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Troels Hvelplund, Bibi Lange, Susanne Djernes Bird, Malene Korsholm,
Published: 11 October 2021
Abstract:
Background Hereditary Haemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by several clinical symptoms including epistaxis, arteriovenous malformations (AVM), and telangiectasia. In 2018, European Reference Network for Rare Vascular Diseases (VASCERN) recommended five outcome measures for HHT-patients to guide health care providers, some with limited experience in treating HHT, and thereby maximizing the number of HHT-patients receiving good care. The outcome measures cover the following aspects: 1) 90% of the patients should receive a pulmonary AVM (PAVM) screening; 2) 90% of the patients should receive written advice on nosebleed; 3) 70% should be assessed for iron deficiency; 4) 100% of the patients should receive written advice on antibiotic (AB) prophylaxis prior to dental and surgical procedures, and; 5) 100% of relevant patients should receive written advice on pregnancy. We have introduced the outcome measures as Benchmarks in our HHT-centre and wanted to evaluate the extend of implementation we have achieved. We constantly struggle to secure the best possible treatment of our HHT-patients.Methods The study was a non-interventional retrospective study. All data was collected from medical journals and from the Danish HHT-database. Results A total of 180 HHT-patients were included, all diagnosed in the period from January 1st 2016 to December 31st 2020. All patients were screened for PAVM. We could confirm that 66% of patients who had epistaxis received thoroughly advice. Assessment for iron deficiency was performed in 80 % of the adult patients. Thoroughly advice on antibiotic prophylaxis was documented in 75%. Thoroughly advice on pregnancy was documented in 80% of female patients 15-45 years of age. There were no significant differences over time for any of the outcome measures. Conclusions The Danish HHT-centre reached the target threshold for outcome measures 1 and 3. We could not document reaching the target thresholds for outcome measures 2, 4, and 5. As information and education is a very important part of HHT care, we will focus on and document that all patients receive the relevant advice and as part of our care, we will in the near future implement an electronic solution with advice for HHT patients.
L Pan, W Xiang, Y Zhao
Published: 24 August 2021
by BMJ
ESMINT 2021 – Abstract book, Volume 13; https://doi.org/10.1136/neurintsurg-2021-esmint.29

Abstract:
Introduction Accurate diagnosis is essentially important for treatment of cerebral arteriovenous malformation (AVM). Conventional digital subtraction angiography (DSA) are limited due to the complex vessel overlapping. 4D DSA with both temporal and spatial resolution is able to reveal AVM angioarchitecture. Objective We compared the performance of 4D imaging with the conventional method for visualizing AVM. Aim To evaluate the diagnostic performance of 4D DSA and 4D prototype. Methods 37 patients were selected. The standard medical records were based on the conventional 2D and 3D DSA combination method. 2 independent experienced surgeons recorded assessments based only on 4D datasets. The evaluation results were then compared with the medical records using agreement analysis. Results Using either 4D DSA or 4D prototype, both reviewers reached a complete agreement with the medical records for Martin-Spetzler Scores and the presence of intracranial aneurysm. Assessing the number of feeding arteries, the agreement between 4D DSA and the medical records was 0.888 for both Reviewer A and B; the agreement between 4D prototype and the medical records was 0.917 for both reviewers. Determining the number of draining veins, the agreement between 4D DSA and the medical records was 0.97 for both reviewers; the agreement between 4D prototype and the medical records was 0.943 for Reviewer A and 0.941 for Reviewer B. Conclusion The diagnostic performance of both 4D DSA product and prototype software were largely equivalent to the combination method for cerebral AVM. 4D prototype further optimized the temporal resolution and image quality compared to 4D product. References Lang S, Gölitz P, Struffert T, Rösch J, Rössler K, Kowarschik M, Strother C, Doerfler A. 4D DSA for dynamic visualization of cerebral vasculature: a single-center experience in 26 cases. AJNR. American Journal of Neuroradiology 2017;38(6):1169–1176. Ognard J, Magro E, Caroff J, Ben Salem D, Andouard S, Nonent M, Gentric JC. A new time-resolved 3D angiographic technique (4D DSA): description, and assessment of its reliability in Spetzler-Martin grading of cerebral arteriovenous malformations. Journal of Neuroradiology = Journal de Neuroradiologie 2018;45(3):177–185. Disclosure Nothing to disclose
, Awais Ashfaq
Published: 20 July 2021
Pediatric Cardiology, Volume 42, pp 1483-1487; https://doi.org/10.1007/s00246-021-02682-2

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Journal of Clinical Interventional Radiology ISVIR, Volume 5, pp 131-132; https://doi.org/10.1055/s-0041-1730759

Abstract:
Prof. Luc Picard, the pioneer French interventional neuroradiologist passed away in April 2021. Absence of his towering figure is a profound loss to neuroradiology, in particular, to the discipline of interventional neuroradiology. Luc Picard was born in Metz, Germany, on November 29, 1937. His father was a family doctor. He was the last of the four children (one brother and two sisters). He was educated in Nancy in Saint Sigisbert College (Catholic college) and then in the Faculty of medicine in Nancy. He is survived by his wife Françoise, a neuropsychiatrist and a brilliant analyst, three children (two daughters and a son who is a family physician near Nancy), nine grandchildren and a great grandchild. He started his training as a clinical neurologist in the early 1960s. Realizing the importance of radiology in neurological diagnosis, he completed additional specialization with a diploma in neuroradiology. He was closely associated with Dr. Rene Djindjan, a pioneer and authority on spinal vasculature and angiography before joining the Department of Radiology in Nancy, France, in 1970. Soon after, he set up an independent division of neuroradiology, thereafter upgraded it to a full-fledged department in 1977, and served as its Director (1977–1980), Professor (1980–1984), and Chairman (1984–2004). He spent his entire career working at this institution until his retirement. In his long career spanning five decades, Prof. Picard held many notable positions—the Professor of Neuroradiology, President of the World Federation of Neuroradiological Societies, and Honorary President of the World Federation of Interventional and Therapeutic Neuroradiology. He was also a founder member of the French Society of Neuroradiology in 1970 and became its President in 1989. He was the Editor of the Journal of Neuroradiology from 1978 to 2002. A detailed biographical sketch of this pioneer is available in the following links (htpp://www. sfrnet.org).[1] [2] My first interaction with Prof. Picard was in 1986when he visited Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram ([Fig. 1]). Dr. Picard delivered guest lectures and demonstrated the techniques of superselective embolization, balloon occlusion, and other techniques that had just become current in the practice of neurointervention in the 1980s. His visit was the impetus and catalyst for transforming our fledgling Interventional Neuroradiology program at SCTIMST into a full-fledged state-of–the-art clinical service. Prof. Picard taught me and my colleagues the use of Ingenor microcatheters, the injection chamber for propelling the catheters under hydrostastic pressure into the cerebral circulation, creating a calibrated leak in the microballoons and mounting them in the microcatheters using latex ligatures. He also demonstrated the correct technique of preparing isobutyl cyanoacrylate (2-IBCA), the then available liquid polymerizing embolic agent, with Myodil and tantalum powder. He performed superselective angiography in a patient with cerebral arterovenous malformation (AVM), deftly navigating the microcatheter into the feeding branch of the middle cerebral artery. Having almost approached the nidus using the Balt Pursil microcatheter in another AVM, he abandoned the procedure, a great lesson to us when and why not to deliver 2-IBCA in the given circumstance. He treated two other patients, one with a peripheral vascular malformation in the leg and the other with an aneurysm of the internal carotid artery near the skull base. He would often quote his first-time experience of witnessing seizures following intra-arterial injection of papaverine in a young female patient for the relief of vasospasm, while demonstrating the procedure at our Institute. His lectures illustrated with excellent, glass-mounted 35-mm slides on a range of topics from treatment of cerebral AVMs, aneurysms, carotid-cavernous fistulae, and spinal AVMs revealed the phenomenal amount of work that this pioneer had undertaken to advance the field of neurointerventional radiology. Current concept of transvenous approach to cerebral AVMs may be based on his simple anatomical drawings of flow dynamics. With profound gratitude, I presented him with ready to use sterilized packets of hydrogel microspheres synthesized at our Research and Development Wing, an embolic material he was unfamiliar with. It was indeed our great fortune to have been guided and tutored by Prof. Picard. Despite restrictions on short-term visits he took personal interest and facilitated my trip to his center at Nancy, France, in the late 1990s. I saw him meticulously noting down relevant and critical points before the procedure in every case file. Organization of his workflow, follow-up, and documentation were extraordinary to emulate. Off working hours Dr. Picard was a very friendly person with a subtle and wry sense of humor ([Fig. 2]). He spoke English with a charming continental accent that was special and amusing. He enjoyed Indian food and regaled us with stories of his visits to other parts of the world, including Shanghai (China had not yet opened up then). He was a fan of modern theatre and art with interest in geopolitics. The demise of Prof. Luc Picard is a great loss to the fraternity of radiologists, particularly the neuroradiologists. He will be missed and will never be forgotten by the interventional community of India. May his soul rest in peace. Publication Date:14 June 2021 (online) © 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon....
, Böhme Tanja, Beschorner Ulrich, Zeller Thomas
Archives of Vascular Medicine, Volume 5, pp 001-003; https://doi.org/10.29328/journal.avm.1001014

Abstract:
Acute and subacute ischemia of the lower limbs represents a major emergency with a high in-hospital mortality, complication, and leg amputation rates. Treatment options for acute limb ischemia include systemic anticoagulation, followed by various catheter based options including infusion of fibrinolytic agents (pharmacological thrombolysis), pharmacomechanical thrombolysis, catheter-mediated thrombus aspiration, mechanical thrombectomy, and any combination of the above or open surgical intervention (thromboembolectomy or surgical bypass). Minor and major bleeding complication during catheter directed thrombolysis (CDT) especially at access site are frequent. Bleeding complications require often an interruption or termination of CDT affecting clinical outcome of the patients. Recently we examined a new access site bleeding protection device during CDT.
Surgical Neurology International, Volume 11; https://doi.org/10.25259/sni_760_2020

Abstract:
Background: Radiosurgery is an effective, alternative treatment modality in managing patients with cerebral arteriovenous malformations (AVMs). The present study aims to highlight the scholarly impact of the top-100 most cited articles on the radiosurgical management of AVMs. Methods: A title-specific search using the keyword “arteriovenous malformation” was conducted in the Scopus database. The outcome of the search was rearranged based on the citations count. Articles were categorized into four entities; clinical, gamma knife radiosurgery, linear accelerator (LINAC) radiosurgery, and proton beam radiosurgery. The exclusion criteria were applied to spinal or non-intracranial AVM, conference papers, non-English articles predominantly discussing the endovascular or microsurgical management. Results: The top-100 articles on the radiosurgical management of AVM were published between 1972 and 2016. Approximately one-third of the publications were produced between 1995 and 2000. The average citations per year for all papers were seven. The most-studied entity was pertinent to the clinical application of gamma knife radiosurgery in AVM (68%). The United States was the most active country in studying the radiosurgical application in AVM. The Journal of Neurosurgery published approximately one-third of the most-cited articles in the list. The top-3 most contributing authors, publishing 80% of articles in the list, were Lunsford et al. Conclusion: The radiosurgical management of AVMs evolved significantly throughout the years. Identifications of the publication trends facilitate the acquisition of evidence-based articles for authors investigating various radiosurgical techniques in the treatment of AVMs.
Dong Ji, Guofeng Chen,
Published: 3 July 2020
Abstract:
Liver cirrhosis consists of an asymptomatic compensated phase and a decompensated phase, which can cause two pulmonary vascular complications: hepatopulmonary syndrome (HPS) characterized by hypoxia, intrapulmonary microvasculature dilatation, angiogenesis and arterio-venous malformations (AVMs) [1Koch D.G. Fallon M.B. Hepatopulmonary syndrome.Clin Liver Dis. 2014; 18: 407-420http://dx.doi.org/10.1016/j.cld.2014.01.003Summary Full Text Full Text PDF PubMed Scopus (18) Google Scholar]; and portopulmonary hypertension (PoPH) characterized by increased pulmonary vascular resistance and pulmonary arterial hypertension (PAH) in the absence of other etiologies of PAH [2Iqbal S. Smith K.A. Khungar V. Hepatopulmonary syndrome and portopulmonary hypertension.Clin Chest Med. 2017; 38: 785-795http://dx.doi.org/10.1016/j.ccm.2017.08.002Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar]. Previous studies have shown that PoPH and HPS are associated with markedly reduced bone morphogenetic protein (BMP) 9/10 [3Rochon E.R. Krowka M.J. Bartolome S. Heresi G.A. Bull T. Roberts K. et al.. BMP 9/10 in pulmonary vascular complications of liver disease.Am J Respir Crit Care Med. 2020; http://dx.doi.org/10.1164/rccm.201912-2514leCrossref PubMed Scopus (2) Google Scholar, 4John M. Kim K.J. Bae S.D.W. Qiao L. George J. Role of BMP-9 in human liver disease.Gut. 2019; 68: 2097-2100http://dx.doi.org/10.1136/gutjnl-2018-317543Crossref PubMed Scopus (5) Google Scholar] and increased soluble endoglin (sEng) levels [5Owen N.E. Alexander G.J. Sen S. Bunclark K. Polwarth G. Pekpe-zaba J. et al.Reduced circulating BMP10 and BMP9 and elevated endoglin are associated with disease severity, decompensation and pulmonary vascular syndromes in patients with cirrhosis.EBioMedicine. 2020; 56102794http://dx.doi.org/10.1016/j.ebiom.2020.102794Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. Approximately 4–40% of cirrhotic patients could develop into HPS [6Soulaidopoulos S. Cholongitas E. Giannakoulas G. Vlachou M. Goulis I. Review article: update on current and emergent data on hepatopulmonary syndrome.World J Gastroenterol. 2018; 24: 1285-1298http://dx.doi.org/10.3748/wjg.v24.i12.1285Crossref PubMed Scopus (14) Google Scholar] and PoPH can develop in 1–6% of patients with portal vein hypertension [7Savale L. Guimas M. Ebstein N. Fertin M. Jevnikar M. Renard S. et al.. Portopulmonary hypertension in the current era of pulmonary hypertension management.Journal of Hepatology. 2020; http://dx.doi.org/10.1016/j.jhep.2020.02.021Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar]. Both of these complications can increase the mortality rate in liver cirrhotic patients and there are few effective precautionary or therapeutic measurements except liver transplantation [8Cosarderelioglu C. Cosar A.M. Gurakar M. Pustavoitau A. Russell S.D. Dagher N.N. et al.Portopulmonary hypertension and liver transplant: recent review of the literature.Exp Clin Transplant. 2016; 14: 113-120PubMed Google Scholar, 9Sendra C. Carballo-Rubio V. Sousa J.M. Hepatopulmonary syndrome and portopulmonary hypertension: management in liver transplantation in the horizon 2020.Transplant. Proc. 2020; http://dx.doi.org/10.1016/j.transproceed.2020.02.057Crossref PubMed Scopus (1) Google Scholar]. The study recently published in EBioMedicine by Owen and co-workers contribute to the literature from three aspects.
Amira Alolyani, Horia Alotaibi, May Adel AlHamid, Faisal Alabbas,
The Arab Journal of Interventional Radiology, Volume 4, pp 092-095; https://doi.org/10.4103/ajir.ajir_11_20

