Pooled blood volume measured by final flat-panel detector computed tomography predicts outcome after endovascular thrombectomy for acute ischemic stroke

Background: Pooled blood volume (PBV), measured in real-time in the angiography room using an angiography system, correlates with cerebral blood volume (CBV). We examined the usefulness of PBV in endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). Methods: EVT for AIS in the anterior circulation (internal carotid artery (ICA) and middle cerebral artery (MCA)) was performed in 31 cases (13 males, 18 females, average age 75.7 years). PBV was acquired using a biplane flat-panel detector (FD) angiographic system. Then, we measured the average PBV value in the M1-6 regions similar to the Alberta Stroke Program Early CT score (ASPECTS) before and after EVT. We investigated factors associated with favorable outcome at 90 days after EVT. Results: There were 13 patients (41.9%) in the good outcome group (mRS (modified Rankin Scale) ≦2) and 18 patients (58.1%) in the poor outcome group (mRS>2). In univariate analysis, NIHSS (National Institutes of Health Stroke Scale) (odds ratio [OR] 0.74, 95% CI 0.57–0.87, p < 0.0001) and post PBV value (odds ratio [OR] 1.13, 95% CI 1.03–1.29, p = 0.0086) were significantly associated with good outcome. The good outcome group had significantly higher post-thrombectomy PBV value (3.69 ± 0.32 ml/100 g versus 2.78 ± 0.93 ml/100 g, P = 0.002) compared to that of the poor outcome group. The relationship between pre-thrombectomy PBV value and outcome at 90 days was not significant. Conclusions: Post-operative PBV value measured by FD-CT (computed tomography) correlated with 90-day outcome after EVT for AIS. FD-CT-PBV would be one of the good predictors of clinical outcome

Successful endovascular treatment of a ruptured saccular aneurysm arising from a fenestrated proximal anterior cerebral artery

Aneurysms arising from fenestrated proximal anterior cerebral arteries are rare. Previous studies primarily reported performing clipping. In contrast, endovascular treatment is rarely selected. In this report, we present a case of coil embolization for a ruptured aneurysm arising from a fenestrated proximal anterior cerebral artery.A sixty-five-year-old woman was transferred to the emergency department of our hospital owing to sudden onset of severe headache and vomiting. A head computed tomography scan showed a diffuse subarachnoid hemorrhage. A cerebral angiogram revealed an aneurysm at the fenestration of the A1 segment. Coil embolization of the aneurysm was performed, and the aneurysm was completely occluded. Both fenestration channels were preserved.The patient’s clinical course was good, and she was discharged from the hospital twenty-six days after admission. Coil embolization of a ruptured aneurysm in the fenestration of the A1 segment was possible without sacrificing the parent arteries forming the fenestration. However, securing a working projection proved difficult due to the aneurysm being surrounded by two parent arteries forming the fenestration

γ-Tubulin in Basal Land Plants: Characterization, Localization, and Implication in the Evolution of Acentriolar Microtubule Organizing Centers

Although seed plants have γ-tubulin, a ubiquitous component of centrosomes associated with microtubule nucleation in algal and animal cells, they do not have discrete microtubule organizing centers (MTOCs) comparable to animal centrosomes, and the organization of microtubule arrays in plants has remained enigmatic. Spindle development in basal land plants has revealed a surprising variety of MTOCs that may represent milestones in the evolution of the typical diffuse acentrosomal plant spindle. We have isolated and characterized the γ-tubulin gene from a liverwort, one of the extant basal land plants. Sequence similarity to the γ-tubulin gene of higher plants suggests that the γ-tubulin gene is highly conserved in land plants. The G9 antibody to fission yeast γ-tubulin recognized a single band of 55 kD in immunoblots from bryophytes. Immunohistochemistry with the G9 antibody clearly documented the association of γ-tubulin with various MTOC sites in basal land plants (e.g., discrete centrosomes with and without centrioles and the plastid surface in monoplastidic meiosis of bryophytes). Changes in the distribution of γ-tubulin occur in a cell cycle–specific manner during monoplastidic meiosis in the liverwort Dumortiera hirsuta. γ-Tubulin changes its localization from the plastid surface in prophase I to the spindle, from the spindle to phragmoplasts and the nuclear envelope in telophase I, and back to the plastid surfaces in prophase II. In vitro experiments show that γ-tubulin is detectable on the surface of isolated plastids and nuclei of D. hirsuta, and microtubules can be repolymerized from the isolated plastids. γ-Tubulin localization patterns on plastid and nuclear surfaces are not affected by the destruction of microtubules by oryzalin. We conclude that γ-tubulin is a highly conserved protein associated with microtubule nucleation in basal land plants and that it has a cell cycle–dependent distribution essential for the orderly succession of microtubule arrays