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Sample records for accidental dural puncture

  1. Bilateral subdural hematoma secondary to accidental dural puncture

    Directory of Open Access Journals (Sweden)

    Sofía Ramírez

    2015-07-01

    Full Text Available We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma.The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time. Resumo: Apresentamos o caso clínico de uma paciente de 25 anos de idade, na qual uma técnica peridural foi realizada durante o trabalho de parto e posteriormente apresentou cefaleia com características de cefaleia pós-punção dural. Foi iniciado tratamento conservador e tampão de sangue peridural. Devido a ausência de melhora clínica e à mudança do componente postural da cefaleia, decidiu-se realizar um exame de imagem cerebral que demostrou a presença de hematoma subdural bilateral.A cefaleia pós-punção dural é relativamente frequente, mas a falta de resposta ao tratamento médico instaurado, assim como a mudança em suas características e a presença de foco neurológico, devem levantar a suspeita de presença de um hematoma subdural que, embora infrequente, pode chegar a ser devastador se não for diagnosticado e tratado oportunamente. Keywords: Accidental dural puncture, Epidural analgesia, Post-dural puncture headache, Subdural hematoma, Epidural blood patch, Palavras chave: Dura-Máter, Analgesia epidural, Cefaleia pós-punção dural, Hematoma subdural, Placa de sangue epidural

  2. Headache in the parturient: Pathophysiology and management of post-dural puncture headache

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    Gita Nath

    2011-01-01

    Full Text Available Headache in the postpartum period is common and multifactorial in origin. Apart from primary causes such as tension headaches and migraine, secondary headaches such as post-dural puncture headache (PDPH are increasingly common because of increasing use of regional anaesthesia and analgesia during childbirth. Preventive measures for PDPH include the use of smaller gauge pencil-point needles for spinal blocks; epidural needles of 18 G or less; using saline rather than air for epidural space identification and the use of ultrasound guidance, especially for difficult cases such as morbid obesity and spinal deformities. In case of accidental dural puncture (ADP, the choice is between inserting the catheter in an adjacent space or intrathecal catheterization. Current evidence seems to be in favour of inserting the epidural catheter into the subarachnoid space and using the intrathecal catheter for analgesia/anaesthesia after prominently labelling it as intrathecal, to prevent misuse. It should be removed after at least 24 hours and a 10 ml bolus of saline injected before removal of catheter may be helpful. Either way, having written protocols for the management of accidental dural puncture helps to reduce the incidence of PDPH. PDPH can be disabling in severity and can mar the whole experience of childbirth. In addition, severe untreated PDPH can cause complications such as nerve palsies, subdural hematoma and cerebral venous thrombosis. Conservative methods of treatment should be tried first such as adequate hydration, paracetamol, caffeine, sumatriptan or ACTH/hydrocortisone. Epidural blood patching is the most effective treatment for PDPH. It is more effective if done 24-48 hours after dural puncture. It is an invasive procedure with its own complications as well as a failure rate of up to 30%, so that a second or even third patch may be necessary. Both these facts should be intimated to the patient beforehand. Meticulous follow-up and evaluation

  3. Comparison of dural puncture epidural technique versus conventional epidural technique for labor analgesia in primigravida

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    Pritam Yadav

    2018-01-01

    Full Text Available >Background: Dural puncture epidural (DPE is a method in which a dural hole is created prior to epidural injection. This study was planned to evaluate whether dural puncture improves onset and duration of labor analgesia when compared to conventional epidural technique.Methods and Materials: Sixty term primigravida parturients of ASA grade I and II were randomly assigned to two groups of 30 each (Group E for conventional epidural and Group DE for dural puncture epidural. In group E, epidural space was identified and 18-gauge multi-orifice catheter was threaded 5 cm into the epidural space. In group DE, dura was punctured using the combines spinal epidural (CSE spinal needle and epidural catheter threaded as in group E followed by 10 ml of injection of Ropivacaine (0.2% with 20 mcg of Fentanyl (2 mcg/ml in fractions of 2.5 ml. Later, Ropivacaine 10 ml was given as a top-up on patient request. Onset, visual analouge scale (VAS, sensory and motor block, haemodynamic variables, duration of analgesia of initial dose were noted along with mode of delivery and the neonatal outcome.Results: Six parturients in group DE achieved adequate analgesia in 5 minutes while none of those in group E (P 0.05.Conclusions: Both techniques of labor analgesia are efficacious; dural puncture epidural has the potential to fasten onset and improve quality of labor analgesia when compared with conventional epidural technique.

  4. Cefalea secundaria a punción dural Headache as a result of dural puncture

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    Ariadna García Rodríguez

    2005-03-01

    Full Text Available Se realizó una revisión bibliográfica sobre cefalea pospunción en el Hospital "Abel Santamaría", de Pinar del Río, en el período comprendido de febrero a junio del 2004, con el objetivo de ampliar los conocimientos de los profesionales de la salud encargados de diagnosticar y tratar esta complicación. La cefalea secundaria a punción dural se debe al escape persistente de LCR (líquido cefalorraquídeo a través del desgarro hecho en la duramadre, causado por la penetración de la aguja; se presenta cuando el paciente adopta la posición erecta y se alivia con el decúbito, característica esta que de no aparecer debe hacer dudar el diagnóstico. La elección de un trocar fino para realizar la punción y la dirección del bisel paralelo a las fibras de la duramadre son los factores determinantes en la profilaxis de la cefalea. Aún existen controversias en cuanto a su tratamiento, pero si hay un consenso unido en que el parche de sangre epidural es el tratamiento definitivo de esta complicación.A review of the most updated literature on dural post-puncture headache was made at Abel Santamaría University Hospital in February - June 2004 aimed at spreading the awareness to health professionals at diagnosing and treating this condition. The headache secondary to dural puncture is caused by the persistent leakage of cerebrospinal fluid through the dura tear because of the needle insertion; it presents when the patient adopts the erect position and it alleviates with the supine position; if this characteristic is not present it may appear some doubts on diagnosis. The selection of a fine trocar for puncture and guiding the bevel parallel to the fibers of dura are the main factors for profilaxis of headache. Its treatment is controversial, but it does exist a consensus in that the epidural blood patch is the definitive treatment for this condition.

  5. [Ropivacaine use in transnasal sphenopalatine ganglion block for post dural puncture headache in obstetric patients - case series].

    Science.gov (United States)

    Furtado, Inês; Lima, Isabel Flor de; Pedro, Sérgio

    2018-02-02

    Sphenopalatine ganglion block is widely accepted in chronic pain; however it has been underestimated in post dural puncture headache treatment. The ganglion block does not restore normal cerebrospinal fluid dynamics but effectively reduces symptoms associated with resultant hypotension. When correctly applied it may avoid performance of epidural blood patch. The transnasal approach is a simple and minimally invasive technique. In the cases presented, we attempted to perform and report the ganglion block effectiveness and duration, using ropivacaine. We present four obstetrics patients with post dural puncture headache, after epidural or combined techniques, with Tuohy needle 18G that underwent a safe and successful Sphenopalatine ganglion block. We performed the block 24-48h after dural puncture, with 4mL of ropivacaine 0.75% in each nostril. In three cases pain recurred within 12-48h, although less intense. In one patient a second block was performed with complete relief and without further recurrence. In the other two patients a blood patch was performed without success. All patients were asymptomatic within 7 days. The average duration of analgesic effect of the block remains poorly defined. In the cases reported, blocking with ropivacaine was a simple, safe and effective technique, with immediate and sustained pain relief for at least 12-24h. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  6. Postpartum cortical venous thrombosis: An unusual presentation of postdural puncture headache

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    Opal Raj

    2016-01-01

    Full Text Available Headache is a common occurrence during pregnancy. A postural headache is invariably considered to be a postdural puncture headache in patients who receive neuraxial anesthesia with or without obvious or incidental dural puncture. Cerebral venous thrombosis (CVT is rare in pregnancy and in the postpartum period, with an incidence of 1:10,000–1:25,000. Pregnancy-induced changes in coagulation result in a hypercoagulable state, which may naturally reduce the incidence of postpartum hemorrhage, but may also increase the risk of CVT. Postpartum headache being frequently encountered may complicate the diagnosis of CVT. We report a case of a woman who developed a postpartum CVT after an accidental wet tap and intrathecal catheter placement during labor.

  7. Effectiveness of autologous epidural blood patch to relieve post dural puncture headache

    International Nuclear Information System (INIS)

    Iqbal, L.A.A.; Naqvi, E.H.

    2013-01-01

    Background: Post-dural puncture headache (PDPH) is a common problem in anaesthesia practice especially in obstetric anaesthesia. Autologous epidural blood patch (AEBP) is the main stay of treatment of PDPH when it is not relieved with conservative management. Objective: To describe the efficacy of AEBP in treatment of PDPH. Study Design: Prospective descriptive study. Setting and Duration: The study was conducted at departments of Anaesthesia and Intensive Care, Military Hospital, Rawalpindi and Combined Military Hospital, Malir, from July 2008 to July 2011. Methodology: All patients who received AEBP during study period secondary to PDPH were included. Up to 20 ml of autologous blood was injected in epidural space. Effectiveness of AEBP was judged by relief of symptom; any complications associated with AEBP i.e. backache and paresthesia were also noted. Data was interpreted as mean and percentages. Results: A total of 30 AEBP were performed during the study period in predominantly female patients (n=27) with mean age of 27.8 years. AEBP was performed after a mean 3.83 days of lumbar puncture. Complete relief was observed in 29 (96%) patients; one patient required a second patch. During the follow-up, 7 (23%) patients complained of backache and 2(6%) of paresthesias. conclusion: AEBP is an effective way of providing relief from PDPH. (author)

  8. Changing the needle for lumbar punctures

    DEFF Research Database (Denmark)

    Engedal, Thorbjørn Søndergaard; Ording, H.; Vilholm, O. J.

    2015-01-01

    Objective: Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar punctures. Both a non-cutting needle design and the use of smaller size needles have been shown to greatly reduce the risk of PDPH. Nevertheless, larger cutting needles are still widely used. This study d...

  9. Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis – a case report

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    Shah R

    2014-01-01

    Full Text Available Reena Shah, Agnieszka Kubisz-Pudelko, Jeremy Reid Yeovil District Hospital, Yeovil, UK Abstract: Posterior reversible encephalopathy syndrome (PRES is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Neuro-imaging revealed features consistent with PRES. The patient went on to make a good recovery, being discharged 21 days postoperatively, with only minor visual disturbances and memory problems. This case highlights the importance of awareness of PRES to all specialties. On reviewing the literature, we feel that PRES may be a potential differential diagnosis to post-procedural neurological symptoms in those patients undergoing routine procedures such as spinal anesthetics or lumbar punctures. Keywords: PRES, neurological disease, lumbar puncture, spinal anesthetic

  10. The effect of intravenous propofol on the incidence of post-dural puncture headache following spinal anesthesia in cesarean section

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    Parisa Golfam

    2016-09-01

    Full Text Available Introduction: Post Dural puncture headache is still a common complication among young women undergone cesarean section, although use of small size spinal needles reduced its prevalence. Several methods have been suggested for prevention and treatment of this side effect; such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effective. The last option would be epidural blood patch, if headache persist. The aim of this study was evaluation the efficacy of intravenous propofol on post dural puncture headache incidence after cesarean section. Methods: In a randomized clinical trial 120 patients aged 18-45 years old in American Society of Anesthesiologist (ASA class I or II, who had no history of headache, analgesic consumption, substance abuse and drug addiction, candidate for elective cesarean section, were randomly assigned into intervention (propofol and control groups. The anesthesia method for both groups was precisely the same. After spinal anesthesia in the first group 30µg/kg/min of intravenous propofol have been infused slowly. Then at 1, 6, 18, 24 hours and 2nd to 7th days after surgery, anesthesiologist asked groups for presence or absence of headache. The data analyzed with SPSS 16.0 software. Results: Headache incidence rate in the group who receiving propofol was significantly reduced (P.V=0.001. Conclusion: This study showed that 30µg/kg/min of intravenous propofol caused reduced the incidence of post spinal headache in young women undergone elective cesarean section.

  11. Cerebrospinal fluid loss at lumbar puncture for caesarean section ...

    African Journals Online (AJOL)

    Background Post dural puncture headache (PDPH) is an unpleasant complication of spinal anaesthesia. Several studies have attempted explanation of its pathophysiology. A widely held view is that it results from loss of cerebrospinal fluid volume resulting from leak following a hole left in the dura after the puncture.

  12. A randomised controlled trial using the Epidrum for labour epidurals.

    LENUS (Irish Health Repository)

    Deighan, M

    2015-03-01

    The aim of our study was to determine if using the Epidrum to site epidurals improves success and reduces morbidity. Three hundred parturients requesting epidural analgesia for labour were enrolled. 150 subjects had their epidural sited using Epidrum and 150 using standard technique. We recorded subject demographics, operator experience, number of attempts, Accidental Dural Puncture rate, rate of failure to site epidural catheter, rate of failure of analgesia, Post Dural Puncture Headache and Epidural Blood Patch rates. Failure rate in Epidrum group was 9\\/150 (6%) vs 0 (0%) in the Control group (P = 0.003). There were four (2.66%) accidental dural punctures in the Epidrum group and none in the Control group (P = 0.060), and 2 epidurals out of 150 (1.33%) in Epidrum group were re-sited, versus 3\\/150 (2%) in the control group (P = 1.000). The results of our study do not suggest that using Epidrum improves success or reduces morbidity.

  13. There is room for improvement in the prevention and treatment of headache after lumbar puncture

    DEFF Research Database (Denmark)

    Stendell, Line; Fomsgaard, Jonna S; Olsen, Karsten S

    2012-01-01

    The incidence of post dural puncture headache (PDPH) after lumbar puncture (LP) can be reduced from 36% to 0-9% by use of an atraumatic needle size 24 gauge (G)/0.56 mm rather than a traumatic needle size 22 G/0.7 mm. The evidence supporting some of the prophylactic and therapeutically treatments...

  14. The effect of second-stage pushing and body mass index on postdural puncture headache.

    Science.gov (United States)

    Franz, Amber M; Jia, Shawn Y; Bahnson, Henry T; Goel, Akash; Habib, Ashraf S

    2017-02-01

    To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles. Retrospective cohort. Obstetric ward and operating rooms at a university-affiliated hospital. One hundred ninety parturients who had witnessed dural puncture with 17 or 18 gauge Tuohy needles from 1999-2014. Patients were categorized by pushing status and body mass index (kg/m 2 ): nonobese push, women who pushed during labor had increased risk of postdural puncture headache (odds ratio [OR], 2.1 [1.1-4.0]; P=.02), more days of headache (P=.02), and increased epidural blood patch placement (P=.02). Super obese patients were less likely to develop headache compared with nonobese (OR, 0.33 [0.13-0.85]; P=.02), obese (OR, 0.37 [0.14-0.98]; P=.045], and morbidly obese patients (OR, 0.20 [0.05-0.68]; Ppushing (OR, 0.57 [0.29-1.10]; P=.096) and super obesity (OR, 0.41 [0.16-1.02]; P=.056] were no longer significantly associated with reduced risk of postdural puncture headache. Parturients who did not push before delivery and parturients with body mass index ≥50kg/m 2 were less likely to develop postdural puncture headache in a univariate analysis. Similar trends were demonstrated in a multivariate model, but were no longer statistically significant. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Evaluation of two different epidural catheters in clinical practice. narrowing down the incidence of paresthesia!

    Science.gov (United States)

    Bouman, E A C; Gramke, H F; Wetzel, N; Vanderbroeck, T H T; Bruinsma, R; Theunissen, M; Kerkkamp, H E M; Marcus, M A E

    2007-01-01

    Although epidural anesthesia is considered safe, several complications may occur during puncture and insertion of a catheter. Incidences of paresthesia vary between 0.2 and 56%. A prospective, open, cohort-controlled pilot study was conducted in 188 patients, ASA I-III, age 19-87 years, scheduled for elective surgery and epidural anesthesia. We evaluated a 20 G polyamide (standard) catheter and a 20 G combined polyurethane-polyamide (new) catheter. Spontaneous reactions upon catheter-insertion, paresthesia on questioning, inadvertent dural or intravascular puncture, and reasons for early catheter removal were recorded. The incidence of paresthesia reported spontaneously was 21.3% with the standard catheter and 16.7% with the new catheter. Systematically asking for paresthesia almost doubled the paraesthesia rate. Intravascular cannulation occurred in 5%. No accidental dural punctures occurred. An overall incidence of 13.3% of technical problems led to early catheter removal. The new catheter was at least equivalent to the standard regarding epidural success rate and safety : rate of paresthesia, intravascular and dural cannulation.

  16. Unintentional arterial puncture during cephalic vein cannulation: case report and anatomical study

    NARCIS (Netherlands)

    Lirk, P.; Keller, C.; Colvin, J.; Colvin, H.; Rieder, J.; Maurer, H.; Moriggl, B.

    2004-01-01

    The cephalic antebrachial vein is often used for venous access. However, superficial radial arteries of the forearm are known and unintentional arterial puncture can result from attempts to cannulate the lateral veins of the arm. Accidental puncture of a superficial radial artery during peripheral

  17. [Posterior reversible encephalopathy syndrome and cerebrovascular constriction syndrome in the differential diagnosis of post-partum headaches].

    Science.gov (United States)

    Ruiz López, N; Cano Hernández, B; Balbás Álvarez, S

    2016-02-01

    Postpartum headache can be due to many causes. In a patient with previous epidural analgesia, the headache can be attributed to post-dural puncture headache, even if the symptoms are not typical of this clinical entity. We report a case of a post-partum with accidental dural tap during the insertion of an epidural catheter for labour analgesia, and who referred to headaches in the third post-partum day. Initially, a post-dural puncture headache was suspected, but the subsequent onset of seizures and visual impairment meant that the diagnosis had to be reconsidered. In this case report, the clinical and pathophysiological features of posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome, as well as the differential diagnosis of post-partum headaches are described. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. INTERNAL BALLOON TAMPONADE - A NONSURGICAL METHOD FOR REMOVAL OF ACCIDENTALLY PLACED SHEATHS FROM THE SUBCLAVIAN ARTERY

    NARCIS (Netherlands)

    VANDIJK, RB; DENHEIJER, P; DEMUINCK, E; LIE, KI

    One of the possible complications of subclavian vein puncture is accidental puncture of the subclavian artery. If this is not noted immediately after the puncture, insertion of a large bore sheath in the subclavian artery is likely to follow. We describe our experience with a new method that enables

  19. Pre-puncture ultrasound guided epidural insertion before vaginal delivery.

    Science.gov (United States)

    Nassar, Mahmoud; Abdelazim, Ibrahim A

    2015-10-01

    Palpation method is widely used in clinical practice to identify the puncture site during combined spinal-epidural (CSE) blocks. Tuffier's line, is an anatomical landmark between two iliac crests (inter-cristal), which is widely used to identify the puncture site during CSE blocks is not always an indicator for specific vertebral level or inter-vertebral space. One hundred and Ten (110) women were scheduled for normal vaginal delivery and were randomized into two equal groups; palpation group and an ultrasound guided group to detect the efficacy of puncture ultrasound before CSE blocks to increase chances of successful CSE procedure on the first attempt and to reduce the number of attempts or punctures during insertion of CSE catheter. There were no significant differences between two studied groups regarding; maternal age, weight and height, while, there was a significant difference between two studied groups regarding; parity. Percentage of successful CSE procedure on the first attempt was significantly higher (67.27%) in ultrasound compared to palpation group (40%). Number of punctures (attempts) were significantly less in ultrasound (1.2 ± 0.6) compared to palpation group (2.3 ± 0.8) and the number of redirections was also significantly less in ultrasound (1.4 ± 0.5) compared to palpation group (2.8 ± 1.6). Although, time to identify puncture site was significantly longer in ultrasound compared to palpation group and total procedure time was longer in ultrasound (9.1 ± 1.5 min) compared to palpation group (6.2 ± 1.2 min), there was no significant difference between two studied groups regarding; time to identify puncture site and total procedure time. Two cases of dural puncture in palpation versus no cases in ultrasound group and two cases of intravascular catheter placement (one in each group), with no significant difference between two groups. Pre- puncture ultrasound guided epidural insertion before vaginal delivery, increases the chance of a

  20. Comparison of the efficacy of epidural autologous blood patch in the treatment of spontaneous intracranial hypotension and post-dural puncture headache

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    Yoon, Sung Hyun; Lee, Jon Woo; Lee, Geun Young; Lee, Eu Gene; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2014-04-15

    To evaluate and compare the effectiveness of fluoroscopy-guided epidural blood patch (EBP) in patients with post-dural puncture headache (PDPH) and spontaneous intracranial hypotension (SIH). Between August 2012 and September 2013, 16 patients (12 with PDPH, 4 with SIH; 5 males, 11 females; age range 19-58 years, mean age 32.8 years) who underwent EBP in the Department of Radiology were included in this study. Pain relief within three days after EBP was evaluated based on medical record and classified on a 3-level scale: complete relief; incomplete relief; and failure. Recurrence is defined as aggravated postural headache after three days. We evaluated and compared treatment outcome between PDPH and SIH, using Fisher's exact test (considered as significant when p < 0.05). In 12 PDPH patients, the EBP provided complete relief in 5 patients (41.7%), and incomplete relief in 7 patients (58.3%). In 4 SIH patients, the EBP provided complete relief in 1 patient (25%), and incomplete relief in 3 patients (75%). There was no significant difference (p = 0.511) of pain relief rate between PDPH and SIH. There was recurrence in 5 patients with PDPH and 1 patient with SIH. Five PDPH patients were retreated by EBP with incomplete relief. Fluoroscopy-guided EBP provides effective treatment of postural headache for both SIH and PDPH patients.

  1. Comparison of the efficacy of epidural autologous blood patch in the treatment of spontaneous intracranial hypotension and post-dural puncture headache

    International Nuclear Information System (INIS)

    Yoon, Sung Hyun; Lee, Jon Woo; Lee, Geun Young; Lee, Eu Gene; Kang, Heung Sik

    2014-01-01

    To evaluate and compare the effectiveness of fluoroscopy-guided epidural blood patch (EBP) in patients with post-dural puncture headache (PDPH) and spontaneous intracranial hypotension (SIH). Between August 2012 and September 2013, 16 patients (12 with PDPH, 4 with SIH; 5 males, 11 females; age range 19-58 years, mean age 32.8 years) who underwent EBP in the Department of Radiology were included in this study. Pain relief within three days after EBP was evaluated based on medical record and classified on a 3-level scale: complete relief; incomplete relief; and failure. Recurrence is defined as aggravated postural headache after three days. We evaluated and compared treatment outcome between PDPH and SIH, using Fisher's exact test (considered as significant when p < 0.05). In 12 PDPH patients, the EBP provided complete relief in 5 patients (41.7%), and incomplete relief in 7 patients (58.3%). In 4 SIH patients, the EBP provided complete relief in 1 patient (25%), and incomplete relief in 3 patients (75%). There was no significant difference (p = 0.511) of pain relief rate between PDPH and SIH. There was recurrence in 5 patients with PDPH and 1 patient with SIH. Five PDPH patients were retreated by EBP with incomplete relief. Fluoroscopy-guided EBP provides effective treatment of postural headache for both SIH and PDPH patients.

  2. Persistent dural cerebrospinal fluid leak shown by retrograde radionuclide myelography: case report

    International Nuclear Information System (INIS)

    Kadrie, H.; Driedger, A.A.; McInnis, W.

    1976-01-01

    Following inadvertent spinal anesthesia for delivery, a patient developed incapacitating post-lumbar puncture headache that persisted for 9 weeks. Scintigrams of the lumbar region, obtained after injection of /sup 99m/Tc-human serum albumin into the cisterna magna, showed the cerebrospinal fluid leak. Blood patch repair was carried out, with immediate relief of all symptoms. Because of subsequent atypical headaches, a second cisternogram was done by the same technique. This study confirmed that there was no further dural leak, and other evidence indicated that the recurrent headache was related to functional problems

  3. Technical compliance to standard guidelines for lumbar puncture and myelography: survey of academic neuroradiology attendings and fellows.

    Science.gov (United States)

    Zhang, Yi C; Chandler, Alexander J; Kagetsu, Nolan J

    2014-05-01

    To assess technical compliance among neuroradiology attendings and fellows to standard guidelines for lumbar puncture and myelography to minimize procedural complications such as iatrogenic meningitis and spinal headache. We surveyed academic neuroradiology attendings and fellows in the e-mail directory of the Association of Program Directors in Radiology. We queried use of face masks, use of noncutting needles, and dural puncture practices. All data were collected anonymously. A total of 110 survey responses were received: 75 from neuroradiology attendings and 34 from fellows, which represents a 14% response rate from a total of 239 fellows. Forty-seven out of 101 (47%) neuroradiologists do not always wear a face mask during myelograms, and 50 out of 105(48%) neuroradiologists do not always wear a face mask during lumbar punctures, placing patients at risk for iatrogenic meningitis. Ninety-six out of 106 neuroradiologists (91%) use the Quincke cutting needle by default, compared to only 17 out of 109 neuroradiologists (16%) who have ever used noncutting needles proven to reduce spinal headache. Duration of postprocedure bed rest does not influence incidence of spinal headache and may subject patients to unnecessary monitoring. Only 15 out of 109 (14%) neuroradiologists in our study do not prescribe bed rest. There was no statistically significant difference in practice between attendings and fellows. Iatrogenic meningitis and spinal headache are preventable complications of dural puncture that neuroradiologists can minimize by conforming to procedural guidelines. Wearing face masks and using noncutting spinal needles will reduce patient morbidity and lower hospitalization costs associated with procedural complications. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  4. Dural ectasia

    Directory of Open Access Journals (Sweden)

    Neha Gupta

    2014-01-01

    Full Text Available Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia. Greater than normal volume of cerebrospinal fluid in the lumber theca in dural ectasia is postulated to restrict the spread of intrathecally injected Local anaesthetic. Here, we report a case of failed spinal anaesthesia but successful epidural anaesthesia in later setting in a patient with dural ectasia.

  5. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25G quince, 27G quince and 27G whitacre spinal needles

    International Nuclear Information System (INIS)

    Shaikh, J.M.; Memon, M.; Khan, M.

    2008-01-01

    To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles. Comparative, randomized, double-blind, interventional study. 480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I (25G Quincke spinal needle: n=168), Group II (27G Quincke spinal needle: n=160) and Group III (27G Whitacre spinal needle: n=152). Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle (Group I), 27G Quincke spinal needle (Group II) and 27G Whitacre spinal needle (Group III) at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache (PDPH) were recorded. Data were analyzed using SPSS-11. Frequency of PDPH following the use of 25G Quincke (Group I), 27G Quincke (Group II) and 27G Whitacre (Group III) spinal needles was 8.3% (14/168), 3.8% (6/160) and 2.0% (3/152) respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on 1st and 2nd postoperative day. When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used. (author)

  6. Magnetic resonance findings associated with intracranial hypotension. A report of three cases occurring after lumbar puncture

    International Nuclear Information System (INIS)

    Galan, J.; Vuelta, R. V.; Oleaga, L.; Grande, D.

    1999-01-01

    The magnetic resonance (MR) findings are presented for three patients who developed intracranial hypotension syndrome following lumbar puncture, one of the most common causes of this complication. All three patients presented the MR findings characteristically associated with this event, consisting of diffuse dural enhancement after administration of a paramagnetic contrast medium, as well as extraaxial collection that played either an accompanying or a causative role. (Author) 7 refs

  7. Dural enhancement with primary calvarial lesions.

    Science.gov (United States)

    Arana, E; Martí-Bonmatí, L; Ricart, V; Pérez-Ebrí, M

    2004-11-01

    The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign ("dural tail") on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms.

  8. Dural enhancement with primary calvarial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Arana, E. [Clinica Quiron, Department of Radiology, Valencia (Spain); Marti-Bonmati, L. [Clinica Quiron, Department of Radiology, Valencia (Spain); Hospital Universitario Dr. Peset, Department of Radiology, Valencia (Spain); Ricart, V. [Hospital de la Ribera, Department of Radiology, Valencia (Spain); Perez-Ebri, M. [Hospital Universitario Dr. Peset, Department of Pathology, Valencia (Spain)

    2004-11-01

    The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign (''dural tail'') on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms. (orig.)

  9. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25 g Quincke, 27 g Quincke and 27 g Whitacre spinal needles.

    Science.gov (United States)

    Shaikh, Jan Muhammad; Memon, Amna; Memon, Muhammad Ali; Khan, Majida

    2008-01-01

    To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles. Comparative, randomized, double-blind, interventional study. Liaquat University Hospital Hyderabad from October 2005 to December 2006. 480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I (25G Quincke spinal needle: n=168), Group II (27G Quincke spinal needle: n=160) and Group III (27G Whitacre spinal needle: n=152). Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle (Group I), 27G Quincke spinal needle (Group II) and 27G Whitacre spinal needle (Group III) at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache (PDPH) were recorded. Data were analyzed using SPSS-11. Frequency of PDPH following the use of 25G Quincke (Group I), 27G Quincke (Group II) and 27G Whitacre (Group III) spinal needles was 8.3% (14/168), 3.8% (6/160) and 2.0% (3/152) respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on 1st and 2nd postoperative day. When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used.

  10. Automated Cross-Sectional Measurement Method of Intracranial Dural Venous Sinuses.

    Science.gov (United States)

    Lublinsky, S; Friedman, A; Kesler, A; Zur, D; Anconina, R; Shelef, I

    2016-03-01

    MRV is an important blood vessel imaging and diagnostic tool for the evaluation of stenosis, occlusions, or aneurysms. However, an accurate image-processing tool for vessel comparison is unavailable. The purpose of this study was to develop and test an automated technique for vessel cross-sectional analysis. An algorithm for vessel cross-sectional analysis was developed that included 7 main steps: 1) image registration, 2) masking, 3) segmentation, 4) skeletonization, 5) cross-sectional planes, 6) clustering, and 7) cross-sectional analysis. Phantom models were used to validate the technique. The method was also tested on a control subject and a patient with idiopathic intracranial hypertension (4 large sinuses tested: right and left transverse sinuses, superior sagittal sinus, and straight sinus). The cross-sectional area and shape measurements were evaluated before and after lumbar puncture in patients with idiopathic intracranial hypertension. The vessel-analysis algorithm had a high degree of stability with <3% of cross-sections manually corrected. All investigated principal cranial blood sinuses had a significant cross-sectional area increase after lumbar puncture (P ≤ .05). The average triangularity of the transverse sinuses was increased, and the mean circularity of the sinuses was decreased by 6% ± 12% after lumbar puncture. Comparison of phantom and real data showed that all computed errors were <1 voxel unit, which confirmed that the method provided a very accurate solution. In this article, we present a novel automated imaging method for cross-sectional vessels analysis. The method can provide an efficient quantitative detection of abnormalities in the dural sinuses. © 2016 by American Journal of Neuroradiology.

  11. Endovascular treatment of a cavernous sinus dural arteriovenous fistula by transvenous embolisation through the superior ophthalmic vein via cannulation of a frontal vein

    International Nuclear Information System (INIS)

    Venturi, C.; Bracco, S.; Cerase, A.; Gennari, P.; Lore, F.; Polito, E.; Casasco, A.E.

    2003-01-01

    We describe a new approach for transvenous embolisation of cavernous sinus dural arteriovenous fistulae through the superior ophthalmic vein (SOV), i.e., via percutaneous cannulation of a frontal vein. Modern neurointerventional angiographic materials make it possible to reach the SOV in this way without puncturing it in the orbit or a surgical exposure. Orbital phlebography should still be in the repertoire of interventional neuroradiology units in large centres. (orig.)

  12. Spinal endoscopy combined with selective CT myelography for dural closure of the spinal dural defect with superficial siderosis: technical note.

    Science.gov (United States)

    Arishima, Hidetaka; Higashino, Yoshifumi; Yamada, Shinsuke; Akazawa, Ayumi; Arai, Hiroshi; Tsunetoshi, Kenzo; Matsuda, Ken; Kodera, Toshiaki; Kitai, Ryuhei; Awara, Kousuke; Kikuta, Ken-Ichiro

    2018-01-01

    The authors describe a new procedure to detect the tiny dural hole in patients with superficial siderosis (SS) and CSF leakage using a coronary angioscope system for spinal endoscopy and selective CT myelography using a spinal drainage tube. Under fluoroscopy, surgeons inserted the coronary angioscope into the spinal subarachnoid space, similar to the procedure of spinal drainage, and slowly advanced it to the cervical spine. The angioscope clearly showed the small dural hole and injured arachnoid membrane. One week later, the spinal drainage tube was inserted, and the tip of the drainage tube was located just below the level of the dural defect found by the spinal endoscopic examination. This selective CT myelography clarifies the location of the dural defect. During surgery, the small dural hole could be easily located, and it was securely sutured. It is sometimes difficult to detect the actual location of the small dural hole even with thin-slice MRI or dynamic CT myelography in patients with SS. The use of a coronary angioscope for the spinal endoscopy combined with selective CT myelography may provide an effective examination to assess dural closure of the spinal dural defect with SS in cases without obvious dural defects on conventional imaging.

  13. Dural sinus filling defect: intrasigmoid encephalocele

    Science.gov (United States)

    Karatag, Ozan; Cosar, Murat; Kizildag, Betul; Sen, Halil Murat

    2013-01-01

    Filling defects of dural venous sinuses are considered to be a challenging problem especially in case of symptomatic patients. Many lesions have to be ruled out such as sinus thrombosis, arachnoid granulations and tumours. Encephalocele into dural sinus is also a rare cause of these filling defects of dural sinuses. Here, we report an extremely rare case with spontaneous occult invagination of temporal brain tissue into the left sigmoid sinus and accompanying cerebellar ectopia. PMID:24311424

  14. DURAL CAROTID-CAVERNOUS FISTULAS

    Directory of Open Access Journals (Sweden)

    Barbara Cvenkel

    2002-12-01

    Full Text Available Background. Dural carotid-cavernous sinus fistulas (CCF are communications fed by meningeal branches of the intracavernous internal carotid artery (ACI or/and external carotid artery (ACE. In contrast to typical CCF, the arteriovenous shunting of blood is usually low flow and low pressure. Spontaneous dural CCF are more common in postmenopausal women. Aetiology is unknown, but congenital malformation or rupture of thin-walled dural arteries within venous sinuses is believed to be the cause.Case reports. 3 cases lacking the typical clinical signs of CCF who had been treated as chronic conjunctivitis, myositis of the extraocular muscle and orbital pseudotumour are presented. Clinical presentation depends on the direction and magnitude of fistular flow and on the anatomy of the collateral branches. If increased blood flow is directed anteriorly in ophthalmic veins the signs of orbito-ocular congestion are present (»redeyed shunt syndrome«. Drainage primarly in the inferior petrosal sinus may cause painful oculomotor and abducens palsies without signs of ocular congestion (»white-eyed shunt syndrome«. Also different therapeutic approaches as well as possible complications are described.Conclusions. For definite diagnosis angiography is obligatory and is also therapeutic as one third to one half of dural CCF close spontaneously. Because of potential severe eye and systemic complications, surgical intervention is indicated only in cases with uncontrolled secondary glaucoma and hypoxic retinopathy.

  15. Fat in the dural sinus

    International Nuclear Information System (INIS)

    Tokiguchi, S.; Ando, K.; Tsuchiya, T.; Ito, J.

    1986-01-01

    Fat density in the dural sinus on computed tomography (CT) is described in eight cases. Of the eight cases, five had fat deposit in the torcular Herophili, and three in the superior sagittal sinus. This finding was incidentally found by CT and there was no common underlying disease in these cases. It is suggested that this finding represents normal adipose tissue in the dural sinus. (orig.)

  16. CT-guided puncture

    International Nuclear Information System (INIS)

    Noeldge, G.; Richter, G.M.; Grenacher, L.; Brado, M.; Kauffmann, G.W.

    1996-01-01

    Sonographic and CT-guided punctures allow the evaluation of suspected lesions in the head, thorax, abdomen, retroperitoneum and skeletal system. The size of the lesion to be evaluated determines the size and the diameter of the puncture needle. The quantity of the material obtained will be defined by the diameter of the needle, i.e. fine-needle biopsy is more adequate for cytological than for histological evaluation. Strict adherence to the indications and contraindications for puncture and painstaking performance of the procedure go a long why towards minimizing the complications. The advantage of CT-guided puncture, in contrast to an ultrasound-guided procedure, is visualization during the puncture procedure free from overshadowing. This permits punctures of lesions located deep in the thorax or the abdomen which are overshadowed by the lungs, by air in the small or large bowel or by bone structures. Moreover, this technique yields much more information about the tissues and organs surrounding the suspected lesion. This information is much more investigator-related with ultrasoundguided puncture. Therefore, the CT-guided puncture has become mandatory in the evaluation of suspected lesions. Moreover, using the same technique, percutaneous drainage of fluids in the interpleural space, abscesses in organs, hematomas, lymphoceles and urinomas; ablation of metastases; and sympathicolysis can be carried out. CT-guided puncture thus changes from a minimally invasive diagnostic procedure to a minimally invasive therapy. (orig./MG) [de

  17. The zero-wall puncture: a novel angiographic puncture technique with substantial benefits

    International Nuclear Information System (INIS)

    Leswick, D.A.; Szkup, P.; Stoneham, G.W.

    2005-01-01

    Medical education can be busy, exhausting, and stressful, with potential adverse effects on trainees' physical and mental health. Radiology residency is no exception. In addition to increased daily workload and study requirements, Canadian radiology residents are performing a diverse and increasing number of emergent diagnostic examinations after hours. In an attempt to improve resident self-worth and efficiency during angiographic rotations, we investigated the effects of a novel angiographic puncture procedure on various resident lifestyle indexes. Standard techniques for accessing the femoral artery are either the single-wall puncture or double-wall puncture (Seldinger technique). Both of these techniques are widely known and practiced. Following procedure completion, hemostasis must be achieved at the puncture site. This has traditionally required manual compression at the puncture site, which may require 15 to 20 minutes. At our institution the standard policy is that 'whoever makes the puncture, compresses the groin,' also known as 'you broke it, you fix it'. This has prompted our industrious resident complement to develop a novel, previously undescribed, angiographic puncture technique known as the 'zero-wall puncture technique.' Preliminary unpublished results from our institution show that when residents employ the zero-wall puncture technique the attending staff radiologist subsequently both performs the puncture and compresses the groin at the end of the procedure. We investigated the effect of zero-wall puncture on various resident lifestyle indexes. (author)

  18. Chronic subdural haematoma complicating spinal anaesthesia: A ...

    African Journals Online (AJOL)

    Subdural haematoma is a rare but serious complication of dural puncture. We report a case of chronic subdural haematoma, which occurred following spinal anaesthesia for elective caesarean section. A 34-year-old multiparous woman presented with a post-dural puncture headache (PDPH) following spinal anaesthesia.

  19. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

    2006-10-15

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  20. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Rooij, Willem Jan van; Sluzewski, Menno; Beute, Guus N.

    2006-01-01

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  1. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    International Nuclear Information System (INIS)

    Ahn, N.U.; Nallamshetty, L.; Ahn, U.M.; Buchowski, J.M.; Kebaish, K.M.; Sponseller, P.D.; Rose, P.S.; Garrett, E.S.

    2001-01-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P 38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  2. Magnetic resonance findings associated with intracranial hypotension. A report of three cases occurring after lumbar puncture; Hallazgos por RM en el sindrome de hipotension intracraneal. A proposito de tres casos tras puncion lumbar

    Energy Technology Data Exchange (ETDEWEB)

    Galan, J. [Hospital General Yague (Spain); Vuelta, R. V. [Hospital de Txagorritxu. Vitoria (Spain); Oleaga, L.; Grande, D. [Hospital de Basurto. Bilbao (Spain)

    1999-07-01

    The magnetic resonance (MR) findings are presented for three patients who developed intracranial hypotension syndrome following lumbar puncture, one of the most common causes of this complication. All three patients presented the MR findings characteristically associated with this event, consisting of diffuse dural enhancement after administration of a paramagnetic contrast medium, as well as extraaxial collection that played either an accompanying or a causative role. (Author) 7 refs.

  3. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    International Nuclear Information System (INIS)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F.

    2006-01-01

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought

  4. Evaluation of three different measurement methods for dural ectasia in Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Weigang, E.; Ghanem, N.; Chang, X.-C.; Richter, H.; Frydrychowicz, A.; Szabo, G.; Dudeck, O.; Knirsch, W.; Samson, P. von; Langer, M.; Beyersdorf, F

    2006-11-15

    Aim: Dural ectasia is a major diagnostic criterion for Marfan syndrome using the Ghent nosology. Our aim was to evaluate the efficacy of three different radiological methods previously proposed for the assessment of dural sac diameter in Marfan syndrome. Methods: Marfan syndrome was diagnosed in our study using the Ghent criteria, disregarding dural ectasia as a criterion. Three proposed radiological methods were applied to measure dural sac diameter, examined for 41 patients (18 patients with and 23 without Marfan syndrome) by computed tomography or magnetic resonance imaging. Results: Using Oosterhof's method, 94% of the patients with and 44% of the patients without Marfan syndrome fulfilled the criteria of dural ectasia. According to Villeirs, dural ectasia was diagnosed in 18% of the patients with and in none of the patients without Marfan syndrome. With Ahn's method, dural ectasia was found in 72% of the patients with and in 44% of the patients without Marfan syndrome. In only two patients with Marfan syndrome was dural ectasia diagnosed by all three methods. Conclusion: Our results reveal overt discrepancy between the three methods of assessing dural ectasia. Considering the key role played by dural ectasia in reinforcing the diagnosis of Marfan syndrome according to the Ghent nosology, a standardized and reliable method should be sought.

  5. Neck massage induced dural sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Verma Ashish

    2007-01-01

    Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

  6. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, N U [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Johns Hopkins Outpatient Center, Dept. of Orthopaedic Surgery, Baltimore, MD (United States); Nallamshetty, L; Ahn, U M; Buchowski, J M; Kebaish, K M; Sponseller, P D [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); Rose, P S [Dept. of Orthopaedic Surgery, Johns Hopkins Univ. School of Medicine, Baltimore (United States); National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (United States); Garrett, E S [Dept. of Oncology, Division of Biostatistics, Johns Hopkins University School of Medicine, Baltimore (United States)

    2001-06-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P<0.03); scalloping values at the L1 and L5 levels (P<0.05); sagittal diameters of the vertebral canal at L5-S1 (P<0.03); transverse process to width ratios at L2 (P<0.03). Criteria were developed for diagnosis of dural ectasia in Marfan patients. These included presence of one of the following: interpediculate distance at L4 >38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  7. Traumatic dural venous sinus thrombosis: A Mini Review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  8. Symptomatic hemorrhagic complications associated with dural substitutes

    Directory of Open Access Journals (Sweden)

    Po-Yuan Chen

    2018-01-01

    Conclusion: The increased risk of hemorrhagic complications associated with craniotomy is modified by choice of dural replacement. Our results could assist clinicians in their decision-making with respect to the optimal timing for synthetic dural substitutes in patients with tumor infiltration of the patient's dura, severe brain swelling in traumatic brain injury, or a result of shrinkage from exposure and electrocautery.

  9. Dural ectasia and FBN1 mutation screening of 40 patients with Marfan syndrome and related disorders: role of dural ectasia for the diagnosis.

    Science.gov (United States)

    Attanasio, Monica; Pratelli, Elisa; Porciani, Maria Cristina; Evangelisti, Lucia; Torricelli, Elena; Pellicanò, Giannantonio; Abbate, Rosanna; Gensini, Gian Franco; Pepe, Guglielmina

    2013-07-01

    Marfan syndrome is an autosomal dominant disorder of connective tissue caused by mutations in the gene encoding fibrillin-1 (FBN1), a matrix component of microfibrils. Dural ectasia, i.e. enlargement of the neural canal mainly located in the lower lumbar and sacral region, frequently occurs in Marfan patients. The aim of our study was to investigate the role of dural ectasia in raising the diagnosis of Marfan syndrome and its association with FBN1 mutations. We studied 40 unrelated patients suspected for MFS, who underwent magnetic resonance imaging searching for dural ectasia. In all of them FBN1 gene analysis was also performed. Thirty-seven patients resulted affected by Marfan syndrome according to the '96 Ghent criteria; in 30 of them the diagnosis was confirmed when revaluated by the recently revised criteria (2010). Thirty-six patients resulted positive for dural ectasia. The degree of dural ectasia was grade 1 in 19 patients, grade 2 in 11 patients, and grade 3 in 6 patients. In 7 (24%) patients, the presence of dural ectasia allowed to reach a positive score for systemic feature criterion. Twenty-four patients carried an FBN1 mutation, that were represented by 13 missense (54%), and 11 (46%) mutations generating a premature termination codon (PTC, frameshifts and stop codons). No mutation was detected in the remaining 16 (6 patients with MFS and 10 with related disorders according to revised Ghent criteria). The prevalence of severe (grade 2 and grade 3) involvement of dura mater was higher in patients harbouring premature termination codon (PTC) mutations than those carrying missense-mutations (8/11 vs 2/13, P = 0.0111). Our data emphasizes the importance of dural ectasia screening to reach the diagnosis of Marfan syndrome especially when it is uncertain and indicates an association between PTC mutations and severe dural ectasia in Marfan patients. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  10. Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

    OpenAIRE

    Vien, Christine; Marovic, Paul; Ingram, Brendan

    2016-01-01

    Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia.

  11. A New Classification for Pathologies of Spinal Meninges, Part 1: Dural Cysts, Dissections, and Ectasias.

    Science.gov (United States)

    Klekamp, Jörg

    2017-07-01

    The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished. For all types, symptoms consisted of local pain followed by signs of radiculopathy or myelopathy, while one patient with dural ectasia presented a low-pressure syndrome and 10 patients with dural dissections additional spinal cord herniation. Type I and type II pathologies required occlusion of their dural defects via extradural (type I) or intradural (type II) approaches. For type III pathologies of the dural sac no surgery was recommended. Favorable results were obtained in all 14 patients with type I and 13 of 15 patients with type II pathologies undergoing surgery. The majority of dural pathologies involving root sleeves remain asymptomatic, while those of the dural sac commonly lead to pain and neurological symptoms. Type I and type II pathologies were treated with good long-term results occluding their dural defects, while ectasias of the dural sac (type III) were managed conservatively. Copyright © 2017 by the Congress of Neurological Surgeons

  12. Dural opening/removal for combined petrosal approach: technical note.

    Science.gov (United States)

    Terasaka, Shunsuke; Asaoka, Katsuyuki; Kobayashi, Hiroyuki; Sugiyama, Taku; Yamaguchi, Shigeru

    2011-03-01

    Detailed descriptions of stepwise dural opening/removal for combined petrosal approach are presented. Following maximum bone work, the first dural incision was made along the undersurface of the temporal lobe parallel to the superior petrosal sinus. Posterior extension of the dural incision was made in a curved fashion, keeping away from the transverse-sigmoid junction and taking care to preserve the vein of Labbé. A second incision was made perpendicular to the first incision. After sectioning the superior petrosal sinus around the porus trigeminus, the incision was extended toward the posterior fossa dura in the middle fossa region. The tentorium was incised toward the incisura at a point just posterior to the entrance of the trochlear nerve. A third incision was made longitudinally between the superior petrosal sinus and the jugular bulb. A final incision was initiated perpendicular to the third incision in the presigmoid region and extended parallel to the superior petrosal sinus connecting the second incision. The dural complex consisting of the temporal lobe dura, the posterior fossa dura, and the freed tentorium could then be removed. In addition to extensive bone resection, our strategic cranial base dural opening/removal can yield true advantages for the combined petrosal approach.

  13. Epidural Anesthesia Complicated by Subdural Hygromas and a Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Christine Vien

    2016-01-01

    Full Text Available Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause life-threatening subdural hematomas or cerebellar tonsillar herniation. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural hematoma following unintentional dural puncture during initiation of epidural anesthesia.

  14. Accidental Strangulation Due to Entrapment of Saree in Crop Thrasher Machine in an Elderly Women Working at Agricultural Field.

    Science.gov (United States)

    Parchake, Manoj Bhausaheb; Kumre, Vikas; Kachare, Rajesh V

    2016-09-01

    Strangulation is generally considered as homicidal death and in accidental strangulation circumstantial evidence alone can point toward the accidental nature of incidence. In present case, a 71-year-old woman, wearing a saree (garment worn by traditional women in India) working in agricultural field, got entangled in the crop thrasher machine and got strangled. Immediately, she was taken to the nearest hospital, where she survived for 6 to 8 hours and then died. The autopsy reveals cross ribbon-shaped ligature mark on neck and anterior chest along with 1 puncture wound at the right lateral aspect of the neck. A lack of proper precaution and safety measures at agricultural field are other contributing factors. Accidental strangulation by saree is extremely rare, hence, this case is presented for its rarity and pattern of injury.

  15. Puncture panel optimization

    International Nuclear Information System (INIS)

    Glass, R.E.; Longenbaugh, R.S.

    1986-01-01

    Sandia National Laboratories developed the TRansUranic PACkage Transporter (TRUPACT) to transport defense contact-handled transuranic wastes. The package has been designed to meet the normal and hypothetical accident conditions in 10CFR71 which includes the demonstrated ability to survive a 1-meter drop onto a mild steel pin. The puncture protection is provided by puncture resistant panels. In conjunction with the development of TRUPACT, a series of experiments has been conducted to reduce the weight of the puncture resistant panels. The initial scoping tests resulted in a preliminary design incorporating 30 layers of Kevlar. This design has been shown to meet the regulatory puncture test. To reduce the weight of this panel, subscale tests were conducted on panels utilizing Kevlar yarns with varying mass per unit length (denier) as well as different resins. This paper reviews the testing undertaken in the original panel development and discusses the results obtained from the recent subscale and full-scale optimization tests

  16. Extrasinusal dural arteriovenous malformations

    International Nuclear Information System (INIS)

    Piske, R.L.; Lasjaunias, P.

    1988-01-01

    Of 60 cases of dural arteriovenous malformations (DAVM) explored and treated in the Vascular Neuroradiology Unit of the Hospital of Bicetre between 1980 and 1986, 3 presented in an extrasinusal location: intraorbital, middle cerebral fossa and the region of the superior orbital fissure. We have not found any prior description of DAVMs in these regions in the literature. The classic concept that DAVMs rise in direct relationship with the dural sinuses is limited. We believe that these lesions may also developed in relationship with the venous drainage system of the sinuses and the venous drainage of the peripheral nervous system. We note that the superior ophthalmic vein which drains DAVMs of the orbit and the olfactory vein which drains DAVMs of the anterior cranial fossa and other veins that accompany the cranial nerves through the skull base have the characteristics of emissary veins. It may be that DAVMs can develop wherever veins follow a transosseous trajectory. (orig.)

  17. Effectiveness of a new gelatin sealant system for dural closure.

    Science.gov (United States)

    Kawai, Hisashi; Nakagawa, Ichiro; Nishimura, Fumihiko; Motoyama, Yasushi; Park, Young-Su; Nakamura, Mitsutoshi; Nakase, Hiroyuki; Suzuki, Shuko; Ikada, Yoshito

    2014-10-01

    Watertight dural closure is imperative after neurosurgical procedures because inadequately treated leakage of cerebrospinal fluid (CSF) can have serious consequences. In this study, the authors test the use of a new gelatin glue as a dural sealant in in vitro and in vivo canine models of transdural CSF leakage. The in vitro model was sutured semicircles of canine dura mater and artificial dural substitute. The sutures were sealed with gelatin glue (n  =  20), fibrin glue (n  =  20), or a polyethylene glycol (PEG)-based hydrogel sealant (n  =  20). Each sample was set in a device to measure water pressure, and pressure was increased until leakage occurred. Bonding strength was subjectively evaluated. The in vivo model was dogs who underwent dural excision and received either no sealant (control group; n  =  5) or gelatin glue sealant (n  =  5) before dural closure. Twenty-eight days post-surgery, the maximum intracranial pressure was measured at the cisterna magna using Valsalva maneuver and tissue adhesion was evaluated. The water pressure at which leakage occurred in the in vitro model was higher with gelatin glue (76·5 ± 39·8 mmHg) than with fibrin glue (38·3 ± 27·4 mmHg, P control group (13·8 ± 4·0 mmHg, P control group (P  =  0·005). The new gelatin glue provides an effective watertight closure when used as an adjunct to sutured dural repair.

  18. A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

    Science.gov (United States)

    O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

    2017-04-01

    Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

  19. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model

    Energy Technology Data Exchange (ETDEWEB)

    He, Shu-kun [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Guo, Jin-hai [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Department of Orthopedics, The Third People' s Hospital of Chengdu, Chengdu, Sichuan 610031 (China); Wang, Zhu-le [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Zhang, Yi [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Tu, Yun-hu [Department of Neurosurgery, Chengdu Military General Hospital, Chengdu, Sichuan 610083 (China); Wu, Shi-zhou [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China); Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Huang, Fu-guo [Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041 (China); Xie, Hui-qi, E-mail: xiehuiqi@scu.edu.cn [Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041 (China)

    2017-04-01

    Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects. SIS or autologous dural mater was patched on the dural defect. Gross and histological evaluations were carried out to evaluate the efficacy and safety of the therapy. Our findings demonstrated that the SIS, which stimulated connective and epithelial tissue responses for dural regeneration and functional recovery without immunological rejection, could provide prolonged defect repair and prevent complications. The mechanical properties of the SIS could be adjusted by application of multiple layers, and the biocompatibility of the material was appropriate. Thus, our data suggested that this material may represent an alternative option for clinical treatment of dural defects. - Highlights: • SIS stimulates dura regeneration without immunological rejection. • SIS has adjustable mechanical properties and appropriate biocompatibility. • SIS may be an effective alternative option for clinical treatment of dural defects.

  20. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model

    International Nuclear Information System (INIS)

    He, Shu-kun; Guo, Jin-hai; Wang, Zhu-le; Zhang, Yi; Tu, Yun-hu; Wu, Shi-zhou; Huang, Fu-guo; Xie, Hui-qi

    2017-01-01

    Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects. SIS or autologous dural mater was patched on the dural defect. Gross and histological evaluations were carried out to evaluate the efficacy and safety of the therapy. Our findings demonstrated that the SIS, which stimulated connective and epithelial tissue responses for dural regeneration and functional recovery without immunological rejection, could provide prolonged defect repair and prevent complications. The mechanical properties of the SIS could be adjusted by application of multiple layers, and the biocompatibility of the material was appropriate. Thus, our data suggested that this material may represent an alternative option for clinical treatment of dural defects. - Highlights: • SIS stimulates dura regeneration without immunological rejection. • SIS has adjustable mechanical properties and appropriate biocompatibility. • SIS may be an effective alternative option for clinical treatment of dural defects.

  1. Lateral cervical puncture for cervical myelography

    International Nuclear Information System (INIS)

    Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck

    1985-01-01

    Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media

  2. Lateral cervical puncture for cervical myelography

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1985-12-15

    Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media.

  3. ''Dural tail'' adjacent to acoustic neuroma on MRI: a case report

    International Nuclear Information System (INIS)

    Lunardi, P.; Mastronardi, L.; Nardacci, B.; Acqui, M.; Fortuna, A.

    1993-01-01

    A 'dural tail' on Gd-DTPA-enhanced MRI has been often observed adjacent to meningiomas and considered to be useful in distinguishing meningioma of the cerebellopontine angle from acoustic neuroma. However, demonstration of a dural tail adjacent to an acoustic neuroma indicates that this sign is not specific. (orig.)

  4. How I do it: surgical ligation of craniocervical junction dural AV fistulas.

    Science.gov (United States)

    Sorenson, Thomas J; La Pira, Biagia; Hughes, Joshua; Lanzino, Giuseppe

    2017-08-01

    Dural arteriovenous fistulas (DAVFs) of the craniocervical junction are uncommon vascular lesions, which often require surgical treatment even in the endovascular era. Most commonly, the fistula is placed laterally, and surgical ligation is performed through a lateral suboccipital craniotomy. After dural opening, the area is inspected, and the arterialized vein is identified emerging from the dura, often adjacent to the entry point of the vertebral artery, and ligated. A far lateral craniotomy is the authors' preferred surgical approach for accessing and treating dural arteriovenous fistulas of the craniocervical junction that cannot be reached endovascularly.

  5. Prevalence of dural ectasia in Loeys-Dietz syndrome: comparison with Marfan syndrome and normal controls.

    Directory of Open Access Journals (Sweden)

    Atsushi K Kono

    Full Text Available BACKGROUND AND PURPOSE: Dural ectasia is well recognized in Marfan syndrome (MFS as one of the major diagnostic criteria, but the exact prevalence of dural ectasia is still unknown in Loeys-Dietz syndrome (LDS, which is a recently discovered connective tissue disease. In this study, we evaluated the prevalence of dural ectasia in LDS according by using qualitative and quantitative methods and compared our findings with those for with MFS and normal controls. MATERIAL AND METHODS: We retrospectively studied 10 LDS (6 males, 4 females, mean age 36.3 years and 20 MFS cases (12 males, 8 females, mean age 37.1 years and 20 controls (12 males, 8 females, mean age 36.1 years both qualitatively and quantitatively using axial CT images and sagittal multi-planar reconstruction images of the lumbosacral region. For quantitative examination, we adopted two methods: method-1 (anteroposterior dural diameter of S1> L4 and method-2 (ratio of anteroposterior dural diameter/vertebral body diameter>cutoff values. The prevalence of dural ectasia among groups was compared by using Fisher's exact test and the Tukey-Kramer test. RESULTS: In LDS patients, the qualitative method showed 40% of dural ectasia, the quantitative method-1 50%, and the method-2 70%. In MFS patients, the corresponding prevalences were 50%, 75%, and 85%, and in controls, 0%, 0%, and 5%. Both LDS and MFS had a significantly wider dura than controls. CONCLUSIONS: While the prevalence of dural ectasia varied depending on differences in qualitative and quantitative methods, LDS as well as MFS, showed, regardless of method, a higher prevalence of dural ectasia than controls. This finding should help the differentiation of LDS from controls.

  6. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    International Nuclear Information System (INIS)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik

    2008-01-01

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses

  7. Comparison of the efficiency, side effects and complications of the synthetic dural grafts: Beriplast and Tissudura

    OpenAIRE

    HAMZAOĞLU, Vural; ÖZALP, Hakan; KARKUCAK, Ahmet; ÇOKLUK, Cengiz

    2015-01-01

    The purpose of this study was to compare human fibrinogen-thrombin-based liquid dural graft; Beriplast® (Behring, Malburg, Germany) and collagen-based dural graft; Tissudura® (Baxter, Heidelberg, Germany) in terms of efficiency, side effects and complications. Thirty Spraque Dawley rats were used in this experimental study. A burrhole was opened on the left parietal bone of each subject and experimental dural defect was created. While 10 subjects were in sham group without any dural defect re...

  8. Bacterial Cellulose Membranes Used as Artificial Substitutes for Dural Defection in Rabbits

    Directory of Open Access Journals (Sweden)

    Chen Xu

    2014-06-01

    Full Text Available To improve the efficacy and safety of dural repair in neurosurgical procedures, a new dural material derived from bacterial cellulose (BC was evaluated in a rabbit model with dural defects. We prepared artificial dura mater using bacterial cellulose which was incubated and fermented from Acetobacter xylinum. The dural defects of the rabbit model were repaired with BC membranes. All surgeries were performed under sodium pentobarbital anesthesia, and all efforts were made to minimize suffering. All animals were humanely euthanized by intravenous injection of phenobarbitone, at each time point, after the operation. Then, the histocompatibility and inflammatory effects of BC were examined by histological examination, real-time fluorescent quantitative polymerase chain reaction (PCR and Western Blot. BC membranes evenly covered the surface of brain without adhesion. There were seldom inflammatory cells surrounding the membrane during the early postoperative period. The expression of inflammatory cytokines IL-1β, IL-6 and TNF-α as well as iNOS and COX-2 were lower in the BC group compared to the control group at 7, 14 and 21 days after implantation. BC can repair dural defects in rabbit and has a decreased inflammatory response compared to traditional materials. However, the long-term effects need to be validated in larger animals.

  9. [Dural arteriovenous fistula involving the superior sagittal and transverse-sigmoid sinuses, treated by thrombolysis: case report].

    Science.gov (United States)

    Arai, T; Ohno, K; Yoshino, Y; Tanaka, Y; Nariai, T; Hirakawa, K; Nemoto, S

    1997-07-01

    A rare case of dural arteriovenous fistula (DAVF) in the superior sagittal sinus (SSS), the transverse sinus and the sigmoid sinus is reported. A 64-year-old man, who had had an episode of temporary visual disturbance after moderate fever for a week about 20 years before, was aware of loss of visual acuity and reduced field of view in the right eye. When he was introduced to our outpatient service, increased intracranial pressure (ICP) was detected by lumbar puncture. Cerebral angiograms showed bilateral DAVFs both in the posterior fossa and the SSS concomitant with thrombosis in the transverse sinus, sigmoid sinus and SSS. Afterwards, endovascular transarterial embolization through bilateral occipital, posterior auricular and left middle meningeal, superior temporal arteries was carried out. In addition, transvenous thrombolytic therapy using a catheter inserted into SSS resulted in the improvement of his visual problems. Although he was discharged at once, he was readmitted to our department with Foster Kennedy syndrome and increased ICP. Cerebral angiograms showed recurrence of both DAVF and sinus thrombosis. Transarterial embolization was performed again resulting in a significant reduction of DAVF, and his visual acuity was recovered to a moderate degree. The origin of DAVF is still controversial. Although two theories, "congenital" and "acquired", are put forward, it has been thought that both factors play important roles. In our case, the patient had stenosis in the jugular canal portions of the sigmoid sinus. In addition, sinus thrombosis seemed to have occurred. It is thought that increased intrasinus pressure may have lead to communication with surrounding arteries through existing dural vessels. We applied transvenous thrombolytic therapy in this case. Our result suggests that we should consider this therapy for some cases of DAVF.