Abstract:
Background: Cerebrovascular malformations are encountered frequently in clinical practice, but not much is known about the pattern of publication in the Middle East and North Africa (MENA) countries. We aim to evaluate the status and pattern of publications of cerebral arteriovenous malformations (AVM) and cavernomas in the MENA. Materials and Methods: PubMed database was searched for publications on cerebral AVM and cavernomas in the MENA between 2009 and 2019. Results: We found only 94 publications in the MENA region out of 31,333 publications pertaining to AVMs (0.3%). The highest publishing country was Turkey, with 50 (53.1%) studies. The case report was the study design used most by authors with 59 (62.7%) studies. The majority of publications were by neurosurgeons with 42 of 94 (42.4%) papers. European journals ranked first in the number of published articles with 42 of 94 (46.1%) articles. Conclusions: We found a limited number of publications on cerebral AVMs and cavernomas by MENA countries in the past decade. Research support and national/regional registries are important factors to improve the academic output on AVMs and cavernomas in the MENA region.
Ahmed Attia Ahmed Hassan, Ali Hassan Elmokadem, Ahmed Bahaa Elden Elserwi, Mohamed Metwally Abo El Atta, Talal Ahmed Youssef Amer
Published: 1 February 2020
PAIRS Annual Meeting, Volume 04; https://doi.org/10.1055/s-0041-1729057

Abstract:
Objectives: (1) To report our institutional initial technical experience in the endovascular management of cerebral arteriovenous malformations (AVMs). (2) To detect the clinical outcome involving efficacy and complications of the endovascular management of cerebral AVMs. Methods: This is a cross-sectional study involving 14 cases diagnosed as having cerebral AVMs, who underwent diagnostic angiography and planned after written consent for a attempt of endovascular embolization. Our standard technique will be performed under a general anesthesia and get through transfemoral artery approach Microcatheter will be advanced through a guiding catheter to the arterial feeders supplying the cerebral AVMs. Onyx or Histoacryl was used as embolizing agent for successfully navigated cerebral AVMs by microcatheter Immediate follow-up conventional angiography was done to assess the size of residual AVM. Continuous clinical and radiological follow-up of our cases is still running every 6 months. Results: Technical results involved successful microcatheter navigation and embolization in 9 of 14 cases (64%) with failed microcatheter navigation in 2 of 4 cases (14%) and failed embolization in 3 cases (22%). Clinical results involved controlled recent intracranial hemorrhage on 2 of 3 cases (67%), controlled seizure on 2 of 5 cases (40%), and complicated hemorrhage on 2 of 9 cases (22.2%) with one reported death. Anatomical results more than 50% decreased size of 4 of 9 cases (44.4%) and less than 50% decreased size in 5 of 9 cases (55.5%). Conclusion: Endovascular embolization of cerebral AVMs by transfemoral artery approach using microcatheter navigation and embolization has some technical difficulties with success rate for navigation and embolization (64%). It is an effective treatment method to control hemorrhagic cerebral AVMs, to decrease associated seizures, and to decrease the size of cerebral AVMs. Publication Date:26 April 2021 (online) © 2020. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
, Asim Shah
Published: 1 February 2020
PAIRS Annual Meeting, Volume 04; https://doi.org/10.1055/s-0041-1729099

Abstract:
Objectives: Pulmonary arteriovenous malformations (PAVMs) are structurally abnormal vessels that provide direct capillary-free communication between the pulmonary and the systemic circulations and hence an anatomic right to left shunt. They are commonly caused by hereditary hemorrhagic telangiectasia (HHT). Treating these lesions is of high clinical priority as they can increase the incidence of developing stroke and cerebral abscesses. The main indication to treat these lesions is when the feeding artery measures more than 4 cm. Here, we present our experience in treating 18 patients with endovascular embolization in Nottingham University Hospitals. Methods: A retrospective review of all the PAVMs underwent endovascular embolization between October 2014 and November 2019 (5 years) was conducted. We reviewed the number of treatments, clinical success, complications, and the recanalization rates. Results: A total of 18 patients with PAVMs treated with endovascular embolization over 5 years. There were 12 males and 6 females with mean age of 56 years. The documented and genetically proven underlying cause was found to be HHT in most cases (15 patients). A total of 25 treatments were performed (4 patients had multiple AVMs treated in separate occasions and two patients had recanalization of previously treated AVMs which were then re-treated). One patient with AVM underwent angiogram which showed multiple small AVMs which were not treated. One patient had difficult embolization with migration of coil into the pulmonary vein and the right ventricle which was then retrieved using a vascular snare with resolution of ectopics and no late complications developed. No major or minor postembolization complications developed; one patient was admitted postembolization with pleuritic pain which was treated conservatively. No patients suffered a stroke or cerebral abscess since treatment. Sixteen treatments had documented successful improvement in their oxygen saturations on respiratory review. Three patients developed recanalization (defined as persistent perfusion through a previously placed coil). Two patients had further treatments and one patient did not have further treatment. Conclusion: Endovascular embolization is a minimally invasive treatment for PAVMs with high technical and clinical success and low complication rate. The most common persistent pattern in our series was found to be recanalization. Publication Date:26 April 2021 (online) © 2020. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
, Sriharsha Kantamneni
Published: 13 December 2019
Frontiers in Neurology, Volume 10; https://doi.org/10.3389/fneur.2019.01322

