Technique for Recanalization of Sheath Introducer Occlusion due to Captured Thrombus during Mechanical Thrombectomy for Acute Ischemic Stroke: A Technical Note.

Objective: Mechanical thrombectomy (MT) is the gold standard treatment for acute ischemic stroke. During these interventions, a thrombus frequently obstructs a guiding catheter. The obstructed guiding catheter should be withdrawn before distal embolism occurs; however, albeit infrequently, the thrombus occludes even a sheath introducer (SI).

Efficacy of transcutaneous cardiac pacing for transient asystole caused by trigeminocardiac reflex: illustrative case.

Background: Trigeminocardiac reflex (TCR) is a brainstem reflex caused by stimulation of the trigeminal nerve, which results in bradycardia, hypotension, and asystole. TCR can occur during any neurosurgical procedure. Initially, it is managed via the immediate removal of the stimulus from the trigeminal nerve.

Crystal structure of -(1-indol-2-yl-methyl-idene)-4-meth-oxy-aniline.

The mol-ecule of the title compound, CHNO, contains an essentially planar indole ring system and a phenyl ring. In the crystal, the mol-ecules are linked by a weak inter-molecular C-H⋯O hydrogen bond and C-H⋯π inter-actions, forming a one-dimensional column structure along the axis direction. These columns are linked by other C-H⋯π inter-actions, forming a two-dimensional network structure.

An anomalous hyperplastic anterior choroidal artery associated with an unruptured internal carotid-posterior communicating artery aneurysm.

The anterior choroidal artery (AChA) injuries can result in severe neurologic deficits, so requiring careful observation to avoid inadvertent damage during neuroendovascular procedures. In this case report, we present the unusual case of an anomalous hyperplastic AChA associated with a fetal-type posterior communicating artery (PCoA), and an unruptured internal carotid artery (ICA) -PCoA aneurysm. A 54-year-old woman presented with persistent headache.

Combined Experimental and Theoretical Studies on Planar Chirality of Partially Overlapped -Symmetric [3.3](3,9)Dicarbazolophanes.

Partially overlapped dicarbazolophanes exhibit a planar chirality. In this study, -symmetrical [3.3](3,9)dicarbazolophane derivatives (-) have been optically resolved by preparative chiral high-performance liquid chromatography for the first time.

Crystal structure of 4-bromo--[(3,6-di--butyl-9-carbazol-1-yl)methyl-idene]aniline.

In the title compound, CHBrN, the carbazole ring system is essentially planar, with an r.m.s.

Melatonin modifies basal and stimulated insulin secretion via NADPH oxidase.

Melatonin is a hormone synthesized in the pineal gland, which modulates several functions within the organism, including the synchronization of glucose metabolism and glucose-stimulated insulin secretion (GSIS). Melatonin can mediate different signaling pathways in pancreatic islets through two membrane receptors and via antioxidant or pro-oxidant enzymes modulation. NADPH oxidase (NOX) is a pro-oxidant enzyme responsible for the production of the reactive oxygen specie (ROS) superoxide, generated from molecular oxygen.

Successful perinatal management of a ruptured brain arteriovenous malformation in a pregnant patient by endovascular embolization followed by elective cesarean section: a single-case experience.

Background: Although brain arteriovenous malformations (AVM) usually remain asymptomatic during pregnancy, they can cause intracranial hemorrhage and lead to serious neurological deficits. Nowadays, it is accepted that treatment of a ruptured brain AVM during pregnancy should be based on neurologic, not obstetric, indications.Recently, endovascular treatment has been recognized as a treatment option associated in pregnant patients with brain AVMs.

High efficiency thermally activated delayed fluorescence based on 1,3,5-tris(4-(diphenylamino)phenyl)-2,4,6-tricyanobenzene.

A trigonal donor-acceptor molecule of 1,3,5-tris(4-(diphenylamino)phenyl)-2,4,6-tricyanobenzene (3DPA3CN) was synthesized to exhibit efficient thermally activated delayed fluorescence. By doping 3DPA3CN into a wide energy gap host, the film had a photoluminescence quantum efficiency of 100% with the reverse intersystem crossing efficiency of 100%. An OLED including the emitter exhibited a very high external quantum efficiency (η(EQE)) of 21.