  10. Evaluation of venous congestion in dural arteriovenous fistulae using the acetazolamide test

    International Nuclear Information System (INIS)

    Deguchi, Jun; Yamada, Makoto; Kobata, Hitoshi; Kuroiwa, Toshihiko

    2002-01-01

    The pattern of venous drainage determines the clinical presentation of dural arteriovenous fistulas (AVFs). We assessed the degree of venous congestion in dural AVFs using acetazolamide test and stable Xenon-CT. In 11 patients (8 sigmoid-transverse dural AVFs, 3 cavernous dural AVFs) before treatment and in 8 patients 6 months after treatment, cerebral hemodynamics were studied by stable Xenon-CT. Regions of interest (ROI) were placed in the temporo-occipital region in cases of sigmoid-transverse AVFs, and in the frontal operculum in cases of cavernous AVFs. Patients were classified into 5 groups according to Cognard's classification. In the groups without venous reflux (Cognard type I) and reflux only to the venous sinus (type IIa), regional cerebral blood flow (rCBF) at rest and after acetazolamide challenge were normal. In the group showing reflux to the cortical vein (type IIb), the increase in rCBF after acetazolamide challenge on the lesion side was less than that on the opposite side. In the group showing reflux to both cortical vein and sinus (type IIa+b), rCBF did not increase after acetazolamide challenge. The CBF and increase in rCBF after acetazolamide in the symptomatic group were significantly lower than those in the asymptomatic group. After embolization, the increase in rCBF by acetazolamide improved in all except for type III cases. Cerebral venous hypertension in dural AVFs causes weak response to acetazolamide challenge. The degree of venous hypertension can be evaluated quantitatively by acetazolamide challenge and stable Xenon-CT. Therefore acetazolamide challenge is useful for determination of the embolization of dural AVFs. (author)

  11. Retrograde vs. Antegrade Puncture for Infra-Inguinal Angioplasty

    International Nuclear Information System (INIS)

    Nice, C.; Timmons, G.; Bartholemew, P.; Uberoi, R.

    2003-01-01

    This study was done to compare antegrade punctures with a retrograde puncture technique for infrainguinal angioplasty. A group of 100 consecutive patients (71 men, 29 women) were randomized for antegrade puncture or retrograde puncture of the common femoral artery. Following retrograde puncture the guidewire was 'turned' and placed into the superficial femoral artery. The time for gaining access, screening time, radiation dose, patient height, weight and complications were recorded. All patients were reviewed the day after the procedure and within 3 months. Data from 46 patients (34 males and 12 females) in the retrograde group and 44 (28 males and 16 females) in the antegrade group were available for analysis. Mean procedure time,screening time, radiation dose, height and weight were 8.3 minutes(range 3-22), 2.1 minutes (0.3-6.5), 7950 mGy cm -2 (820-71250), 169 cm (149-204) and 79 kg (32-108) for retrograde puncture and 8 min (2-60), 0.7 min (0.0-3.2), 1069 mGycm -2 (0-15400), 169 cm (152-186) and 75 kg (39-125) for antegrade punctures, respectively. An average of 1.2 (1-2) punctures was required for retrograde and 1.75 (1-8) for antegrade. Seven small hematomas occurred with antegrade and three for retrograde puncture.Retrograde puncture is technically easier with a tendency to fewer complications but results in a higher radiation dose. This technique should be used in difficult patients at high risk of haematoma formation

  12. The use of lumbar X-rays to facilitate neuraxial anaesthesia during ...

    African Journals Online (AJOL)

    2012-05-10

    May 10, 2012 ... anaesthesia in patients who had undergone previous lumbar spinal surgery. Method ... the ease and safety of the neuraxial anaesthesia procedure. The study group ... There were three dural taps without any post-dural puncture headaches .... methods or aids used during the performance of neuraxial.

  13. A dural metastatic small cell carcinoma of the gallbladder as the first manifestation: a case report.

    Science.gov (United States)

    Tonomura, Shuichi; Kitaichi, Tomoko; Onishi, Rina; Kakehi, Yoshiaki; Shimizu, Hisao; Shimada, Keiji; Kanemasa, Kazuyuki; Fukusumi, Akio; Takahashi, Nobuyuki

    2018-03-16

    A dural metastasis is one of the essential differential diagnoses of meningioma. In general, carcinomas of the breast and lung in females and prostate in males have been the most commonly reported primary lesions of dural metastases. However, dural metastasis of gallbladder carcinoma is extremely rare. Here, we report a unique case of a dural matter metastasis of gallbladder carcinoma as the first manifestation, which was autopsy-defined as small cell carcinoma. A 78-year-old man came to our hospital complaining of left hemianopia. Brain computed tomography (CT) revealed a sizeable parasagittal dural-based extra-axial tumor. However, the findings for meningioma were atypical by magnetic resonance imaging, suggesting a meningioma mimic. A contrast-enhanced CT scan of the abdomen revealed a large gallbladder carcinoma. The patient opted for the best supportive care and died 2 months later. The post-mortem examination revealed small cell carcinoma in gallbladder carcinoma. Moreover, an immunologically similar carcinoma was detected in the dural metastasis. To the best of our knowledge, this is the first case of a dural metastasis of gallbladder small cell carcinoma. A systemic examination is essential for clinicians when atypical findings of meningioma are observed, suggesting a meningioma mimic. We present this rare case with a review of the literature.

  14. Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb.

    Science.gov (United States)

    Tirakotai, W; Benes, L; Kappus, C; Sure, U; Farhoud, A; Bien, S; Bertalanffy, H

    2007-01-01

    Dural arteriovenous fistulas located in the vicinity of the jugular foramen are complex vascular malformations and belong to the most challenging skull base lesions to treat. The authors comprehensively analyze multiple features in a series of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb. Four patients who underwent surgery via the transcondylar approach to treat dural arteriovenous fistulas around the jugular foramen were retrospectively reviewed. Previously, endovascular treatment was attempted in all patients. The success of the surgical treatment was examined with postoperative angiography. Complete obliteration of the dural arteriovenous fistulas (DAVFs) was achieved in three patients, and significant flow reduction in one individual. All patients had a good postoperative outcome, and only one experienced mild hypoglossal nerve palsy. Despite extensive bone drilling, an occipitocervical fusion was necessary in only one patient with bilateral lesions. The use of an individually tailored transcondylar approach to treat dural arteriovenous fistulas at the region of the jugular foramen is most effective. This approach allows for complete obliteration of the connecting arterial feeders, and removal of bony structures containing pathological vessels.

  15. Phase-contrast MR angiography of intracranial dural arteriovenous fistulae

    International Nuclear Information System (INIS)

    Cellerini, M.; Mascalchi, M.; Mangiafico, S.; Ferrito, G.P.; Scardigli, V.; Pellicano, G.; Quilici, N.

    1999-01-01

    MRI and phase-contrast MR angiography (PC MRA) were obtained in 13 patients with angiographically confirmed intracranial dural arteriovenous fistulae (DAVF). Three- and two-dimensional PC MRA was obtained with low (6-20 cm/s) and high (>40 cm/s) velocity encoding along the three main body axes. MRI showed focal or diffuse signal abnormalities in the brain parenchyma in six patients, dilated cortical veins in seven, venous pouches in four with type IV DAVF and enlargement of the superior ophthalmic vein in three patients with DAVF of the cavernous sinus. However, it showed none of the fistula sites and did not allow reliable identification of feeding arteries. 3D PC MRA enabled identification of the fistula and enlarged feeding arteries in six cases each. Stenosis or occlusion of the dural sinuses was detected in six of eight cases on 3D PC MRA with low velocity encoding. In six patients with type II DAVF phase reconstruction of 2D PC MRA demonstrated flow reversal in the dural sinuses or superior ophthalmic vein. (orig.)

  16. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    International Nuclear Information System (INIS)

    Kuśmierska, Małgorzata; Gać, Paweł; Nahorecki, Artur; Szuba, Andrzej; JaŸwiec, Przemysław

    2013-01-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus

  17. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    Energy Technology Data Exchange (ETDEWEB)

    Kuśmierska, Małgorzata; Gać, Paweł [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland); Nahorecki, Artur [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Szuba, Andrzej [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Medical University, Wrocław (Poland); JaŸwiec, Przemysław [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland)

    2013-07-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus.

  18. Meningeal norepinephrine produces headache behaviors in rats via actions both on dural afferents and fibroblasts.

    Science.gov (United States)

    Wei, Xiaomei; Yan, Jin; Tillu, Dipti; Asiedu, Marina; Weinstein, Nicole; Melemedjian, Ohannes; Price, Theodore; Dussor, Gregory

    2015-10-01

    Stress is commonly reported to contribute to migraine although mechanisms by which this may occur are not fully known. The purpose of these studies was to examine whether norepinephrine (NE), the primary sympathetic efferent transmitter, acts on processes in the meninges that may contribute to the pain of migraine. NE was applied to rat dura using a behavioral model of headache. Primary cultures of rat trigeminal ganglia retrogradely labeled from the dura mater and of rat dural fibroblasts were prepared. Patch-clamp electrophysiology, Western blot, and ELISA were performed to examine the effects of NE. Conditioned media from NE-treated fibroblast cultures was applied to the dura using the behavioral headache model. Dural injection both of NE and media from NE-stimulated fibroblasts caused cutaneous facial and hindpaw allodynia in awake rats. NE application to cultured dural afferents increased action potential firing in response to current injections. Application of NE to dural fibroblasts increased phosphorylation of ERK and caused the release of interleukin-6 (IL-6). These data demonstrate that NE can contribute to pro-nociceptive signaling from the meninges via actions on dural afferents and dural fibroblasts. Together, these actions of NE may contribute to the headache phase of migraine. © International Headache Society 2015.

  19. Detector location selection based on VIP analysis in near-infrared detection of dural hematoma

    Directory of Open Access Journals (Sweden)

    Qiuming Sun

    2018-03-01

    Full Text Available Detection of dural hematoma based on multi-channel near-infrared differential absorbance has the advantages of rapid and non-invasive detection. The location and number of detectors around the light source are critical for reducing the pathological characteristics of the prediction model on dural hematoma degree. Therefore, rational selection of detector numbers and their distances from the light source is very important. In this paper, a detector position screening method based on Variable Importance in the Projection (VIP analysis is proposed. A preliminary modeling based on Partial Least Squares method (PLS for the prediction of dural position μa was established using light absorbance information from 30 detectors located 2.0–5.0 cm from the light source with a 0.1 cm interval. The mean relative error (MRE of the dural position μa prediction model was 4.08%. After VIP analysis, the number of detectors was reduced from 30 to 4 and the MRE of the dural position μa prediction was reduced from 4.08% to 2.06% after the reduction in detector numbers. The prediction model after VIP detector screening still showed good prediction of the epidural position μa. This study provided a new approach and important reference on the selection of detector location in near-infrared dural hematoma detection. Keywords: Detector location screening, Epidural hematoma detection, Variable importance in the projection

  20. Unilateral transpedicular percutaneous vertebroplasty using puncture simulation

    International Nuclear Information System (INIS)

    Kobayashi, Ken; Takizawa, Kenji; Koyama, Masamichi; Yoshimatsu, Misako; Sakaino, Shinjiro; Nakajima, Yasuo

    2006-01-01

    The aim of this study was to improve the accuracy of puncture to the median vertebral body using the unilateral transpedicular approach on percutaneous vertebroplasty (PVP). We have developed and evaluated a simple puncture simulation method based on the puncture angle determined by preoperative computed tomography (CT). Two groups were evaluated. The first (group A) comprised 23 patients (34 vertebral bodies) who had undergone PYP without preoperative puncture simulation before May 2004, and the second group (group B) comprised 24 patients (39 vertebral bodies) who had undergone preoperative puncture simulation and PVP after May 2004. CT in the prone position was performed, and the puncture angle on CT (PAC) via the vertebral arch pedicle targeting the anterior one-third median site of the vertebral body was determined. Puncture was performed by targeting the isocenter established on a fluoroscopic monitor based on the PAC. Determinations were made of the success rate (SR) of the median puncture of the vertebral body, the effect of treatment using the visual analogue score, and the overall procedural time between groups A and B. The SR was 56% (19/34 vertebral bodies) in group A, and 97% (37/38 vertebral bodies), including only one vertebral body in which it was difficult to perform the unilateral approach on CT images, in group B, with the difference being significant by Student's t-test (P<0.001). Among patients with available follow-up data, the unipedicular and bipedicular approaches achieved adequate pain relief with mean decreases in pain severity of 5.1±2.6 and 5.9±2.8 respectively. No significant differences in the treatment effect between the two groups was observed (P=0.811). The overall procedure time per puncture was shorten for the simulation group (36.0 min) than for group A (73.1 min), as shown by regression analysis. The preoperative PAC determination for PVP under fluoroscopy increased the completion rate of PVP by the unilateral transpedicular

  1. Dural AVM supplied by the ophthalmic artery.

    LENUS (Irish Health Repository)

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  2. Preclinical characterization and safety of a novel hydrogel for augmenting dural repair

    International Nuclear Information System (INIS)

    Strong, Michael J; Carnahan, Michael A; D’Alessio, Keith; Butlin, Jared D G; Butt, Mark T; Asher, Anthony L

    2015-01-01

    Cerebrospinal fluid (CSF) leakage is a potentially serious complication in surgical procedures involving opening of the dura mater. Although several materials have been developed to help achieve watertight dural closures, CSF leakages persist. The goal of this study was to evaluate the performance of a novel hydrogel designed to provide augmentation to standard methods of dural repair. Performance measures such as polymerization time, dimensional swelling, burst strength, and elasticity were examined in laboratory situations. Additionally, biocompatibility in an in vivo rat model was examined. The results demonstrate that this novel hydrogel has superior mechanical strength and tissue adherence with enhanced flexibility, reduced swelling, and quicker set time compared with existing hydrogel dural sealants approved for intra-cranial use. Furthermore, biocompatibility studies demonstrate that this compound is both non-toxic and non-immunogenic. (paper)

  3. Spontaneous acute subdural hematoma: A rare presentation of a dural intracranial fistula.

    Science.gov (United States)

    de Aguiar, Guilherme Brasileiro; Veiga, José Carlos Esteves; Silva, João Miguel de Almeida; Conti, Mario Luiz Marques

    2016-03-01

    Dural arteriovenous fistulas are acquired lesions between the meningeal arteries and their associated draining veins. They may have highly variable clinical presentations and evolution, from severe neurological deficit to no or trivial symptoms. Intracranial hemorrhage occurs in less than 24% of all dural fistulas, and the bleeding is usually subarachnoid, more infrequently intracerebral, and rarely in the subdural space. Here, we present a rare case of a patient who presented with a subdural spontaneous hemorrhage. After investigation by cerebral angiography, the diagnosis of a dural arteriovenous fistula was made. The patient underwent uneventful endovascular treatment. As there are with only a few reports in the literature of such a presentation, we present this patient and perform a brief review of the literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  5. Anterior dural ectasia mimicking a lytic lesion in the posterior vertebral body in ankylosing spondylitis.

    Science.gov (United States)

    Bele, Keerthiraj; Pendharkar, Hima Shriniwas; Venkat, Easwer; Gupta, Arun Kumar

    2011-12-01

    Anterior dural ectasia is an extremely rare finding in ankylosing spondylitis (AS). The authors describe a unique case of AS in which the patient presented with cauda equina syndrome as well as an unusual imaging finding of erosion of the posterior aspect of the L-1 (predominantly) and L-2 vertebral bodies due to anterior dural ectasia. Symptomatic patients with long-standing AS should be monitored for the presence of dural ectasia, which can be anterior in location, as is demonstrated in the present case.

  6. Refractory seizures due to a dural-based cavernoma masquerading as a meningioma.

    Science.gov (United States)

    Zeng, Xianwei; Mahta, Ali; Kim, Ryan Y; Saad, Ali G; Kesari, Santosh

    2012-04-01

    A 37-year-old female presented with medically intractable complex partial seizures with secondary generalization. She was found to have a dural-based lesion with radiologic features of meningioma. A gross total resection was performed and pathology confirmed a diagnosis of cavernous angioma and she became seizure free after the surgical resection. Cavernous angioma should be considered in differential diagnosis of a dural-based lesion manifesting with refractory seizures.

  7. Evaluation of the effect of hemoglobin or hematocrit level on dural sinus density using unenhanced computed tomography.

    Science.gov (United States)

    Lee, Seung Young; Cha, Sang-Hoon; Lee, Sung-Hyun; Shin, Dong-Ick

    2013-01-01

    To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis.

  8. A Rare Case of Composite Dural Extranodal Marginal Zone Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

    Directory of Open Access Journals (Sweden)

    Mark Bustoros

    2018-04-01

    Full Text Available BackgroundPrimary extranodal marginal zone lymphoma (MZL of the dura is a rare neoplastic entity in the central nervous system (CNS.MethodsWe used literature searches to identify previously reported cases of primary dural MZL. We also reviewed clinical, pathologic, and radiographic data of an adult patient with concurrent dural MZL and chronic lymphocytic leukemia (CLL/small lymphocytic lymphoma (SLL.ResultsWe identified 104 cases of dural MZL in the literature. None of them presented concurrently with another type of non-Hodgkin lymphoma. This is the first report of composite lymphoma consisting of dural MZL and CLL/SLL in the bone marrow and lymph nodes.ConclusionPrimary dural MZL is a rare, indolent low-grade CNS lymphoma, with a relatively good prognosis. Its treatment is multidisciplinary and often requires surgical intervention due to brain compression, along with low to moderate doses of radiotherapy and/or systemic chemotherapy.

  9. Spontaneous Resolution of a Fetal Dural Sinus Thrombosis: One Case Report and Review of the Literatures

    Directory of Open Access Journals (Sweden)

    Chen Wang

    2012-01-01

    Full Text Available Fetal dural sinus thrombosis is a rare finding. Most cases have been terminated without long-term follow-ups. Recently some reports have indicated the potentially favorable evolution of fetal dural sinus thrombosis. Most of the fetuses showing symptoms have been delivered with normal neurologic outcome. We report a case of fetal dural sinus thrombosis. Serial ultrasound and magnetic resonance images (MRI showed the shrinkage of the thrombosis which indicated good prognosis. No physical or neurological abnormality was observed at 8-months follow-up. Conservative treatment is appropriate to prenatally diagnosed dural sinus thrombosis with favorable prognostic factors. Serial MRI or ultrasound should be taken every 1-2 months to monitor the thrombosis development and fetal well-beings.

  10. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules.

    Science.gov (United States)

    Aspelund, Aleksanteri; Antila, Salli; Proulx, Steven T; Karlsen, Tine Veronica; Karaman, Sinem; Detmar, Michael; Wiig, Helge; Alitalo, Kari

    2015-06-29

    The central nervous system (CNS) is considered an organ devoid of lymphatic vasculature. Yet, part of the cerebrospinal fluid (CSF) drains into the cervical lymph nodes (LNs). The mechanism of CSF entry into the LNs has been unclear. Here we report the surprising finding of a lymphatic vessel network in the dura mater of the mouse brain. We show that dural lymphatic vessels absorb CSF from the adjacent subarachnoid space and brain interstitial fluid (ISF) via the glymphatic system. Dural lymphatic vessels transport fluid into deep cervical LNs (dcLNs) via foramina at the base of the skull. In a transgenic mouse model expressing a VEGF-C/D trap and displaying complete aplasia of the dural lymphatic vessels, macromolecule clearance from the brain was attenuated and transport from the subarachnoid space into dcLNs was abrogated. Surprisingly, brain ISF pressure and water content were unaffected. Overall, these findings indicate that the mechanism of CSF flow into the dcLNs is directly via an adjacent dural lymphatic network, which may be important for the clearance of macromolecules from the brain. Importantly, these results call for a reexamination of the role of the lymphatic system in CNS physiology and disease. © 2015 Aspelund et al.

  11. Normal measurement of spinal cord and dural sac by CT myelography

    International Nuclear Information System (INIS)

    Yun, Ku Sub; Choi, Yo Won; Han, Moon Hee; Chang, Kee Hyun

    1988-01-01

    The data on the normal measurement of spinal cord are essential for an objective assessment of equivocal change of spinal cord size in the various clinical settings. The present study was therefore undertaken to evaluate normal range of spinal cord dimensions in Koreas. CT myelography of the cervical and thoracic region was performed in 60 patients who had symptoms referable to lumbosacral region and then computed tomographic measurement of spinal cord and dural sac was performed. The results are as follows: 1. The anteroposterior diameter of spinal cord was maximum at C1 level (8.6±1.4mm) and minimum at T6 level (6.4±1.7mm). 2. The transverse diameter of spinal cord was maximum at C4 and C5 levels (13.3±1.6mm) and minimum at T8 (8.1±1.9mm) and T10 (8.1±1.3mm) levels. 3. The area of spinal cord was maximum at C5 level (76±16mm 2 ) and minimum at T6 (40±24mm 2 ) and T8 (40±23mm 2 ) levels. 4. The ratio of anteroposterior diameter/transverse diameter of spinal cord was smallest at C4 (0.57±0.11) and C5 (0.57±0.09) levels and largest at T12 (0.9±0.17) level. 5. The ratio of anteroposterior diameter of spinal cord/dural sac was maximum at C4 level (0.73±0.14) and minimum at T12 level (0.52±0.15). The ratio of transverse diameter of spinal cord/dural sac was maximum at C3 (0.66±0.10) and C4 (0.66±0.14) levels and minimum at T12 level (0.46±0.18). The ratio of area of spinal cord/dural sac was maximum at C3 level (0.48±0.13) and minimum at T12 level (0.29±0.20). 6. The location of cervical cord in dural sac was mainly ventral (56%) at C1 level, middle (40-73%) from C2 to C6 level and dorsal (44%) at C7 level. The location of thoracic cord in dural sac was chiefly middle (61%) at T2 level and lower thoracic level (T10: 60% and T12: 51%) and mainly ventral (59-84%) at other levels.

  12. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  13. Comparison of Porcine and Bovine Collagen Dural Substitutes in Posterior Fossa Decompression for Chiari I Malformation in Adults.

    Science.gov (United States)

    Lee, Christine K; Mokhtari, Tara; Connolly, Ian D; Li, Gordon; Shuer, Lawrence M; Chang, Steven D; Steinberg, Gary K; Hayden Gephart, Melanie

    2017-12-01

    Posterior fossa decompression surgeries for Chiari malformations are susceptible to postoperative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been used to improve surgical outcomes. This study examined whether the collagen matrix dural substitute type correlated with the incidence of postoperative complications after posterior fossa decompression in adult patients with Chiari I malformations. A retrospective cohort study was conducted of 81 adult patients who underwent an elective decompressive surgery for treatment of symptomatic Chiari I malformations, with duraplasty involving a dural substitute derived from either bovine or porcine collagen matrix. Demographics and treatment characteristics were correlated with surgical outcomes. A total of 81 patients were included in the study. Compared with bovine dural substitute, porcine dural substitute was associated with a significantly higher risk of pseudomeningocele occurrence (odds ratio, 5.78; 95% confidence interval, 1.65-27.15; P = 0.01) and a higher overall complication rate (odds ratio, 3.70; 95% confidence interval, 1.23-12.71; P = 0.03) by univariate analysis. There was no significant difference in the rate of meningitis, repeat operations, or overall complication rate between the 2 dural substitutes. In addition, estimated blood loss was a significant risk factor for meningitis (P = 0.03). Multivariate analyses again showed that porcine dural substitute was associated with pseudomeningocele occurrence, although the association with higher overall complication rate did not reach significance. Dural substitutes generated from porcine collagen, compared with those from bovine collagen, were associated with a higher likelihood of pseudomeningocele development in adult patients undergoing Chiari I malformation decompression and duraplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Prognosis of cerebral vein and dural sinus thrombosis - Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)

    NARCIS (Netherlands)

    Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando

    2004-01-01

    Background and Purpose - The natural history and long-term prognosis of cerebral vein and dural sinus thrombosis (CVT) have not been examined previously by adequately powered prospective studies. Methods - We performed a multinational ( 21 countries), multicenter ( 89 centers), prospective

  15. Using a Motion Sensor-Equipped Smartphone to Facilitate CT-Guided Puncture

    International Nuclear Information System (INIS)

    Hirata, Masaaki; Watanabe, Ryouhei; Koyano, Yasuhiro; Sugata, Shigenori; Takeda, Yukie; Nakamura, Seiji; Akamune, Akihisa; Tsuda, Takaharu; Mochizuki, Teruhito

    2017-01-01

    PurposeTo demonstrate the use of “Smart Puncture,” a smartphone application to assist conventional CT-guided puncture without CT fluoroscopy, and to describe the advantages of this application.Materials and MethodsA puncture guideline is displayed by entering the angle into the application. Regardless of the angle at which the device is being held, the motion sensor ensures that the guideline is displayed at the appropriate angle with respect to gravity. The angle of the smartphone’s liquid crystal display (LCD) is also detected, preventing needle deflection from the CT slice image. Physicians can perform the puncture procedure by advancing the needle using the guideline while the smartphone is placed adjacent to the patient. In an experimental puncture test using a sponge as a target, the target was punctured at 30°, 50°, and 70° when the device was tilted to 0°, 15°, 30°, and 45°, respectively. The punctured target was then imaged with a CT scan, and the puncture error was measured.ResultsThe mean puncture error in the plane parallel to the LCD was less than 2°, irrespective of device tilt. The mean puncture error in the sagittal plane was less than 3° with no device tilt. However, the mean puncture error tended to increase when the tilt was increased.ConclusionThis application can transform a smartphone into a valuable tool that is capable of objectively and accurately assisting CT-guided puncture procedures.

  16. Using a Motion Sensor-Equipped Smartphone to Facilitate CT-Guided Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Masaaki, E-mail: masaaki314@gmail.com [Matsuyama Shimin Hospital, Department of Radiology (Japan); Watanabe, Ryouhei; Koyano, Yasuhiro [Matsuyama Shimin Hospital, Department of Surgery (Japan); Sugata, Shigenori; Takeda, Yukie [Ehime Prefectural Imabari Hospital, Department of Radiology (Japan); Nakamura, Seiji; Akamune, Akihisa [Matsuyama Shimin Hospital, Department of Radiology (Japan); Tsuda, Takaharu; Mochizuki, Teruhito [Ehime University Graduate School of Medicine, Department of Radiology (Japan)

    2017-04-15

    PurposeTo demonstrate the use of “Smart Puncture,” a smartphone application to assist conventional CT-guided puncture without CT fluoroscopy, and to describe the advantages of this application.Materials and MethodsA puncture guideline is displayed by entering the angle into the application. Regardless of the angle at which the device is being held, the motion sensor ensures that the guideline is displayed at the appropriate angle with respect to gravity. The angle of the smartphone’s liquid crystal display (LCD) is also detected, preventing needle deflection from the CT slice image. Physicians can perform the puncture procedure by advancing the needle using the guideline while the smartphone is placed adjacent to the patient. In an experimental puncture test using a sponge as a target, the target was punctured at 30°, 50°, and 70° when the device was tilted to 0°, 15°, 30°, and 45°, respectively. The punctured target was then imaged with a CT scan, and the puncture error was measured.ResultsThe mean puncture error in the plane parallel to the LCD was less than 2°, irrespective of device tilt. The mean puncture error in the sagittal plane was less than 3° with no device tilt. However, the mean puncture error tended to increase when the tilt was increased.ConclusionThis application can transform a smartphone into a valuable tool that is capable of objectively and accurately assisting CT-guided puncture procedures.

  17. Optimizing Residents' Performance of Lumbar Puncture

    DEFF Research Database (Denmark)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle

    2018-01-01

    Background: Lumbar puncture is often associated with uncertainty and limited experience on the part of residents; therefore, preparatory interventions can be essential. There is growing interest in the potential benefit of videos over written text. However, little attention has been given...... to whether the design of the videos impacts on subsequent performance. Objective: To investigate the effect of different preparatory interventions on learner performance and self-confidence regarding lumbar puncture (LP). Design: Randomized controlled trial in which participants were randomly assigned to one...... of three interventions as preparation for performing lumbar puncture: 1) goal- and learner-centered video (GLV) presenting procedure-specific process goals and learner-centered information; 2) traditional video (TV) providing expert-driven content, but no process goals; and 3) written text (WT...

  18. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-02-15

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses.

  19. Dural diverticulum with a symptomatic cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Nicholas Armstrong, MD

    2016-03-01

    Full Text Available A case report of a 63-year-old female patient with a cervical spinal dural diverticulum and intracranial hypotension secondary to a symptomatic CSF leak after minor trauma. The patient responded well after the cervical approach epidural blood patch procedure.

  20. The Termination Level of the Dural Sac Relevant to Caudal Epidural Block in Lumbosacral Transitional Vertebrae: A Comparison between Sacralization and Lumbarization Groups.

    Science.gov (United States)

    Jeon, Ji Young; Jeong, Yu Mi; Lee, Sheen-Woo; Kim, Jeong Ho; Choi, Hye-Young; Ahn, Yong

    2018-01-01

    practical challenge of accurate enumeration of the transitional segment and the constraints on generalizability posed by the single-country study. When planning CEB for patients with LSTV, pre-procedural MRI to check the anatomical structures, including the level of DS termination and caudal margin of perineural cysts, would be of great use for lowering the risk of unexpected dural puncture during the procedure, especially in the lumbarization cases. Termination of the dural sac, dural sac termination, lumbosacral transitional vertebrae, transitional vertebra, caudal epidural block.

  1. Role of penumbra mechanical thrombectomy device in acute dural sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Suraj Mammen

    2017-01-01

    Full Text Available Background: In dural venous sinus thrombosis (DVST, the mortality ranges 5–30%. Deep venous system involvement and septic dural sinus thrombosis have a higher mortality rate. In acute occlusion, collateral flow may not be established, which may result in significant edema and mass effect. Endovascular interventions may be considered as a treatment option in appropriate high-risk patients with DVST. Materials and Methods: Eight patients with magnetic resonance imaging (MRI-confirmed dural sinus thrombosis, who did not respond to the conventional standard medical treatment, were subsequently treated with mechanical thrombectomy using the Penumbra System®. In all cases, medical treatment including anticoagulants were continued following the procedure for a minimum period of 1 year. Results: Recanalization of the dural sinus thrombosis was achieved in all 8 cases. There were no immediate or late endovascular-related complications. One death occurred due to an unrelated medical event. At 6 months, there was notable improvement in the modified Rankin Score (mRS, with 5/8 (62% patients achieving mRS of 2 or less. The follow-up ranged between 3 months and 26 months (mean: 14.5 months, and there were no new neurological events during the follow-up period. Conclusion: Cerebral venous sinus thrombosis is a rare but life-threatening condition that demands timely diagnosis and therapy. In cases of rapidly declining neurological status despite standard therapy with systemic anticoagulation and anti-edema measures, mechanical thrombectomy could be a lifesaving and effective option. In this study, good outcomes were observed in the majority of patients at long-term follow up.

  2. In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Fanou, Evgenia Maria [University Hospital of North Staffordshire, Stoke-on-Trent (United Kingdom); Reeves, Mike J.; Griffiths, Paul D. [Royal Hallamshire Hospital, University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Howe, David T. [Princess Anne Hospital, Wessex Fetal Medicine Unit, Southampton (United Kingdom); Joy, Harriet [University Hospital of Southampton, Department of Radiology, Southampton (United Kingdom); Morris, Susan [University Hospital of Wales, Radiology Department, Cardiff, Wales (United Kingdom); Russell, Sarah [St. Mary' s Hospital, Radiology Department, Manchester (United Kingdom)

    2013-12-15

    Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance. To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance. We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound. In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up. This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution. (orig.)

  3. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    International Nuclear Information System (INIS)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine; Hinz, Kerstin; Prokein, Jana; Becker, Hartmut

    2009-01-01

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  4. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine [Hannover Medical School, Institute of Human Genetics, Hannover (Germany); Hinz, Kerstin [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Vivantes Klinikum Neukoelln, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Prokein, Jana [Hannover Medical School, Institute for Biometrics, Hannover (Germany); Becker, Hartmut [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany)

    2009-06-15

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  5. Aerosol can puncture device operational test plan

    International Nuclear Information System (INIS)

    Leist, K.J.

    1994-01-01

    Puncturing of aerosol cans is performed in the Waste Receiving and Processing Facility Module 1 (WRAP 1) process as a requirement of the waste disposal acceptance criteria for both transuranic (TRU) waste and low-level waste (LLW). These cans have contained such things as paints, lubricating oils, paint removers, insecticides, and cleaning supplies which were used in radioactive facilities. Due to Westinghouse Hanford Company (WHC) Fire Protection concerns of the baseline system's fire/explosion proof characteristics, a study was undertaken to compare the baseline system's design to commercially available puncturing devices. While the study found no areas which might indicate a risk of fire or explosion, WHC Fire Protection determined that the puncturing system must have a demonstrated record of safe operation. This could be obtained either by testing the baseline design by an independent laboratory, or by substituting a commercially available device. As a result of these efforts, the commercially available Aerosolv can puncturing device was chosen to replace the baseline design. Two concerns were raised with the system. Premature blinding of the coalescing/carbon filter, due to its proximity to the puncture and draining operation; and overpressurization of the collection bottle due to its small volume and by blinding of the filter assembly. As a result of these concerns, testing was deemed necessary. The objective of this report is to outline test procedures for the Aerosolv

  6. Combined spinal–epidural anesthesia for an elderly patient with proportionate dwarfism for laparotomy

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-01-01

    Full Text Available Anesthesia in a dwarf patient may be challenging as various anatomical anomalies make both general and regional anesthesia difficult. These patients may have atlantoaxial instability, potential for airway obstruction, and associated respiratory problems that may pose problems for general anesthesia. Spinal stenosis, osteophytes, short pedicles, or a small epidural space could complicate regional anesthesia in dwarfs which could lead to difficulties in locating the epidural space and increase the risk of dural puncture. Spinal stenosis may impair cerebrospinal fluid flow such that identification of dural puncture is difficult. This elderly dwarf patient had history of bronchial asthma with restriction of neck extension, managed successfully using combined spinal–epidural anesthesia.

  7. Transforaminal Lumbar Puncture: An Alternative Technique in Patients with Challenging Access.

    Science.gov (United States)

    Nascene, D R; Ozutemiz, C; Estby, H; McKinney, A M; Rykken, J B

    2018-05-01

    Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1. The L1-2 level was used in 2; the L2-3 level, in 10; the L3-4 level, in 12; and the L4-5 level, in 2 procedures. Post-lumbar puncture headache was observed on 4 occasions, which resolved without blood patching. One patient felt heat and pain at the injection site that resolved spontaneously within hours. One patient had radicular pain that resolved with conservative treatment. Transforaminal lumbar puncture may become an effective alternative to classic interlaminar lumbar puncture or cervical puncture. © 2018 by American Journal of Neuroradiology.

  8. Dural metastasis of Ewing's sarcoma.

    Science.gov (United States)

    Ben Nsir, Atef; Boughamoura, Mohamed; Maatouk, Mezri; Kilani, Mohamed; Hattab, Nejib

    2013-01-01

    Metastatic Ewing's sarcoma to the central nervous system is an uncommon condition and debate concerning the true origin of its metastases is still up to date. To the best of our knowledge, only two cases of dural metastatic Ewing's sarcoma have been published in the English medical literature. We present an additional case in a 24-year-old female and discuss the pathogenesis of these unusual tumors with review of the relevant literature concerning their treatment and outcome. A 24-year-old female with previous history of pelvis Ewing's sarcoma and recently discovered lung metastases, presented with moderate headache for the past 2 weeks and weakness in her left leg for the past 2 days. Computed tomography scan and magnetic resonance imaging revealed an extra-axial right frontoparietal mass invading the superior sagittal sinus but with clear delineation with brain parenchyma. Imaging features were suggestive of a meningioma as no abnormalities in the skull abutting to the tumor were noted. The patient underwent surgical removal of her tumor. Near total resection was achieved and histological examination showed evidence of metastatic Ewing's sarcoma. Postoperative adjuvant radiation and chemotherapy were administered. The patient improved well postoperatively with full recovery of her motor weakness. She is symptom free with no signs of progression, at most recent follow-up, 8 months after surgery. Despite its rarity, metastatic Ewing's sarcoma must be considered in the differential diagnosis of extra-axial dural masses particularly meningiomas.

  9. Spinal movement and dural sac compression during airway management in a cadaveric model with atlanto-occipital instability.

    Science.gov (United States)

    Liao, Shiyao; Schneider, Niko R E; Weilbacher, Frank; Stehr, Anne; Matschke, Stefan; Grützner, Paul A; Popp, Erik; Kreinest, Michael

    2017-12-01

    To analyze the compression of the dural sac and the cervical spinal movement during performing different airway interventions in case of atlanto-occipital dislocation. In six fresh cadavers, atlanto-occipital dislocation was performed by distracting the opened atlanto-occipital joint capsule and sectioning the tectorial membrane. Airway management was done using three airway devices (direct laryngoscopy, video laryngoscopy, and insertion of a laryngeal tube). The change of dural sac's width and intervertebral angulation in stable and unstable atlanto-occipital conditions were recorded by video fluoroscopy with myelography. Three-dimensional overall movement of cervical spine was measured in a wireless human motion track system. Compared with a mean dural sac compression of - 0.5 mm (- 0.7 to - 0.3 mm) in stable condition, direct laryngoscopy caused an increased dural sac compression of - 1.6 mm (- 1.9 to - 0.6 mm, p = 0.028) in the unstable atlanto-occipital condition. No increased compression on dural sac was found using video laryngoscopy or the laryngeal tube. Moreover, direct laryngoscopy caused greater overall extension and rotation of cervical spine than laryngeal tube insertion in both stable and unstable conditions. Among three procedures, the insertion of a laryngeal tube took the shortest time. In case of atlanto-occipital dislocation, intubation using direct laryngoscopy exacerbates dural sac compression and may cause damage to the spinal cord.

  10. A method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus: the "mosquito" method.

    Science.gov (United States)

    Lee, Hee Chang; Lee, Ji Yeoun; Ryu, Seul Ki; Lim, Jang Mi; Chong, Sangjoon; Phi, Ji Hoon; Kim, Seung-Ki; Wang, Kyu-Chang

    2016-12-01

    The posterior fossa dural opening requires the ligation of the occipital sinus to gain successful exposure. However, there could be a prominent occipital sinus which is functioning as the main drainage route and is harboring the risk of unpredictable massive hemorrhage during the dural opening. We introduce a safe method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus using four curved hemostat clamps. For the dural incision at the midline part of the posterior cranial fossa, we used four curved hemostat clamps to occlude the prominent occipital sinus: one pair of clamps at the proximal part and the other pair at the distal part to occlude the occipital sinus. Dural incision was made between the two pairs of the curved hemostat clamps. By clamping of the sinus, it allows observation of possible brain swelling after occlusion of the occipital sinus as well as minimizes hemorrhage during incision of the midline dura of the posterior fossa. This method allows observation of brain swelling after occipital sinus occlusion and is an easy and safe incision of the midline dura minimizing hemorrhage in selected cases with a prominent occipital sinus.

  11. Imaging findings in patients with ventral dural defects and herniation of neural tissue

    International Nuclear Information System (INIS)

    Baur, A.; Staebler, A.; Reiser, M.; Psenner, K.; Hamburger, C.

    1997-01-01

    The aim of this paper is to describe clinical and imaging findings in three patients with ventral dural defects and herniation of the spinal cord or cauda equina. The literature is reviewed and the clinical, radiological and operative findings are compared. Three patients with ventral dural defects of different etiologies are presented. One patient gave a longstanding history of ankylosing spondylitis, the second patient presents 37 years after spinal trauma, and the third patient presents with spontaneous spinal cord herniation. All patients had typically slowly progressive neurological symptoms with multiple hospitalizations until diagnosis was made. Characteristic findings in postmyelographic CT included a ventral or ventrolateral displacement with deformation of the spinal cord or the cauda equina. Sagittal MRI showed this abrupt and localized anterior deviation of the spinal cord or the cauda equina to the posterior portions of a vertebral body with or without a bony vertebral defect optimally. Additionally, due to the ventral displacement of the spinal cord, the dorsal subarachnoid space was relatively enlarged without evidence of an arachnoid cyst, in all patients. Magnetic resonance imaging and postmyelographic CT can diagnose ventral dural defects with spinal cord herniation or nerve root entrapment. Dural defects must be considered in the presence of neurological symptoms in cases of longstanding ankylosing spondylitis, late sequelae of fractures of vertebral bodies, and without history of spinal trauma or surgery. (orig.). With 3 figs

  12. Maass Cusp Forms on Singly Punctured Two-Torus

    International Nuclear Information System (INIS)

    Siddig, Abubaker Ahmed Mohamed; Shah, Nurisya Mohd; Zainuddin, Hishamuddin

    2009-01-01

    Quantum mechanical systems on punctured surfaces modeled by hyperbolic spaces can play an interesting role in exploring quantum chaos and in studying behaviour of future quantum nano-devices. The case of singly-punctured two-torus, for example, has been well-studied in the literature particularly for its scattering states. However, the bound states on the punctured torus given by Maass cusp forms are lesser known. In this note, we report on the algorithm of numerically computing these functions and we present ten lower-lying eigenvalues for each odd and even Maass cusp forms.

  13. MR inflow angiography for the evaluation of dural sinus patency

    International Nuclear Information System (INIS)

    Poncelet, B.; Baleriaux, D.; Grand, C.; Van Dijk, P.; De Graaf, R.; Segebarth, C.

    1990-01-01

    This paper assesses dural sinus patency with two-dimensional inflow MR angiography. Twelve patients with potential dural sinus (superior sagittal and transverse sinus) involvement related to tumors of the falx or the convexity (meningiomas, metastasis) were examined with digital subtraction angiography (DSA), Mr imaging (1.5-T Gyroscan system), including T1-weighted (pre- and post-agadolinium) and T2-weighted spin-echo imaging, and MR angiography. For the MR angiographic study, a gradient-echo fast field echo sequence with flow compensation was used. Thin (2-mm), contiguous coronal or transverse sections were acquired sequentially. Three-dimensional reconstruction with MIP processing was then performed. CT, DSA, and MR imaging were performed for presurgical evaluation. Surgical confirmation of sinus patency was obtained for all patients

  14. Neural-Dural Transition at the Thoracic and Lumbar Spinal Nerve Roots: A Histological Study of Human Late-Stage Fetuses

    Directory of Open Access Journals (Sweden)

    Kwang Ho Cho

    2016-01-01

    Full Text Available Epidural blocks have been used extensively in infants. However, little histological information is available on the immature neural-dural transition. The neural-dural transition was histologically investigated in 12 late-stage (28–30 weeks fetuses. The dural sheath of the spinal cord was observed to always continue along the nerve roots with varying thicknesses between specimens and segments, while the dorsal root ganglion sheath was usually very thin or unclear. Immature neural-dural transitions were associated with effective anesthesia. The posterior radicular artery was near the dorsal root ganglion and/or embedded in the nerve root, whereas the anterior radicular artery was separated from the nearest nerve root. The anterior radicular artery was not associated with the dural sheath but with thin mesenchymal tissue. The numbers of radicular arteries tended to become smaller in larger specimens. Likewise, larger specimens of the upper thoracic and lower lumbar segments did not show the artery. Therefore, elimination of the radicular arteries to form a single artery of Adamkiewicz was occurring in late-stage fetuses. The epidural space was filled with veins, and the loose tissue space extended ventrolaterally to the subpleural tissue between the ribs. Consequently, epidural blocks in infants require special attention although immature neural-dural transitions seemed to increase the effect.

  15. Transcutaneous Drainage of Gel-Like Substance after Application of Hydrogel Dural Sealant: Report of Two Cases.

    Science.gov (United States)

    Siman, Homayoun; Techy, Fernando

    2016-02-01

    Study Design Case report. Objective Incidental durotomy (IDT) is a common complication of spinal surgery. The use of collagen matrix graft along with hydrogel dural sealant is a common method of IDT repair. With this method, there have been several reported cases of detrimental dural sealant expansion in the literature. One case study reported an expansion rate greater than 300%; many report neurologic damage. This article reports the clinical course of two patients who developed postoperative transcutaneous drainage of a gel-like substance after the use of a dural sealant, which is a previously unreported complication. Methods The clinical course and treatment outcome of two patients is presented. Results Both patients experienced postoperative transcutaneous drainage of a gel-like substance at the surgical site. Case one began draining this substance on postoperative day 14. This patient required no further intervention, and the drainage ended after 3 mL of a gel-like substance was expressed from his incision while in the clinic. Case two began draining the gel on postoperative day 16. This patient underwent two washout procedures and resolution of the drainage. No infection was ever detected. Conclusions To our knowledge, our patients are the first reported cases of transcutaneous drainage of expanded dural sealant. It is important to take into consideration the unexpected expansion of a dural sealant when using it for the repair of IDT.

  16. Iatrogene duralæsioner ved dekompressionskirurgi i lumbalcolumna

    DEFF Research Database (Denmark)

    Thomsen, Frederik; Amtoft, Ole; Andersen, Mikkel

    2010-01-01

    at the Private Hospital Hamlet. The study covers cases from the 10-month period from September 1, 2007 to June 30, 2008. Data was collected after this period and consists of surgeon-documented dural tears. At the time of surgery, the surgeon was unaware that there would be a subsequent registration. A total...

  17. Higher-dimensional puncture initial data

    International Nuclear Information System (INIS)

    Zilhao, Miguel; Ansorg, Marcus; Cardoso, Vitor; Gualtieri, Leonardo; Herdeiro, Carlos; Sperhake, Ulrich; Witek, Helvi

    2011-01-01

    We calculate puncture initial data, corresponding to single and binary black holes with linear momenta, which solve the constraint equations of D-dimensional vacuum gravity. The data are generated by a modification of the pseudospectral code presented in [M. Ansorg, B. Bruegmann, and W. Tichy, Phys. Rev. D 70, 064011 (2004).] and made available as the TwoPunctures thorn inside the Cactus computational toolkit. As examples, we exhibit convergence plots, the violation of the Hamiltonian constraint as well as the initial data for D=4,5,6,7. These initial data are the starting point to perform high-energy collisions of black holes in D dimensions.

  18. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations.

    Science.gov (United States)

    Zakhary, Sherry M; Hoehmann, Christopher L; Cuoco, Joshua A; Hitscherich, Kyle; Alam, Hamid; Torres, German

    2017-06-01

    A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5-10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  19. Cavernous sinus invasion by pituitary adenomas. Relationship between magnetic resonance imaging findings and histologically verified dural invasion

    Energy Technology Data Exchange (ETDEWEB)

    Daita, Go; Yonemasu, Yukichi; Nakai, Hirofumi; Takei, Hidetoshi; Ogawa, Katsuhiro [Asahikawa Medical Coll., Hokkaido (Japan)

    1995-01-01

    The relationship between magnetic resonance (MR) imaging findings and histologically verified invasion of the cavernous sinus by tumor cells was studied in 26 patients treated surgically for pituitary adenoma. Dural invasion of the sellar floor by tumor cells was found in 10 cases (38%). All patients were classified according to MR imaging findings into three types. Type I showed a gadolinium-enhanced stripe medial to the carotid artery (5 patients), none of which showed dural invasion. Type II showed no enhanced stripe (17 patients), six of which showed dural invasion. Within this type, tumor size and dural invasion showed no correlation. Type III showed displacement or encasement of the carotid artery by the tumor with or without extracranial extension (4 patients), all of which showed massive infiltration of the tumor cells into the dura mater. This study shows that preoperative MR imaging can provide information for assessment of invasion into the cavernous sinus in patients with pituitary adenoma. (author).

  20. Punctures for theories of class S{sub Γ}

    Energy Technology Data Exchange (ETDEWEB)

    Heckman, Jonathan J. [Department of Physics, University of North Carolina,Chapel Hill, NC 27599 (United States); Jefferson, Patrick; Rudelius, Tom; Vafa, Cumrun [Jefferson Physical Laboratory, Harvard University,Cambridge, MA 02138 (United States)

    2017-03-31

    With the aim of understanding compactifications of 6D superconformal field theories to four dimensions, we study punctures for theories of class S{sub Γ}. The class S{sub Γ} theories arise from M5-branes probing ℂ{sup 2}/Γ, an ADE singularity. The resulting 4D theories descend from compactification on Riemann surfaces decorated with punctures. We show that for class S{sub Γ} theories, a puncture is specified by singular boundary conditions for fields in the 5D quiver gauge theory obtained from compactification of the 6D theory on a cylinder geometry. We determine general boundary conditions and study in detail solutions with first order poles. This yields a generalization of the Nahm pole data present for 1/2 BPS punctures for theories of class S. Focusing on specific algebraic structures, we show how the standard discussion of nilpotent orbits and its connection to representations of su(2) generalizes in this broader context.

  1. Relativistic hydrodynamics in the presence of puncture black holes

    International Nuclear Information System (INIS)

    Faber, Joshua A.; Etienne, Zachariah B.; Shapiro, Stuart L.; Taniguchi, Keisuke; Baumgarte, Thomas W.

    2007-01-01

    Many of the recent numerical simulations of binary black holes in vacuum adopt the moving puncture approach. This successful approach avoids the need to impose numerical excision of the black hole interior and is easy to implement. Here we wish to explore how well the same approach can be applied to moving black hole punctures in the presence of relativistic hydrodynamic matter. First, we evolve single black hole punctures in vacuum to calibrate our Baumgarte-Shapiro-Shibata-Nakamura implementation and to confirm that the numerical solution for the exterior spacetime is invariant to any junk (i.e., constraint-violating) initial data employed in the black hole interior. Then we focus on relativistic Bondi accretion onto a moving puncture Schwarzschild black hole as a numerical test bed for our high-resolution shock-capturing relativistic hydrodynamics scheme. We find that the hydrodynamical equations can be evolved successfully in the interior without imposing numerical excision. These results help motivate the adoption of the moving puncture approach to treat the binary black hole-neutron star problem using conformal thin-sandwich initial data

  2. tropical OCTOBER

    African Journals Online (AJOL)

    Anaesthesia in obstetric patients remains a procedure with special risks .... dural puncture during epidural technique. ... commonly used drugs for postoperative pain during the period of ... intramuscular opioid administration when necessary.

  3. Anaesthetic Management of Caesarean Section in an Achondroplastic Dwarf

    Directory of Open Access Journals (Sweden)

    Kirti N Saxena

    2008-01-01

    A twenty year old parturient with short stature presented to the hospital in early labour. An elective lower segment caesarean section(LSCS was planned in view of cephalopelvic disproportion. She had papers which suggested that she had been diagnosed as a case of achondroplasia though details were not available. Combined spinal epidural(CSE anaesthesia was planned in the patient in view of the death of her first baby following caesarean section under general anaesthesia. Repeatedly dry taps were achieved on attempting dural puncture. Dural puncture was abandoned and an 18 G epidural catheter was threaded via the Tuohy needle. Sensory block till T 6 was achieved with 6ml of local anaesthetic solution. The patient was stable during the intraoperative and postoperative period.

  4. Puncture Wounds: First Aid

    Science.gov (United States)

    ... Skin problems. In: American Medical Association Handbook of First Aid and Emergency Care. New York, N.Y.: Random House; 2009. Jan. 12, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-puncture-wounds/basics/ART-20056665 . Mayo ...

  5. Dural arteriovenous fistula as a treatable dementia.

    Science.gov (United States)

    Enofe, Ikponmwosa; Thacker, Ike; Shamim, Sadat

    2017-04-01

    Dementia is a chronic loss of neurocognitive function that is progressive and irreversible. Although rare, dural arteriovenous fistulas (DAVFs) could present with a rapid decline in neurocognitive function with or without Parkinson-like symptoms. DAVFs represent a potentially treatable and reversible cause of dementia. Here, we report the case of an elderly woman diagnosed with a DAVF after presenting with new-onset seizures, deteriorating neurocognitive function, and Parkinson-like symptoms.

  6. Contribution of dynamic contrast MR imaging to the differentiation between dural metastasis and meningioma

    International Nuclear Information System (INIS)

    Kremer, S.; Grand, S.; Le Bas, J.F.; Remy, C.; Pasquier, B.; Benabid, A.L.; Bracard, S.

    2004-01-01

    To determine the perfusion-sensitive characteristics of cerebral dural metastases and compare them with the data on meningiomas. Twenty-two patients presenting with dural tumor underwent conventional and dynamic susceptibility-contrast MR imaging: breast carcinoma metastases, two patients; colorectal carcinoma metastasis, one patient; lung carcinoma metastasis, one patient; Merkel carcinoma metastasis, one patient; lymphoma, one patient; meningiomas, 16 patients. The imaging characteristics were analyzed using conventional MR imaging. The cerebral blood volume (CBV) maps were obtained for each patient and the relative CBV (rCBV) in different areas was calculated using the ratio between the CBV in the pathological area (CBVp) and in the contralateral white matter (CBVn). The differentiation between a meningioma and a dural metastasis can be difficult using conventional MR imaging. The rCBVs of lung carcinoma metastasis (1 case: 1.26), lymphoma (1 case: 1.29), breast carcinoma metastasis (2 cases: 1.50,1.56) and rectal carcinoma metastasis (1 case: 3.34) were significantly lower than that of meningiomas (16 cases: mean rCBV = 8.97±4.34, range 4-18). Merkel carcinoma metastasis (1 case: 7.56) showed an elevated rCBV, not different from that of meningiomas. Dural metastases are sometimes indistinguishable from meningiomas using conventional MR imaging. rCBV mapping can provide additional information by demonstrating a low rCBV which may suggest the diagnosis of metastasis. (orig.)

  7. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    Directory of Open Access Journals (Sweden)

    Sherry M. Zakhary, DO

    2017-06-01

    Full Text Available A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  8. Retrograde flow in the dural sinuses detected by three-dimensional time-of-flight MR angiography

    International Nuclear Information System (INIS)

    Uchino, Akira; Nomiyama, Keita; Takase, Yukinori; Nakazono, Takahiko; Tominaga, Yukiko; Imaizumi, Takeshi; Kudo, Sho

    2007-01-01

    Retrograde flow in the left dural sinuses is sometimes detected by three-dimensional time-of-flight (3D-TOF) magnetic resonance (MR) angiography. The purpose of this study was to evaluate the incidence of this phenomenon and its characteristic features on 3D-TOF MR angiograms. We retrospectively reviewed cranial MR angiography images of 1,078 patients examined at our institution. All images were obtained by the 3D-TOF technique with one of two 1.5-T scanners. Maximum intensity projection (MIP) images in the horizontal rotation view were displayed stereoscopically. We reviewed the source images, inferosuperior MIP images, and horizontal MIP images and identified retrograde flow in the dural sinuses. We found retrograde flow in the dural sinuses of 67 patients on the source images from 3D-TOF MR angiography; the incidence was 6.2%. In 47 of the 67 patients, retrograde flow was identified in the left inferior petrosal sinus, in 13, it was seen in the left sigmoid sinus, and in 6, it was seen in the left inferior petrosal and left sigmoid sinuses. The remaining patient had retrograde flow in the left inferior petrosal and left and right sigmoid sinuses. The mean age of the patients with retrograde flow was slightly greater than that of the patients without this phenomenon (70 years vs 63 years). Retrograde flow in the dural sinuses frequently occurs on the left side in middle-aged and elderly patients during 3D-TOF MR angiography performed with the patient in the supine position. This phenomenon should not be misdiagnosed as a dural arteriovenous fistula. (orig.)

  9. Ultrasound-guided lumbar puncture in pediatric patients: technical success and safety.

    Science.gov (United States)

    Pierce, David B; Shivaram, Giri; Koo, Kevin S H; Shaw, Dennis W W; Meyer, Kirby F; Monroe, Eric J

    2018-06-01

    Disadvantages of fluoroscopically guided lumbar puncture include delivery of ionizing radiation and limited resolution of incompletely ossified posterior elements. Ultrasound (US) allows visualization of critical soft tissues and the cerebrospinal fluid (CSF) space without ionizing radiation. To determine the technical success and safety of US-guided lumbar puncture in pediatric patients. A retrospective review identified all patients referred to interventional radiology for lumbar puncture between June 2010 and June 2017. Patients who underwent lumbar puncture with fluoroscopic guidance alone were excluded. For the remaining procedures, technical success and procedural complications were assessed. Two hundred and one image-guided lumbar punctures in 161 patients were included. Eighty patients (43%) had previously failed landmark-based attempts. One hundred ninety-six (97.5%) patients underwent lumbar puncture. Five procedures (2.5%) were not attempted after US assessment, either due to a paucity of CSF or unsafe window for needle placement. Technical success was achieved in 187 (95.4%) of lumbar punctures attempted with US guidance. One hundred seventy-seven (90.3%) were technically successful with US alone (age range: 2 days-15 years, weight range: 1.9-53.1 kg) and an additional 10 (5.1%) were successful with US-guided thecal access and subsequent fluoroscopic confirmation. Three (1.5%) cases were unsuccessful with US guidance but were subsequently successful with fluoroscopic guidance. Of the 80 previously failed landmark-based lumbar punctures, 77 (96.3%) were successful with US guidance alone. There were no reported complications. US guidance is safe and effective for lumbar punctures and has specific advantages over fluoroscopy in pediatric patients.

  10. Radiographic anatomy of the distal dural SAC

    International Nuclear Information System (INIS)

    Larsen, J.L.; Olsen, K.O.

    1991-01-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.)

  11. Lumbar puncture in patients using anticoagulants and antiplatelet agents

    Directory of Open Access Journals (Sweden)

    Renan Domingues

    2016-08-01

    Full Text Available ABSTRACT The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

  12. Prestrain-induced Reduction in Skin Tissue Puncture Force of Microneedle

    International Nuclear Information System (INIS)

    Kim, Jonghun; Park, Sungmin; Nam, Gyungmok; Yoon, Sang-Hee

    2016-01-01

    Despite all the recent advances in biodegradable material-based microneedles, the bending and failure (especially buckling) of a biodegradable microneedle during skin tissue insertion remains a major technical hurdle for its large-scale commercialization. A reduction in skin tissue puncture force during microneedle insertion remains an essential issue in successfully developing a biodegradable microneedle. Here, we consider uniaxial and equibiaxial prestrains applied to a skin tissue as mechanophysical stimuli that can reduce the skin tissue puncture force, and investigate the effect of prestrain on the changes in skin tissue puncture force. For a porcine skin tissue similar to that of humans, the skin tissue puncture force of a flat-end microneedle is measured with a z-axis stage equipped with a load cell, which provides a force-time curve during microneedle insertion. The findings of this study lead to a quantitative characterization of the relationship between prestrain and the skin tissue puncture force

  13. Prestrain-induced Reduction in Skin Tissue Puncture Force of Microneedle

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jonghun; Park, Sungmin; Nam, Gyungmok; Yoon, Sang-Hee [Inha Univ., Incheon (Korea, Republic of)

    2016-10-15

    Despite all the recent advances in biodegradable material-based microneedles, the bending and failure (especially buckling) of a biodegradable microneedle during skin tissue insertion remains a major technical hurdle for its large-scale commercialization. A reduction in skin tissue puncture force during microneedle insertion remains an essential issue in successfully developing a biodegradable microneedle. Here, we consider uniaxial and equibiaxial prestrains applied to a skin tissue as mechanophysical stimuli that can reduce the skin tissue puncture force, and investigate the effect of prestrain on the changes in skin tissue puncture force. For a porcine skin tissue similar to that of humans, the skin tissue puncture force of a flat-end microneedle is measured with a z-axis stage equipped with a load cell, which provides a force-time curve during microneedle insertion. The findings of this study lead to a quantitative characterization of the relationship between prestrain and the skin tissue puncture force.

  14. Cranial dural arteriovenous shunts. Part 4. Clinical presentation of the shunts with leptomeningeal venous drainage.

    Science.gov (United States)

    Baltsavias, Gerasimos; Spiessberger, Alex; Hothorn, Torsten; Valavanis, Anton

    2015-04-01

    Cranial dural arteriovenous fistulae have been classified into high- and low-risk lesions mainly based on the pattern of venous drainage. Those with leptomeningeal venous drainage carry a higher risk of an aggressive clinical presentation. Recently, it has been proposed that the clinical presentation should be considered as an additional independent factor determining the clinical course of these lesions. However, dural shunts with leptomeningeal venous drainage include a very wide spectrum of inhomogeneous lesions. In the current study, we correlated the clinical presentation of 107 consecutive patients harboring cranial dural arteriovenous shunts with leptomeningeal venous drainage, with their distinct anatomic and angiographic features categorized into eight groups based on the "DES" (Directness and Exclusivity of leptomeningeal venous drainage and features of venous Strain) concept. We found that among these groups, there are significant angioarchitectural differences, which are reflected by considerable differences in clinical presentation. Leptomeningeal venous drainage of dural sinus shunts that is neither direct nor exclusive and without venous strain manifested only benign symptoms (aggressive presentation 0%). On the other end of the spectrum, the bridging vein shunts with direct and exclusive leptomeningeal venous drainage and venous strain are expected to present aggressive symptoms almost always and most likely with bleeding (aggressive presentation 91.5%). Important aspects of the above correlations are discussed. Therefore, the consideration of leptomeningeal venous drainage alone, for prediction of the clinical presentation of these shunts appears insufficient. Angiographic analysis based on the above concept, offers the possibility to distinguish the higher- from the lower-risk types of leptomeningeal venous drainage. In this context, consideration of the clinical presentation as an additional independent factor for the prediction of their clinical

  15. Fuel rod puncturing and fission gas monitoring system examination techniques

    International Nuclear Information System (INIS)

    Song, Woong Sup

    1999-02-01

    Fission gas products accumulated in irradiated fuel rod is 1-2 cm 3 in CANDU and 40-50 cm 3 in PWR fuel rod. Fuel rod puncturing and fission gas monitoring system can be used for both CANDU and PWR fuel rod. This system comprises puncturing device located at in cell part and monitoring device located at out cell part. The system has computerized 9 modes and can calculate both void volume and mass volume only single puncturing. This report describes techniques and procedure for operating fuel rod puncturing and gas monitoring system which can be play an important role in successful operation of the devices. Results obtained from the analysis can give more influence over design for fuel rods. (Author). 6 refs., 9 figs

  16. Social evaluation of intentional, truly accidental, and negligently accidental helpers and harmers by 10-month-old infants.

