AIM:To investigate the role of angiopoietin (Ang) -1, -2 and -4 and its receptors, Tie-1 and -2, in the growth and differentiation of gastrointestinal stromal tumors (GISTs).
METHODS:Thirty GISTs, seventeen leiomyomas and six schwannomas were examined by immunohistochemistry in this study.
RESULTS:Ang-1, -2 and -4 proteins were expressed in the cytoplasm of tumor cells, and Tie-1 and -2 were expressed both in the cytoplasm and on the membrane of all tumors. Immunohistochemical staining revealed that 66.7% of GISTs (20 of 30), 76.5% of leiomyomas (13 of 17) and 83.3% of schwannomas (5 of 6) were positive for Ang-1. 83.3% of GISTs (25 of 30), 82.4% of leiomyomas (14 of 17) and 100% of schwannomas (6 of 6) were positive for Ang-2. 36.7% of GISTs (11 of 30), 58.8% of leiomyomas (10 of 17) and 83.3% of schwannomas (5 of 6) were positive for Ang-4. 60.0% of GISTs (18 of 30), 82.4% of leiomyomas and 100% of schwannomas (6 of 6) were positive for Tie-1. 10.0% of GISTs (3 of 30), 94.1% of leiomyomas (16 of 17) and 33.3% of schwannomas (2 of 6) were positive for Tie-2. Tie-2 expression was statistically different between GISTs and leiomyomas (P < 0.001). However, there was no correlation between expression of angiopoietin pathway components and clinical risk categories.
CONCLUSION:Our results suggest that the angiopoietin pathway plays an important role in the differentiation of GISTs, leiomyomas and schwannomas.
Clipping of internal carotid artery (ICA)-anterior choroidal artery (AchA) aneurysms (IC-AchA An) is associated with a high rate of ischemic complications, particularly in cases of AchA arising from the dome. Therefore, although angioplastic dome clipping is required, very few reports have described the clipping methods. We therefore focused on these and discuss them together with the
Objective: Treatment for ruptured dissecting aneurysms of the vertebral artery (VA) varies according to the origin of the posterior inferior cerebellar artery (PICA). However, a PICA originating from the V3 segment has not been reported.
Conclusion:Considering the origins of the PICA and anterior spinal artery (ASA) is important when selecting treatment for hemorrhagic vertebral artery dissecting aneurysm. The morphological features of aneurysms, such as that described herein, are challenging, and perforated vessels might become occluded and initiate ischemic complications.
Summary: Distal middle cerebral artery (MCA) aneurysms are relatively rare, and only few reports deal with treatment strategies. The present study retrospectively investigated the characteristics of and surgical approaches to distal MCA aneurysms. The subjects were 10 patients with distal MCA aneurysms selected from among 452 patients with cerebral aneurysms treated with neck clipping between September 2006 and August 2016. Sixteen distal MCA aneurysms were identified, with 13 (81.3%) located on the M2 segment. All the patients showed multiple cerebral aneurysms, and the total number of cerebral aneurysms was 37, representing a mean of 3.7 aneurysms per patient. The multiplicity of the aneurysms appeared markedly higher than the previous study findings in patients with distal MCA aneurysms. Evaluation with preoperative neuroimaging therefore appears important from this perspective. Of the 3 patients with ruptured distal MCA aneurysm, all the aneurysms were embedded in surrounding parenchyma with cerebral hemorrhage. This finding suggests the necessity to expose aneurysms from the surrounding parenchyma to obtain a wide surgical field for neck clipping. As for surgical approaches, anatomically, the M3 segment begins at the circular sulcus after turning 180° from the M2 segment and courses over a narrow space between the frontoparietal and temporal opercula. We therefore recommend the following: aneurysms located on M2 or M2-M3 segments above the limen insulae are accessible by using a distal sylvian approach, whereas aneurysms located from the M3 segment within the narrow and complicated structure of the opercular space need to be approached from sulci beyond the aneurysms.
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