Abstract:
Editorial on the Research TopicCerebrovascular and Neurodegenerative Diseases - New Insights into Molecular Cell Biology and Therapeutic Targets There is a significant gap in our understanding of the molecular and cellular biology of cerebrovascular and neurodegenerative diseases to identify new therapeutic targets and develop diagnostic tools to better understand the disease progression and treatment. The cellular and molecular events linking cerebrovascular pathology and neurodegeneration are also not fully understood. The research articles and review papers published in this topic aim at a multifaceted approach to evaluating recent progress in our understanding some of the underlying molecular mechanisms of disease process and potential therapeutics targeting these diseases. Here we summarize the contributing articles to our topic conveying the aim of the pertaining research. The articles in this Research Topic highlight the challenges inspiring future research to address some of the questions and to exploit new opportunities for development of novel therapeutics for cerebrovascular and neurodegenerative diseases. Smith-Dijak et al. studied the effects of pridopidine, a drug that enhances brain derived neurotrophic factor (BDNF) signaling through stimulation of the sigma-1 receptor (S1R) and S1R agonist, in cortical neurons obtained from a mouse model of Huntington disease (HD). Several pathways implicated in synaptic functions are dysregulated in HD, including BDNF and calcium signaling. The data provide evidence for restoration of synaptic plasticity that maintain the stability of neuronal and synaptic function required for new learning and cognitive function. The results suggest a potential new direction for developing therapy to mitigate cognitive deficits in HD and may provide new avenues for neuroinflammation-related disorders treatment. Agouni et al. provided a comprehensive analysis of circulating extracellular vesicles (EVs) from vascular wall, blood, and immune cells in transient ischemic attacks (TIA) and acute ischemic stroke (AIS) patients from Southeast Asia and the Middle East. This study showed that EVs of various origins, especially those associated with endothelial cell injury and platelet activation, are increased in TIA and AIS patients. The levels of EV continue to be high for up to 30-days post-attacks indicating a sustained cellular activation, which may be associated with an increased risk of recurrence of acute events in this population. D'Angelo et al. carried out a review on antiphospholipid syndrome (APS) and multiple sclerosis (MS). APS and MS are both considered as anti-lipid autoimmune diseases with specific pathophysiological mechanisms and events. Isolated neurological APS represents a significant diagnostic challenge, as epidemiological, clinical, and neuroimaging features may overlap with those of MS. The review draws attention to the clinical relevance of diagnosing isolated neurological APS and suggests that prompt and accurate diagnosis and treatment of APS with anti-aggregant and anticoagulant could be vital to prevent or reduce APS-related morbidity and mortality. Wei et al. examined the cellular mechanisms mediating the neuroprotective effects of Homer1a, a short form of a scaffold protein, which is upregulated in rat cortical neurones following oxygen and glucose deprivation (OGD) mimicking ischemia-reperfusion (I/R) injury. The results showed that overexpression of Homer1a reduced OGD-induced lactate dehydrogenase (LDH) release, cell death, and mitochondrial dysfunctions in cultured cortical neurons. Homer1a also protects against OGD-induced injury by preserving mitochondrial function through inhibiting the protein kinase R-like endoplasmic reticulum kinase (PERK) pathway. In addition, mitochondrial protection of Homer1a was blocked by the ER stress activator tunicamycin (TM) suggesting that Homer1a may be a promising target of protecting neurons from cerebral injury. Yang et al. examined the effect of cyclooxygenase (COX2)/prostaglandin D2 (PGD2)-related autophagy on brain injury in diabetic rats suggesting that the COX2-PGD2 pathway is a potential therapeutic target for diabetic brain injury. Xu et al., reported that low-moderate ethanol consumption may prevent ischemic stroke and reduce brain cerebral ischemia/reperfusion injury (I/R) by suppressing inflammation, whereas heavy alcohol consumption may induce ischemic stroke and worsen brain I/R injury by aggravating inflammation. He et al. found that smilagenin, a steroidal sapogenin from traditional Chinese medicinal herbs, can have neuroprotective effect on dopaminergic neurons in a chronic mouse model of Parkinson's disease (PD) suggesting that this drug could prevent the impairment of dopaminergic neurons in PD. Zhang et al. demonstrated that Naringenin (NAR), a grapefruit flavonoid promoted microglia M1/M2 polarization, thus conferring anti-neuroinflammatory effects via the inhibition of mitogen-activated protein kinase (MAPK) signaling activation. These findings provide new alternative avenues for neuroinflammation-related disorders treatment. Hao et al. showed that heterozygous loss of activin receptor-like kinase 1 (Alk1) can lead to hereditary hemorrhagic telangiectasia, which is a vascular disease characterized by direct connections between arteries and veins leading to arteriovenous malformations (AVMs). The results of the study suggest that Alk1 induces the formation of sporadic human cerebral AVMs through affecting migration and proliferation of endothelial cells combined with vascular endothelial growth factor A. Li et al. developed a flow cytometry protocol to identify microglia and monocyte-derived macrophages from mouse intracerebral hemorrhagic (ICH) stroke model induced by collagenase or blood injection. The authors also combined magnetic-activated cell separation system that allows eight tissue samples to be assessed together. This protocol represents a very important tool for biological functions of microglial and monocyte-derived macrophage in ICH stroke and related brain diseases. Jin et al., showed that glucose-regulated protein (GRP78) a chaperone protein located in the endoplasmic reticulum (ER) is involved in the neuroglial response to neurotoxic insult in rats induced by mitochondrial toxin 3-nitropropionic acid (3-NP), which selectively damages striatal neurons. These data provide novel insights into the phenotypic and functional heterogeneity of GRP78-positive cells within the lesion core and the involvement of GRP78 in the activation/recruitment of activated microglia/macrophages and blood-brain-barrier impairment in response neurotoxic insult. Song et al. reported that the knock down of myosin light chain kinase, a key enzyme in smooth muscle cell contraction, in human brain smooth muscle cells (SMCs) caused effects similar to those observed in cultured SMCs from intracranial aneurysm patients. These results indicate that myosin light chain kinase plays an important role in maintaining smooth muscle contractility, cell survival and inflammation tolerance and is crucial to the normal function of intracranial arteries. Hoyk et al. showed elevated serum triglyceride levels, changes in functional and morphological gene expressions and blood brain barrier dysfunction in transgenic mice overexpressing the human APOB-100 protein, a mouse model of human atherosclerosis suggesting that these transgenic mice could be a useful model to study the link between cerebrovascular pathology and neurodegeneration. Yu et al. reported that injection of hydroxysafflor yellow A (HSYA), a major active chemical component of the safflower via carotid artery improves cognitive impairment and synaptic plasticity in a rat model of stroke induced by middle cerebral artery occlusion. Chen et al. showed that Gap19, a selective Connexin 43 (Cx43) -hemi -channel inhibitor, produces neuroprotective effects in cerebral ischemia/reperfusion injury induced by middle cerebral artery occlusion in mice via suppression of Cx43 and Toll-like receptor 4 (TLR4) mediated signaling pathways. Chang et al. developed a new in vitro cerebral micro-bleed model to study the interactions between brain endothelial cells and red blood cells exposed to oxidative stress. Their findings demonstrate that erythrophagocytosis mediated by the brain endothelial monolayer and the passage of iron-rich hemoglobin and RBC, may be involved in the development of cerebral microbleeds that are not dependent on disruption of the microvasculature. Faustino-Mendes et al. reviewed the current experimental models of immature ischemic brain and highlighted the need for new multifactorial experimental models to attain more efficient therapies to treat this complex vascular condition and related long-term conditions. Chen et al. showed that the compound 22a, a promising neuroprotective compound derived from tetramethylpyrazine and widely used as active ingredient of traditional Chinese medicine, effectively prevented glutamate-induced excitotoxicity in cerebellar granule cells (CGNs) via involvement of the PI3K/Akt and PGC1α/Nrf2 pathways suggesting that this compound might be useful in preventing neuronal death from ischemic stroke. Du et al. tested a hypothesis that chemokine interleukin (IL) eight released by astrocytes and C-X-C motif chemokine receptor 1 (CXCR1) in neurons are involved in neuronal apoptosis induced by methamphetamine (METH), a widely abused illicit drug, which can cause dopaminergic neuron apoptosis and astrocyte-related neuroinflammation. The results suggest that CXCR1 may be a potential target for METH-induced neurotoxicity therapy. Lu et al., aimed to explore the protective effects of rosuvastatin, a 3-hydroxymethyl-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, against haemorrhagic transformation (HT) after recombinant tissue plasminogen activator (rt-PA) treatment in a mouse model of experimental stroke. The beneficial effects are related to inhibition of the inflammation-related nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. Wang et al. showed that mild ER stress (“preconditioning”) induced by tunicamycin (TM), can alleviate LPS-induced astrocytic activation and BBB disruption. Their findings provide a better understanding for the regulatory role of ER stress in neuroinflammation and indicate that mild ER stress might have therapeutic value for the treatment of neurodegenerative diseases. Yang et al., found that adapentpronitrile, a new adamantane-based dipeptidyl peptidase-IV (DPP-IV) inhibitor significantly ameliorated neuronal injury and decreased amyloid precursor protein (APP) and amyloid beta (Aβ) expression in the hippocampus and cortex of rat model of diabetes fed with high fat diet. These authors showed that adapentpronitrile protected against diabetic neuronal injury by inhibiting mitochondrial oxidative stress and the apoptotic pathway. Jang et al. reported intrastriatal injection of adeno-associated viral vector serotype DJ containing N171-82Q mutant huntingtin (HTT) gene to juvenile mice produced Huntington's disease (HD)-like symptoms including mutant HTT aggregation, neurodegeneration, and Neuroinflammation. The authors suggested that this model will a useful tool to better understand neuropathological mechanisms of HD and develop new therapeutics for this disease. Hao et al. established a stable method for the isolation of endothelial cells (ECs) from human cerebral arteriovenous malformation tissues, which play an important role in the manifestation and development of cerebral vascular malformation as well as haemorrhagic stroke and thrombogenesis. The protocol can also be adapted for other vascular diseases. He et al. demonstrated that rosuvastatin treatment significantly increased neurite outgrowth in cortical neurons after oxygen-glucose deprivation (OGD)-induced damage, reduced the generation of reactive oxygen species, protected mitochondrial function and elevated the ATP levels via Notch1 pathway. These findings highlight Notch1 signaling as important player and novel therapeutic target in promoting brain plasticity. In summary, the present Research Topic encompassed several cutting-edge techniques and models for investigating the cellular and molecular mechanisms of cerebrovascular dysfunction and neurodegeneration. Together, they provide a framework for understanding the way some of the diseases progress and potential pathways for therapeutic interventions. We acknowledged that collection of articles in a single topic cannot deal with this extremely vast subject characterized by complex conditions such as cerebrovascular dysfunction and neurodegeneration. The topics addressed, however, help developing clear ideas, not only in terms of recent studies but also the unmet needs for future research in these areas. We trust that the papers assembled in this Research Topic will prove useful in encouraging and stimulating future progress in research related to cerebrovascular and neurodegenerative diseases. SS prepared the editorial and both SK and SS edited the final version. SS and SK made substantial contributions to the review and approved the manuscripts accepted on this topic. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Keywords: neurodegenerative disease, molecular biology, stroke, middle cerebral artery and common carotid artery occlusion, cerebrovascular disease, therapeutics Citation: Saha S and Kantamneni S (2019) Editorial: Cerebrovascular and Neurodegenerative Diseases - New Insights Into Molecular Cell Biology and Therapeutic Targets. Front. Neurol. 10:1322. doi: 10.3389/fneur.2019.01322 Received: 19 September 2019; Accepted: 29 November 2019; Published: 13 December 2019. Edited and reviewed by: Wendy Noble, King's College London, United Kingdom Copyright © 2019 Saha and Kantamneni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. *Correspondence: Sikha Saha, [email protected]
Forhad Hossain Chowdhury, Mohammod Raziul Haque, Afm Momtazul Haque
Journal of Surgical Sciences, Volume 16, pp 106-109; https://doi.org/10.3329/jss.v16i2.43658

Abstract:
Patient presenting as a case of Temporal Lobe Epilepsy (TLE) are usually resistant to antiepileptic drugs and surgery is the treatment of choice. This type of epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Here we report a case of surgically treated TLE that was due to a large tuberculoma in medial temporal lobe. Intractable epilepsy caused by tuberculoma is rare. The only presenting symptoms was Complex partial seizure (Psychomotor epilepsy) for which the patient underwent scalp EEG (Electro Encephalography) and MRI (Magnetic resonance imaging) of brain. The patient was managed by amygdalohippocampectomy with lesionectomy plus standard anterior lobectomy. Postoperatively she was on anti-tubercular therapy and on carbamazepine. The case was seizure and disease free till last follow up. Journal of Surgical Sciences (2012) Vol. 16 (2) : 106-109
New version
Susanna M Zuurbier,
Cochrane Database of Systematic Reviews, Volume 9; https://doi.org/10.1002/14651858.cd003436.pub4

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Michael G. Hennerici
Published: 10 September 2019
Cerebrovascular Diseases, Volume 47, pp 205-206; https://doi.org/10.1159/000502991

Abstract:
In this journal, several authors discuss current issues of acute stroke management and stroke prevention compared with recently published trials of still uncertain clinical significance, for example, what impact on clinical practice has occurred from the large exciting ARUBA study. Reynolds et al. [1] from New York, USA, present their analysis for intervention for brain arteriovenous malformation before and after the publication of ARUBA in the United States (Unruptured Brain Arteriovenous Malformations – AVM; ARUBA). Based on a Nationwide Readmissions Database to assess trends in interventional AVM management in patients ≥18 years of age from 2010 through 2015, they did not observe a significant U.S. population-level change in unruptured brain AVM intervention rates before versus after ARUBA (p = 0.59). The incidence of AVM intervention ranged from 8.0 to 9.2 per 10 million U.S. residents before the trial publication to 7.7–8.3 per 10 million afterwards. The authors discussed carefully the pros and cons of their observation and needs for further investigations.
Miguel Bertelli Ramos, Manoel Jacobsen Teixeira, Mark C. Preul, Robert F. Spetzler,
Published: 15 June 2019
World Neurosurgery, Volume 129, pp 261-268; https://doi.org/10.1016/j.wneu.2019.06.048

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Takaharu Hatano, , Ayaka Deguchi, Heishiro Fujikawa, Shusaku Maeda
Plastic and Reconstructive Surgery - Global Open, Volume 7; https://doi.org/10.1097/gox.0000000000002186

Abstract:
The treatment for arterial venous malformation (AVM) of functionally and aesthetically important parts such as the hand is considered to be challenging.AVM existed in the right forearm and the thenar region of 55-year-old man. Combined method with free omentum flap and split-thickness skin flap was performed for hand reconstruction after radical excision of an AVM. The postoperative course was good. Seven years have passed postoperatively, and functional but aesthetical results are satisfying with no recurrence. Our operative procedure with complete resection of AVM with placement of the free omental flap to the resected area and placing back the original skin as a skin graft is considered to be an ideal curative surgical treatment of the AVM. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
, Abdelmadjid Habba, Mounir Tabouche, Chafa Aimeur, Sidahmed Faraoun, Boudjema Mansouri
Published: 1 February 2019
PAIRS Annual Meeting, Volume 03; https://doi.org/10.1055/s-0041-1730549

Abstract:
Background: Arteriovenous malformations (AVMs) and fistulas (AVFs) are rare vascular disorders, in which embolization is the first line treatment frequently associated to an adjunctive surgery for superficial and facial localizations. The aim of this study was to report our experience in embolization of high flow peripheral AVMs with onyx. Method(s): 5 women and 4 men were treated by percutaneous embolization with onyx, in our institute from January 2016 to June 2017 for superficial facial high flow vascular malformation. 3 patients were treated for acute bleeding and 6 patients for esthetic purpose. Patients were followed at 1, 3 and 12 months. Clinically symptoms, bleeding and esthetic improvement were assessed. Result(s): During this period we have embolized in our department 1 AVFs (Houdart type I) and 8 AVMs: 6 type ii and 2 type III (Houdart classification). Complete occlusion of the malformation in one session was achieved in 5 patients, and 1 patient needed a second session. 2 patients suffered from bruits which had totally disappeared immediately after embolization. Bleeding was controlled in all patients, and esthetic improvement was achieved at one month in 3 patients (labial AVM), and the 3 other at 3 months. None of our patients underwent surgery after embolization. No major complications were recorded. Conclusion(s): Onyx embolization for superficial facial high flow malformation is an effective and safe therapy, could be an option for first and only line treatment in non-complex lesions. Publication Date:11 May 2021 (online) © 2019. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Hany Eldawoody, Mohamed Mostafa Aziz, Wasem Aziz
Published: 1 February 2019
PAIRS Annual Meeting, Volume 03; https://doi.org/10.1055/s-0041-1730531

Abstract:
Background: Posterior fossa arteriovenous malformations (AVMs) are complex neurovascular lesions, relatively infrequent and difficultly is encountered not uncommonly during their treatment. Although they represent less than 15% of all AVMs, studies showed that they have more aggressive natural history. The authors present their initial experience with multimodality management of 20 posterior fossa AVMs, with an emphasis on endovascular treatment in Egypt. Method(s): From January 2012 to august 2015; twenty patients with posterior fossa AVMs treated with endovascular techniques, radiosurgery and/or surgery were analyzed. Result(s): Out of the twenty cases; 15 cases were treated with onyx embolisation through 27 sessions, one case with glue NBCA. Out of these cases 3 were embolised over 90%, the rest of cases were partially embolised and referred for complementary treatment with surgery or gama knife. The most frequent difficulties encountered during endovascular treatment were catheter navigation in the tortuousity of SCA (2 territories), AICA (2 territories), PICA (1 territory). Identification of onyx flow to the vein in the working angle (3 cases), extravasation of onyx (2 cases). The average occlusion rate of the AVM embolised after an average 1.8 (range 1-7) procedure per case was 52.66%. The average size of AVM embolised was 2.6 cm in maximum diameter. 4 cases (20%) complicated by cerebellar tremors and ataxia 2 of them were transitory and 2 were permanent, one case died from pulmonary embolism. Pod2 and two cases with hemihypothesia, one was permanent. Conclusion(s): Considering our early experience, onyx embolisation to posterior fossa AVMs is feasible and can lead considerable obliteration rate when the AVM has single feeder, although the consideration of deep supply to the cerebellar nuclei and brain stem perforators is of utmost importance to diminish the possible untowarded consequences. Publication Date:11 May 2021 (online) © 2019. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Virendersingh Kapoorsingh Sheorain, Manju Bharath Nr
Published: 1 February 2019
PAIRS Annual Meeting, Volume 03; https://doi.org/10.1055/s-0041-1730545