    Science.gov (United States)

    Woo, Brandon M; Steckler, Conor M; Le, Doan T; Hamlin, J Kiley

    2017-11-01

    Whereas adults largely base their evaluations of others' actions on others' intentions, a host of research in developmental psychology suggests that younger children privilege outcome over intention, leading them to condemn accidental harm. To date, this question has been examined only with children capable of language production. In the current studies, we utilized a non-linguistic puppet show paradigm to examine the evaluation of intentional and accidental acts of helping or harming in 10-month-old infants. In Experiment 1 (n=64), infants preferred intentional over accidental helpers but accidental over intentional harmers, suggestive that by this age infants incorporate information about others' intentions into their social evaluations. In Experiment 2 (n=64), infants did not distinguish "negligently" accidental from intentional helpers or harmers, suggestive that infants may find negligent accidents somewhat intentional. In Experiment 3 (n=64), we found that infants preferred truly accidental over negligently accidental harmers, but did not reliably distinguish negligently accidental from truly accidental helpers, consistent with past work with adults and children suggestive that humans are particularly sensitive to negligently accidental harm. Together, these results imply that infants engage in intention-based social evaluation of those who help and harm accidentally, so long as those accidents do not stem from negligence. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Clinical application of CT-guided percutaneous puncturing biopsy of subcarinal lymph node

    International Nuclear Information System (INIS)

    Yuan Xiaodong; Wang Jianhua; Zuo Changjing; Tian Jianming

    2011-01-01

    Objective: To discuss the safety and clinical significance of CT-guided percutaneous puncturing biopsy of subcarinal lymph node. Methods: During the period of July 2006-July 2010, CT-guided percutaneous puncturing biopsy of subcarinal lymph node was carried out in 17 patients (11 males and 6 females, with an average age of 54 years) with enlarged subcarinal lymph nodes. The clinical data were retrospectively analyzed. Immediately after the puncturing procedure was completed, CT scanning was performed to observe if there any complications and to evaluate the safety of puncturing biopsy. Biopsy specimens were sent for pathological examination to assess the puncturing accuracy and to make the pathologic diagnosis. The clinical usefulness of this technique was evaluated. Results: Of the total 17 cases, successful puncturing into the enlarged subcarinal lymph nodes with single procedure was achieved in 14 and sufficient tissue sample was obtained. The biopsy failed in three cases at initial puncturing procedure as the needle could not be placed into the enlarged subcarinal lymph nodes, the puncturing biopsy had to given up in two patients because of hemoptysis and in another patient the second puncturing biopsy performed one week later was successful. The total technical successful rate was 88.2% (15/17). Of the fifteen cases with successful puncturing, definitive pathological diagnosis was obtained in 13 and the diagnosis was uncertain in the remaining two, with a diagnosis positive rate of 86.7% (13/15). Pathologically, the diagnoses included metastatic lymphadenopathy from lung cancer (n=10), proliferative inflammatory lymphadenopathy (n=2) and tuberculous enlargement of lymph nodes (n=1). Complications occurred in 4 patients (23.5%, 4/17), which mainly were pneumothorax and pulmonary hemorrhage. Conclusion: With high successful rate and diagnostic accuracy, CT-guided percutaneous puncturing biopsy of subcarinal lymph node is a safe and effective technique if the

  18. Comparative study of decomposable and indecomposable biopsy needle in lung puncture biopsy

    International Nuclear Information System (INIS)

    Wang Bo; Sheng Zhanxin; Wen Yamin; Zhang Liping; Wen Zongqiu

    2007-01-01

    Objective: To contrast the clinical practice characteristics with decomposable and indecomposable biopsy needle in the CT-guided lung puncture biopsy. Methods: 50 patients with lung tumour carried on puncture biopsy under the CT guidance were divided in two groups randomly: Group A (25 examples): using the indecomposable BioPinceTM biopsy needle; Group B(25 examples): using the decomposable Precisa or Vitesse biopsy needle. The puncture biopsy organization quantity, the first time puncture success rate, the pathological diagnosis result and the incidence of puncture complication were compared in two groups. Results: More striped structures were gained obviously in group A than in group B: 24/25 and 11/25 respectively (P>0.05), The pathological diagnosis 'serious extrusion amoebocyte and nature undetermined' only occurred in group B. But the first time puncture success rate was lower in group A than in B: 52%(13/25) and 80%(20/25) respectively (P>0.05), The incidence of hemorrhage and pneumothorax in group A was higher slightly: 84% and 72%, 16% and 4% respectively (P>0.05). Conclusion: The indecomposable needle (BioPinceTM) was better in lung puncture biopsy, but the lower first time puncture success rate also increases the risk of operation and complication in some degree because of the structure of the needle. On the contrary, decomposable needle (the Precisa or the Vitesse) was not the best choice in lung puncture biopsy. But it had the original superiority, especially regarding the special patient such as patient with small tumour, thin thoracic wall, bad physique for its nimble operation. It is essential for us to use the two different types of biopsy needle rationally to enhance the level of CT-guided lung puncture biopsy. (authors)

  19. The Tension and Puncture Properties of HDPE Geomembrane under the Corrosion of Leachate.

    Science.gov (United States)

    Xue, Qiang; Zhang, Qian; Li, Zhen-Ze; Xiao, Kai

    2013-09-17

    To investigate the gradual failure of high-density polyethylene (HDPE) geomembrane as a result of long-term corrosion, four dynamic corrosion tests were conducted at different temperatures and durations. By combining tension and puncture tests, we systematically studied the variation law of tension and puncture properties of the HDPE geomembrane under different corrosion conditions. Results showed that tension and puncture failure of the HDPE geomembrane was progressive, and tensile strength in the longitudinal grain direction was evidently better than that in the transverse direction. Punctures appeared shortly after puncture force reached the puncture strength. The tensile strength of geomembrane was in inversely proportional to the corrosion time, and the impact of corrosion was more obvious in the longitudinal direction than transverse direction. As corrosion time increased, puncture strength decreased and corresponding deformation increased. As with corrosion time, the increase of corrosion temperature induced the decrease of geomembrane tensile strength. Tensile and puncture strength were extremely sensitive to temperature. Overall, residual strength had a negative correlation with corrosion time or temperature. Elongation variation increased initially and then decreased with the increase in temperature. However, it did not show significant law with corrosion time. The reduction in puncture strength and the increase in puncture deformation had positive correlations with corrosion time or temperature. The geomembrane softened under corrosion condition. The conclusion may be applicable to the proper designing of the HDPE geomembrane in landfill barrier system.

  20. The training and learning process of transseptal puncture using a modified technique.

    Science.gov (United States)

    Yao, Yan; Ding, Ligang; Chen, Wensheng; Guo, Jun; Bao, Jingru; Shi, Rui; Huang, Wen; Zhang, Shu; Wong, Tom

    2013-12-01

    As the transseptal (TS) puncture has become an integral part of many types of cardiac interventional procedures, its technique that was initial reported for measurement of left atrial pressure in 1950s, continue to evolve. Our laboratory adopted a modified technique which uses only coronary sinus catheter as the landmark to accomplishing TS punctures under fluoroscopy. The aim of this study is prospectively to evaluate the training and learning process for TS puncture guided by this modified technique. Guided by the training protocol, TS puncture was performed in 120 consecutive patients by three trainees without previous personal experience in TS catheterization and one experienced trainer as a controller. We analysed the following parameters: one puncture success rate, total procedure time, fluoroscopic time, and radiation dose. The learning curve was analysed using curve-fitting methodology. The first attempt at TS crossing was successful in 74 (82%), a second attempt was successful in 11 (12%), and 5 patients failed to puncture the interatrial septal finally. The average starting process time was 4.1 ± 0.8 min, and the estimated mean learning plateau was 1.2 ± 0.2 min. The estimated mean learning rate for process time was 25 ± 3 cases. Important aspects of learning curve can be estimated by fitting inverse curves for TS puncture. The study demonstrated that this technique was a simple, safe, economic, and effective approach for learning of TS puncture. Base on the statistical analysis, approximately 29 TS punctures will be needed for trainee to pass the steepest area of learning curve.

  1. Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study.

    Science.gov (United States)

    Guo, W-Y; Lee, C-C J; Lin, C-J; Yang, H-C; Wu, H-M; Wu, C-C; Chung, W-Y; Liu, K-D

    2017-01-01

    Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas. Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. "TTP" was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups. Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa. Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases. © 2017 by American Journal of Neuroradiology.

  2. The reasons for delay lumbar puncture

    Directory of Open Access Journals (Sweden)

    MH. Lotfi

    2017-04-01

    Full Text Available Early diagnosis of meningitis and encephalitis and prompt initiation of appropriate therapy is vital and any delay will lead to high mortality and serious and permanent morbidity. The main purpose of this study was to evaluate the management of 220 patients with suspected central nervous system (CNS infections (meningitis and encephalitis to determine the percentage of patients’ suspected CNS infection undergo lumbar puncture in acceptable time (in accordance with conventional algorithms. In this descriptive study, patients with suspected CNS infections admitted to Bu-Ali and Qods hospitals, in the period July 2013 to December 2015 were studied. Information of 220 patients was collected. Continuous variables were summarized as means ± standard deviation and categorical variables as frequencies and percentages. Lumbar puncture (LP in patients was delayed in 200 cases (91%. Most common causes of delay in performing LP were prolongation of the process of determining patient needs to puncture, satisfying patients, CT scan delay and the delay in allowing LP by neurologist. In this study, delaying LP rate was higher than other studies. It seems certain pattern in assistants’ visits for counseling. CT requests and neurologic consultation before LP performed for all adult patients.

  3. Dynamic subtraction magnetic resonance venography: a new real time imaging technique for the detection of dural sinus thrombosis

    International Nuclear Information System (INIS)

    Mandel, C.; Birchall, D.; Connolly, D.; English, P.

    2002-01-01

    Full text: Requests for imaging suspected dural sinus thrombosis are increasing. Conventional magnetic imaging (MRI) and magnetic resonance venography (MRV) are often used to detect venous sinus thrombosis, but these techniques are prone to technical problems. Catheter angiography is sometimes required as the final arbiter in the evaluation of the dural venous sinuses. Recent technical developments in MR scanning have allowed the development of dynamic subtraction MRA. This technique is beginning to be applied to the assessment of intracranial vascular malformations. We have recently applied the technique to the imaging of the dural venous sinuses, and describe our early experience with the technique. Imaging was performed on a Philips Intera 1.5T scanner with gradient strength 33 mT and slew rate 130 T/m/sec. T1-weighed fast field echo imaging was performed (flip angle 400, TR 1.5 msec) during bolus injection of gadolinium (5ml gadolinium followed by a 10 ml saline chaser) at 5-6 ml/sec using a MRI-compatible pump injector. Slice thickness depended on the plane of acquisition, but was between 100- 150 mm. Images were acquired in three orthogonal projections in each case, using 3 separate contrast injections. Mask images were obtained before the arrival of contrast, and subtracted reconstructed images were obtained in real time, providing a dynamic display of the intracranial circulation including the dural venous sinuses. Frame rate was 1 frame per 0.8 seconds. We will present dynamic MR angiographic images in a number of patients. Normal appearances and those seen in venous sinus thrombosis will be presented in the video display. Dynamic MR venography is a new technique for the imaging of dural venous sinuses. In our practice, it has proved a valuable adjunct for the imaging of patients with dural venous sinus thrombosis. Copyright (2002) Blackwell Science Pty Ltd

  4. A new device of CT-targeted percutaneous punctures

    International Nuclear Information System (INIS)

    Ozdoba, C.

    1990-01-01

    This paper reports on a device for CT-targeted percutaneous punctures. After extensive phantom studies, punctures of vertebral disk space (diskography/nucleotomy) and orbit retrobulbar anesthesia/biopsy were performed in 15 patients. The new device is easy to mount on the CT scanner and does not require additional devices affixed to the patient. Its design and construction permit exact calculation of needle angle and depth, even when the gantry is tilted. Percutaneous biopsies can be performed in approximately 40 minutes. The device is accurate within ±0.5 mm, thereby allowing puncture of even small lesions deep in the orbital cone. Retrobulbar anesthesia can be performed safely in patients with a long myopic bulbus; in nucleotomy, instant control of the instrument's position within the disk space is possible

  5. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    OpenAIRE

    Zakhary, Sherry M.; Hoehmann, Christopher L.; Cuoco, Joshua A.; Hitscherich, Kyle; Alam, Hamid; Torres, German

    2017-01-01

    A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a cas...

  6. Histology of the distal dural ring.

    Science.gov (United States)

    Graffeo, Christopher S; Perry, Avital; Copeland, William R; Raghunathan, Aditya; Link, Michael J

    2017-09-01

    The distal dural ring (DDR) is a conserved intracranial anatomic structure marking the boundary point at which the internal carotid artery (ICA) exits the cavernous sinus (CS) and enters the subarachnoid space. Although the CS has been well described in a range of anatomic studies, to our knowledge no prior study has analyzed the histologic relationship between the ICA and DDR. Correspondingly, our objective was to assess the relationship of the DDR to the ICA and determine whether the DDR can be dissected from the ICA and thus divided, or can only be circumferentially trimmed around the artery. The authors examined ten fresh-frozen, adult cadaveric specimens. A standard frontotemporal craniotomy, orbito-optic osteotomy, and extradural anterior clinoidectomy was performed bilaterally. The cavernous ICA, DDR, and supraclinoid ICA were harvested as an en bloc specimen. Specimens formalin-fixed and paraffin-embedded prior to routine histochemical staining with hematoxylin and eosin and Masson trichrome. In all specimens, marked microscopic investment of the DDR throughout the ICA adventitia was noted. Dural collagen fibers extensively permeated the arterial layers superficial to the muscularis propria, with no evidence of a clear separation between the DDR and arterial adventitia. Histologic analysis suggests that the ICA and DDR are highly interrelated, continuous structures, and therefore attempted intraoperative dissection between these structures may carry an elevated risk of injury to the ICA. We correspondingly recommend careful circumferential trimming of the DDR in lieu of direct dissection in cases requiring mobilization of the clinoidal ICA. Clin. Anat. 30:742-746, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. Complications of the lateral C1-C2 puncture myelography for cervical spinal canal

    International Nuclear Information System (INIS)

    Mihale, J.; Traubner, P.

    1998-01-01

    This reviewed the complications of 106 patients of the lateral C1-C2 puncture myelography for cervical spinal canal and cervical spinal cord disorders. Spinal cord puncture and contrast injection, puncture between the occiput and C1, and blood vessel puncture were the main complications. These principally depended on the misdirection of the X ray beam. For preventing major arterial puncture determined the pathway of the vertebral arteries and incidence of anomaly. (authors)

  8. Use of collagen film as a dural substitute: preliminary animal studies.

    Science.gov (United States)

    Collins, R L; Christiansen, D; Zazanis, G A; Silver, F H

    1991-02-01

    Cadaver grafts, laminated metallic materials, and synthetic fabrics have been evaluated as dural substitutes. Use of cadaver tissues is limited by fear of transmission of infectious disease while use of synthetic materials is associated with implant encapsulation and foreign body reactions. The purpose of this study is to evaluate the use of collagen film as a dural substitute. Collagen films prepared from bovine skin were used to replace the dura of rabbits and histological observations were made at 16, 28, 42, and 56 days postimplantation. Controls consisted of dura that was removed and then reattached. Control dura showed no signs of inflammation or adhesion to underlying tissue at 16 and 28 days postimplantation. By 56 days postimplantation, extensive connective tissue deposition was observed in close proximity to adjacent bone as well as pia arachnoid adhesions. Implanted collagen film behaved in a similar manner to control dura showing minimal inflammatory response at all time periods. At 56 days postimplantation collagen film appeared strongly infiltrated by connective tissue cells that deposited new collagen. The results of this study suggest that a reconstituted type I collagen film crosslinked with cyanamide acts as a temporary barrier preventing loss of fluid and adhesion formation. It is replaced after approximately 2 months with host collagen with limited inflammatory and fibrotic complications. Further studies are needed to completely characterize the new connective tissue formed as well as long-term biocompatibility and functioning of a reconstituted collagen dural substitute.

  9. ''Dural tail'' adjacent to a giant posterior cerebral artery aneurysm: case report and review of the literature

    International Nuclear Information System (INIS)

    Good, C.D.; Kingsley, D.P.E.; Taylor, W.J.; Harkness, W.F.

    1997-01-01

    The ''dural tail'' sign on gadolinium (Gd-DTPA)-enhanced MRI has been described in association with meningiomas. Various series with histopathological correlation have shown that in some cases there is tumour invasion into the dura mater, but in the majority of cases it represents a hypervascular, non-neoplastic reaction. While this sign was originally thought to be specific for meningioma, subsequent case reports have described the presence of a dural tail in other intra- and extra-axial lesions. We present a patient with a giant aneurysm arising from the P2 segment of the right posterior cerebral artery, adjacent to the tentorium, with a prominent dural tail on Gd-DTPA-enhanced MRI. In this location, differentiation of an aneurysm from a meningioma was critical. (orig.). With 2 figs

  10. Transcutaneous Drainage of Gel-Like Substance after Application of Hydrogel Dural Sealant: Report of Two Cases

    OpenAIRE

    Siman, Homayoun; Techy, Fernando

    2015-01-01

    Study Design?Case report. Objective?Incidental durotomy (IDT) is a common complication of spinal surgery. The use of collagen matrix graft along with hydrogel dural sealant is a common method of IDT repair. With this method, there have been several reported cases of detrimental dural sealant expansion in the literature. One case study reported an expansion rate greater than 300%; many report neurologic damage. This article reports the clinical course of two patients who developed postoperativ...

  11. Suitability of cerebrospinal fluid as a signal-intensity reference on MRI: evaluation of signal-intensity variations in the lumbosacral dural sac

    International Nuclear Information System (INIS)

    Luoma, E.K.; Luukkonen, R.; Riihimaeki, H.A.; Raininko, R.; Manninen, H.I.; Nummi, P.J.

    1997-01-01

    The suitability of the cerebrospinal fluid (CSF) in the lumbosacral dural sac as an internal signal-intensity reference was studied on magnetic resonance imaging (MRI) of the lumbar spine using a surface coil and motion artefact suppression technique. A signal-intensity reference is needed when signal is compared between images, studies or subjects. Homogeneity of the CSF was estimated visually on T2-weighted images of 60 subjects at 1.5 T and of another 60 subjects at 0.1 T. Spines with a severely narrowed dural sac or marked scoliosis were excluded from the study to avoid partial volume effect. CSF was homogeneous in 82% and 73% of the examinations at 1.5 T and 0.1 T, respectively. The type and location of the local inhomogeneities did not relate to local narrowings of the dural sac. The signal intensity of CSF was measured in 108 examinations at 0.1 T after correcting the spatially-dependent signal-intensity nonuniformities with a phantom-based method. The signal-intensity difference between the CSF in the upper and lower lumbar dural sac was less than 10% in 73% of the examinations. The CSF in the lumbosacral dural sac can be a useful signal-intensity reference for estimation of the signal of the adjacent structures in patients without severe narrowing of the dural sac or marked scoliosis. It may contribute to assessing spinal disease processes. (orig.). With 1 fig., 3 tabs

  12. Quasi-static puncture resistance behaviors of high-strength polyester fabric for soft body armor

    Directory of Open Access Journals (Sweden)

    Qiu-Shi Wang

    Full Text Available A series of economical and flexible fabrics were prepared using high-strength polyester yarns with different fabric structures, weft density and number of layers. The effect of these factors on quasi-static puncture resistance was comparatively studied. The failure mode of the fabrics was analyzed with SEM photographs. Findings indicate that the structure and the weft density affected the quasi-static puncture resistance property of the fabrics, the plain fabrics had better puncture resistance property than twill and satin fabrics. The max puncture force and puncture energy of the plain fabrics with 160 yarn/10 cm reached the max values which were 107.43 N and 0.44 J, respectively. The number of layers had a linear relationship to quasi-static puncture resistance. The contact pressure and friction of the probe against the fibers were the main hindrance during the quasi-static puncture process and the breakage of the fibers during the penetration was caused by the bend and tensile deformation. Keywords: High-strength polyester fabrics, Fabric structure, Multiple-layer fabrics, Quasi-static puncture resistance

  13. Documented development of a dural arteriovenous fistula in an infant subsequent to sinus thrombosis: case report and review of the literature

    International Nuclear Information System (INIS)

    Morales, Humberto; Jones, Blaise V.; Leach, James L.; Abruzzo, Todd A.

    2010-01-01

    Controversy exists as to whether sinus thrombosis is the cause or the result of dural arteriovenous fistula (DAVF) and to whether DAVF are congenital or acquired lesions, especially in children. An infant presented with rupture of an anterior communicating artery aneurysm diagnosed with computed tomography angiography and catheter angiography. Pretreatment hospital course was complicated by extensive dural sinus thrombosis. Subsequent arteriography showed a new adult-type dural arteriovenous fistula to the previously thrombosed right sigmoid sinus. This is the first report of definitive angiographic documentation of the development of an adult-type DAVF after recanalization of a thrombosed dural sinus in a child. This case confirms the acquired etiology of at least one type of DAVF in children, even at this young age. We review the previously documented cases of formation of DAVF subsequent to sinus thrombosis with serial angiography in adults. (orig.)

  14. Puncture Self-Healing Polymers for Aerospace Applications

    Science.gov (United States)

    Gordon, Keith L.; Penner, Ronald K.; Bogert, Phil B.; Yost, W. T.; Siochi, Emilie J.

    2011-01-01

    Space exploration launch costs on the order of $10K per pound provide ample incentive to seek innovative, cost-effective ways to reduce structural mass without sacrificing safety and reliability. Damage-tolerant structural systems can provide a route to avoiding weight penalty while enhancing vehicle safety and reliability. Self-healing polymers capable of spontaneous puncture repair show great promise to mitigate potentially catastrophic damage from events such as micrometeoroid penetration. Effective self-repair requires these materials to heal instantaneously following projectile penetration while retaining structural integrity. Poly(ethylene-co-methacrylic acid) (EMMA), also known as Surlyn is an ionomer-based copolymer that undergoes puncture reversal (self-healing) following high impact puncture at high velocities. However EMMA is not a structural engineering polymer, and will not meet the demands of aerospace applications requiring self-healing engineering materials. Current efforts to identify candidate self-healing polymer materials for structural engineering systems are reported. Rheology, high speed thermography, and high speed video for self-healing semi-crystalline and amorphous polymers will be reported.

  15. CT guided puncture aspiration and sclerosing treatment of ovary cyst

    International Nuclear Information System (INIS)

    Peng Yongjun; Du Xiumei; Yuan Jinrong; Chen Chanqing

    2007-01-01

    Objective: To analyze the method and the curative effect with CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst. Method: 22 ovary cysts in 22 patients were treated with percutaneous puncture aspiration and underwent repeated sclerotherapy with 99.7% ethanol injection. Among the 22 patients, 18 patients had solitary ovary cyst and was aspirated with an 18-22G gauge aspiration needle. The amount of aspirated fluid varied from 30ml-500ml and 25%-30% cyst volume was replaced by appropriate ethanol Post treatment follow-up were achieved every 3 months. Results All the Punctures were successfully completed. During the 3 months to one year follow-up, 16 ovary cyst disappeared, 6 cysts were small over 50%, without main complication. Conclusion CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst is a treatment of choice because of its safety, low complication, and high curative effect. (authors)

  16. Epistaxis caused by a dural AV-fistula at the cribriform plate

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Korsten-Meijer, Astrid G. W.; Mazuri, Aryan

    2014-01-01

    Objectives/HypothesisA dural arteriovenous fistula (DAVF) with cortical venous reflux (CVR) is a dangerous neurovascular entity. A DAVF at the cribriform plate is typically silent until its inevitable presentation with intracranial hemorrhage. Case SummaryA 67-year-old male presented with severe

  17. Dural ectasia of the optic nerve sheath: is it always benign?

    Directory of Open Access Journals (Sweden)

    Berker Bakbak

    2009-11-01

    Full Text Available Berker Bakbak1, Hava Dönmez2, Tülay Kansu3, Hayyam Kiratli41Hacettepe University Institute of Neurological Sciences and Psychiatry, Neuro-ophthalmology Unit, Ankara, Turkey; 2Diskapi Yildirim Beyazid Education and Research Hospital Neurology Clinic, Ankara, Turkey; 3Hacettepe University Medical Faculty, Department of Neurology, Neuro-Ophthalmology Unit, Ankara, Turkey; 4Hacettepe University Medical Faculty, Department of Ophthalmology, Ocular Oncology Unit, Ankara, TurkeyAbstract: A 36-year-old woman with a 3-month history of progressive visual loss had papilledema, dilatation of the optic nerve sheaths and normal cerebrospinal fluid pressures. She was diagnosed as dural ectasia of the optic nerve sheaths and surgical decompression was performed. In this case report, severe visual loss is described as a serious complication of this rare disease and the importance of early surgical intervention is emphasized.Keywords: optic nerve, dural ectasia, meningocele

  18. Discussion on the method to increase the successful rate of L5/S1 intervertebral disc puncture

    International Nuclear Information System (INIS)

    Zhong Xianyi; Li Liangjun; Yu Chengxin

    2007-01-01

    Objective: To study the effective methods of L 5 /S 1 intervertebral disc puncture without drilling to solve the barriers from iliaca. Methods: (1) puncturing with belly-buttock sticking out: to enlarge waist sacro-iliaca angle to move the puncture point up; (2) puncturing through intervertebral edge: puncturing through L 5 to 1/3 intervertebral disc to make the puncture point move Up; (3) puncturing through L 5 /S 1 intervertebral disc with the self-made puncture location instrument. Results with the methods, 280 cases with L 5 /S 1 intervertebral disc protrusion have been successfully punctured, with successful rate 100%. Conclusion: These methods are ideal and easy to use to treat L 5 /S 1 intervertebral disc protrusion puncture, and worth popularizing. (authors)

  19. Cerebellar Herniation after Lumbar Puncture in Galactosemic Newborn

    Directory of Open Access Journals (Sweden)

    Salih Kalay

    2011-09-01

    Full Text Available Cerebral edema resulting in elevated intracranial pressure is a well-known complication of galactosemia. Lumbar puncture was performed for the diagnosis of clinically suspected bacterial meningitis. Herniation of cerebral tissue through the foramen magnum is not a common problem in neonatal intensive care units because of the open fontanelle in infants. We present the case of a 3-week-old infant with galactosemia who presented with signs of cerebellar herniation after lumbar puncture.

  20. Technological advances and changing indications for lumbar puncture in neurological disorders.

    Science.gov (United States)

    Costerus, Joost M; Brouwer, Matthijs C; van de Beek, Diederik

    2018-03-01

    Technological advances have changed the indications for and the way in which lumbar puncture is done. Suspected CNS infection remains the most common indication for lumbar puncture, but new molecular techniques have broadened CSF analysis indications, such as the determination of neuronal autoantibodies in autoimmune encephalitis. New screening techniques have increased sensitvity for pathogen detection and can be used to identify pathogens that were previously unknown to cause CNS infections. Evidence suggests that potential treatments for neurodegenerative diseases, such as Alzheimer's disease, will rely on early detection of the disease with the use of CSF biomarkers. In addition to being used as a diagnostic tool, lumbar puncture can also be used to administer intrathecal treatments as shown by studies of antisense oligonucleotides in patients with spinal muscular atrophy. Lumbar puncture is generally a safe procedure but complications can occur, ranging from minor (eg, back pain) to potentially devastating (eg, cerebral herniation). Evidence that an atraumatic needle tip design reduces complications of lumbar puncture is compelling, and reinforces the need to change clinical practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Experimental inflammation following dural application of complete Freund's adjuvant or inflammatory soup does not alter brain and trigeminal microvascular passage

    DEFF Research Database (Denmark)

    Lundblad, Cornelia; Haanes, Kristian A; Grände, Gustaf

    2015-01-01

    , following dural application of complete Freund's adjuvant (CFA) or inflammatory soup (IS) on brain and trigeminal microvascular passage. METHODS: In order to address this issue, we induced local inflammation in male Sprague-Dawley-rats dura mater by the addition of CFA or IS directly on the dural surface...

  2. Use of Lumbar Punctures in the Management of Ocular Syphilis.

    Science.gov (United States)

    Reekie, Ian; Reddy, Yaviche

    2018-01-01

    Ocular syphilis has become rare in the developed world, but is a common presentation to ophthalmology departments in South Africa. We investigated the proportion of patients diagnosed with ocular syphilis who went on to receive lumbar punctures, and determined the fraction of these who had cerebrospinal fluid findings suggestive of neurosyphilis. We aimed to determine whether the use of lumbar punctures in ocular syphilis patients was beneficial in picking up cases of neurosyphilis. Retrospective study of case notes of patients admitted to two district hospitals in Durban, South Africa, with ocular syphilis over a 20-month period. A total of 31 of 68 ocular syphilis patients underwent lumbar puncture, and of these, eight (25.8%) had findings suggestive of neurosyphilis. Lumbar puncture in ocular syphilis patients should continue to be a routine part of the investigation of these patients; a large proportion of ocular syphilis patients show cerebrospinal fluid findings suggestive of neurosyphilis, are at risk of the complications of neurosyphilis, and should be managed accordingly.

  3. Secondary tracheoesophageal puncture in-office using Seldinger technique.

    Science.gov (United States)

    Britt, Christopher J; Lippert, Dylan; Kammer, Rachael; Ford, Charles N; Dailey, Seth H; McCulloch, Timothy; Hartig, Gregory

    2014-05-01

    Evaluate the safety and efficacy of in-office secondary tracheoesophageal puncture (TEP) technique using transnasal esophagoscopy (TNE) and the Seldinger technique in conjunction with a cricothyroidotomy kit for placement. Case series with chart review. Academic medical center. A retrospective chart review was performed on 83 subjects who underwent in-office secondary TEP. Variables that were examined included disease site, staging, histologic diagnosis, extent of resection and reconstruction, chemoradiation, functional voice status (as assessed by speech pathologist in most recent note), and complications directly related to the procedure. Eighty-three individuals from our institution met our criteria for in-office secondary TEP from 2005 to August 2012. Of these, 97.6% (81/83) had no complications of TEP. The overall complication rate was 2.4% (2/83). Complications included bleeding from puncture site and closure of puncture site after dislodgement of prosthesis at the time of puncture. Fluent conversational speech was achieved in 69.9% of all patients (58/83), and an additional 19.3% (16/83) achieved functional/intelligible speech; of those, 3.6% (3/83) were unable to achieve fluent conversational speech due to anatomic defects from previous surgery. An in-office TEP can be safely performed using the Seldinger technique with direct visualization using TNE, despite the extent of resection or reconstruction, with functional speech outcomes comparable to other studies available in the literature.

  4. Understanding of percutaneous puncture under guidance of ultrasound in treating peritoneal and perinephritic abscess

    International Nuclear Information System (INIS)

    Huang Liying; Wang Jiagang

    2010-01-01

    Objective: To explore the clinical value of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess. Methods: To summarize 68 patients with peritoneal abscess underwent percutaneous puncture under guidance of ultrasound to analyse the method of operation and therapeutic effect. Results: effective power of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess was 96.8%. Conclusion: Percutaneous puncture under guidance of ultrasound in treating peritoneal abscess may avoid injury induced by blinded puncture, with characteristic of easier operation, slighter trauma. higher safety, significant therapeutic effect, and can be spreaded to the clinical application. (authors)

  5. Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

    International Nuclear Information System (INIS)

    Knirsch, Walter; Kurtz, Claudia; Langer, Mathias; Haeffner, Nicole; Kececioglu, Deniz

    2005-01-01

    The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

  6. Normal values of the sagittal diameter of the lumbar spine (vertebral body and dural sac) in children measured by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Knirsch, Walter [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany); University Children' s Hospital Zurich, Division of Paediatric Cardiology, Zurich (Switzerland); Kurtz, Claudia; Langer, Mathias [University Hospital Freiburg, Department of Radiology, Freiburg (Germany); Haeffner, Nicole; Kececioglu, Deniz [University Children' s Hospital Freiburg, Department of Pediatric Cardiology, Freiburg (Germany)

    2005-04-01

    The definition of normal values is a prerequisite for the reliable evaluation of abnormality in the lumbar spine, such as spinal canal stenosis or dural ectasia in patients with Marfan syndrome. Values for vertebral body diameter (VBD) and dural sac diameter (DSD) for the lumbar spine have been published in adults. In children, normal values have been established using conventional radiography or myelography, but not by MRI. To define normal values for the sagittal diameter of the vertebral body and dural sac, and to calculate a dural sac ratio (DSR) in the lumbosacral spine (L1-S1) in healthy children using MRI. A total of 75 healthy children between 6 years and 17 years of age were examined using a sagittal T2-weighted sequence. Sagittal VBD and DSD were measured and a DSR was calculated. This was a retrospective and cross-sectional study. With increasing age there is a significant increase of VBD, a slight increase of DSD, and a slight decrease of DSR. There is no significant sex difference. DSR in healthy children is higher than in healthy adults. MRI is a reliable method demonstrating the natural shape of the lumbosacral spine and its absolute values. These normal values compare well with those established by conventional radiological techniques. Our data may serve as a reference for defining dural ectasia in children with Marfan syndrome. (orig.)

  7. A rare case of spinal dural arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Mariya Apostolova

    2012-12-01

    Full Text Available Spinal dural arteriovenous fistula (SDAVF is a rare vascular malformation of the spine. Only a limited number of cases of SDAVF have been reported in the current literature. We describe the case of a 74 year old male who presented with gradually progressive bilateral lower extremity weakness and bladder dysfunction and was subsequently diagnosed with SDAVF affecting both the thoracic and lumbar spine. The patient later underwent embolization with some improvement in his neurologic symptoms.

  8. Use of computer-assisted design and manufacturing to localize dural venous sinuses during reconstructive surgery for craniosynostosis.

    Science.gov (United States)

    Iyer, Rajiv R; Wu, Adela; Macmillan, Alexandra; Musavi, Leila; Cho, Regina; Lopez, Joseph; Jallo, George I; Dorafshar, Amir H; Ahn, Edward S

    2018-01-01

    Cranial vault remodeling surgery for craniosynostosis carries the potential risk of dural venous sinus injury given the extensive bony exposure. Identification of the dural venous sinuses can be challenging in patients with craniosynostosis given the lack of accurate surface-localizing landmarks. Computer-aided design and manufacturing (CAD/CAM) has allowed surgeons to pre-operatively plan these complex procedures in an effort to increase reconstructive efficiency. An added benefit of this technology is the ability to intraoperatively map the dural venous sinuses based on pre-operative imaging. We utilized CAD/CAM technology to intraoperatively map the dural venous sinuses for patients undergoing reconstructive surgery for craniosynostosis in an effort to prevent sinus injury, increase operative efficiency, and enhance patient safety. Here, we describe our experience utilizing this intraoperative technology in pediatric patients with craniosynostosis. We retrospectively reviewed the charts of children undergoing reconstructive surgery for craniosynostosis using CAD/CAM surgical planning guides at our institution between 2012 and 2016. Data collected included the following: age, gender, type of craniosynostosis, estimated blood loss, sagittal sinus deviation from the sagittal suture, peri-operative outcomes, and hospital length of stay. Thirty-two patients underwent reconstructive cranial surgery for craniosynostosis, with a median age of 11 months (range, 7-160). Types of synostosis included metopic (6), unicoronal (6), sagittal (15), lambdoid (1), and multiple suture (4). Sagittal sinus deviation from the sagittal suture was maximal in unicoronal synostosis patients (10.2 ± 0.9 mm). All patients tolerated surgery well, and there were no occurrences of sagittal sinus, transverse sinus, or torcular injury. The use of CAD/CAM technology allows for accurate intraoperative dural venous sinus localization during reconstructive surgery for craniosynostosis and

  9. Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance

    Directory of Open Access Journals (Sweden)

    Zolnierczyk P

    2015-05-01

    Full Text Available Piotr Zolnierczyk, Krzysztof Cendrowski, Wlodzimierz Sawicki Department of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Abstract: This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index – 38, congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic–therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations. Keywords: ovarian cyst puncture, hysteroscopy, ultrasound guided puncture, transfundal cyst puncture, vaginoscopy 

  10. Puncture mechanics of soft elastomeric membrane with large deformation by rigid cylindrical indenter

    Science.gov (United States)

    Liu, Junjie; Chen, Zhe; Liang, Xueya; Huang, Xiaoqiang; Mao, Guoyong; Hong, Wei; Yu, Honghui; Qu, Shaoxing

    2018-03-01

    Soft elastomeric membrane structures are widely used and commonly found in engineering and biological applications. Puncture is one of the primary failure modes of soft elastomeric membrane at large deformation when indented by rigid objects. In order to investigate the puncture failure mechanism of soft elastomeric membrane with large deformation, we study the deformation and puncture failure of silicone rubber membrane that results from the continuous axisymmetric indentation by cylindrical steel indenters experimentally and analytically. In the experiment, effects of indenter size and the friction between the indenter and the membrane on the deformation and puncture failure of the membrane are investigated. In the analytical study, a model within the framework of nonlinear field theory is developed to describe the large local deformation around the punctured area, as well as to predict the puncture failure of the membrane. The deformed membrane is divided into three parts and the friction contact between the membrane and indenter is modeled by Coulomb friction law. The first invariant of the right Cauchy-Green deformation tensor I1 is adopted to predict the puncture failure of the membrane. The experimental and analytical results agree well. This work provides a guideline in designing reliable soft devices featured with membrane structures, which are present in a wide variety of applications.

  11. Use of a vegetable model as a training tool for PCNL puncture.

    Science.gov (United States)

    Sinha, Maneesh; Krishnamoorthy, Venkatesh

    2015-01-01

    Training residents to perform a PCNL puncture is hampered by the non-availability of a good inanimate model that can be used for demonstration and practice. The ethics of surgical training during actual surgeries is being questioned and the role of simulation is increasingly important. Virtual reality trainers, however, are prohibitively expensive and the use of animal models is fraught with regulatory and ethical concerns. We have devised a model that can be used to teach the concept of depth perception during a PCNL puncture. A bottle gourd was used to mimic the posterior abdominal wall. Cotton pledgets dipped in intravenous contrast were fitted into 4 mm holes made at staggered levels in the bottle gourd which was strapped onto the operating table with the cotton pledgets facing away from the surgeon. Surgeons with varying degrees of experience made fluoroscopy-guided punctures onto the cotton pledgets. We recorded the time taken for puncture in seconds and the distance of the needle exit site from the center of the cotton ball. Speed was measured by recording the fluoroscopy time in seconds on the C-arm. Accuracy was documented by using a Vernier caliper to measure the distance from the edge of the target to the actual puncture. One second of fluoroscopy time and 0.1 mm distance were each given one point. The total points accumulated over a set of 10 punctures was added to give a total score. Longer fluoroscopy times and inaccurate punctures resulted in higher scores. A surgeon with more than 1000 PCNLs to his credit had a score of 99. The average score of five residents was 555. The bottle gourd model provides an ethically acceptable, inexpensive, easy to replicate model that can be used to train residents in the PCNL puncture.

  12. Liouville theory and uniformization of four-punctured sphere

    Science.gov (United States)

    Hadasz, Leszek; Jaskólski, Zbigniew

    2006-08-01

    A few years ago Zamolodchikov and Zamolodchikov proposed an expression for the four-point classical Liouville action in terms of the three-point actions and the classical conformal block [Nucl. Phys. B 477, 577 (1996)]. In this paper we develop a method of calculating the uniformizing map and the uniformizing group from the classical Liouville action on n-punctured sphere and discuss the consequences of Zamolodchikovs conjecture for an explicit construction of the uniformizing map and the uniformizing group for the sphere with four punctures.

  13. Rare patterns of dorsal puncture in Pterostichus oblongopunctatus (Coleoptera: Carabidae

    Directory of Open Access Journals (Sweden)

    Axel Schwerk

    2018-04-01

    Full Text Available Background The carabid beetle species Pterostichus oblongopunctatus is common in different types of forests in Poland and Europe. With respect to this species, some unclarities exist concerning the morphological feature of punctures on the elytra. P. oblongopunctatus has dorsal pits in the third interval of the elytra, the available identification keys, however, provide inconsistent information concerning the puncture in other intervals. During long-term studies at different study sites in Poland, the first author rarely but regularly discovered individuals with unusual dorsal puncture patterns, i.e., pits in the fifth and even in the seventh interval of the elytra. Since such rare patterns might be connected with special habitat characteristics, and thus have a potential as an indicator, the aim of the study was to test if they are connected with specific subpopulations (interaction groups, if they are related to the sex or size of the beetles, and if they are related to specific habitat conditions. Material and Methods We counted the pits on the elytra, determined the sex, and measured the length of the right elytron of individuals of P. oblongopunctatus collected at numerous study sites located within the borders of the Regional Directory of National Forests in Piła (Western Poland over the period 2014–2016. Results Altogether, 1,058 individuals of P. oblongopunctatus were subjected to statistical analysis. Almost 19% of the individuals had a dorsal puncture in the fifth interval of the elytra and about 0.7% had a dorsal puncture in the seventh interval of the elytra. In 2014 and 2015, significantly more females exhibited such unusual patterns of dorsal puncture than males. Even if not statistically significant, in 2016 also relatively more females showed such a pattern. Neither males nor females of the analysed individuals with usual puncture patterns showed a significant difference in the length of the right elytron from those with

  14. Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Universitaetsklinikum Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Henkes, H.; Liebig, T.; Weber, W.; Golik, S.; Kuehne, D. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Esser, J. [Universitaetsklinikum Essen, Zentrum fuer Augenheilkunde, Essen (Germany)

    2006-07-15

    Introduction: The purpose of this study was to evaluate the single-centre experience with transvenous coil treatment of dural carotid-cavernous sinus fistulas. Methods: Between November 1991 and December 2005, a total of 141 patients (112 female) with dural carotid-cavernous sinus fistula underwent 161 transvenous treatment sessions. The patient files and angiograms were analysed retrospectively. Clinical signs and symptoms included chemosis (94%), exophthalmos (87%), cranial nerve palsy (54%), increased intraocular pressure (60%), diplopia (51%), and impaired vision (28%). Angiography revealed in addition cortical drainage in 34% of the patients. Partial arterial embolization was carried out in 23% of the patients. Transvenous treatment comprised in by far the majority of patients complete filling of the cavernous sinus and the adjacent segment of the superior and inferior ophthalmic vein with detachable coils. Complete interruption of the arteriovenous shunt was achieved in 81% of the patients. A minor residual shunt (without cortical or ocular drainage) remained in 13%, a significant residual shunt (with cortical or ocular drainage) remained in 4%, and the attempted treatment failed in 2%. There was a tendency for ocular pressure-related symptoms to resolve rapidly, while cranial nerve palsy and diplopia improved slowly (65%) or did not change (11%). The 39 patients with visual impairment recovered within the first 2 weeks after endovascular treatment. After complete interruption of the arteriovenous shunt, no recurrence was observed. The transvenous coil occlusion of the superior and inferior ophthalmic veins and the cavernous sinus of the symptomatic eye is a highly efficient and safe treatment in dural carotid-cavernous sinus fistulas. In the majority of patients a significant and permanent improvement in clinical signs and symptoms can be achieved. (orig.)

  15. The transabdominal chorionic villus sampling puncture guided by color Doppler ultrasound during early pregnancy

    International Nuclear Information System (INIS)

    Liang Weixiang; Chen Zhiyi; Yuan Wenlin; Cai Kuan; Zhu Junlin; Wang Weiqun; Chen Xia

    2008-01-01

    Objective: To study the operation of chorionic villus sampling (CVS) guided by color Doppler ultrasound (CDU) via abdomen puncture during early pregnancy and investigate the advertences during the operation. Methods: CVS guided by CDU probe via abdomen puncture were operated on 28 pregnant women who had the indications of antenatal diagnosis. CDU was used to observe the implantation position of the fo1iaceous villis and help setting mark of the puncture point and puncture range on body surface before operation. The needle was punctured under real-time ultrasound guidance and villis were aspirated during the operation: The choice of the right time of puncture and the operation skills were emphasized in the study. Results: The CVS puncture approach should be set through CDU ob servation, which attend to avoid the surrounding blood vessels, intestinal canal and surrounding important organs. The puncture point should be chosen in a point where lobif0rmed villis distributed wider and with a larger scope. The operations were performed from 10 to13 weeks of pregnancy, with an average of 11 weeks. Among these 28 cases, 9.6 were successfully drawn materials in one time, 1 in twice and l failure, with the total ratio of achievement was 96.4%. For all the cases, fetal heart pulsating could be seen by real-time CDU observation fight after the operation, and no larger hematoma echo in the placental site occurred. Ultrasound reexamined one week after the operation, fetal heart pulsation could be found in all cases, and no abortion cases occurred after regular follow-up in 25 continued pregnant patients. Conclusion: Abdominal CVS puncture guided by CDU probe is conveniently operated, safe and available in clinic. It is an important method for antenatal diagnosis during early pregnancy. The puncture localization, skills and the time are the key points for the success in obtaining the materials. (authors)

  16. Side effects after diagnostic lumbar puncture and lumbar iohexol myelography

    International Nuclear Information System (INIS)

    Sand, T.; Stovner, L.J.; Salvesen, R.; Dale, L.

    1987-01-01

    A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n=97) and diagnostic lumbar puncture (n=85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early-onset headache occurred significantly more often in the iohexol group (16 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effets after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent. (orig.)

  17. Technological advances and changing indications for lumbar puncture in neurological disorders

    NARCIS (Netherlands)

    Costerus, Joost M.; Brouwer, Matthijs C.; van de Beek, Diederik

    2018-01-01

    Technological advances have changed the indications for and the way in which lumbar puncture is done. Suspected CNS infection remains the most common indication for lumbar puncture, but new molecular techniques have broadened CSF analysis indications, such as the determination of neuronal

  18. Predisposing factors for peripheral intravenous puncture failure in children

    OpenAIRE

    Negri,Daniela Cavalcante de; Avelar,Ariane Ferreira Machado; Andreoni,Solange; Pedreira,Mavilde da Luz Gonçalvez

    2012-01-01

    OBJECTIVE: To identify predisposing factors for peripheral intravenous puncture failure in children. METHODS: Cross-sectional cohort study conducted with 335 children in a pediatric ward of a university hospital after approval of the ethics committee. The Wald Chi-squared, Prevalence Ratio (PR) and backward procedure (p≤0.05) tests were applied. RESULTS: Success of peripheral intravenous puncture was obtained in 300 (89.5%) children and failure in 35 (10.4%). The failure rates were sign...

  19. Needle puncture in rabbit functional spinal units alters rotational biomechanics.

    Science.gov (United States)

    Hartman, Robert A; Bell, Kevin M; Quan, Bichun; Nuzhao, Yao; Sowa, Gwendolyn A; Kang, James D

    2015-04-01

    An in vitro biomechanical study for rabbit lumbar functional spinal units (FSUs) using a robot-based spine testing system. To elucidate the effect of annular puncture with a 16 G needle on mechanical properties in flexion/extension, axial rotation, and lateral bending. Needle puncture of the intervertebral disk has been shown to alter mechanical properties of the disk in compression, torsion, and bending. The effect of needle puncture in FSUs, where intact spinal ligaments and facet joints may mitigate or amplify these changes in the disk, on spinal motion segment stability subject to physiological rotations remains unknown. Rabbit FSUs were tested using a robot testing system whose force/moment and position precision were assessed to demonstrate system capability. Flexibility testing methods were developed by load-to-failure testing in flexion/extension, axial rotation, and lateral bending. Subsequent testing methods were used to examine a 16 G needle disk puncture and No. 11 blade disk stab (positive control for mechanical disruption). Flexibility testing was used to assess segmental range-of-motion (degrees), neutral zone stiffness (N m/degrees) and width (degrees and N m), and elastic zone stiffness before and after annular injury. The robot-based system was capable of performing flexibility testing on FSUs-mean precision of force/moment measurements and robot system movements were elastic zone stiffness in flexion and lateral bending. These findings suggest that disk puncture and stab can destabilize FSUs in primary rotations.

  20. Computation of Quantum Bound States on a Singly Punctured Two-Torus

    International Nuclear Information System (INIS)

    Kar-Tim Chan; Zainuddin Hishamuddin; Molladavoudi Saeid

    2013-01-01

    We study a quantum mechanical system on a singly punctured two-torus with bound states described by the Maass waveforms which are eigenfunctions of the hyperbolic Laplace—Beltrami operator. Since the discrete eigenvalues of the Maass cusp form are not known analytically, they are solved numerically using an adapted algorithm of Hejhal and Then to compute Maass cusp forms on the punctured two-torus. We report on the computational results of the lower lying eigenvalues for the punctured two-torus and find that they are doubly-degenerate. We also visualize the eigenstates of selected eigenvalues using GridMathematica

  1. Analysis of the indications for routine lumbar puncture and results of ...

    African Journals Online (AJOL)

    Lumbar puncture (LP) is an important diagnostic tool for investigating neurological conditions/diseases. This study was carried out to compare the indications for lumbar puncture and findings of cerebrospinal fluid examination in children admitted to Muhimbili National Hospital (MNH) in Dar-es-salaam, Tanzania and Kilifi ...

  2. Preservation of Frontal Sinus Anatomy and Outflow Tract Following Frontal Trauma with Dural Defect

    Directory of Open Access Journals (Sweden)

    James Wei Ming Kwek, MBBS, MRCS

    2015-02-01

    Full Text Available Summary: Our case report describes a young male mechanic who was hit in his face by a spring while repairing a car, resulting in traumatic injury to the frontal sinus, with fractures of both the anterior and the posterior tables with dural defect and cerebrospinal fluid leak. Current guidelines recommend that comminuted and/or displaced fractures of the posterior table of the frontal sinus with dural defects should be either cranialized or obliterated. In this patient, instead of cranializing or obliterating the frontal sinus, we managed to preserve the frontal sinus anatomy and its outflow tract using a combined open bicoronal and nasoendoscopic approach. This avoids the long-term complications associated with cranialization or obliteration including mucocele formation and frontocutaneous fistula.

  3. The interperiosteo-dural concept applied to the perisellar compartment: a microanatomical and electron microscopic study.

    Science.gov (United States)

    François, Patrick; Travers, Nadine; Lescanne, Emmanuel; Arbeille, Brigitte; Jan, Michel; Velut, Stéphane

    2010-11-01

    The dura mater has 2 dural layers: the endosteal layer (outer layer), which is firmly attached to the bone, and the meningeal layer (inner layer), which directly covers the brain. These 2 dural layers join together in the middle temporal fossa or the convexity and separate into the orbital, lateral sellar compartment (LSC), or spinal epidural space to form the extradural neural axis compartment (EDNAC). The aim of this work was to anatomically verify the concept of the EDNAC by using electron microscopy. The authors studied the cadaveric heads obtained from 13 adults. Ten of the specimens (or 20 perisellar areas) were injected with colored latex and fixed in formalin. They carefully removed each brain to allow a superior approach to the perisellar area. The 3 other specimens were studied by microscopic and ultrastructural methods to describe the EDNAC in the perisellar area. Special attention was paid to the dural layers surrounding the perisellar area. The authors studied the anatomy of the meningeal architecture of the LSC, the petroclival venous confluence, the orbit, and the trigeminal cave. After dissection, the authors took photographs of the dural layers with the aid of optical magnification. The 3 remaining heads, obtained from fresh cadavers, were prepared for electron microscopic study. The EDNAC is limited by the endosteal layer and the meningeal layer and contains fat and/or venous blood. The endosteal layer and meningeal layer were not identical on electron microscopy; this finding can be readily related to the histology of the meninges. In this study, the authors demonstrated the existence of the EDNAC concept in the perisellar area by using dissected cadaveric heads and verified the reality of the concept of the meningeal layer with electron microscopy. These findings clearly demonstrated the existence of the EDNAC, a notion that has generally been accepted but never demonstrated microscopically.

  4. MR diagnosis of dural sinus thrombosis. Diagnostico por RM de las trombosis de senos durales

    Energy Technology Data Exchange (ETDEWEB)

    Rovira Caellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castao Duque, Ch.; Grive Isern, E.; Sumalla Sue, J. (Hospital General Vall d' Hebron Barcelona (Spain))

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  5. CT-guided puncture for direct MR-arthrography of the shoulder: Description of possible techniques

    Directory of Open Access Journals (Sweden)

    Hauth E

    2016-07-01

    Full Text Available The following report describes the possible techniques of CT-guided puncture for direct magnetic resonance (MR arthrography of the shoulder. CT-guided puncture can be regarded as an alternative technique to fluoroscopic- or ultrasound-guided puncture for MR-arthrography of the shoulder with high efficiency, low dose and extremely low complication rate.

  6. Changes in cerebral haemodynamics in cases of post-lumbar puncture headache: a prospective transcranial Doppler ultrasound study

    International Nuclear Information System (INIS)

    Goebel, H.; Klostermann, H.; Lindner, V.; Schenkl, S.

    1990-01-01

    Transcranial Doppler ultrasonography was used in 45 patients to investigate if changes in haemodynamics in the major arteries of the brain base occurred after lumbar puncture and whether or not patients with or without post-lumbar puncture headache differ with respect to their cerebral haemodynamic parameters before and after lumbar puncture. Before lumbar puncture, patients with post-lumbar puncture headache differed from patients withoput post-lumbar puncture headache in that they showed significantly higher flow velocities and significant asymmetry of flow velocities with lateralization to the right. Patients without post-lumbar puncture headache, on the other hand, showed non-significant flow velocity lateralization to the left. Forty-eight hours after lumbar puncture, both groups demonstrated symmetrical flow velocities. In addition, only patients with post-lumbar puncture headache showed a significant reduction in the flow velocity of the right middle cerebral artery. These findings suggest that it is not only absolute flow velocity that plays a part in the event of headache; the interhemispheric relation of cerebral haemodynamics also plays a fundamental role. 14 refs., 3 figs., 2 tabs

  7. The dural entrance of cerebral bridging veins into the superior sagittal sinus: an anatomical comparison between cadavers and digital subtraction angiography

    International Nuclear Information System (INIS)

    Han, Hui; Tao, Wei; Zhang, Ming

    2007-01-01

    Intracranial venous structures have received increasing attention due to improved neuroimaging techniques and increased awareness of cerebral venous disease. To date, few studies have attempted to investigate the dural entrance of the cerebral bridging vein (BV). The aim of this study was to use the superior sagittal sinus (SSS) as an example to identify anatomical features of the dural entrance of the BVs into the SSS in both human cadavers and digital subtraction angiography (DSA) images. A total of 30 adult and 7 fetal human cadavers and 36 patients were examined with anatomical dissections, vascular casting and DSA. The number, diameter and angle of the BVs entering the SSS were measured and compared between the cadavers and DSA images. The results demonstrated that (1) the way a BV entered the SSS varied in three dimensions, and thus the BV dural entrance was difficult to precisely localize by DSA, (2) the distribution pattern of the dural entrance of the BVs into the SSS was relatively constant and a nontributary segment of the SSS was centered at the coronal suture and was identifiable by DSA, and (3) nearly all the BVs (97%, 561/581) entered the SSS at an angle opposite to the direction of blood flow. Unique anatomical features of the dural entrance of a BV into the SSS should be considered in neuroimaging interpretation of the sinus and its associated veins. (orig.)

  8. Stenting-plasty with brachial puncture in the treatment of subclavian steal syndrome

    International Nuclear Information System (INIS)

    Chen Quan; Jing Zaiping; Zhao Zhiqing; Feng Xiang; Lu Qingsheng; Mei Zhijun

    2007-01-01

    Objective: To study the clinical effect of stenting-plasty with retrograde brachial puncture for subclavian steal syndrome patients. Methods: To analyze the clinical results of stenting-plasty with retrograde brachial puncture in 15 patients with subclavian steal syndrome. Results: MRA or DSA showed the subclavian arteries with different degrees of stenosis (80%-100%) in all patients. Stenting-plasty with retrograde brachia] puncture was used in all patients. After placement of wall or polmaz stent, the pulse recovered and the syndrome disappeared. Postoperative angiography showed patency of the artery and stent. The patients were followed up for 3-30 months without recurrence of symptoms. Conclusions: Stenting-plasty with retrograde brachial puncture is a rather proper method to treat subclavian steal syndrome with more coincidence to the vascular anatomy, decrease the maneuver trouble and increase the successful rate. (authors)

  9. Dural metastases from prostate carcinoma: A systematic review of the literature apropos of six patients

    International Nuclear Information System (INIS)

    Vasconcelos Sobreira Guedes, Bruno de; Rocha, Antonio Jose da; Pereira Pinto Gama, Hugo; Silva, Carlos Jorge da

    2011-01-01

    Intracranial metastases are a rare manifestation of prostate carcinoma and the dura mater is the most affected site. We report a series of six patients with dural prostate metastases (DPM) and perform a systematic review of the current literature in order to depict imaging trademarks of this condition. This review points to a magnetic resonance imaging (MRI) pattern of meningeal involvement characterized by a diffuse smooth thickening, nodular appearance or dural-based masses. We also demonstrate an osteoblastic pattern of lesions, particularly in sphenoid wing, by computed tomography (CT) scans. We suggest that these imaging findings may support an elevated index of suspicion of DPM in elderly men, including those patients without urologic symptoms.

  10. The clinical value of trans-vaginal ultrasound-guided puncture in the treatment of pelvic abscess

    International Nuclear Information System (INIS)

    Wang Ping; Gong Wei

    2008-01-01

    Objective: To investigate the clinical value of trans-vaginal ultrasound-guided (TVS) puncture in the treatment of pelvic abscess. Methods 30 cases with pelvic abscess were treated by transvaginal ultrasound-guided puncture. The long-dated effects were followed-up. Results: 29 cases were cured by TVS puncture. Operation was performed in 1 patient because of invalid effect. The cure rate was 97%. Conclusion: Ultrasound-guided puncture is a safe and convenient method in the treatment of pelvic abscess. (authors)

  11. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report

    KAUST Repository

    YANG, GUANG

    2014-05-13

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  12. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report

    KAUST Repository

    YANG, GUANG; LI, CHENGUANG; CHEN, XIN; LIU, YAOHUA; HAN, DAYONG; Gao, Xin; KAWAMOTO, KEIJI; ZHAO, SHIGUANG

    2014-01-01

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  13. Development and psychometric evaluation of the arterial puncture self-efficacy scale.

    Science.gov (United States)

    Hernández-Padilla, José Manuel; Granero-Molina, José; Márquez-Hernández, Verónica V; Suthers, Fiona; Fernández-Sola, Cayetano

    2016-05-01

    Arterial puncture for arterial blood gases (ABG) analysis can be a risky, painful, difficult-to-perform procedure that is often insufficiently practised and generates stress and discomfort amongst patients and healthcare professionals. Self-efficacy is a key component in the acquisition of procedural skills. Therefore, professionals' self-efficacy in arterial puncture should be measured before attempting the procedure on real patients. To develop and psychometrically assess a self-efficacy scale in arterial puncture. An observational cross-sectional design was used in this study. Faculty of Education Sciences, Nursing and Physiotherapy in a higher education institution in the south of Spain. A convenience sample of 342 nursing students entered and completed the study. All participants met the following inclusion criteria: (1) ≥18years old and (2) enrolled in a nursing degree programme during the 2014/2015 academic year. Participants were 74% female (n=254) and their age ranged from 18 to 50, with a mean age of 21.74years (SD=5.14). The Arterial Puncture Self-Efficacy Scale (APSES) was developed and psychometrically tested. Reliability and content validity were studied. Predictive validity and concurrent validity assessed criterion validity. In addition, principal component analysis and known-group analysis evaluated construct validity. Principal component analysis revealed the two-subscale structure of the final 22-item version of the Arterial Puncture Self-Efficacy Scale (APSES). A total Cronbach's alpha coefficient of 0.97 showed its high reliability. The APSES' content validity index was excellent (S-CVI/Ave=0.95). Predictive and concurrent validity analysis demonstrated the good criterion validity of the tool. Supporting the APSES' sensitivity and specificity, known-groups analysis evidenced significant differences (pgood psychometric properties for measuring self-efficacy in arterial puncture for ABG analysis. Copyright © 2016 Elsevier Ltd. All rights

  14. Standardization and validation of a novel and simple method to assess lumbar dural sac size

    International Nuclear Information System (INIS)

    Daniels, M.L.A.; Lowe, J.R.; Roy, P.; Patrone, M.V.; Conyers, J.M.; Fine, J.P.; Knowles, M.R.; Birchard, K.R.

