المؤلفون: Ming-Yi Chou, Xuhui Cao, Kuan-Chu Hou, Meng-Han Tsai, Chih-Yu Lee, Meng-Fai Kuo, Vin-Cent Wu, Hsin-Yi Huang, Schahram Akbarian, Sheng-Kai Chang, Chung-Yi Hu, Shu-Wha Lin, Hsien-Sung Huang

المصدر: Communications Biology, Vol 6, Iss 1, Pp 1-12 (2023)

مصطلحات موضوعية: Biology (General), QH301-705.5

الوصف: Knockout of Mir125b-2 in mice leads to defects in hippocampus-related behaviors and affects hippocampal expression of Grin2a and NMDAR-mediated currents.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2399-3642Test

الوصول الحر: https://doaj.org/article/77e4e7f104cc405f84d150a69a607e3aTest

المؤلفون: Kuo-Chuan Wang, Ling-Yu Yang, Jing-Er Lee, Vicent Wu, Te-Fu Chen, Sung-Tsang Hsieh, Meng-Fai Kuo

المصدر: Stem Cell Research & Therapy, Vol 13, Iss 1, Pp 1-14 (2022)

مصطلحات موضوعية: Endothelial progenitor cells, Microcirculation, Neuronal damage, Indirect revascularization, Angiogenesis, Cerebral ischemia, Medicine (General), R5-920, Biochemistry, QD415-436

الوصف: Abstract Objective Endothelial progenitor cells (EPCs) contribute to the recovery of neurological function after ischemic stroke. Indirect revascularization has exhibited promising effects in the treatment of cerebral ischemia related to moyamoya disease and intracranial atherosclerotic disease. The role of EPCs in augmenting the revascularization effect is not clear. In this study, we investigated the therapeutic effects of indirect revascularization combined with EPC transplantation in rats with chronic cerebral ischemia. Methods Chronic cerebral ischemia was induced by bilateral internal carotid artery ligation (BICAL) in rats, and indirect revascularization by encephalo-myo-synangiosis (EMS) was performed 1 week later. During the EMS procedure, intramuscular injection of EPCs and the addition of stromal cell-derived factor 1 (SDF-1), and AMD3100, an SDF-1 inhibitor, were undertaken, respectively, to investigate their effects on indirect revascularization. Two weeks later, the cortical microcirculation, neuronal damage, and functional outcome were evaluated according to the microvasculature density and partial pressure of brain tissue oxygen (PbtO2), regional blood flow, expression of phosphorylated Tau (pTau), TUNEL staining and the rotarod performance test, respectively. Results The cortical microcirculation, according to PbtO2 and regional blood flow, was impaired 3 weeks after BICAL. These impairments were improved by the EMS procedure. The regional blood flow was further increased by the addition of SDF-1 and decreased by the addition of AMD3100. Intramuscular injection of EPCs further increased the regional blood flow as compared with the EMS group. The rotarod test results showed that the functional outcome was best in the EMS combined with EPC injection group. Western blot analysis showed that the EMS combined with EPC treatment group had significantly decreased expressions of phosphorylated Tau and phosphorylated glycogen synthase kinase 3 beta (Y216 of GSK-3β). pTau and TUNEL-positive cells were markedly increased at 3 weeks after BICAL induction. Furthermore, the groups treated with EMS combined with SDF-1 or EPCs exhibited marked decreases in the pTau expression and TUNEL-positive cells, whereas AMD3100 treatment increased TUNEL-positive cells. Conclusion The results of this study suggested that indirect revascularization ameliorated the cerebral ischemic changes. EPCs played a key role in augmenting the effect of indirect revascularization in the treatment of chronic cerebral ischemia.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1757-6512Test

الوصول الحر: https://doaj.org/article/5c7c38a63f924b34802c1dd4d7ae91e6Test

المؤلفون: Sheng-Che Chou, Ya-Fang Chen, Chung-Wei Lee, Shih-Hung Yang, Meng-Fai Kuo

المصدر: Journal of the Formosan Medical Association, Vol 121, Iss 9, Pp 1758-1766 (2022)

مصطلحات موضوعية: Moyamoya disease, Middle adulthood, Adult, Stroke, Indirect revascularization, Medicine (General), R5-920

