MCA

MCA
  • 文章类型: Journal Article
    确定植物感知和响应机械刺激的机制对于揭示植物生长和发育的详细过程至关重要。机械敏感(MS)通道,包括拟南芥中的MCA1及其模拟物MCA2,可能对这些过程至关重要。尽管在阐明MS通道的生理作用方面取得了重大进展,对他们的表达动态的全面见解仍然难以捉摸。这里,我们总结了有关MCA1和MCA2基因时空表达模式的最新进展和新数据,揭示了他们参与各种发展过程。然后,我们描述了我们研究的发现,通过组织化学分析和半定量RT-PCR,在不同发育阶段的不同植物器官中表征了MCA1和MCA2的表达谱。我们的发现揭示了MCA1和MCA2在年轻组织中优先表达。表明它们在细胞分裂等过程中的关键作用,扩展,和机械传感。最后,我们讨论了在生殖器官和毛状体中观察到的差异表达模式,暗示它们的特殊功能以响应机械提示。总的来说,这篇综述为MCA1和MCA2的动态表达模式提供了有价值的见解,为将来研究这些基因在植物中的确切作用铺平了道路。
    Determining the mechanisms by which plants sense and respond to mechanical stimuli is crucial for unraveling the detailed processes by which plants grow and develop. Mechanosensitive (MS) channels, including MCA1 and its paralog MCA2 in Arabidopsis thaliana, may be essential for these processes. Although significant progress has been made in elucidating the physiological roles of MS channels, comprehensive insights into their expression dynamics remain elusive. Here, we summarize recent advancements and new data on the spatiotemporal expression patterns of the MCA1 and MCA2 genes, revealing their involvement in various developmental processes. Then, we describe findings from our study, in which the expression profiles of MCA1 and MCA2 were characterized in different plant organs at various developmental stages through histochemical analyses and semiquantitative RT‒PCR. Our findings revealed that MCA1 and MCA2 are preferentially expressed in young tissues, suggesting their pivotal roles in processes such as cell division, expansion, and mechanosensing. Lastly, we discuss the differential expression patterns observed in reproductive organs and trichomes, hinting at their specialized functions in response to mechanical cues. Overall, this review provides valuable insights into the dynamic expression patterns of MCA1 and MCA2, paving the way for future research on the precise roles of these genes in planta.
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  • 文章类型: Journal Article
    目的:急性缺血性卒中(AIS)是导致死亡的主要原因,但孤立的大脑中动脉夹层(MCAD)很少报道。本文的目的是总结目前有关这种病理的信息,并探讨其血管内治疗的技术方面,重点是新型涂层,抗血栓形成支架和抗血小板管理。本文的另一部分提供了我们对问题的经验,这些问题是由在我们中心接受治疗的一小部分MCAD诊断患者代表的。方法:我们对2022年1月至2024年3月在我们的综合卒中中心接受前循环AIS治疗的患者进行了文献研究和回顾性分析。该队列包括16例诊断为孤立性MCAD的患者,9个接受抗血栓涂层支架,而7只接受了裸金属支架。涂层支架的药理学管理涉及使用Cangrelor进行急性抗血小板治疗,过渡到口服替格瑞洛。结果:在16例接受治疗的患者中,与裸金属支架组相比,使用抗血栓涂层支架的患者无重大并发症,颅内出血发生率较低.两组出院时美国国立卫生研究院卒中量表(NIHSS)的平均评分均得到改善。涂层支架组的功能结局和死亡率略好,但没有统计学意义。结论:抗血栓涂层支架,结合MAPT,证明了治疗孤立MCAD的安全有效选择。与传统治疗相比,这些支架具有改善预后和减少并发症的潜力。建议使用更大的队列进行进一步的多中心研究来验证这些发现。
    Objective: Acute ischemic stroke (AIS) is a leading cause of death, but isolated middle cerebral artery dissection (MCAD) is rarely reported. The aim of this article is to sum up the current information on this pathology and to explore the technical aspects of its endovascular treatment with emphasis on novel coated, antithrombogenic stents and antiplatelet management. Another part of this article offers our experience with the problematics represented by a small sample group of patients with an MCAD diagnosis who were treated in our center. Methods: We conducted literature research and a retrospective review of patients treated for anterior circulation AIS at our comprehensive stroke center from January 2022 to March 2024. The cohort included 16 patients diagnosed with isolated MCAD, 9 received antithrombogenic coated stents, while 7 received bare metal stents. Pharmacological management of coated stents involved the use of Cangrelor for acute antiplatelet therapy, transitioning to oral Ticagrelor. Results: Among the 16 patients treated, those with antithrombogenic coated stents showed no major complications and had a lower incidence of intracranial hemorrhage compared to the bare metal stent group. The average National Institutes of Health Stroke Scale (NIHSS) score at discharge improved in both groups. Functional outcomes and mortality rates were slightly better in the coated stent group, but no statistical significance was proven. Conclusions: Antithrombogenic coated stents, in conjunction with MAPT, demonstrated a safe and effective option for treating isolated MCAD. These stents offer promising potential for improved outcomes and reduced complications compared to traditional treatments. Further multicentric studies with larger cohorts are recommended to validate these findings.