Life-threatening hemorrhagic shock after laparoscopic surgery: a case of postoperative thrombotic thrombocytopenic purpura.

We report the successful management of a female patient who developed postoperative thrombotic thrombocytopenic purpura (TTP) after an uneventful laparoscopic oophorocystectomy. The patient underwent uneventful laparoscopic surgery for ovarian cystoma. One hour after completion of surgery, the patient suddenly went into shock, with her blood pressure dropping to 60/40 mmHg.

Computed three-dimensional atlas of subthalamic nucleus and its adjacent structures for deep brain stimulation in Parkinson's disease.

Background. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is one of the standard surgical treatments for advanced Parkinson's disease. However, it has been difficult to accurately localize the stimulated contact area of the electrode in the subthalamic nucleus and its adjacent structures using a two-dimensional atlas.

Use of 5-aminolevulinic acid for the confirmation of deep-seated brain tumors during stereotactic biopsy. Report of 2 cases.

5-Aminolevulinic acid (ALA) has been successfully used to confirm the target tumor tissues obtained during stereotactic biopsy. The authors report their experience with 2 patients who underwent stereotactic biopsies of thalamic malignant lymphoma and pontine glioma utilizing 5-ALA. Intraoperatively, the tumor specimens fluoresced, allowing for confirmation that the obtained target specimen contained tumor tissues.

Absence of melatonin induces night-time hepatic insulin resistance and increased gluconeogenesis due to stimulation of nocturnal unfolded protein response.

It is known that the circadian rhythm in hepatic phosphoenolpyruvate carboxykinase expression (a limiting catalytic step of gluconeogenesis) and hepatic glucose production is maintained by both daily oscillation in autonomic inputs to the liver and night feeding behavior. However, increased glycemia and reduced melatonin (Mel) levels have been recently shown to coexist in diabetic patients at the end of the night period. In parallel, pinealectomy (PINX) is known to cause glucose intolerance with increased basal glycemia exclusively at the end of the night.

Epithelial regeneration after diffuse alveolar damage in relation to underlying disease and DAD stage: an autopsy study.

Unlabelled: This study was conducted to characterize the distribution of epithelial regeneration in lungs with diffuse alveolar damage (DAD) and to ascertain whether epithelial regeneration is associated with the underlying disease and/or DAD stage.

Methods: Lung specimens obtained at autopsy from 18 patients were studied using p63, PE-10 and Ki-67 immunostaining. The patients were categorized into two groups: patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF; IPF group) and patients without IPF (non-IPF group).

Capsule plication as a protective measure against post-operative intracapsular haematoma formation following trans-sphenoidal removal of pituitary macroadenoma.

Background: Post-operative haematoma and visual deterioration are rare but serious complications after trans-sphenoidal surgery. For more reliable decompression of the optic nerve, we introduce a new technique for volume reduction of the cavity remaining after trans-sphenoidal resection of macroadenomas.

Technique: After intracapsular removal of the adenoma, the suprasellar portion of the tumour 'capsule' spontaneously prolapsed into the sella turcica.

A case of lymphomatoid granulomatosis followed for 14 months on the basis of clinical and histological findings.

Lymphomatoid granulomatosis (LYG) is a systemic granulomatous disease characterized by B-cell proliferation of uncertain malignant potential. It most frequently affects the lungs but also occasionally affects the central nervous system. Its pathophysiology is unclear in numerous respects, thus making it difficult to diagnose and treat.

Extended transsphenoidal surgery for suprasellar craniopharyngiomas: infrachiasmatic radical resection combined with or without a suprachiasmatic trans-lamina terminalis approach.

Background: An extended transsphenoidal approach allowed for direct midline exposure of the parasellar structures such as the hypothalamic-pituitary axis and the third ventricle. To evaluate the capability of this approach for removal of suprasellar craniopharyngiomas, surgical outcomes were retrospectively analyzed.