الوصف: Background/Purpose: Our previous study demonstrated that indirect revascularization is effective in the treatment of adult moyamoya patients. This prospective study aims to evaluate the long-term effectiveness of indirect revascularization in moyamoya patients in middle adulthood. Methods: From January 2013 to June 2019, moyamoya patients more than 40 years of age underwent indirect revascularizations were studied. The hypoperfusion area of brains was revascularized. The cerebral angiography and time-to-peak (TTP) scoring (ranged 0–14) of the magnetic resonance perfusion study were used to evaluate the revascularization effect. Results: During the study period, 50 consecutive adult moyamoya patients underwent indirect revascularization. Seventeen patients (27 cerebral hemispheres) more than 40 years of age were included. The mean age was 47.9 ± 6.4 years, and 13 patients were female. The pre-operative Suzuki stages were I, II, III, IV, V, and VI in 1, 1, 9, 13, 0, and 3 hemispheres, respectively. After a mean follow-up period of 52.5 ± 20.6 months, all patients had improvement or stabilization of their clinical conditions. Available post-operative angiography demonstrated Matsushima grading A in 18 of 20 hemispheres. The mean TTP score of all 27 hemispheres improved from 5.0 ± 3.3 pre-operatively to 12.0 ± 2.1 after surgery (p

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0929664622000079Test; https://doaj.org/toc/0929-6646Test

الوصول الحر: https://doaj.org/article/7a504d2c06cf4d16b7c076bd809c3485Test

المؤلفون: An-Ping Huang, Lu-Ting Kuo, Dar-Ming Lai, Shih-Hung Yang, Meng-Fai Kuo

المصدر: Biomedical Journal, Vol 45, Iss 1, Pp 95-108 (2022)

مصطلحات موضوعية: Ventriculoperitoneal shunt, Antisiphon device, Overdrainage, Slit ventricle, Review, Mechanism, Medicine (General), R5-920, Biology (General), QH301-705.5

الوصف: Overdrainage of cerebrospinal fluid is one of the most notorious complications after ventriculoperitoneal shunt implantation. Siphon effect plays a major role in the development of overdrainage. Various overdrainage-preventing devices have been invented to counteract the siphon effect. Though some of the devices are designed to reduce the flow instead of providing antisiphoning effect, they are generally called antisiphon devices (ASDs). The basics of siphoning, the mechanisms and physical properties of currently available devices are described in this article. The clinical efficacy, shunt survival, and considerations on patient factors are also discussed. There are three kinds of ASD design, diaphragm, gravitational, and flow reducing devices. Flow reducing ASD is always open and the flow it controls is relatively stable. On the other hand, it may not provide sufficient flow in nocturnal intracranial pressure elevations. Diaphragm and gravitational devices are sensitive to the position of the patients. Diaphragm device is sensitive to the external pressure and the relative position of the device to the mastoid process. The gravitational device is sensitive to the angle between the axis of the device and the head. Many studies showed encouraging results with gravitational devices. Studies regarding diaphragm devices either showed better or similar outcomes comparing to differential pressure valves. Clinical studies regarding flow-reducing devices and head-to-head comparison between different mechanisms are warranted. This review aims to provide a useful reference for clinical practice of hydrocephalus.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2319417021001013Test; https://doaj.org/toc/2319-4170Test

الوصول الحر: https://doaj.org/article/243f019a4e6b47aa86c0d40dcf59cbddTest

المؤلفون: Meng-Fai Kuo

المصدر: Biomedical Journal, Vol 43, Iss 3, Pp 268-276 (2020)

مصطلحات موضوعية: Case management, Posthemorrhagic hydrocephalus, Premature infant, Preterm infant, Intraventricular hemorrhage, Ventriculoperitoneal shunt, Medicine (General), R5-920, Biology (General), QH301-705.5

الوصف: Perinatal intraventricular hemorrhage (IVH) with or without development of posthemorrhagic hydrocephalus (PHH) in premature neonates may lead to severe neurological disability. Although the percentage of preterm infants developing IVH has been greatly reduced in the last three decades, increased survival of these very immature infants has meant that large IVH with subsequent PHH is still a serious unsolved problem. Early cerebrospinal fluid diversion as a temporizing measure or a permanent shunt is the treatment of choice. This review summarizes the surgical modalities, techniques, and their complications in the management of IVH and PHH in premature infants. Though there is no level-one evidence to support the superiority of any of the currently available managements in the initial treatment of PHH over others, this review aims to provide pediatric neurosurgeons a comprehensive understanding of the pros and cons of various surgical treatment modalities, focusing on the temporizing measures before the infants is heavy enough to undergo ventriculoperitoneal shunt insertion. Based on the patient's condition, the facility and man power of the institution with minimal complication rate, the pediatric neurosurgeons may choose the best initial approach for the management of IVH and PHH in premature infants.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2319417020300354Test; https://doaj.org/toc/2319-4170Test