Abstract:
Background: Embolization of high flow pAVMs is a technical challenge. ethylene vinyl alcohol (EVOH) copolymer is a safe and effective liquid embolic agent routinely used in intracranial AVMs and its use is recently reported in peripheral AVMs as well. Most important technical challenge during ethylene vinyl alcohol (EVOH) copolymer injection is control of reflux. Modified Pressure Cooker Technique (mPCT) is a medthod to prevent reflux of EVOH which is well described in intracranial AVMs, however not reported in peripheral AVms. In Modified Pressure Cooker Technique a glus plug is created proximal to the devilary tip of detachable microcatheter in a unique way. We describe successful use of modified Pressure Cooker Technique (mPCT) in peripheral AVMs to control reflux and achieve adequate embolization. Method(s): Three patients with high flow peripheral AVMs were treated with ethylene vinyl alcohol (EVOH) copolymer (MENOX 18) embolization using modified Pressure Cooker Technique. We used Ultrasound guided Femoral access in all 3 cases. We used coaxial sytem using 7F 70 cm long Guiding sheath and intermediate catheter DAC 070. We used Combination of EVOH compatible detachable microcatheter (APOLLO 3 cm tip) and a non detachable microcatheter (Echelon 10) for nBCA glue plug creation needed for mPCT. We injected EVOH copolymer (Menox 18) via detachable APOLLO micro catheter and NBCA injection via the proximal catheter to create a glue plug to prevent EVOH copolymer reflux during injection of EVOH copolymer. Result(s): We achieved 100% Technical success: ethylene vinyl alcohol (EVOH) copolymer did not refluxed proximal to the glued segment of the detachable microcatheter and we had safe removal of detachable microcatheter post embolisation. Satisfactory embolization of the target nidus in all. No intra-operative complications. Conclusion(s): Use of modified Pressure Cooker Technique (mPCT)in peripheral AVMs is: (1) Safe and effective for ethylene vinyl alcohol (EVOH) copolymer injection. (2)Prevents reflux and allows forward progression of ethylene vinyl alcohol (EVOH) copolymer into nidus. (3) Can be applied in peripheral AVMs whenever ethylene vinyl alcohol (EVOH) copolymer is used as the embolic agent. Publication Date:11 May 2021 (online) © 2019. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Saima Ahmad, Umair Rashid Chaudhry
Published: 1 February 2019
PAIRS Annual Meeting, Volume 03; https://doi.org/10.1055/s-0041-1730530

Abstract:
Background: Direct puncture embolization with glue is an effective technique for pre-operative devascularisation of craniofacial arteriovenous malformations. Venous outflow and arterial inflow of the lesion need to be limited during injection of embolic material. Manual compression is the standard procedure for flow reduction, but when an AVM has multiple channels of venous drainage, achieving successful blockage of blood is technically difficult. This study demonstrates the use of a circumferential cookie cutter ring to reduce flow, with better results compared to manual compression. Method(s): This is a retrospective study of ten patients, over a period of two years, with craniofacial arteriovenous malformations who were treated with direct percutaneous injection of glue. Pre-embolization angiography was performed to see arterial feeders and venous draining veins. Adjunctive manoeuvres were used during embolization, including external compression of venous pouch with circular cookie cutter rings of different sizes varying based on lesion size. Glue cast was localized within and around the margins of circular cookie cutter ring without any distal migration. Result(s): No neurological complications secondary to the embolization procedure were observed. The arteriovenous shunts were successfully occluded in all cases. There was partial occlusion in two cases. Total occlusion achieved in five cases when embolization was followed by surgery. Only one case required a second session to achieve total occlusion. Post embolization, there was minimal residual flow in one patient, who declined further treatment due to mitigation of symptoms. The shape of glue cast was changed in two cases after removal of cookie cutter when low concentrated glue was used. No skin necrosis was seen post embolization. Conclusion(s): Percutaneous direct puncture embolization with glue saves time and is a safer method for superficial craniofacial AVMs with prominent venous pouch when external compression was applied with circumferential cookie cutters to reduce venous outflow. Publication Date:11 May 2021 (online) © 2019. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
, , Dimitrios Nikolaou, Julian Norman-Taylor, Mark Johnson, Meen-Yau Thum
American Journal of Reproductive Immunology, Volume 80; https://doi.org/10.1111/aji.13037

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Corrigendum
Alja Lüdke, Georg Raiser, Johannes Nehrkorn, Andreas V. M. Herz, C. Giovanni Galizia, Paul Szyszka
Frontiers in Cellular Neuroscience, Volume 12; https://doi.org/10.3389/fncel.2018.00197

Abstract:
A corrigendum onCalcium in Kenyon Cell Somata as a Substrate for an Olfactory Sensory Memory in Drosophilaby Lüdke, A., Raiser, G., Nehrkorn, J., Herz, A. V. M., Galizia, C. G., and Szyszka, P. (2018). Front. Cell. Neurosci. 12:128. doi: 10.3389/fncel.2018.00128 In the original article, we did not indicate the number of analyzed animals and glomeruli/somata/ROIs. We provide this information below: Figures 2, 3, and 7: ORN axons: N = 9 flies, n = 85 glomeruli (glomeruli per fly: 11, 11, 10, 5, 10, 10, 7, 10, 11) PN dendrites: N = 10 flies, n = 88 glomeruli (glomeruli per fly: 9, 5, 8, 9, 11, 10, 10, 12, 7, 7) [In Figures 3C–F the N and n for the odors EACE (N = 3, n = 22) and MCH (N = 7, n = 66) in PN dendrites is lower, since these odors were used alternately]. Figure 4 and Supplementary Figure S2: (same flies as above, with one additional fly and thirteen additional glomeruli in ORN axons): ORN axons: N = 10 flies, n = 98 glomeruli (glom. per fly: 11, 11, 10, 6, 10, 10, 10, 9, 10, 11) PN dendrites: N = 10 flies, n = 88 glomeruli (glom. per fly: 9, 5, 8, 9, 11, 10, 10, 12, 7, 7) Figures 5, 6: PN somata: N = 10 flies, n = 108 somata (somata per fly: 18, 15, 13, 5, 13, 10, 9, 9, 12, 4) KC dendrites: N = 6 flies, n = 343 ROIs (ROIs per fly: 57, 35, 31, 60, 84, 76) KC somata: N = 9 flies, n = 339 somata (somata per fly: 47, 28, 26, 52, 44, 23, 3, 55, 61) (In Figures 6C–F and Supplementary Figure S3 the N and n in the PN somata and KC somata matrices vary for each odor pair, because not every odor was analyzable in every fly. PN somata: N = 4–10 flies, n = 47–108 somata; KC somata: N = 5–8 flies, n = 217–313 somata). Figure 7: PN somata: N = 2 flies, n = 25 somata (somata per fly: 13, 12) KC dendrites: N = 6 flies, n = 343 ROIs (ROIs per fly: 57, 35, 31, 60, 84, 76) KC somata: N = 5 flies, n = 217 somata (somata per fly: 47, 28, 26, 55, 61) (Note that for the SVM we could only use flies with complete data for the same set of odorants (ButL, AceA, ProL, ProA, MO), hence the lower N in PN somata and KC somata). In the original article the following reference was incorrectly cited as “unpublished”. The corrected reference appears below: Betkiewicz, R. L., Lindner, B., and Nawrot, M. P. (2017). Circuit and cellular mechanisms facilitate the transformation from dense to sparse coding in the insect olfactory system. BioRxiv [Preprint]. doi: 10.1101/240671 We apologize for this missing information and emphasize that this does not change the scientific conclusions of the article in any way. The original article has been updated. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Keywords: Drosophila melanogaster, olfaction, sensory memory, mushroom body, Kenyon cells, trace conditioning, calcium imaging Citation: Lüdke A, Raiser G, Nehrkorn J, Herz AVM, Galizia CG and Szyszka P (2018) Corrigendum: Calcium in Kenyon Cell Somata as a Substrate for an Olfactory Sensory Memory in Drosophila. Front. Cell. Neurosci. 12:197. doi: 10.3389/fncel.2018.00197 Received: 08 June 2018; Accepted: 18 June 2018; Published: 03 July 2018. Edited and reviewed by: Dieter Wicher, Max-Planck-Institut für chemische Ökologie, Germany Reviewed by: Copyright © 2018 Lüdke, Raiser, Nehrkorn, Herz, Galizia and Szyszka. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. *Correspondence: Alja Lüdke, [email protected]
Sk Sader Hossain, Abdullah Alamgir, Ferdous Ara Islam, Misbahuddin Ahmed, Shafiul Alam, Amir Mohammad Khan
Journal of National Institute of Neurosciences Bangladesh, Volume 3, pp 62-66; https://doi.org/10.3329/jninb.v3i1.36275

Abstract:
Arteriovenous malformation (AVM) is a rare congenital condition of the brain. In majority of cases AVMs remain asymptomatic and silent till it ruptures. But it can be a cause of cerebral haemorrhage, stroke, seizures, moderate to severe headache, loss of vision, aphasia, numbness or weakness of limbs. In current study, revealed a 25 years age patient of AVM admitted in Department of Neurosurgery at National Institute of Neurosciences (NINS) on December, 2013 with the complaints of loss of consciousness two times before admission, history of generalized seizure started over left side, headache for 2 years and vertigo for 1 year. Following admission the patient was evaluated clinically including all neurological examinations. All routine investigations were done. The patient was further evaluated by MRI, CT scan, CTA. Arteriovenous malformation was found in left frontal region. Under G/A nidus was excised totally in a single mass. Post MRI had shown the total removal of the AVM. Histopathological findings also revealed arteriovenous malformations. The post-operative period was uneventful and patient improved satisfactorily. He was found neurologically stable in follow up after 3 months. These researchers reported this case for its rarity and effective diagnosis and treatment by surgery.Journal of National Institute of Neurosciences Bangladesh, 2017;3(1): 62-66
Yam Bahadur Roka, Mohan Karki
Nepal Journal of Neuroscience, Volume 14, pp 46-48; https://doi.org/10.3126/njn.v14i3.20527

Abstract:
Chronic encapsulated intracerebral hematoma (CE-ICH) is an uncommon pathology that presents with headache, seizure, focal neurological deficits, or as a tumor. Trauma as a cause for CE-ICH is even rare and we believe this is the first case report as “trauma causing chronic encapsulated intracerebral hematoma “search in PubMed did not reveal any results. Repeated micro-hemorrhages in the CM or AVM are supposed to cause this lesion which progress from an earlier encapsulated phase to a thick capsulated stage with edema and clinical symptoms. CT or MRI is the diagnostic modality and it mimics, tumor, AVM, CM, angiomableed, cerebral abscess, metastatic mass or neurocysticercosis. Burr hole, mini-craniotomy, craniotomy, CT guided stereotactic aspiration or endoscopic excision are some options with equally good results. The present case with history of trauma was managed successfully with craniotomy with no recurrence for past one year. Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, page: 46-48
Nguyen Thi Binh Phuong, Van Pham Dang Tri, Nguyen Ba Duy, Nguyen Chanh Nghiem
VIETNAM JOURNAL OF EARTH SCIENCES, Volume 39; https://doi.org/10.15625/0866-7187/39/3/10270

