Search

Background: Hypersensitivity pneumonitis (HP) is a complex and heterogenous interstitial lung disease (ILD) that occurs in susceptible individuals due to certain inhaled antigens. Fibrotic-HP is a major underlying disease of progressive pulmonary fibrosis. Therefore, in addition to the radiological features of HP, quantitatively measuring fibrosis is important to evaluate disease severity and progression. The present study aimed to compare three-dimensional computed tomography (3D-CT)-derived lung volumes (LVs) of patients with HP and determine its association with mortality risk. Methods: In this retrospective and multicenter cohort study, 126 patients diagnosed with HP (fibrotic, n = 72 and non-fibrotic, n = 54) with a confidence level higher than moderate were enrolled. Each lobe LV was measured using 3D-CT at the time of diagnosis and standardized using predicted forced vital capacity. The 3D-CT LV was compared with those of 42 controls and 140 patients with idiopathic pulmonary fibrosis (IPF). Results: Compared to patients with fibrotic-HP, the standardized total LV was significantly higher in controls and patients with non-fibrotic-HP and was similar in patients with IPF. Longitudinal analyses demonstrated that approximately half of the patients with fibrotic-HP had an annual decrease in total LV. Decreased total and lower-lobe LVs were associated with shorter survival, and were independently associated with mortality together with ongoing exposure to inciting antigens. A composite model consisting of ongoing exposure to inciting antigens and total or lower-lobe LV successfully classified mortality risk into three groups. Conclusions: Quantitatively measuring standardized LV can help determine disease severity, progression, and mortality risk in patients with fibrotic-HP. more...

Background: Food protein-induced enterocolitis syndrome caused by solid foods (Solid-FPIES) is a non-immunoglobulin E-mediated allergic disease characterized by delayed gastrointestinal symptoms. An oral food challenge (OFC) test, although necessary, can be inconclusive in cases with mild symptoms. Moreover, limited diagnostic marker availability highlights the need for novel surrogate markers. We aimed to examine the efficacy of fecal hemoglobin (FHb), lactoferrin (FLf), and calprotectin (FCp) over time in evaluating gastrointestinal inflammation degree in Solid-FPIES. Methods: This observational study included 40 patients and 42 episodes at Juntendo University Hospital and affiliated hospitals between October 2020 and March 2024 categorized into FPIES (12 patients with 11 egg yolk, 1 fish, and 1 soybean episodes), control (14 patients with 15 episodes), and remission (14 patients). Fecal tests were performed for 7 days following antigen exposure. The ratios of each value were divided by the baseline value and analyzed over time course. Results: The FPIES group had significantly higher peak ratios of all fecal markers than the control group (p more...

Abstract Background Interstitial pneumonia with autoimmune features (IPAF), which does not meet any of the criteria for connective tissue diseases (CTD), has been attracting an attention in patients with idiopathic interstitial pneumonia (IIP). However, the biomarkers that reflect the clinical course of these patients have not been fully elucidated. Objective To identify useful serum biomarkers reflecting CTD-related features and favorable prognoses in patients with IIP. Methods This was a post hoc analysis of a prospective and multicenter cohort study between 2015 and 2020. Newly diagnosed patients with IIP were consecutively enrolled, and 74 autoimmune features and autoantibodies were comprehensively checked during IIP diagnosis. Serum levels of CXCL10, CXCL1, CCL2, BAFF, angiopoietin-2, and leptin were evaluated at the time of IIP diagnosis. Results Two hundred twenty-two patients (159 men and 63 women) with IIP were enrolled. The median observation duration was 36 months. The median age was 71 years old, and median %forced vital capacity (FVC) was 84.1% at the time of IIP diagnosis. The proportion of patients who met the classification criteria for IPAF was 11.7%. In patients with high serum CXCL10, changes in both %FVC and %diffusion lung capacity for carbon monoxide at one year were significantly higher than those in patients with low CXCL10 (p = 0.014 and p = 0.009, respectively), whereas these changes were not significant for other chemokines and cytokines. High CXCL10 levels were associated with acute/subacute onset (p more...