Methods: During a 9-year period, 20 consecutive patients with suprasellar craniopharyngioma underwent transsphenoidal tumor resection.

Metastatic brain tumor surgery using fluorescein sodium: technical note.

As for the surgical treatment of glioma, the recent employment of fluorescence-guided resection using 5-aminolevulinic acid (5-ALA) or high-dose fluorescein sodium has increased the rate of radical tumor resection. On the other hand, there is no specific technique for metastatic brain tumor surgery. We have used a fluorescence-guided tumor resection procedure with the aid of high-dose fluorescein sodium in surgery for metastatic brain tumor.

Extended transsphenoidal approach to anterior communicating artery aneurysm: aneurysm incidentally identified during macroadenoma resection: technical case report.

Objective: Full exposure of an aneurysm and surrounding structures with minimal brain retraction is important to eliminate the aneurysm safely and accurately. We describe an extended transsphenoidal approach for clipping an anterior communicating artery (ACoA) aneurysm.

Clinical Presentation: A 58-year-old woman had a surgical history significant for subtotal removal of a macroadenoma via the posterior portion of the planum sphenoidale using an extended transsphenoidal approach.

Extended transsphenoidal approach for surgical management of pituitary adenomas invading the cavernous sinus.

Objectives: The authors devised an extended transsphenoidal approach involving a submucosal posterior ethmoidectomy that allows for adequate exposure of the cavernous sinus. To evaluate the adequacy of this approach for removal of adenomas invading the cavernous sinus, the authors retrospectively analyzed the surgical outcomes obtained in treated patients.

Methods: During a 9-year period, 36 patients with pituitary adenomas extending into the cavernous sinus underwent tumor removal at Kinki University Hospital.

Early effects of boron neutron capture therapy on rat glioma models.

Early effects of boron neutron capture therapy (BNCT) on malignant glioma are characterized by reduction of the enhancement area and regression of the peritumoral edema radiologically. The aim of this study was to investigate the early histological changes of tumors and inflammatory cells after BNCT in the rat brain. Rats were treated with BNCT using boronophenylalanine (BPA) 7 days after implantation of C6 glioma cells.

[Effects of deep brain stimulation on urodynamic findings in patients with Parkinson's disease].

Electric stimulation therapy is one of the surgical treatments for Parkinson's disease whereby a chronic stimulating electrode is placed on the subthalmic nucleus (STN). Because medical treatments centered around L-dopa have limitations in severe Parkinson's disease, electric stimulation therapy is regarded as an appropriate treatment modality. Most Parkinson's disease patients experience lower urinary tract disorders such as urgency, daytime frequency or nocturia, due to detrusor overactivity.

Icing and multilayering technique of injectable hydroxyapatite cement paste for cranial base reconstruction after transsphenoidal surgery: technical note.

Objective: Injectable hydroxyapatite cement (HAC, Biopex; Mitsubishi Pharma Corp., Osaka, Japan) can reconstruct the accurate contour of bone defects intraoperatively, and it is slowly replaced with bone by a process of resorption and osteoconduction, making it a useful substrate for the repair of cranial defects. In the operative site with continuous oozing of the cerebrospinal fluid, however, the implanted HAC may be dissolved and washed out as a result of its water solubility during the setting time.

Postoperative improvement in visual function in patients with tuberculum sellae meningiomas: results of the extended transsphenoidal and transcranial approaches.

Object: Recently, extended transsphenoidal surgery (ETSS) has become an alternative to transcranial surgery (TCS) for suprasellar meningiomas, although the relative benefits of ETSS have yet to be established. To evaluate the effectiveness of ETSS, the authors analyzed surgical outcomes of TCS and ETSS.

Methods: During a 12-year period, 28 patients with meningiomas arising from the tuberculum sellae underwent tumor removal at Kinki University Hospital.

Endovascular stent placement of cervical internal carotid artery dissection related to a seat-belt injury: a case report.

Object: The incidence of carotid artery dissection related to blunt injury is very low, but the mortality rate is high. Rapid diagnosis and proper treatments are discussed.

Clinical Presentation: A 48-year-old woman presented diplopia and pulsating tinnitus of the left ear.