In future, artificial intelligence will be helpful for evaluating the CoW

Approaches to treat sensorineural hearing loss by hair-cell regeneration: The current state of therapeutic developments and their potential impact on audiological clinical practice

Sensorineural hearing loss (SNHL) is typically a permanent and often progressive condition that is commonly attributed to sensory cell loss. All vertebrates except mammals can regenerate lost sensory cells. Thus, SNHL is currently only treated with hearing aids or cochlear implants. There has been extensive research to understand how regeneration occurs in nonmammals, how hair cells form during development, and what limits regeneration in maturing mammals. These studies motivated efforts to identify therapeutic interventions to regenerate hair cells as a treatment for hearing loss, with a focus on targeting supporting cells to form new sensory hair cells. The approaches include gene therapy and small molecule delivery to the inner ear. At the time of this publication, early-stage clinical trials have been conducted to test targets that have shown evidence of regenerating sensory hair cells in preclinical models. As these potential treatments move closer to a clinical reality, it will be important to understand which therapeutic option is most appropriate for a given population. It is also important to consider which audiological tests should be administered to identify hearing improvement while considering the pharmacokinetics and mechanism of a given approach. Some impacts on audiological practice could include implementing less common audiological measures as standard procedure. As devices are not capable of repairing the damaged underlying biology, hair-cell regeneration treatments could allow patients to benefit more from their devices, move from a cochlear implant candidate to a hearing aid candidate, or move a subject to not needing an assistive device. Here, we describe the background, current state, and future implications of hair-cell regeneration research

Vesicular glutamatergic transmission in noise-induced loss and repair of cochlear ribbon synapses

Noise-induced excitotoxicity is thought to depend on glutamate. However, the excitotoxic mechanisms are unknown, and the necessity of glutamate for synapse loss or regeneration is unclear. Despite absence of glutamatergic transmission from cochlear inner hair cells in mice lacking the vesicular glutamate transporter-3

Clinical efficacy of the combined use of levofloxacin and different courses of isoniazid and rifampicin in the treatment of mild spinal tuberculosis

Purpose: To investigate the clinical effectiveness of the combined use of levofloxacin and different courses of isoniazid and rifampicin in the treatment of mild spinal tuberculosis (TB). Methods: The clinic data of 100 patients with light spinal TB were retrospectively reviewed. A double-blind technique was used to divide the patients into 6-month treatment group (M6 group, n = 32), 12-month treatment group (M12 group, n = 34) and 18-month treatment group (M18 group, n = 34). All patients were given isoniazid and rifampicin, in combination with levofloxacin. The effects of the different treatment courses on mild spinal TB were determined. Results: There were significantly higher post-treatment levels of inflammatory factors in M6 group than in M12 and M18 groups (p < 0.001). Moreover, there were significantly higher Visual Analogue Scale (VAS) score and erythrocyte sedimentation rate (ESR), and larger focus size in M6 group than in M12 and M18 groups (p < 0.05). However, after treatment, M18 group had significantly higher total incidence of adverse reactions than M6 and M12 groups (p < 0.05). Conclusion: Compared with the short-course treatment, long-course treatment with isoniazid and rifampicin in combination with levofloxacin is more effective in reducing the levels of inflammatory factors and decreasing focus size in patients with mild spinal TB. However, patients given the 18-month treatment tend to develop more adverse reactions. Therefore, 12-month treatment with the combined therapy is a better therapeutic option

Reduced macula microvascular densities may be an early indicator for diabetic peripheral neuropathy