Abstract:
In this study, the method of Fault Movement Potential (FMP) proposed by Lee et al. (1997) is used to assess the Surface water resources played a fundamental role in sustainable development of agriculture and aquaculture. They were the main sectors contributing to economic development in the Vietnamese Mekong Delta. Monitoring surface water quality was also one of the essential missions especially in the context of increasing freshwater demands and loads of wastewater fluxes. Recently, remote sensing technology has been widely applied in monitoring and mapping water quality at a regional scale replacing traditional field-based approaches. The aims of this study were to assess the application of the Landsat 8 (OLI) images for estimating Chemical Oxygen Demand (COD) as well as detecting spatial changes of the COD concentration in river reaches of the Binh Dai district, Ben Tre province, a downstream area of the delta. The results indicated the significant correlation (R=0.89) between the spectral reflectance values of Landsat 8 and the COD concentration by applying the Artificial Neuron Network (ANN) approach. In addition, the spatial distribution of the COD concentration was found slightly exceeded the national standard for irrigation according to the B1 column of QCVN 08:2015. References Ackerman S., Richard F., Kathleen S., Yinghui L., Chris M., Liam G., Bryan B., and Paul M., 2010. Discriminating clear-sky from cloud with MODIS algorithm theoretical basis document (MOD35). Ali Sheikh A.A., Ghorbanali A., and Nouri N., 2007. Coastline change detection using remote sensing. International Journal of Environmental Science and Technology 4(1), 61-66. Bonansea M., María C. R., Lucio P., and Susana F., 2015. Using multi-temporal Landsat imagery and linear mixed models for assessing water quality parameters in Río Tercero reservoir (Argentina). Remote Sensing of Environment 158, 28-41. 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Water Air and Soil Pollution 212(1-4), 183-197. Nguyen D.D., Lam D.D., Ha V. Van, Tan N.T., Tuan D.M., Quang N.M., and Cuc N.T.T., 2010. New stratigraphic unit - The Early Holocene Binh Dai formation at the estuary and coastal area of Cuu Long delta. Vietnam Journal of Earth Sciences 32, 335-342. Pham B.T., Dieu T.B., Hamid R.P., Prakash I., and Dholakia M.B., 2015. Landslide susceptibility assesssment in the Uttarakhand area (India) using GIS: a comparison study of prediction capability of naïve bayes, multilayer perceptron neural networks, and functional trees methods. Theoretical and Applied Climatology 128(1-2), 255-273. Pham Q.S. and Anh N.D., 2011. Evolution of the coastal erosion and accretion in the Hai Hau district (Nam Dinh province) and neighboring region over the last 100 years based on topographic maps and multi-temporal remote sensing data analysis. Vietnam Journal of Earth Sciences 311(2002), 82-85. PPC, 2016. Environmental Impacts Assessment (B-SWAMP). Ben Tre. Renaud F.G. and Claudia K., 2012. The Mekong Delta System: Interdisciplinary Analyses of a River Delta (FG Renaud and C Kuenzer, Eds.). Springer Dordrecht Heidelberg New York London. Sudheer K.P., Indrajeet C., and Vijay G., 2006. Lake water quality assessment from landsat thematic mapper data using neural network: An approach to optimal band combination selection. Journal of the American Water Resources Association 42(6), 1683-1695. Tien Bui D., Pradha B., Owe L., Inge R., and Oystein B.D., 2012. Landslide susceptibility assessment in the Hoa Binh province of Vietnam: A comparison of the Levenberg-Marquardt and Bayesian regularized neural networks. Geomorphology 171-172, 12-29Available at http://dx.doi.org/10.1016/j.geomorph.2012.04.023. Tien Bui D., Tuan T.A., Harald K., Biswajeet P., and Inge R., 2016. Spatial prediction models for shallow landslide hazards: a comparative assessment of the efficacy of support vector machines, artificial neural networks, kernel logistic regression, and logistic model tree. Landslides 13(2), 361-378. Wang Y., Hao X., Jiamo F., and Guoying S., 2004. Water quality change in reservoirs of Shenzhen, China: Detection using LANDSAT/TM data. Science of The Total Environment 328(1-3), 195-206. Available at http://linkinghub.elsevier.com/retrieve/pii/S0048969704001007. Wang J.P., Cheng S.T., and Jia H.F., 1977. Application of Artificial Neural Network Technology in Water Color Remote Sensing Inversion of Inland Water Body Using Tm Data. Waxter M.T., 2014. Analysis of Landsat Satellite Data to Monitor Water Quality Parameters in Tenmile Lake, Oregon. Were K., Dieu T.B., Øystein B.D., and Bal R.S., 2015. A comparative assessment of support vector regression, artificial neural networks, and random forests for predicting and mapping soil organic carbon stocks across an Afromontane landscape. Ecological Indicators 52: 394-403. Available at http://dx.doi.org/10.1016/j.ecolind.2014.12.028. Wu J.L., Chung-Ru H., Chia-Ching H., Arun L.S., Jing-Hua T., and Yao-Tung L., 2014. Hyperspectral sensing for turbid water quality monitoring in freshwater rivers: Empirical relationship between reflectance and turbidity and total solids. Sensors (Switzerland) 14(12), 22670-22688. Yusop S.M., Abdullah K., Lim H.S., and Md N.A.B., 2011. Monitoring water quality from Landsat TM imagery in Penang, Malaysia. Proceeding of the 2011 IEEE International Conference on Space Science and Communication (IconSpace), 249-253. Zhu Z. and Curtis E.W., 2012. Object-based cloud and cloud shadow detection in Landsat imagery. Remote Sensing of Environment 118, 83-94. Zhu Z. Shixiong W., and Curtis E.W., 2015. Improvement and expansion of the Fmask algorithm: Cloud, cloud shadow, and snow detection for Landsats 4-7, 8, and Sentinel 2 images. Remote Sensing of Environment 159, 269-277.
Published: 26 April 2017
PAIRS Annual Meeting, Volume 01; https://doi.org/10.1055/s-0041-1729831

Abstract:
Background: Post partum haemorrhage secondary to placenta accrete is a serious complication of childbirth. The current available treatment ranges from emergency hysterectomy to uterine artery embolisation. We describe a patient who presented with PPH in whom retained placenta accreta associated with vascular malformation was successfully treated with uterine artery embolisation together with review of literatures. Case Report: A 38-year old nulliparus presented with significant post partum haemorrhage of 3.6 Liters, intially controlled by packing. Five weeks post partum, the patient presented with recurrent unprovoked bleed. Ultrasound and Magnetic Resonance Angiography (MRA) were demonstrated retained placental tissue with dilated vessels and increased vascular flowconsistent with retained placenta accreta and vascular malformation. First session embolisation was performed using Embospheres particles 700-900 microns (Merit Medical Inc., USA). A second embolisation procedure was carried out via the left CFA using micro coils (Boston Scientific, Watertown, MA, USA) and gelfoam pledges until complete occlusion was achieved. Two months post-partum, the patient presented complaining of foul smelling vaginal discharge, due to necrotic placenta and received full course of antibiotics with dilatation and curettage. Follow-up US demonstrated no residual vascular malformation. Conclusions: Placenta accreta and uterine AVMs are recognised causes of uterine bleeding. Uterine artery embolization is an alternative treatment for uncontrolled postpartum haemorrhage and an effective treatment for acquired AVM's outside of pregnancy. Publication Date:26 April 2021 (online) © 2017. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
, Erik Bee
Published: 26 April 2017
PAIRS Annual Meeting, Volume 01; https://doi.org/10.1055/s-0041-1729795

Abstract:
Background: The global cosmetic market has been on the rise with a recent surge in minimally invasive procedures. Cosmetic interventional radiology (IR) offers less risk, pain and recovery time. This translates into better care at lower cost when compared to traditional surgery. Medical care is evolving into a minimally invasive specialty which provides interventional radiologists the unique opportunity to take part in the rapidly growing cosmetic medicine marketplace. Methods: Comprehensive literature review was performed to identify the scope of IR within cosmetic medicine. Common cosmetic procedures performed by IR, techniques used and their effectiveness are investigated. Results: Varicose vein treatment, laser lipolysis and liposuction are frequently performed. Additional procedures such as botulinum toxin (Botox) injections, collagen fillers, arterio-venous malformation (AVM) sclerotherapy, laser skin resurfacing and hyperhidrosis treatment are also gaining popularity. Recent advances in endovenous techniques including endovenous laser therapy (EVLT), radiofrequency ablation and sclerotherapy have been revolutionary. EVLT has a 98% success rate and a long-term recurrence rate <7%, surpassing the results produced by traditional vein stripping. Laser lipolysis and liposuction are alternatives to invasive weight loss procedures. Lipolysis has gained popularity due to a study conducted by DiBernardo et al. (2009) where lipolysis was found to have significantly higher mean size shrinkage and skin tightening when compared to traditional liposuction. Conclusions: As radiology's most innovative branch, IR has a broad landscape; thus, it is at an advantageous position to expand into the emerging field of cosmetic medicine. Cosmetic IR offers equal value with no surgical scar, shorter recovery and lower morbidity when compared to open surgery. Advances developed by IR has dramatically changed medicine. In the near future, it will do the same for cosmetic medicine by creating both new and enhancing existing techniques through image guided approach in order to deliver optimal patient care. Publication Date:26 April 2021 (online) © 2017. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Published: 26 April 2017
PAIRS Annual Meeting, Volume 01; https://doi.org/10.1055/s-0041-1729830

Abstract:
Background: Uterine arteriovenous malformations are rare. However, they may present with life threatening bleeding. Traditionally hysterectomy is the mainstay therapy for these patients, however, increasing reports of successful control using endovascular techniques have recently surfaced using various embolic agents and techniques. Here we report two cases of acquired uterine arterio-venous malformations managed successfully using NBCA and PVA and their midterm follow up. Case Report: Two cases were refereed to our interventional radiology department diagnosed by Doppler US and MRI as having uterine AVMs. The first cases presented with menometrorrhagia and significant blood loss during menstruation which necessitated blood transfusion on two separate episodes and refused to undergo hysterectomy. The second case presented in a state of hemodynamic shock following an attack of bleeding and had failed surgery due to extensive pelvic adhesions. Using standard endovascular techniques both uterine arteries were catheterized; glue was injected into the dominant feeding side and PVA was injected in the contralateral side. Both patients returned to their normal menstrual cycle with good control of bleeding. Clinical and radiological follow up was maintained for 29 month and 14 month for the cases, respectively. Conclusions: Endovascular management is a viable alternative in the control of uterine arterio-venous malformations in patients not eligible for surgery. Publication Date:26 April 2021 (online) © 2017. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd.A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
L Chilton, , I Ashworth, D Murdy, A K Burnett, D Grimwade, A V Moorman,
Published: 23 January 2017
Leukemia, Volume 31, pp 1234-1237; https://doi.org/10.1038/leu.2017.37

Abstract:
Grimwade D, Hills RK, Moorman AV, Walker H, Chatters S, Goldstone AH et al. Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials. Blood 2010; 116: 354–365. Papaemmanuil E, Gerstung M, Bullinger L, Gaidzik VI, Paschka P, Roberts ND et al. Genomic classification and prognosis in acute myeloid leukemia. N Engl J Med 2016; 374: 2209–2221. Medeiros BC, Othus M, Estey EH, Fang M, Appelbaum FR . Unsuccessful diagnostic cytogenetic analysis is a poor prognostic feature in acute myeloid leukaemia. Br J Haematol 2014; 164: 245–250. Lazarevic V, Horstedt AS, Johansson B, Antunovic P, Billstrom R, Derolf A et al. Failure matters: unsuccessful cytogenetics and unperformed cytogenetics are associated with a poor prognosis in a population-based series of acute myeloid leukaemia. Eur J Haematol 2015; 94: 419–423. Burnett AK, Hills RK, Hunter AE, Milligan D, Kell WJ, Wheatley K et al. The addition of gemtuzumab ozogamicin to low-dose Ara-C improves remission rate but does not significantly prolong survival in older patients with acute myeloid leukaemia: results from the LRF AML14 and NCRI AML16 pick-a-winner comparison. Leukemia 2013; 27: 75–81. Burnett AK, Milligan D, Goldstone A, Prentice A, McMullin MF, Dennis M et al. The impact of dose escalation and resistance modulation in older patients with acute myeloid leukaemia and high risk myelodysplastic syndrome: the results of the LRF AML14 trial. Br J Haematol 2009; 145: 318–332. Burnett AK, Russell NH, Hills RK, Hunter AE, Kjeldsen L, Yin J et al. Optimization of chemotherapy for younger patients with acute myeloid leukemia: results of the medical research council AML15 trial. J Clin Oncol 2013; 31: 3360–3368. Gibson BE, Webb DK, Howman AJ, De Graaf SS, Harrison CJ, Wheatley K et al. Results of a randomized trial in children with acute myeloid leukaemia: medical research council AML12 trial. Br J Haematol 2011; 155: 366–376. Grimwade D, Walker H, Oliver F, Wheatley K, Harrison C, Harrison G et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukaemia Working Parties. Blood 1998; 92: 2322–2333. Shaffer LG, McGowan-Jordan J, Schmid M. An International System for Human Cytogenetic Nomenclature (ISCN). S Karger: Basel, Switzerland, 2013.. Swansbury GJ . The proportion of clonal divisions varies in different hematologic malignancies. Cancer Genet Cytogenet 1998; 104: 139–145. Moorman AV, Roman E, Kane EV, Dovey GJ, Cartwright RA, Morgan GJ . Karyotype and age in acute myeloid leukaemia: Are they linked? Cancer Genet Cytogenet 2001; 126: 155–161. Cox MC, Panetta P, Venditti A, Del Poeta G, Maurillo L, Tamburini A et al. Fluorescence in situ hybridization and conventional cytogenetics for the diagnosis of 11q23+/mll+ translocation in leukaemia. Br J Haematol 2003; 121: 953–955. Hawkins JM, Secker-Walker LM . Evaluation of cytogenetic samples and pertinent technical variables in adult acute lymphocytic leukemia. Cancer Genet Cytogenet 1991; 52: 79–84. Download references We thank all the patients, clinicians and staff who participated in the Medical Research Council/National Cancer Research Institute AML trials. We are also grateful to the member laboratories of the UK Cancer Cytogenetic Group for providing cytogenetic data and the members of the NCRI AML Working Group for their support. This work was supported by Bloodwise (formerly Leukaemia and Lymphoma Research, UK). Author contributions LC, AVM and RKH designed the study; LC, IA, RKH, DM, CJH and AVM analysed and interpreted the data. DG and RKH provided clinical and follow-up data; AKB was the chief investigator on all trials. CJH and AVM provided financial and administrative support. AVM wrote the manuscript with input and approval from all the other authors. Correspondence to A V Moorman. The authors declare no conflict of interest. Reprints and Permissions Chilton, L., Harrison, C., Ashworth, I. et al. Clinical relevance of failed and missing cytogenetic analysis in acute myeloid leukaemia. Leukemia 31, 1234–1237 (2017) doi:10.1038/leu.2017.37 Download citation 23 January 2017 May 2017 https://doi.org/10.1038/leu.2017.37 Journal of Huazhong University of Science and Technology [Medical Sciences] (2017)
Maksim Zagura, Heleri Konik, Helgi Padari, Tuuli Metsvaht, Toomas Hermlin, Liis Salumäe, Tiiu Tomberg
Abstract:
Arteriovenoosne malformatsioon (AVM) on harva esinev arenguanomaalia, mis koosneb düsplastiliste arterite ja veenide võrgustikust. Kirjandusest võib leida vaid üksikuid haigusjuhtude kirjeldusi retroperitoneaalruumi magistraalveresooni haaravate AVMide kohta.Artiklis on kirjeldatud haigusjuhtu, kus enneaegsena sündinud lapsel tekkisid väljendunud südamepuudulikkus, anasarka, respiratoorne düspnoe ja metaboolne atsidoos. Angiograafial tuvastati AVM lumbaalsete toitearteritega ja vargussündroomiga vistseraalsetest arteriaalsetest tüvedest. Tehti toitearterite emboliseerimine koilide ja tsüanoakrüülliimiga, kuid südamepuudulikkus, oksügenatsioonihäire ja metaboolne atsidoos süvenesid. Vastsündinu suri neljandal elupäeval. Lahangul tuvastati tsüstjatest aladest koosnev AVM, mis oli ühenduses kõhuaordiga ja haaras endasse alumise õõnesveeni. Tegemist on seni teadaolevalt esimese haigusjuhuga, kus AVMi embolisatsioon tehti väga väikese sünnikaaluga enneaegsel vastsündinul.Artikli ingliskeelne versioon on avaldatud ajakirjas International Journal of ClinicalPediatrics (1).Eesti Arst 2015; 94(11):668–673
Maria Benoy, Karthik Vadamalai, , Todd Sheppard
Published: 1 October 2015
Chest, Volume 148, pp 885A-885A; https://doi.org/10.1378/chest.2230349