الوصول الحر: https://doaj.org/article/c51a4ade3a78496bb9c2bfbb7d784a4dTest

المؤلفون: Ming-Jen Lee, Shannon Fallen, Yong Zhou, David Baxter, Kelsey Scherler, Meng-Fai Kuo, Kai Wang

المصدر: Journal of Clinical Medicine, Vol 8, Iss 10, p 1648 (2019)

مصطلحات موضوعية: moyamoya disease, extracellular vesicle, rnaseq, biomarker, cerebrovascular disorder, Medicine

الوصف: Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by occlusion of bilateral internal carotid and intracerebral arteries with the compensatory growth of fragile small vessels. MMD patients develop recurrent infarctions in the basal ganglia and subcortical regions. Symptoms include transient ischemic attack or stroke, seizures, and headaches, which may occur suddenly or in a stepwise progression. Mutations in Ring Finger Protein 213 (RNF213), a Zinc ring finger protein, have been identified in some MMD patients but the etiology of MMD is still largely unknown. To gain insight into the pathophysiology of MMD, we characterized the impact of the RNF213 mutations on plasma protein and RNA profiles. Isobaric tags for relative and absolute quantitation and proximity extension assay were used to characterize the plasma proteome. Next generation sequencing-based small RNAseq was used to analyze the cell-free small RNAs in whole plasma and RNA encapsulated in extracellular vesicles. The changes of miRNAs and proteins identified are associated with signaling processes including angiogenesis and immune activities which may reflect the pathology and progression of MMD.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/8/10/1648Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/b90ac4a48fba439a90aaa12dea1f9ff0Test

المؤلفون: Shin-Joe Yeh, Sung-Chun Tang, Li-Kai Tsai, Chung-Wei Lee, Ya-Fang Chen, Hon-Man Liu, Shih-Hung Yang, Meng-Fai Kuo, Jiann-Shing Jeng

المصدر: PLoS ONE, Vol 12, Iss 12, p e0188948 (2017)

مصطلحات موضوعية: Medicine, Science

الوصف: The cerebral hypoperfusion caused by chronic progressive stenosis or occlusion of intracranial arteries in moyamoya disease can be treated by direct bypass or indirect revascularization procedures. The extent of collaterals from the external carotid artery (ECA) after indirect revascularization surgery is the key point of angiographic follow-up, and the invasiveness of angiography impelled us to investigate the role of ultrasonography in the evaluation of collaterals. We hypothesized that the collaterals shown on angiography might produce corresponding hemodynamic changes in color Doppler ultrasonography. We prospectively recruited moyamoya patients who underwent indirect revascularization surgery and received both preoperative and postoperative angiography and color Doppler ultrasound studies. The collaterals on angiography were graded according to Matsushima method. A total of 21 patients (age, 17 ± 10.2 years) with 24 operated hemispheres were enrolled. Patients who showed better collateral establishment by angiography had higher end-diastolic velocity (EDV), lower resistance index (RI), and larger flow volume in the superficial temporal artery (STA) and ECA (all p < 0.05). In STA, increase of EDV greater than 13.5 cm/sec or reduction of RI greater than 0.19 after operation corresponded to 94% of Matsushima grade A+B. In ECA, post-operative EDV greater than 22 cm/sec or increase of EDV greater than 6.4 cm/sec also corresponded to 94% of Matsushima grade A+B. Our findings revealed potential roles of color Doppler ultrasonography in identifying patients with poor collaterals after indirect revascularization procedures.

وصف الملف: electronic resource

العلاقة: http://europepmc.org/articles/PMC5722285?pdf=renderTest; https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/d0ff06ad46e94369a843d9c859136ef3Test

المؤلفون: Pi-Chuan Fan, Steven Shinn-Forng Peng, Ruoh-Fang Yen, Jeng-Yi Shieh, Meng-Fai Kuo

المصدر: Journal of the Formosan Medical Association, Vol 113, Iss 4, Pp 258-263 (2014)

مصطلحات موضوعية: electroencephalography, fimbria–fornix, glucose metabolism, myoclonic astatic epilepsy, vagus nerve stimulation, Medicine (General), R5-920

