Superficial Temporal Arteries Of Patients Research Articles

High glutamine increases stroke risk by inducing the endothelial-to-mesenchymal transition in moyamoya disease.

At present, there is limited research on the mechanisms underlying moyamoya disease (MMD). Herein, we aimed to determine the role of glutamine in MMD pathogenesis, and 360 adult patients were prospectively enrolled. Human brain microvascular endothelial cells (HBMECs) were subjected to Integrin Subunit Beta 4 (ITGB4) overexpression or knockdown and atorvastatin. We assessed factors associated with various signaling pathways in the context of the endothelial-to-mesenchymal transition (EndMT), and the expression level of related proteins was validated in the superficial temporal arteries of patients. We found glutamine levels were positively associated with a greater risk of stroke (OR=1.599, p=0.022). After treatment with glutamine, HBMECs exhibited enhanced proliferation, migration, and EndMT, all reversed by ITGB4 knockdown. In ITGB4-transfected HBMECs, the MAPK-ERK-TGF-β/BMP pathway was activated, with Smad4 knockdown reversing the EndMT. Furthermore, atorvastatin suppressed the EndMT by inhibiting Smad1/5 phosphorylation and promoting Smad4 ubiquitination in ITGB4-transfected HBMECs. We also found the protein level of ITGB4 was upregulated in the superficial temporal arteries of patients with MMD. In conclusion, our study suggests that glutamine may be an independent risk factor for hemorrhage or infarction in patients with MMD and targeting ITGB4 could potentially be therapeutic approaches for MMD.

5-Fluorouracil combined with cisplatin via arterial induction for advanced T-stage nasopharyngeal carcinoma: A 10-year outcome of a phase I/II study.

Background and PurposeCurrently, there is no optimal dose recommendation for a 120-h continuous infusion of 5-fluorouracil via arterial cannulation for advanced T-stage nasopharyngeal carcinoma (NPC). Thus, the aim of this study was to determine the maximum tolerated dose (MDT), along with the efficacy, late adverse events, and 10-year survival outcome of 5-fluorouracil administered continuously for 120 h combined with cisplatin via the superficial temporal artery in patients with advanced T-stage NPC.Materials and MethodsFifty-one patients with histologically confirmed advanced T-stage NPC were eligible for inclusion in this clinical trial. The patients received induction chemotherapy consisting of cisplatin (20 mg/m2/d for 1–5 d) and 5-fluorouracil, administered continuously for 120 h at different dose gradients via a superficial temporal artery. To identify the MTD of 5-fluorouracil infused arterially, we employed a 3 + 3 design during study phase I. The initial dose administered was 200 mg/m2/d, which then was gradually escalated by 50 mg/m2/d until the MTD was reached. Following two cycles of induction chemotherapy, current radical chemoradiotherapy commenced. We assessed the efficacy, survival, toxicity, and quality of life of patients following treatment.ResultsThe overall response (complete response + partial response) rates following induction chemotherapy in the primary mass and lymph nodes were 100% and 100%, respectively. All 51 (100%) patients achieved T-category down-staging after intra-arterial chemotherapy. The MTD was 450 mg/m2/d for 120 h. No late neurological toxicities, such as brain stem injury, temporal lobe necrosis, and spinal cord injury, were observed. The 5- and 10-year overall survival (OS) rates were 78.0% and 71.7%, respectively, with a median OS of 131 months.ConclusionContinuous infusion of 5-fluorouracil combined with cisplatin via the superficial temporal artery showed promising survival benefits and few toxicities in patients with advanced T-stage NPC.

The Course of Superficial Temporal Artery in Patients with Microtia and its Relationship with the Remnant.