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Published: 1 January 2015
Frontiers in Immunology, Volume 6; https://doi.org/10.3389/fimmu.2015.00371

Abstract:
Since their discovery in the mid-1980s, interest in the immunological significance of γδ T cells has been subject to oscillations. The initial excitement over the unexpected discovery of a second T cell receptor (TCR) was followed by years of uncertainty as to the biological importance of these ambivalent T cells. Major breakthroughs led to the identification of specific and unique antigens for the γδ TCR and accumulating evidence now shows that γδ T cells play a major role in local immunosurveillance, thereby controlling tumorigenesis. Since 2004, biannual international γδ T cell conferences are held to bring together experts in basic and clinical γδ T cell research. To make accessible and synthesize the body of knowledge that has been put together, to date, we have organized a “Research Topic” on γδ T cells consisting of a collection of original articles and focused reviews written by leading experts in the field. The idea of this Research Focus was to present the current status and “hot topics” as well as clinical perspectives on γδ T cell research. The signaling pathways governing γδ T cell differentiation and activation have been discussed in contributions from Carl Wares’s (1) and Bruno Silva-Santos’s (2) groups. Ribeiro et al. discuss the control of γδ T cell activation and differentiation by distinct classes of cell surface receptors, namely (i) the TCR, (ii) costimulatory receptors (with a focus on CD27), (iii) cytokine receptors, (iv) NK receptors, and (v) inhibitory receptors. They further summarize how activation of γδ T cells can be controlled by the TCR as well as by activating NK receptors. To terminate γδ T cell responses, several inhibitory receptors can deliver negative signals, notably PD-1 and B- and T-lymphocyte attenuator (BTLA) (2). Bekiaris et al. focus on the cytokine control of innate γδ T cells, and discuss the role of IL-7 in being critical for thymic development of γδ T cells by regulating the survival of progenitor cells and inducing V(D)J recombination within the TCRγ gene locus. IL-7 also supports homeostatic proliferation of γδ T cells and regulates surface expression of BTLA in a STAT5-dependent manner (1). In recent years, IL-17 has been identified as an essential cytokine that regulates the recruitment of neutrophils during an inflammatory response. IL-17 must be rapidly available in an acute infection. αβ T cells producing IL-17 (Th17 cells) require specific antigenic stimulation and an appropriate cytokine milieu for differentiation. γδ T cells have been identified as an important “innate” source of rapid initial IL-17 production, which is thought to occur without specific TCR triggering (3). Several years ago, the group of Immo Prinz generated a unique mouse model to monitor early steps of γδ T cell development (4). Using these reporter mice, they demonstrated that IL-17 producing γδ T cells develop during the embryonic period and persist in adult mice as self-renewing, long-lived cells (5). Interestingly, Wei and colleagues have provided evidence that the TCR repertoire of such naturally occurring IL-17-producing murine γδ T cells is highly restricted, with little or no junctional diversity, regardless of their anatomical origin. These findings strongly suggest that antigen recognition is involved in the establishment and/or function of such “innate” IL-17 producing γδ T cells (6). Further aspects of IL-17 producing γδ T cells, also addressing their role in various pathophysiological conditions, are discussed in the review article by Patil et al. (7). In addition to production of cytokines, such as IL-17, γδ T cells can induce maturation of dendritic cells (DCs) and B cells. Petrasca and Doherty report on the upregulation of the expression of CD86, HLA-DR, IL-6, and TNFα in both DC and B cells upon coculture with human Vγ9Vδ2 T cells, whereas other cytokines, such as IFNγ or IL-4, were differentially induced in DC versus B cells (8). Collectively, their data indicate that γδ T cells can drive the expression of antigen presenting cell (APC)-associated markers in both DC and B cells (8). Interaction with neighboring cells is a key feature of γδ T cells. This is particularly true for tissue-resident γδ T cells. Witherden et al. have reviewed the multiple molecular interactions that have been characterized between skin-resident dendritic epidermal γδ T cells and keratinocytes. Among their many effector functions, epidermal γδ T cells are involved in wound repair, maintenance of epithelial homeostasis, and protection from malignant transformation (9). A final aspect of γδ T cell differentiation and plasticity is presented in the report of Ziegler et al. (10). These authors made the surprising observation that the small population of human peripheral blood Vδ1 γδ T cells that simultaneously express CD4, can differentiate into bona fide αβ T cells in a process called transdifferentiation. The authors took all measures to avoid the potential contribution of possible artifacts that may influence their results. Their characterization of human CD4+Vδ1 γδ T cells as a source of extrathymic T cell development challenges current dogmas and opens interesting avenues for future research (10). A particularly exciting new area of γδ T cell research is the role of butyrophilin and butyrophilin-like molecules (which consist of all members of the B7 family of co-stimulators) in γδ T cell activation. A member of this family, Skint-1, has been shown as critical for positive selection of mouse Vγ5Vδ5 dendritic epidermal T cells (11). In humans, Butyrophilin 3A1 (BTN3A1) was recently found to play a critical role in the activation of Vγ9Vδ2 T cells by pyrophosphate molecules – collectively termed as “phosphoantigens” (pAgs). These intermediates of the eukaryotic mevalonate and the prokaryotic non-mevalonate pathway for isoprenoid synthesis have been identified as specific ligands for the Vγ9Vδ2 TCR that activate this subset of T cells at pico- to nanomolar (microbial pAgs) or micromolar (eukaryotic pAgs) concentrations. The recognition of metabolites that are produced by microbes [e.g., (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate (HMBPP)] or that are overproduced by transformed eukaryotic cells [e.g., isopentenyl pyrophosphate (IPP)] provides a formal basis for the role of Vγ9Vδ2 T cells in both anti-infective and anti-tumor immunity (12). Interestingly, the recognition of non-peptidic small molecules is not restricted to human γδ T cells. As an example, Zeng et al. recently reported that small molecules, such as haptens, are recognized by specific murine γδ TCRs (13). For many years, it has been enigmatic how pAgs are actually recognized by the human γδ TCR, and whether any “presenting” molecules are involved. A major breakthrough was the identification of an agonistic monoclonal antibody (called 20.1) that specifically triggers Vγ9Vδ2 T cell activation among peripheral blood mononuclear cells in a manner that is very similar to pAgs. This antibody is directed against CD277, a member of the B7 superfamily of butyrophilin (BTN) molecules. Detailed studies by Harly et al. identified an indispensable role of the BTN3A1 isoform in the activation of Vγ9Vδ2 T cells by pAgs (14). BTN3A1 is a transmembrane molecule with two Ig-like extracellular domains and an intracellular B30.2 domain. This discovery of the essential function of BTN3A1 in Vγ9Vδ2 T cell activation stimulated further research, particularly addressing the question whether BTN3A1 is directly involved in “presenting” pAgs to the γδ TCR. In continuation of the above studies, Gennaro de Libero’s group has come up with new evidence that suggests the Ig-like extracellular domain of BTN3A1 can directly bind pAgs and that there is specific and direct interaction of soluble Vγ9Vδ2 TCR with the BTN3A1–pAg complex (15). Quite surprisingly, however, such a “presenting” function of the extracellular BTN3A1 domain could not be verified by Erin Adam’s group. Instead, Adam and colleagues corroborated there being a crucial role of the intracellular B30.2 domain, which may actually directly interact with pAgs (16). In their model, the intracellular B30.2 domain might sense increased levels of intracellular pAgs (due to infection or cellular transformation), possibly inducing a conformational change in the BTN3A1 molecule, which could then be recognized by the Vγ9Vδ2 TCR (16). However, the issue appears to be even more complicated. Using CHO cells reconstituted with chromosome 6 as the only source of human genes, Riaño et al. demonstrate a potential role of other genes on chromosome 6 in addition to BTN3A1 that work to activate human Vγ9Vδ2 T cells (17). The various proponents of the seemingly conflicting models on the capacity of extra- versus intracellular BTN3A1 domains to directly interact with pAgs provide a balanced overview on this controversial issue in this special Research Topic (18–20). Beyond this, “the intracellular pAg sensing model” recently received additional support from John Trowsdale’s group. These authors also reported direct binding of HMBPP to the intracellular B30.2 domain (21). Furthermore, using a yeast-two hybrid screen, theses authors determined that the cytoskeletal protein plakin interacts with the cytoplasmic tail of BTN3A1 in a region proximal to the B30.2 domain. Such protein–protein interactions might be crucial in transmitting signals (e.g., conformational alterations of BTN3A1) from the γδ TCR upon pAg binding to the intracellular B30.2 domain (21). It is thus evident that many of the mechanistic details of BTN3A1 are still unclear, beyond the undisputed fact that it is indispensable for γδ T cell activation by pAgs. Intriguingly, the mouse lacks BTN3A1 genes and homologous γδ TCR that would be able to recognize similar pAgs. Karunakaran and Herrmann (22) have studied the ontogenetic evolution of Vγ9, Vδ2, and BTN3 genes. Their detailed database analysis suggests that these three genes have co-evolved in placental mammals, while they are lost in rodents and lagomorphs (22). Taken together, the controversial issue of the ménage à trois of Vγ9Vδ2 TCR, pAgs, and BTN3A1 awaits additional elucidation. We are grateful that the major players in this particular field have shared their results and thoughtful reflections for this Research Topic. γδ T cells can kill a broad range of tumors of epithelial origin as well as many leukemias and lymphomas, and are further able to produce high levels of the anti-tumor cytokine, IFNγ. Given their HLA non-restricted method of ligand recognition, the role of γδ T cells in anti-tumor immunity has stimulated great interest to explore their potential for cancer immunotherapy (23). Interestingly, the production of endogenous pAgs, such as IPP, can be pharmacologically manipulated by nitrogen-containing bisphosphonates (N-BP), which inhibit the downstream processing of IPP, leading to increased levels of endogenous IPP that is sensed by Vγ9Vδ2 T cells (24). Based on this knowledge, intravenous application of the N-BP zoledronate together with low-dose IL-2 has been evaluated as a means of in vivo activation of γδ T cells in cancer patients (25). A recent survey has reviewed the available published studies on the in vivo activation and adoptive transfer of γδ T cells in cancer patients (26). Most likely, strategies aiming to activate γδ T cells in vivo will have to be combined with other treatment regimens to obtain optimal anti-tumor activity (27). In addition to IPP and related pAgs, which serve as antigens for tumor-reactive Vγ9Vδ2 T cells, several cell surface-expressed antigens have been identified for tumor-reactive human non-Vδ2 γδ T cells. One example illustrating the versatility of γδ T cells is the endothelial protein C receptor (EPCR), which is an HLA-related molecule. We (Déchanet-Merville group) identified EPCR as a target for non-Vδ2 γδ T cells that is expressed on endothelial cells infected by cytomegalovirus (CMV) and is also similarly expressed on epithelial tumor cells (28). It is thus conceivable that non-Vδ2 γδ T cells have a similar potential for cancer immunotherapy as pAg-reactive Vδ2 T cells (23, 29). The recent discovery that CD1d, the closest structural homolog of EPCR, can present self lipids to the human Vδ1 TCR, also deserves further investigations in the domain of γδ T cell-mediated anti-tumor protection and function (30, 31). It should be borne in mind that the anti-tumor efficacy of γδ T cell subsets (Vγ9Vδ2, non-Vδ2) may, of course, vary between different tumor entities (32). One of the basic observations supporting a role of immune surveillance in tumor development and progression is the sticking correlation between the proportion of tumor-infiltrating CD3+ T cells (TIL) and tumor progression and patient survival (33). γδ T cells can represent a significant proportion of CD3+ TIL in different tumors (34, 35). Hidalgo et al. analyzed the presence of γδ T cells among TIL in different types of breast carcinoma. Their results suggest a correlation between higher numbers of γδ TIL and a better prognosis in medullary breast carcinoma as compared to invasive ductal carcinomas, two subtypes of the Her2- and hormone receptor-negative (“triple-negative”) breast carcinoma (35). It is clear, however, that an increased presence of γδ T cells within a tumor per se is not necessarily associated with a beneficial effect. As discussed by Lo Presti et al., there are multiple interactions of tumor-infiltrating γδ T cells within the local tumor microenvironment that strongly influence the functional outcome (36). Relevant factors include (but are not restricted to) tumor-derived immunosuppressive cytokines, such as TGF-β, locally expressed inhibitory molecules, such as PD-1, and myeloid-derived suppressor cells (MDSCs) located within the tumor stroma (36). Moreover, tumor-infiltrating γδ T cells themselves may exert suppressive activity (37) or promote the accumulation of MDSCs (38). Pro-tumoral activity of γδ T cells has also been demonstrated in several mouse models, and this is mainly mediated through their production of IL-17, which, in these instances, results in the attraction of immunosuppressive myeloid cells and promotion of angiogenesis. Depending on the priming signals in the tumor microenvironment, in addition to other γδ T cell subtypes, even pAg-reactive Vγ9Vδ2 T cells may acquire suppressive activity (39). In the context of tumor immunity, multiple scenarios may thus convert γδ T cells into suppressive cells, which can have counter-productive consequences for tumor immunity (40). Taken together, γδ T cells can exert both anti- and pro-tumorigenic activities, and it is a major challenge for future studies to determine how to specifically boost the anti-tumor effects of γδ T cells while simultaneously shunting their suppressive activity (41). This functional plasticity of mouse and human γδ T cells in the anti-tumor immune response has been extensively discussed by Lafont et al. (42). To enhance the anti-tumor activity of γδ T cells, several strategies are under consideration. These include the use of antibodies to trigger Fc receptor-dependent ADCC, or the use of bispecific antibody constructs to cross-link the γδ TCR with tumor cell surface antigens. Seidel et al. have explored Fc-optimized anti-CD19 antibodies as well as CD19/CD16 bispecific antibodies to enhance γδ T cell-mediated killing of CD19+ B cell malignancies (43). For this purpose, they employed a label-free real-time cytotoxicity assay, which allows monitoring the tumor cell–γδ T cell interactions over prolonged periods of time (43). This system was also used by us (Kabelitz group) to demonstrate the efficacy of a Her2-Vγ9 “tribody” construct in enhancing lysis of Her2-expressing pancreatic adenocarcinoma cells by Vγ9Vδ2 effector T cells (34). A different approach to explore the potential use of γδ T cells for cancer immunotherapy would be to develop γδ T cell-based cancer vaccines. This strategy is based on the seminal discovery of Bernhard Moser’s group that found activated human Vγ9Vδ2 T cells may actually serve as “professional” APCs that pick up and process exogenous antigens and load them onto both MHC class II and MHC class I presentation pathways for recognition by CD4+ and CD8+αβ T cells, respectively (44). Toward this end, the capacity of activated human γδ T cells to take up tumor-derived antigens and to present processed peptides to tumor antigen-specific CD8+αβ T cells has been demonstrated (45). As discussed by Khan et al., the ease with which Vγ9Vδ2 T cells are expanded into large numbers in vitro offers an innovative strategy for the development of γδ T cell-based tumor vaccines (46). For the adoptive transfer of in vitro expanded γδ T cells, a multitude of experimental protocols have been developed. One important aspect to bear in mind for this procedure is to design means to fully polarize γδ T cells toward an efficient anti-tumor functionality. Promotion of their IFNγ expression instead of IL-17 will certainly be an important step toward this aim (41). Along this line, Deniger and coworkers have summarized various strategies of in vitro expansion and further discuss additional perspectives involving genetic approaches to increase the efficacy of γδ T cell-based immunotherapy (47). A crucial point in this context is the efficient monitoring of γδ T cell subpopulations in the blood of cancer patients. We (Kabelitz group) have established a system to accurately determine absolute numbers of circulating Vδ1 and Vδ2 γδ T cells from a small sample of whole blood. This method enabled us to determine a threshold number of Vδ2 T cells per microliter blood below which no cytotoxic activity toward pancreatic adenocarcinoma tumor targets could be triggered by pAg or Her2-Vγ9 tribody (48). Another important step for the application of γδ T cell-based immunotherapy involves identifying the antigenic ligands recognized by γδ T cells on tumor cells as they may potentially be used as agonistic drugs either ex vivo for γδ T cell expansion or in vivo for active vaccination trials. Together, the collection of papers published in this Research Topic discuss critical issues pivotal for understanding the precise role of γδ T cells in tumor immunosurveillance or tumor immune evasion as well as highlighting the future potential of γδ T cell-based immunotherapies. In view of the strong activation of human Vγ9Vδ2 T cells by microbial pAgs (notably HMBPP), it is not surprising to see significant expansion of peripheral blood γδ T cells during the acute phase of many infections (49). However, not all microbes produce such γδ T cell-stimulating molecules. The differential production of γδ T cell ligands by microbes can be used for diagnostic purposes to identify the presence of (mostly Gram-negative) bacteria and thus allow for a pathogen-specific immune fingerprinting. This inventive diagnostic application of γδ T cell research in the context of infectious diseases is highlighted in the Opinion Article by Eberl et al. (50). While Vγ9Vδ2 T cells increase in numbers in many bacterial and parasitic infections, these cells are characteristically reduced in HIV infected individuals. Even upon efficient anti-retroviral therapy and CD4 T cell reconstitution, Vγ9Vδ2 T cell numbers usually remain low. Pauza and colleagues discuss the potential consequences of persistent low Vγ9Vδ2 T cell numbers in HIV infected individuals and argue in favor of designing innovative clinical trials to reconstitute normal levels of Vγ9Vδ2 T cells (51). Another example of viral infection with high relevance for γδ T cells is CMV. Our (Déchanet-Merville group) early studies have uncovered a remarkable expansion of Vδ2-negative γδ T cells in CMV-positive but not -negative kidney transplant recipients (52). Further studies have revealed multiple possible functions of CMV-induced γδ T cells, including direct anti-viral activity. Concomitant studies in mouse models point to a protective role of murine γδ T cells against CMV infection (53, 54). All these aspects including the cross-reactivity of CMV-reactive non-Vδ2 γδ T cells with certain epithelial tumor entities are discussed in a review article by Couzi et al. (55). This Research Topic also addresses the role of γδ T cells in non-infectious diseases. In addition to infection and cancer, autoimmune diseases, and wound healing and burn injuries have been addressed by Latha et al. (56). This review summarizes the extensive evidence showing the involvement of γδ T cells in many pathophysiological conditions. An interesting specific example is reported by Marcu-Malina and coworkers (57) who observed a TNF-dependent induction of procoagulant tissue factor-1 (TF-1) in monocytes by zoledronate-stimulated γδ T cells. This seemed to occur specifically in γδ T cells from patients with systemic sclerosis (57). Last but not least, this Research Topic additionally covers the role of γδ T cells in the diagnosis of immunodeficiencies. TCR immunodeficiencies can affect both αβ and γδ T cells. While αβ T cells have been extensively studied, γδ T cells are frequently ignored, partly due to their numerical scarcity in circulation. Garcillán et al. discuss these issues in detail and present a useful diagnostic flowchart (58). After 30 years of γδ T cell research, it is clear that these cells are intimately involved in the control of tissue homeostasis, infection, and malignancy. 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Immunol. 6:371. doi: 10.3389/fimmu.2015.00371 Received: 09 May 2015; Accepted: 06 July 2015; Published: 21 July 2015 Edited by: Reviewed by: Copyright: © 2015 Kabelitz and Déchanet-Merville. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. *Correspondence: Dieter Kabelitz, [email protected]
Sun Ho Ahn,
Seminars in Interventional Radiology, Volume 30, pp 223-224; https://doi.org/10.1055/s-0033-1353488