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  • 文章类型: Journal Article
    我们的研究旨在评估与中线脑移位相关的颅内高压显示的未破裂巨大大脑中动脉(MCA)动脉瘤患者的术后预后。从2012年到2022年,在接受颅内动脉瘤显微外科手术治疗的954例患者中,我们的研究纳入了9例与颅内压增高相关的巨大MCA动脉瘤伴中线脑移位的连续患者.4例患者进行了深低温循环流量减少(DHCFR)血管重建,5例患者采用动脉瘤捕获的脑血管重建术。进行早期(<7天)和长期临床和放射学监测。3个月时mRS评分≤2,认为功能预后良好。治疗时的平均年龄为44岁(范围为17至70岁)。动脉瘤的平均最大直径为49mm(范围为33至70mm)。平均中线脑移位为8.6mm(范围从5到13mm)。在6例患者中发现了远端MCA区域灌注不足。9例患者发生弥漫性术后脑水肿,平均延迟59小时,其中7例发生术后神经功能恶化。术后死亡3例。在6名幸存者中,4例患者需要术后早期去骨瓣减压术。4例患者的功能转归良好。在最后一次随访时,每位患者均发现动脉瘤完全闭塞。我们建议在外科手术结束时讨论系统的减压性半切开术和/或在开始时进行颞叶部分切除术,以减少水肿反应的后果并改善该特定亚组患者的术后预后。更好的术中血流评估也可能减少再灌注综合征的发生。
    Our study aimed to evaluate the postoperative outcome of patients with unruptured giant middle cerebral artery (MCA) aneurysm revealed by intracranial hypertension associated to midline brain shift. From 2012 to 2022, among the 954 patients treated by a microsurgical procedure for an intracranial aneurysm, our study included 9 consecutive patients with giant MCA aneurysm associated to intracranial hypertension with a midline brain shift. Deep hypothermic circulatory flow reduction (DHCFR) with vascular reconstruction was performed in 4 patients and cerebral revascularization with aneurysm trapping was the therapeutic strategy in 5 patients. Early (< 7 days) and long term clinical and radiological monitoring was done. Good functional outcome was considered as mRS score ≤ 2 at 3 months. The mean age at treatment was 44 yo (ranged from 17 to 70 yo). The mean maximal diameter of the aneurysm was 49 mm (ranged from 33 to 70 mm). The mean midline brain shift was 8.6 mm (ranged from 5 to 13 mm). Distal MCA territory hypoperfusion was noted in 6 patients. Diffuse postoperative cerebral edema occurred in the 9 patients with a mean delay of 59 h and conducted to a postoperative neurological deterioration in 7 of them. Postoperative death was noted in 3 patients. Among the 6 survivors, early postoperative decompressive hemicraniotomy was required in 4 patients. Good functional outcome was noted in 4 patients. Complete aneurysm occlusion was noted in each patient at last follow-up. We suggest to discuss a systematic decompressive hemicraniotomy at the end of the surgical procedure and/or a partial temporal lobe resection at its beginning to reduce the consequences of the edema reaction and to improve the postoperative outcome of this specific subgroup of patients. A better intraoperative assessment of the blood flow might also reduce the occurrence of the reperfusion syndrome.
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  • 文章类型: Journal Article
    背景:寻求解决在形成胃空肠造口术(GJ)吻合术中的技术挑战并维持其开放的手段。
    目的:评估新型线性磁性压缩吻合(MCA)装置在猪中形成专利GJ与缝合空肠肠切开术(JE)部位的临床前可行性和愈合效果。
    方法:单中心兽医检测设施。
    方法:在6周内评估了3种原型尺寸(4、6和8cm)的金属MCA装置(MCAD)形成专利GJ的可行性。远端磁铁通过腹腔镜插入空肠,在胃镜下将近端磁铁放置在胃中;将磁铁对齐以逐渐形成吻合口,自我分离,然后被开除.尸检时,评估MCA的通畅性,并与JE组织进行比较,以评估伤口愈合情况。
    结果:MCADs在GJ位置对齐,无并发症。在5/6MCAD对中,移位发生在7至26天之间;排出13-31天;1对MCAD保留在胃中。尸检时,所有的猪都很健康,获得平均15.0公斤。在接受4-cm或6-cmMCADs的2/4猪中,吻合口不够通畅,因为它们的线性长度太小。但是,接受8厘米MCADs的两只猪的吻合口保持完全通畅。与缝合肠切开术相比,MCA标本中的炎症和纤维化最小。
    结论:一种新颖的线性MCA装置是可行的,并且在猪中有效地创建了具有最小炎症和纤维化的专利GJ吻合术。MCAD可能适用于临床评估。
    BACKGROUND: Means of addressing technical challenges in forming gastrojejunostomy (GJ) anastomoses and maintaining their patency are sought.
