AIMS: The aim of this study was to evaluate the effects of Bifidobacterium lactis HY8101 on insulin resistance induced using tumour necrosis factor‐α (TNF‐α) in rat L6 skeletal muscle cells and on ...the KK‐AY mouse noninsulin‐dependent diabetes mellitus (NIDDM) model. METHODS AND RESULTS: The treatment using HY8101 improved the insulin‐stimulated glucose uptake and translocation of GLUT4 via the insulin signalling pathways AKT and IRS‐1(Tyr) in TNF‐α‐treated L6 cells. HY8101 increased the mRNA levels of GLUT4 and several insulin sensitivity‐related genes (PPAR‐γ) in TNF‐α‐treated L6 cells. In KK‐AY mice, HY8101 decreased fasting insulin and blood glucose and significantly improved insulin tolerance. HY8101 improved diabetes‐induced plasma total cholesterol and triglyceride (TG) levels and increased the muscle glycogen content. We observed concurrent transcriptional changes in the skeletal muscle tissue and the liver. In the skeletal muscle tissue, the glycogen synthesis‐related gene pp‐1 and GLUT4 were up‐regulated in mice receiving HY8101 treatment. In the liver, the hepatic gluconeogenesis‐regulated genes (PCK1 and G6PC) were down‐regulated in mice receiving HY8101 treatment. CONCLUSIONS: Bifidobacterium lactis HY8101 can be used to moderate glucose metabolism, lipid metabolism and insulin sensitivity in mice and in cells. SIGNIFICANCE AND IMPACT OF THE STUDY: Bifidobacterium lactis HY8101 might have potential as a probiotic candidate for alleviating metabolic syndromes such as diabetes.
We aimed to evaluate the long-term clinical outcomes and prognostic factors of symptomatic intracranial unruptured vertebrobasilar artery dissection (siu-VBD).
A total of 191 patients (M:F = 127:64; ...median age, 46 years) with siu-VBD were treated between January 2001 and December 2008. Presentations, treatments, outcomes, and prognostic factors were retrospectively analyzed.
Clinical manifestations were ischemic symptoms with headache (n = 97) or without headache (n = 13) and headache without ischemic symptoms (n = 81). Forty-six patients (24.1%) underwent endovascular treatment. The remaining 145 patients (75.9%) were medically treated with anticoagulants (n = 49), antiplatelets (n = 48), or analgesics alone (n = 48). Clinical follow-up data were available in 178 patients (102 ischemic and 76 nonischemic) at 15 to 102 months (mean, 46 months). None of the siu-VBD hemorrhaged. All 76 patients without ischemic presentation had favorable outcomes (modified Rankin Scale, 0-1). Of the 102 patients with ischemic presentation, outcomes were favorable in 92 and unfavorable in 10 patients. Four patients died; 3 died of causes unrelated to VBD, and one died as a result of basilar artery (BA) dissection. Old age (odds ratio OR 1.099; 95% confidence interval CI 1.103-1.204; p = 0.042) and BA involvement (OR 11.886; 95% CI 1.416-99.794; p = 0.023) were independent predictors of unfavorable outcomes in siu-VBD with ischemic presentation.
Clinical outcomes for siu-VBD were favorable in all patients without ischemic symptoms and in most patients with ischemic presentation. None of the siu-VBD caused subarachnoid hemorrhage. Old age and BA involvement were independent predictors of unfavorable outcome in siu-VBD with ischemic presentation.
Hollow TiO2 hemispheres for application in dye‐sensitized solar cells are prepared by means of rf‐sputtering onto colloidal templated substrates. After removing the organic templates by thermal ...decomposition, quasi‐ordered networks of hollow TiO2 hemispheres were formed. This approach should open up new opportunities for processing material architectures with high surface activity and effective charge transport for high performance photovoltaic and photoelectrochemical cells.
Little has been known about the clinical and angiographic follow-up results of stent-only therapy for intracranial vertebrobasilar dissecting aneurysms (VBDA). The purpose of this study was to ...evaluate the feasibility, safety, clinical, and angiographic follow-up of stent-only therapy for VBDA.
Twenty-seven patients with 29 VBDAs (11 ruptured, 18 unruptured), not suitable for deconstructive treatment, underwent stent-only therapy. Feasibility, safety, clinical, and angiographic follow-up were retrospectively evaluated. Angiographic outcomes were compared between single-stent and multiple-stent groups.