Temporoparietal fascia is important for auricular reconstruction or repair after auricular reconstruction. Thus, the course of the superficial temporal artery (STA) is of vital importance to prevent destruction of the artery. The purpose of this study was to evaluate the course of the superficial temporal artery in patients with congenital microtia and its relationship with remnants. This was a prospective study. Patients with microtia who underwent auricular reconstruction in our hospital from January 2021 to July 2021 underwent ultrasound examination of the STA. Under the guidance of ultrasound, the superficial temporal artery and its branches were located and marked on the body surface before the operation, ranging from the zygomatic arch plane to the temporal parietal artery. In addition, the hemodynamics of the STAs were recorded. A total of 108 patients with microtia were collected, including 106 patients with unilateral microtia and 2 patients with bilateral microtia. There were 82 cases of lobule type, 21 cases of small concha type, and 7 cases of large concha type. The superficial temporal artery in 103 ears was divided into two branches: the parietal branch and the frontal branch, but there was only one branch in 7 ears. The parietal branch was absent in 5 cases, and the frontal branch was absent in 2 cases. In most of the ears, the bifurcation was located above the zygomatic arch plane. Only in 2 ears was the bifurcation located below the zygomatic arch, and the most common bifurcation position was the eyebrow arch level (43.7%). Regarding the shortest distances between the STA and the remnant, they were less than 0.5 cm in 47 ears, more than 1 cm in 30 ears, and 0.5 cm to 1 cm in 33 ears. The course of STA varied greatly and there were occasional single branches. The distances between the STA and remnant were often near 0.5 cm by ultrasonography. Therefore, when removing the remnant and separating the pocket, care should be taken to avoid arterial injury. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

An Experience of Scalp Island Flap Based on the Posterior Branch of the Superficial Temporal Artery for Patients with Mucormycosis and Cancer.

To find out the utility of the scalp flap based on the posterior branch of the superficial temporal artery in patients with head and neck mucormycosis and malignancy. This was a multi-institutional observational study conducted at a tertiary cancer centre in North East India and a super-speciality hospital in Maharashtra from January 2021 to June 2021. Patients with malignancy and mucormycosis were only considered. In our study, we have seven patients (n = 7), two of them had mucormycosis and 5 had squamous cell carcinoma of the head and neck region. Out of the 5 cases of the head and neck malignancy, two cases were recurrent ones, another two cases where primary flap failed and in the last case, the patient was unfit for free tissue transfer due to cardiac issues. The mean age in the series was 50.42 years and the average duration of raising the flap was 22.86 min. Average hospital stays for head and neck cancer patients are 4.6 days and for mucormycosis patients, it is 22.5 days. No flap related complications were noted during the series. Scalp flap based on the posterior branch of the superficial temporal artery is a useful option in recurrent malignancy cases, in primary cases as a salvage option and in patients where long duration surgery is not possible due to poor general condition like in critical mucormycosis. Post-operative hair growth at the flap site and alopecia at the donor scalp are concerns and therefore, careful patient selection is a must.

Anatomical features of the superficial temporal artery in hemorrhagic moyamoya disease based on CT angiography.

The superficial temporal artery (STA) is an important continuation of the external carotid artery. It is divided into the frontal branch and the parietal branch at or above the zygomatic arch. In the present study, a comparative analysis of the STA in patients with and without moyamoya disease (MMD) was performed using CT angiography. Patients admitted to our institution for spontaneous intracranial hemorrhage were potential candidates. In general, 25 cases (50 sides) in the MMD group and 25 cases (50 sides) in the non-MMD group were selected for evaluation. The morphology of the STA when crossing the zygomatic arch, the association between the STA bifurcation and the zygomatic arch, the branching characteristics of the STA, the parameters of the STA bifurcation point, the diameter of the STA and the distance from the origin of the STA to the bifurcation point were selected for analysis. There were no significant differences between the two groups with regard to the association between the STA bifurcation and the zygomatic arch, the diameter of the STA or the distance from the origin of the STA to the bifurcation point. However, the bifurcation point of the STA was closer to the posterior edge of the mandibular condyle in the patients with MMD.