Aim: Antigen (Ag) presentation by Ag-presenting cells (APCs) is the first step in the generation of adaptive humoral and cellular immune responses. However, there have been few studies on the effects of flavonoids on APC function. In this study, we examined the effects of five polymethoxyflavones, two isoflavones, and one flavanol on CD11c+ dendritic cell function. Methods: CD11c+ dendritic cells were differentiated from bone marrow cells by culturing with granulocyte macrophage-colony stimulating factor. Cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The Ag-presenting ability was determined by a mixed lymphocyte reaction assay. Expressions of MHC class II, CD40, CD80, and CD86 molecules on CD11c+ cells were determined by flow cytometric analysis. Lipopolysaccharide-induced inflammatory cytokines productions were determined by enzyme-linked immunosorbent assay. Results: The flavonoids used in the study did not show strong toxicity to CD11c+ cells. Nobiletin, heptamethoxyflavone, and genistein enhance Ag-presenting function. Nobiletin and heptamethoxyflavone increased the expression of MHC class II and CD80 molecules. A direct correlation between APC function and lipopolysaccharide-induced cytokine production was not found. Conclusions: The results of the in vitro study indicate that flavonoids, nobiletin, heptamethoxyflavone, and genistein regulate innate dendritic cell function. more...

Background Endovascular treatment of large ischemic cores is challenging. The severity of ischemic stress is assessed using the apparent diffusion coefficient (ADC). We aimed to evaluate the ADC in patients with a low Alberta Stroke Program Early CT [Computed Tomography] Score using diffusion‐weighted imaging and whether it correlates with clinical outcomes. Methods This study included consecutive patients with acute large ischemic stroke (Alberta Stroke Program Early CT Score‐diffusion‐weighted imaging ≤5) who underwent endovascular treatment with successful recanalization between April 2014 and March 2023. The most frequent ADC (peak ADC) and diffusion‐weighted imaging lesion volumes were assessed. The primary outcome was the 3‐month modified Rankin Scale (mRS) score. Good (mRS score, 0–3) and poor clinical outcomes (mRS score, 4–6) were compared to confirm whether ADC was associated with clinical outcomes. Results In total, 78 patients were enrolled in this study; 30 had an mRS score of 0 to 3 at 3 months. The peak ADC in these patients was significantly higher than that in patients with mRS scores of 4 to 6 (P = 0.0002). In multivariate analysis, peak ADC was strongly associated with good clinical outcomes (odds ratio, 1.231; P = 0.0135) rather than onset‐to‐recanalization time and ischemic core volume. The optimal peak ADC threshold for discriminating between the mRS groups was 520×10−6 mm2/s with a sensitivity of 75% and a specificity of 73%. Good clinical outcomes were more frequently observed in patients with peak ADC ≥520×10−6 mm2/s (P more...

Abstract Background Myelodysplastic syndrome (MDS) is a clonal bone marrow disorder defined by cytopenia and is associated with an increased risk of transformation to acute myeloid leukemia (AML). The outcome of MDS is poor, so alternative therapeutic approaches are needed to improve survival. The inhibition of the DNA damage response pathway, including poly (ADP-ribose) polymerase-1 (PARP-1), has been approved to treat several cancers. In addition, WEE1, a nuclear kinase, is overexpressed in many cancers. Therefore, a WEE1 inhibitor combined with a PARP-1 inhibitor could inhibit the proliferation of MDS and AML. Methods We analyzed whether WEE1 was regulated in the progression of MDS and AML. We also evaluated the efficacy of MK-1775 (WEE1 inhibitor) and talazoparib (PARP-1 inhibitor). Results PARP-1 expression was higher in the AML cells than in the MDS cells. However, WEE1 expression remained unchanged. MK-1775 or talazoparib alone inhibited MDS and AML cells after 72 h, and cellular cytotoxicity and caspase 3/7 activity were increased. The combined use of MK-1775 and talazoparib produced superior efficacy than either drug alone and SKM-1 colony formation was reduced. Significant cell populations in the sub-G1 phase were found in the cell-cycle analyses. Additionally, γ-H2AX expression and caspase 3 activity were increased. The combined treatment also changed the mitochondrial membrane potential. Conclusions The combination of a WEE1 inhibitor and PARP-1 inhibitor had enhanced efficacy and is proposed as a new therapeutic option for patients with MDS or AML. Our findings have clinical implications for a potential novel therapeutic strategy for MDS and AML patients. more...