الوصف: Myoclonic astatic epilepsy (MAE) is characterized by multiple seizure types, which are often refractory. Although vagus nerve stimulation (VNS) is an alternative treatment for medically intractable seizures, its exact mechanism of action remains unclear. Herein, we report the case of a 4-year-old boy with intractable MAE who has been in a seizure-free status for 2 years and 3 months since 6 months after the implantation of a vagus nerve stimulator (Model 103, Cyberonics, Inc., Houston, TX). Various test results 6 months after VNS were compared with those before VNS. Results of an electroencephalograph revealed disappearance of epileptiform discharges and an increased beta–gamma spectrum rhythm. The brain diffusion-tensor imaging showed an increased ratio of fraction anisotropy in the right fimbria–fornix, indicating improved diffusion of the white matter tract, and 18F-fluorodeoxyglucose positron emission tomography revealed globally improved cerebral glucose metabolism. His cognitive and social–emotional performances also improved at 2 years after VNS. To the best of our knowledge, this is the first report to describe the effects of VNS on fimbria–fornix and glucose metabolism in MAE.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0929664613000934Test; https://doaj.org/toc/0929-6646Test

الوصول الحر: https://doaj.org/article/7256dde6b8c44f869528a3df3787370dTest

المؤلفون: Shih-Yao Liu, Yi-Ching Tung, Cheng-Ting Lee, Hon-Man Liu, Shinn-Forng Peng, Mu-Zon Wu, Meng-Fai Kuo, Wen-Yu Tsai

المصدر: Journal of the Formosan Medical Association, Vol 112, Iss 10, Pp 616-620 (2013)

مصطلحات موضوعية: central diabetes insipidus, germ cell tumor, hypopituitarism, Langerhans cell histiocytosis, Medicine (General), R5-920

الوصف: Data on the clinical features of children with central diabetes insipidus (CDI) are lacking in Taiwan. This study investigated the clinical manifestations and etiology of CDI in Taiwanese children. Methods: From 1983 to 2012, 62 children with permanent diabetes insipidus were enrolled in the study. They were diagnosed at the Department of Pediatrics of National Taiwan University Hospital. Their medical records were thoroughly reviewed and their clinical symptoms and signs, laboratory data, and etiologies were analyzed. Results: The patients’ median age at diagnosis was 10 years and the median interval between initial manifestations and diagnosis was 0.5 years. The most common symptoms and signs were polyuria, polydipsia, nocturia, and growth retardation. Most patients had low urine osmolality and elevated plasma osmolality on diagnosis. Absence of a posterior pituitary hyperintense signal and thickening of the pituitary stalk were common findings on magnetic resonance imaging. Approximately 80% of the patients had anterior pituitary hormone deficiency and all patients had growth hormone deficiency. Approximately 60% of patients had intracranial lesions, the most common causes of which were germ cell tumor and Langerhans cell histiocytosis. Two patients were initially believed to have idiopathic CDI but intracranial lesions were detected during the follow-up period. Conclusion: Because a delayed diagnosis of CDI is common in Taiwanese children, a high index of suspicion is important. The underlying etiology of CDI in children may not initially be obvious. Long-term surveillance is therefore necessary, especially for the early detection of evolving treatable intracranial lesions.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0929664613002234Test; https://doaj.org/toc/0929-6646Test

الوصول الحر: https://doaj.org/article/75dada0d12b1456cb99b6365a0f639bbTest

المؤلفون: Li-Lan Chiang, Meng-Fai Kuo, Bih-Juan Fan, Wen-Ming Hsu

المصدر: Journal of the Formosan Medical Association, Vol 109, Iss 6, Pp 472-475 (2010)

مصطلحات موضوعية: bowel perforation, transanal repair, ventriculoperitoneal shunt, Medicine (General), R5-920

الوصف: Colonic perforation is an extremely rare complication following ventriculoperitoneal (VP) shunting. Laparotomy to repair the perforation site is usually required for patients with peritonitis. Here we report colonic perforation due to VP shunt in a 4-year-old girl, presenting with a distal catheter protruding out of the anus as well as symptoms and signs of peritonitis. The distal catheter was removed and the perforation site was repaired successfully via the anus. Postoperative course was uneventful. Trans-anal repair of the colonic perforation after removal of the distal shunt may be considered an alternative choice for managing this kind of complication.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0929664610600794Test; https://doaj.org/toc/0929-6646Test

الوصول الحر: https://doaj.org/article/b72d74a9a31943e98263f8942d4eb473Test