    2015-01-01

    Aim: To develop and validate a simple, reproducible method to assess dural sac size using standard imaging technology. Materials and methods: This study was institutional review board-approved. Two readers, blinded to the diagnoses, measured anterior–posterior (AP) and transverse (TR) dural sac diameter (DSD), and AP vertebral body diameter (VBD) of the lumbar vertebrae using MRI images from 53 control patients with pre-existing MRI examinations, 19 prospectively MRI-imaged healthy controls, and 24 patients with Marfan syndrome with prior MRI or CT lumbar spine imaging. Statistical analysis utilized linear and logistic regression, Pearson correlation, and receiver operating characteristic (ROC) curves. Results: AP-DSD and TR-DSD measurements were reproducible between two readers (r = 0.91 and 0.87, respectively). DSD (L1–L5) was not different between male and female controls in the AP or TR plane (p = 0.43; p = 0.40, respectively), and did not vary by age (p = 0.62; p = 0.25) or height (p = 0.64; p = 0.32). AP-VBD was greater in males versus females (p = 1.5 × 10 −8 ), resulting in a smaller dural sac ratio (DSR) (DSD/VBD) in males (p = 5.8 × 10 −6 ). Marfan patients had larger AP-DSDs and TR-DSDs than controls (p = 5.9 × 10 −9 ; p = 6.5 × 10 −9 , respectively). Compared to DSR, AP-DSD and TR-DSD better discriminate Marfan from control subjects based on area under the curve (AUC) values from unadjusted ROCs (AP-DSD p < 0.01; TR-DSD p = 0.04). Conclusion: Individual vertebrae and L1–L5 (average) AP-DSD and TR-DSD measurements are simple, reliable, and reproducible for quantitating dural sac size without needing to control for gender, age, or height. - Highlights: • DSD (L1-L5) does not differ in the AP or TR plane by gender, height, or age. • AP- and TR-DSD measures correlate well between readers with different experience. • Height is positively correlated to AP-VBD in both males and females. • Varying

  15. Impact of Corrugated Paperboard Structure on Puncture Resistance

    Directory of Open Access Journals (Sweden)

    Vaidas Bivainis

    2015-03-01

    Full Text Available Thanks to its excellentprotective properties, lightness, a reasonable price, and ecology, corrugated paperboardis one of the most popular materials used in the production of packaging for variousproducts. During transportation or storage, packaging with goods can be exposedto the mass of other commodities, dropping from heights and transportationshock loads, which can lead to their puncture damage. Depending on the purposeand size of the packaging, the thickness, grammage, constituent paper layers,numbers of layers and type of fluting of corrugated paperboard used in itsproduction differ. A standard triangular prism, corrugated paperboard fixationplates and a universal tension-compression machine were used to investigate theimpact of corrugated paperboard structure and other parameters on the punctureresistance of the material. The investigation determines the maximum punctureload and estimates energy required to penetrate the corrugated paperboard. Itwas found that the greatest puncture resistance is demonstrated by paperboardwith a larger number of corrugating flutings and the board produced from harderpaper with a smaller amount of recycled paper. It was established that thegrammage of three-layered paperboard with two different fluting profiles has thegreatest impact on the level of static puncture energy.DOI: http://dx.doi.org/10.5755/j01.ms.21.1.5713

  16. Ultrasound-guided, minimally invasive, percutaneous needle puncture treatment for tennis elbow.

    Science.gov (United States)

    Zhu, Jiaan; Hu, Bing; Xing, Chunyan; Li, Jia

    2008-10-01

    This report evaluates the efficacy of percutaneous needle puncture under sonographic guidance in treating lateral epicondylitis (tennis-elbow). Ultrasound-guided percutaneous needle puncture was performed on 76 patients who presented with persistent elbow pain. Under a local anesthetic and sonographic guidance, a needle was advanced into the calcification foci and the calcifications were mechanically fragmented. This was followed by a local injection of 25 mg prednisone acetate and 1% lidocaine. If no calcification was found then multiple punctures were performed followed by local injection of 25 mg prednisone acetate and 1% lidocaine. A visual analog scale (VAS) was used to evaluate the degree of pain pre-and posttreatment at 1 week to 24 weeks. Elbow function improvement and degree of self-satisfaction were also evaluated. Of the 76 patients, 55% were rated with excellent treatment outcome, 32% good, 11% average, and 3% poor. From 3 weeks posttreatment, VAS scores were significantly reduced compared with the pretreatment score (Ptennis elbow. Sonography can be used to accurately identify the puncture location and monitor changes.

  17. Acute Renal Failure following Accidental Potassium Bromate ...

    African Journals Online (AJOL)

    Accidental poisoning is common in children. Potassium bromate is a commonly used additive and raising agent in many edibles particularly bread, a staple food worldwide, yet its accidental poisoning has hitherto, not been documented in Nigeria. We report an unusual case of acute renal failure following accidental ...

  18. Embolization of intracranial dural arteriovenous fistulas using PHIL liquid embolic agent in 26 patients

    DEFF Research Database (Denmark)

    Lamin, S.; Chew, H. S.; Chavda, S.

    2017-01-01

    BACKGROUND AND PURPOSE: The introduction of liquid embolic agents has revolutionized endovascular approach to cranial vascular malformations. The aim of the study was to retrospectively assess the efficacy and safety of Precipitating Hydrophobic Injectable Liquid (PHIL), a new nonadhesive liquid......: This was a retrospective multicenter study. Twenty-six consecutive patients with dural arteriovenous fistulas (de novo or previously treated) treated by injection of PHIL only or with PHIL in combination with other embolization products (such as Onyx or detachable coils) were included in the study. Recruitment started......, 3 were retreated with PHIL and 1 achieved angiographic cure. An adverse event was seen in 1 patient who developed worsening of preexisting ataxia due to acute thrombosis of the draining vein. CONCLUSIONS: PHIL appears to be safe and effective for endovascular treatment of cranial dural arteriovenous...

  19. Author Details

    African Journals Online (AJOL)

    Incidence of post dural puncture headache following Caesarean section under spinal anaesthesia at the Aga Khan University Hospital, Nairobi Abstract PDF · Vol 87, No 8 (2010) - Articles Conformity to the Surviving Sepsis Campaign International Guidelines among Physicians in a general Inensive care unit in Nairobi

  20. Performance and complications of lumbar puncture in memory clinics : Results of the multicenter lumbar puncture feasibility study

    NARCIS (Netherlands)

    Duits, Flora H.; Martinez-Lage, Pablo; Paquet, Claire; Engelborghs, Sebastiaan; Lleo, Alberto; Hausner, Lucrezia; Molinuevo, Jose L.; Stomrud, Erik; Farotti, Lucia; Ramakers, Inez H. G. B.; Tsolaki, Magda; Skarsgard, Constance; Astrand, Ragnar; Wallin, Anders; Vyhnalek, Martin; Holmber-Clausen, Marie; Forlenza, Orestes V.; Ghezzi, Laura; Ingelsson, Martin; Hoff, Erik I.; Roks, C.M.A.A.; de Mendonca, Alexandre; Papma, Janne M.; Izagirre, Andrea; Taga, Mariko; Struyfs, Hanne; Alcolea, Daniel A.; Froelich, Lutz; Balasa, Mircea; Minthon, Lennart; Twisk, Jos W. R.; Persson, Staffan; Zetterberg, Henrik; van der Flier, Wiesje M.; Teunissen, Charlotte E.; Scheltens, Philip; Blennow, Kaj

    2016-01-01

    Introduction Lumbar puncture (LP) is increasingly performed in memory clinics. We investigated patient-acceptance of LP, incidence of and risk factors for post-LP complications in memory clinic populations. Methods We prospectively enrolled 3868 patients (50% women, age 66 ± 11 years, mini mental

  1. MR imaging with gadolinium in patients with and without post-lumbar puncture headache

    International Nuclear Information System (INIS)

    Hannerz, J.; Ericson, K.; Bro Skejoe, H.P.

    1999-01-01

    Purpose: To study frequency and extent of meningeal enhancement in patients with and without post-lumbar puncture headache (PLPH) with cerebral MR with Gd-DTPA. Material and methods: Ten consecutive patients with PLPH and 9 consecutive patients without PLPH were included in the study. Nine of the PLPH patients were reinvestigated when the PLPH was over and all non-PLPH patients during the week after the lumbar puncture. Results: Eight of the 9 patients with PLPH showed more enhancement of meningeal structures during PLPH than when PLPH had disappeared. The differences were slight in 5, more marked in 2, and pronounced in 1 patient. The 9th patient showed no change at all. In the 9 patients without PLPH, there was mainly slight enhancement before lumbar puncture and no change in enhancement after lumbar puncture as compared with before. Conclusion: PLPH is related to increased Gd-DTPA enhancement of the meninges, although the increase in enhancement during PLPH is minor in most cases. Pronounced enhancement of the meninges after lumbar puncture may predict long duration of the PLPH. (orig.)

  2. Experimental analysis of Kevlar modification for TRUPACT-I puncture panels

    International Nuclear Information System (INIS)

    Longenbaugh, R.S.; Joseph, B.J.

    1987-05-01

    The Kevlar Test Services was initiated to determine the maximum failure force and the energy-absorbing capability of puncture panels consisting of 16, 20, and 24 layers of 3000-denier 4 x 4 basket weave Kevlar-29, bonded to a 3.41 mm 304 annealed stainless steel puncture plate. Results of these tests were compared to the TRUPACT-1 Unit-0 drop test results to determine if the existing puncture panel configuration of TRUPACT-1 could be reduced. The data indicate for 24 layers of Kevlar, the panels failed at loads greater than those recorded in the TRUPACT-1, Unit 0 tests. Energy absorbed by the 24-layer Kevlar panels was 53% greater than that measured in the TRUPACT-1, Unit 0 test. Thermal performance of 20-layer Kevlar panels was measured in a conservative test environment and exceeded the design specifications

  3. Percutaneous Direct Puncture Embolization with N-butyl-cyanoacrylate for High-flow Priapism

    Energy Technology Data Exchange (ETDEWEB)

    Tokue, Hiroyuki, E-mail: tokue@s2.dion.ne.jp; Shibuya, Kei [Gunma University Hospital, Department of Diagnostic and Interventional Radiology (Japan); Ueno, Hiroyuki [Isesaki Municipal Hospital, Department of Radiology (Japan); Tokue, Azusa; Tsushima, Yoshito [Gunma University Hospital, Department of Diagnostic and Interventional Radiology (Japan)

    2016-09-15

    There are many treatment options in high-flow priapism. Those mentioned most often are watchful waiting, Doppler-guided compression, endovascular highly selective embolization, and surgery. We present a case of high-flow priapism in a 57-year-old man treated by percutaneous direct puncture embolization of a post-traumatic left cavernosal arteriovenous fistula using N-butyl-cyanoacrylate. Erectile function was preserved during a 12-month follow-up. No patients with percutaneous direct puncture embolization for high-flow priapism have been reported previously. Percutaneous direct puncture embolization is a potentially useful and safe method for management of high-flow priapism.

  4. Mechanical deformation and glycosaminoglycan content changes in a rabbit annular puncture disc degeneration model.

    Science.gov (United States)

    Chan, Deva D; Khan, Safdar N; Ye, Xiaojing; Curtiss, Shane B; Gupta, Munish C; Klineberg, Eric O; Neu, Corey P

    2011-08-15

    Evaluation of degenerated intervertebral discs from a rabbit annular puncture model by using specialized magnetic resonance imaging (MRI) techniques, including displacement encoding with stimulated echoes and a fast-spin echo (DENSE-FSE) acquisition and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). To evaluate a rabbit disc degeneration model by using various MRI techniques. To determine the displacements and strains, spin-lattice relaxation time (T1), and glycosaminoglycan (GAG) distribution of degenerated discs as compared to normal and adjacent level discs. Annular puncture of the intervertebral disc produces disc degeneration in rabbits. DENSE-FSE has been previously demonstrated in articular cartilage for the measurement of soft tissue displacements and strains. MRI also can measure the T1 of tissue, and dGEMRIC can quantify GAG concentration in cartilage. METHODS.: In eight New Zealand white rabbits, the annulus fibrosis of a lumbar disc was punctured. After 4 weeks, the punctured and cranially adjacent motion segments were isolated for MRI and histology. MRI was used to estimate the disc volume and map T1. DENSE-FSE was used to determine displacements for the estimation of strains. dGEMRIC was then used to determine GAG distributions. Histology and standard MRI indicated degeneration in punctured discs. Disc volume increased significantly at 4 weeks after the puncture. Displacement of the nucleus pulposus was distinct from that of the annulus fibrosis in most untreated discs but not in punctured discs. T1 was significantly higher and GAG concentration significantly lower in punctured discs compared with untreated adjacent level discs. Noninvasive and quantitative MRI techniques can be used to evaluate the mechanical and biochemical changes that occur with animal models of disc degeneration. DENSE-FSE, dGEMRIC, and similar techniques have potential for evaluating the progression of disc degeneration and the efficacy of treatments.

  5. Use of inelastic analysis to determine the response of packages to puncture accidents

    International Nuclear Information System (INIS)

    Ammerman, D.J.; Ludwigsen, J.S.

    1996-01-01

    The accurate analytical determination of the response of radioactive material transportation packages to the hypothetical puncture accident requires inelastic analysis techniques. Use of this improved analysis method recudes the reliance on empirical and approximate methods to determine the safety for puncture accidents. This paper will discuss how inelastic analysis techniques can be used to determine the stresses, strains and deformations resulting from puncture accidents for thin skin materials with different backing materials. A method will be discussed to assure safety for all of these types of packages

  6. Post-duralpunktur hovedpine

    DEFF Research Database (Denmark)

    Dahl, J B; Rosenberg, J

    1990-01-01

    Post dural puncture headache is one of the major complications of spinal anaesthesia. In order to establish this diagnosis, the headache must be dependent on the position of the patient. The symptoms are probably due to leakage of cerebro-spinal fluid from the subarachnoid space to the epidural...

  7. Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

    LENUS (Irish Health Repository)

    Ogbonnaya, Ebere Sunny

    2011-01-01

    Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

  8. The natural history of pedal puncture wounds in diabetics: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    East Jeffrey M

    2011-10-01

    Full Text Available Abstract Background Surgeons usually witness only the limb-threatening stages of infected, closed pedal puncture wounds in diabetics. Given that this catastrophic outcome often represents failure of conservative management of pre-infected wounds, some suggest consideration of invasive intervention (coring or laying-open for pre-infected wounds in hope of preventing contamination from evolving into infection, there being no evidence based guidelines. However, an invasive pre-emptive approach is only justifiable if the probability of progression to catastrophic infection is very high. Literature search revealed no prior studies on the natural history of closed pedal puncture wounds in diabetics. Methods A survey was conducted via an interviewer-administered questionnaire on 198 adult diabetics resident in the parish of St. James, Jamaica. The sample was selected using a purposive technique designed to mirror the social gradient and residential distribution of the target population and is twice the number needed to detect a prevalence of puncture wounds of 14% with a range of 7-21% in a random sample of the estimated adult diabetic population. Results The prevalence of a history of at least one closed pedal puncture wound since diagnosis of diabetes was 25.8% (CI; 19.6-31.9%. The only modifiable variable associated at the 5% level of significance with risk of pedal puncture wound, after adjustment by multivariable logistic regression, was site of interview/paying status, a variable substantially reflective of income more so than quality-of-care. Of 77 reported episodes of closed pedal puncture wound among 51 participants, 45.4% healed without medical intervention, 27.3% healed after non-surgical treatment by a doctor and 27.3% required surgical intervention ranging from debridement to below-knee amputation. Anesthetic foot (failure to feel the puncture and sole of the forefoot as site of puncture were the variables significantly associated with

  9. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  10. Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE's Lumbar LOcation (HELLO System: A Cadaver Study.

    Directory of Open Access Journals (Sweden)

    Guoxin Fan

    Full Text Available Percutaneous transforaminal endoscopic discectomy (PTED usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence.This cadaver study aimed to investigate the efficacy of HE's Lumbar Location (HELLO system in puncture reduction of PTED.Cadaver study.Comparative groups.HELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A. Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B. On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C.At L4/L5 level, there was significant difference in puncture times between Group A and Group B (P0.05. There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05.Small-sample preclinical study.HELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127.

  11. Hybrid Approach for Biliary Interventions Employing MRI-Guided Bile Duct Puncture with Near-Real-Time Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wybranski, Christian, E-mail: Christian.Wybranski@uk-koeln.de [University Hospital of Cologne, Department of Diagnostic and Interventional Radiology (Germany); Pech, Maciej [Otto-von-Guericke University Medical School, Department of Radiology and Nuclear Medicine (Germany); Lux, Anke [Otto-von-Guericke University Medical School, Institute of Biometry and Medical Informatics (Germany); Ricke, Jens; Fischbach, Frank; Fischbach, Katharina [Otto-von-Guericke University Medical School, Department of Radiology and Nuclear Medicine (Germany)

    2017-06-15

    ObjectiveTo assess the feasibility of a hybrid approach employing MRI-guided bile duct (BD) puncture for subsequent fluoroscopy-guided biliary interventions in patients with non-dilated (≤3 mm) or dilated BD (≥3 mm) but unfavorable conditions for ultrasonography (US)-guided BD puncture.MethodsA total of 23 hybrid interventions were performed in 21 patients. Visualization of BD and puncture needles (PN) in the interventional MR images was rated on a 5-point Likert scale by two radiologists. Technical success, planning time, BD puncture time and positioning adjustments of the PN as well as technical success of the biliary intervention and complication rate were recorded.ResultsVisualization even of third-order non-dilated BD and PN was rated excellent by both radiologists with good to excellent interrater agreement. MRI-guided BD puncture was successful in all cases. Planning and BD puncture times were 1:36 ± 2.13 (0:16–11:07) min. and 3:58 ± 2:35 (1:11–9:32) min. Positioning adjustments of the PN was necessary in two patients. Repeated capsular puncture was not necessary in any case. All biliary interventions were completed successfully without major complications.ConclusionA hybrid approach which employs MRI-guided BD puncture for subsequent fluoroscopy-guided biliary intervention is feasible in clinical routine and yields high technical success in patients with non-dilated BD and/or unfavorable conditions for US-guided puncture. Excellent visualization of BD and PN in near-real-time interventional MRI allows successful cannulation of the BD.

  12. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization.

    Science.gov (United States)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-06-01

    This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ=1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus.

    Science.gov (United States)

    Mizutani, Katsuhiro; Miwa, Tomoru; Akiyama, Takenori; Sakamoto, Yoshiaki; Fujiwara, Hirokazu; Yoshida, Kazunari

    2018-03-01

    The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus. The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults. The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

  14. Progressive subcortical calcifications secondary to venous hypertension in an intracranial dural arteriovenous fistula.

    Science.gov (United States)

    Pascoe, Heather M; Lui, Elaine H; Mitchell, Peter; Gaillard, Frank

    2017-05-01

    Intracranial dural arteriovenous fistulas (dAVF) are acquired lesions, with the most commonly reported findings on CT haemorrhage or focal oedema. We describe a case of progressive subcortical calcification on CT secondary to venous hypertension from a high grade dAVF. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Testing and analysis to determine the shell thickness required to prevent puncture

    International Nuclear Information System (INIS)

    Ammerman, D.J.; Radloff, H.D.; Eifert, E.J.

    1998-05-01

    Type B radioactive material packages are required to withstand a hypothetical puncture accident of a free fall from a height of one meter onto a 15 cm diameter mild steel puncture probe. For many packages it is desirable to have this accident event not result in puncture or tearing of the outer shell of the package. The wall thickness necessary to prevent this has historically been determined by test or the use of empirical relations. This technique generally results in overly conservative designs, but the degree of conservatism is uncertain. The use of modem finite element codes to determine package response to puncture accidents can result in designs that are both safe and economical. The work reported in this paper is aimed at developing a method to analytically determine the wall thickness required to prevent puncture. For designers and regulators to have confidence in this analytical method, however, it must be benchmarked against test results. A series of tests has been conducted with differing shell thicknesses, shell materials of mild steel and stainless steel, and shell backing materials of lead, foam, and air. The results of these tests have been compared with pre-test analytical predictions of the response obtained from the nonlinear transient dynamic finite element program PRONTO-2D. From this comparison it can be seen that the finite element method can accurately predict the response of packages to puncture accidents. This implies that an analytical technique based on the finite element method can be used to design packages having known response and margin of safety against tearing of the outer shell. In addition, the analytical technique can accurately predict the deformed shape of the package following the test. This may be important for subsequent calculations, such as external dose and heat input during a thermal event

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 951 - 1000 of 2005 ... Vol 91, No 5 (2014), Implementation of a School-Based HIV ... P. Falciparum malaria in patients from southwestern Cameroon ... Vol 87, No 6 (2010), Incidence of post dural puncture headache following Caesarean section under spinal ... Vol 87, No 11 (2010), Indications for removal of etonogestrel ...

  17. C6 plate puncture testing report.

    Energy Technology Data Exchange (ETDEWEB)

    Vangoethem, Douglas J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cordova, Theresa Elena [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reu, Phillip L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2013-04-01

    There are numerous scenarios where critical systems could be subject to penetration by projectiles or fixed objects (e.g., collision, natural disaster, act of terrorism, etc.). It is desired to use computational models to examine these scenarios and make risk-informed decisions; however, modeling of material failure is an active area of research, and new models must be validated with experimental data. The purpose of this report is to document the experimental work performed from FY07 through FY08 on the Campaign Six Plate Puncture project. The goal of this project was to acquire experimental data on the puncture and penetration of metal plates for use in model validation. Of particular interest is the PLH failure model also known as the multilinear line segment model. A significant amount of data that will be useful for the verification and validation of computational models of ductile failure were collected during this project were collected and documented herein; however, much more work remains to be performed, collecting additional experimental data that will further the task of model verification.

  18. MR diagnosis of dural sinus thrombosis

    International Nuclear Information System (INIS)

    Rovira Canellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castano Duque, Ch.; Grive Isern, E.; Sumalla Sune, J.

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  19. Radiative accidental matter

    Energy Technology Data Exchange (ETDEWEB)

    Sierra, D. Aristizabal [IFPA, Dép. AGO, Université de Liège,Bât B5, Sart Tilman B-4000 Liège 1 (Belgium); Universidad Técnica Federico Santa María - Departamento de Física,Casilla 110-V, Avda. España 1680, Valparaíso (Chile); Simoes, C.; Wegman, D. [IFPA, Dép. AGO, Université de Liège,Bât B5, Sart Tilman B-4000 Liège 1 (Belgium)

    2016-07-25

    Accidental matter models are scenarios where the beyond-the-standard model physics preserves all the standard model accidental and approximate symmetries up to a cutoff scale related with lepton number violation. We study such scenarios assuming that the new physics plays an active role in neutrino mass generation, and show that this unavoidably leads to radiatively induced neutrino masses. We systematically classify all possible models and determine their viability by studying electroweak precision data, big bang nucleosynthesis and electroweak perturbativity, finding that the latter places the most stringent constraints on the mass spectra. These results allow the identification of minimal radiative accidental matter models for which perturbativity is lost at high scales. We calculate radiative charged-lepton flavor violating processes in these setups, and show that μ→eγ has a rate well within MEG sensitivity provided the lepton-number violating scale is at or below 5×10{sup 5} GeV, a value (naturally) assured by the radiative suppression mechanism. Sizeable τ→μγ branching fractions within SuperKEKB sensitivity are possible for lower lepton-number breaking scales. We thus point out that these scenarios can be tested not only in direct searches but also in lepton flavor-violating experiments.

  20. Laser puncture therapy of nervous system disorders

    Energy Technology Data Exchange (ETDEWEB)

    Anishchenko, G.; Kochetkov, V.

    1984-08-29

    The authors discuss experience with treatment of nervous system disorders by means of laser-puncture therapy. Commenting on the background of the selection of this type of treatment, they explain that once researchers determined the biological action of laser light on specific nerve receptors of the skin, development of laser apparatus capable of concentrating the beam in the millimeter band was undertaken. The devices that are being used for laser-puncture are said to operate in the red helium-neon band of light. The authors identify beam parameters that have been selected for different groups of acupuncture points of the skin, and the courses of treatment (in seconds of radiation) and their time intervals. They go on to discuss the results of treatment of over 800 patients categorized in a group with disorders of the peripheral nervous system and a second group with disorders of the central nervous system.

  1. The influence of age on positions of the conus medullaris, Tuffier's line, dural sac, and sacrococcygeal membrane in infants, children, adolescents, and young adults.

    Science.gov (United States)

    Jung, Ji-Yun; Kim, Eun-Hee; Song, In-Kyung; Lee, Ji-Hyun; Kim, Hee-Soo; Kim, Jin-Tae

    2016-12-01

    The purpose of this study was to analyze the distances between the conus medullaris and the Tuffier's line, and between the dural sac and the sacrococcygeal membrane (SCM) in the same pediatric population. Spinal magnetic resonance images and simple X-ray images of 350 patients aged from 1 month to 20 years were reviewed. Positions of the conus medullaris, Tuffier's line, the dural sac, and the SCM were identified. Each position was recorded in relation to the corresponding vertebral body segments. The distances between the conus medullaris and Tuffier's line, and between the dural sac and the SCM, were measured and then assessed according to age using an analysis of variance and a linear regression analysis. The median levels of the conus medullaris and Tuffier's line were in the lower third of L1 [the first lumbar vertebral body] and the middle third of L5, respectively. The levels of the conus medullaris and Tuffier's line were lower in younger populations. The distance between the conus medullaris and Tuffier's line ranged from 1.5 to 4.75 vertebral body height. However, a narrow range of 1.5-2.5 vertebral height was observed only in children younger than 2 years. The level of the dural sac did not differ greatly by age, but the upper limit of the SCM was lower in older populations. The distance between the dural sac and the upper limit of the SCM increased with age. In children, there is a distance of 1.5-4.75 vertebral body height between the conus medullaris and the Tuffier's line. However, these distances were narrower among younger populations. The distance between the dural sac and the upper limit of the SCM increased with age. © 2016 John Wiley & Sons Ltd.

  2. Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE's Lumbar LOcation (HELLO) System: A Cadaver Study.

    Science.gov (United States)

    Fan, Guoxin; Guan, Xiaofei; Sun, Qi; Hu, Annan; Zhu, Yanjie; Gu, Guangfei; Zhang, Hailong; He, Shisheng

    2015-01-01

    Percutaneous transforaminal endoscopic discectomy (PTED) usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence. This cadaver study aimed to investigate the efficacy of HE's Lumbar Location (HELLO) system in puncture reduction of PTED. Cadaver study. Comparative groups. HELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A). Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B). On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C). At L4/L5 level, there was significant difference in puncture times between Group A and Group B (PHELLO system reduced 39%-45% radiation dosage when comparing Group A and Group B, but there was no significant difference in radiation exposure between Group A and Group C whatever at L4/L5 level or L5/S1 level (P>0.05). There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05). Small-sample preclinical study. HELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127).

  3. [THREE CASES OF ACCIDENTAL AUTO-INJECTION OF ADRENALINE].

    Science.gov (United States)

    Yanagida, Noriyuki; Iikura, Katsuhito; Ogura, Kiyotake; Wang, Ling-jen; Asaumi, Tomoyuki; Sato, Sakura; Ebisawa, Motohiro

    2015-12-01

    Reports on accidental auto-injection of adrenaline are few. We encountered three cases of accidental injection of adrenaline. In this study, we have examined and reported the clinical courses and symptoms of our cases. CASE 1 involved a female physician in her 50s who had attended an explanatory meeting on auto-injection of adrenaline. She mistook EpiPen® to be the EpiPen trainer and accidentally injected herself with 0.3 mg EpiPen®. Her systolic/diastolic pressure peaked at 7 min to reach 144/78 mmHg and decreased to 120/77 mmHg at 14 min. Except for palpitation after 7 min, the only subjective symptom was local pain at the injection site. CASE 2 was noted in a 6-year-old boy. He accidentally pierced his right forefinger with 0.15 mg EpiPen®, and after 20 min, his right forefinger was swollen. The swelling improved 80 min after the accidental injection. CASE 3 was noted in a 4-year-old girl. She accidentally injected herself with 0.15 mg EpiPen®. Her systolic/diastolic pressure peaked at 23 min to reach 123/70 mmHg and decreased to 96/86 mmHg at 28 min. Severe adverse effects of accidental auto-injection of adrenaline were not observed in these three cases. Our findings suggest that while handling adrenaline auto-injectors, we should keep in mind the possibility of accidental injection.

  4. Laparoscopic Removal of a Large Ovarian Mass Utilizing Planned Trocar Puncture

    OpenAIRE

    Stitely, Michael L.

    2012-01-01

    Background: Large cystic ovarian masses pose technical challenges to the laparoscopic surgeon. Removing large, potentially malignant specimens must be done with care to avoid the leakage of cyst fluid into the abdominal cavity. Case: We present the case of a large ovarian cystic mass treated laparoscopically with intentional trocar puncture of the mass to drain and remove the mass. Discussion: Large cystic ovarian masses can be removed laparoscopically with intentional trocar puncture of the ...

  5. Validation of a novel cost effective easy to produce and durable in vitro model for kidney-puncture and PNL-Simulation.

    Science.gov (United States)

    Klein, Jan Thorsten; Rassweiler, Jens; Rassweiler-Seyfried, Marie-Claire Charlotte

    2018-03-29

    Nephrolithiasis is one of the most common diseases in urology. According to the EAU Guidelines, a percutaneous nephrolitholapaxy (PNL) is recommended when treating a kidney stone >2 cm. Nowadays PNL is performed even for smaller stones (PNL is the puncture of the planned site. PNL-novice surgeons need to practice this step in a safe environment with an ideal training model. We developed and evaluated a new, easy to produce, in-vitro model for the training of the freehand puncture of the kidney. Porcine kidneys with ureters were embedded in ballistic gel. Food coloring and preservative agent were added. We used the standard imaging modalities of X-ray and ultrasound to validate the training model. An additional new technique, the iPAD guided puncture, was evaluated. Five novices and three experts conducted 12 punctures for each imaging technique. Puncture time, radiation dose, and number of attempts to a successful puncture were measured. Mann-Whitney-U, Kruskal-Wallis, and U-Tests were used for statistical analyses. The sonographic guided puncture is slightly but not significantly faster than the fluoroscopic guided puncture and the iPAD assisted puncture. Similarly, the most experienced surgeon's time for a successful puncture was slightly less than that of the residents, and the experienced surgeons needed the least attempts to perform a successful puncture. In terms of radiation exposure, the residents had a significant reduction of radiation exposure compared to the experienced surgeons. The newly developed ballistic gel kidney-puncture model is a good training tool for a variety of kidney puncture techniques, with good content, construct, and face validity.

  6. The internal vertebral venous plexus prevents compression of the dural sac during atlanto-axial rotation

    Energy Technology Data Exchange (ETDEWEB)

    Reesink, E.M.; Lataster, L.M.A.; Mameren, H. van [Dept. of Anatomy/Embryology, Maastricht Univ. (Netherlands); Wilmink, J.T. [Dept. of Radiology, University Hospital Maastricht (Netherlands); Kingma, H. [Dept. of ENT, University Hospital Maastricht (Netherlands)

    2001-10-01

    Deformation of the extradural space and the possibility of impression upon the dural sac during atlanto-axial rotation are investigated. Atlanto-axial rotation leads to a reduction in the cross-sectional area of the bony spinal canal of approximately 40 %. Atlanto-axial rotation was recorded by endocanalar views from a video camera fixed inside the skull of six unembalmed cadavers. Axial thin-section T1-weighted MRI slice sets were acquired from three volunteers (mid-position and maximal left and right rotation of the head and cervical spine). The axial cross-sectional areas of the bony spinal canal, dural sac and spinal cord were measured. In two other persons post-gadolinium contrast-enhanced T1-weighted MRI volume scans with fat-suppression prepulse were acquired (mid-position and rotation) to determine venous contents of the extradural space. The 50:50 ratio between left and right extradural halves in mid-position changed to an ipsilateral:contralateral ratio of 20:80 in maximum rotation at the level just above the lateral C1-C2 joints. Directly below these joints the opposite occurred. The post-contrast studies showed an enhancing internal vertebral venous plexus (IVVP), which almost completely occupied the extradural space at the atlanto-axial level. This could not be shown in the cadaver experiments, because of absence of blood and cerebrospinal fluid (CSF) pressure. During atlanto-axial rotation blood displacement in the IVVP allows major deformations of the extradural space. This prevents dural sac impression. (orig.)

  7. Dural Ectasia of the Optic Nerve and Unilateral Proptosis-Two Rare Comorbidities Associated with Idiopathic Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Serkan Dağdelen

    2013-08-01

    Full Text Available A 24-year-old woman with a recent history of visual abnormality (obscurations had bilateral optic disc swellings, dilatation of the optic nerve sheaths, monocular proptosis, and increased cerebrospinal fluid pressures. She was diagnosed as idiopathic intracranial hypertension (IIH. IIH can present with both papilledema and dural ectasia although the latter is usually seen as an isolated entity. Various conditions also have been implicated in IIH. However, apart from female sex, recent weight gain and obesity, there are no proven associations. In this case report, we present a case of IHH associated with two different pathologies: dural ectasia of the optic nerve sheaths and monocular proptosis. (Turk J Ophthalmol 2013; 43: 297-300

  8. Accidental hypothermia-an update

    DEFF Research Database (Denmark)

    Paal, Peter; Gordon, Les; Strapazzon, Giacomo

    2016-01-01

    BACKGROUND: This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest. METHODS: The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce this nar......BACKGROUND: This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest. METHODS: The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce...... this narrative review. RESULTS: The hospital use of minimally-invasive rewarming for non-arrested, otherwise healthy, patients with primary hypothermia and stable vital signs has the potential to substantially decrease morbidity and mortality for these patients. Extracorporeal life support (ECLS) has...... and post-resuscitation care. CONCLUSIONS: Based on new evidence, additional clinical experience and clearer management guidelines and documentation, the treatment of accidental hypothermia has been refined. ECLS has substantially improved survival and is the treatment of choice in the patient with unstable...

  9. The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Rohr, Axel; Bindeballe, Jan; Riedel, Christian; Jansen, Olav [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuroradiology, Kiel (Germany); Baalen, Andreas van [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuropediatrics, Kiel (Germany); Bartsch, Thorsten [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurology, Kiel (Germany); Doerner, Lutz [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurosurgery, Kiel (Germany)

    2012-01-15

    The objective of this study was to explore the volumetric alterations of dural sinuses in patients with idiopathic intracranial hypertension (IIH). Standardized cranial magnetic resonance imaging (MRI) was used in 17 patients prior to and following treatment of IIH and in seven controls. Magnetic resonance venographies (MRV) were employed for (a) judgement of circumscript dural sinus stenoses and (b) computation of sinus volumes. Cross-sectional areas (CSA) of the superior sagittal sinuses (SSS) were measured on T2-weighted images. Results of the initial MRIs were compared to those on follow-up MRIs and to results of controls. Stenoses of the transverse sinuses (TS) resulting in cranial venous outflow obstruction (CVOO) were present in 15/17 (88%) patients, normalizing in 7/15 cases (47%) after treatment of IIH. CVOO was not detected in the control group. Segmentation of MRV revealed decreased dural sinus volumes in patients with IIH as compared to controls (P = 0.018). Sinus volumes increased significantly with normalization of intracranial pressure independent from disappearing of TS stenoses (P = 0.007). The CSA of the SSS were normal on the initial MRIs of patients with IIH and increased on follow-up after treatment (P < 0.001). However, volumetries displayed overlap in patients and controls. Patients with IIH not only exhibit bilateral stenoses of the TS as has been reported, but volume changes of their entire dural sinus system also occur. The potential etiopathological and diagnostic roles of these changes are discussed. (orig.)

  10. Development of puncture resistance tire tube; Nirinsha no taipankusei kojo cube no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Yamagiwa, T; Nakayama, K; Kiyota, S; Tanaka, A [Honda R and D Co. Ltd., Tokyo (Japan); Makisaka, N

    1997-10-01

    A new tire tube with a puncture resistance function was developed. The tube is a two-chamber structure having an air chamber and a liquid chamber, and the liquid chamber at the crown-side half of the tube is filled with an anti-puncture sealant during a manufacturing process. In a market test, it was confirmed that the number of puncture cases were reduced by 90 % in comparison with conventional tire tubes by using the newly developed tube. This paper describes the structure of the tube and the characteristics of the tube rubber, and the manufacturing process and durability of the tube. 3 refs., 17 figs.

  11. Fabrication of Bonding-Type Hollow Microneedle Array by Injection Molding and Evaluation of its Puncture Characteristics

    Science.gov (United States)

    Ogai, Noriyuki; Sugimura, Ryo; Tamaru, Takuya; Takiguchi, Yoshihiro

    A microneedle array which consists from small needles compared to a conventional metal injection needle is expected as a low invasive transdermal medical treatment device, and many fabrication approach have been conducted. In this study, we fabricated plastic hollow microneedle array by a fabrication method based on the combination of injection molding, bonding and assembly techniques. To evaluate puncture characteristics of the fabricated needle, we measured a puncture force to silicone rubber by experimental equipment using loadcell and automatic stage. Furthermore, we propose and demonstrate a new method to measure actual punctured depth from punctured trace on the needle surface modified by O2 plasma treatment.

  12. Rabbit models of cerebral vasospasm established with endovascular puncture

    International Nuclear Information System (INIS)

    Tu Jianfei; Liu Yizhi; Ji Jiansong; Zhao Zhongwei

    2008-01-01

    Objective: To investigate the method of endovascular puncture to establish rabbit models of cerebral vasospasm. Methods: New Zealand white rabbits were divided into 5 groups (12 h, 1 d, 2 d, 3 d and 7 d) randomly, and each group was separated into subarachnoid hemorrhage (SAH) subgroup (n=5) and control subgroup (n=2). cerebral vascular spasm (CVS) models were established after SAH with endovascular puncture. CT scans before and after operation were performed. The internal diameters and the wall thicknesses of posterior communicans artery (PcoA) and basilar artery (BA) were measured with HE stain after the animals were executed. Results: CVS model was successfully eastblished in 35 rabbits (SAH subgroup 25, control subgroup 10), resulting a successful rate of 48.61%. Compared with control subgroup, PcoA and BA showed shrinkage of internal diameters of 43.60% and 51.82% 12 h after SAH, respectively, and the shrinkage appeared as biphasic patterns until the 7th study day with another peaks of 29.32% and 45.19%, respectively. Conclusions: Endovascular puncture is an effective method to establish rabbit of CVS. The death rate of animals can be decreased with the asage of new interventional material and perfection for the details of operation. (authors)

  13. Dural arteriovenous fistula presenting with exophthalmos and seizures.

    Science.gov (United States)

    Feyissa, Anteneh M; Ponce, Lucido L; Patterson, Joel T; Von Ritschl, Rudiger H; Smith, Robert G

    2014-03-15

    Concomitant seizures and exophthalmos in the context of a temporal dural arteriovenous fistula (dAVF) has not been described before. Here, we report a 55-year-old-male who presented with an 8-month history of progressive painless exophthalmos of his left eye, conjunctival chemosis, reduced vision and new onset complex partial seizures. Cerebral angiography demonstrated Cognard Type IIa left cerebral dAVF fed by branches from the left occipital artery and an accessory meningeal artery, with drainage to the superior ophthalmic vein. Following surgical obliteration of dAVF feeding vessels, our patient had dramatic improvement in visual acuity, proptosis and chemosis along with cessation of clinical seizures. Published by Elsevier B.V.

  14. Use of a Collagen-Based Device for Closure of Low Brachial Artery Punctures

    International Nuclear Information System (INIS)

    Belenky, A.; Aranovich, D.; Greif, F.; Bachar, G.; Bartal, G.; Atar, E.

    2007-01-01

    Purpose. To report our experience with the Angioseal vascular closure device for hemostasis of distal brachial artery puncture. Methods. Between September 2003 and August 2005, 64 Angioseal vascular closure devices were inserted in 64 patients (40 men, 24 women; mean age 65 years) immediately after diagnostic or therapeutic arterial angiographies performed through a 5 Fr to 7 Fr sheath via the distal brachial artery. Ultrasound examination of the brachial artery preceded the angiography in all cases and only arteries wider than 4 mm were closed by the Angioseal. In cases of a sonographically evident thin subcutaneous space of the cubital fossa, tissue tumescence, using 1% Lidocaine, was performed prior to the arterial closure. Results. The deployment success rate was 100%. No major complications were encountered; only 2 patients developed puncture site hematoma, and these were followed conservatively. Conclusions. Closure of low brachial artery punctures with the Angioseal is simple and safe. No additional manual compression is required. We recommend its use after brachial artery access interventions, through appropriately wide arteries, to improve early patient ambulation and potentially reduce possible puncture site complications

  15. Development of a new bench for puncturing of irradiated fuel rods in STAR hot laboratory

    Science.gov (United States)

    Petitprez, B.; Silvestre, P.; Valenza, P.; Boulore, A.; David, T.

    2018-01-01

    A new device for puncturing of irradiated fuel rods in commercial power plants has been designed by Fuel Research Department of CEA Cadarache in order to provide experimental data of high precision on fuel pins with various designs. It will replace the current set-up that has been used since 1998 in hot cell 2 of STAR facility with more than 200 rod puncturing experiments. Based on this consistent experimental feedback, the heavy-duty technique of rod perforation by clad punching has been preserved for the new bench. The method of double expansion of rod gases is also retained since it allows upgrading the confidence interval of volumetric results obtained from rod puncturing. Furthermore, many evolutions have been introduced in the new design in order to improve its reliability, to make the maintenance easier by remote handling and to reduce experimental uncertainties. Tightness components have been studied with Sealing Laboratory Maestral at Pierrelatte so as to make them able to work under mixed pressure conditions (from vacuum at 10-5 mbar up to pressure at 50 bars) and to lengthen their lifetime under permanent gamma irradiation in hot cell. Bench ergonomics has been optimized to make its operating by remote handling easier and to secure the critical phases of a puncturing experiment. A high pressure gas line equipped with high precision pressure sensors out of cell can be connected to the bench in cell for calibration purposes. Uncertainty analyses using Monte Carlo calculations have been performed in order to optimize capacity of the different volumes of the apparatus according to volumetric characteristics of the rod to be punctured. At last this device is composed of independent modules which allow puncturing fuel pins out of different geometries (PWR, BWR, VVER). After leak tests of the device and remote handling simulation in a mock-up cell, several punctures of calibrated specimens have been performed in 2016. The bench will be implemented soon in hot

  16. The closure device for the puncture point of femoral artery: an experiment in vitro

    International Nuclear Information System (INIS)

    Sun Jiantao; Zhang Junfeng; Wu Ke; Wang Yi

    2010-01-01

    Objective: To assess the blocking effects of a new-type closure device for the puncture point of femoral artery in vitro. Methods: An embolic colloidal substance with stable swelling value was embedded in an extracorporeal model which was used as an imitator of femoral artery blood flow velocity. Results: The embolization colloid was not displaced by the imitated blood flow lash, the embolic colloid was firmly attached to the puncture point and no fluid extravasation occurred. Conclusion: This new-type closure device for the puncture point of femoral artery is simple in structure and easy to manipulate with satisfactory blocking results. (authors)

  17. [A rare case of tubercular tenosynovitis in hospital surgeon as a result of an occupational accident caused by puncture with an infected needle. Prevention aspects and legal-medical evaluation].

    Science.gov (United States)

    Delli Carri, R; Piscozzi, Paola; Massimelli, M; Falcetta, R

    2010-01-01

    The subject was a hospital surgeon who, in the course of routine outpatient surgery with aspiration to collect right lumbar material in a patient with suspected TB infection, accidentally punctured the fifth finger of the left hand with the needle used for this procedure. This led to involvement of the fifth finger of the left hand restricted to the soft tissue with preservation of joint and bone and tenosynovial involvement of the entire extremity. To draw attention to the repercussions for insurance with resulting absence from work for 126 days and an assessment of biological impairment of 2% by the Insurance Institute (INAIL). A case report is described of rare occupational tubercular synovitis. A rare event is reported that occurred in a senior staff member with particular insurance repercussions.

  18. Brain MRI findings of spontaneous intracranial hypotension

    Energy Technology Data Exchange (ETDEWEB)

    Park, Won Kyu; Byun, Woo Mok; Cho, Jae Ho; Cho Kil Ho; Hwang, Mi Soo; Park, Bok Hwan [Yeungnam Univ. College of Medicine, Taegu (Korea, Republic of); Joo, Yang Gu [Keimyoung Univ. College of Medicine, Taegu (Korea, Republic of); Lee, Sang Jin [Soonchunhyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    To evaluate brain MRI findings of spontaneous intracranial hypotension. A retrospective review of MRI findings was conducted on six patients with clinically proven spontaneous intracranial hypotension; no patient had a history of previous spinal puncture. Follow-up MRI was available in two patients, and to detect CSF leakage, radio-nuclide cisternography(n=3D5), myelography(n=3D1), and MR myelography(n=3D1) were performed. On contrast-enhanced T1WI, diffuse dural enhancement was seen in all cases, subdural hematoma or hygroma was seen in four cases, pituitary gland prominence in four, dural sinus dilatation in four, downward displacement of the cerebellar tonsil in two, downward displacement of the iter in one, and suprasellar and prepontine cistern effacement in two. In no patient was abnormal CSF leakage found. Although dural enhancement, as seen on MRI, is not specific, diffuse enhancement of the dura mater accompanied by subdural hematoma, hygroma, pituitary gland prominence, dural sinus dilatation, downward displacement of the cerebellar tonsil, or suprasellar and prepontine cistern effacement can strongly suggest intracranial hypotension.=20.

  19. Laparoscopic Removal of a Large Ovarian Mass Utilizing Planned Trocar Puncture

    Science.gov (United States)

    2012-01-01

    Background: Large cystic ovarian masses pose technical challenges to the laparoscopic surgeon. Removing large, potentially malignant specimens must be done with care to avoid the leakage of cyst fluid into the abdominal cavity. Case: We present the case of a large ovarian cystic mass treated laparoscopically with intentional trocar puncture of the mass to drain and remove the mass. Discussion: Large cystic ovarian masses can be removed laparoscopically with intentional trocar puncture of the mass to facilitate removal without leakage of cyst fluid. PMID:22906344

  20. Recent Advances in Thermoplastic Puncture-Healing Polymers

    Science.gov (United States)

    Bogert, Philip B.; Working, Dennis C.; Wise, Kristopher E.; Smith, Janice Y.; Topping, Crystal C.; Britton, Sean M.; Bagby, Paul R.; Siochi, Emilie J.

    2010-01-01

    The motivation for this work is to develop self-healing polymeric materials to enable damage tolerant systems, and to tailor puncture healing for use temperatures and applications. This will be a benefit in environments and conditions where access for manual repair is limited or impossible, or where damage may not be detected.

  1. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Junkoh; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru [University of Occupational and Environmental Health, Department of Neurosurgery, Kitakyusyu (Japan); Kakeda, Shingo; Korogi, Yukunori [University of Occupational and Environmental Health, Department of Radiology, Kitakyusyu (Japan)

    2011-06-15

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment. (orig.)

  2. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T

    International Nuclear Information System (INIS)

    Yamamoto, Junkoh; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru; Kakeda, Shingo; Korogi, Yukunori

    2011-01-01

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment. (orig.)

  3. Conformal blocks on a 2-sphere with indistinguishable punctures and implications on black hole entropy

    Directory of Open Access Journals (Sweden)

    Abhishek Majhi

    2016-11-01

    Full Text Available The dimensionality of the Hilbert space of a Chern–Simons theory on a 3-fold, in the presence of Wilson lines carrying spin representations, had been counted by using its link with the Wess–Zumino theory, with level k, on the 2-sphere with points (to be called punctures marked by the piercing of the corresponding Wilson lines and carrying the respective spin representations. It is shown, in the weak coupling (large k limit, the formula decouples into two characteristically distinct parts; one mimics the dimensionality of the Hilbert space of a collection of non-interacting spin systems and the other is an effective overall correction contributed by all the punctures. The exact formula yield from this counting has been shown earlier to have resulted from the consideration of the punctures to be distinguishable. We investigate the same counting problem by considering the punctures to be indistinguishable. Although the full formula remains undiscovered, nonetheless, we are able to impose the relevant statistics for indistinguishable punctures in the approximate formula resulting from the weak coupling limit. As an implication of this counting, in the context of its relation to that of black hole entropy calculation in quantum geometric approach, we are able to show that the logarithmic area correction, with a coefficient of −3/2, that results in this method of entropy calculation, in independent of whether the punctures are distinguishable or not.

  4. Arterial puncture using insulin needle is less painful than with standard needle: a randomized crossover study.

    Science.gov (United States)

    Ibrahim, Irwani; Yau, Ying Wei; Ong, Lizhen; Chan, Yiong Huak; Kuan, Win Sen

    2015-03-01

    Arterial punctures are important procedures performed by emergency physicians in the assessment of ill patients. However, arterial punctures are painful and can create anxiety and needle phobia in patients. The pain score of radial arterial punctures were compared between the insulin needle and the standard 23-gauge hypodermic needle. In a randomized controlled crossover design, healthy volunteers were recruited to undergo bilateral radial arterial punctures. They were assigned to receive either the insulin or the standard needle as the first puncture, using blocked randomization. The primary outcome was the pain score measured on a 100-mm visual analogue scale (VAS) for pain, and secondary outcomes were rate of hemolysis, mean potassium values, and procedural complications immediately and 24 hours postprocedure. Fifty healthy volunteers were included in the study. The mean (±standard deviation) VAS score in punctures with the insulin needle was lower than the standard needle (23 ± 22 mm vs. 39 ± 24 mm; mean difference = -15 mm; 95% confidence interval = -22 mm to -7 mm; p standard needle (31.3% vs. 11.6%, p = 0.035; and 4.6 ±0.7 mmol/L vs. 4.2 ±0.5 mmol/L, p = 0.002). Procedural complications were lower in punctures with the insulin needle both immediately postprocedure (0% vs. 24%; p standard needles. However, due to the higher rate of hemolysis, its use should be limited to conditions that do not require a concurrent potassium value in the same blood sample. © 2015 by the Society for Academic Emergency Medicine.

  5. Accidental childhood poisoning in Benin City: Still a problem ...

    African Journals Online (AJOL)

    Accidental poisoning (AP) is a leading cause of ill – health and deaths among. Nigerian children. Reports on AP are infrequent in Nigeria. This retrospective descriptive study examined the prevailing pattern of accidental childhood poisoning in Benin City. Accidental poisonings were identified in 226 (3.3%) of the cases ...

  6. CT guided percutaneous renal cysts puncture with ethanol therapy

    International Nuclear Information System (INIS)

    Zhang Xuezhe; Lu Yan; Wang Wu; Huang Zhengguo; Ren An

    2002-01-01

    Objective: To analyse our clinical experience with CT guided percutaneous renal cysts puncture and ethanol therapy. Methods: Five hundred and ten renal cysts in 445 patients were undergone CT guided percutaneous renal cysts puncture and ethanol therapy. Among the 445 cases, 385 cases had solitary renal cyst, 53 multiple renal cysts, and 7 polycystic kidneys. The renal cysts varied in size from 1.9 to 13.5 cm in diameter. The amount of aspirated fluid varied from 3 to 780 ml. A 18-21 gauge aspiration needles were used for all patients. A 25.0% cyst volume replacement with 99.7% ethanol was approved to be appropriate. Results: 427 renal cysts in 396 patients were followed up by computed tomographic (CT) or ultrasound for less than 3 months to more than one year duration. The curative effective rate and disappearance rate of the renal cystic cavity in solitary renal cysts were 97% and 82%, respectively. In multiple renal cysts, the corresponding values were 95% and 79%. In polycystic kidneys, the curative rate was 67%. The complications such as local abdominal pain (28 cases) and hematuria (four cases) were observed in this series. There were no fatal complications. Conclusions: CT guided percutaneous renal cyst puncture and ethanol therapy is an useful procedure for the treatment of solitary renal cysts and multiple renal cysts

  7. Design of Rate-Compatible Parallel Concatenated Punctured Polar Codes for IR-HARQ Transmission Schemes

    Directory of Open Access Journals (Sweden)

    Jian Jiao

    2017-11-01

    Full Text Available In this paper, we propose a rate-compatible (RC parallel concatenated punctured polar (PCPP codes for incremental redundancy hybrid automatic repeat request (IR-HARQ transmission schemes, which can transmit multiple data blocks over a time-varying channel. The PCPP coding scheme can provide RC polar coding blocks in order to adapt to channel variations. First, we investigate an improved random puncturing (IRP pattern for the PCPP coding scheme due to the code-rate and block length limitations of conventional polar codes. The proposed IRP algorithm only select puncturing bits from the frozen bits set and keep the information bits unchanged during puncturing, which can improve 0.2–1 dB decoding performance more than the existing random puncturing (RP algorithm. Then, we develop a RC IR-HARQ transmission scheme based on PCPP codes. By analyzing the overhead of the previous successful decoded PCPP coding block in our IR-HARQ scheme, the optimal initial code-rate can be determined for each new PCPP coding block over time-varying channels. Simulation results show that the average number of transmissions is about 1.8 times for each PCPP coding block in our RC IR-HARQ scheme with a 2-level PCPP encoding construction, which can reduce half of the average number of transmissions than the existing RC polar coding schemes.

  8. Utility of the magnetic resonance in the evaluation of the dural sinus occlusive disease

    International Nuclear Information System (INIS)

    Delgado, Jorge Andres; Toro, Nancy; Bolivar, Guillermo; Pulgarin, Luis German

    1998-01-01

    The dural sinus occlusive disease is potentially fatal (20-78% cases) and of unspecific clinical symptoms. CT sensibility is only 75% and angiography is invasive. The MRI offers several advantages in the diagnosis due to its high sensibility to flow, high intrinsic contrast and no invasively. The MRI findings in 7 cases are described

  9. Tension Pneumothorax following an Accidental Kerosene Poisoning ...

    African Journals Online (AJOL)

    Tension pneumothorax is a rare complication following an accidental kerosene poisoning. In such situation, a bed-side needle thoracocentesis is performed because of its potential of becoming fatal; hence its clinical importance. A case of 15 month old boy with tension pneumothorax following accidental kerosene ...

  10. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    International Nuclear Information System (INIS)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F.; Tongerloo, A.J. van; Paepe, A.M. de

    1999-01-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, χ 2 -test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  11. Indocyanine green videoangiography "in negative": definition and usefulness in intracranial dural arteriovenous fistulae.

    Science.gov (United States)

    Simal Julián, Juan Antonio; Miranda Lloret, Pablo; Aparici Robles, Fernando; Beltrán Giner, Andrés; Botella Asunción, Carlos

    2013-09-01

    Indocyanine green videoangiography (IGV) raises important limitations when we use it in vascular pathology, especially in cases with arterialization of the venous system such as arteriovenous malformations and fistulae. Our objective was to provide a simple procedure that overcomes the limitations of conventional IGV. We define IGV in negative (IGV-IN), so-called because, in its first phase, the vessel to analyze is clipped, and we report 3 cases of intracranial dural arteriovenous fistulae treated with this procedure. In 2011, we applied IGV-IN to 3 patients at our center with Borden type III intracranial arteriovenous fistulae. In all 3 cases, IGV-IN enabled both diagnosis and post-dural arteriovenous fistula exclusion control in 1 integrated procedure no longer than 1 minute, requiring only 1 visualization. IGV-IN is an improvement over the conventional IGV method and is able to provide more information in a shorter period of time. It is an intuitive and highly visual procedure, and, more importantly, it is reversible. Studies with larger samples are necessary to determine whether IGV-IN can further reduce the need for postoperative digital subtraction angiography.

  12. Dural venous sinuses distortion and compression with supratentorial mass lesions: a mechanism for refractory intracranial hypertension?

    Science.gov (United States)

    Qureshi, Adnan I.; Qureshi, Mushtaq H.; Majidi, Shahram; Gilani, Waqas I.; Siddiq, Farhan

    2014-01-01

    Objective To determine the effect of supratentorial intraparenchymal mass lesions of various volumes on dural venous sinuses structure and transluminal pressures. Methods Three set of preparations were made using adult isolated head derived from fresh human cadaver. A supratentorial intraparenchymal balloon was introduced and inflated at various volumes and effect on dural venous sinuses was assessed by serial intravascular ultrasound, computed tomographic (CT), and magnetic resonance (MR) venograms. Contrast was injected through a catheter placed in sigmoid sinus for both CT and MR venograms. Serial trasluminal pressures were measured from middle part of superior sagittal sinus in another set of experiments. Results At intraparenchymal balloon inflation of 90 cm3, there was attenuation of contrast enhancement of superior sagittal sinus with compression visualized in posterior part of the sinus without any evidence of compression in the remaining sinus. At intraparenchymal balloon inflation of 180 and 210 cm3, there was compression and obliteration of superior sagittal sinus throughout the length of the sinus. In the coronal sections, at intraparenchymal balloon inflations of 90 and 120 cm3, compression and obliteration of the posterior part of superior sagittal sinus were visualized. In the axial images, basal veins were not visualized with intraparenchymal balloon inflation of 90 cm3 or greater although straight sinus was visualized at all levels of inflation. Trasluminal pressure in the middle part of superior sagittal sinus demonstrated a mild increase from 0 cm H2O to 0.4 cm H2O and 0.5 cm H2O with inflation of balloon to volume of 150 and 180 cm3, respectively. There was a rapid increase in transluminal pressure from 6.8 cm H2O to 25.6 cm H2O as the supratentorial mass lesion increased from 180 to 200 cm3. Conclusions Our experiments identified distortion and segmental and global obliteration of dural venous sinuses secondary to supratentorial mass lesion and

  13. Accidental Poisoning with Otapiapia: a Local Organophasphate ...

    African Journals Online (AJOL)

    Children are prone to accidental poisoning. We report this fatal organophosphate poisoning of a 3-year-old Nigerian boy following accidental ingestion of a homemade cocktail of kerosene and 'Otapiapia': a local rodenticide to highlight the dangers inherent in un-regulated production, home use and storage of this ...

  14. Heme oxygenase-1 modulates degeneration of the intervertebral disc after puncture in Bach 1 deficient mice.

    Science.gov (United States)

    Ohta, Ryo; Tanaka, Nobuhiro; Nakanishi, Kazuyoshi; Kamei, Naosuke; Nakamae, Toshio; Izumi, Bunichiro; Fujioka, Yuki; Ochi, Mitsuo

    2012-09-01

    Intervertebral disc degeneration is considered to be a major feature of low back pain. Furthermore, oxidative stress has been shown to be an important factor in degenerative diseases such as osteoarthritis and is considered a cause of intervertebral disc degeneration. The purpose of this study was to clarify the correlation between oxidative stress and intervertebral disc degeneration using Broad complex-Tramtrack-Bric-a-brac and cap'n'collar homology 1 deficient (Bach 1-/-) mice which highly express heme oxygenase-1 (HO-1). HO-1 protects cells from oxidative stress. Caudal discs of 12-week-old and 1-year-old mice were evaluated as age-related models. Each group and period, 5 mice (a total of 20 mice, a total of 20 discs) were evaluated as age-related model. C9-C10 caudal discs in 12-week-old Bach 1-/- and wild-type mice were punctured using a 29-gauge needle as annulus puncture model. Each group and period, 5 mice (a total of 60 mice, a total of 60 discs) were evaluated. The progress of disc degeneration was evaluated at pre-puncture, 1, 2, 4, 8 and 12 weeks post-puncture. Radiographic, histologic and immunohistologic analysis were performed to compare between Bach 1-/- and wild-type mice. In the age-related model, there were no significant differences between Bach 1-/- and wild-type mice radiologically and histologically. However, in the annulus puncture model, histological scoring revealed significant difference at 8 and 12 weeks post-puncture. The number of HO-1 positive cells was significantly greater in Bach 1-/- mice at every period. The apoptosis rate was significantly lower at 1 and 2 weeks post-puncture in Bach 1-/- mice. Oxidative stress prevention may avoid the degenerative process of the intervertebral disc after puncture, reducing the number of apoptosis cells. High HO-1 expression may also inhibit oxidative stress and delay the process of intervertebral disc degeneration.

  15. Characterisation of childhood and adolescence accidental fatalities ...

    African Journals Online (AJOL)

    Background: Accidental death in childhood and adolescence is posing a public health problem in Nigeria, as most of these deaths were not caused by the victims. There is need to research into the pattern and circumstances surrounding the death. Aim: To characterise and study accidental deaths in childhood and ...

  16. Pleural puncture with thoracic epidural: A rare complication?

    Directory of Open Access Journals (Sweden)

    Rachna Wadhwa

    2011-01-01

    Full Text Available Freedom from pain has almost developed to be a fundamental human right. Providing pain relief via epidural catheters in thoracic and upper abdominal surgeries is widely accepted. Pain relief through this technique not only provides continuous analgesia but also reduces post-operative pulmonary complications and also hastens recovery. But being a blind procedure it is accompanied by certain complications. Hypotension, dura puncture, high epidural, total spinal, epidural haematoma, spinal cord injury and infection are some of the documented side effects of epidural block. There are case reports eliciting neurological complications, catheter site infections, paresthesias, radicular symptoms and worsening of previous neurological conditions. Few technical problems related to breakage of epidural catheter are also mentioned in the literature. The patient had no sequelae on long term follow up even when a portion of catheter was retained. We present a case report where epidural catheter punctured pleura in a patient undergoing thoracotomy for carcinoma oesophagus.