    OBJECTIVE: Evaluation of preclinical feasibility and healing efficacy of a novel linear magnetic compression anastomosis (MCA) device to form a patent GJ versus sutured jejunal enterotomy (JE) sites in swine.
    METHODS: Single-center veterinary testing facility.
    METHODS: Feasibility of 3 prototype sizes (4, 6, and 8 cm) of a metal MCA device (MCAD) to form a patent GJ was evaluated over 6 weeks. A distal magnet was laparoscopically inserted in the jejunum, a proximal magnet was placed gastroscopically in the stomach; magnets were aligned to gradually form an anastomosis, self-detached, and be expelled. At necropsy, MCAs were assessed for patency and compared with JE tissues to evaluate wound healing.
    RESULTS: MCADs aligned at the GJ location without complications. In 5/6 MCAD pairs, dislodgement occurred between 7 and 26 days; expulsion 13-31 days; 1 MCAD pair was retained in the stomach. At necropsy, all pigs were healthy, gaining a mean 15.0 kg. Anastomoses were not adequately patent in 2/4 pigs receiving the 4-cm or 6-cm MCADs because their linear length was too small. But, anastomoses of both pigs receiving the 8-cm MCADs maintained full patency. Minimal inflammation and fibrosis were seen in MCA specimens versus sutured enterotomies.
    CONCLUSIONS: A novel linear MCA device was feasible and effectively created a patent GJ anastomosis in swine with minimal inflammation and fibrosis. The MCAD may be appropriate for clinical evaluation.
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  • 文章类型: Journal Article
    颅内动脉瘤形成和破裂背后的机制尚不完全清楚,由于位置等因素,患者人口统计学,和血液动力学发挥作用。此外,讨论了破裂中气泡等解剖特征的重要性。这凸显了进行综合研究的必要性,该研究将患者特定的危险因素与对气泡和破裂部位的局部血液动力学特征的详细分析相结合。我们的研究分析了268例患者的359个颅内动脉瘤,基于3D旋转血管造影图像和术中视频重建用于血液动力学模拟的患者特定模型。我们确定了动脉瘤亚区域并划定了破裂部位,表征气泡及其区域重叠,采用跨人口统计学的统计比较,和其他风险因素。这项工作确定了动脉瘤破裂部位的模式,主要在圆顶上,随着患者人口统计学的变化。高血压和前交通动脉(ACom)动脉瘤显示出特定的破裂模式和气泡关联,指示两条路径:ACom中的高流量和撞击部位的细气泡和低流量,大脑中动脉(MCA)动脉瘤的振荡条件会引起粗大的气泡。Bleb特征因性别而异,年龄,吸烟,将破裂风险与血流动力学因素和患者资料联系起来。这些见解增强了对导致破裂事件的血液动力学机制的理解。该分析阐明了局部血流动力学在颅内动脉瘤破裂中的作用,通过揭示流量变化如何影响稳定性和风险来挑战对位置的强调。我们确定了壁失效的两种途径-高流量和低流量条件-突出了动脉瘤行为的复杂性。此外,这项研究提高了我们对患者固有特征如何影响这些过程的认识,需要进一步调查。
    The mechanisms behind intracranial aneurysm formation and rupture are not fully understood, with factors such as location, patient demographics, and hemodynamics playing a role. Additionally, the significance of anatomical features like blebs in ruptures is debated. This highlights the necessity for comprehensive research that combines patient-specific risk factors with a detailed analysis of local hemodynamic characteristics at bleb and rupture sites. Our study analyzed 359 intracranial aneurysms from 268 patients, reconstructing patient-specific models for hemodynamic simulations based on 3D rotational angiographic images and intraoperative videos. We identified aneurysm subregions and delineated rupture sites, characterizing blebs and their regional overlap, employing statistical comparisons across demographics, and other risk factors. This work identifies patterns in aneurysm rupture sites, predominantly at the dome, with variations across patient demographics. Hypertensive and anterior communicating artery (ACom) aneurysms showed specific rupture patterns and bleb associations, indicating two pathways: high-flow in ACom with thin blebs at impingement sites and low-flow, oscillatory conditions in middle cerebral artery (MCA) aneurysms fostering thick blebs. Bleb characteristics varied with gender, age, and smoking, linking rupture risks to hemodynamic factors and patient profiles. These insights enhance understanding of the hemodynamic mechanisms leading to rupture events. This analysis elucidates the role of localized hemodynamics in intracranial aneurysm rupture, challenging the emphasis on location by revealing how flow variations influence stability and risk. We identify two pathways to wall failure-high-flow and low-flow conditions-highlighting the complexity of aneurysm behavior. Additionally, this research advances our knowledge of how inherent patient-specific characteristics impact these processes, which need further investigation.