This study examines how the valence and argument of comments affect viewers’ attitudes toward and validation of a pseudo-scientific claim. We developed and tested a hypothesized model based on the elaboration likelihood model. Participants watched a video that introduced pseudo-scientific claims with others’ comments on the same screen. We assigned participants (n = 646) to a control condition with no message presentation and a message condition, with the message condition divided into four conditions based on a combination of valence and substantiveness of the comments. Structural equation modeling analysis revealed that valence affected both heuristic and systematic thought, while substantiveness influenced systematic thought. The negativity of the comments not only suppressed the positive impressions, which were irrelevant to the content, but also facilitated the examination of the reasoning for the pseudoscience claims in the video. Including substantive content in the comments also led to an examination of the rationale for pseudoscience claims. The model also showed that positive impressions irrelevant to the content increased validity judgments, the final positive attitude, and agreement to the pseudo-scientific claim, while examination of the rationale for the claims decreased them. more...

This study sought to develop a short DNA detection method using a deoxyuridine probe and polymerase chain reaction. The probe was hybridized to the target short DNA, which was then extended by DNA polymerase. The extended DNA was used for real-time PCR after the probe was removed by uracil DNA glycosylase. This method measured from 0.01 to 10 nM of a model short DNA sequence of 17 nucleotides. The method was then used to detect the nucleic acid medicine fomivirsen, as well as 21 phosphorothioate nucleotides, and to quantify 0.1–100 nM of fomivirsen. This method may be useful for detecting short DNA fragments, such as functional nucleotides. more...

Background: Hand hygiene is recommended to travellers to prevent common travel-related illnesses such as diarrhoea and respiratory infection. For effective hygiene promotion interventions, we aimed to identify the personal characteristics associated with handwashing behaviour. Methods: Prospective observational studies consisting of pre- and post-travel surveys were conducted among Japanese university students studying abroad between 2016 and 2018 (n = 825; 6–38 travel days). Associations of age, sex, study major, and overseas travel experience with handwashing behaviour (5-point scale) were evaluated using ordinal logistic regression models, with adjustment for destination, travel duration, and psychological factors (risk perception of diarrhoea and concern about hygiene). Results: Among the participants in our analysis (n = 629), 28.0 % washed their hands before every meal while abroad. The male sex and no overseas travel experience were associated with decreased frequency of infrequent handwashing, even after adjusting for all potential confounding factors, whereas the study major was not associated. The adjusted odds ratios (95 % confidence intervals) were 0.74 (0.56–0.99) for men vs. women and 0.69 (0.52–0.93) for no overseas travel experience vs. overseas travel experience but not to the current destination. Conclusions: The lack of overseas travel experience correlated with handwashing frequency in both men and women. In addition to the travel destination, the male sex and no overseas travel experience should be highlighted in pretravel hand hygiene interventions. more...

Evaluation of access routes and shunting points plays a crucial role in the treatment of cavernous sinus dural arteriovenous fistulas (CS-dAVF). Generally, these evaluations are performed using three-dimensional rotation angiography. However, assessing access routes becomes challenging in cases lacking anterior or posterior drainage routes. Zero TE magnetic resonance imaging (MRI) is an innovative technique enabling the visualization of cortical bone. By merging fusion images of zero TE and contrast-enhanced T1 weighted imaging (CE-T1WI), enhanced arteries can be visualized, resembling cranial bone-like three-dimensional rotation angiography. To determine the usefulness of fusion images in evaluating access routes and shunting points for dural arteriovenous fistulas, a comparison was made between these fusion images and three-dimensional rotation angiography in the same case. This report describes the application of fusion images in evaluating access routes and shunting points. more...