Abstract:
It's a Tuesday afternoon. A local orthopedic spine surgeon calls your office, “I have this patient with a T10 RCC met. I need to stabilize the spine, and it will be a bloody mess. Can you help us out?” You are not a fellowship-trained neurointerventional radiologist (NIR). Your answer is: If you answered B, put this journal down. Politely demure and suggest your orthopedic surgeon consider a transfer of the patient or perhaps an attempt at the surgery without pretreatment. You should not perform interventions that could be considered NIR. You should also be lauded for your honesty, compassion, and self-knowledge. You should NOT feel that you are somehow a failure. You might consider discussing with your hospital or group the potential value of adding a staff member with the skillset your local orthopedic surgeon seeks. If you answered A, read on. We're hoping to refresh your memory and maybe even provide you a few pearls. If you answered C or D, this Seminars issue is designed for you! You were trained to do this sort of work. You can and you should use your knowledge and skillset to help as many patients as possible. Your work will make this patient's surgery much safer. You can really help this patient and the referring surgeon and will almost certainly further cement your already strong relationship with this referring provider. Before you perform your T10 embolization, and after reading this issue, you will probably begin by reviewing everything you can about spinal cord vascular anatomy. You should and probably will continue by rereading any texts or journal articles you can about safe vertebral body embolization. You might even talk to a few IR colleagues about their experiences in this clinical arena. You will plan diligently, prepare meticulously, and perform a safe and effective arteriogram and embolization. You will follow up your patient after the spine surgery. You will also see your patient in follow-up in your office. You are an excellent IR and have added value to your health-care system. Regardless of your answer, what you are NOT is a NIR. Though NIR is defined as “physicians providing neurointerventional management of patients with diseases of the brain, spine, head, and neck” by the vision statement of the Society of Neurointerventional Surgery (www.snisonline.org/mission), this edition does NOT propose to make you a NIR; reading it should not inspire you to begin coiling anterior communicating artery (ACOM) aneurysms or gluing cerebral arteriovenous malformation (AVMs) or spinal dural arteriovenous fistula (AVFs). It should rekindle your desire to help manage some clinical problems that share anatomic or pathologic features in common with those problems managed by our NIR brethren. These are the sort of issues that happen frequently and may go either untreated or treated in a delayed fashion if you don't help. Acute ischemic stroke, refractory epistaxis, arterial injuries from head and neck trauma, and severe back pain from compression fractures are diagnoses made every day at community hospitals and Level I trauma centers alike. Unfortunately, the former facility (and even some of the latter) may not have a NIR as readily available as you! Intra-arterial (IA) acute stroke management is a great example of a “neuro IR” area in which IRs can really have more impact. At our institution, more stroke interventions are performed by IR than by our superb NIR team. Although our NIR section is well staffed, there are still only two NIRs available and they are essentially on call every other night for extremely complex clinical issues such as subarachnoid hemorrhage due to aneurysms, dural AVFs, and AVMs. Our system of on-call coverage entails IR performing initial diagnostic cerebral angiography and calling in the NIR if and when they are needed for management. If the eight non-NIRs at our institution didn't do IA stroke care, either many folks would simply not benefit from catheter-directed approaches or our NIRs would likely burn out and look for a better gig! Couple this with the fact that our stroke outcomes between the IRs and NIRs are equal, and, at least for our institution, the math becomes pretty simple. Unofficial results of a recent Society of Interventional Radiology (SIR) stroke survey are interesting. The survey had 486 overall responders, all SIR members: 62% reported working in an accredited (primary or comprehensive) stroke center; 88% report that neurologists and 71% report that emergency department providers offer IV thrombolysis at their centers. Since only 64% of respondents report that their centers offer IA therapy, 36% of respondents' patients appear to be deprived of IA stand-alone or salvage approaches (which we find increasingly useful with drip and ship protocols and in the setting of failed IV therapy). Also, though 64% reported that their centers offer IA stroke care, 54% reported working in a setting with available NIR and only 35% reported that they provided IA stroke care themselves. This suggests that a significant amount of IA stroke management is done by services other than IR or NIR. Although drawing conclusions from this sort of survey may not be possible, keeping in mind the public health impact of acute stroke, it appears that non-NIR specialists are willing, capable, and indispensable in the management of this disease. Given our skillset and clinical acumen, shouldn't IR be one of these non-NIR specialties? In the end, there's no reason why IRs can't have a positive effect in stroke management and a similar impact in other areas involving CNS anatomy. Certainly, assuming this mantle will take effort, education, and—let's face it—some risk. But, I wouldn't want myself or any of my family members to be the patient who needs that vertebral surgery done without an IRs help. Would you?
S Patwari, A K Verma, Alok K Srivastava, Rc Shukla
Nepalese Journal of Radiology, Volume 1, pp 27-29; https://doi.org/10.3126/njr.v1i1.6319