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  • 文章类型: Journal Article
    胆道阻塞,胃肠,由于成功的经皮和内窥镜器官保存程序,泌尿道的数量正在增加。尽管在一定程度上建立了功能恢复,穿越阻塞的失败可能最终需要进行侵入性外科手术。多学科合作可能会跨越每种方法的局限性,从而为患者创造完美的干预。磁压缩吻合术是一种微创手术,可以在选定的胆道病例中提供良好的结果,胃肠,或者尿路阻塞.关键相关声明:在本文中,磁性压缩吻合术的各种应用与说明性的食管病例进行了回顾,胆道,结肠,和无法用电线穿过的尿路阻塞。该方法将扩展在IR单元中执行的干预的范围。关键点:磁铁可以使电线进入一个无法通过的障碍。磁体可以在闭塞处产生解剖和非解剖吻合。磁压缩吻合术是一种微创手术,可以提供良好的效果。
    Obstructions encountered in biliary, gastrointestinal, and urinary tracts are increasing in number due to successful percutaneous and endoscopic organ-saving procedures. Although functional recovery is established to an extent, failure of traversing an obstruction may end up necessitating invasive surgical procedures. Multidisciplinary collaboration may traverse the limitations of each individual approach, therefore creating the perfect intervention for the patient. Magnetic compression anastomosis is a minimally invasive procedure that can provide a great outcome in select cases with biliary, gastrointestinal, or urinary tract obstructions. CRITICAL RELEVANCE STATEMENT: In this article, various applications of magnetic compression anastomosis are reviewed with illustrative cases of esophageal, biliary, colonic, and urinary obstructions that cannot be traversed with a wire. This method will expand the spectrum of interventions performed in the IR unit. KEY POINTS: Magnets can enable wire access beyond an impassable obstruction. Magnets can create anatomical and non-anatomical anastomosis at an occlusion. Magnetic compression anastomosis is a minimally invasive procedure that can provide great outcomes.
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  • 文章类型: Journal Article
    本文提出了对欧洲老年人在家庭外提供的支持的比较研究。在研究社会支持时,网络观点被广泛使用,调查,特别是,以自我为中心的个人支持网络。该分析基于欧洲健康老龄化和退休调查(SHARE)的第7波数据。它研究了12个欧洲国家65岁及以上个人的自我支持网络的特征,它们被归类为一种新的福利制度类型。通过多重对应分析,我们共同研究了描述老年人提供的支持的接受者(改变者)和福利制度分类的分类变量。作为主要结果,归类为“默认情况下高度熟悉”类别的国家/地区,专门支持与家庭有关的变更,特别是儿童保育或个人护理。相比之下,属于“高度去熟悉”类型学的国家的长者提供了更多样化但要求较低的支持,对非亲属的改变和不太注重照顾。分析表明,分享提供了一个坚实的机会来面对这个话题。
    This paper proposes comparative research on support provided outside the household by older adults in Europe. In studying social support, the network perspective is widely used, investigating, in particular, the ego-centered support networks of individuals. The analysis is based on data from Wave 7 of the Survey of Health Ageing and Retirement in Europe (SHARE). It examines the characteristics of ego-support networks of individuals aged 65 and over in 12 European countries, which are grouped into a novel welfare regime typology. Through Multiple Correspondence Analysis, we jointly looked into the categorical variables describing the recipients (alters) of the support provided by older adults and the welfare regime classification. As a main result, countries grouped in \"High degree of familialism by default\" category specialized in supporting family-related alters, particularly with childcare or personal care. In contrast, the elders in countries belonging to \"High degree of de-familialisation\" typology provided a more varied but less demanding support, to non-relatives alters and less oriented to care. The analyses show that the SHARE provides a solid opportunity to face the topic.