Abstract Background Acute exacerbation (AE) of systemic autoimmune disease-related interstitial lung diseases (SAID-ILD) is less common than AE of idiopathic pulmonary fibrosis (IPF) and the details of AE-SAID-ILD have not been elucidated, but the prognosis is similarly devastating. This study was undertaken to determine the incidences of AE-ILD in each SAID and to elucidate the proportion of progressive fibrosing (PF)-ILD in AE-SAID-ILD. Methods We retrospectively analysed data for patients with SAID-ILD who were diagnosed and observed at our hospital between 1999 and 2020. Results Two hundred and thirty-two patients with SAID-ILD were enrolled, with a mean observation period of 100.2 months. AE-SAID-ILD was found in 25 patients (10.78%), mainly in patients with RA (17 patients, 68%) and elderly male patients with a smoking history. The overall incidence of AE-SAID-ILD was 1.29%/person-year, and the incidence for each SAID was as follows: RA 2.193, microscopic polyarteritis (MPA) 3.203, systemic sclerosis (SSc) 2.277, primary Sjögren syndrome 0.426, and polymyositis/dermatomyositis 0.222. The incidence of AE of RA/MPA/SSc-ILD was significantly higher than that of other AE-SAID-ILD (p more...

Abstract Background The assessment of lung physiology via pulmonary function tests (PFTs) is essential for patients with idiopathic pulmonary fibrosis (IPF). However, PFTs require active participation, which can be challenging for patients with severe respiratory failure, such as during moments of acute exacerbation (AE) of IPF. Recent advances have enabled the re-construction of 3-dimensional computed-tomography (3D-CT) images. This study established a standardisation method and quantitative analysis of lung volume (LV) based on anthropometry using 3D-CT images. Methods This is a retrospective multi-center cohort study. The standardised 3D-CT LV in patients with IPF at diagnosis (n = 140) and during AE (cohort1; n = 61 and cohort2; n = 50) and those of controls (n = 53) were assessed. Results The standardised 3D-CT LVs at IPF diagnosis were less than those of control patients, especially in the lower lung lobes. The standardised 3D-CT LVs were correlated with forced vital capacity (FVC) and validated using the modified Gender-Age-Physiology (GAP) index. The standardised 3D-CT LVs at IPF diagnosis were independently associated with prognosis. During AE, PFTs were difficult to perform, 3D-CT analyses revealed reduced lung capacity in both the upper and lower lobes compared to those obtained at diagnosis. Lower standardised 3D-CT LVs during AE were independently associated with worse outcomes in the two independent cohorts. In particular, volume loss in the upper lobe at AE had prognostic values. Conclusions A novel image quantification method for assessing pulmonary physiology using standardised 3D-CT-derived LVs was developed. This method successfully predicts mortality in patients with IPF and AE of IPF, and may be a useful alternative when PFTs cannot be performed. more...

(1) Background: Loneliness is inherently linked to social connections, with interpersonal communication playing a pivotal role. Despite this connection, limited research exists on the relationship between loneliness and communication among young adults. This study investigates the correlation between face-to-face, telephone, and online communication frequencies and loneliness among individuals in their 20s. (2) Methods: Using a dataset from a nationwide survey conducted by the Japanese Cabinet Office, this study focuses on 1812 respondents aged 20–30, selected from a random sample of 20,000 individuals aged 16 and older across Japan. (3) Results: A Multivariate Logistic Regression Analysis reveals a significant association between communication frequency and loneliness, even after adjusting for demographic characteristics. Notably, decreased communication frequency across all modalities correlated with increased loneliness. Online communication exhibited the highest impact, followed by face-to-face communication, with phone call communication ranking last. (4) Conclusions: This study emphasizes the importance of seamlessly integrating social networking service (SNS)-based communication with various forms of social interaction. A well-balanced integration of these approaches is crucial for mitigating loneliness among young individuals and promoting positive mental health outcomes. more...