  17. Implantação de um kit para comunicação de acidente do trabalho (KIT-CAT como facilitador das ações que envolvem os acidentes com perfurocortantes Implantación de un kit para comunicación de accidente de trabajo (KIT CAT como facilitador de las acciones que involucran los accidentes con perfurocortantes Implementation of a kit for the communication of occupational accidents (KIT CAT as a facilitator for the actions involving puncture cutting accidents

    Directory of Open Access Journals (Sweden)

    Cristina Maria Fernandes Porto

    1999-12-01

    Full Text Available Este trabalho destaca a criação e aplicação na prática profissional, de um Kit para Comunicação de Acidente de Trabalho com perfurocortantes para a Secretaria Municipal da Saúde de Ribeirão Preto, como um instrumento indispensável à prestação de serviços de assistência à saúde dos funcionários das Unidades de Saúde do município. Evidencia a notificação e início da prevenção das doenças ocupacionais, sendo assim, um instrumento extremamente útil quando da ocorrência do acidente. A criação deste Kit possibilitou a retomada de medidas de prevenção dos acidentes ocupacionais, culminando com a mobilização de servidores e chefias na intensificação das ações preventivas.Este trabajo destaca la creación y aplicación en la practica profesional de un KIT para Comunicación de Accidente de Trabajo con perfurocortantes para la Secretaría Municipal de la Salud de Ribeirão Preto, como instrumento indispensable a la prestación de servicios de asistencia a la salud de los funcionarios de las Unidades de Salud del Municipio. Evidencia la notificación y el inicio de la prevención de enfermedades ocupacionales, siendo así, un instrumento extremamente útil cuando de la ocurrencia del accidente. La creación de este KIT, ha posibilitado la retomada de medidas de prevención de los accidentes ocupacionales, culminando con la movilización de servidores y jefes en la intensificación de las acciones preventivas.This paper emphasizes the creation and application of a KIT for the communication of occupational accidents with puncture-cutting objects to the Municipal Health Bureau from the city of Ribeirão Preto. It is an essential instrument for the health care services directed to all the employees of the Health Units. It also evidences the notification and the beginning of the prevention of occupational diseases, being a highly useful instrument whenever any accident occurs. The creation of this KIT enabled the use of

  18. Subcutaneous Emphysema Induced by Cryotherapy: A Complication due to Previous Punctures

    Directory of Open Access Journals (Sweden)

    Jared Martínez-Coronado

    2015-01-01

    Full Text Available Cryosurgery is a common therapeutic modality used in dermatology; therefore we must be aware of its possible adverse effects. We report a case of a patient with subcutaneous emphysema which occurred following the application of cryotherapy after multiple punctures of local anesthetic and intralesional steroids in a chest keloid scar. Despite the fact that this condition was gradually resolved after expectant observation, we warn about this complication when sprayed cryotherapy is preceded by multiple punctures on cutaneous lesions above bony surfaces. In similar settings, cryotherapy must be first administered or a cotton-tip applicator should be used.

  19. The anterior medullary-anterior pontomesencephalic venous system and its bridging veins communicating to the dural sinuses: normal anatomy and drainage routes from dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    Kiyosue, Hiro; Tanoue, Shuichi; Sagara, Yoshiko; Okahara, Mika; Kashiwagi, Junji; Mori, Hiromu; Hori, Yuzo; Nagatomi, Hirofumi

    2008-01-01

    We evaluated the normal venous anatomy of the anterior medullary/anterior pontomesencephalic venous (AMV/APMV) system and bridging veins connected to the dural sinuses using magnetic resonance (MR) imaging and demonstrated cases of dural arteriovenous fistulas (DAVFs) with bridging venous drainage. MR images obtained using a 3D gradient echo sequence in 70 patients without lesions affecting the deep or posterior venous channels were reviewed to evaluate the normal anatomy of the AMV/APMV system and bridging veins. MR images and digital subtraction angiography in 80 cases with intracranial or craniocervical junction DAVFs were reviewed to evaluate the bridging venous drainage from DAVFs. MR images clearly revealed AMV/APMV in 35 cases. Fifteen cases showed a direct connection between AMV and APMV, while 15 cases showed an indirect communication via the transverse pontine vein or the bridging vein. In the five remaining cases, the AMV and APMV end separately to the bridging vein or the transverse pontine vein. Bridging veins were identified in 34 cases, connecting to the cavernous sinus in 33, to the suboccipital cavernous sinus in 11, and the inferior petrosal sinus in five cases. In 80 DAVF cases, seven of 40 cavernous sinus DAVFs, two craniocervical junction DAVFs, and one inferior petrosal sinus DAVF drained via bridging veins to the brain stem. The AMV/APMV and bridging veins showed various anatomies and frequently showed a connection to the cavernous sinus. Knowledge of the venous anatomy is helpful for the diagnosis and intravascular treatment of DAVFs. (orig.)

  20. The influence of punctural millimeter wave therapy on clinical presentation of patients with essential hypertention

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

    Full Text Available Aim: to estimate the influence of punctural millimeter wave therapy on clinical presentation. Material and methods. This study includes 102 patients with essential hypertension the I and II stage. Patients were divided into three equal groups depending on the method of treatment: some of them received procedures of punctural millimeter wave therapy, some of them received these procedures as the "placebo" and those who had not received specified procedures. Dynamics of clinical symptomatology and condition of eye bottom vessels was estimated. It was shown that addition of punctural millimeter wave therapy in complex therapy of patients with essential hypertension promotes the expressed regress of clinical symptomatology and state normalization the retinal vessels at these patients. Results. Addition of punctural millimeter wave therapy into the complex therapy was shown to lead to pronounced regress of clinical symptoms. Conclusion. The received results allow to recommend this method to be used in clinical practice for treating patients with essential hypertension.

  1. Routine Cranial Computed Tomography before Lumbar Puncture in ...

    African Journals Online (AJOL)

    Background: Current international guidelines recommend that a cranial computed tomography (CT) be performed on all HIV-positive patients presenting with new onset seizures, before a lumbar puncture (LP) is performed. In the South African setting, however this delay could be life threatening. The present study sought to ...

  2. Is there a dural wall between the cavernous sinus and the pituitary fossa? Anatomical and MRI findings

    International Nuclear Information System (INIS)

    Dietemann, J.L.; Diniz, R.; Reis, M. Jr.; Neugroschl, C.; Vinclair, L.; Maillot, C.

    1998-01-01

    We compared MRI studies of the sellar area and embryological and adult histological studies of the cavernous sinuses and pituitary fossa. MRI studies were performed in 50 normal subjects with coronal sections using a fast inversion-recovery sequence to demonstrate the dural walls of the cavernous sinus and pituitary fossa. With this sequence, dura mater appears as a high-signal linear structure. The lateral and superior walls of the cavernous sinus was easily identified on all studies, but demonstration of a dural wall separating the cavernous sinus from the pituitary fossa was not possible. These results correlated well with embryological and adult histological studies obtained from 14 specimens. The absence of a strong separation between the pituitary fossa and the cavernous sinus explains the high incidence of extension of pituitary tumours to the cavernous sinuses and vice versa. (orig.) (orig.)

  3. The effects of needle deformation during lumbar puncture

    Directory of Open Access Journals (Sweden)

    Hasan Hüseyin Özdemir

    2015-01-01

    Full Text Available Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP. Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1% of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3% of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%. Forty-seven (41.5% patients experienced post lumbar puncture headache (PLPH and 13 (11.5% patients experienced intracranial hypotension (IH. No statistically significant correlation between the degree of deflection and headache was found (P > 0.05. Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

  4. The effects of needle deformation during lumbar puncture

    Science.gov (United States)

    Özdemir, Hasan Hüseyin; Demir, Caner F.; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

    2015-01-01

    Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH. PMID:25883480

  5. About Assessment Criteria of Driver's Accidental Abilities

    Science.gov (United States)

    Lobanova, Yuliya I.; Glushko, Kirill V.

    2016-01-01

    The article points at the importance of studying the human factor as a cause of accidents of drivers, especially in loosely structured traffic situations. The description of the experiment on the measurement of driver's accidental abilities is given. Under accidental ability is meant the capability to ensure the security of driving as a behavior…

  6. Quasiequilibrium states of black hole-neutron star binaries in the moving-puncture framework

    International Nuclear Information System (INIS)

    Kyutoku, Koutarou; Shibata, Masaru; Taniguchi, Keisuke

    2009-01-01

    General relativistic quasiequilibrium states of black hole-neutron star binaries are computed in the moving-puncture framework. We propose three conditions for determining the quasiequilibrium states and compare the numerical results with those obtained in the excision framework. We find that the results obtained in the moving-puncture framework agree with those in the excision framework and with those in the third post-Newtonian approximation for the cases that (i) the mass ratio of the binary is close to unity irrespective of the orbital separation, and (ii) the orbital separation is large enough (m 0 Ω 0 and Ω are the total mass and the orbital angular velocity, respectively) irrespective of the mass ratio. For m 0 Ω > or approx. 0.03, both of the results in the moving-puncture and excision frameworks deviate, more or less, from those in the third post-Newtonian approximation. Thus the numerical results do not provide a quasicircular state, rather they seem to have a non-negligible eccentricity of order 0.01-0.1. We show by numerical simulation that a method in the moving-puncture framework can provide approximately quasicircular states in which the eccentricity is by a factor of ∼2 smaller than those in quasiequilibrium given by other approaches.

  7. Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-arterial nitroglycerin in transradial procedures: a randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Turan, Burak, E-mail: drburakturan@gmail.com; Daşlı, Tolga; Erkol, Ayhan; Erden, İsmail

    2015-10-15

    Aim: Sublingual (SL) nitroglycerin administered before radial artery puncture can improve cannulation success and decrease the incidence of radial artery spasm (RAS) compared with intra-arterial (IA) nitroglycerin in transradial procedures. Methods: Patients undergoing diagnostic transradial angiography were randomized to IA (200 mcg) or SL (400 mcg) nitroglycerin. Primary endpoints were puncture time and puncture attempts. Secondary endpoint was the incidence of RAS. Results: Total of 101 participants (mean age 60 ± 11 years, 53% male) were randomized (51 in IA and 50 in SL groups). Puncture time (50 [36–75] vs 50 [35–90] sec), puncture attempts (1.18 ± 0.48 vs 1.20 ± 0.49), multiple punctures (13.7 vs 16.0%) and RAS (19.6 vs 24.0%) were not statistically different between IA vs SL groups respectively. A composite endpoint of all adverse events related to transradial angiography (multiple punctures, RAS, access site crossover, hypotension/bradycardia associated with nitroglycerin and radial artery occlusion) was very similar in IA vs SL groups (39 vs 40%, respectively). However puncture time was significantly longer with SL nitroglycerin in patients < 1.65 m height (47 [36–66] vs 63 [41–110] sec, p = 0.042). Multiple punctures seemed higher with SL nitroglycerin in patients with diabetes (0 vs 30%, p = 0.028) or in patients < 1.65 m height (7.4 vs 25%, p = 0.085). Likewise, RAS with SL nitroglycerin seemed more frequent in smokers compared to IA nitroglycerin (0 vs 27%, p = 0.089). Conclusions: SL nitroglycerin was not different from IA nitroglycerin in terms of efficiency and safety in overall study population. However it may be inferior to IA nitroglycerin in certain subgroups (shorter individuals, diabetics and smokers). - Highlights: • Improvement in radial artery puncture time and success with subcutaneous nitrate was reported. • Giving nitrate sublingually may have vasodilation along entire length of radial artery and may prevent RAS

  8. Gelatin model for training ultrasound-guided puncture

    Directory of Open Access Journals (Sweden)

    Alexandre Campos Moraes Amato

    2015-09-01

    Full Text Available BACKGROUND: It is indispensable that members of the medical profession receive the technical training needed to enable them to rapidly obtain effective vascular access. Training procedures should be used judiciously to familiarize students with the technique. However, existing models are expensive or ineffective, and models need to be developed that are similar to what will be encountered in real patients.OBJECTIVES: To demonstrate creation and application of a gelatin model for training ultrasound-guided puncture.METHOS: The model was made using a mixture of colorless gelatin and water in a transparent plastic receptacle with two pairs of orifices of different diameters, through which two plastic tubes were inserted, to simulate blood vessels.RESULTS: The model was a close approximation to the real medical procedure in several aspects, since gelatin has a similar consistency to human tissues, providing a more faithful reproduction of the tactile sensation at the moment when the needle reaches the interior of a vessel and its contents are aspirated.CONCLUSIONS: The method proposed here can be used to easily construct a low-cost model using everyday materials that is suitable for large-scale training of ultrasound-guided puncture.

  9. Correlation of Descriptive Analysis and Instrumental Puncture Testing of Watermelon Cultivars.

    Science.gov (United States)

    Shiu, J W; Slaughter, D C; Boyden, L E; Barrett, D M

    2016-06-01

    The textural properties of 5 seedless watermelon cultivars were assessed by descriptive analysis and the standard puncture test using a hollow probe with increased shearing properties. The use of descriptive analysis methodology was an effective means of quantifying watermelon sensory texture profiles for characterizing specific cultivars' characteristics. Of the 10 cultivars screened, 71% of the variation in the sensory attributes was measured using the 1st 2 principal components. Pairwise correlation of the hollow puncture probe and sensory parameters determined that initial slope, maximum force, and work after maximum force measurements all correlated well to the sensory attributes crisp and firm. These findings confirm that maximum force correlates well with not only firmness in watermelon, but crispness as well. The initial slope parameter also captures the sensory crispness of watermelon, but is not as practical to measure in the field as maximum force. The work after maximum force parameter is thought to reflect cellular arrangement and membrane integrity that in turn impact sensory firmness and crispness. Watermelon cultivar types were correctly predicted by puncture test measurements in heart tissue 87% of the time, although descriptive analysis was correct 54% of the time. © 2016 Institute of Food Technologists®

  10. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization

    International Nuclear Information System (INIS)

    Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

    2015-01-01

    Highlights: • 4D CTA showed excellent agreement with DSA with regard to identification of feeding arteries and drainage veins. • The most important finding was 4D CTA in determining the impact of DAVF treatment with transarterial embolization. • 4D CTA provides images similar to those obtained with DSA both before and after treatment. - Abstract: Purpose: This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Patients and Methods: Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Results: Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ = 1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Conclusion: Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings

  11. [The relationship between angle of puncture and distribution of bone cement of unilateral percutaneous kyphoplasty for the treatment of thoracolumbar compression fractures].

    Science.gov (United States)

    Wang, Xiang-fu; Fan, You-fu; Shi, Rui-fang; Deng, Qiang; Li, Zhong-feng

    2015-08-01

    To explore the relationship of bone cement distribution and the puncture angle in the treatment of thoracolumbar compression fractures with unilateral percutaneous kyphoplasty (PKP). The clinical data of 37 patients with thoracolumbar osteoporotic compression fractures underwent PKP between January 2013 to March 2014 were retrospectively analyzed, all punctures were performed unilaterally. There were 6 males, aged from 65 to 78 years old with an average of (71.83 ± 6.15) years; and 31 females, aged from 57 to 89 years old with an average of (71.06 ± 7.89) years. Imaging data were analyzed and puncture angle and puncture point were measured before operation. According to the measured data, the puncture were performeds during the operation. Distribution area of bone cement were calculated by X-rays data after operation. The effect of bone cement distribution on suitable puncture angle was analyzed; VAS score was used to evaluate the clinical effects. The puncture angle of thoracic vertebrae in T8-T12 was from 28° to 33° with an average 30.4°; and the puncture angle of lumbar vertebrae in L1-L5 was from 28° to 35° with an average of 31.3°. Postoperative X-rays showed the area ratios of bilateral bone cement was 0.97 ± 0.15. Bilateral diffuse area were basic equal. Postoperative VAS score decreased significantly (1.89 ± 1.29 vs 7.03 ± 1.42). Through measure imaging data before operation with PKP,the puncture point and entry point can be confirmed. According the measured data to puncture during operation, unilateral puncture can reach the distribution effect of the bilateral puncture in the treatment of thoracolumbar compression fractures.

  12. Acute Tetraparesis with Respiratory Failure after Steroid Administration in a Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction

    Science.gov (United States)

    Takahashi, Hisashi; Ueshima, Taiki; Goto, Daiki; Kimura, Tadashi; Yuki, Natsuko; Inoue, Yasuo; Yoshioka, Akira

    2017-01-01

    A 63-year-old man developed vomiting, paraparesis, dysuria, bulbar palsy, and orthostatic hypotension over a period of 5 months. Neuroradiological examinations showed a swollen lower brainstem with a dural arteriovenous fistula at the craniocervical junction (DAVF-CCJ). A steroid was administered intravenously in the hospital to relieve brainstem edema. A few hours later, however, the patient developed acute tetraparesis with respiratory failure. Recently, there have been several reports describing the acute worsening of paraparesis in patients with a spinal dural arteriovenous fistula after steroid treatment. In addition to these reports, the present case suggests the risk of administering steroids to patients with DAVF-CCJ, especially those with brainstem dysfunction. PMID:29225249

  13. Effect of Hemoconcentration on Dural Sinus Computed Tomography Density in a Pediatric Population.

    Science.gov (United States)

    Yurttutan, Nursel; Kizildag, Betul; Sarica, Mehmet Akif; Baykara, Murat

    2016-10-01

    Unenhanced brain computed tomography (CT) is inexpensive, easily available, and the first-choice imaging modality for patients presenting with various neurologic symptoms. Venous thrombosis is not rare in childhood, but diagnosis can be difficult. In some cases, only denser vessels can be used to highlight an issue. The aim of this study was to retrospectively evaluate the relationship between X-ray attenuation and hemoconcentration in a pediatric population. This study enrolled 99 pediatric patients who had been referred radiology department for unenhanced brain CT. Images were retrospectively evaluated for measurement of dural sinus densities from four distinct dural sinus locations. Correlation between mean Hounsfield unit (HU) values and hemoglobin/hematocrit (Hb/Htc) levels, as well as age and gender were further analyzed. There was a strong correlation between mean HU and Hb levels (r = 0.411; standard deviation: 0.001) and also between mean HU and Htc levels (r = 0.393; p pediatric group. In conclusion, before deciding between a diagnosis of thrombosis and a determination of normal findings during an evaluation of unenhanced CT in a pediatric population, radiologists should consider complete blood count results as well as H:H ratios. Georg Thieme Verlag KG Stuttgart · New York.

  14. A new multiple noncontinuous puncture (pointage technique for corneal tattooing

    Directory of Open Access Journals (Sweden)

    Jin Hyoung Park

    2015-10-01

    Full Text Available AIM:To assess the safety and cosmetic efficacy of a new multiple noncontinuous transepithelial puncture technique for tattooing a decompensated cornea.METHODS:It was anon-comparative clinical case series study.The study examines 33 eyes in 33 patients with total corneal opacity due to corneal decompensation, which developed following intraocular surgery.Corneal tattooing was performed using the multiple noncontinuous transepithelial puncture technique (i.e. pointage. The safety of this new surgical strategy was assessed by occurrence of adverse events for the follow-up period. The cosmetic efficacy was determined by the patient’s cosmetic satisfaction and independent observer’s opinion about patient appearance.RESULTS:Seven women and 26 men were included in the study. The mean age was 46.4±17.5y (range:7-67. In total, 30 of 33 patients (91% reported cosmetic satisfaction within the follow-up period. Only 3 patients (9% required additional tattooing due to cosmetic unsatisfaction. Cosmetic outcomes were analyzed and classified as excellent or good in 13 (39% and 17 (52% patients, respectively. No serious adverse events developed, except delayed epithelial healing in 3 cases.CONCLUSION:The cosmetic outcomes of the multiple noncontinuous transepithelial puncture technique for corneal tattooing were good. The safety of this method is higher than conventional procedures. This new procedure also provides improved cost-effectiveness and safety over current corneal tattooing techniques.

  15. [Examination of the optimal midazolam dose required for loss of puncture memory at the time of spinal anesthesia].

    Science.gov (United States)

    Boku, Aiji; Koyama, Shinichi; Kishimoto, Naotaka; Nakatani, Keiji; Kurita, Satoshi; Nagata, Noboru; Niwa, Hitoshi

    2011-08-01

    We examined midazolam ED50 according to age that was necessary for loss of puncture memory at the time of spinal anesthesia and determined whether we could estimate the presence of puncture memory from the degree of sedation after midazolam administration. We enrolled patients with ASA PS 1 or 2 and patients from 50 to 80 years of age who had been planned for surgery with spinal anesthesia. We divided the patients into groups according to their age--50s, 60s, and 70s as L, M, and H groups, respectively. We evaluated the degree of sedation with six phases of scores after intravenous administration of midazolam and spinal anesthesia was performed. The midazolam dose was based on the ups and downs method. The midazolam ED50s required for the loss of puncture memory in groups L, M, and H were 0.043, 0.035, and 0.026 mg x kg(-1), respectively. We estimated the association between the sedation degree score after midazolam administration and the puncture memory from ROC curve, but AUC was 0.56 for all cases. The midazolam ED50 required for the loss of puncture memory decreased with age but it was difficult to estimate puncture memory from the degree of sedation.

  16. Induced dural lymphangiogenesis facilities soluble amyloid-beta clearance from brain in a transgenic mouse model of Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ya-Ru Wen

    2018-01-01

    Full Text Available Impaired amyloid-β clearance from the brain is a core pathological event in Alzheimer's disease. The therapeutic effect of current pharmacotherapies is unsatisfactory, and some treatments cause severe side effects. The meningeal lymphatic vessels might be a new route for amyloid-β clearance. This study investigated whether promoting dural lymphangiogenesis facilitated the clearance of amyloid-β from the brain. First, human lymphatic endothelial cells were treated with 100 ng/mL recombinant human vascular endothelial growth factor-C (rhVEGF-C protein. Light microscopy verified that rhVEGF-C, a specific ligand for vascular endothelial growth factor receptor-3 (VEGFR-3, significantly promoted tube formation of human lymphatic endothelial cells in vitro. In an in vivo study, 200 μg/mL rhVEGF-C was injected into the cisterna magna of APP/PS1 transgenic mice, once every 2 days, four times in total. Immunofluorescence staining demonstrated high levels of dural lymphangiogenesis in Alzheimer's disease mice. One week after rhVEGF-C administration, enzyme-linked immunosorbent assay results showed that levels of soluble amyloid-β were decreased in cerebrospinal fluid and brain. The Morris water maze test demonstrated that spatial cognition was restored. These results indicate that the upregulation of dural lymphangiogenesis facilities amyloid-β clearance from the brain of APP/PS1 mice, suggesting the potential of the VEGF-C/VEGFR-3 signaling pathway as a therapeutic target for Alzheimer's disease.

  17. The optical "Veress-needle"--initial puncture with a minioptic.

    Science.gov (United States)

    Schaller, G; Kuenkel, M; Manegold, B C

    1995-02-01

    Laparoscopic access is a necessary part of minimally invasive surgery. The double blind puncture with Veress-needle and trocar can cause lethal complications such as bowel injury, bleeding and gas-embolisation. Some authors have reported alternative techniques for laparoscopic abdominal access. Because no blind procedure can absolutely prevent injury, permanent visual control of perforated tissue layers as in open surgery should be achieved to prevent possible injury at an early stage. Previously described procedures could not fulfil all requirements to comply with this ideal, i.e. permanent visual control of abdominal wall penetration prior to establishment of pneumoperitoneum and trocar insertion without further possible damage. We designed a 2 mm fibreglass optic 250 mm in length that is inserted into a suitable cannula. Special construction allows rinsing through the cannula to clear the vision and to open spaces in the puncture track by water dissection. After incision of the skin, all layers of the abdominal wall can be visualised, including blood vessels and internal surfaces. Once the abdominal cavity is reached, the needle tip is retracted and a two-step dilation allows the trocar to be introduced via the puncture track. Only then does insufflation begin. The fibreglass optic-equipped safety needle was used for visually controlled access in 184 laparoscopic surgical procedures. After a period of training, all layers of the abdominal wall could be recognised exactly. In two patients with dense adhesions, perforation of the small bowel was diagnosed immediately by endoscopic viewing. The small injury needed no treatment, and the intended procedure was completed laparoscopically.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. The Accidental Transgressor: Morally Relevant Theory of Mind

    Science.gov (United States)

    Killen, Melanie; Mulvey, Kelly Lynn; Richardson, Cameron; Jampol, Noah

    2014-01-01

    To test young children’s false belief theory of mind in a morally relevant context, two experiments were conducted. In Experiment 1, children (N = 162) at 3.5, 5.5, and 7.5 years of age were administered 3 tasks: prototypic moral transgression task, false belief theory of mind task (ToM), and an “accidental transgressor” task, which measured a morally relevant false belief theory of mind (MoToM). Children who did not pass false belief ToM were more likely to attribute negative intentions to an accidental transgressor than children who passed false belief ToM, and to use moral reasons when blaming the accidental transgressor. In Experiment 2, children (N = 46) who did not pass false belief ToM viewed it as more acceptable to punish the accidental transgressor than did participants who passed false belief ToM. Findings are discussed in light of research on the emergence of moral judgment and theory of mind. PMID:21377148

  19. Meningitis following spinal anaesthesia in an obstetric patient.

    Science.gov (United States)

    Celik, Mine; Kizilkaya, Mehmet; Dostbil, Aysenur; Dogan, Nazim; Parlak, Mehmet; Can, Fatma Kesmez; Bayar, Meral

    2014-07-01

    Meningitis following lumbar puncture and spinal anaesthesia is a rare but serious complication. A 19-year-old woman was administered spinal anaesthesia at another centre prior to a Caesarean section. The following day she experienced headaches. On the fourth day, she started vomiting and having convulsions, and became agitated. Meningitis was diagnosed based on a clinical examination and analysis of a lumbar puncture sample. After 21 days of treatment, she was discharged. Meningitis should be considered in the differential diagnosis of a patient presenting with headaches following spinal anaesthesia. The causes of meningitis following spinal anaesthesia are debated, and it is difficult to distinguish between aseptic and bacterial meningitis. It should be compulsory to wear a face mask while performing a dural puncture. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Influence of repetitive finger puncturing on skin perfusion and capillary blood analysis in patients with diabetes mellitus

    NARCIS (Netherlands)

    de Graaff, J. C.; Hemmes, G. J.; Bruin, T.; Ubbink, D. T.; Michels, R. P.; Jacobs, M. J.; Sanders, G. T.

    1999-01-01

    Frequent puncturing of fingers to check blood glucose in patients with type 1 diabetes might alter skin perfusion and, hence, influence the representativeness of the blood sample. We investigated the influence of repetitive puncturing on skin microcirculatory perfusion using laser Doppler fluxmetry

  1. A New Navigation System of Renal Puncture for Endoscopic Combined Intrarenal Surgery: Real-time Virtual Sonography-guided Renal Access.

    Science.gov (United States)

    Hamamoto, Shuzo; Unno, Rei; Taguchi, Kazumi; Ando, Ryosuke; Hamakawa, Takashi; Naiki, Taku; Okada, Shinsuke; Inoue, Takaaki; Okada, Atsushi; Kohri, Kenjiro; Yasui, Takahiro

    2017-11-01

    To evaluate the clinical utility of a new navigation technique for percutaneous renal puncture using real-time virtual sonography (RVS) during endoscopic combined intrarenal surgery. Thirty consecutive patients who underwent endoscopic combined intrarenal surgery for renal calculi, between April 2014 and July 2015, were divided into the RVS-guided puncture (RVS; n = 15) group and the ultrasonography-guided puncture (US; n = 15) group. In the RVS group, renal puncture was repeated until precise piercing of a papilla was achieved under direct endoscopic vision, using the RVS system to synchronize the real-time US image with the preoperative computed tomography image. In the US group, renal puncture was performed under US guidance only. In both groups, 2 urologists worked simultaneously to fragment the renal calculi after inserting the miniature percutaneous tract. The mean sizes of the renal calculi in the RVS and the US group were 33.5 and 30.5 mm, respectively. A lower mean number of puncture attempts until renal access through the calyx was needed for the RVS compared with the US group (1.6 vs 3.4 times, respectively; P = .001). The RVS group had a lower mean postoperative hemoglobin decrease (0.93 vs 1.39 g/dL, respectively; P = .04), but with no between-group differences with regard to operative time, tubeless rate, and stone-free rate. None of the patients in the RVS group experienced postoperative complications of a Clavien score ≥2, with 3 patients experiencing such complications in the US group. RVS-guided renal puncture was effective, with a lower incidence of bleeding-related complications compared with US-guided puncture. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Accidental and retrospective dosimetry using TL method

    International Nuclear Information System (INIS)

    Mesterházy, D.; Osvay, M.; Kovács, A.; Kelemen, A.

    2012-01-01

    Retrospective dosimetry is one of the most important tools of accidental dosimetry for dose estimation when dose measurement was not planned. In the affected area many objects can be applied as natural dosimeters. The paper discusses our recent investigations on various electronic components and common salt (NaCl) having useful thermoluminescence (TL) properties. Among materials investigated the electronic components of cell phones seem promising for retrospective dosimetry purposes, having high TL responses, proper glow curve peaks and the intensity of TL peaks vs. gamma dose received provided nearly linear response in the dose range of 10 mGy–1.5 Gy. - Highlights: ► Electronic components and common salt were investigated for accidental and retrospective dosimetry. ► SMD resistors seem promising for retrospective dosimetry purposes. ► Table salt can be used effectively for accidental dosimetry purposes, as well.

  3. 40 CFR Table 3 to Subpart Xxxx of... - Emission Limits for Puncture Sealant Application Affected Sources

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Emission Limits for Puncture Sealant Application Affected Sources 3 Table 3 to Subpart XXXX of Part 63 Protection of Environment ENVIRONMENTAL... Manufacturing Pt. 63, Subpt. XXXX, Table 3 Table 3 to Subpart XXXX of Part 63—Emission Limits for Puncture...

  4. 40 CFR Table 4 to Subpart Xxxx of... - Operating Limits for Puncture Sealant Application Control Devices

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Operating Limits for Puncture Sealant Application Control Devices 4 Table 4 to Subpart XXXX of Part 63 Protection of Environment ENVIRONMENTAL... Manufacturing Pt. 63, Subpt. XXXX, Table 4 Table 4 to Subpart XXXX of Part 63—Operating Limits for Puncture...

  5. A new cerebral vasospasm model established with endovascular puncture technique

    International Nuclear Information System (INIS)

    Tu Jianfei; Liu Yizhi; Ji Jiansong; Zhao Zhongwei

    2011-01-01

    Objective: To investigate the method of establishing cerebral vasospasm (CVS) models in rabbits by using endovascular puncture technique. Methods: Endovascular puncture procedure was performed in 78 New Zealand white rabbits to produce subarachnoid hemorrhage (SAH). The survival rabbits were randomly divided into seven groups (3 h, 12 h, 1 d, 2 d, 3 d, 7 d and 14 d), with five rabbits in each group for both study group (SAH group) and control group. Cerebral CT scanning was carried out in all rabbits both before and after the operation. The inner diameter and the thickness of vascular wall of both posterior communicating artery (PcoA) and basilar artery (BA) were determined after the animals were sacrificed, and the results were analyzed. Results: Of 78 experimental rabbits, CVS model was successfully established in 45, including 35 of SAH group and 10 control subgroup. The technical success rate was 57.7%. Twelve hours after the procedure, the inner diameter of PcoA and BA in SAH group was decreased by 45.6% and 52.3%, respectively, when compared with these in control group. The vascular narrowing showed biphasic changes, the inner diameter markedly decreased again at the 7th day when the decrease reached its peak to 31.2% and 48.6%, respectively. Conclusion: Endovascular puncture technique is an effective method to establish CVS models in rabbits. The death rate of experimental animals can be decreased if new interventional material is used and the manipulation is carefully performed. (authors)

  6. Measurement of the cross-sectional area of the dural tube in the lumbar spine on magnetic resonance imaging. Comparison between normal, pre- and post-discectomy conditions

    International Nuclear Information System (INIS)

    Matsubayashi, Yasutomo

    1997-01-01

    This study evaluated the usefulness of pre- and postoperative magnetic resonance imaging (MRI) of lumbar disc hernia with special attention to measurement of the cross-sectional area of the dural tube. Twenty-five patients (20 men and 5 women; 25 discs) who underwent posterior lumbar discectomy and 73 normal individuals (44 men and 29 women; 219 discs) of a similar age distribution were studied. Axial MRI was mainly used for the measurement of the dural tube. In the patient group, MRI examination was performed 1, 3, 6, and 12 months postoperatively. Assessment of the clinical symptoms was also included and used for comparison with the MRI evaluation. The cross-sectional area was significantly reduced to about 50% of the normal preoperatively. One month postoperatively, there was no significant increase in the size of the area, but after three months, the area increased significantly and progressed to the normal size within a year. One-month postoperatively, MRI examination was not considered useful because of postoperative hematoma and/or edema at the surgical site. The increase in the size of the cross-sectional area of the dural tube correlated well with the improvement in clinical symptoms. Three-months postoperatively, MRI evaluation of the lumbar disc seemed useful and measurement of the cross-sectional area of the dural tube appeared to serve as an indicator of the effectiveness of the surgery. (author)

  7. Measurement of the cross-sectional area of the dural tube in the lumbar spine on magnetic resonance imaging. Comparison between normal, pre- and post-discectomy conditions

    Energy Technology Data Exchange (ETDEWEB)

    Matsubayashi, Yasutomo [Juntendo Univ., Tokyo (Japan). School of Medicine

    1997-07-01

    This study evaluated the usefulness of pre- and postoperative magnetic resonance imaging (MRI) of lumbar disc hernia with special attention to measurement of the cross-sectional area of the dural tube. Twenty-five patients (20 men and 5 women; 25 discs) who underwent posterior lumbar discectomy and 73 normal individuals (44 men and 29 women; 219 discs) of a similar age distribution were studied. Axial MRI was mainly used for the measurement of the dural tube. In the patient group, MRI examination was performed 1, 3, 6, and 12 months postoperatively. Assessment of the clinical symptoms was also included and used for comparison with the MRI evaluation. The cross-sectional area was significantly reduced to about 50% of the normal preoperatively. One month postoperatively, there was no significant increase in the size of the area, but after three months, the area increased significantly and progressed to the normal size within a year. One-month postoperatively, MRI examination was not considered useful because of postoperative hematoma and/or edema at the surgical site. The increase in the size of the cross-sectional area of the dural tube correlated well with the improvement in clinical symptoms. Three-months postoperatively, MRI evaluation of the lumbar disc seemed useful and measurement of the cross-sectional area of the dural tube appeared to serve as an indicator of the effectiveness of the surgery. (author)

  8. CT fluoroscopy-assisted puncture of thoracic and abdominal masses: a randomized trial.

    Science.gov (United States)

    Kirchner, Johannes; Kickuth, Ralph; Laufer, Ulf; Schilling, Esther Maria; Adams, Stephan; Liermann, Dieter

    2002-03-01

    We investigated the benefit of real-time guidance of interventional punctures by means of computed tomography fluoroscopy (CTF) compared with the conventional sequential acquisition guidance. In a prospective randomized trial, 75 patients underwent either CTF-guided (group A, n = 50) or sequential CT-guided (group B, n = 25) punctures of thoracic (n = 29) or abdominal (n = 46) masses. CTF was performed on the CT machine (Somatom Plus 4 Power, Siemens Corp., Forchheim, Germany) equipped with the C.A.R.E. Vision application (tube voltage 120 kV, tube current 50 mA, rotational time 0.75 s, slice thickness 10 mm, 8 frames/s). The average procedure time showed a statistically significant difference between the two study groups (group A: 564 s, group B 795 s, P = 0.0032). The mean total mAs was 7089 mAs for the CTF and 4856 mAs for the sequential image-guided intervention, respectively. The sensitivity was 71% specificity 100% positive predictive value 100% and negative predictive value 60% for the CTF-guided puncture, and 68, 100, 100 and 50% for sequential CT, respectively. CTF guidance realizes a time-saving but increases the radiation exposure dosage.

  9. An evaluation of the Johnson-Cook model to simulate puncture of 7075 aluminum plates.

    Energy Technology Data Exchange (ETDEWEB)

    Corona, Edmundo; Orient, George Edgar

    2014-02-01

    The objective of this project was to evaluate the use of the Johnson-Cook strength and failure models in an adiabatic finite element model to simulate the puncture of 7075- T651 aluminum plates that were studied as part of an ASC L2 milestone by Corona et al (2012). The Johnson-Cook model parameters were determined from material test data. The results show a marked improvement, in particular in the calculated threshold velocity between no puncture and puncture, over those obtained in 2012. The threshold velocity calculated using a baseline model is just 4% higher than the mean value determined from experiment, in contrast to 60% in the 2012 predictions. Sensitivity studies showed that the threshold velocity predictions were improved by calibrating the relations between the equivalent plastic strain at failure and stress triaxiality, strain rate and temperature, as well as by the inclusion of adiabatic heating.

  10. Radiographic anatomy of the distal dural SAC; A myelographic investigation of dimensions and termination

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, J.L.; Olsen, K.O. (Haukeland Sykehus, Bergen (Norway). Dept. of Diagnostic Radiology)

    1991-05-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.).

  11. Management of intracranial dural arteriovenous shunts in adults

    International Nuclear Information System (INIS)

    Sarma, Dipanka; Brugge, Karel ter

    2003-01-01

    Dural arteriovenous shunts are abnormal arteriovenous communications within the dura. They are thought to be an acquired condition in adults and can present with a variety of clinical features, ranging from benign bruits to intracranial hemorrhage and neurological deficits. The presentation and natural history of these shunts is largely determined by the pattern of venous drainage. Knowledge of natural history and careful study of the angioarchitexture by angiography is therefore mandatory for correct management of these lesions. In this review, principles of management in adults and the various factors that influence treatment decisions are discussed, with a focus on endovascular therapy. Retrograde leptomeningeal or cortical venous drainage has a strong correlation with adverse clinical events and the requirement for aggressive management in this situation is highlighted. Indications for endovascular treatment, therapeutic goals, approaches and techniques are reviewed. The role of surgical treatment is also briefly discussed

  12. On Railroad Tank Car Puncture Performance: Part I - Considering Metrics

    Science.gov (United States)

    2016-04-12

    This paper is the first in a two-part series on the puncture performance of railroad tank cars carrying hazardous materials in the event of an accident. Various metrics are often mentioned in the open literature to characterize the structural perform...

  13. On Railroad Tank Car Puncture Performance: Part II - Estimating Metrics

    Science.gov (United States)

    2016-04-12

    This paper is the second in a two-part series on the puncture performance of railroad tank cars carrying hazardous materials in the event of an accident. Various metrics are often mentioned in the open literature to characterize the structural perfor...

  14. Clinical application of percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation under CT guidance

    International Nuclear Information System (INIS)

    Wang Linyou; Li Yuan; Shao Yangtong

    2004-01-01

    Objective: To evaluate the effect of the percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation. Methods: 75 cases of lumbar disc herniation with significant clinical signs were confirmed by CT scan. The technique of the percutaneous lumbar puncture led the needle to approach nerve root and injected medicine diffusing into extraduramater, and then relieved the symptom of sciatica. Results: The rate of success of percutaneous lumbar puncture guided by CT reached to 100%. After two weeks of follow-up, the symptom of pain was obviously improved and disappeared in 63.3% cases. There were 23.0% cases needed a second procedure, and no change was obsesved in 9.3% cases. Conclusions: The percutaneous lumbar puncture guided by CT to treat sciatica resulted from lumbar disc herniation is one of the safe, reliable, effective new methods with no complication. The long term effectiveness is still in need of investigation. (authors)

  15. A case of subdural hematoma following lumbar puncture

    Directory of Open Access Journals (Sweden)

    Ramatharaknath Vemuri

    2017-01-01

    Full Text Available Lumbar puncture (LP is a frequent procedure done for administration of spinal anesthesia or for obtaining cerebrospinal fluid for analysis. The common complications of LP are pain at the local site and headache. Fortunately, the serious complications such as infections of central nervous system, brain stem herniation, and subdural hematoma are rare. We present a rare case of subdural hematoma following a LP.

  16. Últimos perfiles del accidente de trabajo en misión

    OpenAIRE

    Poquet Catalá, Raquel

    2017-01-01

    En este trabajo se analiza desde un punto de vista de la doctrina judicial y jurisprudencial la construcción doctrinal del accidente de trabajo en misión como derivación del accidente de trabajo in itinere y como configuración propia del accidente de trabajo en sí. Así, se procede a la delimitación respecto del accidente in itinere, se realiza un análisis de los requisitos configuradores del mismo, tanto genéricos como específicos, así como la aplicabilidad de la presunción iuris tantum de la...

  17. Study of DSA-guided percutaneous puncture location of foramen oval

    International Nuclear Information System (INIS)

    Zhao Xiaojun; He Jiawei; Bai Guanghui; Shi Jianjing; Xu Chongyong; Zhan Gonghao

    2008-01-01

    Objective: To study the technique of digital substraction angiography (DSA)-guided percutaneous puncture location of foramen oval. Methods: 39 cases of trigeminal neuralgia were included in the study from Feb. 2004 to Oct. 2006. The patients were punctured by the amending anterior position. The f0ramen oval was displayed by moving the tube tilted 20-28 degree to the caudal and 16-23 degree to the healthy side. The direction and depth of the needles was determined on the lateral view. Then, radio-frequency thermocoagulation therapy was performed. Results: The needles were located in oval foramen in all the patients. Pain disappeared in 36 cases, alleviated in other cases, and no serious complication occurred during therapy. Conclusions: Oval foramen locations by DSA can improve the successful rate of operation. The foramen oval can be clearly displayed by DSA-guided in amending position, with comfortable position for patients. (authors)

  18. Measurements of Epidural Space Depth Using Preexisting CT Scans Correlate with Loss of Resistance Depth during Thoracic Epidural Catheter Placement

    Directory of Open Access Journals (Sweden)

    Nathaniel H. Greene

    2015-01-01

    Full Text Available Background. Thoracic epidural catheters provide the best quality postoperative pain relief for major abdominal and thoracic surgical procedures, but placement is one of the most challenging procedures in the repertoire of an anesthesiologist. Most patients presenting for a procedure that would benefit from a thoracic epidural catheter have already had high resolution imaging that may be useful to assist placement of a catheter. Methods. This retrospective study used data from 168 patients to examine the association and predictive power of epidural-skin distance (ESD on computed tomography (CT to determine loss of resistance depth acquired during epidural placement. Additionally, the ability of anesthesiologists to measure this distance was compared to a radiologist, who specializes in spine imaging. Results. There was a strong association between CT measurement and loss of resistance depth (P35 changed this relationship (P=0.007. The ability of anesthesiologists to make CT measurements was similar to a gold standard radiologist (all individual ICCs>0.9. Conclusions. Overall, this study supports the examination of a recent CT scan to aid in the placement of a thoracic epidural catheter. Making use of these scans may lead to faster epidural placements, fewer accidental dural punctures, and better epidural blockade.

  19. A New Ultrasound-Guided Puncture Device with Augmented Degrees of Performance Freedom and Ability to Attach to Most Convex Probes

    International Nuclear Information System (INIS)

    Jung, Sung Il; Son, Kyu Ri; Kim, Young Jun; Jeon, Hae Jeong; Park, Sang Woo; Cho, Jeong Yeon; Kim, Seung Hyup

    2008-01-01

    To evaluate the performance of a newly-designed ultrasound (US)-guided puncture device. A newly-designed US-guided puncture device was composed of a guide segment and an attachable segment. The guide segment allowed the needle to be placed in the plane of US view with a maximal degree of freedom, and the attachable segment was designed to attach to most convex US probes. Six operators punctured 144 targets in phantoms using either the new device (n = 72) or free-hand technique (n = 72). The number of required needle passages and the necessary procedure times were compared between the two groups. The number of required needle passages and the necessary procedure time were significantly reduced in five operators when the newly-designed US-guided puncture device was used (p < 0.05). A newly-designed US-guided puncture device, which allows for a maximal degree of freedom in needle placement and can attach to most convex US probes, showed good performance in our study

  20. Use of a Puncture Needle for Recanalization of an Occluded Right Subclavian Vein

    International Nuclear Information System (INIS)

    Gupta, Himanshu; Murphy, Timothy P.; Soares, Gregory M.

    1998-01-01

    We report a patient in whom we used a puncture needle to initiate percutaneous recanalization of a chronic occlusion of the junction between the right subclavian vein and the right brachiocephalic vein. Under fluoroscopic guidance, an 18-gauge needle was used to puncture the right subclavian vein. When contrast material injected through the needle confirmed intravascular location, the needle was advanced until it deflected and perforated an occlusion balloon target positioned within the right brachiocephalic vein. This technique may be useful in patients with central venous occlusions that are refractory to traversal using traditional catheter and guidewire techniques

  1. Late-presenting dural tear: incidence, risk factors, and associated complications.

    Science.gov (United States)

    Durand, Wesley M; DePasse, J Mason; Kuris, Eren O; Yang, JaeWon; Daniels, Alan H

    2018-04-18

    Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), although estimates of LPDT range from 0.6 to 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT. This investigation is the largest yet conducted on LPDT, and sought to identify incidence, risk factors for, and complications associated with LPDT. This observational cohort study employed the American College of Surgeons National Surgical Quality Improvement Program dataset (years 2012-2015). Patients who underwent spine surgery were identified based on presence of primary listed Current Procedural Terminology (CPT) codes corresponding to spinal fusion or isolated posterior decompression without fusion. The primary variable in this study was occurrence of LPDT, identified as reoperation or readmission with durotomy-specific CPT or International Classification of Diseases, Ninth Revision, Clinical Modification codes but without durotomy codes present for the index procedure. Descriptive statistics were generated. Bivariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression, respectively, generating both risk factors for LPDT and independent association of LPDT with postoperative complications. Statistical significance was defined as p<.05. In total, 86,212 patients were analyzed. The overall rate of reoperation or readmission without reoperation for LPDT was 2.0 per 1,000 patients (n=174). Of LPDT patients, 97.7% required one or more unplanned reoperations (n=170), and 5.7% of patients (n=10) required two reoperations. On multivariate analysis, lumbar procedures (odds ratio [OR] 2.79, p

  2. Consensus guidelines for lumbar puncture in patients with neurological diseases

    NARCIS (Netherlands)

    S. Engelborghs (Sebastiaan); Niemantsverdriet, E. (Ellis); H. Struyfs (Hanne); K. Blennow (Kaj); Brouns, R. (Raf); M. Comabella (Manuel); I. Dujmovic (Irena); W.M. van der Flier (Wiesje); L. Frölich (Lutz); D. Galimberti (Daniela); S. Gnanapavan (Sharmilee); B. Hemmer` (Bernhard); E.I. Hoff (Erik I.); Hort, J. (Jakub); E. Iacobaeus (Ellen); M. Ingelsson (Martin); Jan de Jong, F. (Frank); Jonsson, M. (Michael); M. Khalil (Michael); J. Kuhle (Jens); A. Lleo (Alberto); A. De Mendonça (Alexandre); J.L. Molinuevo (José Luis); G. Nagels (Guy); C. Paquet (Claire); L. Parnetti; C.M.A.A. Roks (Gerwin); Rosa-Neto, P. (Pedro); P. Scheltens (Philip); C. Skarsgård (Constance); E. Stomrud (Erik); H. Tumani (Hayrettin); P. Visser (Pim); Wallin, A. (Anders); B. Winblad; H. Zetterberg (Henrik); F.H. Duits (Flora H.); C.E. Teunissen (Charlotte)

    2017-01-01

    textabstractIntroduction Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as

  3. Complications of lumbar puncture in a child treated for leukaemia

    International Nuclear Information System (INIS)

    Staebler, Melanie; Delpierre, Isabelle; Damry, Nash; Christophe, Catherine; Azzi, Nadira; Sekhara, Tayeb

    2005-01-01

    Lumbar puncture may lead to neurological complications. These include intracranial hypotension, cervical epidural haematomas, and cranial and lumbar subdural haematomas. MRI is the modality of choice to diagnose these complications. This report documents MRI findings of such complications in a child treated for leukaemia. (orig.)

  4. Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance.

    Science.gov (United States)

    Zolnierczyk, Piotr; Cendrowski, Krzysztof; Sawicki, Wlodzimierz

    2015-01-01

    This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index - 38), congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic-therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations.

  5. Analysis of accidental UF6 releases

    International Nuclear Information System (INIS)

    Fan Yumao; Tan Rui; Gao Qifa

    2012-01-01

    As interim substance in the nuclear fuel enrichment process, Uranium Hexafluoride (UF 6 ) is widely applied in nuclear processing, enrichment and fuel fabrication plants. Because of its vivid chemical characteristics and special radiological hazard and chemical toxicity, great attention must be paid to accident of UF 6 leakage. The chemical reactions involved in UF 6 release processes were introduced, therewith potential release styles, pathways and characteristics of diffusion were analyzed. The results indicated that the accidental release process of UF 6 is not a simple passive diffusion. So, specific atmospheric diffusion model related to UF 6 releases need be used in order to analyze and evaluate accurately the accidental consequences. (authors)

  6. Dural afferents express acid-sensing ion channels: a role for decreased meningeal pH in migraine headache.

    Science.gov (United States)

    Yan, Jin; Edelmayer, Rebecca M; Wei, Xiaomei; De Felice, Milena; Porreca, Frank; Dussor, Gregory

    2011-01-01

    Migraine headache is one of the most common neurological disorders. The pathological conditions that directly initiate afferent pain signaling are poorly understood. In trigeminal neurons retrogradely labeled from the cranial meninges, we have recorded pH-evoked currents using whole-cell patch-clamp electrophysiology. Approximately 80% of dural-afferent neurons responded to a pH 6.0 application with a rapidly activating and rapidly desensitizing ASIC-like current that often exceeded 20nA in amplitude. Inward currents were observed in response to a wide range of pH values and 30% of the neurons exhibited inward currents at pH 7.1. These currents led to action potentials in 53%, 30% and 7% of the dural afferents at pH 6.8, 6.9 and 7.0, respectively. Small decreases in extracellular pH were also able to generate sustained window currents and sustained membrane depolarizations. Amiloride, a non-specific blocker of ASIC channels, inhibited the peak currents evoked upon application of decreased pH while no inhibition was observed upon application of TRPV1 antagonists. The desensitization time constant of pH 6.0-evoked currents in the majority of dural afferents was less than 500ms which is consistent with that reported for ASIC3 homomeric or heteromeric channels. Finally, application of pH 5.0 synthetic-interstitial fluid to the dura produced significant decreases in facial and hind-paw withdrawal threshold, an effect blocked by amiloride but not TRPV1 antagonists, suggesting that ASIC activation produces migraine-related behavior in vivo. These data provide a cellular mechanism by which decreased pH in the meninges following ischemic or inflammatory events directly excites afferent pain-sensing neurons potentially contributing to migraine headache. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. Massive granular cell ameloblastoma with dural extension and atypical morphology

    Directory of Open Access Journals (Sweden)

    Vandana Raghunath

    2014-01-01

    Full Text Available Ameloblastomas are rare histologically benign, locally aggressive tumors arising from the oral ectoderm that occasionally reach a gigantic size. Giant ameloblastomas are a rarity these days with the advent of panoramic radiography in routine dental practice. Furthermore, the granular cell variant is an uncommon histological subtype of ameloblastoma where the central stellate reticulum like cells in tumor follicles is replaced by granular cells. Although granular cell ameloblastoma (GCA is considered to be a destructive tumor with a high recurrence rate, the significance of granular cells in predicting its biologic behavior is debatable. However, we present a rare case of giant GCA of remarkable histomorphology showing extensive craniofacial involvement and dural extension that rendered a good prognosis following treatment.

  8. Allegheny County Fatal Accidental Overdoses

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Fatal accidental overdose incidents in Allegheny County, denoting age, gender, race, drugs present, zip code of incident and zip code of residence. Zip code of...

  9. Simulation and training of lumbar punctures using haptic volume rendering and a 6DOF haptic device

    Science.gov (United States)

    Färber, Matthias; Heller, Julika; Handels, Heinz

    2007-03-01

    The lumbar puncture is performed by inserting a needle into the spinal chord of the patient to inject medicaments or to extract liquor. The training of this procedure is usually done on the patient guided by experienced supervisors. A virtual reality lumbar puncture simulator has been developed in order to minimize the training costs and the patient's risk. We use a haptic device with six degrees of freedom (6DOF) to feedback forces that resist needle insertion and rotation. An improved haptic volume rendering approach is used to calculate the forces. This approach makes use of label data of relevant structures like skin, bone, muscles or fat and original CT data that contributes information about image structures that can not be segmented. A real-time 3D visualization with optional stereo view shows the punctured region. 2D visualizations of orthogonal slices enable a detailed impression of the anatomical context. The input data consisting of CT and label data and surface models of relevant structures is defined in an XML file together with haptic rendering and visualization parameters. In a first evaluation the visible human male data has been used to generate a virtual training body. Several users with different medical experience tested the lumbar puncture trainer. The simulator gives a good haptic and visual impression of the needle insertion and the haptic volume rendering technique enables the feeling of unsegmented structures. Especially, the restriction of transversal needle movement together with rotation constraints enabled by the 6DOF device facilitate a realistic puncture simulation.

  10. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    Energy Technology Data Exchange (ETDEWEB)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F. [Dept. of Radiology, Univ. Hospital, Gent (Belgium); Tongerloo, A.J. van; Paepe, A.M. de [Dept. of Medical Genetics, Univ. Hospital, Gent (Belgium)

    1999-11-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, {chi} {sup 2}-test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  11. Effectiveness of combined laser-puncture and conventional wound care to accelerate diabetic foot ulcer healing

    Directory of Open Access Journals (Sweden)

    Adiningsih Srilestari

    2017-05-01

    Full Text Available Background: Impaired wound healing is a common complication of diabetes. It has complex pathophysiologic mechanisms and often necessitates amputation. Our study aimed to evaluate the effectiveness of combined laser-puncture and conventional wound care in the treatment of diabetic foot ulcers.Methods: This was a double-blind controlled randomized clinical trial on 36 patients, conducted at the Metabolic Endocrine Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, between May and August 2015. Stimulation by laser-puncture (the treatment group or sham stimulation (the control group were performed on top of the standard wound care. Laser-puncture or sham were done on several acupuncture points i.e. LI4 Hegu, ST36 Zusanli, SP6 Sanyinjiao and KI3 Taixi bilaterally, combined with irradiation on the ulcers itself twice a week for four weeks. The mean reduction in ulcer sizes (week 2–1, week 3–1, week 4–1 were measured every week and compared between the two groups and analyzed by Mann-Whitney test.Results: The initial median ulcer size were 4.75 (0.10–9.94 cm2 and 2.33 (0.90–9.88 cm2 in laser-puncture and sham groups, respectively (p=0.027. The median reduction of ulcer size at week 2–1 was -1.079 (-3.25 to -0.09 vs -0.36 (-0.81 to -1.47 cm2, (p=0.000; at week 3–1 was -1.70 (-3.15 to -0.01 vs -0.36 (-0.80 to -0.28 cm2, (p=0.000; and at week 4–1 was -1.22 (-2.72 to 0.00 vs -0.38 (-0.74 to -0.57 cm2, (p=0.012.Conclusion: Combined laser-puncture and conventional wound care treatment are effective in accelerating the healing of diabetic foot ulcer.

  12. Spinal Dural Arteriovenous Fistula (SDAVF in a Patient with Progressive Paraparesia: A Case Report

    Directory of Open Access Journals (Sweden)

    Mehrdokht Mazdeh

    2016-07-01

    Full Text Available Background: Spinal dural arteriovenous fistula (SDAVF is a known cause of nontraumatic slow progressive araparesia and is frequently overlooked because its clinical features overlap with more common causes of myelopathy and also neuroimaging may be normal. Case Report: A 53 year-old man with developed weakness of both lower limbs had symptoms begun spontaneously 3.5 month before admission and progressed from 1 month ago with bowel and bladder incontinence. The patient's physical examination was normal and neurologic testing revealed lower extremity motor strength of 3/5. Deep tendon reflexes were decreased and superficial abdominal reflexes were absent. Sensation of pinprick and temperature was absent distal to the T4-T5 level. Vibration and proprioception were decreased to the ankle and saddle anesthesia and the patient was non ambulatory. Laboratory routine and specific tests for vitamin B12 level, hepatitis, HIV, HTLV1, 2 were negative. MRI of spine with and without contrast raised the possibility of dural arteriovenous malformation extended from T3 level to conus medullaris which was confirmed by angiography. The patient referred to neurosurgeon for deciding route of treatment. Conclusion: SDAVF can be a significant non traumatic slowly progressive cause of myelopathy. The majority of the affected patients are males older than 50 years of age. Rapid diagnosis in these patients leads to significant improvement.

  13. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine [Hopital Saint Vincent de Paul, Service de Radiopediatrie, Paris (France); Flunker, Sabrina; Couture, Alain [Hopital Arnaud de Villeneuve, Service de Radiopediatrie, Montpellier cedex 5 (France); Eurin, Danielle [Hopital Charles Nicolle, Service de Radiopediatrie, Rouen (France); Grange, Gilles [Hopital Cochin, Service de Gyneco-Obstetrique, Maternite Port-Royal, Paris (France); Garel, Catherine [Hopital Armand Trousseau, Service de Radiopediatrie, Paris (France); Richter, Brigitte [Hopital Clemenceau, Service de Radiopediatrie, Caen (France); Geissler, Frederic [Centre Hospitalier Universitaire, Service de Radiopediatrie, Clermont Ferrand (France)

    2008-04-15

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n = 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  14. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    International Nuclear Information System (INIS)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine; Flunker, Sabrina; Couture, Alain; Eurin, Danielle; Grange, Gilles; Garel, Catherine; Richter, Brigitte; Geissler, Frederic

    2008-01-01

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  15. Effect of needle puncture and electro-acupuncture on mucociliary clearance in anesthetized quails

    Directory of Open Access Journals (Sweden)

    Wang Tianshan

    2006-02-01

    Full Text Available Abstract Background Acupuncture therapy for obstructive respiratory diseases has been effectively used in clinical practice and the acupuncture points or acupoints of Zhongfu and Tiantu are commonly-used acupoints to treat patients with the diseases. Since the impaired mucociliary clearance is among the most important features of airway inflammation in most obstructive respiratory diseases, the effect of needle puncture and electro-acupuncture at the specific acupoints on tracheal mucociliary clearance was investigated in anesthetized quails. Methods Mucociliary transport velocity on tracheal mucosa was measured through observing the optimal pathway, and fucose and protein contents in tracheal lavages were determined with biochemical methods. In the therapeutic group, needle puncture or electro-acupuncture stimulation to the acupoints was applied without or with constant current output in 2 mA and at frequency of 100 Hz for 60 minutes. In the sham group, electro-acupuncture stimulation to Liangmen was applied. Results Our present experiments demonstrated that the electro-acupuncture stimulation to Zhongfu and Tiantu significantly increased tracheal mucociliary transport velocity and decreased the content of protein in the tracheal lavage, compared with the control group. Moreover, either needle puncture or electro-acupuncture stimulation to Zhongfu and Tiantu significantly reverted the human neutrophil elastase-induced decrease in tracheal mucociliary transport velocity and human neutrophil elastase -induced increase in the contents of fucose and protein in the tracheal lavage, compared with the control group. Conclusion These results suggest that either needle puncture or electro-acupuncture stimulation to the effective acupoints significantly improves both airway mucociliary clearance and the airway surface liquid and that the improvements maybe ascribed to both the special function of the points and the substantial stimulation of electricity.

  16. Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

    Directory of Open Access Journals (Sweden)

    Fabiano de Mendonça Grandese

    2010-12-01

    Full Text Available OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuários revisados, após terem sido tratados por meio de um protocolo embasado em reparo primário da lesão, drenagem subaracnoidea fechada, subfascial e subcutânea aspirativa realizados por cirurgião experiente, associado a repouso relativo com mobilidade precoce e terapia medicamentosa. Suas anotações e exames radiológicos foram verificados com seguimento pós-operatório e direcionados para identificação de sintomas sugestivos de complicações. RESULTADOS: todos os pacientes apresentaram boa evolução, sem ocorrência de fístula liquórica ou infecção pós-operatória; três deles apresentaram cefaleia pós-operatória de leve intensidade. Não houve necessidade de reoperação em nenhum desses pacientes. CONCLUSÃO: concluiu-se que a conduta adotada é segura e de bom resultado para os pacientes quando ocorre esse tipo de lesão, independentemente da extensão da mesma.OBJETIVO: un estudio retrospectivo de pacientes con lesión de la duramadre intraoperatoria de cirugía en la columna lumbar, llevada a cabo por medio de un protocolo independiente de la extensión de la lesión, complicaciones asociadas y los resultados de seguimiento después de un mínimo de un año. MÉTODOS: 10 pacientes con durotomía accidental en la descompresión quirúrgica y artrodesis de la columna vertebral lumbar, en el período de enero de 2007 a enero de 2009, para el tratamiento de enfermedades degenerativas, tuvieron sus registros revisados después de

  17. Post accidental small breaks analysis

    International Nuclear Information System (INIS)

    Depond, G.; Gandrille, J.