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  • 文章类型: Journal Article
    背景:完整结肠系膜切除术(CME)和中央血管脱离是结直肠癌手术中非常重要的手术方法。术前和术中评估主要结直肠血管的解剖结构是必要的,以避免大量出血。尤其是在内窥镜手术中。据报道,罕见的异常病例中结肠动脉(MCA)和回结肠动脉(ICA)具有共同的干。
    方法:患者是一名73岁女性,在结肠镜检查中被诊断为升结肠癌。术前腹部对比增强计算机断层扫描证实,MCA和ICA具有共同的躯干。她接受了腹腔镜回盲肠切除术治疗升结肠癌,并进行了D3淋巴结清扫。术中进行吲哚菁绿荧光成像。确认血管分叉后,在MCA分叉的远端解剖ICA。该患者已作为门诊病人被随访,术后2年无复发迹象。
    结论:呈现一例具有独特血管分叉模式的升结肠癌。术前和术中评估结直肠主要血管对于预防围手术期及术后并发症非常重要。
    BACKGROUND: Complete mesocolic excision (CME) and central vascular detachment are very important procedures in surgery for colorectal cancer. Preoperative and intraoperative assessments of the anatomy of major colorectal vessels are necessary to avoid massive bleeding, especially in endoscopic surgery. A case with a rare anomaly in which the middle colic artery (MCA) and ileocolic artery (ICA) had a common trunk is reported.
    METHODS: The patient was a 73-year-old woman diagnosed with ascending colon cancer on colonoscopy. Preoperative abdominal contrast-enhanced computed tomography confirmed that the MCA and ICA had a common trunk. She underwent laparoscopic ileocecal resection for the ascending colon cancer with D3 lymph node dissection. Intraoperative indocyanine green fluorescence imaging was conducted. After confirming vessel bifurcation, the ICA was dissected at the distal end of the MCA bifurcation. The patient has been followed as an outpatient, with no signs of recurrence as of 2 years postoperatively.
    CONCLUSIONS: A case of an ascending colon cancer with a unique vascular bifurcation pattern was presented. Preoperative and intraoperative evaluations of the major colorectal vessels are very important for preventing perioperative and postoperative complications.
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  • 文章类型: Case Reports
    Persistent primitive hypoglossal artery (PPHA) is a highly uncommon abnormal connection between the internal carotid artery (ICA) and vertebral artery (VA), with reported incidences ranging from 0.027 to 0.26%. Attempting endovascular intervention in such cases presents a considerable challenge as it carries a higher risk of embolization and other procedure-related complications that may affect a wide area of the brain. We present a case study involving the utilization of mechanical thrombectomy (MT) to treat an ischemic stroke in the M1 segment of the middle cerebral artery (MCA) despite the presence of PPHA. Performing mechanical thrombectomy in an anomalous vascular connection is feasible; however, it necessitates heightened vigilance, thorough knowledge of the anatomy, and utmost caution.
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  • 文章类型: Case Reports
    一些研究表明了SLE与中风之间的关系。因此,密切关注SLE在复发性卒中中的诊断非常重要。在我们的案例中,她的复发性中风发作可能是由于未确诊的SLE原因所致.
    缺血性中风是一种医疗紧急情况,当部分大脑的血液供应被阻断时发生。需要及早采取行动;因此,时间至关重要。SLE是一种多发性关节痛的自身免疫性疾病,发烧,皮疹,和器官损伤。我们报告了一位老太太,她最近被诊断出患有SLE,患有多次中风发作。尽管她很晚才被诊断出患有SLE,但对她复发性缺血性中风的可能机制感到怀疑。她接受了抗血小板治疗,抗癫痫药,抗高血压药,和羟氯喹药物的治疗。只有在我们提供物理治疗后,神经系统症状才有所改善。
    UNASSIGNED: Some studies have manifested the relationship between SLE and stroke. Therefore, it is very important to pay close attention to the diagnosis of SLE in recurring stroke. In our case, her recurrent stroke attack might be due to the undiagnosed cause of SLE.
    UNASSIGNED: An ischemic stroke is a medical emergency condition which occurs when blood supply to part of the brain is blocked. Early action is needed; therefore, time is crucial. SLE is an autoimmune disease with multiple joint pain, fever, rashes, and organ damage. We report an old lady who was recently diagnosed with SLE with multiple stroke attack. Although she was diagnosed with SLE much later there was a suspicious about the possible mechanism for her recurrent ischemic stroke. She was given antiplatelet, antiepileptic, antihypertensive, and hydroxychloroquine medicines for the treatment. The neurological symptoms improved only after we provided physiotherapy.
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