Kaufmanvelazquez4719

Of those managed conservatively, 177 (73%) remained stable within a mean follow-up of 30 months, 54 (22%) progressed, and 12 (5%) spontaneously regressed. Meanwhile, upfront excision achieved complete remission in all 57 cases over a mean follow-up of 68.3 months. CONCLUSION A small body of evidence has emerged, highlighting the marked heterogeneity and contradictory results between the available studies, limiting our ability to draw solid conclusions. At this point, the decision between surgery and "watchful waiting" should be tailored on an individual patient basis depending on suspicion of malignancy, clinical or radiologic progression, and parental preference. BACKGROUND AND OBJECTIVE The interhemispheric approach (IHA) provides an excellent surgical corridor for clipping anterior communicating artery aneurysms (AcoAA). However, an important disadvantage of the approach is obtaining proximal control at A1 in the last stage of dissection, especially in anterior or superior projecting AcoAA and ruptured cases. The authors describe and evaluate the microsurgical clipping of AcoAA using the IHA with early A1 exposure. METHOD This was a retrospective descriptive study in patients with AcoAA who received microsurgical clipping through the IHA with early A1 exposure between April 2016 and May 2019. Aneurysm morphology, projection, completeness of clipping, surgical complications and outcomes were collected from medical records. RESULT Twenty-five patients with AcoAA received microsurgical clipping via the IHA with early A1 exposure. Twenty-three patients (92%) presented with subarachnoid hemorrhage. Intraoperative rupture while dissecting the interhemispheric fissure occurred in two cases, for which proximal control via subfrontal route was effectively performed. BC-2059 beta-catenin antagonist One hundred percent of the patients achieved complete obliteration of their aneurysms. Postoperative anosmia was detected in 22.7%. In ruptured cases, 16 (88.9%) of the good grade patients achieved a good outcome (Glasgow Outcome Score [GOS] of 4, 5) at 3 months after the operation. CONCLUSION The IHA with early A1 is safe and effective for clipping AcoAA. BACKGROUND In coronary intervention, the transradial approach (TRA) is increasingly used as the primary vascular access due to numerous advantages over the transfemoral approach. However, in neurointerventions, conventional TRA with a straight-shaped guiding system is used as an alternative vascular access because transradial carotid cannulation can be technically challenging for right common carotid artery (CCA) lesions with steep angulation to the right subclavian artery or left CCA lesions with a nonbovine origin. The purpose of the present study was to evaluate the feasibility and safety of TRA as the primary vascular access with a pre-shaped Simmons guiding sheath for anterior circulation interventions. METHODS Between June 2018 and September 2019, 130 consecutive patients (75 carotid artery stenting and 55 cerebral aneurysm coiling cases), who underwent TRA as the primary vascular access, were included in this study. A 6-Fr Simmons guiding sheath was introduced into the target CCA by selecting a cannulation technique based on preprocedural image assessment. We retrospectively analyzed the carotid cannulation success, procedural success, and periprocedural or vascular access site complications. RESULTS Carotid cannulation (69 right CCA, six left CCA with a bovine origin, and 55 left CCA with a nonbovine origin) and the subsequent procedure were successfully performed for all 130 patients without periprocedural or vascular access site complications. CONCLUSIONS TRA with a 6-Fr Simmons guiding sheath for anterior circulation interventions is highly successful and safe for all target CCAs and aortic arch types. This method can be utilized as the primary vascular access for anterior circulation interventions. BACKGROUND Localization of the temporal horn of the lateral ventricle (TH) may be required during temporal lobe and ambient cistern surgery. Most available anatomic landmarks for TH localization are based on adjacent cortical landmarks that are inherently variable or subtle. This study aimed to localize the anterior tip of the TH relative to adjacent bony landmarks. METHODS The TH was exposed on 21 sides of 11 cadaveric heads via removal of the middle temporal gyrus. Two lines were defined (1) a perpendicular line to the zygomatic arch projected from the anterior concavity of the posterior zygomatic root (line A), and (2) a parallel line passing through the anterosuperior corner of the external auditory canal (line B). Sagittal distances from lines A and B to a parallel line passing through the anterior recess of the TH (line H) were measured. RESULTS Mean (standard deviation) distances from lines A and B to line H were 13.3 (2.5) mm and 11.9 (2.2) mm, respectively. Line H was at 53% (8%) of the line A-line B interval measured from line A. The best way to search for the TH was to start approximately 15 mm posterior to line A and progress posteriorly such that a more posteriorly located TH tip would not be missed. CONCLUSIONS The zygomatic-meatal landmark is a reliable tool to localize TH during various approaches. It is independent from the approach trajectory. This landmark may be used as an ancillary tool in conjunction with other cortical landmarks and image guidance. Photodynamic therapy (PDT) is a relatively safe way for disease diagnosis and treatment that is based on light and photosensitizers. A lack of excellent photosensitizers has become the main limitation for the widespread application of photodynamic therapy. LS-HB is a promising photosensitizer with a light absorption peak of 660 nm. AIMS The present study aimed to investigate the anticancer effects of LS-HB-PDT on hepatocellular carcinoma and its underlying molecular mechanism. METHODS In the present study, the MTT assay and xenograft tumor model experiment were used to evaluate its anticancer effects as well as its dark toxicity in hepatocellular carcinoma in vitro and in vivo. Reactive oxygen species assay kit was utilized to detect the reactive oxygen species production induced by LS-HB-PDT. RESULTS In vitro, the MTT assay results revealed that LS-HB-PDT exhibited significant cytotoxic effects both in a drug- and light dose-dependent manner. The IC50 of LS-HB-PDT on hepatocellular carcinoma cells was 2.685 µg/ml.