    1980-04-01

    EDF ordered to FRAMATOME by 1977 to complete post accidental long term studies on 'First Contrat-Programme' reactors, in order to demonstrate the safety criteria long term compliance, to get information on NSSS behaviour and to improve the post accidental procedures. Convenient analytical models were needed and EDF and FRAMATOME respectively developped the AXEL and FRARELAP codes. The main results of these studies is that for the smallest breaks, it is possible to manually undertake cooling and pressure reducing actions by dumping the steam generators secondary side in order to meet the RHR operating specifications and perform long term cooling through this system. A specific small breaks procedure was written on this basis. The EDF and FRAMATOME codes are continuously improved; the results of a French set of separate effects experiments will be incorporated as well as integral system verification

  18. Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

    International Nuclear Information System (INIS)

    Jeon, Min Hee; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Bae, Il Hun; Lee, Seung Young

    2006-01-01

    We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 (± 0.03). The mean femoral head ratio was 0.08 (± 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 ± 0.033, women: 0.44 ± 0.031, ρ < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery

  19. Unexpected High Sensory Blockade during Continuous Spinal Anesthesiology (CSA in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    R. Ketelaars

    2012-01-01

    Full Text Available A 98-year-old woman presented for a hemiarthroplasty of the left hip. Because of her age and cardiac and pulmonary co-existing diseases we decided to provide adequate regional anesthesia by continuous spinal anesthesia. Fragmented doses of isobaric bupivacaine 0.5% were administered through a system consisting of a spinal catheter connected to an antimicrobial filter. After an uneventful surgical procedure, prior to removal of the catheter, this system was flushed with 10 mL of normal saline in order to try to prevent post-dural-puncture headache. After arrival at the postanesthesia care unit and fifteen minutes after removal of the catheter the patient suffered an unexpected high thoracic sensory blockade and hypotension requiring treatment. The continuous spinal anesthesia technique can be used in selected cases to be able to administer local anesthetic agents in a slow and controlled manner to reach the desired effect. The risk of post-dural-puncture headache using this technique in elderly patients is very low and therefore precludes the need to try to prevent it. We have described a potentially dangerous complication of flushing a bupivacaine-filled system into the spinal canal of an elderly patient resulting in an undesirable high sensory blockade.

  20. Puncture resistance of Type B transport systems

    International Nuclear Information System (INIS)

    Rack, H.J.; Cheresh, M.C.

    1980-01-01

    This report describes a recent attempt to develop a test method for use in screening materials and for evaluating the effects of certain parameters, for example section stiffness, on container penetration resistance. In addition, it illustrates the application of this procedure to the selection of a sheet steel for a transuranic waste (TRUPACT) container. The test consists of penetrating a specimen, normally 0.6 m square, with a punch (tup) attached to a falling weight and recording and analyzing the force-time history to determine the energy absorption during the impact event. The test as developed simulates certain aspects of the 10CFR71 drop test in order to provide a means of comparing, for example, the penetrating resistance of various steels, this resistance being defined as the energy required to initiate fracture in the specimen. In summary, this examination suggests that it should be possible to develop a laboratory test to rank and select materials for maximum puncture resistance. Although the initial results appear promising, more effort will be required before this procedure can be routinely applied to examining the various factors which control the puncture resistance of these materials. These results do, nonetheless, show that high-strength, low-alloy steels do offer significant advantages over mild steel for container penetration protection. Indeed, one of these steels, NAX-80, is presently considered as a prime candidate for the TRUPACT container being developed at Sandia National Laboratories

  1. Causes of accidental childhood deaths in China in 2010

    DEFF Research Database (Denmark)

    Chan, Kit Yee; Yu, Xin-Wei; Lu, Jia-Peng

    2015-01-01

    -4 years in China, of which 31 633 (10.1%) were accidental. Accidental deaths contributed 7240 (4.0%) of all deaths in neonatal period, 8838 (10.5%) among all post-neonatal infant deaths, and 15 554 (31.7%) among children with 1-4 years of age. Among four tested models, the most predictive was used...

  2. Doctor Ward's Accidental Terrarium.

    Science.gov (United States)

    Hershey, David R.

    1996-01-01

    Presents the story of the accidental invention of the Wardian case, or terrarium, by Nathaniel Bagshaw Ward. Advocates the use of this story in teaching precollege biology as an illustration of how a chance event can lead to a major scientific advancement and as an example of the common occurrence of multiple discovery in botany. Contains 34…

  3. Single-Session Hematoma Removal and Transcranial Coil Embolization for a Cavernous Sinus Dural Arteriovenous Fistula: A Technical Case Report.

    Science.gov (United States)

    Akamatsu, Yosuke; Sato, Kenichi; Endo, Hidenori; Matsumoto, Yasushi; Tominaga, Teiji

    2017-08-01

    Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein. Because an emergent mass reduction and prevention of rebleeding were necessary, single-session hematoma removal and transcranial embolization of a CS dAVF were performed in the neurosurgical operating room, using a mobile C-arm fluoroscopy. After the right frontotemporal craniotomy, intracerebral hematoma was removed and coil packing of the affected cavernous sinus was successfully performed via the dilated superficial middle cerebral vein. The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward

    DEFF Research Database (Denmark)

    Møller, Anders; Bjerrum, Ole Weis; Afshari, Arash

    2015-01-01

    BACKGROUND/AIMS: Thrombocytopenia and the increasing use and variety of antithrombotic drugs is a challenge prior to lumbar puncture. This study examined the Danish haematology practice regarding drug pausation, assessment of haemostasis and whether fundoscopy is a routine safety measure. METHODS...

  5. Utility of the puncture of the radial artery in interventionist radiology

    International Nuclear Information System (INIS)

    Triana Rodriguez, Carlos Eduardo; Montes S, Mauricio; Barragan F, Jaime; Ucros Diaz Pablo; Ucros Diaz, Ignacio; Castillo, Luis Fernando

    1998-01-01

    We present the radial artery access, previous evaluation of collateral circulation with Allen's Test, as an alternative vascular access in patients with contraindications for femoral or axillary approaches. The radial artery puncture offers advantages, such as diminished bleeding and hematoma formation

  6. Chronic changes in pituitary adenylate cyclase-activating polypeptide and related receptors in response to repeated chemical dural stimulation in rats.

    Science.gov (United States)

    Han, Xun; Ran, Ye; Su, Min; Liu, Yinglu; Tang, Wenjing; Dong, Zhao; Yu, Shengyuan

    2017-01-01

    Background Preclinical experimental studies revealed an acute alteration of pituitary adenylate cyclase-activating polypeptide in response to a single activation of the trigeminovascular system, which suggests a potential role of pituitary adenylate cyclase-activating polypeptide in the pathogenesis of migraine. However, changes in pituitary adenylate cyclase-activating polypeptide after repeated migraine-like attacks in chronic migraine are not clear. Therefore, the present study investigated chronic changes in pituitary adenylate cyclase-activating polypeptide and related receptors in response to repeated chemical dural stimulations in the rat. Methods A rat model of chronic migraine was established by repeated chemical dural stimulations using an inflammatory soup for a different numbers of days. The pituitary adenylate cyclase-activating polypeptide levels were quantified in plasma, the trigeminal ganglia, and the trigeminal nucleus caudalis using radioimmunoassay and Western blotting in trigeminal ganglia and trigeminal nucleus caudalis tissues. Western blot analysis and real-time polymerase chain reaction were used to measure the protein and mRNA expression of pituitary adenylate cyclase-activating polypeptide-related receptors (PAC1, VPAC1, and VPAC2) in the trigeminal ganglia and trigeminal nucleus caudalis to identify changes associated with repetitive applications of chemical dural stimulations. Results All rats exhibited significantly decreased periorbital nociceptive thresholds to repeated inflammatory soup stimulations. Radioimmunoassay and Western blot analysis demonstrated significantly decreased pituitary adenylate cyclase-activating polypeptide levels in plasma and trigeminal ganglia after repetitive chronic inflammatory soup stimulation. Protein and mRNA analyses of pituitary adenylate cyclase-activating polypeptide-related receptors demonstrated significantly increased PAC1 receptor protein and mRNA expression in the trigeminal ganglia, but not

  7. Radiographic appearance of a post-epidural headache.

    LENUS (Irish Health Repository)

    Weekes, G

    2012-02-01

    We report the case of a 35-year-old lady who presented with a 6-day history of a postural headache following an uncomplicated epidural catheter insertion. Meningitis was initially suspected and a neurology review was obtained. CT and MRI brain revealed features suggestive of meningitis. However these radiological features are also consistent with post dural puncture headache (PDPH). This case highlights the under reported and possible misleading radiographical features of PDPH.

  8. J-tipped guidewire as a target for puncture of the subclavian artery in the placement of a reservoir port and catheter system

    International Nuclear Information System (INIS)

    Hama, Yukihiro; Kusano, Shoichi; Makita, Kohzoh

    2004-01-01

    The aim of this study was to verify the feasibility of using a J-tipped guidewire as a target for puncture of the subclavian artery in the placement of a reservoir port and catheter system (RPCS). Twenty-five patients with various hepatic malignancies underwent percutaneous implantation of an RPCS through the left subclavian artery for regional chemotherapy. To successfully puncture the left subclavian artery, a J-tipped guidewire was used as a target with fluoroscopic guidance. Technical success and complication rates, and numbers of puncture failures, were retrospectively analyzed. Implantation of the RPCS was successful in all patients. Eight (32%) patients had minor complications and no patient had major complications. The number of puncture failures per patient was 0 to 1 (mean=0.32). The J-tipped guidewire is a safe and appropriate target for puncture of the subclavian artery in the placement of an RPCS. (orig.)

  9. Observaciones sobre accidentes de trabajo y enfermedades profesionales

    Directory of Open Access Journals (Sweden)

    Guillermo Sarmiento López

    1948-03-01

    Full Text Available En los tiempos antiguos no existía ley ni disposición alguna de carácter social que favoreciera a los trabajadores incapacitados por enfermedad o por accidente, por tanto, eran tratados como esclavos o considerados como animales. Los accidentes de trabajo y las enfermedades profesionales eran casi desconocidas antes de la introducción de la maquinaria en la industria, por lo cual no existía el derecho a indemnización por concepto de daños que sufriera el trabajador en el desempeño de sus labores. Solamente se conocen los edictos de Rotari (año 645 de la éra cristiana lanzados en Italia con el fin de reparar los accidentes de los obreros de la construcción y después, en la época del Renacimiento, algunas publicaciones que hablan de ciertas enfermedades de los trabajadores (Ellemborg 1473, Paracelso 1493-1541. Ya en la edad media la industria comenzó a tomar cierta importancia y dada la escasez de brazos, se vio obligado el patrón por fuerza de las circunstancias a prestar ayuda económica a los trabajadores incapacitados por una u otra causa. Los accidentes sucedidos en las industrias no se consideraban como de trabajo, por no conocerse el peligro que envolvía el empleo de la maqumana. En el siglo XVII y a principios del XVIII un médico italiano, Ramazzini habla del perjuicio que ocasionan ciertos trabajos en el organismo del individuo, produciendo alteraciones anatómicas y funcionales. Solamente a fines del siglo XVIII y a principios del XIX con la producción en masa, con el aumento del número de obreros y con la falta de protección, empezaron los accidentes de trabajo a hacerse notorios.

  10. Liouville theory and uniformization of four-punctured sphere

    OpenAIRE

    Hadasz, Leszek; Jaskolski, Zbigniew

    2006-01-01

    Few years ago Zamolodchikov and Zamolodchikov proposed an expression for the 4-point classical Liouville action in terms of the 3-point actions and the classical conformal block. In this paper we develop a method of calculating the uniformizing map and the uniformizing group from the classical Liouville action on n-punctured sphere and discuss the consequences of Zamolodchikovs conjecture for an explicit construction of the uniformizing map and the uniformizing group for the sphere with four ...

  11. Experimental inflammation following dural application of complete Freund's adjuvant or inflammatory soup does not alter brain and trigeminal microvascular passage.

    Science.gov (United States)

    Lundblad, Cornelia; Haanes, Kristian A; Grände, Gustaf; Edvinsson, Lars

    2015-01-01

    Migraine is a paroxysmal, disabling primary headache that affects 16 % of the adult population. In spite of decades of intense research, the origin and the pathophysiology mechanisms involved are still not fully known. Although triptans and gepants provide effective relief from acute migraine for many patients, their site of action remains unidentified. It has been suggested that during migraine attacks the leakiness of the blood-brain barrier (BBB) is altered, increasing the passage of anti-migraine drugs. This study aimed to investigate the effect of experimental inflammation, following dural application of complete Freund's adjuvant (CFA) or inflammatory soup (IS) on brain and trigeminal microvascular passage. In order to address this issue, we induced local inflammation in male Sprague-Dawley-rats dura mater by the addition of CFA or IS directly on the dural surface. Following 2, 24 or 48 h of inflammation we calculated permeability-surface area product (PS) for [(51)Cr]-EDTA in the trigeminal ganglion (TG), spinal trigeminal nucleus, cortex, periaqueductal grey and cerebellum. We observed that [(51)Cr]-EDTA did not pass into the central nervous system (CNS) in a major way. However, [(51)Cr]-EDTA readily passed the TG by >30 times compared to the CNS. Application of CFA or IS did not show altered transfer constants. With these experiments we show that dural IS/CFA triggered TG inflammation, did not increase the BBB passage, and that the TG is readily exposed to circulating molecules. The TG could provide a site of anti-migraine drug interaction with effect on the trigeminal system.

  12. Intraarterial digital subtraction angiography after plastic surgery by thin-needle puncture

    International Nuclear Information System (INIS)

    Langer, M.; Fiegler, W.; Claussen, C.; Koehler, D.; Felix, R.; Hepp, W.

    1984-01-01

    Over the period of a year (1983), 44 intraarterial digital subtraction angiographies (DSA) via direct thin-needle puncture of a vascular bypass or following vascular graft were carried the rough. The only complication that occured: paravasal injection, was clinically insignificant and could be avoided by a change in the puncture-technique. It was possible to carry through the investigation in out-patients. In all cases, diagnostically useful picture material for a possible surgical intervention was obtained. The pictures always were high-grade, independently of the patient's circulation time. Because this is a simple investigation and because of the small risk of complications, it has come to be regularly carried through as a routine in the authors' clinic. According to investigations carried through on the collective of patients of a vascular surgery department, occlusions or anastomotic aneurismus account for most of the angiological disorders. (orig.) [de

  13. Accidentes de trabajo fatales y violencia interpersonal en Brasil, 2000-2010

    Directory of Open Access Journals (Sweden)

    Vilma Sousa Santana

    2013-01-01

    Full Text Available En el presente estudio se estima la mortalidad proporcional por accidentes de trabajo provocados por violencia interpersonal en Brasil, entre 2000 y 2010. Se analizaron los datos del Sistema de Información sobre Mortalidad, basados en los informes estadísti- cos de defunción del Ministerio de Salud de Brasil, los cuales incluyen un campo para el registro de accidentes de trabajo que debe ser completado en toda defunción por causas externas. Se identificaron 1.368.732 casos de defunciones por causas externas, 31.576 (2,3% por accidentes de trabajo y solo 226 (0,02% por accidentes de trabajo con violen- cia interpersonal. Cerca del 80% de los informes estadísticos de defunción no tenían el campo “accidente de trabajo” completado. La mayor cantidad de casos ocurrió entre hom- bres (94,3% de 25-34 años, con nivel de escolaridad medio, ubicados en la región sudeste y noreste, que trabajan principalmente en la producción de bienes y servicios industriales y la actividad agropecuaria. La mayoría de los casos fueron causados por armas de fuego, seguidos por armas blancas, con un aumento relativo de estos últimos en el período estu- diado. Los resultados sugieren un gran subregistro de diagnósticos que reconocen la rela- ción con el trabajo. Se hace necesaria una mejor capacitación en el llenado de los informes estadísticos, así como estudios que cuantifiquen el subregistro de accidentes de trabajo y accidentes de trabajo con violencia interpersonal.

  14. Effect of puncture through frontal lobe in the treatment of intracranial hematoma

    Directory of Open Access Journals (Sweden)

    DOU Bo-sheng

    2013-12-01

    Full Text Available This study aims to discuss the effect of an easy puncture through frontal lobe in the treatment of deep brain hematoma. The lesions of 37 patients with basal ganglia hemorrhage were accurately positioned by CT scan. Drainage tube was placed in the center of hematoma through frontal lobe and blood was aspirated. Urokinase 30 × 103 U was injected in the hematoma postoperatively to promote the evacuation of hematoma. Postoperative CT scan showed more than 75% hematoma was cleared in all patients after 3-7 d. Two patients died of complications; 2 patients were severely disabled; 3 rebleeding happened. Almost 33 patients had a good recovery. Minimal invasion, convenient operation and exact location were the adventages of this puncture and it does not need complicated device.

  15. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  16. Dural invasion of meningiomas adjacent to the tumor margin on Gd-DTPA-enhanced MR images: histopathologic correlation

    International Nuclear Information System (INIS)

    Hutzelmann, A.; Palmie, S.; Freund, M.; Heller, M.; Buhl, R.

    1998-01-01

    In intracranial meningiomas a flat, contrast-enhancing, dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA-enhanced MR images. We wished to evaluate whether there is a correlation between MR images and meningeal invasion of intracranial meningiomas. The study included 54 patients with intracranial meningioma and the meningeal sign. MR studies included T2-weighted and gadolinium-DTPA-enhanced T1-weighted images in axial, coronal, and sagittal planes. Histopathologic examinations were done on the meningiomas adjacent to the dura mater. The meningeal sign on MRI was observed from 2 up to 35 mm from the main tumor mass in 31 (57 %) of the 54 patients. In 20 of these 31 the histopathologic examination showed tumor invasion, while 11 patients had no tumor invasion but tissue proliferation, hypervascularity, and vascular dilatation. Seven of the 23 meningiomas without the meningeal sign had histologically proven infiltration of the adjacent dura. MR imaging is not able to determine definitive whether or not there is dural infiltration of the meningiomas. In conclusion, resection of the tumor with a wide margin is necessary to achieve complete excision of meningioma and to avoid recurrence. (orig.)

  17. Static and mobile networks design for atmospheric accidental releases monitoring

    International Nuclear Information System (INIS)

    Abida, R.

    2010-01-01

    The global context of my PhD thesis work is the optimization of air pollution monitoring networks, but more specifically it concerns the monitoring of accidental releases of radionuclides in air. The optimization problem of air quality measuring networks has been addresses in the literature. However, it has not been addresses in the context of surveillance of accidental atmospheric releases. The first part of my thesis addresses the optimization of a permanent network of monitoring of radioactive aerosols in the air, covering France. The second part concerns the problem of targeting of observations in case of an accidental release of radionuclides from a nuclear plant. (author)

  18. Tampão peridural com dextran 40 na profilaxia da cefaléia pós-punção acidental da duramáter em paciente HIV positivo: relato de caso Tampón peridural con dextran 40 en la profilaxia de la cefalea pós-punción accidental de la duramáter en paciente SIDA positivo: relato de caso Epidural patch with dextran 40 to prevent postdural puncture headache in an HIV patient: case report

    Directory of Open Access Journals (Sweden)

    Marcos Guilherme Cunha Cruvinel

    2002-11-01

    Quincke needle. During an L3-L4 epidural puncture attempt with an 18G Tuohy needle there was an accidental dural puncture. Twenty milliliters of 10% dextran 40 were administered twice through an epidural catheter. First, 150 minutes after anesthesia and then in the morning following surgery. Patient had no headache complaint and was discharged on the following day. CONCLUSIONS: The use of a patch with colloid solutions, such as dextran 40, is not well established, but there are some successful reports and it is our understanding that its potential should be further investigated.

  19. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    International Nuclear Information System (INIS)

    Byrd, Sharon E.; Elias, Dean; Abramowicz, Jacques S.; Kent, Paul; Kimura, Robert E.; Heydeman, Peter T.

    2012-01-01

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature. (orig.)

  20. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Byrd, Sharon E.; Elias, Dean [Rush Medical College and Rush University Medical Center, Department of Diagnostic Radiology and Nuclear Medicine Section of Neuroradiology, Chicago, IL (United States); Abramowicz, Jacques S. [Rush Medical College and Rush University Medical Center, Department of Obstetrics and Gynecology, Rush Fetal and Neonatal Medicine Center, Chicago, IL (United States); Kent, Paul [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Hematology and Oncology, Chicago, IL (United States); Kimura, Robert E. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Neonatology, Chicago, IL (United States); Heydeman, Peter T. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Pediatric Neurology, Chicago, IL (United States)

    2012-05-15

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature

  1. Significant Improvement of Puncture Accuracy and Fluoroscopy Reduction in Percutaneous Transforaminal Endoscopic Discectomy With Novel Lumbar Location System: Preliminary Report of Prospective Hello Study.

    Science.gov (United States)

    Fan, Guoxin; Guan, Xiaofei; Zhang, Hailong; Wu, Xinbo; Gu, Xin; Gu, Guangfei; Fan, Yunshan; He, Shisheng

    2015-12-01

    Prospective nonrandomized control study.The study aimed to investigate the implication of the HE's Lumbar LOcation (HELLO) system in improving the puncture accuracy and reducing fluoroscopy in percutaneous transforaminal endoscopic discectomy (PTED).Percutaneous transforaminal endoscopic discectomy is one of the most popular minimally invasive spine surgeries that heavily depend on repeated fluoroscopy. Increased fluoroscopy will induce higher radiation exposure to surgeons and patients. Accurate puncture in PTED can be achieved by accurate preoperative location and definite trajectory.The HELLO system mainly consists of self-made surface locator and puncture-assisted device. The surface locator was used to identify the exact puncture target and the puncture-assisted device was used to optimize the puncture trajectory. Patients who had single L4/5 or L5/S1 lumbar intervertebral disc herniation and underwent PTED were included the study. Patients receiving the HELLO system were assigned in Group A, and those taking conventional method were assigned in Group B. Study primary endpoint was puncture times and fluoroscopic times, and the secondary endpoint was location time and operation time.A total of 62 patients who received PTED were included in this study. The average age was 45.35 ± 8.70 years in Group A and 46.61 ± 7.84 years in Group B (P = 0.552). There were no significant differences in gender, body mass index, conservative time, and surgical segment between the 2 groups (P > 0.05). The puncture times were 1.19 ± 0.48 in Group A and 6.03 ± 1.87 in Group B (P HELLO system is accurate preoperative location and definite trajectory. This preliminary report indicated that the HELLO system significantly improves the puncture accuracy of PTED and reduces the fluoroscopic times, preoperative location time, as well as operation time. (ChiCTR-ICR-15006730).

  2. Morphologic features of puncture sites after exoseal vascular closure device implantation: Changes on follow-up computed tomography

    International Nuclear Information System (INIS)

    Ryu, Hwa Seong; Jang, Joo Yeon; Kim, Tae Un; Lee, Jun Woo; Park, Jung Hwan; Choo, Ki Seok; Cho, Mong; Yoon, Ki Tae; Hong, Young Ki; Jeon, Ung Bae

    2017-01-01

    The study aimed to evaluate the morphologic changes in transarterial chemoembolization (TACE) puncture sites implanted with an ExoSeal vascular closure device (VCD) using follow-up computed tomography (CT). 16 patients who used ExoSeal VCD after TACE were enrolled. Using CT images, the diameters and anterior wall thicknesses of the puncture sites in the common femoral artery (CFA) were compared with those of the contralateral CFA before TACE, at 1 month after every TACE session, and at the final follow-up period. The rates of complications were also evaluated. There were no puncture- or VCD-related complications. Follow-up CT images of the CFA's of patients who used ExoSeal VCDs showed eccentric vascular wall thickening with soft-tissue densities considered to be hemostatic plugs. Final follow-up CT images (mean, 616 days; range, 95–1106 days) revealed partial or complete resorption of the hemostatic plugs. The CFA puncture site diameters did not differ statistically from those of the contralateral CFA on the final follow-up CT (p > 0.05), regardless of the number of VCDs used. Follow-up CT images of patients who used ExoSeal VCDs showed no significant vascular stenosis or significant vessel wall thickening

  3. Morphologic features of puncture sites after exoseal vascular closure device implantation: Changes on follow-up computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Hwa Seong; Jang, Joo Yeon; Kim, Tae Un; Lee, Jun Woo; Park, Jung Hwan; Choo, Ki Seok; Cho, Mong; Yoon, Ki Tae; Hong, Young Ki; Jeon, Ung Bae [Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2017-05-15

    The study aimed to evaluate the morphologic changes in transarterial chemoembolization (TACE) puncture sites implanted with an ExoSeal vascular closure device (VCD) using follow-up computed tomography (CT). 16 patients who used ExoSeal VCD after TACE were enrolled. Using CT images, the diameters and anterior wall thicknesses of the puncture sites in the common femoral artery (CFA) were compared with those of the contralateral CFA before TACE, at 1 month after every TACE session, and at the final follow-up period. The rates of complications were also evaluated. There were no puncture- or VCD-related complications. Follow-up CT images of the CFA's of patients who used ExoSeal VCDs showed eccentric vascular wall thickening with soft-tissue densities considered to be hemostatic plugs. Final follow-up CT images (mean, 616 days; range, 95–1106 days) revealed partial or complete resorption of the hemostatic plugs. The CFA puncture site diameters did not differ statistically from those of the contralateral CFA on the final follow-up CT (p > 0.05), regardless of the number of VCDs used. Follow-up CT images of patients who used ExoSeal VCDs showed no significant vascular stenosis or significant vessel wall thickening.

  4. Sudden headache, lumbar puncture, and the diagnosis of subarachnoid hemorrhage in patients with a normal computed tomography scans.

    Science.gov (United States)

    Valle Alonso, Joaquín; Fonseca Del Pozo, Francisco Javier; Vaquero Álvarez, Manuel; De la Fuente Carillo, Juan José; Llamas, José Carlos; Hernández Montes, Yelda

    2018-02-01

    To assess the usefulness of computed tomography (CT) to identify subarachnoid bleeding in patients with neurologic deficits seeking emergency care for sudden headache within 6 hours of onset of symptoms. Retrospective observational study of patients presenting with sudden nontraumatic headache peaking during the previous hour in the absence of neurologic deficits. We ordered CT scans for all patients, and if the scan was normal we performed a lumbar puncture. All patients were then followed for 6 months. Eighty-five patients were included. Subarachnoid bleeding was identified in 10 (10.2%) patients by CT. Seventy- four lumbar punctures were performed in patients with negative CTs; the lumbar puncture was positive in 1 patient and inconclusive in 2 patients. In all 3 patients, bleeding was ruled out with later images; thus, no cases of subarachnoid hemorrhage were confirmed in the 74 patients who underwent lumbar puncture. Nor were any cases found in any of these patients during follow-up. A CT scan taken within 6 hours of onset of sudden headache is sufficient for confirming or ruling out subarachnoid bleeding in patients with sudden headache who have no neurologic deficits.

  5. Accidental Durotomy in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Frequency, Risk Factors, and Management

    Directory of Open Access Journals (Sweden)

    Jan-Helge Klingler

    2015-01-01

    Full Text Available Purpose. To assess the frequency, risk factors, and management of accidental durotomy in minimally invasive transforaminal lumbar interbody fusion (MIS TLIF. Methods. This single-center study retrospectively investigates 372 patients who underwent MIS TLIF and were mobilized within 24 hours after surgery. The frequency of accidental durotomies, intraoperative closure technique, body mass index, and history of previous surgery was recorded. Results. We identified 32 accidental durotomies in 514 MIS TLIF levels (6.2%. Analysis showed a statistically significant relation of accidental durotomies to overweight patients (body mass index ≥25 kg/m2; P=0.0493. Patient age older than 65 years tended to be a positive predictor for accidental durotomies (P=0.0657. Mobilizing patients on the first postoperative day, we observed no durotomy-associated complications. Conclusions. The frequency of accidental durotomies in MIS TLIF is low, with overweight being a risk factor for accidental durotomies. The minimally invasive approach seems to minimize durotomy-associated complications (CSF leakage, pseudomeningocele because of the limited dead space in the soft tissue. Patients with accidental durotomy can usually be mobilized within 24 hours after MIS TLIF without increased risk. The minimally invasive TLIF technique might thus be beneficial in the prevention of postoperative immobilization-associated complications such as venous thromboembolism. This trial is registered with DRKS00006135.

  6. Sensitization of dural afferents underlies migraine-related behavior following meningeal application of interleukin-6 (IL-6

    Directory of Open Access Journals (Sweden)

    Yan Jin

    2012-01-01

    Full Text Available Abstract Background Migraine headache is one of the most common neurological disorders, but the pathophysiology contributing to migraine is poorly understood. Intracranial interleukin-6 (IL-6 levels have been shown to be elevated during migraine attacks, suggesting that this cytokine may facilitate pain signaling from the meninges and contribute to the development of headache. Methods Cutaneous allodynia was measured in rats following stimulation of the dura with IL-6 alone or in combination with the MEK inhibitor, U0126. The number of action potentials and latency to the first action potential peak in response to a ramp current stimulus as well as current threshold were measured in retrogradely-labeled dural afferents using patch-clamp electrophysiology. These recordings were performed in the presence of IL-6 alone or in combination with U0126. Association between ERK1 and Nav1.7 following IL-6 treatment was also measured by co-immunoprecipitation. Results Here we report that in awake animals, direct application of IL-6 to the dura produced dose-dependent facial and hindpaw allodynia. The MEK inhibitor U0126 blocked IL-6-induced allodynia indicating that IL-6 produced this behavioral effect through the MAP kinase pathway. In trigeminal neurons retrogradely labeled from the dura, IL-6 application decreased the current threshold for action potential firing. In response to a ramp current stimulus, cells treated with IL-6 showed an increase in the numbers of action potentials and a decrease in latency to the first spike, an effect consistent with phosphorylation of the sodium channel Nav1.7. Pretreatment with U0126 reversed hyperexcitability following IL-6 treatment. Moreover, co-immunoprecipitation experiments demonstrated an increased association between ERK1 and Nav1.7 following IL-6 treatment. Conclusions Our results indicate that IL-6 enhances the excitability of dural afferents likely via ERK-mediated modulation of Nav1.7 and these responses

  7. Oviposition punctures in cucurbit fruits and their economic damage caused by the sterile female melon fly, Bactrocera cucurbitae Coquillett

    International Nuclear Information System (INIS)

    Miyatake, T.; Irabu, T.; Higa, R.

    1993-01-01

    Oviposition punctures caused by sterile females of the tephritid Bactrocera cucurbitae in cucurbit fruits were examined and economic damage was evaluated in Okinawa, Ryukyu Archipelago, Japan. Cage experiments in the field confirmed that sterile females make punctures (sterile stings) on fruits. The features of sterile stings differed depending on fruit species and were classified into 5 types

  8. Patterns and Trends in Accidental Poisoning Deaths: Pennsylvania's Experience 1979-2014.

    Directory of Open Access Journals (Sweden)

    Lauren C Balmert

    Full Text Available The purpose of this study was to examine county and state-level accidental poisoning mortality trends in Pennsylvania from 1979 to 2014.Crude and age-adjusted death rates were formed for age group, race, sex, and county for accidental poisonings (ICD 10 codes X40-X49 from 1979 to 2014 for ages 15+ using the Mortality and Population Data System housed at the University of Pittsburgh. Rate ratios were calculated comparing rates from 1979 to 2014, overall and by sex, age group, and race. Joinpoint regression was used to detect statistically significant changes in trends of age-adjusted mortality rates.Rate ratios for accidental poisoning mortality in Pennsylvania increased more than 14-fold from 1979 to 2014. The largest rate ratios were among 35-44 year olds, females, and White adults. The highest accidental poisoning mortality rates were found in the counties of Southwestern Pennsylvania, those surrounding Philadelphia, and those in Northeast Pennsylvania near Scranton.The patterns and locations of accidental poisoning mortality by race, sex, and age group provide direction for interventions and policy makers. In particular, this study found the highest rate ratios in PA among females, whites, and the age group 35-44.

  9. Individual housing-based socioeconomic status predicts risk of accidental falls among adults.

    Science.gov (United States)

    Ryu, Euijung; Juhn, Young J; Wheeler, Philip H; Hathcock, Matthew A; Wi, Chung-Il; Olson, Janet E; Cerhan, James R; Takahashi, Paul Y

    2017-07-01

    Accidental falls are a major public health concern among people of all ages. Little is known about whether an individual-level housing-based socioeconomic status measure is associated with the risk of accidental falls. Among 12,286 Mayo Clinic Biobank participants residing in Olmsted County, Minnesota, subjects who experienced accidental falls between the biobank enrollment and September 2014 were identified using ICD-9 codes evaluated at emergency departments. HOUSES (HOUsing-based Index of SocioEconomic Status), a socioeconomic status measure based on individual housing features, was also calculated. Cox regression models were utilized to assess the association of the HOUSES (in quartiles) with accidental fall risk. Seven hundred eleven (5.8%) participants had at least one emergency room visit due to an accidental fall during the study period. Subjects with higher HOUSES were less likely to experience falls in a dose-response manner (hazard ratio: 0.58; 95% confidence interval: 0.44-0.76 for comparing the highest to the lowest quartile). In addition, the HOUSES was positively associated with better health behaviors, social support, and functional status. The HOUSES is inversely associated with accidental fall risk requiring emergency care in a dose-response manner. The HOUSES may capture falls-related risk factors through housing features and socioeconomic status-related psychosocial factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Morphological analysis of the cervical spinal canal, dural tube and spinal cord in normal individuals using CT myelography

    International Nuclear Information System (INIS)

    Inoue, H.; Ohmori, K.; Takatsu, T.; Teramoto, T.; Ishida, Y.; Suzuki, K.

    1996-01-01

    To verify the conventional concept of ''developmental stenosis of the cervical spinal canal'', we performed a morphological analysis of the relations of the cervical spinal canal, dural tube and spinal cord in normal individuals. The sagittal diameter, area and circularity of the three structures, and the dispersion of each parameter, were examined on axial sections of CT myelograms of 36 normal subjects. The spinal canal was narrowest at C4, followed by C5, while the spinal cord was largest at C4/5. The area and circularity of the cervical spinal cord were not significantly correlated with any parameter of the spinal canal nor with the sagittal diameter and area of the dural tube at any level examined, and the spinal cord showed less individual variation than the bony canal. Compression of the spinal cord might be expected whenever the sagittal diameter of the spinal canal is below the lower limit of normal, that is about 12 mm on plain radiographs. Thus, we concluded that the concept of ''developmental stenosis of the cervical spinal canal'' was reasonable and acceptable. (orig.). With 2 figs., 3 tabs

  11. Comportamiento de los accidentes laborales

    Directory of Open Access Journals (Sweden)

    Miguel Gómez Vital

    1999-01-01

    Full Text Available Se realiza una valoración sobre la situación de la accidentalidad en centros de trabajo de la provincia de Villa Clara de 1993 a 1997. El total de accidentes registrados fue de 12 522. Últimamente han disminuido y su índice de incidencia. En el último año se redujo el promedio de días perdidos, pero el índice de gravedad alcanzó la cifra mayor. Se insiste en el cumplimiento del programa de prevención y reducción de accidentes laborales.The situation of the occupational accidents that occurred in the province of Villa Clara from 1993 to 1997 was assessed. 12 522 accidents were registered during that periods. A decrease of these accidents and of their incidence rate has been observed lately. The average of lost days was reduced during the last year, out the severity index reached the highest figure. Emphasis is made on the importance of fulfilling the program of prevention and reduction of occupational accidents.

  12. A descriptive study of accidental skeletal injuries and non-accidental skeletal injuries of child maltreatment.

    Science.gov (United States)

    Ghanem, Maha A H; Moustafa, Tarek A; Megahed, Haidy M; Salama, Naglaa; Ghitani, Sara A

    2018-02-01

    Lack of awareness and recognition of child maltreatment is the major reason behind underreporting. All victims often interact with the health care system for routine or emergency care. In several research works, non-accidental fractures are the second most common injury in maltreated children and it is represented up to one-third of cases. To determine the incidence of different types of accidental and non-accidental skeletal injuries among children, estimate the severity of injuries according to the modified injury severity score and to determine the degree of fractures either closed or opened (Gustiloe-Anderson open fracture classification). Moreover, identifying fractures resulting from child abuse and neglect. This aimed for early recognition of non-accidental nature of fractures in child maltreatment that can prevent further morbidity and mortality. A descriptive study was carried out on all children (109) with skeletal injuries who were admitted to both Main Alexandria and El-Hadara Orthopedic and Traumatology University Hospitals during six months. History, physical examination and investigations were done for the patients. A detailed questionnaire was taken to diagnose child abuse and neglect. Gustiloe-Anderson open fracture classification was used to estimate the degree of open fractures. Out of 109 children, twelve cases (11%) were categorized as child maltreatment. One case was physical abuse, eight cases (7.3%) were child neglect and three cases (2.8%) were labour exploitation. Road traffic accidents (RTA) was the commonest cause of skeletal injuries followed by falling from height. Regarding falls, they included 4 cases of stair falls in neglected children and another four cases of falling from height (balcony/window). The remaining 36 cases of falls were accidental. The skeletal injuries were in the form of fractures in 99 cases, dislocation in two cases, both fracture and/or dislocation in three cases, and bone deformity from brachial plexus injury

  13. Cervical myelography via C1/C2 lateral puncture

    International Nuclear Information System (INIS)

    Grange, B.

    1981-01-01

    The use of the water soluble, tri-iodinated contrast medium, metrizamide, in cervical myelography via C1/C2 lateral puncture is described. Details of the tomographic apparatus and the technique employed are given. The advantages of water soluble myelography using metrizamide are overwhelming due to its miscibility with CSF, improved anatomical demonstration, radiographic visualisation and diagnostic accuracy and advantageous pharmacological properties with reduced toxicity. This technique provided successful diagnoses in a series of 104 patients. (U.K.)

  14. Accidental Innovation

    DEFF Research Database (Denmark)

    Austin, Robert D.; Devin, Lee; Sullivan, Erin E.

    2012-01-01

    Historical accounts of human achievement suggest that accidents can play an important role in innovation. In this paper, we seek to contribute to an understanding of how digital systems might support valuable unpredictability in innovation processes by examining how innovators who obtain value from...... they incorporate accidents into their deliberate processes and arranged surroundings. By comparing makers working in varied conditions, we identify specific factors (e.g., technologies, characteristics of technologies) that appear to support accidental innovation. We show that makers in certain specified...... conditions not only remain open to accident but also intentionally design their processes and surroundings to invite and exploit valuable accidents. Based on these findings, we offer advice for the design of digital systems to support innovation processes that can access valuable unpredictability....

  15. Direct right ventricular puncture for hemodynamic evaluation of a mechanical tricuspid valve prosthesis: a new indication for an old procedure.

    Science.gov (United States)

    Gibson, M A; Carell, E S

    1997-11-01

    The advent of transvenous right heart catheterization has relegated direct transthoracic right ventricular puncture largely to the role of "interesting historical footnote." However, in the case of a right ventricle that is "protected" by a mechanical tricuspid valve prosthesis, direct right ventricular puncture represents a reasonable alternative for obtaining accurate hemodynamic information.

  16. Conduta na lesão dural intraoperatória em artrodese da coluna lombar

    OpenAIRE

    Grandese, Fabiano de Mendonça; Yamazato, Clóvis; Oliveira, Fábio Mastromauro de; Ribeiro, Iberê; Bastos Júnior, José Olympio Catão; Kusabara, René

    2010-01-01

    OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuário...

  17. Retrospective analysis of obstetric and anesthetic management of patients with placenta accreta spectrum disorders.

    Science.gov (United States)

    Riveros-Perez, Efrain; Wood, Cristina

    2018-03-01

    To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. A retrospective chart review was conducted of patients diagnosed with PAS disorders (placenta creta, increta, or percreta) who were treated at a US tertiary care center between February 1, 2011, and January 31, 2016. Obstetric management, anesthetic management, and maternal outcomes were analyzed. A total of 43 cases were identified; placenta previa was diagnosed among 33 (77%). Median age was 33 years (range 23-42). Median blood loss was 1500 mL (interquartile range 1000-2500); blood loss was greatest among the 10 patients with placenta percreta (3250 mL, interquartile range 2200-6000). Transfusion of blood products was necessary among 14 (33%) patients, with no difference in frequency according to the degree of placental invasion (P=0.107). Surgical complications occurred among 10 (23%) patients. Overall, 30 (70%) patients received combined spinal-epidural plus general anesthesia, 4 (9%) received only general anesthesia, and 9 (21%) underwent surgery with combined spinal-epidural anesthesia. One patient experienced difficult airway and another experienced accidental dural puncture. Placenta previa and accreta coexist in many patients, leading to substantial bleeding related to the degree of myometrial invasion. An interdisciplinary team approach plus the use of combined spinal-epidural anesthesia, transitioning to general anesthesia, were advisable and safe. © 2017 International Federation of Gynecology and Obstetrics.

  18. Reinvestigation of moving punctured black holes with a new code

    International Nuclear Information System (INIS)

    Cao Zhoujian; Yo Hweijang; Yu Juiping

    2008-01-01

    We report on our code, in which the moving puncture method is applied and an adaptive/fixed mesh refinement is implemented, and on its preliminary performance on black hole simulations. Based on the Baumgarte-Sharpiro-Shibata-Nakamura (BSSN) formulation, up-to-date gauge conditions and the modifications of the formulation are also implemented and tested. In this work, we present our primary results about the simulation of a single static black hole, of a moving single black hole, and of the head-on collision of a binary black hole system. For the static punctured black hole simulations, different modifications of the BSSN formulation are applied. It is demonstrated that both the currently used sets of modifications lead to a stable evolution. For cases of a moving punctured black hole with or without spin, we search for viable gauge conditions and study the effect of spin on the black hole evolution. Our results confirm previous results obtained by other research groups. In addition, we find a new gauge condition, which has not yet been adopted by any other researchers, which can also give stable and accurate black hole evolution calculations. We examine the performance of the code for the head-on collision of a binary black hole system, and the agreement of the gravitational waveform it produces with that obtained in other works. In order to understand qualitatively the influence of matter on the binary black hole collisions, we also investigate the same head-on collision scenarios but perturbed by a scalar field. The numerical simulations performed with this code not only give stable and accurate results that are consistent with the works by other numerical relativity groups, but also lead to the discovery of a new viable gauge condition, as well as clarify some ambiguities in the modification of the BSSN formulation. These results demonstrate that this code is reliable and ready to be used in the study of more realistic astrophysical scenarios and of numerical

  19. Accidental symmetries and the effective Lagrangian of string theory

    International Nuclear Information System (INIS)

    Ovrut, B.A.

    1989-01-01

    In this paper the relationship between accidental worldsheet symmetries of the string generating functional and target space invariance groups is discussed. Accidental symmetries are used to derive the invariance groups and effective low energy Lagrangian for the bosonic string, and the heterotic string compactified to four-dimensions on Z N orbifolds. The necessity of a new type of Green-Schwarz mechanism, associated with the auxiliary vector field in the four-dimensional N = 1 supergravity multiplet, is shown using these methods

  20. Cerebral venous and sinus thrombosis with cerebrospinal fluid circulation block after the first methotrexate administration by lumbar puncture

    International Nuclear Information System (INIS)

    Bienfait, H.P.; Gijtenbeek, J.M.M.; Bent, M.J. van; Bruin, H.G. de; Voogt, P.J.; Pillay, M.

    2002-01-01

    We report a patient treated for small lymphocytic lymphoma/leukemia with cerebral venous and sinus thrombosis (CVST) after lumbar puncture with intrathecal administration of methotrexate (MTX). He also developed a cerebrospinal fluid flow block. This is the first report of an association between lumbar puncture and intrathecally administered MTX and the development of CVST. Intrathecal treatment in this patient was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously. (orig.)

  1. Night work, long work weeks, and risk of accidental injuries. A register-based study.

    Science.gov (United States)

    Larsen, Ann D; Hannerz, Harald; Møller, Simone V; Dyreborg, Johnny; Bonde, Jens Peter; Hansen, Johnni; Kolstad, Henrik A; Hansen, Åse Marie; Garde, Anne Helene

    2017-11-01

    Objectives The aims of this study were to (i) investigate the association between night work or long work weeks and the risk of accidental injuries and (ii) test if the association is affected by age, sex or socioeconomic status. Methods The study population was drawn from the Danish version of the European Labour Force Survey from 1999-2013. The current study was based on 150 438 participants (53% men and 47% women). Data on accidental injuries were obtained at individual level from national health registers. We included all 20-59-year-old employees working ≥32 hours a week at the time of the interview. We used Poisson regression to estimate the relative rates (RR) of accidental injuries as a function of night work or long work weeks (>40 hours per week) adjusted for year of interview, sex, age, socioeconomic status (SES), industry, and weekly working hours or night work. Age, sex and SES were included as two-way interactions. Results We observed 23 495 cases of accidental injuries based on 273 700 person years at risk. Exposure to night work was statistically significantly associated with accidental injuries (RR 1.11, 99% CI 1.06-1.17) compared to participants with no recent night work. No associations were found between long work weeks (>40 hours) and accidental injuries. Conclusion We found a modest increased risk of accidental injuries when reporting night work. No associations between long work weeks and risk of accidental injuries were observed. Age, sex and SES showed no trends when included as two-way interactions.

  2. A Rare Complication of Spinal Anesthesia: Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Fuldem Yıldırım Dönmez

    2014-03-01

    Full Text Available The most common complication of spinal anesthesia is postdural puncture headache. Any injury of the dura may cause headache. After the injury of the dura, CSF leakage may occur and due to the tension of the veins between the cortex and the dural sinuses, subdural hematoma may be seen. Herein, we present a patient with persistent headache after the spinal anesthesia given during delivery of her baby, and emphasize a rare complication of spinal anesthesia which is subdural hematoma

  3. Experience and nursing needs of school-age children undergoing lumbar puncture during the treatment of acute lymphoblastic leukaemia: a descriptive and qualitative study.

    Science.gov (United States)

    Xie, Anwei; Shan, Yuying; Niu, Mei E; Chen, Yi; Wang, Xiya

    2017-11-01

    To describe experiences and nursing needs of school-age Chinese children undergoing lumbar puncture for the treatment of acute lymphoblastic leukaemia. Lumbar puncture is an invasive procedure, causing psychological changes and physical discomfort in patients. In a previous study, it was proved that distraction intervention, such as music therapy, relieves pain and anxiety. There is limited evidence regarding the experience and needs of school-age children during lumbar puncture after being diagnosed with acute lymphoblastic leukaemia. To minimise their anxiety and pain during the procedure, it is important to collect information directly from these children. A descriptive qualitative research. Twenty-one school-age children with acute lymphoblastic leukaemia participated in semi-structured interviews at a Children's Hospital in China. Data were collected by an experienced and trained interviewer. Qualitative content analysis was chosen to describe experiences of children undergoing lumbar puncture. While undergoing lumbar puncture for the treatment of acute lymphoblastic leukaemia, school-age Chinese children experienced complex psychological feelings (fear, tension, helplessness, sadness and anxiety). They also experienced physical discomfort. They had multipolar needs, such as information, communication, respect, self-actualisation, environment and equipment. This study identified important areas that must be closely monitored by healthcare staff, performing lumbar puncture on acute lymphoblastic leukaemia children. Thus, a successful and smooth procedure can be performed on these patients, and their quality of life can be improved. The experiences described in this study contribute to a better understanding of the needs of acute lymphoblastic leukaemia children undergoing lumbar puncture. They also provide valuable information to professional medical care staff that develops future nursing assessments. © 2016 John Wiley & Sons Ltd.

  4. Los hombres y los accidentes de tránsito: un vistazo al riesgo, conducta de riesgo, notificación de accidentes, educación y formación profesional

    Directory of Open Access Journals (Sweden)

    Cintia Rodrigues

    2017-05-01

    Full Text Available Abstract Los accidentes de tránsito son un grave y complejo problema de salud pública. La literatura señala que los accidentes de tránsito están asociados confactores de comportamiento, seguridad de los vehículos y la precariedad del espacio urbano.Reducir el número de accidentes de tránsito es un reto para los gestores deárea. La educación en el tránsito debe considerar la vigilancia como una estrategia eficaz para cambiar el comportamiento del conductor,principalmente en relación con el exceso de velocidad y el consumo de alcohol asociado con la conducción.La ingeniería tiene un papel importante para promover un entorno seguro,en el que la convivencia de peatones, ciclistas y conductores sea posible. El escenario en que se configura los accidentes de tránsito muestra la necesidad de los profesionales de la salud reconsiderar sus prácticas con el fin de replantear la imagen de la víctima de accidentes, las formas de trabajo de prevención de accidentes, la educación en el tránsito de peatones y conductores, con el fin de promover la salud y la cultura de paz. Existe la necesidad de políticas de salud públicay estrategias que hacen posible acceso a las acciones tanto en el campo preventivo como en el campo de la rehabilitación.

  5. Experimental impact and puncture evaluation of the prototype quarter scale TRU transporter package

    International Nuclear Information System (INIS)

    Meyer, R.J.; Plonski, B.A.; Vigil, M.G.; Joseph, B.J.

    1983-01-01

    The impact tests consist of the TRUPACT model free-falling 9 meters onto a flat, horizontal, unyielding surface as specified in 10CFR71. The model was dropped at five different orientations including: (1) flat on the door end; (2) flat on the side; (3) center of gravity over impact corner; (4) flat on edge; and (5) corner impact edge slapdown. The model instrumentation for these tests included: (1) sixty strain gages located throughout the model structure used to obtain impact stresses; (2) three displacement transducers used to measure relative motion between the inner door and inner cavity frame structure (seal integrity); and (3) two triaxial accelerometers used to estimate the impact forces on the inner and outer frame structures. The drop/puncture tests consisted of the TRUPACT-I model free-falling one meter onto a 38-millimeter (1.5-inch) diameter mild steel punch 0.9 meters (36 inches) long. The punch was welded to an unyielding surface. Model drop/puncture orientations included: (1) flat on the model sides; (2) flat on the door and back ends; and (3) model center of gravity over impact point at various locations of the model (door end, back end, near door seals, near tubular frame structure, center of panels). The test results and subsequent analysis of the data have been used to support the final design of TRUPACT-I and to determine the most damaging impact and puncture orientations for testing the full scale prototype

  6. Detailed puncture analyses tank cars : analysis of different impactor threats and impact conditions.

    Science.gov (United States)

    2013-03-01

    There has been significant research in recent years to analyze and improve the impact behavior and puncture resistance of railroad tank cars. Much of this research has been performed using detailed nonlinear finite element analyses supported by full ...

  7. REcanalisation and Balloon-Oriented Puncture for Re-Insertion of Dialysis Catheter in Nonpatent Central Veins (REBORN)

    International Nuclear Information System (INIS)

    Too, Chow Wei; Sayani, Raza; Lim, Elvin Yuan Ting; Leong, Sum; Gogna, Apoorva; Teo, Terence K.

    2016-01-01

    PurposeTo describe a technique involving REcanalisation and Balloon-Oriented puncture for Re-insertion of dialysis catheter in Nonpatent central veins (REBORN) and to report long-term results.Materials and MethodsThis is a retrospective study of ten subjects in whom dialysis catheters were inserted using the REBORN technique from March 2012 to October 2014 and followed up till April 2016. Data on the duration of catheter usage, complications and reasons for removal were obtained. Seven patients had partially occluded lower internal jugular veins (IJV) recanalised in an antegrade fashion via a more cranial puncture. The balloon was then inflated at usual puncture site with an 18G needle. The collapsed balloon was cannulated with a guide wire, and both balloon and guide wire were advanced together into the superior vena cava. This was followed by tunnelled catheter placement using standard techniques. Two patients had catheters placed in the subclavian vein using a similar antegrade technique, and one patient had catheter placed via the left IJV following retrograde recanalisation from a right femoral puncture.ResultsMean duration of catheter use was 278 days (range 32–503). Three catheters were removed due to matured arteriovenous accesses. Four patients had successful catheter change over the same subcutaneous track due to catheter malfunction. One catheter was removed after 7 months because of sepsis. No complications were reported.ConclusionThe REBORN technique allows for the preservation of central veins for future haemodialysis access, which can be challenging in patients requiring long-term dialysis.

  8. REcanalisation and Balloon-Oriented Puncture for Re-Insertion of Dialysis Catheter in Nonpatent Central Veins (REBORN)

    Energy Technology Data Exchange (ETDEWEB)

    Too, Chow Wei, E-mail: toochowwei@gmail.com [Singapore General Hospital (Singapore); Sayani, Raza [Aga Khan University Hospital (Pakistan); Lim, Elvin Yuan Ting; Leong, Sum; Gogna, Apoorva [Singapore General Hospital (Singapore); Teo, Terence K. [Mount Elizabeth Novena Hospital (Singapore)

    2016-08-15

    PurposeTo describe a technique involving REcanalisation and Balloon-Oriented puncture for Re-insertion of dialysis catheter in Nonpatent central veins (REBORN) and to report long-term results.Materials and MethodsThis is a retrospective study of ten subjects in whom dialysis catheters were inserted using the REBORN technique from March 2012 to October 2014 and followed up till April 2016. Data on the duration of catheter usage, complications and reasons for removal were obtained. Seven patients had partially occluded lower internal jugular veins (IJV) recanalised in an antegrade fashion via a more cranial puncture. The balloon was then inflated at usual puncture site with an 18G needle. The collapsed balloon was cannulated with a guide wire, and both balloon and guide wire were advanced together into the superior vena cava. This was followed by tunnelled catheter placement using standard techniques. Two patients had catheters placed in the subclavian vein using a similar antegrade technique, and one patient had catheter placed via the left IJV following retrograde recanalisation from a right femoral puncture.ResultsMean duration of catheter use was 278 days (range 32–503). Three catheters were removed due to matured arteriovenous accesses. Four patients had successful catheter change over the same subcutaneous track due to catheter malfunction. One catheter was removed after 7 months because of sepsis. No complications were reported.ConclusionThe REBORN technique allows for the preservation of central veins for future haemodialysis access, which can be challenging in patients requiring long-term dialysis.

  9. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy

    International Nuclear Information System (INIS)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-01-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct

  10. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy.

    Science.gov (United States)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-04-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct.

  11. Emergency Medicine Myths: Computed Tomography of the Head Prior to Lumbar Puncture in Adults with Suspected Bacterial Meningitis - Due Diligence or Antiquated Practice?

    Science.gov (United States)

    April, Michael D; Long, Brit; Koyfman, Alex

    2017-09-01

    Various sources purport an association between lumbar puncture and brainstem herniation in patients with intracranial mass effect lesions. Several organizations and texts recommend head computed tomography (CT) prior to lumbar puncture in selected patients. To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis. Observational studies report a risk of post-lumbar puncture brainstem herniation in the presence of intracranial mass effect (1.5%) that is significantly lower than that reported among all patients with bacterial meningitis (up to 13.3%). It is unclear from existing literature whether identifying patients with intracranial mass effect decreases herniation risk. Up to 80% of patients with bacterial meningitis experiencing herniation have no CT abnormalities, and approximately half of patients with intracranial mass effect not undergoing lumbar puncture herniate. Decision rules to selectively perform CT on only those individuals most likely to have intracranial mass effect lesions have not undergone validation. Despite recommendations for immediate antimicrobial therapy prior to imaging, data indicate an association between pre-lumbar puncture CT and antibiotic delays. Recent data demonstrate shortened door-to-antibiotic times and lower mortality from bacterial meningitis after implementation of new national guidelines, which restricted generally accepted CT indications by removing impaired mental status as imaging criterion. Data supporting routine head CT prior to lumbar puncture are limited. Physicians should consider selective CT for those patients at risk for intracranial mass effect lesions based on decision rules or clinical gestalt. Patients undergoing head CT must receive immediate antibiotic therapy. Published by Elsevier Inc.

  12. X-ray targeting puncture collagenase chemonucleolysis combined with injection of medical ozone for the treatment of lumbar disc herniation

    International Nuclear Information System (INIS)

    Yao Lin; Zhu Genfa

    2011-01-01

    Objective: To evaluate the clinical value of X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone for lumbar disc herniation. Methods: One thousand and sixty-two cases of lumbar disc herniation accepted collagenase chemonucleolysis combined with injection of medical ozone targeted by X-ray. The therapeutic effects after operation were analyzed. Results: Of all the 1062 cases, the effective rate of X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone was 95.3% at 3 months, 92.3% at 12 months, and 91.2% at 24 months after operation. Conclusion: X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone is a simple and safe method for the lumbar disc herniation. It also had fewer adverse reactions and better therapeutic effects. (authors)

  13. Therapeutic effects of visual standard channel combined with F4.8 visual puncture super-mini percutaneous nephrolithotomy on multiple renal calculi.

    Science.gov (United States)

    Cui, Zhenyu; Gao, Yanjun; Yang, Wenzeng; Zhao, Chunli; Ma, Tao; Shi, Xiaoqiang

    2018-01-01

    To evaluate the therapeutic effects of visual standard channel combined with F4.8 visual puncture super-mini percutaneous nephrolithotomy (SMP) on multiple renal calculi. The clinical data of 46 patients with multiple renal calculi treated in Affiliated Hospital of Hebei University from October 2015 to September 2016 were retrospectively analyzed. There were 28 males and 18 females aged from 25 to 65 years old, with an average of 42.6. The stone diameters were 3.0-5.2 cm, (4.3 ± 0.8) cm on average. F4.8 visual puncture-assisted balloon expansion was used to establish a standard channel. After visible stones were removed through nephroscopy combined with ultrasound lithotripsy, the stones of other parts were treated through F4.8 visual puncture SMP with holmium laser. Indices such as the total time of channel establishment, surgical time, decreased value of hemoglobin, phase-I stone clearance rate and surgical complications were summarized. Single standard channel was successfully established in all cases with the assistance of F4.8 visual puncture, of whom 24 were combined with a single microchannel, 16 were combined with double microchannels, and six were combined with three microchannels. All patients were placed with nephrostomy tube which was not placed in the microchannels. Both F5 double J tubes were placed after surgery. The time for establishing a standard channel through F4.8 visual puncture was (6.8 ± 1.8) min, and that for establishing a single F4.8 visual puncture microchannel was (4.5 ± 0.9) min. The surgical time was (92 ± 15) min. The phase-I stone clearance rate was 91.3% (42/46), and the decreased value of hemoglobin was (12.21 ± 2.5) g/L. There were 8 cases of postoperative fever which was relieved after anti-inflammatory treatment. Four cases had 0.5-0.8 cm of stone residue in the lower calyx, and all stones were discharged one month after surgery by in vitro shock wave lithotripsy combined with position nephrolithotomy, without stone

  14. La prevención de accidentes (3

    Directory of Open Access Journals (Sweden)

    Chinchilla, M.

    1966-04-01

    Full Text Available The financial loss due to working accidents is very substantial, quite apart from the actual loss of human lives. Hence avoiding these accidents is a most important matter. The accident index in the various industries shows a rate of increase that is larger than should be the case in proportion to the development of the industries concerned, and the larger number of employees. The fact that these indexes are smaller in many countries, however, shows that these accidents can be considerably reduced if suitable measures are taken to avoid them. In chapter 2 of our magazine, issue no. 178, a variety of reasons were discussed that may originate accidents, although these causes are not directly linked to the accident itself. In this article mention is made of some of the measures that can be taken in the handling of cutting and welding equipment, and also of inflammable liquids, to prevent possible accidents.El peso de los accidentes de trabajo sobre la economía supone cantidades muy grandes que, independientemente del inestimable valor de una vida humana, realzan la importancia de la prevención de accidentes. Los índices de accidentes muestran en diferentes industrias un crecimiento mayor de lo que debería corresponder proporcionalmente, habida cuenta del crecimiento laboral. El hecho de que en distintos países los índices sean inferiores, demuestra que se pueden conseguir buenos frutos si se concede primordial importancia a que los trabajos se realicen con las debidas medidas de seguridad. En el Capítulo 2, número 178 de esta Revista, se detallaron diversas causas que pueden originar un accidente sin estar ligadas en forma directa con una tarea determinada. En el presente trabajo se indican algunas de las medidas que deben observarse en el manejo de los equipos de soldadura y corte, así como en el transvase de líquidos inflamables.

  15. Vapocoolant Spray Effectiveness on Arterial Puncture Pain: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shervin Farahmand

    2017-02-01

    Full Text Available Arterial blood gas (ABG sampling is a painful procedure with no perfect technique for quelling the discomfort. An ideal local anesthesia should be rapid, easy to learn, inexpensive, and noninvasive. This study was aimed to compare pain levels from ABG sampling performed with vapocoolant spray in comparison to placebo. We hypothesized that pretreatment with the vapocoolant would reduce the pain of arterial puncture by at least 1 point on a 10 point verbal numeric scale. We have evaluated the effectiveness of a vapocoolant spray in achieving satisfactory pain control in patients undergoing ABG sampling in this randomized placebo controlled trial. Eighty patients were randomized to 2 groups: group A, who received vapocoolant spray, and group B, who received water spray as placebo (Control group. Puncture and spray application pain was assessed with numerical rating scale (0, the absence of pain; 10, greatest imaginable pain and number of attempts was recorded. The pain score during ABG sampling was not lower in group A compared with group B significantly (4.78±1.761 vs. 4.90±1.837; P:0.945. This study showed that while the spray exerts more application pain, the number of attempts required for ABG sampling was not significantly lower in group A compared with group B (1.38±0.54 vs. 1.53±0.68; P=0.372. Vapocoolant spray was not effective in ABG pain reduction, had milder application pain compared to placebo (P<0.05, but did not reduce sampling attempts. At present, this spray cannot be recommended for arterial puncture anesthesia, and further study on different timing is necessary.