All attempted stent placements were successfully accomplished without any treatment-related complication. Of the 11 ruptured VBDAs, 4 were treated by single stents, 6 by double overlapping stents, and 1 by triple overlapping stents. Of the 18 unruptured VBDAs, 6 were treated by stents, and 12 by double overlapping stents. One patient with a ruptured VBDA, treated by single stent, had rebleeding and died. None of the remaining patients had posttreatment bleeding during follow-up (mean, 28 months; range, 7-50 months). Eight patients with ruptured VBDA and all patients with unruptured VBDA had excellent outcomes (modified Rankin Scale, 0-1). The remaining 2 patients with ruptured VBDA were moderately disabled because of the initial damage. Angiographic follow-up was available in 27 VBDAs, 4 to 42 months (mean, 12 months) after treatment. Follow-up angiograms revealed complete obliteration of the dissecting aneurysm in 12, partial obliteration in 12, stable in 1, enlargement in 1, and in-stent occlusion in 1. Angiographic improvement (complete or partial obliteration) was more frequent in the multiple-stent group (17/17) than in the single-stent group (7/9; P < .05).
In this small series, stent-only therapy was safe and effective in the treatment of VBDAs that were not deemed suitable for treatment with parent-artery occlusion.
Abnormality in mitochondria has been suggested to be associated with development of allergic airway disorders. In this study, to evaluate the relationship between mitochondrial reactive oxygen ...species (ROS) and NLRP3 inflammasome activation in allergic asthma, we used a newly developed mitochondrial ROS inhibitor, NecroX-5. NecroX-5 reduced the increase of mitochondrial ROS generation in airway inflammatory cells, as well as bronchial epithelial cells, NLRP3 inflammasome activation, the nuclear translocation of nuclear factor-κB, increased expression of various inflammatory mediators and pathophysiological features of allergic asthma in mice. Finally, blockade of IL-1β substantially reduced airway inflammation and hyperresponsiveness in the asthmatic mice. These findings suggest that mitochondrial ROS have a critical role in the pathogenesis of allergic airway inflammation through the modulation of NLRP3 inflammasome activation, providing a novel role of airway epithelial cells expressing NLRP3 inflammasome as an immune responder.
The Long Term Evolution-Advanced (LTEAdvanced) networks are being developed to provide mobile broadband services for the fourth generation (4G) cellular wireless systems. Deviceto- device (D2D) ...communications is a promising technique to provide wireless peer-to-peer services and enhance spectrum utilization in the LTE-Advanced networks. In D2D communications, the user equipments (UEs) are allowed to directly communicate between each other by reusing the cellular resources rather than using uplink and downlink resources in the cellular mode when communicating via the base station. However, enabling D2D communications in a cellular network poses two major challenges. First, the interference caused to the cellular users by D2D devices could critically affect the performances of the cellular devices. Second, the minimum quality-of-service (QoS) requirements of D2D communications need to be guaranteed. In this article, we introduce a novel resource allocation scheme (i.e. joint resource block scheduling and power control) for D2D communications in LTE-Advanced networks to maximize the spectrum utilization while addressing the above challenges. First, an overview of LTE-Advanced networks, and architecture and signaling support for provisioning of D2D communications in these networks are described. Furthermore, research issues and the current state-of-the-art of D2D communications are discussed. Then, a resource allocation scheme based on a column generation method is proposed for D2D communications. The objective is to maximize the spectrum utilization by finding the minimum transmission length in terms of time slots for D2D links while protecting the cellular users from harmful interference and guaranteeing the QoS of D2D links. The performance of this scheme is evaluated through simulations.
Background and purpose
The rate at which the chance of a good outcome of endovascular stroke therapy (EVT) decays with time when eligible patients are selected by baseline diffusion‐weighted magnetic ...resonance imaging (DWI‐MRI) and whether ischaemic core size affects this rate remain to be investigated.
Methods
This study analyses a prospective multicentre registry of stroke patients treated with EVT based on pretreatment DWI‐MRI that was categorized into three groups: small Diffusion‐Weighted Imaging Alberta Stroke Program Early Computed Tomography Score (DWI‐ASPECTS) (8–10), moderate (5–7) and large (<5) cores. The main outcome was a good outcome at 90 days (modified Rankin Scale 0–2). The interaction between onset‐to‐groin puncture time (OTP) and DWI‐ASPECTS categories regarding functional outcomes was investigated.
Results
Ultimately, 985 patients (age 69 ± 11 years; male 55%) were analysed. Potential interaction effects between the DWI‐ASPECTS categories and OTP on a good outcome at 90 days were observed (Pinteraction = 0.06). Every 60‐min delay in OTP was associated with a 16% reduced likelihood of a good outcome at 90 days amongst patients with large cores, although no associations were observed amongst patients with small to moderate cores. Interestingly, the adjusted rates of a good outcome at 90 days steeply declined between 65 and 213 min of OTP and then remained smooth throughout 24 h of OTP (Pnonlinearity = 0.15).
Conclusions
Our study showed that the probability of a good outcome after EVT nonlinearly decreased, with a steeper decline at earlier OTP than at later OTP. Discrepant effects of OTP on functional outcomes by baseline DWI‐ASPECTS categories were observed. Thus, different strategies for EVT based on time and ischaemic core size are warranted.