The pathogenesis of new visual symptoms after flow diverter stent placement in the ophthalmic artery for internal carotid artery aneurysms remains unclear. We report two cases of patients who developed visual field disturbance and decreased visual acuity following flow diverter placement. The “doughnut sign” was found around the optic nerve on magnetic resonance imaging.The patients had progressive visual field defects and impairment on the side where the flow diverter was placed. Short tau inversion recovery coronal images showed a doughnut-shaped high-signal around the optic nerve on the affected side. Both patients were treated with steroid pulse therapy, and 1 received endovascular therapy. Their symptoms gradually improved, and the “doughnut sign” disappeared.The “doughnut sign” observed around the optic nerve on magnetic resonance imaging may be found alongside visual disturbance symptoms after paraclinoid aneurysm treatment.It is recommended that short tau inversion recovery sequences be performed preoperatively in patients presenting with visual impairment and in whom the possibility of postoperative exacerbation is suspected. more...

Abstract The treatment of multiple myeloma (MM) patients has been dramatically changed by the introduction of new agents; however, many patients relapse. Hypoxia is a critical component of the bone-marrow microenvironment. 6-Phosphofructo-2-kinase/fructose-2,6-bisphosphatase (PFKFB) is responsible for maintaining cellular levels of fructose-2,6-bisphosphate, which regulates glycolysis. We found that the gene expressions of PFKFB3 and PFKFB4 were elevated under hypoxic conditions. Treatments with the PFKFB3 inhibitor, PFK158, and PFKFB4 inhibitor, 5MPN, were found to inhibit the growth of myeloma cells. The combined treatment of myeloma cells with carfilzomib and PFK158 or 5MPN was more cytotoxic than either drug alone. Caspase 3/7 activity and cellular cytotoxicity were also increased. In addition, the combined treatment was effective in the bortezomib-resistant cell line. Our data also suggest that administration of PFKFB3 and PFKFB4 inhibitors may be a powerful strategy against myeloma cells and to enhance the cytotoxic effects of proteasome inhibitors in hypoxic conditions. more...

Abstract Background Mucociliary clearance (MCC) is an essential defense mechanism in airway epithelia for removing pathogens from the respiratory tract. Impaired ciliary functions and MCC have been demonstrated in asthma and chronic obstructive pulmonary disease (COPD). Long-acting muscarinic antagonists (LAMAs) are a major class of inhaled bronchodilators, which are used for treating asthma and COPD; however, the effects of LAMAs on ciliary function remain unclear. This study aimed to identify the effects of LAMAs on airway ciliary functions. Methods Wild-type BALB/c mice were treated with daily intranasal administrations of glycopyrronium for 7 days, and tracheal samples were collected. Cilia-driven flow and ciliary activity, including ciliary beat frequency (CBF), ciliary beating amplitude, effective stroke velocity, recovery stroke velocity and the ratio of effective stroke velocity to recovery stroke velocity, were analyzed by imaging techniques. Using in vitro murine models, tracheal tissues were transiently cultured in media with/without LAMAs, glycopyrronium or tiotropium, for 60 min. Cilia-driven flow and ciliary activity were then analyzed. Well-differentiated normal human bronchial epithelial (NHBE) cells were treated with glycopyrronium, tiotropium, or vehicle for 60 min, and CBF was evaluated. Several mechanistic analyses were performed. Results Intranasal glycopyrronium administration for 7 days significantly increased cilia-driven flow and ciliary activity in murine airway epithelium. In the murine tracheal organ culture models, treatment with glycopyrronium or tiotropium for 60 min significantly increased cilia-driven flow and ciliary activity in airway epithelium. Further, we confirmed that 60-min treatment with glycopyrronium or tiotropium directly increased CBF in well-differentiated NHBE cells. In the mechanistic analyses, neither treatment with glycopyrronium nor tiotropium affected intracellular calcium ion concentrations in well-differentiated NHBE cells. Glycopyrronium did not increase protein kinase A activity in well-differentiated NHBE cells. Moreover, glycopyrronium had no effect on extracellular adenosine triphosphate concentration. Conclusions LAMAs exert a direct effect on airway epithelium to enhance ciliary function, which may improve impaired MCC in asthma and COPD. Further investigations are warranted to elucidate the underlying mechanisms of the effects of LAMAs on the promotion of airway ciliary function. more...