  16. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy

    International Nuclear Information System (INIS)

    Li Zhen; Han Xinwei; Jiao Dechao; Ren Jianzhuang; Su Yu; Ye Hui

    2011-01-01

    Objective: to investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non, vascular interventional biopsy or interventional therapy. Methods: Thirty, one patients, who were encountered in authors' hospital during the period from July 2010 to September 2010, were involved in this study. C-arm CT-guided percutaneous targeted puncturing biopsy or interventional therapy was performed in all 31 patients. All patients had complete clinical data. The complications and positive rate of biopsy were recorded and analyzed. Results: Under C-arm CT-guidance, percutaneous interventional therapy was carried out in 13 patients. The interventional procedures included radiofrequency ablation therapy for hepatic cellular carcinoma (n=2), pelvic abscess draining (n=1), hepatic abscess draining (n=1), ethanol injection for liver cancer (n=4), sclerotic therapy with ethanol injection for renal cyst (n=2), sclerotic therapy with ethanol injection for liver cyst (n=2) and catheter-indwelling drainage for pancreatic pseudocyst (n=1). percutaneous interventional biopsy was performed in the remaining 18 cases, including liver (n=4), lung (n=7), mediastinum (n=2), bone and soft tissue (n=4) and neck mass (n=1). All the procedures were successfully accomplished, no technique, related complications occurred during the operation. For biopsy examination in 18 cases, the positive rate was 94.4% (17/18) and false, negative results was seen in one case with lung lesion. Conclusion: The percutaneous targeted puncturing technique with C, arm CT-guidance combines the advantages of both CT scanning and fluoroscopy. The use of real, time road, mapping function can effectively guide the puncturing and therapeutic management, which can not only optimize the workflow, save the operation time, but also improve the success rate and technical safety. Therefore, it is of great value to popularize this targeted puncturing technique. (authors)

  17. Flavour from accidental symmetries

    International Nuclear Information System (INIS)

    Ferretti, Luca; King, Stephen F.; Romanino, Andrea

    2006-01-01

    We consider a new approach to fermion masses and mixings in which no special 'horizontal' dynamics is invoked to account for the hierarchical pattern of charged fermion masses and for the peculiar features of neutrino masses. The hierarchy follows from the vertical, family-independent structure of the model, in particular from the breaking pattern of the Pati-Salam group. The lightness of the first two fermion families can be related to two family symmetries emerging in this context as accidental symmetries

  18. Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve palsy: Case report

    Directory of Open Access Journals (Sweden)

    Şehnaz Arıcı

    2015-04-01

    Full Text Available Indirect (dural carotid cavernous fistula is formed by the connection between meningeal branches of the internal carotid artery and the cavernous sinüs, and low flow circulation with low pressure is occured. Proptosis, ophtalmoplegia, headache, scleral and conjuctival hyperemia expanding around the eyeball can be observed. A forty-eight year old female patient with a background of diabetes mellitus and hypertension was admitted with complaints of double vision. Isolated oculomotor nerve palsy was found in neurological examination and an indirect carotid cavernous fistula was revealed by digital subtraction angiography. Our case with carotid cavernous fistula as a rare cause of isolated oculomotor nerve palsy is worth to be reported.

  19. Accidental childhood poisoning in Calabar at the turn of the 20 th ...

    African Journals Online (AJOL)

    Background: Accidental poisoning is a preventable cause of childhood morbidity and mortality. Therefore, knowledge of the common causative agents is necessary in order to create awareness among caregivers towards its prevention. Objectives: To document the pattern of accidental childhood poisoning in Calabar from ...

  20. Study of the damage rate caused by intervertebral foramen type inside and outside and the pass of the intervertebral DRG RF puncture way.

    Science.gov (United States)

    Sun, Jiashu; Zhang, Haitao

    2014-09-01

    This paper was to analyze and contrast the damage rate on the thoracic segment different position of the dorsal root ganglion(dorsal root ganglion, DRG) caused by different puncture path in radiofrequency ablation, thus the best RF target way for the thoracic segment of different types of DRG was confirmed. According to the difference of puncture and ablation damage way, 14 segmental spinal specimens were randomly divided into three groups, and then conducted DRG radiofrequency damage on percutaneous puncture path according to the type of DRG position.The damage effect of different puncture path by the judgment standard of the result of pathology analyzed. The experiment showed that RF damage of group A were 72.58 ± 18.88%, 54.16 ± 24.84% and 32.85 ± 28.11%; that of group B were 771.86 ± 15.15% and 72.02 ± 17.86%, 57.14 ± 18.02% and 52.47 ± 20.64%, 68.75 ± 14.63% and 71.78 ± 16.00%; and that of group C were 82.46 ± 14.10%, 81.53 ± 11.81% and 80.83 ± 13.33%. It was concluded that the singleness of DRG puncture route is one of the important reasons for the poor thoracic segments DRG radiofrequency (RF) ablation effect. While according to the type of DRG different positions with double joint puncture path can significantly improve the rate of DRG RF damage.

  1. MR imaging of the lumbar disk herniation : relationship between the direction of herniated disc and pressure effect on nerve root and dural sac

    International Nuclear Information System (INIS)

    Cha, B. H.; Shon, M. Y.; Kim, K. W.; Lim, M. A.; Kwon, K. R; Kim, S. S.

    1996-01-01

    To evaluate the relationship between the direction of herniated disc and pressure effect on nerve root and dural sac, as seen on MRI. We retrospectively reviewed lumbar spine MR images of 122 cases of lumbar disk herniation 75 patients MRI findings were analyzed with regard to the relationship between the direction of the herniated disc and pressure effect on nerve root and dural sac. Pressure effect on nerve root and dural sac was arbitrarily divided into three types. Type I was defined as zero or minimal compression of nerve roots or thecal sac by the herniated disc ; type II was defined as mild to moderate compression, while III was defined as severe compression or displacement of nerve roots and/or thecal sac. Of the 122 cases seen in these 75 patients, 97(80%) were observed at L4-5 and L5-S1. The central type(71cases ; 58%) was more frequently observed than the posterolateral type(48cases ; 40%) or lateral type(3cases ; 2%). The totals of types I, II, and III were 44(36%), 43(35%) and 35 cases(29%), respectively. Seventy-seven %(34/44) of type I and 65%(28/43) of type II were of the central type but for type III, the corresponding figure was only 26%(9/35). On MR imaging, most of lumbar disk herniations were observed at L4-5 and L5-S1, with a predominance of the central type rather than the posterolateral one. Most of the central types were either type I or type II

  2. Dental pain as a risk factor for accidental acetaminophen overdose: a case-control study.

    Science.gov (United States)

    Vogel, Jody; Heard, Kennon J; Carlson, Catherine; Lange, Chad; Mitchell, Garrett

    2011-11-01

    Patients frequent take acetaminophen to treat dental pain. One previous study found a high rate of overuse of nonprescription analgesics in an emergency dental clinic. The purpose of this study is to determine if patients with dental pain are more likely to be treated for accidental acetaminophen poisoning than patients with other types of pain. We conducted a case-control study at 2 urban hospitals. Cases were identified by chart review of patients who required treatment for accidental acetaminophen poisoning. Controls were self-reported acetaminophen users taking therapeutic doses identified during a survey of emergency department patients. For our primary analysis, the reason for taking acetaminophen was categorized as dental pain or not dental pain. Our primary outcome was the odds ratio of accidental overdose to therapeutic users after adjustment for age, sex, alcoholism, and use of combination products using logistic regression. We identified 73 cases of accidental acetaminophen poisoning and 201 therapeutic users. Fourteen accidental overdose patients and 4 therapeutic users reported using acetaminophen for dental pain. The adjusted odds ratio for accidental overdose due to dental pain compared with other reasons for use was 12.8 (95% confidence interval, 4.2-47.6). We found that patients with dental pain are at increased risk to accidentally overdose on acetaminophen compared with patients taking acetaminophen for other reasons. Emergency physicians should carefully question patients with dental pain about overuse of analgesics. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. The exchange algebra for Liouville theory on punctured Riemann sphere

    International Nuclear Information System (INIS)

    Shen Jianmin; Sheng Zhengmao

    1991-11-01

    We consider in this paper the classical Liouville field theory on the Riemann sphere with n punctures. In terms of the uniformization theorem of Riemann surface, we show explicitly the classical exchange algebra (CEA) for the chiral components of the Liouville fields. We find that the matrice which dominate the CEA is related to the symmetry of the Lie group SL(n) in a nontrivial manner with n>3. (author). 10 refs

  4. Accidentes de trabajo en un hospital de agudos

    Directory of Open Access Journals (Sweden)

    Pérez Bermúdez B.

    1998-01-01

    Full Text Available FUNDAMENTO: El mejor conocimiento de los determinantes y circunstancias de producción de los accidentes laborales, favorecerá la implantación de medidas correctoras. El objetivo de este trabajo es describir la evolución temporal de los accidentes de trabajo (AT y determinar los factores de riesgo de baja médica en el Hospital Dr. Peset de Valencia. MÉTODOS: Descripción y análisis retrospectivo de los accidentes de trabajo producidos en el Hospital Dr. Peset de Valencia durante los años 1992 a 1995. Se estimó por métodos deterministas la tendencia y estacionalidad de las series (índices estacionales, IE. Se aplicó un modelo de regresión logística para identificar los factores pronósticos de baja médica y determinar su probabilidad de ocurrencia . RESULTADOS: Las tasas más elevadas de AT se produjeron entre los trabajadores de cocina y lavandería (10,00 AT por 100 trabajadores-año. Los AT con baja médica mantienen una tendencia cercana a cero siendo febrero el mes con I.E más elevado (IE=139,8. Los que cursan sin baja médica tienen una tendencia positiva (r²=0,23, p<0,0001, siendo mayo el mes de mayor siniestralidad (IE=134,2. La probabilidad de que el accidente curse con baja médica aumenta significativamente con la edad, cuando se produce por la tarde, si ha tenido lugar en cocina/lavandería, y si se trata de un esguince o tendinitis. CONCLUSIONES: la actuación sobre la siniestralidad en los AT que cursen con IT, debería centrarse sobre los trabajos menos cualificados y en las áreas de cocina y lavandería.

  5. Mycobacterium ulcerans low infectious dose and mechanical transmission support insect bites and puncturing injuries in the spread of Buruli ulcer.

    Science.gov (United States)

    Wallace, John R; Mangas, Kirstie M; Porter, Jessica L; Marcsisin, Renee; Pidot, Sacha J; Howden, Brian; Omansen, Till F; Zeng, Weiguang; Axford, Jason K; Johnson, Paul D R; Stinear, Timothy P

    2017-04-01

    Addressing the transmission enigma of the neglected disease Buruli ulcer (BU) is a World Health Organization priority. In Australia, we have observed an association between mosquitoes harboring the causative agent, Mycobacterium ulcerans, and BU. Here we tested a contaminated skin model of BU transmission by dipping the tails from healthy mice in cultures of the causative agent, Mycobacterium ulcerans. Tails were exposed to mosquito (Aedes notoscriptus and Aedes aegypti) blood feeding or punctured with sterile needles. Two of 12 of mice with M. ulcerans contaminated tails exposed to feeding A. notoscriptus mosquitoes developed BU. There were no mice exposed to A. aegypti that developed BU. Eighty-eight percent of mice (21/24) subjected to contaminated tail needle puncture developed BU. Mouse tails coated only in bacteria did not develop disease. A median incubation time of 12 weeks, consistent with data from human infections, was noted. We then specifically tested the M. ulcerans infectious dose-50 (ID50) in this contaminated skin surface infection model with needle puncture and observed an ID50 of 2.6 colony-forming units. We have uncovered a biologically plausible mechanical transmission mode of BU via natural or anthropogenic skin punctures.

  6. Mycobacterium ulcerans low infectious dose and mechanical transmission support insect bites and puncturing injuries in the spread of Buruli ulcer.

    Directory of Open Access Journals (Sweden)

    John R Wallace

    2017-04-01

    Full Text Available Addressing the transmission enigma of the neglected disease Buruli ulcer (BU is a World Health Organization priority. In Australia, we have observed an association between mosquitoes harboring the causative agent, Mycobacterium ulcerans, and BU. Here we tested a contaminated skin model of BU transmission by dipping the tails from healthy mice in cultures of the causative agent, Mycobacterium ulcerans. Tails were exposed to mosquito (Aedes notoscriptus and Aedes aegypti blood feeding or punctured with sterile needles. Two of 12 of mice with M. ulcerans contaminated tails exposed to feeding A. notoscriptus mosquitoes developed BU. There were no mice exposed to A. aegypti that developed BU. Eighty-eight percent of mice (21/24 subjected to contaminated tail needle puncture developed BU. Mouse tails coated only in bacteria did not develop disease. A median incubation time of 12 weeks, consistent with data from human infections, was noted. We then specifically tested the M. ulcerans infectious dose-50 (ID50 in this contaminated skin surface infection model with needle puncture and observed an ID50 of 2.6 colony-forming units. We have uncovered a biologically plausible mechanical transmission mode of BU via natural or anthropogenic skin punctures.

  7. Night work, long work weeks, and risk of accidental injuries. A register-based study

    DEFF Research Database (Denmark)

    Larsen, Ann D; Hannerz, Harald; Møller, Simone V

    2017-01-01

    of the European Labour Force Survey from 1999-2013. The current study was based on 150 438 participants (53% men and 47% women). Data on accidental injuries were obtained at individual level from national health registers. We included all 20-59-year-old employees working ≥32 hours a week at the time...... of the interview. We used Poisson regression to estimate the relative rates (RR) of accidental injuries as a function of night work or long work weeks (>40 hours per week) adjusted for year of interview, sex, age, socioeconomic status (SES), industry, and weekly working hours or night work. Age, sex and SES were....... No associations were found between long work weeks (>40 hours) and accidental injuries. Conclusion: We found a modest increased risk of accidental injuries when reporting night work. No associations between long work weeks and risk of accidental injuries were observed. Age, sex and SES showed no trends when...

  8. Diagnostic performance of CT and MRI on the detection of symptomatic intracranial dural arteriovenous fistula: a meta-analysis with indirect comparison

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Heng [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China); Lin, Hsien-Ho [National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (China); Liu, Hon-Man; Lee, Chung-Wei; Chen, Ya-Fang [National Taiwan University Hospital in Taipei and Yuan-Lin Branch, Department of Medical Imaging and Radiology, Hospital and Medical College, Taipei (China)

    2016-08-15

    This study aims to review the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) in symptomatic dural arteriovenous fistula (DAVF). EMBASE, PubMed, and Cochrane Library were searched until April 2015 for studies which compared CT, MRI, or both with angiography for the detection of DAVF. The diagnostic performances of MRI and CT were indirectly compared using modality as a covariate in the analysis. Thirteen studies met our inclusion criteria. MRI had a sensitivity of 0.90 (95 % confidence interval (CI) = 0.83-0.94) and specificity of 0.94 (95 % CI = 0.90-0.96). CT had a sensitivity of 0.80 (95 % CI = 0.62-0.90) and specificity of 0.87 (95 % CI = 0.74-0.94). MRI showed better diagnostic performance than CT (p = 0.02). Contrast medium use and time-resolved MR angiography did not improve MRI diagnostic performance (p = 0.31 and 0.44, respectively). Both CT and MRI had good diagnostic performance. MRI was better than CT on the detection of symptomatic intracranial dural arteriovenous fistula in the indirect comparison. (orig.)

  9. Compact fluorescent lamp phosphors in accidental radiation monitoring

    International Nuclear Information System (INIS)

    Murthy, K. V. R.; Pallavi, S. P.; Ghildiyal, R.; Parmar, M. C.; Patel, Y. S.; Ravi Kumar, V.; Sai Prasad, A. S.; Natarajan, V.; Page, A. G.

    2006-01-01

    The application of lamp phosphors for accidental dosimetry is a new concept. Since the materials used in fluorescent lamps are good photo luminescent materials, if one can either use the inherent defects present in the phosphor or add suitable modifiers to induce thermoluminescence (TL) in these phosphors, then the device (fluorescent lamp) can be used as an accidental dosemeter. In continuation of our search for a suitable phosphor material, which can serve both as an efficient lamp phosphor and as a good radiation monitoring device, detailed examination has been carried out on cerium and terbium-doped lanthanum phosphate material. A 90 Sr beta source with 50 mCi strength (1.85 GBq) was used as the irradiation source for TL studies. The TL response as a function of dose received was examined for all phosphors used and it was observed that the intensity of the TL peak vs. dose received was a linear function in the dose range 0.1-200 Gy in each case. Incidentally LaPO 4 :Ce,Tb is a component of the compact fluorescent lamp marketed recently as an energy bright light source. Besides having very good luminescence efficiency, good dosimetric properties of these phosphors render them useful for their use in accidental dosimetry also. (authors)

  10. Gadolinium enhancement of spinal subdural collection on magnetic resonance imaging after lumbar puncture

    International Nuclear Information System (INIS)

    Teksam, Mehmet; Casey, Sean O.; McKinney, Alexander; Michel, Eduard; Truwit, Charles L.

    2003-01-01

    We report a 35-year-old male with an unusual contrast-enhancing sterile spinal subdural collection on magnetic resonance imaging (MRI), apparently occurring as a complication of lumbar puncture. Follow-up MRI after 4 weeks demonstrated spontaneous resolution of the collection without intervening treatment. (orig.)

  11. Dural arteriovenøs fistel er en sjælden, men behandlelig årsag til transversal myelopati

    DEFF Research Database (Denmark)

    Hansen, Julie Richter; Poulsgaard, Lars; Holtmannspötter, Markus

    2017-01-01

    This is a case report of a 60-year-old male admitted on suspicion of relapse of idiopathic transverse myelitis (TM), who after further diagnostic workup underwent successful closure of a dural arteriovenous fistula (DAVF). Magnetic resonance imaging in DAVF usually shows longitudinal TM, which, u......, unlike DAVF, is also seen with the more common inflammatory or infectious causes usually showing inflammation in the cerebrospinal fluid. The natural history of DAVF is progressive. Since curable options exist, timely diagnosis is most important....

  12. Equilibrium initial data for moving puncture simulations: the stationary 1 + log slicing

    International Nuclear Information System (INIS)

    Baumgarte, T W; Matera, K; Etienne, Z B; Liu, Y T; Shapiro, S L; Taniguchi, K; Murchadha, N O

    2009-01-01

    We discuss a 'stationary 1 + log' slicing condition for the construction of solutions to Einstein's constraint equations. For stationary spacetimes, these initial data give a stationary foliation when evolved with 'moving puncture' gauge conditions that are often used in black hole evolutions. The resulting slicing is time independent and agrees with the slicing generated by being dragged along a timelike Killing vector of the spacetime. When these initial data are evolved with moving puncture gauge conditions, numerical errors arising from coordinate evolution should be minimized. While these properties appear very promising, suggesting that this slicing condition should be an attractive alternative to, for example, maximal slicing, we demonstrate in this paper that solutions can be constructed only for a small class of problems. For binary black hole initial data, in particular, it is often assumed that there exists an approximate helical Killing vector that generates the binary's orbit. We show that 1 + log slices that are stationary with respect to such a helical Killing vector cannot be asymptotically flat, unless the spacetime possesses an additional axial Killing vector.

  13. Ballistic Puncture Self-Healing Polymeric Materials

    Science.gov (United States)

    Gordon, Keith L.; Siochi, Emilie J.; Yost, William T.; Bogert, Phil B.; Howell, Patricia A.; Cramer, K. Elliott; Burke, Eric R.

    2017-01-01

    Space exploration launch costs on the order of $10,000 per pound provide an incentive to seek ways to reduce structural mass while maintaining structural function to assure safety and reliability. Damage-tolerant structural systems provide a route to avoiding weight penalty while enhancing vehicle safety and reliability. Self-healing polymers capable of spontaneous puncture repair show promise to mitigate potentially catastrophic damage from events such as micrometeoroid penetration. Effective self-repair requires these materials to quickly heal following projectile penetration while retaining some structural function during the healing processes. Although there are materials known to possess this capability, they are typically not considered for structural applications. Current efforts use inexpensive experimental methods to inflict damage, after which analytical procedures are identified to verify that function is restored. Two candidate self-healing polymer materials for structural engineering systems are used to test these experimental methods.

  14. Detecting spatiotemporal clusters of accidental poisoning mortality among Texas counties, U.S., 1980 – 2001

    Directory of Open Access Journals (Sweden)

    Harris Ann

    2004-10-01

    Full Text Available Abstract Background Accidental poisoning is one of the leading causes of injury in the United States, second only to motor vehicle accidents. According to the Centers for Disease Control and Prevention, the rates of accidental poisoning mortality have been increasing in the past fourteen years nationally. In Texas, mortality rates from accidental poisoning have mirrored national trends, increasing linearly from 1981 to 2001. The purpose of this study was to determine if there are spatiotemporal clusters of accidental poisoning mortality among Texas counties, and if so, whether there are variations in clustering and risk according to gender and race/ethnicity. The Spatial Scan Statistic in combination with GIS software was used to identify potential clusters between 1980 and 2001 among Texas counties, and Poisson regression was used to evaluate risk differences. Results Several significant (p Conclusion The findings of the present study provide evidence for the existence of accidental poisoning mortality clusters in Texas, demonstrate the persistence of these clusters into the present decade, and show the spatiotemporal variations in risk and clustering of accidental poisoning deaths by gender and race/ethnicity. By quantifying disparities in accidental poisoning mortality by place, time and person, this study demonstrates the utility of the spatial scan statistic combined with GIS and regression methods in identifying priority areas for public health planning and resource allocation.

  15. Successful use of nitrous oxide during lumbar punctures: A call for nitrous oxide in pediatric oncology clinics.

    Science.gov (United States)

    Livingston, Mylynda; Lawell, Miranda; McAllister, Nancy

    2017-11-01

    Numerous reports describe the successful use of nitrous oxide for analgesia in children undergoing painful procedures. Although shown to be safe, effective, and economical, nitrous oxide use is not yet common in pediatric oncology clinics and few reports detail its effectiveness for children undergoing repeated lumbar punctures. We developed a nitrous oxide clinic, and undertook a review of pediatric oncology lumbar puncture records for those patients receiving nitrous oxide in 2011. No major complications were noted. Minor complications were noted in 2% of the procedures. We offer guidelines for establishing such a clinic. © 2017 Wiley Periodicals, Inc.

  16. Involving Parents in Indicated Early Intervention for Childhood PTSD Following Accidental Injury

    Science.gov (United States)

    Cobham, Vanessa E.; March, Sonja; De Young, Alexandra; Leeson, Fiona; Nixon, Reginald; McDermott, Brett; Kenardy, Justin

    2012-01-01

    Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome…

  17. La prevención de accidentes

    Directory of Open Access Journals (Sweden)

    Chinchilla, M.

    1966-02-01

    Full Text Available Working accidents have a high moral and material impact, and are often easy to avoid, at least in about half the cases. Hence it is most important that campaigns for the reduction of these accidents should be correctly planned, so that such campaigns should not merely result in additional expense, and in a lowering of staff morale, when workers find themselves operating in an unpleasant and dangerous activity. In addition to special requirements, which may be studied in a later paper, and which must necessarily cover a very wide number of alternative cases, there are circumstances of a general nature, such as financial and moral consequences, and psychological repercussions, which influence the prevention of accidents and are the subject of this article.La notable repercusión moral y material que tienen los accidentes de trabajo y la fácil evitación de los mismos, por lo menos en la mitad de los casos, hacen sumamente importante que las campañas de prevención de accidentes estén bien orientadas y proyectadas, para evitar que se traduzcan, únicamente, en un gasto más y en una disminución de la moral del personal, al ver, éste, que está situado en medio de un ambiente desagradable y peligroso. Además de las normas particulares, que pueden ser objeto de otro trabajo posterior, y que han de ser forzosamente amplias, debido a la multiplicidad de factores que intervienen, hay, sin embargo, unas consideraciones de carácter general, tales como repercusiones económicas y morales y factores psicológicos que influyen en la prevención de accidentes y que son objeto del presente artículo.

  18. Medical management of accidentally exposed individuals

    International Nuclear Information System (INIS)

    Nenot, J.C.

    1998-01-01

    Bone marrow aplasia is one of the main syndromes following a high dose accidental radiation exposure. Whilst transfusion and bone marrow transplantation have been used with some success starting with the first treatments of accident victims, other therapeutic strategies are needed. With the development of experimental and clinical haematology, promising new approaches to the treatment of aplasia have appeared. New trends for the treatment of haemopoietic injury based on bone marrow transplantation rely on new sources of compatible donor cells, such as cord blood, on the selection of immature haemopoietic cells and on new transplant regimens. Haemopoietic growth factors stimulate the proliferation and/or differentiation of haemopoietic progenitors and, possibly, stem cells. Furthermore, they act on the functions of mature cells. Currently, they have specific uses in haematology related to their role in the regulation of growth and in the differentiation of haemopoietic progenitor cells. Growth factors have already been used for the treatment of accidental radiation induced aplasia and lessons have been learned from their medical management and followup. (author)

  19. Medical management of accidentally exposed individuals

    Energy Technology Data Exchange (ETDEWEB)

    Nenot, Jean-Claude [CEA Centre d`Etudes de Fontenay-aux-Roses, 92 (France). Inst. de Protection et de Surete Nucleaire

    1997-12-31

    Bone marrow aplasia is one of the main syndromes following a high dose accidental radiation exposure. Although both transfusion and bone marrow transplantation have been used with some success since the first treatments of patients, other therapeutic strategies are needed. New promising approaches of the treatment of aplasia have appeared with the development of experimental and clinical hematology. Some new trends for the treatment of the hematopoietic injury based on bone marrow transplantation rely on new sources of compatible donor cells, such as cord blood, on the selection of immature haemopoietic cells and on new transplant regimens. The hematopoietic growth factors stimulate proliferation and/or differentiation of hematopoietic progenitors and possibly stem cells. Furthermore, they act on the functions of mature cells. They have now specific uses in hematology, related to their role in the regulation of growth and differentiation of hematopoietic progenitor cells. Some growth factors have already been used for the treatment of accidental radiation-induced aplasia and lessons have been learned from their medical management and follow-up. (author) 30 refs.

  20. Efficiency comparison of 3 kinds of arterial puncture closing devices

    International Nuclear Information System (INIS)

    Feng Xiaodi; Jin Xian; Chen Yueguang; Xiao Hongbing; Yu Qiang; Chen Chengjun; Zhang Dadong

    2007-01-01

    Objective: To evaluate the efficiencies of arterial puncture closing devices (APCDs) including Angioseal, Perclose and Boomerang in patients undergone coronary angiography or percutaneous vascular interventions. Methods: 1497 patients underwent cardiac catheterization procedures were divided into manual compression group(639 cases) and APCDs closure group (576 cases with Angioseal, 151 cases Perclose and 11.3 cases of Boomerang). The times of maneuver, hemorrhage complication and other rare complications were assessed, recorded and compared. Results: The times for maneuver of standard manual compression group, Angioseal group, Perclose group and Boomerang group were (21.4±2.7) h, (3.5±2.3) h, (3.7± 2.6) h and (3.9±2.8) h respectively. The APCDs could obviously reduce bed rest time in comparing to that of manual compression. The rates of failure of the operations were 2.7%, 1.4%, 8.6% and 3.5% (P =0.006, P<0.001); and the rates of hemorrhage were 9.2%, 5.8%, 12.6% and 8.0% respectively for each of the four mentioned groups (P=0.005). Except the failure operations, the incidence of hemorrhage complications among the groups showed no significant differences. Conclusion: Application of APCDs to close the puncture site can significantly reduce the bed rest time, but not the incidence of hemorrhage complications. (authors)

  1. [Paresthesia and spinal anesthesia for cesarean section: comparison of patient positioning].

    Science.gov (United States)

    Palacio Abizanda, F J; Reina, M A; Fornet, I; López, A; López López, M A; Morillas Sendín, P

    2009-01-01

    To determine the incidence of paresthesia during lumbar puncture performed with the patient in different positions. A single-blind prospective study of patients scheduled for elective cesarean section, randomized to 3 groups. In group 1 patients were seated in the direction of the long axis of the table, with heels resting on the table. In group 2 they were seated perpendicular to the long axis of the table, with legs hanging from the table. In group 3 they were in left lateral decubitus position. Lumbar punctures were performed with a 27-gauge Whitacre needle. One hundred sixty-eight patients (56 per group) were enrolled. Paresthesia occurred most often in group 3 (P = .009). We observed no differences in blood pressure after patients moved from decubitus position to the assigned position. Nor did we observe between-group differences in blood pressure according to position taken during puncture. Puncture undertaken with the patient seated, heels on the table and knees slightly bent, is associated with a lower incidence of paresthesia than puncture performed with the patient seated, legs hanging from the table. Placing the patient's heels on the table requires hip flexion and leads to anterior displacement of nerve roots in the dural sac. Such displacement would increase the nerve-free zone on the posterior side of the sac, thereby decreasing the likelihood of paresthesia during lumbar puncture. A left lateral decubitus position would increase the likelihood of paresthesia, possibly because the anesthetist may inadvertently not follow the medial line when inserting the needle.

  2. Total spinal anesthesia in an achondroplasic patient: case report

    Directory of Open Access Journals (Sweden)

    Amiri H R

    2008-06-01

    Full Text Available Background: Total spinal anesthesia is a complication of lumbar epidural anesthesia following undiagnosed subarachnoid or subdural injection of local anesthetic. Although many achondroplastic dwarfs have a normal spine, catheter insertion may be more problematic with a narrow epidural space making a subarachnoid tap more probable.  Other malformations associated with achondroplasia, such as prolapsed intervertebral discs, reduced interpedicular distance, shortened pedicles, and osteophyte formation, combined with a narrow epidural space may make identification of the space difficult and increases the risk of dural puncture. Furthermore, subarachnoid tap or dural puncture may be hard to recognize if a free flow of CSF is difficult to achieve due spinal stenosis. Yet, for those who meet the criteria, epidural regional anesthesia is frequently preferred over other forms, which often have more or more dangerous side effects in this type of patient.Case report: A 22-year-old achondroplastic male dwarf patient was scheduled for pelvic mass resection and was considered a candidate for continuous epidural anesthesia. The anesthesia became complicated by total spinal anesthesia, which was reversed following supportive management for about two hours.Conclusion: There is significant debate over the composition and volume of the test dose, especially for patients with achondroplasia. We nevertheless recommend repeated test-doses during the accomplishment of epidural anesthesia to exclude unintended intravascular, intrathecal or subdural injection, keeping in mind that a test dose of local anesthetic does not completely prevent complications.

  3. Dynamic changes in the dural space and spinal cord cross-sectional area during flexion and extension in patients with cervical spondylotic myelopathy

    International Nuclear Information System (INIS)

    Machino, Masaaki; Yukawa, Yasutsugu; Ito, Keigo; Nakashima, Hiroaki; Kato, Fumihiko

    2009-01-01

    The number of patients with cervical spondylotic myelopathy (CSM) is increasing with the aging of the population. The patients' during spinal cord tends to be compressed neck extension, because the yellow ligaments and intervertebral discs protrude into the spinal canal during neck extension (pincer mechanism). A total of 100 patients with CSM were prospectively enrolled in this study. After preoperative myelography, multi-detector-row CT (MDCT) scans were acquired in flexion and extension, and the dural space and spinal cord cross-sectional area at each disc level from C2/3 to C7/Th1 were measured by using Scion imaging software. The average dural space and average spinal cord cross-sectional area were smaller in extension than in flexion from the C3/4 to C7/Th1 disc level, and the greatest dynamic changes were seen at the C5/6 level. MDCT demonstrated dynamic factors in patients with CSM. The spinal cord cross-sectional area became narrower during extension in patients with CSM. (author)

  4. Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

    Science.gov (United States)

    Xu, Hong; Liu, Yang; Song, WenYe; Kan, ShunLi; Liu, FeiFei; Zhang, Di; Ning, GuangZhi; Feng, ShiQing

    2017-01-01

    Abstract Background: Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle. Methods: We included all randomly designed trials, assessing the clinical outcomes in patients given elective spinal anesthesia or diagnostic lumbar puncture with either cutting or pencil-point spinal needle as eligible studies. All selected studies and the risk of bias of them were assessed by 2 investigators. Clinical outcomes including success rates, frequency of PDPH, reported severe PDPH, and the use of epidural blood patch (EBP) were recorded as primary results. Results were evaluated using risk ratio (RR) with 95% confidence interval (CI) for dichotomous variables. Rev Man software (version 5.3) was used to analyze all appropriate data. Results: Twenty-five randomized controlled trials (RCTs) were included in our study. The analysis result revealed that pencil-point spinal needle would result in lower rate of PDPH (RR 2.50; 95% CI [1.96, 3.19]; P < 0.00001) and severe PDPH (RR 3.27; 95% CI [2.15, 4.96]; P < 0.00001). Furthermore, EBP was less used in pencil-point spine needle group (RR 3.69; 95% CI [1.96, 6.95]; P < 0.0001). Conclusions: Current evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture. PMID:28383416

  5. Accidental injuries and cutaneous contaminations during general ...

    African Journals Online (AJOL)

    Conclusion: This study has demonstrated that cutaneous, percutaneous, and mucous membrane exposure to patients blood and body fluids are common events during general surgical operations. Most accidental injuries were due to solid suture needle-sticks, mostly injured personnel were the primary operating surgeons, ...

  6. On the accuracy, uniqueness and implication of dimensionless accidental relations between fundamental constants

    International Nuclear Information System (INIS)

    Bahran, M.; Univ. of Oklahoma, Norman-OK,

    2002-01-01

    Ibrahim et al(1) found an accidental formula relating the gravitational coupling constant, the electromagnetic fine structure constant and the proton to electron mass ratio. This work comments on such relation, in particular it studies the accuracy, uniqueness and unification implication of such accidental relation.(author)

  7. CT and MR imaging of non-cavernous cranial dural arteriovenous fistulas: Findings associated with cortical venous reflux

    Energy Technology Data Exchange (ETDEWEB)

    Letourneau-Guillon, Laurent; Cruz, Juan Pablo; Krings, Timo, E-mail: Timo.Krings@uhn.ca

    2015-08-15

    Highlights: • The conventional neuroimaging manifestations of dural arteriovenous fistulas are highly variable. • Identification of cortical venous reflux is important to prevent complications. • Tortuous and dilated vessels without a nidus are associated with cortical venous reflux. • Digital subtraction angiography remains the gold standard for DAVF diagnosis. - Abstract: Purpose: To compare the conventional CT and MR findings of DAVFs in relation to the venous drainage pattern on digital subtraction angiography (DSA). Materials and Methods: Cross-sectional imaging findings (CT and/or MR) in 92 patients were compared to the presence of cortical venous reflux (CVR) on DSA. Results: Imaging features significantly more prevalent in patients with CVR included: abnormally dilated and tortuous leptomeningeal vessels (92% vs. 4%, p < 0.001) or medullary vessels (69% vs. 0%, p < 0.001), venous ectasias (45% vs. 0%, p < 0.001) and focal vasogenic edema (38% vs. 0%, p < 0.001). The following findings trended towards association but did not reach the p value established following Bonferroni correction: dilated external carotid artery branches (71% vs. 38%, p = 0.005), cluster of vessels surrounding dural venous sinus (50% vs. 19%, p = 0.009), presence of hemorrhage (33 vs. 12%, p = 0.040), and parenchymal enhancement (21% vs. 0%, p = 0.030). Conclusion: In the appropriate clinical setting, recognition of ancillary signs presumably related to venous arterialization and congestion as well as arterial feeder hypertrophy should prompt DSA confirmation to identify DAVFs associated with CVR.

  8. Classical and quantum Liouville theory on the Riemann sphere with n>3 punctures (III)

    International Nuclear Information System (INIS)

    Shen Jianmin; Sheng Zhengmao; Wang Zhonghua

    1992-02-01

    We study the Classical and Quantum Liouville theory on the Riemann sphere with n>3 punctures. We get the quantum exchange algebra relations between the chiral components in the Liouville theory from our assumption on the principle of quantization. (author). 5 refs

  9. Accidental sulphuric acid poisoning in a newborn | Abdulkadir ...

    African Journals Online (AJOL)

    Accidental sulphuric acid poisoning in a newborn. I Abdulkadir, L Hassan, F Abdullahi, FD Akeredolu, S Purdue, M Okpe, AM Sobowale, OA Adewumi, U Abdullahi, MA Onadiran, TT Sholadoye, S Baba, WN Ogala ...

  10. An accidental death due to electric grinder: Dupatta as a strangulation hazard

    OpenAIRE

    Deepak Herald D′Souza; Vina R Vaswani; Kishor Kumar Badiadka; Venkat Krishna Shenoy; Boban Babu

    2013-01-01

    Accidents could occur at home in any age group. Accidental ligature strangulation in adults could be prevented. We are reporting a case of a woman who died in her kitchen due to accidental strangulation by her dupatta while working with the electric grinder. This case highlights the need to educate the people about the safety and potential hazards of these machines.

  11. Clinical evaluation of the lateral sagittal infraclavicular block developed by MRI studies

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Zbigniew J; Rasmussen, Henrik; Hesselbjerg, Lars

    2005-01-01

    of 53 mm +/- 10 mm and the needle dorsal angle was 23 degrees +/- 9 degrees . Four patients experienced painful paresthesias and 3 patients had accidental punctures of axillary vessels. Signs or symptoms of complications (hematoma, local anesthetic toxicity, pneumothorax, or neuropraxias) were...

  12. Challenging the wisdom of puncture at the calyceal fornix in percutaneous nephrolithotripsy: feasibility and safety study with 137 patients operated via a non-calyceal percutaneous track.

    Science.gov (United States)

    Kyriazis, Iason; Kallidonis, Panagiotis; Vasilas, Marinos; Panagopoulos, Vasilios; Kamal, Wissam; Liatsikos, Evangelos

    2017-05-01

    To present our experience with a central, non-calyceal puncture protocol for percutaneous nephrolithotripsy (PCNL) in an attempt to challenge the opinion of worldwide adopted calyceal puncture as the less traumatic site of percutaneous entrance into the collecting system. During 2012, a total of 137 consecutive, unselected patients were subjected to PCNL in our department. Non-calyceal punctures were performed to all cases and followed by subsequent track dilations up to 30 Fr. Perioperative and postoperative data were prospectively collected and analyzed. Mean operative time (from skin puncture to nephrostomy tube placement) was 48 min. Patients with single, multiple and staghorn stones had primary stone-free rates of 89.2, 80.4 and 66.7 % after PCNL, respectively. The overall complication rate was 10.2 %, while bleeding complications were minimal. Only 4 patients (2.9 %) required blood transfusion. Five patients (3.6 %) had Clavien Grade IIIa complications requiring an intervention for their management and none Grade IV or V. Despite the absence of evidence that non-calyceal percutaneous tracts could be a risk factor for complications, the concept of calyceal puncture has been worldwide adopted by PCNL surgeons as the sole safe percutaneous entrance into the collective system. Based on our experience, other pathways than the worldwide recognized rule, calyceal puncture, are possible and probably not as dangerous as has been previously stated.

  13. The epidural needle guidance with an intelligent and automatic identification system for epidural anesthesia

    Science.gov (United States)

    Kao, Meng-Chun; Ting, Chien-Kun; Kuo, Wen-Chuan

    2018-02-01

    Incorrect placement of the needle causes medical complications in the epidural block, such as dural puncture or spinal cord injury. This study proposes a system which combines an optical coherence tomography (OCT) imaging probe with an automatic identification (AI) system to objectively identify the position of the epidural needle tip. The automatic identification system uses three features as image parameters to distinguish the different tissue by three classifiers. Finally, we found that the support vector machine (SVM) classifier has highest accuracy, specificity, and sensitivity, which reached to 95%, 98%, and 92%, respectively.

  14. Inadvertent intrathecal injection of labetalol in a patient undergoing post-partum tubal ligation.

    Science.gov (United States)

    Balestrieri, P J; Hamza, M S; Ting, P H; Blank, R S; Grubb, C T

    2005-10-01

    After receiving a continuous spinal anesthetic for labor following an inadvertent dural puncture with a 17-gauge epidural needle, a morbidly obese parturient underwent post-partum tubal ligation 12 h after vaginal delivery. The patient received a total of 2 mL of 0.75% hyperbaric bupivacaine for the surgery. In response to moderate hypertension the patient received intravenous labetalol hydrochloride 20 mg. She subsequently was inadvertently administered approximately 15 mg of labetalol through the spinal catheter. The spinal catheter was removed immediately after the procedure. She suffered no apparent adverse neurologic effects.

  15. Cytogenetic biological dosimetry. Dose estimative in accidental exposure

    International Nuclear Information System (INIS)

    Santos, O.R. dos; Campos, I.M.A. de.

    1988-01-01

    The methodology of cytogenetic biological dosimetry is studied. The application in estimation of dose in five cases of accidental exposure is reported. An hematological study and culture of lymphocytes is presented. (M.A.C.) [pt

  16. Microneedle Manufacture: Assessing Hazards and Control Measures

    Directory of Open Access Journals (Sweden)

    Alexander Martin

    2017-10-01

    Full Text Available Transdermal microneedles have captured the attention of researchers in relation to a variety of applications, and silicone-based moulds required to produce these systems are now widely available and can be readily manufactured on the lab bench. There is however some concern over the potential for accidental needlestick injuries and, as with any sharp hazard, the potential for blood-borne pathogen transmission must be considered. This follows from recent governmental concerns over the use of microneedle systems in dermabrasion. Despite the piercing nature of the microneedle patch sharing many similarities with conventional hypodermic needles, there are notable factors that mitigate the risk of contamination. A range of microneedle systems has been prepared using micromoulding techniques, and their puncture capability assessed. A critical assessment of the potential for accidental puncture and the control measures needed to ensure safe utilisation of the patch systems is presented.

  17. Optic pathway glioma associated with orbital rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia in a child with neurofibromatosis-1

    International Nuclear Information System (INIS)

    Nikas, Ioannis; Theofanopoulou, Maria; Lampropoulou, Penelope; Hadjigeorgi, Christiana; Pourtsidis, Apostolos; Kosmidis, Helen

    2006-01-01

    Neurofibromatosis-1 (NF-1) is a multisystem disorder presenting with a variety of clinical and imaging manifestations. Neural and non-neural tumours, and unusual benign miscellaneous conditions, separately or combined, are encountered in variable locations. We present a 21/2-year-old boy with NF-1 who demonstrated coexisting optic pathway glioma with involvement of the chiasm and optic nerve, orbital alveolar rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia. (orig.)

  18. Comparison the effect of lidocaine gel and inhalation of lavender aromatherapy on pain score of arteriovenous fistula puncture in hemodialysis patients

    OpenAIRE

    Abbaszadeh

    2015-01-01

    Introduction: patients undergoing hemodialysis repetitively experience pain and anxiety related to arterivenous fistula (AVF) punctures. Using of appropriate methods of pain relief in these patients is very important. The purpose of this study was to compare the effect of lidocaine gel and inhalation of lavender aromatherapy on pain intensity of arterivenous fistula puncture in hemodialysis patients. Methods: In this before and after clinical trial study, 40 hemodialysis patients were sele...

  19. Measuring the visual salience of alignments by their non-accidentalness.

    Science.gov (United States)

    Blusseau, S; Carboni, A; Maiche, A; Morel, J M; Grompone von Gioi, R

    2016-09-01

    Quantitative approaches are part of the understanding of contour integration and the Gestalt law of good continuation. The present study introduces a new quantitative approach based on the a contrario theory, which formalizes the non-accidentalness principle for good continuation. This model yields an ideal observer algorithm, able to detect non-accidental alignments in Gabor patterns. More precisely, this parameterless algorithm associates with each candidate percept a measure, the Number of False Alarms (NFA), quantifying its degree of masking. To evaluate the approach, we compared this ideal observer with the human attentive performance on three experiments of straight contours detection in arrays of Gabor patches. The experiments showed a strong correlation between the detectability of the target stimuli and their degree of non-accidentalness, as measured by our model. What is more, the algorithm's detection curves were very similar to the ones of human subjects. This fact seems to validate our proposed measurement method as a convenient way to predict the visibility of alignments. This framework could be generalized to other Gestalts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

    OpenAIRE

    Fabiano de Mendonça Grandese; Clóvis Yamazato; Fábio Mastromauro de Oliveira; Iberê Ribeiro; José Olympio Catão Bastos Júnior; René Kusabara

    2010-01-01

    OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuário...

  1. Personal protective clothing against accidental immersion

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, David; Tipton, Michael [Surrey Univ., Robens Inst. of Health and Safety, Guildford (United Kingdom)

    1997-12-31

    The requirements for protective clothing against accidental immersion are discussed and the advantages and limitations of the main types of immersion protection available are analysed. The variety of designs available reflects the various circumstances under which they may be used. In broad terms in the offshore industry these include the following activities: normal work without risk of immersion but with a possible need to abandon the rig or ship; work in areas where there is risk of accidentally falling into the sea; flying over the sea in a helicopter. The first response to sudden immersion in sea water, which must usually be considered to be cold, is a sudden gasp often followed by an immediate phase of uncontrolled breathing. Since control of ones breathing between and under the breaking waves is essential to staying alive, this is a critical time. After surviving this initial ``cold shock`` phase, the effects of body heat loss become hazardous. Protection against hypothermia has been the priority for those providing survival suits and protective clothing while the hazard of the immediate response to cold immersion has been unrecognised to a large extent. (UK)

  2. An accidental death due to electric grinder: Dupatta as a strangulation hazard

    Directory of Open Access Journals (Sweden)

    Deepak Herald D′Souza

    2013-01-01

    Full Text Available Accidents could occur at home in any age group. Accidental ligature strangulation in adults could be prevented. We are reporting a case of a woman who died in her kitchen due to accidental strangulation by her dupatta while working with the electric grinder. This case highlights the need to educate the people about the safety and potential hazards of these machines.

  3. Evaluation of the effects of electron-beam irradiation on the puncture resistance by Lasioderma serricorne in flexible packaging of granola

    International Nuclear Information System (INIS)

    Oliveira, Vitor M.; Alves, Juliana N.; Nogueira, Beatriz R.; Moura, Esperidiana A.B.; Ortiz, Angel V.; Potenza, Marcos R.

    2009-01-01

    Lasioderma serricorne is a beetle that infests stored and industrialized dry foods such as cereal bars, granola, flour and pasta, amongst others, depreciating the products and causing economic losses. It is therefore critical for these products a packaging that presents, in addition to good mechanical, barrier and machinability properties, a good resistance to puncture by insects, in order to prevent the contact and spread of pests in the packaged food. This study evaluates the changes on mechanical properties and puncture resistance by L. serricorne in BOPP/PP structure, used commercially as granola packaging after electron-beam irradiation. The irradiations were performed using a 1.5 MeV electron beam accelerator, dose rate of 11.22 kGy/s, at room temperature in presence of air, doses up to 120 kGy. After irradiation the BOPP/PP samples were subjected to tests of puncture resistance by L. serricorne, tensile strength, friction coefficient, penetration and seal strength. Results showed decreases in the original mechanical properties of the structure according to the radiation doses applied and effective resistance against punctures by L. serricorne (p<0.05). The results indicate that the irradiated and non-irradiated BOPP/PP structure, in the conditions studied in this work, is resistant against L. serricorne, however the decreases observed in the mechanical properties of the irradiated structure may turn it inappropriate for packaging granola. (author)

  4. Risk assessment for stonecutting enterprises Accidental risks in the course of petroleum production and stone extraction

    Science.gov (United States)

    Aleksandrova, A. J.; Timofeeva, S. S.

    2018-01-01

    The paper is devoted to the assessment of accidental risks occurring at the works engaged in stone extracting and petroleum production. Two basic kinds of accidents common for stone extracting and petroleum production have been chosen to be discussed in the part under consideration. The most dangerous accidental situation characteristic for a stone milling line is an unsanctioned explosion, UE, of blasting agents used for the development of stone deposits. The analysis of a risk occurrence in certain accidental situations is to be carried out. With reference to petroleum extraction, a combustibles and lubricants (C & L) explosion is the most dangerous of characteristic accidental situations. To reveal the most probable causes of accidental situations to be realized, a graph of cause and effect relations has been constructed for each of the accidental situations most probable causes to real situation of an accident. Disasters of a natural origin are the most probable causes of unsanctioned explosions at the deposits of stone raw materials. Technology related natural disasters are the most probable causes of unsanctioned explosions to be realized at multiple well platforms engaged in petroleum production.

  5. Accidental poisoning with detomidine and butorphanol.

    Science.gov (United States)

    Hannah, N

    2010-09-01

    This is a case report concerning a veterinarian who spilled detomidine and butorphanol on dermatitic hands while sedating a horse. This resulted in acute poisoning from which the patient spontaneously recovered with supportive management. Veterinarians often suffer from occupational dermatitis and handle strong sedatives with no gloves while working around unpredictable animals. Thus, this group is at risk of accidental self-poisoning from this method.

  6. accidental injuries in children (physical child abuse)

    African Journals Online (AJOL)

    2016-12-06

    Dec 6, 2016 ... are often due to minor accidental injuries. However ... In dark-skinned children, bruises may be confused with café-au-lait spots. .... A bruise should not be examined in isolation if reason- ... dren with intellectual disability, such as autism and hy- ... opmental stage, social and environmental factors includ-.

  7. Technical measurement of small fission gas inventory in fuel rod with laser puncturing system

    International Nuclear Information System (INIS)

    Kim, Hee Moon; Kim, Sung Ryul; Lee, Byoung Oon; Yang, Yong Sik; Baek, Sang Ryul; Song, Ung Sup

    2012-01-01

    The fission gas release cause degradation of fuel rod. It influences fuel temperature and internal pressure due to low thermal conductivity. Therefore, fission gas released to internal void of fuel rod must be measured with burnup. To measure amount of fission gas, fuel rod must be punctured by a steel needle in a closed chamber. Ideal gas law(PV=nRT) is applied to obtain atomic concentration(mole). Steel needle type is good for large amount of fission gas such as commercial spent fuel rod. But, some cases with small fuel rig in research reactor for R/D program are not available to use needle type because of large chamber volume. The laser puncturing technique was developed to solve measurement of small amount of fission gas. This system was very rare equipment in other countries. Fine pressure gage and strong vacuum system were installed, and the chamber volume was reduced at least. Fiber laser was used for easy operation

  8. 21 CFR 1002.20 - Reporting of accidental radiation occurrences.

    Science.gov (United States)

    2010-04-01

    ...: Accidental Radiation Occurrence Reports (HFZ-240), Office of Communication, Education, and Radiation Programs, 9200 Corporate Blvd., Rockville, MD 20850, and the reports and their envelopes shall be distinctly...

  9. Development of a high frequency single-element ultrasound needle transducer for anesthesia delivery

    Science.gov (United States)

    Ameri, Golafsoun; Son, Jungik; Liang, Jingwei; Foster, F. Stuart; Ganapathy, Sugantha; Peters, Terry M.

    2017-03-01

    Epidural anesthesia is one of the most commonly used and yet challenging techniques employed for pain management and anesthesia delivery. The major complications of this procedure are due to accidental dural puncture, with an incidence of 1-3%, which could lead to both temporary and irreversible permanent neurological complications. Needle placement under ultrasound (US) guidance has received increasing interest for improving needle placement accuracy. However, poor needle visibility in US, difficulties in displaying relevant anatomical structure such as dura mater due to attenuation and bone shadowing, and image interpretation variability among users pose significant hurdles for any US guidance system. As a result, US guidance for epidural injections has not been widely adopted for everyday use for the performance of neuraxial blocks. The difficulties in localizing the ligamentum flavum and dura with respect to the needle tip can be addressed by integrating A-mode US, provided by a single-element transducer at the needle tip, into the B-mode US guidance system. We have taken the first steps towards providing such a guidance system. Our goal is to improve the safety of this procedure with minimal changes to the clinical workflow. This work presents the design and development of a 20 MHz single-element US transducer housed at the tip of a 19 G needle hypodermic tube, which can fit inside an epidural introducer needle. In addition, the results from initial transducer characterization tests and performance evaluation of the transducer in a euthanized porcine model are provided.

  10. Labor epidural analgesia: Past, present and future

    Directory of Open Access Journals (Sweden)

    Reena

    2014-01-01

    Full Text Available One of the most severe pains experienced by a woman is that of childbirth. Providing analgesia for labor has always been a challenge more so because of the myths and controversies surrounding labor. It is imperative to understand the pain transmission during various stages of labor in order to select a proper technique for providing labor analgesia. The adverse effects of labor pain are numerous and affect both the mother as well as the fetus. Currently lumbar epidural is considered to be the gold standard technique for labor analgesia. Local anaesthetics like bupivacaine and ropivacaine are commonly used and adjuvants like clonidine, fentanyl and neostigmine have been extensively studied. However, despite being so popular, epidural analgesia is not without complications, with hypotension being the most common. Other complications include accidental dural puncture, infection, intravascular placement, high block and epidural hematoma. Other neuraxial techniques include continuous caudal analgesia, and combined spinal epidural analgesia. The numerous studies investigating the various aspects of this method have also served to dispel various myths surrounding epidural analgesia like increased incidence of cesarean section and instrumental delivery, prolongation of labor and future back pain. The future of labor analgesia lies in the incorporation of ultrasound in identifying the epidural space helping in proper catheter placement. The keywords "labor epidural" in the PUBMED revealed a total of 5018 articles with 574 review articles and 969 clinical trials. The relevant articles along with their references were extensively studied.

  11. Clinical observation of Ahmed glaucoma valve implantation for refractory glaucoma by directly puncturing the sclerotic tunnel

    Directory of Open Access Journals (Sweden)

    Zhi-Ke Xu

    2015-02-01

    Full Text Available AIM: To observe the clinic effects and complication of Ahmed glaucoma valve(AGVimplantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases(44 eyesof refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure(IOP, visual acuity, and complication of post-operation were contrasted with those of pre-operation. RESULTS:The success rate was 84.1%, the mean preoperative IOP in research group was 52.1±10.1mmHg, and the last follow up mean IOP was 15.6±6.9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber(4 eyes, choroidal detachment(3 eyes, drainage tube shift(1 eye, hyphema(6 eyes, drainage tube blockage(1 eye, expulsive choroidal hemorrhage(1 eye, and fiber wrap of drainage tray(5 eyes.CONCLUSION: AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. It avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. It is an effective procedure for refractory glaucoma.

  12. Mortalidad por accidentes de tránsito en Bayamo, Cuba 2011

    Directory of Open Access Journals (Sweden)

    Arlines Piña-Tornés

    Full Text Available Con el objetivo de describir la mortalidad por accidentes de tránsito en Bayamo, Cuba, en el año 2011 se realizó una revisión de los pacientes lesionados y fallecidos a causa de accidentes de tránsito, registrados en Hospital Carlos M. de Céspedes. Se atendieron en emergencias 1365 lesionados, predominando el grupo etario de 25 a 44 años con 372 pacientes (27,3%, y el sexo masculino con 1071 (78,5%. Fallecieron 46 personas, en su mayoría del mismo grupo de edad y de sexo masculino. Los traumatismos múltiples (52,6% y cráneofaciales (34,2% fueron las localizaciones predominantes. Se destacaron los atropellos por vehículo de motor con mortalidad del 26,3%. En conclusión, la mortalidad por accidentes de tránsito predomina en adultos jóvenes masculinos; cuyas consecuencias fatales son debido a traumatismos múltiples por atropellos.

  13. 40 CFR 63.6000 - How do I conduct tests and procedures for puncture sealant application affected sources?

    Science.gov (United States)

    2010-07-01

    ... Tire Manufacturing Testing and Initial Compliance Requirements for Puncture Sealant Application... balances to demonstrate compliance, if the storage of materials, exhaust, or the wastewater from more than...

  14. Assessment of Residents Readiness to Perform Lumbar Puncture

    DEFF Research Database (Denmark)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle

    2017-01-01

    and 18 novices performing the procedure in a simulated, ward-like setting with a standardized patient. Procedural performance was assessed by three content experts. We used generalizability theory to explore reliability. The discriminative ability of the tool was explored by comparing performance scores......Background: Lumbar puncture is a common procedure in many specialties. The procedure serves to diagnose life-threatening conditions, often requiring rapid performance. However, junior doctors possess uncertainties regarding performing the procedure and frequently perform below expectations. Hence...... between the two groups. The contrasting groups method was used to set a pass/fail standard and the consequences of this was explored. Key results: The interviews identified that in addition to the technical aspects of the procedure, non-technical elements involving planning and conducting the procedure...

  15. Eggshell strength of an obligate brood parasite: a test of the puncture resistance hypothesis

    Czech Academy of Sciences Publication Activity Database

    Antonov, A.; Stokke, B. G.; Moksnes, A.; Kleven, O.; Honza, Marcel; Roskaft, E.

    2006-01-01

    Roč. 60, č. 1 (2006), s. 11-18 ISSN 0340-5443 Grant - others:Research Council of Norway(NO) 151641/432 Institutional research plan: CEZ:AV0Z60930519 Keywords : brood parasitism * eggshell thickness * puncture resistance * Acrocephalus * cuckoo Subject RIV: EG - Zoology Impact factor: 2.316, year: 2006

  16. Mortalidad intrahospitalaria por accidente cerebrovascular

    OpenAIRE

    Federico Rodríguez Lucci; Virginia Pujol Lereis; Sebastián Ameriso; Guillermo Povedano; María F. Díaz; Alejandro Hlavnicka; Néstor A. Wainsztein; Sebastián F. Ameriso

    2013-01-01

    La mortalidad global por accidente cerebrovascular (ACV) ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Str...

  17. Clinical study of lesions caused by accidental local exposure to ionizing radiations

    International Nuclear Information System (INIS)

    Menoux, A.M.

    1977-01-01

    During the last few years the radiopathology service of the Curie Foundation has admitted more than a hundred patients who were followed and treated for irradiation or suspected irradiation after a work accident. Accidents followed by clinical symptoms account for about half the cases examined. Some of these clinical signs were benign whereas others developed very seriously, all possible conditions between these two extremes being represented. This report neglects cases of high total exposure and deals only with those of partial irradiation where local symptoms predominate, usually at the distal extremities of the upper limbs and exceptionally at the root or distal extremity of the lower limbs. Six clinical cases were selected as particularly revealing and are discussed below: accidental exposure of both hands to an iridium-192 source; chronic exposure to X-rays (left hand and right lower half-lip); accidental exposure of the right hand and antero-external face of the right thigh to a iridium-192 source; acute accidental exposure of the left hand to X-rays emitted under 50 kV; accidental exposure of both hands to cobalt-60 radiation; radiolesions of the left lower limb following a critical power excursion (gamma rays and neutrons) [fr

  18. Construction of Rate-Compatible LDPC Codes Utilizing Information Shortening and Parity Puncturing

    Directory of Open Access Journals (Sweden)

    Jones Christopher R

    2005-01-01

    Full Text Available This paper proposes a method for constructing rate-compatible low-density parity-check (LDPC codes. The construction considers the problem of optimizing a family of rate-compatible degree distributions as well as the placement of bipartite graph edges. A hybrid approach that combines information shortening and parity puncturing is proposed. Local graph conditioning techniques for the suppression of error floors are also included in the construction methodology.

  19. Accidentes fuera del trabajo: análisis en el campamento minero de Toquepala 2002-2003

    Directory of Open Access Journals (Sweden)

    Raúl Gomero Cuadra

    2005-06-01

    Full Text Available En general, todas las empresas desarrollan programas para evitar o minimizar los accidentes del trabajo. Sin embargo, existe escasa información técnica relacionado a la prevalencia y costos derivados de los accidentes fuera del trabajo, lo que dificulta el análisis del problema. Objetivo: Revisar y analizar los descansos médicos en los trabajadores de nuestro campamento minero generados por accidentes considerados como particulares o fuera del trabajo. Materiales y métodos: El presente trabajo tiene un diseño transversal periódico, realizado en el Servicio de Salud Ocupacional del Hospital Toquepala. Los diagnósticos médicos fueron informados según el CIE-10 de la OMS. Para la clasificación de accidentes fuera del trabajo, se siguió la del programa de Loss Control Management del DNV, a la cual se le realizaron modificaciones de acuerdo al criterio y experiencia de los autores. Se revisaron 468 y 570 boletas de descanso médico generadas en los años 2002 y 2003 respectivamente. Resultados: Correspondieron al año 2002, 88 (18,8% descansos de accidentes fuera del trabajo, mientras que en el año 2003 fueron 99 (17,37%. La etiología de los accidentes fuera del trabajo fueron: de Transporte 11 (12,5% en el año 2002 y 12 (12,12% en el año 2003; del Hogar 25 (28,41% en el año 2002 y 20 (20,2% en el año 2003; Públicos 21 (23,86% en el año 2002 y 36 (36,36% en el año 2003. Conclusiones: Tenemos valores altos de accidentes fuera del trabajo con relación al número total de accidentes en nuestra empresa en los años 2002 y 2003, sin embargo, ninguno fatal. Además debemos orientar programas preventivos dirigidos hacia la seguridad vial y la buena práctica de deportes. Concluimos que es necesario incorporar el análisis de los accidentes fuera del trabajo con incapacidad temporal dentro del estudio de la morbilidad como parte del Diagnóstico de la Situación de Salud Laboral que confecciona el Médico ocupacional o del Trabajo

  20. Significance of preoperative planning software for puncture and channel establishment in percutaneous endoscopic lumbar DISCECTOMY: A study of 40 cases.