Fusiform aneurysms and ultrawide-neck circumferential aneurysms are still some of the most challenging lesions. The aim of this study was to investigate the efficacy and feasibility of the use of ...multiple overlapping Enterprise stents with coiling for the treatment of fusiform or ultrawide-neck circumferential aneurysms.
Twelve consecutive patients (9 men and 3 women; mean age, 56 years) with fusiform (n = 5) or ultrawide-neck circumferential (n = 7) aneurysms were treated with 2-3 overlapping Enterprise stents and coiling. The feasibility of this procedure and the clinical and angiographic outcomes of this technique were retrospectively evaluated.
All patients were successfully treated by using this technique without any complications. Posttreatment angiographic results revealed grade 4 occlusion of the aneurysm in 6, grade 3 in 4, and grade 2 in 2 patients. Clinical follow-up was performed in all patients (mean, 16 months; range, 5-24 months). Nine patients had an mRS score of 0. Two had an mRS score of 1, one of whom had an initial mRS score of 2 due to the mass effect of a giant aneurysm; the other had a recurrent aneurysm presenting with SAH 5 years after clipping. Angiographic follow-up was performed in 10 patients at 6-20 months posttreatment. Nine had stable or improved occlusion, while 1 had a minor recurrence.
In this small series, multiple overlapping Enterprise stents with coiling were a feasible and effective option for the treatment of fusiform and ultrawide-neck circumferential aneurysms. Further experience and follow-up are required to document the long-term efficacy of this treatment.
Post-polypectomy coagulation syndrome (PPCS) is a well known complication of colonoscopic polypectomy. However, no previous studies have reported on the clinical outcomes or risk factors of PPCS. The ...aim of the current study was to analyze the clinical outcomes and risk factors of PPCS developing after a colonoscopic polypectomy.
Data for all patients who underwent colonoscopic polypectomies and required hospitalization in nine university hospitals were analyzed retrospectively. The incidence, clinicopathological characteristics, and clinical outcomes of PPCS cases were examined. Additionally, patients who developed PPCS were compared with controls who were matched by age and sex, in order to assess for possible risk factors.
The rate of PPCS that required hospitalization after colonoscopic polypectomy was 0.7/1000. All patients with PPCS were treated medically without the need for surgical interventions. The median durations of therapeutic fasting, hospitalization, and antibiotic use were 3 days, 5.5 days, and 7 days, respectively. The rates of major PPCS and mortality were 2.9 % and 0 %, respectively. On multivariate analysis, hypertension (OR = 3.023, 95 %CI 1.034 - 8.832), large lesion size (OR = 2.855, 95 %CI 1.027 - 7.937), and non-polypoid configuration (OR = 3.332, 95 %CI 1.029 - 10.791) were found to be independent risk factors related to the development of PPCS.
In this study, the rates of major PPCS and mortality were only 2.9 % and 0 %, respectively. Hypertension, large lesion size, and non-polypoid configuration of the lesion were independently associated with PPCS. Therefore, patients may be reassured by the excellent prognosis of PPCS, while endoscopists should be especially careful when performing colonoscopic polypectomies in patients with hypertension or large and non-polypoid lesions.
To describe the results of transvenous embolizations of cavernous dural arteriovenous fistua (cDAVF) with an emphasis on identifying the incidence, characteristics, and management strategies ...associated with the complications of transvenous embolization of cDAVFs.
Fifty-six consecutive patients who were treated by transvenous embolization for cDAVFs were reviewed. The approach routes, angiographic results, complications, and clinical outcome were assessed.
Retrograde inferior petrosal sinus (n = 36), transfacial vein (n = 7), transcontralateral intercavernous sinus (n = 4), and direct superior ophthalmic vein (n = 3) approaches were used. Angiographic results showed complete occlusion (n = 29), nearly complete occlusion (n = 13), and incomplete occlusion (n = 14). Complications associated with the procedures were cranial nerve palsy (n = 6), venous perforation (n = 3), and brain stem congestion (n = 2). The cranial nerve signs resolved with conservative treatment. Venous perforations were managed by coil embolizations at the site of the tear with no significant neurologic sequelae. One case of brain stem congestion resulted in hemiplegia after conservative treatment. The other case showed venous congestion as a result of rerouting of the shunted flow after venous embolization that was successfully managed by covered stent deployment for occlusion of the residual feeders. Clinical follow-up data were available in 46 patients. Complete resolution or improvement of symptoms was seen in 42 patients (91%).
Cavernous DAVFs may be effectively treated by transvenous embolization. However, the procedure can be associated with various complications, some of which can potentially result in significant morbidity. Prompt diagnosis of the complications with appropriate management strategies is mandatory for a safe procedure.
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