Pulmonary pleomorphic carcinoma (PPC) has an aggressive clinical course and poor prognosis mainly because of the difficulty in achieving therapeutic effects. Despite a small fraction of patients with PPC possessing an epidermal growth factor receptor (EGFR) activating mutation, only a limited number of studies have reported the efficacy of EGFR tyrosine kinase inhibitors in those patients. Here, we present successful treatment with first-line afatinib in a patient with EGFR mutation-positive, metastatic PPC. more...

Objective: Transarterial embolization under intrasinus balloon protection is an efficient treatment strategy for intracranial arteriovenous fistula. Ordinary balloon protection methods using the Copernic RC balloon may occlude the normal drainage route, and the occurrence of venous complications is concerning. The aim of this study was to report the efficacy of the supercompliant SHOURYU balloon catheter for intrasinus balloon protection while preserving the normal venous outlet. Methods: Eighteen patients with dural arteriovenous fistulas who were treated with transarterial embolization under intrasinus balloon protection between April 2011 and July 2020 were included. All lesions were treated with transarterial embolization under intrasinus balloon protection using the SHOURYU balloon catheter. Clinical and angiographic data were retrospectively collected, and the occlusion rate, complications, and clinical outcomes were analyzed. Results: Nine men and nine women were treated, and their average age was 61.1 years. Fistulas were located at the transverse-sigmoid sinus (n = 13), superior sagittal sinus (n = 3), tentorial sinus (n = 1), and around the torcular Herophili (n = 1). Ten patients were classified as Borden typeⅠand eight as Borden type Ⅱ. Complete (n = 9) or near-complete (n = 4) occlusion was achieved in 72.2% of the patients. Periprocedural complications, but no venous complications were observed in two patients. Symptoms were not aggravated after treatment. Conclusions: Transarterial embolization under intrasinus balloon protection using the SHOURYU balloon catheter is effective and safe for treatment of dural arteriovenous fistulas while maintaining the patency of the venous sinus. more...

We performed a prospective observational study of chronic myeloid leukemia (CML) patients after anti-SARS-CoV-2 BNT162b2 vaccination (VC). In total, 32 CML patients with tyrosine kinase inhibitor (TKI) therapy, 10 CML patients with treatment-free remission, and 16 healthy subjects participated in the study. From April 2021 to September 2021, all cases (median age = 58 years) were vaccinated twice. Immunoglobulin G for SARS-CoV-2 spike protein (S-IgG) was measured at three timepoints (before the first VC, 1–5 weeks after the second VC (T1), and approximately 6 months after the second VC (T2)). S-IgG was not observed before the first VC in any participant. At T1, all cases had acquired S-IgG. There were no significant differences in S-IgG levels among groups. A paired sample comparison of median S-IgG titers between T1 and T2 in all groups showed a significant reduction in T2 S-IgG titers. There were no significant differences in S-IgG levels among groups. When all patients were analyzed, those aged ≥58 years had significantly lower S-IgG levels than those aged more...