    Science.gov (United States)

    Hu, Zhouyang; Li, Xinhua; Cui, Jian; He, Xiaobo; Li, Cong; Han, Yingchao; Pan, Jie; Yang, Mingjie; Tan, Jun; Li, Lijun

    2017-05-01

    Preoperative planning software has been widely used in many other minimally invasive surgeries, but there is a lack of information describing the clinical benefits of existing software applied in percutaneous endoscopic lumbar discectomy (PELD). This study aimed to compare the clinical efficacy of preoperative planning software in puncture and channel establishment of PELD with routine methods in treating lumbar disc herniation (LDH). From June 2016 to October 2016, 40 patients who had single L4/5 or L5/S1 disc herniation were divided into two groups. Group A adopted planning software for preoperative puncture simulation while Group B took routine cases discussion for making puncture plans. The channel establishment time, operative time, fluoroscopic times and complications were compared between the two groups. The surgical efficacy was evaluated according to the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and modified Macnab's criteria. The mean channel establishment time was 25.1 ± 4.2 min and 34.6 ± 5.4 min in Group A and B, respectively (P  0.05). The findings of modified Macnab's criteria at each follow-up also showed no significant differences (P > 0.05). The application of preoperative planning software in puncture and cannula insertion planning in PELD was easy and reliable, and could reduce the channel establishment time, operative time and fluoroscopic times of PELD significantly. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Posture and lumbar puncture headache: a controlled trial in 50 patients.

    OpenAIRE

    Handler, C E; Smith, F R; Perkin, G D; Rose, F C

    1982-01-01

    A prospective single blind trial in 50 patients was performed to investigate the effect of posture on post lumbar puncture headache (LPH). A difference between the frequency of headache at five hours between the two groups (prone for four hours, versus 30 degrees head down tilt for 30 minutes followed by supine posture for 3 1/2 hours) did not reach significance. These findings do not support the suggestion that a prone posture, by possibly reducing cerebrospinal fluid (CSF) leakage, signific...

  2. Percutaneous evacuation of diffuse pulmonary interstitial emphysema by lung puncture in a baby with extremely low birth weight: a case report

    Directory of Open Access Journals (Sweden)

    Watanabe Masahiro

    2012-09-01

    Full Text Available Abstract Introduction Pulmonary interstitial emphysema is a serious complication of mechanical ventilation and can become life-threatening if progression occurs. Therapeutic lung puncture is a treatment option for severe pulmonary interstitial emphysema but has a limited use in babies with extremely low birth weight. We present a case of pulmonary interstitial emphysema in a Japanese baby (1-day-old boy with extremely low birth weight. The emphysema was successfully decompressed by therapeutic lung puncture performed with a trocar catheter. Case presentation The baby was born with a weight of 420g, which, to the best of our knowledge, is the lowest reported birth weight among babies with pulmonary interstitial emphysema. A chest X-ray on postnatal day 2 revealed pulmonary interstitial emphysema, which gradually progressed to diffuse pseudocystic changes. His condition became life-threatening despite the use of high-frequency oscillatory ventilation and lateral decubitus positioning. We evacuated the pulmonary interstitial emphysema by lung puncture with a trocar catheter to avoid respiratory and cardiovascular collapse. This resulted in adequate evacuation of the emphysema and a dramatic improvement in his clinical condition. Conclusions Therapeutic lung puncture performed with a trocar catheter is beneficial in babies with extremely low birth weight and diffuse pulmonary interstitial emphysema. This treatment option may be broadly applicable, especially in an emergency situation.

  3. Gamma Knife radiosurgery for intracranial meningiomas : Do we need to treat the dural tail? A single-center retrospective analysis and an overview of the literature

    NARCIS (Netherlands)

    Bulthuis, Vincent J; Hanssens, Patrick E J; Lie, Suan Te; van Overbeeke, Jacobus J

    2014-01-01

    BACKGROUND: The dural tail (DT) has been described as a common feature in meningiomas. There is a great variation of tumor invasion and extent of tumor cells in the DT. Therefore, the necessity to include the whole DT in Gamma Knife radiosurgery is not clear, since inclusion increases the target

  4. Accidental Kähler moduli inflation

    International Nuclear Information System (INIS)

    Maharana, Anshuman; Rummel, Markus; Sumitomo, Yoske

    2015-01-01

    We study a model of accidental inflation in type IIB string theory where inflation occurs near the inflection point of a small Kähler modulus. A racetrack structure helps to alleviate the known concern that string-loop corrections may spoil Kähler Moduli Inflation unless having a significant suppression via the string coupling or a special brane setup. Also, the hierarchy of gauge group ranks required for the separation between moduli stabilization and inflationary dynamics is relaxed. The relaxation becomes more significant when we use the recently proposed D-term generated racetrack model

  5. Patterns of accidental deaths in Kuwait: a retrospective descriptive study from 2003-2009.

    Science.gov (United States)

    Al-Kandary, Nadia; Al-Waheeb, Salah

    2015-03-28

    Accidents are a preventable cause of death. Unfortunately it accounts for a large number of deaths in many societies. In Kuwait, road traffic accidents (RTA) is the leading cause of death in young people. The study investigated the patterns of accidental deaths in Kuwait, one of the Gulf States which incorporates a wide variety of multi-ethnic communities. The study was retrospective from 2003-2009. Data of forensic cases were collected from the general department of criminal evidence (GDCE) in the ministry of interior (MOI).We attempted to find out causes of accidental death and the prevelance of each cause. Furthermore, the relationship of demographic factors (eg. Age, sex, marital status and nationality) with each cause of accidental death in Kuwait were studied. The material of this study constituted a total of 4886 reported accidental deaths referred for Medico-legal examination. Road traffic accidents was by far the most prevalent cause of death (64.6%) followed by fall from height (13.1%). Poisoning and mine explosions were amongst the least common causes. The government of Kuwait needs to take strong measures to promote safety in the workplace and households by educational campaigns.

  6. Accidentes en el hogar

    Directory of Open Access Journals (Sweden)

    Nereida Pacios Alfonso

    1999-04-01

    Full Text Available Se realiza un estudio descriptivo de los accidentes domésticos ocurridos durante un año en la población de un consultorio del Médico de la Familia. Resultan más afectados los sujetos del sexo femenino y los grupos en edades extremas de la vida. El horario de la tarde fue el más peligroso. La relación con el uso de bebidas alcohólicas estuvo ausente en menores de 15 años y ancianos; en adultos jóvenes el dato requiere de otros estudios. Las contusiones por caídas fue el tipo más frecuente de lesión; los miembros superiores, la región corporal más afectada. Hubo secuelas en la quinta parte de los lesionados. Sólo cuatro de cada diez accidentes ocurridos se diagnostican en consulta. Más de la mitad de la morbilidad es oculta y cada lesionado pierde un promedio de 10 días de vida plenaA descriptive study of those home accidents reported by the population of a family physician´s office during a year was conducted. Females and the group at extreme ages of life were the most affected. Afternions were more dangerous. Drinking was not present among patients under 15 and aged people. As to young adults, this datum should be further studied. Contusions caused by falls were the most frequent type of injuries, whereas the upper limbs were the most injured. A fifth of these had sequelae. Only 4 accidents out of 10 were diagnosed at the physician´s office. More than falf of morbidity was hidden and every injured person lost an average of 10 days of full life

  7. Main problems of external monitoring in the accidental zone

    International Nuclear Information System (INIS)

    Gavrikov, O.K.; Gul'din, A.N.; Komarov, V.I.; Malkov, V.L.; Smirnov, N.V.; Sukhoruchkin, A.K.; Proskuryakov, A.G.

    1989-01-01

    Operational experience of the external monitoring service during emergency response is analysed as applied to the problems of optimization of environmental monitoring under accidental conditions. Problems of rapid and strategical environmental radiation monitoring are considered

  8. Accidentes biológicos en estudiantes de medicina de una universidad peruana: prevalencia, mecanismos y factores de riesgo

    Directory of Open Access Journals (Sweden)

    Elizabeth Inga

    2010-03-01

    Full Text Available Introducción: Una de las más serias amenazas que enfrentan los estudiantes de medicina durante su práctica clínica es la posibilidad de exposición a accidentes biológicos, debido en la mayoría de los casos a la inexperiencia y el escaso desarrollo de las habilidades manuales. Objetivos: Establecer la frecuencia, mecanismos, circunstancias y factores de riesgo de los accidentes biológicos ocurridos entre estudiantes de medicina. Diseño: Estudio descriptivo observacional de corte transversal. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Estudiantes de medicina. Metodología: Se aplicó una encuesta estructurada anónima, voluntaria y autoadministrada. Principales medidas de resultados: Accidentes biológicos. Resultados: En total fueron 307 entrevistados. La prevalencia de accidentes biológicos en la población estudiada fue de 51,5% (158/307. La media de accidentes biológicos en el último año fue de 1,06. El 91,1% de los estudiantes del último año presentó al menos un accidente biológico, versus 11,9% en los estudiantes del primer año. Los estudiantes del último año informaron con más frecuencia accidentes de riesgo alto para transmisión de infecciones, siendo 47,6% por pinchazo con objeto punzocortante, y 80,6% tuvo exposición a sangre; los accidentes de riesgo alto son mucho más frecuentes en quirófanos y sala de partos (51,9%. Conclusiones: La prevalencia de accidentes biológicos fue 51,5%, siendo el pinchazo la forma más frecuente. Es necesario desarrollar estrategias que permitan velar por la bioseguridad de los estudiantes de medicina.

  9. Comparison of intracranial computed tomographic (CT) findings in pediatric abusive and accidental head trauma

    International Nuclear Information System (INIS)

    Hymel, K.P.; Rumack, C.M.; Hay, T.C.; Strain, J.D.; Jenny, C.

    1997-01-01

    Background. Child abuse specialists rely heavily on diagnostic neuroimaging. Objectives. Study objectives were: (1) to compare the frequencies of six specific intracranial CT abnormalities in accidental and non-accidental pediatric head trauma, and (2) to assess interobserver agreement regarding these CT findings. Materials and methods. Three pediatric radiologists blindly and independently reviewed cranial CT scans of pediatric patients who sustained closed head trauma between 1991 and 1994. All patients were less than 4 years of age. Study cases included thirty-nine (50 %) with non-accidental head trauma and thirty-nine (50 %) with accidental head trauma. Each scan was evaluated for the presence or absence of the following six intracranial findings: (1) interhemispheric falx hemorrhage, (2) subdural hemorrhage, (3) large (non-acute) extra-axial fluid, (4) basal ganglia edema, (5) posterior fossa hemorrhage, and (6) frontal-parietal shearing tear(s). Interobserver agreement was calculated as the percentage of total cases in which all reviewers agreed a specific CT finding was present or absent. Diagnosis required independent agreement by all three pediatric radiologists. The frequencies of these six intracranial CT abnormalities were compared between the two study groups by Chi-square analysis and Fisher's exact test. Results. Interobserver agreement between radiologists was greater than 80 % for all lesions evaluated, with the exception of frontal-parietal shearing tear(s). Interhemispheric falx hemorrhage, subdural hemorrhage, large (non-acute) extra-axial fluid, and basal ganglia edema were discovered significantly more frequently in non-accidental trauma (P ≤.05). Conclusion. Although not specific for child abuse, discovery of these intracranial CT abnormalities in young patients should prompt careful evaluation of family and injury circumstances for indicators of non-accidental trauma. (orig.). With 6 figs., 2 tabs

  10. Letalidad por accidentes de trabajo en Villa Clara

    Directory of Open Access Journals (Sweden)

    Miguel Gómez Vital

    1999-01-01

    Full Text Available Se valora la problemática de la letalidad por accidentes laborales en la provincia de Villa Clara, en el período comprendido entre 1987 y 1997. Se determinan las principales causas, y fue la conducta negligente del individuo la que más incidió. En los últimos años de la década del 80 se registraron más cantidad de muertes por accidentes de trabajo, los que ocurrieron fundamentalmente en el puesto laboral. Queda puntualizado el importante rol del equipo médico en instituciones laborales.The problem of letality from working accidents in the province of Villa Clara from 1987 to 1997 was evaluated. The main causes were also determined. Individual negligent behaviour proved to be the first cause. More deaths from working accidents were registered late in the 1980s. Most of these accidents occurred at the working place. It was stressed the important role played by the medical team at the working institutions

  11. ST-segment elevation and ventricular fibrillation shortly after transseptal puncture for left atrial catheter ablation

    Directory of Open Access Journals (Sweden)

    Daisuke Ishigaki, MD

    2013-10-01

    Full Text Available A 47-year-old man with drug-resistant paroxysmal atrial fibrillation underwent left atrial (LA catheter ablation. After sheaths were inserted into the LA using the Brockenbrough method, he complained of angina and developed ST-segment elevation in the II, III, aVF, V5, and V6 leads. Ventricular fibrillation (VF occurred followed by ventricular tachycardia. The VF was successfully treated with direct current shock. Coronary angiography with isosorbide dinitrate showed neither spasm nor embolism in the coronary artery. The chest pain disappeared after 6 min with resolution of the ST-segment elevation. A summarized review of ST-segment elevation associated with transseptal puncture disclosed that ST-segment elevation is often found in inferior leads (87.5%, while concomitant bradyarrhythmia has been reported in 43.8% of patients. Our patient is the first recorded case with potentially lethal tachyarrhythmia. Although ST-segment elevation and VF is a rare complication associated with transseptal puncture, awareness of this complication is important.

  12. Shrunk loop theorem for the topology probabilities of closed Brownian (or Feynman) paths on the twice punctured plane

    International Nuclear Information System (INIS)

    Giraud, O; Thain, A; Hannay, J H

    2004-01-01

    The shrunk loop theorem proved here is an integral identity which facilitates the calculation of the relative probability (or probability amplitude) of any given topology that a free, closed Brownian (or Feynman) path of a given 'duration' might have on the twice punctured plane (plane with two marked points). The result is expressed as a 'scattering' series of integrals of increasing dimensionality based on the maximally shrunk version of the path. Physically, this applies in different contexts: (i) the topology probability of a closed ideal polymer chain on a plane with two impassable points, (ii) the trace of the Schroedinger Green function, and thence spectral information, in the presence of two Aharonov-Bohm fluxes and (iii) the same with two branch points of a Riemann surface instead of fluxes. Our theorem starts from the Stovicek scattering expansion for the Green function in the presence of two Aharonov-Bohm flux lines, which itself is based on the famous Sommerfeld one puncture point solution of 1896 (the one puncture case has much easier topology, just one winding number). Stovicek's expansion itself can supply the results at the expense of choosing a base point on the loop and then integrating it away. The shrunk loop theorem eliminates this extra two-dimensional integration, distilling the topology from the geometry

  13. Closure Using a Surgical Closure Device of Inadvertent Subclavian Artery Punctures During Central Venous Catheter Placement

    International Nuclear Information System (INIS)

    Berlet, Matthew H.; Steffen, Diana; Shaughness, George; Hanner, James

    2001-01-01

    Severe complications can and do occur when central venous catheters are inadvertently placed into subclavian arteries. Two cases are discussed that describe how these inadvertent arterial punctures can be closed using the Perclose device (Abbott Laboratories, Redwood City, CA, USA)

  14. Effects of electron beam radiation on mechanical properties and on the resistance to punctures caused by Plodia interpunctella in cereal bar packaging

    International Nuclear Information System (INIS)

    Alves, Juliana N.; Moura, Esperidiana A.B.; Oliveira, Vitor M.; Potenza, Marcos R.; Arthur, Valter

    2009-01-01

    Plodia interpunctella is an important pest in stored products in the tropical and subtropical regions, infesting grains and flours. The adult of P. interpunctella is a small butterfly with about 15 - 20mm of spread and the female places separately of 100 the 400 eggs in groups on the grains whose hard incubation some days. This insect infesting diverse types of food packaging, depreciating the products and causing economic losses. It is therefore critical for these products a packaging that presents, in addition to good mechanical, barrier and machinability properties, a good resistance to puncture by insects, in order to prevent the contact and spread of pests in the packaged food. This study evaluates the changes on mechanical properties and puncture resistance by P. interpunctella in BOPPmet/BOPP structure, used commercially as cereal bar packaging, after electron beam irradiation. The material samples were irradiated up to 120 kGy using a 1.5 MeV electrostatic accelerator, at room temperature, in air, dose rate 11.22 kGy/s. Irradiation doses were measured using cellulose triacetate film dosimeters 'CTA-FTR-125' from Fuji Photo Film Co. Ltd. After irradiation the BOPPmet/BOPP samples were subjected to tests of puncture resistance by P. interpunctella, tensile tests and penetration resistance. The results showed significant decreases (p<0.05) in the original mechanical properties of the structures according to the radiation doses applied and effective resistance against punctures by P. interpunctella for irradiated and nonirradiated BOPPmet/BOPP samples. These results indicate that non-irradiated and irradiated BOPPmet/BOPP structure presents puncture resistance against P. interpunctella and that electron-beam irradiation, in conditions studied in this work, may turn the structure inappropriate for cereal bar packaging, due to high reduction its mechanical properties after irradiation. (author)

  15. Intra-operative cerebrospinal fluid sampling versus post-operative lumbar puncture for detection of leptomeningeal disease in malignant paediatric brain tumours.

    Directory of Open Access Journals (Sweden)

    Sharon Y Y Low

    Full Text Available Leptomeningeal disease is a feared sequelae of malignant paediatric brain tumours. Current methods for its detection is the combined use of cranio-spinal MRI, and CSF cytology from a post-operative lumbar puncture. In this study, the authors hypothesize that CSF taken at the start of surgery, either from an external ventricular drain or neuroendoscope will have equal sensitivity for positive tumour cells, in comparison to lumbar puncture. Secondary hypotheses include positive correlation between CSF cytology and MRI findings of LMD. From a clinical perspective, the key aim of the study was for affected paediatric patients to avoid an additional procedure of a lumbar puncture, often performed under anaesthesia after neurosurgical intervention.This is single-institution, retrospective study of paediatric patients diagnosed with malignant brain tumours. Its main aim was to compare cytological data from CSF collected at the time of surgery versus data from an interval lumbar puncture. In addition, MRI imaging of the same cohort of patients was examined for leptomeningeal disease and corroborated against CSF tumour cytology findings.Thirty patients are recruited for this study. Data analysis demonstrates a statistically significant association between our intra-operative CSF and LP sampling. Furthermore, our results also show for significant correlation between evidence of leptomeningeal disease on MRI findings versus intra-operative CSF positivity for tumour cells.Although this is a retrospective study with a limited population, our data concurs with potential to avoid an additional procedure for the paediatric patient diagnosed with a malignant brain tumour.

  16. Suicide and accidental deaths in children and adolescents in England and Wales, 2001-2010.

    Science.gov (United States)

    Windfuhr, Kirsten; While, David; Hunt, Isabelle M; Shaw, Jenny; Appleby, Louis; Kapur, Nav

    2013-12-01

    To investigate the impact of narrative verdicts on suicide statistics among 10-19-year-olds; to identify the number and rate of suicide and accidental deaths, particularly in 10-14-year-olds. National cohort study. England and Wales. Mid-year population estimates from the Office for National Statistics (ONS) were used to calculate rates per 100,000 population for suicide (undetermined and suicide verdicts) and accidental deaths (poisoning, hanging) for those aged 10-14 and 15-19. Trends in rates over time (2001-2010) were investigated using Poisson regression. Interaction tests were carried out to determine differences in trends between the two time periods (2001-2005 and 2006-2010). There were 1523 suicides (2.25/100,000). Suicide rates were highest in those aged 15-19 years (4.04/100,000) and in males (3.14/100,000). Between 2001 and 2010, rates significantly decreased among those aged 15-19 years (incidence rate-ratio (IRR): 0.95; 95% CI 0.93 to 0.97), with no change in rates of accidental deaths (IRR: 1.01, 95% CI 0.95 to 1.07). However, there was a significant interaction between the two time periods for accidental poisonings (2001-2005: IRR: 0.79 (95% CI 0.69 to 0.91); 2006-2010: IRR: 1.01 (95% CI 0.89 to 1.15), interaction p=0.012) and accidental hangings (2001-2005: IRR: 0.93 (95% CI 0.76 to 1.14); 2006-2010: IRR: 1.25 (95% CI 1.04 to 1.49), interaction=0.01) Undetermined deaths significantly decreased among females aged 15-19 yeras (IRR: 0.93; 95% CI 0.88 to 0.98). There were no significant trends among 10-14-year-olds. Rates of suicide are higher among older adolescents and males. There was a significant fall in suicide rates in males aged 15-19 years that was not accounted for by changes in rates of accidental death. The absence of a significant trend in suicide or accidental deaths in those aged 10-14 years may have been the result of small numbers. However, monitoring should continue to identify longitudinal trends in all young people.

  17. Infusion cisternography

    International Nuclear Information System (INIS)

    Magnaes, B.; Rootwelt, K.; Sjaastad, O.

    1976-01-01

    A source of error in cerebrospinal fluid (CSF) infusion tests is leakage at the dural puncture site. The addition of a bolus of radionuclide to the infusion fluid was helpful in detecting the existence of leakage as shown by increased infusion pressure in six of eight patients studied with and without scintigraphic evidence of leakage. Comparison of CSF dynamics in 26 patients studied by infusion cisternography and conventional cisternography showed similar patterns, suggesting no alteration of CSF dynamics by the artificial CSF infusion. Combining the two tests, therefore, resulted in simple identification of the leakage and saved the patient time and discomfort

  18. Experimental study on venography with carbon dioxide by fine-needle direct-puncture of abdominal viscera

    International Nuclear Information System (INIS)

    Zhu Chi; Xu Changliang; Zhang Dezhi; Zheng Feiqun; Sheng Qiang; Zhang Xiuze; Xiong Zhuang; Yu Yongqiang

    2005-01-01

    Objective: To evaluate the feasibility and safety of CO 2 venography by fine-needle direct-puncture of abdominal viscera. Methods: Two healthy female pigs and two healthy female dogs were used in this study. Multi-point punctures of abdominal viscera including liver, spleen, kidney, pancreas, walls of small intestines, and uterus with 25-gauge needle were performed for CO 2 venography in all animals. Diagnostic image quality of the angiographic images was assessed by 3 independent observers. Results: Splenic-portal vein, hepatic vein, portal vein, renal vein and inferior vena cava, uterine vein and ovarian vein could be visualized by fine needle direct CO 2 injection into the related organic parenchyma, while draining vein of small intestines and pancreas could not be shown. Splenic-portal veins were revealed especially well with grade A of 87.5% (7/8) , grade B of 12.5% (1/8), and grade C of 0%. The image quality of hepatic veins were 81.8% (9/11), 18.2% (2/11), and 0% for grade A, B, and C, respectively. The portal veins were 77.8% (7/9), 22.2%(2/9), and 0% for grade A, B, and C, respectively. The renal vein and inferior vena cava were 38.5% (5/13), 61.5% (8/13), and 0% for grade A, B, and C respectively. The uterine veins and ovarian veins were 0%, 33.3% (2/6), and 66.7% (4/6) for grade A, B, and C, respectively. During the CO 2 angiographic procedure, vital signs remained stable in all animals. Conclusion: CO 2 venography with fine-needle direct-puncture of abdominal viscera, excluding small intestines and pancreas, is feasible and safe. (authors)

  19. Rapid Clearance of Lateral Ventricular Hematoma via Frontal Eminence Puncture and Aspiration: A Technical Note.

    Science.gov (United States)

    Li, Zhaojian; Yao, Weicheng; Han, Kun; Lan, Xiaolei; Bo, Yongli

    2017-01-01

    Background  Intraventricular extension of a parenchymal hemorrhage is an independent predictor of poor outcome and might be complicated by delayed hydrocephalus. We describe a method for the rapid and effective removal of a lateral ventricular hematoma via catheter-based puncture and aspiration. Methods  A catheter-based aspiration of a ventricular hematoma via a frontal eminence (FE) puncture was performed in 10 patients with thalamic and ganglionic hemorrhage perforating into the lateral ventricle. Paralleling the long axis of the lateral ventricle, a flexible silicone catheter was moved anteroposteriorly and rotated simultaneously to facilitate clot aspiration and removal. Computed tomography scans before and after surgery were compared for assessment of ventricular clot volume, Graeb score, and the ventriculocranial ratio (VCR). The Glasgow Coma Scale (GCS) score and Glasgow Outcome Scale (GOS) score were assessed at 14 days and 12 months following surgery, respectively. Results  In all 10 patients, catheter-based aspiration resulted in substantial hematoma removal with a clearance rate of 64.9%, a reduced Graeb score by 61.8%, and an elevated GCS score by 52.7%. The procedure was performed safely without occurrence of another hemorrhage, infection, and catheter obstruction in any case. At 12-month follow-up, VCR was reduced by 22.5%, no delayed hydrocephalus occurred, and a favorable outcome with an average GOS of 4.6 was observed in this small cohort of patients. Conclusion  Catheter-based aspiration of a ventricular hematoma via FE puncture rapidly, efficiently, and safely reduced the clot in the ventricular system, prevented delayed hydrocephalus sufficiently, and produced a favorable outcome. Georg Thieme Verlag KG Stuttgart · New York.

  20. The effect of self-selected soothing music on fistula puncture-related pain in hemodialysis patients.

    Science.gov (United States)

    Shabandokht-Zarmi, Hosniyeh; Bagheri-Nesami, Masoumeh; Shorofi, Seyed Afshin; Mousavinasab, Seyed Nouraddin

    2017-11-01

    This study was intended to examine the effect of selective soothing music on fistula puncture-related pain in hemodialysis patients. This is a randomized clinical trial in which 114 participants were selected from two hemodialysis units by means of a non-random, convenience sampling method. The participants were then allocated in three groups of music (N = 38), headphone (N = 38), and control (N = 38). The fistula puncture-related pain was measured 1 min after venipuncture procedure in all three groups. The music group listened to their self-selected and preferred music 6 min before needle insertion into a fistula until the end of procedure. The headphone group wore a headphone alone without listening to music 6 min before needle insertion into a fistula until the end of procedure. The control group did not receive any intervention from the research team during needle insertion into a fistula. The pain intensity was measured immediately after the intervention in all three groups. This study showed a significant difference between the music and control groups, and the music and headphone groups in terms of the mean pain score after the intervention. However, the analysis did not indicate any significant difference between the headphone and control groups with regard to the mean pain score after the intervention. It is concluded that music can be used effectively for pain related to needle insertion into a fistula in hemodialysis patients. Future research should investigate the comparative effects of pharmacological and non-pharmacological interventions on fistula puncture-related pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Accidental poisoning with autumn crocus.

    Science.gov (United States)

    Gabrscek, Lucija; Lesnicar, Gorazd; Krivec, Bojan; Voga, Gorazd; Sibanc, Branko; Blatnik, Janja; Jagodic, Boris

    2004-01-01

    We describe a case of a 43-yr-old female with severe multiorgan injury after accidental poisoning with Colchicum autumnale, which was mistaken for wild garlic (Allium ursinum). Both plants grow on damp meadows and can be confused in the spring when both plants have leaves but no blossoms. The autumn crocus contains colchicine, which inhibits cellular division. Treatment consisted of supportive care, antibiotic therapy, and granulocyte-directed growth factor. The patient was discharged from the hospital after three weeks. Three years after recovery from the acute poisoning, the patient continued to complain of muscle weakness and intermittent episodes of hair loss.

  2. Results of dose calculations for NET accidental and normal operation releases of tritium and activation products

    International Nuclear Information System (INIS)

    Raskob, W.; Hasemann, I.

    1992-08-01

    This report documents conditions, data and results of dose calculations for accidental and normal operation releases of tritium and activation products, performed within the NET subtask SEP2.2 ('NET-Benchmark') of the European Fusion Technology Programme. For accidental releases, the computer codes UFOTRI and COSYMA for assessing the radiological consequences, have been applied for both deterministic and probabilistic calculations. The influence on dose estimates of different release times (2 minutes / 1 hour), two release heights (10 m / 150 m), two chemical forms of tritium (HT/HTO), and two different model approaches for the deposition velocity of HTO on soil was investigated. The dose calculations for normal operation effluents were performed using the tritium model of the German regulatory guidelines, parts of the advanced dose assessment model NORMTRI still under development, and the statistical atmospheric dispersion model ISOLA. Accidental and normal operation source terms were defined as follows: 10g (3.7 10 15 Bq) for accidental tritium releases, 10 Ci/day (3.7 10 11 Bq/day) for tritium releases during normal operation and unit releases of 10 9 Bq for accidental releases of activation products and fission products. (orig./HP) [de

  3. Dosimetric significance of cytogenetic examinations in human accidental over exposures

    International Nuclear Information System (INIS)

    Doloy-Biola, M.T.; Lego, R.; Ducatez, G.; Lepetit, J.; Bourguignon, M.

    1975-01-01

    The damage to 13 workers following accidental exposures was assessed from lymphocyte chromosomal aberrations, and the results compared with those supplied by physical dosimetry and the clinical syndromes [fr

  4. Accidental transection of flexometallic endotracheal tube during partial maxillectomy

    Directory of Open Access Journals (Sweden)

    Sushma D Ladi

    2011-01-01

    Full Text Available We report a rare case of an 18-year-old female patient in whom accidental sectioning of flexometallic endotracheal tube occurred during partial maxillectomy for mass lesion under general anaesthesia. She was managed successfully by tracheostomy.

  5. Computer code to assess accidental pollutant releases

    International Nuclear Information System (INIS)

    Pendergast, M.M.; Huang, J.C.

    1980-07-01

    A computer code was developed to calculate the cumulative frequency distributions of relative concentrations of an air pollutant following an accidental release from a stack or from a building penetration such as a vent. The calculations of relative concentration are based on the Gaussian plume equations. The meteorological data used for the calculation are in the form of joint frequency distributions of wind and atmospheric stability

  6. Limits to radioactive effluents and countermeasures in accidental situations

    International Nuclear Information System (INIS)

    Nowotny, G.; Gonzalez, A.

    1978-01-01

    The paper discusses the criteria used by the Argentine Atomic Energy Commission, as competent authority, to set limits to radioactive effluents from nuclear installations. It also discusses the selection of action levels for carrying out countermeasures in accidental situations. (author)

  7. Accuracy and feasibility of frameless stereotactic and robot-assisted CT-based puncture in interventional radiology. A comparative phantom study

    International Nuclear Information System (INIS)

    Stoffner, R.; Widmann, G.; Bale, R.; Augschoell, C.; Boehler, D.

    2009-01-01

    Purpose: To compare the accuracy of frameless stereotactic and robot-assisted puncture in vitro based on computed tomography (CT) imaging with a slice thickness of 1, 3, and 5 mm. Materials and Methods: 300 punctures were carried out with help of the Atlas aiming device guided by the optical navigation system Stealth Station TREONplus and 150 punctures were guided by the robotic assistance system Innomotion. Conically shaped rods were punctured with Kirschner wires. The accuracy was evaluated on the basis of control CTs by measuring the Euclidean distance between the wire tip and target and the normal distance between the target and wire. Results: With the Stealth Station a mean Euclidean distance of 1.94±0.912, 2.2±1.136, and 2.74±1.166 mm at a slice thickness of 1, 3 and 5 mm, respectively, was reached. The mean normal distance was 1.64±0.919, 1.84±1.189, and 2.48±1.196 mm, respectively. The Innomotion system resulted in a mean Euclidean distance of 1.69±0.772, 1.91±0.673, and 2.30±0.881 mm, respectively, while the mean normal distance was (1.42±0.78), 1.60±0.733, and 1.98±1.002 mm, respectively. A statistical significance between accuracies with both systems with 1 mm and 3 mm slices could not be detected (p > 0.05). At a slice thickness of 5 mm, the robot was significantly more accurate, but not as accurate as when using thinner slices (p < 0.05). The procedure time is longer for the Innomotion system (∝30 vs. ∝18 min), and the practicability is higher with the Stealth Station. (orig.)

  8. Accidental Childhood Poisoning in Enugu, South‑East, Nigeria

    African Journals Online (AJOL)

    Accidental childhood poisoning is one of the recognized causes of ... are those undergoing the oral phase of their psychological development. .... Palm oil ingestion and induction of emesis were the most commonly used ... poisoning. Kerosene is found in most homes in Nigeria as it is the ... Ingestion of coconut water. 2. 3.1.

  9. Natural convection accidental conditions in nuclear power plants

    International Nuclear Information System (INIS)

    Delmastro, D.F.; Clausse, A.

    1990-01-01

    Under certain conditions, wether accidental or in nuclear reactor design, a nuclear reactor core may be found to be refrigerated by a fluid in natural circulation. Before the possible density waves phenomenon occurrence, it is essential to have a good knowledge of the flow evolution and thermohydraulic variables under these conditions. (Author) [es

  10. Accidental Childhood Poisoning in Enugu, South‑East, Nigeria ...

    African Journals Online (AJOL)

    Background: Accidental childhood poisoning is one of the recognized causes of morbidity and mortality in children under the age of 5 years worldwide. The prevalence and type of substance ingested vary from place to place and over time. Aim: This study was conducted with the aim of ascertaining the frequency and ...

  11. FACTORES DE RIESGO QUE OCASIONAN ACCIDENTES LABORALES EN EL PERSONAL DE ENFERMERÍA DE UNA CLÍNICA ACREDITADA DE LA CIUDAD DE AREQUIPA, 2007-2008

    OpenAIRE

    GARCIA SUTTA, PATRICIA CONCEPCION

    2014-01-01

    FACTORES DE RIESGO CONCEPTUALIZACIÓN TIPOS RIESGOS NO MECÁNICOS RUIDOS RADIACIONES IONIZANTES ILUMINACIÓN CALOR FRÍO RIESGOS FÍSICOS MECÁNICOS RIESGOS QUÍMICOS RIESGOS ERGONÓMICOS POSTURA RIESGOS BIOLÓGICOS CARGA DE TRABAJO LABORAL DEFINICIÓN ACCIDENTES LABORALES ACCIDENTE CAUSAS BÁSICAS Y CAUSAS INMEDIATAS ACCIDENTES LABORALES CAUSAS DE LOS ACCIDENTES TIPOS DE ACCIDENTE TIPOS DE ACCIDENTES LABORALES

  12. Screen for intracranial dural arteriovenous fistulae with carotid duplex sonography.

    Science.gov (United States)

    Tsai, L-K; Yeh, S-J; Chen, Y-C; Liu, H-M; Jeng, J-S

    2009-11-01

    Early diagnosis and management of intracranial dural arteriovenous fistulae (DAVF) may prevent the occurrence of stroke. This study aimed to identify the best carotid duplex sonography (CDS) parameters for screening DAVF. 63 DAVF patients and 170 non-DAVF patients received both CDS and conventional angiography. The use of seven CDS haemodynamic parameter sets related to the resistance index (RI) of the external carotid artery (ECA) for the diagnosis of DAVF was validated and the applicability of the best CDS parameter set in 20 400 patients was tested. The CDS parameter set (ECA RI (cut-off point = 0.7) and internal carotid artery (ICA) to ECA RI ratio (cut-off point = 0.9)) had the highest specificity (99%) for diagnosis of DAVF with moderate sensitivity (51%). Location of the DAVF was a significant determinant of sensitivity of detection, which was 70% for non-cavernous DAVF and 0% for cavernous sinus DAVF (pdetected abnormality in 92 of 20 400 patients. These abnormalities included DAVF (n = 25), carotid stenosis (n = 32), vertebral artery stenosis (n = 7), intracranial arterial stenosis (n = 6), head and neck tumour (n = 3) and unknown aetiology (n = 19). Combined CDS parameters of ECA RI and ICA to ECA RI ratio can be used as a screening tool for the diagnosis of DAVF.

  13. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  14. Prospective Nonrandomized Trial of Manual Compression and Angio-Seal and Starclose Arterial Closure Devices in Common Femoral Punctures

    International Nuclear Information System (INIS)

    Ratnam, Lakshmi A.; Raja, Jowad; Munneke, Graham J.; Morgan, Robert A.; Belli, Anna-Maria

    2007-01-01

    We compared the use of manual compression and Angio-Seal and Starclose arterial closure devices to achieve hemostasis following common femoral artery (CFA) punctures in order to evaluate safety and efficacy. A prospective nonrandomized, single-center study was carried out on all patients undergoing CFA punctures over 1 year. Hemostasis was achieved using manual compression in 108 cases, Angio-Seal in 167 cases, and Starclose in 151 cases. Device-failure rates were low and not significantly different in the two groups (manual compression and closure devices; p = 0.8). There were significantly more Starclose (11.9%) patients compared to Angio-Seal (2.4%), with successful initial deployment subsequently requiring additional manual compression to achieve hemostasis (p < 0.0001). A significant number of very thin patients failed to achieve hemostasis (p = 0.014). Major complications were seen in 2.9% of Angio-Seal, 1.9% of Starclose, and 3.7% of manual compression patients, with no significant difference demonstrated; 4.7% of the major complications were seen in female patients compared to 1.3% in males (p = 0.0415). All three methods showed comparable safety and efficacy. Very thin patients are more likely to have failed hemostasis with the Starclose device, although this did not translate into an increased complication rate. There is a significant increased risk of major puncture-site complications in women with peripheral vascular disease

  15. Leading global projects for professional and accidental project leaders

    CERN Document Server

    Moran, Robert T

    2008-01-01

    This book is a must-read for anyone responsible for projects and initiatives that span functional and geographical divides. Authors Moran and Youngdahl bring extensive experience and learning from industry practice to present a clear and straightforward treatment of the leadership skills and knowledge required to lead projects that are global in nature. They have written the first book of its kind to address the three essential skills of global project leaders - strategic project management, project leadership, and cross-cultural leadership. The authors argue that global project leadership is an essential skill in our project-based world and that we are all either intentional or accidental project leaders. Intentional project leaders pursue formal project management education and even certification whereas accidental project leaders find themselves leading global projects and initiatives as a result of a special assignment or promotion. Moran and Youndahl have found that the vast majority of global projects ...

  16. Non-accidental injury: a review of the radiology

    International Nuclear Information System (INIS)

    Carty, H.

    1997-01-01

    There have been many descriptions of the radiological features of non-accidental injury since John Caffey introduced the concept of inflicted injury and initially described some of the patterns of injury. Since then, our understanding of the radiologically detectable injuries has increased. This article provides a review of our current understanding of the lesions. (orig.)

  17. Accidental Beam Losses and Protection in the LHC

    Science.gov (United States)

    Schmidt, R.; Working Group On Machine Protection

    2005-06-01

    At top energy (proton momentum 7 TeV/c) with nominal beam parameters, each of the two LHC proton beams has a stored energy of 350 MJ threatening to damage accelerator equipment in case of accidental beam loss. It is essential that the beams are properly extracted onto the dump blocks in case of failure since these are the only elements that can withstand full beam impact. Although the energy stored in the beams at injection (450 GeV/c) is about 15 times smaller compared to top energy, the beams must still be properly extracted in case of large accidental beam losses. Failures must be detected at a sufficiently early stage and initiate a beam dump. Quenches and power converter failures will be detected by monitoring the correct functioning of the hardware systems. In addition, safe operation throughout the cycle requires the use of beam loss monitors, collimators and absorbers. Ideas of detection of fast beam current decay, monitoring of fast beam position changes and monitoring of fast magnet current changes are discussed, to provide the required redundancy for machine protection.

  18. Accidental Beam Losses and Protection in the LHC

    International Nuclear Information System (INIS)

    Schmidt, R.; Wenninger, J.

    2005-01-01

    At top energy (proton momentum 7 TeV/c) with nominal beam parameters, each of the two LHC proton beams has a stored energy of 350 MJ threatening to damage accelerator equipment in case of accidental beam loss. It is essential that the beams are properly extracted onto the dump blocks in case of failure since these are the only elements that can withstand full beam impact. Although the energy stored in the beams at injection (450 GeV/c) is about 15 times smaller compared to top energy, the beams must still be properly extracted in case of large accidental beam losses. Failures must be detected at a sufficiently early stage and initiate a beam dump. Quenches and power converter failures will be detected by monitoring the correct functioning of the hardware systems. In addition, safe operation throughout the cycle requires the use of beam loss monitors, collimators and absorbers. Ideas of detection of fast beam current decay, monitoring of fast beam position changes and monitoring of fast magnet current changes are discussed, to provide the required redundancy for machine protection

  19. Removal of non-deflatable retained foley catheter in the bladder by percutaneous puncture of catheter balloon

    International Nuclear Information System (INIS)

    Yoo, Jae Duk; Kim, Jae Kyu; Park, Jin Gyun; Chung, Hyon De

    1988-01-01

    Nondeflatable Foley catheter in the bladder is an uncommon event. We recently experienced a patient in whom the urologist were unable to remove a Foley catheter with cystoscope due to public bone fractures. The procedure, which was successfully carried out, consists of puncturing the ballon under fluoroscope.

  20. CT-Guided Superior Vena Cava Puncture: A Solution to Re-Establishing Access in Haemodialysis-Related Central Venous Occlusion Refractory to Conventional Endovascular Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Khalifa, Mohamed, E-mail: mkhalifa@nhs.net; Patel, Neeral R., E-mail: neeral.patel06@gmail.com; Moser, Steven, E-mail: steven.moser@imperial.nhs.uk [Hammersmith Hospital, Department of Radiology, Imperial College Healthcare NHS Trust (United Kingdom)

    2016-04-15

    PurposeThe purpose of this technical note is to demonstrate the novel use of CT-guided superior vena cava (SVC) puncture and subsequent tunnelled haemodialysis (HD) line placement in end-stage renal failure (ESRF) patients with central venous obstruction refractory to conventional percutaneous venoplasty (PTV) and wire transgression, thereby allowing resumption of HD.MethodsThree successive ESRF patients underwent CT-guided SVC puncture with subsequent tract recanalisation. Ultrasound-guided puncture of the right internal jugular vein was performed, the needle advanced to the patent SVC under CT guidance, with subsequent insertion of a stabilisation guidewire. Following appropriate tract angioplasty, twin-tunnelled HD catheters were inserted and HD resumed.ResultsNo immediate complications were identified. There was resumption of HD in all three patients with a 100 % success rate. One patient’s HD catheter remained in use for 2 years post-procedure, and another remains functional 1 year to the present day. One patient died 2 weeks after the procedure due to pancreatitis-related abdominal sepsis unrelated to the Tesio lines.ConclusionCT-guided SVC puncture and tunnelled HD line insertion in HD-related central venous occlusion (CVO) refractory to conventional recanalisation options can be performed safely, requires no extra equipment and lies within the skill set and resources of most interventional radiology departments involved in the management of HD patients.

  1. Development of Postdural Puncture Headache Following Therapeutic Acupuncture Using a Long Acupuncture Needle

    OpenAIRE

    Jo, Dae-Jean; Lee, Bong Jae; Sung, Joon Kyung; Yi, Jae-Woo

    2010-01-01

    Acupuncture appears to be a clinically effective treatment for acute and chronic pain. A considerable amount of research has been conducted to evaluate the role that acupuncture plays in pain suppression; however, few studies have been conducted to evaluate the side effects of the acupuncture procedure. This case report describes a suspected postdural puncture headache following acupuncture for lower back pain. Considering the high opening pressure, cerebrospinal fluid leakage, and the patien...

  2. The Accidental Transgressor: Morally-Relevant Theory of Mind

    Science.gov (United States)

    Killen, Melanie; Mulvey, Kelly Lynn; Richardson, Cameron; Jampol, Noah; Woodward, Amanda

    2011-01-01

    To test young children's false belief theory of mind in a morally relevant context, two experiments were conducted. In Experiment 1, children (N=162) at 3.5, 5.5, and 7.5 years of age were administered three tasks: prototypic moral transgression task, false belief theory of mind task (ToM), and an "accidental transgressor" task, which measured a…

  3. Safety assessment technology on the free drop impact and puncture analysis of the cask for radioactive material transport

    International Nuclear Information System (INIS)

    Lee, Dew Hey; Lee, Young Shin; Ryu, Chung Hyun; Kim, Hyun Su; Lee, Ho Chul; Hong, Song Jin; Choi, Young Jin; Lee, Jae Hyung; Na, Jae Yun

    2001-03-01

    In this study, the regulatory condition and analysis condition is analyzed for the free drop and puncture impact analysis to develop the safety assessment technology. Impact analysis is performed with finite element method which is one of the many analysis methods of the shipping cask. LS-DYNA3D and ABAQUS is suitable for the free drop and the puncture impact analysis of the shipping cask. For the analysis model, the KSC-4 that is the shipping cask to transport spent nuclear fuel is investigated. The results of both LS-DYNA3D and ABAQUS is completely corresponded. And The integrity of the shipping cask is verified. Using this study, the reliable safety assessment technology is supplied to the staff. The efficient and reliable regulatory tasks is performed using the standard safety assessment technology

  4. Safety assessment technology on the free drop impact and puncture analysis of the cask for radioactive material transport

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dew Hey [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of); Lee, Young Shin; Ryu, Chung Hyun; Kim, Hyun Su; Lee, Ho Chul; Hong, Song Jin; Choi, Young Jin; Lee, Jae Hyung; Na, Jae Yun [Chungnam National Univ., Taejon (Korea, Republic of)

    2001-03-15

    In this study, the regulatory condition and analysis condition is analyzed for the free drop and puncture impact analysis to develop the safety assessment technology. Impact analysis is performed with finite element method which is one of the many analysis methods of the shipping cask. LS-DYNA3D and ABAQUS is suitable for the free drop and the puncture impact analysis of the shipping cask. For the analysis model, the KSC-4 that is the shipping cask to transport spent nuclear fuel is investigated. The results of both LS-DYNA3D and ABAQUS is completely corresponded. And The integrity of the shipping cask is verified. Using this study, the reliable safety assessment technology is supplied to the staff. The efficient and reliable regulatory tasks is performed using the standard safety assessment technology.

  5. Accidental degeneracy of double Dirac cones in a phononic crystal

    KAUST Repository

    Chen, Ze-Guo; Ni, Xu; Wu, Ying; He, Cheng; Sun, Xiao-Chen; Zheng, Li-Yang; Lu, Ming-Hui; Chen, Yan-Feng

    2014-01-01

    Artificial honeycomb lattices with Dirac cone dispersion provide a macroscopic platform to study the massless Dirac quasiparticles and their novel geometric phases. In this paper, a quadruple-degenerate state is achieved at the center of the Brillouin zone in a two-dimensional honeycomb lattice phononic crystal, which is a result of accidental degeneracy of two double-degenerate states. In the vicinity of the quadruple-degenerate state, the dispersion relation is linear. Such quadruple degeneracy is analyzed by rigorous representation theory of groups. Using method, a reduced Hamiltonian is obtained to describe the linear Dirac dispersion relations of this quadruple-degenerate state, which is well consistent with the simulation results. Near such accidental degeneracy, we observe some unique properties in wave propagating, such as defect-insensitive propagating character and the Talbot effect.

  6. Accidental degeneracy of double Dirac cones in a phononic crystal

    KAUST Repository

    Chen, Ze-Guo

    2014-04-09

    Artificial honeycomb lattices with Dirac cone dispersion provide a macroscopic platform to study the massless Dirac quasiparticles and their novel geometric phases. In this paper, a quadruple-degenerate state is achieved at the center of the Brillouin zone in a two-dimensional honeycomb lattice phononic crystal, which is a result of accidental degeneracy of two double-degenerate states. In the vicinity of the quadruple-degenerate state, the dispersion relation is linear. Such quadruple degeneracy is analyzed by rigorous representation theory of groups. Using method, a reduced Hamiltonian is obtained to describe the linear Dirac dispersion relations of this quadruple-degenerate state, which is well consistent with the simulation results. Near such accidental degeneracy, we observe some unique properties in wave propagating, such as defect-insensitive propagating character and the Talbot effect.

  7. Angio-Architectural Features of High-Grade Intracranial Dural Arteriovenous Fistulas: Correlation With Aggressive Clinical Presentation and Hemorrhagic Risk.

    Science.gov (United States)

    Della Pepa, Giuseppe Maria; Parente, Paolo; D'Argento, Francesco; Pedicelli, Alessandro; Sturiale, Carmelo Lucio; Sabatino, Giovanni; Albanese, Alessio; Puca, Alfredo; Fernandez, Eduardo; Olivi, Alessando; Marchese, Enrico

    2017-08-01

    High-grade dural arteriovenous fistulas (dAVFs) can present shunts with very different angio-architectural characteristics. Specific hemodynamic factors may affect clinical history and determine very different clinical courses. To evaluate the relationship between some venous angio-architectural features in high-grade dAVFs and clinical presentation. Specific indicators of moderate or severe venous hypertension were analyzed, such as altered configurations of the dural sinuses (by a single or a dual thrombosis), or overload of cortical vessels (restrictions of outflow, pseudophlebitic cortical vessels, and venous aneurysms). The institutional series was retrospectively reviewed (49 cases), and the pattern of venous drainage was analyzed in relationship with clinical presentation (benign/aggressive/hemorrhage). Thirty-five of 49 cases displayed cortical reflux (high-grade dAVFs). This subgroup displayed a benign presentation in 31.42% of cases, an aggressive in 31.42%, and hemorrhage in 37.14%. Our data confirm that within high-grade dAVFs, 2 distinct subpopulations exist according to severity of clinical presentation. Some indicators we examined showed correlation with aggressive nonhemorrhagic manifestations (outflow restriction and pseudophlebitic cortical vessels), while other showed a correlation with hemorrhage (dual thrombosis and venous aneurysms). Current classifications appear insufficient to identify a wide range of conditions that ultimately determine the organization of the cortical venous drainage. Intermediate degrees of venous congestion correlate better with the clinical risk than the simple definition of cortical reflux. The angiographic aspects of venous drainage presented in this study may prove useful to assess dAVF hemodynamic characteristics and identify conditions at higher clinical risk. Copyright © 2017 by the Congress of Neurological Surgeons

  8. Design of ACM system based on non-greedy punctured LDPC codes

    Science.gov (United States)

    Lu, Zijun; Jiang, Zihong; Zhou, Lin; He, Yucheng

    2017-08-01

    In this paper, an adaptive coded modulation (ACM) scheme based on rate-compatible LDPC (RC-LDPC) codes was designed. The RC-LDPC codes were constructed by a non-greedy puncturing method which showed good performance in high code rate region. Moreover, the incremental redundancy scheme of LDPC-based ACM system over AWGN channel was proposed. By this scheme, code rates vary from 2/3 to 5/6 and the complication of the ACM system is lowered. Simulations show that more and more obvious coding gain can be obtained by the proposed ACM system with higher throughput.

  9. Accidental radioisotope burns - Management of late sequelae

    Directory of Open Access Journals (Sweden)

    Varghese Bipin

    2010-10-01

    Full Text Available Accidental radioisotope burns are rare. The major components of radiation injury are burns, interstitial pneumonitis, acute bone marrow suppression, acute renal failure and adult respiratory distress syndrome. Radiation burns, though localized in distribution, have systemic effects, and can be extremely difficult to heal, even after multiple surgeries. In a 25 year old male who sustained such trauma by accidental industrial exposure to Iridium192 the early presentation involved recurrent haematemesis, pancytopenia and bone marrow suppression. After three weeks he developed burns in contact areas in the left hand, left side of the chest, abdomen and right inguinal region. All except the inguinal wound healed spontaneously but the former became a non-healing ulcer. Pancytopenia and bone marrow depression followed. He was treated with morphine and NSAIDs, epidural buprinorphine and bupivicaine for pain relief, steroids, antibiotics followed by wound excision and reconstruction with tensor fascia lata(TFL flap. Patient had breakdown of abdominal scar later and it was excised with 0.5 cm margins up to the underlying muscle and the wound was covered by a latissimis dorsi flap. Further scar break down and recurrent ulcers occurred at different sites including left wrist, left thumb and right heel in the next two years which needed multiple surgical interventions.

  10. Ventricular fibrillation after accidental injection of bupivacaine into the pericardium

    NARCIS (Netherlands)

    Even, B. J.; de Jongh, R. F.; de Hert, S. G.

    1992-01-01

    A postoperative cardiac surgical patient developed ventricular fibrillation immediately after accidental pericardial injection of bupivacaine at room temperature. The possible causes, which include systemic toxicity, local vasoconstriction with myocardial ischaemia, local toxic effect of bupivacaine

  11. Timing, severity of deficits, and clinical improvement after surgery for spinal dural arteriovenous fistulas.

    Science.gov (United States)

    Safaee, Michael M; Clark, Aaron J; Burkhardt, Jan-Karl; Winkler, Ethan A; Lawton, Michael T

    2018-04-20

    OBJECTIVE Spinal dural arteriovenous fistulas (dAVFs) are rare vascular abnormalities caused by arteriovenous shunting. They often form at the dural root sleeve between a radicular feeding artery and draining medullary vein causing venous congestion and edema, decreased perfusion, and ischemia of the spinal cord. Treatment consists of either surgical ligation of the draining vein or selective embolization via an endovascular approach. There is a paucity of data on which modality provides more durable and effective outcomes. METHODS The authors performed a retrospective review of a prospectively maintained database by the senior author to assess clinical outcomes in patients undergoing surgical treatment of spinal dAVFs. Preoperative and postoperative motor and Aminoff-Logue Scale (ALS) scores were collected. RESULTS A total of 41 patients with 44 spinal dAVFs were identified, with a mean patient age of 64 years. The mean symptom duration was 14 months, with weakness (82%), urinary symptoms (47%), and sensory symptoms (29%) at presentation. The fistula locations were as follows: 30 thoracic, 9 lumbar, 3 sacral, and 2 cervical. Five patients had normal motor and ALS scores at presentation. Among the remaining 36 patients with motor deficits or abnormal gait and micturition at presentation, 78% experienced an improvement while the remaining 22% continued to be stable. There was a trend toward improved outcomes in patients with shorter symptom duration; mean symptom duration among patients with clinical improvement was 13 months compared with 22 months among those without improvement. Additionally, rates of improvement were higher for lower thoracic and lumbosacral dAVFs (85% and 83%) compared with those in the upper thoracic spine (57%). No patient developed recurrent fistulas or worsening neurological deficits. CONCLUSIONS Surgery is associated with excellent outcomes in the treatment of spinal dAVFs. Early diagnosis and treatment are critical, with a trend toward

  12. Accidentes de trabajo en el Hospital Clínico de la Universidad de Chile durante el año 2007

    Directory of Open Access Journals (Sweden)

    Carlos Valdés

    2011-01-01

    Full Text Available Objetivo: Conocer el número de los accidentes laborales en el Hospital Clínico de la Universidad de Chile (HCUCH el año 2007 y su caracterización de acuerdo a variables como: sexo, edad, tipo de lesión, día de la semana, mes del año, cargo desempeñado y días perdidos. Diseño: Estudio descriptivo, transversal, retrospectivo y observacional. Lugar: Hospital Clínico de la Universidad de Chile (HCUCH. Participantes: Accidentes laborales reportados entre el 1 de Enero y el 31 de Diciembre del 2007. Intervención: Se utilizó la base de datos del Registro de Notificación de Accidentes Laborales, proporcionada por el Departamento de Prevención de Riesgos del HCUCH Principales medidas de Resultados: Porcentajes y Medidas de Tendencia Central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows ®. Resultados: Se observan 104 accidentes laborales, con un mayor número de eventos en el personal femenino (69,2%, en el rango etareo de 30-39 años (34,3%, el tipo de lesión más frecuente fueron las contusiones policontusiones (39,4%, el grupo más accidentado fue los auxiliares y técnicos (71.1%. El estudio por días de la semana revela que hay más accidentes los días miércoles y jueves (43,27% y los meses del año con más accidentes fueron enero, agosto y diciembre. La mayor cantidad de accidentes laborales comprometen entre 1 a 5 días perdidos. Conclusiones: Durante el año 2007, se pesquisó 104 accidentes laborales, lo que significó 804 días de ausentismo. Este estudio muestra que el sexo femenino, tener entre 30-39 años y ejercer como auxiliar o técnico fueron factores de asociados al incremento de los accidentes laborales. Palabras clave: Accidentes de trabajo, ausentismo, notificación de accidentes de trabajo.

  13. Accidental bound states in the continuum in an open Sinai billiard

    Energy Technology Data Exchange (ETDEWEB)

    Pilipchuk, A.S. [Kirensky Institute of Physics, Federal Research Center KSC SB RAS, 660036 Krasnoyarsk (Russian Federation); Siberian Federal University, 660080 Krasnoyarsk (Russian Federation); Sadreev, A.F., E-mail: almas@tnp.krasn.ru [Kirensky Institute of Physics, Federal Research Center KSC SB RAS, 660036 Krasnoyarsk (Russian Federation)

    2017-02-19

    The fundamental mechanism of the bound states in the continuum is the full destructive interference of two resonances when two eigenlevels of the closed system are crossing. There is, however, a wide class of quantum chaotic systems which display only avoided crossings of eigenlevels. As an example of such a system we consider the Sinai billiard coupled with two semi-infinite waveguides. We show that notwithstanding the absence of degeneracy bound states in the continuum occur due to accidental decoupling of the eigenstates of the billiard from the waveguides. - Highlights: • Bound states in the continuum in open chaotic billiards occur to accidental vanishing of coupling of eigenstate of billiard with waveguides.

  14. Accidental deposition of local anaesthetic in the subdural space ...

    African Journals Online (AJOL)

    The incidence of accidental injection of local anaesthetic into the subdural space during neuraxial blockade is rare. The presentation of unexplainable clinical signs that do not match the clinical picture of subarachnoid or intravascular injection of the local anaesthetic agent should invoke high suspicion of unintentional ...

  15. Accidental Carbon Monoxide Poisonings in Adana, Turkey: A 14-year Study

    Directory of Open Access Journals (Sweden)

    Murat Darçın

    2017-03-01

    Full Text Available Aim: Carbon monoxide (CO is often referred to as the “silent killer” because its victims cannot see it, smell it or taste it. CO is responsible for a large percentage of the accidental poisonings and deaths reported throughout the world. CO poisoning therefore is considered a serious global health threat. The aim of the present study was to describe the cases of CO poisoning in a rural areas of Adana, Turkey between 2002 and 2015 based on data collected from incident reports. Methods: The cases of accidental CO poisoning were statistically analyzed. During that period, 74 incidents occurred and 154 people were poisoned by accidental CO poisoning. Results: The results of this analysis indicate that men and adults aged ≥65 years were more likely to die from CO poisoning than others. The number of CO poisoning cases was highest during the heating season. The majority (72% of poisoning resulting in hospitalization with a life-threatening condition or death occurred within the home. Conclusion: CO poisoning is a serious danger. People must be informed about this hazard. By educating risk groups about the dangers of CO poisoning, it is possible to save many lives as well as reduce the health risks.

  16. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    International Nuclear Information System (INIS)

    Issy, A.C.; Castania, V.; Castania, M.; Salmon, C.E.G.; Nogueira-Barbosa, M.H.; Bel, E. Del; Defino, H.L.A.

    2013-01-01

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration

  17. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Issy, A.C.; Castania, V.; Castania, M. [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Salmon, C.E.G. [Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Nogueira-Barbosa, M.H. [Divisão de Radiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Bel, E. Del [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Defino, H.L.A. [Departamento de Biomecânica, Medicina e Reabilitação do Sistema Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-03-15

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  18. Fratura de agulha durante punção subaracnóidea: relato de caso Fractura de aguja durante punción subaracnóidea: relato de caso Needle fracture during spinal puncture: case report

    Directory of Open Access Journals (Sweden)

    Marcos G C Cruvinel

    2004-12-01

    introduction and consequent decrease in post dural puncture headache, spinal anesthesia is being increasingly used. Its complications are uncommon however recently we have observed a seemingly unusual complication: needle fracture during spinal puncture. This report aimed at describing the fact and at pointing its possible causes in addition to its prevention. CASE REPORT: Male patient, 53 years old, 90 kg, 175 cm, with chronic systemic hypertension and renal failure presented for emergency renal transplantation. Spinal morphine was proposed for postoperative analgesia. Puncture at L3-L4 with 27G needle was attempted without success, and was followed by attempt at L2-L3 when needle deformation was observed. Needle has broken at removal, leaving behind a 43 mm fragment in the L2-L3 interspinous ligament, which was confirmed by fluoroscopy. General anesthesia was induced and fragment was removed by fluoroscopic surgical exploration. Renal transplantation was then performed uneventfully. CONCLUSIONS: Decreased needle gauge has decreased post dural puncture headache but has also made needles fragiles. When ligaments are more resistant and puncture is attempted more than once there may be material stress leading to needle fracture. In conclusion, when there is increased resistance to needle introduction and puncture difficulty, the risk of deformation and potential fracture should be balanced against fine needle advantages.

  19. Brugada syndrome unmasked by accidental inhalation of gasoline vapors

    DEFF Research Database (Denmark)

    Kranjcec, Darko; Bergovec, Mijo; Rougier, Jean-Sébastien

    2007-01-01

    Loss-of-function mutations in the gene SCN5A can cause Brugada syndrome (BrS), which is an inherited form of idiopathic ventricular fibrillation. We report the case of a 46-year-old patient, with no previous medical history, who had ventricular fibrillation after accidental inhalation of gasoline...

  20. Curative effect of minimally invasive puncture and drainage assisted with alteplase on treatment of acute intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Jun-Lin Hu

    2017-01-01

    >Conclusions: As for the effect on evacuation of hematoma and also the ameliorative effect on nerve injury, inflammatory reaction and oxidative stress response in treatment of acute intracerebral hemorrhage, minimally invasive puncture and drainage assisted with alteplase was superior to adjuvant therapy with urokinase.