Abstract:
Acute or subacute myelopathy with spontaneous thrombosis of the veins in a patient with a spinal arteriovenous malformation (AVM) has been referred to as "Foix-Alajouanine syndrome (FAS)". A previously healthy 35-year-old man developed neurological illness with progressive lower extremity weakness and low back pain. MRI demonstrated diffuse swelling of the thoracic spinal cord, suggesting myelopathy with few intradural extramedullary serpeginous flow voids. We report a case of Foix-Alajouanine syndrome with a review of the literature. DOI: http://dx.doi.org/10.3126/njr.v1i1.6319 Nepalese Journal of Radiology Vol.1(1): 27-29
, Mike Male
Published: 1 November 2011
Journal of Consumer Marketing, Volume 28, pp 484-490; https://doi.org/10.1108/07363761111181464

Abstract:
Purpose – The purpose of this paper is to discuss the main reasons driving the anti-vaccination movement (AVM) and relate similarities and differences of the AVM with the anti-consumption of other products. Design/methodology/approach – The paper conducts thematic analysis of various online sources, including medical journals, blogs, science articles and business/social science databases. Findings – First, the paper outlines the main themes (religion, freedom of choice, risk, and uncertainty) driving the anti-consumption of vaccines. Second, it explains why the AVM is a unique and paradoxical form of anti-consumption. Third, although much anti-consumption behaviour is motivated by the belief that rejecting certain acts of consumption may be beneficial to society, the paper uses the AVM to show that not all anti-consumption behavior has clear-cut benefits for society. Research limitations/implications – While this is predominately a conceptual paper, a commentary on the AVM has never been attempted by business scholars. This is surprising since business scholars are able to bring a more impartial viewpoint to the debate than both the medical establishment and proponents of natural therapy. As this paper is not associated with medical interests, nor the AVM, the focus is on the welfare of consumers and as such, a more detached perspective may be useful in this controversial area. Practical implications – Since the AVM debate is filled with much uncertainty, the paper recommends a more balanced/respectful approach by the medical community, pro-vaccinators and the AVM. Originality/value – Unlike previous work in the area, this research intersects commercial, societal, and medical interests. It also highlights AVM as an interesting case where large groups of people sharing similar anti-consumption behaviours are actually incompatible with one another.
Comment
, , J. Hernesniemi
American Journal of Neuroradiology, Volume 32; https://doi.org/10.3174/ajnr.a2755

Abstract:
In the May 2011 issue of the American Journal of Neuroradiology , Raymond et al[1][1] scrutinized at length the methodologic weaknesses of 2 recent articles about the natural history and risk of hemorrhage in brain arteriovenous malformations (AVMs), one from our department[2][2] and the other from
D. Nath, M. Kumath
Published: 26 June 2010
British Dental Journal, Volume 208, pp 549-549; https://doi.org/10.1038/sj.bdj.2010.544

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, G.K. Ricciardi, E. Piovan, P. Zampieri, A. Pasqualin, A. Nicolato, R. Foroni, F. Sala, L. Bassi, M. Gerosa
Published: 1 September 2009
Interventional Neuroradiology, Volume 15, pp 266-274; https://doi.org/10.1177/159101990901500303

Abstract:
The most important issue when dealing with a patient with a brain AVM is the decision whether to treat or not. Only after this decision has been made, taking into consideration a number of factors depending on both the patient and the specific type of AVM, can the best option for treatment be chosen. An operative classification of brain AVMs, previously adopted in the Department of Neuroradiology and Neurosurgery of Verona (Italy) and published in this journal, was subjected to validation in a consecutive group of 104 patients clinically followed for at least three years after completion of treatment. This classification, slightly modified from the original version concerning the importance of some specific items, allowed us to assess the indication to treat in each case, whatever type of treatment was offered to the patient.
Hanne Baillieux, Frank Weyns, , Peter P. De Deyn, Peter Mariën
Published: 1 September 2007
Pediatric Neurosurgery, Volume 43, pp 386-395; https://doi.org/10.1159/000106388

Abstract:
The posterior fossa syndrome (PFS) is a well-known clinical consequence of posterior fossa surgery that has only been reported in a limited number of cases with a nontumoral etiology. It consists of transient cerebellar mutism, behavioral abnormalities and personality changes. We describe a 12-year-old child who developed transient cerebellar mutism associated with behavioral and emotional symptoms following rupture of a vermis arteriovenous malformation (AVM). Following the stroke, the girl experienced a 24-hour symptom-free interval. After that, she became mute and her emotional state was characterized by severe anxiety, irritability and withdrawal. After 3 days, mutism resolved and dysarthria became apparent. Two weeks after stroke, the AVM was surgically removed and the postoperative course was uneventful. This case is the first reported in which the PFS occurred after focal nonsurgically induced cerebellar damage.Case ReportsJournal ArticleResearch Support, Non-U.S. Gov'tReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe
V Rahimi-Movaghar,
East African Medical Journal, Volume 83, pp 393-400; https://doi.org/10.4314/eamj.v83i7.9452

Abstract:
Objectives: To determine the physics, biology, outcomes and risks of gamma knife radiosurgery (GKRS) in treating brain tumours, arteriovenous malformations (AVMs), pain and movement disorders. Data sources: A retrospective MEDLINE search was used to find all gamma knife radiosurgery studies published from 1967 to 12th March 2005 and strict inclusion criteria were applied. Study selection: Limited to the review articles in the human study with the key word of gamma knife radiosurgery. Data extraction: In each subject, both authors reviewed related articles separately. Data synthesis: Adding up data and compare the results. Conclusions: The GKRS represents one of the most advanced means available to treat brain tumours, arteriovenous malformations (AVMs), pain and movement disorders safely and effectively. At present, the long-term results after GKRS procedures remain to be documented. The physics, biology, current indications and expected outcomes after GKRS are discussed. East African Medical Journal Vol. 83(7) 2006: 393-400
, P.E. Burrows
Published: 1 October 2006
American Journal of Neuroradiology, Volume 27, pp 1927-1929

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, Muneyoshi Yasuda, Kentoaro Furusho, Hiroyuki Asakawa, Yuji Matsumaru, Masayuki Noguchi, Tadao Nose
Nepal Journal of Neuroscience, Volume 2, pp 81-84; https://doi.org/10.3126/njn.v2i1.20001

Abstract:
Spontaneous intracerebral hematomas usually produce the sudden onset of devastating neurological symptoms. We describe a case showing slowly progressive clinical symptoms followed by a sudden deterioration caused by two different types of intracerebral hematomas coexisting in the adjacent area. A 72-year-old female with a 2-year history of Alzheimer’s disease and a 3-month history of occasional headache and vomiting was admitted after she experienced the sudden onset of right hemiparesis and a speech disturbance. Neuroradiological examinations demonstrated two different types of intracerebral hematomas coexisting in the left temporal lobe. The patient underwent a left frontotemporal craniotomy. A solid hematoma was found immediately below the cortex and a large hematoma cavity, which contained degraded bloody fluid, was found below the solid hematoma. Histological study demonstrated an arteriovenous malformation (AVM). The AVM may have been responsible for the pathogenesis of these two different types of intracerebral hematomas. Initially, a silent intracerebral hemorrhage from the AVM and liquefaction of the hematoma probably formed the cavity and repeated small subclinical hemorrhages into the cavity during a prolonged period of time may have caused the growth of the inner hematoma. The sudden rupture of the AVM most likely caused the outer solid hematoma, resulting in the abrupt onset of hemiparesis and speech disturbance. This is the first case to demonstrate two different types of intracerebral hematomas coexisting in the adjacent area. A possible mechanism for this rare condition is discussed. Nepal Journal of Neuroscience, Volume 2, Number 1, 2005
Comment
B. H. Gerald Rogers
Archives of Internal Medicine, Volume 164, pp 678-679; https://doi.org/10.1001/archinte.164.6.678-b

Abstract:
This letter is in response to the article by Batur et al, "Increased Prevalence of Aortic Stenosis in Patients With Arteriovenous Malformations of the Gastrointestinal Tract in Heyde Syndrome," that appeared in the August 11/25, 2003, issue.1 I would like to congratulate Drs Batur, Stewart, and Isaacson for showing a relationship between aortic stenosis and arteriovenous malformations (AVMs) of the gastrointestinal tract. The large number of patients in their retrospective review and their use of objective data from endoscopy, angiography, and echocardiography should make their conclusion convincing. However, I strongly object to describing it as the "Heyde syndrome." In a 1-paragraph Letter to the Editor in the New England Journal of Medicine in 1958, Heyde2 noted that he had seen 10 patients in the previous 10 years with calcific aortic stenosis who had gastrointestinal bleeding for which he could discover no cause. Nowhere did he describe the bleeding to be coming from an AVM. Galloway and associates3 were among the first to angiographically demonstrate vascular malformations in the right large bowel in patients who had aortic stenosis and lower intestinal bleeding of obscure cause. I was the first to perform colonoscopy in the Chicago area, so early in my career many patients were referred to me with obscure gastrointestinal bleeding. In a short time I had seen 5 patients who had an acquired vascular abnormality of the cecal area. I was able to control the bleeding by electrocoagulation in all 5 patients. None had "pure" aortic stenosis but all had cardiovascular disease.4 Baum and associates5 were instrumental in bringing this lesion to the attention of angiographers. Boley and associates6 did an injection study of resected colon specimens and found the vascular abnormalities quite frequent, even in apparently healthy patients. In my practice I accumulated more patients with bleeding vascular abnormalities of the gastrointestinal tract and published 27 of the cases in 1980.7 Twenty-four patients had the lesions in the colon and 3 in the stomach. Only 4 had aortic stenosis. Shortly after publishing this article I found typical bleeding vascular abnormalities in the jejunum at peroral enteroscopy in an elderly patient with advanced coronary artery disease. The problem with this syndrome is that it is not clear-cut. Not all patients with aortic stenosis develop an AVM lesion. Many incidental vascular abnormalities are found in the gastrointestinal tract not related to any other obvious diagnosis. My own theory is that acquired vascular abnormalities of the gastrointestinal tract are related to localized ischemia. It is generally accepted that ischemia induces the formation of angiogenesis factors. The lesions would have a predilection for the cecal area because that part of the anatomy is supplied by end arteries from the long superior mesenteric. In addition, the mucosa is exposed to the large volume of anaerobic content in the cecum, which acts as an oxygen sink. Localized ischemia can be caused by many factors, both local and ischemic. Thus, we have inconsistencies in the relationship between aortic stenosis and other conditions associated with acquired vascular abnormalities of the gastrointestinal tract.
, Yutaka Kai, Motohiro Morioka, Kiyoshi Kazekawa, Yasuji Ishimaru, Hiroo Iwata, Yukitaka Ushio
Journal of Neurosurgery, Volume 97, pp 889-895; https://doi.org/10.3171/jns.2002.97.4.0889

Abstract:
Object. The authors have developed a mixture of ethylene vinyl alcohol copolymer (EVAL) and iopamidol, which is dissolved in ethanol, as an alternative solvent to provide a safe means of embolizing arteriovenous malformations (AVMs). Methods. A two-stage delivery technique is required to prevent premature precipitation in the catheter when using this material: the catheter is first infused with 30% ethanol and this is followed by the delivery of the EVAL—ethanol mixture. Acute angiographic changes were analyzed after superselective delivery of dimethyl sulfoxide (DMSO) and 30% ethanol into the renal artery of rabbits. Histological changes following the embolization of the renal artery achieved using the EVAL—ethanol mixture were recorded at 1 hour and at 2 and 16 weeks after the procedure. Although DMSO always produced severe, rapidly progressive vasospasm in the renal artery during a 1- to 60-minute postinfusion, 30% ethanol did not. Microscopically, the lumens of embolized vessels examined 1 hour after embolization with EVAL—ethanol appeared to be filled with EVAL sponges, leaving almost no open spaces. The space between the EVAL sponges and the inner surface of the vessels was filled with fresh thrombus. In the vessel walls of specimens examined 2 weeks after embolization there was no or a slight inflammatory reaction. Scattered in the EVAL sponges were almost equal numbers of neutrophilic granulocytes and mononuclear cells, indicative of a mild inflammatory response. In specimens examined 16 weeks postembolization, the changes noted at 2 weeks were intensified. There was no definite histopathological evidence of mural hemorrhage, perivascular extravasation of the mixture, or perivascular hemorrhage in any specimen that was examined. Conclusions. Although the degree of permanence of this embolization material is yet unknown, the mixture was easy to handle, and appeared safe and effective for AVM embolization. Its nonadhesive characteristic and its ability to be infused by repeated injections make it an attractive alternative to currently available materials. The good results obtained in this study led us to undertake a clinical trial, the results of which are contained in a companion article in this issue of the Journal of Neurosurgery.
Jennifer H. Gill, Judith M. Redwin, Jan A. Van Wyk, Ernest Lacey
Published: 30 November 1991
International Journal for Parasitology, Volume 21, pp 771-776; https://doi.org/10.1016/0020-7519(91)90144-v

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