Most pediatric intravenous anesthesia in Japan is performed outside the operating theatre by non-anesthetists. The 2020 revision increased reimbursement for long-term intravenous anesthesia (Category 3) by anesthesiologists, but its impact on practice behavior is unknown. We analyzed the annual number of calculations for each category of intravenous anesthesia and their age distribution from the national reimbursement data for the three-year period fiscal years (FY) 2018-20 to elucidate trends in the pediatric age group. Regional disparities of calculation rate of pediatric addition per capita were examined. According to FY 2019 statistics, 5,774 outpatient intravenous anesthesia and 50,686 inpatient intravenous anesthesia procedures were performed annually in patients under 15 years of age. Of these, no case was complex anesthesia (Category 3) performed by a specialist anesthesiologist in outpatient settings and 1,162(3.9%) in inpatient settings. Category 3 occupancy was slightly higher in infants and decreased with age. (P < 0.01) In FY 2020 data, 41(0.7%) new Category 3 procedure were calculated in outpatient cases. The share of Category 3 in inpatient cases decreased to 2.0%. There was no decrease in the number of overall venous anesthesia due to COVID-19 pandemic. Regional disparities in calculations were up to 20 times greater. Long-term total intravenous anesthesia by anesthesiologists is rarely performed in Japan. Improvements in reimbursement are not sufficient to enable total intravenous anesthesia by a specialized anesthesiologist. A system for safe intravenous anesthesia by non-anesthesiologists is needed. [ABSTRACT FROM AUTHOR] more...

Objective: Recently, the occlusion rate of transarterial embolization (TAE) for intracranial non-sinus-type dural arteriovenous fistulas (NSDAVFs) has improved after ONYX was introduced. Additionally, when TAE for NSDAVF is unsuccessful, transvenous embolization (TVE) has become available as an alternative treatment. We investigated the factor for the favorable occlusion rate of endovascular treatment for NSDAVF at our institutions. Methods: Two hundred and twenty-seven patients with intracranial dural arteriovenous fistulas (DAVFs) were treated at our institutions between September 2014 and October 2022. The patients diagnosed with NSDAVF in all DAVFs who underwent endovascular treatment were included. The clinical characteristics, angiographical outcomes, and clinical outcomes of patients who underwent endovascular treatment were evaluated. Results: Thirty-eight patients had intracranial NSDAVF (tentorial: 23 cases, parasagittal-convexity: 7, anterior cranial fossa: 6, middle cranial fossa: 2). Our participants' mean age was 64.8 ± 11.3 years, and 31 (81.6%) of them were males. Patients' symptoms were as follows: asymptomatic (24), hemorrhage (10), tinnitus (3), and trigeminal neuralgia (1). TAE and TVE were performed on 35 and 3 patients, respectively. The rate of immediate angiographical occlusion was 84.2% (32/38). The follow-up angiographical occlusion rate in 6 months was 88.5% (31/35). Complications occurred in three cases. There was no morbidity or mortality after 30 days. Conclusion: TAE using the combination of the new microcatheter and microguidewire and TVE in the case of difficult or failed TAE for NSDAVF could achieve high success rates and safety. [ABSTRACT FROM AUTHOR] more...

Background: There are few reports on the treatment of carotid artery stenosis after arterial vessel replacement. We report and discuss an illustrative case of carotid artery stenting (CAS) performed for stenosis after carotid artery replacement. Case Description: A woman in her 20s experienced injury to the right carotid artery during an operation for removal of a carotid body tumor 6 years before presentation. The right common carotid artery and internal carotid artery were replaced with an artificial vessel graft at that time. Intraluminal stenosis in the graft was not identified 3 years after surgery; however, 4 years after surgery, stenosis was recognized at the non-anastomotic site inside the artificial vessel graft. Subsequently, antiplatelet therapy was initiated. The stenosis was noted to progress gradually in follow-up appointments. Therefore, we decided to intervene because of the patient's young age and the risk of long-term hemodynamic stress. Angiography revealed pseudo-occlusion in the artificial vessel. Percutaneous transluminal angioplasty was performed for stenosis with distal protection; subsequently, CAS was performed. The patient was discharged without neurological deficits 4 days after the operation, and no apparent restenosis was observed as of the 1-year follow-up. Conclusion: Stenosis after cervical artery replacement can be safely treated with CAS. Inflation pressure and stent should be selected according to the pathology of the stenosis. [ABSTRACT FROM AUTHOR] more...