5-Fluorouracil Combined with Cisplatin Via Arterial Induction for Advanced T-Stage Nasopharyngeal Carcinoma: A 10-Year Outcome Study

The aim of this study was to determine the efficacy, late adverse events, and 10-year survival outcome of 5-fluorouracil administered continuously for 120 h combined with cisplatin via a superficial temporal artery in patients with advanced T-stage nasopharyngeal carcinoma (NPC). Forty-five patients with histologically confirmed advanced T-stage NPC were eligible for inclusion in this clinical trial. The patients received induction chemotherapy consisting of cisplatin (20 mg/m2/d for 1–5 d) and 5-fluorouracil, administered continuously for 120 h at different dose gradients(200-500mg/m2/d) via a superficial temporal artery. Following two cycles of induction chemotherapy, radical radiotherapy was commenced. We assessed the efficacy, survival, toxicity, and quality of life of patients following treatment, especially in terms of oral mucositis and radiation-induced brain damage. The overall response (complete response + partial response) rates following induction chemotherapy in the primary mass and lymph nodes were 100% and 100%, respectively. The maximum tolerated dose(MTD) of 5-Fluorouracil was 450mg/m2,we also determined the optimal dose was 400mg/m2 according to the response, toxicities and survival. All 45 (100%) patients achieved down-staging of T-category after induction chemotherapy. No late neurological toxicities, such as brain stem injury, temporal lobe necrosis, and spinal cord injury, were observed. The 5-year and 10-year overall survival (OS) rates were 79% and 64.7%, with a median OS of 128 months. 5-Fluorouracil continuous infusion combined with cisplatin via a superficial temporal artery showed promising survival and low toxicities in patients with advanced T-stage NPC.

Anatomy of the superficial temporal artery in patients with unilateral microtia

This retrospective study evaluated the anatomical distribution of the superficial temporal artery (STA) in supply of the temporoparietal fascial (TPF) flap for use in patients with unilateral microtia undergoing reconstruction. We aimed to determine whether embryologic arrest of pharyngeal arch development would lead to aberrant STA, which impedes reliable harvest of the TPF flap in patients requiring microtia repair. CT angiograms (CTAs) and 3D reconstruction of the face and neck of 41 patients with microtia, aged 6-21 years, were examined. The number of STA branches, branching pattern, vessel diameter, and the presence or absence of the external auditory canal atresia were documented. The STA crosses the zygoma on average 4mm more anterior to the porion (anterior-inferior lip of the tympanic part of the temporal bone) on the side with microtia compared to the nonmicrotia side. There were no statistically significant differences between vessel caliber or STA branches between the two sides. The STA is anatomically reliable for inclusion in TPF flaps, which is used for auricular reconstruction in patients with microtia. A TPF flap can be safely harvested by the routine technique; however, surgeons should be cognizant of the STA coursing more anteriorly on the microtia ear.

Anatomical variants of the superficial temporal artery in patients with microtia: a pilot descriptive study.

Superficial temporal artery (STA) based pedicled fascial flap plays a pivotal role in ear reconstruction for microtia patients. There is paucity of literature on the anatomy of the STA in microtia patients. The present study aimed to describe any possible anatomical variations seen in the STA of patients afflicted with microtia. Pre-operative carotid computer tomographic angiography images of patients under the microtia database of Plastic and Reconstructive Surgery Unit at a tertiary medical centre were selected and 3-dimensionally reconstructed. Measurements were made on the 3D reconstructed computed tomographic angiography images of the STA on both the sides of the microtic ear and the non-microtic ear to assess its various anatomical parameters. We managed to obtain a total of 39 computed tomographic angiography images of STAs for analysis. There was a significant difference in the number of main branches of STA between the two groups (P=0.006). The proportion of ears with 2 main branches was higher in the non-microtia group (89.5%) compared to the microtia group (45.0%). A significant difference was found in the STA diameter between the two groups (P=0.012). The mean diameter of STA in the non-microtia group was larger by 0.4 mm. Furthermore, the median angle of STA was larger on the side of the non-microtic ears compared to that of microtic ears by 24.5°, with a P-value of 0.011. The results of the study may be of clinical importance while planning and performing ear reconstructive surgeries using STA based pedicled fascial flaps.

Role of transforming growth factor-beta1 in the pathogenesis of moyamoya disease.