Purpose: To assess the alteration in the macular microvascular in type 2 diabetic patients with peripheral neuropathy (DPN) and without peripheral neuropathy (NDPN) by optical coherence tomography angiography (OCTA) and explore the correlation between retinal microvascular abnormalities and DPN disease.Methods: Twenty-seven healthy controls (42 eyes), 36 NDPN patients (62 eyes), and 27 DPN patients (40 eyes) were included. OCTA was used to image the macula in the superficial vascular complex (SVC) and deep vascular complex (DVC). In addition, a state-of-the-art deep learning method was employed to quantify the microvasculature of the two capillary plexuses in all participants using vascular length density (VLD).Results: Compared with the healthy control group, the average VLD values of patients with DPN in SVC (p = 0.010) and DVC (p = 0.011) were significantly lower. Compared with NDPN, DPN patients showed significantly reduced VLD values in the SVC (p = 0.006) and DVC (p = 0.001). Also, DPN patients showed lower VLD values (p < 0.05) in the nasal, superior, temporal and inferior sectors of the inner ring of the SVC when compared with controls; VLD values in NDPN patients were lower in the nasal section of the inner ring of SVC (p < 0.05) compared with healthy controls. VLD values in the DVC (AUC = 0.736, p < 0.001) of the DPN group showed a higher ability to discriminate microvascular damage when compared with NDPN.Conclusion: OCTA based on deep learning could be potentially used in clinical practice as a new indicator in the early diagnosis of DM with and without DPN

Nomenclatural and taxonomic notes on Rubus davidianus Kuntze and R. viburnifolius Franch

Critical examinations of specimens, with literature reviews, have shown that Rubus davidianus is conspecific with R. lambertianus. Therefore, we treat R. davidianus as a new synonym within Rubus. We propose a new name, Rubus loirensis Ti R. Huang nom. nov. to replace the later homonym of R. pycnanthus Genev. Additionally, lectotypification of three names, R. davidianus Kuntze, R. malifolius Focke and R. viburnifolius Franch., are designated here after examination of previous works

Smoking and Risk of Kidney Failure in the Singapore Chinese Health Study

Background:The relationship between smoking and risk of kidney failure, especially in people of Chinese origin, is not clear. We analyzed data from the Singapore Chinese Health Study to investigate whether smoking increases the risk of kidney failure.Methods:The Singapore Chinese Health Study is a population-based cohort of 63,257 Chinese adults enrolled between 1993 and 1998. Information on smoking status was collected at baseline. Incidence of kidney failure was identified via record linkage with the nationwide Singapore Renal Registry until 2008. Kidney failure was defined by one of the following: 1) serum creatinine level of more than or equal to 500 μmol/l (5.7 mg/dl), 2) estimated glomerular filtration rate of less than 15 ml/min/1.73 m2, 3) undergoing hemodialysis or peritoneal dialysis, 4) undergone kidney transplantation. Cox proportional hazard regression analysis was performed for the outcome of kidney failure after adjusting for age, education, dialect, herbal medications, body mass index, sex, physician-diagnosed hypertension and diabetes mellitus.Results:The mean age of subjects was 55.6 years at baseline, and 44% were men. Overall 30.6% were ever smokers (current or former) at baseline. A total of 674 incident cases of kidney failure occurred during a median follow-up of 13.3 years. Among men, smokers had a significant increase in the adjusted risk of kidney failure [hazard ratio (HR): 1.29; 95% CI: 1.02-1.64] compared to never smokers. There was a strong dose-dependent association between number of years of smoking and kidney failure, (p for trend = 0.011). The risk decreased with prolonged cessation (quitting ≥10 years since baseline). The number of women smokers was too few for conclusive relationship.Limitation:Information on baseline kidney function was not available.Conclusions:Cigarette smoking is associated with increased risk of kidney failure among Chinese men. The risk appears to be dose- and duration-dependent and modifiable after long duration of cessation. © 2013 Jin et al

A more accurate half-discrete Hardy-Hilbert-type inequality with the logarithmic function

Abstract By means of the weight functions, the technique of real analysis and Hermite-Hadamard’s inequality, a more accurate half-discrete Hardy-Hilbert-type inequality related to the kernel of logarithmic function and a best possible constant factor is given. Moreover, the equivalent forms, the operator expressions, the reverses and some particular cases are also considered