Kissing Aneurysm of the Distal Anterior Cerebral Artery: Preoperative CT Angiography and Surgical Management: A

We describe a patient with mirror-image aneurysms in the bilateral distal anterior cerebral artery (ACA). The larger aneurysm was clearly disclosed with digital subtraction angiography (DSA), but the smaller one could not be definitely identified. The bilateral aneurysms were confirmed with computed tomographic (CT) angiography, which showed the right ACA aneurysm to be hidden behind the left ACA aneurysm, likely buried in the cingulate gyrus. During surgery, the left ACA aneurysm was clipped first. The right ACA aneurysm was exposed by a small subpial resection of the cingulate gyrus, and the right ACA aneurysm, which strongly adhered to the surrounding tissue, was safely dissected. Multiple aneurysms associated with a distal ACA aneurysm are not rare. We conclude that further examination with CT angiography is important when kissing aneurysms are suggested by DSA

Role of the transcription factor Sp1 in regulating the expression of the murine cathepsin E gene

Cathepsin E (CE) is an intracellular aspartic proteinase that is exclusively expressed in cells of the gastrointestinal tracts, lymphoid tissues, urinary organs and red blood cells. However, the molecular mechanism by which CE is predominantly expressed in these cells remains unknown. Here, we report the identification of several transcription start sites of the CE gene and their regulatory factors in gastric adenosarcoma cells. We first identified several unique transcription start sites in mouse CE genes by an oligo cap method. Their analysis also revealed the existence of a non-coding region ∼24-kb upstream of exon 1 in the CE gene and also the existence of two transcripts for CE. Luciferase analyses in upstream of exon 1 revealed that this site contained putative binding regions for the transcription factors Sp1, AP-1 and cEts-1 essential for the expression of CE gene. Moreover, electrophoretic mobility shift assays revealed that the protein–oligonucleotides complex of the Sp1 site were supershifted by an anti-Sp1 antibody. The chromatin immunoprecipitation assay showed that Sp1 bound to the CE promoter region. In addition, overexpression of the Sp1 protein increased the expression of the CE protein. Altogether, these results suggest that Sp1 binding plays a particularly important role in the regulation of CE gene expression