Prominent features of moyamoya disease are intimal thickening of the cerebral arterial trunks and abundant angiogenesis for collateral blood supplies, but its pathogenesis is still unknown. The aim of this study was to test the possibility that transforming growth factor-beta1 (TGFbeta1) may play a role in the pathogenesis of moyamoya disease. The authors used reverse transcription-polymerase chain reaction to analyze the expression level of TGFbeta1 in smooth-muscle cells cultured from the superficial temporal arteries (STAs) and measured the serum level of TGFbeta1 by using enzyme-linked immunosorbent assay. Although the STA is not predominantly involved with moyamoya disease, it has been used in studies of the pathogenesis of this disease. In this report, the STAs from six patients with moyamoya disease and four with arteriosclerotic cerebrovascular disease, along with sera from 14 patients with moyamoya disease and 10 normal healthy volunteers, were studied. The expression of TGFbeta1 was significantly higher in cultured smooth-muscle cells derived from the STAs of patients with moyamoya disease than in those derived from the STAs of patients with arteriosclerotic cerebrovascular disease (p < 0.05). The serum level of TGFbeta1 was also significantly higher in patients with moyamoya disease than in controls (p < 0.0005). Taking into account the functional roles of TGFbeta1 in the expression of connective tissue genes and angiogenesis, these investigators suggest that TGFbeta1 is associated with the pathogenesis of moyamoya disease, including abundant neovascularization, although their findings do not necessarily mean that TGFbeta1 is a causative factor in this disease.

Elastin Degradation in the Superficial Temporal Arteries of Patients with Intracranial Aneurysms Reflects Changes in Plasma Elastase

Elastin Degradation in the Superficial Temporal Arteries of Patients with Intracranial Aneurysms Reflects Changes in Plasma Elastase

Elastin Degradation in the Superficial Temporal Arteries of Patients with Intracranial Aneurysms Reflects Changes in Plasma Elastase&lt;subtitle&gt;Converting K08 and K23 to R01 Awards&lt;/subtitle&gt;

Elastin Degradation in the Superficial Temporal Arteries of Patients with Intracranial Aneurysms Reflects Changes in Plasma Elastase&lt;subtitle&gt;Converting K08 and K23 to R01 Awards&lt;/subtitle&gt;

Elastin degradation in the superficial temporal arteries of patients with intracranial aneurysms reflects changes in plasma elastase.

alpha 1-Antitrypsin (AAT) and alpha 2-macroglobulin (AMG) are elastase inhibitors that bind the enzyme and reduce measured levels of free elastase. It was recently demonstrated that some patients with intracranial aneurysms have significantly elevated plasma elastase (PE) levels. Although this elevation is unrelated to plasma AAT, it is unknown whether abnormal AAT phenotypes or reduced AMG levels play a role. Moreover, the pathological significance of this elevation is not understood. Plasma from 24 patients with aneurysms (ruptured, n = 15; unruptured, n = 9) and 10 age-matched patients who comprised a control group was analyzed for PE and AMG levels by enzyme-linked immunosorbent assay and for AAT phenotype by isoelectric focusing. Sections of superficial temporal temporal artery obtained from these patients at the time of surgery were examined for evidence of elastin degradation by using a van Gieson stain, with scoring on a nine-point quantitative scale. Patients with aneurysms showed significantly elevated PE levels (119 +/- 28 versus 17 +/- 7 micrograms/ml, P < 0.05), but AMG levels were not decreased. AAT phenotypic abnormalities were observed in 10% (2 of 20) of the patients with aneurysms, but this was not different from the expected population incidence (7%). Elastin degradation scores were significantly higher in patients with aneurysms than in patients control group (4.26 +/- 0.54 versus 1.21 +/- 0.43, P < 0.05). In addition, patients with higher elastase levels (> 80 micrograms/ml) demonstrated 55% higher degradation scores than did those with lower elastase levels (< 80 micrograms/ml). These data suggest that high PE levels may play a role in systemic arterial elastin degradation seen in patients with intracranial aneurysms. These data also support the contention that elevated elastase levels are not the result of decreased protease inhibitor levels. Although PE levels were significantly higher for the entire group of patients with aneurysms, this assay has relatively low sensitivity for predicting the presence of unruptured aneurysms. Additional study is necessary to determine whether serum elastase levels greater than 80 micrograms/ml, in the setting of other risk factors, are useful in identifying asymptomatic patients for additional screening.

Histological Examinations of the Superficial Temporal Artery in Patients Suffering from Cluster Headache

Histological Examinations of the Superficial Temporal Artery in Patients Suffering from Cluster Headache