No abstract

All ICA BBAs that were treated by endosaccular coil embolization exhibited regrowth of the aneurysm. Some of the lesions rebled. The majority of patients who underwent ICA trapping experienced excellent outcomes. Based on the authors' experiences, they suggest that ICA trapping including the lesion segment should be considered as a first option for definitive treatment if a BOT reveals satisfactory results. Regarding trapping methods, endovascular treatment may be preferred because of its convenience and safety.

We evaluated immunometabolic functions of novel Lactobacillus fermentum strains (KBL374 and KBL375) isolated from feces of healthy Koreans. The levels of inflammatory cytokines, such as interleukin (IL)-2, interferon-γ, IL-4, IL-13, and IL-17A, were decreased, and that of the antiinflammatory cytokine IL-10 was increased, in human peripheral blood mononuclear cells (PBMCs) treated with the L. fermentum KBL374 or KBL375 strain. When these strains were orally administered to mice with dextran sulfate sodium (DSS)-induced colitis, both L. fermentum KBL374 and KBL375 showed beneficial effects on body weight, disease activity index score, colon length, cecal weight, and histological scores. Furthermore, both L. fermentum KBL374 and KBL375 modulated the innate immune response by improving gut barrier function and reducing leukocyte infiltration. Consistent with the PBMC data, both L. fermentum KBL374-and KBL375-treated DSS mice demonstrated decreased Th1-, Th2-, and Th17-related cytokine levels and increased IL-10 in the colon compared with the DSS control mice. Administration of L. fermentum KBL374 or KBL375 to mice increased the CD4+CD25+Foxp3+Treg cell population in mesenteric lymph nodes. Additionally, L. fermentum KBL374 or KBL375 administration reshaped and increased the diversity of the gut microbiota. In particular, L. fermentum KBL375 increased the abundance of beneficial microorganisms, such as Lactobacillus spp. and Akkermansia spp. Both L. fermentum KBL374 and KBL375 may alleviate inflammatory diseases, such as inflammatory bowel disease, in the gut by regulating immune responses and altering the composition of gut microbiota.

No abstract

A co-operative study was conducted to determine the clinical characteristics of patients with moyamoya disease who were diagnosed and treated at neurosurgical institutes in Korea before 1995. Twenty-six hospitals contributed 505 cases and among them, the clinical characteristics of 334 patients with definite moyamoya disease were evaluated. The number of patients began to increase from the late 1980s, and after that approximately 20 patients were treated each year. There were two age peaks: from six to 15 and from 31 to 40 years of age. Haemorrhagic manifestations occurred in approximately 43% of the patients. The major clinical manifestations were haemorrhage in adults (62.4%) and ischaemia in children (61.2%). Overall 54.5% of the patients experienced decreased consciousness levels, mainly due to intracranial haemorrhage or cerebral infarction. In the patients with ischemic manifestations, the adult patients were more likely to have cerebral infarction than the pediatric patients (80% vs. 39%) and the pediatric patients were more likely to have TIA (61% vs. 25%). Thirty eight percent of the patients underwent bypass surgery and 53% of these procedures were performed bilaterally. Treatment policies, including indications for bypass surgery and commonly used drugs, were somewhat different according to the institution. Overall favorable outcome was 73%, and the most significant factor affecting poor outcome was haemorrhagic manifestation. This article describes the characteristics of 334 patients with moyamoya disease, who were diagnosed and treated at neurosurgical institutes in Korea before 1995.

Agenesis or aplasia of ICA may be entirely harmless. However, associated conditions such as cerebral aneurysm or abnormal collateral channels should alert clinicians to the possibility of deterioration to life-threatening conditions, such as subarachnoid haemorrhage or irreversible ischemia. Other associated anomalies are commonly depicted on the same side as the ICA aplasia and may also give rise to issues of clinical importance.

A poor GCS score (≤ 8) and an age of ≥ 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.

To clarify clinical features and to elucidate prognostic factors and prognosis, the authors retrospectively analyzed 16 cases of gliomatosis cerebri treated at Seoul National University Hospital between January 1988 and December 1995. Age at diagnosis ranged from 19 to 62 (median 34) years and male to female ratio was 10:6. Most presented with headache or seizure, and the mean duration of symptoms was 12.8 months. A poorly defined diffuse high signal intensity lesion, extending in T2-weighted images for two lobes or more, was the characteristic magnetic resonance (MR) image finding. On postcontrast T1-weighted MR imaging, focal enhancement of the lesion was detected in five cases. All patients underwent histological confirmation by craniotomy (9 cases) or stereotactic biopsy (7 cases). Histologically, all patients had compatible findings of gliomatosis cerebri which are the widespread infiltration of neoplastic glial cells with minimal destruction of pre-existing structures. After histological diagnosis, external radiation therapy was begun except in one case, who declined this treatment. Fourteen patients completed the whole procedure and received the planned dose (mean 5780 cGy). Median survival time after diagnosis was 38.4 months. In univariate analysis, the Ki-67 labelling index (> 1) showed significant correlation with the length of survival (p = 0.006). It is suggested that 1) gliomatosis cerebri can be diagnosed by a combination of MR imaging findings and histological examination; 2) histological diagnosis and external radiation therapy might be a good treatment modality; 3) the Ki-67 labelling index correlates significantly with survival time.